Contribution of above- and below-ground plant traits to the structure and function of grassland soil microbial communities.

BACKGROUND AND AIMS: Abiotic properties of soil are known to be major drivers of the microbial community within it. Our understanding of how soil microbial properties are related to the functional structure and diversity of plant communities, however, is limited and largely restricted to above-ground plant traits, with the role of below-ground traits being poorly understood. This study investigated the relative contributions of soil abiotic properties and plant traits, both above-ground and below-ground, to variations in microbial processes involved in grassland nitrogen turnover. METHODS: In mountain grasslands distributed across three European sites, a correlative approach was used to examine the role of a large range of plant functional traits and soil abiotic factors on microbial variables, including gene abundance of nitrifiers and denitrifiers and their potential activities. KEY RESULTS: Direct effects of soil abiotic parameters were found to have the most significant influence on the microbial groups investigated. Indirect pathways via plant functional traits contributed substantially to explaining the relative abundance of fungi and bacteria and gene abundances of the investigated microbial communities, while they explained little of the variance in microbial activities. Gene abundances of nitrifiers and denitrifiers were most strongly related to below-ground plant traits, suggesting that they were the most relevant traits for explaining variation in community structure and abundances of soil microbes involved in nitrification and denitrification. CONCLUSIONS: The results suggest that consideration of plant traits, and especially below-ground traits, increases our ability to describe variation in the abundances and the functional characteristics of microbial communities in grassland soils.

The clinical bioinformatics ontology: a curated semantic network utilizing RefSeq information.

Existing medical vocabularies lack rich terms to describe findings that are generated by modem molecular diagnostic procedures. Most bioinformatics resources were designed primarily to support the needs of the research community. We describe the development of a curated resource, the Clinical Bioinformatics Ontology (CBO), a semantic network appropriate for describing clinically significant genomics concepts. The CBO includes concepts appropriate for both molecular diagnostics and cytogenetics. A standardized methodology based on consistent application of RefSeq information is applied to the curation of the CBO in order to provide a reproducible and reliable tool. Challenges related to this curation process are discussed in this paper. At the time of submission the CBO included 4,069 concepts, associated by 8,463 relationships.

Drug-induced lupus following treatment with infliximab in rheumatoid arthritis.

After introduction of infliximab for the treatment of rheumatoid arthritis (RA), there have been many reports of patients developing asymptomatic higher rate of antinuclear antibodies and anti-dsDNA antibodies than in non-infliximab-treated patients. However, only five clinical drug-induced lupus (DIL) cases have been documented following treatment with infliximab, in RA and in Crohn's diseases. We report a case of a 69-year-old female with a 5 year history of RA, whowas successfully treated with low-dose methotrexate (MTX) and infliximab (initially 3 mg/kg and from the fourth infusion 5 mg/kg) for 23 weeks. Before the sixth infusion, she was diagnosed with DIL by both clinical features (fever > 38 degrees C, recurrence of active synovitis, myalgia, erythematous rash and general malaise) and laboratory findings (antinuclear antibodies 1:160, anti-double-stranded DNA positive by ELISA assay, decreased serum complement C3 andC4, hypergammaglobulinaemia, increased erythrocyte sedimentation rate). After discontinuation of treatment and therapy with oral prednisone, lupus resolved within 8 weeks.

Efficacy and safety profile of cyclosporin A in the treatment of juvenile chronic (idiopathic) arthritis. Results of a 10-year prospective study.

OBJECTIVE: This open prospective trial was performed in order to assess the efficacy and safety of cyclosporin A in the treatment of patients with juvenile chronic arthritis (JCA). METHODS: Thirty-four of the patients enrolled were affected by systemic-onset disease and seven by chronic anterior uveitis associated with JCA. The cyclosporin dose was usually 3-5 mg/kg per day. The average duration of therapy was 1.4 yr, with a maximum of 7.2 yr. RESULTS: The efficacy of treatment was mainly evident in terms of control of fever and reduction of steroid therapy. The benefits with respect to arthritis, laboratory parameters and uveitis seemed to be less clear-cut. Side-effects were frequent but usually mild or reversible. Sixty-six per cent of the study population withdrew from therapy because of inefficacy or side-effects. Eight systemic patients withdrew from therapy owing to complete remission. CONCLUSION: Cyclosporin can be used in the treatment of JCA, its main benefits being the control of fever and a steroid-sparing effect.

[Tolerability, safety and efficacy of Iloprost infusion without peristaltic pump in systemic sclerosis] / Tollerabilità, sicurezza ed efficacia del trattamento infusivo con Iloprost senza pompa peristaltica in pazienti affetti da sclerosi sistemica.

OBJECTIVE: To evaluate safety, tolerability and efficacy on Raynaud's phenomenon (Rp) of iloprost infusion without peristaltic pump in patients with systemic sclerosis (SSc). PATIENTS AND METHODS: The inclusion criteria were diagnosis of SSc, age between 18 and 65 years, presence of Rp, and absence of any contraindication to the use of iloprost. The treatment was carried out in a day hospital setting and consisted first of 5 consecutive days of iloprost infusion (from an initial dose of 1.0 ng/Kg/min up to 2 ng/kg/min), and then of 2 days of infusions at the maximum possible dose every 45 days for one year. All of the adverse events were carefully recorded and the changes in the Rp were measured by a 5 grade scale (worsened, unmodified, slightly improved, very improved, disappeared). RESULTS: Thirty-eight SSc patients (all females), mean age 49 years (range 18.5-65), disease duration 1.5 years (range 0.5-10.8) were enrolled in the study. During the first cycle of therapy, 14 adverse events occurred in 11 (28.9%) patients and during the next cycles, 3 adverse events were seen in 3 (7.9%) patients. In all of the cases they were mild and transient. Rp was considered very improved in 15 (39.5%) patients, slightly improved in 13 (34.2%), unmodified in 8 (21%) and worse in 2 (5.2%). DISCUSSION: In this study intravenous iloprost without peristaltic pump proved to be safe, well tolerated, and as effective as traditional infusion through peristaltic pump in improving Rp in patients with SSc.

Microvascular obstruction in avascular necrosis. Immunohistochemistry of 14 femoral heads.

14 femoral heads with late stage avascular necrosis of different etiologies were histologically examined, with special attention to vascular structures. Decalcified slices were stained with hematoxylin-eosin, safranin-O, van Gieson stain, and Martius Scarlet Blue. Immunohistochemical techniques with antibodies against Factor VIII, and Ulex Europeus Lectin were used to visualize the endothelium of the blood vessels. 5 distinct zones of the necrotic femoral head could be identified. The necrotic zone contained areas with richly vascularized connective tissue. In the transitional zone, several areas with intravascular aggregations of newly formed and older fibrin clots were noticed, mainly on the venous side of the vascular system. Other small vessels were collapsed, with a few endothelial cells clumped together in the center of a concentric fibrous tissue. We suggest that obstruction to the venous outflow due to intravascular thrombosis as well as to perivascular fibrosis is important in the pathogenesis of non-traumatic avascular necrosis of the femoral head.

Blood perfusion uneven in femoral head osteonecrosis. Doppler flowmetry and intraosseous pressure in 12 cases.

We measured the microvascular regional perfusion in 12 hips with non-traumatic osteonecrosis of the femoral head, using laser Doppler flowmetry (LDF). Simultaneously, the intraosseous pressure (IOP) was measured in the femoral head. For comparison, the same 2 parameters were measured in 6 normal femoral heads during surgery of the contralateral hip. In osteonecrosis, the regional blood cell flux in the intertrochanteric area was 165 mV, at the rim of the lesion 430 mV, and in the necrotic lesion 35 mV. In the same areas, the IOP was 38 mmHg, 61 mmHg and 55 mmHg. In the normal hips, the LDF signal was 221 mV and 224 mV, and the IOP was 21 mmHg and 19 mmHg intertrochanterically and in the femoral head, respectively. We conclude that the microvascular blood perfusion is uneven in an osteonecrotic head.

Arthroplasty for congenital hip dislocation. Techniques for acetabular reconstruction.

We investigated a series of 63 arthroplasties for chronically dislocated hips or severe dysplasia with at least two thirds of the femoral head uncovered. Direct cementation into the neoacetabulum at the pelvic wing was followed by 6/20 revision arthroplasties and 3/20 impending failures. Cups supported by cortical bone grafts were revised in 8/16 and found loose in 2/12 arthroplasties. The best technique was restoration of the rotational center of the hip joint and roof reconstruction with a femoral head graft with 2/25 revisions and signs of loosening in 2/25.

Prognostic factors in osteosarcomas. A regression analysis.

A multivariate regression analysis of survival data, using the Cox proportional hazards model (PHM), was performed on the retrospective material of 184 osteosarcoma patients treated at the Aarhus and Copenhagen oncology centers, Denmark, from 1963 to 1984. All patients were previously untreated. Radical surgery, in general ablative when possible, was the primary treatment goal throughout this period. A number of clinical and pathologic variables were tested in the model to elucidate their prognostic importance. Tumors localized to the trunk, pelvis, or femur, and symptom duration of less than 6 months were poor prognostic signs. Tumors dominated by fibroblastic cells and a patient age of approximately 25 to 30 years were associated with an especially good prognosis. The prognosis worsened with advancing age. Children, adolescents, and adults ages 5 to 25 years had significantly poorer prognosis than young adults 25 to 30 years of age. Sex, radiologic appearance, and year of referral had no significant prognostic value in this series. Based on the regression model, a prognostic index is derived and survival is calculated for a good and a poor prognostic case. The overall 10-year survival with one standard deviation was 28.6 +/- 3.5%. Cancer deaths continue to occur 10 years after initial treatment, and the estimated hazard rate is still four times greater than that of a sex- and age-matched group of healthy individuals.

Soft tissue sarcomas in adults. Surgical, radiologic and cytotoxic treatment.

Soft tissue sarcomas are a heterogeneous group of malignant tumours of mesenchymal and neuroectodermal origin, comprising about one per cent of all malignant diseases. The prognosis of soft tissue sarcomas is generally poor with 5 and 10 year survival rates of about 50 and 40 per cent, respectively. The modern guidelines for the different treatment modalities in soft tissue sarcomas, including local therapy (surgery, radiation therapy) and systemic therapy (cytotoxic chemotherapy) are described. The multidisciplinary approach to the treatment, optionally organised in national or international cooperative groups is emphasized .

Osteotomy of the patella in the patellofemoral pain syndrome. The significance of increased intraosseous pressure during sustained knee flexion.

In 40 patients with patellofemoral pain, intra-osseous pressure measurements were recorded under anaesthesia with the knee first in extension and then in flexion prior to performing a longitudinal osteotomy of the patella. There was a statistically significant increase of pressure in painful knees compared with normal knees (29 mm Hg. vs 15 mm Hg.), and a marked increase when compared during sustained flexion (97 mm Hg. vs 60 mm Hg.). However wide variability of individual results made the diagnostic value of a single pressure measurement unreliable. A clinical test, based on reproduction of the characteristic pain by sustained knee flexion, proved to be reliable in predicting a good response to operation. The effect of the operation was encouraging, with significant relief of pain as measured by a visual analogue scale.

Experimental osteoarthritis in the rabbit. A study of 133xenon washout rates from the synovial cavity.

Synovial perfusion in 6 rabbit knees, with experimentally induced osteoarthritis (joint instability), was studied by recording the initial 133Xe washout rates from the joint space. The unstable osteoarthritic knee was compared with the contralateral sham operated control knee at intervals of 6 to 96 weeks postoperatively. Within the first half year the ratio between the 133Xe washout rates in the osteoarthritic and control joints was significantly increased. These findings were supported by the increased blood flow to the joint region, visualized by scintigraphy of osteoarthritic rabbits given 99mTc-microspheres intracardially. However, methodological sources of error do not allow any conclusions regarding the much less increased 133Xe washout rates found in advanced osteoarthritis. The initially increased synovial blood flow coincided with the existence of joint effusion and the early development of osteophytes, all conditions supposed to be a consequence of posttraumatic synovitis. Attention is drawn to these pathogenic phenomena in studies dealing with the initial changes in experimental models of osteoarthritis and to a possible etiological significance.

Resurfacing of depression fractures of the lateral tibial condyle. A report of five cases.

Five patients with fractures of the lateral tibial condyle were treated operatively by resurfacing of the lateral tibial plateau by means of a Marmor polyethylene tibial prosthesis. The indications were persistent pain and valgus deformity. In four patients, in whom the cartilage of the lateral femoral condyle was normal at the time of operation, the results were excellent. One patient with osteoarthritic cartilage degeneration of the femoral condyle was not improved by the operation.

The effect of joint position on juxta-articular bone marrow pressure. Relation to intra-articular pressure and joint effusion--an experimental study on horses.

Six metacarpo-phalangeal joints of adult horses were studied. Pressure measurements were made in the joint and the metacarpal bone with simultaneous measurement of the systemic arterial blood pressure. Investigations performed to study the effect of joint position on juxta-articular bone marrow pressure showed that an increase in joint flexion was always followed by a rise in intraosseous pressure with a significant increase at flexion above 60 degrees. Increase in intra-articular pressure which was achieved by injection of saline was always followed by a slower rise in intraosseous pressure. Furthermore, it was shown that even a few millilitres of saline in the joint caused a rise in intra-articular pressure. The findings indicate that changes in joint position as well as effusion may block the drainage vessels from the bone marrow as they pass through the joint.

The synovial membrane in human coxathrosis: light and electron microscopic studies.

Changes of the synovium are in integral part of osteoarthritis. Most authors regard these changes as secondary to cartilage degeneration. However, synovitis is a very early feature in osteoarthritis, and increased knowledge of changes in the chemical composition of the synovia focused our attention on the histologic characteristics of osteoarthritic synovium. Light and electron microscopic studies of the synovial membrane from patients with osteoarthritis and rheumatoid arthritis of the hip joints were performed. Two distinct types of osteoarthritic synovitis were observed: an early proliferative from characterized by venous stasis with edema, free erythrocytes and hemosiderine deposits in the interstitial tissue, that suggested increased capillary permeability. In the late form, fibrous synovitis, the microscopic picture was dominated by dense fibrous tissue. Synovium from rheumatoid arthritis showed the same vascular changes as in osteoarthritis. In addition, the histologic picture was characterized by severe inflammatory changes. In osteoarthritis the signs of inflammation were moderate or absent. The development from proliferative into fibrous synovitis is probably the result of long-standing chronic venous insufficiency. The essential feature of osteoarthritic proliferative synovitis--venous stasis with increased capillary permeability--correlates well with most of the known changes in the composition of the synovial fluid.