Management of Radiation Induced, Bilateral Primary THA Loosening with an Aseptic Paprosky Type IIB Acetabular Defect and a Contralateral Septic Type IIIB Acetabular Defect: A Case Report and Review of Literature

INTRODUCTION: Primary THA in an irradiated hip poses risk for early loosening and inadequate ingrowth. Adverse effects such as decreased vascularity and increased infection risk pose a threat. CASE PRESENTATION: Our patient was a case of post-irradiation (for cervical cancer) bilateral THA loosening causing aseptic acetabular loosening on one side and catastrophic septic loosening with a Paprosky type IIIB acetabular defect with pelvic discontinuity on the contralateral side. DISCUSSION: There have been various studies documenting deleterious effects of irradiation on osseoin-tegration and provide a challenge for long-term implant stability in THA patients. CONCLUSION: A meticulous treatment protocol with contemporary implant technology and staged bilateral stepwise management can lead to satisfactory clinical outcomes.This case report highlights on such specific nuances and principles

Efficient Genetic Method for Establishing Drosophila Cell Lines Unlocks the Potential to Create Lines of Specific Genotypes

Analysis of cells in culture has made substantial contributions to biological research. The versatility and scale of in vitro manipulation and new applications such as high-throughput gene silencing screens ensure the continued importance of cell-culture studies. In comparison to mammalian systems, Drosophila cell culture is underdeveloped, primarily because there is no general genetic method for deriving new cell lines. Here we found expression of the conserved oncogene RasV12 (a constitutively activated form of Ras) profoundly influences the development of primary cultures derived from embryos. The cultures become confluent in about three weeks and can be passaged with great success. The lines have undergone more than 90 population doublings and therefore constitute continuous cell lines. Most lines are composed of spindle-shaped cells of mesodermal type. We tested the use of the method for deriving Drosophila cell lines of a specific genotype by establishing cultures from embryos in which the warts (wts) tumor suppressor gene was targeted. We successfully created several cell lines and found that these differ from controls because they are primarily polyploid. This phenotype likely reflects the known role for the mammalian wts counterparts in the tetraploidy checkpoint. We conclude that expression of RasV12 is a powerful genetic mechanism to promote proliferation in Drosophila primary culture cells and serves as an efficient means to generate continuous cell lines of a given genotype

2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary

The International Liaison Committee on Resuscitation has initiated a near-continuous review of cardiopulmonary resuscitation science that replaces the previous 5-year cyclic batch-and-queue approach process. This is the first of an annual series of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations summary articles that will include the cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation in the previous year. The review this year includes 5 basic life support and 1 paediatric Consensuses on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Each of these includes a summary of the science and its quality based on Grading of Recommendations, Assessment, Development, and Evaluation criteria and treatment recommendations. Insights into the deliberations of the International Liaison Committee on Resuscitation task force members are provided in Values and Preferences sections. Finally, the task force members have pri-oritised and listed the top 3 knowledge gaps for each population, intervention, comparator, and outcome question. (C) 2017 European Resuscitation Council and American Heart Association, Inc. Published by Elsevier B.V. All rights reserved.Peer reviewe

Sex and limb-specific ischemic reperfusion and vascular reactivity

With little known regarding sex and limb heterogeneity, we investigated vascular reactivity and ischemic reperfusion (IR) in the upper and lower extremities of 15 healthy men (26 ± 2 yr) and women (23 ± 1 yr). Doppler ultrasound was used to evaluate IR and flow-mediated dilation (FMD) after suprasystolic cuff occlusion in both the arm [brachial artery (BA)] and the leg [popliteal artery (PA)]. Cumulative IR [area under the curve (AUC)], normalized for muscle mass, revealed no sex-related differences in either limb (forearm: men 38 ± 3 and women 44 ± 4 ml/100 g; lower leg: men 12 ± 2 and women 14 ± 2 ml/100 g), while both groups revealed a greater IR per unit of arm muscle mass (AUC) compared with the lower leg (P < 0.05). The BA and PA were smaller in women (BA 0.31 ± 0.1, PA 0.47 ± 0.1 cm) than in men (BA 0.41 ± 0.1, PA 0.6 ± 0.2 cm). Absolute FMD/shear rate revealed attenuated vascular function in the PA of the women [women 3.3 ± 0.6, men 5.0 ± 0.8 (all ×10−6) cm/s−1·s] and no sex difference in the BA [women 1.2 ± 0.2, men 1.6 ± 0.1 (all ×10−6) cm/s−1·s]. In both sexes the PA demonstrated greater vascular reactivity than the BA. Thus vascular reactivity in healthy young people is greater in the legs, regardless of sex, and women have vascular function similar to men in the upper extremities but appear to have poorer vascular function normalized for shear rate in the lower extremities

Role of α1-adrenergic vasoconstriction in the regulation of skeletal muscle blood flow with advancing age

α1-Adrenergic vasoconstriction during dynamic leg exercise is diminished in younger individuals, although the extent of this exercise-induced “sympatholysis” in the elderly remains uncertain. Thus, in nine young (25 ± 1 yr) and six older (72 ± 2 yr) healthy volunteers, we evaluated changes in leg blood flow (ultrasound Doppler) during blood flow-adjusted intra-arterial infusion of phenylephrine (PE; a selective α1-adrenergic agonist) at rest and during knee-extensor leg exercise at 20, 40, and 60% of maximal work rate (WRmax). To probe the potential contributors to exercise-induced changes in α1-adrenergic receptor sensitivity, exercising leg O2 consumption (V̇o2) and lactate efflux were also evaluated (n = 10). At rest, the PE-induced vasoconstriction (i.e., decrease in leg blood flow) was diminished in older (−37 ± 3%) compared with young (−54 ± 4%) subjects. During exercise, the magnitude of α1-adrenergic vasoconstriction in the active leg decreased in both groups. However, compared with young, older subjects maintained a greater vasoconstrictor response to PE at 40% WRmax (−14 ± 3%, older; −7 ± 2%, young) and 60% WRmax (−11 ± 3%, older; −4 ± 3%, young). It is possible that this observation may be attributed to lower absolute work rates in the older group, because, for a similar absolute work rate (≈10 W) and leg V̇o2 (≈0.36 l/min), vasoconstriction to PE was not different between groups (−14 ± 3%; older; −17 ± 5%, young). Together, these data challenge the concept of reduced sympatholysis in the elderly, suggesting instead that the inhibition of α1-adrenergic vasoconstriction in the exercising leg is associated with work performed and, therefore, more closely related to the rate of oxidative metabolism than to age per se