Total ankle replacement. The results in 200 ankles.

Between 1993 and 2000 we implanted 200 cementless, mobile-bearing STAR total ankle replacements. None was lost to follow-up for reasons other than the death of a patient. The mean follow-up was for 46 months (24 to 101). A complication requiring further surgery developed in eight ankles and 14 were revised or fused. The cumulative survival rate at five years was 92.7% (95% CI 86.6 to 98.8) with time to decision to revision or fusion as an endpoint. The most frequent complications were delayed wound healing and fracture of a malleolus. These became less common with experience of the operation. The radiological appearance of the interface of the tibial implant was significantly related to its operative fit and to the type of bioactive coating.

Active habitat selection for sand by juvenile western king prawns, Melicertus latisulcatus (Kishinouye).

This paper presents the results of a series of habitat selection experiments aimed at determining if juvenile Melicertus latisulcatus generally occur on intertidal sand- and mud-flats as a result of active selection of unvegetated areas, or due to extrinsic factors (e.g. differential predation). In the laboratory, juvenile M. latisulcatus showed a clear preference for habitats containing sand irrespective of the presence or absence of predators. If sand was not available, artificial seagrass was chosen as a secondary preference but was avoided when sand alone was also present. Importantly, the combinations of habitats chosen for testing allowed us to determine that artificial seagrass provided a good surrogate for real seagrass, and that the presence of potential food (epiphytes) did not appear to influence habitat selection. There was also no difference in the habitat selected between day and night, and only minor differences with prawn size. Thus, juvenile M. latisulcatus appear to have a hierarchy of mechanisms for avoiding predators, with burying in sand being the preferred option. If burying is not possible, then seagrass is used for shelter. Active habitat selection to avoid predation appears likely to play a substantial role in determining the distribution of these animals on unvegetated sand- and mud-flats.

Decreased stability of the M54 isoform of paraoxonase as a contributory factor to variations in human serum paraoxonase concentrations.

There are considerable variations in serum concentrations of the high density lipoprotein (HDL)-associated enzyme, paraoxonase (PON), which is an important determinant of the antioxidant capacity of HDL. The present study examined the hypothesis that differences in the stability of isoforms arising from the coding region L54M polymorphism could contribute to such variations. A model system was developed using transfected Chinese hamster ovary cells to secrete recombinant PON corresponding to human L or M isoforms. The recombinant peptides exhibited the molecular properties of human serum PON. They formed complexes with lipoproteins in culture medium, notably binding to apolipoprotein A-I-containing particles. The enzymatic properties of the recombinant isoforms were comparable to those of human serum PON. The recombinant M isoform lost activity more rapidly and to a greater extent than the recombinant L isoform [26.0 +/- 3.0% vs. 14.0 +/- 1.0% (phenylacetate substrate) and 36.1 +/- 2.0% vs. 19.3 +/- 2.0% (paraoxon substrate) over 96 h (P < 0.01)] in medium containing fetal calf serum or PON-free human serum. Addition of a protease inhibitor resulted in retention of activity by both isoforms. Parallel results were obtained in incubation studies of human serum from donors homozygous LL or MM for the L54M polymorphism. Enzyme activity was lost more rapidly and to a greater extent from MM than LL sera (P < 0.01). A parallel loss of PON peptide mass was also observed, with a significantly greater loss from MM homozygotes (P < 0.001). It corresponded to the appearance of a smaller molecular mass band on SDS-PAGE analysis. Direct analysis of the proteolytic effect using HDL isolated from homozygotes and incubated with purified kallikrein confirmed the greater loss of activity from MM homozygotes and the protective effect of proteolysis inhibitor. The results provide evidence for lesser stability of the M54 isoform of PON, apparently involving greater susceptibility to proteolysis. It provides one mechanism to explain variations in serum levels of PON and has implications for the antioxidant capacity of HDL.