Macrophage PPARg , a Lipid Activated Transcription Factor Controls the Growth Factor GDF3 and Skeletal Muscle Regeneration

Tissue regenerationrequiresinflammatoryand repar- atory activity of macrophages. Macrophages detect and eliminate the damaged tissue and subsequently promote regeneration. This dichotomy requires the switch of effector functions of macrophages coordi- nated with other cell types inside the injured tissue.\ud The gene regulatory events supporting the sensory and effector functions of macrophages involved in tissue repair are not well understood. Here we show that the lipid activated transcription factor, PPAR g , is required for proper skeletal muscle regeneration, acting in repair macrophages. PPAR g controls the expression of the transforming growth factor- b (TGF- b ) family member, GDF3, which in turn regu- lates the restoration of skeletal muscle integrity by promoting muscle progenitor cell fusion. This work establishes PPAR g as a required metabolic sensor and transcriptional regulator of repair macrophages. Moreover, this work also establishes GDF3 as a secreted extrinsic effector protein acting on myo- blasts and serving as an exclusively macrophage- derived regeneration factor in tissue repair

3D analysis of the distal ulna with regard to the design of a new ulnar head prosthesis

STUDY DESIGN A retrospective, single center, data analysis. OBJECTIVE Persistent pain and instability are common complications after distal ulnar head arthroplasty. One main reason may be the insufficient representation of the anatomical structures with the prosthesis. Some anatomical structures are neglected such as the ulnar head offset and the ulnar torsion which consequently influences the wrist biomechanics. METHODS CT scans of the ulnae of forty healthy and asymptomatic patients were analyzed in a three-dimensional surface calculation program. In the best fit principle, cylinders were fitted into the medullary canal of the distal ulna and the ulnar head to determine their size. The distance between the central axes of the two cylinders was measured, which corresponds to the ulnar offset, and also their rotational orientation was measured, which corresponds to the ulnar torsion. RESULTS The mean medullary canal diameter was 5.8 mm (±0.8), and the ulnar head diameter was 15.8 mm (±1.5). The distance between the two cylinder axes was 3.89 mm (±0.78). The orientation of this offset was at an average of 8.63° (±15.28) of supination, reaching from 23° pronation to 32° supination. CONCLUSION With these findings, a novel ulnar head prosthesis should have different available stem and head sizes but also have an existing but variable offset between these two elements. A preoperative three-dimensional analysis is due to the high variation of offset orientation highly recommended. These findings might help to better represent the patients natural wrist anatomy in the case of an ulnar head arthroplasty. LEVEL OF EVIDENCE III

Acute myeloid leukemia with myelodysplasia related changes

Acute myeloid leukemia (AML) is a heterogeneous clonal disorder with two prominent features: i) hematopoietic progenitor cells loose the ability to differentiate normally and ii) the transformed leukemia cells show an impaired regulation of myeloid proliferation. AML with myelodysplasia-related changes is a sub-entity of AML that has a poor prognosis. It is characterized by a history of MDS, significant morphologic dysplasia, or MDS-related cytogenetic features such as -7/del(7q) and others. Whereas the prognosis of AML is quite different with respect to genetic aberrations, the therapy - except of acute promyelocytic leukemia (APL) - is still relatively unchanged from 30 years ago. Therefore, new treatment strategies are needed

Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures

Background and Objectives: Three-dimensional planning and guided osteotomy utilizing patient-specific instrumentation (PSI) with the contralateral side used as a reference have been proven as effective in the treatment of malunions following complex fractures of the distal radius. However, this approach has not yet been described in relation to fracture reduction of the distal radius. The aim of this study was to assess the technical and logistical feasibility of computer-assisted surgery in a clinical setting using PSI for fracture reduction and fixation. Materials and Methods: Five patients with varied fracture patterns of the distal radius underwent operative treatment with using PSI. The first applied PSI guide allowed specific and accurate placement of Kirschner wires inside the multiple fragments, with subsequent concurrent reduction using a second guide. Results: Planning, printing of the guides, and operations were performed within 5.6 days on average (range of 1-10 days). All patients could be treated within a reasonable period of time, demonstrating good outcomes, and were able to return to work after a follow-up of three months. Mean wrist movements (°) were 58 (standard deviation (SD) 21) in flexion, 62 (SD 15) in extension, 73 (SD 4) in pronation and 74 (SD 10) in supination at a minimum follow-up of 6 months. Conclusions: Three-dimensional planned osteosynthesis using PSI for treatment of distal radius fractures is feasible and facilitates reduction of multiple fracture fragments. However, higher costs must be taken into consideration for this treatment

Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures

Background and Objectives: Three-dimensional planning and guided osteotomy utilizing patient-specific instrumentation (PSI) with the contralateral side used as a reference have been proven as effective in the treatment of malunions following complex fractures of the distal radius. However, this approach has not yet been described in relation to fracture reduction of the distal radius. The aim of this study was to assess the technical and logistical feasibility of computer-assisted surgery in a clinical setting using PSI for fracture reduction and fixation. Materials and Methods: Five patients with varied fracture patterns of the distal radius underwent operative treatment with using PSI. The first applied PSI guide allowed specific and accurate placement of Kirschner wires inside the multiple fragments, with subsequent concurrent reduction using a second guide. Results: Planning, printing of the guides, and operations were performed within 5.6 days on average (range of 1–10 days). All patients could be treated within a reasonable period of time, demonstrating good outcomes, and were able to return to work after a follow-up of three months. Mean wrist movements (°) were 58 (standard deviation (SD) 21) in flexion, 62 (SD 15) in extension, 73 (SD 4) in pronation and 74 (SD 10) in supination at a minimum follow-up of 6 months. Conclusions: Three-dimensional planned osteosynthesis using PSI for treatment of distal radius fractures is feasible and facilitates reduction of multiple fracture fragments. However, higher costs must be taken into consideration for this treatment

Exact Energy-Time Uncertainty Relation for Arrival Time by Absorption

We prove an uncertainty relation for energy and arrival time, where the arrival of a particle at a detector is modeled by an absorbing term added to the Hamiltonian. In this well-known scheme the probability for the particle's arrival at the counter is identified with the loss of normalization for an initial wave packet. Under the sole assumption that the absorbing term vanishes on the initial wave function, we show that $\Delta T \Delta E \geq \sqrt p \hbar/2$ and $\Delta E\geq 1.37\sqrt p\hbar$, where $e$ denotes the mean arrival time, and $p$ is the probability for the particle to be eventually absorbed. Nearly minimal uncertainty can be achieved in a two-level system, and we propose a trapped ion experiment to realize this situation.Comment: 8 pages, 2 figure

Long-term outcomes of the four-corner fusion of the wrist: A systematic review

BACKGROUND: Four-corner fusion (4CF) is a motion sparing salvage procedure that is used to treat osteoarthritis secondary to advanced scapholunate collapse or longstanding scaphoid nonunion advanced collapse. Little is known about the long-term survivorship and outcomes of 4CF. AIM: To report on clinical and functional long-term outcomes as well as conversion rates to total wrist fusion or arthroplasty. METHODS: The systematic review protocol was registered in the international prospective register of systematic reviews (PROSPERO) and followed the PRISMA guidelines. Original articles were screened using four different databases. Studies with a minimum Level IV of evidence that reported on long-term outcome after 4CF with a minimum follow-up of 5 years were included. Quality assessment was performed using the Methodological Index for Non-Randomized Studies criteria. RESULTS: A total of 11 studies including 436 wrists with a mean follow-up of 11 ± 4 years (range: 6-18 years) was included. Quality assessment according to Methodological Index for Non-Randomized Studies criteria tool averaged 69% ± 11% (range: 50%-87%). Fusion rate could be extracted from 9/11 studies and averaged 91%. Patient-reported outcomes were extracted at last follow-up from 8 studies with an average visual analog scale of 1 ± 1 (range: 0-2) and across 9 studies with an average Disabilities of the Arm, Shoulder and Hand score of 21 ± 8 (range: 8-37). At last follow-up, the cumulative conversion rate to total wrist fusion averaged 6%. There were no conversions to total wrist arthroplasty. CONCLUSION: The 4CF of the wrist is a reliable surgical technique, capable of achieving a good long-term patient satisfaction and survivorship with low rates of conversion to total wrist fusion

All in the name of work? Nonwork orientations as predictors of salary, career, satisfaction, and life satisfaction

Career development increasingly demands a successful integration of work and nonwork domains. Based on work-nonwork conflict and enrichment theories, this study explored the relationship between nonwork orientations (i.e., family, personal life, and community) and both objective (i.e., salary) and subjective (i.e., career satisfaction) career success and life satisfaction over a period of six months among a sample of 548 employees from Germany. The results generally support the enrichment perspective. Family orientation showed a positive relationship with career satisfaction. All three nonwork orientations, especially family orientation, were positively related to life satisfaction. We also explored gender and age effects but found no differences in nonwork orientations between young employees aged 25–34 years and older workers aged 50–59 years. Men showed lower levels of personal life orientation than women, but no differences in family or community orientation based on gender were found. We also did not observe gender x age interaction effects. We discuss the study's implications for a whole-life perspective on career development, career success, and well-being