MR imaging of meniscal tears

Background: Menisci transmit the forces across the joint and cushion the mechanical loading of the joint. Thus, it is important to identify meniscal tear. A thorough understanding of normal meniscal anatomy and surrounding structure is critical for diagnosis. Magnetic resonance imaging is the current modality of choice providing fine resolution and multi-planar imaging for identifying the meniscal injuries and the various pattern of tear, helping to plan the subsequent management. The purpose of the work was to study the role of MRI in classifying the meniscal injuries.Methods: MRI Knee of 136 patients with meniscal injuries was studied. All the MR imaging scans were performed on 1.5-T MR system (Siemens magnetom Essenza).Results: A total of 136 patients were studied in which majority of the patient’s i.e.  90.44 % had medial meniscal tear while 18.38 % patients had lateral meniscal tear. Both medial and lateral meniscal tears were found in 8.82 % patients. Among the different types of tears, horizontal tear was the most common tear in both medial and lateral meniscus comprising 52.8 % and 52 % respectively. The tears being most common in the age group 41-50years. There were associated injuries to the other ligaments of the knee joint along with meniscal tear, ACL tear being the most common and was seen in 50% of patients.Conclusions: MRI is a good modality for classifying meniscal injury and evaluation of injuries to the associated ligaments. Secondary signs are good predictors of underlying meniscal tear in equivocal cases

Transcriptomic analysis of Clostridium thermocellum ATCC 27405 cellulose fermentation

<p>Abstract</p> <p>Background</p> <p>The ability of C<it>lostridium thermocellum </it>ATCC 27405 wild-type strain to hydrolyze cellulose and ferment the degradation products directly to ethanol and other metabolic byproducts makes it an attractive candidate for consolidated bioprocessing of cellulosic biomass to biofuels. In this study, whole-genome microarrays were used to investigate the expression of <it>C. thermocellum </it>mRNA during growth on crystalline cellulose in controlled replicate batch fermentations.</p> <p>Results</p> <p>A time-series analysis of gene expression revealed changes in transcript levels of ~40% of genes (~1300 out of 3198 ORFs encoded in the genome) during transition from early-exponential to late-stationary phase. K-means clustering of genes with statistically significant changes in transcript levels identified six distinct clusters of temporal expression. Broadly, genes involved in energy production, translation, glycolysis and amino acid, nucleotide and coenzyme metabolism displayed a decreasing trend in gene expression as cells entered stationary phase. In comparison, genes involved in cell structure and motility, chemotaxis, signal transduction and transcription showed an increasing trend in gene expression. Hierarchical clustering of cellulosome-related genes highlighted temporal changes in composition of this multi-enzyme complex during batch growth on crystalline cellulose, with increased expression of several genes encoding hydrolytic enzymes involved in degradation of non-cellulosic substrates in stationary phase.</p> <p>Conclusions</p> <p>Overall, the results suggest that under low substrate availability, growth slows due to decreased metabolic potential and <it>C. thermocellum </it>alters its gene expression to (i) modulate the composition of cellulosomes that are released into the environment with an increased proportion of enzymes than can efficiently degrade plant polysaccharides other than cellulose, (ii) enhance signal transduction and chemotaxis mechanisms perhaps to sense the oligosaccharide hydrolysis products, and nutrient gradients generated through the action of cell-free cellulosomes and, (iii) increase cellular motility for potentially orienting the cells' movement towards positive environmental signals leading to nutrient sources. Such a coordinated cellular strategy would increase its chances of survival in natural ecosystems where feast and famine conditions are frequently encountered.</p

STRIDER (Sildenafil TheRapy in dismal prognosis early onset fetal growth restriction): An international consortium of randomised placebo-controlled trials

Background: Severe, early-onset fetal growth restriction due to placental insufficiency is associated with a high risk of perinatal mortality and morbidity with long-lasting sequelae. Placental insufficiency is the result of abnormal formation and function of the placenta with inadequate remodelling of the maternal spiral arteries. There is currently no effective therapy available. Some evidence suggests sildenafil citrate may improve uteroplacental blood flow, fetal growth, and meaningful infant outcomes. The objective of the Sildenafil TheRapy In Dismal prognosis Early onset fetal growth Restriction (STRIDER) collaboration is to evaluate the effectiveness of sildenafil versus placebo in achieving healthy perinatal survival through the conduct of randomised clinical trials and systematic review including individual patient data meta-analysis.  Methods: Five national/bi-national multicentre randomised placebo-controlled trials have been launched. Women with a singleton pregnancy between 18 and 30 weeks with severe fetal growth restriction of likely placental origin, and where the likelihood of perinatal death/severe morbidity is estimated to be significant are included. Participants will receive either sildenafil 25 mg or matching placebo tablets orally three times daily from recruitment to 32 weeks gestation.  Discussion: The STRIDER trials were conceived and designed through international collaboration. Although the individual trials have different primary outcomes for reasons of sample size and feasibility, all trials will collect a standard set of outcomes including survival without severe neonatal morbidity at time of hospital discharge. This is a summary of all the STRIDER trial protocols and provides an example of a prospectively planned international clinical research collaboration. All five individual trials will contribute to a pre-planned systematic review of the topic including individual patient data meta-analysis

MR imaging of meniscal tears

Background: Menisci transmit the forces across the joint and cushion the mechanical loading of the joint. Thus, it is important to identify meniscal tear. A thorough understanding of normal meniscal anatomy and surrounding structure is critical for diagnosis. Magnetic resonance imaging is the current modality of choice providing fine resolution and multi-planar imaging for identifying the meniscal injuries and the various pattern of tear, helping to plan the subsequent management. The purpose of the work was to study the role of MRI in classifying the meniscal injuries.Methods: MRI Knee of 136 patients with meniscal injuries was studied. All the MR imaging scans were performed on 1.5-T MR system (Siemens magnetom Essenza).Results: A total of 136 patients were studied in which majority of the patient’s i.e.  90.44 % had medial meniscal tear while 18.38 % patients had lateral meniscal tear. Both medial and lateral meniscal tears were found in 8.82 % patients. Among the different types of tears, horizontal tear was the most common tear in both medial and lateral meniscus comprising 52.8 % and 52 % respectively. The tears being most common in the age group 41-50years. There were associated injuries to the other ligaments of the knee joint along with meniscal tear, ACL tear being the most common and was seen in 50% of patients.Conclusions: MRI is a good modality for classifying meniscal injury and evaluation of injuries to the associated ligaments. Secondary signs are good predictors of underlying meniscal tear in equivocal cases