Outcome of anterior cruciate ligament reconstruction using bone-patellar tendon-bone auto graft

Introductions: A rupture of the Anterior Cruciate Ligament (ACL) is the most common ligament injury resulting in instability of the knee which can cause secondary articular injury and early osteoarthritis (OA). Aim of this study was to evaluate the short term outcomes of ACL reconstruction using Bone Patellar Tendon Bone Auto Graft (BPTB) auto graft and factors that might contribute to poor results. Methods: Patients with Anterior Cruciate Ligament injury during the period of July 2013 to May 2014 were enrolled to observe the outcome of the ACL reconstruction using BPTB without arthroscopy. Lysholm Knee Scoring Scale was used to determine the clinical outcome. Outcome parameters were evaluated using Statistical Package for Social Science Version 20 (SPSS). Results: Total 30 normal or near normal function outcome of knee was reported in 29 (97%) patients after ACL reconstruction using BPTB without arthroscopy. There was no failure of grafts. Good static knee stability achieved with increased patient’s satisfaction. Lysholm Score was excellent in 27 (90%) and good in 3 (10 %) cases. Anterior knee pain persisted in 6 cases (20%). Conclusions: Excellent functional outcome with BPTB auto graft in Anterior Cruciate Ligament injury was achieved. Keywords: ACL reconstruction, bone-patellar tendon-bone auto graft, clinical outcom

Propuesta de virtualización de servidores con Hyper-V en el centro de datos de la Facultad de Ciencias Médicas de la UNAN-Managua

La importancia del crecimiento en la potencia de cómputo y la existencia de problemas relacionados con el uso del hardware, ha hecho de la virtualización la solución más idónea para resolver tales dificultades, dentro de sus propósitos se encuentran hacer uso eficiente de los recursos y disminuir el costo total asociado a los mismos. Este trabajo de investigación fue realizado con la finalidad de proponer una solución para la virtualización servidores. La virtualización es una tecnología que permite la creación de equipos, basados en software, que reproducen el ambiente de una máquina física en sus aspectos de CPU, memoria, almacenamiento y entrada y salida de dispositivos. Se limita a trabajar básicamente con Hyper-V con el fin de acotar y definir la solución de virtualización , debido a la numerosa cantidad de soluciones que existen actualmente, como lo son VMware, Cytrix, entre otros. El enfoque principal se encontrará relacionado principalmente a la virtualización de servidores, a la disposición de Hyper-V para trabajar en cluster y al tipo de cluster que se puede implementar. El objetivo general de este trabajo es entonces, proponer una solución para efectuar la virtualización ya manera explicativa se describe como trabaja un cluster de alta disponibilidad con Hyper-V para efectuar tareas de migración de maquinas virtuales, empleando técnicas propias que vienen incorporadas en el software, como Live Migration ó Quick Migration que facilitan de gran forma la gestión y administración del entorno virtual. También se describirá brevemente los detalles técnicos para la implementación del centro de datos, la disposición de las áreas funcionales, el diagrama de distribución y otros parámetros importantes a tenerse en cuenta para disponer de un centro de datos confiable

Combating subclonal evolution of resistant cancer phenotypes

Metastatic breast cancer remains challenging to treat, and most patients ultimately progress on therapy. This acquired drug resistance is largely due to drug-refractory sub-populations (subclones) within heterogeneous tumors. Here, we track the genetic and phenotypic subclonal evolution of four breast cancers through years of treatment to better understand how breast cancers become drug-resistant. Recurrently appearing post-chemotherapy mutations are rare. However, bulk and single-cell RNA sequencing reveal acquisition of malignant phenotypes after treatment, including enhanced mesenchymal and growth factor signaling, which may promote drug resistance, and decreased antigen presentation and TNF-α signaling, which may enable immune system avoidance. Some of these phenotypes pre-exist in pre-treatment subclones that become dominant after chemotherapy, indicating selection for resistance phenotypes. Post-chemotherapy cancer cells are effectively treated with drugs targeting acquired phenotypes. These findings highlight cancer's ability to evolve phenotypically and suggest a phenotype-targeted treatment strategy that adapts to cancer as it evolves

A Comparison of the lichen floras of four locations in the Intermountain Western United States

The Intermountain Region of the western United States has a rich and diverse lichen flora. Various research projects have examined the lichen communities of this region. This study compares the lichen floras of four Intermountain Area locations, Dinosaur National Monument, Utah and Colorado; the Gila Wilderness Area, New Mexico; the Manti La Sal National Forest, Utah; and the San Juan – Rio Grande National Forest, Colorado. A total of 392 species in 122 genera have been identified from these four general locations. The San Juan – Rio Grande National Forest has the highest number of species (313 species in 109 genera). The Dinosaur National Monument and the Manti La Sal National Forest lichen floras were dominated by crustose species; a condition typical of many Intermountain Area locations; however, the Gila Wilderness Area and San Juan – Rio Grande National Forest were dominated by foliose species. Substrate distribution patterns for all four sites indicated a preponderance of saxicolous species. In addition, a total of 69 pollution sensitive indicator species were identified from the four study areas of which 16 species were common to all 4 locations. The relatively high percentage of pollution sensitive species at all study areas generally suggests that air pollution-related impact on this area has been minimal

The expansion of targetable biomarkers for CAR T cell therapy

Abstract Biomarkers are an integral part of cancer management due to their use in risk assessment, screening, differential diagnosis, prognosis, prediction of response to treatment, and monitoring progress of disease. Recently, with the advent of Chimeric Antigen Receptor (CAR) T cell therapy, a new category of targetable biomarkers has emerged. These biomarkers are associated with the surface of malignant cells and serve as targets for directing cytotoxic T cells. The first biomarker target used for CAR T cell therapy was CD19, a B cell marker expressed highly on malignant B cells. With the success of CD19, the last decade has shown an explosion of new targetable biomarkers on a range of human malignancies. These surface targets have made it possible to provide directed, specific therapy that reduces healthy tissue destruction and preserves the patient’s immune system during treatment. As of May 2018, there are over 100 clinical trials underway that target over 25 different surface biomarkers in almost every human tissue. This expansion has led to not only promising results in terms of patient outcome, but has also led to an exponential growth in the investigation of new biomarkers that could potentially be utilized in CAR T cell therapy for treating patients. In this review, we discuss the biomarkers currently under investigation and point out several promising biomarkers in the preclinical stage of development that may be useful as targets

A Checklist of the Lichens of the Beaver Dam Slope, Washington County, Utah, USA

The lichen flora of the extreme northeastern corner of the Mojave Desert was investigated during the spring of 2009. Collections were made from five sites on the Beaver Dam Slope in Washington Co., Utah, including the privately owned Lytle Ranch Preserve. We have identified 41 lichen-forming fungal species in 23 genera, including 30 saxicolous, 7 terricolous, and 4 corticolous taxa; including, 16 species recorded from Utah for the first time and 10 new records for the Mojave Desert. This study provides a baseline for documenting the distribution of common and sensitive lichen communities along a transition zone between the Mojave Desert, Great Basin, and Colorado Plateau. Key words: Lichens, floristics, Beaver Dam Slope, Mojave Desert

Teuvoa, a new lichen genus in Megasporaceae (Ascomycota: Pertusariales), including Teuvoa junipericola sp nov.

The relationship of Aspicilia uxoris within Megasporaceae is assessed within a phylogenetic context. 'Aspicilia' uxoris and other related species are recovered as sister to the genus Lobothallia s. str. and described here as a new genus. Teuvoa (Ascomycota, Megasporaceae) is erected based on nuclear ITS and LSU sequence data and morphological characters. In addition to Teuvoa uxoris, a second species, T. junipericola, is added to the new genus based on material collected from North America. Teuvoa junipericola, T. uxoris and T. tibetica form a group with 8-spored asci, absence of extrolites, rather short-sized conidia and ascospores, lack of a subhypothecial algal layer, and different substratum preferences (on organic substratum) with a sister relationship to genus Lobothallia s. lat. (Aspicilia subgenus Pachyothallia Clauzade & C. Roux). Based on spore measurements of the holo-types, Lecanora ferganensis Tomin from central Asia (Kyrgyzstan, Tajikistan and Uzbekistan), Lecanora atrodiscata Gintovt, from Tajikistan and Lecanora takyroides Dzhur. from Turkmenistan are new synonyms to T. uxoris. A lectotype for Lecanora ferganensis is designated, expanding the known distribution of T. uxoris from Algeria, Morocco and Spain, into Central Asia

Flexible intramedullary nailing for femoral diaphyseal fractures in children

Background &amp; Objectives: Although various treatment options are available for the treatment of femoral diaphyesal fractures in children, the titanium flexible nailing has gained popularity because it is safe, easy procedure with rapid recovery and high success rate. The aim of this study was to evaluate the outcome of titanium elastic nails in treating paediatric femoral diaphyesal fractures at Patan Hospital.Materials &amp; Methods: There were 35 cases which were all fixed with titanium flexible intramedullary nail under image intensifier at the Patan hospital from January 2013 and December 2015. Patients were evaluated in follow-ups to observe the alignment of fracture, infection, delayed union, nonunion, limb length discrepancy, implant failure, range of movement of hip and knee joints, and time to unite the fracture. The final results were evaluated using criteria of titanium elastic nail (TEN) outcome score described by Flynn et al.Results: The mean age of the patients was 8.51 years. Among 35 patients (22 boys and 13 girls), there were 19 mid-shaft fractures, nine proximal third fractures and seven distal third fractures. Fracture patterns were transverse (22), oblique (10), spiral (2), and comminuted (2). The mean time for fracture union was 8.17 weeks radiologically whereas 9.83 weeks clinically. According to TEN outcome score, excellent and good results were in 28 cases (80%) and seven cases (20%) respectively.Conclusion: Flexible titanium nailing is a safe and satisfactory treatment for diaphyseal femoral fractures in children, because it provides rapid recovery, short rehabilitation and immobilization as well as very high union rate with few complications. </p