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1.
Sci Rep ; 14(1): 3365, 2024 02 09.
Article in English | MEDLINE | ID: mdl-38336890

ABSTRACT

Becker muscular dystrophy (BMD) is characterised by fiber loss and expansion of fibrotic and adipose tissue. Several cells interact locally in what is known as the degenerative niche. We analysed muscle biopsies of controls and BMD patients at early, moderate and advanced stages of progression using Hyperion imaging mass cytometry (IMC) by labelling single sections with 17 markers identifying different components of the muscle. We developed a software for analysing IMC images and studied changes in the muscle composition and spatial correlations between markers across disease progression. We found a strong correlation between collagen-I and the area of stroma, collagen-VI, adipose tissue, and M2-macrophages number. There was a negative correlation between the area of collagen-I and the number of satellite cells (SCs), fibres and blood vessels. The comparison between fibrotic and non-fibrotic areas allowed to study the disease process in detail. We found structural differences among non-fibrotic areas from control and patients, being these latter characterized by increase in CTGF and in M2-macrophages and decrease in fibers and blood vessels. IMC enables to study of changes in tissue structure along disease progression, spatio-temporal correlations and opening the door to better understand new potential pathogenic pathways in human samples.


Subject(s)
Muscular Dystrophy, Duchenne , Humans , Muscular Dystrophy, Duchenne/pathology , Muscular Atrophy/metabolism , Muscles/metabolism , Collagen/metabolism , Disease Progression , Image Cytometry , Muscle, Skeletal/metabolism
2.
Sci Rep ; 11(1): 14887, 2021 07 21.
Article in English | MEDLINE | ID: mdl-34290268

ABSTRACT

WRKY transcription factors play key roles in stress responses, growth, and development. We previously reported on the evolution of WRKYs from unicellular green algae to land plants. To address recent evolution events, we studied three domesticated and eight wild species in the genus Oryza, an ideal model due to its long history of domestication, economic importance, and central role as a model system. We have identified prevalence of Group III WRKYs despite differences in breeding of cultivated and wild species. Same groups of WRKY genes tend to cluster together, suggesting recent, multiple duplication events. Duplications followed by divergence may result in neofunctionalizations of co-expressed WRKY genes that finely tune the regulation of target genes in a same metabolic or response pathway. WRKY genes have undergone recent rearrangements to form novel genes. Group Ib WRKYs, unique to AA genome type Oryza species, are derived from Group III genes dated back to 6.76 million years ago. Gene tree reconciliation analysis with the species tree revealed details of duplication and loss events in the 11 genomes. Selection analysis on single copy orthologs reveals the highly conserved nature of the WRKY domain and clusters of fast evolving sites under strong positive selection pressure. Also, the numbers of single copy orthologs under positive or negative selection almost evenly split. Our results provide valuable insights into the preservation and diversification of an important gene family under strong selective pressure for biotechnological improvements of the world's most valued food crop.


Subject(s)
Domestication , Evolution, Molecular , Genes, Plant/genetics , Oryza/genetics , Transcription Factors/genetics , Oryza/classification
3.
Spine Deform ; 9(6): 1549-1557, 2021 11.
Article in English | MEDLINE | ID: mdl-34133013

ABSTRACT

PURPOSE: Determine the efficacy of intraoperative traction (IOT) on curve correction in AIS. METHODS: A prospective, multicenter, longitudinal database identified patients with major thoracic AIS (Lenke 1-4) treated with surgery using IOT and follow-up of 2 years. These cases were matched to comparable cases treated without traction (non-IOT). All patients were treated with single-stage posterior only surgery with pedicle screw constructs. Perioperative, radiographic and clinical outcome data at 2 years post-op were compared between the groups. RESULTS: 104 cases treated with IOT were matched to 104 treated without IOT. Operating room time was significantly greater in the IOT group (339 vs. 306 min, p = < 0.001). Neuromonitoring alerts were more frequent in the IOT group (23% vs. 5%, p < 0.001). There were no postoperative neurological deficits in either group. The IOT group showed significantly greater MT curve correction (IOT 71% vs. non-IOT 66.7%, p < 0.003), with the effect most pronounced in curves > 70° (IOT 72% vs. non-IOT 64%, p = 0.04). IOT was associated with a significant reduction in 2D T5-T12 kyphosis measurements (IOT - 6.5° vs non-IOT + 0.48°, p < 0.001), yet significant improvements in estimated 3D thoracic kyphosis were made in both groups, with the non-IOT group making greater improvement when compared to the IOT group (IOT + 18.1° vs. non-IOT + 22.3° vs., p = 0.008). CONCLUSIONS: IOT is associated with modestly enhanced coronal deformity correction. Surgeons should be aware of the increased rates of neuromonitoring alerts when using this technique and its affect on the sagittal profile. Given this IOT may be best suited to larger curves. LEVEL OF EVIDENCE: 3.


Subject(s)
Kyphosis , Pedicle Screws , Scoliosis , Spinal Fusion , Adolescent , Humans , Kyphosis/diagnostic imaging , Kyphosis/surgery , Prospective Studies , Retrospective Studies , Scoliosis/diagnostic imaging , Scoliosis/surgery , Spinal Fusion/adverse effects , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/surgery , Traction , Treatment Outcome
4.
Int Orthop ; 45(9): 2331-2336, 2021 09.
Article in English | MEDLINE | ID: mdl-34143253

ABSTRACT

PURPOSE: The Hintegra total ankle replacement (TAR) has been widely used worldwide for ankle arthroplasty since its introduction in 2000. The implant survivorship, patient reported outcomes, rate of periprosthetic cyst formation and reoperation rates are variably reported. The purpose of this study is to determine the functional outcomes and survivorship of the Hintegra TAR, in consecutive cases by multiple surgeons in a single UK institution, with a minimum of five year follow-up. METHODS: A retrospective review of prospectively collected data for 70 consecutive Hintegra TAR cases performed between 2010 and 2014. Data collected included patient demographics, complications, reoperations, revisions and patient reported outcome measures (PROMS: AOS, MOX-FQ, pain VAS and EQ-5D 3L). RESULTS: Seventy patients underwent Hintegra TAR (54 male/16 female) with an average age of 69 (range 48-84 years). Mean follow up was 76 months (range 60-104), 10 patients died during the follow-up. Implant survivorship was 81.7% at most recent follow-up. The commonest radiographic finding was periprosthetic cysts (n = 28, 40%): size range (7-40 mm). Nine patients required re-operation: six periprosthetic cyst debridement and grafting at a mean of 61 months (range 27-91), one lateral gutter debridement, one periprosthetic fracture and one debridement for deep infection. PROMS data was available for the majority of patients. Mean final follow-up scores were total AOS 35 (range: 0-97), MOX-FQ 36 (range: 2-93), pain VAS 34.6 (range: 0-100) and EQ-5D 3L Index 0.69 (range: 0.08-1.00). CONCLUSION: Our experience demonstrates implant survivorship similar to other TAR studies. We have identified a high incidence of periprosthetic cysts and would recommend ongoing surveillance of these patients.


Subject(s)
Arthroplasty, Replacement, Ankle , Joint Prosthesis , Aged , Aged, 80 and over , Arthroplasty, Replacement, Ankle/adverse effects , Female , Follow-Up Studies , Humans , Male , Middle Aged , Patient Reported Outcome Measures , Prosthesis Failure , Reoperation , Retrospective Studies , Survivorship , Treatment Outcome
5.
Spine (Phila Pa 1976) ; 46(21): 1461-1467, 2021 Nov 01.
Article in English | MEDLINE | ID: mdl-34091563

ABSTRACT

STUDY DESIGN: Prospective case series. OBJECTIVE: Determine the efficacy of anterior vertebral body tethering (AVBT) in skeletally immature patients. SUMMARY OF BACKGROUND DATA: The value of AVBT is currently unclear given the paucity of available data. METHODS: Consecutive skeletally immature patients with idiopathic scoliosis were treated with AVBT between 2012 and 2018 by one of two surgeons working at two independent centers and followed up for >2 years. Data were collected prospectively and supplemented retrospectively where necessary. Outcomes were measured preoperatively, at first erect radiograph (FE), 1-year postoperatively and at most recent follow up (FU). RESULTS: One hundred twelve patients underwent 116 primary tethering procedures (108 thoracic and eight lumbar tethers). Four patients had primary tethering of both lumbar and thoracic curves. At surgery mean age was 12.7 ±â€Š1.4 years (8.2-16.7) and Risser 0.5 ±â€Š0.9 (0-3). Follow up was mean 37 ±â€Š9 months (15-64). Preoperative mean coronal Cobb angle of the 130 tethered curves was 50.8°â€Š±â€Š10.2 (31-81) and corrected significantly to 26.6°â€Š±â€Š10.1 (-3-61) at FE radiograph (P < 0.001). Further significant improvement was seen from FE to 1-year, to mean 23.1°â€Š±â€Š12.4 (-37-57) (P < 0.001). There was a small but significant increase between 1-year and FU to 25.7°â€Š±â€Š16.3 (-32-58) (P < 0.001), which appeared to reflect tether breakage. Untethered minor curves were corrected from 31.0°â€Š±â€Š9.5 (3-57) to 20.3°â€Š±â€Š10.3 (0-52) at FU (P < 0.001). Rib hump was corrected from 14.1 ±â€Š4.8 (0-26) to 8.8°â€Š±â€Š5.4 (0-22) at FU (P < 0.01). Twenty-five patients (22%) had 28 complications. Fifteen patients (13%) requiring 18 revision operations including six completed and one awaited fusions. CONCLUSION: AVBT of immature cases is associated with satisfactory deformity correction in the majority of cases. However, complication and revision rates suggest the need for improved implants and patient selection. Long-term follow-up remains crucial to establish the true efficacy of this procedure.Level of Evidence: 3.


Subject(s)
Scoliosis , Spinal Fusion , Adolescent , Child , Follow-Up Studies , Humans , Retrospective Studies , Scoliosis/diagnostic imaging , Scoliosis/surgery , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/surgery , Treatment Outcome , Vertebral Body
6.
Eur Spine J ; 30(7): 1905-1911, 2021 07.
Article in English | MEDLINE | ID: mdl-33544222

ABSTRACT

PURPOSE: Determine the incidence of metallosis around MAGEC rods. METHODS: A multicentre explant database was searched to identify cases with complete intraoperative findings at rod removal. Surgeons removing rods detailed the presence or absence of tissue metallosis associated with rods. More recently surgeons measured the 'length' of tissue metallosis. Prior to rod disassembly, the majority underwent testing with an external remote controller (ERC). The impact of clinical and explant variables on metallosis was assessed. RESULTS: Sixty-six cases were identified. Mean age at insertion was 8.1 ± 2.3 years with mean duration of implantation 37.6 ± 15.1 months. Tissue metallosis was noted at revision surgery in 52/66 cases (79%). Metallosis was noted more commonly when rods were removed during fusion surgery than rod removal/exchange (97% vs. 58% (p = < 0.01)). The mass at insertion was greater in cases with metallosis (25.9 ± 7.8 kg vs. 21.1 ± 6.2 kg, p = 0.04). Length of tissue metallosis was reported for 45 rods, median 9 cm (range 1-25). Metallosis was noted in 43/59 (73%) rods that produced no force and 22/30 (73%) rods that produced some force on ERC activation (p = 0.96). Wear debris was found within the actuator in all rods, and all but 3 rods had damaged O-rings. CONCLUSION: MAGEC rods are associated with tissue metallosis in the majority of cases. It is seen with functional rods as well as failed rods and appears related to wear debris within the actuator and high rates of O-ring failure. Until the implications of metal debris in children are known, we urge caution with the use of this implant.


Subject(s)
Scoliosis , Child , Databases, Factual , Humans , Prostheses and Implants , Reoperation , Scoliosis/surgery
7.
J Orthop Case Rep ; 11(8): 6-10, 2021 Aug.
Article in English | MEDLINE | ID: mdl-35004365

ABSTRACT

INTRODUCTION: Magnetically controlled growing rods (MCGRs) have been widely adopted in the management of early-onset scoliosis since they were first described in 2012. Recent reports have highlighted concerns around their safety. To date, little is understood about the risk factors and modes of failure in these devices. CASE REPORT: We report a novel mechanism of device failure in a 14-year-old patient following multiple revisions of MCGRs.Clinically, there was no evidence of device failure and the MCGRs appeared radiologically intact. Explantation analysis revealed multiple compromised/non-functional components. A previously undocumented phenomenon of complete magnet fracture was also seen. CONCLUSION: The absence of clinical or radiological features of device failure in this case makes the findings of great concern. Given the relative paucity of high-quality evidence surrounding the use of MCGRs, we support calls for urgent comparative studies and further investigation of risk factors for device failure.

8.
Bone Joint J ; 102-B(12): 1703-1708, 2020 12.
Article in English | MEDLINE | ID: mdl-33249889

ABSTRACT

AIMS: Spinal fusion remains the gold standard in the treatment of idiopathic scoliosis. However, anterior vertebral body tethering (AVBT) is gaining widespread interest, despite the limited data on its efficacy. The aim of our study was to determine the clinical efficacy of AVBT in skeletally immature patients with idiopathic scoliosis. METHODS: All consecutive skeletally immature patients with idiopathic scoliosis treated with AVBT enrolled in a longitudinal, multicentre, prospective database between 2013 and 2016 were analyzed. All patients were treated by one of two surgeons working at two independent centres. Data were collected prospectively in a multicentre database and supplemented retrospectively where necessary. Patients with a minimum follow-up of two years were included in the analysis. Clinical success was set a priori as a major coronal Cobb angle of < 35° at the most recent follow-up. RESULTS: A total of 57 patients were included in the study. Their mean age was 12.7 years (SD 1.5; 8.2 to 16.7), with 95% being female. The mean preoperative Sanders score and Risser grade was 3.3 (SD 1.2), and 0.05 (0 to 3), respectively. The majority were thoracic tethers (96.5%) and the mean follow-up was 40.4 months (SD 9.3). The mean preoperative major curve of 51° (SD 10.9°; 31° to 81°) was significantly improved to a mean of 24.6° (SD 11.8°; 0° to 57°) at the first postoperative visit (45.6% (SD 17.6%; 7% to 107%); p < 0.001)) with further significant correction to a mean of 16.3° (SD 12.8°; -12 to 55; p < 0.001) at one year and a significant correction to a mean of 23° (SD 15.4°; -18° to 57°) at the final follow-up (42.9% (-16% to 147%); p < 0.001). Clinical success was achieved in 44 patients (77%). Most patients reached skeletal maturity, with a mean Risser score of 4.3 (SD 1.02), at final follow-up. The complication rate was 28.1% with a 15.8% rate of unplanned revision procedures. CONCLUSION: AVBT is associated with satisfactory correction of deformity and an acceptable complication rate when used in skeletally immature patients with idiopathic scoliosis. Improved patient selection and better implant technology may improve the 15.8% rate of revision surgery in these patients. Further scrutiny of the true effectiveness and long-term risks of this technique remains critical. Cite this article: Bone Joint J 2020;102-B(12):1703-1708.


Subject(s)
Scoliosis/surgery , Vertebral Body/surgery , Adolescent , Child , Female , Follow-Up Studies , Humans , Longitudinal Studies , Lumbar Vertebrae/surgery , Male , Retrospective Studies , Thoracic Vertebrae/surgery , Treatment Outcome
9.
Spine (Phila Pa 1976) ; 45(13): 872-876, 2020 Jul 01.
Article in English | MEDLINE | ID: mdl-32539289

ABSTRACT

STUDY DESIGN: Analysis of explanted MAGnetic Expansion Control (MAGEC) growing rods. OBJECTIVE: The aim of this study was to quantify the rate of locking pin breakage in explanted MAGEC rods and compare with the manufacturer's data. SUMMARY OF BACKGROUND DATA: On June 25, 2019, NuVasive released an Urgent Field Safety Notice stating that MAGEC rods manufactured before March 26, 2015 had a higher than expected locking pin breakage rate of 5%. For rods made on or after that date, no pin breakages had occurred. METHODS: From our independent explant database of 139 explanted MAGEC rods supplied from 10 UK spinal centers (Belfast, Bristol, Birmingham, Edinburgh, Exeter, Leeds, Newcastle, Nottingham, Oxford, and Sheffield) and one Danish center (Aarhus), we divided the rods into those manufactured before March 26, 2015, and those manufactured on or after that date. MAGEC rods were cut open to fully assess internal components including locking pins. From each of the two cohorts, 10 locking pins were selected at random and their diameters were measured using a micrometer. RESULTS: One hundred and five explanted MAGEC rods were made before March 26, 2015 and could be disassembled to allow the locking pin to be examined. Fifty-nine percent (62/105) of these locking pins had fractured. For the MAGEC rods manufactured on or after March 26, 2015, 21% (6/29) were found to have fractured locking pins. Locking pins in MAGEC rods made on or after March 26, 2015 were of a stronger material and a larger diameter. CONCLUSION: Fifty-nine percent of the locking pins in MAGEC rods manufactured before March 26, 2015 had fractured, far greater than the 5% stated in the Urgent Field Safety Notice. Locking pin fracture still occurred in MAGEC rods manufactured on or after that date, in 21% of cases. This contrasted with the 0% reported by the manufacturer. LEVEL OF EVIDENCE: 4.


Subject(s)
Orthopedic Fixation Devices/statistics & numerical data , Prostheses and Implants/statistics & numerical data , Prosthesis Failure , Scoliosis/surgery , Adolescent , Child , Child, Preschool , Databases, Factual , Device Removal , Female , Humans , Male , Manufacturing Industry/statistics & numerical data , Orthopedic Fixation Devices/adverse effects , Prostheses and Implants/adverse effects
10.
Bone Joint J ; 102-B(4): 513-518, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32228067

ABSTRACT

AIMS: Significant correction of an adolescent idiopathic scoliosis in the coronal plane through a posterior approach is associated with hypokyphosis. Factors such as the magnitude of the preoperative coronal curve, the use of hooks, number of levels fused, preoperative kyphosis, screw density, and rod type have all been implicated. Maintaining the normal thoracic kyphosis is important as hypokyphosis is associated with proximal junctional failure (PJF) and early onset degeneration of the spine. The aim of this study was to determine if coronal correction per se was the most relevant factor in generating hypokyphosis. METHODS: A total of 95 patients (87% female) with a median age of 14 years were included in our study. Pre- and postoperative radiographs were measured and the operative data including upper instrumented vertebra (UIV), lower instrumented vertebra (LIV), metal density, and thoracic flexibility noted. Further analysis of the post-surgical coronal outcome (group 1 < 60% correction and group 2 ≥ 60%) were studied for their association with the postoperative kyphosis in the sagittal plane using univariate and multivariate logistic regression. RESULTS: Of the 95 patients, 71.6% (68) had a thoracic correction of > 60%. Most (97.8%) had metal density < 80%, while thoracic flexibility > 50% was found in 30.5% (29). Preoperative hypokyphosis (< 20°) was present in 25.3%. A postoperative thoracic hypokyphosis was four times more likely to occur in patients with thoracic correction ≥ 60% (odds ratio (OR) 4.08; p = 0.005), after adjusting for confounding variables. This association was not affected by metal density, thoracic flexibility, LIV, UIV, age, or sex. CONCLUSION: Our study supports the 'essential lordosis' hypothesis of Roaf and Dickson, i.e. with a greater ability to translate the apical vertebra towards the midline, there is a commensurate lengthening of the anterior column due to the vertebral wedging. Cite this article: Bone Joint J 2020;102-B(4):513-518.


Subject(s)
Scoliosis/surgery , Thoracic Vertebrae/surgery , Adolescent , Child , Female , Humans , Male , Pedicle Screws , Postoperative Complications/etiology , Radiography , Range of Motion, Articular , Retrospective Studies , Scoliosis/diagnostic imaging , Scoliosis/pathology , Scoliosis/physiopathology , Spinal Curvatures/etiology , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/pathology , Thoracic Vertebrae/physiopathology , Young Adult
11.
Spine (Phila Pa 1976) ; 45(3): 170-176, 2020 Feb 01.
Article in English | MEDLINE | ID: mdl-31513114

ABSTRACT

STUDY DESIGN: Laboratory analysis of explanted MAGnetic Expansion Control (MAGEC) rods. OBJECTIVE: The aim of this study was to identify the in vivo lengthening of MAGEC rods. SUMMARY OF BACKGROUND DATA: Little data is available regarding the lengthening achieved by MAGEC rods. METHODS: Cases were identified from the largest series of independently analyzed explanted MAGEC rods. The in vivo growth of rods was determined by the distance between the first "growth mark" and the actuator. The instrumented spinal lengthening was calculated for each construct. Constructs were considered functional if all rods could lengthen with external remote controller activation and no rods were "telescoping". RESULTS: Fifty-five MAGEC constructs (99 rods) from 53 patients treated at 10 centers were included. The mean age at insertion was 8.5 years with rods implanted a mean of 35 months. Sixty rods were suitable for analysis with mean lengthening 21.7 mm, 8.9 mm/year. Of these 60 rods, three were maximally distracted. Mean instrumented spinal lengthening for 38 suitable cases was 22.1 mm, 8.4 mm/year. This was positively correlated with the duration of implantation (r = 0.34, P = 0.04) but negatively with patient age at insertion (r = -0.35, P = 0.03). The rate of instrumented spinal lengthening was negatively correlated with duration of implantation (r = -0.47, P = 0.004). Of 55 constructs, 34 were nonfunctional at time of removal with nine functional and 12 indeterminate. Functional constructs had been implanted significantly less time (20.0 vs. 39.7 months, P < 0.001) and lengthened less than those nonfunctional (12.3 mm vs. 23.3 mm, P = 0.04). CONCLUSION: This multicenter explant study represents the largest cohort managed with MAGEC rods reported. Rods are very rarely removed having fully lengthened with mean instrumented spinal growth of 22 mm over the implant's life. This may be explained by a high rate of lengthening mechanism failure in received rods after around 3 years in vivo. Our findings question the effectiveness of the MAGEC system and mandate urgent comparative clinical studies. LEVEL OF EVIDENCE: 4.


Subject(s)
Bone Lengthening , Magnets , Orthopedic Fixation Devices , Spine/surgery , Adolescent , Bone Lengthening/instrumentation , Bone Lengthening/methods , Child , Child, Preschool , Cohort Studies , Female , Humans , Male , Scoliosis/surgery , Treatment Outcome
12.
Spine (Phila Pa 1976) ; 44(4): 233-239, 2019 02 15.
Article in English | MEDLINE | ID: mdl-30044365

ABSTRACT

STUDY DESIGN: Laboratory analysis of explanted MAGnetic Expansion Control (MAGEC) growing rods. OBJECTIVE: The aim of this study was to measure the force produced by explanted MAGEC rods compared with new rods and assess the influence of clinical variables. SUMMARY OF BACKGROUND DATA: MAGEC rods are increasingly used in early-onset scoliosis. Some data are available describing the structure of explanted MAGEC rods, but to date, no study has assessed their function. METHODS: Explanted MAGEC rods were received from seven UK and one Danish center. The force produced by explanted rods on activation with the external remote controller was measured using a dedicated jig. Forces were compared with two unused rods as well as the manufacturer's defined standard (42 Ibf). Clinical variables were collected from contributing centers where possible and correlated with the force measurements. RESULTS: Forty-five MAGEC rods from 25 cases were received for analysis. The mean age at insertion was 8.6 years and rods were in vivo for a mean of 2.7 years in predominantly dual rod constructs. Two unused MAGEC rods produced a mean force of 45.3 (0.25) and 50.2 (1.4) Ibf, above the manufacturer's stated standard. Of the 45 explanted rods, 10 (22%) produced force greater or equal to manufacturer's standard, mean 46.7 (2.7) Ibf. Six rods (13%) produced some force but less than the manufacturer's standard, mean 34.8 (3.6) Ibf. Twenty-nine rods (64%) produced no force. The duration the rods were in vivo was significantly negatively correlated with the force produced on testing (r = -0.63, P < 0.005). Of the 12 rods implanted longer than 38 months, none produced any force. CONCLUSION: This is the first study of the force, and hence likely function, of explanted MAGEC rods. The majority of explanted rods produced no force, while others produced reduced force. These findings raise questions regarding the longevity of the implant and further clinical outcome studies are recommended. LEVEL OF EVIDENCE: 4.


Subject(s)
Internal Fixators , Magnets , Scoliosis/surgery , Child , Female , Humans , Male , Materials Testing , Time Factors
13.
Spine (Phila Pa 1976) ; 43(20): E1239-E1240, 2018 10 15.
Article in English | MEDLINE | ID: mdl-30272641
14.
Spine (Phila Pa 1976) ; 43(1): E16-E22, 2018 Jan 01.
Article in English | MEDLINE | ID: mdl-28459777

ABSTRACT

STUDY DESIGN: Analysis of explanted MAGnetic Expansion Control (MAGEC) growing rods. OBJECTIVE: To analyze explanted MAGEC rods used in management of early onset scoliosis and identify the mode of failure in such cases. SUMMARY OF BACKGROUND DATA: Magnetically controlled growing rods are increasingly used as the option of choice for early onset scoliosis. However, being more complex than conventional growing rods they are perhaps more likely to succumb to multifarious failure modes. In addition, metallosis has been reported around failed MAGEC rods. METHODS: Explanted MAGEC rods from seven UK spinal centers were obtained for independent analysis. Thirty-four MAGEC rods, from 18 children, explanted for reasons including failure of rod lengthening and maximum rod distraction reached, were cut open to allow internal components to be evaluated and assessed. RESULTS: Externally, all MAGEC rods showed localized marks, which were termed "growth marks" as they indicated growth of the rod in vivo, on the extending bar component. After cutting open, titanium wear debris was found inside all 34 (100%) MAGEC rods. Ninety-one percent (31/34) of MAGEC rods showed measurable wear of the extending bar, towards the magnet end. Substantial damage to the radial bearing was seen inside 74% (25/34) of MAGEC rods while O-ring seal failure was seen in 53% (18/34) of cases. In 44% (15/34) of MAGEC rods the drive pin was fractured but this was felt to be an effect of rod failure, not a cause. CONCLUSION: The combination of high volumes of titanium wear debris alongside O-ring seal damage likely accounts for the metallosis reported clinically around some MAGEC rods. Based on this explant data, a failure mechanism in MAGEC rods due to the natural off axis loading in the spine was proposed. This is the largest data set reporting a complete analysis of explanted MAGEC rods to date. LEVEL OF EVIDENCE: 4.


Subject(s)
Prostheses and Implants , Prosthesis Failure , Scoliosis/surgery , Spine/growth & development , Child , Humans , Magnets , Registries , Spine/surgery , United Kingdom
15.
Plants (Basel) ; 6(2)2017 May 25.
Article in English | MEDLINE | ID: mdl-28587097

ABSTRACT

Soybean is an important crop that is continually threatened by abiotic stresses, especially drought and heat stress. At molecular levels, reduced yields due to drought and heat stress can be seen as a result of alterations in metabolic homeostasis of vegetative tissues. At present an incomplete understanding of abiotic stress-associated metabolism and identification of associated metabolites remains a major gap in soybean stress research. A study with a goal to profile leaf metabolites under control conditions (28/24 °C), drought [28/24 °C, 10% volumetric water content (VWC)], and heat stress (43/35 °C) was conducted in a controlled environment. Analyses of non-targeted metabolomic data showed that in response to drought and heat stress, key metabolites (carbohydrates, amino acids, lipids, cofactors, nucleotides, peptides and secondary metabolites) were differentially accumulated in soybean leaves. The metabolites for various cellular processes, such as glycolysis, the tricarboxylic acid (TCA) cycle, the pentose phosphate pathway, and starch biosynthesis, that regulate carbohydrate metabolism, amino acid metabolism, peptide metabolism, and purine and pyrimidine biosynthesis, were found to be affected by drought as well as heat stress. Computationally based regulatory networks predicted additional compounds that address the possibility of other metabolites and metabolic pathways that could also be important for soybean under drought and heat stress conditions. Metabolomic profiling demonstrated that in soybeans, keeping up with sugar and nitrogen metabolism is of prime significance, along with phytochemical metabolism under drought and heat stress conditions.

16.
Front Plant Sci ; 8: 190, 2017.
Article in English | MEDLINE | ID: mdl-28261245

ABSTRACT

Indoor farming is becoming a popular alternative approach in food production to meet the demand of a growing world population. Under this production system, artificial light provides the main source of illumination in sustaining plant growth and development. The use of light-emitting diodes (LEDs) is a popular source of artificial light for indoor farms due to its narrow light spectra, modular design and energy efficiency. This study purposely assessed the effect of monochromatic LED light quality on the growth of three varieties of artichoke seedlings compared to greenhouse condition. Spectral quality assessment showed that photosynthetic photon flux density (PPFD) was highest under red LED light, but only a third of the total PPFD under natural light. Seedlings grown under red light showed 60-100% more shoot dry weight and were 67-115% taller than seedlings grown in the greenhouse. However, seedlings under blue or white light conditions showed 67-76% less in biomass compared to greenhouse-grown seedlings. Overall, plant response of seedlings under red light condition was much better compared to greenhouse-grown seedlings emphasizing the importance of red light spectral quality in plant growth and development.

17.
Biomed Res Int ; 2017: 3065251, 2017.
Article in English | MEDLINE | ID: mdl-28127554

ABSTRACT

Understanding how plants respond to water deficit is important in order to develop crops tolerant to drought. In this study, we compare two large metabolomics datasets where we employed a nontargeted metabolomics approach to elucidate metabolic pathways perturbed by progressive dehydration in tobacco and soybean plants. The two datasets were created using the same strategy to create water deficit conditions and an identical metabolomics pipeline. Comparisons between the two datasets therefore reveal common responses between the two species, responses specific to one of the species, responses that occur in both root and leaf tissues, and responses that are specific to one tissue. Stomatal closure is the immediate response of the plant and this did not coincide with accumulation of abscisic acid. A total of 116 and 140 metabolites were observed in tobacco leaves and roots, respectively, while 241 and 207 were observed in soybean leaves and roots, respectively. Accumulation of metabolites is significantly correlated with the extent of dehydration in both species. Among the metabolites that show increases that are restricted to just one plant, 4-hydroxy-2-oxoglutaric acid (KHG) in tobacco roots and coumestrol in soybean roots show the highest tissue-specific accumulation. The comparisons of these two large nontargeted metabolomics datasets provide novel information and suggest that KHG will be a useful marker for drought stress for some members of Solanaceae and coumestrol for some legume species.


Subject(s)
Glycine max/metabolism , Nicotiana/metabolism , Biomarkers/metabolism , Coumestrol/metabolism , Dehydration/metabolism , Droughts , Ketoglutaric Acids/metabolism , Metabolic Networks and Pathways , Metabolome , Plant Leaves/metabolism , Plant Roots/metabolism , Glycine max/growth & development , Nicotiana/growth & development
18.
Eur Spine J ; 26(6): 1652-1657, 2017 06.
Article in English | MEDLINE | ID: mdl-27154169

ABSTRACT

PURPOSE: To compare scoliosis progression in quadriplegic spastic cerebral palsy with and without intrathecal baclofen (ITB) pumps. METHODS: A retrospective matched cohort study was conducted. Patients with quadriplegic spastic cerebral palsy, GMFCS level 5, treated with ITB pumps with follow-up >1 year were matched to comparable cases by age and baseline Cobb angle without ITB pumps. Annual and peak coronal curve progression, pelvic obliquity progression and need for spinal fusion were compared. RESULTS: ITB group: 25 patients (9 female), mean age at pump insertion 9.4 and Risser 0.9. Initial Cobb angle 25.6° and pelvic tilt 3.2°. Follow-up 4.3 (1.0-7.8) years. Cobb angle at follow-up 76.1° and pelvic tilt 18.9°. Non-ITB group: 25 patients (14 female), mean age at baseline 9.2 and Risser 1.0. Initial Cobb angle 29.7° and pelvic tilt 7.1°. Follow-up 3.5 (1.0-7.5) years. Cobb angle at follow-up 69.1° and pelvic tilt 21.0°. The two groups were statistically similar for baseline age, Cobb angle and Risser grade. Mean curve progression was 13.6°/year for the ITB group vs 12.6°/year for the non-ITB group (p = 0.39). Peak curve progression was similar between the groups. Pelvic tilt progression was comparable; ITB group 4.5°/year vs non-ITB 4.6°/year (p = 0.97). During follow-up 5 patients in the ITB group and 9 in the non-ITB group required spinal fusion surgery for curve progression (p = 0.35). CONCLUSIONS: Patients with quadriplegic spastic cerebral palsy with and without ITB pumps showed significant curve progression over time. ITB pumps do not appear to alter the natural history of curve progression in this population.


Subject(s)
Baclofen/administration & dosage , Cerebral Palsy/drug therapy , Disease Progression , Infusion Pumps, Implantable , Muscle Relaxants, Central/administration & dosage , Scoliosis/complications , Case-Control Studies , Cerebral Palsy/complications , Child , Cohort Studies , Female , Humans , Male , Quadriplegia/complications , Retrospective Studies , Scoliosis/surgery
19.
Methods Mol Biol ; 1482: 1-13, 2016.
Article in English | MEDLINE | ID: mdl-27557757

ABSTRACT

The molecular components of transcriptional regulation are modular. Transcription factors have domains for specific functions such as DNA binding, dimerization, and protein-protein interactions associated with transcriptional activation and repression. Similarly, promoters are modular. They consist of combinations of cis-acting elements that are the binding sites for transcription factors. It is this promoter architecture that largely determines the expression pattern of a gene. The modular nature of promoters is supported by the observation that many cis-acting elements retain their activities when they are taken out of their native promoter context and used as building blocks in synthetic promoters. We therefore have a large collection of cis-acting elements to use in building synthetic promoters and many minimal promoters upon which to build them. This review discusses what we have learned concerning how to use these building blocks to make synthetic promoters. It has become clear that we can increase the strength of a promoter by adding increasing numbers of cis-acting elements. However, it appears that there may be a sweet spot with regard to inducibility as promoters with increasing numbers of copies of an element often show increased background expression. Spacing between elements appears important because if elements are placed too close together activity is lost, presumably due to reduced transcription factor binding due to steric hindrance. In many cases, promoters that contain combinations of cis-acting elements show better expression characteristics than promoters that contain a single type of element. This may be because multiple transcription factor binding sites in the promoter places it at the end of multiple signal transduction pathways. Finally, some cis-acting elements form functional units with other elements and are inactive on their own. In such cases, the complete unit is required for function in a synthetic promoter. Taken together, we have learned much about how to construct synthetic promoters and this knowledge will be crucial in both designing promoters to drive transgenes and also as components of defined regulatory networks in synthetic biology.


Subject(s)
Genes, Synthetic/genetics , Promoter Regions, Genetic/genetics , Transcription, Genetic , Binding Sites/genetics , Enhancer Elements, Genetic , Gene Expression Regulation, Plant , Humans , Transcription Factors/genetics , Transcriptional Activation/genetics
20.
Bioinformatics ; 32(13): 2024-5, 2016 07 01.
Article in English | MEDLINE | ID: mdl-27153680

ABSTRACT

UNLABELLED: Transcript Structure and Domain Display (TSDD) is a publicly available, web-based program that provides publication quality images of transcript structures and domains. TSDD is capable of producing transcript structures from GFF/GFF3 and BED files. Alternatively, the GFF files of several model organisms have been pre-loaded so that users only needs to enter the locus IDs of the transcripts to be displayed. Visualization of transcripts provides many benefits to researchers, ranging from evolutionary analysis of DNA-binding domains to predictive function modeling. AVAILABILITY AND IMPLEMENTATION: TSDD is freely available for non-commercial users at http://shenlab.sols.unlv.edu/shenlab/software/TSD/transcript_display.html CONTACT: : jeffery.shen@unlv.nevada.edu.


Subject(s)
Computational Biology/methods , Protein Domains , Software , Internet , Sequence Analysis, Protein
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