Scapular hydatidosis with extraosseous involvement

A forty three-year-old female, born in a rural area of southern Chile, at the age of 30 presented pain and limitation of motility of the right shoulder. Later on, she presented an increasing of volume at the right scapular region. A radiography showed an osteolytic lesion of the scapula. In a biopsy an osseous hydatidosis was found and a hydatid cyst was extirpated from the soft tissues. Four years later, as she presented again pain and volume increasing in the same anatomical area, albendazole was given to her, and a CAT practiced revealed osteolytic lesions of the bone, several periosteal ruptures and multiple cysts in the muscles. She was submitted to surgery again in order to extirpate cysts. After two years the patient presented the same clinical manifestations and radiological and CAT images previously observed. In considering all these facts a radical surgery was decided.     

Local variations in the micromechanical properties of mouse femur: the involvement of collagen fiber orientation and mineralization

In this study we sought to understand the material level basis for local variations in the uniaxial micromechanical properties of mouse cortical bone. It was hypothesized that the opposing anterior and posterior quadrants will significantly differ in terms of their mechanical function, such that, the anterior portion will be stronger in tension whereas the posterior quadrant will be stronger in compression. Mechanical properties were assessed via microtensile and microcompressive tests of standardized coupon-shaped specimens from femurs of Swiss Webster mice (9 weeks). The mineralization and mineral quality was assessed via Raman spectroscopy and the overall collagen orientation was investigated with quantitative polarized imaging. Micromechanical tests demonstrated that the modulus, yield stress, maximum stress and fracture energy of the posterior quadrant was 66%, 53%, 42% and 31% of anterior quadrant; however, the compressive properties did not differ between the two quadrants. Raman microspectroscopic analysis indicated that the mineral matrix ratio, mineral crystallinity and carbonation did not vary between the quadrants. However, the collagen fibers in the anterior quadrant were significantly (p<0.05) more oriented along the longer axis of the diaphyseal shaft than the collagen fibers of the posterior quadrant. Therefore, we concluded that the orientation of collagen fibers with respect to the anatomical loading axis has a profound effect on the uniaxial mechanical function of murine bone. It will be a matter of further research to reveal the role of local variations in the mode of stress on this material level dichotomy in tissue organization and mechanical function.     

The epidemiology of hydatidosis with special reference to the Mediterranean area.

In the Mediterranean area 2 subspecies of Echinococcus granulosus exist: E. g. equinus and E. g. granulosus. The latter is divided into sheep, cattle, pig and camel strains, the adult forms of which mainly occur in farm-dogs but sometimes in wild canidae. Some of these strains can infect man: namely, the sheep and the pig strain. The infectivity of the cattle strains for man is not certain. The epidemiological cycle is mainly a rural one, but it can become sylvatic or even urban. Thus, the epidemiological features of hydatidosis in the Mediterranean area are not basically different from the general epidemiology of the disease. But extensive rearing of sheep, combined with the carelessness and ignorance of people and with some particular habits, favours the maintenance of the infection.     

Surgical alternatives in the treatment of hepatic hydatidosis]

Echinococcosis is an endemic zoonosis in the south of Chile, so we have the opportunity to treat many patients especially the liver location which is the most common situation of this disease. Hepatic hydatid cyst presents its own morbidity and mortality due its complications and associated with surgical procedures. Morbidity has rates between 11 and 86% and is related with previous surgical interventions, cysts complications, the necessity of perform additional procedures during surgery and the treatment of other disease locations. Mortality by otherwise has rates below 5%. But both, morbidity and mortality persist high in spite of technological advances and therapeutical improvement. The surgical treatment of hepatic hydatidosis can be divided in four phases: surgical area isolation, cysts evacuation, treatment of cyst complications (biliary tract rupture, hepatothoracic transit, etc.), and residual cavity treatment. For each one exist different alternatives. On the other hand, hydatid cyst surgery can be classified in conservative and resective procedures. In the first group we consider marsupialization, cystostomy, Knowsly or Posadas operation and cystojejunostomy. In the resective group we include pericystectomy, partial or subtotal cystectomy and the different types of hepatectomies. Finally, some other surgical procedures are under evaluation. These include the laparoscopic approach of liver echinoccosis with few studies in the field, but with hopeful results.     

Our experiences with the treatment of periprosthetic fractures of femur

In the statement authors want to draw attention to the possibilities of treatment of periprosthetic fractures of femur. They present their own experiences with the treatment of these fractures by using various types of internal and external fixation evaluated from 1996 to 2003. They present some less common types of internal fixation as e.g. fixation by clamp plates.     

Epidemiology of hydatidosis in the province of Sassari, Italy

Cystic echinococcosis is endemic in certain parts of the world, including Sardinia, Italy. It was performed a study in the province of Sassari in order to evaluate the incidence of the infection in man and the effects of control programs since 1964 to 2002. Data obtained by surgical records, hospital discharge forms, radiological and pathological files were collected using a case report form. During the years 1964-2002, 2702 new cases were identified (average annual incidence: 17 per 100,000) and 1981 (73.3%) were submitted to surgical treatment. In 57.3% municipalities no cases were observed during the years 1998-2002. Males are more affected (56.2%), mostly farmers-shepherdess (68.6 per 100,000) and pensioners (59.6 per 100,000). Control measures led to a significant decline in the incidence rate of hydatidosis during the period 1964-2002, dropping by 27.6 per 100,000. The mean age of surgical patients increased during the years of surveillance, such as the surgical liver/lung ratio as a consequence of a cohort effect. The durability of control programs is the corner stone for obtaining a significant decrease of this infection.     

Hotspot of Adult Cuban Treefrog and Cane Toad Multi-organ Abnormality in Suburban South-west Florida

This study represents a continuation of the Florida hotspot of tadpole abnormality found in the Southwest Florida suburban roadside drainage ditches in 2012 to determine if the adult frogs and toads frequenting the study sites were anatomically abnormal. The gross examination of all organs included 397 adult anurans and 40 metamorphs representing five anuran species:Osteopilus septentrionalis(N=364), Rhinella marina(N=60), Lithobates sphenocephala(N=7), Anaxyrus terrestris(N=5) and Anaxyrus americanus(N=1). The gonads, liver, kidney and intestines were abnormal at a frequency of 87.4%. The few normal anurans(12.6%) were females and young male adults. We found a significant difference in organ abnormality type and f requency between sexes. Almost all f rog and toad males had testicular abnormality(92%) with only 6% with normal testes, whereas the female gonad abnormality was lower,at 41.6%. Hermaphroditism was found in both sexes at a frequency of 26.2%. The toads had a significantly higher frequency of hermaphroditism than the frogs. The toad hermaphroditism frequency was found to be 40%,whereas the frog hermaphroditism 23.3%. A hermaphrodite Cane toad male with a female phenotype coexisted with the normal male phenotype hermaphrodite. The fertility of 27 in situ pairs was assessed. The fertile testicular abnormal male and hermaphrodite pairs produced offspring with abnormal larval morphology. This information adds new evidence of the effect of chemicals on wild populations and the effect on non-target species which has always been underestimated.     

Multi-organ Abnormalities and mTORC1 Activation in Zebrafish Model of Multiple Acyl-CoA Dehydrogenase Deficiency

Multiple Acyl-CoA Dehydrogenase Deficiency (MADD) is a severe mitochondrial disorder featuring multi-organ dysfunction. Mutations in either the ETFA, ETFB, and ETFDH genes can cause MADD but very little is known about disease specific mechanisms due to a paucity of animal models. We report a novel zebrafish mutant dark xavier (dxa^vu463) that has an inactivating mutation in the etfa gene. dxa^vu463 recapitulates numerous pathological and biochemical features seen in patients with MADD including brain, liver, and kidney disease. Similar to children with MADD, homozygote mutant dxa^vu463 zebrafish have a spectrum of phenotypes ranging from moderate to severe. Interestingly, excessive maternal feeding significantly exacerbated the phenotype. Homozygous mutant dxa^vu463 zebrafish have swollen and hyperplastic neural progenitor cells, hepatocytes and kidney tubule cells as well as elevations in triacylglycerol, cerebroside sulfate and cholesterol levels. Their mitochondria were also greatly enlarged, lacked normal cristae, and were dysfunctional. We also found increased signaling of the mechanistic target of rapamycin complex 1 (mTORC1) with enlarged cell size and proliferation. Treatment with rapamycin partially reversed these abnormalities. Our results indicate that etfa gene function is remarkably conserved in zebrafish as compared to humans with highly similar pathological, biochemical abnormalities to those reported in children with MADD. Altered mTORC1 signaling and maternal nutritional status may play critical roles in MADD disease progression and suggest novel treatment approaches that may ameliorate disease severity.     

Prediction of the mechanical response of the femur with uncertain elastic properties

A mandatory requirement for any reliable prediction of the mechanical response of bones, based on quantitative computer tomography, is an accurate relationship between material properties (usually Young's modulus E) and bone density ρ. Many such E-ρ relationships are available based on different experiments on femur specimens with a large spread due to uncertainties. The first goal of this study is to pool and analyze the relevant available experimental data and develop a stochasticE-ρ relationship. This analysis highlights that there is no experimental data available to cover the entire density range of the human femur and that some "popular" E-ρ relationships are based on data that contains extreme scatter, while others are based on a very limited amount of information. The second goal is to use the newly developed stochastic E-ρ relationship in high-order finite element analyses (FEAs) for the computation of strains and displacements in two human proximal femurs, mimicking in vitro experiments. When compared with the experimental observations, the FEA predictions using the median of the stochastic E-ρ relationship follow the underlying distribution of the stochastic E-ρ relationship. Thus, most deviations of the FEA predictions from experimental observations can possibly be explained by uncertain elastic properties of the femur.