Molecular basis of flowering under natural long-day conditions in Arabidopsis.

Plants sense light and temperature changes to regulate flowering time. Here, we show that expression of the Arabidopsis florigen gene, FLOWERING LOCUS T (FT), peaks in the morning during spring, a different pattern than we observe in the laboratory. Providing our laboratory growth conditions with a red/far-red light ratio similar to open-field conditions and daily temperature oscillation is sufficient to mimic the FT expression and flowering time in natural long days. Under the adjusted growth conditions, key light signalling components, such as phytochrome A and EARLY FLOWERING 3, play important roles in morning FT expression. These conditions stabilize CONSTANS protein, a major FT activator, in the morning, which is probably a critical mechanism for photoperiodic flowering in nature. Refining the parameters of our standard growth conditions to more precisely mimic plant responses in nature can provide a powerful method for improving our understanding of seasonal response.

Primary synovial chondromatosis of the subtalar joint: case report and review of the literature.

Primary synovial chondromatosis is a rare benign condition of uncertain etiology manifested by synovial proliferation. In the radiology literature, there is only 1 prior case report of primary synovial chondromatosis involving the subtalar joint with only partial description of the imaging appearance. We present a 28-year-old female with primary synovial chondromatosis of the subtalar joint and conduct a literature review of the imaging features of primary synovial chondromatosis presenting in the feet.

TCP4-dependent induction of CONSTANS transcription requires GIGANTEA in photoperiodic flowering in Arabidopsis.

Photoperiod is one of the most reliable environmental cues for plants to regulate flowering timing. In Arabidopsis thaliana, CONSTANS (CO) transcription factor plays a central role in regulating photoperiodic flowering. In contrast to posttranslational regulation of CO protein, still little was known about CO transcriptional regulation. Here we show that the CINCINNATA (CIN) clade of class II TEOSINTE BRANCHED 1/ CYCLOIDEA/ PROLIFERATING CELL NUCLEAR ANTIGEN FACTOR (TCP) proteins act as CO activators. Our yeast one-hybrid analysis revealed that class II CIN-TCPs, including TCP4, bind to the CO promoter. TCP4 induces CO expression around dusk by directly associating with the CO promoter in vivo. In addition, TCP4 binds to another flowering regulator, GIGANTEA (GI), in the nucleus, and induces CO expression in a GI-dependent manner. The physical association of TCP4 with the CO promoter was reduced in the gi mutant, suggesting that GI may enhance the DNA-binding ability of TCP4. Our tandem affinity purification coupled with mass spectrometry (TAP-MS) analysis identified all class II CIN-TCPs as the components of the in vivo TCP4 complex, and the gi mutant did not alter the composition of the TCP4 complex. Taken together, our results demonstrate a novel function of CIN-TCPs as photoperiodic flowering regulators, which may contribute to coordinating plant development with flowering regulation.

Lengthening in Congenital Femoral Deficiency: A Comparison of Circular External Fixation and a Motorized Intramedullary Nail.

BACKGROUND: Circular external fixation for limb-lengthening is associated with frequent and numerous complications. Intramedullary lengthening devices represent a potential advance in limb-lengthening. The purpose of this study was to compare the outcomes of femoral lengthening in pediatric patients treated by either circular external fixation or a motorized intramedullary nail. METHODS: All patients with a diagnosis of congenital femoral deficiency who had undergone femoral lengthening with either circular external fixation or a motorized intramedullary nail were identified. The motorized intramedullary nail (FITBONE) was used with approval of the U.S. Food and Drug Administration on an individual compassionate-use basis. RESULTS: Fourteen skeletally mature patients underwent fourteen femoral lengthening sessions using circular external fixation, and thirteen patients underwent fifteen lengthening sessions using the motorized nail. The amount lengthened was similar, with a mean of 4.8 cm (range, 1.0 to 7.4 cm) in the circular fixation group and 4.4 cm (range, 1.5 to 7.0 cm) in the motorized nail group. Complications occurred in all lengthening sessions in all fourteen patients managed with the circular external fixation and in 73% of fifteen lengthening sessions in the thirteen patients managed with the motorized nail. The circular external fixation group averaged 2.36 complications per lengthening session compared with 1.2 per session in the motorized nail group. Twenty-nine percent of the circular fixation group failed to achieve a lengthening goal of at least 4 cm compared with 27% of the motorized nail group who failed to reach the goal. Eight patients had undergone eleven femoral lengthening sessions with circular external fixation prior to undergoing ten lengthening sessions by motorized nail. These patients had a comparable rate of complications with both types of lengthening, but the total number of complications averaged 2.6 per lengthening session with circular external fixation compared with 1.6 per lengthening session with the motorized nail. CONCLUSIONS: A decreased number of complications was noted with use of a motorized intramedullary nail compared with circular external fixation in pediatric patients undergoing femoral lengthening for congenital femoral deficiency. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cervical spine alignment in the youth football athlete: recommendations for emergency transportation.

BACKGROUND: Substantial literature exists regarding recommendations for the on-field treatment and subsequent transportation of adult collision-sport athletes with a suspected injury to the cervical spine. PURPOSE: To develop an evidence-based recommendation for transportation of suspected spine-injured youth football players. STUDY DESIGN: Descriptive laboratory study. METHODS: Three lateral radiographs were obtained in supine to include the occiput to the cervical thoracic junction from 31 youth football players (8-14 years). Each child was imaged while wearing helmet and shoulder pads, without equipment, and with shoulder pads only. Two independent observers measured cervical spine angulation as Cobb angle from C1 to C7 and subaxial angulation from C2 to C7. We calculated intraclass correlation coefficients for intraobserver reliability analysis and compared Cobb and C2 to C7 angles between equipment conditions with t tests. RESULTS: Interobserver analysis showed excellent reliability among measurements. Cobb and subaxial angle measurements indicated significantly greater cervical lordosis while children wore shoulder pads only, compared with the other 2 conditions (no equipment and helmet and shoulder pads) (P .05). CONCLUSIONS: Equipment removal for the youth football athlete with suspected cervical spine injury should abide by the "all or none" policy that has been widely accepted for adult athletes. Helmet and shoulder pads should be left in place during emergency transport of the suspected spine-injured youth athlete. CLINICAL RELEVANCE: Despite differences in head to torso size ratios between youth and adult players, helmet removal alone is not recommended for either during emergency transportation.

Does surgical approach affect total hip arthroplasty dislocation rates?

Dislocation is a common complication of total hip arthroplasty, but exact effect of surgical approach on dislocation rates remains unclear. Because little randomized prospective data exist in this context, we performed a meta-analysis comparing dislocation rates using the posterior approach with and without soft tissue repair. A systematic literature review resulted in five studies which directly compared the posterior approach with and without soft tissue repair. The dislocation rates with and without repair were 0.49% and 4.46%, respectively. The relative risk for dislocation was determined using a fixed effects model with chi square test for interstudy heterogeneity. The posterior approach without soft tissue repair was found to have an 8.21 times greater relative risk of dislocation than with soft tissue repair (95% confidence interval, 4.05-16.67). A separate systematic review of 11 studies revealed comparable dislocation rates associated with the anterolateral, direct lateral, and posterior approaches with soft tissue repair (0.70%, 0.43%, and 1.01%, respectively). These data demonstrate that adequate soft tissue repair greatly reduces the relative risk of dislocation using the posterior approach, and that the dislocation rates for the three most prevalent approaches are similar. Further prospective randomized trials examining dislocation rates and other clinical parameters are needed.

A novel total knee arthroplasty infection model in rabbits.

Infection of biomaterial implants is an expensive and devastating complication of orthopaedic surgery historically ranging from less than 1% in primary total knee arthroplasty (TKA) to 10% in revision TKA. An in vivo animal model was developed to test the efficacy of innovative therapies for the prevention of biomaterial centered infections caused by methicillin-resistant Staphylococcus aureus bacteria (MRSA). Twenty-two New Zealand White rabbits were used in this study. After proper anesthesia, a stainless-steel screw with a high molecular weight polyethylene (UHMWPE) washer was cemented in a defect created in the intra-articular, non-articulating portion of the lateral femoral condyle of each knee. After closure of the joint capsule, each knee was inoculated with 0, 10(2), 10(3), or 10(4) colony forming units (CFU) of MRSA. Animals were sacrificed after 7 days at which time joint aspirate, tissues and biomaterial samples were examined for evidence of infection. A total of 42 knees were used for analysis. When saline was injected into the knee, 0/10 of the knees demonstrated evidence of biomaterial centered infection (with the contralateral knee receiving 10(4)CFU MRSA). Four of 10 knees developed a biomaterial centered infection when 10(2)CFU MRSA was introduced. Seven out of 10 knees developed a biomaterial centered infection when either 10(3) or 10(4)CFU MRSA was injected. No evidence of septicemia (positive blood cultures) was found in any animal. This rabbit knee model utilizes commonly employed inexpensive orthopaedic implant materials in an in vivo milieu and provides an effective method for the evaluation of treatments for biomaterial centered infections.