Lateral Type Research Articles

Pelvic Binder Radiography Is Safe and Feasible for Quantifying Fracture Instability in LC1 Pelvis Fractures: A Clinical Trial.

To demonstrate fracture displacement, patient tolerance, and in-hospital safety quantifying lateral compression type 1 (LC1) pelvis fracture stability with awake stress radiography using a pelvic binder (PBR). Prospective clinical trial of PBR diagnostic intervention. Two centers, Level I trauma center and academic hospital. Alert adults with LC1 (OTA/AO B1.1/2.1) pelvic fractures from blunt mechanism presenting within 3 weeks of injury between February and December 2023 without hypotension or injury precluding pelvic binder application. The primary outcome was fracture displacement on PBR. Secondary outcomes included feasibility (≥85% patient tolerance) and safety (no major adverse events). Exploratory outcomes included pain during examination, opioid medication consumption within 96 hours, length of hospital stay, discharge destination, and correlation between fracture displacement on PBR and examination under anesthetic. One hundred sixty-nine patients with pelvis fractures were screened, 58 were eligible, and 31 were enrolled. The mean age of enrolled patients was 58.7 ± 23 years, 54.8% were female, 22.6% were White, and 67.7% Hispanic. Fracture displacement was 4.3 ± 4.7 mm on PBR at 5 kg and 8.4 ± 9.0 mm at 10 kg. All patients tolerated PBR. Sixteen patients (52%) reported pain during PBR but completed the test. No patient experienced an adverse event. Patients received 40.4 ± 56.4 mg oral morphine equivalents within 96 hours of PBR. Ten patients (32.2%) received internal fixation. The median hospital stay was 6 days (interquartile range 5.5 days) with no inpatient mortality. Fourteen patients (45.2%) discharged home. PBR is feasible and safe as a point-of-care test for LC1 pelvis fracture instability. Level II Diagnostic.

Associations between neurolinguistic deficits and personality traits in people with epilepsy.

People with epilepsy (PWE) have been hypothesized to have higher prevalence of personality disorders and cognitive disorders. The objective of this study was to investigate the controversial notion of "epileptic personality," a series of supposedly specific personality traits of people with epilepsy (PWE). For this purpose, 29 individuals with Mesial Temporal lobe Epilepsy (MTLE) and 23 with Juvenile myoclonic epilepsy (JME) as confirmed by electroencephalography (EEG), MRI scans and clinical examination, underwent a thorough neuropsychological and personality assessment. The resulting neuropsychological profiles were statistically analyzed considering possible personality disorders, character traits, cognitive and linguistic deviations from 20 healthy controls (HC). Our findings suggest accumulative cognitive and linguistic deficits in individuals with epilepsy compared to controls. It is possible that these might be misinterpreted as personality disorders. Specifically, personality traits (p = 0.049) and verbal fluency (p = 0.013), were significantly different between PWEs and controls. Also, the type of epilepsy and lateralization seem to affect executive function (p = 0.049) and pragmatology scores (p < 0.001), exhibiting differences in subgroup analysis. Different theories are considered as plausible pathophysiological explanations for the aforementioned differences. This research might serve as a basis to further investigate the cognitive aspects of epilepsy and possible pharmacological interventions, which are currently lacking.

Allele-specific silencing of a dominant SETX mutation in familial amyotrophic lateral sclerosis type 4.

Amyotrophic lateral sclerosis 4 (ALS4) is an autosomal dominant motor neuron disease that is molecularly characterized by reduced R-loop levels and caused by pathogenic variants in senataxin (SETX). SETX encodes an RNA/DNA helicase that resolves three-stranded nucleic acid structures called R-loops. Currently, there are no disease-modifying therapies available for ALS4. Given that SETX is haplosufficient, removing the product of the mutated allele presents a potential therapeutic strategy. We designed a series of siRNAs to selectively target the RNA transcript from the ALS4 allele containing the c.1166T>C mutation (p.Leu389Ser). Transfection of HEK293 cells with siRNA and plasmids encoding either wild-type or mutant (Leu389Ser) epitope tagged SETX revealed that three siRNAs specifically reduced mutant SETX protein levels without affecting the wild-type SETX protein. In ALS4 primary fibroblasts, siRNA treatment silenced the endogenous mutant SETX allele, while sparing the wild-type allele, and restored R-loop levels in patient cells. Our findings demonstrate that mutant SETX, differing from wild-type by a single nucleotide, can be effectively and specifically silenced by RNA interference, highlighting the potential of allele-specific siRNA as a therapeutic approach for ALS4.

Evaluation of Sphenoid Sinus Variations in Cleft Lip and Palate Patients: A Comprehensive Cone Beam Computed Tomography Analysis.

This study aims to compare sphenoid sinus variations between unilateral and bilateral cleft lip and palate (CLP) patients and healthy controls using CBCT images. It is notable for its large sample size and comparison of unilateral and bilateral cleft patients, cleft and noncleft sides, and different age groups. Retrospective cohort study. University Hospital. CBCT images of 97 CLP patients (76 unilateral, 21 bilateral) and 97 healthy controls were evaluated.Main Outcome Measures: Sphenoid sinus main types, sellar subtypes, clival, and lateral extensions were assessed for all groups. A significant increase in the anterior type was observed in both unilateral and bilateral CLP groups. The bilateral CLP group had a higher prevalence of the lesser wing type. In CLP and control groups, lesser wing, combined type, and lateral type were statistically significantly lower under 13 years of age. The study highlights an elevated prevalence of anterior pneumatization in unilateral and bilateral CLP individuals, emphasizing its significance in surgery planning due to proximity to critical structures like the optic nerve and sphenopalatine artery. The increased prevalence of the lesser wing type in bilateral CLP patients requires extra caution during anterior clinoidectomy. Lower pneumatization rates in CLP patients under 13 suggest their sphenoid sinus development is similar to that of healthy individuals. Understanding these variations is crucial for appropriate surgical planning and avoiding complications during transsphenoidal surgery.

Short-term mobility in low-energy pelvic ring fractures after conservative treatment

BackgroundThe growing population of elderly people is leading to a rising number of pelvic ring fractures. These often involve combinations of pubic branch and sacrum fractures, as seen in lateral compression type 1 (LC1) and 2 (LC2) fractures or more precisely classified as fragility fractures of the pelvis (FFP). The combined impact on the anterior and posterior ring brings the risk of prolonged pain, resulting in decreased mobility and increased complications. Given the higher multimorbidity of this population, surgical treatment poses a greater risk of intra- and post-operative complications. Hence, the management and treatment of this particular type of fracture remain challenging. MethodsA retrospective data analysis of 41 patients (F/M; 27/14) treated conservatively for low-energy LC1 or LC2 fractures was performed between 2017 and 2020. The fractures were classified using Rommens’ FFP classification. The primary outcome was mobility at 2 and 6 weeks, assessed through chart analysis and phone interviews. To determine factors influencing patient outcomes fracture consolidation was assessed via X-ray analysis. As a secondary outcome logistic regression and decision tree analyzes were conducted. ResultsThe mean age at the time of fracture was 79.8 ± 12.5 (SD) years. Thirty-two patients regained mobility (F/M; 25/7) after 2 weeks. Another 7 patients were mobile after 6 weeks (F/M; 2/5). Two male patients did not regain mobility. Male sex emerged as the sole independent predictor of non-mobility at 2 weeks (p = 0.0037). Age, BMI, pubic branch fracture dislocation >5 mm, analgesic use of opiates, corticosteroid therapy, alcohol and smoking showed no association with mobility recovery. Fracture consolidation was observed in 73.2 % of patients (F/M; 21/9), while one female had no consolidation. Ten patients (F/M; 5/5) were lost to follow-up. ConclusionsOur study shows that LC1 (FFP IIb, IIc) and LC2 (FFP IIIc, IVb) fractures can be effectively treated conservatively, with successful remobilization within 6 weeks. The only independent negative predictor of early mobilization was male sex. Pubic branch displacement >5 mm did not affect the outcome. Therefore, conservative management proves to be a viable option for low-energy LC1 or LC2 fractures.Level of Evidence: IV (retrospective study).

Anatomical Features and Morphometric Characteristics of the Sphenoidal Sinus in MRI Studies.

Differential access to pathological sellar processes and adjacent regions is determined by the anatomic structures identified through diagnostic imaging. Both direct endonasal access (microscopic or endoscopic) and sublabial access utilize the sphenoid sinus (SS) as the primary surgical pathway. Critical factors include the pneumatization of the sinus, its intermediate septa, and the presence of a double wall, consisting of a connective tissue membrane along the dorsal wall of the SS. The present study aims to demonstrate the significance of the size and type of the SS based on MRI measurements. The type of SS, its pneumatization, and the proximity of adjacent brain structures are crucial for different surgical approaches to the SS and pituitary fossa. In neurosurgical practice, six main types of sinuses are recognized: sphenoid body type, lateral type, clival type, lesser wing type, anterior type, and combined type. Failure to consider these variations can lead to damage to the cavernous sinus, Meckel's cave, nerve structures in the middle cranial fossa, planum sphenoidale, suprasellar region, and vital brainstem structures located on the clivus. Randomly included MRI measurements were conducted on 112 patients from Pulmed University Hospital, Plovdiv, Bulgaria, categorized into two cohorts based on gender, with mean ages of 51 years for men and 47.8 years for women. The measurements, recorded in centimeters, were obtained using two imaging software programs, RadiAnt DICOM Viewer (Medixant, Poznan, Poland) and Weasis DICOM Viewer (Nicolas Roduit, https://github.com/nroduit/Weasis). No statistically significant differences were observed between the measurements produced by the two programs. Measurements of the SS were taken in two equal groups, using three different projections: axial, sagittal, and coronal. The results for height, width, and depth showed average sizes of 2.73-3.04 cm in axial projections, 1.70-2.64 cm in sagittal projections, and 2.86-3.03 cm in coronal projections. The minor differences between axial and coronal measurements of the same parameters (height and width) are statistically acceptable and attributed to the varying angles of the MRI scans. These measurements are crucial for planning surgical access to the sellar and parasellar regions, determining the necessary bony resection of the posterior wall of the SS, and preventing complications from excessive bony trepanation.

Lhowa Phonology: A Typological Perspective

Lhowa exhibits a large inventory of forty-one consonant phonemes. In terms of points of articulation, it contains seven types of consonants, viz., labial, dental, alveolar, retroflex, palatal, velar and glottal. In terms of manner of articulation, it presents seven types of consonants, viz., stops, nasals, affricates, fricatives, trills, laterals and approximants. In terms of voicing, there are two types of consonant phonemes, viz., voiceless and voiced. Lhowa has voiceless unaspirated, voiceless aspirated, voiced murmured and voiceless murmured sounds. It exhibits a distinct consonant distribution. Lhowa has eight basic and two fronted vowels. There are four diphthongs. Lhowa displays a moderately complex syllable structure. It presents a canonical structure of the syllable in which V is obligatory and other constituents, (Ci, initial consonant), (X, voiced palatal approximant), and (Cf, final consonant) are optional. Lhowa permits only five types of syllable patterns. Each syllable is intrinsically high or low. It exhibits simple tone system. The high vs. low tone is distinguished only on the first syllable of a word. In Lhowa, like in Lhasa Tibetan, compound words demonstrate four types of tone melodies, viz., HH, LH, LL and HL.

Development of assessment criteria for elderly lateral torso deformity for 3D scan anthropometry

PurposeWe aimed to establish criteria for determining the deformed lateral torso type to identify individuals requiring measurement methods different from standard methods before extracting dimensions from three-dimensional (3D) scan data.Design/methodology/approachWe collected the 3D body scan data of 119 women aged 70–85 years collected in the 6th Size Korea. Three axes were defined to determine the deformation of the lateral shape, and the angle of each reference axis was used for the analysis. Additionally, to classify the lateral torso shape, 14 experts made visual judgments on the side-view images of the participants.FindingsTo identify the axis that best represented the lateral torso shape, we used each angle value of the three reference axes as an independent variable and the expert’s visual classification as a dependent variable. Each discriminant function was obtained and accuracy calculated. The whole torso axis exhibited the highest accuracy. Next, an assessment scale was developed to determine the shape of the lateral torso using the angular value of the whole torso axis.Originality/valueThe scale developed in this study has the potential to reduce measurement errors arising from elderly deformed torso shapes, thereby enhancing data reliability.

Transcriptomic analysis of the human habenula in schizophrenia.

Transcriptomic analysis of the human habenula and identification of molecular changes associated with schizophrenia risk and illness state.

Numerical Simulation of Gas Production Behavior Using Radial Lateral Well and Horizontal Snake Well Depressurization Mining of Hydrate Reservoir in the Shenhu Sea Area of the South China Sea

Improving the production capacity of natural gas hydrates (NGHs) is crucial for their commercial development. Based on the data of the first on-site testing production of NGHs in the Shenhu Sea area, numerical methods were used to analyze the production behavior of radial lateral well (RLW) and horizontal snake well (HSW) with different completion lengths when they deployed at different layers of the Class-1 type hydrate reservoir (with a fixed pressure difference of 6 MPa and continuous production for 360 days). The results indicate that compared with the single vertical well production, RLW and HSW can effectively increase production capacity by enlarging drainage area and the productivity is directly proportional to the total completion length. The RLW and HSW deployed at the three-phase layer (TPL) have optimal mining performance within a 360-day production period. Different to the previous research findings, during a short-term production period of 360 days, regardless of the deployment layer, the overall production capacity of HSW is better than RLW’s. The total gas production of HSW-2 circles well type is about four times that of a single vertical well, reaching 1.554 × 107 ST m3. Moreover, the HSW-1 lateral well type stands out with an average Qg of 3.63 × 104 ST m3/d and a specific production index J of 16.93; it has the highest J-index among all well types, which means the best mining efficiency. It is recommended to choose the HSW-1 circle well type, if the coiled tubing drilling technique is used for on-site testing production of NGHs in the future. The research results provide insights into the potential applications of RLW and HSW in this sea area.

A novel small non-coding RNA 562 mediates the virulence of Pseudomonas plecoglossicida by regulating the expression of fliP, a key component of flagella T3SS

Pseudomonas plecoglossicida is a vital pathogen that poses a substantial risk to aquaculture. Small RNAs (sRNAs) are non-coding regulatory molecules capable of sensing environmental changes and modulating virulence-associated signaling pathways, such as the assembly of flagella. However, the relevant researches on P. plecoglossicida are an urgent need. Here, we report a novel sRNA, sRNA562, which has potential to regulate the post-transcriptional of fliP, a key component of the lateral flagellar type III secretion system. In this study, the effects of sRNA562 on the virulence of P. plecoglossicida and its role in regulating the pathogenic process were investigated through the use of a constructed sRNA562 deletion strain. The deletion of sRNA562 resulted in an up-regulation of fliP in P. plecoglossicida, and leading to increased swarming motility and enhanced the ability of biofilm formation, adhesion and chemotaxis. Subsequent artificial infection experiment demonstrated that the deletion of sRNA562 increased the virulence of P. plecoglossicida towards hybrid grouper, as evidenced by a reduction in survival rate, elevation of tissue bacterial load, and the exacerbation of histopathological damage. Further studies have found that the deletion of sRNA562 lead to an up-regulation of fliP expression during hybrid grouper infection, thereby enhancing bacterial swarming ability and ultimately heightening pathogenicity, leading to a dysregulated host response to infection, tissue damage and eventually death. Our work revealed a sRNA that exerts negative regulation on the expression of lateral flagella in P. plecoglossicida, thereby impacting its virulence. These findings provide a new perspective on the virulence regulation mechanism of P. plecoglossicida, contributing to a more comprehensive understanding in the field of pathogenicity research.

Spontaneous intracranial hypotension - a spinal disease.

Spontaneous intracranial hypotension (SIH) remains an underdiagnosed condition despite increasing awareness due to recent scientific advances. Diagnosis can be delayed by the broad clinical presentation and imaging pitfalls. This results in a high degree of physical impairment for patients, including social and psychological sequelae as well as long-term damage in the case of delayed diagnosis and treatment.The study is based on a selective literature search on PubMed including articles from 1990 to 2023 and the authors' clinical experience from working in a CSF center.SIH mostly affects middle-aged women, with the primary symptom being position-dependent orthostatic headache. In addition, there is a broad spectrum of possible symptoms that can overlap with other clinical conditions and therefore complicate the diagnosis. The causative spinal CSF loss can be divided into three main types: ventral (type 1) or lateral (type 2) dural leak and CSF-venous fistula (type 3). The diagnosis can be made using a two-stage workup. As a first step, noninvasive MRI of the head and spine provides indicators of the presence of SIH. The second step using focused myelography can identify the exact location of the cerebrospinal fluid leak and enable targeted therapy (surgical or interventional). Intrathecal pressure measurement or intrathecal injection of gadolinium is no longer necessary for primary diagnosis. Serious complications in the course of the disease can include space-occupying subdural hematomas, superficial siderosis, and symptoms of brain sagging, which can lead to misinterpretations. Treatment consists of closing the dural leak or the cerebrospinal fluid fistula. Despite successful treatment, a relapse can occur, which highlights the importance of follow-up MRI examinations and emphasizes the chronic nature of the disease. This paper provides an overview of the diagnostic workup of patients with suspected SIH and new developments in imaging and therapy. · SIH is an underdiagnosed condition with a wide range of possible symptoms.. · The first diagnostic step using MRI provides indications of the presence of SIH.. · The second diagnostic step using (dynamic) myelography can identify the CSF leak.. · Collaboration with a CSF center is advisable for further diagnosis and treatment.. · Prompt detection and treatment of SIH improves the outcome.. · Zander C, Wolf K, El Rahal A et al. Spontaneous intracranial hypotension - a spinal disease. Fortschr Röntgenstr 2024; DOI 10.1055/a-2318-8994.

Role of senataxin in R-loop-mediated neurodegeneration.

Senataxin is an RNA:DNA helicase that plays an important role in the resolution of RNA:DNA hybrids (R-loops) formed during transcription. R-loops are involved in the regulation of biological processes such as immunoglobulin class switching, gene expression and DNA repair. Excessive accumulation of R-loops results in DNA damage and loss of genomic integrity. Senataxin is critical for maintaining optimal levels of R-loops to prevent DNA damage and acts as a genome guardian. Within the nucleus, senataxin interacts with various RNA processing factors and DNA damage response and repair proteins. Senataxin interactors include survival motor neuron and zinc finger protein 1, with whom it co-localizes in sub-nuclear bodies. Despite its ubiquitous expression, mutations in senataxin specifically affect neurons and result in distinct neurodegenerative diseases such as amyotrophic lateral sclerosis type 4 and ataxia with oculomotor apraxia type 2, which are attributed to the gain-of-function and the loss-of-function mutations in senataxin, respectively. In addition, low levels of senataxin (loss-of-function) in spinal muscular atrophy result in the accumulation of R-loops causing DNA damage and motor neuron degeneration. Senataxin may play multiple functions in diverse cellular processes; however, its emerging role in R-loop resolution and maintenance of genomic integrity is gaining attention in the field of neurodegenerative diseases. In this review, we highlight the role of senataxin in R-loop resolution and its potential as a therapeutic target to treat neurodegenerative diseases.

Evaluation of Sphenoid Sinus Pneumatization Subtypes in Posteroanterior and Lateral Directions on CT Imaging

Background: Sphenoid sinus (SS) variations are diverse, and identifying them before transsphenoidal interventions is essential. The gold standard imaging method for assessing the morphological characteristics of the SS is computed tomography (CT), which yields valuable information. Objectives: This study used CT imaging to evaluate SS pneumatization in the Turkish population's posteroanterior (PA) and lateral directions. Methods: Head CT images of 509 cases in total were evaluated retrospectively. Initially, SS types were determined based on PA pneumatization. Afterward, the new classification was used, and SS pneumatizations were defined in the lateral direction accordingly. Results: According to PA pneumatization, conchal (0.6%), presellar (16.7%), sellar (66.4%), and post-sellar pneumatization (16.3%) were detected. Accordingly, the relationship between SS type and gender was insignificant (P = 0.354). When the lateral type pneumatization classification was used, the right lateral body (39.9%) and left lateral body (32.2%) were found to be the most common types. The relationship between SS lateral-type pneumatization and gender was insignificant (P = 0.388). Conclusions: Sphenoid sinus pneumatization shows significant individual variability, which is beneficial to evaluate before surgery. In addition, more information was obtained about pneumatization using lateral direction typing as a new classification.

Spheno-Orbital Meningiomas: The Rationale behind the Decision-Making Process of Treatment Strategy.

Surgery stands as the primary treatment for spheno-orbital meningiomas, following a symptoms-oriented approach. We discussed the decision-making process behind surgical strategies through a review of medical records from 80 patients who underwent surgical resection at the University of Naples Federico II. Different surgical approaches were employed based on the tumor's location relative to the optic nerve's long axis, categorized into lateral (type I), medial (type II), and diffuse (type III). We examined clinical, neuroradiological, surgical, pathological, and outcome factors. Proptosis emerged as the most frequent symptom (97%), followed by visual impairment (59%) and ocular motility issues (35%). Type I represented 20%, type II 43%, and type III 17%. Growth primarily affected the optic canal (74%), superior orbital fissure (65%), anterior clinoid (60%), and orbital apex (59%). The resection outcomes varied, with Simpson grades I and II achieved in all type I cases, 67.5% of type II, and 18% of type III. Recurrence rates were highest in type II (41.8%) and type III (59%). Improvement was notable in proptosis (68%) and visual function (51%, predominantly type I). Surgery for spheno-orbital meningiomas should be tailored to each patient, considering individual characteristics and tumor features to improve quality of life by addressing primary symptoms like proptosis and visual deficits.

Non-surgical treatment of maxillary lateral incisor double dens invaginatus type Ⅲ with apical periodontitis.

Dental invagination is an abnormality of the crown or root development induced during tooth germ development when the enamel-forming apparatus or epithelial root sheath overpopulates and folds into the papilla. In severe cases, the invaginated channels are connected to the pulp and periodontal tissues, often causing endodontic and periapical diseases. The complex anatomical pattern of this disease adds difficulty in its preoperative diagnosis and clinical operation. In this paper, we report a case of non-surgical treatment assisted by cone beam CT and microscopy for maxillary lateral incisor double dens invaginatus type Ⅲ (Ⅲa and Ⅲb) with apical periapical infection. After 1-year follow-up, the affected tooth was asymptomatic and the periapical lesion was significantly reduced.

Patient Preferences for Operative Versus Nonoperative Treatment of LC1 Pelvis Fracture: A Discrete Choice Experiment.

To quantify how patients with lateral compression type 1 (LC1) pelvis fracture value attributes of operative versus nonoperative treatment. Discrete choice experiment. Three US Level 1 trauma centers. Adult survivors of an LC1 pelvis treated between June 2016 and March 2023 were identified from institutional registries. The choice experiment was administered as a survey from March through August 2023. Participants chose between 12 hypothetical comparisons of treatment attributes including operative or nonoperative care, risk of death, severity of pain, risk of secondary surgery, shorter hospital stay, discharge destination, and independence in ambulation within 1 month of injury. The marginal utility of each treatment attribute, for example, the strength of participants' aggregate preference for an attribute as indicated by their survey choices, was estimated by multinomial logit modeling with and without stratification by treatment received. Four hundred forty-nine eligible patients were identified. The survey was distributed to 182 patients and collected from 72 patients (39%) at a median 2.3 years after injury. Respondents were 66% female with a median age of 59 years (IQR, 34-69 years). Before injury, 94% ambulated independently and 75% were working; 41% received operative treatment. Independence with ambulation provided the highest relative marginal utility (21%, P < 0.001), followed by discharge to home versus skilled nursing (20%, P < 0.001), moderate versus severe postdischarge pain (17%, P < 0.001), shorter hospital stay (16%, P < 0.001), secondary surgery (15%, P < 0.001), and mortality (10%, P = 0.02). Overall, no relative utility for operative versus nonoperative treatment was observed (2%, P = 0.54). However, respondents strongly preferred the treatment they received: operative patients valued operative treatment (utility, 0.37 vs. -0.37, P < 0.001); nonoperative patients valued nonoperative treatment (utility, 0.19 vs. -0.19, P < 0.001). LC1 pelvis fracture patients valued independence with ambulation, shorter hospital stay, and avoiding secondary surgery and mortality in the month after their injury. Patients preferred the treatment they received rather than operative versus nonoperative care.

Spinal cord neurone loss and foot placement changes in a rat knock-in model of amyotrophic lateral sclerosis type 8

Abstract Amyotrophic Lateral Sclerosis is an age-dependent cell type-selective degenerative disease. Genetic studies indicate that Amyotrophic Lateral Sclerosis is part of a spectrum of disorders ranging from spinal muscular atrophy to frontotemporal dementia that share common pathological mechanisms. Amyotrophic Lateral Sclerosis type 8 is a familial disease caused by mis-sense mutations in VAPB. VAPB is localised to the cytoplasmic surface of the endoplasmic reticulum where it serves as a docking point for cytoplasmic proteins and mediates inter-organelle interactions with the endoplasmic reticulum membrane. A gene knock-in model of Amyotrophic Lateral Sclerosis type 8 based on the VapBP56S mutation and VapB gene deletion have been generated in the rat. These animals display a range of age-dependent phenotypes distinct from those previously reported in mouse models of Amyotrophic Lateral Sclerosis type 8. A loss of motor neurones in VapBP56S/+ and VapBP56S/P56Sanimals is indicated by a reduction in the number of large choline acetyl transferase-staining cells in the spinal cord. VapB-/-animals exhibit a relative increase in cytoplasmic TDP-43 levels compared to the nucleus, but no large protein aggregates. Concomitant with these spinal cord pathologies VapBP56S/+, VapBP56S/P56S and VapB-/-animals exhibit age-dependent changes in paw placement and exerted pressures when traversing a CatWalk apparatus, consistent with a somatosensory dysfunction. Extra motor dysfunction is reported in half the cases of motor neurone disease, and this is the first indication of an associated sensory dysfunction in a rodent model of Amyotrophic Lateral Sclerosis. Different rodent models may offer complementary experimental platforms with which to understand the human disease.

Proximal femoral varus osteotomy for Legg–Calvé–Perthes disease: Do age and lateral pillar classifications influence short-to-mid-term clinical and radiological outcomes?

IntroductionProximal femoral varus osteotomy (FVO) is one of the most used treatment methods with acceptable outcomes for Legg–Calvé–Perthes disease (LCPD). We aimed to investigate the influence of age at disease onset and the Lateral Pillar classification on clinical and radiological outcomes of FVO surgery LCPD patients between 6–12years of age. HypothesisProximal FVO surgery in the early fragmentation phase of LCPD patients led to acceptable clinical and radiographic outcomes in a 3-year follow-up, regardless of preoperative age and Herring type. Material and methodsFifty patients with LCPD (Herring groups B, B/C, and C) who underwent FVO were retrospectively reviewed. We evaluated radiological [center-edge angle, extrusion index, epiphyseal index, acetabular index, articulo-trochanteric distance (ATD)] and clinical [hip abduction range of motion (ROM), Trendelenburg sign, pain, and Harris hip score (HHS)] outcomes with a follow-up of 37.3±10.5months (range: 24–180months). Finally, the overall treatment outcome was assessed using the Stulberg classification. ResultsThe ROC curve analysis did not reveal any significant relationship between age and clinical or radiological outcomes, and there was no predictable age cut-off for surgical outcomes (p=0.13). No significant difference was found in Stulberg classification at the follow-up between patients with type B, B/C, and C of the lateral pillar (p>0.05). DiscussionOur results demonstrated that open-wedge proximal FVO surgery in the early fragmentation phase of LCPD patients led to acceptable clinical and radiographic outcomes in a 3-year follow-up. Each sample of our study was very small and a lot of variables were measured, making this result not adequately strong enough to draw a robust conclusion. However, FVO surgery remains a possible suggestion for patients in the early fragmentation phase, and age and lateral pillar type may not be limiting factors. Level of evidenceIV; therapeutic retrospective cohort.

Larger lateral hinges increase the probability of Takeuchi type II and III fractures in high tibial osteotomy.

Lateral hinge fractures are the main complications in the high tibial osteotomy to treat varus deformities. The aim of present study is to answer the question whether the lateral hinge length (H) has an effect on the type of fracture and required force during the opening in high tibia osteotomy. It was hypothesized in this comparative research that extending the hinge length increased opening force and probability of a type II and type III fractures. A monoplanar medial open wedge osteotomy with different intact hinge lengths varying from 9 to 32mm was performed in 20 ostrich bones. A biomechanical experiment using unidirectional tensile testing apparatus was performed to open the wedge, and the required force was increased until a 10mm opening was reached; then, the presence of fracture in the lateral cortex and its direction were evaluated. Lateral hinge fracture type based on direction was classified as suggested by Takeuchi etal. Fracture that grows along the osteotomy line (type I) was observed in 4 samples with the mean hinge length (H) of 11 ± 1.54mm. For seven bones with Takeuchi fracture type II, with downward crack propagation, the mean H was 16 ± 3.36mm. For the mean H of 25 ± 6.53mm, the crack propagated upward to the cutting path, displaying a Takeuchi type III fracture in seven samples. The statistical analysis showed that the fracture type significantly depends on the hinge length (P value < 0.05). Also, the mean opening force significantly increased with hinge lengthening (P value < 0.05). The peak forces at crack initiation were 41.8 ± 21.9, 115.2 ± 41.5, and 167 ± 135.3 N, respectively, for the fracture types I, II, and III samples. The lateral cortical hinge length was significantly associated with hinge fracture type. The experimental tests indicated that the hinge lengthening increases the risk of type II and III fractures, as classified by Takeuchi.