Management of anterior cruciate ligament rupture in patients aged 40 years and older

The aim of anterior cruciate ligament (ACL) reconstruction is essentially to restore functional stability of the knee and to allow patients to return to their desired work and activities. While in the young and active population, surgery is often the best therapeutic option after an ACL tear, ACL reconstruction in middle-aged people is rather more controversial due to concerns about a higher complication rate. The purpose of our article is to establish, through a systematic review of the literature, useful decision-making criteria for the management of anterior cruciate ligament rupture in patients aged 40 years and older, guiding surgeons to the most appropriate therapeutic approach. Various reports have shown excellent results of ACL reconstruction in patients over the age of 40 in terms of subjective satisfaction, return to previous activity level, and reduced complication and failure rates. Some even document excellent outcomes in subjects of 50 years and older. Although there are limited high-level studies, data reported in the literature suggest that ACL reconstruction can be successful in appropriately selected, motivated older patients with symptomatic knee instability who want to return to participating in highly demanding sport and recreational activities. Deciding factors are based on occupation, sex, activity level of the subject, amount of time spent performing such highly demanding activities, and presence of associated knee lesions. Physiological age and activity level are more important than chronological age as deciding factors when considering ACL reconstruction

EDITORIAL

We have projected this issue of volume 44 of the European Journal of Histochemistry, the first issue of the third millennium, to celebrate the achievements of the just-ended twentieth century, quite agreed upon as the century of histochemistry. The issue opens with a review by van der Ploeg entitled “Cytochemical nucleic acid research during the twentieth century”. This is the text of a lecture he presented in Camerino to the 1999 Congress of Histochemistry on the occasion of his receiving the 1st International Histochemical Award. The award, in memory of the founder of our Society, Maffo Vialli, was instituted for the express purpose of linking more closely our Society with other European histochemical centers, and more generally with their cell biology activities. Prof. van der Ploeg in his article traces a very analytical history of the last century’s research on nucleic acids and, through this, how our knowledge about cell biology and about how life is regulated, progressed. He begins right from the discovery at the end of the seventeenth century of a simple microscope, “insensitive to optical aberration”, which permitted Van Leeuwenhoek to observe unicellular organisms for the first time. From this follows, clearly and compellingly, the evolution of biological thought about the nucleus and cell life, closely correlating it with the development of the instruments of observation and measurement, and the techniques of imaging and quantification of nucleic acids

Kinetics of DNase I digestion of interphase chromatin in differentiated cell nuclei of the mouse: a flow cytometric study.

The process of DNA digestion with DNase I was monitored in interphase chromatin of differentiated cells by flow cytometry after DNA staining with either the intercalating dye propidium iodide (PI) or the AT specific dye Hoechst 33258 (HO). Nuclei from the liver, kidney and spleen of the mouse were studied after different digestion times (0 to 120 min). During the first 30 min of treatment, a tissue specific digestion pattern was found after PI staining; from 60 min onward, the digestion curves ran parallel, with minor quantitative differences among the cell types. After HO staining, the digestion kinetics appeared to be similar for all the cell types; this is likely due to the peculiar base composition of the mouse genome, where inactive c-heterochromatin is exceptionally AT-rich. No quantitative correlation was found between interphase "heterochromatin" and chromatin DNA which is resistant to DNase I cleavage, while the amount of DNase-I-sensitive DNA does not correspond to the interphase "euchromatic" component. It was confirmed that the flow cytometric approach is a tool for quantifying relative changes in the functional state of chromatin in differentiated cell system

Sanificazione in sala operatoria:progetto sperimentale.

L’insorgere di infezioni ospedaliere dipende da una molteplicità di fattori legati ai contatti interumani ma anche dall’inquinamento ambientale. Nel presente lavoro vengono non solo analizzate le differenti metodiche di sanificazione delle superfici di sale operatorie ma viene anche posto l’accento sull’importanza di monitorare la carica microbica totale e l’eventuale presenza di microrganismi indicatori quali Staphylococcus aureus, inclusi gli MRSA, il Clostridium difficile, un bacillo Gram negativo sporigeno multi resistente, gli Enterococchi vancomicina resistenti (VRE) e le Salmonelle. Questi microrganismi presentano una particolare resistenza sia all’essiccamento che ai disinfettanti ed inoltre tali microrganismi appaiono spesso responsabili dell’insorgenza delle infezioni ospedaliere

Genome size and constitutive heterochromatin in Hylobates muelleri and Symphalangus syndactylus and in their viable hybrid.

Genome size was measured as the amount of Feulgen-stained DNA in six species of the family Hylobatidae and in a hybrid of the gibbon (Hylobates muelleri) and siamang (Symphalangus syndactylus). The family, on the whole, exhibits a wider range of genome sizes than pongids; in particular, the siamang has about 15% more DNA than the 44-chromosome Hylobates species of the "lar" group. Quantitative analysis of C-heterochromatin in hybrid metaphases showed that the difference in genome size of the parental species correlates with the amount of C-band-positive material. Hylobatids are the only group of primates in which karyotype diversification has taken place with a massive quantitative change in constitutive heterochromatin