Bilateral osteochondral defects of the patellae in an 11-year-old girl

Osteochondral defect or osteochondritis dissecans (OCD) of the knee usually affects young, active populations. It is a challenging diagnosis as patients typically present with poorly localised activity-related pain, which is non-specific and covers many differentials. We present an active 11-year-old girl with bilateral osteochondral defects of the patellae: a rare clinical disorder which was affecting her sporting activities. She had a 12-month history of bilateral anterior knee pain before the diagnosis was achieved with appropriate imaging. Her pain significantly improved with activity modification and physiotherapy. Follow-up will require outpatient clinic assessment and imaging to determine if non-operative management continues to be successful or surgery may be required. This case report emphasises the importance of appropriate high index of suspicion when managing patients with non-specific knee pain. It also demonstrates the importance of judicious use of imaging to avoid a missed or delayed diagnosis

Complete improvement in a patient with multiple irreversible defects of the left ventricle on 99m technetium-sestamibi SPECT after percutaneous coronary intervention.

99mTc-sestamibi has been investigated as a potential viability marker; initial studies have shown good concordance between 201Tl and 99mTc-sestamibi activities in both viable and nonviable myocardium. However, assessment of myocardial viability by 99mTc-sestamibi remains controversial for tissue recovery after revascularization. Here, we present a patient with several regions of severely diminished and irreversible (defect persisting in both early and delay images of each set scanning) defects on initial scan which were dissolved completely on the follow up scan after an intervention. In a 75 year-old Asian woman with acute myocardial infarction who received thrombolytic therapy and subjected to percutaneous coronary angiography (PCI) on day 28 after acute myocardial infarction(MI), resting 99mTc-sestamibi SPECT was applied on day 4 (initial scan) and 138 (follow up scan) after acute MI at 30 and 180 min after injection of tracer (740 MBq); Two-dimensional echocardiography was carried out at the same time. On the initial image set, there was irreversible defects in the apex, anteroapical, inferoapical, anteroseptal, septal and also anterior walls, while the follow up image was normal in all regions.The angiography intervention showed just significant stenosis on left anterior descending (LAD) vessel (95). This may highlight the failure of 99mTc-sestamibi as a marker of myocardial viability and also mandate further validating of the procedure with follow up scan or other modalities for myocardial viability investigation

A new method to measure anatomic knee alignment for large studies of OA: data from the Osteoarthritis Initiative

SummaryObjectiveTo develop and validate a new and improved software method to rapidly determine femur–tibia angle (FTA).MethodsThree readers, two skilled and one unskilled, without any formal medical training, measured FTA in 142 subjects from the Osteoarthritis Initiative (OAI). The reader reliability was assessed using the intra-class correlation coefficient (ICC), root mean square standard deviation (RMSSD), and Bland–Altman plots, comparing the existing and new FTA methods. Gender-specific linear regression assessed the relationship of FTA with the hip–knee–ankle angle (HKA).ResultsThe ICC (RMSSD) for intra- and inter-reader reproducibility of the existing FTA method was 0.96 (0.77°) and 0.92 (1.38°), respectively, and for the new technique was 0.98 (0.25°) and 0.98 (0.37°), with similar results for all three readers. Bland–Altman 95% limits of agreement were greater than ±2° for the existing, and ±1° for the new method. The r-value for the relation of FTA to HKA was 0.68 and 0.72 for the existing and new methods, respectively. Varus (HKA ≤ −2°)/neutral (−2° < HKA < 2°)/valgus (HKA ≥ 2°) alignment based on predicted HKA agreed moderately with measured HKA (weighted kappa = 0.53), and had moderate sensitivity (73%) and specificity (84%) for varus malalignment. The new FTA was related to HKA using a linear equation with a slope of 0.98 and an offset of 4.0°.ConclusionsSince it is largely automated and uses unambiguous anatomical landmarks, the new method is highly reproducible and can be made on a standard posteroanterior (PA) knee radiograph by a relatively unskilled reader

Deferoxamine preconditioning to restore impaired HIF-1α-mediated angiogenic mechanisms in adipose-derived stem cells from STZ-induced type 1 diabetic rats

Objectives: Both excessive and insufficient angiogenesis are associated with progression of diabetic complications, of which poor angiogenesis is an important feature. Currently, adipose-derived stem cells (ADSCs) are considered to be a promising source to aid therapeutic neovascularization. However, functionality of these cells is impaired by diabetes which can result from a defect in hypoxia-inducible factor-1 (HIF-1), a key mediator involved in neovascularization. In the current study, we sought to explore effectiveness of pharmacological priming with deferoxamine (DFO) as a hypoxia mimetic agent, to restore the compromised angiogenic pathway, with the aid of ADSCs derived from streptozotocin (STZ)-induced type 1 diabetic rats ('diabetic ADSCs'). Materials and methods: Diabetic ADSCs were treated with DFO and compared to normal and non-treated diabetic ADSCs for expression of HIF-1α, VEGF, FGF-2 and SDF-1, at mRNA and protein levels, using qRT-PCR, western blotting and ELISA assay. Activity of matrix metalloproteinases -2 and -9 were measured using a gelatin zymography assay. Angiogenic potential of conditioned media derived from normal, DFO-treated and non-treated diabetic ADSCs were determined by in vitro (in HUVECs) and in vivo experiments including scratch assay, three-dimensional tube formation testing and surgical wound healing models. Results: DFO remarkably enhanced expression of noted genes by mRNA and protein levels and restored activity of matrix metalloproteinases -2 and -9. Compromised angiogenic potential of conditioned medium derived from diabetic ADSCs was restored by DFO both in vitro and in vivo experiments. Conclusion: DFO preconditioning restored neovascularization potential of ADSCs derived from diabetic rats by affecting the HIF-1α pathway. © 2015 John Wiley & Sons Ltd

Giant congenital left ventricular diverticulum associated with infective endocarditis: A diagnosis made by tissue Doppler echocardiography

Left ventricular (LV) diverticulum is a relatively rare condition, and it is important to differentiate it from pseudoaneurysm. The increasing use of noninvasive imaging modalities can help to demonstrate different types of ventricular outpouching structures. We report a case of congenital LV diverticulum that is much larger than the usual size and is diagnosed with tissue Doppler echocardiography and cardiac magnetic resonance imaging. Although a ventricular diverticulum is mostly asymptomatic, in the case of this particular patient, it has become complicated with infective endocarditis. © 2016 Japanese College of Cardiolog

Guided random walk calculation of energies and <\sq {r^2} > values of the 1Σg^1\Sigma_g state of H_2 in a magnetic field

Energies and spatial observables for the $^1\Sigma_g$ state of the hydrogen molecule in magnetic fields parallel to the proton-proton axis are calculated with a guided random walk Feynman-Kac algorithm. We demonstrate that the accuracy of the results and the simplicity of the method may prove it a viable alternative to large basis set expansions for small molecules in applied fields.Comment: 10 pages, no figure

Scintigraphic parameters with emphasis on perfusion appraisal in rest 99mTc-sestamibi SPECT in the recovery of myocardial function after thrombolytic therapy in patients with ST elevation myocardial infarction (STEMI)

Introduction: This study was performed to determine the clinical application of rest 99mTc-sestamibi in the assessment of viability and functional improvement of the left ventricle (LV) myocardium in the post-thrombolytic therapy of acute myocardial infarction (AMI). Material and methods: In 37 patients with AMI who received thrombolytic therapy, 2-dimensional (2D) echocardiography, as well as the resting redistribution of 99mTc-sestamibi, was investigated, both within 1 week and 3-5 months after AMI. The predictive capacity of the perfusion percentage for myocardial function recovery was evaluated. Also, the capacities of the possible variables in the prediction of recovery of myocardial function resulting from a change in LV ejection fraction (EF) were evaluated using stepwise multiple regression analysis. Results: Thirty-seven patients (30 men and 7 women; mean age: 58±14 years) with AMI were enrolled in the study. Redistribution was observed in 35 and 50 segments of the initial and follow-up scans, respectively. In addition, 146 segments with reverse redistribution (RR), both in the initial scan (118 segments) and the follow-up scan (86 segments), were also observed. An apparent difference in wall motion scores was seen between the initial and follow-up echocardiographs (p<0.001). Furthermore, using the optimal cut-off point of perfusion percentage in each image set, sensitivity as well as specificity and likelihood ratio (LR) for the improvement of regional wall motion after 3-5 months were defined. Conclusion: These data showed that redistribution and reverse redistribution of 99mTc-sestamibi post thrombolytic therapy can be used as a marker of viability to predict the recovery of segmental wall motion abnormality (stunning), as well as the improvement of segmental perfusion uptake. This study also demonstrates that the resting 99mTc-sestamibi SPECT can be used for an approximate assessment of LV function status and can predict the recovery of jeopardized myocardium function after thrombolytic therapy. © 2011 SAGE Publications

Significance of microalbuminuria in predicting silent myocardial ischemia in patients with type 2 diabetes using myocardial perfusion imaging

Objectives: In light of increased risk of cardiovascular events and the poor prognosis of coronary artery disease (CAD) in diabetic versus non-diabetic patients and also with respect to the importance of early diagnosis of CAD in this status, the study was aimed to assess the importance of microalbuminuria in predicting silent myocardial ischemia (SMI) in patients with type 2 diabetes using myocardial perfusion imaging (MPI). Methods: This study included 120 patients with diabetes type 2, but without previously known CAD or any cardiac symptoms that were stratified into two groups based on presence/absence of microalbuminuria. All participants underwent CAD evaluation using gated myocardial perfusion single-photon emission computed tomography (MPS) imaging. Other clinical and laboratory indices were also recorded. Results: Studied population consisted of 84 males (70%) and 36 females (30%), totally 120 patients with mean age of 58.61±9.90). In total, asymptomatic ischemia was detected in 78 (65%) of the included diabetic patients. Stress induced ischemia was found in 56 patients (87.5%) of albumin+ (Alb) group and in 22 patients (39.3%) of Alb-group. The frequency of stress induced ischemia was 10.81 times higher in the patients with microalbuminuria compared to Alb-ones [p0.05). Conclusion: The current study showed that abnormal MPI findings are significantly more common in diabetic patients with microalbuminuria. With respect to low cost and availability of urine Alb detection tests, it might be as a biomarker for prediction of SMI in diabetic population. © 2019 by Turkish Society of Nuclear Medicine Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi

Анализ тенденций развития внешнеэкономической деятельности машиностроительных предприятий Республики Беларусь

Материалы XIII Междунар. науч. конф. студентов, магистрантов, аспирантов и молодых ученых, Гомель, 21–22 мая 2020 г

The trochlear isometric point is different in patients with recurrent patellar instability compared to controls: a radiographical study

Purpose: The purpose of the study was to investigate the theoretical isometric point based of the curve of the femoral groove and relating it to the origin of the MPFL femoral tunnel on lateral radiograph by comparing a patellar instability cohort with a control cohort. Methods: From a Patellar Instability database the radiographs of 40 consecutive patients were analysed to define Schöttle’s point, and the arc of the circle of the trochlear groove. A comparison population of 20 radiographs from comparable patients with tibiofemoral joint disorders was used as a control. The distance from Schöttle’s point to the most anterior part of the groove (extension) was also compared to the distance to the distal end of the roof of the notch (flexion). Results: The trochlea was circular in the controls but not the Patellofemoral Instability cohort where trochlear dysplasia is usually present. The difference between the extension and flexion length was a mean of − 2.0 ± 0.5 mm in the controls and + 6.0 ± 0.5 mm in the patellofemoral cohort. In neither cohort did the centre of the circle correspond to Schöttle’s point. The extension distance correlated with the boss height. Conclusions: The dysplastic trochlea is not circular and the centre of the best matched circle was different to the control trochleae which were circular. The circle centres did not correlate with Schöttle’s point for either cohort, and was more proximal in the Patellofemoral Instability cohort. Clinical relevance: For the MPFL to have equal tension throughout flexion within the groove, the length should not change. In normal knees the MPFL does not behave isometrically. The change in length, as measured from Schöttle’s point to the trochlea, was greater for patellofemoral instability patients explaining why an isolated MPFL reconstruction in the presence of severe trochlear dysplasia risks poor outcomes