Chronic Osteomyelitis in the Femoral Midshaft Following Arthroscopic ACL Reconstruction.

A 25 year-old man presented with pain, swelling, and intermittent drainage from distal lateral aspect of his left knee three months after undergoing isolated ACL reconstruction with arthroscopic hamstring autograft and endobottom technique. His surgeon at that time tried to eliminate the pathology through arthroscopic wash out in two attempts. However, the pain, edema, and discharge recurred after a year of being symptom free. The patient underwent imaging assessment and anteroposterior and lateral radiographs demonstrated a sclerotic area beneath the femoral condoyle in femoral tunnel and a fusiform sclerotic area in the lateral aspect of femoral midshaft. Magnetic Resonance Imaging revealed necrotic tissue with bone edema consistent with the sclerotic area in radiographs indicating micro abscesses and osteomyelitis. A diagnosis of femoral chronic osteomyelitis was made and the patient underwent arthroscopic drainage and washout, followed by open surgery for diaphysial femoral osteomyelitis. Rehabilitation was started and after six months the patient returned to his work.

Energy budget for the cultured, zooxanthellate octocoral Sinularia flexibilis.

The zooxanthellate octocoral Sinularia flexibilis is a producer of potential pharmaceutically important metabolites such as antimicrobial and cytotoxic substances. Controlled rearing of the coral, as an alternative for commercial exploitation of these compounds, requires the study of species-specific growth requirements. In this study, phototrophic vs. heterotrophic daily energy demands of S. flexibilis was investigated through light and Artemia feeding trials in the laboratory. Rate of photosynthetic oxygen by zooxanthellae in light (≈200 µmol quanta m⁻² s⁻¹) was measured for the coral colonies with and without feeding on Artemia nauplii. Respiratory oxygen was measured in the dark, again with and without Artemia nauplii. Photosynthesis-irradiance curve at light intensities of 0, 50, 100, 200, and 400 µmol quanta m⁻² s⁻¹ showed an increase in photosynthetic oxygen production up to a light intensity between 100 and 200 µmol quanta m⁻² s⁻¹. The photosynthesis to respiration ratio (P/R > 1) confirmed phototrophy of S. flexibilis. Both fed and non-fed colonies in the light showed high carbon contribution by zooxanthellae to animal (host) respiration values of 111-127%. Carbon energy equivalents allocated to the coral growth averaged 6-12% of total photosynthesis energy (mg C g⁻¹ buoyant weight day⁻¹ and about 0.02% of the total daily radiant energy. "Light utilization efficiency (ε)" estimated an average ε value of 75% 12 h⁻¹ for coral practical energetics. This study shows that besides a fundamental role of phototrophy vs. heterotrophy in daily energy budget of S. flexibilis, an efficient fraction of irradiance is converted to useable energy.

Light-dependency of growth and secondary metabolite production in the captive zooxanthellate soft coral Sinularia flexibilis.

The branching zooxanthellate soft coral Sinularia flexibillis releases antimicrobial and toxic compounds with potential pharmaceutical importance. As photosynthesis by the symbiotic algae is vital to the host, the light-dependency of the coral, including its specific growth rate (micro day(-1)) and the physiological response to a range of light intensities (10-1,000 micromol quanta m(-2) s(-1)) was studied for 12 weeks. Although a range of irradiances from 100 to 400 micromol quanta m(-2) s(-1) was favorable for S. flexibilis, based on chlorophyll content, a light intensity around 100 micromol quanta m(-2) s(-1) was found to be optimal. The contents of both zooxanthellae and chlorophyll a were highest at 100 micromol quanta m(-2) s(-1). The specific budding rate showed almost the same pattern as the specific growth rate. The concentration of the terpene flexibilide, produced by this species, increased at high light intensities (200-600 micromol quanta m(-2) s(-1)).

Cell cultures from the symbiotic soft coral Sinularia flexibilis.

The symbiotic octocoral Sinularia flexibilis is a producer of potential pharmaceuticals. Sustainable mass production of these corals as a source of such compounds demands innovative approaches, including coral cell culture. We studied various cell dissociation methodologies and the feasibility of cultivation of S. flexibilis cells on different media and cell dissociation methodologies. Mechanical dissociation of coral tissue always yielded the highest number of cells and allowed subsequent cellular growth in all treatments. The best results from chemical dissociation reagents were found with trypsin-ethylene diamine tetraacetic acid. Coral cells obtained from spontaneous dissociation did not grow. Light intensity was found to be important for coral cell culture showing an enduring symbiosis between the cultured cells and their intracellular algae. The Grace's insect medium and Grace's modified insect medium were found to be superior substrates. To confirm the similarity of the cultured cells and those in the coral tissue, a molecular test with Internal Transcribed Spacer primers was performed. Thereby, the presence of similar cells of both the coral cells and zooxanthella in different culture media was confirmed.