The effect of temperature on testicular steroid production in the rainbow trout, Salmo gairdneri, in vivo and in vitro

The effect of temperature on steroidogenesis in the male rainbow trout has been studied both in vitro using endogenous precursors under gonadotrophin stimulation and in vivo in fish held for 2 weeks at three different temperatures. In vitro, the optimum temperature for formation of testosterone and its 11-oxygenated derivatives was 10 degrees, whereas glucuronide formation showed an optimum at 18 degrees. In vivo, plasma levels of testosterone and 11-keto-testosterone were significantly higher at 6 than at 17 degrees, whereas glucuronide levels showed no significant difference. Milt was obtained only from fish held at 6 and 12 degrees. The optimum temperature for free steroid formation in response to gonadotrophin stimulus is shown to be dependent upon glucuronyl transferase content, and its progressive increase during the reproductive cycle may provide a mechanism for the inhibition of free steroid synthesis and hence spermiation at elevated temperatures where gamete survival is poor.     

An outcome study of chronic Achilles tendinosis after excision of the Achilles tendon and flexor hallucis longus tendon transfer

BACKGROUND: A number of operative techniques, including decompression with debridement and flexor hallucis longus (FHL) tendon augmentation, have been described for chronic degenerative Achilles tendinosis. Decompression with debridement has been shown to be effective; however, pain and functional limitation can persist in individuals with more severe tendon involvement. Augmentation with the FHL tendon can add mechanical support; however, difficulty in achieving proper tendon tensioning and the potential to leave behind painful diseased tendon are disadvantages of the technique. The purpose of this study was to present the results of a modified technique in which the Achilles tendon is completely excised and the FHL tendon is transferred. METHODS: Fifty-six surgeries using this modified technique were done between October, 1994, and March, 2002, for patients with chronic degenerative Achilles tendinosis. Forty-four patients with and average age of 58.2 (SD 10.1) years and an average time of followup of 3.4 (SD 1.9) years were available for testing. All subjects were mailed a packet of standardized questionnaire information that included the Self-Reported Health Related Quality of Life measures Short Form (SF-36) and the subjective component of the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Score. Nineteen patients returned to the clinic for objective assessment. Statistical analysis tested for a difference in the SF-36 scores between our subjects and the general United States population and for a difference in strength and range of motion between the involved and uninvolved lower extremities. RESULTS: Pain decreased in 95.5% (n = 42) patients, and 86.4% (n = 38) patients were satisfied with the result. There was no significant difference (p > .05) between the SF-36 scores obtained by our sample compared to the general United States population. The average AOFAS score for the 19 patients was 91.6 (SD 7.7). Dorsiflexion range of motion was not significantly different (p = 0.17); however, significant deficits were found in plantarflexion range of motion (p = 0.001) and plantarflexion strength (p < 0.025). Strength deficits were 30% on average; however, all but one patient could do a heel raise. CONCLUSION: Complete Achilles tendon excision reduces pain while preserving functional status. Although strength deficits persisted, these deficits did not seem to affect the functional status in this sample of patients.     

Influence of increasing construct constraint in the presence of posterolateral deficiency at knee replacement: A biomechanical study

When faced with posterolateral corner (PLC) deficiency, surgeons must choose a total knee replacement (TKR) construct that provides the appropriate level of constraint. This should match the internal constraint of the device to the soft tissue host laxity pattern. Little guidance is available peroperatively, with factors influencing final component choice remaining ill defined. This study aimed to quantify the effect of PLC insufficiency on the “envelope of laxity” (EoL) after TKR and the effect of increasingly component constraint upon knee behavior through a functional arc of flexion. Using computer navigation, mixed effect modeling and loaded cadaveric legs—laxity was quantified under separate states: the native knee, after implantation of a posterior stabilized (PS)‐TKR, after sectioning the lateral (fibular) collateral ligament and popliteus tendon (PS‐TKR‐PLC), and after re‐implantation with a semi‐constrained “total stabilized” knee replacement (TS‐TKR). Laxity was quantified from 0 to 110° of flexion for anterior draw, varus–valgus, and internal–external rotation. Implantation of the PS‐TKR was consistently associated with increased constraint when compared to the native knee. PLC sectioning led to significantly increased laxity during varus stress from mid to deep flexion. Revision to a TS‐TKR construct restored constraint mimicking that of the primary state but only for the arc of motion 0–90°. In a posterolateral deficient state, a fixed bearing semi‐constrained TS‐TKR restored the knee to near normal kinematics but this was only achieved from an arc of motion 0–90° of flexion. At higher flexion angles, there remained an unfavorable laxity pattern with varus stress opening. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:427–434, 2016.     

PTEN抑癌基因在乳腺癌组织中的表达及其与乳腺癌微小转移灶的关系

目的:研究PTEN抑癌基因在乳腺癌组织中的表达,探讨其与乳腺癌病人的外周血、骨髓及前哨淋巴结微小转移灶之间的关系。方法:选择53例乳腺癌病人的组织标本,用免疫组织化学方法检测原发肿瘤PTEN蛋白的表达;用定量RT鄄PCR法测定原发肿瘤PTENmRNA的表达。以免疫细胞化学法检测外周血和骨髓中的微小转移灶;HE染色和免疫组织化学法检测前哨淋巴结中的微小转移灶。结果:外周血、骨髓及前哨淋巴结中微小转移灶的检出率分别是24.5%,56.6%,26.4%和41.5%。乳腺癌组织中PTEN蛋白表达呈丢失者占35.8%,后者与外周血和骨髓微小转移灶间无显著关系,而与前哨淋巴结中的微小转移密切相关(P≤0.001)。PTENmRNA的表达与外周血、骨髓及前哨淋巴结中的微小转移灶之间均无显著相关性。结论:乳腺癌组织中PTEN蛋白表达的丢失与前哨淋巴结中的微小转移有密切关系,可作为预测其早期转移的重要指标。     

Snapshots of five clinical ethics committees in the UK

Each of the following papers gives an account of a different UK clinical ethics committee. The committees vary in the length of time they have been established, and also in the main focus of their work. The accounts discuss the development of the committees and some of the ethical problems that have been brought to them. The issues raised will be relevant for other National Health Service (NHS) trusts in the UK that wish to set up such a committee.