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

Upgrading a Social Media Strategy to Increase Twitter Engagement During the Spring Annual Meeting of the American Society of Regional Anesthesia and Pain Medicine.

Microblogs known as tweets are a rapid, effective method of information dissemination in health care. Although several medical specialties have described their Twitter conference experiences, Twitter-related data in the fields of anesthesiology and pain medicine are sparse. We therefore analyzed the Twitter content of 2 consecutive spring meetings of the American Society of Regional Anesthesia and Pain Medicine using publicly available online transcripts. We also examined the potential contribution of a targeted social media campaign on Twitter engagement during the conferences. The original Twitter meeting content was largely scientific in nature and created by meeting attendees, the majority of whom were nontrainee physicians. Physician trainees, however, represent an important and increasing minority of Twitter contributors. Physicians not in attendance predominantly contributed via retweeting original content, particularly picture-containing tweets, and thus increased reach to nonattendees. A social media campaign prior to meetings may help increase the reach of conference-related Twitter discussion

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

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

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

Exploring cell surface markers and cell-cell interactions of human breast milk stem cells

Background: Breakthrough studies have shown that pluripotent stem cells are present in human breast milk. The expression of pluripotency markers by breast milk cells is heterogeneous, relating to cellular hierarchy, from early-stage multi-lineage stem cells to fully differentiated mammary epithelial cells, as well as weeks of gestation and days of lactation. Design and methods: Here, we qualitatively analyze cell marker expression in freshly isolated human breast milk cells, without any manipulation that could influence protein expression. Moreover, we use electron microscopy to investigate cell-cell networks in breast milk for the first time, providing evidence of active intercellular communication between cells expressing different cellular markers. Results: The immunocytochemistry results of human breast milk cells showed positive staining in all samples for CD44, CD45, CD133, and Ki67 markers. Variable positivity was present with P63, Tβ4 and CK14 markers. No immunostaining was detected for Wt1, nestin, Nanog, OCT4, SOX2, CK5, and CD34 markers. Cells isolated from human breast milk form intercellular connections, which together create a cell-to-cell communication network. Conclusions: Cells freshly isolated form human breast milk, without particular manipulations, show heterogeneous expression of stemness markers. The studied milk staminal cells show "pluripotency" at different stages of differentiation, and are present as single cells or grouped cells. The adjacent cell interactions are evidenced by electron microscopy, which showed the formation of intercellular connections, numerous contact regions, and thin pseudopods

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