The importance of early arthroscopy in athletes with painful cartilage lesions of the ankle: a prospective study of 61 consecutive cases

BACKGROUND Ankle sprains are common in sports and can sometimes result in a persistent pain condition. PURPOSE Primarily to evaluate clinical symptoms, signs, diagnostics and outcomes of surgery for symptomatic chondral injuries of the talo crural joint in athletes. Secondly, in applicable cases, to evaluate the accuracy of MRI in detecting these injuries. Type of study: Prospective consecutive series. METHODS Over around 4 years we studied 61 consecutive athletes with symptomatic chondral lesions to the talocrural joint causing persistent exertion ankle pain. RESULTS 43% were professional full time athletes and 67% were semi-professional, elite or amateur athletes, main sports being soccer (49%) and rugby (14%). The main subjective complaint was exertion ankle pain (93%). Effusion (75%) and joint line tenderness on palpation (92%) were the most common clinical findings. The duration from injury to arthroscopy for 58/61 cases was 7 months (5.7–7.9). 3/61 cases were referred within 3 weeks from injury. There were in total 75 cartilage lesions. Of these, 52 were located on the Talus dome, 17 on the medial malleolus and 6 on the Tibia plafond. Of the Talus dome injuries 18 were anteromedial, 14 anterolateral, 9 posteromedial, 3 posterolateral and 8 affecting mid talus. 50% were grade 4 lesions, 13.3% grade 3, 16.7% grade 2 and 20% grade 1. MRI had been performed pre operatively in 26/61 (39%) and 59% of these had been interpreted as normal. Detection rate of cartilage lesions was only 19%, but subchondral oedema was present in 55%. At clinical follow up average 24 months after surgery (10–48 months), 73% were playing at pre-injury level. The average return to that level of sports after surgery was 16 weeks (3–32 weeks). However 43% still suffered minor symptoms. CONCLUSION Arthroscopy should be considered early when an athlete presents with exertion ankle pain, effusion and joint line tenderness on palpation after a previous sprain. Conventional MRI is not reliable for detecting isolated cartilage lesions, but the presence of subchondral oedema should raise such suspicion

Composite Fermion Pairing in Bilayer Quantum Hall Systems

We derive the effective Hamiltonian for the composite fermion in double-layer quantum Hall systems with inter-layer tunneling at total Landau-level filling factor $\nu=1/m$, where $m$ is an integer. We find that the ground state is the triplet p-wave BCS pairing state of the composite fermions. At $\nu=1/2$, the ground state of the system evolves from the Halperin $(3,3,1)$-state toward the Pfaffian-state with increasing the tunneling amplitude. On the other hand, at $\nu=1$, the pairing state is uniquely determined independent of tunneling amplitude.Comment: 13 pages, 2 figure

Thermodynamic properties of spontaneous magnetization in Chern-Simons QED_3

The spontaneous magnetization in Chern-Simons QED_3 is discussed in a finite temperature system. The thermodynamical potential is analyzed within the weak field approximation and in the fermion massless limit. We find that there is a linear term with respect to the magnetic field with a negative coefficient at any finite temperature. This implies that the spontaneous magnetic field does not vanish even at high temperature. In addition, we examine the photon spectrum in the system. We find that the bare Chern-Simons coefficient is cancelled by the radiative effects. The photons then become topologically massless according to the magnetization, though they are massive by finite temperature effects. Thus the magnetic field is a long-range force without the screening even at high temperature.Comment: 32 pages, Latex, 4 eps figure

Supersymmetry Breaking in Chern-Simons-matter Theories

Some of supersymmetric Chern-Simons theories are known to exhibit supersymmetry breaking when the Chern-Simons level is less than a certain number. The mechanism of the supersymmetry breaking is, however, not clear from the field theory viewpoint. In this paper, we discuss vacuum states of ${\cal N}=2$ pure Chern-Simons theory and ${\cal N}=2$ Chern-Simons-matter theories of quiver type using related theories in which Chern-Simons terms are replaced with (anti-)fundamental chiral multiplets. In the latter theories, supersymmetry breaking can be shown to occur by examining that the vacuum energy is non-zero.Comment: 17 pages, 3 figures, v2) references adde

Analysis of adam12-mediated ephrin-a1 cleavage and its biological functions

Accumulating evidence indicates that an elevated ephrin-A1 expression is positively correlated with a worse prognosis in some cancers such as colon and liver cancer. The detailed mechanism of an elevated ephrin-A1 expression in a worse prognosis still remains to be fully elucidated. We previously reported that ADAM12-cleaved ephrin-A1 enhanced lung vascular permeability and thereby induced lung metastasis. However, it is still unclear whether or not cleaved forms of ephrin-A1 are derived from primary tumors and have biological activities. We identified the ADAM12-mediated cleavage site of ephrin-A1 by a Matrix-assisted laser desorption ionization mass spectrometry and checked levels of ephrin-A1 in the serum and the urine derived from the primary tumors by using a mouse model. We found elevated levels of tumor-derived ephrin-A1 in the serum and the urine in the tumor-bearing mice. Moreover, inhibition of ADAM-mediated cleavage of ephrin-A1 or antagonization of the EphA receptors resulted in a significant reduction of lung metastasis. The results suggest that tumor-derived ephrin-A1 is not only a potential biomarker to predict lung metastasis from the primary tumor highly expressing ephrin-A1 but also a therapeutic target of lung metastasis

Steady state properties of a driven granular medium

We study a two-dimensional granular system where external driving force is applied to each particle in the system in such a way that the system is driven into a steady state by balancing the energy input and the dissipation due to inelastic collision between particles. The velocities of the particles in the steady state satisfy the Maxwellian distribution. We measure the density-density correlation and the velocity-velocity correlation functions in the steady state and find that they are of power-law scaling forms. The locations of collision events are observed to be time-correlated and such a correlation is described by another power-law form. We also find that the dissipated energy obeys a power-law distribution. These results indicate that the system evolves into a critical state where there are neither characteristic spatial nor temporal scales in the correlation functions. A test particle exhibits an anomalous diffusion which is apparently similar to the Richardson law in a three-dimensional turbulent flow.Comment: REVTEX, submitted to Phys. Rev.

Interface dynamics for layered structures

We investigate dynamics of large scale and slow deformations of layered structures. Starting from the respective model equations for a non-conserved system, a conserved system and a binary fluid, we derive the interface equations which are a coupled set of equations for deformations of the boundaries of each domain. A further reduction of the degrees of freedom is possible for a non-conserved system such that internal motion of each domain is adiabatically eliminated. The resulting equation of motion contains only the displacement of the center of gravity of domains, which is equivalent to the phase variable of a periodic structure. Thus our formulation automatically includes the phase dynamics of layered structures. In a conserved system and a binary fluid, however, the internal motion of domains turns out to be a slow variable in the long wavelength limit because of concentration conservation. Therefore a reduced description only involving the phase variable is not generally justified.Comment: 16 pages; Latex; revtex aps; one figure. Revision: screened coulomb interaction with coulomb limi

Velocity and density profiles of granular flow in channels using lattice gas automaton

We have performed two-dimensional lattice-gas-automaton simulations of granular flow between two parallel planes. We find that the velocity profiles have non-parabolic distributions while simultaneously the density profiles are non-uniform. Under non-slip boundary conditions, deviation of velocity profiles from the parabolic form of newtonian fluids is found to be characterized solely by ratio of maximal velocity at the center to the average velocity, though the ratio depends on the model parameters in a complex manner. We also find that the maximal velocity ($u_{max}$) at the center is a linear function of the driving force (g) as $u_{max} = \alpha g - \delta$ with non-zero $\delta$ in contrast with newtonian fluids. Regarding density profiles, we observe that densities near the boundaries are higher than those in the center. The width of higher densities (above the average density) relative to the channel width is a decreasing function of a variable which scales with the driving force (g), energy dissipation parameter ($\epsilon$) and the width of the system (L) as $g^{\mu} L^{\nu}/\epsilon$ with exponents $\mu = 1.4 \pm 0.1$ and $\nu = 0.5 \pm 0.1$. A phenomenological theory based on a scaling argument is presented to interpret these findings.Comment: Latex, 15 figures, to appear in PR

Salmonella exploits HLA-B27 and host Unfolded Protein Responses to promote intracellular replication

Objective Salmonella enterica infections can lead to Reactive Arthritis (ReA), which can exhibit an association with human leucocyte antigen (HLA)-B*27:05, a molecule prone to misfolding and initiation of the unfolded protein response (UPR). This study examined how HLA-B*27:05 expression and the UPR affect the Salmonella life-cycle within epithelial cells. Methods Isogenic epithelial cell lines expressing two copies of either HLA-B*27:05 and a control HLA-B*35:01 heavy chain (HC) were generated to determine the effect on the Salmonella infection life-cycle. A cell line expressing HLA-B*27:05.HC physically linked to the light chain beta-2-microglobulin and a specific peptide (referred to as a single chain trimer, SCT) was also generated to determine the effects of HLA-B27 folding status on S. enterica life-cycle. XBP-1 venus and AMP dependent Transcription Factor (ATF6)-FLAG reporters were used to monitor UPR activation in infected cells. Triacin C was used to inhibit de novo lipid synthesis during UPR, and confocal imaging of ER tracker stained membrane allowed quantification of glibenclamide-associated membrane. Results S. enterica demonstrated enhanced replication with an altered cellular localisation in the presence of HLA-B*27:05.HC but not in the presence of HLA-B*27:05.SCT or HLA-B*35:01. HLA-B*27:05.HC altered the threshold for UPR induction. Salmonella activated the UPR and required XBP-1 for replication, which was associated with endoreticular membrane expansion and lipid metabolism. Conclusions HLA-B27 misfolding and a UPR cellular environment are associated with enhanced Salmonella replication, while Salmonella itself can activate XBP-1 and ATF6. These data provide a potential mechanism linking the life-cycle of Salmonella with the physicochemical properties of HLA-B27 and cellular events that may contribute to ReA pathogenesis. Our observations suggest that the UPR pathway maybe targeted for future therapeutic intervention