Stem Extension Research Articles

Gluten Protein Compositional Changes in Response to Nitrogen Application Rate

Field trials were conducted to evaluate the effect of nitrogen level on wheat protein content and composition in 16 cultivars over two years at three locations. The nitrogen treatment comprised two nitrogen levels, 0 kg ha−1 as low and 100 kg ha−1 as high nitrogen, applied as top dressings of 50 kg nitrogen per ha at tillering and stem extension growth stages. Increased nitrogen level generally enhanced grain protein by 11.3% (11.5% vs. 12.8%). Considering protein composition determined by reversed phase–high-pressure liquid chromatography, higher nitrogen supply generally enhanced the proportion of total gliadins, α-gliadins, γ-gliadins and high-molecular-weight glutenin subunits by 1.1%, 2.0%, 3.7%, 0.6% and 0.9%, respectively, and reduced albumins and globulins, ω-gliadins, total glutenins and low-molecular-weight glutenin subunits by 1.1%, 1.7%, 1.9% and 3.2%. Under a high nitrogen level, the historical cultivars Libellula, San Pastore and U-1 had a higher protein content (13.1–15.2%) with significantly higher total gliadins, which resulted in a significantly higher gliadin/glutenin ratio (1.68–1.92). In the modern cultivars, protein content varied between 11.4% and 14.6% with a well-balanced gliadin/glutenin ratio (1.08–1.50), except for cultivar MV Nemere which had a high gliadin/glutenin ratio at both nitrogen levels (1.81 vs. 1.87). In summary, increasing nitrogen level enhanced grain protein content while the composition of gliadin and glutenin fractions was changed to a lesser extent and was largely cultivar specific and therefore should be considered for wheat baking quality assessment and breeding purposes.

Population dynamics of Rhizoctonia, Oculimacula, and Microdochium species in soil, roots, and stems of English wheat crops

AbstractThis study aimed to elucidate the population dynamics of Rhizoctonia, Oculimacula, and Microdochium species, causing the stem base disease complex of sharp eyespot, eyespot, and brown foot rot in cereals. Pathogen DNA in soil, roots, and stem fractions, and disease expression were quantified in 102 English wheat fields in two seasons. Weather data for each site was collected to determine patterns that correlate with assessed diseases. Oculimacula spp. (66%) and R. solani AG 2‐1 (63%) were most frequently detected in soil, followed by R. cerealis (54%) and Microdochium spp. (33%). Oculimacula spp. (89%) and R. cerealis (56%) predominated on roots and soil but were not associated with root rot symptoms, suggesting that these species used soil and roots for survival and as inoculum source. M. nivale was more frequently detected than M. majus on stems up to GS 21–30 and co‐occurred on plant samples with O. acuformis. O. yallundae had higher DNA concentration than O. acuformis at the lower 5 cm basal region at GS 37–45. R. cerealis predominated in the upper 15 cm above the base beyond stem extension. Brown foot rot by Microdochium spp. was favoured by cool and wet autumns/winters and dominated in English wheat. Eyespot and sharp eyespot disease index by Oculimacula spp. and R. cerealis, respectively, correlated with wet/humid springs and summers. Results suggested that stem base pathogens generally coexisted; however, their abundance in time and space was influenced by favourable weather patterns and host development, with niche differentiation after stem extension.

Incidence and Causes of Tibial Component Loosening Based on Level of Obesity in a Large Consecutive Cohort of Cemented Primary TKAs without Stem Extensions

Background and Hypothesis: Aseptic loosening is one of the most common failure mechanisms of total knee arthroplasty (TKA) requiring revision. The influence of obesity on tibial component aseptic loosening remains unknown. Some surgeons advocate the addition of a tibial stem extension to reduce the risk of loosening. The purpose of this study was to quantify the incidence and causes of revision for tibial component loosening in a large consecutive cohort of cemented primary TKAs without stem extensions based upon level of obesity. 
 
 Experimental Design or Project Methods: 534 consecutive cemented primary TKAs performed between 2016 and 2018 by one surgeon were retrospectively reviewed. Procedures were performed using consistent surgical, perioperative medical, and pain-control protocols. All tibial implants were tapered thin keeled designs without stem extensions and implanted with low viscosity cement. Medical records were examined and all-cause revisions of the index surgery were documented. 
 
 Results: After exclusions for confounds, 525 TKAs were analyzed. Mean age and BMI were 67.8 years and 33.9kg/m2 respectively and 72% were female. Mean follow-up was 19.1 (SD 10.5) months and 48% had minimum two-year follow-up. 41.3% of patients had a BMI greater than 35kg/m2 and 21.9% above 40kg/m2. There were 11 revisions in 10 patients, 1.9% out of all TKAs performed. Five TKAs required both-component revision and three involved the femoral component only. No tibial component revisions were performed for aseptic loosening. 
 
 Conclusion and Potential Impact: None of the standard tibial implants with a keeled design without stem extensions failed in a patient population with greater than 40% obesity. Despite some suggesting tibial stem extensions should be used in obese TKA patients, these findings suggest that tibial component failure in obese patients may be design specific and routinely utilizing stem extensions may not be warranted and could result in deleterious bone loss at revision if required for reasons other than aseptic loosening.

Modular Tibial Stem Use and Risk of Revision for Aseptic Loosening in Cemented Primary Total Knee Arthroplasty

BackgroundModular tibial stem extensions in total knee arthroplasty (TKA) are designed to reduce the risk of aseptic loosening of the tibial base plate. However, these implants add significant cost and an evaluation of their effectiveness in reducing this risk of loosening has not been studied in a large cohort. We sought to evaluate modular tibial stem utilization in primary TKA. MethodsWe conducted a cohort study using our integrated healthcare system’s Total Joint Replacement Registry. Patients who underwent cemented primary TKA were identified (2009-2019). Propensity scores were used to 1:1 match patients without to those with a stem extension. Cox proportional-hazards regression was used to evaluate the risk for revision due to aseptic loosening. ResultsTen thousand four hundred seventy six TKA with a modular tibial stem were matched to 10,476 TKA without a tibial stem. Stem utilization associated with a lower risk of revision for loosening across all postoperative follow-up (hazard ratio = 0.38, 95% confidence interval = 0.17-0.85). ConclusionIn a matched cohort study, we observed presence of a stem extension was associated with a lower risk of revision for aseptic loosening. Further study to identify specific risk factors for aseptic loosening and confirm the findings presented here are warranted. Level of EvidenceLevel III.

Outcomes of Cemented Total Knee Arthroplasty for Secondary Osteonecrosis of the Knee

BackgroundSecondary osteonecrosis of the knee (SOK) generally occurs in relatively young patients; at advanced stages of SOK, the only viable surgical option is total knee arthroplasty (TKA). We conducted a retrospective study to investigate implant survivorship, clinical and radiographic outcomes, and complications of contemporary cemented bicompartmental TKA with/without patellar resurfacing for SOK. MethodsThirty-eight cemented TKAs in 27 patients with atraumatic SOK, mean age 43 years (17 to 65), were retrospectively reviewed. Seventy-four percent had a history of corticosteroid use, and 18% had a history of alcohol abuse. Patellar osteonecrosis was coincidentally found in six knees (16%), and all were asymptomatic without joint collapse. The mean followup was 7 years (2 to 12). Knee Society Score (KSS) and radiographic outcomes were evaluated at 6 weeks, 1 year, then every 2 to 3 years. ResultsNinety-two percent had implant survivorship free from revision with significant improvement in KSS. Causes of revision included aseptic tibial loosening (one), deep infection (one), and instability with patellofemoral issues (one). Four of six cases also with patellar osteonecrosis received resurfacing, including one with periprosthetic patellar fracture after minor trauma, with satisfactory clinical results after conservative treatment. None of the unrevised knees had progressive radiolucent lines or evidence of loosening. An unresurfaced patella, use of a stem extension or a varus-valgus constrained prosthesis constituted 18%, 8% and 3%, respectively. ConclusionCemented TKAs with selective stem extension in patients with SOK had satisfactory implant survivorship and reliable outcomes. Secondary osteonecrosis of the patella should be carefully evaluated prior to operation.

Secondary osteoarthritis of the knee due to 40-year nonunion of a medial femoral condyle fracture: A case with good outcome without arthroplasty

Isolated femoral condyle fracture is an uncommon entity. It accounts for only 0.65% of all femoral fractures, with lateral condyle involvement three times more frequently than the medial condyle. In neglected cases, nonunion and malalignment may occur, which results in osteoarthritis of the knee due to uneven distribution of load across respective compartments. In treating such cases, both osteoarthritis and nonunion have to be tackled to reconstruct a stable, mobile, pain-free, and well-aligned knee joint. There are a number of surgical options, including excision of the nonunion fragment, fixation of the nonunion fragment with or without bone graft, and total knee arthroplasty with or without stem extension. In the following, we present a case of 40-year non union of the lateral condyle and our rationale of management for a relatively young lady. During the course of treatment, there was an unexpected success even though arthroplasty was not performed. A management strategy for this challenging condition was also suggested.

Exogenous Silicon Enhanced Salt Resistance by Maintaining K+/Na+ Homeostasis and Antioxidant Performance in Alfalfa Leaves.

Silicon (Si) has been known to enhance salt resistance in plants. In this experiment, 4-weeks-old alfalfa seedlings were exposed to different NaCl concentrations (0–200 mM) with or without 2 mM Si for two weeks. The results showed that NaCl-stressed alfalfa seedlings showed a decrease in growth performance, such as stem extension rate, predawn leaf water potential (LWP) and the chlorophyll content, potassium (K+) concentration, as well as the ratio of potassium/sodium ion (K+/Na+). In contrast, NaCl-stressed alfalfa seedlings increased leaf Na+ concentration and the malondialdehyde (MDA) level, as well as the activities of superoxide dismutase (SOD), catalase (CAT), and peroxidase (POD) in alfalfa leaves. Besides, exogenous Si application enhanced photosynthetic parameters of NaCl-stressed alfalfa seedlings, which was accompanied by the improvement in predawn LWP, level of chlorophyll content, and water use efficiency (WUE). The Si-treated plants enhanced salinity tolerance by limiting Na+ accumulation while maintaining K+ concentration in leaves. It also established K+/Na+ homeostasis by increasing K+/Na+ radio to protect the leaves from Na+ toxicity and thereby maintained higher chlorophyll retention. Simultaneously, Si-treated plants showed higher antioxidant activities and decreased MDA content under NaCl stress. Our study concluded that Si application enhanced salt tolerance of alfalfa through improving the leaves photosynthesis, enhancing antioxidant performance and maintaining K+/Na+ homeostasis in leaves. Our data further indicated exogenous Si application could be effectively manipulated for improving salt resistance of alfalfa grown in saline soil.

Effectiveness of varietal resistance and risk prediction for the control of ramularia leaf spot of barley under Irish growing conditions

Ramularia leaf spot (RLS) of barley, caused by the fungal pathogen Ramularia collo-cygni, is a significant threat to the viability of spring barley production in Ireland. As a relatively new disease of barley, limited information is available on the development and impact of the disease under Irish conditions. RLS symptoms often only develop after anthesis and the final fungicide application, therefore some decision support is required for growers to be able to make sound integrated pest management (IPM) decisions. In the present study field trials were conducted on spring barley in 2016–2018 to determine if environmental conditions during stem extension, specifically leaf wetness, could be used to aid decisions relating to the intensity of fungicide control required later in the season for the control of RLS. The trials were conducted on four spring barley varieties subjected to one of five fungicide treatments at awn emergence 1) untreated control 2) pyraclostrobin 3) prothioconazole and chlorothalonil 4) decreased/increased rates of prothioconazole and chlrothalonil depending on risk of RLS development and 5) exclusion of prothioconazole or addition of bixafen depending on risk of RLS development. In 2018, although moderate-high levels of disease were predicted, a prolonged dry period post-stem extension resulted in no disease development. In 2016, 2017 moderate levels of disease developed in the trials, with various significant (P < 0.05) interactions recorded between site, year, variety and fungicide treatment, depending on specific variable assessed: visual leaf symptoms, pathogen load in the leaf or grain as determined by qPCR or final grain yield. This was further evident in the relationships between visual symptoms and detectable R. collo-cygni biomass in the leaf with yield, these contrasted between seasons with weak relationships detected in 2016 (R2 = −0.019 and R2 = 0.176 for visual and biomass respectively) and strong relationships detected in 2017 (R2 = −0.748 and R2 = −0.5 for visual and biomass respectively). The variability in responses to the variety and fungicide treatments and the relationships between visual disease symptoms and biomass further highlight the unpredictability of RLS.

Growth and morphology responses to narrow-band blue light and its co-action with low-level UVB or green light: A comparison with red light in four microgreen species

To explore the action mode of blue light on plant elongation growth, the growth and morphology traits of arugula (Brassica eruca L., ‘Rocket’), cabbage (Brassica oleracea, unknown variety name), mustard (Brassica juncea, ‘Ruby Streaks’), and kale (Brassica napus, ‘Red Russian’) microgreens were compared under four light quality treatments: (1) R, narrow-band red light (660 nm); (2) B, narrow-band blue light (455 nm); (3) BU, broad-band blue light created by mixing B with a low level (≈ 0.7 μmol m−2 s−1) of UVB (310 nm); and (4) BG, broad-band blue light created by mixing B with a low level (≈ 6 %) of green light (530 nm). Continuous (24 -h) light-emitting diode lighting with 100 μmol m−2 s−1 photosynthetic photon flux density was used in the above treatments at ≈ 22 °C. After 7–8 days of light treatment, B, compared to R, had promoted elongation growth (i.e., longer hypocotyls or petioles, faster stem extension), and induced some other typical shade-avoidance responses (e.g., smaller cotyledons, lighter plant color, or greater biomass allocation to stem), which was associated with longer cells in the hypocotyls and lower cell density in the cotyledons except for mustard. Compared with B, the elongation growth was inhibited under BU for arugula and kale, but was promoted under BG for all the species except arugula. If considering all the plant traits together, BU and BG effect was similar to B, but different from R. Therefore, narrow-band blue vs. red light can promote elongation growth as a shade-avoidance response at both plant and cell levels, and adding low-level UVB or green light can only slightly change the narrow-band-blue-light-promoted shade-avoidance response, despite varying sensitivity among species.

Metaphyseal Stem Extension Improves Tibial Stability in Cementless Total Knee Arthroplasty

BackgroundThe goal was to determine if the addition of a metaphyseal stem extension limits micromotion of a cementless tibial component during cyclic loading in primary total knee arthroplasty. The hypothesis tested was that the use of a 50-mm stem extension on a cementless tibial component would limit motion compared with an identical cementless component without a stem extension. MethodsThe study used 3 variations of a tibial component from the same total knee arthroplasty system. Group 1 consisted of a cementless tibial component without a stem extension. Group 2 used the same cementless component as group 1, but with the addition of a short 50-mm stem. Group 3 consisted of a cemented tibial component without a stem extension to serve as a “control” (gold standard). The tibial specimens were implanted into a synthetic bone model and tested using a physiological medial-lateral 60/40 load distribution for 5000 cycles. ResultsThe results demonstrated a significant decrease in motion at the anterior region of the cementless stem extension (group 2) components compared with the cementless with no stem extension (group 1). The cementless with stem extension (group 2) demonstrated similar results at all cycles to the cemented (group 3) components at the anterior region. ConclusionThe addition of a short metaphyseal stem (50mm) to a keel plus 4-peg tibial component design provides a significant reduction in micromotion during cyclic loading of a cementless tibial baseplate in a synthetic foam bone model, similar to a cemented implant.

Maximum elongation growth promoted as a shade-avoidance response by blue light is related to deactivated phytochrome: a comparison with red light in four microgreen species

To clarify detailed patterns of responses to blue light associated with decreasing phytochrome activity, the growth and morphology traits of arugula, cabbage, mustard, and kale microgreens were compared under the treatments: (1) R, pure red light; (2) B, pure blue light; (3) BRF0, (4) BRF2, (5) BRF4, and (6) BRF6: unpure blue lights created by mixing B with low-level (6%) R, and further adding 0, 2, 4, and 6 μmol m−2 s−1 of far-red light, respectively. The calculated phytochrome photostationary state (PPS) value, indicating phytochrome activity, gradually decreased in the order of R (0.89), BRF0 (0.69), BRF2 (0.65), BRF4 (0.63), BRF6 (0.60), and B (0.50). Generally, the elongation growth (including stem extension rate, hypocotyl length, or petiole length) under blue lights increased with the decreasing PPS values, showing the highest and lowest sensitivity for arugula and mustard, respectively. However, the elongation promoted by blue lights gradually became saturated once the PPS values decreased below 0.60, a level which deactivates phytochrome. Other plant traits, such as biomass allocation and plant color, varied with increasing shade-avoidance responses to blue lights with decreasing PPS values relative to R, and these traits reached saturation at a similar PPS value as elongation. The response sensitivity was highest in elongation growth for arugula and cabbage, and highest in plant color for kale and mustard. This suggests that deactivated phytochrome contributes to the maximum elongation promotion as a shade-avoidance response induced by blue light, although the response sensitivity varies with plant traits and species.

Submergence tolerance and recovery in Lotus: Variation among fifteen accessions in response to partial and complete submergence

Several Lotus species are perennial forage legumes which tolerate waterlogging, but knowledge of responses to partial or complete shoot submergence is scant. We evaluated the responses of 15 Lotus accessions to partial and complete shoot submergence and variations in traits associated with tolerance and recovery after de-submergence. Accessions of Lotus tenuis, L. corniculatus, L. pedunculatus and L. japonicus were raised for 43 d and then subjected to aerated root zone (control), deoxygenated stagnant root zone with shoots in air (stagnant), stagnant root zone with partial (75 %) and complete submergence of shoots, for 7 d. The recovery ability from complete submergence was also assessed. We found inter- and intra-specific variations in the stem extension responses (i.e. promoted or restricted compared to controls) depending on water depth. Eight of 15 accessions promoted the stem extension when in partial submergence, while three of those eight (all L. tenuis accessions) had a restricted stem extension when under complete submergence. Two accessions (belonging to L. corniculatus and L. penduculatus species) also promoted the stem extension under complete submergence. The accessions that attained better recovery in terms of leaves produced after de-submergence, were those that had high leaf and root sugar concentration at de-submergence, and high thickness and persistence of gas films on leaves during submergence (all L. tenuis accessions). We conclude that all Lotus accessions were able to tolerate 7 d of partial and complete shoot submergence, despite adopting different stem extension responses.

Knee Arthroplasty in Severe Varus Advanced Knee Osteoarthritis with Proximal Tibia Malunion: a case report

Alignment is crucial for successful knee arthroplasty.1 Tibia malunion will make arthroplasty more challenging. In this case, we present advanced knee osteoarthritis with tibia vara due to malunion that needs corrective osteotomy during knee arthroplasty.Case Presentation:A 70 years old female presented to our office complaining pain in both knees markedly on the left, profoundly felt during walking. She has a history of being hit by motorcycle 15 months ago and left knee was more bent since then. Physical examination of the left knee showed severe varus, mild effusion, tenderness on medial tibial condyle, otherwise normal. Plain radiographs showed advanced bilateral knee osteoarthritis with left proximal tibia malunion. Patient underwent left knee arthroplasty with corrective tibia and fibula osteotomy.Solutions and Outcome:Patient underwent closed wedge tibial osteotomy together with fibula osteotomy followed by knee arthroplasty with posterior-stabilized implant and tibial stem extension in a single surgery. Tibial osteotomy was reinforced using plate and screws. Partial weight bearing was achieved in second postoperative day and discharged on the third day. Patient able to walk with painless left knee after 1 month.Discussion:Severe deformity that causes huge malalignment makes knee arthroplasty difficult. Some methods are available to correct malalignment.1 In this case, the surgeon chose to do closed wedge tibial osteotomy reinforced with plate and screws to correct the proximal tibia malunion. Arthroplasty was done using posterior-stabilized implant and tibial stem extension. Patient shows good result in alignment and function.Conclusion:Correcting the associated deformity is crucial in achieving good alignment in knee arthroplasty. Even in our case of severe genu varus due to proximal tibia malunion, correcting proximal tibia varus deformity prior to knee arthroplasty shows good alignment and function.

Blackout Reduces Height of Easter Lily but End-of-day Red Light Treatment Using Light-emitting Diodes Does Not

One principle for reducing undesirable stem extension in greenhouse production is to counteract the decrease in red-to-far red ratio that occurs naturally during twilight periods. This study evaluated three lighting treatments on the morphology of easter lily (Lilium longiflorum): 1) a 1-hour end-of-day treatment providing 20 μmol·m−2·s−1 of monochromatic red light (EOD R), 2) blackout curtains closed 45 to 75 minutes before sunset and kept closed until 0 to 60 minutes after sunrise (BO), and 3) a control with natural twilight (CTRL). Plants under the BO treatment were 11% shorter than CTRL, while plants exposed to EOD R did not differ in height compared with BO or CTRL. There were no treatment effects on any other measured parameters, including aspects of flowering.

Comparison of Intercropping and Pure Cropping as Determinants of the Stem and Canopy Foliage of Linseed (Linum Usitatissimum L.) and Pea (Pisum Sativum L.) Cultivars and Their Productivity

ABSTRACT In a two-factor field experiment, the stem and leaf characteristics and productivity of the ‘Flanders’ and ‘Barbara’ linseed cultivars were compared in four developmental stages in relation to the sowing method. The linseed grown in intercropping with pea, irrespective of the cultivar, was characterized by small leaves in the stem extension stage, but the leaf area significantly increased beginning with the budding phase. Comparison of the cultivars showed that the Barbara cultivar had significantly more leaves on the stems, which significantly affected the final protein yield. The choice of linseed cultivar for oilseed–legume intercropping was of great importance for the final yield. Among the mixtures compared, the one composed of ‘Barbara’ linseed and ‘Phönix’ pea was more productive. Cultivation of ‘Flanders’ linseed resulted in high yield in the pure stand and a high-fat yield. Intercropping of linseed with pea resulted in REI values above 1, which demonstrates the agrobiological suitability of the mixture.

Increased survival rate in extension stemmed TKA in obese patients at minimum 2 years follow-up.

Total knee arthroplasty (TKA) is frequently performed for obese patients. TKA in this population shows a high rate of complication, particularly tibial component loosening. The aim of this study is to compare the survival rate of tibial components in obese population using TKA with stem versus without stem. From a prospective database of 4216 TKA, obese patients [body mass index (BMI) > 30 kgm²] with primary TKA using a tibial short stem extension (30 mm) at a minimum follow-up of 2 years were retrospectively reviewed and compared to a matched control group (1:3 ratio) with a standard tibial stem. Inclusion criteria were BMI > 30 kgm², first knee surgery and 24 months minimum of follow-up. The primary outcome was revision for tibial aseptic loosening. Secondary outcomes were all-cause revisions and Knee Society Scores (KSS). The final study population consisted of 35 TKA with tibial extension stem versus 105 TKA with standard stem. The mean age was 69.2 and 69.5 years, respectively, with a mean follow-up of 52 months. Both groups were comparable before surgery. After 2 years of follow-up, we observed seven tibial loosening in the group without stem (6.6%) versus no tibial loosening in the stemmed group (p < 0.001). The difference in KSS knee score (83 versus 86; p = 0.06) and the KSS function score (73 versus 77; p = 0.84) were not statistically significant at the final follow-up. Using stemmed TKA for obese patients significantly decreased tibial loosening rate at minimum 2 years of follow-up. Case-control study, Level III.

Reduced Aseptic Loosening With Fully Cemented Short-Stemmed Tibial Components in Primary Cemented Total Knee Arthroplasty

BackgroundRecently, the use of short tibial stems in the obese population undergoing total knee arthroplasty (TKA) has been proposed. Thus, we designed a study to assess tibial component survivorship after primary TKA using a single implant both with and without a fully cemented stem extension performed by a single surgeon. MethodsA search of our institutional research database was performed. A minimum 2-year follow-up was selected. Cohorts were created according to patient body mass index (BMI; >40 kg/m2 and <40 kg/m2) and the presence (stemmed tibia [ST]) or absence (non-stemmed tibia [NST]) of a short tibial stem extension. Kaplan-Meier survival analyses for aseptic loosening and log-rank tests were performed. ResultsA total of 236 patients were identified (ST = 162, NST = 74). Baseline patient characteristics were statistically similar between cohorts with the exception of BMI which was greater in the ST cohort (32.9 kg/m2, 30.6 kg/m2; P = .01). Kaplan-Meier survival analysis at 5 years was superior for the BMI < 40 kg/m2 cohort (98.9%, 93.1%; P = .045), the ST cohort (100%, 94.5%; P = .006), and the BMI > 40 kg/m2 with ST cohort at 4 years (71.4%, 100%; P = .008). ConclusionMorbid obesity and a short native tibial stem design appear to be associated with aseptic loosening in primary TKA. This appears to be mitigated through the use of an ST. As such, the use of ST may be considered in at-risk patients. Alternatively, implants with longer native stem designs can be employed. Modern short-stemmed tibial components may need to be redesigned.

Increased survival rate for primary TKA with tibial short extension stems for severe varus deformities at a minimum of 2 years follow-up.

The purpose of this study was to compare the clinical results, radiographic loosening and early complications between patients undergoing primary knee arthroplasty (TKA) with tibial short stem extension and those with standard stem for gross varus deformities at minimum two years after surgery. From a prospective TKA database of 4216 patients, patients with a primary TKA with a tibial short stem extension (30mm) for severe varus deformity (hip-kneeankle angle, HKA < 170°) and a minimum follow-up of 2years, were reviewed and compared to a matched control group with tibial components with a standard stem, in a 1:3 ratio. Demographics, surgical parameters, pre- and postoperative alignment and outcome parameters were collected for all patients. The primary outcome was aseptic loosening of the tibial component. Secondary outcomes were knee society scores (KSS), postoperative HKA, general postoperative complications and implant survival rates. Forty-five patients with tibial short stem extensions (mean HKA 166.2°) were compared in a 1:3 ratio to a matched case-control group of 135 patients with standard stems (mean HKA 167.1°) at a mean follow-up of 57 and 64months respectively after primary TKA. In the extension stem group, 4 patients encountered complications (8.9%) versus 12 patients in the standard stem group (8.9%). There were no cases of tibial component loosening in the short extension stem versus four cases in the standard stem group (3%). This difference was significant between groups, p = 0.04. In patients with varus deformities > 10°, undergoing primary total knee arthroplasty, prophylactic use of a tibial short extension stem may lead to less loosening of the tibial component. In this study, 3% of patient with big varus deformity without stemmed TKA had a tibial implant loosening versus 0% in the stemmed TKA group. Level III, case-control study.

ACT-22 CLINICAL RESULT AND CONSIDERATION OF 70 CASES OF INSULAR GLIOMA

Our policy for insular glioma has achieved more than 90% removal. The policy influence grade 2 to postpone farther treatment and grade 3 to extend prognosis. In this study, we analyzed our clinical data to be sure how this policy effect to insular glioma. First-onset tumor since 2006 to 2015 were collected and following parameters were analyzed retrospectively, such as the tumor, extension, surgical removal rate, complications, pathological and genomic diagnosis. Of all 70 cases, the average age was 41 years old (24–76). The pathological diagnosis and number of patients were DAmt 20, DAwt 1, AAmt 8, AAwt 5, AO 5, O 18. PFS of each pathological grade(2,3,4) were 55,5m, 42,6m and 4,7m, OS were nr, nr, 32,8 months. 57 cases of IDHmt showed 60,2m of PFS and n.r of OS. 10 cases of IDHwt showed 19,9m PFS and 35,8m OS. The average and median removal rate were 91.4% and 95%. The number of complication case were mild 9 and moderate 2 at 3 months after surgery. The invasion pattern from temporal stem showed that frontal base invasion cases was resulted as poor prognosis comparing with temporal or parietal extension. Number of patients with IDHwt, Oligodedroglial tumor and GBM were relatively low. Surgical complications are mainly caused in the first half of the proficiency process, 15% had paralysis due to LSA infarction. Most of grade 2 cases were treated without post-operative treatment and the prognosis was almost same as grade 3 cases which were treated by chemo and radiation therapy such as 55m, 43m of PFS and n.r of OS. AA wt and GBM showed almost same OS of 32m.We have reconsidered a new classification based on temporal stem extension from surgical point of view. Insular glioma is somewhat different from the other location glioma.

Blue versus Red Light Can Promote Elongation Growth Independent of Photoperiod: A Study in Four Brassica Microgreens Species

An elongated stem has beneficial effects on microgreen production. Previous studies indicate that under 24-hour light-emitting diode (LED) lighting, monochromatic blue light, compared with red light, can promote plant elongation for some species. The objective of this study was to investigate whether shortened photoperiod can change blue vs. red light effects on elongation growth. The growth and morphology traits of arugula (Brassica eruca, ‘Rocket’), cabbage (Brassica oleracea, unknown variety name), mustard (Brassica juncea, ‘Ruby Streaks’), and kale (Brassica napus, ‘Red Russian’) seedlings were compared during the stage from seeding to cotyledon unfolding under two light quality × two photoperiod treatments: 1) R, monochromatic red light (665 nm) and 2) B, monochromatic blue light (440 nm) using continuous (24-hour light/0-hour dark) or periodic (16-hour light/8-hour dark) LED lighting. A photosynthetic photon flux density of ≈100 μmol·m−2·s−1 and an air temperature of ≈22 °C was used for the preceding treatments. After 7 to 8 days of lighting treatment, regardless of photoperiod, B promoted elongation growth compared with R, as demonstrated by a greater stem extension rate, hypocotyl length, or petiole length in the tested microgreen species, except for mustard. The promotion effects on elongation were greater under 24- vs. 16-hour lighting in many cases. Among the tested species, mustard showed the lowest sensitivity in elongation response to B vs. R, which was independent of photoperiod. This suggests that the blue-light-promoted elongation is not specifically from 24-hour lighting, despite the varying promotion degree under different photoperiods or for different species. The elongation growth promoted by blue LED light under a photoperiod of either 24 hours or 16 hours can potentially benefit indoor production of microgreens.