Basophil tryptase mMCP-11 plays a crucial role in IgE-mediated, delayed-onset allergic inflammation in mice.

Recent studies have identified nonredundant roles for basophils in immune responses including allergy and protective immunity. It is well known that activated basophils release granule contents such as histamine and proteases as do mast cells. However, the functional significance of basophil-derived proteases remains poorly understood in contrast to those released from mast cells. For this study we generated a line of knockout (KO) mice deficient for mouse mast cell protease-11 (mMCP-11) that is preferentially expressed by basophils rather than mast cells. In spite of normal development of basophils, the mMCP-11-deficient mice showed amelioration of immunoglobulin E-mediated chronic allergic inflammation (IgE-CAI), with reduction of cutaneous swelling, microvascular permeability, and leukocyte infiltration in the skin lesion, when KO mice were compared with wild-type mice. Repeated administration of recombinant mMCP-11 in the skin induced infiltration of leukocytes, including basophils, in a tryptase activity-dependent manner. The transwell migration assay in vitro suggested that mMCP-11-mediated proteolytic products of serum protein promoted migration of basophils, eosinophils, and macrophages via 1 or more G protein-coupled receptors. Thus, basophil tryptase mMCP-11 is a crucial effector molecule for the induction of IgE-CAI. This is the first demonstration that the basophil-derived protease plays a significant role in vivo.

Should we use cortical bone screws for cortical bone trajectory?

OBJECT: In 2009, Santoni et al. reported cortical bone trajectory (CBT) as a method of inserting pedicle screws to obtain more solid fixation, and proposed the use of cortical trajectory screws with a more closely placed thread (cortical screws) for CBT. Since the entry trajectory in CBT differs from that in the traditional trajectory, it is unclear whether the increased strength derives from the specific trajectory or the shape of the screw thread in contact with the cortical bone. Whether the use of cortical screws is always required with CBT thus remains unclear. The authors therefore investigated the relationship between screw entry trajectory and screw thread characteristics and pullout strength in animal experiments. METHODS: Lumbar vertebrae (L1-L4) from 4-month-old female pigs were randomly assigned to one of 4 groups, with cancellous screws or cortical screws inserted via the traditional trajectory or CBT. For pullout strength testing, the screw was pulled out vertically against the direction of insertion. Rod pullout testing (toggle testing) was also performed, and the peak breaking strength was measured. RESULTS: The maximum pullout strength was significantly greater for CBT using cortical screws than for the traditional trajectory using cancellous screws. Pullout strength tended to be higher when cortical screws were used in both CBT and the traditional trajectory, although the difference was not significant. Toggle testing showed no significant differences among the 4 groups. CONCLUSIONS: The specific unconventional trajectory seemed to have a major impact on the increased strength obtained with CBT.

Comparison of internal fixations for distal clavicular fractures based on loading tests and finite element analyses.

It is difficult to apply strong and stable internal fixation to a fracture of the distal end of the clavicle because it is unstable, the distal clavicle fragment is small, and the fractured region is near the acromioclavicular joint. In this study, to identify a superior internal fixation method for unstable distal clavicular fracture, we compared three types of internal fixation (tension band wiring, scorpion, and LCP clavicle hook plate). Firstly, loading tests were performed, in which fixations were evaluated using bending stiffness and torsional stiffness as indices, followed by finite element analysis to evaluate fixability using the stress and strain as indices. The bending and torsional stiffness were significantly higher in the artificial clavicles fixed with the two types of plate than in that fixed by tension band wiring (P < 0.05). No marked stress concentration on the clavicle was noted in the scorpion because the arm plate did not interfere with the acromioclavicular joint, suggesting that favorable shoulder joint function can be achieved. The stability of fixation with the LCP clavicle hook plate and the scorpion was similar, and plate fixations were stronger than fixation by tension band wiring.

Hammering sound frequency analysis and prevention of intraoperative periprosthetic fractures during total hip arthroplasty.

Adequate fixation at the time of cementless stem implantation depends on the operator's experience. An objective evaluation method to determine whether the stem has been appropriately implanted may be helpful. We studied the relationship between the hammering sound frequency during stem implantation and internal stress in a femoral model, and evaluated the possible usefulness of hammering sound frequency analysis for preventing intraoperative fracture. Three types of cementless stem (BiCONTACT®, SL-PLUS®, and AI-Hip®) were used. Surgeons performed stem insertion using a procedure similar to that employed in a routine operation. Stress was estimated by finite element analysis, the hammering force was measured, and frequency analysis of hammering sound data obtained using a microphone. Finite element analysis showed a decrease in the hammering sound frequency with an increase in the estimated maximum stress. When a decrease in frequency was observed, adequate hammering had occurred, and the continuation of hammering risked fracture. Based on the relationship between stress and frequency, the evaluation of changes in frequency may be useful for preventing the development of intraoperative fractures. Using our method, when a decrease in frequency is observed, the hammering force should be reduced. Hammering sound frequency analysis may allow the prediction of bone fractures that can be visually confirmed, and may be a useful objective evaluation method for the prevention of intraoperative periprosthetic fractures during stem insertion.