Evaluation of Anthropometric Measurements of the Aspect Ratio of Knee in Indian Population and its Correlation with the Sizing of Current Knee Arthroplasty System.

Background: Most of the commercially available TKR implants are designed for western populations, which are known to have larger build and stature compared to Asian counterparts often leading to mismatch between resected bony surfaces and implant components. There is paucity of morphometric data of distal femur and proximal tibia in the Indian population. Thus, it becomes important to obtain anthropometric data to achieve the best stability and long-term success of implant. Materials and Methods: Intraoperative morphological measurements of 100 knees (59 female and 41 males) were done using vernier calliper during TKR. The anteroposterior (AP) and mediolateral (ML) dimensions of cross-section of the femur and tibia were noted before bony resection. The aspect ratios were calculated and compared with that of implant used (DePuy, Stryker, Maxx). Results: We have found that Indian males have larger dimensions of distal femur as well as proximal tibia than females. There exists some degree of mismatch in patients' dimensions and the sizes of all the three commercially available implant system as well their aspect ratios. Conclusion: Specific designing of implants with dimensions in accordance with the morphometric measurements of Indian population should be done. Also gender specific implant designing should be done.

Osteochondrosis of Primary Center of Patella: A Case Report.

INTRODUCTION: Osteochondrosis of the primary ossification center of the patella (Kohler's Disease) is a rare and self-limiting condition of unknown etiology. Sometimes it may be found as normal variant. CASE REPORT: A 7-year-old boy presented with anterior right knee pain. On radiological examination, there was increased density, irregularity, and fragmentation of the patellar primary ossification center. Activity modification and exercise led to marked symptomatic improvement after 1 year. CONCLUSION: It was concluded that the disease either physiological or pathological, diagnosis is usually difficult. However, the treatment is simple. There was improvement functionally as well as radiologically with activity modification.

Enhanced antioxidant enzyme activities in developing anther contributes to heat stress alleviation and sustains grain yield in wheat.

Climatic variations along with a rise in temperature during the winter season impose severe heat stress during the anthesis stage of spring wheat, resulting in severe yield losses. The present study was conducted to evaluate the influence of heat stress on redox homeostasis in developing anthers and flag leaves of wheat. Five Indian bread wheat genotypes were studied under field conditions during the dry season, with two extreme sowing dates (timely and very late sown) to explore the effect of heat stress on anthesis stage. Results showed that elevated temperature during anthesis caused significant increase in reactive oxygen species (ROS) content and malondialdehyde (MDA) accumulation in developing anthers, triggering pollen mortality. Moreover, defective source (leaf) to the sink (anthers) mobilisation of starch also contributes in reducing pollen viability. However, ROS-induced oxidative damage of developing anthers under heat stress varied among the wheat genotypes depending upon differential antioxidant enzyme activities. Wheat genotype with enhanced antioxidant activities and reduced ROS built up in developing anthers sustained their grain yield, suggesting thermo-tolerance in wheat to be associated with antioxidant enzyme-mediated improved ROS-scavenging mechanism not only in leaves even in developing anther also. In the present study, heat stressed wheat genotype WH 730 exhibited effective source to sink mobilisation and sustainable grain yield with improved ROS scavenging, conferring greater potential for heat tolerance. We conclude that redox homeostasis and balanced source sink activity played a significant role for sustainable yield and heat tolerance in wheat.

Robotic surgery rapidly and successfully implemented in a high volume laparoscopic center on living kidney donation.

BACKGROUND: It is important to minimize risks associated with live donor nephrectomy. In this study we evaluated the results of left-sided robot-assisted donor nephrectomies in comparison with standard techniques. METHODS: Data on perioperative results, kidney function, and recipient and graft survival were collected. All left-sided laparoscopic and hand-assisted procedures were selected as control groups. RESULTS: Fifty-nine robot-assisted procedures were performed by two surgeons. Operative time was significantly longer in the robot-assisted group compared with both control groups. However, it decreased significantly during procedures 40-59 compared with procedures 20-39 (P = 0.014) to median 172.5 (114.0-242.0) min. One conversion to the open approach occurred in the robot group due to a bleeding of the renal artery stump. No difference was found between all techniques at 3 months post-donation. CONCLUSION: Left-sided robot-assisted donor nephrectomy is feasible with over time a significant decrease in operative time with good outcomes for donor and recipient. Copyright © 2016 John Wiley & Sons, Ltd.

Vascular management during live donor nephrectomy: an online survey among transplant surgeons.

In 2006, a survey from the American Society of Transplant Surgeons disclosed significant and sometimes fatal hemorrhagic events in live donor nephrectomies (LDN) related to failure of clips, leading to the contraindication of the Weck® Hem-o-lok® clip for control of the renal artery during LDN. A survey regarding vascular control techniques, their perceived safety ratings and their failures was sent to 645 European Society for Organ Transplantation members who profiled their profession as "surgeon" and selected "kidney" as organ type. Two hundred forty-three (41%) members responded, of whom 171 (63.3%) independently perform LDN. Their responses were analyzed. For arterial and venous vascular control, the GIA™ and TA™stapler are used most frequently, and were rated the safest. Of the 121 reported hemorrhagic events, slippage and dislodgement of clips occurred at least 58 times, while stapler malfunction occurred at least 40 times. One donor death from hemorrhage related to clip dysfunction was reported. Hemorrhagic complications of LDN with fatal and non-fatal outcomes still occur. Strikingly, many surgeons do not use the vascular closing technique that they consider most safe. Failure of non-transfixion techniques is associated with greater risks for the donor. Control of major vessels in LDN must employ transfixion techniques for optimal donor safety.

The myeloid master regulator transcription factor PU.1 is inactivated by AML1-ETO in t(8;21) myeloid leukemia.

The transcription factor PU.1 plays a pivotal role in normal myeloid differentiation. PU.1(-/-) mice exhibit a complete block in myeloid differentiation. Heterozygous PU.1 mutations were reported in some patients with acute myeloid leukemia (AML), but not in AML with translocation t(8;21), which gives rise to the fusion gene AML1-ETO. Here we report a negative functional impact of AML1-ETO on the transcriptional activity of PU.1. AML1-ETO physically binds to PU.1 in t(8;21)(+) Kasumi-1 cells. AML1-ETO binds to the beta(3)beta(4) region in the DNA-binding domain of PU.1 and displaces the coactivator c-Jun from PU.1, thus down-regulating the transcriptional activity of PU.1. This physical interaction of AML1-ETO and PU.1 did not abolish the DNA-binding capacity of PU.1. AML1-ETO down-regulates the transactivation capacity of PU.1 in myeloid U937 cells, and the expression levels of PU.1 target genes in AML French-American-British (FAB) subtype M2 patients with t(8;21) were lower than in patients without t(8;21). Conditional expression of AML1-ETO causes proliferation in mouse bone marrow cells and inhibits antiproliferative function of PU.1. Overexpression of PU.1, however, differentiates AML1-ETO-expressing Kasumi-1 cells to the monocytic lineage. Thus, the function of PU.1 is down-regulated by AML1-ETO in t(8;21) myeloid leukemia, whereas overexpression of PU.1 restores normal differentiation.