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Background: Familial papillary thyroid microcarcinoma (FPTMC) appears to be more aggressive than sporadic papillary thyroid microcarcinoma (SPTMC). However, there are authors who indicate that unicentric FPTMC has a similar prognosis to SPTMC. The objective is to analyze whether unicentric FPTMC has a better prognosis than multicentric FPTMC. Design and methods: Type of study: National multicenter longitudinal analytical observational study. Study population: Patients with FPTMC. Study groups: Two groups were compared: Group A (unicentric FPTMC) vs. Group B (multicentric FPTMC). Study variables: It is analyzed whether between the groups there are: a) differentiating characteristics; and b) prognostic differences. Statistical analysis: Cox regression analysis and survival analysis. Results: Ninety-four patients were included, 44% (n = 41) with unicentric FPTMC and 56% (n = 53) with multicentric FPTMC. No differences were observed between the groups according to socio-familial, clinical or histological variables. In the group B a more aggressive treatment was performed, with higher frequency of total thyroidectomy (99 vs. 78%; p = 0.003), lymph node dissection (41 vs. 15%; p = 0.005) and therapy with radioactive iodine (96 vs. 73%; p = 0.002). Tumor stage was similar in both groups (p = 0.237), with a higher number of T3 cases in the group B (24 vs. 5%; p = 0.009). After a mean follow-up of 90 ± 68.95 months, the oncological results were similar, with a similar disease persistence rate (9 vs. 5%; p = 0.337), disease recurrence rate (21 vs. 8%; p = 0.159) and disease-free survival (p = 0.075). Conclusions: Unicentric FPTMC should not be considered as a SPTMC due to its prognosis is similar to multicentric FPTMC. [ABSTRACT FROM AUTHOR]

Purpose: Familial papillary thyroid microcarcinoma (FPTMC) can present a more aggressive behavior than the sporadic microcarcinoma. However, few studies have analyzed this situation. The objective is to analyze the recurrence rate of FPTMC and the prognostic factors which determine that recurrence in Spain. Methods: Spanish multicenter longitudinal analytical observational study was conducted. Patients with FPTMC received treatment with curative intent and presented cure criteria 6 months after treatment. Recurrence rate and disease-free survival (DFS) were analyzed. Two groups were analyzed: group A (no tumor recurrence) vs. group B (tumor recurrence). Results: Ninety-four patients were analyzed. During a mean follow-up of 73.3 ± 59.3 months, 13 recurrences of FPTMC (13.83%) were detected and mean DFS was 207.9 ± 11.5 months. There were multifocality in 56%, bilateral thyroid involvement in 30%, and vascular invasion in 7.5%; that is to say, they are tumors with histological factors of poor prognosis in a high percentage of cases. The main risk factors for recurrence obtained in the multivariate analysis were the tumor size (OR: 2.574, 95% CI 1.210–5.473; p = 0.014) and the assessment of the risk of recurrence of the American Thyroid Association (ATA), both intermediate risk versus low risk (OR: 125, 95% CI 10.638–1000; p < 0.001) and high risk versus low risk (OR: 45.454, 95% CI 5.405–333.333; p < 0.001). Conclusion: FPTMC has a recurrence rate higher than sporadic cases. Poor prognosis is mainly associated with the tumor size and the risk of recurrence of the ATA. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to assess the impact of ileostomy closure following preoperative physiological stimulation (PPS) on postoperative ileus (POI) in patients with loop ileostomy after low anterior resection for rectal cancer. Methods: Patients who underwent ileostomy closure between January 2017 and February 2020 in two tertiary referral centers were prospectively included. PPS stimulation was compared to standard treatment. Stimulation was carried out daily during the 15 days prior to ileostomy closure by the patient's self-instillation of 200 ml of fecal contents from the ileostomy bag via the efferent loop, using a rectal catheter. Standard treatment (ST) consisted of observation. Outcomes measures were POI, morbidity, stimulation feasibility, and predictors to ileus. Results: A total of 58 patients were included [42 males and 16 females, median age 67 (43–85) years]. PPS was used in 24 patients, who completed the entire stimulation process, and ST in 34 patients. No differences in preoperative factors were found between the two groups. POI was significantly lower in the PPS group (4.2%) vs the ST group (32.4%); p < 0.01, OR: 0.05 (CI 95% 0.01–0.65). The PPS group had a shorter time to restoration of bowel function (1 day vs 3 days) p = 0.02 and a shorter time to tolerance of liquids (1 day vs 2 days), p = 0.04. Age (p = 0.01), open approach at index surgery, p = 0.03, adjuvant capecitabine (p = 0.01). and previous abdominal surgeries (p = 0.02) were associated with POI in the multivariate analysis. C-reactive-protein values on the 3rd (p = 0.02) and 5th (p < 0.01) postoperative day were also associated with POI. Conclusions: PPS for patients who underwent ileostomy closure after low anterior resection for rectal cancer is feasible and might reduce POI. [ABSTRACT FROM AUTHOR]

Purpose: Major concern during surgery for high-grade spondylolisthesis (HGS) is to reduce lumbosacral kyphosis and restore sagittal alignment. Despite the numerous methods described, lumbosacral fixation in HGS is a challenging technique associated with high complication rate. Few series have described outcomes and most of the results are limited to lumbosacral correction without global sagittal alignment analysis. This study aims at analyzing clinical and radiological outcomes of HGS patients treated with intrasacral rods on full spine radiographs.Methods: HGS patients (Meyerding III or higher) operated between 2004 and 2014 were reviewed. All patients underwent full spine stereoradiographic images. After L5 and S1 decompression, reduction and circumferential fusion with intrasacral rod fixation and fusion up to L4 were performed under fluoroscopy. The entry points for S1 screws were located 3-5 mm above and 5 mm lateral to the first sacral hole, toward the promontory. The two short distal fusion rods were then positioned into the sacrum guided by anteroposterior fluoroscopy using Jackson's technique. Then, sacral dome resection was performed and a PEEK cage was impacted in L5S1 after reduction. Postoperatively, the hip and knee were kept flexed at 45° for 1 week and extended progressively. Preoperative, 3 months postoperative and last follow-up (> 2 years minimum) clinical and radiographic data were collected. Sagittal parameters included lumbosacral angle (LSA), olisthesis, T1 spinopelvic inclination (T1SPi) and spinopelvic parameters.Results: 20 HGS patients were included (8 ptosis, 5 Meyerding IV). The mean age was 14 years. At final FU (7.2 years ± 3), LSA kyphosis and olisthesis were reduced (65° ± 14 vs 99° ± 11, p < 0.001 and 81% ± 19 vs 45% ± 18, p < 0.001, respectively). While L1L5 lordosis decreased, T1T12 kyphosis increased. At FU, global alignment with T1SPi was - 6° ± 3. No significant loss of correction was observed. Regarding complications, ten patients presented transient L5 motor deficit that occurred when patients were put in standing position. However, all recovered before 3 months postoperatively.Conclusion: Intrasacral rod fixation appears to be an effective technique to correct LSA kyphosis, compensatory hyperlordosis and restore global sagittal alignment with a postoperative T1SPi corresponding to the value of the asymptomatic subject and achieve fusion. However, it remains a demanding technique with high risk of transient neurologic complications. [ABSTRACT FROM AUTHOR]

Purpose: Cobalt chromium (CoCr) rods have recently gained popularity in adolescent idiopathic scoliosis (AIS) surgical treatment, replacing titanium (Ti) rods, with promising frontal correction rates in all-screw constructs. Posteromedial translation has been shown to emphasize thoracic sagittal correction, but the influence of rod material in this correction technique has never been investigated. The aim of this study was to compare the postoperative correction between Ti and CoCr rods for the treatment of thoracic AIS using posteromedial translation technique.Methods: 70 patients operated for thoracic (Lenke 1 or 2) AIS, in 2 institutions, between 2010 and 2013, were included. All patients underwent posterior fusion with hybrid constructs using posteromedial translation technique. The only difference between groups in the surgical procedure was the rod material (Ti or CoCr rods). Radiological measurements were compared preoperatively, postoperatively and at last follow-up (minimum 2 years).Results: Preoperatively, groups were similar in terms of coronal and sagittal parameters. Postoperatively, no significant difference was observed between Ti and CoCr regarding frontal corrections, even when the preoperative flexibility of the curves was taken into account (p = 0.13). CoCr rods allowed greater restoration of T4T12 thoracic kyphosis, which remained stable over time (p = 0.01). Most common postoperative complication was proximal junctional kyphosis (n = 4). However, no significant difference was found between groups regarding postoperative complications rate.Conclusion: CoCr and Ti rods both provide significant and stable frontal correction in AIS treated with posteromedial translation technique using hybrid constructs. However, CoCr might be considered to emphasize sagittal correction in hypokyphotic patients. [ABSTRACT FROM AUTHOR]

Purpose: Recent literature has reported that the ]progression risk of Lenke 5 adolescent idiopathic scoliosis (AIS) during adulthood had been underestimated. Surgery is, therefore, proposed more to young patients with progressive curves. However, choice of the approach and fusion levels remains controversial. The aim of this study was to analyze the influence of the length of posterior fusion on clinical and radiological outcomes in Lenke 5 AIS.Methods: All Lenke 5 AIS operated between 2008 and 2012 were included with a minimum 2-year follow-up. Patients were divided into two groups according to the length of fusion. In the first group (selective), the upper instrumented level (UIV) was the upper end vertebra of the main structural curve and distally the fusion was extended to the stable and neutral vertebra, according to Lenke's classification. In the second group (hyperselective), shorter fusions were performed and the number of levels fused depended on the location of the apex of the curve (at maximum, 2 levels above and below, according to Hall's criteria). Apart from the fusion level selection, the surgical procedure was similar in both groups. Radiological outcomes and SRS-22 scores were reported.Results: 78 patients were included (35 selective and 43 hyperselective). The number of levels fused was significantly higher in the first group (7.8 ± 3 vs 4.3 ± 0.6). None of the patients was fused to L4 in selective group. No correlation was found between length of fusion and complication rate. Eight patients had adding-on phenomenon among which 6 (75%) had initially undergone hyperselective fusions and had significantly higher postoperative lower instrumented vertebra (LIV) tilt. In the adding-on group, LIV was located above the last touching vertebra (LTV) in 62.5% of the cases and above the stable vertebra (SV) in 87.5%. Patients in the selective group reported a significantly lower score in the SRS function domain.Conclusion: Coronal alignment was restored in both groups. Hyperselective posterior fusions can be considered in Lenke 5 AIS, preserving one or two mobile segments, with similar clinical and radiological outcomes. However, selection of the LIV according to SV and LTV need to be accurately analyzed in order to avoid adding-on during follow-up. [ABSTRACT FROM AUTHOR]

The article presents author's comments on the complication rate in adolescent idiopathic scoliosis (AIS) surgery. It mentions that the neurologic deficit occurs in less than 1 percent. It focuses on the postoperative complication of adolescent idiopathic scoliosis surgery. It focuses on the progressive paraparesis due to intraspinal rod migration .

Purpose: Obesity is a risk factor for the development of human colorectal cancer (CC). The aim of this work is to report the inflammatory and angiogenic scenario in lean (BMI < 25 kg/m) and obese (BMI > 30 kg/m) patients with and without CC and to assess the role of peritumoral adipose tissue in CC-induced inflammation. Material and methods: Patients were divided in four experimental groups: obese patients with CC (OB-CC), lean patients with CC (LEAN-CC), obese patients without CC (OB), and lean patients without CC (LEAN). Results: Plasma levels of pro-inflammatory cytokines (interleukin (IL)-6, IL-4, IL-8) and granulocyte-macrophage colony-stimulating factor (GM-CSF) were increased in OB-CC patients. Peritumoral adipose tissue (TF) explants and cultured mature adipocytes secreted higher amounts of nitrites and nitrates than did control and non-tumoral (NTF) adipose tissue both alone and in response to lipopolysaccharide (LPS). Nitrite and nitrate secretion was also increased in TF explants from OB-CC patients compared with that from LEAN-CC patients. Gene expression of adiponectin, tumor necrosis factor alpha (TNF-α), insulin-like growth factor type I (IGF-I), cyclooxygenase-2 (COX-2), and peroxisome proliferator-activated receptor γ (PPAR-γ) was increased in TF explants from CC patients. LPS increased the gene expression of IL-6, IL-10, TNF-α, vascular endothelial growth factor (VEGF), and COX-2 in OB and in TF explants from OB-CC patients. COX-2 and PPAR-γ inhibition further increased LPS-induced release of nitrites and nitrates in TF explants and adipocytes from OB-CC patients. Conclusions: In conclusion, OB-CC patients have increased plasma levels of pro-inflammatory and angiogenic factors. TF from OB-CC patients shows an increased secretion of inflammatory markers compared with both TF from LEAN-CC and non-tumoral adipose tissue (AT) through a COX-2- and PPAR-γ-independent mechanism. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the inter- and intra-observer variability of the computerized radiologic measurements using Keops and to determine the bias between the software and the standard paper measurement. Methods: Four individuals measured all frontal and sagittal variables on the 30 X-rays randomly selected on two occasions (test and retest conditions). The Bland-Altman plot was used to determine the degree of agreement between the measurement on paper X-ray and the measurement using Keops for all reviewers and for the two measures; the intraclass correlation coefficient (ICC) was calculated for each pair of analyses to assess interobserver reproducibility among the four reviewers for the same patient using either paper X-ray or Keops measurement and finally, concordance correlation coefficient (rc) was calculated to assess intraobserver repeatability among the same reviewer for one patient between the two measure using the same method (paper or Keops). Results: The mean difference calculated between the two methods was minimal at −0, 4° ± 3.41° [−7.1; 6.4] for frontal measurement and 0.1° ± 3.52° [−6.7; 6.8] for sagittal measurement. Keops has a better interobserver reproducibility than paper measurement for determination of the sagittal pelvic parameter (ICC = 0.9960 vs. 0.9931; p = 0.0001). It has a better intraobserver repeatability than paper for determination of Cobbs angle (rc = 0.9872 vs. 0.9808; p < 0.0001) and for pelvic parameter (rc = 0.9981 vs. 0.9953; p < 0.0001). Conclusions: We conclude that Keops has no bias compared to the traditionally paper measurement, and moreover, the repeatability and the reproducibility of measurements with this method is much better than with similar standard radiologic measures done manually in both frontal and sagittal plane and that the use of this software can be recommended for clinical application. Level of evidence: Diagnostic, level III. [ABSTRACT FROM AUTHOR]

Purpose: Thoracic adolescent idiopathic scoliosis (AIS) curves (Lenke 1-4) are often characterized by hypokyphosis. Sagittal alignment remains challenging to correct, even with recent posterior segmental instrumentation. Some authors recommend anterior endoscopic release (AER) to reduce anterior column height, and facilitate thoracic kyphosis correction. The aim of this study was to assess the contribution of AER to sagittal correction in hypokyphotic AIS. Methods: Fifty-six hypokyphotic (T4T12<20°) AIS patients were included. In group 1 (28 patients), patients first underwent AER, followed by posterior instrumentation and correction 5-7 days later. In group 2 (28 patients), patients underwent the same posterior procedure without AER. Posterior correction was performed in all cases using posteromedial translation and hybrid constructs consisting of lumbar pedicle screws and thoracic sublaminar bands. From radiological measurements performed using low-dose EOS radiographs, the correction of thoracic kyphosis was compared between the two groups. Results: Groups 1 and 2 were comparable regarding demographic data and preoperative thoracic kyphosis (group 1: 11.7° ± 6.9° vs group 2: 12.1° ± 6.3°, p = 0.89). Postoperative thoracic kyphosis increase averaged 18.3° ± 13.6° in group 1 and 15.2° ± 9.0° in group 2. The benefit of anterior release was not statistically significant ( p = 0.35). Conclusion: Although previous studies have suggested that thoracoscopic release improved correction compared to posterior surgery alone, the current study did not confirm this finding. Moreover, results of the current series showed that no significant benefit can be expected from AER in terms of sagittal plane improvement when the posteromedial translation technique is used, even in challenging hypokyphotic patients. [ABSTRACT FROM AUTHOR]

Introduction: Incisional hernia is a long-term complication of laparotomy. Its exact frequency varies according to different authors, but is always around 10-15%. There are patients who present with systemic associated diseases [chronic obstructive pulmonary disease (COPD), obesity, severe cardiopathies, immunodeficiencies, etc.] that favour or increase the risk of appearance of an incisional hernia. The aim of the present study was to assess whether the prophylactic placement of a polypropylene mesh in patients at risk can reduce or avoid the appearance of an incisional hernia. Materials and methods: Seventy-two selected patients with clear risk factors and colon pathology underwent surgical intervention through median infraumbilical laparotomy. During laparotomy the preperitoneal space was dissected at a point where a low-molecular weight polypropylene mesh was to be placed when closing the peritoneum. Meshes were about 7-8 cm wide and had a variable length that depended on the length of the surgical incision. Of the 72 patients, 41 were obese (BMI > 30 kg/m), 45 presented with COPD, and 42 with colorectal neoplasia; 29 patients had two risk factors, and 15 had three risk factors. The mesh was held in place with polypropylene stitches in 28% of cases, and with fibrin glue in 72% of cases. Results: All patients were assessed by a protocol that included interview, examination of the surgical wound, and abdominal CT scan. Follow-up was between 3 and 5 years. There were no noteworthy complications or operative mortality. No mesh had to be removed in any patient. Two patients developed liver metastasis, and in a second surgery the good condition of the abdominal wall and the absence of hernia were confirmed. Twenty patients required postoperative chemotherapy. Two patients died at 37 and 43 months after surgery because of progression of the neoplastic disease. Fourteen patients were monitored for more than 5 years after surgery, and 46 patients were monitored for 48 months. None of the 72 patients developed an incisional hernia. Conclusion: Prophylactic use of a low-molecular-weight polypropylene mesh in abdominal surgery may be useful for the prevention of incisional hernia. [ABSTRACT FROM AUTHOR]

n efficient method based in template wetting is applied for fabrication of ordered Poly(9,9-dioctylfluorene) (PFO) nanopillars with β-phase morphology. In this process, nanoporous alumina obtained by anodization process is used as template. PFO nanostructures are prepared under ambient conditions via infiltration of the polymeric solution into the pores of the alumina with an average pore diameter of 225 nm and a pore depth of 500 nm. The geometric features of the resulting structures are characterized with environmental scanning electron microscopy (ESEM), luminescence fluorimeter (PL) and micro μ-X-ray diffractometer (μ-XRD). The characterization demonstrates the β-phase of the PFO in the nanopillars fabricated. Furthermore, the PFO nanopillars are characterized by Raman spectroscopy to study the polymer conformation. These ordered nanostructures can be used in optoelectronic applications such as polymer light-emitting diodes, sensors and organic solar cells. [ABSTRACT FROM AUTHOR]

Turbulence closures are fundamental for modelling the atmospheric diffusion in numerical codes and the resulting eddy diffusivities are key parameters in describing the transport and dispersion in the boundary layer. In this work, four turbulence closure schemes have been applied for reproducing a neutral flow over schematic complex terrain using the meteorological model RAMS. Two of the closures, a one-equation (E-l) and a two-equations (E-e) model, have been implemented in RAMS in alternative to the ones originally available. In these cases, an analytical method based on the similarity theory for the atmospheric surface layer and boundary layer is adopted to calculate the empirical constants of the turbulence closures. Some examples of numerical studies performed to simulate the flow and turbulence over a 3-D hill in wind-tunnel experiment in neutral stratification are presented and discussed. An intercomparison of simulations related to different closures is considered by analysing the main features of the flow over the hill and by comparing calculated vertical profiles of turbulent kinetic energy with measured ones. [ABSTRACT FROM AUTHOR]

The crustacean hyperglycaemic hormones (cHHs) are multifunctional neuropeptides that play a central role in the physiology of crustaceans. A partial cDNA coding for cHH of the Norway lobster, Nephrops norvegicus, was cloned; this cDNA was fused to glutathione-S-transferase (GST) to obtain a recombinant fusion protein that was used to raise a rabbit antiserum and to perform a biological assay. The specificity of the purified antibody was demonstrated by means of Western blotting. To validate the specificity of the purified antibody to the cHH of N. norvegicus and its cross-reactivity with other species, we performed standard immunocytochemistry of the eyestalk on: (1) paraffin sections of the decapod species N. norvegicus, Munida rugosa and Astacus leptodactylus and of the stomatopod Squilla mantis; (2) semithin resin sections of N. norvegicus and Palaemon elegans; (3) ultrathin sections of N. norvegicus sinus gland (transmission electron microscopy studies). The pattern of immunoreactivity shown by N. norvegicus eyestalk sections conforms to distribution, relative amount and ultrastructural features of cHH-containing neurons and nerve endings as reported in the previous literature. In all the crustacean species examined, the antibody marks precisely the X organ-sinus gland complex and unspecific staining is completely lacking. In addition, its specific cross-reaction by immunoprecipitation depletes shrimp eyestalk extract of hyperglycaemic activity in an in vivo bioassay. The results obtained show a cHH-specific molecular recognition despite the fact that the species tested belong to systematic groups increasingly remote in the phylogenetic tree. The antibody could be used for advancing our knowledge on cHH activity in a variety of crustacean species, e.g. for monitoring reproductive and stress conditions. [ABSTRACT FROM AUTHOR]

Agricultural and industrial activities cause heavy metal pollution of the aquatic environment. The sensitivity of crustaceans to heavy metals is well documented. However, the hormonal and metabolic target of physiological functions affected by sublethal toxicity and stress responses have been scarcely investigated. Exposure of Palaemon elegans to increasing concentrations of heavy metals dissolved in artificial sea water resulted in an order of toxicity tested by LC50 for 96 h in intact and eyestalkless animals in which Hg is the most toxic, followed by Cd, Cu, Zn, and Pb. Eyestalkless animals were found to be more sensitive than intact individuals. Heavy metals affect the blood glucose levels, yet manipulative stress does not. The intermediate sublethal concentrations of Hg, Cd, and Pb produced significant hyperglycemic responses within 3 h, while the highest concentrations elicited no hyperglycemia in 24 h. In contrast, animals exposed to Cu and Zn showed hyperglycemia even at high concentrations. This difference in response between Cu or Zn and the nonessential heavy metals Cd, Hg, or Pb can probably be explained by the physiological roles of the former in crustaceans and by tolerance adaptations. Involvement of the crustacean hyperglycemic hormone (cHH) was tested by routine bioassay on eyestalkless individuals; each group was injected with a two-eyestalk-equivalent extract from control animals or from shrimp exposed to high concentrations of Cd, Hg, Pb, or low concentrations of Cu or Zn. All showed a hyperglycemic response within 2 h. In contrast, extracts of eyestalk removed from animals that had developed a full hyperglycemic reaction after exposure to low concentrations of Hg, Cd, Pb, or high concentrations of Cu and Zn were depleted of cHH as shown by the attenuation of the response after injection of the extracts into eyestalkless animals. This generalized and predictable sublethal response can be used as a quantitative physiological biomarker for water quality monitoring assessment. [ABSTRACT FROM AUTHOR]

Eulerian turbulence observations, made in the surface layer under unstable conditions (z/L > 0), by a sonic anemometer were used to estimate the Lagrangian structure function constant O. Two methods were considered. The first one makes use of a relationship, widely used in the Lagrangian stochastic dispersion models, relating O to the turbulent kinetic energy dissipation rate ℇ, wind velocity variance and Lagrangian decorrelation time. The second one employs a novel equation, connecting O to the constant of the second-order Eulerian structure function. Before estimating O, the measurements were processed in order to discard non-stationary cases at least to a first approximation and cases in which local isotropy could not be assumed. The dissipation ℇ was estimated either from the best fit of the energy spectrum in the inertial subrange or from the best fit of the third-order longitudinal Eulerian structure function. The first method was preferred and applied to the subsequent part of the analysis. Both methods predict the partitioning of O in different spatial components as a consequence of the directional dependence of the Eulerian correlation functions due to the isotropy. The O values computed by both methods are presented and discussed. In conclusion, both methods provide realistic estimates of O that compare well with previous estimations reported in the literature, even if a preference is to be attributed to the second method. [ABSTRACT FROM AUTHOR]

CD38 is a leukocyte activation antigen and ectoenzyme [NAD(P)+ glycohydrolase; EC 3.2.2.6] involved in numerous immune functions. The human CD38 gene is complex [eight exons, >80 kilobases (kb) long] located on Chromosome 4p15, and part of the eukaryotic NAD+ glycohydrolase/ADP-ribosyl cyclase gene family. Because of the increasing relevance of the CD38 molecule in the host immune response to infectious, tumoral, and metabolic diseases, we investigated the genetic variability and linkage of the human CD38 locus. We report that (1) the restriction endonuclease Pvu II identifies a bi-allelic polymorphism here defined as formed by the alleles CD38* A (12 kb) and CD38* B (9/2.5 kb); (2) their frequency in the healthy Italian Caucasian population is 14% and 86%, respectively; (3) the polymorphic Pvu II site is located at the 5′ end of the first intron of the CD38 gene; (4) in conjunction with the polymorphic site, we identified a 900 base pair CpG island associated with the CD38 gene, with two potential Sp1 binding sites; (5) the CpG island may play a role in the regulation of CD38 expression and is hypomethylated in various cell lines; (6) by pulsed-field gel electrophoresis we show that CD38 and its paralogue, the bone-marrow stromal cell antigen BST-1 ( CD157), map to the same 800 kb Avi II fragment, indicating that the two human ecto-NADase genes are closely linked. [ABSTRACT FROM AUTHOR]

One of the most intriguing problems concerning the interaction of subsynoptic and synoptic atmospheric flows with topographic features is orographic cyclogenesis. A fully satisfactory prediction theory is not yet available, but a lot of efforts have been made by theoreticians to implement reliable numerical models simulating the different phases of this complex phenomenon. An attempt to perform a laboratory experiment to simulate physically this kind of interaction has been made by us, through the generation of a baroclinic frontal system in the rotating hydraulic platform of the «Coriolis Laboratory-LEGI-IMG-Grenoble». The adopted technique consists in a device which produces, at the interface separating two water layers of different density (ϱ and ϱ), a stream of stratified fluid whose density has an intermediate value ϱ < ϱ < ϱ. This stream is generated at the height of the interface between the two layers; due to the rotation of the platform, the attainment of geostrophic equilibrium brings about an intermediate-water flow running along a wall, giving rise to a three-layer baroclinic structure which can represent some of the main outstanding features of an atmospheric frontal system impinging on a mountain. In a well-defined range of the Rossby and Burger numbers, the instability of this current gives rise to a couple of persistent cyclonic and anticyclonic vortices, whose horizontal dimensions and vertical extents reproduce quite faithfully the synoptic situation supporting the onset of the orographic cyclogenesis, with its characteristic cold front stretching between the two vortex structures. It is enough to place an obstacle of a suitable size in the proper geographic position, to make the cyclogenesis start. The first results of our simulations have been encouraging, showing the occurrence of lee cyclogenesis when the stream conditions in our model correspond to the synoptic features which have been recognized as the precursors of orographic cyclogenesis in the lee of the Alps. [ABSTRACT FROM AUTHOR]

This paper presents the results of laboratory experiments designed to simulate some basic process of large-scale flows interacting with obstacles, also in order to better understand details of subsynoptic disturbances that are created in the lee of large topographic features. For this event, the experimental facilities of the Istituto di Cosmogeofisica of Consiglio Nazionale delle Ricerche (CNR) were exploited, consisting in a hydraulic channel mounted on a rotating platform, along whose longitudinal axis a hemispherical obstacle was towed at various speeds. Because of the conversion of potential vorticity, the experimental results showed, as expected, the existence of a region of anticyclonic circulation, located above the obstacle; however, also an asymmetric pattern of positive vorticity located downwind of the obstacle did appear, which cannot be interpreted in terms of simple quasi-geostrophic inviscid dynamics. This behaviour is not surprising, if one considers that the real flow near the obstacle could hardly ever match the conditions of inviscid quasi-geostrophy (Ro≪1, E∼0), but was similar to that characterising the zone close to the surface of the obstacle, where inertial and viscous effects are not negligible. Finally, in order to investigate the importance of these effects on the interaction processes, simple numerical and analytical models were applied, by which the consistency of some laboratory simulations, chosen among the most significant ones, could be compared. [ABSTRACT FROM AUTHOR]

The experimental research described here deals with a problem of diffusion and transport on local scale (30 km) of pollutants of urban and industrial origin, emitted into the atmosphere of a complex terrain site, with noticeable orographical features. The diffusion process was visualized and analysed in detail. The results of this research allowed acquiring the capability of forecasting environmental impact on the area, due to the sources considered. On account of its spatial scale, the phenomenon was investigated in a rotating hydraulic channel, by the method of simulation on physical model at reduced scale. Typical local atmospheric conditions, taking into account diurnal evolution of stability inside a turbulent, rotating planetary boundary layer, were modeled. Seasonal variations of sources emission rates were considered. Measurements of dilution factors at several spatial points of the model and at five levels (from ground up to a height equivalent to about 1000m) allowed mapping out concentration isolines over the site in various conditions and producing evolving contour plots which visualized the diffusion processes in a very useful way for planning purposes. [ABSTRACT FROM AUTHOR]

A particle model LAMDA suitable for dealing with the atmospheric dispersion is presented. The reliability of the model is tested comparing the results of its simulations to the wind tunnel measurements by Khurshudyan et al. (1981). Two versions of the model, both based on the Langevin equation and askewed distribution of the vertical wind velocity fluctuations, are considered. To develop the second version of the model we derived a proper scheme to produce skewed distributions of particle velocities consistent with the observed first and second moments of turbulent fluctuating velocities, with their horizontal and vertical derivatives, and their cross-correlations. The 2D geometry of the obstacle (in the wind tunnel experiment considered) allowed some simplifications. Due to the lack of some input data (such as the vertical profiles of crosswind standard deviation of wind velocity fluctuations and of the Lagrangian time scales) we looked for three different parametrizations. It was found that particular combinations of measured and parametrized data could give rise to critical vertical regions in which the derived scheme for the generation of random vertical velocity fluctuations cannot be applied. The best vertical distributions of the Lagrangian time scales (third parametrization) were estimated by fitting simple formulations for the average plume height and lateral variances to the measured data. The main results of this work were the model performance in simulating dispersion in shear flow over flat terrain, and its sensivity to the shape of the crosscorrelation term $$\overline {u'w'} $$ . [ABSTRACT FROM AUTHOR]

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In the isolated anterior-ventral cephalothorax of the lobster, Homarus gammarus, the motor nerve to mandibular muscle M9 (nerve imn5, see Table 1) has a single spontaneously active motoneurone. This motoneurone is precisely coupled to the homologous motoneurone in the contralateral imn5 nerve (Fig. 1 A). The motoneurone sends branches into two other mandibular nerves, imn4 amd omn3 (Figs. 3-5). Although under certain conditions bilateral coupling can be decreased (Figs. 1B-C, 2A), homolateral motor nerves invariably exhibit identical spike patterning (Fig. 3A), suggesting that the activity is due to a single pair of neurones. These neurones make synaptic contact with some muscle fibres in all the major mandibular muscles, producing small inhibitory junctional potentials (ijp) of less than 2 mV (Fig. 6). The function of the mandibular common inhibitor system is discussed and it is clear that no single existing hypothesis can describe its function. It is proposed that common inhibitors may be fulfilling more than one function, particularly where they innervate antagonistic muscle groups. [ABSTRACT FROM AUTHOR]

The mandibular common inhibitor neurones of Homarus gammarus receive sensory input from a wide receptive field (Table 1, Figs. 2, 3) and from their symmetrical homologue (Ferrero and Wales, 1976). The CI system receives excitatory input from mandibular proprioceptors, with the notable exception of the mandibular muscle receptor organ, and its activity increases, during mandible opening and closing, towards the extremes of movement (Fig. 1). The output of CI neurones is usually coupled except during some high frequency bursts. Unilateral sensory input usually produces a coupled output. Electrical stimulation of a wide range of mandibular nerves (Table 2) has a similar effect and entrains the CI output at lower frequencies (Figs. 4, 5). Antidromic stimulation of a CI neurone causes excitation of its homologue but to a lower level of activity and without enhanced coupling. Even when the excitatory state is raised, by concurrent stimulation of a sensory nerve, the pathway activated by antidromic stimuli does not produce coupled activity at frequencies above 20 Hz (Fig. 8). Stimulation with single pulses will frequently produce short trains of impulses from the CI neurones (Figs. 6, 7) suggesting reciprocal excitation between the neurones. A model of the system based on current knowledge is presented. [ABSTRACT FROM AUTHOR]

The fine structure of the seminal vesicles of Zosterisessor ophiocephalus, the annual changes during the reproductive cycle, and the composition of the secretion are investigated by electron microscopy and by enzyme, polysaccharide, and protein histochemistry. The seminal vesicles are accessory glands of the male reproductive system which produce sialoglycoproteins during the spawning period. They show a significant annual cycle. During the postspawning period they have a regressive phase, followed by a regeneration phase during interspawning and a proliferation phase during prespawning. Possible functions of the seminal vesicle secretion are discussed. [ABSTRACT FROM AUTHOR]

The distribution and morphology of the internal proprioceptive organs in the thoracic appendages of the stomatopod crustacean, Squilla mantis, are described. Five distinct types of proprioceptor are recognised; connective chordotonal organ, myochordotonal organ, cuticular stress detector, multiterminal stretch receptor and apodeme stretch receptor. The connective chordotonal organs and multiterminal receptors exhibit a wide variety of structural and functional complexity. The stomatopods resemble the decapods in that the basic proprioceptive unit of the thoracic appendages appears to be the connective chordotonal organ, but differs in the higher occurrence of multiterminal stretch receptors. As described for decapods, the pereiopods of stomatopods possess the largest number and greatest variety of proprioceptors, suggesting that locomotion exerts greater selective pressure on proprioceptor development than do the other thoracic limb functions, including the raptorial strike. [ABSTRACT FROM AUTHOR]

Some results of physical simulations of interactions between atmospheric baroclinic flows and a tridimensional mountain, carried out in a rotating tank, are presented and discussed. Complex dynamic and thermodynamic processes occur when the so called lee, or secondary, cyclogenesis can develop; in this case, potential energy of the basic flow is converted into kinetic energy of its perturbation field, giving rise to strengthening and deepening of its pressure troughs. The presence of an obstacle can exert a blocking on the colder lower layers of the impinging stably stratified airflow, forcing it to deflect horizontally round its borders. In this way, these layers get the lee region with a delay. These two effects, of blocking and delay, are the responsible for the initial pressure decrease downwind of the mountain and for the subsequent proper downstream baroclinic development. Following this rather simple scheme, the lee cyclogenesis has been simulated in the rotating tank of the IMG of GRENOBLE. The experiments were observed by three TV cameras continuously recording the trajectories of dye tracers at three levels of the stratified fluid. In order to measure the vertical density profiles, a rectangular mesh of samplers was rapidly moved up and down in the tank. The results of the simulations, both from a qualitative and quantitative point of view, are here shown. They indicate a possibility of reproducing the main features of the lee cyclogenesis and encourage to go on with this kind of experimental approach in order to better understand the atmospheric processes occurring downwind from actual mountain chains, like the Alps and the Pyrenees. [ABSTRACT FROM AUTHOR]

We report the case of a white male who underwent a classic hemipelvectomy due to a femur fibrosarcoma with inguinal metastases, which 33 years later, developed into a posthemipelvectomy hernia in the amputation stump that impaired the use of his Canadian prosthesis. The hernia was repaired with a polypropylene mesh in a subaponeurotic position. A seroma was drained in the postoperative and it was only 2 months after the operation that he could use his prosthesis with any difficulty. A year after the operation, the hernia had not recurred. Only seven similar cases have been published, and there are only four cases with details of their correction, two with a mesh as was our case, and the rest with a primary suture of the aponeurotic borders. A brief review of the bibliography is given on this subject. [ABSTRACT FROM AUTHOR]

Purpose: The Morbidity and Mortality (M&M) report of the Scoliosis Research Society (SRS) has been collected since 1965 and since 1968 submission of complications has been required of all members. Since 2009, the SRS has collected information on death, blindness, and neurological deficit, with acute infection being added in 2012 and unintentional return to the operating room (OR) being added in 2017. In this report, we use the most recent data submitted to the SRS M&M database to determine the rate of neurological deficit, blindness, acute infection, unintentional return to the OR, and death, while also comparing this information to previous reports., Methods: The SRS M&M database was queried for all cases from 2013 to 2020. The rates of death, vision loss, neurological deficit, acute infection, and unintentional return to the OR were then calculated and analyzed. The rates were compared to previously published data if available. Differences in complication rates between years were analyzed with Poisson regression with significance set at α = 0.05., Results: The total number of cases submitted per year varied with a maximum of 49,615 in 2018 and a minimum of 40,464 in 2020. The overall reported complication rate from 2013 to 2020 was 2.86%. The overall mortality rate ranged from 0.09% in 2018 to 0.14% in 2015. The number of patients with visual impairment ranged from 4 to 13 between 2013 and 2015 (no data on visual impairment were collected after 2015). The overall infection rate varied from 0.95 in 2020 to 1.30% in 2015. When the infection rate was analyzed based on spinal deformity group, the neuromuscular scoliosis group consistently had the highest infection rate ranging from 3.24 to 3.94%. The overall neurological deficit rate ranged from 0.74 to 0.94%, with the congenital kyphosis and dysplastic spondylolisthesis groups having the highest rates. The rates of unintentional return to the OR ranged from 1.60 to 1.79%. Multiple groups showed a statistically significant decreasing trend for infection, return to the operating room, neurologic deficit, and death., Conclusions: Neuromuscular scoliosis had the highest infection rate among all spinal deformity groups. Congenital kyphosis and dysplastic spondylolisthesis had the highest rate of neurological deficit postoperatively. This is similar to previously published data. Contrary to previous reports, neuromuscular scoliosis did not have the highest annual death rate. Multiple groups showed a statistically significant decreasing trend in complication rates during the reporting period, with only mortality in degenerative spondylolisthesis significantly trending upwards., Level of Evidence: Level III., (© 2022. The Author(s).)

Purpose: Spinal muscles are a major component of posture in spinal pathologies and changes to the spine with aging. Specifically, spinopelvic muscles may compensate for underlying anomalies such as pelvic retroversion, knee flexion, and cervical or thoracic spinal balance abnormalities. To increase understanding between muscular characteristics and compensatory mechanisms, this study aimed to compare the volume of spinopelvic muscles in adults with a spinal deformity (ASD) to a control group of well-aligned adult subjects., Methods: Twenty-eight lumbar ASD patients [Cobb angle > 20°, > 40 years old (yo)] were prospectively included and compared to 35 normal subjects divided into 2 different groups: one group of young (Y) subjects (n = 23, < 20 yo) and one group of old (O) subjects (n = 12, > 40 yo). All subjects had a fat/water separation MRI (from C7 to the knees). Volumetric 3D reconstructions of 30 spinopelvic muscles were performed and muscles volumes were compared., Results: Mean age was 60 ± 16 yo, without significant differences between the ASD and O groups (57 ± 11 yo). Age and BMI were smaller in the young group. Mean Cobb angle of the ASD group was 45 ± 11°. Comparing the ASD and O groups, total muscular volume was similar; however, erector spinae (0.24 ± 0.06 vs 0.68 ± 0.08 dm 3 , p = 0.001), iliopsoas (0.49 ± 0.09 vs 0.60 ± 0.09 dm 3 , p = 0.001) and obliquus (0.42 ± 0.08 vs 0.50 ± 0.08 dm 3 , p = 0.02) were significantly smaller in the ASD group. Comparing the Y and the ASD groups, total muscular volume was higher in the Y group than the ASD group (+ 3.3 dm 3 , p = 0.003) and erector spinae (0.24 ± 0.06 vs 0.74 ± 0.08, p = 0.0001), gluteus medius (0.51 ± 0.07 vs 0.62 ± 0.13, p = 0.01) and vastus lateralis (1.33 ± 0.21 vs 2.08 ± 0.29, p = 0.001) were significantly bigger in the Y group., Conclusion: This is the first study to compare volume of spinopelvic muscles between ASD patients and a control group without spinal deformity. Our results demonstrate that muscular degeneration has a double origin: aging and deformity. Erector spinae, iliopsoas, and obliquus are the muscles most affected by degeneration., (© 2021. Scoliosis Research Society.)

Study Design: Multicenter retrospective., Objective: To determine the long-term complication rate associated with surgical treatment of spondylolisthesis in adolescents. There is limited information on the complication rate associated with posterior spinal fusion (PSF) of spondylolisthesis in the pediatric and adolescent population., Methods: Patients who underwent PSF for spondylolisthesis between 2004 and 2015 at four spine centers, < 21 years of age, were included. Exclusion criteria were < 2 years of follow-up or anterior approach. Charts and radiographs were reviewed., Results: 50 patients had PSF for spondylolisthesis, 26 had PSF alone, while 24 had PSF with trans-foraminal lumbar interbody fusion (TLIF). Mean age was 13.9 years (range 9.6-18.4). Mean follow-up was 5.5 years (range 2-15). Mean preoperative slip was 61.2%. 20/50 patients (40%) experienced 23 complications requiring reoperation at a mean of 2.1 years (range 0-9.3) for the following: implant failure (12), persistent radiculopathy (3), infection (3), persistent back pain (2), extension of fusion (2), and hematoma (1). In addition, there were 22 cases of radiculopathy (44%) that were transient. Rate of implant failure was related to preoperative slip angle (p = 0.02). Reoperation rate and rates of implant failure were not associated with preoperative % slip (reoperation: p = 0.42, implant failure: p = 0.15), postoperative % slip (reoperation: p = 0.42, implant failure: p = 0.99), postoperative kyphosis of the lumbosacral angle (reoperation: p = 0.81, implant failure: p = 0.48), change in % slip (reoperation: p = 0.30, implant failure: p = 0.12), change in slip angle (reoperation: p = 0.42, implant failure: p = 0.40), graft used (reoperation: p = 0.22, implant failure: p = 0.81), or addition of a TLIF (reoperation: p = 0.55, implant failure: p = 0.76)., Conclusion: PSF of spondylolisthesis in the adolescent population was associated with a 40% reoperation rate and high rate of post-operative radiculopathy. Addition of a TLIF did not impact reoperation rate or rate of radiculopathy.

Study Design: Retrospective monocentric database study., Objectives: To describe the "frame" reduction technique and report the 3D quantitative analysis of postoperative corrections in a consecutive series of thoracic adolescent idiopathic scoliosis (AIS) patients., Summary of Background Data: Posteromedial translation technique using sublaminar bands have been proved to be efficient and safe for 3D correction of the deformity and overall cosmetic aspect of the trunk. However, the ability to correct the axial plane may tend to rotate the vertebra clockwise instead of counterclockwise, thus increasing apical vertebra axial rotation (AVR) and the rib hump. A technical improvement was developed to emphasize axial correction., Methods: 60 thoracic AIS patients consecutively operated by posteromedial translation using the "frame" reduction technique were included with a minimum 2-year follow-up. Precontoured rods were connected with fixed transverse connectors according to a personalized preoperative planning. Rods were first inserted distally in the pedicle screws to achieve lumbar correction, and then in the upper anchors, and finally sublaminar bands were connected to their corresponding rods to progressively bring the concave lamina to the concave rod to correct the thoracic deformity. Sagittal and coronal 3D measures were performed preoperatively and at the latest follow-up using SterEOS (EOS Imaging, Paris, France) to assess the efficiency of the technique., Results: The distance from the center of the apical vertebra to the reference axis in the frontal plane was reduced from 4.7 to 1.1 cm, traducing the efficient medial translation of the spine during correction. T1-T12 kyphosis significantly increased after surgery (28°-35°). 3D location of the upper instrumented vertebra (UIV) was not affected. The apical rotation was significantly reduced after surgery (19°-11°), and the AVR correction rate averaged 42.2%., Conclusion: The "frame" technique is an innovative way of using polyester bands, optimizing axial correction while respecting sagittal alignment., Level of Evidence: Level IV., (Copyright © 2018. Published by Elsevier Inc.)

Study Design: Electronic survey administered to Scoliosis Research Society members., Objective: To determine the prevalence of minimally invasive surgery (MIS) techniques for the treatment of adult spinal deformity., Summary of Background Data: There is a paucity of data available on the practice pattern, prevalence of minimally invasive spine surgery, and the preferred minimally invasive techniques in the treatment of adult spine deformity., Methods: An electronic nine-question survey regarding individual usage pattern of minimally invasive spine surgery techniques was administered in 2016 to the members of the Scoliosis Research Society. Determinants included complexity in condition of patient population, prevalence of use of minimally invasive techniques in the surgeon's practice, prevalence of use of a particular MIS technique, strategy elected during surgery, adoption of staging of procedures and timing between staging of procedures., Results: A total of 357 surgeons responded (61.3% response rate), and 154 (43.1%) of the respondents said that they use MIS as a part of their surgical treatment of adult spinal deformity. However, of these 154 respondents, 67 (43.5%) said that their MIS usage in deformity practice was between 1% and 20%. Only 11 (7.2%) said that they used MIS 81% to 100% of the time. The top MIS approaches that surgeons chose were MIS lateral lumbar interbody fusion 109 (70.59%) and MIS percutaneous screws 91 (58.8%)., Conclusions: The low rate of adoption of these techniques among the SRS members may be due to the false perception that there is not enough data to support that MIS techniques are better. This and the fact that a practitioner needs to be facile at different MIS techniques may be the true impediment to the adoption of MIS techniques in the treatment of ASD., Level of Evidence: Level IV., (Copyright © 2018 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.)

Study Design: Retrospective single-center., Objective: To investigate rotatory subluxation (RS) in adult spinal deformity (ASD) with three-dimensional (3D) stereoradiographic images and analyze relationships between RS, transverse plane parameters, spinopelvic parameters, and clinical outcomes., Background: Recent research has demonstrated that sagittal plane malalignment and listhesis correlate with ASD patient-reported outcomes. However, there is still a lack of knowledge regarding the clinical impact of 3D evaluation and rotatory subluxation. Recent developments in stereoradiography allow clinicians to obtain full-body standing radiographs with low-dose radiation and 3D reconstruction., Methods: One hundred thirty lumbar ASD patients underwent full-spine biplanar radiographs (EOS Imaging, Paris, France). Clinical outcomes were recorded. Using sterEOS software, spinopelvic parameters and lateral listhesis were measured. 3D transverse plane parameters included apical axial vertebral rotation, axial intervertebral rotation (AIR), and torsion index (sum of AIR in the curve). ASD patients were divided in three groups: AIR <5°, 5°< AIR <10°, AIR >10°. Groups were compared with respect to radiographic and clinical data. Correlations were performed between the transverse and sagittal plane parameters and clinical outcomes., Results: Patients with AIR >10° were significantly older, with larger Cobb angle (39.5°) and greater sagittal plane deformity (pelvic incidence-lumbar lordosis mismatch 11.7° and pelvic tilt 22.6°). The AIR >10° group had significantly greater apical vertebra axial rotation apex (24.8°), torsion index (45°), and upper-level AIR (21.5°) than the two other groups. Overall, 27% of AIR patients did not have two-dimensional (2D) lateral listhesis. Patients with AIR >10° had significantly worse Oswestry Disability Index and more low back pain., Conclusion: For patients in which lateral listhesis was unreadable in 2D imaging, rotatory subluxation was revealed using stereoradiography and at an earlier disease stage. Moreover, different 3D transverse plane parameters are related to different patient-reported outcomes. Therefore, axial rotation can be considered in evaluation of lumbar degenerative scoliosis severity and prognosis., Level of Evidence: Level III., (Copyright © 2017 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.)