Spectrum of injuries associated with paediatric ACL tears: an MRI pictorial review

OBJECTIVE: Magnetic resonance imaging (MRI) findings in anterior cruciate ligament (ACL) injury are well known, but most published reviews show obvious examples of associated injuries and give little focus to paediatric patients. Here, we demonstrate the spectrum of MRI appearances at common sites of associated injury in adolescents with ACL tears, emphasising age-specific issues. METHODS: Pictorial review using images from children with surgically confirmed ACL tears after athletic injury. RESULTS: ACL injury usually occurs with axial rotation in the valgus near full extension. The MRI findings can be obvious and important to management (ACL rupture), subtle but clinically important (lateral meniscus posterior attachment avulsion), obvious and unimportant to management (femoral condyle impaction injury), or subtle and possibly important (medial meniscocapsular junction tear). Paediatric-specific issues of note include tibial spine avulsion, normal difficulty visualising a thin ACL and posterolateral corner structures, and differentiation between incompletely closed physis and impaction fracture. CONCLUSION: ACL tear is only the most obvious sign of a complex injury involving multiple structures. Awareness of the spectrum of secondary findings illustrated here and the features distinguishing them from normal variation can aid in accurate assessment of ACL tears and related injuries, enabling effective treatment planning and assessment of prognosis. TEACHING POINTS: • The ACL in children normally appears thin or attenuated, while thickening and oedema suggest tear. • Displaced medial meniscal tears are significantly more common later post-injury than immediately. • The meniscofemoral ligaments merge with the posterior lateral meniscus, complicating tear assessment. • Tibial plateau impaction fractures can be difficult to distinguish from a partially closed physis. • Axial MR sequences are more sensitive/specific than coronal for diagnosis of medial collateral ligament (MCL) injury

Diagnositic value of pelvic enthesitis on MRI of the sacroiliac joints in enthesitis related arthritis

Background: To determine the prevalence and diagnostic value of pelvic enthesitis on MRI of the sacroiliac (SI) joints in enthesitis related arthritis (ERA). Methods: We retrospectively studied 143 patients aged 6-18 years old who underwent MRI of the SI joints for clinically suspected sacroiliitis between 2006-2014. Patients were diagnosed with ERA according to the International League of Associations for Rheumatology (ILAR) criteria. All MRI studies were reassessed for the presence of pelvic enthesitis, which was correlated to the presence of sacroiliitis on MRI and to the final clinical diagnosis. The added value for detection of pelvic enthesitis and fulfilment of criteria for the diagnosis of ERA was studied. Results: Pelvic enthesitis was seen in 23 of 143 (16 %) patients. The most commonly affected sites were the entheses around the hip (35 % of affected entheses) and the retroarticular interosseous ligaments (32 % of affected entheses). MRI showed pelvic enthesitis in 21 % of patients with ERA and in 13 % of patients without ERA. Pelvic enthesitis was seen on MRI in 7/51 (14 %) patients with clinically evident enthesitis, and 16/92 (17 %) patients without clinically evident enthesitis. In 7 of 11 ERA-negative patients without clinical enthesitis but with pelvic enthesitis on MRI, the ILAR criteria could have been fulfilled, if pelvic enthesitis on MRI was included in the criteria. There is a high correlation between pelvic enthesitis and sacroiliitis, with sacroiliitis present in 17/23 (74 %) patients with pelvic enthesitis. Conclusions: Pelvic enthesitis may be present in children with or without clinically evident peripheral enthesitis. There is a high correlation between pelvic enthesitis and sacroiliitis on MRI of the sacroiliac joints in children. As pelvic enthesitis indicates active inflammation, it may play a role in assessment of the inflammatory status. Therefore, it should be carefully sought and noted by radiologists examining MRI of the sacroiliac joints in children

BMI1 regulates PRC1 architecture and activity through homo- and hetero-oligomerization.

BMI1 is a core component of the polycomb repressive complex 1 (PRC1) and emerging data support a role of BMI1 in cancer. The central domain of BMI1 is involved in protein-protein interactions and is essential for its oncogenic activity. Here, we present the structure of BMI1 bound to the polyhomeotic protein PHC2 illustrating that the central domain of BMI1 adopts an ubiquitin-like (UBL) fold and binds PHC2 in a beta-hairpin conformation. Unexpectedly, we find that the UBL domain is involved in homo-oligomerization of BMI1. We demonstrate that both the interaction of BMI1 with polyhomeotic proteins and homo-oligomerization via UBL domain are necessary for H2A ubiquitination activity of PRC1 and for clonogenic potential of U2OS cells. Here, we also emphasize need for joint application of NMR spectroscopy and X-ray crystallography to determine the overall structure of the BMI1-PHC2 complex

Mr imaging findings of lesions involving cartilage and bone in the paediatric knee: a pictorial review

The knee is the joint which is most commonly imaged by MRI in children and adolescents. With increasing participation in competitive sports, traumatic knee injuries with osteochondral lesions are increasingly common in children. However, it is also important to exclude non traumatic conditions that result in defects of the articular cartilage and/or subchondral bone plate or growth plate of the knee, since timely diagnosis and therapy may help prevent lifelong disability in these patients. Moreover, there are normal variants that occur in the ossifying knee that should not be mistaken for lesions. The aim of this essay is to review the wide range of conditions that may result in MRI signal changes of the ossifying knee in children

Mr imaging findings of lesions involving cartilage and bone in the paediatric knee: a pictorial review

The knee is the joint which is most commonly imaged by MRI in children and adolescents. With increasing participation in competitive sports, traumatic knee injuries with osteochondral lesions are increasingly common in children. However, it is also important to exclude non traumatic conditions that result in defects of the articular cartilage and/or subchondral bone plate or growth plate of the knee, since timely diagnosis and therapy may help prevent lifelong disability in these patients. Moreover, there are normal variants that occur in the ossifying knee that should not be mistaken for lesions. The aim of this essay is to review the wide range of conditions that may result in MRI signal changes of the ossifying knee in children

A pilot study of occupational exposure to ultrafine particles during 3D printing in research laboratories

Introduction3D printing is increasingly present in research environments, and could pose health risks to users due to air pollution and particulate emissions. We evaluated the nanoparticulate emissions of two different 3D printers, utilizing either fused filament fabrication with polylactic acid, or stereolithography (SLA) with light curing resin. MethodsNanoparticulate emissions were evaluated in two different research environments, both by environmental measurements in the laboratory and by personal sampling. ResultsThe SLA printer had higher nanoparticulate emissions, with an average concentration of 4,091 parts/cm(3), versus 2,203 particles/cm(3) for the fused filament fabrication printer. The collected particulate matter had variable morphology and elemental composition with a preponderance of carbon, sulfur and oxygen, the main byproducts. DiscussionOur study implies that when considering the health risks of particulate emissions from 3D printing in research laboratories, attention should be given to the materials used and the type of 3D printer

Cooking Particulate Matter: A Systematic Review on Nanoparticle Exposure in the Indoor Cooking Environment

Background: Cooking and fuel combustion in the indoor environment are major sources of respirable suspended particulate matter (RSPM), which is an excellent carrier of potentially harmful absorbed inorganic and organic compounds. Chronic exposure to RSPM can lead to acute pulmonary illness, asthma, cardiovascular disease, and lung cancer in people involved in cooking. Despite this, questions remain about the harmfulness of different particulate matter (PM) sources generated during cooking, and the factors influencing PM physico-chemical properties. The most reliable methods for sampling and analyzing cooking emissions remain only partially understood. Objectives: This review aims to comprehensively assess the risks of PM generated during cooking, considering the main sources of PM, PM chemical composition, and strategies for PM physico-chemical analysis. We present the first systematic analysis of PM sources and chemical composition related to cooking. We highlight significant differences between studies using different experimental conditions, with a lack of a standard methodology. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement rules and the Patient, Intervention, Comparison, and Outcome (PICO) strategy for scientific research, three different scientific databases (PubMed, Scopus, and Web of Science) were screened to find scientific articles that measure, collect, and analyze the chemical composition of nanometer-and micrometer-sized PM generated during cooking activities under different conditions. Data are summarized to assess risk, evaluating the main sources and factors influencing PM generation, their chemical composition, and how they have been collected and analyzed in changing experimental conditions. Results: From 2474 search results, there were 55 studies that met our criteria. Overall, the main variable sources of PM in cooking activities relate to the stove and fuel type. The concentration and chemical–physical properties of PM are also strongly influenced by the food and food additive type, food processing type, cooking duration, temperature, and utensils. The most important factor influencing indoor PM concentration is ventilation. The PM generated during cooking activities is composed mainly of elemental carbon (EC) and its derivatives, and the porous structure of PM with high surface-to-volume ratio is a perfect carrier of inorganic and organic matter. Conclusions: This review reveals a growing interest in PM exposure during cooking activities and highlights significant variability in the chemical–physical properties of particles, and thus variable exposure risks. Precise risk characterization improves possible preventive strategies to reduce the risk of indoor pollutant exposure. However, comprehensive PM analysis needs proper sampling and analysis methods which consider all factors influencing the physico-chemical properties of PM in an additive and synergistic way. Our analysis highlights the need for method standardization in PM environmental analyses, to ensure accuracy and allow deeper comparisons between future studies

The dynamic nature of the human origin recognition complex revealed through five cryoEM structures

Genome replication is initiated from specific origin sites established by dynamic events. The Origin Recognition Complex (ORC) is necessary for orchestrating the initiation process by binding to origin DNA, recruiting CDC6, and assembling the MCM replicative helicase on DNA. Here we report five cryoEM structures of the human ORC (HsORC) that illustrate the native flexibility of the complex. The absence of ORC1 revealed a compact, stable complex of ORC2-5. Introduction of ORC1 opens the complex into several dynamic conformations. Two structures revealed dynamic movements of the ORC1 AAA+ and ORC2 winged-helix domains that likely impact DNA incorporation into the ORC core. Additional twist and pinch motions were observed in an open ORC conformation revealing a hinge at the ORC5·ORC3 interface that may facilitate ORC binding to DNA. Finally, a structure of ORC was determined with endogenous DNA bound in the core revealing important differences between human and yeast origin recognition

Importance of highly selective LC–MS/MS analysis for the accurate quantification of tamoxifen and its metabolites: focus on endoxifen and 4-hydroxytamoxifen

The antiestrogenic effect of tamoxifen is mainly attributable to the active metabolites endoxifen and 4-hydroxytamoxifen. This effect is assumed to be concentration-dependent and therefore quantitative analysis of tamoxifen and metabolites for clinical studies and therapeutic drug monitoring is increasing. We investigated the large discrepancies in reported mean endoxifen and 4-hydroxytamoxifen concentrations. Two published LC–MS/MS methods are used to analyse a set of 75 serum samples from patients treated with tamoxifen. The method from Teunissen et al. (J Chrom B, 879:1677–1685, 2011) separates endoxifen and 4-hydroxytamoxifen from other tamoxifen metabolites with similar masses and fragmentation patterns. The second method, published by Gjerde et al. (J Chrom A, 1082:6–14, 2005) however lacks selectivity, resulting in a factor 2–3 overestimation of the endoxifen and 4-hydroxytamoxifen levels, respectively. We emphasize the use of highly selective LC–MS/MS methods for the quantification of tamoxifen and its metabolites in biological samples

Development and Validation of an OMERACT MRI Whole-Body Score for Inflammation in Peripheral Joints and Entheses in Inflammatory Arthritis (MRI-WIPE)

Objective: To develop a whole-body MRI-scoring system for peripheral arthritis and enthesitis. Methods: After consensus on definitions/locations of MRI pathologies, four multi-reader exercises were performed. Eighty-three joints were scored 0-3 separately for synovitis and osteitis, thirty-three entheses 0-3 separately for soft tissue inflammation and osteitis. Results: In the last exercise, reliability was moderate-good for musculoskeletal radiologists and rheumatologists with previously demonstrated good scoring proficiency. Median pairwise single-measure/average-measure ICCs were 0.67/0.80 for status scores and 0.69/0.82 for change scores; kappas ranged 0.35-0.77. Conclusion: WBMRI scoring of peripheral arthritis and enthesitis is reliable which encourages further testing and refinement in clinical trials