Draft Genome Sequence of Thermomicrobium sp. Strain 4228-Ro, a Thermophilic Bacterium Isolated from a Kamchatka Hot Spring.

The genome of Thermomicrobium sp. strain 4228-Ro, an aerobic thermophilic bacterium isolated from a Kamchatka hot spring, was sequenced and analyzed. The genome assembly comprises 13 contigs with a total length of 3,068,448 bp. Genome analysis revealed the pathway of aerobic utilization of sugars, which was corroborated by growth experiments.

Molecular species selectivity of lipid transport creates a mitochondrial sink for di-unsaturated phospholipids.

Mitochondria depend on the import of phospholipid precursors for the biosynthesis of phosphatidylethanolamine (PE) and cardiolipin, yet the mechanism of their transport remains elusive. A dynamic lipidomics approach revealed that mitochondria preferentially import di-unsaturated phosphatidylserine (PS) for subsequent conversion to PE by the mitochondrial PS decarboxylase Psd1p. Several protein complexes tethering mitochondria to the endomembrane system have been implicated in lipid transport in yeast, including the endoplasmic reticulum (ER)-mitochondrial encounter structure (ERMES), ER-membrane complex (EMC), and the vacuole and mitochondria patch (vCLAMP). By limiting the availability of unsaturated phospholipids, we created conditions to investigate the mechanism of lipid transfer and the contributions of the tethering complexes in vivo. Under these conditions, inactivation of ERMES components or of the vCLAMP component Vps39p exacerbated accumulation of saturated lipid acyl chains, indicating that ERMES and Vps39p contribute to the mitochondrial sink for unsaturated acyl chains by mediating transfer of di-unsaturated phospholipids. These results support the concept that intermembrane lipid flow is rate-limited by molecular species-dependent lipid efflux from the donor membrane and driven by the lipid species' concentration gradient between donor and acceptor membrane.

Pattern of recovery and outcomes of patient reported physical function and pain interference after ankle fusion: a retrospective cohort study.

BACKGROUND: Research on outcomes after ankle fusion focuses on basic activities of daily living, fusion rates, and gait parameters. Little has been reported on the patient's perspective after surgery. The purpose of this study was to determine the change in patient reported physical function and pain interference after ankle fusion surgery to guide patient expectations and improve provider communication. METHODS: This was a retrospective review of prospectively collected patient reported outcome measurement information system (PROMIS) data in 88 ankle arthrodesis procedures performed from May 2015 to March 2018. The PROMIS Physical function (PF) and pain interference (PI) measures were collected as routine care. Linear mixed models were used to assess differences at each follow-up point for PF and PI. Preoperative to last follow-up in the 120-365 day interval was assessed using analysis of variance. Outcomes included T-scores, z-scores, and PROMIS-Preference (PROPr) utility scores for PF and PI and the percentage of patients improving by at least 4 T-score points. RESULTS: The linear mixed model analysis for PF after the 120-149 days, and for PI, after 90-119 days, indicated recovery plateaued at 39-40 for PF and 57-59 for PI T-scores. The change in the PI T-score was the greatest with a mean T-score improvement of - 5.4 (95% CI - 7.7 to - 3.1). The proportion of patients improving more than 4 points was 66.2% for either PF or PI or both. The change in utility T-scores for both PF (0.06, 95% CI 0.02 to 0.11) and PI (0.15, 95% CI 0.09 to 0.20) was significantly improved, however, only PI approached clinical significance. CONCLUSION: Average patients undergoing ankle fusion experience clinically meaningful improvement in pain more so than physical function. Average patient recovery showed progressive improvement in pain and function until the four-month postoperative time point. Traditional dogma states that recovery after an ankle fusion maximizes at a year, however based on the findings in this study, 4 months is a more accurate marker of recovery. A decline in function or an increase in pain after 4 months from surgery may help to predict nonunion and other complications after ankle arthrodesis. LEVEL OF EVIDENCE: Level II, prospective single cohort study.

[Growing Pains : Cause, Significance and Treatment]. / Wachstumsschmerzen : Ursprung, Bedeutung und Behandlung.

BACKGROUND: Leg pain is a common reason for consultation in the children's orthopedic clinic. It can occur across all age groups, although most patients are of pre-school or elementary school age. As there are a series of possibly severe differential diagnoses that might cause such pains in children and adolescents apart from benign pains that occur in the context of growth, a thorough patient history and physical examination are essential. PATHOGENESIS: Despite extensive research, the cause of benign growing pains has not been elucidated so far. Several possible factors play a role on an anatomical, metabolic or functional basis, ; thus, various theories exist with regard to their origin. DIAGNOSIS: Growing pains constitute a diagnosis of exclusion. If a possible organic cause of the pains is suspected, an extended diagnosis of the person affected should be made. Growing pains primarily occur at night and are always self-resolving. THERAPY: With regard to treatment, mild pain medications can be employed in more severely affected patients. It is much more important to inform family members about the benign nature of the condition. Reassuring words and physical relaxation exercises, in addition to massaging and stretching of the leg muscles, can cause a significant reduction in pain without medication.

[Sirenomelia--a rare cause of an oligoanhydramnion in the second trimester--a case report]. / Sirenomelie--eine seltene Ursache für ein Oligo-hydramnion im zweiten Trimester--Ein Fallbericht.

Sirenomelia is a rare, but complex and lethal malformation. It is caused by a primary defect of the caudal axial skeleton and damage to the primary streak, which appears due to a vascular steal phenomenon. Sirenomelia appears sporadic with an incidence of 1-64,000 births. A risk for sirenomelia can be also found in patients with poorly controlled diabetes mellitus and in monocygotic twins. Leading ultrasound findings are fusioned lower extremities, bilateral renal agenesis, single umbilical artery and a distinct oligohydramnios. 3D ultrasound and color Doppler sonography can additionally be used for diagnostic, as well as amnioninfusion. There are 3 forms of sirenomelia, depending on missing or presence of the feet it is distinguished as sympus apus, monopus or dipus. We are presenting a case of sirenomelia with sympus dipus, which was transferred for further diagnostic of severe oligohydramnios in 21 weeks of gestation by the gynecologist.

Midfoot arthritis.

Midfoot arthritis is a common cause of significant pain and disability. Although the medial tarsometatarsal (TMT) joints provide < 7 degrees of sagittal plane motion, the more mobile lateral fourth and fifth TMT joints provide balance and accommodation on uneven ground. These small constrained TMT joints also provide stability and translate the forward propulsion motion of the hindfoot and ankle joint to the forefoot metatarsophalangeal joints from heel rise to toe-off. Posttraumatic degeneration is the primary cause of midfoot arthritis, although primary degeneration and inflammatory conditions can also affect this area. The result is a painful midfoot that can no longer effectively transmit load from the hindfoot to the forefoot. Shoe modifications and orthotic inserts are the mainstay of nonsurgical management. Successful management of midfoot arthritis with orthoses is predicated on achieving adequate joint stabilization while still allowing function. Surgical intervention typically involves arthrodesis of the medial midfoot, although the best treatment of the more mobile lateral column is a subject of debate.