Genomic characterization of a cell-culture-adapted Korean human G9P[8] rotavirus, CAU05-202

The human rotavirus G9 strain is the fifth most common rotavirus worldwide. A human rotavirus G9P[8] strain CAU05-202 was isolated from a young child with diarrhea using a cell culture system, and its major gene sequences were determined. Phylogenetic analysis of the VP7 gene revealed that CAU05-202 clustered into genetic lineage III-d and was most closely related to G9 rotaviruses from Turkey (strain GUH13) and Sri Lanka (strain 05SLC056 and 05SLC057). VP4 and NSP4 gene analysis showed that CAU05-202 belongs to the P[8]-3 lineage and genotype B, respectively. In addition, CAU05-202 has a long RNA electropherotype, supported by VP6 gene analysis, which is clearly associated with subgroup II specificity. Analysis of the G9 rotavirus strain CAU05-202 provides information concerning the genetic relationships among global rotavirus G9 strains, suggesting that closely related G9 strains are persistent and widespread in Asian countries.     

3D CT analysis of femoral and tibial tunnel positions after modified transtibial single bundle ACL reconstruction with varus and internal rotation of the tibia

IntroductionWe analyzed the location of femoral and tibial tunnels by three-dimensional (3D) CT reconstruction images after modified transtibial single bundle (SB) anterior cruciate ligament (ACL) reconstruction, creating a femoral tunnel with varus and internal rotation of the tibia.Material and methodsData from 50 patients (50 knees) analyzed by 3D CT after modified transtibial SB ACL reconstructions were evaluated. 3D CT images were analyzed according to the quadrant method by Bernard at the femur and the technique of Forsythe at the tibia.ResultsThe mean distance of the femoral tunnel center locations parallel to the Blumensaat's line was 29.6% ± 1.9% along line t measured from the posterior condylar surface. The mean distances perpendicular to the Blumensaat's line were 37.9% ± 2.5% along line h measured from the Blumensaat's line. At the tibia, the mean anterior-to-posterior distance for the tunnel center location was 37.8% ± 1.2% and the mean medial-to-lateral distance was 50.4% ± 0.9%.DiscussionThe femoral and tibial tunnels after modified transtibial SB ACL reconstruction creating a femoral tunnel with varus and internal rotation of the tibia (figure-of-4 position) were located between the anatomical anteromedial and posterolateral footprints.     

Permeability characteristics of monovalent cations in atrial myocytes of the rat heart

We investigated the permeability of Cs+ and Na+ through various ion channels in rat atrial myocytes using the whole-cell voltage-clamp technique. With isotonic CsCl (140 mM) on both sides of the membrane and nominally [Ca2+]o-free conditions, depolarising clamp pulses induced an increase of outward currents which showed a biphasic time course. Repolarisation to the holding potential induced inward tail currents. With isotonic NaCl, depolarisation also induced outward currents which showed a monotonic decay, but inward tail currents were not observed. Both in NaCl and CsCl, currents were hardly affected by TEA (10 mM), 4-AP (5 mM) and DIDS (100 microM). Nicardipine (1 M) almost completely blocked time-dependent outward currents in isotonic NaCl solution, leaving only time-independent currents which showed linear I-V relationship. In isotonic CsCl conditions, nicardipine blocked outward current considerably, but there still remained time-dependent outward currents and inward tail currents. Addition of E-4031 (2-20 M) which is known as a specific blocker of the rapidly activating delayed rectifier K+ current (IKr) completely blocked these time-dependent outward and inward currents, leaving only a time-independent current. Time-independent currents recorded in the presence of nicardipine and E-4031 were inhibited by GdCl3, which is known to block non-selective cation (NSC) currents. From these results, it was suggested that NSC current in atrial myocytes can be investigated in isotonic Cs+ or Na+ solution in the presence of Ca2+ channel and IKr blockers.     

A case of huge sclerosing stromal tumor of the ovary weighing 10 kg in a 71-year-old postmenopausal woman

Sclerosing stromal tumor (SST) is a rare benign neoplasm of ovarian stromal origin and predominantly affects young women in the second and third decades. This tumor characteristically differentiates itself histologically and clinically from both thecomas and fibromas. We present a case of huge SST of the ovary weighing 10 kg in a 71-year-old postmenopausal woman with a brief review of the literature.     

Community Sexual Bridging Among Heterosexuals at High-Risk of HIV in New York City

Community sexual bridging may influence the socio-geographic distribution of heterosexually transmitted HIV. In a cross-sectional study, heterosexual adults at high-risk of HIV were recruited in New York City (NYC) in 2010 for the Centers for Disease Control and Prevention-sponsored National HIV Behavioral Surveillance system. Eligible participants were interviewed about their HIV risk behaviors and sexual partnerships and tested for HIV. Social network analysis of the geographic location of participants’ recent sexual partnerships was used to calculate three sexual bridging measures (non-redundant ties, flow-betweenness and walk-betweenness) for NYC communities (defined as United Hospital Fund neighborhoods), which were plotted against HIV prevalence in each community. The analysis sample comprised 494 participants and 1534 sexual partnerships. Participants were 60.1 % male, 79.6 % non-Hispanic black and 19.6 % Hispanic race/ethnicity; the median age was 40 years (IQR 24–50); 37.7 % had ever been homeless (past 12 months); 16.6 % had ever injected drugs; in the past 12 months 76.7 % used non-injection drugs and 90.1 % engaged in condomless vaginal or anal sex; 9.6 % tested HIV positive (of 481 with positive/negative results). Sexual partnerships were located in 33 (78.6 %) of 42 NYC communities, including 13 “high HIV-spread communities”, 7 “hidden bridging communities”, 0 “contained high HIV prevalence communities”, and 13 “latent HIV bridging communities”. Compared with latent HIV bridging communities, the population racial/ethnic composition was more likely (p < 0.0001) to be black or Hispanic in high HIV-spread communities and to be black in hidden bridging communities. High HIV-spread and hidden bridging communities may facilitate the maintenance and spread of heterosexually transmitted HIV in black and Hispanic populations in NYC.     

Subchondral Calcium Phosphate is Ineffective for Bone Marrow Edema Lesions in Adults With Advanced Osteoarthritis

Background

Injury to subchondral bone is associated with knee pain and osteoarthritis (OA). A percutaneous calcium phosphate injection is a novel approach in which subchondral bone marrow edema lesions are percutaneously injected with calcium phosphate. In theory, calcium phosphate provides structural support while it is gradually replaced by bone. However, little clinical evidence supports the efficacy of percutaneous calcium phosphate injections.

Questions/purposes

We asked: (1) Does percutaneous calcium phosphate injection improve validated patient-reported outcome measures? (2) What proportion of patients experience failure of treatment (defined as a low score on the Tegner Lysholm Knee Scoring Scale)? (3) Is there a relationship between outcome and age, sex, BMI, and preoperative grade of OA?

Methods

Between September 2012 and January 2014, we treated 33 patients with percutaneous calcium phosphate injections. Twenty-five satisfied our study inclusion criteria; of those, three patients were lost to followup and 22 (88%; 13 men, nine women) with a median age of 53.5 years (range, 38–70 years) were available for retrospective chart review and telephone evaluation at a minimum of 6 months (median, 12 months; range, 6–24 months). Our general indications for this procedure were the presence of subchondral bone marrow edema lesions observed on MR images involving weightbearing regions of the knee associated with localized pain on weightbearing and palpation and failure to respond to conservative therapy (> 3 months). Patients with pain secondary to extensive nondegenerative meniscal tears with a flipped displaced component at the level of bone marrow edema lesions, or with mechanical axis deviation greater than 8° were excluded. All patients had Grades III or IV chondral lesions (modified Outerbridge grading system for chondromalacia) overlying MRI-identified subchondral bone marrow edema lesions. Percutaneous calcium phosphate injection was performed on the medial tibial condyle (15 patients), the medial femoral condyle (five patients), and the lateral femoral condyle (two patients). Concomitant partial meniscectomy was performed in 18 patients. Preoperative and postoperative scores from the Knee Injury and Arthritis Outcome Score (KOOS) and the Tegner Lysholm Knee Scoring Scale were analyzed.

Results

For patients available for followup, the outcome scores improved after treatment. The KOOS improved from a mean of 39.5 ± 21.8 to 71.3 ± 23 (95% CI, 18.6–45.2; p < 0.001) and the Tegner and Lysholm score from 48 ± 15.1 to 77.5 ± 20.6 (95% CI, 18.8–40.2; p < 0.001). However, seven of the 22 patients had poor clinical outcomes as assessed by the Tegner Lysholm Knee Scoring Scale, whereas three had fair results, five had good results, and seven had excellent results. The postoperative Tegner Lysholm score was inversely related to the preoperative Kellgren-Lawrence OA grade (R² = 0.292; F (1.20) = 9.645; p = 0.006). We found no relationship between outcome scores and age, sex, or BMI.

Conclusions

In a study that would have been expected to present a best-case analysis (short-term followup, loss to followup of patients with potentially unsatisfactory results, and use of invasive cotreatments including arthroscopic débridements), we found that percutaneous calcium phosphate injection in patients with symptomatic bone marrow edema lesions of the knee and advanced OA yielded poor results in a concerning proportion of our patients. Based on these results, we advise against the use of percutaneous calcium phosphate injections for patients with advanced osteoarthritic changes.

Level of Evidence

Level IV, therapeutic study.     

Apoptosis in the Osteonecrosis of the Femoral Head

Background

Osteonecrosis of the femoral head is classified into idiopathic and secondary forms. A number of etiological factors in the development of osteonecrosis have been suggested but the biological mechanisms are still unclear. Recently, some reports suggested that the apoptosis is closely related to osteonecrosis of the femoral head. Therefore, this study examined the expression of apoptosis in osteonecrosis of the femoral head.

Methods

Of the patients diagnosed preoperatively with osteonecrosis and underwent total hip replacement arthroplasty between August 2004 and July 2005, 58 patients (58 hips) were available for this study. Their diagnoses were confirmed by the postoperative pathology findings. Tissue samples of the femoral head sections were terminal deoxynucleotydyl transferase mediated dUTP nick-end labeling (TUNEL) stained using an in situ cell death detection POD kit. The number of total and TUNEL-positive osteocytes, and the average ratio of TUNEL-positive cells were calculated and analyzed according to the cause.

Results

Osteonecrosis was steroid-induced in 8 cases (13.8%), alcohol-induced in 29 cases (50%), post-traumatic in 6 cases (10.3%) and idiopathic in 15 cases (25.9%). The percentage of TUNEL-positive osteocytes was high in patients with steroid- and alcohol-induced osteonecrosis of the femoral head but low in patients with post-traumatic and idiopathic osteonecrosis. The difference in the percentage of TUNEL-positive osteocytes between these groups was significant (p < 0.05).

Conclusions

Apoptosis might play an important role in the pathogenesis of osteonecrosis of the femoral head induced by steroid and alcohol. These findings highlight a need for further research into the role of apoptosis in the development of osteonecrosis of the femoral head.