Reducing Recurrence in Campanacci Type Three Giant Cell Tumor of Bone: Outcomes from an 82-Case Study Evaluating Psuedocapsule Excision with Extended Curettage

Background & Objective: In Campanacci type 3 giant cell tumor of bone (GCT), soft tissue expansion of the tumor has been considered the most important factor for recurrence. We report the outcomes in 82 consecutive patients with GCT of the extremities treated with the excision of pseudocapsule along with extended curettage in terms of recurrence and functional results. Material and Methods: We treated 82 cases with histologically proven, radiological grade 3 GCT of the extremities, which had at least two cortices intact. We performed soft tissue expansion excision along with extended curettage using a high-speed burr, phenol, hydrogen peroxide, and electrocautery. Reconstruction was done with bone cement or bone graft, and internal fixation was performed in all cases. Cases were followed up for a minimum of two years. Results: The highest incidence of GCT was found in the distal femur (28 , 34.1%), followed by the proximal tibia (18, 21.9%), with the third most common sites being in the upper limb, where the distal radius and proximal humerus each had an equal incidence of 12 cases (14.6%). Eight patients had preoperative pathological fractures. Reconstruction with bone cement was done in 65 cases, and bone grafting was done in 17 cases. Recurrence of GCT was not observed in study population. Post-operative infections were seen in 2 patients. Conclusion: Soft tissue expansion and pseudocapsule excision along with extended curettage are effective methods for decreasing the rate of recurrence in giant cell tumors of bone

A Review: Protein Interaction & Behavior Assessment in Host Cells after Novel Drug Compound Administration using Systems Biology Approach

To understand complex biological systems requires the integration of experimental and computational research; in other words systems biology approach. Computational biology, through via different software helps in exploration more than one gene expression at a time and also understanding the connectivity, Systems Biology provides a powerful foundation from which to address critical scientific questions head-on. The reviews in this Insight cover many different aspects of this energetic field, although all, in one way or another, illuminate the functioning of modular circuits, including their robustness, design and manipulation. Computational systems biology addresses questions fundamental to our understanding of life, yet progress here will lead to practical innovations in medicine, drug discovery and engineering, In this study we have evaluated th

Obeticholic acid for the treatment of non-alcoholic steatohepatitis: interim analysis from a multicentre, randomised, placebo-controlled phase 3 trial

Background Non-alcoholic steatohepatitis (NASH) is a common type of chronic liver disease that can lead to cirrhosis. Obeticholic acid, a farnesoid X receptor agonist, has been shown to improve the histological features of NASH. Here we report results from a planned interim analysis of an ongoing, phase 3 study of obeticholic acid for NASH. Methods In this multicentre, randomised, double-blind, placebo-controlled study, adult patients with definite NASH,non-alcoholic fatty liver disease (NAFLD) activity score of at least 4, and fibrosis stages F2–F3, or F1 with at least oneaccompanying comorbidity, were randomly assigned using an interactive web response system in a 1:1:1 ratio to receive oral placebo, obeticholic acid 10 mg, or obeticholic acid 25 mg daily. Patients were excluded if cirrhosis, other chronic liver disease, elevated alcohol consumption, or confounding conditions were present. The primary endpointsfor the month-18 interim analysis were fibrosis improvement (≥1 stage) with no worsening of NASH, or NASH resolution with no worsening of fibrosis, with the study considered successful if either primary endpoint was met. Primary analyses were done by intention to treat, in patients with fibrosis stage F2–F3 who received at least one dose of treatment and reached, or would have reached, the month 18 visit by the prespecified interim analysis cutoff date. The study also evaluated other histological and biochemical markers of NASH and fibrosis, and safety. This study is ongoing, and registered with ClinicalTrials.gov, NCT02548351, and EudraCT, 20150-025601-6. Findings Between Dec 9, 2015, and Oct 26, 2018, 1968 patients with stage F1–F3 fibrosis were enrolled and received at least one dose of study treatment; 931 patients with stage F2–F3 fibrosis were included in the primary analysis (311 in the placebo group, 312 in the obeticholic acid 10 mg group, and 308 in the obeticholic acid 25 mg group). The fibrosis improvement endpoint was achieved by 37 (12%) patients in the placebo group, 55 (18%) in the obeticholic acid 10 mg group (p=0·045), and 71 (23%) in the obeticholic acid 25 mg group (p=0·0002). The NASH resolution endpoint was not met (25 [8%] patients in the placebo group, 35 [11%] in the obeticholic acid 10 mg group [p=0·18], and 36 [12%] in the obeticholic acid 25 mg group [p=0·13]). In the safety population (1968 patients with fibrosis stages F1–F3), the most common adverse event was pruritus (123 [19%] in the placebo group, 183 [28%] in the obeticholic acid 10 mg group, and 336 [51%] in the obeticholic acid 25 mg group); incidence was generally mild to moderate in severity. The overall safety profile was similar to that in previous studies, and incidence of serious adverse events was similar across treatment groups (75 [11%] patients in the placebo group, 72 [11%] in the obeticholic acid 10 mg group, and 93 [14%] in the obeticholic acid 25 mg group). Interpretation Obeticholic acid 25 mg significantly improved fibrosis and key components of NASH disease activity among patients with NASH. The results from this planned interim analysis show clinically significant histological improvement that is reasonably likely to predict clinical benefit. This study is ongoing to assess clinical outcomes

A Paradigmatic and Methodological Examination of Market Orientation Research

Yadav, V ORCiD: 0000-0001-5237-1186Research on market orientation has evolved for more than two decades, and is now ripe for reflection on its paradigmatic and methodological moorings. We review market orientation research to understand research paradigms adopted in the studies using an operations research paradigm framework, and compare and contrast methodologies and research designs used in the literature. This study used the citation pearl-growing method to identify and review 137 studies on market orientation. The study finds a dominance of the positivist paradigm in the extant research, particularly in the North American journals. There have only been a few interpretive studies on market orientation in the past two decades. This study makes a case for methodological pluralism in the research on market orientation. The findings will benefit academia and practitioners in understanding the past research trends and identify potential future research areas. The review adds value to the literature in terms of presenting an overview of market orientation research, where the research field stands today, and where it is heading in the future

An Efficient Method of Image Segmentation for Harvest Time Identification

The aim of development and advancements in every research and technology is to provide easy solutions to any user’s problems including the day to day ones. One problem that a farmer might face is to identify whether his crop is ready for harvesting or not. Hence the efforts are taken to figure out an easy solution for a farmer where he can use his cellular phone to identify whether his crop is ready for harvesting or not. This he can do by taking picture of his crop through the digital camera of his cellular phone. Therefore image processing plays an active role to figure out the solution to this problem. This paper proposes image segmentation of the image of a crop such as tomato to identify whether the crop is ripe enough or not. The feature that is extracted for image segmentation is moment. The classification technique used for segmentation is K-means clustering algorithm. The values for the segmented image viz. Mismatching Rate, Misclassification Rate, PSNR and MSE are then calculated Then to identify how much the system is robust noise is inserted in the image and then again the image is segmented and the above mentioned values are calculated. Then the image is denoised and again segmentation of the image is performed and the same process is followed. This paper presents the above mentioned process and the system produces equivalent results in all the three cases. The research work presents here the result of the image segmentation done on the image of a tomato using MATLAB version 7.10

Monteggia fracture dislocation equivalents - analysis of eighteen cases treated by open reduction and internal fixation

【Abstract】 Objective: Monteggia fracture dislocation equivalent, though already described by Bado, is still an unclassified entity. We aimed to retrospectively analyze 18 cases of Monteggia variants and discuss the injury mechanisms, management, and outcome along with a review of the literature. Methods: A retrospective record of Monteggia fracture dislocation (2003-2008) was reviewed from medical record department of our institute. Classic Monteggia fracture dislocation, children below 12 years or adults over 50 years, as well as open grade II & III cases were excluded from this study. Monteggia variant inclusion criteria included fracture of the proximal ulna together with a fracture of the radial head or neck and skeletal maturity. Totally 26 patients were identified with Monteggia variants and 18 were available for follow-up, including 11 males and 7 females with the mean age of 35 years. The ulna fracture was treated by compression plating along with tension band wiring. Radial head/neck was reconstructed in 12 patients while excised in 6 patients. Results: Follow-up ranged from 1-4 years, mean 2.6 years. Patients were assessed clinicoradiologically. Mayo Elbow Performance Score was employed to assess the outcomes. At final follow-up, the results were excellent in 10 patients, good in 4, fair in 2 and poor in 2. Mean range of motion of the elbow was 20°, 116°, 50° and 55° for extension, flexion, pronation and supination, respectively. Two patients had complications in the form of heterotopic ossification and stiffness of the elbow. One nonunion ulna, primarily treated by tension band wiring, was managed by refixation with locking reconstruction plate and bone grafting. Bone grafting was only required in this patient for nonunion. Another patient had implants removed on his request. The results in our series closely correlated with extent of intraarticular damage, coronoid fracture and comminuted fractures. Conclusions: Monteggia fracture dislocation equivalents are rare injuries and pre-surgery recognition by radiographs and 3-D CT helps make optimal plan. The poor results usually relate to intraarticular damage, coronoid fractures and comminution of the ulna and radial head fractures. Key words: Monteggia’s fracture; Radius fracture; Uln

Nonunion of coronal shear fracture of femoral condyle

【Abstract】Isolated coronal fractures of femoral condyle are rare in adults and nonunion of Hoffa fracture is reported only a few times in the literature. We analyzed six cases of nonunion of Hoffa fractures over a period of three years. Three patients were treated conservatively and three patients had fixation failures. Delay of presentation was 2 months to one year. Treatment protocol consisted of open reduction, excision of pseudoarthrosis, bone grafting and internal fixation along with knee arthrolysis. Union was achieved in all patients at mean 16 weeks. The treatment of nonunion of Hoffa fractures requires careful preoperative planning and meticulous surgical technique. The literature regarding the controversies in fracture management and surgical technique are reviewed. Key words: Femoral fracture; Fracture fixation, internal; Retrospective studie

Temporal Quantitative Phosphoproteomics Profiling of Interleukin-33 Signaling Network Reveals Unique Modulators of Monocyte Activation

Interleukin-33 (IL-33), a member of the IL-1 superfamily cytokines, is an endogenous danger signal and a nuclear-associated cytokine. It is one of the essential mediators of both innate and adaptive immune responses. Aberrant IL-33 signaling has been demonstrated to play a defensive role against various infectious and inflammatory diseases. Although the signaling responses mediated by IL-33 have been previously reported, the temporal signaling dynamics are yet to be explored. To this end, we applied quantitative temporal phosphoproteomics analysis to elucidate pathways and proteins induced by IL-33 in THP-1 monocytes. Employing a TMT labeling-based quantitation and titanium dioxide (TiO2)-based phosphopeptide enrichment strategy followed by mass spectrometry analysis, we identified and quantified 9448 unique phosphopeptides corresponding to 3392 proteins that showed differential regulation. Of these, 171 protein kinases, 60 phosphatases and 178 transcription factors were regulated at different phases of IL-33 signaling. In addition to the confirmed activation of canonical signaling modules including MAPK, NFκB, PI3K/AKT modules, pathway analysis of the time-dependent phosphorylation dynamics revealed enrichment of several cellular processes, including leukocyte adhesion, response to reactive oxygen species, cell cycle checkpoints, DNA damage and repair pathways. The detailed quantitative phosphoproteomic map of IL-33 signaling will serve as a potentially useful resource to study its function in the context of inflammatory and pathological conditions