Surgical treatment of osteoarthritis of the carpometacarpal joint of the thumb: a systematic review

In most cases of basal joint osteoarthritis, surgery becomes an option at stages II, III, and IV, as classified by Eaton. Controversy exists regarding which technique achieves the best outcome. This systematic review was undertaken to address the question of which technique, if any, offers the best outcome to patients with osteoarthritis of the first carpometacarpal joint greater than stage II. A thorough search of the electronic databases Cochrane, Cinahl, Healthstar, and MEDLINE/PubMed was undertaken to identify reviews and articles on primary comparative studies of the different surgical options. The methodological quality of the retrieved articles was assessed on the basis of specific criteria. Inclusion criteria were applied to 44 of 254 possibly relevant articles. Eight reviews and 18 comparative studies met the criteria and were reviewed. Each of the techniques, arthrodesis, trapeziectomy with or without biological/synthetic interposition, osteotomy, and joint replacement, was associated with unique benefits and risks. There was great variability in outcome measurements. The majority of retrieved review articles claim that ligamentous reconstruction and tendon interposition may represent the best option; however, validity assessment of these studies revealed methodological flaws. Furthermore, results from the articles on comparative studies indicate that ligamentous reconstruction and tendon interposition may provide no additional benefit when compared with arthrodesis and trapeziectomy alone or with tendon interposition. There is no consensus as to which clinical outcomes are most important in thumb basal joint surgery and how these should be measured. This renders the appraisal and comparison of such studies a challenging task. Until large randomized controlled trials that compare techniques in similar populations with respect to staging and prognostic factors are undertaken and the clinical outcomes are clearly defined, surgeons will continue to claim superiority of one technique over another without supporting evidence.     

Ecophysiological differences between male and female plants of Pistacia lentiscus L.

Previous studies in spatial distribution of male and female shrubs of Pistacia lentiscus have demonstrated that less perturbed areas, older communities with a well developed cover, have male-biased sex ratios, whereas in abandoned old agricultural areas there are no significant differences between the number of male and female plants. In this study, we analyse both sexes in terms of their photosynthetic features that could provide a physiological basis for habitat partitioning between sexes. Rates of light-saturated assimilation and stomatal conductance were studied in male and female plants during summer. Assimilation rates were higher in the morning than in the afternoon and mean daily maximum assimilation rates reached 10.9 and 6.6 mol m^–2 s^–1, for male and female plants, respectively. In the absence of drought stress (laboratory conditions), the measured photosynthetic characteristics of leaves of male and female plants, provided by fluorescence studies and light and CO₂ response curves, were similar. Under natural stress conditions however, lower CO₂ assimilation rates and stomatal conductances were recorded in female plants. The differences in the light response curve of effective quantum yield (_II) recorded under stress conditions showed also higher quantum yield for male plants under low irradiances. From this study we suggest that the differences observed between male and females are largely due to different degrees of stomatal control rather than to differences in photosynthetic activity, leading to higher water use efficiency (WUE) in female plants. However, despite the higher leaf control of water loss by females, they reduce the water potential to the same values as male plants, probably due to specific characteristics of the root system or of the conducting xylem. These results suggest that the ecological advantage of male plants in older communities is due to a higher competition for water uptake, while in the youngest open areas is the higher WUE in female plants that confer an ecological advantage.     

The morphology of the thumb carpometacarpal joint does not differ between men and women,but changes with aging and early osteoarthritis

The high prevalence of thumb carpometacarpal (CMC) joint osteoarthritis (OA) in women has been previously linked to the articular morphology of the trapezium. Studies report conflicting results on how the articular shapes of male and female trapezia compare to one another, however, mainly because their findings are based on data from older cadaveric specimens. The purpose of this in vivo study was to dissociate the effect of sex from that of aging and early OA by using cohorts of healthy young and healthy older subjects, as well as patients with early stage OA. Computed tomography scans from 68 healthy subjects and 87 arthritic subjects were used to obtain 3-D bone models. The trapezial and metacarpal articular surfaces were manually delineated on scaled bone models and compared between sex, age, and health groups by using polar histograms of curvature and average curvatures. We found no sex-related differences, but significant age-group and health-group differences, in the articular surfaces of both bones. Older healthy subjects had higher curvature in the concave and lower curvature in the convex directions of both the trapezial and metacarpal saddles than healthy young subjects. Subjects with early OA had significantly different metacarpal and trapezial articular shapes from healthy subjects of the same age group. These findings suggest that aging and OA affect the articular shape of the CMC joint, but that, in contrast to previously held beliefs, inherent sex differences are not responsible for the higher incidence of CMC OA in women.     

Joint surfaces of the carpometacarpal articulation of the thumb in man

With respect of height and width of the proximal joint surface of the macerated 1st metacarpal bone as well as of height of the left trapezium results significant minor values compared with bones of right extremities. The measurement datas of height and width of both joint surfaces at the left macerated specimens are less significant than at left humid preparations. With respect of height of the proximal articular surfaces of the right 1st metacarpal bone, there are greater values than at the cartilageneous preparations by statistical significance. At macerated and humid preparated articulation surfaces of the saddle moint of the thumb there are 3 typical profiles in the 2 main planes: a spiral curve (vaulted in the dorsal or ulnar direction), a circular curve, and a s-shaped curve. The radius of the curve will be determined with adaptation of defined curve patterns. At the distal joint surface of the macerated trapezium, the circularly and spirally curved profiles are significantly much more crooked in the dorso-palmar direction than at the cartilageneous articulation surface on the contrary. The humid preparated distal joint surface of the trapezium in the radio-ulnar direction is clearly much more curved. The spiral form is found in 52,6% of all macerated and in 41,6% of all humid preparated specimens. The s-shaped profile is very rarely found at macerated joints (8%), whereas it appears in 26% at humid preparated surfaces. Corresponding cartilageneous saddle joints of the thumb are even similarly curved in 47% of the radio-ulnar and 40,5% of the dorso-palmar joints slices. The clear majority of the opposite carpometacarpal joint surfaces of the thumb show an individually variabel, partly an incongruent curving attitude. If different profiles at corresponding humid preparated joint surfaces assemble the following curvatures prevail: a) In the radio-ulnar cutting direction the combination: circular curve of the distal joint surface of the trapezium and spiral curve of the proximal surface of the 1st metacarpal bone, b) in the dorso-palmar direction: the combination spiral curve of the distal surface of the trapezium and circular curve of the 1st metacarpal bone.     

绍兴地区男女泌尿生殖道支原体感染特点及药敏差异分析

目的 了解绍兴地区男女泌尿生殖道支原体属感染的特点,比较男女两性对几种抗菌药物的耐药情况的差异.方法 应用法国生物梅里埃公司MycoplasmaISI试剂盒对2010年1月至201 1年10月男女两性泌尿生殖道标本进行支原体培养及药敏试验,统计解脲脲支原体和人支原体的检出率及耐药情况.结果 共1722例泌尿生殖道感染病例中,支原体属阳性869例,总阳性率50.46％,其中单纯解脲脲原体(Uu)感染702例,单纯人型支原体(Mh)感染29例,Uu及Mh混合感染138例;714例男性中支原体阳性190例,阳性率26.61％,1008例女性中支原体阳性679例,阳性率67.36％;男性单纯Uu感染耐药率较高的主要是:环丙沙星(80.50％)、氧氟沙星(63.60％),女性单纯Uu感染耐药率较高的主要是:环丙沙星(91.97％)、氧氟沙星(73.72％)、红霉素(47.81％).男女两性单纯Uu感染对红霉素、阿奇霉素、克拉霉素和交沙霉素的敏感性差异有统计学意义(P＜0.05).结论 男女两性泌尿生殖道支原体感染以Uu为主,且两者对多种抗菌药物的敏感性具有显著性差异,临床应根据药敏结果合理选取使用抗菌药物.     

Dietary differences between male and female fallow deer in sympatry and in allopatry

Composition of the diet of fallow deer in the New Forest in southern England was determined on a monthly basis from faecal analyses. The deer were shown to be predominantly grazers: grasses accounted for approximately 70% of annual forage intake, with the remainder of the diet dominated by sedges, rushes, heather and broadleaved browse. Differences in dietary composition and diet quality could be shown between males and females where buck and doe groups occupied discrete home ranges. Differences between the male and female diets were also maintained in areas where the two sexes. while still socially segregated, occupied overlapping ranges. Males had higher quality diets in winter, while females consumed higher quality diets in spring and summer. These results are considered in the context of general theories of dietary difference between the sexes in dimorphic species of ungulates.     

雌雄子午沙鼠的认知行为及其神经内分泌水平的差异

本研究通过对雌雄子午沙鼠进行新物体识别和社会认知实验,运用免疫组化方法检测其相关脑区合成催产素（OT）、加压素（AVP）和多巴胺（DA）能的神经元数量,采用酶联免疫试验（ELISA）方法检测了其血清中OT、AVP的水平,探究了雌雄子午沙鼠的两性认知差异及其神经内分泌水平的差异。结果表明,雌雄子午沙鼠对新物体的探究时间均要显著高于旧物体,雌雄子午沙鼠的辨别指数无显著差异（P＞0.05）;雄性子午沙鼠随着探究次数的增加对重复刺激鼠a的探究时间不断减少,对陌生刺激鼠b的探究时间显著高于刺激鼠a（P＜0.05）;雌性子午沙鼠没有此趋势。雄性子午沙鼠OT能神经元数量在下丘脑室旁核(PVN)和视上核(SON)均要显著少于雌性（P＜0.05）;雄性个体DA能神经元数量在黑质显著高于雌性（P＜0.01）;然而雄性个体DA能神经元数量在腹侧被盖区显著少于雌性（P＜0.01）;雌雄子午沙鼠血清OT、AVP水平均无显著差异。综上所述,雌雄子午沙鼠对新物体的识别能力无显著差异,然而雄性子午沙鼠的社会认知能力强于雌性。在神经内分泌水平上,雌雄子午沙鼠PVN和SON中OT能神经元数量、黑质和腹侧背盖区的DA能神经元数量均呈现出了两性差异。     

Morphological and functional differences in the elbow extensor muscle between highly trained male and female athletes

The purpose of this study was to investigate the difference in the morphological and functional aspects of the triceps brachii muscle between highly trained male and female athletes who were members of the 1996 Japanese Olympic teams in each of three different events: soccer, gymnastics and judo. The thickness (TB_mt) and fibre pennation angle (TB_pen) of the triceps brachii muscle and force output during elbow extensions were determined using a B-mode ultrasound apparatus and an isokinetic dynamometer, respectively. The TB_mt and its value relative to upper arm length (TB_mt/l _ua) were significantly larger in the men than in the women in all the events except judo. In all the subjects, a significant correlation was found between TB_mt/l _ua) and TB_pen (r= 0.721, P < 0.05). The existence of the sex difference in TB_pen within the same event was in agreement with that observed in TB_mt/l _ua except for the soccer players. The TB_pen of the soccer players were similar in both sexes although a significant sex differences was found in TB_mt/l _ua. The isokinetic forces measured using the two velocities 60°· s⁻¹ (F ₆₀) and 180°· s⁻¹ (F ₁₈₀) were significantly correlated to the cross-sectional area (CSA) of the triceps brachii muscle estimated from TB_mt (r= 0.702, P < 0.05 for F ₆₀, and r= 0.776, P < 0.05 for F ₁₈₀). No significant sex differences were found in either F ₆₀/CSA or F ₁₈₀/CSA in any of the events. From these results, it could be assumed, at least in the Olympic athletes tested in this study, that the fibre angulation of the triceps brachii muscle was almost the same in the two sexes if allowance was made for the difference in the muscle size, and the sex difference in force generation capability of the triceps brachii muscle could in the main be attributed to the difference in CSA rather than in the architectural characteristics. Accepted: 7 January 1998     

Schistosoma mansoni: mortality, pathophysiology, and susceptibility differences in male and female mice.

In parallel studies of Schistosoma mansoni infections in male and female CBA/J mice, major sex-related differences are seen in the development of infection and disease. Upon equal subcutaneous exposures to 45 cercariae female mice present a more severe clinical course with consequent higher mortality than male mice. By 12 weeks of infection, more than 80% of female mice die, while less than 20% of infected males succumb to infection. This greater index of mortality is apparently due to the higher susceptibility of female mice to the development of adult worms. Exposed to 45 cercariae, virtually all females develop patent infections, but 8-34% of male mice do not do so. Also, the recovery rate of adult worms per cercariae from female mice is much higher than that from males, indicating that schistosomula are more successful in developing into adult worms in female mice. Additional studies indicate that this dichotomy of schistosomiasis in the sexes is not restricted to mice of the CBA/J strain, but also occurs in C57BL/6 and outbred CF1 strain mice.     

Molecular differences in Alzheimer's disease between male and female patients determined by integrative network analysis

Alzheimer's disease (AD) is a complex neurodegenerative disease and the most common cause of dementia among the elderly. There has been increasing recognition of sex differences in AD prevalence, clinical manifestation, disease course and prognosis. However, there have been few studies on the molecular mechanism underlying these differences. To address this issue, we carried out global gene expression and integrative network analyses based on expression profiles (GSE84422) across 17 cortical regions of 125 individuals with AD. There were few genes that were differentially expressed across the 17 regions between the two sexes, with only four (encoding glutamate metabotropic receptor 2, oestrogen‐related receptor beta, kinesin family member 26B, and aspartoacylase) that were differentially expressed in three regions. A pan‐cortical brain region co‐expression network analysis identified pathways and genes (eg, glycogen synthase kinase 3β) that were significantly associated with clinical characteristics of AD (such as neurofibrillary score) in males only. Similarity analyses between region‐specific networks indicated that male patients exhibited greater variability, especially in the superior parietal lobule, dorsolateral prefrontal cortex and occipital visual cortex. A network module analysis revealed an association between clinical traits and crosstalk of sex‐specific modules. An examination of temporal and spatial patterns of sex differences in AD showed that molecular networks were more conserved in females than in males in different cortical regions and at different AD stages. These findings provide insight into critical molecular pathways governing sex differences in AD pathology.     

Behavioural differences between male and female replacement reproductives in Kalotermes flavicollis (Isoptera, Kalotermitidae)

Summary: An ethogram type study was performed on representative colonies of Kalotermes flavicollis to investigate the behavioural repertoires of replacement king and queen. Our observations suggested a sex-based behavioural specialisation in the two reproductives, affecting colony organisation and equilibrium. Interesting differences were detected in overall activity of the two reproductives, with the male showing the greatest frequency of movements in the nest, vibratory acts, and the highest rate and range of social contacts. In addition to his importance for periodical insemination of the queen, the king might also play a basic role in the social structure and dynamic development of the colony, as a "mediator" in social interactions between the queen and the other colony members.