Radiographic evaluation of calcaneal fractures: To measure or not to measure

Objective: The aim of this study was to correlate the functional outcome after treatment for displaced intra-articular calcaneal fracture with plain radiography. Design: The design was a prognostic study of a retrospective cohort with concurrent follow-up. Patients: A total of 33 patients with a unilateral calcaneal fracture and a minimum follow-up of 13 months participated. Patients filled in three disease-specific questionnaires, graded their satisfaction and the indication for an arthrodesis was noted. Standardised radiographs were made of the previously injured side and the normal (control) side. Different angles and distances were measured on these radiographs and compared with values described in the literature. The differences in values in angles and distances between the injured and uninjured (control) foot were correlated with the outcome of the questionnaires, and the indication for an arthrodesis. Results: None of the angles correlated with the disease-specific outcome scores. Of the angles only the tibiotalar angle correlated with the VAS (r=0.35, p=0.045) and only the absolute foot height correlated with the indication for an arthrodesis (odds=0.70, CI=0.50-0.99). Conclusion: In this study the radiographic evaluation correlated poorly with the final outcome. Measurements on plain radiographs seem not to be useful in determining outcome after intra-articular calcaneal fractures

Network analysis of human glaucomatous optic nerve head astrocytes

<p>Abstract</p> <p>Background</p> <p>Astrocyte activation is a characteristic response to injury in the central nervous system, and can be either neurotoxic or neuroprotective, while the regulation of both roles remains elusive.</p> <p>Methods</p> <p>To decipher the regulatory elements controlling astrocyte-mediated neurotoxicity in glaucoma, we conducted a systems-level functional analysis of gene expression, proteomic and genetic data associated with reactive optic nerve head astrocytes (ONHAs).</p> <p>Results</p> <p>Our reconstruction of the molecular interactions affected by glaucoma revealed multi-domain biological networks controlling activation of ONHAs at the level of intercellular stimuli, intracellular signaling and core effectors. The analysis revealed that synergistic action of the transcription factors AP-1, vitamin D receptor and Nuclear Factor-kappaB in cross-activation of multiple pathways, including inflammatory cytokines, complement, clusterin, ephrins, and multiple metabolic pathways. We found that the products of over two thirds of genes linked to glaucoma by genetic analysis can be functionally interconnected into one epistatic network via experimentally-validated interactions. Finally, we built and analyzed an integrative disease pathology network from a combined set of genes revealed in genetic studies, genes differentially expressed in glaucoma and closely connected genes/proteins in the interactome.</p> <p>Conclusion</p> <p>Our results suggest several key biological network modules that are involved in regulating neurotoxicity of reactive astrocytes in glaucoma, and comprise potential targets for cell-based therapy.</p

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

The minimally invasive osteotomy &quot;S.E.R.I.&quot; (simple, effective, rapid, inexpensive) for correction of bunionette deformity.

A bunionette is a deformity of the fifth metatarsal bone with a varus deviation of the toe which can require surgical correction. Although numerous bony or soft tissue surgical procedures have been described, the ideal treatment has not yet been identified. The aim of this study was to retrospectively evaluate the results of a series of 50 consecutive feet affected by symptomatic bunionette deformity treated by S.E.R.I. (simple, effective, rapid, inexpensive) osteotomy. MATERIALS AND METHODS: Between February 1998 and March 2004, 50 feet with symptomatic type II-III bunionette deformity in 32 patients (18 bilateral) underwent S.E.R.I osteotomy. The average age of the patients at the time of operation was 33 +/- 13 years. The average followup was 4.8 (range, 2 to 8) years. RESULTS: The average modified lesser toe AOFAS score increased from 62.8 +/- 15.2 points preoperatively to 94 +/- 6.8 points at last followup (p &lt; 0.0005). The average fifth metatarsophalangeal (MTP) angle decreased from 16.8 +/- 5.1 degrees preoperatively to 7.9 +/- 3.1 degrees at final followup (p &lt; 0.0005). The 4-5 intermetatarsal angle (I.M.A) averaged 12 +/- 1.7 degrees preoperatively, while postoperatively was 6.7 +/- 1.7 degrees (p &lt; 0.0005). Complications included a skin inflammatory reaction around the Kirschner wire and 2 symptomatic plantar callosities under the fourth metatarsal heads. CONCLUSIONS: The minimally invasive osteotomy is an effective and reliable technique for the treatment of painful bunionette, and it achieved more than 90% excellent and good results with reduced surgical time and complications