Defective proliferation and osteogenic potential with altered immunoregulatory phenotype of native bone marrow-multipotential stromal cells in atrophic fracture non-union

Bone marrow-Multipotential stromal cells (BM-MSCs) are increasingly used to treat complicated fracture healing e.g., non-union. Though, the quality of these autologous cells is not well characterized. We aimed to evaluate bone healing-related capacities of non-union BM-MSCs. Iliac crest-BM was aspirated from long-bone fracture patients with normal healing (U) or non-united (NU). Uncultured (native) CD271highCD45low cells or passage-zero cultured BM-MSCs were analyzed for gene expression levels, and functional assays were conducted using culture-expanded BM-MSCs. Blood samples were analyzed for serum cytokine levels. Uncultured NU-CD271highCD45low cells significantly expressed fewer transcripts of growth factor receptors, EGFR, FGFR1, and FGRF2 than U cells. Significant fewer transcripts of alkaline phosphatase (ALPL), osteocalcin (BGLAP), osteonectin (SPARC) and osteopontin (SPP1) were detected in NU-CD271highCD45low cells. Additionally, immunoregulation-related markers were differentially expressed between NU- and U-CD271highCD45low cells. Interestingly, passage-zero NU BM-MSCs showed low expression of immunosuppressive mediators. However, culture-expanded NU and U BM-MSCs exhibited comparable proliferation, osteogenesis, and immunosuppression. Serum cytokine levels were found similar for NU and U groups. Collectively, native NU-BM-MSCs seemed to have low proliferative and osteogenic capacities; therefore, enhancing their quality should be considered for regenerative therapies. Further research on distorted immunoregulatory molecules expression in BM-MSCs could potentially benefit the prediction of complicated fracture healing

Prosthetic replacement of elbow in postburn bony ankylosis: long-term results

Fifteen patients with 17 post-burn bony ankylosed elbows (two bilateral) fixed at a mean of 72.5° ± 27.5° flexion were treated with Baksi sloppy hinge elbow arthroplasty. All patients agreed to avoid strenuous use of their replaced elbows. There were four males and 11 females whose ages varied from 21 to 48 years (average 31.6 years). One of the five patients who had severe anterior skin contracture required release. One patient died during the early follow-up period. During the follow-up studies which ranged from 11 to 23 years (average 14.1), eleven patients (68.7%) regained painless stable motion with mean recovery of arc of flexion from 20°±10° to 107.5°±17.5° with mean range of flexion 90°±20°. Good forearm motion was retained in all cases. According to the assessment score (Morrey BF, The elbow and it’s disorder, 2nd edn. W.B. Saunders, Philadelphia, 1993), nine (56.2%) patients were recorded as excellent, two (12.5%) as good, and five (31.5%) as poor who were considered as failures. The five failures required removal of the prosthesis but retained acceptable elbow function due to periprosthetic fibrosis connecting the adjacent bone ends

The predictability of near-coastal currents using a baroclinic unstructured grid model

A limited domain, coastal ocean forecast system consisting of an unstructured grid model, a meteorological model, a regional ocean model, and a global tidal database is designed to be globally relocatable. For such a system to be viable, the predictability of coastal currents must be well understood with error sources clearly identified. To this end, the coastal forecast system is applied at the mouth of Chesapeake Bay in response to a Navy exercise. Two-day forecasts are produced for a 10-day period from 4 to 14 June 2010 and compared to real-time observations. Interplay between the temporal frequency of the regional model boundary forcing and the application of external tides to the coastal model impacts the tidal characteristics of the coastal current, even contributing a small phase error. Frequencies of at least 3 h are needed to resolve the tidal signal within the regional model; otherwise, externally applied tides from a database are needed to capture the tidal variability. Spatial resolution of the regional model (3 vs 1 km) does not impact skill of the current prediction. Tidal response of the system indicates excellent representation of the dominant M2 tide for water level and currents. Diurnal tides, especially K1, are amplified unrealistically with the application of coarse 27-km winds. Higher-resolution winds reduce current forecast error with the exception of wind originating from the SSW, SSE, and E. These winds run shore parallel and are subject to strong interaction with the shoreline that is poorly represented even by the 3-km wind fields. The vertical distribution of currents is also well predicted by the coastal model. Spatial and temporal resolution of the wind forcing including areas close to the shoreline is the most critical component for accurate current forecasts. Additionally, it is demonstrated that wind resolution plays a large role in establishing realistic thermal and density structures in upwelling prone regions