Method for producing capsular polysaccharides

NASA Technical Reports Server (NTRS)

Richards, Gil F. (Inventor); Kern, Roger G. (Inventor); Petersen, Gene R. (Inventor)

1994-01-01

Structurally altered capsular polysaccharides are produced by mutant bacteria. These polysaccharides are isolated by selecting a wild type bacterial strain and a phage producing degradative enzymes that have substrate specificity for the capsular polysaccharides produced by the wild type bacteria. Phage-resistant mutants producing capsular polysaccharides are selected and the structurally altered capsular polysaccharide is isolated therefrom.

Thickening of the inferior glenohumeral capsule: an ultrasound sign for shoulder capsular contracture.

PubMed

Michelin, Paul; Delarue, Yohann; Duparc, Fabrice; Dacher, Jean Nicolas

2013-10-01

The aim of this retrospective study was to measure the inferior glenohumeral capsule thickness of shoulders clinically affected by capsular contracture by comparison to the contralateral asymptomatic side. Bilateral shoulder ultrasound (US) examinations of 20 patients with clinically or MRI proven unilateral capsular contracture were retrospectively assessed. Inferior capsule evaluation was performed with a transducer placed within the axilla in maximally abducted shoulders. Measurements were symmetrically performed orthogonally to the inferior glenohumeral ligament (IGHL) in the axial plane; the coronal plane was used to ensure the tension of the IGHL. The significance of any difference in thickening was assessed with the Mann-Whitney test. The average thickness was 4.0 mm in shoulders with capsular contracture vs. 1.3 mm in asymptomatic contralateral shoulders (P < 0.0001). Twenty per cent of patients with capsular contracture and inferior capsule thickness increase showed US features of other painful diseases of the rotator cuff. The thickness of the inferior capsule is measurable through ultrasound examination and appears to be increased in shoulders with capsular contracture. Exploration of the inferior aspect of the shoulder joint could be added to shoulder US examination protocols for capsular contracture assessment even if other rotator cuff abnormalities are diagnosed by US. • Ultrasound is increasingly used to diagnose shoulder problems. • The thickness of the inferior glenohumeral ligament is measurable in the axilla. • The inferior glenohumeral ligament appears thickened in shoulders with capsular contracture. • Capsular contracture ultrasound features can be associated with other rotator cuff problems.

Evaluating outcomes of endoscopic full-thickness plication for gastroesophageal reflux disease (GERD) with impedance monitoring.

PubMed

von Renteln, Daniel; Schmidt, Arthur; Riecken, Bettina; Caca, Karel

2010-05-01

Endoscopic full-thickness plication allows transmural suturing at the gastroesophageal junction to recreate the antireflux barrier. Multichannel intraluminal impedance monitoring (MII) can be used to detect nonacid or weakly acidic reflux, acidic swallows, and esophageal clearance time. This study used MII to evaluate the outcome of endoscopic full-thickness plication. In this study, 12 subsequent patients requiring maintenance proton pump inhibitor therapy underwent endoscopic full-thickness plication for treatment of gastroesophageal reflux disease. With patients off medication, MII was performed before and 6-months after endoscopic full-thickness plication. The total median number of reflux episodes was significantly reduced from 105 to 64 (p = 0.016). The median number of acid reflux episodes decreased from 73 to 43 (p = 0.016). Nonacid reflux episodes decreased from 23 to 21 (p = 0.306). The median bolus clearance time was 12 s before treatment and 11 s at 6 months (p = 0.798). The median acid exposure time was reduced from 6.8% to 3.4% (p = 0.008), and the DeMeester scores were reduced from 19 to 12 (p = 0.008). Endoscopic full-thickness plication significantly reduced total reflux episodes, acid reflux episodes, and total reflux exposure time. The DeMeester scores and total acid exposure time for the distal esophagus were significantly improved. No significant changes in nonacid reflux episodes and median bolus clearance time were encountered.

Traumatic Extra-capsular and Intra-capsular Floating Fat: Fat-fluid Levels of the Knee Revisited

PubMed Central

Davis, Derik L; Vachhani, Prasann

2015-01-01

Floating fat is a sign of acute bone injury at the knee following trauma. The goal of this article is to review the etiology, patterns, and mimickers of extra-capsular and intra-capsular floating fat, with the major emphasis on knee trauma in the acute setting. We will discuss the spectrum of multimodal imaging findings for rare presentations of extra-capsular floating fat, and contrast these with common and atypical forms of intra-capsular lipohemarthrosis, as an aid to the assessment of acute bone trauma at the knee. PMID:26713176

In patients with a tumour invading the phrenic nerve does prophylactic diaphragm plication improve postoperative lung function?

PubMed

Beattie, Gwyn W; Dunn, William G; Asif, Mohammed

2016-09-01

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'In patients with tumours involving the phrenic nerve, does prophylactic diaphragm plication improve lung function following tumour resection?' Using the reported search, 258 papers were found of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Three case reports and one case series represent 37 patients in the literature along with two relevant animal studies. Patients treated with prophylactic plication at the time of injury or sacrifice of the phrenic nerve had reduced radiological evidence of diaphragm paralysis, lower reported shortness of breath and reduced requirement for ventilatory support. In patients with prophylactic diaphragm plication and a concurrent pulmonary resection, the predicted postoperative lung function correlated closely with the postoperative measured FEV1, FVC and gas transfer. The postoperative measured FEV1 was reported as 86-98%, the FVC 82-89% and gas transfer 97% of the predicted values. Two animal models investigate the mechanics of respiration, spirometry and gas exchange following diaphragmatic plication. A randomized control study in four dogs measured a 50% reduction in tidal volume and respiratory rate, a 40% decrease in arterial PO2 and a 43% increase in arterial CO2 when the phrenic nerve was crushed in animals with a pneumonectomy but without prophylactic diaphragm plication. A further randomized control animal study with 28 dogs found that plicating the diaphragm after unilateral phrenic nerve transection resulted in a significant increase in tidal volume and lung compliance and a significant decrease in respiratory frequency and the work of breathing. Prophylactic diaphragm plication may preserve lung function, reduce the risk of

Early hemi-diaphragmatic plication through a video assisted mini-thoracotomy in postcardiotomy phrenic nerve paresis

PubMed Central

Tsakiridis, Kosmas; Visouli, Aikaterini N.; Machairiotis, Nikolaos; Christofis, Christos; Stylianaki, Aikaterini; Katsikogiannis, Nikolaos; Mpakas, Andreas; Courcoutsakis, Nicolaos; Zarogoulidis, Konstantinos

2012-01-01

New symptom onset of respiratory distress without other cause, and new hemi-diaphragmatic elevation on chest radiography postcardiotomy, are usually adequate for the diagnosis of phrenic nerve paresis. The symptom severity varies (asymptomatic state to severe respiratory failure) depending on the degree of the lesion (paresis vs. paralysis), the laterality (unilateral or bilateral), the age, and the co-morbidity (respiratory, cardiac disease, morbid obesity, etc). Surgical treatment (hemi-diaphragmatic plication) is indicated only in the presence of symptoms. The established surgical treatment is plication of the affected hemidiaphragm which is generally considered safe and effective. Several techniques and approaches are employed for diaphragmatic plication (thoracotomy, video-assisted thoracoscopic surgery, video-assisted mini-thoracotomy, laparoscopic surgery). The timing of surgery depends on the severity and the progression of symptoms. In infants and young children with postcardiotomy phrenic nerve paresis the clinical status is usually severe (failure to wean from mechanical ventilation), and early plication is indicated. Adults with postcardiotomy phrenic nerve paresis usually suffer from chronic dyspnoea, and, in the absence of respiratory distress, conservative treatment is recommended for 6 months -2 years, since improvement is often observed. Nevertheless, earlier surgical treatment may be indicated in non-resolving respiratory failure. We present early (25th day postcardiotomy) right hemi-diaphragm plication, through a video assisted mini-thoracotomy in a high risk patient with postcardiotomy phrenic nerve paresis and respiratory distress. Early surgery with minimal surgical trauma, short operative time, minimal blood loss and postoperative pain, led to fast rehabilitation and avoidance of prolonged hospitalization complications. The relevant literature is discussed. PMID:23304442

Modified 16-Dot plication technique for correction of penile curvature: prevention of knot-related complications.

PubMed

Salem, Emad A

2018-05-08

Penile curvature is a common urological disease. Tunical plication for correction of penile curvature has been much popularized being simpler, adjustable to avoid overcorrection, less bleeding, and less postoperative erectile dysfunction. This study aims to assess the results of modified 16-dot plication technique for correction of congenital and acquired penile curvature and avoidance of knot-associated complications. Eighteen patients underwent correction of their penile curvature using the modified 16-dot plication technique between January 2014 and October 2015. Patients' pre and postoperative data were analyzed. The mean age of patients is 44 years old. Of the patients 15 who were available for follow-up, 8 patients had congenital penile curvature (CPC) and 7 had Peyronie's disease (PD). The angle of deviation ranged from 30° to 90°. Erectile function (EF) was assessed preoperative by IIEF score and duplex ultrasound. Postoperative follow-up at 3 and 6 months revealed straight erect penis in all patients. Longer follow-up at 1 to 2 years, 2 patients complained from slight recurrence of curve (<20°) and 2 patients complained of worsening of their erectile function. Penile shortening was noted by 6 patients. None of our patients stated any knot complication or bothersome, nor do hematomas, numbness, or painful erections. The modified 16-dot plication technique for correction if penile curvature is a safe and effective method. This modification allowed the knots to be tucked in the plicate tunical tissue avoiding knot-associated complications. More investigation on a large scale of patients or multicenter studies is recommended.

Improvements in Vertebral-Column Angles and Psychological Metrics After Abdominoplasty With Rectus Plication.

PubMed

Temel, Metin; Türkmen, Arif; Berberoğlu, Ömer

2016-05-01

Substantial fluctuations in body weight can result in diastasis recti and weakening of the connections between the lateral abdominal muscles and the rectus sheath. The authors sought to determine the postural and psychological effects of abdominoplasty with vertical rectus plication. Forty women with substantial back and lumbar pain owing to abdominal lipodystrophy were evaluated in a prospective study. Preoperatively and 6 months postoperatively, patients underwent bidirectional radiography of the thoracic and lumbar regions. A visual analog scale (VAS), the Beck Depression Inventory (BDI), and the Nottingham Health Profile (NHP) were applied to assess physical, psychological, and quality-of-life changes following surgery. Significant improvements in posture, assessed in terms of lumbar lordosis, thoracic kyphosis, and the lumbosacral angle, were observed 6 months after abdominoplasty with rectus plication. Results of the VAS and BDI indicated significant improvements in pain and quality of life, respectively. Results of the NHP indicated significant postoperative improvements in fatigue, pain, and sleep. Abdominoplasty with rectus plication improves posture by tightening the thoracolumbar fascia. In selected patients, abdominoplasty can reduce back and lumbar pain, thereby improving quality of life. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

SIMULTANEOUS PRODUCTION OF TWO CAPSULAR POLYSACCHARIDES BY PNEUMOCOCCUS

PubMed Central

Austrian, Robert; Bernheimer, Harriet P.; Smith, Evelyn E. B.; Mills, George T.

1959-01-01

Study of the capsular genome of pneumococcus has shown that it controls a multiplicity of biochemical reactions essential to the synthesis of capsular polysaccharide. Mutation affecting any one of several biochemical reactions concerned with capsular synthesis may result in loss of capsulation without alteration of other biochemical functions similarly concerned. Mutations affecting the synthesis of uronic acids are an important cause of loss of capsulation and of virulence by strains of pneumococcus Type I and Type III. The capsular genome appears to have a specific location in the total genome of the cell, this locus being occupied by the capsular genome of whatever capsular type is expressed by the cell. Transformation of capsulated or of non-capsulated pneumococci to heterologous capsular type results probably from a genetic exchange followed by the development of a new biosynthetic pathway in the transformed cell. The new capsular genome is transferred to the transformed cell as a single particle of DNA. Binary capsulation results from the simultaneous presence within the pneumococcal cell of two capsular genomes, one mutated, the other normal. Interaction between the biochemical pathways controlled by the two capsular genomes leads to augmentation of the phenotypic expression of the product controlled by one and to partial suppression of the product determined by the other. Knowledge of the biochemical basis of binary capsulation can be used to indicate the presence of uronic acid in the capsular polysaccharide of a pneurnococcal type the composition of the capsule of which is unknown. PMID:13795197

Evidence for rare capsular switching in Streptococcus agalactiae.

PubMed

Martins, Elisabete Raquel; Melo-Cristino, José; Ramirez, Mário

2010-03-01

The polysaccharide capsule is a major antigenic factor in Streptococcus agalactiae (Lancefield group B streptococcus [GBS]). Previous observations suggest that exchange of capsular loci is likely to occur rather frequently in GBS, even though GBS is not known to be naturally transformable. We sought to identify and characterize putative capsular switching events, by means of a combination of phenotypic and genotypic methods, including pulsed-field gel electrophoretic profiling, multilocus sequence typing, and surface protein and pilus gene profiling. We show that capsular switching by horizontal gene transfer is not as frequent as previously suggested. Serotyping errors may be the main reason behind the overestimation of capsule switching, since phenotypic techniques are prone to errors of interpretation. The identified putative capsular transformants involved the acquisition of the entire capsular locus and were not restricted to the serotype-specific central genes, the previously suggested main mechanism underlying capsular switching. Our data, while questioning the frequency of capsular switching, provide clear evidence for in vivo capsular transformation in S. agalactiae, which may be of critical importance in planning future vaccination strategies against this pathogen.

Evidence for Rare Capsular Switching in Streptococcus agalactiae▿

PubMed Central

Martins, Elisabete Raquel; Melo-Cristino, José; Ramirez, Mário

2010-01-01

The polysaccharide capsule is a major antigenic factor in Streptococcus agalactiae (Lancefield group B streptococcus [GBS]). Previous observations suggest that exchange of capsular loci is likely to occur rather frequently in GBS, even though GBS is not known to be naturally transformable. We sought to identify and characterize putative capsular switching events, by means of a combination of phenotypic and genotypic methods, including pulsed-field gel electrophoretic profiling, multilocus sequence typing, and surface protein and pilus gene profiling. We show that capsular switching by horizontal gene transfer is not as frequent as previously suggested. Serotyping errors may be the main reason behind the overestimation of capsule switching, since phenotypic techniques are prone to errors of interpretation. The identified putative capsular transformants involved the acquisition of the entire capsular locus and were not restricted to the serotype-specific central genes, the previously suggested main mechanism underlying capsular switching. Our data, while questioning the frequency of capsular switching, provide clear evidence for in vivo capsular transformation in S. agalactiae, which may be of critical importance in planning future vaccination strategies against this pathogen. PMID:20023016

Structurally altered capsular polysaccharides produced by mutant bacteria

NASA Technical Reports Server (NTRS)

Petersen, Gene R. (Inventor); Kern, Roger G. (Inventor); Richards, Gil F. (Inventor)

1995-01-01

Structurally altered capsular polysaccharides are produced by mutant bacteria. These polysaccharides are isolated by selecting a wild type bacterial strain and a phage producing degradative enzymes that have substrate specificity for the capsular polysaccharides produced by the wild type bacteria. Phage-resistant mutants producing capsular polysaccharides are selected and the structurally altered capsular polysaccharide is isolated therefrom.

Wide abdominal rectus plication abdominoplasty for the treatment of chronic intractable low back pain.

PubMed

Oneal, Robert M; Mulka, Joseph P; Shapiro, Paul; Hing, David; Cavaliere, Christi

2011-01-01

A previous report demonstrated that the wide abdominal rectus plication abdominoplasty is an effective treatment modality in select patients with low back pain who failed to achieve relief with conservative therapy. The authors studied eight female patients who presented with chronic low back pain and marked lower abdominal wall muscular laxity. All had failed to respond to conservative management for their chronic back pain. They all underwent wide abdominal rectus plication abdominoplasty. Patient selection and details of the procedure are discussed. There were no significant complications in this series, and all the patients had prompt and prolonged alleviation of their back pain. Length of follow-up ranged from 2 to 11 years. Changes in the biomechanics of the lower abdominal musculature as a result of the wide abdominal rectus plication abdominoplasty are discussed in the context of increasing spinal stability, leading to an alleviation of chronic low back pain. An argument is made that this abdominoplasty procedure produces a spine-stabilizing effect by (1) tightening the muscles of the lateral abdominal complex and thus increasing intraabdominal pressure and (2) increasing the efficiency of these muscles so that their effectiveness as spine stabilizers is increased. Even though this is a small series, the fact that all the patients sustained long-term alleviation of their preoperative chronic back pain suggests that the wide abdominal rectus plication abdominoplasty should be considered as an option for patients with weak lower abdominal muscles and intractable low back pain who have failed conservative management.

Adjustable small-incision selective tenotomy and plication for correction of incomitant vertical strabismus and torsion

PubMed Central

Chang, Melinda Y.; Pineles, Stacy L.; Velez, Federico G.

2015-01-01

PURPOSE To evaluate the effectiveness of adjustable small-incision selective tenotomy and plication of vertical rectus muscles in correcting vertical strabismus incomitant in horizontal gaze positions and cyclotorsion. METHODS The medical records of all patients who underwent adjustable small-incision selective tenotomy or plication of a vertical rectus muscle for correction of horizontally incomitant vertical strabismus or cyclotorsion by a single surgeon at a single eye institute from July 2013 to September 2014 were retrospectively reviewed. Selective tenotomy and plication were performed on either the nasal or temporal side of vertical rectus muscles, based on the direction of cyclotorsion and incomitance of vertical strabismus. RESULTS Of 9 patients identified, 8 (89%) had successful correction of horizontally incomitant vertical strabismus, with postoperative vertical alignment within 4Δ of orthotropia in primary position, lateral gazes, and downgaze. Of the 8 patients with preoperative cyclotorsion, 4 (50%) were successfully corrected, with <5° of cyclotorsion postoperatively. Of the 4 patients in whom cyclotorsion did not improve, 3 had undergone prior strabismus surgery, and 2 had restrictive strabismus. Eight of the 9 patients (89%) reported postoperative resolution of diplopia. CONCLUSIONS Adjustable small-incision selective tenotomy and plication effectively treat horizontally incomitant vertical strabismus. These surgeries may be less effective for correcting cyclotorsion in patients with restriction or prior strabismus surgery. Advantages are that they may be performed in an adjustable manner and, in some cases, under topical anesthesia. PMID:26486021

Splenic arteriogastric fistula from plication of a gastric ulcer. Therapeutic embolization.

PubMed

Morse, S S; Siskind, B N; Horowitz, N R; Strauss, E B

1987-08-01

Massive upper gastrointestinal hemorrhage occurred in a 66-year-old man 18 days after suture plication of a giant gastric ulcer. Arteriography revealed a splenic arteriogastric fistula. Therapeutic embolization with tissue adhesive (bucrylate) successfully controlled hemorrhage after failure of attempted particulate embolization.

Chronic neck pain: making the connection between capsular ligament laxity and cervical instability.

PubMed

Steilen, Danielle; Hauser, Ross; Woldin, Barbara; Sawyer, Sarah

2014-01-01

The use of conventional modalities for chronic neck pain remains debatable, primarily because most treatments have had limited success. We conducted a review of the literature published up to December 2013 on the diagnostic and treatment modalities of disorders related to chronic neck pain and concluded that, despite providing temporary relief of symptoms, these treatments do not address the specific problems of healing and are not likely to offer long-term cures. The objectives of this narrative review are to provide an overview of chronic neck pain as it relates to cervical instability, to describe the anatomical features of the cervical spine and the impact of capsular ligament laxity, to discuss the disorders causing chronic neck pain and their current treatments, and lastly, to present prolotherapy as a viable treatment option that heals injured ligaments, restores stability to the spine, and resolves chronic neck pain. The capsular ligaments are the main stabilizing structures of the facet joints in the cervical spine and have been implicated as a major source of chronic neck pain. Chronic neck pain often reflects a state of instability in the cervical spine and is a symptom common to a number of conditions described herein, including disc herniation, cervical spondylosis, whiplash injury and whiplash associated disorder, postconcussion syndrome, vertebrobasilar insufficiency, and Barré-Liéou syndrome. When the capsular ligaments are injured, they become elongated and exhibit laxity, which causes excessive movement of the cervical vertebrae. In the upper cervical spine (C0-C2), this can cause a number of other symptoms including, but not limited to, nerve irritation and vertebrobasilar insufficiency with associated vertigo, tinnitus, dizziness, facial pain, arm pain, and migraine headaches. In the lower cervical spine (C3-C7), this can cause muscle spasms, crepitation, and/or paresthesia in addition to chronic neck pain. In either case, the presence of

Causes of hepatic capsular retraction: a pictorial essay.

PubMed

Tan, Gary Xia Vern; Miranda, Rhian; Sutherland, Tom

2016-12-01

Hepatic capsular retraction refers to the loss of the normal convex hepatic contour, with the formation of an area of flattening or concavity. This can result from myriad causes, including intrinsic hepatic conditions such as cirrhosis, biliary obstruction, benign tumours, malignancy and infections, as well as extrahepatic causes such as trauma. This article aims to provide familiarity with this wide spectrum of conditions, including mimics of hepatic capsular retraction, by highlighting the anatomic, pathologic and imaging features that help distinguish these entities from one another. • Hepatic capsular retraction can occur due to various intrinsic or extrinsic hepatic causes. • Hepatic capsular retraction is observed in both benign and malignant conditions. • Recognising associated imaging features can help elicit causes of hepatic capsular retraction.

Tricuspid annuloplasty with the MC3 ring and septal plication technique.

PubMed

Isomura, Tadashi; Hirota, Masanori; Hoshino, Joji; Fukada, Yasuhisa; Kondo, Taichi; Takahashi, Yu

2015-01-01

Functional tricuspid regurgitation is caused by annular dilation mainly in the posterior annulus. However, ring annuloplasty does not always prevent the recurrence of tricuspid regurgitation due to dilation of the septal annulus. We developed a septal plication technique with a 3-dimensional MC3 ring. Between 2006 and 2011, 76 patients (male/female 30/46; mean age 68 ± 11 years) with functional tricuspid regurgitation received tricuspid ring annuloplasty. After placement of the annular sutures, the 3 commissural ring portions were fixed on the equivalent commissures to plicate the anterior and posterior annulus. The end of the septal ring portion was fixed at the optimal annular position to obtain minimal tricuspid regurgitation. All patients were followed-up for a mean of 47 ± 18 months; the longest duration was 79 months. Although there was no operative death, one patient died of sepsis during hospitalization (hospital mortality 1.3%). After implantation of the MC3 ring (mean size 31.0 ± 3.3 mm), additional edge-to-edge sutures were required for minor leakage in 5 (7%) patients. The degree of tricuspid regurgitation was significantly reduced at discharge (0.5 ± 0.6) and midterm (0.6 ± 0.6) compared to 2.5 ± 0.7 before the operation (p < 0.0001). The surgical durability of the MC3 ring was satisfactory at early and midterm follow-up, suggesting that correct plication of the septal annulus is effective for tricuspid ring annuloplasty with a 3-dimensional MC3 ring. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Outcomes of Hip Arthroscopy in Competitive Athletes.

PubMed

Perets, Itay; Hartigan, David E; Chaharbakhshi, Edwin O; Ashberg, Lyall; Ortiz-Declet, Victor; Domb, Benjamin G

2017-08-01

To evaluate the minimum 2-year postoperative clinical outcomes and the rate of return to sports in athletes who underwent capsular plication for the treatment of ligamentous laxity and/or borderline dysplasia during hip arthroscopy for the treatment of femoroacetabular impingement and labral pathology. Since 2008, data were prospectively collected on patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears. Inclusion criteria were as follows: athlete at the high school, collegiate, or professional levels preoperatively, underwent capsular plication, and preoperatively recorded patient-reported outcome scores including modified Harris hip score (mHHS), nonarthritic athletic hip score (NAHS), hip outcome score-sports-specific subscale (HOS-SSS), and visual analog scale (VAS). Exclusion criteria were as follows: <16 years old, preoperative Tönnis grade >1, and previous hip conditions. Sports activity and competitive levels were collected at a minimum of 2 years postoperatively. Fifty-one hips (49 patients) met the inclusion criteria, and 41 hips (39 patients) had minimum 2-year follow-up (80.4% follow-up). Mean mHHS increased from 67.1 preoperatively to 83.5 (P < .0001). Mean NAHS increased from 66.8 to 88.8 (P < .0001). Mean HOS-SSS improved from 46.8 to 80.1 (P < .0001). Mean VAS decreased from 5.1 to 1.7 (P < .0001). Thirty-five (85.4%) hip arthroscopies allowed the patients to return to sports at follow-up. Thirty-four (82.9%) hip arthroscopies allowed the patients to maintain their competitive physical abilities at follow-up. Patient-reported outcomes and VAS in athletes significantly improved at a minimum of 2 years after capsular plication as a part of hip arthroscopy addressing varying pathologies. In addition, most patients returned to sports at similar or higher competitive levels. These results suggest that capsular plication is a favorable treatment option in athletes with ligamentous laxity and

Effects of Ultrasound-guided intra-articular ketorolac injection with capsular distension.

PubMed

Ahn, Jae Ki; Kim, Jongwoo; Lee, Sang Jae; Park, Yongbum; Bae, Byung; Lee, Woo

2015-01-01

Frozen shoulder is a painful condition with gradual onset and loss of range of motion in the glenohumeral joint. To investigate the efficacy of ultrasound(US)-guided intra-articular (IA) ketorolac injection with capsular distension compared with steroid injection alone in patients with frozen shoulder by assessing pain relief, functional improvements, and range of motion at 1,3 and 6 months after the last injections. Between January 2009 and December 2012, 121 patient were treated with US-guided IA steroid injection or IA ketorolac injection with capsular distension for frozen shoulder. Patients (n= 57) of US-guided IA steroid injection group were administered with a mixture of 0.5% lidocaine (4 ml) plus triamcinolone (40 mg/ml; 1 ml) and patients (n= 64) of US-guided IA ketorolac injection with capsular distension group were administered by using 0.5% lidocaine (19 mL) plus ketorolac (30 mg/ml; 1 mL) for capsular distension. Outcome measurement was assessed by Shoulder Pain and Disability Index (SPADI), Verbal Numeric pain Scale (VNS) and passive range of motion (ROM) before injections and at 1, 3 and 6 months after the last injections. We regarded the outcomes as a success if patients obtained significant pain relief (as measured by > 50% improvement in the VNS score and 20 point improvement in the SPASI) at 1, 3 and 6 months after the last injections. SPADI, VNS and passive ROM were improved 1, 3 and 6 months after the last injections in both groups. The statistical differences were not observed in SPADI, VNS between groups (p< 0.05). Successful treatment rate were not significantly different between the groups as well as in 1, 3 and 6 month outcomes. However, greater improvement was found in a matter of range of motion in patients receiving IA ketorolac injection with capsular distension than participants receiving US-guided IA steroid injection alone. Significant differences in improvement at 3 and 6 months were observed for shoulder passive abduction and

Chronic Neck Pain: Making the Connection Between Capsular Ligament Laxity and Cervical Instability

PubMed Central

Steilen, Danielle; Hauser, Ross; Woldin, Barbara; Sawyer, Sarah

2014-01-01

The use of conventional modalities for chronic neck pain remains debatable, primarily because most treatments have had limited success. We conducted a review of the literature published up to December 2013 on the diagnostic and treatment modalities of disorders related to chronic neck pain and concluded that, despite providing temporary relief of symptoms, these treatments do not address the specific problems of healing and are not likely to offer long-term cures. The objectives of this narrative review are to provide an overview of chronic neck pain as it relates to cervical instability, to describe the anatomical features of the cervical spine and the impact of capsular ligament laxity, to discuss the disorders causing chronic neck pain and their current treatments, and lastly, to present prolotherapy as a viable treatment option that heals injured ligaments, restores stability to the spine, and resolves chronic neck pain. The capsular ligaments are the main stabilizing structures of the facet joints in the cervical spine and have been implicated as a major source of chronic neck pain. Chronic neck pain often reflects a state of instability in the cervical spine and is a symptom common to a number of conditions described herein, including disc herniation, cervical spondylosis, whiplash injury and whiplash associated disorder, postconcussion syndrome, vertebrobasilar insufficiency, and Barré-Liéou syndrome. When the capsular ligaments are injured, they become elongated and exhibit laxity, which causes excessive movement of the cervical vertebrae. In the upper cervical spine (C0-C2), this can cause a number of other symptoms including, but not limited to, nerve irritation and vertebrobasilar insufficiency with associated vertigo, tinnitus, dizziness, facial pain, arm pain, and migraine headaches. In the lower cervical spine (C3-C7), this can cause muscle spasms, crepitation, and/or paresthesia in addition to chronic neck pain. In either case, the presence of

Arthroscopic R-LCL plication for symptomatic minor instability of the lateral elbow (SMILE).

PubMed

Arrigoni, Paolo; Cucchi, Davide; D'Ambrosi, Riccardo; Menon, Alessandra; Aliprandi, Alberto; Randelli, Pietro

2017-07-01

Minor instability has been proposed as a possible aetiology of lateral elbow pain. This study presents the results of the arthroscopic plication of the radial component of the lateral collateral ligament (R-LCL) to reduce minor instability of the lateral elbow. Twenty-seven patients with recalcitrant lateral epicondylitis who had failed conservative therapy and who had no previous trauma or overt instability, were included. R-LCL plication was performed in the presence of at least one sign of lateral ligamentous patholaxity and one intra-articular abnormal finding. Single-assessment numeric evaluation (SANE), Oxford Elbow Score (OES), quickDASH (Disabilities of the Arm, Shoulder, Hand), patient satisfaction and post-operative range of motion were evaluated. SANE improved from a median of 30 [2-40] points pre-operatively to 90 [80-100] at final follow-up (p < 0.0001), and 96.3% patients obtained good or excellent subjective results. Post-operative median quickDASH was 9.1 [0-25] points and OES 42 [34-48]. Median post-operative flexion was 145°, and extension was 0°. Post-operative flexion was restrained in seven patients and extension in eight patients; 59% of patients reached full ROM at final follow-up. R-LCL plication produces subjective satisfaction and positive clinical results in patients presenting with a symptomatic minor instability of the lateral elbow (SMILE) at 2-year median follow-up. A slight limitation in range of motion is a possible undesired consequence of this intervention. Retrospective case series, Level IV.

[Etiopathogenesis and treatment of breast capsular contracture].

PubMed

Pereira Leite, Luis; Correia Sá, Inês; Marques, Marisa

2013-01-01

Capsular contracture is a chronic and the most frequent complication of augmentation mammoplasty with breast implants and the main cause of patient's and surgeon's dissatisfaction. The mammary capsule consists of a fibrous tissue that surrounds the implant that may contract, changing the shape and consistency of the breast. In its advanced stage is accompanied by pronounced deformity, hardness and pain, being indicated for surgical treatment. All the articles indexed on PubMed through the search 'capsular contracture' (2000 - January 2012) were reviewed and were included the articles of greater interest in terms of etiology, prophylaxis and treatment. Articles referred in relevant publications were also examined. Everything indicates that its etiology is multifactorial; the etiopathology of breast capsular contracture continues being subject of multiple pre-clinical investigations. There are many studies performed in order to prevent the onset of capsular contracture but, although promising results, little is set for its application on clinical practice. The capsulectomy/capsulotomy continues being the gold standard treatment although the future may undergo non invasive techniques, at least in mild stages of disease. Although the surgical techniques and the quality of breast implants have been improving drastically in recent years, capsular contracture remains a real complication with great incidence and that continues affecting thousands of women all over the world.

A versatile breast reduction technique: Conical plicated central U shaped (COPCUs) mammaplasty

PubMed Central

Copcu, Eray

2009-01-01

Background There have been numerous studies on reduction mammaplasty and its modifications in the literature. The multitude of modifications of reduction mammaplasty indicates that the ideal technique has yet to be found. There are four reasons for seeking the ideal technique. One reason is to preserve functional features of the breast: breastfeeding and arousal. Other reasons are to achieve the real geometric and aesthetic shape of the breast with the least scar and are to minimize complications of prior surgical techniques without causing an additional complication. Last reason is the limitation of the techniques described before. To these aims, we developed a new versatile reduction mammaplasty technique, which we called conical plicated central U shaped (COPCUs) mammaplasty. Methods We performed central plication to achieve a juvenile look in the superior pole of the breast and to prevent postoperative pseudoptosis and used central U shaped flap to achieve maximum NAC safety and to preserve lactation and nipple sensation. The central U flap was 6 cm in width and the superior conical plication was performed with 2/0 PDS. Preoperative and postoperative standard measures of the breast including the superior pole fullness were compared. Results Forty six patients were operated with the above mentioned technique. All of the patients were satisfied with functional and aesthetic results and none of them had major complications. There were no changes in the nipple innervation. Six patients becoming pregnant after surgery did not experience any problems with lactation. None of the patients required scar revision. Conclusion Our technique is a versatile, safe, reliable technique which creates the least scar, avoids previously described disadvantages, provides maximum preservation of functions, can be employed in all breasts regardless of their sizes. PMID:19575809

Video assisted thoracoscopic plication of the left hemidiaphragm in symptomatic eventration in adulthood

PubMed Central

Visouli, Aikaterini N.; Mpakas, Andreas; Machairiotis, Nikolaos; Stylianaki, Aikaterini; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Courcoutsakis, Nicolaos; Zarogoulidis, Konstantinos

2012-01-01

Diaphragmatic eventration is a rare congenital developmental defect of the muscular portion of the diaphragm, which appears attenuated and membranous, maintaining its normal attachments and its anatomical continuity. It has been attributed to abnormal myoblast migration to the septum transversum and the pleuroperitoneal membrane. Eventration can be unilateral or bilateral, partial or complete. It is more common in males, and involves more often the left hemidiaphragm. Eventration results in diaphragmatic elevation (cephalad displacement). Most adults are asymptomatic and the diagnosis is incidentally made by chest radiography. The commonest symptom in the adults is dyspnoea, while orthopnoea, mild hypoxemia, tachypnoea, respiratory alkalosis, palpitations, and non specific gastrointestinal symptoms may be present. Surgery is indicated only in the presence of symptoms. The established surgical treatment is diaphragmatic plication. Various techniques and approaches have been employed. We present a simple surgical technique of a 3-port video assisted thoracoscopic plication of the left hemidiaphragm in the adult. PMID:23304437

The Effect of Capsulotomy and Capsular Repair on Hip Distraction: A Cadaveric Investigation.

PubMed

Khair, M Michael; Grzybowski, Jeffrey S; Kuhns, Benjamin D; Wuerz, Thomas H; Shewman, Elizabeth; Nho, Shane J

2017-03-01

To quantify how increasing interportal capsulotomy size affects the force required to distract the hip and to biomechanically compare simple side-to-side suture repair to acetabular-based suture anchors as capsular repair techniques. Twelve fresh-frozen cadaveric hip specimens were dissected to the capsuloligamentous complex of the hip joint and fixed in a material testing system, such that a pure axial distraction of the iliofemoral ligament could be achieved. After each hip in was tested an intact state, sequential distraction was tested with 2, 4, 6, and 8 cm capsulotomies. Specimens were assigned randomly to be repaired with either 4 side-to-side suture repair (n = 6) or 2 double-loaded all-suture anchors (n = 6). The distraction force as well as the relative distraction force percentage normalized to the intact capsule were compared between suture repair and suture anchor repair groups. Increasing the size of the capsulotomy resulted in less force required to distract the hip to 6 mm. The force decreased as the capsulotomy was extended with statistical significance in distraction force seen between the intact state and the 4 cm (P = .003), 6 cm (P < .001), and 8 cm (P ≤ .001) capsulotomy but not for the intact state compared to the 2 cm capsulotomy (P = .28). Statistical significance in relative distraction force was seen for each of the capsulotomy conditions (P < .001 for all conditions compared with the intact state). The side-to-side suture repair construct (104.3% of intact force) required greater force to distraction to 6 mm compared with the suture anchor repair (87.1% of intact force) (P = .008). An interportal capsulotomy significantly affected the force required to distract the hip in a cadaveric model, with the larger the size of capsulotomy resulting in less force required to distract the hip. When we performed an interportal capsulotomy, the iliofemoral ligament strength was altered significantly but capsular repair with either

Acute and chronic menisco-capsular separation in the young athlete: diagnosis, treatment and results in thirty seven consecutive patients.

PubMed

Hirtler, Lena; Unger, Julia; Weninger, Patrick

2015-05-01

Menisco-capsular separation (MCS) is an avulsion type of injury of the medial and/or lateral meniscus and is defined as detachment of the meniscus from its capsular attachment. The aims of this study were to show the results of arthroscopic all-inside menisco-capsular repair in a large number of consecutive patients with acute or chronic MCS, emphasise the advantages of this safe treatment option and stress the superiority of the treatment on the basis of thorough physical examination of the knee joint over magnetic resonance imaging (MRI) diagnosis in MCS. We evaluated data of patients treated between October 2011 and July 2012. Inclusion and exclusion criteria were defined and demographic variables evaluated. All patients were examined physically and with MRI. Knee arthroscopy was performed and the MCS repaired through all-inside menisco-capsular repair. Postoperative treatment was standardised. Patients were followed up for at least 24 weeks. Thirty-seven athletes (12 women, 25 men) were evaluated. Only in six patients was MCS detected on MRI. In all patients, MCS was diagnosed via physical examination. Arthroscopic treatment led to significant (p < 0.01) improvement. There were no complications reported postoperatively. Isolated MCS is not as rare a meniscus pathology after trauma in young athletes as could be expected after reviewing current literature. It is occult on MRI scans in most of the cases and should therefor be taken into consideration in patients with acute or chronic tenderness at the level of the joint line and negative MRI scans. Thorough physical examination has higher diagnostic value than MRI alone, as shown in this study. Treatment of MCS using all-inside nonabsorbable sutures, as described in this study using Ultra FasT Fix®, is effective if performed by an experienced surgeon.

Is the Capsular Bag Perimeter Round or Elliptical?

PubMed Central

Amigó, Alfredo; Bonaque-González, Sergio

2016-01-01

Purpose: To report findings that could suggest an elliptical shape of the capsular bag. Methods: Five eyes of three patients with axial length greater than 24 mm underwent phacoemulsification cataract surgery with plate-haptic multifocal toric intraocular lens (IOL) implantation oriented in the vertical meridian. Results: In all cases, correct orientation of the IOLs was verified 30 minutes after surgery. After 24 hours, all eyes demonstrated unwanted rotation of the IOLs ranging from 15 to 45 degrees. The IOLs remained stable in the new position in all cases until adhesion of the capsular bag took place. Conclusion: These observations could suggest that the perimeter of the capsular bag has an elliptical shape. Therefore, the IOL tends to become fixated in a meridian of the capsular bag that best fits the diagonal diameter of the IOL. PMID:27413495

Plication procedures—excisional and incisional corporoplasty and imbrication for Peyronie’s disease

PubMed Central

Chen, Roger; McCraw, Casey

2016-01-01

Plication procedures for the correction of Peyronie’s disease (PD) curvature are management options for PD patients. There are basically three types of procedures: excisional corporoplasty, incisional corporoplasty, and plication-only. This review is a compilation of English literature, peer-reviewed, published articles addressing these types of operations for Peyronie’s curvature correction, not congenital curvature. According to the urology literature, this surgical type was initially used for correction of curvature associated with hypospadias repair or congenital penile curvature. The procedures also, for the most part, historically became an alternative for plaque excision and graft repair, because of the difficulty with such repairs and the often-resultant erectile dysfunction (ED). A brief section traces some of the origins of these various repairs, followed by a brief section on the selection criteria for these types of surgery for the patient with PD penile curvature. We also review the significant articles in which the three types were presented with modifications. Finally, several articles that compare the various surgical repairs are summarized in the order that they appear in the literature. These types of surgery have become a mainstay for the surgical correction of penile curvature due to PD. PMID:27298779

The Outcome of Multiple Slit on Plaque with Plication Technique for the Treatment of Peyronie's Disease

PubMed Central

Shin, Su Hwan; Jeong, Hyeong Guk; Park, Jong Jin; Chae, Ji Yun; Kim, Jong Wook; Oh, Mi Mi; Park, Hong Seok; Kim, Je Jong

2016-01-01

Purpose To evaluate the postoperative outcome of the multiple slit on plaque plication technique for the treatment of Peyronie's disease. Materials and Methods We retrospectively evaluated 22 patients who underwent plaque incision with penile plication for the surgical treatment of Peyronie's disease, who had failed medical treatment between 2009 and 2014. Patients were grouped by preoperative degree of penile curvature into Group I: mild (n=5, 22.7%), Group II: moderate (n=11, 50.0%), and Group III: severe (n=6, 27.3%). After a thorough review of the medical records, we evaluated (a) the correction of the curvature; (b) sexual function; and (c) any penile shortening or other complications. Results The mean postoperative follow-up period was 39 months. Complete correction of the curvature was attained in 21 patients (95.5%). As an inevitable complication, minimal penile shortening (<1.5 cm) was reported by 14 patients (82.4%) but did not adversely affect sexual intercourse (0%), and all patients found the extent of penile shortening to be acceptable. Nineteen patients had good erectile function (International Index of Erectile Function >21). The most frequent complication was subcutaneous penile edema in three patients (13.6%), which was resolved within about 3 months following surgery. Conclusions As a modified technique, multiple slit on plaque with plication is a simple, minimally-invasive and effective technique for correcting penile curvature regardless of curvature severity. The degree of penile curvature does not significantly predict the amount of penile length loss. PMID:27169125

Posterior capsular rent: Prevention and management.

PubMed

Chakrabarti, Arup; Nazm, Nazneen

2017-12-01

This review article deals with a potentially sight threatening complication - rupture of the posterior capsule - during cataract surgery. Cataract surgery is the most commonly performed surgical procedure in ophthalmology and despite tremendous technical and technological advancements, posterior capsular rent (PCR) still occurs. PCR occurs both in the hands of experienced senior surgeons and the neophyte surgeons, although with a higher frequency in the latter group. Additionally, certain types of cataracts are prone to this development. If managed properly in a timely manner the eventual outcome may be no different from that of an uncomplicated case. However, improper management may lead to serious complications with a higher incidence of permanent visual disability. The article covers the management of posterior capsular rent from two perspectives: 1. Identifying patients at higher risk and measures to manage such patients by surgical discipline, and 2. Intraoperative management of posterior capsular rent and various case scenarios to minimize long-term complications.This review is written for experienced and not-so-experienced eye surgeons alike to understand and manage PCR.

Hepatic capsular retraction: spectrum of diagnosis at MRI

PubMed Central

Mons, Antoine; Braidy, Chadi; Montoriol, Pierre François; Garcier, Jean-Marc; Vilgrain, Valérie

2014-01-01

Hepatic capsular retraction is an imaging feature that deserves the attention of the radiologist. Hepatic capsular retraction is associated with a number of hepatic lesions, benign or malignant, treated or untreated. The purpose of this pictorial review is to discuss the most common benign and malignant hepatic lesions associated with this feature with an emphasis on magnetic resonance imaging (MRI). PMID:25535571

Short-term evaluation of arthroscopic management of tennis elbow; including resection of radio-capitellar capsular complex.

PubMed

Babaqi, AbdulRahman A; Kotb, Mohammed M; Said, Hatem G; AbdelHamid, Mohamed M; ElKady, Hesham A; ElAssal, Maher A

2014-06-01

There has been controversy regarding the pathogenesis and treatment of lateral epicondylitis. Different surgical techniques for the treatment of lateral epicondylitis prescribed. The purpose of this study was to evaluate the short-term outcomes of arthroscopic management including resection of the radio-capitellar capsular complex, using different validated scores. In this study, arthroscopic resection of a capsular fringe complex was done beside debridement of the undersurface of Extensor Carpi Radialis Brevis (ECRB). Thirty-one patients with recalcitrant lateral epicondylitis for a minimum of 6 months had surgery. In all patients, a collar-like band of radio-capitellar capsular complex was found to impinge on the radial head and subluxate into the radio-capitellar joint with manipulation under direct vision. Outcomes were assessed using Mayo Elbow Performance Index (MEPI), the Patient-Rated Tennis Elbow Evaluation (PRTEE), and the Disability of the Arm, Shoulder, and Hand (DASH), beside visual analog scale (VAS) for pain and satisfaction criteria. After arthroscopic surgery, overall satisfaction was extremely positive, over the 31 patients, 93.5% of the patients are satisfied. The mean score for pain improved from 8.64 to 1.48 points. The total PRTEE improved from 55.53 to 10.39 points. The mean MEPI score was improved from 61.82 to 94.10 points. DASH score also improved from 24.46 to 4.81 points. All improvements are statistically significant (P < 0.05). Arthroscopic release of ECRB in patients with chronic lateral epicondylitis is a reproducible method with a marked improvement in function within a short period, with special consideration for resection of radio-capitellar capsular complex.

[Capsular retensioning in anterior unidirectional glenohumeral instability].

PubMed

Benítez Pozos, Leonel; Martínez Molina, Oscar; Castañeda Landa, Ezequiel

2007-01-01

To present the experience of the Orthopedics Service PEMEX South Central Hospital in the management of anterior unidirectional shoulder instability with an arthroscopic technique consisting of capsular retensioning either combined with other anatomical repair procedures or alone. Thirty-one patients with anterior unidirectional shoulder instability operated-on between January 1999 and December 2005 were included. Fourteen patients underwent capsular retensioning and radiofrequency, and in 17 patients, capsular retensioning was combined with suture anchors. Patients with a history of relapsing glenohumeral dislocations and subluxations, with anterior instability with or without associated Bankart lesions were selected; all of them were young. The results were assessed considering basically the occurrence of instability during the postoperative follow-up. No cases of recurring instability occurred. Two cases had neuroma and one experienced irritation of the suture site. Six patients had residual limitation of combined lateral rotation and abduction movements, of a mean of 10 degrees compared with the healthy contralateral side. The most frequent incident was the leak of solutions to the soft tissues. Capsular retensioning, whether combined or not with other anatomical repair techniques, has proven to result in a highly satisfactory rate of glenohumeral stabilization in cases of anterior unidirectional instabilities. The arthroscopic approach offers the well-known advantages of causing less damage to the soft tissues, and a shorter time to starting rehabilitation therapy and exercises.

Noninvasive Shock Wave Treatment for Capsular Contractures After Breast Augmentation: A Rabbit Study.

PubMed

Chen, Po Chou; Kuo, Shyh Ming; Jao, Jo Chi; Yang, Shiou Wen; Hsu, Ching Wen; Wu, Yu Chiuan

2016-06-01

Capsular contracture is the most common complication of breast augmentation. Although numerous procedures are intended to prevent capsular contracture, their efficacy does not satisfy surgeons or patients. In the present study, we used shock waves to develop innovative protocols to treat capsular contracture in rabbits. We used shock waves to treat capsular contracture in a rabbit model. Six clinical parameters were evaluated to determine the treatment efficacy of shock waves on the pathological histology of capsular contracture. Dual-flip-angle T1-mapping magnetic resonance imaging was used to confirm the pathological findings. Among the parameters, myxoid change, vascular proliferation, and lymphoplasma cell infiltration around the capsule increased more after treatment than they did in a control group. Capsular thickness, inner thinner collagen layer, and capsule wall collagen deposition decreased after shock wave treatment; only the inner thinner collagen layer and capsule wall collagen deposition changed significantly. The MRI findings for both scar thickness and water content were consistent with pathological biology findings. This was the first pilot study and trial to treat capsular contractures using shock waves. We found that shock waves can cause changes in the structure or the composition of capsular contracture. We conclude that the treatment could decrease water content, loosen structure, decrease collagen deposition, and might alleviate scar formation from capsular contracture. We believe that the treatment could be a viable remedy for capsular contractures. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Excessive radiofrequency application: effects on capsular tissue in an animal model.

PubMed

Wolf, Brian R; Heiner, Anneliese D; Albright, John P; Nepola, James V

2005-01-01

Capsular attenuation has been seen after thermal capsulorrhaphy surgery. The purpose of this study was to evaluate the mechanical, histologic, and morphologic effects on capsular tissue after cumulative applications of radiofrequency energy. Ovine patellofemoral capsular tissue was treated with 1, 2, 4, or 8 applications of bipolar radiofrequency energy and then analyzed. No acute capsular ablation or destruction was seen grossly, even in the 8-application group. No definitive visual clues that excessive radiofrequency energy had been applied were seen. There was significant shrinkage and loss of tensile stiffness for all thermal application groups. Given the small sample sizes, post-application failure load, percent relaxation, and stiffness were not observed to be significantly different among the groups. Cumulative applications produced minimal further tissue shrinkage but were accompanied by larger, though not statistically significant, mechanical property losses and increased depth of tissue penetration. These findings suggest that there is no benefit to repeated applications of radiofrequency energy to capsular tissue.

Phrenic Nerve Reconstruction and Bilateral Diaphragm Plication After Lobectomy.

PubMed

Shinohara, Shuichi; Yamada, Tetsu; Ueda, Mitsuhiro; Ishinagi, Hiroyoshi; Matsuoka, Takahisa; Nagai, Shinjiro; Matsuoka, Katsunari; Miyamoto, Yoshihiro

2017-07-01

A 49-year-old man with left phrenic nerve paralysis caused by mediastinal tumor resection 28 years earlier was found to have a nodule in the right upper lobe. The right phrenic nerve was severed during right upper lobectomy but was reconstructed along with bilateral plication of the diaphragm. The patient was weaned from the ventilator during the daytime on postoperative day 13 and was discharged home on postoperative day 48. Three months postoperatively, chest fluoroscopic imaging showed recovery of movement of the right diaphragm. Nerve conduction studies showed improvement of function of the reconstructed right phrenic nerve. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Neisseria meningitidis serogroup A capsular polysaccharide acetyltransferase, methods and compositions

DOEpatents

Stephens, David S [Stone Mountain, GA; Gudlavalleti, Seshu K [Kensington, MD; Tzeng, Yih-Ling [Atlanta, GA; Datta, Anup K [San Diego, CA; Carlson, Russell W [Athens, GA

2011-02-08

Provided are methods for recombinant production of an O-acetyltransferase and methods for acetylating capsular polysaccharides, especially those of a Serogroup A Neisseria meningitidis using the recombinant O-acetyltransferase, and immunogenic compositions comprising the acetylated capsular polysaccharide.

[Posterior capsule opacification, capsular bag distension syndrome, and anterior capsular phimosis: A retrospective cohort study].

PubMed

González-Martín-Moro, J; González-López, J J; Gómez-Sanz, F; Zarallo-Gallardo, J; Cobo-Soriano, R

2015-02-01

To determine the incidence and the risk factors involved in the development of the three main postoperative capsular complications: posterior capsule opacification (PCO), capsular bag distension syndrome (CBDS), and anterior capsular phimosis syndrome (ACP). A retrospective cohort study was conducted on 801 patients submitted to cataract surgery in the ophthalmology unit of Hospital del Henares (Madrid) from March 2, 2009 to February 28, 2010. Computerized clinical charts were reviewed during July 2012. PCO was studied using the Kaplan-Meier method (log rank test). A total of 167 patients developed PCO. No association could be demonstrated between PCO and age, sex, diabetes mellitus, phaco technique, IOL model, tamsulosin intake, glaucoma, and age-related macular degeneration. Three patients developed CBDS, all of them have received and Akreos Adapt AO(®) (Bausch & Lomb). Two of them were young men who had received surgery for posterior subcapsular cataracts. Three patients developed ACP, 2 of whom had received a MicroSlim(®) IOL (PhysIOL). No association was found between PCO and any of the studied variables. Male gender, young age, subcapsular cataract and large non-angulated lens such as Akreos Adapt AO(®) could be associated with CBDS. ACP could be more frequent when microincision IOLs (like MicroSlim(®)) are implanted. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Ligamentous and capsular injuries to the metacarpophalangeal joints of the hand.

PubMed

Shah, Smiresh Suresh; Techy, Fernando; Mejia, Alfonso; Gonzalez, Mark H

2012-01-01

The mechanism of dorsal dislocation of the metacarpophalangeal (MCP) joint is with forced hyperextension of the joint and the main structure injured is the volar plate. A simple dislocation can be reduced by closed means whereas a complex dislocation cannot. Care must be taken not to put traction across the joint, which may cause the volar plate to slip into the joint, converting a simple dislocation into a complex dislocation. Volar dislocations are rare and mainly treated nonoperatively. Sagittal band injuries can be treated with extension splinting or surgical management with direct repair or reconstruction. A locked MCP joint can usually be treated with closed manipulation. This article discusses these injuries and management options.

Inorganic Phosphate Limitation Modulates Capsular Polysaccharide Composition in Mycobacteria.

PubMed

van de Weerd, Robert; Boot, Maikel; Maaskant, Janneke; Sparrius, Marion; Verboom, Theo; van Leeuwen, Lisanne M; Burggraaf, Maroeska J; Paauw, Nanne J; Dainese, Elisa; Manganelli, Riccardo; Bitter, Wilbert; Appelmelk, Ben J; Geurtsen, Jeroen

2016-05-27

Mycobacterium tuberculosis is protected by an unusual and highly impermeable cell envelope that is critically important for the successful colonization of the host. The outermost surface of this cell envelope is formed by capsular polysaccharides that play an important role in modulating the initial interactions once the bacillus enters the body. Although the bioenzymatic steps involved in the production of the capsular polysaccharides are emerging, information regarding the ability of the bacterium to modulate the composition of the capsule is still unknown. Here, we study the mechanisms involved in regulation of mycobacterial capsule biosynthesis using a high throughput screen for gene products involved in capsular α-glucan production. Utilizing this approach we identified a group of mutants that all carried mutations in the ATP-binding cassette phosphate transport locus pst These mutants collectively exhibited a strong overproduction of capsular polysaccharides, including α-glucan and arabinomannan, suggestive of a role for inorganic phosphate (Pi) metabolism in modulating capsular polysaccharide production. These findings were corroborated by the observation that growth under low Pi conditions as well as chemical activation of the stringent response induces capsule production in a number of mycobacterial species. This induction is, in part, dependent on σ factor E. Finally, we show that Mycobacterium marinum, a model organism for M. tuberculosis, encounters Pi stress during infection, which shows the relevance of our findings in vivo. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

Preoperative and postoperative size and movements of the lens capsular bag: ultrasound biomicroscopy analysis.

PubMed

Modesti, Marina; Pasqualitto, Giacomo; Appolloni, Rossella; Pecorella, Irene; Sourdille, Philippe

2011-10-01

To evaluate capsular bag size and accommodative movement before and after cataract surgery using ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT). Ophthalmology Unit, Fabia Mater Clinic, Rome, Italy. Cohort study. Eyes having cataract surgery and monofocal intraocular lens (IOL) implantation were studied using UBM. The following parameters were measured preoperatively and 1, 2, and 12 months postoperatively: anterior chamber depth (ACD) (also by AS-OCT), capsular bag thickness, capsular bag diameter, ciliary ring diameter, sulcus-to-sulcus (STS) diameter, ciliary process-capsular bag distance, ciliary apex-capsular bag plane, and IOL tilting. The preoperative and postoperative capsular bag volumes were calculated at 12 months. The results were compared with the changes during accommodation. The study comprised 24 eyes. With the exception of the ciliary apex-capsular bag plane, which appeared to be unmodified postoperatively, all measured parameters showed significant variation after IOL implantation. Only the ACD did not change significantly during accommodation. After cataract surgery, the capsular bag stretched horizontally and with reduced vertical diameter as a result of adaptation to the implanted IOL. The capsular bag-IOL complex filled all available space, compressing the zonular fibers and almost abolishing the space between the ciliary apex and the capsular bag. There was anterior chamber deepening and a decrease in the ciliary ring diameter and STS diameter. In the absence of zonular fiber tension, the shape of the ciliary processes may be modified. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Imaging late capsular block syndrome: ultrasound biomicroscopy versus Scheimpflug camera.

PubMed

Kucukevcilioglu, Murat; Hurmeric, Volkan; Erdurman, Fazıl Cuneyt; Ceylan, Osman Melih

2011-11-01

We describe 2 patients with late capsular block syndrome whose anterior chamber morphology was evaluated with ultrasound biomicroscopy and Scheimpflug imaging before and after neodymium:YAG laser capsulotomy. Pretreatment ultrasound biomicroscopy examination showed significant capsular bag distension in both patients. Scheimpflug imaging failed to capture the posterior capsule displaced far behind the intraocular lens. Automatic anterior chamber depth measurements were incorrect with Scheimpflug imaging in 1 patient. Ultrasound biomicroscopy seems to be superior to Scheimpflug imaging in eyes with extremely distended capsular bags. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

The Relationship of Bacterial Biofilms and Capsular Contracture in Breast Implants

PubMed Central

Ajdic, Dragana; Zoghbi, Yasmina; Gerth, David; Panthaki, Zubin J.; Thaller, Seth

2016-01-01

Capsular contracture is a common sequelae of implant-based breast augmentation. Despite its prevalence, the etiology of capsular contracture remains controversial. Numerous studies have identified microbial biofilms on various implantable materials, including breast implants. Furthermore, biofilms have been implicated in subclinical infections associated with other surgical implants. In this review, we discuss microbial biofilms as a potential etiology of capsular contracture. The review also outlines the key diagnostic modalities available to identify the possible infectious agents found in biofilm, as well as available preventative and treatment measures. PMID:26843099

Ceramic debris in hip prosthesis: correlation between synovial fluid and joint capsule.

PubMed

De Pasquale, Dalila; Stea, Susanna; Beraudi, Alina; Montesi, Monica; Squarzoni, Stefano; Toni, Aldo

2013-05-01

Detection of ceramic particles in synovial fluids allows early diagnosis of ceramic damage, but there is no evidence of a relationship between ceramic debris in the articular space and in the joint capsule. The aim of the present study is to verify if the particles isolated in the synovial fluid are comparable with those stored in the capsular tissue. Twenty-one patients were enrolled. Both synovial fluid and capsular samples were collected during revision surgery and ceramic particles were isolated and analyzed by scanning electron microscopy and energy-dispersive X-ray microanalysis. It resulted a significant correlation between the samples couples (18 out of 21). This study confirms that the synovial fluid analysis can give a clear definition of the presence of particles in the joint capsule. Copyright © 2013 Elsevier Inc. All rights reserved.

An unanswered question in pediatric urology: the post pubertal persistence of prepubertal congenital penile curvature correction by tunical plication

PubMed Central

Ozkuvanci, Ünsal; Ziylan, Orhan; Dönmez, M. Irfan; Yucel, Omer Baris; Oktar, Tayfun; Ander, Haluk; Nane, Ismet

2017-01-01

ABSTRACT Objective: The aim of this study is to analyze post pubertal results of pre pubertal tunica albuginea plication with non-absorbable sutures in the correction of CPC. Materials and Methods: The files of patients who underwent tunica albuginea plication without incision (dorsal/lateral) were retrospectively reviewed. Patients younger than 13 years of age at the time of operation and older than 14 years of age in November 2015 were included. Patients with a penile curvature of less than 30 degrees & more than 45 degrees and penile/urethral anomalies were excluded. All of the patients underwent surgery followed by circumcision. Results: The mean age of patients at the time of the operation was 9.7 years (range, 6-13 years). The mean degree of ventral penile curvature measured during the operation was 39 degrees while it was 41 degrees in the lateral curvatures. All of the patients were curvature-free at the end of the operation. At the time of the follow-up examination, the mean age was 16.7 years (range, 14-25 years). Six patients had a straight (0-10 degrees) penis during erection and seven patients had recurrent penile curvatures ranging from 30 to 50 degrees. Conclusion: Pre pubertal tunica albuginea plication of congenital penile curvature (30-45 degrees) with non-absorbable sutures performed without incision is a minimal invasive method especially when performed during circumcision. However, recurrence might be observed in half of the patients after puberty. PMID:28727375

An unanswered question in pediatric urology: the post pubertal persistence of prepubertal congenital penile curvature correction by tunical plication.

PubMed

Ozkuvanci, Ünsal; Ziylan, Orhan; Dönmez, M Irfan; Yucel, Omer Baris; Oktar, Tayfun; Ander, Haluk; Nane, Ismet

2017-01-01

The aim of this study is to analyze post pubertal results of pre pubertal tunica albuginea plication with non-absorbable sutures in the correction of CPC. The files of patients who underwent tunica albuginea plication without incision (dorsal/lateral) were retrospectively reviewed. Patients younger than 13 years of age at the time of operation and older than 14 years of age in November 2015 were included. Patients with a penile curvature of less than 30 degrees & more than 45 degrees and penile/urethral anomalies were excluded. All of the patients underwent surgery followed by circumcision. The mean age of patients at the time of the operation was 9.7 years (range, 6-13 years). The mean degree of ventral penile curvature measured during the operation was 39 degrees while it was 41 degrees in the lateral curvatures. All of the patients were curvature-free at the end of the operation. At the time of the follow-up examination, the mean age was 16.7 years (range, 14-25 years). Six patients had a straight (0-10 degrees) penis during erection and seven patients had recurrent penile curvatures ranging from 30 to 50 degrees. Pre pubertal tunica albuginea plication of congenital penile curvature (30-45 degrees) with non-absorbable sutures performed without incision is a minimal invasive method especially when performed during circumcision. However, recurrence might be observed in half of the patients after puberty. Copyright® by the International Brazilian Journal of Urology.

Phospholipids Trigger Cryptococcus neoformans Capsular Enlargement during Interactions with Amoebae and Macrophages

PubMed Central

Chrisman, Cara J.; Albuquerque, Patricia; Guimaraes, Allan J.; Nieves, Edward; Casadevall, Arturo

2011-01-01

A remarkable aspect of the interaction of Cryptococcus neoformans with mammalian hosts is a consistent increase in capsule volume. Given that many aspects of the interaction of C. neoformans with macrophages are also observed with amoebae, we hypothesized that the capsule enlargement phenomenon also had a protozoan parallel. Incubation of C. neoformans with Acanthamoeba castellanii resulted in C. neoformans capsular enlargement. The phenomenon required contact between fungal and protozoan cells but did not require amoeba viability. Analysis of amoebae extracts showed that the likely stimuli for capsule enlargement were protozoan polar lipids. Extracts from macrophages and mammalian serum also triggered cryptococcal capsular enlargement. C. neoformans capsule enlargement required expression of fungal phospholipase B, but not phospholipase C. Purified phospholipids, in particular, phosphatidylcholine, and derived molecules triggered capsular enlargement with the subsequent formation of giant cells. These results implicate phospholipids as a trigger for both C. neoformans capsule enlargement in vivo and exopolysaccharide production. The observation that the incubation of C. neoformans with phospholipids led to the formation of giant cells provides the means to generate these enigmatic cells in vitro. Protozoan- or mammalian-derived polar lipids could represent a danger signal for C. neoformans that triggers capsular enlargement as a non-specific defense mechanism against potential predatory cells. Hence, phospholipids are the first host-derived molecules identified to trigger capsular enlargement. The parallels apparent in the capsular response of C. neoformans to both amoebae and macrophages provide additional support for the notion that certain aspects of cryptococcal virulence emerged as a consequence of environmental interactions with other microorganisms such as protists. PMID:21637814

Klebsiella capsular type versus site of isolation.

PubMed Central

Riser, E; Noone, P

1981-01-01

More than 1750 clinical isolates of klebsiella were collected over a period of six years from two different hospitals and capsular typed by the fluorescent antibody technique. A correlation was made between type and site of isolation. Many types were found to be associated more frequently with one site, which suggested a predilection of some capsular types for certain sites of infection. The site may also be a factor contributing to the virulence of a particular type. A greater antibiotic resistance was often noted in types isolated from their predominant sites; however, antibiograms were not consistent for a type from a given site. The combination of site specificity, resistance, and another 'virulence factor' may all be involved in the determination of a pathogenic strain. PMID:7251896

Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation

PubMed Central

Tan, Xuhua; Lin, Haotian; Lin, Zhuoling; Chen, Jingjing; Tang, Xiangchen; Luo, Lixia; Chen, Weirong; Liu, Yizhi

2016-01-01

Abstract The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement. This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China. Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I—capsule with mild opacification but no invasion into the capsule opening; Type II—capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III—capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed. The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I—120 eyes (38.1%); Type II—157 eyes (49.8%); Type III—38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = −0.572, P < 0.001), but no significant correlation with intraoperative posterior capsulorhexis size (R = −0.16, P = 0.122) was observed. The ACOA significantly decreased from Type I to Type II to Type III, the PCOA increased in size from Type I to Type

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

PubMed Central

Ferreira, Daniela M.; Gordon, Stephen B.; Rylance, Jamie

2017-01-01

ABSTRACT Immunity to pneumococcal infections is impaired in older people, and current vaccines are poorly protective against pneumococcal disease in this population. Naturally acquired immunity to pneumococcal capsular polysaccharides develops during childhood and is robust in young adults but deteriorates with advanced age. In particular, antibody levels and function are reduced in older people. Pneumococcal vaccines are recommended for people >65 years old. However, the benefits of polysaccharide and protein-conjugated vaccines in this population are small, because of both serotype replacement and incomplete protection against vaccine serotype pneumococcal disease. In this review, we overview the immune mechanisms by which naturally acquired and vaccine-induced pneumococcal capsular polysaccharide immunity declines with age, including altered colonization dynamics, reduced opsonic activity of antibodies (particularly IgM), and impaired mucosal immunity. PMID:28424198

Revision surgery for failed thermal capsulorrhaphy.

PubMed

Park, Hyung Bin; Yokota, Atsushi; Gill, Harpreet S; El Rassi, George; McFarland, Edward G

2005-09-01

With the failure of thermal capsulorrhaphy for shoulder instability, there have been concerns with capsular thinning and capsular necrosis affecting revision surgery. To report the findings at revision surgery for failed thermal capsulorrhaphy and to evaluate the technical effects on subsequent revision capsular plication. Case series; Level of evidence, 4. Fourteen patients underwent arthroscopic evaluation and open reconstruction for a failed thermal capsulorrhaphy. The cause of the failure, the quality of the capsule, and the ability to suture the capsule were recorded. The patients were evaluated at follow-up for failure, which was defined as recurrent subluxations or dislocations. The origin of the instability was traumatic (n = 6) or atraumatic (n = 8). At revision surgery in the traumatic group, 4 patients sustained failure of the Bankart repair with capsular laxity, and the others experienced capsular laxity alone. In the atraumatic group, all patients experienced capsular laxity as the cause of failure. Of the 14 patients, the capsule quality was judged to be thin in 5 patients and ablated in 1 patient. A glenoid-based capsular shift could be accomplished in all 14 patients. At follow-up (mean, 35.4 months; range, 22 to 48 months), 1 patient underwent revision surgery and 1 patient had a subluxation, resulting in a failure rate of 14%. Recurrent capsular laxity after failed thermal capsular shrinkage is common and frequently associated with capsular thinning. In most instances, the capsule quality does not appear to technically affect the revision procedure.

Factors determining the level and changes in intra-articular pressure in the knee joint of the dog.

PubMed Central

Nade, S; Newbold, P J

1983-01-01

Intra-articular pressure levels were determined for joint positions throughout the normal physiological range of movement of dogs' knee joints. Change in joint position resulted in change in intra-articular pressure. It was demonstrated that intra-articular pressure is highest with the joint in the fully flexed position. Minimum pressure was recorded at a position between 80 degrees and 120 degrees. Minimum pressures were usually subatmospheric. The rate of change of joint position affected intra-articular pressure. The relationship of intra-articular pressure and joint position before and after full flexion demonstrated a hysteresis effect; the pressures were lower than for the same joint position before flexion. Maintenance of the joint in the fully flexed position for increasing periods of time between repeated movement cycles resulted in a similar reduction, of constant magnitude, in pressure between joint positions before and after each period of flexion. However, there was also a progressive decrease in pressure for all joint angles over the total number of movement cycles. There is a contribution to intra-articular pressure of joint capsular compliance and fluid movement into and out of the joint (both of which are time-dependent). The recording of intra-articular pressure in conscious, upright dogs revealed similar pressure levels to those measured in anaesthetized supine dogs. The major determinants of intra-articular pressure in normal dog knee joints include joint size, synovial fluid volume, position of joint, peri-articular tissue and joint anatomy, membrane permeability, capsular compliance, and movement of fluid into and out of the joint. Images Fig. 1 PMID:6875957

Endoluminal full-thickness plication and radiofrequency treatments for GERD: an outcomes comparison.

PubMed

Jeansonne, Louis O; White, Brent C; Nguyen, Vien; Jafri, Syed M; Swafford, Vickie; Katchooi, Mina; Khaitan, Leena; Davis, S Scott; Smith, C Daniel; Sedghi, Shahriar; Lin, Edward

2009-01-01

Endoluminal therapies have emerged as adjuncts for the treatment of gastroesophageal reflux disease (GERD) in select patients. To compare the effectiveness of endoscopic full-thickness plication and endoscopic radiofrequency treatments for patients with GERD. A total of 126 patients who underwent either endoscopic full-thickness plication (FTP) of the gastric cardia or endoscopic radiofrequency (RF) treatment of the esophagogastric junction during a 4-year period were included (68 underwent RF and 58 underwent FTP). Follow-up data was obtained for 51% of patients (mean follow-up, 6 months). Comparison of medication use, symptom scores, and pH values at baseline and follow-up. In the RF group, patients with moderate to severe heartburn decreased from 55% to 22% (P < .01), and proton pump inhibitor (PPI) use decreased from 84% to 50% (P = .01). Decreases were also seen for dysphagia, voice symptoms, and cough. Percentage of time the pH was less than 4 was unchanged. In the FTP group, patients with moderate to severe heartburn decreased from 53% to 43% (P = .3), and PPI use decreased from 95% to 43% (P = .01). Percentage of time the pH was less than 4 decreased from 10.0% to 6.1% (P = .05). Decreases were also seen for regurgitation, voice symptoms, and dysphagia. There was no change in scores for chest pain or asthma in either group. For patients with GERD, RF and FTP both resulted in a decrease in both PPI use and in scores for voice symptoms and dysphagia. In addition, RF resulted in decreased heartburn and cough, while FTP resulted in the most dramatic reduction in regurgitation. Our experience indicates that both procedures are effective, providing symptomatic relief and reduction in PPI use. For patients whose chief complaint is regurgitation, FTP may be the preferred procedure.

Arthroscopic Management of Scaphoid-Trapezium-Trapezoid Joint Arthritis.

PubMed

Pegoli, Loris; Pozzi, Alessandro

2017-11-01

Scaphoid-trapezium-trapezoid (STT) joint arthritis is a common condition consisting of pain on the radial side of the wrist and base of the thumb, swelling, and tenderness over the STT joint. Common symptoms are loss of grip strength and thumb function. There are several treatments, from symptomatic conservative treatment to surgical solutions, such as arthrodesis, arthroplasties, and prosthesis implant. The role of arthroscopy has grown and is probably the best treatment of this condition. Advantages of arthroscopic management of STT arthritis are faster recovery, better view of the joint during surgery, and possibility of creating less damage to the capsular and ligamentous structures. Copyright © 2017 Elsevier Inc. All rights reserved.

Preservation of capsular material of streptococcal cells by specific lectins determined by immunoelectron microscopy.

PubMed

Molinari, A; Orefici, G; Donelli, G; Von Hunolstein, C; Paradisi, S; Arancia, G

1988-09-01

We describe the use of lectins as specific stabilizing agents for the polysaccharide capsular components of two Gram-positive bacteria, Streptococcus agalactiae and Streptococcus bovis. Treatment of bacterial suspensions with wheatgerm agglutinin and concanavalin A allowed better morphological preservation as well as immunoelectron microscopic localization of a capsular component (lipoteichoic acid) by employing specific antibodies and the protein A-gold technique. Data obtained indicate that lectins are useful agents in preserving highly water-soluble capsular components during the electron microscopy procedures for both unembedded and embedded samples.

The capsular ligaments provide more hip rotational restraint than the acetabular labrum and the ligamentum teres

PubMed Central

van Arkel, R. J.; Amis, A. A.; Cobb, J. P.; Jeffers, J. R. T.

2015-01-01

In this in vitro study of the hip joint we examined which soft tissues act as primary and secondary passive rotational restraints when the hip joint is functionally loaded. A total of nine cadaveric left hips were mounted in a testing rig that allowed the application of forces, torques and rotations in all six degrees of freedom. The hip was rotated throughout a complete range of movement (ROM) and the contributions of the iliofemoral (medial and lateral arms), pubofemoral and ischiofemoral ligaments and the ligamentum teres to rotational restraint was determined by resecting a ligament and measuring the reduced torque required to achieve the same angular position as before resection. The contribution from the acetabular labrum was also measured. Each of the capsular ligaments acted as the primary hip rotation restraint somewhere within the complete ROM, and the ligamentum teres acted as a secondary restraint in high flexion, adduction and external rotation. The iliofemoral lateral arm and the ischiofemoral ligaments were primary restraints in two-thirds of the positions tested. Appreciation of the importance of these structures in preventing excessive hip rotation and subsequent impingement/instability may be relevant for surgeons undertaking both hip joint preserving surgery and hip arthroplasty. Cite this article: Bone Joint J 2015; 97-B:484–91. PMID:25820886

The colonisation of the glenohumeral joint by Propionibacterium acnes is not associated with frozen shoulder but is more likely to occur after an injection into the joint.

PubMed

Booker, S J; Boyd, M; Gallacher, S; Evans, J P; Auckland, C; Kitson, J; Thomas, W; Smith, C D

2017-08-01

. acnes (OR 165, 95% CI 13.51 to 2015.24, p < 0.01). These results show a statistically significant association between subcutaneous skin P. acnes culture and P. acnes capsular culture, especially when the patient has undergone a previous injection. The results refute the hypothesis that P. acnes causes frozen shoulder. Cite this article: Bone Joint J 2017;99-B:1067-72. ©2017 The British Editorial Society of Bone & Joint Surgery.

The mechanism of joint capsule thermal modification in an in-vitro sheep model.

PubMed

Hayashi, K; Peters, D M; Thabit, G; Hecht, P; Vanderby, R; Fanton, G S; Markel, M D

2000-01-01

The purpose of this study was to understand the mechanism responsible for joint capsule shrinkage after nonablative laser application in an in-vitro sheep model. Femoropatellar joint capsular tissue specimens harvested from 20 adult sheep were treated with one of three power settings of a holmium:yttrium-aluminum-garnet laser or served as a control. Laser treatment significantly shortened the tissue and decreased tissue stiffness in all three laser groups, whereas failure strength was not altered significantly by laser treatment. Transmission electron microscopic examination showed swollen collagen fibrils and loss of membrane integrity of fibroblasts. A thermometric study revealed nonablative laser energy caused tissue temperature to rise in the range of 64 degrees C to 100 degrees C. Electrophoresis after trypsin digestion of the tissue revealed significant loss of distinct alpha bands of Type I collagen in laser treated samples, whereas alpha bands were present in laser treated tissue without trypsin digestion. The results of this study support the concept that the primary mechanism responsible for the effect of nonablative laser energy is thermal denaturation of collagen in joint capsular tissue associated with unwinding of the triple helical structure of the collagen molecule.

Current status of meningococcal group B vaccine candidates: capsular or noncapsular?

PubMed

Diaz Romero, J; Outschoorn, I M

1994-10-01

Meningococcal meningitis is a severe, life-threatening infection for which no adequate vaccine exists. Current vaccines, based on the group-specific capsular polysaccharides, provide short-term protection in adults against serogroups A and C but are ineffective in infants and do not induce protection against group B strains, the predominant cause of infection in western countries, because the purified serogroup B polysaccharide fails to elicit human bactericidal antibodies. Because of the poor immunogenicity of group B capsular polysaccharide, different noncapsular antigens have been considered for inclusion in a vaccine against this serogroup: outer membrane proteins, lipooligosaccharides, iron-regulated proteins, Lip, pili, CtrA, and the immunoglobulin A proteases. Alternatively, attempts to increase the immunogenicity of the capsular polysaccharide have been made by using noncovalent complexes with outer membrane proteins, chemical modifications, and structural analogs. Here, we review the strategies employed for the development of a vaccine for Neisseria meningitidis serogroup B; the difficulties associated with the different approaches are discussed.

Current status of meningococcal group B vaccine candidates: capsular or noncapsular?

PubMed Central

Diaz Romero, J; Outschoorn, I M

1994-01-01

Meningococcal meningitis is a severe, life-threatening infection for which no adequate vaccine exists. Current vaccines, based on the group-specific capsular polysaccharides, provide short-term protection in adults against serogroups A and C but are ineffective in infants and do not induce protection against group B strains, the predominant cause of infection in western countries, because the purified serogroup B polysaccharide fails to elicit human bactericidal antibodies. Because of the poor immunogenicity of group B capsular polysaccharide, different noncapsular antigens have been considered for inclusion in a vaccine against this serogroup: outer membrane proteins, lipooligosaccharides, iron-regulated proteins, Lip, pili, CtrA, and the immunoglobulin A proteases. Alternatively, attempts to increase the immunogenicity of the capsular polysaccharide have been made by using noncovalent complexes with outer membrane proteins, chemical modifications, and structural analogs. Here, we review the strategies employed for the development of a vaccine for Neisseria meningitidis serogroup B; the difficulties associated with the different approaches are discussed. PMID:7834605

Hip capsular thickness correlates with range of motion limitations in femoroacetabular impingement.

PubMed

Zhang, Kailai; de Sa, Darren; Yu, Hang; Choudur, Hema Nalini; Simunovic, Nicole; Ayeni, Olufemi Rolland

2018-03-24

Femoroacetabular impingement (FAI) is a clinical entity of the hip causing derangements in range of motion, pain, gait, and function. Computer-assisted modeling and clinical studies suggest that patients with FAI have increased capsular thickness compared to those without.A retrospective chart review was performed to assess relationships between capsular thickness, hip range of motion, and demographic factors in patients with FAI. Local Research Ethics Board approval was obtained to extract electronic medical records for 188 patients at a single institution who had undergone hip arthroscopy. Procedures were performed from 2009 to 2017 by a single, fellowship-trained, board-certified sports medicine orthopaedic surgeon. Inclusion criteria were preoperative hip range of motion testing, positive clinical impingement testing, and magnetic resonance imaging (MRI) of the affected hip. Patient demographics, hip range of motion, and time to surgery were recorded. MRIs were reviewed by a board-certified musculoskeletal radiologist blinded to clinical data. Maximum thickness of the anterior hip capsule was measured in axial, axial oblique, and sagittal oblique sequences. Anterior capsular thickness was also measured at the level of the femoral head-neck junction in axial sequences (axial midline). Axial midline capsular thickness was negatively correlated with hip flexion (r = - 0.196, p = 0.0042) and internal rotation (r = - 0.143, p = 0.0278). Significant differences were seen between genders in axial midline thickness (5.3 ± 1.4 mm males/4.8 ± 1.3 mm females, p = 0.0079), flexion (113° ± 18° males/120° ± 17° females, p = 0.0029), and internal rotation (23° ± 13° males/29° ± 12° females, p = 0.0155). Significant differences also existed between side affected in flexion (116° ± 17° right/119° ± 17° left, p = 0.0396) and internal rotation (26° ± 12° right/29° ± 13° left

Hip Arthroscopy Update

PubMed Central

Buly, Robert L.

2005-01-01

The management of hip injuries in the athlete has evolved significantly in the past few years with theadvancement of arthroscopic techniques. The application of minimally invasive surgical techniques has facilitated relatively rapid returns to sporting activity in recreational and elite athletes alike. Recent advancements in both hip arthroscopy and magnetic resonance imaging have elucidated several sources of intraarticular pathology that result in chronic and disabling hip symptoms. Many of these conditions were previously unrecognized and thus, left untreated. Current indications for hip arthroscopy include management of labral tears, osteoplasty for femoroacetabular impingement, thermal capsulorrhaphy and capsular plication for subtle rotational instability and capsular laxity, lateral impact injury and chondral lesions, osteochondritis dissecans, ligamentum teres injuries, internal and external snapping hip, removal of loose bodies, synovial biopsy, subtotal synovectomy, synovial chondromatosis, infection, and certain cases of mild to moderate osteoarthritis with associated mechanical symptoms. In addition, patients with long-standing, unresolved hip joint pain and positive physical findings may benefit from arthroscopic evaluation. Patients with reproducible symptoms and physical findings that reveal limited functioning, and who have failed an adequate trial of conservative treatment will have the greatest likelihood of success after surgical intervention. Strict attention to thorough diagnostic examination, detailed imaging, and adherence to safe and reproducible surgical techniques, as described in this review, are essential for the success of this procedure. PMID:18751808

Arthroscopic Hemitrapeziectomy for First Carpometacarpal Arthritis: Results at 7-year Follow-up

PubMed Central

Leak, Robert S.; Culp, Randall W.; Osterman, A. Lee

2008-01-01

The purpose of this study was to determine the outcome of arthroscopic hemitrapeziectomy combined with thermal capsular plication and temporary K-wire fixation in patients with painful thumb basal joint due to either osteoarthritis or posttraumatic arthritis. There were 18 thumbs that were evaluated in this retrospective study of arthroscopic hemitrapeziectomy of the distal trapezium in addition to a pancapsular thermal shrinkage at an average of 7.6-year follow-up. No patient has required further surgery. A subjective improvement in pain, pinch activities, strength, and range of motion (ROM) was noted in all patients, and no patient had further surgery on their thumb. On exam, no patient had a first carpal–metacarpal grind or laxity. Total ROM of the thumb axis decreased by 20%, but all patients could oppose to the fifth finger. Grip strength remained unchanged, key pinch improved from 8 to 11 lbs, and tip pinch improved from 4 to 5 lbs. Radiographs showed a metacarpal subsidence of 1.8 mm (0–4 mm). Four complications were noted: two cases of dorsal radial nerve neuritis, one rupture of the flexor pollicis longus, and one prolonged hematoma. Results demonstrate that arthroscopic hemitrapeziectomy and capsular shrinkage for first carpometacarpal arthritis is an effective technique that provides high patient satisfaction, a functional pain-free thumb, and a reliable rate of return to activity. PMID:18820976

Forces on intraocular lens haptics induced by capsular fibrosis. An experimental study.

PubMed

Guthoff, R; Abramo, F; Draeger, J; Chumbley, L C; Lang, G K; Neumann, W

1990-01-01

Electronic dynamometry measurements, performed upon intraocular lens (IOL) haptics of prototype one-piece three-loop silicone lenses, accurately defined the relationships between elastic force and haptic displacement. Lens implantations in the capsular bag of dogs (loop span equal to capsular bag diameter, loops underformed immediately after the operation) were evaluated macrophotographically 5-8 months postoperatively. The highly constant elastic property of silicon rubber permitted quantitative correlation of subsequent in vivo haptic displacement with the resultant force vectors responsible for tissue contraction. The lens optics were well centered in 17 (85%) and slightly offcenter in 3 (15%) of 20 implanted eyes. Of the 60 supporting loops, 28 could be visualized sufficiently well to permit reliable haptic measurement. Of these 28, 20 (71%) were clearly displaced, ranging from 0.45 mm away from to 1.4 mm towards the lens' optic center. These extremes represented resultant vector forces of 0.20 and 1.23 mN respectively. Quantitative vector analysis permits better understanding of IOL-capsular interactions.

Anterior capsular rupture following blunt ocular injury

PubMed Central

Gremida, Anas; Kassem, Iris; Traish, Aisha

2011-01-01

Summary A 10-year-old boy suffered a large, oblique anterior capsular tear following blunt injury to his right eye. The boy was followed daily for hyphema resolution and progressive traumatic cataract formation. After the hyphema had resolved, the lens was removed using an anterior approach and an intraocular lens was placed with excellent visual outcome. PMID:23362402

Capsular Management in Hip Arthroscopy: An Anatomic, Biomechanical, and Technical Review

PubMed Central

Kuhns, Benjamin D.; Weber, Alexander E.; Levy, David M.; Bedi, Asheesh; Mather, Richard C.; Salata, Michael J.; Nho, Shane J.

2016-01-01

Hip arthroscopy has become an increasingly utilized surgical technique for the treatment of the young, active patients with hip pain. The clinical outcomes of hip arthroscopy in this patient population have been largely successful; however, there is increasing interest in the contribution of hip capsule in postoperative clinical and functional outcomes. The structure and function of the normal hip capsule will be reviewed. Capsular contributions to hip stability will be discussed in the setting of hip arthroscopy with an emphasis on diagnosis-based considerations. Lastly, clinical outcomes following hip arthroscopy will be discussed as they relate to capsular management. PMID:26973840

Posterior capsular fibrosis in professional baseball pitchers: case series of MR arthrographic findings in six patients with glenohumeral internal rotational deficit.

PubMed

Tehranzadeh, Arash D; Fronek, Jan; Resnick, Donald

2007-01-01

In the high-performance athlete, acquired thickening of the posterior joint capsule is a proposed etiology for glenohumeral internal rotational deficit (GIRD). The purpose of this study was to present our MR arthrographic imaging observations of posterior capsular thickening in professional baseball players who present with reduced throwing velocity related to pain and clinical findings of internal rotational deficit of the glenohumeral joint. Our observations of MR imaging features in patients with clinical and arthroscopic manifestations of GIRD lesions include articular surface partial thickness tears of the supraspinatus and infraspinatus tendons, superoposterior subluxation of the humeral head and SLAP tears of the labrum. Although no empiric standard currently exists for the axial dimension thickness of the shoulder capsule, we have observed a thickened appearance of the posterior band of the inferior glenohumeral ligament in these patients.

Medial capsular interpositional arthroplasty for severe hallux rigidus.

PubMed

Hahn, Michael Patrick; Gerhardt, Nels; Thordarson, David B

2009-06-01

Multiple surgical options have been described for severe hallux rigidus. One option is capsular interpositional arthroplasty. We report our initial results with a technique using the thicker medial capsule as our interpositional material instead of the dorsal capsule and extensor hallucis brevis (EHB). Twenty-two patients with grade IV hallux rigidus underwent minimal proximal phalanx resection (modified Keller) with preservation of the flexor hallucis brevis (FHB) insertion and medial capsular interpositional arthroplasty. Postoperative AOFAS hallux MTP-IP scores (mean 77.8), and SF-36 scores (mean 68.7 on physical function, 79.5 role limitations) demonstrated clinical improvement compared to historical controls. Alignment and stability were well maintained (mean preoperative HV angle of 11.8 degrees, mean postoperative HV angle of 13.0 degrees). Dorsiflexion/plantarflexion arc of motion showed sustained improvement (mean 38.4 degrees preoperative, mean 62.3 degrees postoperative). These results are comparable to other forms of interpositional arthroplasty and arthrodesis for end stage arthritis of the hallux MTPJ.

Capsulorhexis ovaling and capsular bag stretch after rigid and foldable intraocular lens implantation: experimental study in pediatric human eyes.

PubMed

Pandey, Suresh K; Werner, Liliana; Wilson, M Edward; Izak, Andrea M; Apple, David J

2004-10-01

To compare the amount of capsulorhexis ovaling and capsular bag stretch produced by various intraocular lenses (IOLs) implanted in pediatric human eyes obtained post-mortem. David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, Salt Lake City, Utah, USA. In this nonrandomized comparative study, 16 pediatric human eyes obtained postmortem were divided into 2 groups: Eight eyes were obtained from children younger than 2 years (Group A), and 8 eyes were obtained from children older than 2 years (Group B). All eyes were prepared according to the Miyake-Apple posterior video technique. Six types of rigid and foldable posterior chamber IOLs manufactured from poly(methyl methacrylate) (single-piece), silicone (plate and loop haptics), and hydrophobic acrylic (single-piece and 3-piece AcrySof, Alcon Laboratories) biomaterials were implanted. The capsulorhexis opening and capsular bag diameters were measured before IOL implantation and after in-the-bag IOL fixation with the haptics (or the main axis) at the 3 to 9 o'clock meridian. The percentage of ovaling of the capsulorhexis opening was calculated by noting the difference in the opening's horizontal diameter before and after IOL implantation. The percentage of capsular bag stretch was also calculated by noting the difference in the horizontal capsular bag diameter before and after IOL implantation. All IOLs produced ovaling of the capsulorhexis opening and stretching of the capsular bag parallel to the IOL haptics. There were significant differences in capsulorhexis ovaling and capsular bag stretch (P<.001, analysis of variance) between the 6 IOL types in each group of eyes. The postimplantation difference was significant only between the single-piece hydrophobic acrylic IOL (AcrySof) and the other IOLs. The single-piece hydrophobic acrylic IOL was associated with significantly less capsulorhexis ovaling and capsular bag stretch in both groups (mean 12.06% +/- 0.59% [SD] and 7

Capsular Polysaccharide Expression in Commensal Streptococcus Species: Genetic and Antigenic Similarities to Streptococcus pneumoniae.

PubMed

Skov Sørensen, Uffe B; Yao, Kaihu; Yang, Yonghong; Tettelin, Hervé; Kilian, Mogens

2016-11-15

Expression of a capsular polysaccharide is considered a hallmark of most invasive species of bacteria, including Streptococcus pneumoniae, in which the capsule is among the principal virulence factors and is the basis for successful vaccines. Consequently, it was previously assumed that capsule production distinguishes S. pneumoniae from closely related commensals of the mitis group streptococci. Based on antigenic and genetic analyses of 187 mitis group streptococci, including 90 recognized serotypes of S. pneumoniae, we demonstrated capsule production by the Wzy/Wzx pathway in 74% of 66 S. mitis strains and in virtually all tested strains of S. oralis (subspecies oralis, dentisani, and tigurinus) and S. infantis Additional analyses of genomes of S. cristatus, S. parasanguinis, S. australis, S. sanguinis, S. gordonii, S. anginosus, S. intermedius, and S. constellatus revealed complete capsular biosynthesis (cps) loci in all strains tested. Truncated cps loci were detected in three strains of S. pseudopneumoniae, in 26% of S. mitis strains, and in a single S. oralis strain. The level of sequence identities of cps locus genes confirmed that the structural polymorphism of capsular polysaccharides in S. pneumoniae evolved by import of cps fragments from commensal Streptococcus species, resulting in a mosaic of genes of different origins. The demonstrated antigenic identity of at least eight of the numerous capsular polysaccharide structures expressed by commensal streptococci with recognized serotypes of S. pneumoniae raises concerns about potential misidentifications in addition to important questions concerning the consequences for vaccination and host-parasite relationships both for the commensals and for the pathogen. Expression of a capsular polysaccharide is among the principal virulence factors of Streptococcus pneumoniae and is the basis for successful vaccines against infections caused by this important pathogen. Contrasting with previous

Fishtail on a line technique for capsular tension ring insertion.

PubMed

Rixen, Jordan J; Oetting, Thomas A

2014-07-01

We describe a capsular tension ring (CTR) insertion technique that is a modification of the previously described fishtail technique. A suture line is used to pull the leading eyelet out through the main incision to form the fish configuration. Similar to the fishtail technique, this insertion technique minimizes the risk for zonular damage or a capsule tear because the CTR is not dialed into the capsular bag. The advantage of the suture line is that it prevents over bending of the CTR during insertion through the main incision, which can occur using the traditional fishtail technique. Neither author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Production of capsular polysaccharide of Streptococcus pneumoniae type 14 and its purification by affinity chromatography.

PubMed

Suárez, N; Fraguas, L F; Texeira, E; Massaldi, H; Batista-Viera, F; Ferreira, F

2001-02-01

We describe a rapid and efficient method for producing the capsular polysaccharide of Streptococcus pneumoniae by fermentation on tryptic soy broth and purification of this compound by using immobilized soybean lectin as an affinity adsorbent. In principle, the same strategy can be used to produce purified capsular polysaccharides from other streptococcal serotypes by selecting the appropriate lectin adsorbents.

Breast Massage, Implant Displacement, and Prevention of Capsular Contracture After Breast Augmentation With Implants: A Review of the Literature.

PubMed

Sood, Aditya; Xue, Erica Y; Sangiovanni, Christopher; Therattil, Paul J; Lee, Edward S

2017-01-01

Objective: Capsular contracture, the most common complication following breast augmentation with implants, is a complex inflammatory reaction that ultimately leads to fibrosis at the contact site between the implant and tissue. A number of peri-, pre-, and postoperative techniques have been postulated and implemented by many surgeons to reduce the incidence of capsular contracture. Breast massage and implant displacement technique is a commonly recommended practice that has not been well studied in regard to capsular contracture prevention. The authors present a review of the literature addressing methods and efficacy of massage and implant displacement techniques after breast augmentation. Methods: A literature review was performed using PubMed and the Cochrane Collaboration Library for primary research articles on breast massage or implant displacement after breast augmentation with implants for breast contracture prevention between January 1975 and March 2017. Exclusion criteria were studies that were focused on the treatment rather than prevention of breast contracture, addressed other strategies of preventing contracture as the main focus, or did not report the number of patients studied. Information related to massage technique and capsular contracture outcomes was extracted. Results: The literature search yielded 4 relevant studies, with a total of 587 patients. Outcomes evaluated included massage technique, onset of massage, frequency of massage, and incidence of capsular contracture. Breast massage was introduced between 2 days and 2 weeks postoperatively, performed twice daily, and lasted from 2 to 5 minutes for each breast. Final postoperative follow-up concluded between 6 and 36 months. The average capsular contracture rate was similar, 31% (range, 0-35) in the massage group versus 40% (range, 30-90) in the nonmassage group. Conclusions: While multiple techniques have been proposed and practiced in the prevention of capsular contracture, breast massage

Production of Capsular Polysaccharide of Streptococcus pneumoniae Type 14 and Its Purification by Affinity Chromatography

PubMed Central

Suárez, Norma; Fraguas, Laura Franco; Texeira, Esther; Massaldi, Hugo; Batista-Viera, Francisco; Ferreira, Fernando

2001-01-01

We describe a rapid and efficient method for producing the capsular polysaccharide of Streptococcus pneumoniae by fermentation on tryptic soy broth and purification of this compound by using immobilized soybean lectin as an affinity adsorbent. In principle, the same strategy can be used to produce purified capsular polysaccharides from other streptococcal serotypes by selecting the appropriate lectin adsorbents. PMID:11157270

Functional anatomy of the temporo-mandibular joint (II).

PubMed

Sava, Anca; Scutariu, Monica

2012-01-01

Jaw movement is analyzed as an action between two rigid components jointed together in a particular way, the movable mandible against the stabilized cranium. Opening and closing movements are symmetrical; that is, both sides of the cranio-mandibular articulation are making the same movements. Protrusive and retrusive movements may also be symmetrical. The mandibular muscles determine all the complicated postures and-movements of the jaw. Their behavior can be greatly clarified by restating certain fundamentals crucial to purposive muscular activity. The joint derives its arterial supply from the superficial temporal artery and the maxillary artery. Branches of the auriculo-temporal and masseteric nerves and postganglionic sympathetic nerves supply the tissues associated with the capsular ligament and the looser posterior bilaminar extension of the disc.

Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation: Qualitative Classification and Quantitative Measurement.

PubMed

Tan, Xuhua; Lin, Haotian; Lin, Zhuoling; Chen, Jingjing; Tang, Xiangchen; Luo, Lixia; Chen, Weirong; Liu, Yizhi

2016-03-01

The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement.This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China.Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I-capsule with mild opacification but no invasion into the capsule opening; Type II-capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III-capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed.The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I-120 eyes (38.1%); Type II-157 eyes (49.8%); Type III-38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = -0.572, P < 0.001), but no significant correlation with intraoperative posterior capsulorhexis size (R = -0.16, P = 0.122) was observed. The ACOA significantly decreased from Type I to Type II to Type III, the PCOA increased in size from Type I to Type II, and the PCOO increased

Innervation of the wrist joint and surgical perspectives of denervation.

PubMed

Van de Pol, Gerrit J; Koudstaal, Maarten J; Schuurman, Arnold H; Bleys, Ronald L A W

2006-01-01

Because our experience with the techniques used in denervation surgery of the wrist joint often has proven insufficient in treating chronic pain we conducted an anatomic study to clarify the exact contributions of the nerves supplying the wrist joint. Our goal was to reveal all periosteal and capsular nerve connections and if necessary adjust our technique used in denervation surgery. Innervation of the wrist joint was investigated by microdissection and histologic examination of 18 human wrists. An acetylcholinesterase method was used to identify the nerves, both in whole-mount preparations and in sections. We found that the main innervation to the wrist capsule and periosteal nerve network came from the anterior interosseous nerve, lateral antebrachial cutaneous nerve, and posterior interosseous nerve. The palmar cutaneous branch of the median nerve, the deep branch of the ulnar nerve, the superficial branch of the radial nerve, and the dorsal branch of the ulnar nerve also were found to have connections with the capsule. The periosteal nerve branches did not appear to play a major role in the innervation of the capsule and ligaments; here the specific articular nerve branches proved more important. The posterior and medial antebrachial cutaneous nerves did not connect to the wrist capsule or periosteum but rather terminated in the extensor and flexor retinaculum. Based on our findings we propose to denervate the wrist by making 2 incisions. With one palmar and one dorsal incision it should be possible to disconnect the periosteum from the capsule and interrupt the majority of the capsular nerve branches.

Surgical management of spontaneous in-the-bag intraocular lens and capsular tension ring complex dislocation.

PubMed

Gunenc, Uzeyir; Kocak, Nilufer; Ozturk, A Taylan; Arikan, Gul

2014-08-01

We describe a technique to manage late spontaneous intraocular lens (IOL) and capsular tension ring (CTR) dislocation within the intact capsular bag. The subluxated IOL and CTR complex can be positioned in a closed chamber and fixed to the pars plana at both 3 and 9 o'clock quadrants with the presented ab externo direct scleral suturation technique which provides an easy, safe and effective surgical option for such cases.

The influence of injection volume and capsular bag contraction on the refractive power of polymer refilled lenses - a finite element modelling simulation study.

PubMed

Martin, Heiner; Guthoff, Rudolf; Schmitz, Klaus-Peter

2011-09-01

Polymer injection into the capsular bag after phakoemulsification is an interesting and promising approach to lens surgery. Safe clinical application of this technique will require an appropriate estimate of the effect of implantation variables on the lens power. This article details the results of finite element investigations into the effects of the injected polymer volume and capsular bag contraction on the resultant lens power and accommodation amplitude. An axisymmetric finite element model was created from literature sources. Polymer injection and the capsular contraction were simulated, and their effect on the lens power was calculated. The simulations show that overfilling during polymer injection leads to a refractive power increase of the lens. Capsular bag contraction also results in a power increase. The calculated accommodative amplitude of the lens is minimally affected by capsular bag contraction but decreases significantly with increased capsular bag stiffness as a result of fibrosis. © 2010 The Authors. Journal compilation © 2010 Acta Ophthalmol.

Reevaluating the serotype II capsular locus of Streptococcus agalactiae.

PubMed

Martins, E R; Melo-Cristino, J; Ramirez, M

2007-10-01

We report a novel sequence of the serotype II capsular locus of group B streptococcus that resolves inconsistencies among the results of various groups and the sequence in GenBank. This locus was found in diverse lineages and presents genes consistent with the complete synthesis of the type II polysaccharide.

PAIN FROM INTRA-ARTICULAR NGF OR JOINT INJURY IN THE RAT REQUIRES CONTRIBUTIONS FROM PEPTIDERGIC JOINT AFFERENTS

PubMed Central

Kras, Jeffrey V.; Weisshaar, Christine L.; Pall, Parul S.; Winkelstein, Beth A.

2015-01-01

Non-physiological stretch of the cervical facet joint’s capsular ligament induces persistent behavioral hypersensitivity and spinal neuronal hyperexcitability via an intra-articular NGF-dependent mechanism. Although that ligament is innervated by nociceptors, it is unknown if a subpopulation is exclusively responsible for the behavioral and spinal neuronal responses to intra-articular NGF and/or facet joint injury. This study ablated joint afferents using the neurotoxin saporin targeted to neurons involved in either peptidergic ([Sar9,Met(O2)11]-substance P-saporin (SSP-Sap)) or non-peptidergic (isolectin B4-saporin (IB4-Sap)) signaling to investigate the contributions of those neuronal populations to facet-mediated pain. SSP-Sap, but not IB4-Sap, injected into the bilateral C6/C7 facet joints 14 days prior to an intra-articular NGF injection prevents NGF-induced mechanical and thermal hypersensitivity in the forepaws. Similarly, only SSP-Sap prevents the increase in mechanical forepaw stimulation-induced firing of spinal neurons after intra-articular NGF. In addition, intra-articular SSP-Sap prevents both behavioral hypersensitivity and upregulation of NGF in the dorsal root ganglion after a facet joint distraction that normally induces pain. These findings collectively suggest that disruption of peptidergic signaling within the joint may be a potential treatment for facet pain, as well as other painful joint conditions associated with elevated NGF, such as osteoarthritis. PMID:26240991

Rotationally asymmetric multifocal IOL implantation with and without capsular tension ring: refractive and visual outcomes and intraocular optical performance.

PubMed

Alió, Jorge L; Plaza-Puche, Ana B; Piñero, David P

2012-04-01

To ascertain whether the refractive, visual, and intraocular optical quality outcomes of a rotationally asymmetric multifocal intraocular lens (IOL) are enhanced by the use of a capsular tension ring. Ninety consecutive eyes from 53 patients (age range: 36 to 82 years) were divided into two groups: the no ring group comprised 43 eyes implanted with the multifocal rotationally asymmetric Lentis Mplus LS-312 (Oculentis GmbH) without a capsular tension ring; and the ring group comprised 47 eyes with the same IOL with a capsular tension ring. Distance and near visual acuity and refractive outcomes were evaluated pre- and postoperatively. Contrast sensitivity, intraocular aberrations, and defocus curve were evaluated postoperatively. Significant postoperative differences between groups were found in sphere, spherical equivalent refraction, and near addition (P<.02). Regarding defocus curve, significantly better visual acuity was present in eyes with the capsular tension ring for intermediate vision conditions (P<.05). Intraocular aberrometry did not differ significantly between groups (P<.09). Refractive predictability and intermediate visual outcomes with the Lentis Mplus LS-312 IOL improved significantly when implanted in combination with a capsular tension ring. Copyright 2012, SLACK Incorporated.

Capture of intraocular lens optic by residual capsular opening in secondary implantation: long-term follow-up.

PubMed

Tian, Tian; Chen, Chunli; Jin, Haiying; Jiao, Lyu; Zhang, Qi; Zhao, Peiquan

2018-04-02

To introduce a novel surgical technique for optic capture by residual capsular opening in secondary intraocular lens (IOL) implantation and to report the outcomes of a long follow-up. Twenty patients (20 eyes) who had received secondary IOL implantation with the optic capture technique were retrospectively reviewed. We used the residual capsular opening for capturing the optic and inserted the haptics in the sulcus during surgery. Baseline clinical characteristics and surgical outcomes, including best-corrected visual acuity (BCVA), refractive status, and IOL position were recorded. The postoperative location and stability of IOL were evaluated using the ultrasound biomicroscopy. Optic capture technique was successfully performed in all cases, including 5 cases with large area of posterior capsular opacity, 6 cases with posterior capsular tear or rupture,and 9 cases with adhesive capsules. BCVA improved from 0.60 logMAR at baseline to 0.36 logMAR at the last follow-up (P < 0.001). Spherical equivalent changed from 10.67 ± 4.59 D at baseline to 0.12 ± 1.35 D at 6 months postoperatively (P < 0.001). Centered IOLs were observed in all cases and remained captured through residual capsular opening in 19 (95%) eyes at the last follow-up. In one case, the captured optic of IOL slid into ciliary sulcus at 7 months postoperatively. No other postoperative complications were observed in any cases. This optic capture technique by using residual capsule opening is an efficacious and safe technique and can achieve IOL stability in the long follow-up.

Pain from intra-articular NGF or joint injury in the rat requires contributions from peptidergic joint afferents.

PubMed

Kras, Jeffrey V; Weisshaar, Christine L; Pall, Parul S; Winkelstein, Beth A

2015-09-14

Non-physiological stretch of the cervical facet joint's capsular ligament induces persistent behavioral hypersensitivity and spinal neuronal hyperexcitability via an intra-articular NGF-dependent mechanism. Although that ligament is innervated by nociceptors, it is unknown if a subpopulation is exclusively responsible for the behavioral and spinal neuronal responses to intra-articular NGF and/or facet joint injury. This study ablated joint afferents using the neurotoxin saporin targeted to neurons involved in either peptidergic ([Sar(9),Met (O2)(11)]-substance P-saporin (SSP-Sap)) or non-peptidergic (isolectin B4-saporin (IB4-Sap)) signaling to investigate the contributions of those neuronal populations to facet-mediated pain. SSP-Sap, but not IB4-Sap, injected into the bilateral C6/C7 facet joints 14 days prior to an intra- articular NGF injection prevents NGF-induced mechanical and thermal hypersensitivity in the forepaws. Similarly, only SSP- Sap prevents the increase in mechanical forepaw stimulation- induced firing of spinal neurons after intra-articular NGF. In addition, intra-articular SSP-Sap prevents both behavioral hypersensitivity and upregulation of NGF in the dorsal root ganglion after a facet joint distraction that normally induces pain. These findings collectively suggest that disruption of peptidergic signaling within the joint may be a potential treatment for facet pain, as well as other painful joint conditions associated with elevated NGF, such as osteoarthritis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Biomechanical Effects of Capsular Shift in the Treatment of Hip Microinstability: Creation and Testing of a Novel Hip Instability Model.

PubMed

Jackson, Timothy J; Peterson, Alexander B; Akeda, Masaki; Estess, Allyson; McGarry, Michelle H; Adamson, Gregory J; Lee, Thay Q

2016-03-01

A capsular shift procedure has been described for the treatment of hip instability; however, the biomechanical effects of such a shift are unknown. To create a cadaveric model of hip capsule laxity and evaluate the biomechanical effects of a capsular shift used to treat hip instability on this model. Controlled laboratory study. Eight cadaveric hips with an average age of 58.5 years were tested with a custom hip testing system in 6 conditions: intact, vented, instability, capsulotomy, side-to-side repair, and capsular shift. To create the hip model, the capsule was stretched in extension under 35 N·m of torque for 1 hour in neutral rotation. Measurements included internal and external rotation with 1.5 N·m of torque at 5 positions: 5° of extension and 0°, 15°, 30°, and 45° of flexion for each of the above conditions. The degree of maximum extension with 5 N·m of torque and the amount of femoral distraction with 40 N and 80 N of force were measured. Statistical analysis was performed by use of repeated-measures analysis of variance with Tukey post hoc analysis. The instability state significantly increased internal rotation at all flexion angles and increased distraction compared with the intact state. The capsulotomy condition resulted in significantly increased external rotation and internal rotation at all positions, increased distraction, and maximum extension compared with the intact state. The side-to-side repair condition restored internal rotation back to the instability state but not to the intact state at 5° of extension and 0° of flexion. The capsular shift state significantly decreased internal rotation compared with the instability state at 5° of extension and 0° and 15° of flexion. The capsular shift and side-to-side repair conditions had similar effects on external rotation at all flexion-extension positions. The capsular shift state decreased distraction and maximum extension compared with the instability state, but the side

Localized cervical facet joint kinematics under physiological and whiplash loading.

PubMed

Stemper, Brian D; Yoganandan, Narayan; Gennarelli, Thomas A; Pintar, Frank A

2005-12-01

Although facet joints have been implicated in the whiplash injury mechanism, no investigators have determined the degree to which joint motions in whiplash are nonphysiological. The purpose of this investigation was to quantify the correlation between facet joint and segmental motions under physiological and whiplash loading. Human cadaveric cervical spine specimens were exercise tested under physiological extension loading, and intact human head-neck complexes were exercise tested under whiplash loading to correlate the localized component motions of the C4-5 facet joint with segmental extension. Facet joint shear and distraction kinematics demonstrated a linear correlation with segmental extension under both loading modes. Facet joints responded differently to whiplash and physiological loading, with significantly increased kinematics for the same-segmental angulation. The limitations of this study include removal of superficial musculature and the limited sample size for physiological testing. The presence of increased facet joint motions indicated that synovial joint soft-tissue components (that is, synovial membrane and capsular ligament) sustain increased distortion that may subject these tissues to a greater likelihood of injury. This finding is supported by clinical investigations in which lower cervical facet joint injury resulted in similar pain patterns due to the most commonly reported whiplash symptoms.

Serotyping of Streptococcus pneumoniae Based on Capsular Genes Polymorphisms

PubMed Central

Raymond, Frédéric; Boucher, Nancy; Allary, Robin; Robitaille, Lynda; Lefebvre, Brigitte; Tremblay, Cécile

2013-01-01

Streptococcus pneumoniae serotype epidemiology is essential since serotype replacement is a concern when introducing new polysaccharide-conjugate vaccines. A novel PCR-based automated microarray assay was developed to assist in the tracking of the serotypes. Autolysin, pneumolysin and eight genes located in the capsular operon were amplified using multiplex PCR. This step was followed by a tagged fluorescent primer extension step targeting serotype-specific polymorphisms. The tagged primers were then hybridized to a microarray. Results were exported to an expert system to identify capsular serotypes. The assay was validated on 166 cultured S. pneumoniae samples from 63 different serotypes as determined by the Quellung method. We show that typing only 12 polymorphisms located in the capsular operon allows the identification at the serotype level of 22 serotypes and the assignation of 24 other serotypes to a subgroup of serotypes. Overall, 126 samples (75.9%) were correctly serotyped, 14 were assigned to a member of the same serogroup, 8 rare serotypes were erroneously serotyped, and 18 gave negative serotyping results. Most of the discrepancies involved rare serotypes or serotypes that are difficult to discriminate using a DNA-based approach, for example 6A and 6B. The assay was also tested on clinical specimens including 43 cerebrospinal fluid samples from patients with meningitis and 59 nasopharyngeal aspirates from bacterial pneumonia patients. Overall, 89% of specimens positive for pneumolysin were serotyped, demonstrating that this method does not require culture to serotype clinical specimens. The assay showed no cross-reactivity for 24 relevant bacterial species found in these types of samples. The limit of detection for serotyping and S. pneumoniae detection was 100 genome equivalent per reaction. This automated assay is amenable to clinical testing and does not require any culturing of the samples. The assay will be useful for the evaluation of serotype

Gastroresistant capsular device prepared by injection molding.

PubMed

Zema, Lucia; Loreti, Giulia; Melocchi, Alice; Maroni, Alessandra; Palugan, Luca; Gazzaniga, Andrea

2013-01-20

In the present work, the possibility of manufacturing by injection molding (IM) a gastro-resistant capsular device based on hydroxypropyl methyl cellulose acetate succinate (HPMCAS) was investigated. By performing as an enteric soluble container, such a device may provide a basis for the development of advantageous alternatives to coated dosage forms. Preliminarily, the processability of the selected thermoplastic polymer was evaluated, and the need for a plasticizer (polyethylene glycol 1500) in order to counterbalance the glassy nature of the molded items was assessed. However, some critical issues related to the physical/mechanical stability (shrinkage and warpage) and opening time of the device after the pH change were highlighted. Accordingly, an in-depth formulation study was carried out taking into account differing release modifiers potentially useful for enhancing the dissolution/disintegration rate of the capsular device at intestinal pH values. Capsule prototypes with thickness of 600 and 900 μm containing Kollicoat(®) IR and/or Explotab(®) CLV could be manufactured, and a promising performance was achieved with appropriate gastric resistance in pH 1.2 medium and break-up in pH 6.8 within 1h. These results would support the design of a dedicated mold for the development of a scalable manufacturing process. Copyright © 2012 Elsevier B.V. All rights reserved.

Population-based study of capsular warning syndrome and prognosis after early recurrent TIA.

PubMed

Paul, Nicola L M; Simoni, Michela; Chandratheva, Arvind; Rothwell, Peter M

2012-09-25

Many guidelines recommend emergency assessment for patients with ≥2 TIAs within 7 days, perhaps in recognition of the capsular warning syndrome. However, it is unclear whether all patients with multiple TIAs are at high early risk of stroke and whether treatable underlying pathologies are more prevalent in this group. We studied clinical characteristics, Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, and risk of stroke in 1,000 consecutive patients with incident and recurrent TIAs in a prospective, population-based study (Oxford Vascular Study). Of 1,000 patients with TIAs, 170 had a further TIA within 7 days (105 within 24 hours). Multiple TIAs were not associated with carotid stenosis or atrial fibrillation, and much of the 10.6 (95% confidence interval [CI] 6.5-15.9) risk of stroke during the 7 days after the first TIA was due to patients with small-vessel disease (SVD) etiology (10 of 24 vs 8 of 146, odds ratio [OR] = 12.3, 95% CI 3.7-41.9, p < 0.0001), particularly those with motor weakness (i.e., capsular warning syndrome) compared with hemisensory events (9 of 15 [60%], 95% CI 35.3-84.7 vs 1 of 9 [11.1%], 95% CI 0-31.7, p = 0.03). The 7-day risk of stroke after a recurrent TIA was similar to the risk after a single TIA in patients with non-SVD TIA (8 of 146 [5.5%] vs 76 of 830 [9.2%], OR = 0.58, 95% CI 0.25-1.3, p = 0.20). Of the 9 patients with stroke after a capsular warning syndrome, all had the recurrent TIA within 24 hours after the first TIA, and the subsequent stroke occurred within 72 hours of the second TIA in 8. The ABCD2 scores of all preceding TIAs were ≥4 in all 9 patients with capsular warning syndrome before stroke. Capsular warning syndrome is rare (1.5% of TIA presentations) but has a poor prognosis (7-day stroke risk of 60%). Otherwise, recurrent TIA within 7 days is not associated with a greater stroke risk than that after a single TIA.

Delayed splenic rupture: dating the sub-capsular hemorrhage as a useful task to evaluate causal relationships with trauma.

PubMed

Riezzo, Irene; Di Battista, Benedetta; De Salvia, Alessandra; Cantatore, Santina; Neri, Margherita; Pomara, Cristoforo; Turillazzi, Emanuela; Fineschi, Vittorio

2014-01-01

The aim of the paper was to perform a chronological assessment of the phenomenon of delayed rupture of the spleen, to assess the phenomenological order about the sub-capsular hematoma transformation to determine the causal relationship with trauma as hypothetical cause of death. 80 cases of blunt trauma with splenic capsular hematoma and subsequent rupture of the spleen were evaluated: 38 had an acute rupture of the spleen, 42 presented a break in days or weeks after the traumatic injury. Time between the traumatic event and delayed rupture of the spleen is within a range of time from one day to more than one month. Data recorded included age, sex, type of trauma, injury severity score, grade of splenic injury, associated intra-abdominal injuries, pathologic specimen evaluation. Immunohistochemical investigation of perisplenic hematoma or laceration was performed utilizing polyclonal antibodies anti-fibrinogen, CD61 and CD68, and showed structural chronological differences of sub-capsular hematoma. Expression of modification and organization of erythrocytes, fibrinogen, platelets and macrophages provides an informative picture of the progression of reparative phenomena associated with sub-capsular hematoma and subsequent delayed splenic rupture. Sub-capsular splenic hematoma dating, which we divided into 4 phases, is representing a task in both clinical practice and forensic pathology. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Investigation of vesicle-capsular plague antigen complex formation by elastic laser radiation scattering

NASA Astrophysics Data System (ADS)

Guseva, N. P.; Maximova, Irina S.; Romanov, Sergey V.; Shubochkin, L. P.; Tatarintsev, Sergey N.

1991-05-01

Recently a great deal of attention has been given to the investigation artificial lipid liposomes, due to their application as "containers" for directed transport of biologically active compounds into particular cells, organs and tissues for prophylaxis and therapy of infectious diseases. The use of traditional methods of liposome investigation, such as sedimentation, electrophoresis and chromatography is impeded by low liposome resistivity to different deformations. In conjunction with this, optical methods of laser light scattering are promising as they allow nondisturbing, precise and quick investigations. This paper describes the investigation of vesicle systems prepared from egg lecithin of Serva Corporation and their complexes with the capsular antigen of the plague microbe. The capsular antigen Fl was obtained from EV plague microbe grown at 37° C on Huttinger agar. Fl was isolated by gel-filtration on ASA-22 followed by freeze drying of the preparation. Angular dependences of polarized radiation scattering were measured for several liposome suspension samples in a saline solution before and after the interaction with the plague microbe capsular antigen. The aim of the investigation was to analyze the nature of mutual antigen arrangement in a liposome and to develop methods for measuring its inclusion percentage.

Do textured breast implants decrease the rate of capsular contracture compared to smooth implants?

PubMed

Cifuentes, Ignacio; Dagnino, Bruno; Rada, Gabriel

2017-08-31

The use of breast implants for aesthetic and reconstructive purposes has become one of the most common procedures performed by plastic surgeons. Several breast implants models exist. They differ in their size, filling, shape and characteristic of the shell, which can be smooth or textured. Capsular contracture is one of the main complications of breast implants. It has been suggested that the use of textured implants could reduce the incidence of capsular contracture. To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We identified 15 studies overall, of which 13 were randomized trials relevant for the question of interest. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded the use of textured breast implants probably decreases the risk of capsular contracture, however, they might be associated to an increased risk of anaplastic large cell lymphoma.

Analysis of periprosthetic capsular tissue from women with silicone breast implants by magic-angle spinning NMR.

PubMed

Garrido, L; Young, V L

1999-09-01

The amount of silicone (polydimethylsiloxane [PDMS]) in capsular tissue surgically removed from women with breast implants was measured by using (29)Si and (1)H magic-angle spinning solid-state NMR spectroscopy. Twelve women having smooth surface silicone gel-filled implants, including a subject with "low-bleed" double-lumen implants, had detectable levels of PDMS ranging from 0. 05 to 9.8% silicon in wet tissue (w/w). No silicon-containing compounds other than PDMS were detected. No correlation was found between the amount of PDMS measured in the capsular tissue and the length of implantation time (Pearson correlation coefficient, r = 0. 22). The results showed no relationship between higher amounts of PDMS and capsular contracture (p = 0.74) or other symptoms (p = 0. 53). Magn Reson Med 42:436-441, 1999. Copyright 1999 Wiley-Liss, Inc.

Serological response following re-vaccination with Salmonella typhi Vi-capsular polysaccharide vaccines in healthy adult travellers.

PubMed

Roggelin, Louise; Vinnemeier, Christof D; Fischer-Herr, Johanna; Johnson-Weaver, Brandi T; Rolling, Thierry; Burchard, Gerd D; Staats, Herman F; Cramer, Jakob P

2015-08-07

An injectable Vi-capsular polysaccharide vaccine against typhoid fever is available but vaccine-induced immunity tends to wane over time. The phenomenon of immunotolerance or hyporesponsiveness has earlier been described for polysaccharide vaccines such as pneumococcal capsular polysaccharide vaccine and some publications also suggest a possible immunotolerance after revaccination with Vi-capsular polysaccharide vaccines. In this study, post-immunisation antibody concentrations in adult travellers first vaccinated with a Salmonella typhi Vi-capsular polysaccharide vaccine (primary vaccination group) were compared with those having received one or more vaccinations previously (multiple vaccinations group). Vaccines administered were Typherix(®) (GlaxoSmithKline), Typhim Vi(®) (Sanofi Pasteur MSD) or Hepatyrix(®) (GlaxoSmithKline). Blood samples were obtained prior to vaccination (day 0) and on day 28 (-1/+14) after vaccination. Serum Vi-Antigen IgG concentrations were measured by ELISA. Of the 85 subjects included in the per protocol data set, 45 (53%) belonged to the multiple vaccinations group. In both groups, geometric mean antibody concentrations (GMCs) were significantly higher after vaccination than before vaccination. Pre-vaccination GMCs were lower in the primary vaccination group than in the multiple vaccinations group (3.40 μg/ml versus 6.13 μg/ml, P=0.005), while there was no significant difference in the post vaccination GMCs between groups (11.34 μg/ml versus 14.58 μg/ml, P=0.4). In the multiple vaccinations group, vaccination was performed 18 to 57 months after the last vaccination (median 38 months) and there was a negative correlation between time since last vaccination and antibody concentration on day 0. In conclusion, we were not able to demonstrate a relevant immunotolerance after multiple versus primary vaccination with S. typhi Vi-capsular polysaccharide vaccines. Copyright © 2015 Elsevier Ltd. All rights reserved.

Capsular Polysaccharide Expression in Commensal Streptococcus Species: Genetic and Antigenic Similarities to Streptococcus pneumoniae

PubMed Central

Skov Sørensen, Uffe B.; Yao, Kaihu; Yang, Yonghong; Tettelin, Hervé

2016-01-01

ABSTRACT Expression of a capsular polysaccharide is considered a hallmark of most invasive species of bacteria, including Streptococcus pneumoniae, in which the capsule is among the principal virulence factors and is the basis for successful vaccines. Consequently, it was previously assumed that capsule production distinguishes S. pneumoniae from closely related commensals of the mitis group streptococci. Based on antigenic and genetic analyses of 187 mitis group streptococci, including 90 recognized serotypes of S. pneumoniae, we demonstrated capsule production by the Wzy/Wzx pathway in 74% of 66 S. mitis strains and in virtually all tested strains of S. oralis (subspecies oralis, dentisani, and tigurinus) and S. infantis. Additional analyses of genomes of S. cristatus, S. parasanguinis, S. australis, S. sanguinis, S. gordonii, S. anginosus, S. intermedius, and S. constellatus revealed complete capsular biosynthesis (cps) loci in all strains tested. Truncated cps loci were detected in three strains of S. pseudopneumoniae, in 26% of S. mitis strains, and in a single S. oralis strain. The level of sequence identities of cps locus genes confirmed that the structural polymorphism of capsular polysaccharides in S. pneumoniae evolved by import of cps fragments from commensal Streptococcus species, resulting in a mosaic of genes of different origins. The demonstrated antigenic identity of at least eight of the numerous capsular polysaccharide structures expressed by commensal streptococci with recognized serotypes of S. pneumoniae raises concerns about potential misidentifications in addition to important questions concerning the consequences for vaccination and host-parasite relationships both for the commensals and for the pathogen. PMID:27935839

Primary iris claw IOL retrofixation with intravitreal triamcinolone acetonide in cases of inadequate capsular support.

PubMed

Kelkar, Aditya; Shah, Rachana; Vasavda, Viraj; Kelkar, Jai; Kelkar, Shreekant

2018-02-01

To assess the outcomes and analyze complication rates following primary iris claw IOL retrofixation with intravitreal triamcinolone acetonide. This is a retrospective interventional case series. Patients with poor capsular support-diagnosed preoperatively or owing to intraoperative complications-were treated with iris claw IOL retrofixation with intravitreal triamcinolone acetonide. The data were retrospectively analyzed. 104 eyes of 102 patients with poor capsular support who underwent the procedure between 2010 and 2013 were analyzed. The minimum follow-up period was 12 months (ranging from 12 to 36 months). Iris claw IOL was implanted in-traumatic subluxated cataracts-24 cases (23.07%), non-traumatic subluxated cataracts in 16 cases (15.38%), or as a complication of cataract surgery-intraoperative posterior capsular rent in 48 cases (46.15%) and intraoperative nucleus drop in 16 cases (15.38%). The final mean best-corrected logMAR visual acuity improved from 1.36 ± 0.64 preoperatively to 0.36 ± 0.32 at 1-year follow-up. Complications included pupil ovalization in 11 cases (10.57%), transient elevation in intraocular pressure in 7 eyes (6.73%), postoperative hypotony in 5 eyes (4.80%), cystoid macular edema in 2 eyes (1.92%), retinal detachment in 1 eye (0.96%), vitreous hemorrhage in 1 eye (0.96%), and hyphema in 1 eye (0.96%). Primary iris claw IOL retrofixation provided excellent alternative in patients with inadequate capsular support. The visual outcomes were good along with favorable rates of complications. The addition of triamcinolone acetonide helps in reducing the chances of cystoid macular edema.

Production of capsular polysaccharide from Escherichia coli K4 for biotechnological applications.

PubMed

Cimini, Donatella; Restaino, Odile Francesca; Catapano, Angela; De Rosa, Mario; Schiraldi, Chiara

2010-02-01

The production of industrially relevant microbial polysaccharides has recently gained much interest. The capsular polysaccharide of Escherichia coli K4 is almost identical to chondroitin, a commercially valuable biopolymer that is so far obtained from animal tissues entailing complex and expensive extraction procedures. In the present study, the production of capsular polysaccharide by E. coli K4 was investigated taking into consideration a potential industrial application. Strain physiology was first characterized in shake flask experiments to determine the optimal culture conditions for the growth of the microorganism and correlate it to polysaccharide production. Results show that the concentration of carbon source greatly affects polysaccharide production, while the complex nitrogen source is mainly responsible for the build up of biomass. Small-scale batch processes were performed to further evaluate the effect of the initial carbon source concentration and of growth temperatures on polysaccharide production, finally leading to the establishment of the medium to use in following fermentation experiments on a bigger scale. The fed-batch strategy next developed on a 2-L reactor resulted in a maximum cell density of 56 g(cww)/L and a titre of capsular polysaccharide equal to 1.4 g/L, approximately ten- and fivefold higher than results obtained in shake flask and 2-L batch experiments, respectively. The release kinetics of K4 polysaccharide into the medium were also explored to gain insight into the mechanisms underlying a complex aspect of the strain physiology.

3D printed multi-compartment capsular devices for two-pulse oral drug delivery.

PubMed

Maroni, A; Melocchi, A; Parietti, F; Foppoli, A; Zema, L; Gazzaniga, A

2017-12-28

In the drug delivery area, versatile therapeutic systems intended to yield customized combinations of drugs, drug doses and release kinetics have drawn increasing attention, especially because of the advantages that personalized pharmaceutical treatments would offer. In this respect, a previously proposed capsular device able to control the release performance based on its design and composition, which could extemporaneously be filled, was improved to include multiple separate compartments so that differing active ingredients or formulations may be conveyed. The compartments, which may differ in thickness and composition, resulted from assembly of two hollow halves through a joint also acting as a partition. The systems were manufactured by fused deposition modeling (FDM) 3D printing, which holds special potential for product personalization, and injection molding (IM) that would enable production on a larger scale. Through combination of compartments having wall thickness of 600 or 1200μm, composed of promptly soluble, swellable/erodible or enteric soluble polymers, devices showing two-pulse release patterns, consistent with the nature of the starting materials, were obtained. Systems fabricated using the two techniques exhibited comparable performance, thus proving the prototyping ability of FDM versus IM. Copyright © 2017 Elsevier B.V. All rights reserved.

Transverse musculocutaneous gracilis flap for treatment of capsular contracture in tertiary breast reconstruction.

PubMed

Pülzl, Petra; Huemer, Georg M; Schoeller, Thomas

2015-02-01

Capsular contracture is a common complication associated with implant-based breast reconstruction and augmentation leading to pain, displacement, and rupture. After capsulectomy and implant exchange, the problem often reappears. We performed 52 deepithelialized free transverse musculocutaneous gracilis (TMG) flaps in 33 patients for tertiary breast reconstruction or augmentation of small- and medium-sized breasts. The indications for implant removal were unnatural feel and emotion of their breasts with foreign body feel, asymmetry, pain, and sensation of cold. Anyway, most of the patients did not have a severe capsular contracture deformity. The TMG flap is formed into a cone shape by bringing the tips of the ellipse together. Depending on the contralateral breast, the muscle can also be shaped in an S-form to get more projection if needed. The operating time for unilateral TMG flap breast reconstruction or augmentation was on average 3 hours and for bilateral procedure 5 hours. One patient had a secondary revision of the donor site due to disruption of the normal gluteal fold. Eighty percent of the unilateral TMG flap reconstructions had a lipofilling procedure afterward to correct small irregularities or asymmetry. The advantages of the TMG flap such as short harvesting time, inconspicuous donor site, and the possibility of having a natural breast shape make it our first choice to treat capsular contracture after breast reconstruction and augmentation.

[Imaging manifestations and pathologic basis for hepatic capsular retraction syndrome caused by benign and malignant liver tumors].

PubMed

Ou, Youkuan; Xiao, Enhua; Shang, Quanliang; Chen, Juan

2015-10-01

To investigate the imaging manifestations of CT, MRI and pathological basis for hepatic capsular retraction syndrome caused by benign and malignant liver tumors.
 CT or MRI images and pathological features for hepatic capsular retraction syndrome were retrospectively analyzed in 50 patients with benign and malignant liver tumors. Picture archive and communication system (PACS) was used to observe and compare the morphology, size, width, depth, edge of the capsular retraction and the status of liquid under the liver capsule. The structure, differentiation and proliferation of the tumor were analyzed under the microscope.
 There were malignant liver tumors in 44 patients and benign tumor in 6 patients. The smooth or rough for the edge of capsular retraction was significant difference between the benign tumors and the malignant tumors with three differentiated grades (all P<0.05). There were significant difference in the width and depth for capsule retraction with different amount of fibrous tissues (all P<0.05). The width and depth of capsule retraction were positively correlated to the size of the tumors (r=0.557, 0.309 respectively, both P<0.05).
 Benign and malignant hepatic tumors may appear capsule retraction syndrome, but there are morphological differences between them. The differences are closely related with the lesion size, differentiated degree of tumor and fibrous tissue proliferation.

Dendritic Cell-Derived Exosomes Express a Streptococcus pneumoniae Capsular Polysaccharide Type 14 Cross-Reactive Antigen That Induces Protective Immunoglobulin Responses against Pneumococcal Infection in Mice

DTIC Science & Technology

2007-01-01

Microbiology. All Rights Reserved. Dendritic Cell-Derived Exosomes Express a Streptococcus pneumoniae Capsular Polysaccharide Type 14 Cross-Reactive...cross-reactive with the capsular polysaccharide of Streptococcus pneumoniae type 14 (Cps14-CRA). Cps14-CRA was localized to the cholesterol-enriched...for S. pneumoniae capsular polysaccharides (Cps) (17). More than 90 Cps sero- types have been described, with no cross-reaction among each other (16

Long-segment plication technique for arteriovenous fistulae threatened by diffuse aneurysmal degeneration: short-term results.

PubMed

Powell, Alexis; Wooster, Mathew; Carroll, Megan; Cardentey-Oliva, Damian; Cavanagh-Voss, Sean; Armstrong, Paul; Shames, Murray; Illig, Karl; Gabbard, Wesley

2015-08-01

A substantial number of patients with autologous arteriovenous fistulas (AVFs) develop diffuse aneurysmal degeneration, which frequently interferes with successful access. These AVFs are often deemed unsalvageable. We hypothesize that long-segment plication in these patients can be performed safely with acceptable short-term AVF salvage rates. We reviewed a prospectively maintained database to identify all patients with extensive AVF aneurysmal disease operated on for this problem. Thirty-five patients, 25 (71%) male and 10 (29%) female were operated on between July 2012 and January 2014. AVFs included 23 (66%) brachiocephalic, 5 (14%) radiocephalic, and 7 brachiobasilic (20%) fistulae (one first stage only but in use). The cohort had one or a combination of local pain, arm edema, cannulation issue, recurrent thrombosis, dysfunctional during dialysis, or extreme tortuousity. Time range for AVF creation to consultation ranged from 3 months to 11 years. All underwent long-segment plication over a 20-Fr Bougie with or without segmental vein resection; 3 underwent concomitant first rib resection for costoclavicular stenosis; 21 patients had tunneled catheter placement for use while healing, whereas 13 were allowed segmental use of their AVF during the perioperative period (1 patient was not yet on dialysis). Early in our experience, AVFs were left under the wound, whereas all but one repaired since early 2013 were left under a lateral flap. All patients were followed by clinical examination and duplex. In the 30-day postoperative period, 2 AVFs (5.7%) became infected requiring excision, 2 occluded (5.7%), 1 day 1 and the other at 24 days out, 1 patient developed steal and required DRIL 1 week postoperatively, and 1 patient died, unrelated to his surgery. Postoperative functional primary patency was 88% (30 of 34). Of the patients needing temporary access catheter, mean time to first fistula use was 44 days. No wound or bleeding complications have occurred in repaired

High throughput quantification of capsular polysaccharides for multivalent vaccines using precipitation with a cationic surfactant.

PubMed

Noyes, Aaron; Boesch, Austin; Godavarti, Ranga; Titchener-Hooker, Nigel; Coffman, Jonathan; Mukhopadhyay, Tarit

2013-11-19

The increasing requirement for multivalent vaccines containing diverse capsular polysaccharides has created an unmet need for a fast and straightforward assay for polysaccharide titer. We describe a novel and robust assay for the quantitation of anionic capsular polysaccharides. The binding of hexadecyltrimethyammonium bromide (Hb) to anionic capsular polysaccharides results in a precipitation reaction wherein the suspension turbidity is proportional to polysaccharide titer. The turbidity can be quickly measured as absorbance across a range of wavelengths that resolve scattering light. Carbohydrates comprised of repeating units of one to seven monosaccharides with phosphodiester groups, uronic acids, and sialic acids all reacted strongly and there does not appear to be specificity with respect to the particular anionic moiety. The assay is compatible with an array of common buffers across a pH range of 3.0-8.75 and with NaCl concentration exceeding 400 mM. Interference from DNA can be eliminated with a short incubation step with DNase. With these treatments, the assay has been employed in samples as complex as fermentation broth. A two-log dynamic range has been established with a mean relative standard deviation less than 10% across this range although inferior performance has been observed in fermentation broth. The precipitation assay enables the rapid quantitation of anionic polysaccharides. The resulting procedure can robustly measure the titer of myriad anionic capsular polysaccharides (CPS) in 96 samples in less than 30 min using low toxicity reagents and routine laboratory equipment. This development will greatly reduce the effort required to measure polysaccharide titer and yield during process development of polysaccharide vaccines. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Diagnosis and treatment of anteroinferior capsular redundancy associated with anterior shoulder instability using an open Latarjet procedure and capsulorrhaphy.

PubMed

Ropars, Mickaël; Cretual, Armel; Kaila, Rajiv; Bonan, Isabelle; Hervé, Anthony; Thomazeau, Hervé

2016-12-01

There is a paucity of data detailing management of anterior capsular redundancy (ACR) when using the Latarjet procedure for unidirectional instability. This study aimed to describe the surgical management and to assess the clinical profile of patients presenting with anterior capsular redundancy [ACR(+)] with anterior shoulder instability. Seventy-seven patients who had a Latarjet procedure were followed for a 55-month period. Per-operative ACR was assessed during surgery. ACR was considered present if the inferior capsular flap of a Neer T-shaft capsulorrhaphy was able to cover the superior capsular flap with the arm in the neutral position. Patients with ACR(+) received an additional Neer capsulorrhaphy, while patients with ACR(-) did not. This per-operative finding was correlated with demographics, clinical, radiological pre-operative data and surgical outcome. Patients presenting with a per-operative ACR(+) were significantly associated with a sulcus sign (P < 0.001), a Beighton score >4 (P < 0.01), a low-energy instability history (P < 0.05), a predominant history of subluxations (P < 0.05), fewer Hill-Sachs lesion (P < 0.05) and a female gender (P < 0.05), but not significantly with external rotation >85°. Open standard Latarjet procedures with Neer capsulorrhaphy in ACR(+) patients showed excellent or good results and stability rate of 95 %. All patients except four who presented with a new dislocation after surgery were satisfied with their outcome. Thirteen patients (16 %) had a persistent apprehension sign at the last follow-up. ACR(+) and ACR(-) groups did not show significant difference in the mean values of Rowe, Walch-Duplay and Constant-Murley scores. ACR correlated with a sulcus sign, Beighton score and instability history. In anterior shoulder instability associated with ACR, the Latarjet procedure with a Neer capsulorrhaphy appears a satisfactory treatment alternative to arthroscopic or open capsular shift. It decreased

Histopathologic and immunohistochemical features of capsular tissue around failed Ahmed glaucoma valves.

PubMed

Mahale, Alka; Fikri, Fatma; Al Hati, Khitam; Al Shahwan, Sami; Al Jadaan, Ibrahim; Al Katan, Hind; Khandekar, Rajiv; Maktabi, Azza; Edward, Deepak P

2017-01-01

Impervious encapsulation around Ahmed glaucoma valve (AGV) results in surgical failure raising intraocular pressure (IOP). Dysregulation of extracellular matrix (ECM) molecules and cellular factors might contribute to increased hydraulic resistance to aqueous drainage. Therefore, we examined these molecules in failed AGV capsular tissue. Immunostaining for ECM molecules (collagen I, collagen III, decorin, lumican, chondroitin sulfate, aggrecan and keratan sulfate) and cellular factors (αSMA and TGFβ) was performed on excised capsules from failed AGVs and control tenon's tissue. Staining intensity of ECM molecules was assessed using Image J. Cellular factors were assessed based on positive cell counts. Histopathologically two distinct layers were visible in capsules. The inner layer (proximal to the AGV) showed significant decrease in most ECM molecules compared to outer layer. Furthermore, collagen III (p = 0.004), decorin (p = 0.02), lumican (p = 0.01) and chondroitin sulfate (p = 0.02) was significantly less in inner layer compared to tenon's tissue. Outer layer labelling however was similar to control tenon's for most ECM molecules. Significantly increased cellular expression of αSMA (p = 0.02) and TGFβ (p = 0.008) was detected within capsular tissue compared to controls. Our results suggest profibrotic activity indicated by increased αSMA and TGFβ expression and decreased expression of proteoglycan (decorin and lumican) and glycosaminoglycans (chondroitin sulfate). Additionally, we observed decreased collagen III which might reflect increased myofibroblast contractility when coupled with increased TGFβ and αSMA expression. Together these events lead to tissue dysfunction potentially resulting in hydraulic resistance that may affect aqueous flow through the capsular wall.

Pseudomonas aeruginosa inactivation mechanism is affected by capsular extracellular polymeric substances reactivity with chlorine and monochloramine.

PubMed

Xue, Zheng; Hessler, Christopher M; Panmanee, Warunya; Hassett, Daniel J; Seo, Youngwoo

2013-01-01

The reactivity of capsular extracellular polymeric substances (EPS) to chlorine and monochloramine was assessed and compared in this study. The impact of capsular EPS on Gram-negative bacteria Pseudomonas aeruginosa inactivation mechanisms was investigated both qualitatively and quantitatively using a combination of batch experiments, viability tests with LIVE/DEAD staining, and Fourier transform infrared spectroscopy (FTIR). Both wild-type and isogenic mutant strains with different alginate EPS production capabilities were used to evaluate their susceptibility to chlorine and monochloramine. The mucA22 mutant strain, which overproduces the EPS composed largely of acidic polysaccharide alginate, exhibited high resistance and prolonged inactivation time to both chlorine and monochloramine relative to PAO1 (wild-type) and algT(U) mutant strains (alginate EPS deficient). Multiple analyses were combined to better understand the mechanistic role of EPS against chlorine-based disinfectants. The extracted EPS exhibited high reactivity with chlorine and very low reactivity with monochloramine, suggesting different mechanism of protection against disinfectants. Moreover, capsular EPS on cell membrane appeared to reduce membrane permeabilization by disinfectants as suggested by deformation of key functional groups in EPS and cell membrane (the C-O-C stretching of carbohydrate and the C=O stretching of ester group). The combined results supported that capsular EPS, acting either as a disinfectant consumer (for chlorine inactivation) or limiting access to reactive sites on cell membrane (for monochloramine inactivation), provide a protective role for bacterial cells against regulatory residual disinfectants by reducing membrane permeabilization. © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

Enhanced bioavailability of EPA from emulsified fish oil preparations versus capsular triacylglycerol

USDA-ARS?s Scientific Manuscript database

Pre-emulsified fish oil supplements, an alternative to capsular triacylglycerol, may enhance the uptake of LCn3 fatty acids it contains. A randomized, Latin-square crossover design was used to compare the effects of four fish oil supplement preparations on phospholipid (PLFA) and chylomicron fatty ...

Streptococcus iniae cpsG alters capsular carbohydrate composition and is a cause of serotype switching in vaccinated fish.

PubMed

Heath, Candice; Gillen, Christine M; Chrysanthopoulos, Panagiotis; Walker, Mark J; Barnes, Andrew C

2016-09-25

Streptococcus iniae causes septicaemia and meningitis in marine and freshwater fish wherever they are farmed in warm-temperate and tropical regions. Although serotype specific, vaccination with bacterins (killed bacterial cultures) is largely successful and vaccine failure occurs only occasionally through emergence of new capsular serotypes. Previously we showed that mutations in vaccine escapes are restricted to a limited repertoire of genes within the 20-gene capsular polysaccharide (cps) operon. cpsG, a putative UDP-galactose 4-epimerase, has three sequence types based on the insertion or deletion of the three amino acids leucine, serine and lysine in the substrate binding site of the protein. To elucidate the role of cpsG in capsular polysaccharide (CPS) biosynthesis and capsular composition, we first prepared isogenic knockout and complemented mutants of cpsG by allelic exchange mutagenesis. Deletion of cpsG resulted in changes to colony morphology and cell buoyant density, and also significantly decreased galactose content relative to glucose in the capsular polysaccharide as determined by GC-MS, consistent with epimerase activity of CpsG. There was also a metabolic penalty of cpsG knockout revealed by slower growth in complex media, and reduced proliferation in whole fish blood. Moreover, whilst antibodies raised in fish against the wild type cross-reacted in whole cell and cps ELISA, they did not cross-opsonise the mutant in a peripheral blood neutrophil opsonisation assay, consistent with reported vaccine escape. We have shown here that mutation in cpsG results in altered CPS composition and this in turn results in poor cross-opsonisation that explains some of the historic vaccination failure on fish farms in Australia. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Facet joint laser radiation: tissue effects of a new clinical laser application

NASA Astrophysics Data System (ADS)

Werkmann, Klaus; Thal, Dietmar R.

1996-01-01

Chronic unilateral and bilateral back pain with pseudoradicular symptoms, is a common clinical syndrome, which in many cases can be related to the facet joint syndrome. The pain is caused by mechanical affection of synovial and capsular nerve terminals. Therefore, current therapeutical attempts including physical therapy, intra-articular injection of local anesthetics and steroids and thermocoagulation of the facet joint with a thermocoagulator, are performed. We confirmed laser coagulation of the facet joint. Porcine cadaveric spines were treated immediately after death by intra-articular facet joint laser radiation. With the pulsed Nd:YAG laser (1064 nm) altogether 600 J were applied in three different places 4 mm apart at the top of the facet joint. The results showed that facet joint laser radiation leads to a small (about 1 - 2 mm diameter) lesion restricted to the facet joint cavity and its synovia. Histologically, we found a central carbonization zone and necrosis, including almost the whole cartilage and approximately 0.2 mm of the adjacent bone. These changes are similar to Nd:Yag-laser applications in other skeletal regions. It is suggested that these changes may lead to facet joint denervation by coagulation of the synovial nerve terminals. Cicatration of the laser lesion might cause ankylosis of this joint. In sum, facet joint laser radiation could be an alternative therapeutical tool for lower back pain of the facet joint syndrome type. Therefore, future clinical application of this technique seems to be very promising.

Calcaneocuboid joint instability: a novel operative technique for anatomic reconstruction.

PubMed

Lohrer, Heinz; Arentz, Sabine

2004-05-01

A case history of a 13-year-old female national top-level gymnast, suffering from calcaneocuboid joint instability, is presented. The procedure was done as an anatomic repair by capsular reefing, which was augmented using a local periosteal flap. Initially, the athlete twisted her ankle. Clinical investigation revealed no sign of a lateral ankle ligament injury, but following this initial examination, recurrent giving-way of the foot occurred. She additionally felt significant but diffuse pain on the lateral side of the foot during loading in training and competition. For 2 months she was unable to run and conservative treatment failed. Diagnosis of a calcaneocuboid instability was established 4 months after the initial lesion by clinical and x-ray stress examination of the calcaneocuboid joint. Open surgery was successfully performed. Early functional posttreatment was done and the patient returned to full high-level gymnastics ability 16 weeks after surgery. Two years later, a similar injury occurred to the opposite calcaneocuboid joint and the same operative procedure again led to full sports ability.

Anatomic and Histological Investigation of the Anterolateral Capsular Complex in the Fetal Knee.

PubMed

Sabzevari, Soheil; Rahnemai-Azar, Amir Ata; Albers, Marcio; Linde, Monica; Smolinski, Patrick; Fu, Freddie H

2017-05-01

There is currently disagreement with regard to the presence of a distinct ligament in the anterolateral capsular complex of the knee and its role in the pivot-shift mechanism and rotatory laxity of the knee. To investigate the anatomic and histological properties of the anterolateral capsular complex of the fetal knee to determine whether there exists a distinct ligamentous structure running from the lateral femoral epicondyle inserting into the anterolateral tibia. Descriptive laboratory study. Twenty-one unpaired, fresh fetal lower limbs, gestational age 18 to 22 weeks, were used for anatomic investigation. Two experienced orthopaedic surgeons performed the anatomic dissection using loupes (magnification ×3.5). Attention was focused on the anterolateral and lateral structures of the knee. After the skin and superficial fascia were removed, the iliotibial band was carefully separated from underlying structures. The anterolateral capsule was then examined under internal and external rotation and varus-valgus manual loading and at different knee flexion angles for the presence of any ligamentous structures. Eight additional unpaired, fetal lower limbs, gestational age 11 to 23 weeks, were used for histological analysis. This study was not able to prove the presence of a distinct capsular or extracapsular ligamentous structure in the anterolateral capsular complex area. The presence of the fibular collateral ligament, a distal attachment of the biceps femoris, the entire lateral capsule, the iliotibial band, and the popliteus tendon in the anterolateral and lateral area of the knee was confirmed in all the samples. Histological analysis of the anterolateral capsule revealed a loose, hypocellular connective tissue with less organized collagen fibers compared with ligament and tendinous structures. The main finding of this study was that the presence of a distinct ligamentous structure in the anterolateral complex is not supported from a developmental point of view

Direct identification of Streptococcus agalactiae and capsular type by real-time PCR in vaginal swabs from pregnant women.

PubMed

Morozumi, Miyuki; Chiba, Naoko; Igarashi, Yuko; Mitsuhashi, Naoki; Wajima, Takeaki; Iwata, Satoshi; Ubukata, Kimiko

2015-01-01

Most group B streptococcus (GBS) infections in newborns are with capsular type Ia, Ib, or III. To prevent these infections more effectively, we developed a real-time PCR method to simultaneously detect GBS species and identify these 3 capsular types in vaginal swab samples from women at 36-39 weeks of gestation. DNA to be detected included those of the dltS gene (encoding a histidine kinase specific to GBS) and cps genes encoding capsular types. PCR sensitivity was 10 CFU/well for a 33-35 threshold cycle. Results were obtained within 2 h. Direct PCR results were compared with results obtained from cultures. Samples numbering 1226 underwent PCR between September 2008 and August 2012. GBS positivity rates by direct PCR and after routine culture were 15.7% (n = 192) and 12.6% (n = 154), respectively. Sensitivity and specificity of direct PCR relative to culture were 96.1% and 95.9%. Of GBS positive samples identified by PCR, capsular types determined directly by real-time PCR were Ia (n = 24), Ib (n = 32), and III (n = 26). Real-time PCR using our designed cycling probe is a practical, highly sensitive method for identification of GBS in pregnant carriers, allowing use of prophylactic intrapartum antibiotics in time to cover the possibility of unexpected premature birth. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Arthroscopic therapy of recurrent anterior luxation of the shoulder by capsular repair.

PubMed

Landsiedl, F

1992-01-01

Sixty-five cases of recurrent anterior unidirectional dislocation of the shoulder were treated by arthroscopic capsular repair. In this approach, the arthroscope is inserted through a posterior portal. Using mostly an anterior portal, a 5-mm hole is drilled across the neck of the glenoid, between the 3 and 4 o'clock positions. A 5-mm working cannula is passed from the posterior portal into the joint. Mostly through the anterior portal, four to six retention U-sutures are placed in the labrum, the middle and inferior glenohumeral ligament, and the subscapularis tendon. A 25-cm-long, 2.0-mm K-wire with an eye is used. The sutures are pulled out posteriorly through the cannula and tied on the fascia of the infraspinatus muscle. The goal of the procedure is to reattach the detached labrum-ligament complex (LLC) and achieve a capsulorrhaphy in a medial-lateral and superior-inferior direction. There were nine redislocations during a follow-up period of 24-60 months (average, 35.3 months). Reasons for redislocation were (a) fewer than four sutures; (b) no sutures of the LLC; (c) placement of the drill hole in the top third of the glenoid; (d) nontraumatic dislocation; (e) no Bankart or Hill-Sachs lesion; (f) transverse tear of the LLC; or (g) technical errors. Redislocation was more common in male patients.

Genomic Investigation Reveals Highly Conserved, Mosaic, Recombination Events Associated with Capsular Switching among Invasive Neisseria meningitidis Serogroup W Sequence Type (ST)-11 Strains.

PubMed

Mustapha, Mustapha M; Marsh, Jane W; Krauland, Mary G; Fernandez, Jorge O; de Lemos, Ana Paula S; Dunning Hotopp, Julie C; Wang, Xin; Mayer, Leonard W; Lawrence, Jeffrey G; Hiller, N Luisa; Harrison, Lee H

2016-07-03

Neisseria meningitidis is an important cause of meningococcal disease globally. Sequence type (ST)-11 clonal complex (cc11) is a hypervirulent meningococcal lineage historically associated with serogroup C capsule and is believed to have acquired the W capsule through a C to W capsular switching event. We studied the sequence of capsule gene cluster (cps) and adjoining genomic regions of 524 invasive W cc11 strains isolated globally. We identified recombination breakpoints corresponding to two distinct recombination events within W cc11: A 8.4-kb recombinant region likely acquired from W cc22 including the sialic acid/glycosyl-transferase gene, csw resulted in a C→W change in capsular phenotype and a 13.7-kb recombinant segment likely acquired from Y cc23 lineage includes 4.5 kb of cps genes and 8.2 kb downstream of the cps cluster resulting in allelic changes in capsule translocation genes. A vast majority of W cc11 strains (497/524, 94.8%) retain both recombination events as evidenced by sharing identical or very closely related capsular allelic profiles. These data suggest that the W cc11 capsular switch involved two separate recombination events and that current global W cc11 meningococcal disease is caused by strains bearing this mosaic capsular switch. © The Author 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Evaluation of lipopolysaccharide and capsular polysaccharide as subunit vaccines against experimental melioidosis.

PubMed

Nelson, Michelle; Prior, Joann L; Lever, M Stephen; Jones, Helen E; Atkins, Timothy P; Titball, Richard W

2004-12-01

Burkholderia pseudomallei is the causative agent of melioidosis, which is a major cause of morbidity and mortality in endemic regions. Currently there is no human vaccine against melioidosis. In this study, LPS or capsular polysaccharide was used to immunize BALB/c mice. The different polysaccharide antigens induced antibody responses. Mice vaccinated with LPS developed predominantly IgM and IgG3 responses. Contrastingly, mice vaccinated with capsular polysaccharide developed a predominantly IgG2b response. After immunization, mice were challenged by the intra-peritoneal route and an increased mean time to death was observed compared with unvaccinated controls. Immunization with LPS provided an optimal protective response. Mice challenged by the aerosol route showed a small increase in the mean time to death compared with the unvaccinated controls. The passive transfer of antigen from immunized into naive mice provided protection against a subsequent challenge. This study is the first time antigens protective by active immunization have been identified and suggests that polysaccharides have potential as vaccine candidates against melioidosis.

Arthroscopic capsular release for idiopathic frozen shoulder with intra-articular injection and a controlled manipulation

PubMed Central

Hamer, P; Bunker, TD

2014-01-01

INTRODUCTION The aim of this prospective study was to assess the immediate and long-term effectiveness of arthroscopic capsular release in a large cohort of patients with a precise and isolated diagnosis of stage II idiopathic frozen shoulder. METHODS All patients underwent a preoperative evaluation. Patients with secondary frozen shoulder and those with concurrent pathology at arthroscopy were excluded. This left 136 patients with a stage II arthroscopically confirmed idiopathic frozen shoulder. At each postoperative attendance, a record was made of pain, function and range of motion. At 12 months, the Oxford shoulder score was calculated, and pain and range of motion were assessed. RESULTS Fifty per cent achieved good pain relief within a week and eighty per cent within six weeks of arthroscopic capsular release. The mean preoperative visual analogue scale pain score was 6.6 and the mean postoperative score was 1.0. The mean time to achieving good pain relief was 16 days following surgery. No patient could sleep through the night prior to surgery while 90% reported having a complete night’s sleep at a mean of 12 days after surgery. The mean postoperative Oxford shoulder score was 38/48 and the mean improvement was 19.2. CONCLUSIONS This large series demonstrates that arthroscopic capsular release is a safe procedure, with rapid improvement in pain and a marked improvement in range of motion. PMID:24417832

Genetics of Capsular Polysaccharides and Cell Envelope (Glyco)lipids

PubMed Central

Daffé, Mamadou; Crick, Dean C.; Jackson, Mary

2014-01-01

This chapter summarizes what is currently known of the structures, physiological roles, involvement in pathogenicity and biogenesis of a variety of non-covalently bound cell envelope lipids and glycoconjugates of Mycobacterium tuberculosis and other Mycobacterium species. Topics addressed in this chapter include phospholipids; phosphatidylinositol mannosides; triglycerides; isoprenoids and related compounds (polyprenyl phosphate, menaquinones, carotenoids, non-carotenoid cyclic isoprenoids); acyltrehaloses (lipooligosaccharides, trehalose mono- and di-mycolates, sulfolipids, di- and poly-acyltrehaloses); mannosyl-beta-1-phosphomycoketides; glycopeptidolipids; phthiocerol dimycocerosates, para-hydroxybenzoic acids and phenolic glycolipids; mycobactins; mycolactones; and capsular polysaccharides. PMID:25485178

High mortality among patients infected with hypervirulent antimicrobial-resistant capsular type K1 Klebsiella pneumoniae strains in Taiwan.

PubMed

Lin, Yi-Tsung; Cheng, Yi-Hsiang; Juan, Chih-Han; Wu, Ping-Feng; Huang, Yi-Wei; Chou, Sheng-Hua; Yang, Tsuey-Ching; Wang, Fu-Der

2018-06-12

Capsular type K1 Klebsiella pneumoniae, highly virulent strains which are common in Asian countries, can cause pyogenic infections. These hypervirulent strains are usually susceptible to most antimicrobials, except for ampicillin. Little is known regarding the clinical and molecular characteristics of antimicrobial-resistant K1 K. pneumoniae strains. This retrospective study evaluated patients infected with capsular type K1 K. pneumoniae strains in a Taiwanese medical centre between April 2013 and March 2016. Antimicrobial-resistant strains were defined based on non-susceptibility to antimicrobial agents except ampicillin. We compared the clinical outcome of patients infected with and without antimicrobial-resistant strains. The in vivo virulence, genetic relatedness, and resistance mechanisms of these hypervirulent antimicrobial-resistant strains were also investigated. A total of 182 capsular type K1 K. pneumoniae strains were identified, including 18 antimicrobial-resistant strains. The 28-day mortality rate among the 18 cases caused by antimicrobial-resistant strains was significantly higher than that among 164 cases caused by antimicrobial-sensitive strains (50% vs. 10.4%, p < 0.001). Infection with antimicrobial-resistant strain independently increased the 28-day mortality risk. Most antimicrobial -resistant strains were not clonally related, and they exhibited high in vivo virulence in a mouse lethality experiment. The major resistance mechanisms involved the presence of β-lactamases and the overexpression of efflux pumps. In conclusion, hypervirulent antimicrobial-resistant capsular type K1 K. pneumoniae strains can predispose to a fatal outcome. These strains may represent an emerging threat to public health in Taiwan. Copyright © 2018. Published by Elsevier B.V.

Comparative genome analysis of novel Podoviruses lytic for hypermucoviscous Klebsiella pneumoniae of K1, K2, and K57 capsular types.

PubMed

Solovieva, Ekaterina V; Myakinina, Vera P; Kislichkina, Angelina A; Krasilnikova, Valentina M; Verevkin, Vladimir V; Mochalov, Vladimir V; Lev, Anastasia I; Fursova, Nadezhda K; Volozhantsev, Nikolay V

2018-01-02

Hypermucoviscous (HV) strains of capsular types K1, K2 and K57 are the most virulent representatives of the Klebsiella pneumoniae species. Eight novel bacteriophages lytic for HV K. pneumoniae were isolated and characterized. Three bacteriophages, KpV41, KpV475, and KpV71 were found to have a lytic activity against mainly K. pneumoniae of capsular type K1. Two phages, KpV74, and KpV763 were lytic for K2 capsular type K. pneumoniae, and the phage KpV767 was specific to K57-type K. pneumoniae only. Two more phages, KpV766, and KpV48 had no capsular specificity. The phage genomes consist of a linear double-stranded DNA of 40,395-44,623bp including direct terminal repeats of 180-246 bp. The G + C contents are 52.3-54.2 % that is slightly lower than that of genomes of K. pneumoniae strains being used for phage propagation. According to the genome structures, sequence similarity and phylogenetic data, the phages are classified within the genus Kp32virus and Kp34virus of subfamily Autographivirinae, family Podoviridae. In the phage genomes, genes encoding proteins with putative motifs of polysaccharide depolymerase were identified. Depolymerase genes of phages KpV71 and KpV74 lytic for hypermucoviscous K. pneumoniae of K1 and K2 capsular type, respectively, were cloned and expressed in Escherichia coli, and the recombinant gene products were purified. The specificity and polysaccharide-degrading activity of the recombinant depolymerases were demonstrated. Copyright © 2017 Elsevier B.V. All rights reserved.

Limited capsular release and controlled manipulation under anaesthesia for the treatment of frozen shoulder

PubMed Central

Bidwai, Amit S; Nielsen, Maryke; Brownson, Peter

2015-01-01

Background In light of recent interest in the cost-effectiveness of the treatment options available for frozen shoulder, we aimed to determine the results of limited anterior capsular release and controlled manipulation under anaesthesia (MUA) in the treatment of primary frozen shoulder in terms of patient-related outcomes measure, range of motion and re-intervention rates. Methods This single-surgeon series included prospectively collected data on all patients undergoing capsular release with MUA from March 2011 until June 2013, with a minimum follow-up of 6 months from the index procedure. Outcome measures included pre- and postoperative Oxford Shoulder Score (OSS), range of motion and need for re-intervention. Results Fifty-four procedures were performed in 52 patients. Mean age 50 years (range 42 years to 59 years); male: female ratio = 11: 41. There was a highly statistically significant improvement in both pain and function modules of the OSS (p < 0.005) and range of motion (p < 0.005) at 6 months. The median postoperative score was 41 from a maximum of 48 points, with an average mean improvement of 24 points. Seventeen patients were diabetics. There was no significant difference in pre-operative and postoperative OSS or range of motion between the diabetic group and the non-diabetic groups. No patients required surgical re-intervention. Conclusions A combination of limited capsular release and MUA for the treatment of primary frozen shoulder is a safe and effective procedure resulting in marked improvement in pain, function and range of motion. PMID:27582995

Limited capsular release and controlled manipulation under anaesthesia for the treatment of frozen shoulder.

PubMed

Bidwai, Amit S; Mayne, Alistair Iw; Nielsen, Maryke; Brownson, Peter

2016-01-01

In light of recent interest in the cost-effectiveness of the treatment options available for frozen shoulder, we aimed to determine the results of limited anterior capsular release and controlled manipulation under anaesthesia (MUA) in the treatment of primary frozen shoulder in terms of patient-related outcomes measure, range of motion and re-intervention rates. This single-surgeon series included prospectively collected data on all patients undergoing capsular release with MUA from March 2011 until June 2013, with a minimum follow-up of 6 months from the index procedure. Outcome measures included pre- and postoperative Oxford Shoulder Score (OSS), range of motion and need for re-intervention. Fifty-four procedures were performed in 52 patients. Mean age 50 years (range 42 years to 59 years); male: female ratio = 11: 41. There was a highly statistically significant improvement in both pain and function modules of the OSS (p < 0.005) and range of motion (p < 0.005) at 6 months. The median postoperative score was 41 from a maximum of 48 points, with an average mean improvement of 24 points. Seventeen patients were diabetics. There was no significant difference in pre-operative and postoperative OSS or range of motion between the diabetic group and the non-diabetic groups. No patients required surgical re-intervention. A combination of limited capsular release and MUA for the treatment of primary frozen shoulder is a safe and effective procedure resulting in marked improvement in pain, function and range of motion.

Arthroscopic Subscapularis Augmentation of Bankart Repair in Chronic Anterior Shoulder Instability With Bone Loss Less Than 25% and Capsular Deficiency: Clinical Multicenter Study.

PubMed

Maiotti, Marco; Massoni, Carlo; Russo, Raffaele; Schroter, Steffen; Zanini, Antonio; Bianchedi, Diana

2017-05-01

To assess the short-term outcomes of the arthroscopic subscapularis augmentation (ASA) technique, consisting of a tenodesis of the upper third of the subscapularis tendon and a Bankart repair, and its effect on shoulder external rotation. Patients selected for this study were involved in contact sports, with a history of traumatic recurrent shoulder dislocations and a minimum of 2-year follow-up. Inclusion criteria were patients with glenoid bone loss (GBL) ranging from 5% to 25%, anterior capsular deficiency, and Hill-Sachs lesion who underwent ASA technique. Exclusion criteria were GBL >25%, multidirectional instability, preexisting osteoarthritis, and overhead sports activities. Visual analog scale (VAS) scale for pain, Rowe score, and American Shoulder and Elbow Surgeons (ASES) scores were used to assess results. Loss of shoulder external rotation was measured with the arm at the side (ER1 position) or 90° in abduction (ER2 position). Analysis of variance and Fisher tests were used for data evaluation. Significance was established at P ≤ .05. One hundred ten patients (84 men and 26 women, mean age 27 years) were evaluated with a mean follow-up of 40.5 months (range: 24 to 65 months). In 98 patients, a Hill-Sachs lesion was observed and in 57 patients a capsular deficiency was present. Three patients (2.7%) had a traumatic redislocation. At final follow-up, the mean scores were as follows: VAS scale decreased from a mean of 3.5 to 0.5 (P = .015), Rowe score increased from 57.4 to 95.3 (P = .035), and ASES score increased from 66.5 to 96.5 (P = .021). The mean deficit of external rotation was 8° ± 2.5° in the ER1 position and 4° ± 1.5° in the ER2 position. The ASA procedure has been shown to be effective in restoring joint stability in patients practicing sports, affected by chronic anterior shoulder instability associated with anterior GBL (<25%), capsular deficiency, and Hill-Sachs lesions, with mild restriction of external rotation. Level IV

NeuA sialic acid O-acetylesterase activity modulates O-acetylation of capsular polysaccharide in group B Streptococcus.

PubMed

Lewis, Amanda L; Cao, Hongzhi; Patel, Silpa K; Diaz, Sandra; Ryan, Wesley; Carlin, Aaron F; Thon, Vireak; Lewis, Warren G; Varki, Ajit; Chen, Xi; Nizet, Victor

2007-09-21

Group B Streptococcus (GBS) is a common cause of neonatal sepsis and meningitis. A major GBS virulence determinant is its sialic acid (Sia)-capped capsular polysaccharide. Recently, we discovered the presence and genetic basis of capsular Sia O-acetylation in GBS. We now characterize a GBS Sia O-acetylesterase that modulates the degree of GBS surface O-acetylation. The GBS Sia O-acetylesterase operates cooperatively with the GBS CMP-Sia synthetase, both part of a single polypeptide encoded by the neuA gene. NeuA de-O-acetylation of free 9-O-acetyl-N-acetylneuraminic acid (Neu5,9Ac(2)) was enhanced by CTP and Mg(2+), the substrate and co-factor, respectively, of the N-terminal GBS CMP-Sia synthetase domain. In contrast, the homologous bifunctional NeuA esterase from Escherichia coli K1 did not display cofactor dependence. Further analyses showed that in vitro, GBS NeuA can operate via two alternate enzymatic pathways: de-O-acetylation of Neu5,9Ac(2) followed by CMP activation of Neu5Ac or activation of Neu5,9Ac(2) followed by de-O-acetylation of CMP-Neu5,9Ac(2). Consistent with in vitro esterase assays, genetic deletion of GBS neuA led to accumulation of intracellular O-acetylated Sias, and overexpression of GBS NeuA reduced O-acetylation of Sias on the bacterial surface. Site-directed mutagenesis of conserved asparagine residue 301 abolished esterase activity but preserved CMP-Sia synthetase activity, as evidenced by hyper-O-acetylation of capsular polysaccharide Sias on GBS expressing only the N301A NeuA allele. These studies demonstrate a novel mechanism regulating the extent of capsular Sia O-acetylation in intact bacteria and provide a genetic strategy for manipulating GBS O-acetylation in order to explore the role of this modification in GBS pathogenesis and immunogenicity.

Should all acromioclavicular joint injections be performed under image guidance?

PubMed

Javed, S; Sadozai, Z; Javed, A; Din, A; Schmitgen, G

2017-01-01

Steroid and local anaesthetic injection to the acromioclavicular joint (ACJ) is a very common diagnostic and therapeutic procedure, which is often performed in the outpatient department. However, it can be difficult to localize this joint because of its small size, presence of osteophytes and variable morphology in the population. We performed a study to determine whether the use of an image intensifier (X-ray guidance), in theatre, improves the accuracy of this injection. This was a prospective study carried out between March 2014 and March 2015. The injections were performed by two senior orthopaedic surgeons. First, we clinically palpated the ACJ and marked the area over this point as A. Then, with the use of a needle and an image intensifier in a single plane, we identified the actual location of the ACJ and marked this point as B. We measured the distance between A and B in millimetres (mm) and determined the accuracy of the injections. Further analysis taking into account the ACJ capsular attachments was also performed. In total, 45 patients and 50 injections were included in the study; five patients had repeated injections at different times. We found that only 12 injections (24%) were palpated to be correct with no discrepancies between A and B (95% confidence interval: 14-37%). For the remaining 38 injections (76%), the use of an image intensifier had significantly improved the accuracy of ACJ location ( p < 0.05). Taking the capsular attachments of the ACJ into consideration reduced the number of inaccurate injections to 27 (54%). We recommend the use of an image intensifier (or ultrasound guidance) to accurately determine the location of the ACJ for steroid and local anaesthetic injections. This prevents an injection into the wrong place, which can lead to wrong diagnosis and/or suboptimal treatment.

Conjugate-like immunogens produced as protein capsular matrix vaccines.

PubMed

Thanawastien, Ann; Cartee, Robert T; Griffin, Thomas J; Killeen, Kevin P; Mekalanos, John J

2015-03-10

Capsular polysaccharides are the primary antigenic components involved in protective immunity against encapsulated bacterial pathogens. Although immunization of adolescents and adults with polysaccharide antigens has reduced pathogen disease burden, pure polysaccharide vaccines have proved ineffective at conferring protective immunity to infants and the elderly, age cohorts that are deficient in their adaptive immune responses to such antigens. However, T-cell-independent polysaccharide antigens can be converted into more potent immunogens by chemically coupling to a "carrier protein" antigen. Such "conjugate vaccines" efficiently induce antibody avidity maturation, isotype switching, and immunological memory in immunized neonates. These immune responses have been attributed to T-cell recognition of peptides derived from the coupled carrier protein. The covalent attachment of polysaccharide antigens to the carrier protein is thought to be imperative to the immunological properties of conjugate vaccines. Here we provide evidence that covalent attachment to carrier proteins is not required for conversion of T-independent antigens into T-dependent immunogens. Simple entrapment of polysaccharides or a d-amino acid polymer antigen in a cross-linked protein matrix was shown to be sufficient to produce potent immunogens that possess the key characteristics of conventional conjugate vaccines. The versatility and ease of manufacture of these antigen preparations, termed protein capsular matrix vaccines (PCMVs), will likely provide improvements in the manufacture of vaccines designed to protect against encapsulated microorganisms. This in turn could improve the availability of such vaccines to the developing world, which has shown only a limited capacity to afford the cost of conventional conjugate vaccines.

Different accumulation profiles of multiple components between pericarp and seed of Alpinia oxyphylla capsular fruit as determined by UFLC-MS/MS.

PubMed

Chen, Feng; Li, Hai-Long; Tan, Yin-Feng; Guan, Wei-Wei; Zhang, Jun-Qing; Li, Yong-Hui; Zhao, Yuan-Sheng; Qin, Zhen-Miao

2014-04-10

Plant secondary metabolites are known to not only play a key role in the adaptation of plants to their environment, but also represent an important source of active pharmaceuticals. Alpinia oxyphylla capsular fruits, made up of seeds and pericarps, are commonly used in traditional East Asian medicines. In clinical utilization of these capsular fruits, inconsistent processing approaches (i.e., hulling pericarps or not) are employed, with the potential of leading to differential pharmacological effects. Therefore, an important question arises whether the content levels of pharmacologically active chemicals between the seeds and pericarps of A. oxyphylla are comparable. Nine secondary metabolites present in A. oxyphylla capsular fruits, including flavonoids (e.g., tectochrysin, izalpinin, chrysin, apigenin-4',7-dimethylether and kaempferide), diarylheptanoids (e.g., yakuchinone A and B and oxyphyllacinol) and sesquiterpenes (e.g., nootkatone), were regarded as representative constituents with putative pharmacological activities. This work aimed to investigate the abundance of the nine constituents in the seeds and pericarps of A. oxyphylla. Thirteen batches of A. oxyphylla capsular fruits were gathered from different production regions. Accordingly, an ultra-fast high performance liquid chromatography/quadrupole tandem mass spectrometry (UFLC-MS/MS) method was developed and validated. We found that: (1) the nine secondary metabolites were differentially concentrated in seeds and fruit capsules; (2) nootkatone is predominantly distributed in the seeds; in contrast, the flavonoids and diarylheptanoids are mainly deposited in the capsules; and (3) the content levels of the nine secondary metabolites occurring in the capsules varied greatly among different production regions, although the nootkatone levels in the seeds were comparable among production regions. These results are helpful to evaluating and elucidating pharmacological activities of A. oxyphylla capsular

Immune cell activation and cytokine release after stimulation of whole blood with pneumococcal C-polysaccharide and capsular polysaccharides.

PubMed

Sundberg-Kövamees, Marianne; Grunewald, Johan; Wahlström, Jan

2016-11-01

Streptococcus pneumonia is a major cause of morbidity and mortality in children and adults worldwide. Lack of fully effective pneumococcal vaccines is a problem. Streptococcus pneumoniae exposes on its surface C-polysaccharide (cell wall polysaccharide, CWPS) and serospecific capsular polysaccharides, used in pneumococcal vaccines. We investigated the effect of CWPS and individual capsular polysaccharides, with regard to activation of subsets of immune cells of healthy controls. Three different capsular polysaccharides, CWPS and LPS were used for in vitro stimulation of whole blood. Cell activation (CD69 expression) was assessed in CD4+ and CD4- T cells, NK-like T cells, NK cells and monocytes by flow cytometry. Cytokine levels in supernatants were quantified by Cytometric Bead Array (CBA). CWPS and the capsules activated immune cell subsets, but to different degrees. NK cells and NK-like T cells showed the strongest activation, followed by monocytes. Among the three capsules, capsule type 23 induced the strongest activation and cytokine release, followed by type 9 and type 3. This study increases the understanding of how the human immune system reacts to pneumococcal vaccine components. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

An in vitro evaluation of the Anew Zephyr open-bag IOL in the prevention of posterior capsule opacification using a human capsular bag model.

PubMed

Eldred, Julie A; Spalton, David J; Wormstone, I Michael

2014-09-18

During cataract surgery an IOL is placed within the capsular bag. Clinical studies show that IOLs with a square edge profile and complete contact between the IOL and the anterior capsule (AC) are currently the best way to prevent posterior capsule opacification (PCO). This has been challenged by recent clinical and experimental observations, which suggest that if the capsular bag is kept open with separation of contact between the AC and posterior capsule (PC) by an "open-bag device" PCO is dramatically reduced. Therefore, the current study set out to evaluate the putative merits of an open-bag IOL (Anew Zephyr) in a human capsular bag model. An in vitro organ culture model using the bag-zonular-ciliary body complex isolated from fellow human donor eyes was prepared. A capsulorhexis and lens extraction were performed, and an Alcon Acrysof IOL or Anew Zephyr IOL implanted. Preparations were secured by pinning the ciliary body to a silicone ring and maintained in 6 mL Eagle's minimum essential medium (EMEM) or EMEM supplemented with 2% vol/vol human serum (HS) and 10 ng/mL TGF-β2 for 28 days. Cell growth and capsular modifications were monitored with phase-contrast and modified dark-field microscopy. In serum-free EMEM culture conditions, cells were observed growing onto the PC of preparations implanted with an Anew Zephyr IOL, but this was retarded relative to observations in match-paired capsular bags implanted with an Alcon Acrysof IOL. In the case of cultures maintained in 2% HS-EMEM plus TGF-β2, the movement on to the PC was again delayed with the presence of an Anew Zephyr IOL. Differences in the degree of growth on the PC and matrix modifications were apparent with the different donors, but in each case the match-paired Alcon Acrysof implanted bag exhibited significantly greater coverage and modification of the capsule. The Anew Zephyr open-bag IOL performs consistently better than the Alcon Acrysof IOL in the human capsular bag model. We propose that the

Effects of radiofrequency probe application on irrigation fluid temperature in the wrist joint.

PubMed

Sotereanos, Dean G; Darlis, Nickolaos A; Kokkalis, Zinon T; Zanaros, George; Altman, Gregory T; Miller, Mark Carl

2009-12-01

Radiofrequency (RF) probes used in wrist arthroscopy may raise joint fluid temperature, increasing the risk of capsular and ligamentous damage. The purposes of the current study were to measure joint fluid temperature during wrist arthroscopy with the use of RF probes, and to determine whether using an outlet portal will reduce the maximum temperature. We performed wrist arthroscopy on 8 cadaveric arms. Ablation and coagulation cycles using RF probe were performed at documented locations within the joint. This was done for 60-second intervals on both the radial and ulnar side of the wrist, to mimic clinical practice. We used 4 fiberoptic phosphorescent probes to measure temperature (radial, ulnar, inflow-tube, and outflow-tube probes) and measured joint fluid temperature with and without outflow. There was a significant difference between wrists with and without outflow when examining maximum ablation temperatures (p < .002). All specimens showed higher maximum and average ablation temperatures without outflow. Maximum joint temperatures, greater than 60 degrees C, were observed in only no-outflow conditions. In performing RF ablation during wrist arthroscopy, the use of an outlet portal reduces the joint fluid temperature. Without an outlet portal, maximum temperatures can exceed desirable levels when using ablation; such temperatures have the potential to damage adjacent tissues. It is useful to maintain adequate outflow when using the radiofrequency probes during wrist arthroscopy.

Non-terminal animal model of post-traumatic osteoarthritis induced by acute joint injury

PubMed Central

Boyce, Mary K.; Trumble, Troy N.; Carlson, Cathy S.; Groschen, Donna M.; Merritt, Kelly A.; Brown, Murray P.

2013-01-01

Objective Develop a non-terminal animal model of acute joint injury that demonstrates clinical and morphological evidence of early post-traumatic osteoarthritis (PTOA). Methods An osteochondral (OC) fragment was created arthroscopically in one metacarpophalangeal (MCP) joint of 11 horses and the contralateral joint was sham operated. Eleven additional horses served as unoperated controls. Every 2 weeks, force plate analysis, flexion response, joint circumference, and synovial effusion scores were recorded. At weeks 0 and 16, radiographs (all horses) and arthroscopic videos (OC injured and sham joints) were graded. At week 16, synovium and cartilage biopsies were taken arthroscopically from OC injured and sham joints for histologic evaluation and the OC fragment was removed. Results Osteochondral fragments were successfully created and horses were free of clinical lameness after fragment removal. Forelimb gait asymmetry was observed at week 2 (P=0.0012), while joint circumference (P<0.0001) and effusion scores (P<0.0001) were increased in injured limbs compared to baseline from weeks 2 to 16. Positive flexion response of injured limbs was noted at multiple time points. Capsular enthesophytes were seen radiographically in injured limbs. Articular cartilage damage was demonstrated arthroscopically as mild wear-lines and histologically as superficial zone chondrocyte death accompanied by mild proliferation. Synovial hyperemia and fibrosis were present at the site of OC injury. Conclusion Acute OC injury to the MCP joint resulted in clinical, imaging, and histologic changes in cartilage and synovium characteristic of early PTOA. This model will be useful for defining biomarkers of early osteoarthritis and for monitoring response to therapy and surgery. PMID:23467035

Capsular profiling of the Cronobacter genus and the association of specific Cronobacter sakazakii and C. malonaticus capsule types with neonatal meningitis and necrotizing enterocolitis.

PubMed

Ogrodzki, P; Forsythe, S

2015-10-08

Cronobacter sakazakii and C. malonaticus can cause serious diseases especially in infants where they are associated with rare but fatal neonatal infections such as meningitis and necrotising enterocolitis. This study used 104 whole genome sequenced strains, covering all seven species in the genus, to analyse capsule associated clusters of genes involved in the biosynthesis of the O-antigen, colanic acid, bacterial cellulose, enterobacterial common antigen (ECA), and a previously uncharacterised K-antigen. Phylogeny of the gnd and galF genes flanking the O-antigen region enabled the defining of 38 subgroups which are potential serotypes. Two variants of the colanic acid synthesis gene cluster (CA1 and CA2) were found which differed with the absence of galE in CA2. Cellulose (bcs genes) were present in all species, but were absent in C. sakazakii sequence type (ST) 13 and clonal complex (CC) 100 strains. The ECA locus was found in all strains. The K-antigen capsular polysaccharide Region 1 (kpsEDCS) and Region 3 (kpsMT) genes were found in all Cronobacter strains. The highly variable Region 2 genes were assigned to 2 homology groups (K1 and K2). C. sakazakii and C. malonaticus isolates with capsular type [K2:CA2:Cell(+)] were associated with neonatal meningitis and necrotizing enterocolitis. Other capsular types were less associated with clinical infections. This study proposes a new capsular typing scheme which identifies a possible important virulence trait associated with severe neonatal infections. The various capsular polysaccharide structures warrant further investigation as they could be relevant to macrophage survival, desiccation resistance, environmental survival, and biofilm formation in the hospital environment, including neonatal enteral feeding tubes.

Capsular Sialyltransferase Specificity Mediates Different Phenotypes in Streptococcus suis and Group B Streptococcus

PubMed Central

Roy, David; Takamatsu, Daisuke; Okura, Masatoshi; Goyette-Desjardins, Guillaume; Van Calsteren, Marie-Rose; Dumesnil, Audrey; Gottschalk, Marcelo; Segura, Mariela

2018-01-01

The capsular polysaccharide (CPS) represents a key virulence factor for most encapsulated streptococci. Streptococcus suis and Group B Streptococcus (GBS) are both well-encapsulated pathogens of clinical importance in veterinary and/or human medicine and responsible for invasive systemic diseases. S. suis and GBS are the only Gram-positive bacteria which express a sialylated CPS at their surface. An important difference between these two sialylated CPSs is the linkage between the side-chain terminal galactose and sialic acid, being α-2,6 for S. suis but α-2,3 for GBS. It is still unclear how sialic acid may affect CPS production and, consequently, the pathogenesis of the disease caused by these two bacterial pathogens. Here, we investigated the role of sialic acid and the putative effect of sialic acid linkage modification in CPS synthesis using inter-species allelic exchange mutagenesis. To this aim, a new molecular biogenetic approach to express CPS with modified sialic acid linkage was developed. We showed that sialic acid (and its α-2,6 linkage) is crucial for S. suis CPS synthesis, whereas for GBS, CPS synthesis may occur in presence of an α-2,6 sialyltransferase or in absence of sialic acid moiety. To evaluate the effect of the CPS composition/structure on sialyltransferase activity, two distinct capsular serotypes within each bacterial species were compared (S. suis serotypes 2 and 14 and GBS serotypes III and V). It was demonstrated that the observed differences in sialyltransferase activity and specificity between S. suis and GBS were serotype unrestricted. This is the first time that a study investigates the interspecies exchange of capsular sialyltransferase genes in Gram-positive bacteria. The obtained mutants represent novel tools that could be used to further investigate the immunomodulatory properties of sialylated CPSs. Finally, in spite of common CPS structural characteristics and similarities in the cps loci, sialic acid exerts differential

Arthroscopic Bankart repair and capsular shift for recurrent anterior shoulder instability: functional outcomes and identification of risk factors for recurrence.

PubMed

Ahmed, Issaq; Ashton, Fiona; Robinson, Christopher Michael

2012-07-18

Arthroscopic Bankart repair and capsular shift is a well-established technique for the treatment of anterior shoulder instability. The purpose of this study was to evaluate the outcomes following arthroscopic Bankart repair and capsular shift and to identify risk factors that are predictive of recurrence of glenohumeral instability. We performed a retrospective review of a prospectively collected database consisting of 302 patients who had undergone arthroscopic Bankart repair and capsular shift for the treatment of recurrent anterior glenohumeral instability. The prevalence of patient and injury-related risk factors for recurrence was assessed. Cox proportional hazards models were used to estimate the predicted probability of recurrence within two years. The chief outcome measures were the risk of recurrence and the two-year functional outcomes assessed with the Western Ontario shoulder instability index (WOSI) and disabilities of the arm, shoulder and hand (DASH) scores. The rate of recurrent glenohumeral instability after arthroscopic Bankart repair and capsular shift was 13.2%. The median time to recurrence was twelve months, and this complication developed within one year in 55% of these patients. The risk of recurrence was independently predicted by the patient's age at surgery, the severity of glenoid bone loss, and the presence of an engaging Hill-Sachs lesion (all p < 0.001). These variables were incorporated into a model to provide an estimate of the risk of recurrence after surgery. Varying the cutoff level for the predicted probability of recurrence in the model from 50% to lower values increased the sensitivity of the model to detect recurrences but decreased the positive predictive value of the model to correctly predict failed repairs. There was a significant improvement in the mean WOSI and DASH scores at two years postoperatively (both p < 0.001), but the mean scores in the group with recurrence were significantly lower than those in the group

Structure of the Type IX Group B Streptococcus Capsular Polysaccharide and Its Evolutionary Relationship with Types V and VII

PubMed Central

Berti, Francesco; Campisi, Edmondo; Toniolo, Chiara; Morelli, Laura; Crotti, Stefano; Rosini, Roberto; Romano, Maria Rosaria; Pinto, Vittoria; Brogioni, Barbara; Torricelli, Giulia; Janulczyk, Robert; Grandi, Guido; Margarit, Immaculada

2014-01-01

The Group B Streptococcus capsular polysaccharide type IX was isolated and purified, and the structure of its repeating unit was determined. Type IX capsule →4)[NeupNAc-α-(2→3)-Galp-β-(1→4)-GlcpNAc-β-(1→6)]-β-GlcpNAc-(1→4)-β-Galp-(1→4)-β-Glcp-(1→ appears most similar to types VII and V, although it contains two GlcpNAc residues. Genetic analysis identified differences in cpsM, cpsO, and cpsI gene sequences as responsible for the differentiation between the three capsular polysaccharide types, leading us to hypothesize that type V emerged from a recombination event in a type IX background. PMID:24990951

Autologous Collagen Matrix (ACM): Lower Pole Support With a Supero-Anterior Capsular Flap in Secondary Subpectoral Breast Augmentation.

PubMed

Montemurro, Paolo; Cheema, Mubashir; Hedén, Per; Avvedimento, Stefano; Agko, Mouchammed; Quattrini Li, Alessandro

2017-05-01

Secondary aesthetic breast surgery is a complex and challenging scenario. It requires the surgeon to identify contributing factors, provide patient education, make a further management plan, and optimize the conditions for a favorable result. Various techniques have been described in literature but the rate of reoperation is still high. The first author has been using a supero-anterior capsular flap with a neopectoral subcapsular pocket and an implant change in these cases. To review the patient characteristics, indications, and early results of using part of the existing implant capsule for secondary subpectoral breast augmentations. All patients who underwent secondary breast augmentation, over a period of 2 years by the first author (P.M.), using the supero-anterior capsular flap technique were included. The technique involves dissection of a new subpectoral pocket and uses the existing implant capsule as an internal brassiere. A total of 36 patients were operated by this technique. Of these, 17 patients had developed a complication while 19 patients wanted a change in size only. At a mean follow up of 10.2 months, there was no bottoming out, double bubble, or capsular contracture. This reliable technique provides stable results as shown by low rate of complications with the existing follow up. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

A multiplex PCR assay for molecular capsular serotyping of Mannheimia haemolytica serotypes 1, 2, and 6

USDA-ARS?s Scientific Manuscript database

Mannheimia haemolytica is an important respiratory pathogen of ruminants. Of the 12 capsular serovars identified, 1 and 6 are most frequently associated with disease in cattle, while 2 is largely a commensal. Comparative analysis of 24 M. haemolytica genomes was used to identify unique genes associa...

NEW TECHNIQUE FOR OBESITY SURGERY: INTERNAL GASTRIC PLICATION TECHNIQUE USING INTRAGASTRIC SINGLE-PORT (IGS-IGP) IN EXPERIMENTAL MODEL.

PubMed

Müller, Verena; Fikatas, Panagiotis; Gül, Safak; Noesser, Maximilian; Fuehrer, Kirs Ten; Sauer, Igor; Pratschke, Johann; Zorron, Ricardo

2017-01-01

Bariatric surgery is currently the most effective method to ameliorate co-morbidities as consequence of morbidly obese patients with BMI over 35 kg/m2. Endoscopic techniques have been developed to treat patients with mild obesity and ameliorate comorbidities, but endoscopic skills are needed, beside the costs of the devices. To report a new technique for internal gastric plication using an intragastric single port device in an experimental swine model. Twenty experiments using fresh pig cadaver stomachs in a laparoscopic trainer were performed. The procedure was performed as follow in ten pigs: 1) volume measure; 2) insufflation of the stomach with CO2; 3) extroversion of the stomach through the simulator and installation of the single port device (Gelpoint Applied Mini) through a gastrotomy close to the pylorus; 4) performance of four intragastric handsewn 4-point sutures with Prolene 2-0, from the gastric fundus to the antrum; 5) after the performance, the residual volume was measured. Sleeve gastrectomy was also performed in further ten pigs and pre- and post-procedure gastric volume were measured. The internal gastric plication technique was performed successfully in the ten swine experiments. The mean procedure time was 27±4 min. It produced a reduction of gastric volume of a mean of 51%, and sleeve gastrectomy, a mean of 90% in this swine model. The internal gastric plication technique using an intragastric single port device required few skills to perform, had low operative time and achieved good reduction (51%) of gastric volume in an in vitro experimental model. A cirurgia bariátrica é atualmente o método mais efetivo para melhorar as co-morbidades decorrentes da obesidade mórbida com IMC acima de 35 kg/m2. Técnicas endoscópicas foram desenvolvidas para tratar pacientes com obesidade leve e melhorar as comorbidades, mas habilidades endoscópicas são necessárias, além dos custos. Relatar uma nova técnica para a plicatura gástrica interna

Capture of Pb2+ and Cu2+ Metal Cations by Neisseria meningitidis-type Capsular Polysaccharides.

PubMed

Ghimire, Sujan; McCarthy, Pumtiwitt C

2018-05-05

Heavy metal pollution of water is a significant environmental and public health concern. Current biological strategies for heavy metal removal from water are performed using microbial biopolymers, including polysaccharides, that are already fully formed. This creates limitations in adapting polysaccharides to increase binding affinity for specific metals. We propose that altering the specificity of polysaccharide-producing enzymes could be beneficial to improving metal capture by modified polysaccharides. We assess binding of Cu 2+ and Pb 2+ metal cations to Neisseria meningitidis -type polysaccharides. All concentrations of metal cations tested were able to completely bind to colominic acid. This polymer is equivalent to the capsular polysaccharide of N. meningitidis serogroup B comprised of a homopolymer of negatively charged sialic acid. There was slightly less binding observed with N. meningitidis serogroup W, which contains repeating units of the neutral sugar galactose and sialic acid. Our work represents the first assessment of the metal-binding properties of these capsular polysaccharides. Future work will seek to optimize metal-binding with Neisseria meningitidis serogroup W polysaccharide.

Structural characterization of an all-aminosugar-containing capsular polysaccharide from Colwellia psychrerythraea 34H

PubMed Central

Casillo, Angela; Ståhle, Jonas; Parrilli, Ermenegilda; Sannino, Filomena; Mitchell, Daniel E.; Pieretti, Giuseppina; Gibson, Matthew I.; Marino, Gennaro; Lanzetta, Rosa; Parrilli, Michelangelo; Widmalm, Göran; Tutino, Maria L.; Corsaro, Maria M.

2017-01-01

Colwellia psychrerythraea strain 34H, a Gram-negative bacterium isolated from Arctic marine sediments, is considered a model to study the adaptation to cold environments. Recently, we demonstrated that C. psychrerythraea 34H produces two different extracellular polysaccharides, a capsular polysaccharide and a medium released polysaccharide, which confer cryoprotection to the bacterium. In this study, we report the structure of an additional capsular polysaccharide produced by Colwellia grown at a different temperature. The structure was determined using chemical methods, and one- and two-dimensional NMR spectroscopy. The results showed a trisaccharide repeating unit made up of only amino-sugar residues: N-acetyl-galactosamine, 2,4-diacetamido-2,4,6-trideoxy-glucose (bacillosamine), and 2-acetamido-2-deoxyglucuronic acid with the following structure: →4)-β-d-GlcpNAcA-(1→3)-β-d-QuipNAc4NAc-(1→3)-β-d-GalpNAc-(1→. The 3D model, generated in accordance with 1H,1H-NOE NMR correlations and consisting of ten repeating units, shows a helical structure. In contrast with the other extracellular polysaccharides produced from Colwellia at 4 °C, this molecule displays only a low ice recrystallization inhibition activity. PMID:28161737

Non-terminal animal model of post-traumatic osteoarthritis induced by acute joint injury.

PubMed

Boyce, M K; Trumble, T N; Carlson, C S; Groschen, D M; Merritt, K A; Brown, M P

2013-05-01

Develop a non-terminal animal model of acute joint injury that demonstrates clinical and morphological evidence of early post-traumatic osteoarthritis (PTOA). An osteochondral (OC) fragment was created arthroscopically in one metacarpophalangeal (MCP) joint of 11 horses and the contralateral joint was sham operated. Eleven additional horses served as unoperated controls. Every 2 weeks, force plate analysis, flexion response, joint circumference, and synovial effusion scores were recorded. At weeks 0 and 16, radiographs (all horses) and arthroscopic videos (OC injured and sham joints) were graded. At week 16, synovium and cartilage biopsies were taken arthroscopically from OC injured and sham joints for histologic evaluation and the OC fragment was removed. OC fragments were successfully created and horses were free of clinical lameness after fragment removal. Forelimb gait asymmetry was observed at week 2 (P = 0.0012), while joint circumference (P < 0.0001) and effusion scores (P < 0.0001) were increased in injured limbs compared to baseline from weeks 2 to 16. Positive flexion response of injured limbs was noted at multiple time points. Capsular enthesophytes were seen radiographically in injured limbs. Articular cartilage damage was demonstrated arthroscopically as mild wear-lines and histologically as superficial zone chondrocyte death accompanied by mild proliferation. Synovial hyperemia and fibrosis were present at the site of OC injury. Acute OC injury to the MCP joint resulted in clinical, imaging, and histologic changes in cartilage and synovium characteristic of early PTOA. This model will be useful for defining biomarkers of early osteoarthritis and for monitoring response to therapy and surgery. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Rupture after Previous Endovascular Aneurysm Repair due to Type IA Endoleak: Complete Endograft Preservation Is Feasible with Proximal Suturing, Aortic Neck Banding, and Sac Plication.

PubMed

Karkos, Christos D; Mitka, Maria; Pliatsios, Ioannis; Xanthopoulou, Efthalia; Giagtzidis, Ioakeim T; Papadimitriou, Christina T; Papazoglou, Konstantinos O

2018-05-01

Rupture of an abdominal aortic aneurysm (AAA) after previous endovascular repair (EVAR) may require endograft explantation and replacement with a prosthetic surgical graft. Recent reports have suggested that total endograft removal during late surgical conversion in the nonruptured setting may not be necessary and that preserving functional parts of the endograft may improve results. Similar techniques may be used for ruptured cases diminishing the magnitude of an already difficult and complex procedure. We describe the successful treatment of a ruptured AAA after previous EVAR with complete endograft preservation by combining transmural endograft fixation with sutures, proximal aortic neck banding, and sac plication. Copyright © 2018 Elsevier Inc. All rights reserved.

The risk of capsular breakage from phacoemulsification needle contact with the lens capsule: a laboratory study.

PubMed

Meyer, Jay J; Kuo, Annie F; Olson, Randall J

2010-06-01

To determine capsular breakage risk from contact by phacoemulsification needles by machine and tip type. Experimental laboratory investigation. Infiniti (Alcon, Inc.) with Intrepid cartridges and Signature (Abbott Medical Optics, Inc.) phacoemulsification machines were tested using 19- and 20-gauge sharp and rounded tips. Actual and unoccluded flow vacuum were determined at 550 mm Hg, bottle height of 75 cm, and machine-indicated flow rate of 60 mL/minute. Breakage from brief tip contact with a capsular surrogate and human cadaveric lenses was calculated. Nineteen-gauge tips had more flow and less unoccluded flow vacuum than 20-gauge tips for both machines, with highest unoccluded flow vacuum in the Infiniti. The 19-gauge sharp tip was more likely than the 20-gauge sharp tip to cause surrogate breakage for Signature with micropulse and Ellips (Abbott Medical Optics, Inc.) ultrasound at 100% power. For Infiniti using OZil (Alcon, Inc.) ultrasound, 20-gauge sharp tips were more likely than 19-gauge sharp tips to break the membrane. For cadaveric lenses, using rounded 20-gauge tips at 100% power, breakage rates were micropulse (2.3%), Ellips (2.3%), OZil (5.3%). Breakage rates for sharp 20-gauge Ellips tips were higher than for rounded tips. Factors influencing capsular breakage may include active vacuum at the tip, flow rate, needle gauge, and sharpness. Nineteen-gauge sharp tips were more likely than 20-gauge tips to cause breakage in lower vacuum methods. For higher-vacuum methods, breakage is more likely with 20-gauge than with 19-gauge tips. Rounded-edge tips are less likely than sharp-edged tips to cause breakage. Copyright 2010 Elsevier Inc. All rights reserved.

[A cadaveric study of a new capsulorrhaphy for the surgical treatment of hallux valgus].

PubMed

Orozco-Villaseñor, S L; Monzó-Planella, M; Martín-Oliva, X; Vázquez-Escamilla, J; Mayagoitia-Vázquez, J J; Frías-Chimal, J E

2017-01-01

There are many surgical options for the treatment of hallux valgus in combination with capsular repairs for the correction of hallux valgus. This report corresponds to a descriptive study where a new capsulorrhaphy technique in hallux valgus is proposed. Six dissections were performed on cadavers with hallux valgus deformity using the following surgical technique: medial approach on the first toe longitudinally, dissecting by planes and locating the metatarsophalangeal joint capsule; it was incised longitudinally. The capsule was separated and an exostectomy of the first metatarsal head was done, the edges were regularized and a release of the abductor hallucis was performed. Later, the capsular remnant was resected and repaired. Six cadaveric feet with hallux valgus were studied, five with mild deformity, one with moderate deformity, one foot with the 2nd finger on supraductus. Many capsular repairs have been reported in the literature, including «L», triangular, «V-Y», rectangular, with satisfactory results, along with osteotomy of the first metatarsal. In this report, a new capsular repair was described. Applying this new capsular repair, we reduced the metatarsophalangeal and intermetatarsal angles and achieved a capsular closure with suitable tension; the metatarsophalangeal joint mobility was preserved.

Does the Hip Capsule Remain Closed After Hip Arthroscopy With Routine Capsular Closure for Femoroacetabular Impingement? A Magnetic Resonance Imaging Analysis in Symptomatic Postoperative Patients.

PubMed

Weber, Alexander E; Kuhns, Benjamin D; Cvetanovich, Gregory L; Lewis, Paul B; Mather, Richard C; Salata, Michael J; Nho, Shane J

2017-01-01

The purpose of this study was to examine the hip capsule in a subset of symptomatic patients who underwent capsular closure during hip arthroscopy. All patients undergoing primary hip arthroscopy for femoroacetabular impingement (FAI) with routine capsular closure between January 1, 2012, and December 31, 2015, were eligible. Only patients with unilateral surgery and a postoperative magnetic resonance imaging (MRI; ordered for persistent symptoms) were included. Four independent reviewers evaluated each hip capsule for thickness and the absence or presence of defects. During the study, 1,463 patients had hip arthroscopy for FAI with routine capsular closure, and 53 (3.6%) underwent a postoperative MRI. Fourteen of the 53 were excluded owing to revision status or additional procedures. The final study population included 39 patients (23 female patients and 16 male patients), with an average patient age of 31.7 ± 11.4 years and an average body mass index of 23.3 ± 2.9. There were 3 (7.5%) capsular defects, and the intraclass correlation coefficient (ICC) was 0.82. The operative hip capsule was significantly thicker in the zone of capsulotomy, and subsequent repair as compared with the unaffected, contralateral hip capsule (5.0 ± 1.2 mm vs 4.6 ± 1.4 mm; P = .02), ICC 0.83. Additionally, males had thicker hip capsules as compared with their female counterparts, on the operative side (5.4 ± 1.1 mm vs 4.5 ± 1.2 mm; P = .02) and the nonoperative side (4.8 ± 1.6 mm vs 4.1 ± 0.9 mm; P = .08). In a subset of symptomatic patients after hip arthroscopy for FAI, the majority (92.5%) of the repaired hip capsules remained closed at greater than 1 year of follow-up. The hip capsule adjacent to the capsulotomy and subsequent repair is thickened compared with the same location on the contralateral, nonoperative hip. Aside from gender, patient-related and FAI-related factors do not correlate with capsular thickness nor do they seem to correlate with the propensity

Titres and cross reactions of commercial antisera for the capsular typing of Klebsiella species.

PubMed Central

Casewell, M W

1975-01-01

Ninety commercially supplied sera for the capsular typing of Klebsiella species were tested in a full chequerboard against 72 type strains. Only four of 144 homologous reactions could not be detected. Of the 6336 possible heterologous reactions, 91 actual cross reactions were found. All positive reactions were titrated and working dilutions deduced. This provides essential information for the successful typing of unknown strains with these sera. PMID:1091662

Solving intraocular lens-related pigment dispersion syndrome with repositioning of primary sulcus implanted single-piece IOL in the capsular bag.

PubMed

Kohnen, Thomas; Kook, Daniel

2009-08-01

We describe 2 cases of pigment dispersion syndrome (PDS) after uneventful phacoemulsification and implantation of a posterior chamber single-piece intraocular lens (IOL) with a sharp-edge design. In both cases, several days after IOL implantation, marked pigment dispersion was seen on the iris and in the trabecular meshwork, associated with an elevation in intraocular pressure (IOP). Thorough examination showed that the implanted IOL was in the ciliary sulcus. After surgical repositioning of both IOLs in the capsular bag, the pigment dispersion regressed and the IOP returned to normal limits. The 2 cases suggest that particularly in PDS patients, an IOL with an anterior sharp-edge design should be implanted in the capsular bag. Implantation in the ciliary sulcus should be avoided.

Selective biotinylation of Neisseria meningitidis group B capsular polysaccharide and application in an improved ELISA for the detection of specific antibodies.

PubMed

Diaz Romero, J; Outschoorn, I

1993-03-15

A method is described for the selective biotinylation of meningococcal capsular polysaccharide from Neisseria meningitidis group B and its application to an enzyme-linked immunoabsorbent assay (ELISA) to detect specific antibodies by immobilization on streptavidin-coated microtiter wells. Capsular polysaccharide from Neisseria meningitidis B has been biotinylated by specific periodate oxidation of terminal residues and condensation of the resulting aldehydes with biotin hydrazide, using a spin-column technique in the intermediate purification steps. The ELISA was optimized employing an extended reaction time between the label alkaline phosphatase and its most common substrate, p-nitrophenyl phosphate, together with evaluation of blocking agents to minimize non-specific binding. Specificity was demonstrated by a direct competitive enzyme immunoassay (EIA).

Structure of a protective epitope of group B Streptococcus type III capsular polysaccharide.

PubMed

Carboni, Filippo; Adamo, Roberto; Fabbrini, Monica; De Ricco, Riccardo; Cattaneo, Vittorio; Brogioni, Barbara; Veggi, Daniele; Pinto, Vittoria; Passalacqua, Irene; Oldrini, Davide; Rappuoli, Rino; Malito, Enrico; Margarit, Immaculada Y Ros; Berti, Francesco

2017-05-09

Despite substantial progress in the prevention of group B Streptococcus (GBS) disease with the introduction of intrapartum antibiotic prophylaxis, this pathogen remains a leading cause of neonatal infection. Capsular polysaccharide conjugate vaccines have been tested in phase I/II clinical studies, showing promise for further development. Mapping of epitopes recognized by protective antibodies is crucial for understanding the mechanism of action of vaccines and for enabling antigen design. In this study, we report the structure of the epitope recognized by a monoclonal antibody with opsonophagocytic activity and representative of the protective response against type III GBS polysaccharide. The structure and the atomic-level interactions were determined by saturation transfer difference (STD)-NMR and X-ray crystallography using oligosaccharides obtained by synthetic and depolymerization procedures. The GBS PSIII epitope is made by six sugars. Four of them derive from two adjacent repeating units of the PSIII backbone and two of them from the branched galactose-sialic acid disaccharide contained in this sequence. The sialic acid residue establishes direct binding interactions with the functional antibody. The crystal structure provides insight into the molecular basis of antibody-carbohydrate interactions and confirms that the conformational epitope is not required for antigen recognition. Understanding the structural basis of immune recognition of capsular polysaccharide epitopes can aid in the design of novel glycoconjugate vaccines.

Relationship between naturally occurring human mucosal and serum antibody to the capsular polysaccharide of Haemophilus influenzae type b.

PubMed

Pichichero, M E; Insel, R A

1982-08-01

The prevalence of natural mucosal antibody to the capsular polysaccharide (polyribosylribitolphosphate [PRP]) of Haemophilus influenzae type b in adults at multiple secretory sites and the relationship between natural serum and mucosal antibodies with respect to their amount and fine binding specificity were examined. All of 16 lactating women had antibody to PRP in serum and mammary samples; 11 of 14 studied had nasal antibody and 12 of 14 had salivary antibody. The amount of serum antibody to PRP in an individual positively correlated with the amount of mucosal antibody at each of the three secretory sites examined, and the antibody amount between certain secretions were also positively correlated. Antibody to PRP that is cross-reactive with Escherichia coli K100 or Streptococcus pneumoniae type 6 capsular polysaccharides was detected in the secretions of seven and one subjects, respectively, but the amount was not correlated with serum cross-reactive antibody.

A model of high-affinity antibody binding to type III group B Streptococcus capsular polysaccharide.

PubMed

Wessels, M R; Muñoz, A; Kasper, D L

1987-12-01

We recently reported that the single repeating-unit pentasaccharide of type III group B Streptococcus (GBS) capsular polysaccharide is only weakly reactive with type III GBS antiserum. To further elucidate the relationship between antigen-chain length and antigenicity, tritiated oligosaccharides derived from type III capsular polysaccharide were used to generate detailed saturation binding curves with a fixed concentration of rabbit antiserum in a radioactive antigen-binding assay. A graded increase in affinity of antigen-antibody binding was seen as oligosaccharide size increased from 2.6 repeating units to 92 repeating units. These differences in affinity of antibody binding to oligosaccharides of different molecular size were confirmed by immunoprecipitation and competitive ELISA, two independent assays of antigen-antibody binding. Analysis of the saturation binding experiment indicated a difference of 300-fold in antibody-binding affinity for the largest versus the smallest tested oligosaccharides. Unexpectedly, the saturation binding values approached by the individual curves were inversely related to oligosaccharide chain length on a molar basis but equivalent on a weight basis. This observation is compatible with a model in which binding of an immunoglobulin molecule to an antigenic site on the polysaccharide facilitates subsequent binding of antibody to that antigen.

The ability of multi-site, multi-depth sacral lateral branch blocks to anesthetize the sacroiliac joint complex.

PubMed

Dreyfuss, Paul; Henning, Troy; Malladi, Niriksha; Goldstein, Barry; Bogduk, Nikolai

2009-01-01

To determine the physiologic effectiveness of multi-site, multi-depth sacral lateral branch injections. Double-blind, randomized, placebo-controlled study. Outpatient pain management center. Twenty asymptomatic volunteers. The dorsal innervation to the sacroiliac joint (SIJ) is from the L5 dorsal ramus and the S1-3 lateral branches. Multi-site, multi-depth lateral branch blocks were developed to compensate for the complex regional anatomy that limited the effectiveness of single-site, single-depth lateral branch injections. Bilateral multi-site, multi-depth lateral branch green dye injections and subsequent dissection on two cadavers revealed a 91% accuracy with this technique. Session 1: 20 asymptomatic subjects had a 25-g spinal needle probe their interosseous (IO) and dorsal sacroiliac (DSI) ligaments. The inferior dorsal SIJ was entered and capsular distension with contrast medium was performed. Discomfort had to occur with each provocation maneuver and a contained arthrogram was necessary to continue in the study. Session 2: 1 week later; computer randomized, double-blind multi-site, multi-depth lateral branch blocks injections were performed. Ten subjects received active (bupivicaine 0.75%) and 10 subjects received sham (normal saline) multi-site, multi-depth lateral branch injections. Thirty minutes later, provocation testing was repeated with identical methodology used in session 1. Presence or absence of pain for ligamentous probing and SIJ capsular distension. Seventy percent of the active group had an insensate IO and DSI ligaments, and inferior dorsal SIJ vs 0-10% of the sham group. Twenty percent of the active vs 10% of the sham group did not feel repeat capsular distension. Six of seven subjects (86%) retained the ability to feel repeat capsular distension despite an insensate dorsal SIJ complex. Multi-site, multi-depth lateral branch blocks are physiologically effective at a rate of 70%. Multi-site, multi-depth lateral branch blocks do not

Recombinant Escherichia coli K5 strain with the deletion of waaR gene decreases the molecular weight of the heparosan capsular polysaccharide.

PubMed

Huang, Haichan; Liu, Xiaobo; Lv, Shencong; Zhong, Weihong; Zhang, Fuming; Linhardt, Robert J

2016-09-01

Heparosan, the capsular polysaccharide of Escherichia coli K5 having a carbohydrate backbone similar to that of heparin, has become a potential precursor for bioengineering heparin. In the heparosan biosynthesis pathway, the gene waaR encoding α-1-, 2- glycosyltransferase catalyze s the third glucosyl residues linking to the oligosaccharide chain. In the present study, a waaR deletion mutant of E. coli K5 was constructed. The mutant showed improvement of capsule polysaccharide yield. It is interesting that the heparosan molecular weight of the mutant is reduced and may become more suitable as a precursor for the production of low molecular weight heparin derived from the wild-type K5 capsular polysaccharide.

Use of the chop hook to stabilize the capsular bag in patients with crystalline lens dislocations and cataracts.

PubMed

Zeng, Yanfeng; Fan, Licheng; Lu, Peirong

2017-04-01

Objective To observe the treatment effects of chop hook-assisted phacoemulsification surgery in patients with crystalline lens dislocation. Methods Thirty-seven eyes with cataracts and crystalline lens dislocations underwent cataract surgery. An L-shaped chop hook was introduced into the anterior chamber, and the tip was pushed or pulled to the centre of the anterior capsular edge of the zonular dialysis during the cataract operation. Postoperative follow-up was conducted for ≥ 1 month. Results All patients' postoperative visual abilities improved except one patient with glaucoma. One patient who underwent -5D intraocular lens implantation exhibited vision of 1/50. Visual acuity was less than 6/20 in 6 eyes, 6/20 to 10/20 in 7 eyes, and greater than 10/20 in 22 eyes. Conclusions L-shaped chop hooks can be used to push or pull the anterior capsular edge of the zonular dialysis for protection and avoidance of further zonular damage. This strategy provides satisfactory effects and reduces use of additional instruments.

Articular soft tissue anatomy of the archosaur hip joint: Structural homology and functional implications.

PubMed

Tsai, Henry P; Holliday, Casey M

2015-06-01

Archosaurs evolved a wide diversity of locomotor postures, body sizes, and hip joint morphologies. The two extant archosaurs clades (birds and crocodylians) possess highly divergent hip joint morphologies, and the homologies and functions of their articular soft tissues, such as ligaments, cartilage, and tendons, are poorly understood. Reconstructing joint anatomy and function of extinct vertebrates is critical to understanding their posture, locomotor behavior, ecology, and evolution. However, the lack of soft tissues in fossil taxa makes accurate inferences of joint function difficult. Here, we describe the soft tissue anatomies and their osteological correlates in the hip joint of archosaurs and their sauropsid outgroups, and infer structural homology across the extant taxa. A comparative sample of 35 species of birds, crocodylians, lepidosaurs, and turtles ranging from hatchling to skeletally mature adult were studied using dissection, imaging, and histology. Birds and crocodylians possess topologically and histologically consistent articular soft tissues in their hip joints. Epiphyseal cartilages, fibrocartilages, and ligaments leave consistent osteological correlates. The archosaur acetabulum possesses distinct labrum and antitrochanter structures on the supraacetabulum. The ligamentum capitis femoris consists of distinct pubic- and ischial attachments, and is homologous with the ventral capsular ligament of lepidosaurs. The proximal femur has a hyaline cartilage core attached to the metaphysis via a fibrocartilaginous sleeve. This study provides new insight into soft tissue structures and their osteological correlates (e.g., the antitrochanter, the fovea capitis, and the metaphyseal collar) in the archosaur hip joint. The topological arrangement of fibro- and hyaline cartilage may provide mechanical support for the chondroepiphysis. The osteological correlates identified here will inform systematic and functional analyses of archosaur hindlimb evolution and

Application of three-dimensional rendering in joint-related ganglion cysts.

PubMed

Spinner, Robert J; Edwards, Phillip K; Amrami, Kimberly K

2006-05-01

with standard MR imaging. We believe that these joint-related cysts have a common pathogenesis; they dissect through a capsular rent and follow the path of least resistance; they may form simple cysts by dissecting out into the soft tissue, or more complex cysts by dissecting within the epineurium of nerves or adventitia of vessels (along an articular branch), or various combinations of all of these types of cysts. Understanding the pathogenesis for cyst formation will improve surgical management and outcomes. We have adapted this 3D technique to enhance the visualization of cysts occurring at other joints.

Population Structure of Invasive Streptococcus pneumoniae in the Netherlands in the Pre-Vaccination Era Assessed by MLVA and Capsular Sequence Typing

PubMed Central

Elberse, Karin E. M.; van de Pol, Ingrid; Witteveen, Sandra; van der Heide, Han G. J.; Schot, Corrie S.; van Dijk, Anita; van der Ende, Arie; Schouls, Leo M.

2011-01-01

The introduction of nationwide pneumococcal vaccination may lead to serotype replacement and the emergence of new variants that have expanded their genetic repertoire through recombination. To monitor alterations in the pneumococcal population structure, we have developed and utilized Capsular Sequence Typing (CST) in addition to Multiple-Locus Variable number tandem repeat Analysis (MLVA). To assess the serotype of each isolate CST was used. Based on the determination of the partial sequence of the capsular wzh gene, this method assigns a capsular type of an isolate within a single PCR reaction using multiple primersets. The genetic background of pneumococcal isolates was assessed by MLVA. MLVA and CST were used to create a snapshot of the Dutch pneumococcal population causing invasive disease before the introduction of the 7-valent pneumococcal conjugate vaccine in the Netherlands in 2006. A total of 1154 clinical isolates collected and serotyped by the Netherlands Reference Laboratory for Bacterial Meningitis were included in the snapshot. The CST was successful in discriminating most serotypes present in our collection. MLVA demonstrated that isolates belonging to some serotypes had a relatively high genetic diversity whilst other serotypes had a very homogeneous genetic background. MLVA and CST appear to be valuable tools to determine the population structure of pneumococcal isolates and are useful in monitoring the effects of pneumococcal vaccination. PMID:21637810

Endorectal MR imaging of prostate cancer: Evaluation of tumor capsular contact length as a sign of extracapsular extension.

PubMed

Mendez, Gustavo; Foster, Bryan R; Li, Xin; Shannon, Jackilen; Garzotto, Mark; Amling, Christopher L; Coakley, Fergus V

2018-04-25

To evaluate the length of contact between dominant tumor foci and the prostatic capsule as a sign of extracapsular extension at endorectal multiparametric MR imaging. We retrospectively identified 101 patients over a three-year interval who underwent endorectal multiparametric prostate MR imaging prior to radical prostatectomy for prostate cancer. Two readers identified the presence of dominant tumor focus (largest lesion with PI-RADS version 2 score of 4 or 5), and measured the length of tumor capsular contact and likelihood of extracapsular extension by standard criteria (1-5 Likert scale). Results were analyzed using histopathological review as reference standard. Extracapsular extension was found at histopathological review in 27 patients. Reader 1 (2) identified dominant tumor in 79 (73) patients, with mean tumor capsular contact length of 18.2 (14.0) mm. The area under the receiver operating characteristic curve for identification of extracapsular extension by tumor capsular contact length was 0.76 for reader 1 and 0.77 for reader 2, with optimal discrimination at values of 18 mm and 21 mm, respectively. In the subset of patients without obvious extracapsular extension by standard criteria (Likert scores 1-3), corresponding values were 0.74 and 0.66 with optimal thresholds of 24 and 21 mm. Length of contact between the dominant tumor focus and the capsule is a moderately useful sign of extracapsular extension at endorectal multiparametric prostate MR imaging, including the subset of patients without obvious extracapsular extension by standard criteria, with optimal discrimination at threshold values of 18 to 24 mm. Copyright © 2018 Elsevier Inc. All rights reserved.

Comparison of virulence factors and capsular types of Streptococcus agalactiae isolated from human and bovine infections.

PubMed

Emaneini, Mohammad; Khoramian, Babak; Jabalameli, Fereshteh; Abani, Samira; Dabiri, Hossein; Beigverdi, Reza

2016-02-01

Streptococcus agalactiae is a leading cause of human and bovine infections. A total of 194 S. agalactiae isolates, 55 isolates from bovines and 139 from humans, were analyzed for capsular types, virulence genes (scpB, hly, rib, bca and bac) and mobile genetic elements (IS1548 and GBSi1) using polymerase chain reaction (PCR) and multiplex PCR. Capsular type III was predominant (61%), followed by types V, II, Ib, and IV. The scpB, hly, bca and bac virulence genes were only found among human isolates. Twelve and 2 distinct virulence gene profiles were identified among human and bovine isolates respectively. The virulence gene profiles scpB- hly- IS1548- rib-bca (51%) and scpB- hly- IS1548- bca (19%) were only predominant among human isolates. The rib gene was the most common virulence gene in both human and bovine isolates. The study showed a high prevalence of virulence genes in S. agalactiae strains isolated from human infections, these result can support the idea that S. agalactiae isolated from humans and bovines are generally unrelated and probably belonged to separate populations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Experiences with sheep as an animal model for shoulder surgery: strengths and shortcomings.

PubMed

Turner, A Simon

2007-01-01

Sheep (and goats) are a convenient large-animal model for rotator cuff repair because of availability, ease of handling and housing, animal cost, and acceptance to society as a research animal. Tenotomy of the infraspinatus tendon and subsequent reattachment to the proximal humerus is useful to address the biomechanical, histologic, and biochemical processes of rotator cuff repair. Detaching this tendon and immediately reattaching it does not represent the clinical picture but serves as a relatively rapid way to screen different suture anchors, suture patterns, scaffolds, growth factors, and other biologics or a combination of these treatments to enhance the healing process. To minimize spontaneous reattachment and reproduce a chronic rotator cuff injury, the end of the tendon can be covered and then reattached 4 weeks later if bone-to-tendon healing is to be evaluated. This chronic model is useful to understand the biology (degree of muscle atrophy and fatty infiltration) of rotator cuff muscles as well as innovative methods of repair. Close-stall confinement is required during the convalescence in acute and chronic studies. Ultrasound in the awake animal can be used to monitor gap formation and tissue organization. Sheep have also been used to determine whether capsular healing after plication is equivalent to open capsular shift.

New meniscus repair technique for peripheral tears near the posterior tibial attachment of the posterior horn of the medial meniscus.

PubMed

Park, In-Seop; Kim, Sung-Jae

2006-08-01

We introduce a suture technique to repair a peripheral tear near the posterior tibial attachment of the posterior horn. A suture hook was inserted through the posteromedial portal, and the peripheral capsular rim was penetrated from superior to inferior by the sharp hook. Both relay limbs were brought out through the posteromedial portal. The outer limb of the superior peripheral capsular rim was identified with a hemostat. An 18-gauge spinal needle loaded with a No. 0 polydioxanone suture (PDS) was introduced into the joint from the anteromedial portal; it was passed through the joint space until it penetrated the inner torn meniscus. The PDS suture loaded within the needle was pushed into the joint and picked up through the posteromedial portal. The needle was pulled out of the torn meniscus and readvanced over it while the suture was kept loaded. The other limb of the suture from the tip of the spinal needle was retrieved through the posteromedial portal. The initial PDS suture limb was hooked to the shuttle-relay system; it then was passed through the inner torn meniscus and the peripheral capsular rim. The suture limb exiting from the peripheral capsular rim was used as a post and was joined to the other suture limb to form a sliding knot.

[Arthroscopic therapy of the unstable shoulder joint--acceptance and critical considerations].

PubMed

Jerosch, J

1997-01-01

The purpose of this study was to document and to present the acceptance of arthroscopically performed stabilising procedures of the glenohumeral joint. In a nationwide survey of instructors of the association of arthroscopy, members of the arthroscopy group of the german orthopedic society, and orthopedic and trauma surgeons with special interest in joint surgery we evaluated the current treatment modalities for patients with unstable shoulder joints. After an average of 2.09 +/- 1.0 shoulder redislocations surgery is recommended. The Bankart-operation (63.4%) is the favourite procedure for open surgery. In a descended order the Weber rotation-osteotomie, the Putti-Platt operation, the Max-Lange procedure, and in a minimal amount of the cases the Bristow-procedure are performed. Looking at the arthroscopic procedures, the distribution is much more equal. The Caspari technique is used by 27.6% and the Morgan technique by 25.1%. Bone anchors are used by 20.4% and the Suretac is used by 18.9% of the surgeons. The anchor knot technique (8%) is only rarely performed. In case of an elongated capsule the majority of the surgeons would not perform arthroscopic surgery. 42.4% of the surgeons judge the arthroscopic technique less secure. However, 38.9% do not see any difference to open procedures. Taking the available information, arthroscopic stabilising procedures seems to have slightly inferior results compared to standard open surgery. The Bankart procedure with or without a capsular shift is still the golden standard.

Open inferior capsular shift for multidirectional shoulder instability in adolescents with generalized ligamentous hyperlaxity or Ehlers-Danlos syndrome.

PubMed

Vavken, Patrick; Tepolt, Frances A; Kocher, Mininder S

2016-06-01

The objective of this study was to assess the outcome of open inferior capsular shift for multidirectional shoulder instability in patients with generalized ligamentous hyperlaxity or Ehlers-Danlos syndrome. Data were obtained for 18 open inferior capsular shift surgeries in 15 adolescent patients with generalized ligamentous hyperlaxity or Ehlers-Danlos syndrome with a mean follow-up of 7.5 years. End points were subjective clinical outcome (pain, stability, satisfaction, return to sport), objective clinical outcome (recurrence, complications), and functional outcome scores (American Shoulder and Elbow Surgeons, 11-item version of the Disabilities of Arm, Shoulder and Hand). Thirteen patients (87%) reported improved pain and stability and were satisfied with the procedure. Nine patients (64%) were able to return to sports. One patient (7%) was dissatisfied with continuous pain and recurrent instability and considered a surgical failure. Seven patients (47%) reported no further episodes of instability. The mean American Shoulder and Elbow Surgeons score at a mean of 7.5 years of follow-up was 88 ± 10 points, and the mean score for the 11-item version of the Disabilities of Arm, Shoulder and Hand was 14 ± 14 points. The management of multidirectional shoulder instability in adolescent patients with generalized ligamentous hyperlaxity or Ehlers-Danlos syndrome is challenging. Open inferior capsular shift results in improvement in subjective and objective shoulder function and stability in adolescent patients with ligamentous hyperlaxity or Ehlers-Danlos who have failed nonoperative treatment. We found no effect of the recalled number of prior dislocations, laterality, and type of hyperlaxity on subjective and objective clinical outcomes. Level IV; Case Series; Treatment Study. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Predictors for perioperative blood transfusion in elderly patients with extra capsular hip fractures treated with cephalo-medullary nailing.

PubMed

Fazal, M Ali; Bagley, Caroline; Garg, Parag

2018-02-01

The aim of our study was to determine predictive factors and requirement for perioperative blood transfusion in elderly patients with extra capsular hip fractures treated with cephalo-medullary device. Seventy-nine patients with extra capsular hip fractures treated with cephalo-medullary nailing were included in the study. Age, sex, ASA grade, timing of surgery, preoperative and postoperative haemoglobin, length of hospital stay, fracture type, number of units transfused and 30-day mortality were recorded. The mean age was 82.3 years. Forty-seven patients underwent a short nail and 32 patients a long nail; 53.4% patients required blood transfusion postoperatively. Transfusion was required in 71.8% of the long nails (p < 0.05), 65.8% patients above the age of 80 (p < 0.05), 100% of the patients with hemoglobin below 90 g/L and 20 patients with a ASA grade of 3 (p < 0.05). 78.5% patients with A2 fracture and 75% of A3 fractures needed blood transfusion (p > 0.05). Length of hospital stay in non-transfusion group was 13 days and in transfusion group was 19 days (p < 0.05). 55.1% operated within 36 h and 47.6% operated after 36 h of admission needed transfusion (p > 0.05). Thirty-day mortality in patients needing blood transfusion was 5% and in non-transfusion group was 3.7% (p > 0.05). Patient age, ASA grade, preoperative haemoglobin and length of nail are reliable predictors for perioperative blood transfusion in extra capsular hip fractures in elderly patients treated with cephalo-medullary nailing and reinforce a selective transfusion policy. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

Peptidoglycan Association of Murein Lipoprotein Is Required for KpsD-Dependent Group 2 Capsular Polysaccharide Expression and Serum Resistance in a Uropathogenic Escherichia coli Isolate

PubMed Central

Diao, Jingyu; Bouwman, Catrien; Yan, Donghong; Kang, Jing; Katakam, Anand K.; Liu, Peter; Pantua, Homer; Abbas, Alexander R.; Nickerson, Nicholas N.; Austin, Cary; Reichelt, Mike; Sandoval, Wendy; Xu, Min

2017-01-01

ABSTRACT Murein lipoprotein (Lpp) and peptidoglycan-associated lipoprotein (Pal) are major outer membrane lipoproteins in Escherichia coli. Their roles in cell-envelope integrity have been documented in E. coli laboratory strains, and while Lpp has been linked to serum resistance in vitro, the underlying mechanism has not been established. Here, lpp and pal mutants of uropathogenic E. coli strain CFT073 showed reduced survival in a mouse bacteremia model, but only the lpp mutant was sensitive to serum killing in vitro. The peptidoglycan-bound Lpp form was specifically required for preventing complement-mediated bacterial lysis in vitro and complement-mediated clearance in vivo. Compared to the wild-type strain, the lpp mutant had impaired K2 capsular polysaccharide production and was unable to respond to exposure to serum by elevating capsular polysaccharide amounts. These properties correlated with altered cellular distribution of KpsD, the predicted outer membrane translocon for “group 2” capsular polysaccharides. We identified a novel Lpp-dependent association between functional KpsD and peptidoglycan, highlighting important interplay between cell envelope components required for resistance to complement-mediated lysis in uropathogenic E. coli isolates. PMID:28536290

A novel injection-molded capsular device for oral pulsatile delivery based on swellable/erodible polymers.

PubMed

Gazzaniga, Andrea; Cerea, Matteo; Cozzi, Alberto; Foppoli, Anastasia; Maroni, Alessandra; Zema, Lucia

2011-03-01

The feasibility of injection molding was explored in the preparation of a novel capsular device for oral pulsatile/delayed delivery based on swellable/erodible polymers. For this purpose, a mold intended to be coupled with a bench-top injection-molding press was designed. This was expected to enable the preparation of matching capsule cap and body items within a single manufacturing cycle and the selection of differing shell thicknesses (300, 600, and 900 μm). Hydroxypropylcellulose (Klucel(®) EF, LF, and GF) was employed as the release-controlling polymer in admixture with polyethylene glycol 1500 (10%, w/w) as the plasticizer. After preliminary trials aimed at the setup of operating conditions, Klucel(®) EF and LF capsule shells with satisfactory technological properties were manufactured. The performance of capsular devices filled with a tracer drug powder was studied by means of a modified USP31 disintegration apparatus. Typical in vitro delayed release patterns were thereby obtained, with lag time increasing as a function of the wall thickness. A good correlation was found between the latter parameter and t (10%), i.e., the time to 10% release, for both polymer grades employed. On the basis of the overall results, the investigated technique was proven suitable for the manufacturing of an innovative pulsatile release platform. © 2011 American Association of Pharmaceutical Scientists

[Characteristics in treatment of the hip in patients with Down syndrome].

PubMed

Peterlein, C-D; Schiel, M; Timmesfeld, N; Schofer, M D; Eberhardt, O; Wirth, T; Fernandez, F F

2013-12-01

preoperative and postoperative range of motion of the hip joint between groups detected capsular insufficiency, increased ligamentous laxity and muscular hypotonia in patients with Down syndrome. Comparison of pelvic radiographs demonstrated significant improvement concerning measured angles in both groups. Preoperative values with respect to AC angle and CE angle were demonstrated to be lower in the hip dysplasia group (p < 0.01); whereas values for ACM angle were comparable between groups. Hypermobility and secondary dislocation of the hip joint is a common problem in patients with Down syndrome, which often requires surgical intervention at an early stage. According to our data and clinical results we suggest a complete redirectional acetabular osteotomy in combination with capsular plication for treatment of this challenging condition. Georg Thieme Verlag KG Stuttgart · New York.

Combined Special Capsular Tension Ring and Toric IOL Implantation for Management of Astigmatism and High Axial Myopia with Cataracts.

PubMed

Zhao, Yang; Li, Jiaxin; Yang, Ke; Li, Xiao; Zhu, Siquan

2018-01-01

This study aimed to compare the effects of toric intraocular lens (IOL) implantation with a capsular tension ring and toric IOL implantation only in patients with axial myopic astigmatism who had undergone cataract surgery. Of 34 patients with axial myopia, 16 patients who had received IOL and capsular tension ring (CTR) implantation were included in the combined group and 18 patients who received toric IOL implantation only were included in the simple group. Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were evaluated by measuring subjective refraction, residual astigmatism, and the toric IOL axis six months post-surgery. At six months postoperatively, the UCVA for the combined and simple groups was 4.6 ± 0.1 and 4.5 ± 0.2, respectively, a statistically significant difference (t = 3.531, P<0.05). The toric IOL in all of the cases was located in the capsular sac, but there were more cases with IOL rotation (12 eyes) in the simple group than in the combined group (4 eyes). The rotation angles were 20°~30° (one eye), 10°~20° (four eyes), and <10° (seven eyes) compared with 2°~5° (four eyes). The residual astigmatism was -0.50 ± 0.25 D in the combined group, not a significant difference from the predicted residual astigmatism (-0.35 ± 0.13 D). There was a significant difference in the simple group (-1.25 ± 0.33 D) when the predicted residual astigmatism was compared (-0.37 ± 0.11 D) (t = -9.511, P < 0.01). In patients with axial myopic astigmatism, CTR can effectively increase the rotational stability of a toric IOL, achieving improvement in corneal astigmatism and visual acuity.

Production of polyclonal and monoclonal antibodies against group A, B, and C capsular polysaccharides of Neisseria meningitidis and preparation of latex reagents.

PubMed Central

Nato, F; Mazie, J C; Fournier, J M; Slizewicz, B; Sagot, N; Guibourdenche, M; Postic, D; Riou, J Y

1991-01-01

Polyclonal and monoclonal antibodies against capsular polysaccharides of Neisseria meningitidis serogroups A, B, and C were produced in order to develop immunological reagents allowing both the detection of soluble antigens during meningococcal meningitis and antigenic serogrouping of N. meningitidis cultures. The performance characteristics of monoclonal and polyclonal antibody latex reagents were compared. For the detection of soluble polysaccharide antigen, polyclonal antibody latex reagent was selected for N. meningitidis A and C. The latex reagent prepared with polyclonal antibodies against N. meningitidis B could not detect capsular polysaccharide even at 1 mg/ml. The monoclonal antibody B latex reagent which detected 100 ng of polysaccharide per ml was therefore chosen. For the serogroup identification of N. meningitidis, the use of a confirmatory test results in an overall specificity of 100% with polyclonal or monoclonal antibody latex reagents. PMID:1909346

Multimodal infiltration of local anaesthetic in total knee arthroplasty; is posterior capsular infiltration worth the risk? a prospective, double-blind, randomised controlled trial.

PubMed

Pinsornsak, P; Nangnual, S; Boontanapibul, K

2017-04-01

Multimodal infiltration of local anaesthetic provides effective control of pain in patients undergoing total knee arthroplasty (TKA). There is little information about the added benefits of posterior capsular infiltration (PCI) using different combinations of local anaesthetic agents. Our aim was to investigate the effectiveness of the control of pain using multimodal infiltration with and without infiltration of the posterior capsule of the knee. In a double-blind, randomised controlled trial of patients scheduled for unilateral primary TKA, 86 were assigned to be treated with multimodal infiltration with (Group I) or without (Group II) PCI. Routine associated analgesia included the use of bupivacaine, morphine, ketorolac and epinephrine. All patients had spinal anaesthesia and patient-controlled analgesia (PCA) post-operatively. A visual analogue scale (VAS) for pain and the use of morphine were recorded 24 hours post-operatively. Side effects of the infiltration, blood loss, and length of stay in hospital were recorded. There were no statistically significant differences between the groups in relation to: VAS pain scores in the first 24 hours post-operatively (p = 0.693), the use of morphine in the PCA (p = 0.647), blood loss (p = 0.625), and length of stay (p = 0.17). There were no neurovascular complications in either group. The multimodal infiltration of local anaesthetic with infiltration of the posterior capsule did not provide significant added analgesic benefits or reduce the use of morphine after TKA. Multimodal infiltration is a satisfactory technique for the management of pain in these patients without the attendant risks of PCI. Cite this article: Bone Joint J 2017; 99-B:483-8. ©2017 The British Editorial Society of Bone & Joint Surgery.

Primary and Secondary Consequences of Rotator Cuff Injury on Joint Stabilizing Tissues in the Shoulder.

PubMed

Rahman, Hafizur; Currier, Eric; Johnson, Marshall; Goding, Rick; Johnson, Amy Wagoner; Kersh, Mariana E

2017-11-01

Rotator cuff tears (RCTs) are one of the primary causes of shoulder pain and dysfunction in the upper extremity accounting over 4.5 million physician visits per year with 250,000 rotator cuff repairs being performed annually in the U.S. While the tear is often considered an injury to a specific tendon/tendons and consequently treated as such, there are secondary effects of RCTs that may have significant consequences for shoulder function. Specifically, RCTs have been shown to affect the joint cartilage, bone, the ligaments, as well as the remaining intact tendons of the shoulder joint. Injuries associated with the upper extremities account for the largest percent of workplace injuries. Unfortunately, the variable success rate related to RCTs motivates the need for a better understanding of the biomechanical consequences associated with the shoulder injuries. Understanding the timing of the injury and the secondary anatomic consequences that are likely to have occurred are also of great importance in treatment planning because the approach to the treatment algorithm is influenced by the functional and anatomic state of the rotator cuff and the shoulder complex in general. In this review, we summarized the contribution of RCTs to joint stability in terms of both primary (injured tendon) and secondary (remaining tissues) consequences including anatomic changes in the tissues surrounding the affected tendon/tendons. The mechanical basis of normal shoulder joint function depends on the balance between active muscle forces and passive stabilization from the joint surfaces, capsular ligaments, and labrum. Evaluating the role of all tissues working together as a system for maintaining joint stability during function is important to understand the effects of RCT, specifically in the working population, and may provide insight into root causes of shoulder injury.

A FOUR-PHASE PHYSICAL THERAPY REGIMEN FOR RETURNING ATHLETES TO SPORT FOLLOWING HIP ARTHROSCOPY FOR FEMOROACETABULAR IMPINGEMENT WITH ROUTINE CAPSULAR CLOSURE

PubMed Central

Weber, Alexander E.; Batko, Brian; Nho, Shane J.; Stegemann, Catherine

2017-01-01

Hip preservation surgery has become more common over the past decade and is now a preferred treatment modality for an increasingly diverse array of pathology in the young, active patient with hip pain. In particular, hip arthroscopy has become an increasingly popular treatment choice for active patients diagnosed with femoroacetabular impingement (FAI). Appropriate postoperative rehabilitation is critical for overall patient success and optimal long-term outcome. As surgical techniques continue to evolve, rehabilitation protocols must adapt to accommodate changes in the surgical procedure and ultimately provide the safest and fastest recovery of function for the patient. One such surgical modification has been the incorporation of routine capsular closure as part of the treatment of FAI in the young, active patient. The purpose of this clinical commentary is to present a four-phase rehabilitation protocol for returning to sport following arthroscopic correction of FAI with routine capsular closure. Level of Evidence 5 PMID:28900574

Solution properties of the capsular polysaccharide produced by Klebsiella pneumoniae K40.

PubMed

Flaibani, A; Leonhartsberger, S; Navarini, L; Cescutti, P; Paoletti, S

1994-04-01

This paper reports some physicochemical properties of the capsular polysaccharide produced by Klebsiella pneumoniae serotype K40 (K40-CPS) in aqueous solution. The polymer has a linear hexasaccharide repeating unit containing one glucuronic acid residue as the only ionizable group. Potentiometric, viscometric, chiro-optical and rheological measurements have been carried out over a range of ionic strength, pH and temperature, with the aim of characterizing the conformational state of the polysaccharide in aqueous solution. All the data reported indicate that the K40-CPS does not undergo a cooperative conformational transition under the investigated experimental conditions. Furthermore, the viscosity data and the viscoelastic spectra suggest that the K40-CPS is rather flexible and adopts a random coil conformation in solution.

The "Floating Labrum": Bankart Lesion Repair With Anterior Capsular Extension Using 2 Anterior Working Portals.

PubMed

Rao, Allison J; Verma, Nikhil N; Trenhaile, Scott W

2017-10-01

Surgical repair of a Bankart lesion requires thorough recognition of the capsulolabral attachment and adequate visualization for suture anchor repair. The glenoid labrum usually detaches from its capsule and bony attachment anteriorly and inferiorly; however, the labral and capsule detachment can sometimes extend beyond this zone of injury. Identification and repair may require additional viewing and working portals to allow for ease of suture passage and anchor placement. This technique guide describes a case scenario of a Bankart lesion with anterior extension of the capsular tear, repaired with use of 2 anterior working portals.

The KineSpring® Knee Implant System: an implantable joint-unloading prosthesis for treatment of medial knee osteoarthritis

PubMed Central

Clifford, Anton G; Gabriel, Stefan M; O’Connell, Mary; Lowe, David; Miller, Larry E; Block, Jon E

2013-01-01

Symptomatic medial compartment knee osteoarthritis (OA) is the leading cause of musculoskeletal pain and disability in adults. Therapies intended to unload the medial knee compartment have yielded unsatisfactory results due to low patient compliance with conservative treatments and high complication rates with surgical options. There is no widely available joint-unloading treatment for medial knee OA that offers clinically important symptom alleviation, low complication risk, and high patient acceptance. The KineSpring® Knee Implant System (Moximed, Inc, Hayward, CA, USA) is a first-of-its-kind, implantable, extra-articular, extra-capsular prosthesis intended to alleviate knee OA-related symptoms by reducing medial knee compartment loading while overcoming the limitations of traditional joint-unloading therapies. Preclinical and clinical studies have demonstrated excellent prosthesis durability, substantial reductions in medial compartment and total joint loads, and clinically important improvements in OA-related pain and function. The purpose of this report is to describe the KineSpring System, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The KineSpring System has potential to bridge the gap between ineffective conservative treatments and irreversible surgical interventions for medial compartment knee OA. PMID:23717052

Structural determination of the capsular polysaccharide produced by Klebsiella pneumoniae serotype K40. NMR studies of the oligosaccharide obtained upon depolymerisation of the polysaccharide with a bacteriophage-associated endoglycanase.

PubMed

Cescutti, P; Toffanin, R; Kvam, B J; Paoletti, S; Dutton, G G

1993-04-01

The Klebsiella pneumoniae K40 capsular polysaccharide has been isolated and investigated by use of methylation analysis, specific degradations and NMR spectroscopy. The polysaccharide was depolymerised by a bacteriophage-associated endogalactosidase, and the resulting oligosaccharide was characterised by one-dimensional and two-dimensional NMR spectroscopy and direct chemical ionisation MS. The repeating unit of the K40 capsular polysaccharide was shown to be a linear hexasaccharide with the composition-->3)- alpha-L-Rhap-(1-->2)-alpha-L-Rhap-(1-->4)-alpha-D-GlcpA++ +-(1-->2-)- alpha-D-Manp-(1-->2)-alpha-D-Manp-(1-->3)-alpha-D-Galp-(1--> (Rha, rhamnose).

THE PROSTAGLANDIN E2 RECEPTOR, EP2, IS UPREGULATED IN THE DRG AFTER PAINFUL CERVICAL FACET JOINT INJURY IN THE RAT

PubMed Central

Kras, Jeffrey V.; Dong, Ling; Winkelstein, Beth A.

2012-01-01

Study Design This study implemented immunohistochemistry to assay prostaglandin E2 (PGE2) receptor EP2 expression in the dorsal root ganglion (DRG) of rats after painful cervical facet joint injury. Objective The objective of this study was to identify if inflammatory cascades are induced in association with cervical facet joint distraction-induced pain by investigating the time course of EP2 expression in the DRG. Summary of Background Data The cervical facet joint is a common source of neck pain and non-physiological stretch of the facet capsular ligament can initiate pain from the facet joint via mechanical injury. PGE2 levels are elevated in painful inflamed and arthritic joints, and PGE2 sensitizes joint afferents to mechanical stimulation. Although in vitro studies suggest the EP2 receptor subtype contributes to painful joint disease the EP2 response has not been investigated for any association with painful mechanical joint injury. Methods Separate groups of male Holtzman rats underwent either a painful cervical facet joint distraction injury or sham procedure. Bilateral forepaw mechanical allodynia was assessed, and immunohistochemical techniques were used to quantify EP2 expression in the DRG at days 1 and 7. Results Facet joint distraction induced mechanical allodynia that was significant (p<0.024) at all time points. Painful joint injury also significantly elevated total EP2 expression in the DRG at day 1 (p=0.009), which was maintained also at day 7 (p<0.001). Neuronal expression of EP2 in the DRG was only increased over sham levels at day 1 (p=0.013). Conclusions Painful cervical facet joint distraction induces an immediate and sustained increase of EP2 expression in the DRG, implicating peripheral inflammation in the initiation and maintenance of facet joint pain. The transient increase in neuronal EP2 suggests, as in other painful joint conditions, that after joint injury non-neuronal cells may migrate to the DRG, some of which likely express EP2

Scanning electron microscopic and histologic evaluation of the AcrySof SA30AL acrylic intraocular lens. Manufacturing quality and morphology in the capsular bag.

PubMed

Escobar-Gomez, Marcela; Apple, David J; Vargas, Luis G; Werner, Liliana; Arthur, Stella N; Pandey, Suresh K; Izak, Andrea M; Schmidbauer, Josef M

2003-01-01

To evaluate the properties of the AcrySof(R) SA30AL (Alcon Laboratories, Inc.) single-piece foldable posterior chamber intraocular lens (IOL). Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. Two nonimplanted clinical-quality AcrySof IOLs were examined by gross, light, and scanning electron microscopy (SEM). In addition, 2 eyes implanted with this IOL obtained post-mortem, the first such eyes accessioned in our laboratory and the first described to date, were examined using the Miyake-Apple posterior photographic technique and by histologic sections. Scanning electron microscopy of the SA30AL IOL showed excellent surface finish. The edge of the optic was square (truncated) and had a matte (velvet or ground-glass) appearance, a feature that may minimize edge glare and other visual phenomena. A well-fabricated square or truncated optic edge was demonstrated. Miyake-Apple analysis revealed that the SA30AL IOL showed appropriate fit and configuration within the capsular bag. Histologic correlation of the IOL's square edge and its relation to the capsular bag and adjacent Soemmering's ring were noted. The AcrySof SA30AL IOL is a well-fabricated lens that situates well in the capsular bag. The truncated optic and its relationship to adjacent structures show a morphological profile that has been shown to be highly efficacious in reducing the rate of posterior capsule opacification.

Capsular bag opacification after experimental implantation of a new accommodating intraocular lens in rabbit eyes.

PubMed

Werner, Liliana; Pandey, Suresh K; Izak, Andrea M; Vargas, Luis G; Trivedi, Rupal H; Apple, David J; Mamalis, Nick

2004-05-01

To evaluate the development of capsular bag opacification in rabbit eyes after implantation of an intraocular lens (IOL) designed to minimize contact between the anterior capsule and the IOL and ensure expansion of the capsular bag. David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Ten New Zealand white rabbits had a study IOL (new accommodating silicone IOL [Synchrony, Visiogen, Inc.]) implanted in 1 eye and a control IOL (1-piece plate silicone IOL with large fixation holes) implanted in the other eye. Intraocular lens position, anterior capsule opacification (ACO), and posterior capsule opacification (PCO) were qualitatively assessed using slitlamp retroillumination photographs of the dilated eyes. Anterior capsule opacification and PCO were graded on a 0 to 4 scale after the eyes were enucleated (Miyake-Apple posterior and anterior views after excision of the cornea and iris). The eyes were also evaluated histopathologically. The rate of ACO and PCO was significantly higher in the control group. Fibrosis and ACO were almost absent in the study group; the control group exhibited extensive capsulorhexis contraction, including capsulorhexis occlusion. Postoperative IOL dislocation into the anterior chamber and pupillary block syndrome were observed in some eyes in the study group. The special design features associated with the study IOL appeared to help prevent PCO. Complications in the study group were probably caused by the increased posterior vitreous pressure in rabbit eyes compared to human eyes and the relatively large size of the study IOL relative to the anterior segment of rabbit eyes.

Conformational studies of the capsular polysaccharide produced by Neisseria meningitidis group A.

PubMed

Foschiatti, Michela; Hearshaw, Meredith; Cescutti, Paola; Ravenscroft, Neil; Rizzo, R

2009-05-12

The effect of different cations on the conformational and morphological properties of the capsular polysaccharide produced by Neisseria meningitidis group A was investigated. Circular dichroism studies showed that the presence of Na(+), NH4+ or Ca(2+) ions induced different local conformations of the polysaccharide chain through interactions with the phosphodiester group bridging the saccharide residues in the polymer chain. Atomic force microscopy experiments confirmed that the morphology of the polysaccharide chains was different depending on the nature of the counterion. Ammonium ions were associated with the presence of single polymer chains in an elongated conformation, whereas sodium ions favored the folding of the chains into a globular conformation. The addition of calcium ions produced the aggregation of a limited number of globular polysaccharide chains to form a 'toroidal-like' structure.

Arthroscopic Hip Revision Surgery for Residual Femoroacetabular Impingement (FAI): Surgical Outcomes Compared With a Matched Cohort After Primary Arthroscopic FAI Correction.

PubMed

Larson, Christopher M; Giveans, M Russell; Samuelson, Kathryn M; Stone, Rebecca M; Bedi, Asheesh

2014-08-01

There are limited data reporting outcomes after revision arthroscopic surgery for residual femoroacetabular impingement (FAI). (1) Revision arthroscopic FAI correction results in improved outcomes, but they are inferior to those of primary arthroscopic FAI correction. (2) Improved postrevision radiographic parameters are predictive of better outcomes. Cohort study; Level of evidence, 3. Patients who underwent arthroscopic hip revision for residual FAI were reviewed. Pathomorphological findings, intraoperative findings, and preoperative and postoperative modified Harris Hip Score (MHHS), Short Form-12 (SF-12), and pain on a visual analog scale (VAS) values were evaluated. Outcomes after revision arthroscopic FAI correction were compared with outcomes of a matched cohort who underwent primary arthroscopic FAI correction. A total of 79 patients (85 hips) with a mean age of 29.5 years underwent arthroscopic revision FAI correction (mean follow-up, 26 months). The labrum was debrided (27 hips), repaired (49 hips), or reconstructed (7 hips). Two labrums were stable and required no treatment. The results of revision arthroscopic FAI correction were compared with those of 220 age- and sex-matched patients (237 hips) who underwent primary arthroscopic FAI correction (mean follow-up, 23 months). The mean improvement in outcome scores after revision FAI correction was 17.8 (MHHS), 12.5 (SF-12), and 1.4 (VAS) points compared with 23.4 (MHHS), 19.7 (SF-12), and 4.6 (VAS) points after primary arthroscopic FAI correction. The mean improvement was significantly better in the primary cohort compared with the revision cohort (P < .01 for MHHS, SF-12, and VAS values). Good/excellent results were achieved in 81.7% of the primary cohort and 62.7% of the revision cohort (P < .01). Greater postoperative head-neck offset (P = .024), subspine/anterior inferior iliac spine (AIIS) decompression (P = .014), labral repair/reconstruction (P = .009), and capsular plication (P = .032) were

Microplasma Induced Cell Morphological Changes and Apoptosis of Ex Vivo Cultured Human Anterior Lens Epithelial Cells – Relevance to Capsular Opacification

PubMed Central

Hojnik, Nataša; Filipič, Gregor; Lazović, Saša; Vesel, Alenka; Primc, Gregor; Mozetič, Miran; Hawlina, Marko; Petrovski, Goran; Cvelbar, Uroš

2016-01-01

Inducing selective or targeted cell apoptosis without affecting large number of neighbouring cells remains a challenge. A plausible method for treatment of posterior capsular opacification (PCO) due to remaining lens epithelial cells (LECs) by reactive chemistry induced by localized single electrode microplasma discharge at top of a needle-like glass electrode with spot size ~3 μm is hereby presented. The focused and highly-localized atmospheric pressure microplasma jet with electrode discharge could induce a dose-dependent apoptosis in selected and targeted individual LECs, which could be confirmed by real-time monitoring of the morphological and structural changes at cellular level. Direct cell treatment with microplasma inside the medium appeared more effective in inducing apoptosis (caspase 8 positivity and DNA fragmentation) at a highly targeted cell level compared to treatment on top of the medium (indirect treatment). Our results show that single cell specific micropipette plasma can be used to selectively induce demise in LECs which remain in the capsular bag after cataract surgery and thus prevent their migration (CXCR4 positivity) to the posterior lens capsule and PCO formation. PMID:27832099

Effective weight loss management with endoscopic gastric plication using StomaphyX device: is it achievable?

PubMed

Ong'uti, Sharon K; Ortega, Gezzer; Onwugbufor, Michael T; Ivey, Gabriel D; Fullum, Terrence M; Tran, Daniel D

2013-01-01

Despite the effectiveness of Roux-en-Y gastric bypass (RYGB) in promoting excess weight loss, 40% of the patients regain weight. Endoscopic gastric plication (EGP) using the StomaphyX device can serve as a less-invasive procedure for promoting the loss of regained weight. Our objective was to evaluate the effectiveness of the StomaphyX device in sustaining ongoing weight loss in patients who have regained weight after RYGB at the Division of Minimally Invasive and Bariatric Surgery, Howard University Hospital. We performed a retrospective chart review of patients undergoing EGP using the StomaphyX device from April 2008 to May 2010. The patient demographics and clinical information were assessed. Effective weight loss and the proportion of weight lost after EGP relative to the weight regained after achieving the lowest weight following RYGB was calculated. A total of 27 patients underwent EGP using the StomaphyX device; of these, most were women (n = 25, 93%) and black (n = 14, 52%), followed by white (n = 11, 42%), and Hispanic (n = 1, 4%). The median interval between RYGB and EGP was 6 years, with an interquartile range of 5-8 years. After the EGP procedure, the median effective weight loss was 37% (interquartile range 24-61%). Of the 27 patients, 18 had ≥6 months of follow-up after EGP. Eleven patients had achieved their lowest weight at 1-3 months, 7 at 6 months, and 3 at 12 months. Of the 18 patients, 13 (72%) experienced an increase in weight after achieving their lowest weight after EGP. The use of the StomaphyX device achieved the maximum effective weight loss during the 1-6-month period after EGP. Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Arthroscopy of the Nondistractable Hip: A Novel Extracapsular Approach

PubMed Central

Doron, Ran; Amar, Eyal; Rath, Ehud; Sampson, Thomas; Ochiai, Derek; Matsuda, Dean K.

2014-01-01

Adequate traction to achieve hip joint distraction is essential for avoiding iatrogenic injury to the joint during hip arthroscopy. An inability to distract the joint is a relative contraindication for hip arthroscopy. This report describes a novel technique involving an extracapsular approach to gain safe access to a hip joint that fails a trial of traction during positioning for hip arthroscopy. The anterolateral portal is established under fluoroscopic guidance. The arthroscope is positioned on the lateral rim of the acetabulum. A shaver, introduced through a modified anterior portal, is used to facilitate capsular exposure. An arthroscopic capsular incision is made proximal to the lateral acetabular rim and extended anteriorly with a radiofrequency probe. Osteoplasty of the anterolateral acetabular rim is carried out with a burr while protecting the labrum. Distraction of the hip is then possible, allowing safe central-compartment access and subsequent chondrolabral procedures. PMID:25685682

Platinum concentration in silicone breast implant material and capsular tissue by ICP-MS.

PubMed

Maharaj, S V M

2004-09-01

Inductively coupled plasma-mass spectrometry (ICP-MS) was used to determine the concentration of platinum (Pt) in silicone breast implant gel (range, 0.26-48.90 microg g(-1) Pt; n=15), elastomer (range, 3.05-28.78 microg g(-1) Pt; n=7), double lumen (range, 5.79-125.27 microg g(-1) Pt; n=7), foam (range, 5.79-8.36 microg g(-1) Pt; n=2), and capsular tissue (range, 0.003-0.272 microg g(-1) Pt; n=15). The results show that very high levels of Pt are present in the encasing elastomer, double lumen, and foam envelope materials. Silicone breast implants can be a source of significant Pt exposure for individuals with these implants.

Greater Curvature Plication with Duodenal-Jejunal Bypass: a Novel Metabolic Surgery for Type 2 Diabetes Mellitus.

PubMed

Qiu, Nian-Cun; Cen, Xiao-Xia; Liu, Miao-E; Liu, Qing; Zha, Si-Luo; Shan, Cheng-Xiang; Zhang, Wei; Wang, Ling-Di; Wang, Yang; Qiu, Ming

2018-06-01

The study investigated the use of great curvature plication with duodenal-jejunal bypass (GCP-DJB) in a type 2 diabetic with obesity rat model. Twenty-two Sprague-Dawley rats were given a high fat and sugar diet with subsequent intraperitoneal injection of a small dosage of streptozotocin (30 mg/kg) and randomly assigned to either GCP-DJB (n = 12) or Sham surgery (n = 10). Body weight, peripheral blood glucose, and fasting serum insulin were assayed, and insulin resistance index (IRI) was calculated, before and at 1, 2, 4, and 8 weeks after surgery. No differences were found in the preoperative characteristics of the two groups (P > 0.05). At week 1, the body weights decreased significantly, but there was no significant difference between the two groups (P > 0.05).The fasting blood glucose was significantly lower in the GCP-DJB than in the Sham group (P < 0.05), serum insulin levels were higher (P < 0.05), and IRI began to decline (P < 0.05). From 2 to 8 weeks, the body weight of Sham group gradually recovered and continued to rise, while the GCP-DJB group remained at a relatively lower state. Compared to the Sham group, the body weight, fasting blood glucose as well as IRI of GCP-DJB rats had significantly decreased (P < 0.05). But, the fasting insulin concentrations had significantly increased (P < 0.05). This novel GCP-DJB procedure established a stable animal model for the study of metabolic surgery to treat type 2 diabetes mellitus (T2DM).

Capsular lesions with glenohumeral ligament injuries in patients with primary shoulder dislocation: magnetic resonance imaging and magnetic resonance arthrography evaluation

PubMed Central

Liavaag, S; Stiris, M G; Svenningsen, S; Enger, M; Pripp, A H; Brox, J I

2011-01-01

The glenohumeral ligaments are important structures for the stability of the shoulder. They are integrated parts of the capsule and are at risk to be injured in a traumatic shoulder dislocation. The aim was to examine the prevalence of capsular ligament lesions in the acute phase and at minimum 3 weeks' follow-up after first-time traumatic shoulder dislocation. Forty-two patients aged 16–40 years were included. All patients underwent computed tomography and magnetic resonance imaging (MRI) scans shortly after the injury and MR-arthrography (MRA) at follow-up. The median time from dislocation to MRI was 7 (range 2–14) days and to MRA 30 (range 21–54) days. We found capsular ligament lesions in 22 patients (52.4%) in the acute stage and in five patients (11.9%) at follow up. Nine patients (21.4%) had a humeral avulsion of the anterior glenohumeral ligament (HAGL lesion) on MRI. Three patients (7.1%) had this lesion at follow-up. The rate of HAGL lesions in the acute stage was higher than reported previously, but the prevalence at follow-up was in keeping with earlier published studies. PMID:21401723

The detection of the capsular tear at the undersurface of the extensor carpi radialis brevis tendon in chronic tennis elbow: the value of magnetic resonance imaging and computed tomography arthrography.

PubMed

Sasaki, Koichi; Tamakawa, Mitsuharu; Onda, Kazunori; Iba, Kosuke; Sonoda, Tomoko; Yamashita, Toshihiko; Wada, Takuro

2011-04-01

This study compared the diagnostic efficacy of magnetic resonance imaging (MRI) and computed tomography arthrography (CTA) in the assessment of capsular tears at the undersurface of the extensor carpi radials brevis tendon in chronic tennis elbow using arthroscopy as a gold standard. Because of the higher spatial resolution of CT, we hypothesized that CTA is superior to MRI for assessing capsular tears. We retrospectively reviewed 19 consecutive patients with chronic tennis elbow with preoperative MRI and CTA studies who underwent arthroscopic surgery. Three observers with different levels of training and experience (musculoskeletal radiologist, experienced elbow surgeon, and hand fellow) evaluated the capsular tear by MRI and CTA in a blinded manner. The results of the MRI and CTA were compared and the agreement among the 3 observers was determined using an intraclass correlation coefficient (ICC). Then, the results of the MRI and CTA examinations were compared with the intraoperative findings of the arthroscopic examination. The sensitivity, specificity, and κ value were calculated. The ICC of CTA (0.855) was superior to MRI (0.645). The sensitivity, specificity, and κ value of CTA were superior to those of MRI in each of the 3 observers. The κ value was 0.79, 0.89, and 0.79 for CTA, and 0.48, 0.48, and 0.27 for MRI for the radiologist, surgeon, and fellow, respectively. CTA was a reliable and accurate diagnostic modality compared with MRI to detect the capsular tear in patients with chronic tennis elbow. CTA was less influenced by the observer's experience. Copyright © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Genetic and structural elucidation of capsular polysaccharides from Streptococcus pneumoniae serotype 23A and 23B, and comparison to serotype 23F.

PubMed

Ravenscroft, Neil; Omar, Aneesa; Hlozek, Jason; Edmonds-Smith, Cesarina; Follador, Rainer; Serventi, Fabio; Lipowsky, Gerd; Kuttel, Michelle M; Cescutti, Paola; Faridmoayer, Amirreza

2017-10-10

Streptococcus pneumoniae is a globally important encapsulated human pathogen with approximately 100 different serotypes recognized. Serogroup 23 consists of serotype 23F, present in licensed vaccines, and emerging serotypes 23A and 23B. Here, we report the previously unknown structures of the pneumococcal capsular polysaccharides serotype 23A and 23B determined using genetic analysis, NMR spectroscopy, composition and linkage analysis and Smith degradation (of polysaccharide 23A). The structure of the serotype 23A capsular polysaccharide is: →4)-β-D-Glcp-(1→3)-[[α-L-Rhap-(1→2)]-[Gro-(2→P→3)]-β-D-Galp-(1→4)]-β-L-Rhap-(1→. This structure differs from polysaccharide 23F as it features a disaccharide backbone and the di-substituted β-Gal is linked to β-Rha as a side chain. This is due to the different polymerization position catalysed by the unusually divergent repeat unit polymerase Wzy in the 23A cps biosynthesis locus. Steric crowding in 23A, confirmed by molecular models, causes the NMR signal for H-1 of the di-substituted 2,3-β-Gal to resonate in the α-anomeric region. The structure of the serotype 23B capsular polysaccharide is the same as 23F, but without the terminal α-Rha: →4)-β-D-Glcp-(1→4)-[Gro-(2→P→3)]-β-D-Galp-(1→4)-β-L-Rhap-(1→. The immunodominant terminal α-Rha of 23F is more sterically crowded in 23A and absent in 23B. This may explain the reported typing cross reactions for serotype 23F: slight with 23A and none with 23B. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fabrication of a micro-fluid gathering tool for the gastrointestinal juice sampling function of a versatile capsular endoscope.

PubMed

Koo, Kyo-In; Lee, Sangmin; Cho, Dong-il Dan

2011-01-01

This paper presents a micro-fluid gathering tool for a versatile capsular endoscope that employs a solid chemical propellant, azobisisobutyronitrile (AIBN). The proposed tool consists of a micro-heater, an AIBN matrix, a Venturi tube, a reservoir, an inlet, and an outlet. The micro-heater heats the AIBN matrix to be decomposed into by-products and nitrogen gas. This nitrogen gas generates negative pressure passing through the Venturi tube. The generated negative pressure inhales a target fluid from around the inlet into the reservoir. All the parts are designed to be embedded inside a cylindrical shape with a diameter of 17 mm and a height of 2.3 mm in order to integrate it into a versatile developmental capsular endoscope without any scaledown. Two sets of the proposed tools are fabricated and tested: one is made of polydimethylsiloxane (PDMS) and the other is made of polymethylmethacrylate (PMMA). In performance comparisons, the PDMS gathering tool can withstand a stronger pulling force, and the PMMA gathering tool requires a less negative pressure for inhaling the same target fluid. Due to the instant and full activation of the thin AIBN matrix, both types of gathering tool show analogous performance in the sample gathering evaluation. The gathered volume is approximately 1.57 μL using approximately 25.4 μL of AIBN compound.

Fabrication of a Micro-Fluid Gathering Tool for the Gastrointestinal Juice Sampling Function of a Versatile Capsular Endoscope

PubMed Central

Koo, Kyo-in; Lee, Sangmin; Cho, Dong-il Dan

2011-01-01

This paper presents a micro-fluid gathering tool for a versatile capsular endoscope that employs a solid chemical propellant, azobisisobutyronitrile (AIBN). The proposed tool consists of a micro-heater, an AIBN matrix, a Venturi tube, a reservoir, an inlet, and an outlet. The micro-heater heats the AIBN matrix to be decomposed into by-products and nitrogen gas. This nitrogen gas generates negative pressure passing through the Venturi tube. The generated negative pressure inhales a target fluid from around the inlet into the reservoir. All the parts are designed to be embedded inside a cylindrical shape with a diameter of 17 mm and a height of 2.3 mm in order to integrate it into a versatile developmental capsular endoscope without any scaledown. Two sets of the proposed tools are fabricated and tested: one is made of polydimethylsiloxane (PDMS) and the other is made of polymethylmethacrylate (PMMA). In performance comparisons, the PDMS gathering tool can withstand a stronger pulling force, and the PMMA gathering tool requires a less negative pressure for inhaling the same target fluid. Due to the instant and full activation of the thin AIBN matrix, both types of gathering tool show analogous performance in the sample gathering evaluation. The gathered volume is approximately 1.57 μL using approximately 25.4 μL of AIBN compound. PMID:22163997

Protection against Escherichia coli K1 infection in newborn rats by antibody to K1 capsular polysaccharide antigen.

PubMed

Bortolussi, R; Ferrier, P

1980-04-01

The protective value of antibody to the K1 capsular polysaccharide antigen of Escherichia coli was investigated in a newborn rat model of E. coli K1 infection. Pregnant rats were immunized intravenously with E. coli, and the agglutinating titer to meningococcal group B polysaccharide, which is identical to K1 polysaccharide, was measured in the serum of rats and their offspring. Convalescent serum from rat mothers showed an increased antibody titer in animals injected twice but not once with E. coli K1. Although no agglutinating antibody was detected in the serum of rat pups, animals suckled by mothers having a meningococcal group B agglutinating titer of 1:8 or greater had reduced infection and mortality rates after intraperitoneal injection with E. coli K1 compared with animals suckled by mothers having a low titer of agglutinating antibody (P less than 0.05). In addition, greater protection could be conferred on rat sucklings by oral supplementation with a horse serum rich in antibody to meningococcal group B polysaccharide, suggesting that antibody was abosorbed from the gastrointestinal tract and by itself could be protective. These studies demonstrated that antibody to the capsular polysaccharide of E. coli K1 altered the severity of E. coli K1 infection. Final clearance of bacteria from the blood appeared to await the maturation of other host defense systems in the newborn rat.

Femoral neck-shaft angle in extra-capsular proximal femoral fracture fixation; does it make a TAD of difference?

PubMed

Walton, N P; Wynn-Jones, H; Ward, M S; Wimhurst, J A

2005-11-01

The effect of femoral neck-shaft angle and implant type on the accuracy of lag screw placement in extra-capsular proximal femoral fracture fixation was investigated. Radiographs of all extra-capsular proximal femoral fractures seen in one unit over 18 months were reviewed. Of 399 cases, 307 (237 female, 70 male) were included in the study as they had no contra-lateral proximal femoral metal work. Femoral neck-shaft angle (NSA) of the uninjured hip and magnification adjusted tip-apex distance (TAD) of femoral head lag screw were measured. Type of fixation implant was 135 degrees classic hip screw (CHS) (n=144) or 130 degrees intra-medullary hip screw (IMHS) (n=163). Mean contra-lateral NSA was 130.2 degrees (112.9--148 degrees ) and 64 patients (58 female, 6 male) had a NSA <125 degrees . Mean adjusted TAD was 18.7 mm (5.8--43.8mm) and 88.9% of cases had a TAD of less than 25 mm. TAD values were significantly greater using an IMHS if NSA was <125 degrees than if NSA was >125 degrees (p=0.028). This was not the case with the CHS. The use of the 130 degrees -IMHS in patients with a NSA <125 degrees leads to poorer lag screw placement than if NSA >125 degrees and caution is advocated when using this device in such cases.

Breast-implant texturing associated with delamination of capsular layers: A histological analysis of the double capsule phenomenon.

PubMed

Efanov, J I; Giot, J P; Fernandez, J; Danino, M A

2017-06-01

Macro-texturing of breast implants was developed with the double goal of improving implant stabilization within the breast cavity and decreasing the rate of capsular contractures. However, recent evidence suggests that double capsular formation, a potentially worrisome phenomenon associated with late seromas and biofilms, occurs with preponderance in macro-textured implants. Our objective was to analyze histologically different regions of double capsules to determine if they are more prone to mechanical movements. A prospective analysis including patients undergoing second-stage expander to definitive breast-implant reconstruction post-mastectomy was conducted after intraoperative identification of the double capsule phenomenon. Two samples were collected from each capsules around the implant, located centrally and laterally. The specimens were sent for histological analysis by the institution's pathologist. In total, 10 patients were identified intraoperatively with partial double capsule phenomenon. Among samples retrieved from the lateral aspect of the breast implant, all were associated with delamination and fractures in the collagen matrix of the double capsules. This phenomenon was not observed in any sample from the dome of the breast. Breast-implant macro-texturing plays an important role on delamination of capsules on lateral portions of the breast, which may have an etiologic role in double capsule formation. Manufacturing implants with macro-texturing on one side and smooth surface on the other could diminish mechanical shear forces responsible for these findings. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Structural investigation of the capsular polysaccharide produced by a novel Klebsiella serotype (SK1). Location of O-acetyl substituents using NMR and MS techniques.

PubMed

Cescutti, P; Ravenscroft, N; Ng, S; Lam, Z; Dutton, G G

1993-06-21

The capsular polysaccharide of Klebsiella SK1 was investigated by methylation analysis, Smith degradation, and 1H NMR spectroscopy. The oligosaccharides (P1 and P2) obtained by bacteriophage phi SK1 degradation of the polymer were studied by methylation analysis, and 1D- and 2D-NMR spectroscopy. The resulting data showed that the parent repeating unit is a branched pentasaccharide having a structure identical to the revised structure recently proposed for Klebsiella serotype K8 capsular polysaccharide. [Formula: see text] The 2D-NMR data showed that one third of the glucuronic acid residues in the SK1 polymer are acetylated at O-2, O-3, or O-4. FABMS studies confirmed the presence of monoacetylated glucuronic acid residues. Thus, the relationship between the Klebsiella K8 and SK1 polymers is akin to that found for Klebsiella polysaccharides K30 and K33, which have been typed as serologically distinct yet their structures differ only in the degree of acetylation.

Improvement of Uveal and Capsular Biocompatibility of Hydrophobic Acrylic Intraocular Lens by Surface Grafting with 2-Methacryloyloxyethyl Phosphorylcholine-Methacrylic Acid Copolymer

PubMed Central

Tan, Xuhua; Zhan, Jiezhao; Zhu, Yi; Cao, Ji; Wang, Lin; Liu, Sa; Wang, Yingjun; Liu, Zhenzhen; Qin, Yingyan; Wu, Mingxing; Liu, Yizhi; Ren, Li

2017-01-01

Biocompatibility of intraocular lens (IOL) is critical to vision reconstruction after cataract surgery. Foldable hydrophobic acrylic IOL is vulnerable to the adhesion of extracellular matrix proteins and cells, leading to increased incidence of postoperative inflammation and capsule opacification. To increase IOL biocompatibility, we synthesized a hydrophilic copolymer P(MPC-MAA) and grafted the copolymer onto the surface of IOL through air plasma treatment. X-ray photoelectron spectroscopy, atomic force microscopy and static water contact angle were used to characterize chemical changes, topography and hydrophilicity of the IOL surface, respectively. Quartz crystal microbalance with dissipation (QCM-D) showed that P(MPC-MAA) modified IOLs were resistant to protein adsorption. Moreover, P(MPC-MAA) modification inhibited adhesion and proliferation of lens epithelial cells (LECs) in vitro. To analyze uveal and capsular biocompatibility in vivo, we implanted the P(MPC-MAA) modified IOLs into rabbits after phacoemulsification. P(MPC-MAA) modification significantly reduced postoperative inflammation and anterior capsule opacification (ACO), and did not affect posterior capsule opacification (PCO). Collectively, our study suggests that surface modification by P(MPC-MAA) can significantly improve uveal and capsular biocompatibility of hydrophobic acrylic IOL, which could potentially benefit patients with blood-aqueous barrier damage. PMID:28084469

Image-based multiscale mechanical modeling shows the importance of structural heterogeneity in the human lumbar facet capsular ligament.

PubMed

Zarei, Vahhab; Liu, Chao J; Claeson, Amy A; Akkin, Taner; Barocas, Victor H

2017-08-01

The lumbar facet capsular ligament (FCL) primarily consists of aligned type I collagen fibers that are mainly oriented across the joint. The aim of this study was to characterize and incorporate in-plane local fiber structure into a multiscale finite element model to predict the mechanical response of the FCL during in vitro mechanical tests, accounting for the heterogeneity in different scales. Characterization was accomplished by using entire-domain polarization-sensitive optical coherence tomography to measure the fiber structure of cadaveric lumbar FCLs ([Formula: see text]). Our imaging results showed that fibers in the lumbar FCL have a highly heterogeneous distribution and are neither isotropic nor completely aligned. The averaged fiber orientation was [Formula: see text] ([Formula: see text] in the inferior region and [Formula: see text] in the middle and superior regions), with respect to lateral-medial direction (superior-medial to inferior-lateral). These imaging data were used to construct heterogeneous structural models, which were then used to predict experimental gross force-strain behavior and the strain distribution during equibiaxial and strip biaxial tests. For equibiaxial loading, the structural model fit the experimental data well but underestimated the lateral-medial forces by [Formula: see text]16% on average. We also observed pronounced heterogeneity in the strain field, with stretch ratios for different elements along the lateral-medial axis of sample typically ranging from about 0.95 to 1.25 during a 12% strip biaxial stretch in the lateral-medial direction. This work highlights the multiscale structural and mechanical heterogeneity of the lumbar FCL, which is significant both in terms of injury prediction and microstructural constituents' (e.g., neurons) behavior.

Levels of Antibodies Specific to Tetanus Toxoid, Haemophilus influenzae Type b, and Pneumococcal Capsular Polysaccharide in Healthy Children and Adults

PubMed Central

Schauer, Uwe; Stemberg, Frank; Rieger, Christian H. L.; Büttner, Wolfgang; Borte, Michael; Schubert, Simone; Möllers, Helga; Riedel, Frank; Herz, Udo; Renz, Harald; Herzog, Wilhelm

2003-01-01

Antibody levels specific for capsular polysaccharides of Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) and for tetanus toxoid were measured in serum samples of 386 age-stratified subjects. The study group consists of healthy adult blood donors and hospitalized children undergoing elective surgery, excluding individuals with a history of infection. In children, anti-tetanus toxoid antibody levels displayed two peaks of 1.20 IU/ml (20.4 mg/liter) and 1.65 IU/ml (28.1 mg/liter) related to the schedule of routine childhood immunization in the first year and at 8 years of age. Eighty percent of the antibodies are of the immunoglobulin G1 (IgG1) isotype. For pneumococcal capsular polysaccharide (PCP), the specific antibody levels represent the acquisition of natural immunity. The initial concentration of 9.2 mg/liter was low in infancy (0.5 to 1 years of age) and remained low until 3 to 4 years of age (14.6 mg/liter). During this period PCP antibodies were almost 100% of the IgG2 subclass. Thereafter, IgG anti-PCP antibody titers increased steadily to adult levels (59.5 mg/liter). The data are intended to provide reference ranges to aid in the interpretation of specific antibody determinations in the clinical setting. PMID:12626443

Antimicrobial susceptibilities and capsular types of invasive Streptococcus pneumoniae isolated in children in Mexico City.

PubMed

Echániz-Aviles, G; Velázquez-Meza, M E; Carnalla-Barajas, M N; Soto-Noguerón, A; Solórzano-Santos, F; Pérez Miravete, A; Gatica-Marquina, R; di Fabio, J L

1997-01-01

As part of the Sistema Regional de Vacunas (SIREVA) initiative, we conducted a surveillance study to determine the relative prevalence of capsular types of Streptococcus pneumoniae and antimicrobial susceptibility of invasive isolates in children less than 5 years old. We collected 220 isolates and found 33 of the 90 known types, with type 23F as the most common followed by types 6A+B, 14, 19F, and 19A. High penicillin resistance was found in 49 strains (22.2%), 31 belonging to type 23F. Twenty-nine (13.1%) were resistant to erythromycin, 95 (43.1%) were resistant to chloramphenicol, and 24 (10.9%) were resistant to cefotaxime. No strains were resistant to vancomycin.

The effect of glenosphere diameter in reverse shoulder arthroplasty on muscle force, joint load, and range of motion.

PubMed

Langohr, G Daniel G; Giles, Joshua W; Athwal, George S; Johnson, James A

2015-06-01

Little is known about the effects of glenosphere diameter on shoulder joint loads. The purpose of this biomechanical study was to investigate the effects of glenosphere diameter on joint load, load angle, and total deltoid force required for active abduction and range of motion in internal/external rotation and abduction. A custom, instrumented reverse shoulder arthroplasty implant system capable of measuring joint load and varying glenosphere diameter (38 and 42 mm) and glenoid offset (neutral and lateral) was implanted in 6 cadaveric shoulders to provide at least 80% power for all variables. A shoulder motion simulator was used to produce active glenohumeral and scapulothoracic motion. All implant configurations were tested with active and passive motion with joint kinematics, loads, and moments recorded. At neutral and lateralized glenosphere positions, increasing diameter significantly increased joint load (+12 ± 21 N and +6 ± 9 N; P < .01) and deltoid load required for active abduction (+9 ± 22 N and +11 ± 15 N; P < .02), whereas joint load angle was unaffected (P > .8). Passive internal rotation was reduced with increased diameter at both neutral and lateralized glenosphere positions (-6° ± 6° and -12° ± 6°; P < .002); however, external rotation was not affected (P > .05). At neutral glenosphere position, increasing diameter increased the maximum angles of both adduction (+1° ± 1°; P = .03) and abduction (+8° ± 9°; P < .05). Lateralization also increased abduction range of motion compared with neutral (P < .01). Although increasing glenosphere diameter significantly increased joint load and deltoid force, the clinical impact of these changes is presently unclear. Internal rotation, however, was reduced, which contradicts previous bone modeling studies, which we postulate is due to increased posterior capsular tension as it is forced to wrap around a larger 42 mm implant assembly. Copyright © 2015 Journal of

DNA-Sequence Based Typing of the Cronobacter Genus Using MLST, CRISPR-cas Array and Capsular Profiling

PubMed Central

Ogrodzki, Pauline; Forsythe, Stephen J.

2017-01-01

The Cronobacter genus is composed of seven species, within which a number of pathovars have been described. The most notable infections by Cronobacter spp. are of infants through the consumption of contaminated infant formula. The description of the genus has greatly improved in recent years through DNA sequencing techniques, and this has led to a robust means of identification. However some species are highly clonal and this limits the ability to discriminate between unrelated strains by some methods of genotyping. This article updates the application of three genotyping methods across the Cronobacter genus. The three genotyping methods were multilocus sequence typing (MLST), capsular profiling of the K-antigen and colanic acid (CA) biosynthesis regions, and CRISPR-cas array profiling. A total of 1654 MLST profiled and 286 whole genome sequenced strains, available by open access at the PubMLST Cronobacter database, were used this analysis. The predominance of C. sakazakii and C. malonaticus in clinical infections was confirmed. The majority of clinical strains being in the C. sakazakii clonal complexes (CC) 1 and 4, sequence types (ST) 8 and 12 and C. malonaticus ST7. The capsular profile K2:CA2, previously proposed as being strongly associated with C. sakazakii and C. malonaticus isolates from severe neonatal infections, was also found in C. turicensis, C. dublinensis and C. universalis. The majority of CRISPR-cas types across the genus was the I-E (Ecoli) type. Some strains of C. dublinensis and C. muytjensii encoded the I-F (Ypseudo) type, and others lacked the cas gene loci. The significance of the expanding profiling will be of benefit to researchers as well as governmental and industrial risk assessors. PMID:29033918

Versatility of Capsular Flaps in the Salvage of Exposed Breast Implants

PubMed Central

Tenna, Stefania; Cagli, Barbara; Pallara, Tiziano; Campa, Stefano; Persichetti, Paolo

2015-01-01

Summary: Breast implant exposure due to poor tissue coverage or previous irradiation represents a surgical challenge both in the reconstructive and aesthetic plastic surgery practice. In case of implant extrusion or incipient exposure, the commonly suggested strategies, such as targeted antibiotic therapy, drainage and lavage of the cavity, fistulectomy, and primary closure, may be ineffective leading the surgeon to an unwanted implant removal or to adopt more invasive flap coverage procedures. Breast implant capsule, in its physiological clinical behavior, can be considered as a new reliable source of tissue, which can be used in a wide range of clinical situations. In our hands, capsular flaps proved to be a versatile solution not only to treat breast contour deformities or inframammary fold malpositions but also to salvage exposed breast implants. In this scenario, the use of more invasive surgical techniques can be avoided or simply saved and delayed for future recurrences.(Plast Reconstr Surg Glob Open 2015;3:e340; doi:10.1097/GOX.0000000000000307; Published online 30 March 2015.) PMID:26034647

Solution properties of the capsular polysaccharide produced by Klebsiella pneumoniae SK1.

PubMed

Cescutti, P; Paoletti, S; Navarini, L; Flaibani, A

1993-08-01

The solution properties of the capsular polysaccharide produced by Klebsiella pneumoniae SK1, SK1-CPS, were investigated by various methods. The SK1-CPS repeating unit is a branched pentasaccharide containing one glucuronic acid as single unit side chain; acetyl groups are present as non-carbohydrate substituents on the uronic acid residue in non-stoichiometric amounts. Chiro-optical, potentiometric, viscometric and rheological measurements have been performed in order to characterize the conformational behaviour of the polymer in water and in aqueous salt solutions. Under the investigated experimental conditions, changes of temperature, ionic strength and pH were shown not to induce any cooperative conformational transition. All the results obtained suggest that the solution conformation of SK1-CPS is a random coil with a certain degree of chain flexibility. The removal of the acetyl substituents apparently does not modify the overall conclusions drawn for the native polymer, except for an incipient tendency to aggregation revealed for high salt conditions.

The Capsular Polysaccharide of Staphylococcus aureus Is Attached to Peptidoglycan by the LytR-CpsA-Psr (LCP) Family of Enzymes*

PubMed Central

Chan, Yvonne Gar-Yun; Kim, Hwan Keun; Schneewind, Olaf; Missiakas, Dominique

2014-01-01

Envelope biogenesis in bacteria involves synthesis of intermediates that are tethered to the lipid carrier undecaprenol-phosphate. LytR-CpsA-Psr (LCP) enzymes have been proposed to catalyze the transfer of undecaprenol-linked intermediates onto the C6-hydroxyl of MurNAc in peptidoglycan, thereby promoting attachment of wall teichoic acid (WTA) in bacilli and staphylococci and capsular polysaccharides (CPS) in streptococci. S. aureus encodes three lcp enzymes, and a variant lacking all three genes (Δlcp) releases WTA from the bacterial envelope and displays a growth defect. Here, we report that the type 5 capsular polysaccharide (CP5) of Staphylococcus aureus Newman is covalently attached to the glycan strands of peptidoglycan. Cell wall attachment of CP5 is abrogated in the Δlcp variant, a defect that is best complemented via expression of lcpC in trans. CP5 synthesis and peptidoglycan attachment are not impaired in the tagO mutant, suggesting that CP5 synthesis does not involve the GlcNAc-ManNAc linkage unit of WTA and may instead utilize another Wzy-type ligase to assemble undecaprenyl-phosphate intermediates. Thus, LCP enzymes of S. aureus are promiscuous enzymes that attach secondary cell wall polymers with discrete linkage units to peptidoglycan. PMID:24753256

Do Ligamentum Teres Tears Portend Inferior Outcomes in Patients With Borderline Dysplasia Undergoing Hip Arthroscopic Surgery? A Match-Controlled Study With a Minimum 2-Year Follow-up.

PubMed

Chaharbakhshi, Edwin O; Perets, Itay; Ashberg, Lyall; Mu, Brian; Lenkeit, Christopher; Domb, Benjamin G

2017-09-01

Arthroscopic surgery in borderline dysplastic hips remains controversial, but the role of the ligamentum teres (LT) has not been studied in this setting. Borderline dysplastic patients with LT tears have worse short-term outcomes than those without LT tears. Cohort study; Level of evidence, 3. Data were prospectively collected on patients who underwent arthroscopic surgery between February 2008 and April 2014. The inclusion criteria were borderline dysplasia (lateral center-edge angle [LCEA], 18°-25°) and labral tears; arthroscopic treatments including labral preservation and capsular plication; and preoperative patient-reported outcome scores including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport-Specific Subscale, and visual analog scale for pain. Patients were excluded for preoperative Tönnis osteoarthritis grade >0, workers' compensation claims, previous ipsilateral hip surgery and conditions, or frank dysplasia (LCEA <18°). Patients with LT tears were pair-matched to patients without tears for sex, age at surgery ±10 years, body mass index (<30 kg/m 2 vs ≥30 kg/m 2 ), labral treatment type, and microfracture. Of 68 eligible patients, 63 (93%) had a minimum 2-year follow-up, and 30 (48%) had LT tears. Twenty patients in each group were pair-matched. The mean follow-up time was 54.3 months (range, 24.2-83.8 months) for the LT tear group and 38.6 months (range, 24.6-70.6 months) for the control group ( P = .002). Ninety percent were female. There were no significant differences regarding demographics or intra-operative procedures. The LT tear group trended toward lower postoperative mHHS ( P = .09) and NAHS ( P = .09) values. Mean satisfaction was 8.1 for the LT tear group and 7.9 for the control group. Preoperative and follow-up scores were not significantly different between the groups. The LT tear group had 5 revisions, with 1 revision in the control group. Three patients (15%) in the LT tear group

Recombinant expression of Streptococcus pneumoniae capsular polysaccharides in Escherichia coli

PubMed Central

Kay, Emily J.; Yates, Laura E.; Terra, Vanessa S.; Cuccui, Jon; Wren, Brendan W.

2016-01-01

Currently, Streptococcus pneumoniae is responsible for over 14 million cases of pneumonia worldwide annually, and over 1 million deaths, the majority of them children. The major determinant for pathogenesis is a polysaccharide capsule that is variable and is used to distinguish strains based on their serotype. The capsule forms the basis of the pneumococcal polysaccharide vaccine (PPV23) that contains purified capsular polysaccharide from 23 serotypes, and the pneumococcal conjugate vaccine (PCV13), containing 13 common serotypes conjugated to CRM197 (mutant diphtheria toxin). Purified capsule from S. pneumoniae is required for pneumococcal conjugate vaccine production, and costs can be prohibitively high, limiting accessibility of the vaccine in low-income countries. In this study, we demonstrate the recombinant expression of the capsule-encoding locus from four different serotypes of S. pneumoniae within Escherichia coli. Furthermore, we attempt to identify the minimum set of genes necessary to reliably and efficiently express these capsules heterologously. These E. coli strains could be used to produce a supply of S. pneumoniae serotype-specific capsules without the need to culture pathogenic bacteria. Additionally, these strains could be applied to synthetic glycobiological applications: recombinant vaccine production using E. coli outer membrane vesicles or coupling to proteins using protein glycan coupling technology. PMID:27110302

Type 5 and 8 capsular polysaccharides are expressed by Staphylococcus aureus isolates from rabbits, poultry, pigs, and horses.

PubMed Central

Poutrel, B; Sutra, L

1993-01-01

A total of 103 Staphylococcus aureus isolates from rabbits (n = 37), poultry (n = 33), pigs (n = 27), and horses (n = 6) and 14 Staphylococcus intermedius isolates from wild animals were serotyped for capsular polysaccharide types 5 and 8 by an enzyme-linked immunosorbent assay using polyclonal rabbit antibodies. About 98% of the S. aureus isolates were typeable. Type 5 was predominant in the poultry (75.8%) and pig (66.7%) isolates, whereas type 8 was more frequent among the isolates from rabbits (59.5%) and horses (83.3%). By contrast, none of the 14 S. intermedius isolates was typeable. PMID:8432841

Surgical Outcomes of Plaque Excision and Grafting and Supplemental Tunica Albuginea Plication for Treatment of Peyronie's Disease With Severe Compound Curvature.

PubMed

Chow, Alexander K; Sidelsky, Steven A; Levine, Laurence A

2018-05-22

There are limited data in the literature that describe the management of Peyronie's disease (PD) with severe compound curvature, which often requires additional straightening procedures after plaque excision and grafting (PEG) to achieve functional penile straightening (<20 degrees). This study highlights the clinical distinction and our experience with men with PD and severe compound curvature treated with PEG and supplemental tunica albuginea plication (TAP). We performed a retrospective chart review of patients with PD and acute angulation who underwent PEG (group 1) and patients with compound curvature who underwent PEG with TAP (group 2) between 2007 and 2016. Primary post-operative outcomes of interest include change in penile curvature, change in measured stretched penile length, and subjective report on penile sensation and sexually induced penile rigidity. 240 Men with PD were included in the study, of which 79 (33%) patients in group 1 underwent PEG and 161 (67%) in group 2 underwent PEG and TAP. There was no difference in associated PD co-morbidities including age, hypertension, hyperlipidemia, hypogonadism, diabetes, or tobacco use. After artificial induction of erection with intracorporal trimix injection, the average primary curvature was 73 (range, 20-120) degrees for group 1 compared to 79 (range, 35-140) degrees for group 2 (P = .01). Group 2 had an average secondary curvature of 36 (20-80 degrees). After completion of PEG, men in group 2 had an average residual curvature of 30 (range, 20-50) degrees which required 1-6 TAPs to achieve functional straightness (<20 degrees). At an average follow-up of 61 months, there was no difference for group 1 and group 2, respectively, for recurrent curvature (11.4% vs 12.4%, P = .33), change in penile length (+0.57 vs +0.36 cm, P = .27) or decreased penile sensation (6% vs 13%, P = .12). In all, 81% of group 1 and 79% of group 2 were able to engage in penetrative sex after penile straightening with or

The genetic organization of the capsular polysaccharide biosynthesis region of Actinobacillus pleuropneumoniae serotype 15

PubMed Central

ITO, Hiroya; SUEYOSHI, Masuo

2014-01-01

Nucleotide sequence determination and analysis of the cps gene involved in the capsular polysaccharide biosynthesis of Actinobacillus pleuropneumoniae serotype 15 revealed the presence of three open reading frames, designated as cps15ABC genes. At the protein level, Cps15A and Cps15B showed considerably high homology to CpsA (67.0 to 68.7%) and CpsB (31.7 to 36.8%), respectively, of A. pleuropneumoniae serotypes 1, 4 and 12, revealing the common genetic organization of the cps among serotypes 1, 4, 12 and 15. However, Cps15C showed no homology to any proteins of A. pleuropneumoniae serotypes, indicating that cps15C may be specific to serotype 15. This study will provide the basic molecular knowledge necessary for the development of diagnostics and a vaccine for A. pleuropneumoniae serotype 15. PMID:25502540

An unusual lesion in the knee of a breaststroke swimmer.

PubMed

Wethelund, J O; de Carvalho, A

1985-06-01

In a 21-year-old male breaststroke swimmer with characteristic symptoms in the medial aspect of the knee joint, synovial leakage suggesting medial capsular rupture caused by the whip kick was demonstrated arthrographically.

Two-year outcomes of open shoulder anterior capsular reconstruction for instability from severe capsular deficiency.

PubMed

Dewing, Christopher B; Horan, Marilee P; Millett, Peter J

2012-01-01

To document outcomes after anterior capsulolabral reconstruction for recurrent shoulder instability in 15 patients (20 shoulders) who have had multiple failed stabilizations or collagen disorders. Twenty shoulders with recurrent instability underwent revision stabilization with allograft reconstruction of anterior capsulolabral structures, which re-creates the labrum and capsular ligaments. The patients comprised 3 men and 12 women (mean age, 26 years [range, 18 to 38 years]) in whom multiple prior repairs failed and who had disability from continued pain and instability. Patients could choose to undergo either arthrodesis or salvage allograft reconstruction or to live with permanent disability. Of the patients, 5 had Ehlers-Danlos syndrome whereas 10 had hyperlaxity syndromes without genetic confirmation. Failure was defined as further instability surgery. Pain, shoulder function, instability (dislocations/subluxation), and American Shoulder and Elbow Surgeons scores were documented. At follow-up, 9 of 20 shoulders (45%) remained stable. Recurrent instability was reported in 5 shoulders (25%), but the patients chose not to undergo further surgery. In the 14 shoulders without further stabilization (nonfailures), the mean American Shoulder and Elbow Surgeons score increased 43 points at a mean of 3.8 years (range, 2 to 6 years) postoperatively (P < .05). Mean satisfaction with outcome in nonfailures was 7 of 10 points (range, 1 to 10). Six shoulders failed by progressing to instability surgery at a mean of 8.6 months (range, 2.8 to 24 months). In the 6 shoulders that failed, the mean number of prior surgeries was 8 (range, 3 to 15) compared with a mean of 4 prior surgeries (range, 1 to 16) for the 9 nonfailures. Treating patients in whom multiple stabilizations have failed remains challenging. In our series 9 shoulders (45%) remained completely stable at 3.8 years. Recurrent instability (3 reinjuries) requiring further stabilization occurred in 6 (30%). Subsequent

Rotation stability of a toric intraocular lens with a second capsular tension ring.

PubMed

Sagiv, Oded; Sachs, Dan

2015-05-01

An Acrysof toric intraocular lens (IOL) and a capsular tension ring (CTR) were implanted in the highly myopic eye of a 74-year-old white man during cataract surgery. On the first postoperative day, the IOL was found 90 degrees from the required position, with a consequent high amount of astigmatism. A second procedure was performed and because it was not possible to secure the toric IOL in the correct position, an additional in-the-bag CTR was inserted, with an immediate optimal outcome. The IOL remained stable up to the final follow-up examination. Co-implantation of a toric IOL and a single CTR has been reported. In our case, 2 CTRs were required to fixate the toric IOL in the correct position. This procedure is simple and safe and should be considered in cases of postoperatively misaligned toric IOLs. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Effects of light wavelengths on extracellular and capsular polysaccharide production by Nostoc flagelliforme.

PubMed

Han, Pei-pei; Sun, Ying; Jia, Shi-ru; Zhong, Cheng; Tan, Zhi-lei

2014-05-25

The influences of different wavelengths of light (red 660nm, yellow 590nm, green 520nm, blue 460nm, purple 400nm) and white light on extracellular polysaccharide (EPS) and capsular polysaccharide (CPS) production by Nostoc flagelliforme in liquid culture were demonstrated in this study. The results showed that, compared with white light, red and blue lights significantly increased both EPS and CPS production while yellow light reduced their production; purple and green lights stimulated EPS production but inhibited CPS formation. Nine constituent monosaccharides and one uronic acid were detected in both EPS and CPS, and their ratios showed significant differences among treatment with different light wavelengths. However, the advanced structure of EPS and CPS from various light conditions did not present obvious difference through Fourier transform infrared spectroscopy and X-ray diffraction characterization. These findings establish a basis for development of high-yielding polysaccharide production process and understanding their regulation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cryptococcus neoformans inhibits nitric oxide synthesis caused by CpG-oligodeoxynucleotide-stimulated macrophages in a fashion independent of capsular polysaccharides.

PubMed

Xiao, Gang; Miyazato, Akiko; Inden, Ken; Nakamura, Kiwamu; Shiratori, Kohei; Nakagawa, Kiyotaka; Miyazawa, Teruo; Suzuki, Kazuo; Kaku, Mitsuo; Kawakami, Kazuyoshi

2008-03-01

Cryptococcus neoformans is eradicated by macrophages via production of NO. Unmethylated CpG-ODN protect mice from infection with this fungal pathogen by inducing IFN-gamma. The present study was designed to elucidate the effect of C. neoformans on the synthesis of NO by alveolar macrophages. For this purpose, MH-S, an alveolar macrophage cell line, was stimulated with CpG-ODN in the presence of IFN-gamma. A highly virulent strain of C. neoformans with thick capsule suppressed the production of NO. Capsular polysaccharides were not essential for this suppression, because there was no difference between acapsular mutant (Cap67) and its parent strain. Physical or close interaction of Cap67 with MH-S was necessary, as shown by the loss of such effect when direct contact was interfered by nitrocellulose membrane. Similar effects were observed by disrupted as well as intact Cap67. Whereas the inhibitory effect of intact Cap67 was completely abrogated by heat treatment, disrupted Cap67 did not receive such influence. Finally, disrupted Cap67 did not show any inhibitory effect on the TLR9-mediated activation of NF-kappaB in a luciferase reporter assay with HEK293T cells, although the TLR4-mediated activation was suppressed. These results revealed that C. neoformans suppressed the synthesis of NO by CpG-ODN and IFN-gamma-stimulated macrophages in a fashion independent of capsular polysaccharides, although the precise mechanism remains to be elucidated.

Purification and Protective Efficacy of Monomeric and Modified Yersina pestis Capsular F1-V Antigen Fusion Proteins for Vaccination Against Plague

DTIC Science & Technology

2006-12-31

Yersinia pestis capsular F1-V antigen fusion proteins for vaccination against plague Jeremy L. Goodin a,1, David F. Nellis b,1, Bradford S. Powell a, Vinay...USA Received 4 October 2006, and in revised form 19 December 2006 Available online 31 December 2006Abstract The F1-V vaccine antigen, protective...After a two-dose vaccination with 2 · 20 lg of F1-V, respec- tively, 100%, 80%, 80%, and 70% of injected mice survived a subcutaneous lethal plague

Management of extra-capsular temporo-mandibular joint ankylosis: does conservative approach to treatment have a role?

PubMed

Anyanechi, C E; Osunde, O D; Bassey, G O

2015-06-01

The conventional management of fibrous extracapsular temporo-mandibular joint (TMJ) ankylosis, a debilitating disease, is associated with surgical complications and financial burden on the patients. To assess the outcome of conservative approach to the management of fibrous extracapsular TMJ ankylosis. This is a prospective study of patients who presented at the Dental and Maxillofacial Surgery Clinic of the University of Calabar Teaching Hospital, Nigeria, during the period from January 1999 to December 2012 with a history of inability to open the mouth diagnosed as fibrous extracapsular TMJ ankylosis. Twenty-one subjects were treated and their ages ranged from 11 to 22 years with mean at 15.0 years. There were 13 (61.9 %) males and 8 (38.1 %) females with male: female ratio of 1.6:1. The aetiological factor that predisposed to formation of extracapsular TMJ ankylosis was facial trauma. There was no facial asymmetry and the side distribution of the affliction showed that 1 (4.8 %) was bilateral while 20 (95.2 %) were unilateral. Eight cases (38.1 %) were incomplete ankylosis while the rest (n = 13, 61.9 %) were complete. The shorter the duration of fibrous ankylosis and the greater the initial inter-incisal distance before treatment, the better the treatment outcome. The outcome of treatment suggests that the conservative approach to management of this condition was beneficial to these patients because they presented early. However, randomized controlled clinical trials are needed to validate this treatment option.

Arthroscopic Revision Surgery for Failure of Open Latarjet Technique.

PubMed

Cuéllar, Adrián; Cuéllar, Ricardo; de Heredia, Pablo Beltrán

2017-05-01

To evaluate the efficacy in treating pain, limited range of motion, and continued instability of the Latarjet open technique via the use of arthroscopy. A retrospective review of patients who underwent arthroscopic capsule plication after failure of an open Latarjet technique was performed. Revision surgery was indicated in cases of recurrent instability and associated pain. Only patients with a glenoid defect <25% were considered. The Constant and Rowe scores were administered, whereas pain was assessed with a visual analog scale before the reoperation and at 24 months after operation. Radiographs, computed tomography, and CT arthrography scans were performed. Twelve patients met the inclusion criteria. All patients had capsular distension and consequently were subjected to a capsuloplasty. Shoulder function, stability, and pain had all improved significantly at 24 months after arthroscopic revision (P < .0001). In particular, the Constant score increased from 44.9 (standard deviation [SD] 7.10) to 89.3 (SD 12.6) points, the Rowe score improved from 49.5 (SD 10.1) to 80.9 (SD 10.9), whereas the visual analog scale pain score decreased from 6.75 (SD 1.17) to 1.38 (SD 1.06). Primary open Latarjet with a glenoid bone defect <25% that failed due to capsular redundancy is amenable to successful treatment with arthroscopic capsuloplasty. Arthroscopic approaches can offer a good solution for treating previously failed open Latarjet procedures. Level IV, therapeutic case series. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Best Practices During Hip Arthroscopy: Aggregate Recommendations of High-Volume Surgeons.

PubMed

Gupta, Asheesh; Suarez-Ahedo, Carlos; Redmond, John M; Gerhardt, Michael B; Hanypsiak, Bryan; Stake, Christine E; Finch, Nathan A; Domb, Benjamin G

2015-09-01

To survey surgeons who perform a high volume of hip arthroscopy procedures regarding their operative technique, type of procedure, and postoperative management. We conducted a cross-sectional survey of 27 high-volume orthopaedic surgeons specializing in hip arthroscopy to report their preferences and practices related to their operative practice and postoperative rehabilitation protocol. All participants completed the survey in person in an anonymous fashion during a meeting of the American Hip Institute. All surgeons perform hip arthroscopy with the patient in the supine position, accessing the central compartment of the hip initially, using intraoperative fluoroscopy. All surgeons perform labral repair (100%), with the majority performing labral reconstructions (77.8%) and gluteus medius repairs (81.5%). There is variability in the type of anchors used during labral repair. Most surgeons perform capsular closure in most cases (88.9%), inject either intra-articular cortisone or platelet-rich plasma at the conclusion of the procedure (59%), and prescribe a postoperative hip brace for some or all patients (59%). There is considerable variability in rehabilitation protocols. All surgeons routinely prescribe postoperative heterotopic ossification prophylaxis to their patients, with most surgeons (88.9%) prescribing a nonsteroidal anti-inflammatory medication for 3 weeks. Forty percent of the respondents use the modified Harris Hip Score as the most important outcome measure. Consistent practices such as use of intraoperative fluoroscopy, heterotopic ossification prophylaxis, and labral repair skills were identified by surveying 27 hip arthroscopy surgeons at high-volume centers. Most of the surgeons performed routine capsular closure unless underlying conditions precluded capsular release or plication. The survey identified higher variability between surgeons regarding postoperative rehabilitation protocols and use of intra-articular pharmacologic injections at the

Peptidoglycan Association of Murein Lipoprotein Is Required for KpsD-Dependent Group 2 Capsular Polysaccharide Expression and Serum Resistance in a Uropathogenic Escherichia coli Isolate.

PubMed

Diao, Jingyu; Bouwman, Catrien; Yan, Donghong; Kang, Jing; Katakam, Anand K; Liu, Peter; Pantua, Homer; Abbas, Alexander R; Nickerson, Nicholas N; Austin, Cary; Reichelt, Mike; Sandoval, Wendy; Xu, Min; Whitfield, Chris; Kapadia, Sharookh B

2017-05-23

Murein lipoprotein (Lpp) and peptidoglycan-associated lipoprotein (Pal) are major outer membrane lipoproteins in Escherichia coli Their roles in cell-envelope integrity have been documented in E. coli laboratory strains, and while Lpp has been linked to serum resistance in vitro , the underlying mechanism has not been established. Here, lpp and pal mutants of uropathogenic E. coli strain CFT073 showed reduced survival in a mouse bacteremia model, but only the lpp mutant was sensitive to serum killing in vitro The peptidoglycan-bound Lpp form was specifically required for preventing complement-mediated bacterial lysis in vitro and complement-mediated clearance in vivo Compared to the wild-type strain, the lpp mutant had impaired K2 capsular polysaccharide production and was unable to respond to exposure to serum by elevating capsular polysaccharide amounts. These properties correlated with altered cellular distribution of KpsD, the predicted outer membrane translocon for "group 2" capsular polysaccharides. We identified a novel Lpp-dependent association between functional KpsD and peptidoglycan, highlighting important interplay between cell envelope components required for resistance to complement-mediated lysis in uropathogenic E. coli isolates. IMPORTANCE Uropathogenic E. coli (UPEC) isolates represent a significant cause of nosocomial urinary tract and bloodstream infections. Many UPEC isolates are resistant to serum killing. Here, we show that a major cell-envelope lipoprotein (murein lipoprotein) is required for serum resistance in vitro and for complement-mediated bacterial clearance in vivo This is mediated, in part, through a novel mechanism by which murein lipoprotein affects the proper assembly of a key component of the machinery involved in production of "group 2" capsules. The absence of murein lipoprotein results in impaired production of the capsule layer, a known participant in complement resistance. These results demonstrate an important role for

Nucleotide sequence analysis of a DNA region involved in capsular polysaccharide biosynthesis reveals the molecular basis of the nontypeability of two Actinobacillus pleuropneumoniae isolates.

PubMed

Ito, Hiroya; Ogawa, Torata; Fukamizu, Dai; Morinaga, Yuiko; Kusumoto, Masahiro

2016-11-01

The aim of our study was to reveal the molecular basis of the serologic nontypeability of 2 Actinobacillus pleuropneumoniae field isolates. Nine field strains of A. pleuropneumoniae, the causative agent of porcine pleuropneumonia, were isolated from pigs raised on the same farm and sent to our diagnostic laboratory for serotyping. Seven of the 9 strains were identified as serovar 15 strains by immunodiffusion tests. However, 2 strains, designated FH24-2 and FH24-5, could not be serotyped with antiserum prepared against serovars 1-15. Strain FH24-5 showed positive results in 2 serovar 15-specific PCR tests, whereas strain FH24-2 was only positive in 1 of the 2 PCR tests. The nucleotide sequence analysis of gene clusters involved in capsular polysaccharide biosynthesis of the 2 nontypeable strains revealed that both had been rendered nontypeable by the action of ISApl1, a transposable element of A. pleuropneumoniae belonging to the IS30 family. The results showed that ISApl1 of A. pleuropneumoniae can interfere with both the serologic and molecular typing methods, and that nucleotide sequence analysis across the capsular gene clusters is the best means of determining the cause of serologic nontypeability in A. pleuropneumoniae. © 2016 The Author(s).

Antibodies to Staphylococcus aureus capsular polysaccharides 5 and 8 perform similarly in vitro but are functionally distinct in vivo.

PubMed

Liu, Bo; Park, Saeyoung; Thompson, Christopher D; Li, Xue; Lee, Jean C

2017-08-18

The capsular polysaccharide (CP) produced by Staphylococcus aureus is a virulence factor that allows the organism to evade uptake and killing by host neutrophils. Polyclonal antibodies to the serotype 5 (CP5) and type 8 (CP8) capsular polysaccharides are opsonic and protect mice against experimental bacteremia provoked by encapsulated staphylococci. Thus, passive immunotherapy using CP antibodies has been considered for the prevention or treatment of invasive antibiotic-resistant S. aureus infections. In this report, we generated monoclonal antibodies (mAbs) against S. aureus CP5 or CP8. Backbone specific mAbs reacted with native and O-deacetylated CPs, whereas O-acetyl specific mAbs reacted only with native CPs. Reference strains of S. aureus and a selection of clinical isolates reacted by colony immunoblot with the CP5 and CP8 mAbs in a serotype-specific manner. The mAbs mediated in vitro CP type-specific opsonophagocytic killing of S. aureus strains, and mice passively immunized with CP5 mAbs were protected against S. aureus bacteremia. Neither CP8-specific mAbs or polyclonal antibodies protected mice against bacteremia provoked by serotype 8 S. aureus clinical isolates, although these same antibodies did protect against a serotype 5 S. aureus strain genetically engineered to produce CP8. We detected soluble CP8 in culture supernatants of serotype 8 clinical isolates and in the plasma of infected animals. Serotype 5 S. aureus released significantly less soluble CP5 in vitro and in vivo. The release of soluble CP8 by S. aureus may contribute to the inability of CP8 vaccines or antibodies to protect against serotype 8 staphylococcal infections.

Anterior capsule phimosis and capsular block syndrome in a patient with Steinert myotonic dystrophy: a case report

PubMed Central

2009-01-01

A 55-year-old man with myotonic dystrophy underwent phacoemulsification with IOL implantation in the right eye. 3 months after surgery, the patient showed a decreased visual acuity and an intraocular pressure (IOP) of 30 mmHg. Slit lamp examination showed a dense fibrosis of the anterior capsule with capsulorexis' shrinkage. Gonioscopy showed a closed angle. After a YAG laser iridotomy no decrease in the IOP was detected; following surgical peeling of the anterior capsule, the slit lamp showed a distended capsular bag. A YAG laser posterior capsulotomy was performed, without decrease in the IOP. Myotonic patients need to be closely followed up after cataract surgery, because in case of CBS development a prompt posterior capsulotomy could avoid more severe complications. PMID:20062622

Comparison of Polypropylene Sling with Combined Transconjunctival Retractor Plication and Lateral Tarsal Strip for Correction of Involutional Lower Eye Lid Ectropion.

PubMed

Goel, Ruchi; Sanoria, Abhilasha; Kumar, Sushil; Arya, Deepanjali; Nagpal, Smriti; Rathie, Neha

2017-01-01

The study aims to compare the effectiveness and complications of transconjunctival retractor plication (TRP) with lateral tarsal strip (LTS) and the polypropylene sling (PS) surgery for treatment of involutional lower lid ectropion. A prospective randomised pilot study was conducted on 30 eyes of 30 patients suffering from epiphora having horizontal eyelid laxity >6mm and age >50 years at a tertiary care centre from December 2014 to March 2015. They were randomly divided into two equal groups for TRP with LTS (group A) and PS (group B). Success was defined as relief in epiphora and lid laxity ≤4mm at 12 months post operatively. There were 19 male and 11 female patients with age ranging from 55-80 years. The mean grade of ectropion was 2.80±1.32 in group A and 2.87±1.60 in group B. The preoperative horizontal laxity increased with the grade of ectropion (p <0.001) while medial canthal laxity was variable. The average surgical time per procedure in group A was 66 minutes and in group B was 24 minutes. Group A had a success rate of 93.33%, while group B had a success rate of 87%. Post-operative complications occurred in 2 eyes in group B only. Both LTS with TRP and PS are effective in the management of involutional ectropion. LTS with TRP though more invasive has higher success rates and a lower incidence of complications as compared to PS. However, PS is an easy to perform out- patient procedure that is faster and better tolerated in old patients.

On the specificity of a bacteriophage-borne endoglycanase for the native capsular polysaccharide produced by Klebsiella pneumoniae SK1 and its derived polymers.

PubMed

Cescutti, P; Paoletti, S

1994-02-15

The specificity of the endoglycanase associated with the bacteriophage phi SK1 particles was tested on the native capsular polysaccharide produced by Klebsiella pneumoniae serotype SK1 and on three chemically modified polymers derived from it. The primary structure of the SK1 capsular polysaccharide is: [formula: see text] and the beta 1-3 linkage between the glucose and the galactose residues is the one cleaved by the phage enzyme. The enzyme activity was assayed on the deacetylated polysaccharide and on two derivatives obtained by removal of both the side-chain sugars and of only the alpha-D-galactosyl unit, respectively. The endoglycanase was more active on the deacetylated polysaccharide than on the native one, suggesting that the presence of the acetyl groups interferes with the enzyme-polysaccharide interaction. A possible role of the acetyl groups in the control of the polysaccharide chain length and hence on the rheological behaviour of the capsule cannot be ruled out, as already indicated for other bacterial polysaccharides. On the contrary, the removal of the side chains, either complete or selective, caused the modification of the recognition site in such a way that the enzymatic depolymerization no longer occurred. Therefore, it can be inferred that the phi SK1 endoglycanase requires the presence of both the side chain sugars to exhibit its cleaving activity, although this latter is in the main chain.

A Novel Vitreous Substitute of Using a Foldable Capsular Vitreous Body Injected with Polyvinylalcohol Hydrogel

PubMed Central

Feng, Songfu; Chen, Han; Liu, Yaqin; Huang, Zhen; Sun, Xuyuan; Zhou, Lian; Lu, Xiaohe; Gao, Qianying

2013-01-01

Hydrogels may be the ideal vitreous substitutes due to their wonderful physical features and biocompatibility. However, their drawbacks, short residence time, and biodegradation in vivo, have led to the fact that none of them have been approved for clinical use. In this study, we developed a novel approach of using a foldable capsular vitreous body (FCVB) injected with polyvinylalcohol (PVA) hydrogel as a vitreous substitute for long-term tamponade. The 3% PVA hydrogel that was cross-linked by gamma irradiation showed good rheological and physical properties and had no toxicity in vitro. After 180 days retention, the 3% PVA hydrogel inside FCVB remained transparent and showed good viscoelasticity without biodegradation and showed good biocompatibility and retina support. This new approach may develop into a valuable tool to improve the stability performance of PVA hydrogel as a vitreous substitute and to extend the application function of FCVB for long-term implantation in vitreous cavity. PMID:23670585

A novel vitreous substitute of using a foldable capsular vitreous body injected with polyvinylalcohol hydrogel.

PubMed

Feng, Songfu; Chen, Han; Liu, Yaqin; Huang, Zhen; Sun, Xuyuan; Zhou, Lian; Lu, Xiaohe; Gao, Qianying

2013-01-01

Hydrogels may be the ideal vitreous substitutes due to their wonderful physical features and biocompatibility. However, their drawbacks, short residence time, and biodegradation in vivo, have led to the fact that none of them have been approved for clinical use. In this study, we developed a novel approach of using a foldable capsular vitreous body (FCVB) injected with polyvinylalcohol (PVA) hydrogel as a vitreous substitute for long-term tamponade. The 3% PVA hydrogel that was cross-linked by gamma irradiation showed good rheological and physical properties and had no toxicity in vitro. After 180 days retention, the 3% PVA hydrogel inside FCVB remained transparent and showed good viscoelasticity without biodegradation and showed good biocompatibility and retina support. This new approach may develop into a valuable tool to improve the stability performance of PVA hydrogel as a vitreous substitute and to extend the application function of FCVB for long-term implantation in vitreous cavity.

The Vi Capsular Polysaccharide Enables Salmonella enterica Serovar Typhi to Evade Microbe-Guided Neutrophil Chemotaxis

PubMed Central

Wangdi, Tamding; Lee, Cheng-Yuk; Spees, Alanna M.; Yu, Chenzhou; Kingsbury, Dawn D.; Winter, Sebastian E.; Hastey, Christine J.; Wilson, R. Paul

2014-01-01

Salmonella enterica serovar Typhi (S. Typhi) causes typhoid fever, a disseminated infection, while the closely related pathogen S. enterica serovar Typhimurium (S. Typhimurium) is associated with a localized gastroenteritis in humans. Here we investigated whether both pathogens differ in the chemotactic response they induce in neutrophils using a single-cell experimental approach. Surprisingly, neutrophils extended chemotactic pseudopodia toward Escherichia coli and S. Typhimurium, but not toward S. Typhi. Bacterial-guided chemotaxis was dependent on the presence of complement component 5a (C5a) and C5a receptor (C5aR). Deletion of S. Typhi capsule biosynthesis genes markedly enhanced the chemotactic response of neutrophils in vitro. Furthermore, deletion of capsule biosynthesis genes heightened the association of S. Typhi with neutrophils in vivo through a C5aR-dependent mechanism. Collectively, these data suggest that expression of the virulence-associated (Vi) capsular polysaccharide of S. Typhi obstructs bacterial-guided neutrophil chemotaxis. PMID:25101794

Do Patients With Borderline Dysplasia Have Inferior Outcomes After Hip Arthroscopic Surgery for Femoroacetabular Impingement Compared With Patients With Normal Acetabular Coverage?

PubMed

Cvetanovich, Gregory L; Levy, David M; Weber, Alexander E; Kuhns, Benjamin D; Mather, Richard C; Salata, Michael J; Nho, Shane J

2017-07-01

The literature contains conflicting reports regarding whether outcomes of hip arthroscopic surgery for patients with borderline dysplasia are inferior to outcomes in patients with normal acetabular coverage. To assess differences in the outcomes of hip arthroscopic surgery for femoroacetabular impingement (FAI) in groups of patients with borderline dysplasia and normal coverage. Cohort study; Level of evidence, 3. A registry of consecutive patients who had undergone primary hip arthroscopic surgery with capsular plication for FAI between January 2012 and January 2014 were divided based on the preoperative lateral center-edge angle (LCEA) into 2 distinct groups: (1) borderline dysplasia (LCEA 18°-25°) and (2) normal acetabular coverage (LCEA 25.1°-40°). There were 36 patients in the borderline dysplastic group and 312 patients in the normal coverage group. The primary outcome measure was the Hip Outcome Score-Activities of Daily Living (HOS-ADL) at a minimum of 2 years postoperatively. Secondary outcome measures included the HOS-Sports and modified Harris Hip Score (mHHS). The mean preoperative LCEA differed significantly between groups (23.4° ± 1.5° for borderline dysplastic, 32.5° ± 3.8° for normal coverage; P < .001). The borderline dysplastic group had a higher percentage of female patients than the normal coverage group (27/36 [75%] vs 177/312 [57%], respectively; P = .048). There were no differences in other preoperative demographics and radiographic parameters. At a minimum 2 years after hip arthroscopic surgery (mean follow-up, 2.6 ± 0.6 years), both groups demonstrated significant improvements in all patient-reported outcome scores ( P < .001 in all cases). There were no significant differences between the borderline dysplastic and normal coverage groups in final outcome scores, score improvements, or percentage of patients experiencing clinically significant improvements. One patient in the borderline dysplastic group (3%) underwent revision hip

The genetic organization of the capsular polysaccharide biosynthesis region of Actinobacillus pleuropneumoniae serotype 14

PubMed Central

ITO, Hiroya

2015-01-01

The genetic organization of the gene involved in the capsular polysaccharide (CPS) biosynthesis of Actinobacillus pleuropneumoniae serotype 14 has been determined. The DNA region for the CPS biosynthesis of serotype 14 (cps14) comprised 9 open reading frames, designated as cps14AB1B2B3CDEFG genes, encoding Cps14A to Cps14G protein, respectively. Cps14A was similar to CpsA of A. pleuropneumoniae serotypes 1, 4 and 12; the Cps14B1 and Cps14B2 were similar to CpsB of A. pleuropneumoniae serotypes 1, 4 and 12, suggesting that CPS structure of A. pleuropneumoniae serotype 14 would belong to Group I including A. pleuropneumoniae serotypes 1, 4, 12 and 15. Surprisingly, the overall nucleotide sequence, deduced amino acid sequence, and the genetic organization of the cps14 were nearly identical to those of Actinobacillus suis. This study will provide the molecular basic knowledge for development of diagnostics and vaccine of A. pleuropneumoniae serotype 14. PMID:25648373

Effect of electrostatic interactions on the ultrafiltration behavior of charged bacterial capsular polysaccharides.

PubMed

Hadidi, Mahsa; Buckley, John J; Zydney, Andrew L

2016-11-01

Charged polysaccharides are used in the food industry, as cosmetics, and as vaccines. The viscosity, thermodynamics, and hydrodynamic properties of these charged polysaccharides are known to be strongly dependent on the solution ionic strength because of both inter- and intramolecular electrostatic interactions. The goal of this work was to quantitatively describe the effect of these electrostatic interactions on the ultrafiltration behavior of several charged capsular polysaccharides obtained from Streptococcus pneumoniae and used in the production of Pneumococcus vaccines. Ultrafiltration data were obtained using various Biomax™ polyethersulfone membranes with different nominal molecular weight cutoffs. Polysaccharide transmission decreased with decreasing ionic strength primarily because of the expansion of the charged polysaccharide associated with intramolecular electrostatic repulsion. Data were in good agreement with a simple theoretical model based on solute partitioning in porous membranes, with the effective size of the different polysaccharide serotypes evaluated using size exclusion chromatography at the same ionic conditions. These results provide fundamental insights and practical guidelines for exploiting the effects of electrostatic interactions during the ultrafiltration of charged polysaccharides. © 2016 American Institute of Chemical Engineers Biotechnol. Prog., 32:1531-1538, 2016. © 2016 American Institute of Chemical Engineers.

Protective Immunity Against a Lethal Respiratory Yersinia pestis Challenge Induced by V Antigen or the F1 Capsular Antigen Incorporated into Adenovirus Capsid

PubMed Central

Boyer, Julie L.; Sofer-Podesta, Carolina; Ang, John; Hackett, Neil R.; Chiuchiolo, Maria J.; Senina, Svetlana; Perlin, David

2010-01-01

Abstract The aerosol form of the bacterium Yersinia pestis causes pneumonic plague, a rapidly fatal disease that is a biothreat if deliberately released. At present, no plague vaccines are available for use in the United States, but subunit vaccines based on the Y. pestis V antigen and F1 capsular protein show promise when administered with adjuvants. In the context that adenovirus (Ad) gene transfer vectors have a strong adjuvant potential related to the ability to directly infect dendritic cells, we hypothesized that modification of the Ad5 capsid to display either the Y. pestis V antigen or the F1 capsular antigen on the virion surface would elicit high V antigen- or F1-specific antibody titers, permit boosting with the same Ad serotype, and provide better protection against a lethal Y. pestis challenge than immunization with equivalent amounts of V or F1 recombinant protein plus conventional adjuvant. We constructed AdYFP-pIX/V and AdLacZ-pIX/F1, E1–, E3– serotype 5 Ad gene transfer vectors containing a fusion of the sequence for either the Y. pestis V antigen or the F1 capsular antigen to the carboxy-terminal sequence of pIX, a capsid protein that can accommodate the entire V antigen (37 kDa) or F1 protein (15 kDa) without disturbing Ad function. Immunization with AdYFP-pIX/V followed by a single repeat administration of the same vector at the same dose resulted in significantly better protection of immunized animals compared with immunization with a molar equivalent amount of purified recombinant V antigen plus Alhydrogel adjuvant. Similarly, immunization with AdLacZ-pIX/F1 in a prime–boost regimen resulted in significantly enhanced protection of immunized animals compared with immunization with a molar-equivalent amount of purified recombinant F1 protein plus adjuvant. These observations demonstrate that Ad vaccine vectors containing pathogen-specific antigens fused to the pIX capsid protein have strong adjuvant properties and stimulate more robust

The impact of postoperative expansion initiation timing on breast expander capsular characteristics: a prospective combined clinical and scanning electron microscopy study.

PubMed

Paek, Laurence S; Giot, Jean-Philippe; Tétreault-Paquin, Jean-Olivier; St-Jacques, Samuel; Nelea, Monica; Danino, M Alain

2015-04-01

In the first stage of expander-to-implant breast reconstruction, postoperative expansion is classically initiated at 10 to 14 days (conventional approach). The authors hypothesized that it may be beneficial to wait 6 weeks postoperatively before initiating serial expansion (delayed approach). Clinical and ultrastructural periprosthetic capsule analysis is first required before determining whether a delayed approach ultimately improves capsular tissue adherence and expansion process predictability. Patients undergoing two-stage implant-based breast reconstruction were enrolled prospectively in this study. During expander-to-implant exchange, the clinical presence of "Velcro" effect, biofilm, and double capsule was noted. Periprosthetic capsule samples were also sent for scanning electron microscopic observation of three parameters: surface relief, cellularity, and biofilm. Samples were divided into four groups for data analysis (group 1, conventional/Biocell; group 2, delayed/Biocell; group 3, conventional/Siltex; and group 4, delayed/Siltex). Fifty-six breast reconstructions were included. Each group comprised between 13 and 15 breasts. In group 1, no cases exhibited the Velcro effect and there was a 53.8 percent incidence of both biofilm and double capsule. In group 2, all cases demonstrated the Velcro effect and there were no incidences of biofilm or double capsule. Group 3 and group 4 cases did not exhibit a Velcro effect or double-capsule formation; however, biofilm was present in up to 20.0 percent. All group 2 samples revealed more pronounced three-dimensional relief on scanning electron microscopy. Variations in expansion protocols can lead to observable modifications in periprosthetic capsular architecture. There may be real benefits to delaying expander inflation until 6 weeks postoperatively with Biocell expanders.

Bifunctional capsular dosage form: novel fanicular cylindrical gastroretentive system of clarithromycin and immediate release granules of ranitidine HCl for simultaneous delivery.

PubMed

Rajput, Pallavi; Singh, Deshvir; Pathak, Kamla

2014-01-30

The study was aimed to develop a bifunctional single unit capsular system containing gastroretentive funicular cylindrical system (FCS) for controlled local delivery of clarithromycin and immediate release of ranitidine HCl. A 2(3) full factorial design was used to prepare gastroretentive FCS of clarithromycin using polyacrylamide (PAM), HPMC E15LV and Carbopol 934 P. The FCSs were evaluated for % cumulative drug release, floating time and in vitro detachment stress. Among the eight formulations, FCS5 (containing PAM and Carbopol 934 P at high and HPMC E15LV at low levels) showed % cumulative drug release of 97.09±1.14% in 8 h, floating time of 3 h and detachment stress of 8303.64±0.34 dynes/cm(2). Evaluation of optimized FCS by novel dynamic in vitro test proved superior bioadhesivity than cylindrical system under aggressive simulated peristaltic activity. Magnetic resonance imaging elucidated zero order release via constant swelling and erosion of FCS5. In vitro permeability across gastric mucin ensured its potential for effective eradication of deep seated Helicobactor pylori in gastric linings. The optimized FCS was combined with immediate release granules of rantidine HCl to get a bifunctional capsular dosage form. In vitro simultaneous drug release of clarithromycin and rantidine estimated by Vierordt's method exhibited a controlled drug release of 97.72±0.4% in 8 h for clarithromycin through FCS5 and 98.8±1.2% in 60 min from IR granules of ranitidine HCl. The novel system thus established its capability of simultaneous variable delivery of acid suppression agent and macrolide antibiotic that can be advantageous in clinical setting. Copyright © 2013 Elsevier B.V. All rights reserved.

Significance of lymph node capsular invasion in esophageal squamous cell carcinoma.

PubMed

Sakai, Makoto; Suzuki, Shigemasa; Sano, Akihiko; Tanaka, Naritaka; Inose, Takanori; Sohda, Makoto; Nakajima, Masanobu; Miyazaki, Tatsuya; Kuwano, Hiroyuki

2012-06-01

Extranodal invasion (ENI) has been reported to be associated with a poor prognosis in several malignancies. However, previous studies have included perinodal fat tissue tumor deposits in their definitions of ENI. To investigate the precise nature of ENI in esophageal squamous cell carcinoma (ESCC), we excluded these tumor deposits from our definition of ENI and defined tumor cell invasion through the lymph node capsule and into the perinodal tissues as lymph node capsular invasion (LNCI). The aim of the current study was to elucidate the significance of LNCI in ESCC. We investigated the associations between LNCI and other clinicopathologic features in 139 surgically resected ESCC. We also investigated the prognostic significance of LNCI in ESCC. LNCI was detected in 35 (25.2%) of 139 patients. The overall survival rate of the ESCC patients with LNCI was significantly lower than that of the ESCC patients with lymph node metastasis who were negative for LNCI. The survival difference between the patients with 1–3 lymph node metastases without LNCI and those with no lymph node metastasis was not significant. LNCI was significantly associated with distant organ recurrence. LNCI was also found to be an independent predictor of overall survival in addition to the number of lymph node metastases. LNCI in ESCC patients is an indicator of distant organ recurrence and a worse prognosis. LNCI could be used as a candidate marker for designing more precise staging and therapeutic strategies for ESCC.

Cryptococcus neoformans Capsular Enlargement and Cellular Gigantism during Galleria mellonella Infection

PubMed Central

García-Rodas, Rocío; Casadevall, Arturo; Rodríguez-Tudela, Juan Luís; Cuenca-Estrella, Manuel; Zaragoza, Oscar

2011-01-01

We have studied infection of Cryptococcus neoformans in the non-vertebrate host Galleria mellonella with particular interest in the morphological response of the yeast. Inoculation of C. neoformans in caterpillars induced a capsule-independent increase in haemocyte density 2 h after infection. C. neoformans manifested a significant increase in capsule size after inoculation into the caterpillar. The magnitude of capsule increase depended on the temperature, being more pronounced at 37°C than at 30°C, which correlated with an increased virulence of the fungus and reduced phagocytosis at 37°C. Capsule enlargement impaired phagocytosis by haemocytes. Incubation of the yeast in G. mellonella extracts also resulted in capsule enlargement, with the polar lipidic fraction having a prominent role in this effect. During infection, the capsule decreased in permeability. A low proportion of the cells (<5%) recovered from caterpillars measured more than 30 µm and were considered giant cells. Giant cells recovered from mice were able to kill the caterpillars in a manner similar to regular cells obtained from in vivo or grown in vitro, establishing their capacity to cause disease. Our results indicate that the morphological transitions exhibited by C. neoformans in mammals also occur in a non-vertebrate host system. The similarities in morphological transitions observed in different animal hosts and in their triggers are consistent with the hypothesis that the cell body and capsular responses represent an adaptation of environmental survival strategies to pathogenesis. PMID:21915338

Arthroscopic Management of Triangular Fibrocartilage Complex Peripheral Injury.

PubMed

Haugstvedt, Jan Ragnar; Søreide, Endre

2017-11-01

Patients suffering from ulnar-sided wrist pain after trauma may develop tenderness, clicking, a positive fovea sign, or instability of the distal radioulnar joint. If the pain is persistent, conservative treatment does not help, and the patient agrees to surgery, arthroscopy may reveal a triangular fibrocartilage complex (TFCC) injury with capsular detachment, foveal avulsion, or a combination thereof. Capsular reattachment is possible using an arthroscopic assisted technique. The reattachment can be performed with an inside-out, outside-in, or all-inside technique, providing good to excellent results, which tend to persist over time, in 60% to 90% of cases. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparative immunolocalisation of perlecan with collagen II and aggrecan in human foetal, newborn and adult ovine joint tissues demonstrates perlecan as an early developmental chondrogenic marker.

PubMed

Smith, Susan M; Shu, Cindy; Melrose, James

2010-09-01

We undertook a comparative immunolocalisation study on type II collagen, aggrecan and perlecan in a number of 12- to 14-week-old human foetal and postnatal (7-19 months) ovine joints including finger, toe, knee, elbow, hip and shoulder. This demonstrated that perlecan followed a virtually identical immunolocalisation pattern to that of type II collagen in the foetal tissues, but a slightly divergent localisation pattern in adult tissues. Aggrecan was also localised in the cartilaginous joint tissues, which were clearly delineated by toluidine blue staining and the type II collagen immunolocalisations. It was also present in the capsular joint tissues and in ligaments and tendons in the joint, which stained poorly or not at all with toluidine blue. In higher power microscopic views, antibodies to perlecan also stained small blood vessels in the synovial lining tissues of the joint capsule; however, this was not discernable in low power macroscopic views where the immunolocalisation of perlecan to pericellular regions of cells within the cartilaginous rudiments was a predominant feature. Perlecan was also evident in small blood vessels in stromal connective tissues associated with the cartilage rudiments and with occasional nerves in the vicinity of the joint tissues. Perlecan was expressed by rounded cells in the enthesis attachment points of tendons to bone and in rounded cells in the inner third of the meniscus, which stained prominently with type II collagen and aggrecan identifying the chondrogenic background of these cells and local compressive loads. Flattened cells within the tendon and in the surface laminas of articular cartilages and the meniscus did not express perlecan. Collected evidence presented herein, therefore, indicates that besides being a basement membrane component, perlecan is also a marker of chondrogenic cells in prenatal cartilages. In postnatal cartilages, perlecan displayed a pericellular localisation pattern rather than the territorial

Bacterially induced mineralization of calcium carbonate: the role of exopolysaccharides and capsular polysaccharides.

PubMed

Ercole, Claudia; Cacchio, Paola; Botta, Anna Lucia; Centi, Valeria; Lepidi, Aldo

2007-02-01

Bacterially induced carbonate mineralization has been proposed as a new method for the restoration of limestones in historic buildings and monuments. We describe here the formation of calcite crystals by extracellular polymeric substances isolated from Bacillus firmus and Bacillus sphaericus. We isolated bacterial outer structures (glycocalix and parietal polymers), such as exopolysaccharides (EPS) and capsular polysaccharides (CPS) and checked for their influence on calcite precipitation. CPS and EPS extracted from both B. firmus and B. sphaericus were able to mediate CaCO3 precipitation in vitro. X-ray microanalysis showed that in all cases the formed crystals were calcite. Scanning electron microscopy showed that the shape of the crystals depended on the fractions utilized. These results suggest the possibility that biochemical composition of CPS or EPS influences the resulting morphology of CaCO3. There were no precipitates in the blank samples. CPS and EPS comprised of proteins and glycoproteins. Positive alcian blue staining also reveals acidic polysaccharides in CPS and EPS fractions. Proteins with molecular masses of 25-40 kDa and 70 kDa in the CPS fraction were highly expressed in the presence of calcium oxalate. This high level of synthesis could be related to the binding of calcium ions and carbonate deposition.

[Nuclear magnetic resonance tomography diagnosis of changes in the glenoid process in patients with unstable shoulder joints].

PubMed

Jerosch, J; Castro, W H; Assheuer, J

1992-09-01

In 4 fresh specimens and in 14 healthy volunteers we studied normal anatomy of the glenoid labrum by MRI. In a total of 124 patients we examined the shoulder joints by MRI. 69 patients had any kind of subacromial pathology. 55 patients showed a glenohumeral instability. All MRI findings were compared with the surgical findings during arthroscopy and during open surgery. 44 patients showed a recurrent anterior instability, 7 patients showed a multidirectional instability, 2 patients showed a posterior instability, and 2 patients presented acute anterior dislocation. We found significant variability in the labral shape as well as significant variability of anterior capsular attachment. The pathologic changes of the glenoid labrum were classified in four different types. In 78% we found a concomitant Hill-Sachs lesion of various diameter. 5 patients suffered from an additional complete rotator cuff tear. Compared to the intraoperative findings MRI had a sensitivity of 95%, a specificity of 94%, an accuracy of 94%, a positive predictive value of 91%, and a negative predictive value of 96% in detecting labral pathology. Presenting a high diagnostic value for detecting Bankart lesions, MRI may replace other diagnostic modalities like CT-arthrography.

[Ganglions of the wrist: proposals for topographical systematization and natural history].

PubMed

Kuhlmann, J-N; Luboinski, J; Baux, S; Mimoun, M

2003-06-01

We looked for the anatomic origin and mechanism of constitution of the so-called "ganglions" of the wrist. Fifty-nine formations considered to be synovial ganglions were dissected and removed according to the same protocol by the same surgeon. Eleven were re-examined by a pathologist. All ganglions were extra-articular but had intra- and extra-capsular components. The extra-capsular part was the clinically palpable main cyst. The intra-capsular part was composed of the cystic stalk and its base of implantation. An intra-capsular stalk was present in 58 cases. The stalk was situated between the joint synovium and the capsula which it perforated at a weak point between two ligaments, forming a collar before expanding outwardly. Based on our findings, we propose a topographical systematization and natural history of ganglions of the wrist. The stalk's implantation base was always located on bone and found in the intermediate area of Colomniati and Soubbotine, which lies outside the articular cartilage between the synovium and the ligamentous capsula. This area is exposed to mechanical stress initiating histological degenerative lesions, particularly mucoid degeneration. At the radiocarpal joint, the stalk's base of implantation was located at the distal end of the lateral dorsal or volar edge of the lunate bone or at the corresponding part of the scaphoid. The collar of the proximal ganglions was situated between the dorsal radiocarpal and transverse scaphotriquetral ligament. The collar of distal dorsal ganglions was situated between the transverse scaphotriquetral and the trapezotriquetral ligament. The collar of the lateral ganglions was situated between the lateral collateral and the transverse ligament. The collar of the volar ganglions was situated between the stylocarpal ligament and the radiolunotriquetral ligament, or between the different stylocarpal ligaments. At the level of the scaphotrapezal joint, the stalk's base of implantation was located near the

Capsular Polysaccharide Interferes with Biofilm Formation by Pasteurella multocida Serogroup A

PubMed Central

Petruzzi, Briana; Briggs, Robert E.; Swords, W. Edward; De Castro, Cristina; Molinaro, Antonio

2017-01-01

ABSTRACT Pasteurella multocida is an important multihost animal and zoonotic pathogen that is capable of causing respiratory and multisystemic diseases, bacteremia, and bite wound infections. The glycosaminoglycan capsule of P. multocida is an essential virulence factor that protects the bacterium from host defenses. However, chronic infections (such as swine atrophic rhinitis and the carrier state in birds and other animals) may be associated with biofilm formation, which has not been characterized in P. multocida. Biofilm formation by clinical isolates was inversely related to capsule production and was confirmed with capsule-deficient mutants of highly encapsulated strains. Capsule-deficient mutants formed biofilms with a larger biomass that was thicker and smoother than the biofilm of encapsulated strains. Passage of a highly encapsulated, poor-biofilm-forming strain under conditions that favored biofilm formation resulted in the production of less capsular polysaccharide and a more robust biofilm, as did addition of hyaluronidase to the growth medium of all of the strains tested. The matrix material of the biofilm was composed predominately of a glycogen exopolysaccharide (EPS), as determined by gas chromatography-mass spectrometry, nuclear magnetic resonance, and enzymatic digestion. However, a putative glycogen synthesis locus was not differentially regulated when the bacteria were grown as a biofilm or planktonically, as determined by quantitative reverse transcriptase PCR. Therefore, the negatively charged capsule may interfere with biofilm formation by blocking adherence to a surface or by preventing the EPS matrix from encasing large numbers of bacterial cells. This is the first detailed description of biofilm formation and a glycogen EPS by P. multocida. PMID:29162713

Spleen deposition of Cryptococcus neoformans capsular glucuronoxylomannan in rodents occurs in red pulp macrophages and not marginal zone macrophages expressing the C-type lectin SIGN-R1.

PubMed

De Jesus, Magdia; Park, Chae Gyu; Su, Ya; Goldman, David L; Steinman, Ralph M; Casadevall, Arturo

2008-03-01

The fate of microbial polysaccharides in host tissues is an important consideration because these compounds are often immune modulators. Splenic marginal zone macrophages that express the C-type lectin receptor SIGN-R1, take up neutral polysaccharides such as dextran and the capsular polysaccharide of Streptococcus pneumoniae. Given that the major component of Cryptococcus neoformans capsular polysaccharide, glucuronoxylomannan (GXM), localizes in the spleen when injected intravenously, we investigated whether GXM uptake was mediated by splenic macrophages expressing the SIGN-R1 receptor in mice. No significant differences in the amount and location of GXM deposition were detected in the spleens of mice treated with a SIGN-R1 blocking antibody when compared to controls. Similarly, a blocking antibody to Dectin-1, a co-receptor of -SIGN-R1, had no effects on GXM distribution within the spleen. Histological examination of spleens from mice and rats injected with FITC-Dextran and GXM revealed no significant co-localization, with Dextran and GXM being found in marginal and red pulp macrophages, respectively. Hence we conclude that GXM was not deposited in marginal zone macrophages. However, GXM deposition was found in the red pulp. These results indicate that there is a selective localization of these polysaccharides to different receptors such as SIGN-R1 for FITC dextran in marginal zone and a to-be-identified receptor selectively expressed by red pulp macrophages for GXM.

A Liver Capsular Network of Monocyte-Derived Macrophages Restricts Hepatic Dissemination of Intraperitoneal Bacteria by Neutrophil Recruitment.

PubMed

Sierro, Frederic; Evrard, Maximilien; Rizzetto, Simone; Melino, Michelle; Mitchell, Andrew J; Florido, Manuela; Beattie, Lynette; Walters, Shaun B; Tay, Szun Szun; Lu, Bo; Holz, Lauren E; Roediger, Ben; Wong, Yik Chun; Warren, Alessandra; Ritchie, William; McGuffog, Claire; Weninger, Wolfgang; Le Couteur, David G; Ginhoux, Florent; Britton, Warwick J; Heath, William R; Saunders, Bernadette M; McCaughan, Geoffrey W; Luciani, Fabio; MacDonald, Kelli P A; Ng, Lai Guan; Bowen, David G; Bertolino, Patrick

2017-08-15

The liver is positioned at the interface between two routes traversed by pathogens in disseminating infection. Whereas blood-borne pathogens are efficiently cleared in hepatic sinusoids by Kupffer cells (KCs), it is unknown how the liver prevents dissemination of peritoneal pathogens accessing its outer membrane. We report here that the hepatic capsule harbors a contiguous cellular network of liver-resident macrophages phenotypically distinct from KCs. These liver capsular macrophages (LCMs) were replenished in the steady state from blood monocytes, unlike KCs that are embryonically derived and self-renewing. LCM numbers increased after weaning in a microbiota-dependent process. LCMs sensed peritoneal bacteria and promoted neutrophil recruitment to the capsule, and their specific ablation resulted in decreased neutrophil recruitment and increased intrahepatic bacterial burden. Thus, the liver contains two separate and non-overlapping niches occupied by distinct resident macrophage populations mediating immunosurveillance at these two pathogen entry points to the liver. Copyright © 2017 Elsevier Inc. All rights reserved.

A Predicted Mannoprotein Participates in Cryptococcus gattii Capsular Structure

PubMed Central

Reuwsaat, Julia Catarina Vieira; Motta, Heryk; Garcia, Ane Wichine Acosta; Vasconcelos, Carolina Bettker; Marques, Bárbara Machado; Oliveira, Natália Kronbauer; Rodrigues, Jéssica; Ferrareze, Patrícia Aline Gröhns; Frases, Susana; Barcellos, Vanessa Abreu; Squizani, Eamim Daidrê; Horta, Jorge André; Schrank, Augusto; Staats, Charley Christian; Vainstein, Marilene Henning

2018-01-01

ABSTRACT The yeast-like pathogen Cryptococcus gattii is an etiological agent of cryptococcosis. The major cryptococcal virulence factor is the polysaccharide capsule, which is composed of glucuronoxylomannan (GXM), galactoxylomannan (GalXM), and mannoproteins (MPs). The GXM and GalXM polysaccharides have been extensively characterized; however, there is little information about the role of mannoproteins in capsule assembly and their participation in yeast pathogenicity. The present study characterized the function of a predicted mannoprotein from C. gattii, designated Krp1. Loss-of-function and gain-of-function mutants were generated, and phenotypes associated with the capsular architecture were evaluated. The null mutant cells were more sensitive to a cell wall stressor that disrupts beta-glucan synthesis. Also, these cells displayed increased GXM release to the culture supernatant than the wild-type strain did. The loss of Krp1 influenced cell-associated cryptococcal polysaccharide thickness and phagocytosis by J774.A1 macrophages in the early hours of interaction, but no difference in virulence in a murine model of cryptococcosis was observed. In addition, recombinant Krp1 was antigenic and differentially recognized by serum from an individual with cryptococcosis, but not with serum from an individual with candidiasis. Taken together, these results indicate that C. gattii Krp1 is important for the cell wall structure, thereby influencing capsule assembly, but is not essential for virulence in vivo. IMPORTANCE Cryptococcus gattii has the ability to escape from the host’s immune system through poorly understood mechanisms and can lead to the death of healthy individuals. The role of mannoproteins in C. gattii pathogenicity is not completely understood. The present work characterized a protein, Kpr1, that is essential for the maintenance of C. gattii main virulence factor, the polysaccharide capsule. Our data contribute to the understanding of the role of Kpr

Comparison of Capsular Genes of Streptococcus pneumoniae Serotype 6A, 6B, 6C, and 6D Isolates▿

PubMed Central

Song, Jae-Hoon; Baek, Jin Yang; Ko, Kwan Soo

2011-01-01

Recently, Streptococcus pneumoniae serotypes 6C and 6D have been identified. It is thought that they emerged by the replacement of wciNβ in the capsular loci of serotypes 6A and 6B, respectively. However, their evolution has not been unveiled yet. To investigate the evolution of four serotypes of S. pneumoniae serogroup 6, four genes of the capsular polysaccharide synthesis (cps) locus, wchA, wciN, wciO, and wciP, of isolates of S. pneumoniae serotypes 6A, 6B, 6C, and 6D were sequenced. Multilocus sequence typing (MLST) was performed to investigate their genetic backgrounds. The wchA gene of serotype 6C and 6D isolates was distinct from that of serotype 6A and 6B isolates, which may suggest cotransfer of wchA with wciNβ. Otherwise, serotypes 6C and 6D displayed different genetic backgrounds from serotypes 6A and 6B, which was suggested by MLST analysis. In addition, serotype 6C isolates showed distinct wciP polymorphisms from other serotypes, which also indicated that serotype 6C had not recently originated from serotype 6A. Although serotype 6D shared the same amino acid polymorphisms of wciO with serotype 6B, wciP of serotype 6D differed from that of serotype 6B. The data indicate the implausibility of the scenario of a recent emergence of the cps locus of serotype 6D by genetic recombination between serotypes 6B and 6C. In addition, five serotype 6A and 6B isolates (6X group) displayed cps loci distinct from those of other isolates. The cps locus homogeneity and similar sequence types in MLST analysis suggest that most of the 6X group of isolates originated from the same ancestor and that the entire cps locus might have recently been transferred from an unknown origin. Serotype 6B isolates showed two or more cps locus subtypes, indicating a recombination-mediated mosaic structure of the cps locus of serotype 6B. The collective data favor the emergence of cps loci of serotypes 6A, 6B, 6C, and 6D by complicated recombination. PMID:21411593

Structural and Biological Characterization of a Capsular Polysaccharide Produced by Staphylococcus haemolyticus▿

PubMed Central

Flahaut, Sigrid; Vinogradov, Evgeny; Kelley, Kathryn A.; Brennan, Shannon; Hiramatsu, Keiichi; Lee, Jean C.

2008-01-01

The DNA sequence of the genome of Staphylococcus haemolyticus JCSC1435 revealed a putative capsule operon composed of 13 genes in tandem. The first seven genes (capABCDEFGSh) showed ≥57% similarity with the Staphylococcus aureus cap5 or cap8 locus. However, the capHIJKLMSh genes are unique to S. haemolyticus and include genes encoding a putative flippase, an aminotransferase, two glycosyltransferases, and a transcriptional regulator. Capsule-like material was readily apparent by immunoelectron microscopy on bacteria harvested in the postexponential phase of growth. Electron micrographs of a JCSC1435 mutant with a deleted cap region lacked the capsule-like material. Both strains produced small amounts of surface-associated material that reacted with antibodies to polyglutamic acid. S. haemolyticus cap genes were amplified from four of seven clinical isolates of S. haemolyticus from humans, and three of these strains produced a serologically cross-reactive capsular polysaccharide. In vitro assays demonstrated that the acapsular mutant strain showed greater biofilm formation but was more susceptible to complement-mediated opsonophagocytic killing than the parent strain. Structural characterization of capsule purified from S. haemolyticus strain JCSC1435 showed a trisaccharide repeating unit: −3-α-l-FucNAc-3-(2-NAc-4-N-Asp-2,4,6-trideoxy-β-d-Glc)-4-α-d-GlcNAc-. This structure is unique among staphylococcal polysaccharides in that its composition includes a trideoxy sugar residue with aspartic acid as an N-acyl substituent. PMID:18165309

Structural and biological characterization of a capsular polysaccharide produced by Staphylococcus haemolyticus.

PubMed

Flahaut, Sigrid; Vinogradov, Evgeny; Kelley, Kathryn A; Brennan, Shannon; Hiramatsu, Keiichi; Lee, Jean C

2008-03-01

The DNA sequence of the genome of Staphylococcus haemolyticus JCSC1435 revealed a putative capsule operon composed of 13 genes in tandem. The first seven genes (capABCDEFG(Sh)) showed > or = 57% similarity with the Staphylococcus aureus cap5 or cap8 locus. However, the capHIJKLM(Sh) genes are unique to S. haemolyticus and include genes encoding a putative flippase, an aminotransferase, two glycosyltransferases, and a transcriptional regulator. Capsule-like material was readily apparent by immunoelectron microscopy on bacteria harvested in the postexponential phase of growth. Electron micrographs of a JCSC1435 mutant with a deleted cap region lacked the capsule-like material. Both strains produced small amounts of surface-associated material that reacted with antibodies to polyglutamic acid. S. haemolyticus cap genes were amplified from four of seven clinical isolates of S. haemolyticus from humans, and three of these strains produced a serologically cross-reactive capsular polysaccharide. In vitro assays demonstrated that the acapsular mutant strain showed greater biofilm formation but was more susceptible to complement-mediated opsonophagocytic killing than the parent strain. Structural characterization of capsule purified from S. haemolyticus strain JCSC1435 showed a trisaccharide repeating unit: -3-alpha-L-FucNAc-3-(2-NAc-4-N-Asp-2,4,6-trideoxy-beta-D-Glc)-4-alpha-D-GlcNAc-. This structure is unique among staphylococcal polysaccharides in that its composition includes a trideoxy sugar residue with aspartic acid as an N-acyl substituent.

M-Ficolin Binds Selectively to the Capsular Polysaccharides of Streptococcus pneumoniae Serotypes 19B and 19C and of a Streptococcus mitis Strain

PubMed Central

Kjaer, Troels R.; Hansen, Annette G.; Sørensen, Uffe B. S.; Holm, Anne T.; Sørensen, Grith L.; Jensenius, Jens C.

2013-01-01

The three human ficolins (H-, L-, and M-ficolins) and mannan-binding lectin are pattern recognition molecules of the innate immune system mediating activation of the lectin pathway of the complement system. These four human proteins bind to some microorganisms and may be involved in the resolution of infections. We investigated binding selectivity by examining the binding of M-ficolin to a panel of more than 100 different streptococcal strains (Streptococcus pneumoniae and Streptococcus mitis), each expressing distinct polysaccharide structures. M-ficolin binding was observed for three strains only: strains of the pneumococcal serotypes 19B and 19C and a single S. mitis strain expressing a similar polysaccharide structure. The bound M-ficolin, in association with MASP-2, mediated the cleavage of complement factor C4. Binding to the bacteria was inhibitable by N-acetylglucosamine, indicating that the interaction with the bacterial surface takes place via the fibrinogen-like domain. The common N-acetylmannosamine residue present in the structures of the four capsular polysaccharides of group 19 is linked via a phosphodiester bond. This residue is apparently not a ligand for M-ficolin, since the lectin binds to two of the group 19 polysaccharides only. M-ficolin bound strongly to serotype 19B and 19C polysaccharides. In contrast to those of serotypes 19A and 19F, serotype 19B and 19C polysaccharides contain an extra N-acetylmannosamine residue linked via glycoside linkage only. Thus, this extra residue seems to be the M-ficolin ligand. In conclusion, we were able to demonstrate specific binding of M-ficolin to some capsular polysaccharides of the opportunistic pathogen S. pneumoniae and of the commensal bacterium S. mitis. PMID:23184524

Evaluation and Management of Failed Shoulder Instability Surgery.

PubMed

Cartucho, António; Moura, Nuno; Sarmento, Marco

2017-01-01

Failed shoulder instability surgery is mostly considered to be the recurrence of shoulder dislocation but subluxation, painful or non-reliable shoulder are also reasons for patient dissatisfaction and should be considered in the notion. The authors performed a revision of the literature and online contents on evaluation and management of failed shoulder instability surgery. When we look at the reasons for failure of shoulder instability surgery we point the finger at poor patient selection, technical error and an additional traumatic event. More than 80% of surgical failures, for shoulder instability, are associated with bone loss. Quantification of glenoid bone loss and investigation of an engaging Hill-Sachs lesion are determining facts. Adequate imaging studies are determinant to assess labrum and capsular lesions and to rule out associated pathology as rotator cuff tears. CT-scan is the method of choice to diagnose and quantify bone loss. Arthroscopic soft tissue procedures are indicated in patients with minimal bone loss and no contact sports. Open soft tissue procedures should be performed in patients with small bone defects, with hiperlaxity and practicing contact sports. Soft tissue techniques, as postero-inferior capsular plication and remplissage, may be used in patients with less than 25% of glenoid bone loss and Hill-Sachs lesions. Bone block procedures should be used for glenoid larger bone defects in the presence of an engaging Hill-Sachs lesion or in the presence of poor soft tissue quality. A tricortical iliac crest graft may be used as a primary procedure or as a salvage procedure after failure of a Bristow or a Latarjet procedure. Less frequently, the surgeon has to address the Hill-Sachs lesion. When a 30% loss of humeral head circumference is present a filling graft should be used. Reasons for failure are multifactorial. In order to address this entity, surgeons must correctly identify the causes and tailor the right solution.

Evaluation of Safe Systemic Immunosuppression Created with Dexamethasone in Prevention of Capsular Contracture: A Glance to Distinct Perspectives with Toll-Like Receptors.

PubMed

Colak, Ozlem; Ozer, Kadri; Dikmen, Adile; Ozakinci, Hilal; Ozkaya, Ozay

2018-03-21

The toll-like receptors (TLRs) stand at the interface of innate immune activation. We hypothesize to decrease the response of innate immunity activated by TLR4 by a safe, short-term, systemic immunosuppression. Two silicone block implants were placed into two dorsal subcutaneous pockets in 32 rats that were subdivided into four groups: The two study groups were the IV DEX group (single intravenous injection of dexamethasone 1 h before surgery) and the IV DEX + IP DEX group (in addition to a single intravenous injection of dexamethasone 1 h before surgery, intraperitoneal dexamethasone was administered for 10 days after surgery), and the two control groups were the untreated control group and the saline-treated control group. After 10 weeks, all animals were killed to determine capsular thickness, inflammatory cell density, presence of pseudoepitheliomatous hyperplasia, edema, necrosis, vascularization, TLR4 expression and myofibroblast proliferation. No significant difference was observed in any parameter between the untreated and saline-treated control groups (p > 0.05). Capsular thickness, myofibroblast proliferation, TLR4 expression density were statistically different among study groups compared to control (p < 0.05). This study demonstrates the relationship between toll-like receptors and fibrous capsule after implant surgery. Decreasing the innate immunity by a safe, short-term perioperative systemic immunosuppression resulted in decreased TLR4 expression and myofibroblast differentiation which could be a new research field in profibrotic pathophysiology underlying breast capsule formation. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Pseudotumors after primary abdominal lipectomy as a new sequela in patients with abdominal apron.

PubMed

Dragu, Adrian; Bach, Alexander D; Polykandriotis, Elias; Kneser, Ulrich; Horch, Raymund E

2009-11-01

Malnutrition and overweight is a common problem in modern societies. Primary abdominal lipectomy is a standard surgical tool in patients with these problems. However, unknown secondary problems result from recent advances in obesity surgery. Plication of the anterior musculoaponeurotic wall is a widely and commonly used operative technique during abdominoplasty. Many different plication techniques have been published. So far no common standard and long-term effectiveness is proven. In addition, there is no sufficient literature dealing with the postoperative risks of plication of the musculoaponeurotic wall. Four patients with development of pseudotumors were reviewed. All four patients received 12 months in advance a primary abdominal lipectomy including a vertical plication of the musculoaponeurotic wall. All four patients were females with mean age of 61 years and mean body mass index (BMI) of 37 kg/m(2). All four patients had developed a pseudotumor of the abdomen as a long-term complication more than 12 months after primary abdominal lipectomy including a vertical plication of the anterior rectus sheath. One should be aware of the potential long-term risk of secondary postoperative hematoma formation, with or without partial necrosis of the anterior rectus sheath after vertical plication of the anterior musculoaponeurotic wall. Viewed clinically and radiologically, such sequelas may appear as pseudotumor like masses and require immediate revision.

Dynamics of the Murine Humoral Immune Response to Neisseria meningitidis Group B Capsular Polysaccharide

PubMed Central

Colino, Jesús; Outschoorn, Ingrid

1998-01-01

Immunization with Neisseria meningitidis group B capsular polysaccharide (CpsB) elicited responses in adult mice that showed the typical dynamic characteristics of the response to a thymus-independent antigen, in contrast to the thymus-dependent behavior of antibody responses to CpsC. The former had a short latent period and showed a rapid increase in serum antibodies that peaked at day 5, and immunoglobulin M (IgM) was the major isotype even though IgG (mainly IgG2a and IgG2b) was also detectable. This response was of short duration, and the specific antibodies were rapidly cleared from the circulation. The secondary responses were similar in magnitude, kinetics, IgM predominance, and IgG distribution. Nevertheless, a threefold IgG increase, a correlation between IgM and IgG levels, and dose-dependent secondary responses were observed. Hyperimmunization considerably reinforced these responses: 10-fold for IgM and 300-fold for IgG. This favored isotype switch was accompanied by a progressive change in the subclass distribution to IgG3 (62%) and IgG1 (28%), along with the possible generation of B-cell memory. The results indicate that CpsB is being strictly thymus independent and suggest that unresponsiveness to purified CpsB is due to tolerance. PMID:9453603

Dynamics of the murine humoral immune response to Neisseria meningitis group B capsular polysaccharide.

PubMed

Colino, J; Outschoorn, I

1998-02-01

Immunization with Neisseria meningitidis group B capsular polysaccharide (CpsB) elicited responses in adult mice that showed the typical dynamic characteristics of the response to a thymus-independent antigen, in contrast to the thymus-dependent behavior of antibody responses to CpsC. The former had a short latent period and showed a rapid increase in serum antibodies that peaked at day 5, and immunoglobulin M (IgM) was the major isotype even though IgG (mainly IgG2a and IgG2b) was also detectable. This response was of short duration, and the specific antibodies were rapidly cleared from the circulation. The secondary responses were similar in magnitude, kinetics, IgM predominance, and IgG distribution. Nevertheless, a threefold IgG increase, a correlation between IgM and IgG levels, and dose-dependent secondary responses were observed. Hyperimmunization considerably reinforced these responses: 10-fold for IgM and 300-fold for IgG. This favored isotype switch was accompanied by a progressive change in the subclass distribution to IgG3 (62%) and IgG1 (28%), along with the possible generation of B-cell memory. The results indicate that CpsB is being strictly thymus independent and suggest that unresponsiveness to purified CpsB is due to tolerance.

Wrist kinetics after luno-triquetral dissociation: the changes in moment arms of the flexor carpi ulnaris tendon.

PubMed

Tang, Jin Bo; Xie, Ren Gou; Yu, Xiao Wei; Chen, Feng

2002-11-01

Wrist biomechanics after luno-triquetral (LT) dissociation is important for understanding the clinical sequelae of the disease and for determining its treatment options. The LT interosseous ligament plays an important role in stabilizing the joint and damage to the ligament would be expected to significantly increase moment arms of tendon of the flexor carpi ulnaris (FCU), the principal ulnar wrist flexor. We investigated the changes in moment arms of FCU tendon after various amounts of sectioning of the ligaments proven to be associated with LT dissociation. In six fresh frozen cadaveric upper extremities, excursions of the FCU tendon were recorded simultaneously with wrist joint angulation during wrist flexion-extension and radioulnar deviation. Tendon excursions were measured in intact wrists, in wrists with sectioning of the dorsal portion of the LT interosseous ligament, in wrists with sectioning of the entire LT interosseous ligament, and finally in wrists with further sectioning of the dorsal radiotriquetral and intercarpal ligaments. Moment arms of the tendon were calculated from tendon excursions and joint motion angulations and expressed as percentage changes from those in the intact wrist. During wrist flexion-extension, moment arms of the FCU tendon after sectioning of the entire LT interosseous ligament and after sectioning of the two capsular ligaments were 112 +/- 7% and 114 +/- 8%, respectively; these values were significantly greater than those in the intact wrist. During radioulnar deviation, the moment arms were 114 +/- 11% after sectioning of the dorsal portion of the LT interosseous ligament, 134 +/- 15% after sectioning of the entire ligament, and 153 +/- 18% after sectioning of the capsular ligaments, again being significantly greater than the normal wrist. Increase in moment arms of the FCU tendon after loss of integrity of the LT interosseous ligament and dorsal capsular ligaments may contribute to clinical sequelae of LT dissociation and

Modulation of matrix metalloproteinase activity by EDTA prevents posterior capsular opacification

PubMed Central

Guha, Rajdeep; Jongkey, Geram; Palui, Himangshu; Mishra, Akhilesh; Vemuganti, Geeta K.; Basak, Samar K.; Mandal, Tapan Kumar; Konar, Aditya

2012-01-01

Purpose To evaluate the effect of ethylenediaminetetraacetic acid (EDTA) on posterior capsular opacification (PCO) of rabbits and to assess its effect on intraocular tissues. Methods Modulation of matrix metalloproteinase (MMP) activity in the aqueous following cataract surgery in rabbits and its prevention by different doses of EDTA was determined by zymography. For evaluation of PCO, lensectomized rabbits were intracamerally injected with single dose of either 5 mg EDTA or normal saline. After one month, the degree of PCO was determined by slitlamp biomicroscopy, Miyake-Apple view, and histology of the lens capsule. The effect of EDTA on intra ocular pressure (IOP), corneal endothelial cells, and the retina was evaluated by tonometry, specular microscopy and scanning electron microscopy, and electroretinography. The concentration of EDTA in the aqueous was determined by high performance liquid chromatography (HPLC) at different time points. Results The MMP activity was significantly increased in the aqueous of the operated eyes, and EDTA reduced the degree of increase in a dose-dependent manner. EDTA treatment significantly reduced the degree of PCO (p<0.05). Histopathology of the lens capsule showed a reduction in the number of proliferating and migrating cells as well as MMP2 expression in the EDTA-treated eyes. EDTA treatment did not change the IOP; density, morphology and ultrastructure of the corneal endothelial cells; and electroretinography (ERG). EDTA was detectable in the aqueous humor up to 72 h following a single intracameral injection. Conclusions EDTA reduces the degree of PCO by suppressing the MMP activity and it is not toxic to intra ocular structures at the concentration used. PMID:22815623

Congenital penile curvature: update and management.

PubMed

Makovey, Iryna; Higuchi, Ty T; Montague, Drogo K; Angermeier, Kenneth W; Wood, Hadley M

2012-08-01

Congenital penile curvature results from disproportionate development of the tunica albuginea of the corporal bodies and is not associated with urethral malformation. Patients usually present after reaching puberty as the curvature becomes more apparent with erections, and severe curvature can make intercourse difficult or impossible, at which point surgical repair is recommended. Excellent outcomes can be expected with surgical intervention. The three most commonly used repair techniques are the original Nesbit procedure, modified Nesbit procedure, and plication. Nesbit and modified Nesbit techniques require that an incision is made in the tunica albuginea while plication techniques utilize plicating sutures without an incision. While Nesbit and modified Nesbit techniques are more complex operations, these generally result in less recurrences and more satisfactory outcomes as opposed to the quicker and simpler plication technique.

Degenerative joint disease: multiple joint involvement in young and mature dogs.

PubMed

Olsewski, J M; Lust, G; Rendano, V T; Summers, B A

1983-07-01

Radiologic, pathologic, and ancillary methods were used to determine the occurrence of degenerative joint disease involving multiple joints of immature and adult dogs. Animals were selected for the development of hip joint dysplasia and chronic degenerative joint disease. Of disease-prone dogs, 82% (45 of 55 dogs) had radiologic changes, indicative of hip dysplasia, by 1 year of age. At necropsy, more abnormal joints were identified than by radiographic examination. Among 92 dogs between 3 to 11 months of age that had joint abnormalities, 71% had hip joint involvement; 38%, shoulder joint involvement; 22%, stifle joint involvement; and 40% had multiple joint involvement. Polyarthritis was asymptomatic and unexpected. Radiographic examination of older dogs also revealed evidence of degenerative joint disease in many joints. Multiple joint involvement was substantiated at necropsy of young and mature dogs. A similar pattern of polyarticular osteoarthritis was revealed in a survey (computer search) of necropsy reports from medical case records of 100 adult and elderly dogs. Usually, the joint disease was an incidental observation, unrelated to the clinical disease or to the cause of death. The frequent occurrence of degenerative changes in several joints of dogs aged 6 months to 17 years indicated that osteoarthritis may be progressive in these joints and raises the possibility that systemic factors are involved in the disease process.

Determination of Parachute Joint Factors using Seam and Joint Testing

NASA Technical Reports Server (NTRS)

Mollmann, Catherine

2015-01-01

This paper details the methodology for determining the joint factor for all parachute components. This method has been successfully implemented on the Capsule Parachute Assembly System (CPAS) for the NASA Orion crew module for use in determining the margin of safety for each component under peak loads. Also discussed are concepts behind the joint factor and what drives the loss of material strength at joints. The joint factor is defined as a "loss in joint strength...relative to the basic material strength" that occurs when "textiles are connected to each other or to metals." During the CPAS engineering development phase, a conservative joint factor of 0.80 was assumed for each parachute component. In order to refine this factor and eliminate excess conservatism, a seam and joint testing program was implemented as part of the structural validation. This method split each of the parachute structural joints into discrete tensile tests designed to duplicate the loading of each joint. Breaking strength data collected from destructive pull testing was then used to calculate the joint factor in the form of an efficiency. Joint efficiency is the percentage of the base material strength that remains after degradation due to sewing or interaction with other components; it is used interchangeably with joint factor in this paper. Parachute materials vary in type-mainly cord, tape, webbing, and cloth -which require different test fixtures and joint sample construction methods. This paper defines guidelines for designing and testing samples based on materials and test goals. Using the test methodology and analysis approach detailed in this paper, the minimum joint factor for each parachute component can be formulated. The joint factors can then be used to calculate the design factor and margin of safety for that component, a critical part of the design verification process.

Spacesuit mobility joints

NASA Technical Reports Server (NTRS)

Vykukal, H. C. (Inventor)

1978-01-01

Joints for use in interconnecting adjacent segments of an hermetically sealed spacesuit which have low torques, low leakage and a high degree of reliability are described. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics. Linkages which restrain the joint from longitudinal distension and a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli are featured. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

Development of capsular polysaccharide-based glycoconjugates for immunization against melioidosis and glanders.

PubMed

Burtnick, Mary N; Heiss, Christian; Roberts, Rosemary A; Schweizer, Herbert P; Azadi, Parastoo; Brett, Paul J

2012-01-01

Burkholderia pseudomallei and Burkholderia mallei, the etiologic agents of melioidosis and glanders, respectively, cause severe disease in humans and animals and are considered potential agents of biological warfare and terrorism. Diagnosis and treatment of infections caused by these pathogens can be challenging and, in the absence of chemotherapeutic intervention, acute disease is frequently fatal. At present, there are no human or veterinary vaccines available for immunization against these emerging/re-emerging infectious diseases. One of the long term objectives of our research, therefore, is to identify and characterize protective antigens expressed by B. pseudomallei and B. mallei and use them to develop efficacious vaccine candidates. Previous studies have demonstrated that the 6-deoxy-heptan capsular polysaccharide (CPS) expressed by these bacterial pathogens is both a virulence determinant and a protective antigen. Consequently, this carbohydrate moiety has become an important component of the various subunit vaccines that we are currently developing in our laboratory. In the present study, we describe a reliable method for isolating CPS antigens from O-polysaccharide (OPS) deficient strains of B. pseudomallei; including a derivative of the select agent excluded strain Bp82. Utilizing these purified CPS samples, we also describe a simple procedure for covalently linking these T-cell independent antigens to carrier proteins. In addition, we demonstrate that high titer IgG responses can be raised against the CPS component of such constructs. Collectively, these approaches provide a tangible starting point for the development of novel CPS-based glycoconjugates for immunization against melioidosis and glanders.

Granulocyte colony-stimulating factor enhances protection by anti-K1 capsular IgM antibody in murine Escherichia coli sepsis.

PubMed

Hustinx, W; Benaissa-Trouw, B; Van Kessel, K; Kuenen, J; Tavares, L; Kraaijeveld, K; Verhoef, J; Hoepelman, A

1997-12-01

Combined prophylactic treatment with recombinant murine granulocyte colony-stimulating factor (G-CSF) and a suboptimal dose of anti-K1 capsular IgM monoclonal antibody (MAb) significantly enhanced survival in an experimental mouse Escherichia coli O7:K1 peritonitis model compared with untreated animals (67% vs. 11% survival; P < 0.001) and with either treatment alone (67 vs. 29% and 27% survival, respectively; P < 0.01), which suggests synergism between these agents. Enhanced survival by combined treatment was associated with increased neutrophil counts in blood and peritoneal lavage fluid, lower systemic and higher levels of local tumour necrosis factor (TNF) and lower bacterial counts in blood cultures. Mouse neutrophils treated with G-CSF but not infected with E. coli showed enhanced phagocytic and respiratory burst capacity, down-regulation of L-selectin receptors and enhanced expression of Fc RII-III receptors but not of complement receptors.

Rapid and Easy Identification of Capsular Serotypes of Streptococcus pneumoniae by Use of Fragment Analysis by Automated Fluorescence-Based Capillary Electrophoresis

PubMed Central

Selva, Laura; del Amo, Eva; Brotons, Pedro

2012-01-01

The purpose of this study was to develop a high-throughput method for the identification of pneumococcal capsular types. Multiplex PCR combined with fragment analysis and automated fluorescent capillary electrophoresis (FAF-mPCR) was utilized. FAF-mPCR was composed of only 3 PCRs for the specific detection of serotypes 1, 2, 3, 4, 5, 6A/6B, 6C, 7F/7A, 7C/(7B/40), 8, 9V/9A, 9N/9L, 10A, 10F/(10C/33C), 11A/11D/11F, 12F/(12A/44/46), 13, 14, 15A/15F, 15B/15C, 16F, 17F, 18/(18A/18B/18C/18F), 19A, 19F, 20, 21, 22F/22A, 23A, 23B, 23F, 24/(24A/24B/24F), 31, 33F/(33A/37), 34, 35A/(35C/42), 35B, 35F/47F, 38/25F, and 39. In order to evaluate the assay, all invasive pneumococcal isolates (n = 394) characterized at Hospital Sant Joan de Déu, Barcelona, Spain, from July 2010 to July 2011 were included in this study. The Wallace coefficient was used to evaluate the overall agreement between two typing methods (Quellung reaction versus FAF-mPCR). A high concordance with Quellung was found: 97.2% (383/394) of samples. The Wallace coefficient was 0.981 (range, 0.965 to 0.997). Only 11 results were discordant with the Quellung reaction. However, latex reaction and Quellung results of the second reference laboratory agreed with FAF-mPCR for 9 of these 11 strains (82%). Therefore, we considered that only 2 of 394 strains (0.5%) were not properly characterized by the new assay. The automation of the process allowed the typing of 30 isolates in a few hours with a lower cost than that of the Quellung reaction. These results indicate that FAF-mPCR is a good method to determine the capsular serotype of Streptococcus pneumoniae. PMID:22875895

Cusp repair in aortic valve reconstruction: does the technique affect stability?

PubMed

Aicher, Diana; Langer, Frank; Adam, Oliver; Tscholl, Dietmar; Lausberg, Henning; Schäfers, Hans-Joachim

2007-12-01

Cusp prolapse may be an isolated cause of aortic regurgitation or may exist in conjunction with dilatation of the proximal aorta. Prolapse can be corrected by central plication, triangular resection, or pericardial patch implantation. We retrospectively analyzed our results with these techniques. From October 1995 to December 2006, 604 patients (aged 3-86 years) underwent aortic valve repair. Cusp prolapse was found in 427 patients (246 tricuspid, 181 bicuspid). Prolapse was corrected by central plication (n = 275) or triangular resection (n = 80). A pericardial patch was implanted for pre-existing cusp defects or after excision of calcium (n = 72). One cusp was repaired in 198 patients; the remaining patients underwent repair of 2 (n = 189) or 3 cusps (n = 40). In 102 patients more than one technique was used, and the patients were allocated to the group of the assumedly more complex repair (central plication < triangular resection < pericardial patch plasty). Cumulative follow-up was 1238 patient-years (mean 35 +/- 27 months). Hospital mortality was 2.6% (11/427). Actuarial freedom from aortic regurgitation of grade II or more at 5 years was 92% (central plication), 90% (triangular resection), and 90% (pericardial patch plasty). Thirteen patients were reoperated on, with prolapse as the most common reason for failure (n = 7); 6 underwent re-repair. Freedom from reoperation at 5 years was 95% (central plication), 94% (triangular resection), and 94% (pericardial patch plasty). Freedom from valve replacement at 5 years was 97% (central plication), 99% (triangular resection), and 98% (pericardial patch plasty). In aortic valve repair, cusp prolapse can be treated reliably by central plication. In the presence of more complex disease, triangular resection or pericardial patch plasty may be used without compromising midterm durability.

Outbreak of Neisseria meningitidis capsular group W among scouts returning from the World Scout Jamboree, Japan, 2015

PubMed Central

Smith-Palmer, Alison; Oates, Ken; Webster, Diana; Taylor, Sarah; Scott, Kevin J; Smith, Gemma; Parcell, Benjamin; Lindstrand, Ann; Wallensten, Anders; Fredlund, Hans; Widerström, Micael; McMenamin, Jim

2016-01-01

The 23rd World Scout Jamboree was held in Japan from 28 July to 8 August 2015 and was attended by over 33,000 scouts from 162 countries. An outbreak of invasive meningococcal disease capsular group W was investigated among participants, with four confirmed cases identified in Scotland, who were all associated with one particular scout unit, and two confirmed cases in Sweden; molecular testing showed the same strain to be responsible for illness in both countries. The report describes the public health action taken to prevent further cases and the different decisions reached with respect to how wide to extend the offer of chemoprophylaxis in the two countries; in Scotland, chemoprophylaxis was offered to the unit of 40 participants to which the four cases belonged and to other close contacts of cases, while in Sweden chemoprophylaxis was offered to all those returning from the Jamboree. The report also describes the international collaboration and communication required to investigate and manage such multinational outbreaks in a timely manner. PMID:27918267

Periprosthetic joint infection: are patients with multiple prosthetic joints at risk?

PubMed

Jafari, S Mehdi; Casper, David S; Restrepo, Camilo; Zmistowski, Benjamin; Parvizi, Javad; Sharkey, Peter F

2012-06-01

Patients who present with a periprosthetic joint infection in a single joint may have multiple prosthetic joints. The risk of these patients developing a subsequent infection in another prosthetic joint is unknown. Our purposes were (1) to identify the risk of developing a subsequent infection in another prosthetic joint and (2) to describe the time span and organism profile to the second prosthetic infection. We retrospectively identified 55 patients with periprosthetic joint infection who had another prosthetic joint in place at the time of presentation. Of the 55 patients, 11 (20%) developed a periprosthetic joint infection in a second joint. The type of organism was the same as the first infection in 4 (36%) of 11 patients. The time to developing a second infection averaged 2.0 years (range, 0-6.9 years). Copyright © 2012 Elsevier Inc. All rights reserved.

Glued intraocular lens implantation for eyes with inadequate capsular support: Analysis of the postoperative visual outcome.

PubMed

Mohan, Sujatha; John, Bina; Rajan, Mohan; Malkani, Harsha; Nagalekshmi, S V; Singh, Siddhartha

2017-06-01

The aim of this study is to analyze the postoperative visual outcomes of fibrin glue-assisted, suture-less posterior chamber (PC) intraocular lens (IOL) implantation technique in eyes with inadequate capsule support at a tertiary eye care hospital in South India. This is a retrospective, nonrandomized case series. This study analyzes 94 eyes which underwent PC-IOL implantation by fibrin glue-assisted, suture-less technique. All patients who had IOL implants by the fibrin glue-assisted PC-IOL technique from August 2009 to January 2014 were included in the study. Intra- and post-operative complications were analyzed. The postoperative best spectacle-corrected visual acuity (BSCVA) was evaluated and recorded at the end of 6 months. The data were analyzed using SPSS version 16.1 (SPSS Inc., Chicago, Illinois, USA) using two sample paired t-test and independent t-test. A total of 94 eyes of 92 patients that underwent glued IOL implantation over a period of 5 years were analyzed. Out of 94 eyes, 77 eyes (84.6%) maintained or improved on their preoperative BSCVA (P = 0.012). We conclude that glued IOL implantation is a feasible option in rehabilitating patients with aphakia without adequate capsular support.

Collagen Organization in Facet Capsular Ligaments Varies With Spinal Region and With Ligament Deformation.

PubMed

Ban, Ehsan; Zhang, Sijia; Zarei, Vahhab; Barocas, Victor H; Winkelstein, Beth A; Picu, Catalin R

2017-07-01

The spinal facet capsular ligament (FCL) is primarily comprised of heterogeneous arrangements of collagen fibers. This complex fibrous structure and its evolution under loading play a critical role in determining the mechanical behavior of the FCL. A lack of analytical tools to characterize the spatial anisotropy and heterogeneity of the FCL's microstructure has limited the current understanding of its structure-function relationships. Here, the collagen organization was characterized using spatial correlation analysis of the FCL's optically obtained fiber orientation field. FCLs from the cervical and lumbar spinal regions were characterized in terms of their structure, as was the reorganization of collagen in stretched cervical FCLs. Higher degrees of intra- and intersample heterogeneity were found in cervical FCLs than in lumbar specimens. In the cervical FCLs, heterogeneity was manifested in the form of curvy patterns formed by collections of collagen fibers or fiber bundles. Tensile stretch, a common injury mechanism for the cervical FCL, significantly increased the spatial correlation length in the stretch direction, indicating an elongation of the observed structural features. Finally, an affine estimation for the change of correlation length under loading was performed which gave predictions very similar to the actual values. These findings provide structural insights for multiscale mechanical analyses of the FCLs from various spinal regions and also suggest methods for quantitative characterization of complex tissue patterns.

Agglutination by anti-capsular polysaccharide antibody is associated with protection against experimental human pneumococcal carriage

PubMed Central

Reiné, J; Zangari, T; Owugha, JT; Pennington, SH; Gritzfeld, JF; Wright, AD; Collins, AM; van Selm, S; de Jonge, MI; Gordon, SB; Weiser, JN; Ferreira, DM

2016-01-01

The ability of pneumococcal conjugate vaccine (PCV) to decrease transmission by blocking the acquisition of colonization has been attributed to herd immunity. We describe the role of mucosal IgG to capsular polysaccharide (CPS) in mediating protection from carriage, translating our findings from a murine model to humans. We used a flow-cytometric assay to quantify antibody-mediated agglutination demonstrating that hyperimmune sera generated against an unencapsulated mutant was poorly agglutinating. Passive immunization with this antiserum was ineffective to block acquisition of colonization compared to agglutinating antisera raised against the encapsulated parent strain. In the human challenge model samples were collected from PCV and control vaccinated adults. In PCV-vaccinated subjects IgG levels to CPS were increased in serum and nasal wash (NW). IgG to the inoculated strain CPS dropped in NW samples after inoculation suggesting its sequestration by colonizing pneumococci. In post-vaccination NW samples pneumococci were heavily agglutinated compared to pre-vaccination samples in subjects protected against carriage. Our results indicate that pneumococcal agglutination mediated by CPS specific antibodies is a key mechanism of protection against acquisition of carriage. Capsule may be the only vaccine target that can elicit strong agglutinating antibody responses, leading to protection against carriage acquisition and generation of herd immunity. PMID:27579859

Impact extractive fracture of jointed steel plates of a bolted joint

NASA Astrophysics Data System (ADS)

Daimaruya, M.; Fujiki, H.; Ambarita, H.

2012-08-01

This study is concerned with the development of a fracture criterion for the impact fracture of jointed steel plates of a bolted joint used in a car body. For the accurate prediction of crash characteristics of car bodies by computer-aided engineering (CAE), it is also necessary to examine the behavior and fracture of jointed steel plates subjected to impact loads. Although the actual impact fracture of jointed steel plates of a bolted joint used in cars is complicated, for simplifying the problem it might be classified into the shear fracture and the extractive fracture of jointed steel plates. Attention is given to the extractive fracture of jointed steel plates in this study. The extractive behavior and fracture of three kinds of steel plates used for cars are examined in experiments and numerical simulations. The impact extraction test of steel plates jointed by a bolt is performed using the one-bar method, together with the static test. In order to understand the mechanism of extractive fracture process of jointed steel plates, numerical simulations by a FEM code LS-DYNA are also carried out. The obtained results suggest that a stress-based fracture criterion may be developed for the impact extractive fracture of jointed steel plates of a bolted joint used in a car body.

Joint Instability and Osteoarthritis

PubMed Central

Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

2015-01-01

Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184

Joint instability and osteoarthritis.

PubMed

Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

2015-01-01

Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA.

Extraluminal venous interruption for free-floating thrombus in the deep veins of lower limbs.

PubMed

Casian, D; Gutsu, E; Culiuc, V

2010-01-01

The free-floating thrombus (FFT) represents a particular form of deep vein thrombosis with extremely high potential of fatal pulmonary embolism. The purpose of the study was to evaluate the early results of aggressive surgical approach to FFT. During the period 2005-2008 years FFT was diagnosed in 13 patients. Demographic characteristics of patients: medium age--54.7 years, male--76.9%, significant comorbidity--5 (38.5%) cases. Localization of FFT: superficial femoral vein (SFV)--5 (38.5%), common femoral vein (CFV)--4 (30.7%), external iliac vein (EIV)--2 (15.4%), inferior cava vein (ICV)--2 (15.4%). Manifestations of previous pulmonary embolism were documented preoperatively in 3 (23.1%) cases. The following emergency surgical procedures were performed: ligation--3 (23.1%) or plication--2 (15.4%) of SFV; plication of CFV--5 (38.5%) patients, combined in 4 cases with partial thrombectomy (free-floating part of thrombus); plication of common iliac vein--1 (7.6%); plication of ICV--2 (15.4%) cases. Primary or recurrent cases of clinically significant pulmonary embolism were not detected in the postoperative period. The accumulated experience of surgical management of patients with FFT reveals the important role of deep vein ligation/plication in prevention of fatal pulmonary embolism.

The hindlimb in walking horses: 2. Net joint moments and joint powers.

PubMed

Clayton, H M; Hodson, E; Lanovaz, J L; Colborne, G R

2001-01-01

The objective of the study was to describe net joint moments and joint powers in the equine hindlimb during walking. The subjects were 5 sound horses. Kinematic and force data were collected synchronously and combined with morphometric information to determine net joint moments at each hindlimb joint throughout stance and swing. The results showed that the net joint moment was on the caudal/plantar side of all hindlimb joints at the start of stance when the limb was being actively retracted. It moved to the cranial/dorsal side around 24% stride at the hip and stifle and in terminal stance at the more distal joints. It remained on the cranial/dorsal side of all joints during the first half of swing to provide active limb protraction, then moved to the caudal/plantar aspect to reverse the direction of limb motion prior to ground contact. The hip joint was the main source of energy generation throughout the stride. It was assisted by the tarsal joint in both stance and swing phases and by the fetlock joint during the stance phase. The coffin joint acted as an energy damper during stance, whereas the stifle joint absorbed almost equal amounts of energy in the stance and swing phases. The coffin and fetlock joints absorbed energy as the limb was protracted and retracted during the swing phase, suggesting that their movements were driven by inertial forces. Future studies will apply these findings to detect changes in the energy profiles due to specific soft tissue injuries.

The Analysis of Adhesively Bonded Advanced Composite Joints Using Joint Finite Elements

NASA Technical Reports Server (NTRS)

Stapleton, Scott E.; Waas, Anthony M.

2012-01-01

The design and sizing of adhesively bonded joints has always been a major bottleneck in the design of composite vehicles. Dense finite element (FE) meshes are required to capture the full behavior of a joint numerically, but these dense meshes are impractical in vehicle-scale models where a course mesh is more desirable to make quick assessments and comparisons of different joint geometries. Analytical models are often helpful in sizing, but difficulties arise in coupling these models with full-vehicle FE models. Therefore, a joint FE was created which can be used within structural FE models to make quick assessments of bonded composite joints. The shape functions of the joint FE were found by solving the governing equations for a structural model for a joint. By analytically determining the shape functions of the joint FE, the complex joint behavior can be captured with very few elements. This joint FE was modified and used to consider adhesives with functionally graded material properties to reduce the peel stress concentrations located near adherend discontinuities. Several practical concerns impede the actual use of such adhesives. These include increased manufacturing complications, alterations to the grading due to adhesive flow during manufacturing, and whether changing the loading conditions significantly impact the effectiveness of the grading. An analytical study is conducted to address these three concerns. Furthermore, proof-of-concept testing is conducted to show the potential advantages of functionally graded adhesives. In this study, grading is achieved by strategically placing glass beads within the adhesive layer at different densities along the joint. Furthermore, the capability to model non-linear adhesive constitutive behavior with large rotations was developed, and progressive failure of the adhesive was modeled by re-meshing the joint as the adhesive fails. Results predicted using the joint FE was compared with experimental results for various

Spacesuit mobility knee joints

NASA Technical Reports Server (NTRS)

Vykukal, H. C. (Inventor)

1979-01-01

Pressure suit mobility joints are for use in interconnecting adjacent segments of an hermetically sealed spacesuit in which low torques, low leakage and a high degree of reliability are required. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics and includes linkages which restrain the joint from longitudinal distension and includes a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

Joint Enabling Capabilities Command

Science.gov Websites

Executive Director Chief of Staff Joint Planning Support Element Joint Communications Support Element mission Joint Enabling Capabilities Command provides decisive joint communications, planning and public and responsive support for joint communications, planning and public affairs. Priorities * Deliver

Solution conformation and flexibility of capsular polysaccharides from Neisseria meningitidis and glycoconjugates with the tetanus toxoid protein

NASA Astrophysics Data System (ADS)

Abdelhameed, Ali Saber; Morris, Gordon A.; Almutairi, Fahad; Adams, Gary G.; Duvivier, Pierre; Conrath, Karel; Harding, Stephen E.

2016-10-01

The structural integrity of meningococcal native, micro-fluidized and activated capsular polysaccharides and their glycoconjugates - in the form most relevant to their potential use as vaccines (dilute solution) - have been investigated with respect to their homogeneity, conformation and flexibility. Sedimentation velocity analysis showed that the polysaccharide size distributions were generally bimodal with some evidence for higher molar mass forms at higher concentration. Weight average molar masses Mw where lower for activated polysaccharides. Conjugation with tetanus toxoid protein however greatly increased the molar mass and polydispersity of the final conjugates. Glycoconjugates had an approximately unimodal log-normal but broad and large molar mass profiles, confirmed by sedimentation equilibrium “SEDFIT MSTAR” analysis. Conformation analysis using HYDFIT (which globally combines sedimentation and viscosity data), “Conformation Zoning” and Wales-van Holde approaches showed a high degree of flexibility - at least as great as the unconjugated polysaccharides, and very different from the tetanus toxoid (TT) protein used for the conjugation. As with the recently published finding for Hib-TT complexes, it is the carbohydrate component that dictates the solution behaviour of these glycoconjugates, although the lower intrinsic viscosities suggest some degree of compaction of the carbohydrate chains around the protein.

Solution conformation and flexibility of capsular polysaccharides from Neisseria meningitidis and glycoconjugates with the tetanus toxoid protein.

PubMed

Abdelhameed, Ali Saber; Morris, Gordon A; Almutairi, Fahad; Adams, Gary G; Duvivier, Pierre; Conrath, Karel; Harding, Stephen E

2016-10-26

The structural integrity of meningococcal native, micro-fluidized and activated capsular polysaccharides and their glycoconjugates - in the form most relevant to their potential use as vaccines (dilute solution) - have been investigated with respect to their homogeneity, conformation and flexibility. Sedimentation velocity analysis showed that the polysaccharide size distributions were generally bimodal with some evidence for higher molar mass forms at higher concentration. Weight average molar masses M w where lower for activated polysaccharides. Conjugation with tetanus toxoid protein however greatly increased the molar mass and polydispersity of the final conjugates. Glycoconjugates had an approximately unimodal log-normal but broad and large molar mass profiles, confirmed by sedimentation equilibrium "SEDFIT MSTAR" analysis. Conformation analysis using HYDFIT (which globally combines sedimentation and viscosity data), "Conformation Zoning" and Wales-van Holde approaches showed a high degree of flexibility - at least as great as the unconjugated polysaccharides, and very different from the tetanus toxoid (TT) protein used for the conjugation. As with the recently published finding for Hib-TT complexes, it is the carbohydrate component that dictates the solution behaviour of these glycoconjugates, although the lower intrinsic viscosities suggest some degree of compaction of the carbohydrate chains around the protein.

Susceptibility to antimicrobial agents of Streptococcus suis capsular type 2 strains isolated from pigs.

PubMed

Seol, B; Kelneric, Z; Hajsig, D; Madic, J; Naglic, T

1996-03-01

The minimal inhibitory concentrations (MICs) for thirty-three epidemiologicaly unrelated clinical isolates of Streptococcus suis capsular type 2 were determined in relation to ampicillin, ampicillin-sulbactam, amoxicillin, clavulanate-amoxicillin, penicillin G, cephalexin, gentamicin, streptomycin, erythromycin, tylosin and doxycycline, using the microtitre broth dilution procedure described by the U.S. National Committee for Clinical Laboratory Standards (NCCLS). Gentamicin was the most active compound tested, with an MIC for 90% of the strains tested (MIC(90)) of 0.4 mg/L. Overall, 70% of strains were resistant to doxycycline (MIC(90) > or = 100.0 mg/L), followed by penicillin G (51% of strains) (MIC(90) + or = 100.0 mg/L). Resistance to amoxicillin and ampicillin was 36.4% (MIC(90) 12.5 mg/L) and 33.3% (MIC(90) 50.0 mg/L), respectively. 15.2% of S. suis strains were resistant to streptomycin, tylosin and cephalexin with MIC90 values of 25.0 mg/L, 12.5 mg/L and 25.0 mg/L, respectively. A combination of ampicillin and sulbactam (MIC(90) 6.3 mg/L) and a combination of amoxicillin and clavulanate (MIC(90) 3.1 mg/L) as well as erythromycin (1.6 mg/L) were of the same efficacy, with a total of 9.1% resistant S. suis strains. This high percentage of resistance to doxycycline and penicillin G precludes the use of these antibiotics as empiric therapy of swine diseases.

Gastric full-thickness suturing during EMR and for treatment of gastric-wall defects (with video).

PubMed

von Renteln, Daniel; Schmidt, Arthur; Riecken, Bettina; Caca, Karel

2008-04-01

The endoscopic full-thickness Plicator device was initially developed to provide an endoscopic treatment option for patients with GERD. Because the endoscopic full-thickness Plicator enables rapid and easy placement of transmural sutures, comparable with surgical sutures, we used the Plicator device for endoscopic treatment or prevention of GI-wall defects. To describe the outcomes and complications of endoscopic full-thickness suturing during EMR and for the treatment of gastric-wall defects. A report of 4 cases treated with the endoscopic full-thickness suturing between June 2006 and April 2007. A large tertiary-referral center. Four subjects received endoscopic full-thickness suturing. The subjects were women, with a mean age of 67 years. Of the 4 subjects, 3 received endoscopic full-thickness suturing during or after an EMR. One subject received endoscopic full-thickness suturing for treatment of a fistula. Primary outcome measurements were clinical procedural success and procedure-related adverse events. The mean time for endoscopic full-thickness suturing was 15 minutes. In all cases, GI-wall patency was restored or ensured, and no procedure-related complications occurred. All subjects responded well to endoscopic full-thickness suturing. The resection of one GI stromal tumor was incomplete. Because of the Plicator's 60F distal-end diameter, endoscopic full-thickness suturing could only be performed with the patient under midazolam and propofol sedation. The durable Plicator suture might compromise the endoscopic follow-up after EMR. The endoscopic full-thickness Plicator permits rapid and easy placement of transmural sutures and seems to be a safe and effective alternative to surgical intervention to restore GI-wall defects or to ensure GI-wall patency during EMR procedures.

Staphylococcus aureus capsular polysaccharide types 5 and 8 reduce killing by bovine neutrophils in vitro.

PubMed

Kampen, Annette H; Tollersrud, Tore; Lund, Arve

2005-03-01

Isogenic variants of Staphylococcus aureus strain Reynolds expressing either no capsule or capsular polysaccharide (CP) type 5 (CP5) or type 8 (CP8) were used to assess the effect of CP on bacterial killing and the respiratory burst of bovine neutrophils. The effects of antisera specific for CP5 and CP8 were also evaluated. The killing of live bacteria by isolated neutrophils was quantified in a bactericidal assay, while the respiratory burst after stimulation with live bacteria in whole blood was measured by flow cytometry. The expression of a CP5 or CP8 capsule protected the bacteria from being killed by bovine neutrophils in vitro (P <0.001), and the capsule-expressing variants did not stimulate respiratory burst activity in calf whole blood. The addition of serotype-specific antisera increased the killing of the capsule-expressing bacteria and enhanced their stimulating effect in the respiratory burst assay (P <0.01). When the S. aureus variants were grown under conditions known not to promote capsule expression, there were no significant differences between them. The present study demonstrates that the expression of S. aureus CP5 or CP8 confers resistance to opsonophagocytic killing and prevents the bacteria from inducing respiratory burst of bovine neutrophils in vitro and that these effects can be reversed by the addition of serotype-specific antisera.

MP Joint Arthritis

MedlinePlus

... is extensive and severe, joint replacement or joint fusion are effective surgical options. Learn more about joint ... the tabs at the top (Video, Articles/WEB, Images, JHS, Products/Vendors), or the filters on the ...

Clinical and experimental study of TMJ distraction: preliminary results.

PubMed

Festa, F; Galluccio, G

1998-01-01

A physiotherapeutic approach, with manual maneuvers and/or distraction appliances, is indicated in the treatment of temporomandibular joint disorders (TMDs) to prevent the progressive fibrosis of the muscle fibers. In this article, the authors report preliminary results of experimental and clinical studies conducted to assess the real effect of distraction in temporomandibular joint disorders. The experimental invivo studies confirmed the structural alteration due to compression and distraction on the capsular and condylar tissues. Clinical cases are reported to show the increase of the intraarticular vertical dimension, with a forward and downward movement of the condyles in a more physiologic condition.

Joint sealant study

DOT National Transportation Integrated Search

1987-09-01

ADOT has approximately 550 lane miles of jointed portland cement pavement under its jurisdiction. The current practice is to saw and seal the joints at the time of construction and reseal the joints under a rehabilitation project. ADOT does not speci...

Antigenic determinants of Staphylococcus aureus type 5 and type 8 capsular polysaccharide vaccines.

PubMed

Fattom, A I; Sarwar, J; Basham, L; Ennifar, S; Naso, R

1998-10-01

Bacterial capsular polysaccharides (CP) are carbohydrate polymers comprised of repeating saccharide units. Several of these CP have side chains attached to their backbone structures. The side chains may include O-acetyl, phosphate, sialic acid, and other moieties. Those moieties represent the immunodominant epitopes and the most functional ones. The clinically significant Staphylococcus aureus type 5 CP (CP 5) and type 8 CP (CP 8) are comprised of a trisaccharide repeat unit with one O-acetyl group attached to each repeat unit. The immunogenicity of these CP and the functionality of antibodies to the backbone and the O-acetyl moieties were investigated. Immunization with the native CP conjugates (CP with 75% O-acetylation) elicited a high proportion of antibodies directed against the O-acetyl moiety. Nonetheless, all of the vaccinees produced antibodies to the backbone moieties as well. Conjugate vaccines made of de-O-acetylated CP elicited backbone antibodies only. Antibodies to both backbone and O-acetyl groups were found to be opsonic against S. aureus strains which varied in their O-acetyl content. Absorption studies with O-acetylated and de-O-acetylated CP showed that (i) native CP conjugates generated antibodies to both backbone and O-acetyl groups and (ii) O-acetylated isolates were opsonized by both populations of antibodies while the non-O-acetylated strains were predominantly opsonized by the backbone antibodies. These results suggest that S. aureus CP conjugate vaccines elicit multiple populations of antibodies with diverse specificities. Moreover, the antibodies of different specificities (backbone or O-acetyl) are all functional and efficient against the variations in bacterial CP that may occur among clinically significant S. aureus pathogenic isolates.

Protection against Streptococcus suis Serotype 2 Infection Using a Capsular Polysaccharide Glycoconjugate Vaccine

PubMed Central

Calzas, Cynthia; Shiao, Tze Chieh; Neubauer, Axel; Kempker, Jennifer; Roy, René; Gottschalk, Marcelo

2016-01-01

Streptococcus suis serotype 2 is an encapsulated bacterium and one of the most important bacterial pathogens in the porcine industry. Despite decades of research for an efficient vaccine, none is currently available. Based on the success achieved with other encapsulated pathogens, a glycoconjugate vaccine strategy was selected to elicit opsonizing anti-capsular polysaccharide (anti-CPS) IgG antibodies. In this work, glycoconjugate prototypes were prepared by coupling S. suis type 2 CPS to tetanus toxoid, and the immunological features of the postconjugation preparations were evaluated in vivo. In mice, experiments evaluating three different adjuvants showed that CpG oligodeoxyribonucleotide (ODN) induces very low levels of anti-CPS IgM antibodies, while the emulsifying adjuvants Stimune and TiterMax Gold both induced high levels of IgGs and IgM. Dose-response trials comparing free CPS with the conjugate vaccine showed that free CPS is nonimmunogenic independently of the dose used, while 25 μg of the conjugate preparation was optimal in inducing high levels of anti-CPS IgGs postboost. With an opsonophagocytosis assay using murine whole blood, sera from immunized mice showed functional activity. Finally, the conjugate vaccine showed immunogenicity and induced protection in a swine challenge model. When conjugated and administered with emulsifying adjuvants, S. suis type 2 CPS is able to induce potent IgM and isotype-switched IgGs in mice and pigs, yielding functional activity in vitro and protection against a lethal challenge in vivo, all features of a T cell-dependent response. This study represents a proof of concept for the potential of glycoconjugate vaccines in veterinary medicine applications against invasive bacterial infections. PMID:27113360

Joint swelling

MedlinePlus

... of arthritis caused by buildup of uric acid crystals in a joint ( gout ) Arthritis caused by wear ... osteoarthritis ) Arthritis caused by buildup of calcium-type crystals in joints ( pseudogout ) Disorder that involves arthritis and ...

The joint flanker effect and the joint Simon effect: On the comparability of processes underlying joint compatibility effects.

PubMed

Dittrich, Kerstin; Bossert, Marie-Luise; Rothe-Wulf, Annelie; Klauer, Karl Christoph

2017-09-01

Previous studies observed compatibility effects in different interference paradigms such as the Simon and flanker task even when the task was distributed across two co-actors. In both Simon and flanker tasks, performance is improved in compatible trials relative to incompatible trials if one actor works on the task alone as well as if two co-actors share the task. These findings have been taken to indicate that actors automatically co-represent their co-actor's task. However, recent research on the joint Simon and joint flanker effect suggests alternative non-social interpretations. To which degree both joint effects are driven by the same underlying processes is the question of the present study, and it was scrutinized by manipulating the visibility of the co-actor. While the joint Simon effect was not affected by the visibility of the co-actor, the joint flanker effect was reduced when participants did not see their co-actors but knew where the co-actors were seated. These findings provide further evidence for a spatial interpretation of the joint Simon effect. In contrast to recent claims, however, we propose a new explanation of the joint flanker effect that attributes the effect to an impairment in the focusing of spatial attention contingent on the visibility of the co-actor.

A Modelling Method of Bolt Joints Based on Basic Characteristic Parameters of Joint Surfaces

NASA Astrophysics Data System (ADS)

Yuansheng, Li; Guangpeng, Zhang; Zhen, Zhang; Ping, Wang

2018-02-01

Bolt joints are common in machine tools and have a direct impact on the overall performance of the tools. Therefore, the understanding of bolt joint characteristics is essential for improving machine design and assembly. Firstly, According to the experimental data obtained from the experiment, the stiffness curve formula was fitted. Secondly, a finite element model of unit bolt joints such as bolt flange joints, bolt head joints, and thread joints was constructed, and lastly the stiffness parameters of joint surfaces were implemented in the model by the secondary development of ABAQUS. The finite element model of the bolt joint established by this method can simulate the contact state very well.

Presence of B. thailandensis and B. thailandensis expressing B. pseudomallei-like capsular polysaccharide in Thailand, and their associations with serological response to B. pseudomallei.

PubMed

Hantrakun, Viriya; Thaipadungpanit, Janjira; Rongkard, Patpong; Srilohasin, Prapaporn; Amornchai, Premjit; Langla, Sayan; Mukaka, Mavuto; Chantratita, Narisara; Wuthiekanun, Vanaporn; Dance, David A B; Day, Nicholas P J; Peacock, Sharon J; Limmathurotsakul, Direk

2018-01-01

Burkholderia pseudomallei is an environmental Gram-negative bacillus and the cause of melioidosis. B. thailandensis, some strains of which express a B. pseudomallei-like capsular polysaccharide (BTCV), is also commonly found in the environment in Southeast Asia but is considered non-pathogenic. The aim of the study was to determine the distribution of B. thailandensis and its capsular variant in Thailand and investigate whether its presence is associated with a serological response to B. pseudomallei. We evaluated the presence of B. pseudomallei and B. thailandensis in 61 rice fields in Northeast (n = 21), East (n = 19) and Central (n = 21) Thailand. We found BTCV in rice fields in East and Central but not Northeast Thailand. Fourteen fields were culture positive for B. pseudomallei alone, 8 for B. thailandensis alone, 11 for both B. pseudomallei and B. thailandensis, 6 for both B. thailandensis and BTCV, and 5 for B. pseudomallei, B. thailandensis and BTCV. Serological testing using the indirect hemagglutination assay (IHA) of 96 farmers who worked in the study fields demonstrated that farmers who worked in B. pseudomallei-positive fields had higher IHA titers than those who worked in B. pseudomallei-negative fields (median 1:40 [range: <1:10-1:640] vs. <1:10 [range: <1:10-1:320], p = 0.002). In a multivariable ordered logistic regression model, IHA titers were significantly associated with the presence of B. pseudomallei (aOR = 3.7; 95% CI 1.8-7.8, p = 0.001) but were not associated with presence of B. thailandensis (p = 0.32) or BTCV (p = 0.32). One sequence type (696) was identified for the 27 BTCV isolates tested. This is the first report of BTCV in Thailand. The presence of B. pseudomallei and B. thailandensis in the same field was not uncommon. Our findings suggest that IHA positivity of healthy rice farmers in Thailand is associated with the presence of B. pseudomallei in rice fields rather than B. thailandensis or BTCV.

Mutual coordination strengthens the sense of joint agency in cooperative joint action.

PubMed

Bolt, Nicole K; Poncelet, Evan M; Schultz, Benjamin G; Loehr, Janeen D

2016-11-01

Philosophers have proposed that when people coordinate their actions with others they may experience a sense of joint agency, or shared control over actions and their effects. However, little empirical work has investigated the sense of joint agency. In the current study, pairs coordinated their actions to produce tone sequences and then rated their sense of joint agency on a scale ranging from shared to independent control. People felt more shared than independent control overall, confirming that people experience joint agency during joint action. Furthermore, people felt stronger joint agency when they (a) produced sequences that required mutual coordination compared to sequences in which only one partner had to coordinate with the other, (b) held the role of follower compared to leader, and (c) were better coordinated with their partner. Thus, the strength of joint agency is influenced by the degree to which people mutually coordinate with each other's actions. Copyright © 2016 Elsevier Inc. All rights reserved.

Joint Chiefs of Staff > Leadership

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Signaling networks in joint development

PubMed Central

Salva, Joanna E.; Merrill, Amy E.

2016-01-01

Here we review studies identifying regulatory networks responsible for synovial, cartilaginous, and fibrous joint development. Synovial joints, characterized by the fluid-filled synovial space between the bones, are found in high-mobility regions and are the most common type of joint. Cartilaginous joints unite adjacent bones through either a hyaline cartilage or fibrocartilage intermediate. Fibrous joints, which include the cranial sutures, form a direct union between bones through fibrous connective tissue. We describe how the distinct morphologic and histogenic characteristics of these joint classes are established during embryonic development. Collectively, these studies reveal that despite the heterogeneity of joint strength and mobility, joint development throughout the skeleton utilizes common signaling networks via long-range morphogen gradients and direct cell-cell contact. This suggests that different joint types represent specialized variants of homologous developmental modules. Identifying the unifying aspects of the signaling networks between joint classes allows a more complete understanding of the signaling code for joint formation, which is critical to improving strategies for joint regeneration and repair. PMID:27859991

EDTA Inhibits Biofilm Formation, Extracellular Vesicular Secretion, and Shedding of the Capsular Polysaccharide Glucuronoxylomannan by Cryptococcus neoformans

PubMed Central

Robertson, Emma J.; Wolf, Julie M.

2012-01-01

The fungal pathogen Cryptococcus neoformans can grow as a biofilm on a range of synthetic and prosthetic materials. Cryptococcal biofilm formation can complicate the placement of shunts used to relieve increased intracranial pressure in cryptococcal meningitis and can serve as a nidus for chronic infection. Biofilms are generally advantageous to pathogens in vivo, as they can confer resistance to antimicrobial compounds, including fluconazole and voriconazole in the case of C. neoformans. EDTA can inhibit biofilm formation by several microbes and enhances the susceptibility of biofilms to antifungal drugs. In this study, we evaluated the effect of sublethal concentrations of EDTA on the growth of cryptococcal biofilms. EDTA inhibited biofilm growth by C. neoformans, and the inhibition could be reversed by the addition of magnesium or calcium, implying that the inhibitory effect was by divalent cation starvation. EDTA also reduced the amount of the capsular polysaccharide glucuronoxylomannan shed into the biofilm matrix and decreased vesicular secretion from the cell, thus providing a potential mechanism for the inhibitory effect of this cation-chelating compound. Our data imply that the growth of C. neoformans biofilms requires the presence of divalent metals in the growth medium and suggest that cations are required for the export of materials needed for biofilm formation, possibly including extracellular vesicles. PMID:22941091

Influence of head size on the development of metallic wear and on the characteristics of carbon layers in metal-on-metal hip joints

PubMed Central

Sprecher, Christoph M; Wimmer, Markus A; Milz, Stefan; Taeger, Georg

2009-01-01

Background and purpose Particles originating from the articulating surfaces of hip endoprostheses often induce an inflammatory response, which can be related to implant failure. We therefore analyzed the metal content in capsular tissue from 44 McKee-Farrar metal-on-metal hip prostheses (with 3 different head sizes) and we also analyzed the morphological structure of layers located on articulating surfaces. Methods Atomic absorption spectrometry (AAS) was used to analyze the metal content in capsular tissue. Visually detectable carbon layers located on the articulating surfaces were evaluated using scanning electron microscopy (SEM), energy-dispersive Xray spectroscopy (EDX), and X-ray photoelectron spectroscopy (XPS). Results Metallic debris was detected in all capsular tissue samples but no statistically significant differences in metal content were found in relation to implant head size. The morphological characteristics of the different layer zones allowed an exact analysis of contact and non-contact areas. Furthermore, surface layers appear to have a protective function because they can prevent sharp-edged particles from damaging the prostheses surface. Interpretation The implant head size does not appear to influence the amount of metallic debris. The layers obviously act like a lubricating agent because the protection function does not occur in regions without layers where the metal surface often shows numerous scratches. As layers are not generated immediately after the implantation of hip prostheses, these findings may at least partially explain the high amount of wear early after implantation. PMID:19421914

Streptococcus suis capsular polysaccharide inhibits phagocytosis through destabilization of lipid microdomains and prevents lactosylceramide-dependent recognition.

PubMed

Houde, Mathieu; Gottschalk, Marcelo; Gagnon, Fleur; Van Calsteren, Marie-Rose; Segura, Mariela

2012-02-01

Streptococcus suis type 2 is a major swine pathogen and a zoonotic agent, causing meningitis in both swine and humans. S. suis infects the host through the respiratory route, reaches the bloodstream, and persists until breaching into the central nervous system. The capsular polysaccharide (CPS) of S. suis type 2 is considered a key virulence factor of the bacteria. Though CPS allows S. suis to adhere to the membrane of cells of the immune system, it provides protection against phagocytosis. In fact, nonencapsulated mutants are easily internalized and killed by macrophages and dendritic cells. The objective of this work was to study the molecular mechanisms by which the CPS of S. suis prevents phagocytosis. By using latex beads covalently linked with purified CPS, it was shown that CPS itself was sufficient to inhibit entry of both latex beads and bystander fluorescent beads into macrophages. Upon contact with macrophages, encapsulated S. suis was shown to destabilize lipid microdomains at the cell surface, to block nitric oxide (NO) production during infection, and to prevent lactosylceramide accumulation at the phagocytic cup during infection. In contrast, the nonencapsulated mutant was easily internalized via lipid rafts, in a filipin-sensitive manner, leading to lactosylceramide recruitment and strong NO production. This is the first report to identify a role for CPS in lipid microdomain stability and to recognize an interaction between S. suis and lactosylceramide in phagocytes.

Fine Specificity and Cross-Reactions of Monoclonal Antibodies to Group B Streptococcal Capsular Polysaccharide Type III

PubMed Central

Pincus, Seth H.; Moran, Emily; Maresh, Grace; Jennings, Harold J.; Pritchard, David G.; Egan, Marianne L.; Blixt, Ola

2012-01-01

Group B streptococcus (GBS) is a major cause of neonatal sepsis and meningitis. Despite aggressive campaigns using antenatal prophylactic antibiotic therapy, infections continue. Developing an effective maternal vaccine is a public health priority. Antibody (Ab) to the capsular polysaccharide (CPS) is considered the dominant “protective” immune mediator. Here we study the fine specificity and potential host reactivity of a panel of well-characterized murine monoclonal Abs against the type III CPS by examining the binding of the Abs to intact and neuraminidase-digested GBS, purified CPS, synthetic carbohydrate structures, and cells. The results showed marked differences in the fine specificity among these mAbs to a single carbohydrate structure. Cross-reactions with synthetic GD3 and GT3 carbohydrates, representing structures found on surfaces of neural and developing cells, were demonstrated using carbohydrate array technology. The anti-CPSIII mAbs did not react with cells expressing GD3 and GT3, nor did mAbs specific for the host carbohydrates cross-react with GBS, raising questions about the physiological relevance of this cross-reaction. But in the process of these investigations, we serendipitously demonstrated cross-reactions of some anti-CPSIII mAbs with antigens, likely carbohydrates, found on human leukocytes. These studies suggest caution in the development of a maternal vaccine to prevent infection by this important human pathogen. PMID:22634296

Fine specificity and cross-reactions of monoclonal antibodies to group B streptococcal capsular polysaccharide type III.

PubMed

Pincus, Seth H; Moran, Emily; Maresh, Grace; Jennings, Harold J; Pritchard, David G; Egan, Marianne L; Blixt, Ola

2012-07-06

Group B streptococcus (GBS) is a major cause of neonatal sepsis and meningitis. Despite aggressive campaigns using antenatal prophylactic antibiotic therapy, infections continue. Developing an effective maternal vaccine is a public health priority. Antibody (Ab) to the capsular polysaccharide (CPS) is considered the dominant "protective" immune mediator. Here we study the fine specificity and potential host reactivity of a panel of well-characterized murine monoclonal Abs against the type III CPS by examining the binding of the Abs to intact and neuraminidase-digested GBS, purified CPS, synthetic carbohydrate structures, and cells. The results showed marked differences in the fine specificity among these mAbs to a single carbohydrate structure. Cross-reactions with synthetic GD3 and GT3 carbohydrates, representing structures found on surfaces of neural and developing cells, were demonstrated using carbohydrate array technology. The anti-CPS(III) mAbs did not react with cells expressing GD3 and GT3, nor did mAbs specific for the host carbohydrates cross-react with GBS, raising questions about the physiological relevance of this cross-reaction. But in the process of these investigations, we serendipitously demonstrated cross-reactions of some anti-CPS(III) mAbs with antigens, likely carbohydrates, found on human leukocytes. These studies suggest caution in the development of a maternal vaccine to prevent infection by this important human pathogen. Copyright © 2012 Elsevier Ltd. All rights reserved.

Novel joint cupping clinical maneuver for ultrasonographic detection of knee joint effusions.

PubMed

Uryasev, Oleg; Joseph, Oliver C; McNamara, John P; Dallas, Apostolos P

2013-11-01

Knee effusions occur due to traumatic and atraumatic causes. Clinical diagnosis currently relies on several provocative techniques to demonstrate knee joint effusions. Portable bedside ultrasonography (US) is becoming an adjunct to diagnosis of effusions. We hypothesized that a US approach with a clinical joint cupping maneuver increases sensitivity in identifying effusions as compared to US alone. Using unembalmed cadaver knees, we injected fluid to create effusions up to 10 mL. Each effusion volume was measured in a lateral transverse location with respect to the patella. For each effusion we applied a joint cupping maneuver from an inferior approach, and re-measured the effusion. With increased volume of saline infusion, the mean depth of effusion on ultrasound imaging increased as well. Using a 2-mm cutoff, we visualized an effusion without the joint cupping maneuver at 2.5 mL and with the joint cupping technique at 1 mL. Mean effusion diameter increased on average 0.26 cm for the joint cupping maneuver as compared to without the maneuver. The effusion depth was statistically different at 2.5 and 7.5 mL (P < .05). Utilizing a joint cupping technique in combination with US is a valuable tool in assessing knee effusions, especially those of subclinical levels. Effusion measurements are complicated by uneven distribution of effusion fluid. A clinical joint cupping maneuver concentrates the fluid in one recess of the joint, increasing the likelihood of fluid detection using US. © 2013 Elsevier Inc. All rights reserved.

Shear fracture of jointed steel plates of bolted joints under impact load

NASA Astrophysics Data System (ADS)

Daimaruya, M.; Fujiki, H.; Ambarita, H.; Kobayashi, H.; Shin, H.-S.

2013-07-01

The present study is concerned with the development of a fracture criterion for the impact fracture of jointed steel plates of bolted joints used in a car body, which contributes to crash simulations by CAE. We focus our attention on the shear fracture of the jointed steel plates of lap-bolted joints in the suspension of a car under impact load. Members of lap-bolted joints are modelled as a pair of steel plates connected by a bolt. One of the plates is a specimen subjected to plastic deformation and fracture and the other is a jig subjected to elastic deformation only. Three kinds of steel plate specimens are examined, i.e., a common steel plate with a tensile strength of 270 MPa and high tensile strength steel plates of 440 and 590 MPa used for cars. The impact shear test was performed using the split Hopkinson bar technique for tension impact, together with the static test using a universal testing machine INSTRON 5586. The behaviour of the shear stress and deformation up to rupture taking place in the joint was discussed. The obtained results suggest that a stress-based fracture criterion may be developed for the impact fracture of jointed steel plates of a lap-bolted joint.

Early, asymptomatic stage of degenerative joint disease in canine hip joints.

PubMed

Lust, G; Summers, B A

1981-11-01

The early stages of degenerative joint disease were investigated in coxofemoral joints from dogs with a hereditary predisposition to hip dysplasia. Alterations observed included mild nonsuppurative synovitis, increased volume of both synovial fluid and the ligamentum teres, and focal degenerative articular cartilage lesions. On radiologic examination, subluxation of the femoral head was seen, but only in the most severely affected joints. Synovial inflammation with increased synovial fluid and ligament volumes were indicators of early degenerative joint disease in dogs. These changes seemed to coincide with, or perhaps to precede, microscopic evidence for articular cartilage degeneration and occurred before radiologic abnormalities were detected.

Joint Contact Stress

PubMed Central

Brand, Richard A

2005-01-01

A joint's normal mechanical history contributes to the maintenance of articular cartilage and underlying bone. Loading facilitates the flow of nutrients into cartilage and waste products away, and additionally provides the mechanical signals essential for normal cell and tissue maintenance. Deleteriously low or high contact stresses have been presumed to result in joint deterioration, and particular aspects of the mechanical environment may facilitate repair of damaged cartilage. For decades, investigators have explored static joint contact stresses (under some more or less arbitrary condition) as a surrogate of the relevant mechanical history. Contact stresses have been estimated in vitro in many joints and in a number of species, although only rarely in vivo. Despite a number of widely varying techniques (and spatial resolutions) to measure these contact stresses, reported ranges of static peak normal stresses are relatively similar from joint to joint across species, and in the range of 0.5 to 5.0 MPa. This suggests vertebrate diarthrodial joints have evolved to achieve similar mechanical design criteria. Available evidence also suggests some disorders of cartilage deterioration are associated with somewhat higher peak pressures ranging from 1-20 MPa, but overlapping the range of normal pressures. Some evidence and considerable logic suggests static contact stresses per se do not predict cartilage responses, but rather temporal aspects of the contact stress history. Static contact stresses may therefore not be a reasonable surrogate for biomechanical studies. Rather, temporal and spatial aspects of the loading history undoubtedly induce beneficial and deleterious biological responses. Finally, since all articular cartilage experiences similar stresses, the concept of a "weight-bearing" versus a "non-weight-bearing" joint seems flawed, and should be abandoned. PMID:16089079

Memory without context: amnesia with confabulations after infarction of the right capsular genu.

PubMed Central

Schnider, A; Gutbrod, K; Hess, C W; Schroth, G

1996-01-01

OBJECTIVE--To explore the mechanism of an amnesia marked by confabulations and lack of insight in a patient with an infarct of the right inferior capsular genu. The confabulations could mostly be traced back to earlier events, indicating that the memory disorder ensued from an inability to store the temporal and spatial context of information acquisition rather than a failure to store new information. METHODS--To test the patient's ability to store the context of information acquisition, two experiments were composed in which she was asked to decide when or where she had learned the words from two word lists presented at different points in time or in different rooms. To test her ability to store new information, two continuous recognition tests with novel non-words and nonsense designs were used. Recognition of these stimuli was assumed to be independent of the context of acquisition because the patient could not have an a priori sense of familiarity with them. RESULTS--The patient performed at chance in the experiments probing knowledge of the context of information acquisition, although she recognised the presented words almost as well as the controls. By contrast, her performance was normal in the recognition tests with non-words and nonsense designs. CONCLUSION--These findings indicate that the patient's amnesia was based on an inability to store the context of information acquisition rather than the information itself. Based on an analysis of her lesion, which disconnected the thalamus from the orbitofrontal cortex and the amygdala, and considering the similarities between her disorder, Wernicke-Korsakoff syndrome, and the amnesia after orbitofrontal lesions, it is proposed that contextual amnesia results from interruption of the loop connecting the amygdala, the dorsomedial nucleus, and the orbitofrontal cortex. Images PMID:8708688

Modeling Progressive Failure of Bonded Joints Using a Single Joint Finite Element

NASA Technical Reports Server (NTRS)

Stapleton, Scott E.; Waas, Anthony M.; Bednarcyk, Brett A.

2010-01-01

Enhanced finite elements are elements with an embedded analytical solution which can capture detailed local fields, enabling more efficient, mesh-independent finite element analysis. In the present study, an enhanced finite element is applied to generate a general framework capable of modeling an array of joint types. The joint field equations are derived using the principle of minimum potential energy, and the resulting solutions for the displacement fields are used to generate shape functions and a stiffness matrix for a single joint finite element. This single finite element thus captures the detailed stress and strain fields within the bonded joint, but it can function within a broader structural finite element model. The costs associated with a fine mesh of the joint can thus be avoided while still obtaining a detailed solution for the joint. Additionally, the capability to model non-linear adhesive constitutive behavior has been included within the method, and progressive failure of the adhesive can be modeled by using a strain-based failure criteria and re-sizing the joint as the adhesive fails. Results of the model compare favorably with experimental and finite element results.

Modeling of Human Joint Structures.

DTIC Science & Technology

1982-09-01

Acromioclavicular Joint .... ............. ... 20 Glenohumeral Joint .... ................ . 20 HIP JOINT .................. ...... 21 Iliofemoral Ligament...clavicle articulates with the manubrium of the sternum, and the acromioclavicular joint, where the clavicle articulates with the acromion process of the...the interclavicular ligament. Acromioclavicular Joint This articulation between the distal end of the clavicle and the acromion of the scapula is

Joint Chiefs of Staff > Media

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Senior Enlisted Advisor Joint Staff History Joint Staff Inspector General Joint Staff Structure Origin of J8 | Force Structure, Resources & Assessment Contact Joint Staff Media News Videos Chairman's

Experimental joint immobilization in guinea pigs. Effects on the knee joint

NASA Technical Reports Server (NTRS)

Marcondesdesouza, J. P.; Machado, F. F.; Sesso, A.; Valeri, V.

1980-01-01

In young and adult guinea pigs, the aftermath experimentally induced by the immobilization of the knee joint in hyperextended forced position was studied. Joint immobilization which varied from one to nine weeks was attained by plaster. Eighty knee joints were examined macro and microscopically. Findings included: (1) muscular hypotrophy and joint stiffness in all animals, directly proportional to the length of immobilization; (2) haemoarthrosis in the first week; (3) intra-articular fibrous tissue proliferation ending up with fibrous ankylosis; (4) hyaline articular cartilage erosions; (5) various degrees of destructive menisci changes. A tentative explanation of the fibrous tissue proliferation and of the cartilage changes is offered.

An analysis of technical aspects of the arthroscopic Bankart procedure as performed in the United States.

PubMed

Burks, Robert T; Presson, Angela P; Weng, Hsin-Yi

2014-10-01

variation in performance of the arthroscopic Bankart repair in the United States. Areas of concern include completeness of the diagnostic examination, the adequacy of capsulolabral mobilization, variation in the use of accessory portals, and inconsistent use of additional capsular or labral plication or fixation. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

A Review of Natural Joint Systems and Numerical Investigation of Bio-Inspired GFRP-to-Steel Joints

PubMed Central

Avgoulas, Evangelos I.; Sutcliffe, Michael P. F.

2016-01-01

There are a great variety of joint types used in nature which can inspire engineering joints. In order to design such biomimetic joints, it is at first important to understand how biological joints work. A comprehensive literature review, considering natural joints from a mechanical point of view, was undertaken. This was used to develop a taxonomy based on the different methods/functions that nature successfully uses to attach dissimilar tissues. One of the key methods that nature uses to join dissimilar materials is a transitional zone of stiffness at the insertion site. This method was used to propose bio-inspired solutions with a transitional zone of stiffness at the joint site for several glass fibre reinforced plastic (GFRP) to steel adhesively bonded joint configurations. The transition zone was used to reduce the material stiffness mismatch of the joint parts. A numerical finite element model was used to identify the optimum variation in material stiffness that minimises potential failure of the joint. The best bio-inspired joints showed a 118% increase of joint strength compared to the standard joints. PMID:28773688

A Review of Natural Joint Systems and Numerical Investigation of Bio-Inspired GFRP-to-Steel Joints.

PubMed

Avgoulas, Evangelos I; Sutcliffe, Michael P F

2016-07-12

There are a great variety of joint types used in nature which can inspire engineering joints. In order to design such biomimetic joints, it is at first important to understand how biological joints work. A comprehensive literature review, considering natural joints from a mechanical point of view, was undertaken. This was used to develop a taxonomy based on the different methods/functions that nature successfully uses to attach dissimilar tissues. One of the key methods that nature uses to join dissimilar materials is a transitional zone of stiffness at the insertion site. This method was used to propose bio-inspired solutions with a transitional zone of stiffness at the joint site for several glass fibre reinforced plastic (GFRP) to steel adhesively bonded joint configurations. The transition zone was used to reduce the material stiffness mismatch of the joint parts. A numerical finite element model was used to identify the optimum variation in material stiffness that minimises potential failure of the joint. The best bio-inspired joints showed a 118% increase of joint strength compared to the standard joints.

Effect of Strain Rate on Joint Strength and Failure Mode of Lead-Free Solder Joints

NASA Astrophysics Data System (ADS)

Lin, Jian; Lei, Yongping; Fu, Hanguang; Guo, Fu

2018-03-01

In surface mount technology, the Sn-3.0Ag-0.5Cu solder joint has a shorter impact lifetime than a traditional lead-tin solder joint. In order to improve the impact property of SnAgCu lead-free solder joints and identify the effect of silver content on tensile strength and impact property, impact experiments were conducted at various strain rates on three selected SnAgCu based solder joints. It was found that joint failure mainly occurred in the solder material with large plastic deformation under low strain rate, while joint failure occurred at the brittle intermetallic compound layer without any plastic deformation at a high strain rate. Joint strength increased with the silver content in SnAgCu alloys in static tensile tests, while the impact property of the solder joint decreased with increasing silver content. When the strain rate was low, plastic deformation occurred with failure and the tensile strength of the Sn-3.0Ag-0.5Cu solder joint was higher than that of Sn-0.3Ag-0.7Cu; when the strain rate was high, joint failure mainly occurred at the brittle interface layer and the Sn-0.3Ag-0.7Cu solder joint had a better impact resistance with a thinner intermetallic compound layer.

The Joint Master Operational Planner

DTIC Science & Technology

2016-04-04

Daniel H. Hibner, United States Army Joint Forces Staff College Joint Advanced Warfighting School 7800 Hampton Blvd. Norfolk, VA 23511-1702 Approved...Operational Art. Unclass Unclass Unclass Unclassified Unlimited 66 757-443-6301 NATIONAL DEFENSE UNIVERSITY JOINT FORCES STAFF COLLEGE JOINT ADVANCED...of this paper reflect my own personal views and are not necessarily endorsed by the Joint Forces Staff College or the department of Defense. Thesis

Arthrographic and clinical findings in patients with hemiplegic shoulder pain.

PubMed

Lo, Sui-Foon; Chen, Shu-Ya; Lin, Hsiu-Chen; Jim, Yick-Fung; Meng, Nai-Hsin; Kao, Mu-Jung

2003-12-01

To identify the etiology of hemiplegic shoulder pain by arthrographic and clinical examinations and to determine the correlation between arthrographic measurements and clinical findings in patients with hemiplegic shoulder pain. Case series. Medical center of a 1582-bed teaching institution in Taiwan. Thirty-two consecutive patients with hemiplegic shoulder pain within a 1-year period after first stroke were recruited. Not applicable. Clinical examinations included Brunnstrom stage, muscle spasticity distribution, presence or absence of subluxation and shoulder-hand syndrome, and passive range of motion (PROM) of the shoulder joint. Arthrographic measurements included shoulder joint volume and capsular morphology. Most patients had onset of hemiplegic shoulder pain less than 2 months after stroke. Adhesive capsulitis was the main cause of shoulder pain, with 50% of patients having adhesive capsulitis, 44% having shoulder subluxation, 22% having rotator cuff tears, and 16% having shoulder-hand syndrome. Patients with adhesive capsulitis showed significant restriction of passive shoulder external rotation and abduction and a higher incidence of shoulder-hand syndrome (P=.017). Those with irregular capsular margins had significantly longer shoulder pain duration and more restricted passive shoulder flexion (P=.017) and abduction (P=.020). Patients with shoulder subluxation had significantly larger PROM (flexion, P=.007; external rotation, P<.001; abduction, P=.001; internal rotation, P=.027), lower muscle tone (P=.001), and lower Brunnstrom stages of the proximal upper extremity (P=.025) and of the distal upper extremity (P=.001). Muscle spasticity of the upper extremity was slightly negatively correlated with shoulder PROM. Shoulder joint volume was moderately positively correlated with shoulder PROM. After investigating the hemiplegic shoulder joint through clinical and arthrographic examinations, we found that the causes of hemiplegic shoulder pain are complicated

Neuroanatomical distribution of mechanoreceptors in the human cadaveric shoulder capsule and labrum

PubMed Central

Witherspoon, Jessica W; Smirnova, Irina V; McIff, Terence E

2014-01-01

The distribution, location, and spatial arrangement of mechanoreceptors are important for neural signal conciseness and accuracy in proprioceptive information required to maintain functional joint stability. The glenohumeral joint capsule and labrum are mechanoreceptor-containing tissues for which the distribution of mechanoreceptors has not been determined despite the importance of these tissues in stabilizing the shoulder. More recently, it has been shown that damage to articular mechanoreceptors can result in proprioceptive deficits that may lead to recurrent instability. Awareness of mechanoreceptor distribution in the glenohumeral joint capsule and labrum may allow preservation of the mechanoreceptors during surgical treatment for shoulder instability, and in turn retain the joint's proprioceptive integrity. For this reason, we sought to develop a neuroanatomical map of the mechanoreceptors within the capsule and labrum. We postulated that the mechanoreceptors in these tissues are distributed in a unique pattern, with mechanoreceptor-scarce regions that may be more appropriate for surgical dissection. We determined the neuroanatomical distribution of mechanoreceptors and their associated fascicles in the capsule and labrum from eight human cadaver shoulder pairs using our improved gold chloride staining technique and light microscopy. A distribution pattern was consistently observed in the capsule and labrum from which we derived a neuroanatomical map. Both tissues demonstrated mechanoreceptor-dense and -scarce regions that may be considered during surgical treatment for instability. Capsular fascicles were located in the subsynovial layer, whereas labral fascicles were concentrated in the peri-core zone. The capsular fascicles presented as a lattice network and with a plexiform appearance. Fascicles within the labrum resembled a cable structure with the fascicles running in parallel. Our findings contribute to the neuroanatomical knowledge of the two

Cellular Pressure-Actuated Joint

NASA Technical Reports Server (NTRS)

McGuire, John R.

2003-01-01

A modification of a pressure-actuated joint has been proposed to improve its pressure actuation in such a manner as to reduce the potential for leakage of the pressurizing fluid. The specific joint for which the modification is proposed is a field joint in a reusable solid-fuel rocket motor (RSRM), in which the pressurizing fluid is a mixture of hot combustion gases. The proposed modification could also be applicable to other pressure-actuated joints of similar configuration.

Mechanics of Suture Joints

NASA Astrophysics Data System (ADS)

Li, Yaning; Song, Juha; Ortiz, Christine; Boyce, Mary; Ortiz Group/DMSE/MIT Team; Boyce Group/ME/MIT Team

2011-03-01

Biological sutures are joints which connect two stiff skeletal or skeletal-like components. These joints possess a wavy geometry with a thin organic layer providing adhesion. Examples of biological sutures include mammalian skulls, the pelvic assembly of the armored fish Gasterosteus aculeatus (the three-spined stickleback), and the suture joints in the shell of the red-eared slider turtle. Biological sutures allow for movement and compliance, control stress concentrations, transmit loads, reduce fatigue stress and absorb energy. In this investigation, the mechanics of the role of suture geometry in providing a naturally optimized joint is explored. In particular, analytical and numerical micromechanical models of the suture joint are constructed. The anisotropic mechanical stiffness and strength are studied as a function of suture wavelength, amplitude and the material properties of the skeletal and organic components, revealing key insights into the optimized nature of these ubiquitous natural joints.

Generalised joint hypermobility and knee joint hypermobility: prevalence, knee joint symptoms and health-related quality of life in a Danish adult population.

PubMed

Junge, Tina; Henriksen, Peter; Hansen, Sebrina; Østengaard, Lasse; Golightly, Yvonne M; Juul-Kristensen, Birgit

2017-10-27

Several biomechanical factors, such as knee joint hypermobility (KJH), are suggested to play a role in the etiology of knee joint symptoms and knee osteoarthritis. Nevertheless, the prevalence or consequences of KJH solely or included in the classification of generalized joint hypermobility (GJHk) is unknown for a general population. Therefore, the objectives were to report the prevalence of self-reported GJHk and KJH, as well as the association of these conditions to knee joint symptoms, severity and duration of symptoms, and health-related quality of life (HRQoL) in a Danish adult population. This study is a cross-sectional population-based survey of 2056 Danish adults. Respondents received online questionnaires of GJHk and KJH, knee joint symptoms, the severity and duration of these, as well as HRQoL. Total response rate was 49% (n = 1006). The prevalence of self-reported GJHk and KJH was 13% and 23%, mostly representing women. More than half of the respondents with GJHk and KJH had knee joint symptoms. The odds for reporting knee joint symptoms, severity of knee joint symptoms and duration of knee joint symptoms were twice as high for respondents with GJHk and KJH. Respondents with GJHk and KJH reported lower HRQoL. GJHk and KJH were frequently reported in the Danish adult population, mostly in women. Respondents with GJHk and KJH were two times more likely to report knee joint-related symptoms such as pain, reduced performance of usual activity and lower HRQoL. The impact of these conditions on HRQoL is comparable with knee osteoarthritis. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

The Interface of Mechanics and Nociception in Joint Pathophysiology: Insights From the Facet and Temporomandibular Joints

PubMed Central

Sperry, Megan M.; Ita, Meagan E.; Kartha, Sonia; Zhang, Sijia; Yu, Ya-Hsin; Winkelstein, Beth

2017-01-01

Chronic joint pain is a widespread problem that frequently occurs with aging and trauma. Pain occurs most often in synovial joints, the body's load bearing joints. The mechanical and molecular mechanisms contributing to synovial joint pain are reviewed using two examples, the cervical spinal facet joints and the temporomandibular joint (TMJ). Although much work has focused on the macroscale mechanics of joints in health and disease, the combined influence of tissue mechanics, molecular processes, and nociception in joint pain has only recently become a focus. Trauma and repeated loading can induce structural and biochemical changes in joints, altering their microenvironment and modifying the biomechanics of their constitutive tissues, which themselves are innervated. Peripheral pain sensors can become activated in response to changes in the joint microenvironment and relay pain signals to the spinal cord and brain where pain is processed and perceived. In some cases, pain circuitry is permanently changed, which may be a potential mechanism for sustained joint pain. However, it is most likely that alterations in both the joint microenvironment and the central nervous system (CNS) contribute to chronic pain. As such, the challenge of treating joint pain and degeneration is temporally and spatially complicated. This review summarizes anatomy, physiology, and pathophysiology of these joints and the sensory pain relays. Pain pathways are postulated to be sensitized by many factors, including degeneration and biochemical priming, with effects on thresholds for mechanical injury and/or dysfunction. Initiators of joint pain are discussed in the context of clinical challenges including the diagnosis and treatment of pain. PMID:28056123

RGD Surface Functionalization of the Hydrophilic Acrylic Intraocular Lens Material to Control Posterior Capsular Opacification

PubMed Central

Huang, Yi-Shiang; Bertrand, Virginie; Bozukova, Dimitriya; Pagnoulle, Christophe; Labrugère, Christine; De Pauw, Edwin; De Pauw-Gillet, Marie-Claire; Durrieu, Marie-Christine

2014-01-01

Posterior Capsular Opacification (PCO) is the capsule fibrosis developed on implanted IntraOcular Lens (IOL) by the de-differentiation of Lens Epithelial Cells (LECs) undergoing Epithelial Mesenchymal Transition (EMT). Literature has shown that the incidence of PCO is multifactorial including the patient's age or disease, surgical technique, and IOL design and material. Reports comparing hydrophilic and hydrophobic acrylic IOLs have shown that the former has more severe PCO. On the other hand, we have previously demonstrated that the adhesion of LECs is favored on hydrophobic compared to hydrophilic materials. By combining these two facts and contemporary knowledge in PCO development via the EMT pathway, we propose a biomimetically inspired strategy to promote LEC adhesion without de-differentiation to reduce the risk of PCO development. By surface grafting of a cell adhesion molecule (RGD peptide) onto the conventional hydrophilic acrylic IOL material, the surface-functionalized IOL can be used to reconstitute a capsule-LEC-IOL sandwich structure, which has been considered to prevent PCO formation in literature. Our results show that the innovative biomaterial improves LEC adhesion, while also exhibiting similar optical (light transmittance, optical bench) and mechanical (haptic compression force, IOL injection force) properties compared to the starting material. In addition, compared to the hydrophobic IOL material, our bioactive biomaterial exhibits similar abilities in LEC adhesion, morphology maintenance, and EMT biomarker expression, which is the crucial pathway to induce PCO. The in vitro assays suggest that this biomaterial has the potential to reduce the risk factor of PCO development. PMID:25501012

RGD surface functionalization of the hydrophilic acrylic intraocular lens material to control posterior capsular opacification.

PubMed

Huang, Yi-Shiang; Bertrand, Virginie; Bozukova, Dimitriya; Pagnoulle, Christophe; Labrugère, Christine; De Pauw, Edwin; De Pauw-Gillet, Marie-Claire; Durrieu, Marie-Christine

2014-01-01

Posterior Capsular Opacification (PCO) is the capsule fibrosis developed on implanted IntraOcular Lens (IOL) by the de-differentiation of Lens Epithelial Cells (LECs) undergoing Epithelial Mesenchymal Transition (EMT). Literature has shown that the incidence of PCO is multifactorial including the patient's age or disease, surgical technique, and IOL design and material. Reports comparing hydrophilic and hydrophobic acrylic IOLs have shown that the former has more severe PCO. On the other hand, we have previously demonstrated that the adhesion of LECs is favored on hydrophobic compared to hydrophilic materials. By combining these two facts and contemporary knowledge in PCO development via the EMT pathway, we propose a biomimetically inspired strategy to promote LEC adhesion without de-differentiation to reduce the risk of PCO development. By surface grafting of a cell adhesion molecule (RGD peptide) onto the conventional hydrophilic acrylic IOL material, the surface-functionalized IOL can be used to reconstitute a capsule-LEC-IOL sandwich structure, which has been considered to prevent PCO formation in literature. Our results show that the innovative biomaterial improves LEC adhesion, while also exhibiting similar optical (light transmittance, optical bench) and mechanical (haptic compression force, IOL injection force) properties compared to the starting material. In addition, compared to the hydrophobic IOL material, our bioactive biomaterial exhibits similar abilities in LEC adhesion, morphology maintenance, and EMT biomarker expression, which is the crucial pathway to induce PCO. The in vitro assays suggest that this biomaterial has the potential to reduce the risk factor of PCO development.

Evaluation of the Immunomodulatory Properties of Streptococcus suis and Group B Streptococcus Capsular Polysaccharides on the Humoral Response

PubMed Central

Calzas, Cynthia; Taillardet, Morgan; Fourati, Insaf Salem; Roy, David; Gottschalk, Marcelo; Soudeyns, Hugo; Defrance, Thierry; Segura, Mariela

2017-01-01

Streptococcus suis and group B Streptococcus (GBS) are encapsulated streptococci causing septicemia and meningitis. Antibodies (Abs) against capsular polysaccharides (CPSs) have a crucial protective role, but the structure/composition of the CPS, including the presence of sialic acid, may interfere with the generation of anti-CPS Ab responses. We investigated the features of the CPS-specific Ab response directed against S. suis serotypes 2 and 14 and GBS serotypes III and V after infection or immunization with purified native or desialylated CPSs in mice. Whereas S. suis-infected mice developed a very low/undetectable CPS-specific IgM response, significant anti-CPS IgM titers were measured in GBS-infected animals (especially for type III GBS). No isotype switching was detected in S. suis- or GBS-infected mice. While the expression of sialic acid was essential for the immunogenicity of purified GBS type III CPS, this sugar was not responsible for the inability of purified S. suis types 2, 14 and GBS type V CPSs to induce a specific Ab response. Thus, other biochemical criteria unrelated to the presence of sialic acid may be responsible for the inaptitude of the host immune system to mount an effective response against certain S. suis and GBS CPS types. PMID:28425925

Strength Variation of Parachute Joints

NASA Technical Reports Server (NTRS)

Mollmann, Catherine

2017-01-01

A parachute joint is defined as a location where a component is sewn or connected to another component. During the design and developmental phase of a parachute system, the joints for each structural component are isolated and tested through a process called seam and joint testing. The objective of seam and joint testing is to determine the degradation on a single component due to interaction with other components; this data is then used when calculating the margin of safety for that component. During the engineering developmental phase of CPAS (Capsule Parachute Assembly System), the parachute system for the NASA Orion Crew Module, testing was completed for every joint of the six subsystems: the four parachutes (main, drogue, pilot, and FBCP [forward bay cover parachute]), the retention release bridle, and the retention panels. The number of joint tests for these subsystems totaled 92, which provides a plethora of data and results for further analysis. In this paper, the data and results of these seam and joint tests are examined to determine the effects, if any, of different operators and sewing machines on the strength of parachute joints. Other variables are also studied to determine their effect on joint strength, such as joint complexity, joint strength magnitude, material type, and material construction. Findings reveal that an optimally-run seam and joint test program could result in an increased understanding of the structure of the parachute; this should lead to a parachute built with optimal components, potentially saving system weight and volume.

Joint Enrollment Report, 2014

ERIC Educational Resources Information Center

Iowa Department of Education, 2014

2014-01-01

The Iowa Department of Education collects information on joint enrollment in Iowa's 15 community colleges. Jointly enrolled students are high school students enrolled in community college credit coursework. Most jointly enrolled students enroll through Senior Year Plus (SYP) programs such as Postsecondary Enrollment Options (PSEO) and concurrent…

Joint Enrollment Report, 2015

ERIC Educational Resources Information Center

Iowa Department of Education, 2015

2015-01-01

The Iowa Department of Education collects information on joint enrollment from Iowa's 15 community colleges. Jointly enrolled students are high school students enrolled in community college credit coursework. Most jointly enrolled students enroll through Senior Year Plus programs such as Postsecondary Enrollment Options (PSEO) and concurrent…

Streptococcus suis Capsular Polysaccharide Inhibits Phagocytosis through Destabilization of Lipid Microdomains and Prevents Lactosylceramide-Dependent Recognition

PubMed Central

Houde, Mathieu; Gottschalk, Marcelo; Gagnon, Fleur; Van Calsteren, Marie-Rose

2012-01-01

Streptococcus suis type 2 is a major swine pathogen and a zoonotic agent, causing meningitis in both swine and humans. S. suis infects the host through the respiratory route, reaches the bloodstream, and persists until breaching into the central nervous system. The capsular polysaccharide (CPS) of S. suis type 2 is considered a key virulence factor of the bacteria. Though CPS allows S. suis to adhere to the membrane of cells of the immune system, it provides protection against phagocytosis. In fact, nonencapsulated mutants are easily internalized and killed by macrophages and dendritic cells. The objective of this work was to study the molecular mechanisms by which the CPS of S. suis prevents phagocytosis. By using latex beads covalently linked with purified CPS, it was shown that CPS itself was sufficient to inhibit entry of both latex beads and bystander fluorescent beads into macrophages. Upon contact with macrophages, encapsulated S. suis was shown to destabilize lipid microdomains at the cell surface, to block nitric oxide (NO) production during infection, and to prevent lactosylceramide accumulation at the phagocytic cup during infection. In contrast, the nonencapsulated mutant was easily internalized via lipid rafts, in a filipin-sensitive manner, leading to lactosylceramide recruitment and strong NO production. This is the first report to identify a role for CPS in lipid microdomain stability and to recognize an interaction between S. suis and lactosylceramide in phagocytes. PMID:22124659

Migrating lumbar facet joint cysts.

PubMed

Palmieri, Francesco; Cassar-Pullicino, Victor N; Lalam, Radhesh K; Tins, Bernhard J; Tyrrell, Prudencia N M; McCall, Iain W

2006-04-01

The majority of lumbar facet joint cysts (LFJCs) are located in the spinal canal, on the medial aspect of the facet joint with characteristic diagnostic features. When they migrate away from the joint of origin, they cause diagnostic problems. In a 7-year period we examined by computed tomography (CT) and magnetic resonance (MR) imaging five unusual cases of facet joint cysts which migrated from the facet joint of origin. Three LFJCs were identified in the right S1 foramen, one in the right L5-S1 neural foramen and one in the left erector spinae and multifidus muscles between the levels of L2-L4 spinous process. Awareness that spinal lesions identified at MRI and CT could be due to migrating facet joint cyst requires a high level of suspicion. The identification of the appositional contact of the cyst and the facet joint needs to be actively sought in the presence of degenerative facet joints.

Joint Chiefs of Staff > Directorates > J7 | Joint Force Development

Science.gov Websites

development: Doctrine, Education, Concept Development & Experimentation, Training, Exercises and Lessons Coalition Partners. Joint Education Develop policies governing officer and enlisted Joint Professional Military Education (JPME), and the National Defense University. Direct JPME educational advisory group and

Effects of joints in truss structures

NASA Technical Reports Server (NTRS)

Ikegami, R.

1988-01-01

The response of truss-type structures for future space applications, such as Large Deployable Reflector (LDR), will be directly affected by joint performance. Some of the objectives of research at BAC were to characterize structural joints, establish analytical approaches that incorporate joint characteristics, and experimentally establish the validity of the analytical approaches. The test approach to characterize joints for both erectable and deployable-type structures was based upon a Force State Mapping Technique. The approach pictorially shows how the nonlinear joint results can be used for equivalent linear analysis. Testing of the Space Station joints developed at LaRC (a hinged joint at 2 Hz and a clevis joint at 2 Hz) successfully revealed the nonlinear characteristics of the joints. The Space Station joints were effectively linear when loaded to plus or minus 500 pounds with a corresponding displacement of about plus or minus 0.0015 inch. It was indicated that good linear joints exist which are compatible with errected structures, but that difficulty may be encountered if nonlinear-type joints are incorporated in the structure.

Culture - joint fluid

MedlinePlus

... this page: //medlineplus.gov/ency/article/003742.htm Culture - joint fluid To use the sharing features on this page, please enable JavaScript. Joint fluid culture is a laboratory test to detect infection-causing ...

Joint Chiefs of Staff > About > Joint Staff Inspector General

Science.gov Websites

DD Form 2949, Joint Inspector General Action Request (available at the link below). However, if you action if you intentionally make false statements. When you sign a DD Form 2949, you are signing a . DD Form 2949, Joint Inspector General Action Request Click here to expand content Click here to

Ceramic joints

DOEpatents

Miller, Bradley J.; Patten, Jr., Donald O.

1991-01-01

Butt joints between materials having different coefficients of thermal expansion are prepared having a reduced probability of failure of stress facture. This is accomplished by narrowing/tapering the material having the lower coefficient of thermal expansion in a direction away from the joint interface and not joining the narrow-tapered surface to the material having the higher coefficient of thermal expansion.

Sacroiliac joint dysfunction.

PubMed

Ilaslan, Hakan; Arslan, Ahmet; Koç, Omer Nadir; Dalkiliç, Turker; Naderi, Sait

2010-07-01

Sacroiliac joint dysfunction is a disorder presenting with low back and groin pain. It should be taken into consideration during the preoperative differential diagnosis of lumbar disc herniation, lumbar spinal stenosis and facet syndrome. Four cases with sacroiliac dysfunction are presented. The clinical and radiological signs supported the evidence of sacroiliac dysfunction, and exact diagnosis was made after positive response to sacroiliac joint block. A percutaneous sacroiliac fixation provided pain relief in all cases. The mean VAS scores reduced from 8.2 to 2.2. It is concluded that sacroiliac joint dysfunction diagnosis requires a careful physical examination of the sacroiliac joints in all cases with low back and groin pain. The diagnosis is made based on positive response to the sacroiliac block. Sacroiliac fixation was found to be effective in carefully selected cases.

Cytokine mRNA expression in synovial fluid of affected and contralateral stifle joints and the left shoulder joint in dogs with unilateral disease of the stifle joint.

PubMed

de Bruin, Tanya; de Rooster, Hilde; van Bree, Henri; Duchateau, Luc; Cox, Eric

2007-09-01

To examine mRNA expression of cytokines in synovial fluid (SF) cells from dogs with cranial cruciate ligament (CrCL) rupture and medial patellar luxation (MPL) and determine mRNA expression for 3 joints (affected stifle, unaffected contralateral stifle, and left shoulder joints) in dogs with unilateral CrCL rupture. 29 stifle joints with CrCL rupture (29 dogs), 8 stifle joints with MPL (7 dogs), and 24 normal stifle joints (16 clinically normal dogs). Immediately before reconstructive surgery, SF was aspirated from the cruciate-deficient stifle joint or stifle joint with MPL. Fourteen of 29 dogs had unilateral CrCL rupture; SF was also aspirated from the unaffected contralateral stifle joint and left shoulder joint. Those 14 dogs were examined 6 and 12 months after reconstructive surgery. Total RNA was extracted from SF cells and reverse transcription-PCR assay was performed to obtain cDNA. Canine-specific cytokine mRNA expression was determined by use of a real-time PCR assay. Interleukin (IL)-8 and -10 and interferon-gamma expression differed significantly between dogs with arthropathies and dogs with normal stifle joints. For the 14 dogs with unilateral CrCL rupture, a significant difference was found for IL-8 expression. Before reconstructive surgery, IL-8 expression differed significantly between the affected stifle joint and left shoulder joint or contralateral stifle joint. Six months after surgery, IL-8 expression was significantly increased in the unaffected contralateral stifle joint, compared with the shoulder joint. No conclusions can be made regarding the role of the examined cytokines in initiation of CrCL disease.

Hip joint injection

MedlinePlus

... medicine into the joint. The provider uses a real-time x-ray (fluoroscopy) to see where to place ... Wakefield RJ. Arthrocentesis and injection of joints and soft tissue. In: Firestein GS, Budd RC, Gabriel SE, ...

Joint Aspiration (Arthrocentesis)

MedlinePlus

... arthritis, or JRA), systemic lupus erythematosus (SLE), and Lyme disease. Joint aspiration is diagnostic but it also can ... topic for: Parents Kids Teens Evaluate Your Child's Lyme Disease Risk Living With Lupus Bones, Muscles, and Joints ...

Longitudinal joint study.

DOT National Transportation Integrated Search

2001-09-01

In previous years there has been a problem with longitudinal joint : deterioration, due in part to poor construction techniques. : The degradation of the longitudinal joints has increased the cost of : maintaining these projects and caused unnecessar...

Joint Control for Dummies: An Elaboration of Lowenkron's Model of Joint (Stimulus) Control

ERIC Educational Resources Information Center

Sidener, David W.

2006-01-01

The following paper describes Lowenkron's model of joint (stimulus) control. Joint control is described as a means of accounting for performances, especially generalized performances, for which a history of contingency control does not provide an adequate account. Examples are provided to illustrate instances in which joint control may facilitate…

Analysis of the ontogeny of the murine humoral response to Neisseria meningitidis B capsular polysaccharide reveals levels of complexity relevant to vaccine development.

PubMed

Colino, J; Outschoorn, I

2001-12-15

Although purified capsular polysaccharide of Neisseria meningitidis group B (CpsB) is not immunogenic at any age, CpsB on the bacterial surface elicits antibody responses late in ontogeny. Therefore, a detailed analysis of the ontogeny of the murine anti-CpsB response to N. meningitidis could determine key parameters regarding the poor immunogenicity of CpsB. The effects of bacterial dose, hyperimmunization, age, and sex on the induction of primary and secondary anti-CpsB immunoglobulin isotype profiles were studied. It was demonstrated that the timing and repetition of immunization and of the bacterial dose have a marked differential effect on the primary induction of anti-CpsB immunoglobulin isotypes and on the ability to induce anti-CpsB antibody responses after subsequent rechallenge. It is noteworthy that the ontogeny of the response is related to the appearance of natural anti-CpsB antibodies, but this is not associated with the presence of CpsB cross-reactive antigens in the microflora.

High pressure ceramic joint

DOEpatents

Ward, Michael E.; Harkins, Bruce D.

1993-01-01

Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures.

Joint Implications for Contracted Logistics

DTIC Science & Technology

2007-03-30

authority with the host nation country and policy on using UCMJ for contracted personnel. As tailored theater policies are developed and contracting...responsibility, this paper recommends better joint training, leader development and joint enablers for contracting operations. JOINT...U.S. Joint Forces Command (JFCOM) are analyzing Congressional and DOD policy to develop procedures and force structure to support contractor

Comparison of the use of notched wedge joints vs. traditional butt joints in Connecticut

DOT National Transportation Integrated Search

2008-11-07

Performance of Hot Mix Asphalt (HMA) longitudinal joints have been an item of increasing scrutiny in : Connecticut. The traditional butt joint has typically been the method used in Connecticut. These joints : have been reportedly opening up, creating...

Evaluation of narrow transverse contraction joints in jointed plain concrete pavements.

DOT National Transportation Integrated Search

2006-03-01

This report presents the results of a research project conducted at the Louisiana Transportation Research Center (LTRC) to evaluate the performance of narrow transverse contraction joints to control cracking in jointed plain concrete pavements. In ad...

Experimental Investigation of Composite Pressure Vessel Performance and Joint Stiffness for Pyramid and Inverted Pyramid Joints

NASA Technical Reports Server (NTRS)

Verhage, Joseph M.; Bower, Mark V.; Gilbert, Paul A. (Technical Monitor)

2001-01-01

The focus of this study is on the suitability in the application of classical laminate theory analysis tools for filament wound pressure vessels with adhesive laminated joints in particular: pressure vessel wall performance, joint stiffness and failure prediction. Two 18-inch diameter 12-ply filament wound pressure vessels were fabricated. One vessel was fabricated with a 24-ply pyramid laminated adhesive double strap butt joint. The second vessel was fabricated with the same number of plies in an inverted pyramid joint. Results from hydrostatic tests are presented. Experimental results were used as input to the computer programs GENLAM and Laminate, and the output compared to test. By using the axial stress resultant, the classical laminate theory results show a correlation within 1% to the experimental results in predicting the pressure vessel wall pressure performance. The prediction of joint stiffness for the two adhesive joints in the axial direction is within 1% of the experimental results. The calculated hoop direction joint stress resultant is 25% less than the measured resultant for both joint configurations. A correction factor is derived and used in the joint analysis. The correction factor is derived from the hoop stress resultant from the tank wall performance investigation. The vessel with the pyramid joint is determined to have failed in the joint area at a hydrostatic pressure 33% value below predicted failure. The vessel with the inverted pyramid joint failed in the wall acreage at a hydrostatic pressure within 10% of the actual failure pressure.

Longitudinal joint treatment.

DOT National Transportation Integrated Search

2006-03-01

Maine highways have been showing signs of longitudinal joint failure for a number of years. In an effort : to reduce the amount of joint failures the Maine Department of Transportation (MDOT) is currently : evaluating two projects. One project is mon...

Determination of representative dimension parameter values of Korean knee joints for knee joint implant design.

PubMed

Kwak, Dai Soon; Tao, Quang Bang; Todo, Mitsugu; Jeon, Insu

2012-05-01

Knee joint implants developed by western companies have been imported to Korea and used for Korean patients. However, many clinical problems occur in knee joints of Korean patients after total knee joint replacement owing to the geometric mismatch between the western implants and Korean knee joint structures. To solve these problems, a method to determine the representative dimension parameter values of Korean knee joints is introduced to aid in the design of knee joint implants appropriate for Korean patients. Measurements of the dimension parameters of 88 male Korean knee joint subjects were carried out. The distribution of the subjects versus each measured parameter value was investigated. The measured dimension parameter values of each parameter were grouped by suitable intervals called the "size group," and average values of the size groups were calculated. The knee joint subjects were grouped as the "patient group" based on "size group numbers" of each parameter. From the iterative calculations to decrease the errors between the average dimension parameter values of each "patient group" and the dimension parameter values of the subjects, the average dimension parameter values that give less than the error criterion were determined to be the representative dimension parameter values for designing knee joint implants for Korean patients.

Novel Ultrasound Joint Selection Methods Using a Reduced Joint Number Demonstrate Inflammatory Improvement when Compared to Existing Methods and Disease Activity Score at 28 Joints.

PubMed

Tan, York Kiat; Allen, John C; Lye, Weng Kit; Conaghan, Philip G; D'Agostino, Maria Antonietta; Chew, Li-Ching; Thumboo, Julian

2016-01-01

A pilot study testing novel ultrasound (US) joint-selection methods in rheumatoid arthritis. Responsiveness of novel [individualized US (IUS) and individualized composite US (ICUS)] methods were compared with existing US methods and the Disease Activity Score at 28 joints (DAS28) for 12 patients followed for 3 months. IUS selected up to 7 and 12 most ultrasonographically inflamed joints, while ICUS additionally incorporated clinically symptomatic joints. The existing, IUS, and ICUS methods' standardized response means were -0.39, -1.08, and -1.11, respectively, for 7 joints; -0.49, -1.00, and -1.16, respectively, for 12 joints; and -0.94 for DAS28. Novel methods effectively demonstrate inflammatory improvement when compared with existing methods and DAS28.

Accuracy of acromioclavicular joint injections.

PubMed

Wasserman, Bradley R; Pettrone, Sarah; Jazrawi, Laith M; Zuckerman, Joseph D; Rokito, Andrew S

2013-01-01

Injection to the acromioclavicular (AC) joint can be both diagnostic and therapeutic. The purpose of this study was to evaluate the accuracy of in vivo AC joint injections. Case series; Level of evidence, 4. Thirty patients with pain localized to the AC joint were injected with 1 mL of 1% lidocaine and 0.5 mL of radiographic contrast material (Isovue). Radiographs of the AC joint were taken after the injection. Each radiograph was reviewed by a musculoskeletal radiologist and graded as intra-articular, extra-articular, or partially intra-articular. Of the 30 injections performed, 13 (43.3%) were intra-articular, 7 (23.3%) were partially articular, and 10 (33.3%) were extra-articular. When the intra-articular and the partially articular groups were combined, 20 patients (66.7%) had some contrast dye in the AC joint. This study demonstrates that despite the relatively superficial location of the AC joint, the clinical accuracy of AC joint injections remains relatively low.

[Effects of exercise on joints.

PubMed

Moriyama, Hideki

Joints are composed of several different tissues(cartilage, capsule, meniscus, and ligament), and articular cartilage plays an important role in maintaining mechanical competence during exercise. Weight-bearing exercise has several benefit, including improved blood and synovial fluid circulation in a given joint. Consistent moderate activities facilitate cycles of anabolism and catabolism. Mechanical stresses are crucial for the maintenance of the morphologic and functional integrity of articular cartilage. Healthy cartilage is exposed by hydrostatic pressure and tensile strain, when cartilage degeneration develops, abnormal cartilage is exposed by shear stress. Moderate(physiological)exercise is characterized by a range of equilibrium between matrix anabolic and catabolic processes, or anabolism beyond catabolism. Joints are susceptible to insufficient or excessive activities, leading to joint degeneration. Lack of exercise is known to induce joint contracture seen clinically as a consequence of disuse changes, and excess mechanical stresses induce joint destruction such as osteoarthritis. Joint diseases resulting from insufficient or excessive activities are new and major challenging issues with our aging population. Thus, it is highly desirable to have an effective and efficient treatment to improve and protect against these joint diseases, and thereby to solve these clearly unanswered issues.

Can the Long-Term Complications of Adjustable Gastric Banding Be Overcome? Preliminary Results of Adding Gastric Plication in Patients with Impending Gastric Band Failure.

PubMed

Kim, Su Bin; Kim, Seong Min

2015-09-01

A small percentage of patients fitted with a gastric band still experience "failure." Here, the authors demonstrate the safety and feasibility of band preserving-laparoscopic gastric plication (BP-LGP), which was designed to improve weight loss and decrease gastric band adjustment frequency and thereby improve patient quality of life. All 6 patients involved in this study had a gastric band in place for more than 1 year; the median interval from gastric banding to BP-LGP was 31.7 months (range, 19.7-49.9 months). Five (83.3%) patients were female. Preoperative median body mass index (BMI) at gastric banding was 35.4 kg/m(2) (range, 31.9-43.9 kg/m(2)), median nadir BMI with the gastric band was 25.7 kg/m(2) (range, 20.9-31.0 kg/m(2)), and percentage excess BMI loss (%EBMIL) ranged from 24.3% to 123.6%. Indications for BP-LGP were as follows: chronic gastric prolapse in 2 patients (33.3%), pouch-esophageal dilatation in 3 (50.0%), and insufficient weight loss in 4 (66.6%), which included 2 patients with weight loss failure (%EBMIL of <30%). The 6 patients consecutively underwent surgery from May 2014 to January 2015. No conversion to open surgery was necessary, and no perioperative complication or mortality occurred. Mean operative time was 190 minutes. All patients showed weight loss after revision and showed resolution of troublesome signs and symptoms. Median follow-up after revision was 7.3 months (range, 5.7-10.1 months), median BMI at last follow-up was 27.6 kg/m(2) (range, 22.7-34.0 kg/m(2)), and median %EBMIL was 75.7% (range, 21.0%-103.6%). Median fill volume before revision was 6.1 mL (range, 2.7-11.0 mL), and median fill volume after revision was 0.3 mL (range, 0.0-5.3 mL). Three patients (50%) had an empty band at last follow-up. This novel method of bariatric revision (modified BP-LGP) might have a role as a salvage procedure in patients with impending gastric band failure.

Functional disorders of the temporomandibular joints: Internal derangement of the temporomandibular joint.

PubMed

Chang, Chih-Ling; Wang, Ding-Han; Yang, Mu-Chen; Hsu, Wun-Eng; Hsu, Ming-Lun

2018-04-01

Temporomandibular joint (TMJ) is one of the most complex joints of the human body. Due to its unique movement, in terms of combination of rotation and translator movement, disc of the joint plays an important role to maintain its normal function. In order to sustain the normal function of the TMJ, disc must be kept in proper position as well as maintain normal shape in all circumstances. Once the disc is not any more in its normal position during function of the joint, disturbance of the joint can be occurred which will lead to subsequent distortion of the disc. Shape of the disc can be influenced by many factors i.e.: abnormal function or composition of the disc itself. Etiology of the internal derangement of the disc remains controversial. Multifactorial theory has been postulated in most of previous manuscripts. Disc is composed of mainly extracellular matrix. Abnormal proportion of collagen type I & III may also leads to joint hypermobility which may be also a predisposing factor of this disorder. Thus it can be recognized as local manifestation of a systemic disorder. Different treatment modalities with from conservative treatment to surgical intervention distinct success rate have been reported. Recently treatment with extracellular matrix injection becomes more and more popular to strengthen the joint itself. Since multifactorial in character, the best solution of the treatment modalities should be aimed to resolve possible etiology from different aspects. Team work may be indication to reach satisfied results. Copyright © 2018. Published by Elsevier Taiwan.

Predicting the Functional Roles of Knee Joint Muscles from Internal Joint Moments.

PubMed

Flaxman, Teresa E; Alkjær, Tine; Simonsen, Erik B; Krogsgaard, Michael R; Benoit, Daniel L

2017-03-01

Knee muscles are commonly labeled as flexors or extensors and aptly stabilize the knee against sagittal plane loads. However, how these muscles stabilize the knee against adduction-abduction and rotational loads remains unclear. Our study sought 1) to classify muscle roles as they relate to joint stability by quantifying the relationship between individual muscle activation patterns and internal net joint moments in all three loading planes and 2) to determine whether these roles change with increasing force levels. A standing isometric force matching protocol required subjects to modulate ground reaction forces to elicit various combinations and magnitudes of sagittal, frontal, and transverse internal joint moments. Surface EMG measured activities of 10 lower limb muscles. Partial least squares regressions determined which internal moment(s) were significantly related to the activation of individual muscles. Rectus femoris and tensor fasciae latae were classified as moment actuators for knee extension and hip flexion. Hamstrings were classified as moment actuators for hip extension and knee flexion. Gastrocnemius and hamstring muscles were classified as specific joint stabilizers for knee rotation. Vastii were classified as general joint stabilizers because activation was independent of moment generation. Muscle roles did not change with increasing effort levels. Our findings indicate muscle activation is not dependent on anatomical orientation but perhaps on its role in maintaining knee joint stability in the frontal and transverse loading planes. This is useful for delineating the roles of biarticular knee joint muscles and could have implications in robotics, musculoskeletal modeling, sports sciences, and rehabilitation.

New Joint Sealants. Criteria, Design and Materials.

ERIC Educational Resources Information Center

Building Research Inst., Inc., Washington, DC.

Contents include--(1) sealing concrete joints, (2) sealing glass and metal joints, (3) metal and glass joint sealants from a fabricator's viewpoint, (4) a theory of adhesion for joint sealants, (5) geometry of simple joint seals under strain, (6) joint sealant specifications from a manufacturer's viewpoint, (7) joint sealant requirements from an…

Steroid injections - tendon, bursa, joint

MedlinePlus

... a small amount of corticosteroid and a local anesthetic into the bursa. JOINT Any joint problem, such ... A small amount of corticosteroid and a local anesthetic will be injected into the joint. TENDON A ...

High pressure ceramic joint

DOEpatents

Ward, M.E.; Harkins, B.D.

1993-11-30

Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures. 4 figures.

[Classification and Treatment of Sacroiliac Joint Dislocation].

PubMed

Tan, Zhen; Huang, Zhong; Li, Liang; Meng, Wei-Kun; Liu, Lei; Zhang, Hui; Wang, Guang-Lin; Huang, Fu-Guo

2017-09-01

To develop a renewed classification and treatment regimen for sacroiliac joint dislocation. According to the direction of dislocation of sacroiliac joint,combined iliac,sacral fractures,and fracture morphology,sacroiliac joint dislocation was classified into 4 types. Type Ⅰ (sacroiliac anterior dislocation): main fracture fragments of posterior iliac wing dislocated in front of sacroiliac joint. Type Ⅱ (sacroiliac posterior dislocation): main fracture fragments of posterior iliac wing dislocated in posterior of sacroiliac joint. Type Ⅲ (Crescent fracturedislocation of the sacroiliac joint): upward dislocation of posterior iliac wing with oblique fracture through posterior iliac wing. Type ⅢA: a large crescent fragment and dislocation comprises no more than onethird of sacroiliac joint,which is typically inferior. Type ⅢB: intermediatesize crescent fragment and dislocation comprises between one and twothirds of joint. Type ⅢC: a small crescent fragment where dislocation comprises most,but not the entire joint. Different treatment regimens were selected for different types of fractures. Treatment for type Ⅰ sacroiliac joint dislocation: anterior iliac fossa approach pry stripping reset; sacroiliac joint fixed with sacroiliac screw through percutaneous. Treatment for type Ⅱ sacroiliac joint dislocation: posterior sacroiliac joint posterior approach; sacroiliac joint fixed with sacroiliac screw under computer guidance. Treatment for type ⅢA and ⅢB sacroiliac joint dislocation: posterior sacroiliac joint approach; sacroiliac joint fixed with reconstruction plate. Treatment for type ⅢC sacroiliac joint dislocation: sacroiliac joint closed reduction; sacroiliac joint fixed with sacroiliac screw through percutaneous. Treatment for type Ⅳ sacroiliac joint dislocation: posterior approach; sacroiliac joint fixed with spinal pelvic fixation. Results of 24 to 72 months patient follow-up (mean 34.5 months): 100% survival,100% wound healing,and 100

Metal to ceramic sealed joint

DOEpatents

Lasecki, J.V.; Novak, R.F.; McBride, J.R.

1991-08-27

A metal to ceramic sealed joint which can withstand wide variations in temperature and maintain a good seal is provided for use in a device adapted to withstand thermal cycling from about 20 to about 1000 degrees C. The sealed joint includes a metal member, a ceramic member having an end portion, and an active metal braze forming a joint to seal the metal member to the ceramic member. The joint is positioned remote from the end portion of the ceramic member to avoid stresses at the ends or edges of the ceramic member. The sealed joint is particularly suited for use to form sealed metal to ceramic joints in a thermoelectric generator such as a sodium heat engine where a solid ceramic electrolyte is joined to metal parts in the system. 11 figures.

Metal to ceramic sealed joint

DOEpatents

Lasecki, John V.; Novak, Robert F.; McBride, James R.

1991-01-01

A metal to ceramic sealed joint which can withstand wide variations in temperature and maintain a good seal is provided for use in a device adapted to withstand thermal cycling from about 20 to about 1000 degrees C. The sealed joint includes a metal member, a ceramic member having an end portion, and an active metal braze forming a joint to seal the metal member to the ceramic member. The joint is positioned remote from the end portion of the ceramic member to avoid stresses at the ends or edges of the ceramic member. The sealed joint is particularly suited for use to form sealed metal to ceramic joints in a thermoelectric generator such as a sodium heat engine where a solid ceramic electrolyte is joined to metal parts in the system.

Sacroiliac joint tuberculosis

PubMed Central

Govender, S.

2006-01-01

Infections of the sacroiliac joint are uncommon and the diagnosis is usually delayed. In a retrospective study, 17 patients who had been treated for tuberculosis sacroiliitis between 1994 and 2004 were reviewed. Two patients were excluded due to a short follow-up (less than 2 years). Low back pain and difficulty in walking were the most common presenting features. Two patients presented with a buttock abscess and spondylitis of the lumbar spine was noted in two patients. The Gaenslen’s and FABER (flexion, abduction and external rotation) tests were positive in all patients. Radiological changes included loss of cortical margins with erosion of the joints. An open biopsy and curettage was performed in all patients; histology revealed chronic infection and acid-fast bacilli were isolated in nine patients. Antituberculous (TB) medication was administered for 18 months and the follow-up ranged from 3 to 10 years (mean: 5 years). The sacroiliac joint fused spontaneously within 2 years. Although all patients had mild discomfort in the lower back following treatment they had no difficulty in walking. Sacroiliac joint infection must be included in the differential diagnosis of lower back pain and meticulous history and clinical evaluation of the joint are essential. PMID:16673102

Lower limb joint work and joint work contribution during downhill and uphill walking at different inclinations.

PubMed

Alexander, Nathalie; Strutzenberger, Gerda; Ameshofer, Lisa Maria; Schwameder, Hermann

2017-08-16

Work performance and individual joint contribution to total work are important information for creating training protocols, but were not assessed so far for sloped walking. Therefore, the purpose of this study was to analyze lower limb joint work and joint contribution of the hip, knee and ankle to total lower limb work during sloped walking in a healthy population. Eighteen male participants (27.0±4.7yrs, 1.80±0.05m, 74.5±8.2kg) walked on an instrumented ramp at inclination angles of 0°, ±6°, ±12° and ±18° at 1.1m/s. Kinematic and kinetic data were captured using a motion-capture system (Vicon) and two force plates (AMTI). Joint power curves, joint work (positive, negative, absolute) and each joint's contribution to total lower limb work were analyzed throughout the stance phase using an ANOVA with repeated measures. With increasing inclination positive joint work increased for the ankle and hip joint and in total during uphill walking. Negative joint work increased for each joint and in total work during downhill walking. Absolute work was increased during both uphill (all joints) and downhill (ankle & knee) walking. Knee joint contribution to total negative and absolute work increased during downhill walking while hip and ankle contributions decreased. This study identified, that, when switching from level to a 6° and from 6° to a 12° inclination the gain of individual joint work is more pronounced compared to switching from 12° to an 18° inclination. The results might be used for training recommendations and specific training intervention with respect to sloped walking. Copyright © 2017 Elsevier Ltd. All rights reserved.

Transcatheter Arterial Embolization of Angiographically Visible and Occult Renal Capsular Artery Hemorrhage in 28 Patients.

PubMed

Park, Hyo Jung; Shin, Ji Hoon; Han, Ki-Chang; Yoon, Hyun-Ki; Ko, Gi-Young; Sung, Kyu-Bo

2016-07-01

To evaluate the effectiveness and safety of transcatheter arterial embolization to control bleeding from the renal capsular artery (RCA). Embolization was performed in 28 patients (14 men; mean age, 49.7 y). Presence and type of previous invasive procedures, initial presentation, and coagulation profile were reviewed. Any preceding abdominal computed tomography (CT) findings were analyzed. Angiographic findings were categorized as active bleeding, suspicious for bleeding, or no bleeding. Technical and clinical success and clinical outcomes were evaluated. Changes in hemoglobin level and transfusion volume of packed red blood cells (pBRCs) before and after embolization were evaluated with the paired t test and Wilcoxon signed-rank test, respectively. Technical and clinical success rates of therapeutic embolization for active bleeding (n = 11) were 90.9% and 80%, respectively. One case of technical failure (5.9%) and 3 cases of postembolization bleeding (18.7%) were noted in the prophylactic embolization group in patients with suspicion of bleeding (n = 13) or no bleeding (n = 4). Transient renal insufficiency occurred in 4 patients (14.3%). The average hemoglobin level and volume of transfused pBRCs changed from 8.1 g/dL to 9.9 g/dL and from 871 mL to 543 mL, respectively (P < .05). Extravasation of contrast media or acute hematoma in the right subhepatic or perirenal space on CT was noted in 21 patients (78%). Embolization can provide an effective and safe method to control RCA bleeding. Perirenal invasive procedures and signs of active or recent right subhepatic or perirenal hemorrhage should raise the suspicion of an RCA source. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Shoulder instability: evaluation with MR imaging.

PubMed

Seeger, L L; Gold, R H; Bassett, L W

1988-09-01

Instability of the glenohumeral joint is a common cause of chronic shoulder pain and disability. One or more episodes of subluxation or dislocation may result in a tear, detachment, or attenuation of the glenoid labrum, stripping of the joint capsule from the scapula, or trauma to the tendons or muscles of the rotator cuff. A series of 27 shoulders examined with magnetic resonance (MR) imaging showed changes of glenohumeral instability, which were confirmed with open or arthroscopic surgery. MR imaging was capable of displaying common types of pathologic conditions resulting from instability, including labral trauma, capsular detachment, and retraction of the subscapularis muscle. MR imaging is a valuable diagnostic tool for the evaluation of glenohumeral instability.

A critical analysis of the surgical outcomes for the treatment of Peyronie’s disease

PubMed Central

Mandava, Sree H.; Trost, Landon W.; Hellstrom, Wayne J.G.

2013-01-01

Peyronie’s disease (PD) is a relatively common condition, which can impair sexual function and result in emotional and psychological distress. Despite an abundance of minimally invasive treatments, few have confirmed efficacy for improving penile curvature and function. Surgical therapies include many different techniques and are reserved for patients with stable disease of ⩾12 months’ duration. We searched PubMed for all articles from 1990 to the present relating to the surgical management of PD. Preference was given to recent articles, larger series, and those comparing various techniques and/or materials. Outcomes were subsequently analysed and organised by surgical technique and the graft material used. Available surgical techniques include plication/corporoplasty procedures, incision and grafting (I&G), and placing a penile prosthesis with or without adjunctive procedures. Although several surgical algorithms have been reported, in general, plication/corporoplasty procedures are reserved for patients with adequate erectile function, simple curvatures of <60°, and with no deformities (hour-glass, hinge). I&G are reserved for complex curvatures of >60° and those with deformities. Penile prostheses are indicated for combined erectile dysfunction and PD. Overall outcomes show high rates of improved curvature and patient satisfaction, with mildly decreased erectile function with both plication and the I&G procedure (I&G >plication) and decreases in penile length (plication >I&G). Surgical management of PD remains an excellent treatment option for patients with penile curvature precluding or impairing sexual activity. Surgical algorithms are available to assist treating clinicians in appropriately stratifying surgical candidates. Additional research is needed to identify optimal surgical techniques and materials based on patient and disease characteristics. PMID:26558094

[Temporo-mandibular joint. Morpho-functional considerations].

PubMed

Scutariu, M D; Indrei, Anca

2004-01-01

The temporo-mandibular joint is distinguished from most other synovial joints of the body by two features: 1. the two jointed components carry teeth whose position and occlusion introduce a very strong influence on the movements of the temporo-mandibular joint and 2. its articular surfaces are not covered by hyaline cartilage, but by a dense, fibrous tissue. This paper describes the parts of the temporo-mandibular joint: the articular surfaces (the condylar process of the mandible and the glenoid part of the temporal bone), the fibrocartilaginous disc which is interposed between the mandibular and the temporal surface, the fibrous capsule of the temporo-mandibular joint and the ligaments of this joint. All these parts present a very strong adaptation at the important functions of the temporo-mandibular joint.

CpsR, a GntR family regulator, transcriptionally regulates capsular polysaccharide biosynthesis and governs bacterial virulence in Streptococcus pneumoniae.

PubMed

Wu, Kaifeng; Xu, Hongmei; Zheng, Yuqiang; Wang, Libin; Zhang, Xuemei; Yin, Yibing

2016-07-08

Transcriptional regulation of capsule expression is critical for pneumococcal transition from carriage to infection, yet the underlying mechanism remains incompletely understood. Here, we describe the regulation of capsular polysaccharide, one of the most important pneumococcal virulence factor by a GntR family regulator, CpsR. Electrophoretic mobility-shift assays have shown the direct interaction between CpsR and the cps promoter (cpsp), and their interaction could be competitively interfered by glucose. DNase I footprinting assays localized the binding site to a region -146 to -114 base pairs relative to the transcriptional start site of the cps locus in S. pneumoniae D39. We found that CpsR negatively controlled the transcription of the cps locus and hence CPS production, which was confirmed by fine-tuning expression of CpsR in a ΔcpsR complemented strain. Increased expression of CpsR in complemented strain led to a decreased resistance to the whole-blood-mediated killing, suggesting a protective role for CpsR-cpsp interaction in the establishment of invasive infection. Finally, animal experiments showed that CpsR-cpsp interaction was necessary for both pneumococcal colonization and invasive infection. Taken together, our results provide a thorough insight into the regulation of capsule production mediated by CpsR and its important roles in pneumococcal pathogenesis.

Utilization of Facet Joint and Sacroiliac Joint Interventions in Medicare Population from 2000 to 2014: Explosive Growth Continues!

PubMed

Manchikanti, Laxmaiah; Hirsch, Joshua A; Pampati, Vidyasagar; Boswell, Mark V

2016-10-01

Increasing utilization of interventional techniques in managing chronic spinal pain, specifically facet joint interventions and sacroiliac joint injections, is a major concern of healthcare policy makers. We analyzed the patterns of utilization of facet and sacroiliac joint interventions in managing chronic spinal pain. The results showed significant increase of facet joint interventions and sacroiliac joint injections from 2000 to 2014 in Medicare FFS service beneficiaries. Overall, the Medicare population increased 35 %, whereas facet joint and sacroiliac joint interventions increased 313.3 % per 100,000 Medicare population with an annual increase of 10.7 %. While the increases were uniform from 2000 to 2014, there were some decreases noted for facet joint interventions in 2007, 2010, and 2013, whereas for sacroiliac joint injections, the decreases were noted in 2007 and 2013. The increases were for cervical and thoracic facet neurolysis at 911.5 % compared to lumbosacral facet neurolysis of 567.8 %, 362.9 % of cervical and thoracic facet joint blocks, 316.9 % of sacroiliac joints injections, and finally 227.3 % of lumbosacral facet joint blocks.

Ball-joint grounding ring

NASA Technical Reports Server (NTRS)

Aperlo, P. J. A.; Buck, P. A.; Weldon, V. A.

1981-01-01

In ball and socket joint where electrical insulator such as polytetrafluoroethylene is used as line to minimize friction, good electrical contact across joint may be needed for lightning protection or to prevent static-charge build-up. Electrical contact is maintained by ring of spring-loaded fingers mounted in socket. It may be useful in industry for cranes, trailers, and other applications requiring ball and socket joint.

Multicenter comparison of levels of antibody to the Neisseria meningitidis group A capsular polysaccharide measured by using an enzyme-linked immunosorbent assay.

PubMed Central

Carlone, G M; Frasch, C E; Siber, G R; Quataert, S; Gheesling, L L; Turner, S H; Plikaytis, B D; Helsel, L O; DeWitt, W E; Bibb, W F

1992-01-01

There is no standard immunoassay for evaluating immune responses to meningococcal vaccines. We developed an enzyme-linked immunosorbent assay to measure total levels of antibody to Neisseria meningitidis group A capsular polysaccharide. Five laboratories measured the antibody levels in six paired pre- and postvaccination serum samples by using the enzyme-linked immunosorbent assay. Methylated human serum albumin was used to bind native group A polysaccharide to microtiter plate surfaces. The between-laboratory coefficients of variation for pre- and postvaccination sera had ranges of 31 to 91 and 17 to 31, respectively. The mean laboratory coefficients of variation for pre- and postvaccination sera, respectively, were 17 and 11 (Molecular Biology Laboratory, Centers for Disease Control), 12 and 15 (Immunodiagnostic Methods Laboratory, Centers for Disease Control), 22 and 19 (Dana-Farber Cancer Institute), 38 and 38 (Bacterial Polysaccharide Laboratory, U.S. Food and Drug Administration), and 11 and 10 (Praxis Biologics, Inc.). Standardization of this enzyme-linked immunosorbent assay should allow interlaboratory comparison of meningococcal vaccine immunogenicity, thus providing a laboratory-based assessment tool for evaluating meningococcal vaccines. PMID:1734048

Cytidine Diphosphoramidate Kinase: An Enzyme Required for the Biosynthesis of the O-Methyl Phosphoramidate Modification in the Capsular Polysaccharides of Campylobacter jejuni.

PubMed

Taylor, Zane W; Raushel, Frank M

2018-04-17

Campylobacter jejuni, a leading cause of gastroenteritis, produces a capsular polysaccharide that is derivatized with a unique O-methyl phosphoramidate (MeOPN) modification. This modification contributes to serum resistance and invasion of epithelial cells. Previously, the first three biosynthetic steps for the formation of MeOPN were elucidated. The first step is catalyzed by a novel glutamine kinase (Cj1418), which catalyzes the adenosine triphosphate (ATP)-dependent phosphorylation of the amide nitrogen of l-glutamine. l-Glutamine phosphate is used by cytidine triphosphate (CTP):phosphoglutamine cytidylyltransferase (Cj1416) to displace pyrophosphate from CTP to generate cytidine diphosphate (CDP)-l-glutamine, which is then hydrolyzed by γ-glutamyl-CDP-amidate hydrolase (Cj1417) to form cytidine diphosphoramidate (CDP-NH 2 ). Here, we show that Cj1415 catalyzes the ATP-dependent phosphorylation of CDP-NH 2 to form 3'-phospho-cytidine-5'-diphosphoramidate. Cj1415 will also catalyze the phosphorylation of adenosine diphosphoramidate (ADP-NH 2 ) and uridine diphosphoramidate (UDP-NH 2 ) but at significantly reduced rates. It is proposed that Cj1415 be named cytidine diphosphoramidate kinase.

14 CFR 23.693 - Joints.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Systems § 23.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion... factor may be reduced to 2.0 for joints in cable control systems. For ball or roller bearings, the...

Wrist joint assembly

NASA Technical Reports Server (NTRS)

Kersten, L.; Johnson, J. D. (Inventor)

1978-01-01

A wrist joint assembly is provided for use with a mechanical manipulator arm for finely positioning an end-effector carried by the wrist joint on the terminal end of the manipulator arm. The wrist joint assembly is pivotable about a first axis to produce a yaw motion, a second axis is to produce a pitch motion, and a third axis to produce a roll motion. The wrist joint assembly includes a disk segment affixed to the terminal end of the manipulator arm and a first housing member, a second housing member, and a third housing member. The third housing member and the mechanical end-effector are moved in the yaw, pitch, and roll motion. Drive means are provided for rotating each of the housings about their respective axis which includes a cluster of miniature motors having spur gears carried on the output drive shaft which mesh with a center drive gear affixed on the housing to be rotated.

[GERD: endoscopic antireflux therapies].

PubMed

Caca, K

2006-08-02

A couple of minimally-invasive, endoscopic antireflux procedures have been developed during the last years. Beside endoscopic suturing these included injection/implantation technique of biopolymers and application of radiofrequency. Radiofrequency (Stretta) has proved only a very modest effect, while implantation techniques have been abandoned due to lack of long-term efficacy (Gatekeeper) or serious side effects (Enteryx). While first generation endoluminal suturing techniques (EndoCinch, ESD) demonstrated a proof of principle their lack of durability, due to suture loss, led to the development of a potentially durable transmural plication technique (Plicator). In a prospective-randomized, sham-controlled trial the Plicator procedure proved superiority concerning reflux symptoms, medication use and esophageal acid exposure (24-h-pH-metry). While long-term data have to be awaited to draw final conclusions, technical improvements will drive innovation in this field.

Clinical and serological responses following primary and booster immunization with Salmonella typhi Vi capsular polysaccharide vaccines.

PubMed

Keitel, W A; Bond, N L; Zahradnik, J M; Cramton, T A; Robbins, J B

1994-01-01

Clinical and serum antibody responses following intramuscular injection of two formulations of Salmonella typhi Vi capsular polysaccharide (Vi) were assessed in a double-blind evaluation. Healthy adults were randomly assigned to receive a 25 micrograms dose of liquid (Vi-Liq; n = 182) or freeze-dried Vi vaccine (Vi-Lyoph; n = 55), or placebo (n = 86). Erythema and/or induration > or = 1 cm in diameter at the injection site developed in 13/182 (7%) of Vi-Liq and 3/55 (5%) of Vi-Lyoph recipients (not significant, n.s.). Fever (oral temperature > or = 100 degrees F (37.8 degrees C)) occurred in < 2% of vaccinees. The frequencies of rises of fourfold or greater and of maximal Vi antibody levels were similar in the two vaccine groups. Fourfold or greater rises in serum Vi antibody levels (RIA) developed in 53% of Vi-Lyoph and 60% of Vi-Liq recipients by 1 week (n.s.), and 98 and 93%, respectively, by 1 month (n.s.). The frequencies of adverse reactions and mean Vi antibody levels following booster immunization with Vi-Liq 27 to 34 months after primary immunization (n = 55) were similar to those observed following primary immunization, although subjects given a booster dose were more likely to develop local reactions > or = 1 cm in diameter than those given a first dose (10/55 versus 13/182, p = 0.013 by the chi 2 test). Primary and booster immunizations with the Vi vaccines are well tolerated in healthy adults; mean Vi antibody levels remain significantly elevated for up to 34 months after primary immunization.

Product evaluation : Ruscoe 983 joint sealant

DOT National Transportation Integrated Search

1986-07-10

This report contains a product evaluation of Ruscoe's 983 joint sealant. Ruscoe 983 is an asphalt base single compound joint sealant. It contains an aluminum fortified adhesive and is designed for use on highway expansion joints, bridge joints, and r...

Gene-expression changes in knee-joint tissues with aging and menopause: implications for the joint as an organ

PubMed Central

Rollick, Natalie C; Lemmex, Devin B; Ono, Yohei; Reno, Carol R; Hart, David A; Lo, Ian KY; Thornton, Gail M

2018-01-01

Background When considering the “joint as an organ”, the tissues in a joint act as complementary components of an organ, and the “set point” is the cellular activity for homeostasis of the joint tissues. Even in the absence of injury, joint tissues have adaptive responses to processes, like aging and menopause, which result in changes to the set point. Purpose The purpose of this study in a preclinical model was to investigate age-related and menopause-related changes in knee-joint tissues with the hypothesis that tissues will change in unique ways that reflect their differing contributions to maintaining joint function (as measured by joint laxity) and the differing processes of aging and menopause. Methods Rabbit knee-joint tissues from three groups were evaluated: young adult (gene expression, n=8; joint laxity, n=7; water content, n=8), aging adult (gene expression, n=6; joint laxity, n=7; water content, n=5), and menopausal adult (gene expression, n=8; joint laxity, n=7; water content, n=8). Surgical menopause was induced with ovariohysterectomy surgery and gene expression was assessed using reverse-transcription quantitative polymerase chain reaction. Results Aging resulted in changes to 37 of the 150 gene–tissue combinations evaluated, and menopause resulted in changes to 39 of the 150. Despite the similar number of changes, only eleven changes were the same in both aging and menopause. No differences in joint laxity were detected comparing young adult rabbits with aging adult rabbits or with menopausal adult rabbits. Conclusion Aging and menopause affected the gene-expression patterns of the tissues of the knee joint differently, suggesting unique changes to the set point of the knee. Interestingly, aging and menopause did not affect knee-joint laxity, suggesting that joint function was maintained, despite changes in gene expression. Taken together, these findings support the theory of the joint as an organ where the tissues of the joint adapt to

Macroscopic and microscopic analysis of the thumb carpometacarpal ligaments: a cadaveric study of ligament anatomy and histology.

PubMed

Ladd, Amy L; Lee, Julia; Hagert, Elisabet

2012-08-15

Stability and mobility represent the paradoxical demands of the human thumb carpometacarpal joint, yet the structural origin of each functional demand is poorly defined. As many as sixteen and as few as four ligaments have been described as primary stabilizers, but controversy exists as to which ligaments are most important. We hypothesized that a comparative macroscopic and microscopic analysis of the ligaments of the thumb carpometacarpal joint would further define their role in joint stability. Thirty cadaveric hands (ten fresh-frozen and twenty embalmed) from nineteen cadavers (eight female and eleven male; average age at the time of death, seventy-six years) were dissected, and the supporting ligaments of the thumb carpometacarpal joint were identified. Ligament width, length, and thickness were recorded for morphometric analysis and were compared with use of the Student t test. The dorsal and volar ligaments were excised from the fresh-frozen specimens and were stained with use of a triple-staining immunofluorescent technique and underwent semiquantitative analysis of sensory innervation; half of these specimens were additionally analyzed for histomorphometric data. Mixed-effects linear regression was used to estimate differences between ligaments. Seven principal ligaments of the thumb carpometacarpal joint were identified: three dorsal deltoid-shaped ligaments (dorsal radial, dorsal central, posterior oblique), two volar ligaments (anterior oblique and ulnar collateral), and two ulnar ligaments (dorsal trapeziometacarpal and intermetacarpal). The dorsal ligaments were significantly thicker (p < 0.001) than the volar ligaments, with a significantly greater cellularity and greater sensory innervation compared with the anterior oblique ligament (p < 0.001). The anterior oblique ligament was consistently a thin structure with a histologic appearance of capsular tissue with low cellularity. The dorsal deltoid ligament complex is uniformly stout and robust; this

Knee joint mobilization reduces secondary mechanical hyperalgesia induced by capsaicin injection into the ankle joint.

PubMed

Sluka, K A; Wright, A

2001-01-01

Joint mobilization is a treatment approach commonly used by physical therapists for the management of a variety of painful conditions. However, the clinical effectiveness when compared to placebo and the neurophysiological mechanism of action are not known. The purpose of this study was to establish that application of a manual therapy technique will produce antihyperalgesia in an animal model of joint inflammation and that the antihyperalgesia produced by joint mobilization depends on the time of treatment application. Capsaicin (0.2%, 50 microl) was injected into the lateral aspect of the left ankle joint and mechanical withdrawal threshold assessed before and after capsaicin injection in Sprague-Dawley rats. Joint mobilization of the ipsilateral knee joint was performed 2 h after capsaicin injection for a total of 3 min, 9 min or 15 min under halothane anaesthesia. Control groups included animals that received halothane for the same time as the group that received joint mobilization and those whose limbs were held for the same duration as the mobilization (no halothane). Capsaicin resulted in a decreased mechanical withdrawal threshold by 2 h after injection that was maintained through 4 h. Both 9 and 15 min of mobilization, but not 3 min of mobilization, increased the withdrawal threshold to mechanical stimuli to baseline values when compared with control groups. The antihyperalgesic effect of joint mobilization lasted 30 min. Thus, joint mobilization (9 or 15 min duration) produces a significant reversal of secondary mechanical hyperalgesia induced by intra-articular injection of capsaicin. Copyright 2001 European Federation of Chapters of the International Association for the Study of Pain.

Adjustable bias column end joint assembly

NASA Technical Reports Server (NTRS)

Wallsom, Richard E. (Inventor); Bush, Harold G. (Inventor)

1994-01-01

An adjustable mechanical end joint system for connecting structural column elements and eliminating the possibility of free movement between joint halves during loading or vibration has a node joint body having a cylindrical engaging end and a column end body having a cylindrical engaging end. The column end joint body has a compressible preload mechanism and plunger means housed therein. The compressible preload mechanism may be adjusted from the exterior of the column end joint body through a port.

Arch structure is associated with unique joint work, relative joint contributions and stiffness during landing.

PubMed

Powell, Douglas W; Queen, Robin M; Williams, D S Blaise

2016-10-01

To examine lower extremity joint contributions to a landing task in high-(HA) and low-arched (LA) female athletes by quantifying vertical stiffness, joint work and relative joint contributions to landing. Twenty healthy female recreational athletes (10 HA and 10 LA) performed five barefoot drop landings from a height of 30cm. Three-dimensional kinematics (240Hz) and ground reaction forces (960Hz) were recorded simultaneously. Vertical stiffness, joint work values and relative joint work values were calculated using Visual 3D and MatLab. HA athletes had significantly greater vertical stiffness compared to LA athletes (p=0.013). Though no differences in ankle joint work were observed (p=0.252), HA athletes had smaller magnitudes of knee (p=0.046), hip (p=0.019) and total lower extremity joint work values (p=0.016) compared to LA athletes. HA athletes had greater relative contributions of the ankle (p=0.032) and smaller relative contributions of the hip (p=0.049) compared to LA athletes. No differences in relative contributions of the knee were observed (p=0.255). These findings demonstrate that aberrant foot structure is associated with unique contributions of lower extremity joints to load attenuation during landing. These data may provide insight into the unique injury mechanisms associated with arch height in female athletes. Copyright © 2016 Elsevier B.V. All rights reserved.

Dissimilar metals joint evaluation

NASA Technical Reports Server (NTRS)

Wakefield, M. E.; Apodaca, L. E.

1974-01-01

Dissimilar metals tubular joints between 2219-T851 aluminum alloy and 304L stainless steel were fabricated and tested to evaluate bonding processes. Joints were fabricated by four processes: (1) inertia (friction) weldings, where the metals are spun and forced together to create the weld; (2) explosive welding, where the metals are impacted together at high velocity; (3) co-extrusion, where the metals are extruded in contact at high temperature to promote diffusion; and (4) swaging, where residual stresses in the metals after a stretching operation maintain forced contact in mutual shear areas. Fifteen joints of each type were prepared and evaluated in a 6.35 cm (2.50 in.) O.D. size, with 0.32 cm (0.13 in.) wall thickness, and 7.6 cm (3.0 in) total length. The joints were tested to evaluate their ability to withstand pressure cycle, thermal cycle, galvanic corrosion and burst tests. Leakage tests and other non-destructive test techniques were used to evaluate the behavior of the joints, and the microstructure of the bond areas was analyzed.

14 CFR 23.693 - Joints.

Code of Federal Regulations, 2011 CFR

2011-01-01

... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Design and Construction Control Systems § 23.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion... factor may be reduced to 2.0 for joints in cable control systems. For ball or roller bearings, the...

14 CFR 23.693 - Joints.

Code of Federal Regulations, 2010 CFR

2010-01-01

... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Design and Construction Control Systems § 23.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion... factor may be reduced to 2.0 for joints in cable control systems. For ball or roller bearings, the...

14 CFR 23.693 - Joints.

Code of Federal Regulations, 2012 CFR

2012-01-01

... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Design and Construction Control Systems § 23.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion... factor may be reduced to 2.0 for joints in cable control systems. For ball or roller bearings, the...

14 CFR 23.693 - Joints.

Code of Federal Regulations, 2014 CFR

2014-01-01

... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Design and Construction Control Systems § 23.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion... factor may be reduced to 2.0 for joints in cable control systems. For ball or roller bearings, the...

Quick-connect threaded attachment joint

NASA Technical Reports Server (NTRS)

Lucy, M. H.; Messick, W. R.; Vasquez, P.

1979-01-01

Joint is self-aligning and tightens with only sixty-five degrees of rotation for quick connects and disconnects. Made of injection-molded plastics or cast or machined aluminum, joint can carry wires, tubes, liquids, or gases. When two parts of joint are brought together, their shapes align them. Small projections on male section and slots on female section further aid alignment; slight rotation of male form engages projections in slots. At this point, threads engage and male section is rotated until joint is fully engaged.

The contribution of quasi-joint stiffness of the ankle joint to gait in patients with hemiparesis.

PubMed

Sekiguchi, Yusuke; Muraki, Takayuki; Kuramatsu, Yuko; Furusawa, Yoshihito; Izumi, Shin-Ichi

2012-06-01

The role of ankle joint stiffness during gait in patients with hemiparesis has not been clarified. The purpose of this study was to determine the contribution of quasi-joint stiffness of the ankle joint to spatiotemporal and kinetic parameters regarding gait in patients with hemiparesis due to brain tumor or stroke and healthy individuals. Spatiotemporal and kinetic parameters regarding gait in twelve patients with hemiparesis due to brain tumor or stroke and nine healthy individuals were measured with a 3-dimensional motion analysis system. Quasi-joint stiffness was calculated from the slope of the linear regression of the moment-angle curve of the ankle joint during the second rocker. There was no significant difference in quasi-joint stiffness among both sides of patients and the right side of controls. Quasi-joint stiffness on the paretic side of patients with hemiparesis positively correlated with maximal ankle power (r=0.73, P<0.01) and gait speed (r=0.66, P<0.05). In contrast, quasi-joint stiffness in controls negatively correlated with maximal ankle power (r=-0.73, P<0.05) and gait speed (r=-0.76, P<0.05). Our findings suggested that ankle power during gait might be generated by increasing quasi-joint stiffness in patients with hemiparesis. In contrast, healthy individuals might decrease quasi-joint stiffness to avoid deceleration of forward tilt of the tibia. Our findings might be useful for selecting treatment for increased ankle stiffness due to contracture and spasticity in patients with hemiparesis. Copyright © 2011 Elsevier Ltd. All rights reserved.

Double slotted socket spherical joint

DOEpatents

Bieg, Lothar F.; Benavides, Gilbert L.

2001-05-22

A new class of spherical joints is disclosed. These spherical joints are capable of extremely large angular displacements (full cone angles in excess of 270.degree.), while exhibiting no singularities or dead spots in their range of motion. These joints can improve or simplify a wide range of mechanical devices.

Clinical synovitis in a particular joint is associated with progression of erosions and joint space narrowing in that same joint, but not in patients initially treated with infliximab.

PubMed

Klarenbeek, N B; Güler-Yüksel, M; van der Heijde, D M F M; Hulsmans, H M J; Kerstens, P J S M; Molenaar, T H E; de Sonnaville, P B J; Huizinga, T W J; Dijkmans, B A C; Allaart, C F

2010-12-01

To assess the relationship between joint tenderness, swelling and joint damage progression in individual joints and to evaluate the influence of treatment on these relationships. First-year data of the Behandel Strategieën (BeSt) study were used, in which patients recently diagnosed as having rheumatoid arthritis (RA) were randomly assigned into four different treatment strategies. Baseline and 1-year x-rays of the hands and feet were assessed using the Sharp-van der Heijde score (SHS). With generalised estimating equations, 3-monthly assessments of tender and swollen joints of year 1 were related to erosion progression, joint space narrowing (JSN) progression and total SHS progression at the individual joint level (definition > 0.5 SHS units) in year 1, corrected for potential confounders and within-patient correlation for multiple joints per patient. During year 1, 59% of all 13 959 joints analysed were ever tender and 45% ever swollen, 2.1% showed erosion progression, 1.9% JSN progression and 3.6% SHS progression. Swelling and tenderness were both independently associated with erosion and JSN progression with comparable OR, although with higher OR in the hands than in the feet. Local swelling and tenderness were not associated with local damage progression in patients initially treated with infliximab. Clinical signs of synovitis are associated with erosion and JSN progression in individual joints after 1 year in RA. A disconnect between synovitis and joint damage progression was observed at joint level in patients who were treated with methotrexate and infliximab as initial treatment, confirming the disconnect between synovitis and the development of joint damage in tumour necrosis factor blockers seen at patient level.

Hip joint replacement - slideshow

MedlinePlus

... this page: //medlineplus.gov/ency/presentations/100006.htm Hip joint replacement - series—Normal anatomy To use the ... to slide 5 out of 5 Overview The hip joint is made up of two major parts: ...

Sacroiliac joint pain - aftercare

MedlinePlus

... this page: //medlineplus.gov/ency/patientinstructions/000610.htm Sacroiliac joint pain - aftercare To use the sharing features on this page, please enable JavaScript. The sacroiliac joint (SIJ) is a term used to describe ...

Metacarpophalangeal joint arthroscopy: indications revisited.

PubMed

Choi, Alexander K Y; Chow, Esther C S; Ho, P C; Chow, Y Y

2011-08-01

Arthroscopic surgery has become the gold standard for the diagnosis and treatment of major joint disorders. With advancement in arthroscopic technique, arthroscopy has become feasible in most human joints, even those as small as the finger joints. The metacarpophalangeal joint (MCPJ) can become spacious with simple traction, the intra-articular anatomy is simple, and its major structures can be easily visualized and identified. However, MCPJ arthroscopy has never been popular. This article describes our experience with MCPJ arthroscopy and seeks to establish its role in clinical practice. Copyright © 2011 Elsevier Inc. All rights reserved.

Joint Attention in Autism: Teaching Smiling Coordinated with Gaze to Respond to Joint Attention Bids

ERIC Educational Resources Information Center

Krstovska-Guerrero, Ivana; Jones, Emily A.

2013-01-01

Children with autism demonstrate early deficits in joint attention and expressions of affect. Interventions to teach joint attention have addressed gaze behavior, gestures, and vocalizations, but have not specifically taught an expression of positive affect such as smiling that tends to occur during joint attention interactions. Intervention was…

Sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion.

PubMed

Zhu, Guo; Jiang, Li-Yuan; Yi, Zhang; Ping, Li; Duan, Chun-Yue; Yong, Cao; Liu, Jin-Yang; Hu, Jian-Zhong

2017-11-29

Sacroiliac joint tuberculosis(SJT) is relatively uncommon, but it may cause severe sacroiliac joint destruction and functional disorder. Few studies in the literature have been presented on SJT, reports of surgical treatment for SJT are even fewer. In this study, we retrospectively reviewed surgical management of patients with severe SJT of 3 different types and proposed to reveal the clinical manifestations and features and aim to determine the efficiency and security of such surgical treatment. We reviewed 17 patients with severe SJT of 3 different types who underwent posterior open-window focal debridement and bone graft for joint fusion. Among them,five patients with anterior sacral abscess had anterior abscess curettage before debridement. Two patients with lumbar vertebral tuberculosis received one-stage posterior tuberculous debridement, interbody fusion and instrumentation. Follow-up was performed 36 months (26 to 45 months) using the following parameters: erythrocyte sedimentation rate(ESR), status of joint bony fusion on CT scan, visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Buttock pain and low back pain were progressively relieved with time. 6 months later, pain was not obvious, and ESR resumed to normal levels within 3 months. Solid fusion of the sacroiliac joint occurred within 12 months in all cases. No complications or recurrence occurred. At final follow-up, all patients had no pain or only minimal discomfort over the affected joint and almost complete functional recovery. Posterior open-window focal debridement and joint fusion is an efficient and secure surgical method to treat severe SJT. If there is an abscess in the front of the sacroiliac joint, anterior abscess curettage should be performed as a supplement.

Use of abdominal field block injections with liposomal bupivicaine to control postoperative pain after abdominoplasty.

PubMed

Morales, Rolando; Mentz, Henry; Newall, Germán; Patronella, Christopher; Masters, Oscar

2013-11-01

It is well known that improving postoperative pain control in plastic surgery procedures leads to earlier mobilization, shortened hospital stay, reduced hospital costs, and increased patient satisfaction. The authors evaluate the use of abdominal field block injections with liposomal bupivicaine (Exparel; Pacira Pharmaceuticals, Inc, San Diego, California) in postoperative pain management in patients undergoing abdominoplasty with rectus plication. Case records from 64 female patients who underwent abdominoplasty with rectus plication were reviewed. We performed a total of 118 abdominoplasties with rectus plication, alone or in combination with other surgical procedures, from August 2012 to December 2012, but 54 patients were excluded from the series due to inadequate follow-up. Patients received liposomal bupivicaine injections in an abdominal field block fashion. Patient age, height, weight, and smoking status were recorded. Delivery of standardized postoperative intramuscular or intravenous injections and oral pain pills was recorded. Postoperative data and questionnaires were used to evaluate clinical efficacy. The average number of procedures (including abdominoplasty with rectus plication) per patient was 7. Average patient body mass index was 27 kg/m(2). Average pain scores were 3.5 (postoperative visit 1) and 2.8 (visit 2). The average number of oral pain pills required was 14 at the first postoperative visit and 11.5 at the second postoperative visit. Patients were able to resume normal activity at an average of 6.4 days. Our experience with liposomal bupivicaine injections for regional blocks in abdominoplasty with rectus plication indicates that patients experienced reduced postoperative pain, required less postoperative narcotic medication, and resumed both earlier ambulation and normal activity. Further investigation is warranted with more clinical cases to recommend the use of this medication for routine pain management after an abdominoplasty.

Jointness for the Rest of Us: Reforming Joint Professional Development

DTIC Science & Technology

2016-06-10

where service capabilities are combined to maximize effectiveness while minimizing vulnerabilities. However, despite the passage of thirty years ...staff of the Joint Advance Warfighting School and the Joint Forces Staff College for their support during the academic year . Special thanks to my...seminar faculty Colonel Chris Rogers, Dr. Mike Pavlec, and Captain Miguel “Boo” Peko for the lessons and laughs that have made this year so enjoyable

12 CFR 347.107 - Joint ventures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Joint ventures. 347.107 Section 347.107 Banks... INTERNATIONAL BANKING § 347.107 Joint ventures. (a) Joint ventures. If a bank, directly or indirectly, acquires or holds an equity interest in a foreign organization that is a joint venture, and the bank or its...

About the Joint Chiefs of Staff

Science.gov Websites

JCS: Search Home Media News Photos Videos Publications About The Joint Staff Chairman Vice Chairman J8 | Force Structure, Resources & Assessment Contact Joint Staff Structure Home : About About the Joint Chiefs of Staff Download the CJCS Historic Guide The Joint Chiefs of Staff consist of the Chairman

A glycoconjugate of Haemophilus influenzae Type b capsular polysaccharide with tetanus toxoid protein: hydrodynamic properties mainly influenced by the carbohydrate.

PubMed

Abdelhameed, Ali Saber; Adams, Gary G; Morris, Gordon A; Almutairi, Fahad M; Duvivier, Pierre; Conrath, Karel; Harding, Stephen E

2016-02-26

Three important physical properties which may affect the performance of glycoconjugate vaccines against serious disease are molar mass (molecular weight), heterogeneity (polydispersity), and conformational flexibility in solution. The dilute solution behaviour of native and activated capsular polyribosylribitol (PRP) polysaccharides extracted from Haemophilus influenzae type b (Hib), and the corresponding glycoconjugate made by conjugating this with the tetanus toxoid (TT) protein have been characterized and compared using a combination of sedimentation equilibrium and sedimentation velocity in the analytical ultracentrifuge with viscometry. The weight average molar mass of the activated material was considerably reduced (Mw ~ 0.24 × 10(6) g.mol(-1)) compared to the native (Mw ~ 1.2 × 10(6) g.mol(-1)). Conjugation with the TT protein yielded large polydisperse structures (of Mw ~ 7.4 × 10(6) g.mol(-1)), but which retained the high degree of flexibility of the native and activated polysaccharide, with frictional ratio, intrinsic viscosity, sedimentation conformation zoning behaviour and persistence length all commensurate with highly flexible coil behaviour and unlike the previously characterised tetanus toxoid protein (slightly extended and hydrodynamically compact structure with an aspect ratio of ~3). This non-protein like behaviour clearly indicates that it is the carbohydrate component which mainly influences the physical behaviour of the glycoconjugate in solution.

26 CFR 1.6015-1 - Relief from joint and several liability on a joint return.

Code of Federal Regulations, 2010 CFR

2010-04-01

... they claim losses attributable to H's limited partnership interest in Partnership A. In January 2006... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Relief from joint and several liability on a... joint and several liability on a joint return. (a) In general. (1) An individual who qualifies and...

Large displacement spherical joint

DOEpatents

Bieg, Lothar F.; Benavides, Gilbert L.

2002-01-01

A new class of spherical joints has a very large accessible full cone angle, a property which is beneficial for a wide range of applications. Despite the large cone angles, these joints move freely without singularities.

Chronic bilateral dislocation of temporomandibular joint.

PubMed

Shakya, S; Ongole, R; Sumanth, K N; Denny, C E

2010-01-01

Dislocation of the condyle of the mandible is a common condition that may occur in an acute or chronic form. It is characterised by inability to close the mouth with or without pain. Dislocation has to be differentiated from subluxation which is a self reducible condition. Dislocation can occur in any direction with anterior dislocation being the commonest one. Various predisposing factors have been associated with dislocation like muscle fatigue and spasm, the defect in the bony surface like shallow articular eminence, and laxity of the capsular ligament. People with defect in collagen synthesis like Ehler Danlos syndrome, Marfan syndrome are said to be genetically predisposed to this condition. Various treatment modalities have been used ranging from conservative techniques to surgical methods. Acute dislocations can be reduced manually or with conservative approach and recurrent and chronic cases can be reduced by surgical intervention. Though the dislocation in our case was 4 months a simple manual reduction proved to be successful. We believe that manual reduction can be attempted as first line of treatment prior to surgical intervention.

Does Success Of Arthroscopic Laser Surgery In The Knee Joint Warrant Its Extension To "Non-Knee" Joints?

NASA Astrophysics Data System (ADS)

Smith, Chadwick F.; Johansen, W. Edward; Vangness, C. Thomas; Yamaguchi, Ken; McEleney, Emmett T.; Bales, Peter

1987-03-01

One of the authors has performed 162 arthroscopic laser surgeries in the knee joint without any major complication. Other investigators have recently proposed diagnostic arthroscopy and arthroscopic surgery for "non-knee" joints. The authors have proposed that arthroscopic laser surgery he extended to "non-knee" joints. The authors have performed arthroscopic laser surgery on "non-knee" joints of twelve cadavers. One of the authors have performed one successful arthroscopic surgery on a shoulder joint with only a minor, transient complication of subcutaneous emphysema. Is laser arthroscopic surgery safe and effective in "non-knee" joints? The evolving answer appears to be a qualified "Yes," which needs to be verified by a multicenter trial.

Estimation of Time-Varying, Intrinsic and Reflex Dynamic Joint Stiffness during Movement. Application to the Ankle Joint

PubMed Central

Guarín, Diego L.; Kearney, Robert E.

2017-01-01

Dynamic joint stiffness determines the relation between joint position and torque, and plays a vital role in the control of posture and movement. Dynamic joint stiffness can be quantified during quasi-stationary conditions using disturbance experiments, where small position perturbations are applied to the joint and the torque response is recorded. Dynamic joint stiffness is composed of intrinsic and reflex mechanisms that act and change together, so that nonlinear, mathematical models and specialized system identification techniques are necessary to estimate their relative contributions to overall joint stiffness. Quasi-stationary experiments have demonstrated that dynamic joint stiffness is heavily modulated by joint position and voluntary torque. Consequently, during movement, when joint position and torque change rapidly, dynamic joint stiffness will be Time-Varying (TV). This paper introduces a new method to quantify the TV intrinsic and reflex components of dynamic joint stiffness during movement. The algorithm combines ensemble and deterministic approaches for estimation of TV systems; and uses a TV, parallel-cascade, nonlinear system identification technique to separate overall dynamic joint stiffness into intrinsic and reflex components from position and torque records. Simulation studies of a stiffness model, whose parameters varied with time as is expected during walking, demonstrated that the new algorithm accurately tracked the changes in dynamic joint stiffness using as little as 40 gait cycles. The method was also used to estimate the intrinsic and reflex dynamic ankle stiffness from an experiment with a healthy subject during which ankle movements were imposed while the subject maintained a constant muscle contraction. The method identified TV stiffness model parameters that predicted the measured torque very well, accounting for more than 95% of its variance. Moreover, both intrinsic and reflex dynamic stiffness were heavily modulated through the

Hip and knee joints are more stabilized than driven during the stance phase of gait: an analysis of the 3D angle between joint moment and joint angular velocity.

PubMed

Dumas, R; Cheze, L

2008-08-01

Joint power is commonly used in orthopaedics, ergonomics or sports analysis but its clinical interpretation remains controversial. Some basic principles on muscle actions and energy transfer have been proposed in 2D. The decomposition of power on 3 axes, although questionable, allows the same analysis in 3D. However, these basic principles have been widely criticized, mainly because bi-articular muscles must be considered. This requires a more complex computation in order to determine how the individual muscle force contributes to drive the joint. Conversely, with simple 3D inverse dynamics, the analysis of both joint moment and angular velocity directions is essential to clarify when the joint moment can contribute or not to drive the joint. The present study evaluates the 3D angle between the joint moment and the joint angular velocity and investigates when the hip, knee and ankle joints are predominantly driven (angle close to 0 degrees and 180 degrees ) or stabilized (angle close to 90 degrees ) during gait. The 3D angle curves show that the three joints are never fully but only partially driven and that the hip and knee joints are mainly stabilized during the stance phase. The notion of stabilization should be further investigated, especially for subjects with motion disorders or prostheses.

Swivel Joint For Liquid Nitrogen

NASA Technical Reports Server (NTRS)

Milner, James F.

1988-01-01

Swivel joint allows liquid-nitrogen pipe to rotate through angle of 100 degree with respect to mating pipe. Functions without cracking hard foam insulation on lines. Pipe joint rotates on disks so mechanical stress not transmitted to thick insulation on pipes. Inner disks ride on fixed outer disks. Disks help to seal pressurized liquid nitrogen flowing through joint.

The Standard Joint Unit.

PubMed

Casajuana Kögel, Cristina; Balcells-Olivero, María Mercedes; López-Pelayo, Hugo; Miquel, Laia; Teixidó, Lídia; Colom, Joan; Nutt, David John; Rehm, Jürgen; Gual, Antoni

2017-07-01

Reliable data on cannabis quantities is required to improve assessment of cannabis consumption for epidemiological analysis and clinical assessment, consequently a Standard Joint Unit (SJU) based on quantity of 9-Tetrahydrocannabinol (9-THC) has been established. Naturalistic study of a convenience sample recruited from February 2015-June 2016 in universities, leisure spaces, mental health services and cannabis clubs in Barcelona. Adults, reporting cannabis use in the last 60 days, without cognitive impairment or language barriers, answered a questionnaire on cannabis use and were asked to donate a joint to further determine their 9-THC and Cannabidiol (CBD) content. 492 participants donated 315 valid joints. Donators were on average 29 years old, mostly men (77%), single (75%), with at least secondary studies (73%) and in active employment (63%). Marijuana joints (N=232) contained a median of 6.56mg of 9-THC (Interquartile range-IQR=10,22) and 0.02mg of CBD (IQR=0.02); hashish joints (N=83) a median of 7.94mg of 9-THC (IQR=10,61) and 3.24mg of CBD (IQR=3.21). Participants rolled 4 joints per gram of cannabis and paid 5€ per gram (median values). Consistent 9-THC-content in joints lead to a SJU of 7mg of 9-THC, the integer number closest to the median values shared by both cannabis types. Independently if marijuana or hashish, 1 SJU = 1 joint = 0.25 g of cannabis = 7 mg of 9-THC. For CBD, only hashish SJU contained relevant levels. Similarly to the Standard Drink Unit for alcohol, the SJU is useful for clinical, epidemiological and research purposes. Copyright © 2017 Elsevier B.V. All rights reserved.

Temporo mandibular joint ankylosis.

PubMed

Vasconcelos, Belmiro Cavalcanti do Egito; Porto, Gabriela Granja; Bessa-Nogueira, Ricardo Viana

2008-01-01

Ankylosis may be defined as joint surfaces fusion. The treatment of temporomandibular joint ankylosis poses a significant challenge because of the high recurrence rate. The aim of this study is to report six cases treated by joint reconstruction, evaluate the results of these surgeries and review the literature. The sample in this retrospective study was obtained from the records of the university hospital, patients who had to undergo ankylosis treatment by alloplastic or autogenous graft between March 2001 and October 2005. Pre - and post-operative assessment included a throughout history and physical examination to determine the cause of ankylosis, the Maximum mouth opening (MMO), etiology and type of ankylosis, recurrence rate and presence of facial nerve paralysis. The mean MMO in the pre-operative period was 9.6 mm (0 mm to 17 mm) and in the post-operative period it was of 31.33 mm (14 mm to 41 mm), there was no facial nerve paralysis and there was recurrence in just one case. The joint reconstruction with alloplastic or autogenous grafts for the ankylosis treatment proved to be efficient in relation to the post-operative MMO, recurrence and joint function.

Minimally invasive arthrodesis for chronic sacroiliac joint dysfunction using the SImmetry SI Joint Fusion system.

PubMed

Miller, Larry E; Block, Jon E

2014-01-01

Chronic sacroiliac (SI) joint-related low back pain (LBP) is a common, yet under-diagnosed and undertreated condition due to difficulties in accurate diagnosis and highly variable treatment practices. In patients with debilitating SI-related LBP for at least 6 months duration who have failed conservative management, arthrodesis is a viable option. The SImmetry(®) SI Joint Fusion System is a novel therapy for SI joint fusion, not just fixation, which utilizes a minimally invasive surgical approach, instrumented fixation for immediate stability, and joint preparation with bone grafting for a secure construct in the long term. The purpose of this report is to describe the minimally invasive SI Joint Fusion System, including patient selection criteria, implant characteristics, surgical technique, postoperative recovery, and biomechanical testing results. Advantages and limitations of this system will be discussed.

Unloading joints to treat osteoarthritis, including joint distraction.

PubMed

Lafeber, Floris P J G; Intema, Femke; Van Roermund, Peter M; Marijnissen, Anne C A

2006-09-01

Patients are increasingly becoming interested in nonpharmacologic approaches to manage their osteoarthritis. This review examines the recent literature on the potential beneficial effects of unloading joints in the treatment of osteoarthritis, with a focus on joint distraction. Mechanical factors are involved in the development and progression of osteoarthritis. If "loading" is a major cause in development and progression of osteoarthritis, then "unloading" may be able to prevent progression. There is evidence that unloading may be effective in reducing pain and slowing down structural damage. This review describes unloading by footwear and bracing (nonsurgical), unloading by osteotomy (surgical), and has a focus on unloading by joint distraction. Excellent reviews in all these three fields have been published over the past few years. Recent studies argue for the usefulness of a biomechanical approach to improve function and possibly reduce disease progression in osteoarthritis. To improve patient function and possibly reduce disease progression, a biomechanical approach should be considered in treating patients with osteoarthritis. Further research (appropriate high-quality clinical trials) and analysis (clinical as well as preclinical and fundamental) are still necessary, however, to understand, validate, and refine the different approaches of unloading to treat osteoarthritis.

Joint design of QC-LDPC codes for coded cooperation system with joint iterative decoding

NASA Astrophysics Data System (ADS)

Zhang, Shunwai; Yang, Fengfan; Tang, Lei; Ejaz, Saqib; Luo, Lin; Maharaj, B. T.

2016-03-01

In this paper, we investigate joint design of quasi-cyclic low-density-parity-check (QC-LDPC) codes for coded cooperation system with joint iterative decoding in the destination. First, QC-LDPC codes based on the base matrix and exponent matrix are introduced, and then we describe two types of girth-4 cycles in QC-LDPC codes employed by the source and relay. In the equivalent parity-check matrix corresponding to the jointly designed QC-LDPC codes employed by the source and relay, all girth-4 cycles including both type I and type II are cancelled. Theoretical analysis and numerical simulations show that the jointly designed QC-LDPC coded cooperation well combines cooperation gain and channel coding gain, and outperforms the coded non-cooperation under the same conditions. Furthermore, the bit error rate performance of the coded cooperation employing jointly designed QC-LDPC codes is better than those of random LDPC codes and separately designed QC-LDPC codes over AWGN channels.

The joint venture alternative to mergers.

PubMed

Enders, R J

1995-02-01

However, while a joint venture may be "safe" from antitrust challenge, it is not without some practical difficulties, especially with respect to consolidating services at one location or jointly offering services provided at multiple facilities. These practical concerns include: 1. Who will exercise operational management of the joint venture? 2. How will the joint venture deal with different pricing for services that will be provided at multiple locations? 3. What criteria will be used to decide the location at which consolidated tertiary services will be offered? 4. In what circumstances can the joint venture be unwound, either in its entirety or as to discrete functions? When clinical services have been consolidated at one location, there is an appropriate concern by the other hospital that it will be unable to provide or re-enter the market for those services if the joint venture dissolves. These operational concerns, of course, are not addressed in the Consent Decree. Thus, even if a joint venture relationship survives antitrust scrutiny, the parties must still negotiate and resolve these operational issues in order for the joint venture to be viable.

Innervation of the Anterior Sacroiliac Joint.

PubMed

Cox, Marcus; Ng, Garrett; Mashriqi, Faizullah; Iwanaga, Joe; Alonso, Fernando; Tubbs, Kevin; Loukas, Marios; Oskouian, Rod J; Tubbs, R Shane

2017-11-01

Sacroiliac joint pain can be disabling and recalcitrant to medical therapy. The innervation of this joint is poorly understood, especially its anterior aspect. Therefore, the present cadaveric study was performed to better elucidate this anatomy. Twenty-four cadaveric sides underwent dissection of the anterior sacroiliac joint, with special attention given to any branches from regional nerves to this joint. No femoral, obturator, or lumbosacral trunk branches destined to the anterior sacroiliac joint were identified in the 24 sides. In 20 sides, one or two small branches (less than 0.5 mm in diameter) were found to arise from the L4 ventral ramus (10%), the L5 ventral ramus (80%), or simultaneously from both the L4 and L5 ventral rami (10%). The length of the branches ranged from 5 to 31 mm (mean, 14 mm). All these branches arose from the posterior part of the nerves and traveled to the anterior surface of the sacroiliac joint. No statistical significance was found between sides or sexes. An improved knowledge of the innervation of the anterior sacroiliac joint might decrease suffering in patients with chronic sacroiliac joint pain. Copyright © 2017 Elsevier Inc. All rights reserved.

Bolted joints in graphite-epoxy composites

NASA Technical Reports Server (NTRS)

Hart-Smith, L. J.

1976-01-01

All-graphite/epoxy laminates and hybrid graphite-glass/epoxy laminates were tested. The tests encompassed a range of geometries for each laminate pattern to cover the three basic failure modes - net section tension failure through the bolt hole, bearing and shearout. Static tensile and compressive loads were applied. A constant bolt diameter of 6.35 mm (0.25 in.) was used in the tests. The interaction of stress concentrations associated with multi-row bolted joints was investigated by testing single- and double-row bolted joints and open-hole specimens in tension. For tension loading, linear interaction was found to exist between the bearing stress reacted at a given bolt hole and the remaining tension stress running by that hole to be reacted elsewhere. The interaction under compressive loading was found to be non-linear. Comparative tests were run using single-lap bolted joints and double-lap joints with pin connection. Both of these joint types exhibited lower strengths than were demonstrated by the corresponding double-lap joints. The analysis methods developed here for single bolt joints are shown to be capable of predicting the behavior of multi-row joints.

Space Station alpha joint bearing

NASA Technical Reports Server (NTRS)

Everman, Michael R.; Jones, P. Alan; Spencer, Porter A.

1987-01-01

Perhaps the most critical structural system aboard the Space Station is the Solar Alpha Rotary Joint which helps align the power generation system with the sun. The joint must provide structural support and controlled rotation to the outboard transverse booms as well as power and data transfer across the joint. The Solar Alpha Rotary Joint is composed of two transition sections and an integral, large diameter bearing. Alpha joint bearing design presents a particularly interesting problem because of its large size and need for high reliability, stiffness, and on orbit maintability. The discrete roller bearing developed is a novel refinement to cam follower technology. It offers thermal compensation and ease of on-orbit maintenance that are not found in conventional rolling element bearings. How the bearing design evolved is summarized. Driving requirements are reviewed, alternative concepts assessed, and the selected design is described.

[Application of joint reconstruction with autogenous coronoid process graft to treat temporomandibular joint ankylosis].

PubMed

Xie, Qing-tiao; Huang, Xuan-ping; Jiang, Xian-fang; Yang, Yuan-yuan; Li, Hua; Lin, Xi

2013-08-01

To evaluate the clinical effect of joint reconstruction by using autogenous coronoid process graft to treat temporomandibular joint(TMJ) ankylosis. Nine cases of TMJ ankylosis from September 2008 to September 2010 were surgically treated by joint reconstruction with autogenous coronoid process graft, using autogenous articular disc or prosthodontic membrane as interpositional material. Mouth opening, occlusion and cone beam CT(CBCT) were used for evaluation before and after surgery. Satisfactory mouth opening was achieved in all patients and no one got occlusal changes or reankylosis during follow-up. CBCT showed that coronoid process graft reached bone union with the ramus and turned to be round. It is effective to cure TMJ ankylosis through joint reconstruction with autogenous coronoid process graft.

The Opportunistic Pathogen Vibrio vulnificus Produces Outer Membrane Vesicles in a Spatially Distinct Manner Related to Capsular Polysaccharide

PubMed Central

Hampton, Cheri M.; Guerrero-Ferreira, Ricardo C.; Storms, Rachel E.; Taylor, Jeannette V.; Yi, Hong; Gulig, Paul A.; Wright, Elizabeth R.

2017-01-01

Vibrio vulnificus, a bacterial species that inhabits brackish waters, is an opportunistic pathogen of humans. V. vulnificus infections can cause acute gastroenteritis, invasive septicemia, tissue necrosis, and potentially death. Virulence factors associated with V. vulnificus include the capsular polysaccharide (CPS), lipopolysaccharide, flagellum, pili, and outer membrane vesicles (OMVs). The aims of this study were to characterize the morphology of V. vulnificus cells and the formation and arrangement of OMVs using cryo-electron microscopy (cryo-EM). cryo-EM and cryo-electron tomography imaging of V. vulnificus strains grown in liquid cultures revealed the presence of OMVs (diameters of ∼45 nm for wild-type, ∼30 nm for the unencapsulated mutant, and ∼50 nm for the non-motile mutant) in log-phase growth. Production of OMVs in the stationary growth phase was limited and irregular. The spacing of the OMVs around the wild-type cells was in regular, concentric rings. In wild-type cells and a non-motile mutant, the spacing between the cell envelope and the first ring of OMVs was ∼200 nm; this spacing was maintained between subsequent OMV layers. The size, arrangement, and spacing of OMVs in an unencapsulated mutant was irregular and indicated that the polysaccharide chains of the capsule regulate aspects of OMV production and order. Together, our results revealed the distinctive organization of V. vulnificus OMVs that is affected by expression of the CPS. PMID:29163452

Phase 1 Program Joint Report

NASA Technical Reports Server (NTRS)

Nield, George C. (Editor); Vorobiev, Pavel Mikhailovich (Editor)

1999-01-01

This report consists of inputs from each of the Phase I Program Joint Working Groups. The Working Groups were tasked to describe the organizational structure and work processes that they used during the program, joint accomplishments, lessons learned, and applications to the International Space Station Program. This report is a top-level joint reference document that contains information of interest to both countries.

Self-Alining Quick-Connect Joint

NASA Technical Reports Server (NTRS)

Lucy, M. H.

1983-01-01

Quick connect tapered joint used with minimum manipulation and force. Split ring retainer holds locking ring in place. Minimal force required to position male in female joint, at which time split-ring retainers are triggered to release split locking rings. Originally developed to assemble large space structures, joint is simple, compact, strong, lightweight, self alining, and has no loose parts.

Feature-extracted joint transform correlation.

PubMed

Alam, M S

1995-12-10

A new technique for real-time optical character recognition that uses a joint transform correlator is proposed. This technique employs feature-extracted patterns for the reference image to detect a wide range of characters in one step. The proposed technique significantly enhances the processing speed when compared with the presently available joint transform correlator architectures and shows feasibility for multichannel joint transform correlation.

Cancer risk among patients with finger and hand joint and temporo-mandibular joint prostheses in Denmark.

PubMed

Fryzek, J P; Mellemkjaer, L; McLaughlin, J K; Blot, W J; Olsen, J H

1999-05-31

The use of artificial joint implants has risen greatly over the past years. However, few investigations of the cancer risk associated with implants have been performed. We investigated cancer risk in patients with finger and hand joint and temporo-mandibular (TMJ) joint implants. A nationwide cohort in Denmark of patients with finger and hand joint prostheses (n = 858) or TMJ implants (n = 389) was followed from January 1, 1977, to December 31, 1995, to evaluate any potential cancer risks subsequent to receiving these implants. Standardized incidence ratios (SIRs) for all cancers were 1.0 (95% CI = 0.8-1.2) for the finger and hand joint cohort and 1.1 (95% CI = 0.8-1.7) for the TMJ cohort. A significant risk for non-Hodgkin's lymphoma was found in the finger and hand joint cohort (SIR = 3.8, 95% CI = 1.5-7.8). When the finger and hand joint cohort was stratified by diagnosis of rheumatoid arthritis, the excess risk was seen only in the group with rheumatoid arthritis. This is consistent with past studies, which have found an association between rheumatoid arthritis and non-Hodgkin's lymphoma. Our results provide evidence that the cancer risk for patients with finger and hand joint prostheses and TMJ implants is similar to that for the general population.

JointMMCC: Joint Maximum-Margin Classification and Clustering of Imaging Data

PubMed Central

Filipovych, Roman; Resnick, Susan M.; Davatzikos, Christos

2012-01-01

A number of conditions are characterized by pathologies that form continuous or nearly-continuous spectra spanning from the absence of pathology to very pronounced pathological changes (e.g., normal aging, Mild Cognitive Impairment, Alzheimer's). Moreover, diseases are often highly heterogeneous with a number of diagnostic subcategories or subconditions lying within the spectra (e.g., Autism Spectrum Disorder, schizophrenia). Discovering coherent subpopulations of subjects within the spectrum of pathological changes may further our understanding of diseases, and potentially identify subconditions that require alternative or modified treatment options. In this paper, we propose an approach that aims at identifying coherent subpopulations with respect to the underlying MRI in the scenario where the condition is heterogeneous and pathological changes form a continuous spectrum. We describe a Joint Maximum-Margin Classification and Clustering (JointMMCC) approach that jointly detects the pathologic population via semi-supervised classification, as well as disentangles heterogeneity of the pathological cohort by solving a clustering subproblem. We propose an efficient solution to the non-convex optimization problem associated with JointMMCC. We apply our proposed approach to an MRI study of aging, and identify coherent subpopulations (i.e., clusters) of cognitively less stable adults. PMID:22328179

Minimally invasive arthrodesis for chronic sacroiliac joint dysfunction using the SImmetry SI Joint Fusion system

PubMed Central

Miller, Larry E; Block, Jon E

2014-01-01

Chronic sacroiliac (SI) joint-related low back pain (LBP) is a common, yet under-diagnosed and undertreated condition due to difficulties in accurate diagnosis and highly variable treatment practices. In patients with debilitating SI-related LBP for at least 6 months duration who have failed conservative management, arthrodesis is a viable option. The SImmetry® SI Joint Fusion System is a novel therapy for SI joint fusion, not just fixation, which utilizes a minimally invasive surgical approach, instrumented fixation for immediate stability, and joint preparation with bone grafting for a secure construct in the long term. The purpose of this report is to describe the minimally invasive SI Joint Fusion System, including patient selection criteria, implant characteristics, surgical technique, postoperative recovery, and biomechanical testing results. Advantages and limitations of this system will be discussed. PMID:24851059

HMA Longitudinal Joint Evaluation and Construction

DOT National Transportation Integrated Search

2011-02-01

Longitudinal joint quality is essential to the successful performance of asphalt pavements. A number of states have begun to implement longitudinal joint specifications, and most are based on determinations of density. However, distress at the joint ...

The volume of the human knee joint.

PubMed

Matziolis, Georg; Roehner, Eric; Windisch, Christoph; Wagner, Andreas

2015-10-01

Despite its clinical relevance, particularly in septic knee surgery, the volume of the human knee joint has not been established to date. Therefore, the objective of this study was to determine knee joint volume and whether or not it is dependent on sex or body height. Sixty-one consecutive patients (joints) who were due to undergo endoprosthetic joint replacement were enrolled in this prospective study. During the operation, the joint volume was determined by injecting saline solution until a pressure of 200 mmHg was achieved in the joint. The average volume of all knee joints was 131 ± 53 (40-290) ml. The volume was not found to be dependent on sex, but it was dependent on the patients' height (R = 0.312, p = 0.014). This enabled an estimation of the joint volume according to V = 1.6 height - 135. The considerable inter-individual variance of the knee joint volume would suggest that it should be determined or at least estimated according to body height if the joint volume has consequences for the diagnostics or therapy of knee disorders.

Method of forming a joint

DOEpatents

Butt, Darryl Paul; Cutler, Raymond Ashton; Rynders, Steven Walton; Carolan, Michael Francis

2006-08-22

A method of joining at least two sintered bodies to form a composite structure, including providing a first multicomponent metallic oxide having a perovskitic or fluorite crystal structure; providing a second sintered body including a second multicomponent metallic oxide having a crystal structure of the same type as the first; and providing at an interface a joint material containing at least one metal oxide containing at least one metal identically contained in at least one of the first and second multicomponent metallic oxides. The joint material is free of cations of Si, Ge, Sn, Pb, P and Te and has a melting point below the sintering temperatures of both sintered bodies. The joint material is heated to a temperature above the melting point of the metal oxide(s) and below the sintering temperatures of the sintered bodies to form the joint. Structures containing such joints are also disclosed.

RSRM Nozzle-to-Case Joint J-leg Development

NASA Technical Reports Server (NTRS)

Albrechtsen, Kevin U.; Eddy, Norman F.; Ewing, Mark E.; McGuire, John R.

2003-01-01

Since the beginning of the Space Shuttle Reusable Solid Rocket Motor (RSRM) program, nozzle-to-case joint polysulfide adhesive gas paths have occurred on several flight motors. These gas paths have allowed hot motor gases to reach the wiper O-ring. Even though these motors continue to fly safely with this condition, a desire was to reduce such occurrences. The RSRM currently uses a J-leg joint configuration on case field joints and igniter inner and outer joints. The J-leg joint configuration has been successfully demonstrated on numerous RSRM flight and static test motors, eliminating hot gas intrusion to the critical O-ring seals on these joints. Using the proven technology demonstrated on the case field joints and igniter joints, a nozzle-to-case joint J-leg design was developed for implementation on RSRM flight motors. This configuration provides an interference fit with nozzle fixed housing phenolics at assembly, with a series of pressurization gaps incorporated outboard of the joint mating surface to aid in joint pressurization and to eliminate any circumferential flow in this region. The joint insulation is bonded to the nozzle phenolics using the same pressure sensitive adhesive used in the case field joints and igniter joints. An enhancement to the nozzle-to-case joint J-leg configuration is the implementation of a carbon rope thermal barrier. The thermal barrier is located downstream of the joint bondline and is positioned within the joint in a manner where any hot gas intrusion into the joint passes through the thermal barrier, reducing gas temperatures to a level that would not affect O-rings downstream of the thermal barrier. This paper discusses the processes used in reaching a final nozzle-to-case joint J-leg design, provides structural and thermal results in support of the design, and identifies fabrication techniques and demonstrations used in arriving at the final configuration.

Rotary Joints With Electrical Connections

NASA Technical Reports Server (NTRS)

Osborn, F. W.

1986-01-01

Power and data transmitted on many channels. Two different rotary joints equipped with electrical connections between rotating and stationary parts. One joint transmits axial thrust and serves as interface between spinning and nonspinning parts of Galileo spacecraft. Other is scanning (limitedrotation) joint that aims scientific instruments from nonspinning part. Selected features of both useful to designers of robots, advanced production equipment, and remotely controlled instruments.

Prosthetic Joint Infections

PubMed Central

Aslam, Saima; Darouiche, Rabih O.

2012-01-01

Prosthetic joint infections represent a major therapeutic challenge for both healthcare providers and patients. This paper reviews the predisposing factors, pathogenesis, microbiology, diagnosis, treatment and prophylaxis of prosthetic joint infection. The most optimal management strategy should be identified based on a number of considerations including type and duration of infection, antimicrobial susceptibility of the infecting pathogen, condition of infected tissues and bone stock, patient wishes and functional status. PMID:22847032

Common Bolted Joint Analysis Tool

NASA Technical Reports Server (NTRS)

Imtiaz, Kauser

2011-01-01

Common Bolted Joint Analysis Tool (comBAT) is an Excel/VB-based bolted joint analysis/optimization program that lays out a systematic foundation for an inexperienced or seasoned analyst to determine fastener size, material, and assembly torque for a given design. Analysts are able to perform numerous what-if scenarios within minutes to arrive at an optimal solution. The program evaluates input design parameters, performs joint assembly checks, and steps through numerous calculations to arrive at several key margins of safety for each member in a joint. It also checks for joint gapping, provides fatigue calculations, and generates joint diagrams for a visual reference. Optimum fastener size and material, as well as correct torque, can then be provided. Analysis methodology, equations, and guidelines are provided throughout the solution sequence so that this program does not become a "black box:" for the analyst. There are built-in databases that reduce the legwork required by the analyst. Each step is clearly identified and results are provided in number format, as well as color-coded spelled-out words to draw user attention. The three key features of the software are robust technical content, innovative and user friendly I/O, and a large database. The program addresses every aspect of bolted joint analysis and proves to be an instructional tool at the same time. It saves analysis time, has intelligent messaging features, and catches operator errors in real time.

Adhesive-bonded scarf and stepped-lap joints

NASA Technical Reports Server (NTRS)

Hart-Smith, L. J.

1973-01-01

Continuum mechanics solutions are derived for the static load-carrying capacity of scarf and stepped-lap adhesive-bonded joints. The analyses account for adhesive plasticity and adherend stiffness imbalance and thermal mismatch. The scarf joint solutions include a simple algebraic formula which serves as a close lower bound, within a small fraction of a per cent of the true answer for most practical geometries and materials. Digital computer programs were developed and, for the stepped-lap joints, the critical adherend and adhesive stresses are computed for each step. The scarf joint solutions exhibit grossly different behavior from that for double-lap joints for long overlaps inasmuch as that the potential bond shear strength continues to increase with indefinitely long overlaps on the scarf joints. The stepped-lap joint solutions exhibit some characteristics of both the scarf and double-lap joints. The stepped-lap computer program handles arbitrary (different) step lengths and thickness and the solutions obtained have clarified potentially weak design details and the remedies. The program has been used effectively to optimize the joint proportions.

Dynamic Analyses Including Joints Of Truss Structures

NASA Technical Reports Server (NTRS)

Belvin, W. Keith

1991-01-01

Method for mathematically modeling joints to assess influences of joints on dynamic response of truss structures developed in study. Only structures with low-frequency oscillations considered; only Coulomb friction and viscous damping included in analysis. Focus of effort to obtain finite-element mathematical models of joints exhibiting load-vs.-deflection behavior similar to measured load-vs.-deflection behavior of real joints. Experiments performed to determine stiffness and damping nonlinearities typical of joint hardware. Algorithm for computing coefficients of analytical joint models based on test data developed to enable study of linear and nonlinear effects of joints on global structural response. Besides intended application to large space structures, applications in nonaerospace community include ground-based antennas and earthquake-resistant steel-framed buildings.

Joint contact forces can be reduced by improving joint moment symmetry in below-knee amputee gait simulations.

PubMed

Koelewijn, Anne D; van den Bogert, Antonie J

2016-09-01

Despite having a fully functional knee and hip in both legs, asymmetries in joint moments of the knee and hip are often seen in gait of persons with a unilateral transtibial amputation (TTA), possibly resulting in excessive joint loading. We hypothesize that persons with a TTA can walk with more symmetric joint moments at the cost of increased effort or abnormal kinematics. The hypothesis was tested using predictive simulations of gait. Open loop controls of one gait cycle were found by solving an optimization problem that minimizes a combination of walking effort and tracking error in joint angles, ground reaction force and gait cycle duration. A second objective was added to penalize joint moment asymmetry, creating a multi-objective optimization problem. A Pareto front was constructed by changing the weights of the objectives and three solutions were analyzed to study the effect of increasing joint moment symmetry. When the optimization placed more weight on moment symmetry, walking effort increased and kinematics became less normal, confirming the hypothesis. TTA gait improved with a moderate increase in joint moment symmetry. At a small cost of effort and abnormal kinematics, the peak hip extension moment in the intact leg was decreased significantly, and so was the joint contact force in the knee and hip. Additional symmetry required a significant increase in walking effort and the joint contact forces in both hips became significantly higher than in able-bodied gait. Copyright © 2016 Elsevier B.V. All rights reserved.

77 FR 39560 - International Joint Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-03

... DEPARTMENT OF STATE [Public Notice 7945] International Joint Commission International Joint Commission Invites Public Comment on Upper Great Lakes Report The International Joint Commission (IJC) announced today that it is inviting public comment on the final report of its International Upper Great...

Joint torques in a freely walking insect reveal distinct functions of leg joints in propulsion and posture control

PubMed Central

2016-01-01

Determining the mechanical output of limb joints is critical for understanding the control of complex motor behaviours such as walking. In the case of insect walking, the neural infrastructure for single-joint control is well described. However, a detailed description of the motor output in form of time-varying joint torques is lacking. Here, we determine joint torques in the stick insect to identify leg joint function in the control of body height and propulsion. Torques were determined by measuring whole-body kinematics and ground reaction forces in freely walking animals. We demonstrate that despite strong differences in morphology and posture, stick insects show a functional division of joints similar to other insect model systems. Propulsion was generated by strong depression torques about the coxa–trochanter joint, not by retraction or flexion/extension torques. Torques about the respective thorax–coxa and femur–tibia joints were often directed opposite to fore–aft forces and joint movements. This suggests a posture-dependent mechanism that counteracts collapse of the leg under body load and directs the resultant force vector such that strong depression torques can control both body height and propulsion. Our findings parallel propulsive mechanisms described in other walking, jumping and flying insects, and challenge current control models of insect walking. PMID:26791608

Early Osteoarthritis of the Trapeziometacarpal Joint Is Not Associated With Joint Instability during Typical Isometric Loading

PubMed Central

Halilaj, Eni; Moore, Douglas C.; Patel, Tarpit K.; Ladd, Amy L.; Weiss, Arnold-Peter C.; Crisco, Joseph J.

2015-01-01

The saddle-shaped trapeziometacarpal (TMC) joint contributes importantly to the function of the human thumb. A balance between mobility and stability is essential in this joint, which experiences high loads and is prone to osteoarthritis (OA). Since instability is considered a risk factor for TMC OA, we assessed TMC joint instability during the execution of three isometric functional tasks (key pinch, jar grasp, and jar twist) in 76 patients with early TMC OA and 44 asymptomatic controls. Computed tomography images were acquired while subjects held their hands relaxed and while they applied 80% of their maximum effort for each task. Six degree-of-freedom rigid body kinematics of the metacarpal with respect to the trapezium from the unloaded to the loaded task positions were computed in terms of a TMC joint coordinate system. Joint instability was expressed as a function of the metacarpal translation and the applied force. We found that the TMC joint was more unstable during a key pinch task than during a jar grasp or a jar twist task. Sex, age, and early OA did not have an effect on TMC joint instability, suggesting that instability during these three tasks is not a predisposing factor in TMC OA. PMID:25941135

Improved Automatically Locking/Unlocking Orthotic Knee Joint

NASA Technical Reports Server (NTRS)

Weddendorf, Bruce

1995-01-01

Proposed orthotic knee joint improved version of one described in "Automatically Locking/Unlocking Orthotic Knee Joint" (MFS-28633). Locks automatically upon initial application of radial force (wearer's weight) and unlocks automatically, but only when all loads (radial force and bending) relieved. Joints lock whenever wearer applies weight to knee at any joint angle between full extension and 45 degree bend. Both devices offer increased safety and convenience relative to conventional orthotic knee joints.

Real-Time Visualization of Joint Cavitation

PubMed Central

Rowe, Lindsay

2015-01-01

Cracking sounds emitted from human synovial joints have been attributed historically to the sudden collapse of a cavitation bubble formed as articular surfaces are separated. Unfortunately, bubble collapse as the source of joint cracking is inconsistent with many physical phenomena that define the joint cracking phenomenon. Here we present direct evidence from real-time magnetic resonance imaging that the mechanism of joint cracking is related to cavity formation rather than bubble collapse. In this study, ten metacarpophalangeal joints were studied by inserting the finger of interest into a flexible tube tightened around a length of cable used to provide long-axis traction. Before and after traction, static 3D T1-weighted magnetic resonance images were acquired. During traction, rapid cine magnetic resonance images were obtained from the joint midline at a rate of 3.2 frames per second until the cracking event occurred. As traction forces increased, real-time cine magnetic resonance imaging demonstrated rapid cavity inception at the time of joint separation and sound production after which the resulting cavity remained visible. Our results offer direct experimental evidence that joint cracking is associated with cavity inception rather than collapse of a pre-existing bubble. These observations are consistent with tribonucleation, a known process where opposing surfaces resist separation until a critical point where they then separate rapidly creating sustained gas cavities. Observed previously in vitro, this is the first in-vivo macroscopic demonstration of tribonucleation and as such, provides a new theoretical framework to investigate health outcomes associated with joint cracking. PMID:25875374

Joint Disorders - Multiple Languages

MedlinePlus

... a new window. Arabic (العربية) Expand Section Home Care After Total Joint Replacement - العربية (Arabic) Bilingual PDF Health Information Translations Bosnian (bosanski) Expand Section Home Care After Total Joint Replacement - bosanski (Bosnian) Bilingual PDF Health Information ...

15 CFR 296.8 - Joint venture agreement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS TECHNOLOGY INNOVATION PROGRAM General § 296.8 Joint venture agreement. NIST shall not issue a TIP award to a joint venture and... joint venture agreement has been executed by all of the joint venture members and approved by NIST. ...

15 CFR 296.8 - Joint venture agreement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS TECHNOLOGY INNOVATION PROGRAM General § 296.8 Joint venture agreement. NIST shall not issue a TIP award to a joint venture and... joint venture agreement has been executed by all of the joint venture members and approved by NIST. ...

15 CFR 296.8 - Joint venture agreement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS TECHNOLOGY INNOVATION PROGRAM General § 296.8 Joint venture agreement. NIST shall not issue a TIP award to a joint venture and... joint venture agreement has been executed by all of the joint venture members and approved by NIST. ...

15 CFR 296.8 - Joint venture agreement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS TECHNOLOGY INNOVATION PROGRAM General § 296.8 Joint venture agreement. NIST shall not issue a TIP award to a joint venture and... joint venture agreement has been executed by all of the joint venture members and approved by NIST. ...

15 CFR 296.8 - Joint venture agreement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS TECHNOLOGY INNOVATION PROGRAM General § 296.8 Joint venture agreement. NIST shall not issue a TIP award to a joint venture and... joint venture agreement has been executed by all of the joint venture members and approved by NIST. ...

Second-site prosthetic joint infection in patients with multiple prosthetic joints.

PubMed

Clesham, Kevin; Hughes, Andrew J; O' hEireamhoin, Sven; Fleming, Catherine; Murphy, Colin G

2018-04-10

Prosthetic joint infections (PJIs) are among the most serious complications in arthroplasty. A second-site PJI in patients with multiple prosthetic joints increases morbidity, with many requiring further revision procedures. We aimed to establish why some patients with multiple joints develop second-site infections. Our institution's arthroplasty database was reviewed from 2004 to 2017. All PJIs were identified, and all patients with more than one prosthetic joint in situ were included. We recorded risk factors, causative organisms, number of procedures and length of stay. Forty-four patients meeting the criteria were identified. Four patients (9.1%) developed second-site infection. Eight patients (18.2%) developed re-infection of the primary PJI. Positive MRSA carrier status and PJI of a total knee replacement were associated with an increased risk of a second episode of infection. Patients who developed further infection had more frequent admission and longer lengths of stay than isolated PJIs. Higher morbidity and use of hospital resources are associated with this cohort of patients. PJIs in total knee replacements and positive MRSA status are associated with higher rates of second infection. Identifying this vulnerable cohort of patients at an early stage is critical to ensure measures are taken to reduce the risks of further infection.

Structural analysis of Aircraft fuselage splice joint

NASA Astrophysics Data System (ADS)

Udaya Prakash, R.; Kumar, G. Raj; Vijayanandh, R.; Senthil Kumar, M.; Ramganesh, T.

2016-09-01

In Aviation sector, composite materials and its application to each component are one of the prime factors of consideration due to the high strength to weight ratio, design flexibility and non-corrosive so that the composite materials are widely used in the low weight constructions and also it can be treated as a suitable alternative to metals. The objective of this paper is to estimate and compare the suitability of a composite skin joint in an aircraft fuselage with different joints by simulating the displacement, normal stress, vonmises stress and shear stress with the help of numerical solution methods. The reference Z-stringer component of this paper is modeled by CATIA and numerical simulation is carried out by ANSYS has been used for splice joint presents in the aircraft fuselage with three combinations of joints such as riveted joint, bonded joint and hybrid joint. Nowadays the stringers are using to avoid buckling of fuselage skin, it has joined together by rivets and they are connected end to end by splice joint. Design and static analysis of three-dimensional models of joints such as bonded, riveted and hybrid are carried out and results are compared.

Dorsoradial capsulodesis for trapeziometacarpal joint instability.

PubMed

Rayan, Ghazi; Do, Viet

2013-02-01

We describe an alternative method for treating chronic trapeziometacarpal (TM) joint instability after acute injury or chronic repetitive use of the thumb by performing a dorsoradial capsulodesis procedure. The procedure is done by imbricating the redundant TM joint dorsoradial ligament and capsule after reducing the joint by pronating the thumb. The dorsoradial capsulodesis is a reasonable reconstructive option for chronic TM joint instability and subluxation. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Technology needs for the development of the accommodative intraocular lens

NASA Astrophysics Data System (ADS)

Nishi, Okihiro

2010-02-01

Refilling the lens capsule while preserving capsular integrity offers the potential to restore ocular accommodation. There are two persisting problems in capsular bag refilling for possible clinical application: Leakage of the injectable material through the capsular opening and capsular opacification. Numerous attempts for solving these cardinal problems have not been proven to be clinically applicable. Recently, we developed a novel capsular bag refilling procedure using a novel accommodative intraocular lens that serves as an optic as well as a plug for sealing the capsular opening. The procedure and the results of monkey experiments will be presented.

Fluoroscopic Sacroiliac Joint Injection: Is Oblique Angulation Really Necessary?

PubMed

Khuba, Sandeep; Agarwal, Anil; Gautam, Sujeet; Kumar, Sanjay

2016-01-01

The conventional technique for sacroiliac (SI) joint injection involves aligning the anterior and posterior aspects of the SI joint under fluoroscopic guidance and then entering the SI joint in the most caudal aspect. We wish to highlight that there is no added advantage to aligning both the anterior and posterior joint lines of the SI joint as it is time consuming, associated with additional radiation exposure, and may make the entry into the posterior SI joint technically more difficult. Observational study. Pain Clinic, Department of Anesthesiology. With the patient lying prone on fluoroscopy table, SI joint injection is performed with a 22 G, 10 cm spinal needle in a true anteroposterior (AP) view, where anterior and posterior SI joint spaces are seen as separate entities, where the medial joint space represents the posterior SI joint and the lateral joint space represents the anterior SI joint. The distal 1 cm of the medial joint space is entered under AP view. If the SI joint is seen as a straight line rather than 2 joint spaces in the AP view then the image intensifier of the fluoroscope was tilted cranially to elongate the image of the lower part of the posterior SI joint, thus facilitating entry into this part of the joint which was confirmed by administering 0.3 to 0.5 mL of radiopaque contrast medium. Sixty SI joints of 58 patients were injected under an AP fluoroscopic view. Forty-two (70%) SI joints were seen as 2 separate medial and lateral joint spaces and were entered in distal 1 cm of the medial joint space. In 18 (30%) joints seen as a straight line rather than 2 separate spaces, the image intensifier of the fluoroscope was tilted cranially to elongate the image of the lower part of the posterior SI joint and then the SI joint was entered in its distal 1 cm. Confirmation of entry into the SI joint was confirmed by with 0.3 to 0.5 mL of radiopaque contrast medium. In 4 cases the joints did not show the correct radiopaque contrast spread (3/42 and 1

Increased expression of damage-associated molecular patterns (DAMPs) in osteoarthritis of human knee joint compared to hip joint.

PubMed

Rosenberg, John H; Rai, Vikrant; Dilisio, Matthew F; Sekundiak, Todd D; Agrawal, Devendra K

2017-12-01

Osteoarthritis (OA) is a degenerative disease characterized by the destruction of cartilage. The greatest risk factors for the development of OA include age and obesity. Recent studies suggest the role of inflammation in the pathogenesis of OA. The two most common locations for OA to occur are in the knee and hip joints. The knee joint experiences more mechanical stress, cartilage degeneration, and inflammation than the hip joint. This could contribute to the increased incidence of OA in the knee joint. Damage-associated molecular patterns (DAMPs), including high-mobility group box-1, receptor for advanced glycation end products, and alarmins (S100A8 and S100A9), are released in the joint in response to stress-mediated chondrocyte and cartilage damage. This facilitates increased cartilage degradation and inflammation in the joint. Studies have documented the role of DAMPs in the pathogenesis of OA; however, the comparison of DAMPs and its influence on OA has not been discussed. In this study, we compared the DAMPs between OA knee and hip joints and found a significant difference in the levels of DAMPs expressed in the knee joint compared to the hip joint. The increased levels of DAMPs suggest a difference in the underlying pathogenesis of OA in the knee and the hip and highlights DAMPs as potential therapeutic targets for OA in the future.

49 CFR 213.351 - Rail joints.

Code of Federal Regulations, 2011 CFR

2011-10-01

... replaced. (d) Each rail shall be bolted with at least two bolts at each joint. (e) Each joint bar shall be... in this subpart. (f) No rail shall have a bolt hole which is torch cut or burned. (g) No joint bar shall be reconfigured by torch cutting. ...

Objective Assessment of Joint Stiffness: A Clinically Oriented Hardware and Software Device with an Application to the Shoulder Joint.

PubMed

McQuade, Kevin; Price, Robert; Liu, Nelson; Ciol, Marcia A

2012-08-30

Examination of articular joints is largely based on subjective assessment of the "end-feel" of the joint in response to manually applied forces at different joint orientations. This technical report aims to describe the development of an objective method to examine joints in general, with specific application to the shoulder, and suitable for clinical use. We adapted existing hardware and developed laptop-based software to objectively record the force/displacement behavior of the glenohumeral joint during three common manual joint examination tests with the arm in six positions. An electromagnetic tracking system recorded three-dimensional positions of sensors attached to a clinician examiner and a patient. A hand-held force transducer recorded manually applied translational forces. The force and joint displacement were time-synchronized and the joint stiffness was calculated as a quantitative representation of the joint "end-feel." A methodology and specific system checks were developed to enhance clinical testing reproducibility and precision. The device and testing protocol were tested on 31 subjects (15 with healthy shoulders, and 16 with a variety of shoulder impairments). Results describe the stiffness responses, and demonstrate the feasibility of using the device and methods in clinical settings.

Antibody Response Specific to the Capsular Polysaccharide Is Impaired in Streptococcus suis Serotype 2-Infected Animals

PubMed Central

Calzas, Cynthia; Lemire, Paul; Auray, Gael; Gerdts, Volker; Gottschalk, Marcelo

2014-01-01

Streptococcus suis serotype 2 is an extracellular encapsulated bacterium that causes severe septicemia and meningitis in swine and humans. Albeit crucial in the fight against encapsulated bacteria, the nature of the capsular polysaccharide (CPS)-specific antibody (Ab) response during S. suis type 2 infection is unknown. We compared for the first time the features of CPS-specific versus protein-specific Ab responses during experimental infections with live virulent S. suis type 2 in mice. The primary protein-specific Ab response was dominated by both type 1 and 2 IgG subclasses, whereas IgM titers were more modest. The secondary protein-specific Ab response showed all of the features of a memory response with faster kinetics and boosted the titers of all Ig isotypes. In contrast, the primary CPS-specific Ab response was either inexistent or had titers only slightly higher than those in noninfected animals and was essentially composed of IgM. A poor CPS-specific memory response was observed, with only a moderate boost in IgM titers and no IgG. Both protein- and CPS-specific Ab responses were Toll-like receptor 2 independent. By using S. suis type 2 strains of European or North American origin, the poor CPS-specific Ab response was demonstrated to be independent of the genotypic/phenotypic diversity of the strain within serotype 2. Finally, the CPS-specific Ab response was also impaired and lacked isotype switching in S. suis-infected pigs, the natural host of the bacterium. The better resistance of preinfected animals to reinfection with the same strain of S. suis type 2 might thus more likely be related to the development of a protein rather than CPS Ab response. PMID:25385801

Joint Newspaper Operating Agreements.

ERIC Educational Resources Information Center

Parsons, Marie

The number of competing daily newspapers in American cities has dwindled until only about 50 cities boast two papers. Of the newspapers in those cities, 23 now maintain separate editorial operations but have joint printing, advertising, and circulation departments. The concept of joint operation is 50 years old, dating from the Depression years…

Strength evaluation of socket joints

NASA Technical Reports Server (NTRS)

Rash, Larry C.

1994-01-01

This report documents the development of a set of equations that can be used to provide a relatively simple solution for identifying the strength of socket joints and for most cases avoid the need of more lengthy analyses. The analytical approach was verified by comparison of the contact load distributions to results obtained from a finite element analysis. The contacting surfaces for the specific joint in this analysis are in the shape of frustrums of a cone and are representative of the tapered surfaces in the socket-type joints used to join segments of model support systems for wind tunnels. The results are in the form of equations that can be used to determine the contact loads and stresses in the joint from the given geometry and externally applied loads. Equations were determined to define the bending moments and stresses along the length of the joints based on strength and materials principles. The results have also been programmed for a personal computer and a copy of the program is included.

37 CFR 1.45 - Joint inventors.

Code of Federal Regulations, 2010 CFR

2010-07-01

... joint application under 35 U.S.C. 116. If multiple inventors are named in a provisional application... disclosed in the provisional application and the provisional application will be considered to be a joint... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Joint inventors. 1.45 Section...

BIOMECHANICS AND PATHOMECHANICS OF THE PATELLOFEMORAL JOINT

PubMed Central

2016-01-01

The patellofemoral joint is a joint that can be an area of concern for athletes of various sports and ages. The joint is somewhat complex with multiple contact points and numerous tissues that attach to the patella. Joint forces are variable and depend on the degree of knee flexion and whether the foot is in contact with the ground. The sports medicine specialist must have a good working knowledge of the anatomy and biomechanics of the patellofemoral joint in order to treat it effectively. PMID:27904787

Geared Electromechanical Rotary Joint

NASA Technical Reports Server (NTRS)

Vranish, John M.

1994-01-01

Geared rotary joint provides low-noise ac or dc electrical contact between electrical subsystems rotating relative to each other. Designed to overcome some disadvantages of older electromechanical interfaces, especially intermittency of sliding-contact and rolling-contact electromechanical joints. Hollow, springy planetary gears provide continuous, redundant, low-noise electrical contact between inner and outer gears.

Approach to management of penile fracture in men with underlying Peyronie's disease.

PubMed

Minor, Thomas X; Brant, William O; Rahman, Nadeem U; Lue, Tom F

2006-10-01

To report on a series of patients with Peyronie's disease (PD) who experienced a penile fracture, examining the history, presentation, and management. Additionally, we describe an unreported surgical technique implementing combined fracture repair and tunica plication. PD is an acquired inflammatory condition of the penis that can cause fibrotic, nonexpansile thickening of the tunica albuginea, resulting in a focal bend or narrowing on erection. From October 1999 to July 2003, 4 patients with nonsurgically treated PD had a penile fracture during sexual activity. The mean patient age was 43 years (range 29 to 52), with an average of 5.5 days (range 3 to 8) transpiring from the time of penile trauma to surgery in the men presenting early. Penile ultrasonography was used to locate the site of tunica laceration. Either circumcising or ventral midline incisions were selected to treat these patients. During penile exploration, the tunica defect in the corpus cavernosum was identified and closed with 2-0 Maxon suture. Subsequent artificial erection displayed penile curvature in 3 patients, and plication was then performed to straighten the tunica angulation using 2-0 TiCron suture. The fourth patient had a minimal bend with slight waisting, not requiring plication. No perioperative complications occurred. These 4 patients regained their preoperative level of erectile rigidity with lasting nonpainful correction of their deformity. Patients with PD who have a penile fracture are candidates for combined fracture repair and tunica plication at the same setting.

Long-term Results of Ventral Penile Curvature Repair in Childhood.

PubMed

Golomb, Dor; Sivan, Bezalel; Livne, Pinhas M; Nevo, Amihay; Ben-Meir, David

2018-02-01

To assess the postpubertal outcome of ventral penile curvature repaired in infancy in terms of recurrence and aesthetics. Postpubertal patients treated for hypospadias and ventral penile curvature in infancy at a tertiary medical center were invited to undergo assessment of the quality of the repair. Findings were compared between patients with a straight penis after skin release and patients who required dorsal plication. The cohort included 27 patients of mean age 16.5 years who were reported with straight penis after surgery. Postpubertal curvature was found in 6 of 14 patients (43%) successfully treated by skin release and 10 of 13 patients (77%) who underwent dorsal plication (P = .087). Significant curvature (≥30 degrees) was found in 1 of 14 patients in the skin-release group and 4 of 13 in the dorsal plication group (P = .16). Rates of redo urethroplasty were 2 of 14 (14%) and 5 of 10 (50%), respectively. Patient satisfaction with the appearance of the penis did not differ significantly. Ventral penile curvature repaired in infancy often recurs after puberty. The need for dorsal plication has a trend-level association with recurrence of penile curvature in puberty. It might also be related to the degree of postpubertal penile curvature and the need for redo urethroplasty. Procedure type does not affect patient satisfaction with the postpubertal appearance of the penis. Copyright © 2017 Elsevier Inc. All rights reserved.

Temporal gene expression profiling of the rat knee joint capsule during immobilization-induced joint contractures.

PubMed

Wong, Kayleigh; Sun, Fangui; Trudel, Guy; Sebastiani, Paola; Laneuville, Odette

2015-05-26

Contractures of the knee joint cause disability and handicap. Recovering range of motion is recognized by arthritic patients as their preference for improved health outcome secondary only to pain management. Clinical and experimental studies provide evidence that the posterior knee capsule prevents the knee from achieving full extension. This study was undertaken to investigate the dynamic changes of the joint capsule transcriptome during the progression of knee joint contractures induced by immobilization. We performed a microarray analysis of genes expressed in the posterior knee joint capsule following induction of a flexion contracture by rigidly immobilizing the rat knee joint over a time-course of 16 weeks. Fold changes of expression values were measured and co-expressed genes were identified by clustering based on time-series analysis. Genes associated with immobilization were further analyzed to reveal pathways and biological significance and validated by immunohistochemistry on sagittal sections of knee joints. Changes in expression with a minimum of 1.5 fold changes were dominated by a decrease in expression for 7732 probe sets occurring at week 8 while the expression of 2251 probe sets increased. Clusters of genes with similar profiles of expression included a total of 162 genes displaying at least a 2 fold change compared to week 1. Functional analysis revealed ontology categories corresponding to triglyceride metabolism, extracellular matrix and muscle contraction. The altered expression of selected genes involved in the triglyceride biosynthesis pathway; AGPAT-9, and of the genes P4HB and HSP47, both involved in collagen synthesis, was confirmed by immunohistochemistry. Gene expression in the knee joint capsule was sensitive to joint immobility and provided insights into molecular mechanisms relevant to the pathophysiology of knee flexion contractures. Capsule responses to immobilization was dynamic and characterized by modulation of at least three

Conarticular congruence of the hominoid subtalar joint complex with implications for joint function in Plio-Pleistocene hominins.

PubMed

Prang, Thomas C

2016-07-01

The purpose of this study is to test the hypothesis that conarticular surfaces areas and curvatures are correlates of mobility at the hominoid talocalcaneal and talonavicular joints. Articular surface areas and curvatures of the talonavicular, anterior talocalcaneal, and posterior talocalcaneal joints were quantified using a total of 425 three-dimensional surface models of extant hominoid and fossil hominin tali, calcanei, and naviculars. Quadric surface fitting was used to calculate curvatures, pairwise comparisons were used to evaluate statistical differences between taxa, and regression was used to test for the effects of allometry. Pairwise comparisons show that the distributions of values for joint curvature indices follow the predicted arboreal-terrestrial morphocline in hominoid primates with no effect of body mass (PGLS p > 0.05). OH 8 (Homo habilis) and LB 1 (Homo floresiensis) can be accommodated within the range of human variation for the talonavicular joint, whereas MH2 (Australopithecus sediba) falls within the ranges of variation for Pan troglodytes and Gorilla gorilla in measures of posterior talocalcaneal joint congruity. Joint curvature indices are better discriminators than joint surface area indices, which may reflect a greater contribution of rotation, rather than translation, to joint movement in plantigrade taxa due to discrepancies in conarticular congruence and the "convex-concave" rule. The pattern of joint congruence in Au. sediba contributes to other data on the foot and ankle suggesting that the lateral side of the foot was more mobile than the medial side, which is consistent with suggestions of increased medial weight transfer associated with hyperpronation. Am J Phys Anthropol 160:446-457, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Key Role of Capsular Polysaccharide in the Induction of Systemic Infection and Abortion by Hypervirulent Campylobacter jejuni

PubMed Central

Sahin, Orhan; Terhorst, Samantha A.; Burrough, Eric R.; Shen, Zhangqi; Wu, Zuowei; Dai, Lei; Tang, Yizhi; Plummer, Paul J.; Ji, Ju; Yaeger, Michael J.

2017-01-01

ABSTRACT Campylobacter jejuni is a zoonotic pathogen, and a hypervirulent clone, named clone SA, has recently emerged as the predominant cause of ovine abortion in the United States. To induce abortion, orally ingested Campylobacter must translocate across the intestinal epithelium, spread systemically in the circulation, and reach the fetoplacental tissue. Bacterial factors involved in these steps are not well understood. C. jejuni is known to produce capsular polysaccharide (CPS), but the specific role that CPS plays in systemic infection and particularly abortion in animals remains to be determined. In this study, we evaluated the role of CPS in bacteremia using a mouse model and in abortion using a pregnant guinea pig model following oral challenge. Compared with C. jejuni NCTC 11168 and 81-176, a clone SA isolate (IA3902) resulted in significantly higher bacterial counts and a significantly longer duration of bacteremia in mice. The loss of capsule production via gene-specific mutagenesis in IA3902 led to the complete abolishment of bacteremia in mice and abortion in pregnant guinea pigs, while complementation of capsule expression almost fully restored these phenotypes. The capsule mutant strain was also impaired for survival in guinea pig sera and sheep blood. Sequence-based analyses revealed that clone SA possesses a unique CPS locus with a mosaic structure, which has been stably maintained in all clone SA isolates derived from various hosts and times. These findings establish CPS as a key virulence factor for the induction of systemic infection and abortion in pregnant animals and provide a viable candidate for the development of vaccines against hypervirulent C. jejuni. PMID:28373351

Functional outcome from sacroiliac joint prolotherapy in patients with sacroiliac joint instability.

PubMed

Hoffman, Martin D; Agnish, Vikram

2018-04-01

Examine the effectiveness of sacroiliac (SI) joint prolotherapy for SI joint instability, and characterize the patients most likely to benefit from this treatment. Retrospective cohort study. Department of Veterans Affairs outpatient physical medicine clinic. Patients referred for low back pain and diagnosed with SI joint instability received a series of three SI joint prolotherapy injections (15% dextrose in lidocaine) at approximately a one-month interval. The outcome of those completing treatment was retrospectively examined, and characteristics were compared between those with at least a minimum clinically important improvement and those without improvement. Patients completed the Oswestry Disability Index (ODI) before treatment was initiated, immediately preceding each prolotherapy injection, and at 3-4 month follow-up. Of 103 treated patients returning for post-treatment follow-up at a median of 117 days, 24 (23%) showed a minimum clinically important improvement despite a median of 2 years with low back pain and a mean (±SD) pre-intervention ODI of 54 ± 15 points. Much of the improvement was evident after the initial prolotherapy injection, and a 15-point improvement in ODI prior to the second prolotherapy injection had a sensitivity of 92% and specificity of 80% for determining which patients would improve. A satisfactory proportion of patients with symptomatic SI joint instability as an etiology of low back pain can have clinically meaningful functional gains with prolotherapy treatment. The patients who are not likely to improve with prolotherapy are generally evident by lack of improvement following the initial prolotherapy injection. Published by Elsevier Ltd.