Advanced microscopy analysis of the micro-nanoscale architecture of human menisci.

The complex inhomogeneous architecture of the human meniscal tissue at the micro and nano scale in the absence of artefacts introduced by sample treatments has not yet been fully revealed. The knowledge of the internal structure organization is essential to understand the mechanical functionality of the meniscus and its relationship with the tissue's complex structure. In this work, we investigated human meniscal tissue structure using up-to-date non-invasive imaging techniques, based on multiphoton fluorescence and quantitative second harmonic generation microscopy complemented with Environmental Scanning Electron Microscopy measurements. Observations on 50 meniscal samples extracted from 6 human menisci (3 lateral and 3 medial) revealed fundamental features of structural morphology and allowed us to quantitatively describe the 3D organisation of elastin and collagen fibres bundles. 3D regular waves of collagen bundles are arranged in "honeycomb-like" cells that are comprised of pores surrounded by the collagen and elastin network at the micro-scale. This type of arrangement propagates from macro to the nanoscale.

Inhibition of multidrug-resistant Staphylococci by sodium chlorate and select nitro- and medium chain fatty acid compounds.

AIMS: Determine the antimicrobial effects of 5 µmol ml-1 sodium chlorate, 9 µmol ml-1 nitroethane or 2-nitropropanol as well as lauric acid, myristic acid and the glycerol ester of lauric acid Lauricidin® , each at 5 mg ml-1 , against representative methicillin-resistant staphylococci, important mastitis- and opportunistic dermal-pathogens of humans and livestock. METHODS AND RESULTS: Three methicillin-resistant Staphylococcus aureus and two methicillin-resistant coagulase-negative staphylococci were cultured at 39°C in 5 µmol ml-1 nitrate-supplemented half-strength Brain Heart Infusion broth treated without or with the potential inhibitors. Results revealed that 2-nitropropanol was the most potent and persistent of all compounds tested, achieving 58-99% decreases in mean specific growth rates and maximum optical densities when compared with untreated controls. Growth inhibition did not persist by cultures treated solely with chlorate or nitroethane, with adaptation occurring by different mechanisms after 7 h. Adaptation did not occur in cultures co-treated with nitroethane and chlorate. The medium chain fatty acid compounds had modest effects on all the staphylococci tested except the coagulase-negative Staphylococcus epidermidis strain NKR1. CONCLUSIONS: The antimicrobial activity of nitrocompounds, chlorate and medium chain fatty acid compounds against different methicillin-resistant staphylococci varied in potency. SIGNIFICANCE AND IMPACT OF THE STUDY: Results suggest that differential antimicrobial activities exhibited by mechanistically dissimilar inhibitors against methicillin-resistant staphylococci may yield potential opportunities to combine the treatments to overcome their individual limitations and broaden their activity against other mastitis and dermal pathogens.

Growth of Candida norvegensis (strain Levazoot 15) with different energy, nitrogen, vitamin, and micromineral sources.

To examine the growth of Candida norvegensis (strain Levazoot 15), four experiments were conducted with different sources of energy, nitrogen, vitamins, and microminerals. Optical density was used as an indirect measure of strain growth in a fully randomized factorial design, in which principal factor A was the source of energy, nitrogen, vitamins, or microminerals and principal factor B was the measurement time point (0, 20, or 40 h). The results showed that the yeast strain used glucose (primarily sucrose and lactose) as the energy source and tryptone as the nitrogen source. The addition of B-complex vitamins or microminerals was not necessary for strain growth. It is concluded that the strain Levazoot 15 preferentially utilizes glucose as a source of energy, tryptone as a source of nitrogen and manganese as a mineral source, and that no vitamin source was necessary for growth.

Lesiones destructivas de la línea media facial secundarias al consumo de cocaína: caso clínico / Cocaine induced midline destructive lesions: report of one case

Vasculitic midline destructive lesions can be a complication of cocaine use. We report a 44-year-old man who presented with a two months history of left facial pain associated with ipsilateral facial paralysis and a cheek phlegmon. Magnetic resonance imaging showed broad soft tissue destruction linked to important cranial nerve involvement. Antibiotic and antifungal therapy was started and multiple surgical debridement procedures were performed, with no clinical improvement. Microbiological analysis was negative. Finally, thanks to the histologic findings corresponding to vasculitis and granuloma formation and the history of cocaine abuse, a cocaine induced midline destructive lesion was diagnosed.

[Cocaine induced midline destructive lesions. Report of one case]. / Lesiones destructivas de la línea media facial secundarias al consumo de cocaína. Caso clínico.

Vasculitic midline destructive lesions can be a complication of cocaine use. We report a 44-year-old man who presented with a two months history of left facial pain associated with ipsilateral facial paralysis and a cheek phlegmon. Magnetic resonance imaging showed broad soft tissue destruction linked to important cranial nerve involvement. Antibiotic and antifungal therapy was started and multiple surgical debridement procedures were performed, with no clinical improvement. Microbiological analysis was negative. Finally, thanks to the histologic findings corresponding to vasculitis and granuloma formation and the history of cocaine abuse, a cocaine induced midline destructive lesion was diagnosed.

Understanding and mitigating hydrogen embrittlement of steels: a review of experimental, modelling and design progress from atomistic to continuum.

Hydrogen embrittlement is a complex phenomenon, involving several length- and timescales, that affects a large class of metals. It can significantly reduce the ductility and load-bearing capacity and cause cracking and catastrophic brittle failures at stresses below the yield stress of susceptible materials. Despite a large research effort in attempting to understand the mechanisms of failure and in developing potential mitigating solutions, hydrogen embrittlement mechanisms are still not completely understood. There are controversial opinions in the literature regarding the underlying mechanisms and related experimental evidence supporting each of these theories. The aim of this paper is to provide a detailed review up to the current state of the art on the effect of hydrogen on the degradation of metals, with a particular focus on steels. Here, we describe the effect of hydrogen in steels from the atomistic to the continuum scale by reporting theoretical evidence supported by quantum calculation and modern experimental characterisation methods, macroscopic effects that influence the mechanical properties of steels and established damaging mechanisms for the embrittlement of steels. Furthermore, we give an insight into current approaches and new mitigation strategies used to design new steels resistant to hydrogen embrittlement.

Enteritis lúpica como manifestación inicial de lupus eritematoso sistémico: caso clínico / Lupus enteritis as initial manifestation of systemic lupus erythematosus: report of one case

Although gastrointestinal symptoms are not rare in Systemic lupus erythematosus, enteritis is an atypical manifestation of the disease. We report a 54 year-old woman who presented acute symptoms of diarrhea, fever and abdominal pain, receiving empiric antibiotic therapy for bacterial enteritis with no response. Computed tomography showed diffuse small intestine inflammation and serositis. Antinuclear antibodies, anti-Ro and anti-La were positive on blood tests. A lupic enteropathy was diagnosed and steroid treatment was initiated, with subsequent clinical improvement.

[Lupus enteritis as initial manifestation of systemic lupus erythematosus. Report of one case]. / Enteritis lúpica como manifestación inicial de lupus eritematoso sistémico. Caso clínico.

Although gastrointestinal symptoms are not rare in Systemic lupus erythematosus, enteritis is an atypical manifestation of the disease. We report a 54 year-old woman who presented acute symptoms of diarrhea, fever and abdominal pain, receiving empiric antibiotic therapy for bacterial enteritis with no response. Computed tomography showed diffuse small intestine inflammation and serositis. Antinuclear antibodies, anti-Ro and anti-La were positive on blood tests. A lupic enteropathy was diagnosed and steroid treatment was initiated, with subsequent clinical improvement.

Isolation and characterization of yeasts from fermented apple bagasse as additives for ruminant feeding

Abstract Solid-state fermentation can be used to produce feeds for ruminants, which can provide an enriched population of yeasts to improve ruminal fermentation. Fermentation of apple bagasse was performed to obtain a yeast-rich product, with the objective of isolating, identifying, and characterizing yeast strains and testing their capability to enhance in vitro ruminal fermentation of fibrous feeds. Yeasts were isolated from apple bagasse fermented under in vitro conditions, using rumen liquor obtained from cannulated cows and alfalfa as a fibrous substrate. A total of 16 new yeast strains were isolated and identified by biochemical and molecular methods. The strains were designated Levazot, followed by the isolate number. Their fermentative capacity was assessed using an in vitro gas production method. Strain Levazot 15 (Candida norvegensis) showed the greatest increase in gas production (p < 0.05) compared with the yeast-free control and positively affected in vitro ruminal fermentation parameters of alfalfa and oat straw. Based on these results, it was concluded that the Levazot 15 yeast strain could be potentially used as an additive for ruminants consuming high-fiber diets. However, further studies of effects of these additives on rumen digestion, metabolism, and productive performance of ruminants are required.

Isolation and characterization of yeasts from fermented apple bagasse as additives for ruminant feeding.

Solid-state fermentation can be used to produce feeds for ruminants, which can provide an enriched population of yeasts to improve ruminal fermentation. Fermentation of apple bagasse was performed to obtain a yeast-rich product, with the objective of isolating, identifying, and characterizing yeast strains and testing their capability to enhance in vitro ruminal fermentation of fibrous feeds. Yeasts were isolated from apple bagasse fermented under in vitro conditions, using rumen liquor obtained from cannulated cows and alfalfa as a fibrous substrate. A total of 16 new yeast strains were isolated and identified by biochemical and molecular methods. The strains were designated Levazot, followed by the isolate number. Their fermentative capacity was assessed using an in vitro gas production method. Strain Levazot 15 (Candida norvegensis) showed the greatest increase in gas production (p<0.05) compared with the yeast-free control and positively affected in vitro ruminal fermentation parameters of alfalfa and oat straw. Based on these results, it was concluded that the Levazot 15 yeast strain could be potentially used as an additive for ruminants consuming high-fiber diets. However, further studies of effects of these additives on rumen digestion, metabolism, and productive performance of ruminants are required.

Utilidad de la ultrasonografía en la orientación diagnóstica en una artritis indiferenciada a raíz de un caso clínico / Utility of ultrasonography in diagnostic orientation for undifferentiated arthritis, based on a clinical case

La ultrasonografía se ha convertido en un examen muy útil para el estudio de artritis inflamatorias indiferenciadas, ya que posee mayor sensibilidad que el examen físico para detectar sinovitis y entesitis. La necesidad de realizar el diagnóstico de forma precoz, ha permitido que esta herramienta se vuelva un pilar fundamental en el enfrentamiento de estas patologías. Se presenta el caso de una paciente de 37 años que consulta por cuadro de seis meses de evolución de poliartralgias de distribución asimétrica en manos, hombros y codos. Al examen físico se detecta sinovitis en articulaciones metacarpofalángicas e interfalángicas proximales. Finalmente se solicita ultrasonografía de manos, la cual revela sinovitis activa en articulaciones interfalángicas distales. En base a esto se rescata antecedente familiar de psoriasis, se realiza HLA-B27 que resulta negativo y un TAC de sacroiliacas sugerente de sacroileítis bilateral. Por los hallazgos y el nuevo antecedente se diagnostica como Artritis Psoriática.

Ultrasonography has become a useful imaging test in the assessment of undifferentiated arthritis, due to its greater sensitivity in detecting synovitis and enthesitis in comparison with physical examination. In the need of making an early diagnosis, this exam has turn into a cornerstone when approaching certain arthritis. We present the case of a 37 years old women, with a six months history of asymmetric polyarthralgias in hands, shoulders and elbows. Synovitis is detected with physical exam in metacarpophalangeal and proximal interphalangeal joints. An ultrasonography is requested, revealing active synovitis in distal interphalangeal joints. Based on these information, the family background of psoriasis is obtained. HLA-B27 results negative and a sacroiliac CT suggests bilateral sacroiliitis. According to these findings the diagnosis of Psoriatic Arthritis is finally made.

Abordaje Clínico de un Incisivo Maxilar Permanente con Fractura Corono Radicular Compleja Mediante Reimplante Intencional / Clinical Approach of Permanent Maxillary Incisor with Complicated Crown-root Fracture Through Intentional Replantation

El manejo de las fracturas corono radiculares es un desafío clínico interdisciplinario, tanto en su atención de urgencia como en la planificación y ejecución del tratamiento definitivo. Se describen tres alternativas principales como terapia: tracción quirúrgica u ortodóncica del remanente corono radicular, gingivectomía y reimplante intencional dependiendo algunos factores como: edad del paciente, condición ligamento periodontal, longitud radicular, extensión del rasgo e fractura, entre otros. Paciente de sexo masculino de 10 años, con trauma dentoalveolar complejo, donde destaca la fractura corono radicular, diente 11, que presenta extensión subgingival mayor a 5 mm. Dada la complejidad de la situación clínica, se optó por el reimplante intencional, para permitir la reposición del fragmento con técnica adhesiva extra-oral. Luego de los primeros dieciséis meses de seguimiento se observa una adecuada cicatrización periodontal y un resultado estético aceptable. El reimplante intencional puede ser considerado un adecuado tratamiento en casos de fracturas corono radiculares complejas, cuando el rasgo de fractura se encuentra ubicado en zonas que impiden la utilización de otras técnicas, para su rehabilitación. De igual manera se permite la mantención de la altura y volumen del hueso alveolar de pacientes en crecimiento.

Crown root fracture management is a clinical and interdisciplinary challenge, either in its initial emergency care as in the definitive treatment planning and execution. Three main treatment alternatives are described: surgical and orthodontic extrusion of crown-root remnant, gingivectomy and intentional reimplantation, depending on factors such as: age of patient, clinical conditions of periodontal ligament and root length. This paper reports a clinical case of an adhesive fragment reattachment in a complicated crown root fracture in upper maxillary central incisor through intentional replantation. A 10 year-old male patient with complex dentoalveolar trauma, which highlights a complicated crown root fracture on tooth 11 with subgingival extension greater than 5 mm. Given the complexity of the clinical situation, we opted for intentional replantation, to allow reattachment of the crown fragment by adhesive technique. After the first sixteen months of follow-up, an adequate periodontal healing, acceptable aesthetic and functional outcome were observed. The intentional replantation can be considered adequate treatment in cases of complex crown root fractures when the fracture feature is located in areas that prevent the use of other techniques for rehabilitation. In the same way it allows the maintenance of the height and volume of the alveolar bone of growing patients.

Particle size distribution and chemical composition of total mixed rations for dairy cattle: water addition and feed sampling effects.

Four dairy farms were used to determine the effects of water addition to diets and sample collection location on the particle size distribution and chemical composition of total mixed rations (TMR). Samples were collected weekly from the mixing wagon and from 3 locations in the feed bunk (top, middle, and bottom) for 5 mo (April, May, July, August, and October). Samples were partially dried to determine the effect of moisture on particle size distribution. Particle size distribution was measured using the Penn State Particle Size Separator. Crude protein, neutral detergent fiber, and acid detergent fiber contents were also analyzed. Particle fractions 19 to 8, 8 to 1.18, and <1.18 mm were judged adequate in all TMR for rumen function and milk yield; however, the percentage of material>19 mm was greater than recommended for TMR, according to the guidelines of Cooperative Extension of Pennsylvania State University. The particle size distribution in April differed from that in October, but intermediate months (May, July, and August) had similar particle size distributions. Samples from the bottom of the feed bunk had the highest percentage of particles retained on the 19-mm sieve. Samples from the top and middle of the feed bunk were similar to that from the mixing wagon. Higher percentages of particles were retained on >19, 19 to 8, and 8 to 1.18 mm sieves for wet than dried samples. The reverse was found for particles passing the 1.18-mm sieve. Mean particle size was higher for wet than dried samples. The crude protein, neutral detergent fiber, and acid detergent fiber contents of TMR varied with month of sampling (18-21, 40-57, and 21-34%, respectively) but were within recommended ranges for high-yielding dairy cows. Analyses of TMR particle size distributions are useful for proper feed bunk management and formulation of diets that maintain rumen function and maximize milk production and quality. Water addition may help reduce dust associated with feeding TMR.

Towards a standard in assessment of bone cutting for total knee replacement.

Arthroplasty outcome is influenced by the 'quality' of bone preparation for implant insertion. Surgeons face increasing choices of technique and instrumentation, yet clinical scoring methods assess the overall outcome and patient satisfaction but not the bone cuts directly. 'Quality management' of bone reshaping is needed to evaluate different bone cutting methods and computer assisted orthopaedic surgery (CAOS) systems. Analyses and experiments in this study were formulated for measurement and computation of four quantitative characteristics of bone preparation 'quality' and produced a highly condensed index for each. These represented (a) surface finish of cuts, (b) implant fit/looseness possible with the cut shape, (c) implant location/misalignment, and (d) accuracy of individual planar cuts. Assessment of synthetic bone cuts verified the robustness of the method for wide application in arthroplasty intraoperatively, in vitro and for comparing navigation systems.

Minimally invasive total knee arthroplasty surgery through navigated freehand bone cutting: winner of the 2005 "HAP" PAUL AWARD.

Navigated freehand bone cutting (NFC) is introduced as a concept to eliminate alignment jigs and facilitate smaller arthroplasty incisions. We compare experimental cuts with this technique to conventional jigs. Using an in-house-built computer-aided orthopedic surgery system directly navigating a bone saw, users with different levels of surgical skills were timed performing full sets of distal femoral total knee arthroplasty cuts with jigs and with NFC. The cut surfaces were digitized to measure roughness and 3-dimensional translational/rotational errors. Navigated freehand cutting was 15% faster and produced 200% rougher surfaces than jigs, although its worst peaks/valleys were less than 1.2 mm. Implant fit/looseness, assessed by special navigated tools, was similar; but alignment was 400% better with NFC. Even at its infancy, NFC appears not to prohibitively compromise time and quality of cutting. Without requiring jigs, it has potential for radically less invasive total knee arthroplasty surgery.

Influencia de la infección por VIH/SIDA sobre indicadores antropométricos del estado nutricional / HIV-AIDS infection influence on anthropometric indicators of nutritional state

Analisa a influência da infecção pelo HIV e o estágio clínico da doença sobre diferentes indicadores antropométricos do estado nutricional do indivíduo

[Influence of HIV/AIDS infection on some biochemical indicators of the nutritional status]. / Influencia de la infección por VIH/SIDA sobre algunos indicadores bioquímicos del estado nutricional.

The main objective of this study was to analyze the influence of nutritional state among HIV-1 infected people, according to the different clinical stages referred by the CDC (Control Disease Center of the United States) in 1987, as well as the changes in the concentrations of some biochemical markers linked to nutritional state. A similar study was carried out in a control group with UltramicroELISA non-reagent healthy individuals, anthropometrically classified. Concentrations of total proteins, albumin, cholesterol, triglycerides, urea, uric acid and creatinine were analyzed by sex and clinical group, comparing the levels obtained through a variance study. When comparing HIV-1 asymptomatic infected patients to HIV-1 and HIV-2 non infected people, the results showed a non significant increase in the level of total proteins with a significant decrease of albumin and creatinine, the latter observed only in male patients. In stage IV patients, an important decrease of cholesterol and a significant increase of the triglycerides were found, as well as the lowest albumin levels. Urea and uric acid levels did not experience statistically significant changes. It was concluded that the study of biochemical markers is advisable, since it contributes to the detection by default of malnutrition marginal states in infected individuals.

Influencia de la infección por VIH/sida sobre algunos indicadores bioquímicos del estado nutricional / influence of HIV/AIDS infection on some nutritional state biochemical markers

Con el objetivo de analizar la influencia de la infección por el VIH y el estadio clínico de la enfermedad sobre indicadores bioquímicos del estado nutricional del individuo, se estudió un grupo de individuos infectados y clasificados en diferentes grupos clínicos, de acuerdo con los criterios propuestos en 1987 por el Centro de Control de Enfermedades de los Estados Unidos, así como un grupo control integrado por sujetos seronegativos al VIH y clasificados antropométricamente con un estado nutricional normal. Se analizaron las variaciones experimentadas por las proteínas totales, albúmina, colesterol, triacilglicéridos, urea, ácido úrico y creatinina, según sexo y grupo clínico, para lo cual se realizó la comparación de las medias obtenidas por medio de un análisis de la varianza. Al compararlos con los seronegativos, se encontró en los seropositivos asintomáticos un incremento no significativo de las proteínas totales con disminusión significativa de la albúmina y la creatinina; esta última sólo en el sexo masculino. En los pacientes del estadio IV se manifestó la disminución más importante del colesterol y un aumento significativo de los triglicéridos, así como los niveles más bajos de albúmina. La urea y el ácido úrico no experimentaron cambios con significación estadística. Se recomienda la determinación de indicadores bioquímicos en la detección de estados marginales de malnutrición por defecto en individuos VIH/SIDA