Functional outcome of elbow joint in AO type 13C fractures treated with open reduction and internal fixation using dual plates

Background: Distal end of the humerus, with its unique orientation of articular surfaces supported by a meagre amount of cancellous bone, makes its fracture a constant challenge to orthopaedic surgeons. Aim of the study is to evaluate the functional outcome of surgical management of intercondylar AO type C fractures of distal end of humerus using dual plating.Methods: A prospective study was conducted at our hospital between January 2015 to December 2016. Thirty five consecutive patients with intercondylar (AO Type C) fracture of distal humerus, included in study as per inclusion criteria. All patients were treated surgically using triceps reflecting approach and posterior trans-olecranon approach with ulnar nerve exploration and fixation using dual plating and tension band wiring for olecranon osteotomy wherever done.Results: In 35 patients, final results using MEPS scoring system excellent outcome is noticed in 15 patients (42.86%), good results is noticed in 13 patients (37.14%), fair result is noticed in 5 patients (14.29%) and poor result is noticed in 2 patients (5.71%). There was statistical significant difference in flexion range of movement arc at 2 and 6 months in our study.Conclusions: Open reduction and internal fixation of AO type 13C fractures is challenge to surgeon, preoperative planning and mastering the technique over a period of time gives good to excellent functional outcomes.

Operando XANES study of the role of CeO2 in the oxidation of propane over CuO-CeO2/γ-Al2O3

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Perivascular Mural Cells of the Mouse Choroid Demonstrate Morphological Diversity That Is Correlated to Vasoregulatory Function

<div><p>Objective</p><p>Perivascular mural cells of the choroid have been implicated in physiological functioning as well as in retinal disease pathogenesis. However details regarding their form and function are not well understood. We aim to characterize choroidal mural cells in the adult mouse choroid in terms of their distribution and morphology, and correlate these to their contractile behavior.</p><p>Methods</p><p>Sclerochoroidal flat-mounted explants were prepared from albino transgenic mice in which the α-smooth muscle actin (α-SMA) promoter drives the expression of green fluorescent protein (GFP). α-SMA-expressing smooth muscle cells and pericytes in the living choroid were thereby rendered fluorescent and imaged with confocal microscopy and live-cell imaging <i>in situ.</i></p><p>Results</p><p>Choroidal perivascular mural cells demonstrate significant diversity in terms of their distribution and morphology at different levels of the vasculature. They range from densely-packed circumferentially-oriented cells that provide complete vascular coverage in primary arteries to widely-spaced stellate-shaped cells that are distributed sparsely over terminal arterioles. Mural cells at each level are immunopositive for contractile proteins α-SMA and desmin and demonstrate vasoconstrictory contractile movements in response to endothelin-1 and the calcium ionophore, A23187, and vasodilation in response to the calcium chelator, BAPTA. The prominence of vasoregulatory contractile responses varies with mural cell morphology and density, and is greater in vessels with dense coverage of mural cells with circumferential cellular morphologies. In the choriocapillaris, pericytes demonstrate a sparse, horizontal distribution and are selectively distributed only to the scleral surface of the choriocapillaris.</p><p>Conclusions</p><p>Diversity and regional specialization of perivascular mural cells may subserve varying requirements for vasoregulation in the choroid. The model of the α-SMA-GFP transgenic albino mouse provides a useful and intact system for the morphological and functional study of choroidal mural cells.</p></div

Distribution of green fluorescent protein (GFP)-labeled cells in the choroid of an adult albino α-SMA-GFP transgenic mouse.

<p>(<b>A</b>) Choroidal vasculature as visualized by confocal microscopy through the RPE cell layer in a sclerochoroidal flat-mount. GFP-positive perivascular mural cells are present in choroidal arteries (box 1), smaller secondary arterioles (box 2), and branching precapillary arterioles (box 3). (<b>B</b>) Labeling of the endothelial layer throughout the choroidal vasculature was achieved with systemic perfusion of the lipophilic dye DiI, which becomes incorporated into endothelial cell membranes. (<b>C</b>) Superposition of the GFP and DiI signals demonstrates the perivascular nature of GFP-positive cells in the choroid. Scale bar = 50 µm.</p

Quantitative comparison of choroidal arteries (Type 1), choroidal arterioles (Type 2), and choroidal precapillary arterioles (Type 3).

<p>(<b>A</b>) Quantitation of the linear density of perivascular mural cells along choroidal vessels at different levels of the vascular system. Density of mural cells is significantly higher in arteries (type 1 vessels) relative to arterioles (type 2 vessels), which are in turn significantly higher than precapillary arterioles (type 3 vessels) (* indicates p<0.05 on 1-way ANOVA using the Kruskal-Wallis test, with the Dunn’s multiple comparison test, n≥13 measurements from ≥3 biological replicates). (<b>B</b>) Mean cross-sectional area of choroidal vessels by type, as calculated from vessel diameter measurements, estimating vessels to have a cylindrical geometry. Cross-sectional areas of arteries (Type 1) were significantly greater than those of arterioles (Type 2 and Type 3) (* indicates p<0.05, 1-way ANOVA using the Kruskal-Wallis test, with the Dunn’s multiple comparison test,n≥51 measurements from ≥3 biological replicates).</p

Desmin is expressed in GFP-positive perivascular mural cells in choroidal arterioles.

<p>(<b>A–D</b>) Secondary choroidal arterioles (Type 2 vessels) with circumferential perivascular GFP-positive mural cells (A) were immunopositive for desmin, an intermediate filament protein (B), which colocalized with the circumferential mural cell processes (C). A confocal section in the longitudinal plane of the arteriole (D) demonstrates that desmin immunopositivity in mural cells has a banded appearance owing to its localization within circumferential mural cell processes (<i>arrowheads</i>). Scale bar  = 10 µm. (<b>E–H</b>) Precapillary arterioles (Type 3 vessels) with stellate-shaped GFP-positive mural cells (E) were also immunopositive for desmin (F) and had a branching, rather than banded, appearance. Superposition with the GFP-positive mural cells (G) also demonstrated a colocalization to mural cell processes as evidenced in orthogonal confocal images (<i>arrowheads</i>) in (H). Scale bar = 25 µm.</p

Morphology and distribution of GFP-positive perivascular mural cells of primary choroidal arteries (Type 1 vessels).

<p>Perivascular GFP-positive mural cells (<b>A</b>) are densely distributed along the length of DiI-perfused large main choroidal arteries (<b>B</b>). Superposition of a z-stack of confocal images for GFP- and DiI-derived signals (<b>C</b>) demonstrates that perivascular mural cells completely envelop the vessel walls. GFP-positive striations of smooth muscle mural cells (<i>arrowhead, C</i>) are visible around vessel walls, indicating the presence of encircling processes that wrap around vessels in a continuous manner. A single frame confocal image through large main choroidal arteries (<b>D</b>) demonstrates that individual mural cells possess rounded protuberant nuclei and long circumferential processes (<i>upper arrowheads</i>). Mural cells and their processes provide a near complete coverage of the choroidal artery walls (<i>arrowheads in lower cross-sectional panel</i>) with no significant gaps between neighboring mural cell processes. Scale bar = 50 µm.</p