Chronic osteomyelitis: what the surgeon needs to know

Chronic osteomyelitis represents a progressive inflammatory process caused by pathogens, resulting in bone destruction and sequestrum formation. It may present with periods of quiescence of variable duration, whereas its occurrence, type, severity and prognosis is multifactorial. The ‘gold standard’ for the diagnosis of chronic osteomyelitis is the presence of positive bone cultures and histopathologic examination of the bone. Its management remains challenging to the treating physician, with a multidisciplinary approach involving radiologists, microbiologists with expertise in infectious diseases, orthopaedic surgeons and plastic surgeons. Treatment should be tailored to each patient according the severity and duration of symptoms, as well as to the clinical and radiological response to treatment. A combined antimicrobial and surgical treatment should be considered in all cases, including appropriate dead space management and subsequent reconstruction. Relapse can occur, even following an apparently successful treatment, which has a major impact on the quality of life of patients and is a substantial financial burden to any healthcare system

Shear Bond Strength and Remineralisation Effect of a Casein Phosphopeptide-Amorphous Calcium Phosphate-Modified Glass Ionomer Cement on Artificial “Caries-Affected” Dentine

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Impact of dye interlayer on the performance of organic photovoltaic devices

The influences of buffer interlayer at the donor/acceptor interface on the open circuit voltage (VOC) of typical copper phthalocyanine (CuPc) / C60 organic photovoltaic devices are studied. Six fluorescent dyes with progressively increasing ionization potentials (I P) were used to investigate the factors influencing the VOC. The short-circuit current and fill factor of CuPc/ C60 device incorporating dye interlayer are lower than those of standard bilayer device. On the other hand, the VOC increases linearly with the I P of dye material and falls off when the I P is equal to or greater than 5.6 eV, in which the energy offset between the highest occupied molecular orbitals at the interlayer/ C60 heterojunction is smaller than the C60 exciton binding energy. The findings underscore the importance of energy offsets in photovoltaic responses. © 2009 American Institute of Physics.published_or_final_versio

Psychological, social and health issues in Hong Kong women with osteoporotic fractures

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Genetic variability and heritability studies of some reproductive traits in cowpea (Vigna unguiculate (L.) Walp.)

The success of most crop improvement programs largely depends upon the genetic variability and the heritability of desirable traits. The magnitude and type of genetic variability help the breeder to determine the selection criteria and breeding schemes to be used for improvement purposes. A screen house experiment was carried out at Samaru, Nigeria in 1999 and 2000 dry seasons to estimate the genotypic variability of some reproductive traits and their heritability in some selected cowpea varieties. Results of the study showed that there was considerable variation among cultivars for duration of reproductive phase and rate of photosynthate partitioning. Genotypic coefficients of variation were also high for days to first flower, 100-seed weight, plant height, and harvest index. Broad-sense heritability estimate (h2) was 98.9% for 100-seed weight, 94% for duration of reproductive phase, 84.5% for days to first flower, 83.9% for days to maturity, and 77.3% for harvest index. This information showed that there is sufficient genetic variance to warrant selection for improvement in the cowpea genotypes studied. We concluded that considerable progress in cowpea breeding could be achieved by exploiting these traits

Suitability and use of two molecular markers to track race-specific resistance striga gesnerioides in cowpea (Vigna unguiculata (L.) Walp.)

The obligate root parasitic weed Striga gesnerioides poses a severe constraint to cowpea productivity in the dry savannahs of West and Central Africa, where cowpea is a major crop. At least seven races of S.gesnerioides have been identified within the cowpea-growing regions of West and Central Africa, based onhost differential response and genetic diversity analysis. Molecular markers linked to resistance to  different races of S. gesneriodes have been identified. It was desirable to demonstrate the applicability and efficiency for use in marker-assisted selection (MAS) to fast-track the development of cowpea for resistance to S. gesnerioides. The objective of the study was to determine the suitability of two molecular markers in tracking race-specific S. gesnerioides resistance in cowpea (SG3), the predominant race found in Nigeria. F2 mapping populations and recombinant inbred lines (RILs) derived from the cross involving IT97K-499-35 and a susceptible local landrace (Borno Brown), and another resistant parent B301 with the same susceptible land race (Borno Brown) were assayed using two linked markers. Genetic analysis showed that resistance to S. gesnerioides in cowpea is qualitatively inherited with single dominant gene action. Two SCAR markers, 61RM2 and C42-2B were validated in the same F2 populations and subsequent recombinant inbred lines (RILs). The two markers were able to discriminate between resistance and susceptibility and the genotypic score was quite similar to the phenotypic score with the markers score showing greater efficiency in selection than phenotypic score. The 61RM2 had two bands in resistant cultivars and amplified a ~450 bp fragment with marker efficiency of 98% while C42-2B amplified a single ~250 bp fragment with marker efficiency of 96% in resistant cultivars and absent in susceptible cultivars. The genetic distance between 61RM2 and phenotypic score was 3.5 cM while that of C42-2B and phenotypic score was 8.5 cM. The two marker data set were significantly correlated with the phenotypic data (r=0.95). Based on the tight linkage with the resistant locus, 61RM2 was found to be a utility marker to initiate MAS in cowpea breeding for resistance to S. gesnerioides.Key words: Cowpea, Striga, molecular marker, genetic distance, race-specific, obligate parasitic weed, Vigna unguiculata

Down-regulation of TIMP2 by HIF-1α/miR-210/HIF-3α regulatory feedback circuit enhances cancer metastasis in hepatocellular carcinoma

Cancer metastasis is a multistep process that involves a series of tumor-stromal interaction, including extracellular matrix (ECM) remodeling, which requires a concerted action of multiple proteolytic enzymes and their endogenous inhibitors. This study investigated the role of tissue inhibitor of metalloproteinases (TIMP) 2 in the context of hepatocellular carcinoma (HCC) metastasis. We found that TIMP2 was the most significantly down-regulated member among the TIMP family in human HCCs. Moreover, TIMP2 underexpression was frequent (41.8%; 23 of 55) in human HCCs and was significantly associated with liver invasion and poorer survival outcomes of HCC patients. Furthermore, stable silencing of TIMP2 in HCC cell lines enhanced cell invasive ability and ECM degradation associated with formation of invadopodia-like feature, suggesting that TIMP2 is a negative regulator of HCC metastasis. Using an orthotopic tumor xenograft model, we demonstrated that ectopic expression of TIMP2 open reading frame in the highly metastatic HCC cell line, MHCC-97L, significantly reduced HCC progression as well as pulmonary metastasis. Mechanistically, TIMP2 suppression, in a hypoxic environment, was induced through a regulatory feedback circuit consisting of hypoxia-inducible factor (HIF) 1 alpha, microRNA-210 (miR-210), and HIF-3alpha. CONCLUSION: TIMP2 is frequently down-regulated in human HCCs and its down-regulation is associated with aggressive tumor behavior and poorer patient outcome. Its suppression is under the regulation of a novel feedback circuit consisting of HIF-1alpha/miR-210/HIF-3alpha. TIMP2 is an important regulator of ECM degradation and HCC metastasis. (Hepatology 2016;64:473-487).published_or_final_versio

Use of Doppler ultrasound renal resistive index and neutrophil gelatinase-associated lipocalin in prediction of acute kidney injury in patients with septic shock

Poster PresentationThis journal suppl. contain meeting abstracts of the 31st International Symposium on Intensive Care and Emergency MedicineINTRODUCTION: Acute kidney injury (AKI) is common in septic shock and there is no good marker to predict it. Neutrophil gelatinase-associated lipocalin (NGAL) is a novel renal biomarker showing promising results in prediction of AKI in patients across diff erent clinical settings. Another potential marker is the resistive index (RI) of renal interlobar artery (calculated as (peak systolic velocity – end diastolic velocity) / peak systolic velocity), which has been shown to be useful in identifying those who will develop AKI in patients with septic shock. The aim of this study is to evaluate the usefulness of RI and NGAL in the early detection of AKI. METHODS: A prospective, observational study in a 20-bed medical/surgical ICU of a university teaching hospital. All patients with septic shock were recruited, excluding those with chronic renal failure (serum creatinine >120 μmol/l). Within the fi rst 24 hours after the introduction of vasopressor, urine and serum were collected for NGAL measurement and RI was determined by two independent operators. The occurrence of AKI was measured at day 3, according to RIFLE criteria. RI and NGAL were compared between patients with (RIFLE-F) and without (RIFLE-0/R/I) AKI. RESULTS: During the period from August to November 2010, 20 patients (age 58 ± 16) with septic shock were recruited. Eleven patients were classifi ed as having AKI. No signifi cant diff erence in baseline characteristics such as APACHE II score and baseline creatinine was shown at enrollment. RI, serum-NGAL and urine-NGAL were all higher in patients with AKI (RI: 0.749 ± 0.0697 (mean ± SD) vs. 0.585 ± 0.0983, P <0.001; serum-NGAL: 2,182 ± 838 ng/ml (mean ± SD) vs. 1,075 ± 1,006, P = 0.015; urine-NGAL: 2,009 ± 3,370 vs. 993 ± 1,789 (median ± IQR), P = 0.025). Area under the ROC curve for RI and serum-NGAL was 0.909 (±0.088, P = 0.002) and 0.808 (±0.113, P = 0.02), respectively. For RI, using 0.65 as the cut-off , sensitivity and specifi city was 1 and 0.89, respectively. For serum-NGAL, using a cut-off of 1,200 ng/ml, it had a sensitivity of 1 and specifi city of 0.67. Inter-observer diff erence of RI was low (0.0015 ± 0.0074 (mean ± SD)). CONCLUSIONS: Doppler ultrasound renal RI is non-invasive, rapidly available and easily reproducible, and is at least as good as NGAL as a predictor of AKI in patients with septic shock.link_to_OA_fulltextThe 31st International Symposium on Intensive Care and Emergency Medicine, Brussels, Belgium. 22-25 March 2011. In Critical Care, 2011, v. 15 suppl 1, p. 539, abstract no. P10