Comparison of analog 2D and digital 3D preoperative templating for predicting implant size in total knee arthroplasty.

The aim of this study was to compare the accuracy of preoperative templating in total knee arthroplasty (TKA) using conventional two-dimensional (2D) and computed tomography (CT)-based three-dimensional (3D) procedures, and to confirm the necessity of 3D evaluation for preoperative planning. One hundred consecutive primary TKAs were analyzed. Preoperative templating was performed for each TKA using both conventional 2D radiographs and a CT-based 3D image model created using KneeCAS software. Accuracies with regard to the predicted and actual implant sizes were determined for each procedure. The 3D procedure was found to be more accurate (59%) than the 2D procedure (56%) in predicting implant size, but the difference was not statistically significant (p = 0.67). Computer-assisted surgery systems are often used for preoperative planning in TKA. However, our results do not support the superiority of 3D preoperative templating over 2D conventional evaluation in predicting implant size. Thus, 3D templating may not be necessary for preoperatively predicting implant size in TKA, and can only be used as an approximate guide.

Expansion of unconventional T cells with natural killer markers in malaria patients.

Immunological states during human malarial infection were examined. In parallel with parasitemia and anemia, granulocytosis was induced in the blood of patients, especially those infected with Plasmodium (P.) falciparum. At that time, the level of lymphocytes remained unchanged or slightly increased in the blood. However, the distribution of lymphocyte subsets was modulated, showing that the proportion of CD56(+)T cells, CD57(+)T cells, and gammadeltaT cells (i.e. all unconventional T cells) had increased in patients infected with P. falciparum or P. vivax. This phenomenon occurred at the early phase of infection and disappeared in the course of recovery. The data from patients with multiple attacks of P. vivax infection showed that there was no augmentation of these responses. In adult cases, the increase in the proportion of unconventional T cells seemed to closely parallel disease severity. However, all these responses were weak in children, even those infected with P. falciparum. In conjunction with accumulating evidence from mouse malaria experiments, the present results suggest that the immunological state induced by malarial infection might mainly be an event of unconventional T cells and that the immunological memory might not be long-lasting, possibly due to the properties of unconventional T cells.