Low-field-strength MR imaging of failed hip arthroplasty: association of femoral periprosthetic signal intensity with radiographic, surgical, and pathologic findings.

PURPOSE: To investigate the association between periprosthetic signal intensity at low-field-strength magnetic resonance (MR) imaging after failed hip arthroplasty and radiographic, surgical, and pathologic findings. MATERIALS AND METHODS: The study group comprised 22 consecutive women who underwent hip arthroplasty (mean age, 62 years; age range, 35-74 years). All patients underwent MR imaging prior to revision surgery. Coronal fast short inversion time inversion-recovery (STIR) images and spin-echo T1-weighted images were obtained with a 0.5-T MR imaging unit before and after administration of contrast material. The periprosthetic region was divided into the seven femoral Gruen zones. Two observers retrospectively analyzed signal intensity patterns. Association of signal intensity patterns with radiographic, surgical, and pathologic findings was determined with chi2 analysis and generalized estimating equations. RESULTS: Diagnostic-quality images were obtained for 150 zones. Periprosthetic signal intensity was greater than that of bone marrow in the distal femur on the fast STIR images, and no contrast enhancement was seen on the T1-weighted images (type I signal intensity pattern) in 11 zones. Signal intensity was greater than that of bone marrow on the fast STIR images, and contrast enhancement was seen on the T1-weighted images (type II signal intensity pattern) in 45 zones. Signal intensity was less than or equal to that of bone marrow on the fast STIR images, and no contrast enhancement was seen on the T1-weighted images (type III signal intensity pattern) in 94 zones. Type I and II patterns were associated with focal or nonfocal lucency, an unstable stem, and fibrosis or granuloma. A type III pattern was associated with a normal radiographic appearance, a stable stem, and normal bone tissue. Significant association was demonstrated between periprosthetic signal intensity and radiographic (P <.001, chi2 test and generalized estimating equations), surgical (P <.05, Mantel-Haenszel chi2 test and generalized estimating equations), and pathologic findings (P <.05, chi2 test). CONCLUSION: Low-field-strength MR imaging depicted periprosthetic tissue signal intensity that was significantly associated with radiographic, surgical, and pathologic findings.

Case report: rheumatoid arthritis occurring during observation after surgery for localized pigmented villonodular synovitis.

Abstract In the rare case presented here, arthroscopic resection was performed after a diagnosis of localized pigmented villonodular synovitis (LPVS) of the knee, but the disorder recurred after about 1 year as the diffuse form, and synovectomy was performed through a medial parapatella incision. Subsequently, rheumatoid arthritis (RA) occurred during the postoperative observation period. The course of this case is interesting because of the combination of the two diseases. In cases of PVS, the possibility of RA should always be considered.

Frictional torque and wear of retrieved hip prostheses: a comparison between alumina/PE and Co-Cr/PE prostheses.

Frictional torque and wear were measured in 67 retrieved cups with internal diameters of 32 mm. Thirty cups were combined with alumina heads and 37 were combined with metal heads. A lower prevalence of cup loosening was observed in alumina-polyethylene implants than in metal-polyethylene implants. No relation between frictional torque and stability of implants was detected for either type, whereas retrieved cups of alumina-polyethylene implants showed lower frictional torque than those of metal-polyethylene implants. Less wear was observed in the cups of alumina-polyethylene implants (0.13 mm/y) than in those of metal-polyethylene implants (0.19 mm/y). Less wear was observed in cups without loosening than in those with loosening in both types. These results suggest that wear has a greater influence on the stability of cups than frictional torque.

Proteome analysis of Bacillus subtilis extracellular proteins: a two-dimensional protein electrophoretic study.

To analyse the proteome of Bacillus subtilis extracellular proteins, extracellular protein samples were prepared from culture media (minimal medium containing 0.4% glucose) of parental B. subtilis 168, a secA-temperature sensitive mutant and an ffh conditional mutant, and examined by two-dimensional gel electrophoresis. Approximately 100 to 110 spots were visualized in a gel of B. subtilis 168 extracellular proteins. Over 90% and 80% of these disappeared in the absence of SecA and Ffh, respectively. Thirty-eight obvious spots on the gel of the B. subtilis 168 preparation were selected and compared with spots obtained under SecA- or Ffh-deficient conditions. The appearance of 36 of these 38 spots depended on SecA and Ffh. Nineteen additional extracellular proteins were detected in cultures maintained in cellobiose, maltose and soluble starch. Among 23 proteins of which the N-terminal amino acid sequences were determined, 17 were extracellular proteins having signal peptides in their precursor form. Two membrane proteins, Yfnl and YflE, were cleaved behind 226Ala-Tyr-Ala228 and 213Ala-Leu-Ala215, respectively, and of which products seemed to be liberated into the culture medium. The production of Yfnl and YflE were also dependent on SecA and Ffh. These results indicate that most extracellular proteins target to and translocate across the cytoplasmic membrane by co-operation between the signal-recognition particle and Sec protein-secretion pathways. In contrast, a spot for Hag appeared independent from SecA and Ffh. Intracellular proteins Gap, SodA and KatA were identified in the extracellular protein samples. On the basis of these results and computer searches, it was predicted that B. subtilis produces 150 to 180 proteins extracellularly.