Impact of associated injuries in the Floating knee: A retrospective study

<p>Abstract</p> <p>Background</p> <p>Floating knee injuries are usually associated with other significant injuries. Do these injuries have implications on the management of the floating knee and the final outcome of patients? Our study aims to assess the implications of associated injuries in the management and final outcome of floating knee.</p> <p>Methods</p> <p>29 patients with floating knees were assessed in our institution. A retrospective analysis of medical records and radiographs were done and all associated injuries were identified. The impact of associated injuries on delay in initial surgical management, delay in rehabilitation & final outcome of the floating knee were assessed.</p> <p>Results</p> <p>38 associated injuries were noted. 7 were associated with ipsilateral knee injuries. Lower limb injuries were most commonly associated with the floating knee. Patients with some associated injuries had a delay in surgical management and others a delay in post-operative rehabilitation. Knee ligament and vascular injuries were associated with poor outcome.</p> <p>Conclusion</p> <p>The associated injuries were quite frequent with the floating knee. Some of the associated injuries caused a delay in surgical management and post-operative rehabilitation. In assessment of the final outcome, patients with associated knee and vascular injuries had a poor prognosis. Majority of the patients with associated injuries had a good or excellent outcome.</p

Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System

The type IX secretion system (T9SS) has been recently discovered and is specific to Bacteroidetes species. Porphyromonas gingivalis, a keystone pathogen for periodontitis, utilizes the T9SS to transport many proteins including the gingipain virulence factors across the outer membrane and attach them to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated and the structural organization of these components is unknown. In this study, we purified PorK and PorN complexes from P. gingivalis and using electron microscopy we have shown that PorN and the PorK lipoprotein interact to form a 50 nm diameter ring-shaped structure containing approximately 32?36 subunits of each protein. The formation of these rings was dependent on both PorK and PorN, but was independent of PorL, PorM and PorP. PorL and PorM were found to form a separate stable complex. PorK and PorN were protected from proteinase K cleavage when present in undisrupted cells, but were rapidly degraded when the cells were lysed, which together with bioinformatic analyses suggests that these proteins are exposed in the periplasm and anchored to the outer membrane via the PorK lipid. Chemical cross-linking and mass spectrometry analyses confirmed the interaction between PorK and PorN and further revealed that they interact with the PG0189 outer membrane protein. Furthermore, we established that PorN was required for the stable expression of PorK, PorL and PorM. Collectively, these results suggest that the ring-shaped PorK/N complex may form part of the secretion channel of the T9SS. This is the first report showing the structural organization of any T9SS component

First detection of the emerging fungal pathogen Batrachochytrium salamandrivorans in Germany

The emerging infectious disease chytridiomycosis is one of the major factors triggering global amphibian declines. A recently discovered species of chytrid fungus, Batrachochytrium salamandrivorans (Bsal), likely originated in East Asia, has led to massive declines in populations of fire salamanders (Salamandra salamandra) after its apparent introduction to the Netherlands and Belgium. Here, we report the first detection of this pathogen in Germany where it caused mass mortality of fire salamanders in a captive collection. Salamanders from this collection showed an almost 100% prevalence of infection with Bsal. Supposed Bsal-induced mortality occurred in multiple Salamandra species (S. salamandra, S. algira, S. corsica, and S. infraimmaculata), while Bsal infection was confirmed in nine subspecies of S. salamandra and in S. algira. Our study indicates that this pathogen can potentially infect all fire salamander species and subspecies. If Bsal spreads from captive collections to wild populations, then a similar devastating effect associated with high mortality should be expected