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Inverse restricted kinematic alignment (irKA) was modified from restricted kinematic alignment for total knee arthroplasty (TKA). This prospective single-center study aimed to evaluate the outcomes of irKA-TKA on all knee subtypes classified by Asia specific (Huang’s) phenotypes. A total of 96 knees that underwent irKA-TKA at one hospital between January 2018 and June 2020 were included, with 15 knees classified in Type 1, nine in Type 2, 15 in Type 3, 47 in Type 4, and 10 in Type 5 by Huang’s phenotypes. Outcomes were knee alignment measures and patient-reported satisfaction evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and traditional Chinese version of the Forgotten Joint Score-12 (FJS-12). Follow-up was one year. Type 4 knee was most significantly corrected in all angles by irKA-TKA, followed by Type 2 and 3 knees. Type 5 and 1 knee were only significantly corrected in some angles. The correlation between FJS-12 and WOMAC was good at 6 months (Pearson correlation coefficient (r) = 0.74) and moderate at 6 weeks, 3 months, and 12 months during follow-up (r = 0.37~0.47). FJS-12 and WOMAC displayed comparable hip–knee–ankle angle cut-off value (4.71° vs. 6.20°), sensitivity (70.49% vs. 67.19%), specificity (84.00% vs. 85.71%), and Youden index (54.49% vs. 52.90%) in prediction of good prognosis. In conclusion, irKA-TKA corrects knee alignment in all knee types with increasing satisfaction for one-year follow-up. Knees with presurgical varus deformity are most recommended for irKA-TKA. Both presurgical scores of the traditional Chinese version of FJS-12 and WOMAC predict the prognosis of irKA-TKA.

Objective Chronic osteomyelitis (COM) can induce systemic inflammation, and systemic inflammation may be associated with suicide tendency. However, no studies have investigated the correlation between COM and suicide tendency. Methods The aim of this population-based study was to determine the epidemiology of fatal/non-fatal suicide among COM patients. Subjects with at least two outpatient visits or one course of inpatient care diagnosed with COM were recruited into a COM cohort. The control/COM subject ratio was approximately 4:1 matched by age, sex, major depression coding and index year (COM patients). Subjects with suicide attempts before COM diagnosis and subjects aged Results COM patients had 1.93 (95% confidence interval [CI]: 1.11–3.36) times the risk of fatal/non-fatal suicide as control subjects. Considering death as the competing event of fatal/non-fatal suicide, COM patients had 1.76 (95% CI: 1.03–3.01) times the risk of fatal/non-fatal suicide (competing risk regression model). The effect of COM on fatal/non-fatal suicide was more prominent among diabetic patients. COM severity also correlated with the risk of fatal/non-fatal suicide. Conclusions More attention must be paid to suicide tendency among COM patients.

Bone has a complex hierarchical structure with the capability of self-regeneration. In the case of critical-sized defects, the regeneration capabilities of normal bones are severely impaired, thus causing non-union healing of bones. Therefore, bone tissue engineering has since emerged to solve problems relating to critical-sized bone defects. Amongst the many biomaterials available on the market, calcium silicate-based (CS) cements have garnered huge interest due to their versatility and good bioactivity. In the recent decade, scientists have attempted to modify or functionalize CS cement in order to enhance the bioactivity of CS. Reports have been made that the addition of mesoporous nanoparticles onto scaffolds could enhance the bone regenerative capabilities of scaffolds. For this study, the main objective was to reuse gelatin from fish wastes and use it to combine with bone morphogenetic protein (BMP)-2 and Sr-doped CS scaffolds to create a novel BMP-2-loaded, hydrogel-based mesoporous SrCS scaffold (FGSrB) and to evaluate for its composition and mechanical strength. From this study, it was shown that such a novel scaffold could be fabricated without affecting the structural properties of FGSr. In addition, it was proven that FGSrB could be used for drug delivery to allow stable localized drug release. Such modifications were found to enhance cellular proliferation, thus leading to enhanced secretion of alkaline phosphatase and calcium. The above results showed that such a modification could be used as a potential alternative for future bone tissue engineering research.

Rationale Talar fracture accompanied with malleolar fracture is rare, and its management is complex. Ankle soft tissue is much thinner than other parts of the human body, and the shape of the ankle makes wounds difficult to close immediately after surgery, which may result in poor skin condition if the wound tension is too high. However, joint congruity and osteonecrosis are the main concerns of talar fracture. Patient concerns A 57-year-old man presented at the emergency department following a motorcycle accident. Diagnoses Physical examination revealed swelling and tenderness of the left ankle and midfoot. The patient had comminuted talar fracture and was indicated for dual-screw fixation or even plate with screw fixation. Interventions We performed single screw fixation after assessing the soft tissue condition and employed a technique of using continuous longitudinal force to bring together fracture fragments (ankle ligamentotaxis) during surgery. Open reduction with a mini-hook plate and tension band wire was used for bimalleolar fracture repair using the combined anteromedial and anterolateral approach with extension of the incision. Kirschner wire for temporary fixation was performed using ligamentotaxis, and a 2.4 headless screw was inserted from the posteromedial to the anterolateral direction. Outcomes The patient was discharged with a standard short leg splint and was instructed not to bear weight on the affected ankle for 2 months. The patient walked well without discomfort, and the Hawkins sign was clearly visible. Single screw fixation preserves the integrity of the talus bone as minimal space is used for this operative technique. Single screw fixation preserves more bony stock when most of the internal fixator is located within the bone. Additionally, surgery time is shorter than multiple implantations even when performing the same procedure; as a result, there was less ankle soft tissue swelling. Lessons This case provides evidence of using the single screw fixation technique for addressing both malleolar and talar fractures, and that talar fracture management can be less aggressive with limited weight bearing and initial limited range of motion given the presence of malleolar fracture. The alignment and stability of bony fragments also benefit from ankle ligamentotaxis.

Recently, cases of bone defects have been increasing incrementally. Thus, repair or replacement of bone defects is gradually becoming a huge problem for orthopaedic surgeons. Three-dimensional (3D) scaffolds have since emerged as a potential candidate for bone replacement, of which titanium (Ti) alloys are one of the most promising candidates among the metal alloys due to their low cytotoxicity and mechanical properties. However, bioactivity remains a problem for metal alloys, which can be enhanced using simple immersion techniques to coat bioactive compounds onto the surface of Ti&ndash, 6Al&ndash, 4V scaffolds. In our study, we fabricated magnesium-calcium silicate (Mg&ndash, CS) and chitosan (CH) compounds onto Ti&ndash, 4V scaffolds. Characterization of these surface-modified scaffolds involved an assessment of physicochemical properties as well as mechanical testing. Adhesion, proliferation, and growth of human Wharton&rsquo, s Jelly mesenchymal stem cells (WJMSCs) were assessed in vitro. In addition, the cell attachment morphology was examined using scanning electron microscopy to assess adhesion qualities. Osteogenic and mineralization assays were conducted to assess osteogenic expression. In conclusion, the Mg&ndash, CS/CH coated Ti&ndash, 4V scaffolds were able to exhibit and retain pore sizes and their original morphologies and architectures, which significantly affected subsequent hard tissue regeneration. In addition, the surface was shown to be hydrophilic after modification and showed mechanical strength comparable to natural bone. Not only were our modified scaffolds able to match the mechanical properties of natural bone, it was also found that such modifications enhanced cellular behavior such as adhesion, proliferation, and differentiation, which led to enhanced osteogenesis and mineralization downstream. In vivo results indicated that Mg&ndash, 4V enhances the bone regeneration and ingrowth at the critical size bone defects of rabbits. These results indicated that the proposed Mg&ndash, 4V scaffolds exhibited a favorable, inducive micro-environment that could serve as a promising modification for future bone tissue engineering scaffolds.

Background. Osteoporosis and fragility fracture are the major complications after liver transplantation (LT). The aim of the study was to determine the incidence and risk factors of hip fracture after LT. Methods. We conducted a retrospective population-based cohort study, enrolling the patients receiving LT between January 1999 and December 2010. Control subjects were randomly matched to every recipient by age and sex by 1 : 10 ratios. Results. During the follow-up period, 17 recipients (0.77%) and 70 (0.32%) control subjects suffered from hip fractures. The incident rates (per 10000 person-years) were 21.49 for recipients and 7.52 for controls (adjusted hazard ratio = 2.71; 95% confidence interval = 1.21–6.05). The cumulative incidence of hip fracture was significantly higher among the recipients (p<0.0001). Among the recipients, the subjects aged >65 years at transplantation and with pretransplant steroid use are more susceptible to posttransplant hip fracture. Immunosuppressive agents did not significantly affect the risk of hip fracture among recipients. Conclusions. Liver transplantation is a risk factor for hip fractures. Aged >65 years at transplantation and pretransplant steroid use are risk factors for posttransplant hip fractures among the recipients.

Resistin is a recently discovered adipocyte-secreting adipokine, which may play a critical role in modulating cancer pathogenesis. Chondrosarcoma is a highly malignant tumor known to frequently metastasize; however, the role of resistin in the metastasis of human chondrosarcoma is largely unknown. Here, we found that the expression of resistin was higher in chondrosarcoma biopsy tissues than in normal cartilage. Moreover, treatment with resistin increased matrix metalloproteinase (MMP)-2 expression and promoted cell migration in human chondrosarcoma cells. Co-transfection with microRNA (miR)-519d mimic resulted in reversed resistin-mediated cell migration and MMP-2 expression. Additionally, AMP-activated protein kinase (AMPK) and p38 inhibitors or siRNAs reduced the resistin-increased cell migration and miR-519d suppression, and inhibition of resistin expression resulted in suppression of MMP-2 expression and lung metastasis in vivo. Taken together, our results indicate that resistin promotes chondrosarcoma metastasis and MMP-2 expression through activation of the AMPK/p38 signaling pathway and down-regulation of miR-519d expression. Therefore, resistin may represent a potential novel molecular therapeutic target in chondrosarcoma metastasis.

// Chun-Hao Tsai 1,2,* , Hsiao-Chi Tsai 3,* , Ho-Ning Huang 4 , Chih-Hung Hung 2 , Chin-Jung Hsu 2,5 , Yi-Chin Fong 2,5 , Horng-Chaung Hsu 1,2 , Yuan-Li Huang 4 and Chih-Hsin Tang 3,4,6 1 Department of Medicine and Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan 2 Department of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan 3 Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan 4 Department of Biotechnology, College of Health Science, Asia University, Taichung, Taiwan 5 School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan 6 Department of Pharmacology, School of Medicine, China Medical University, Taichung, Taiwan * These authors contributed equally to this work Correspondence: Chih-Hsin Tang , email: // Yuan-Li Huang , email: // Keywords : Chondrosarcoma; MicroRNA; MMP; Resistin; Metastasis Received : Septemeber 05, 2014 Accepted : November 06, 2014 Published : November 06, 2014 Abstract Resistin is a recently discovered adipocyte-secreting adipokine, which may play a critical role in modulating cancer pathogenesis. Chondrosarcoma is a highly malignant tumor known to frequently metastasize; however, the role of resistin in the metastasis of human chondrosarcoma is largely unknown. Here, we found that the expression of resistin was higher in chondrosarcoma biopsy tissues than in normal cartilage. Moreover, treatment with resistin increased matrix metalloproteinase (MMP)-2 expression and promoted cell migration in human chondrosarcoma cells. Co-transfection with microRNA (miR)-519d mimic resulted in reversed resistin-mediated cell migration and MMP-2 expression. Additionally, AMP-activated protein kinase (AMPK) and p38 inhibitors or siRNAs reduced the resistin-increased cell migration and miR-519d suppression, and inhibition of resistin expression resulted in suppression of MMP-2 expression and lung metastasis in vivo . Taken together, our results indicate that resistin promotes chondrosarcoma metastasis and MMP-2 expression through activation of the AMPK/p38 signaling pathway and down-regulation of miR-519d expression. Therefore, resistin may represent a potential novel molecular therapeutic target in chondrosarcoma metastasis.

Bridging the gap between the theoretical modeling and the practical implementation is always essential for fault detection, classification, and location methods in a power transmission-line network. In this paper, a novel hybrid framework that is able to rapidly detect and locate a fault on power transmission lines is presented. The proposed algorithm presents a fault discrimination method based on the three-phase current and voltage waveforms measured when fault events occur in the power transmission-line network. Negative-sequence components of the three-phase current and voltage quantities are applied to achieve fast online fault detection. Subsequently, the fault detection method triggers the fault classification and fault-location methods to become active. A variety of methods-including multilevel wavelet transform, principal component analysis, support vector machines, and adaptive structure neural networks-are incorporated into the framework to identify fault type and location at the same time. This paper lays out the fundamental concept of the proposed framework and introduces the methodology of the analytical techniques, a pattern-recognition approach via neural networks and a joint decision-making mechanism. Using a well-trained framework, the tasks of fault detection, classification, and location are accomplished in 1.28 cycles, significantly shorter than the critical fault clearing time.

This paper is the second part of a series of two papers addressing a hybrid framework for achieving fault detection, classification, and location, simultaneously. The proposed framework is formed by a variety of analysis techniques, including symmetrical component analysis, wavelet transforms, principal component analysis, support vector machines, and adaptive structure neural networks. In our previous paper, the mathematical foundation of this framework with numerical results obtained by computer-based simulations has been presented. This paper is devoted to discuss the field-programmable gate-array implementation and experimental results acquired by using real-world scenarios. The hardware implementation of the runtime training technique in the proposed framework is an evolvable hardware tested by the power signals used in a power company transmission network for performance evaluation. The runtime training technique allows the FPGA to have learning and re-training capabilities. The main purpose of this paper is to show the applicability of the proposed framework on a hardware platform and test the framework's robustness and evolvability against noises from the system and measurements.

This study prepares novel metal mesh hybrid polymer composite bipolar plates for proton exchange membrane fuel cells (PEMFCs) via inserting a copper or aluminum mesh in polymer composites. The composition of polymer composites consists of 70 wt% graphite powder and 0–2 wt% modified multi-walled carbon nanotubes (m-MWCNTs). Results indicate that the in-plane electrical conductivity of m-MWCNTs/polymer composite bipolar plates increased from 156 S cm −1 (0 wt% MWCNT) to 643 S cm −1 (with 1 wt% MWCNT) (D.O.E. target >100 S cm −1 ). The bulk thermal conductivities of the copper and aluminum mesh hybrid polymer composite bipolar plates (abbreviated to Cu-HPBP and Al-HPBP) increase from 27.2 W m −1 K −1 to 30.0 W m −1 K −1 and 30.4 W m −1 K −1 , respectively. The through-plane conductivities decrease from 37.8 S cm −1 to 36.7 S cm −1 for Cu-HPBP and 22.9 S cm −1 for Al-HPBP. Furthermore, the current and power densities of a single fuel cell using copper or aluminum mesh hybrid polymer composite bipolar plates are more stable than that of using neat polymer composite bipolar plates, especially in the ohmic overpotential region of the polarization curves of single fuel cell tests. The overall performance confirms that the metal mesh hybrid polymer composite bipolar plates prepared in this study are promising for PEMFC application.

Novel multiwalled carbon nanotubes (MWNTs) were prepared using poly(oxypropylene)-backboned diamines of molecular weights M w 400 and 2000 to disperse acid-treated MWNTs, improving the performance of composite bipolar plates in polymer electrolyte membrane fuel cells. A lightweight polymer composite bipolar plate that contained vinyl ester resin, graphite powder and MWNTs was fabricated using a bulk molding compound (BMC) process. Results demonstrate that the qualitative dispersion of MWNTs crucially determined the resultant bulk electrical conductivity, the mechanical properties and the physical properties of bipolar plates. The flexural strength of the composite bipolar plate with 1 phr of MWNTs was approximately 48% higher than that of the original composite bipolar plate. The coefficient of thermal expansion of the composite bipolar plate was reduced from 37.00 to 20.40 μm m −1 °C −1 by adding 1 phr of MWNTs, suggesting that the composite bipolar plate has excellent thermal stability. The porosity of the composite bipolar plate was also evaluated. Additionally, the bulk electrical conductivity of the composite bipolar plate with different MWNTs types and contents exceeds 100 S cm −1 . The results of the polarization curves confirm that the addition of MWNTs leads to a significant improvement on the single cell performance.

A novel functional organoclay was prepared using POP-backboned quaternary ammonium salts that contained sulfonic acid (–SO3H) to improve the performance of Nafion® membranes used in direct methanol fuel cells. Modified layered silicate clays were cast with Nafion®. The performance of the Nafion®/MMT-POPD400-PS composite membranes was evaluated in terms of methanol permeability, proton conductivity and cell performance. The methanol permeability of the composite membrane declined as the MMT-POPD400-PS content increased. The MMT was functionalized using organic sulfonic acid to enhance proton conductivity. The proton conductivity of the composite membrane exceeded that of pristine Nafion®. These effects essentially improved the single-cell performance of DMFC.

Various spatially enlarged organoclays were prepared by using poly(oxyproplene)-backboned quaternary ammonium salts of various molecular weights M w 230, 400 and 2000 as the intercalating agents for Na + -montmorillonite. The modified MMT was utilized to improve the compatibility with Nafion ® . Sufficient interaction of the modified MMT with Nafion ® was studied by using X-ray diffraction (XRD) and X-ray photoelectron spectra (XPS). The performance of the Nafion ® / m -MMT composite membranes for direct methanol fuel cell (DMFCs) was evaluated in terms of water uptake, ion exchange capacity (IEC), methanol permeability, proton conductivity, and cell performance. The methanol permeability of the composite membrane decreased with the increasing of m -MMT content. The proton conductivity of the membrane was lowered slightly from that of pristine Nafion ® membrane. These results led to an essential improvement in the single-cell performance of DMFCs.

Background The choice of primary hip hemiarthroplasty or total hip arthroplasty for displaced femoral neck fracture is still controversial. Revision hip arthroplasty not only increases risk and cost but also could result in worse outcome. Determining the risk factors for revision can help inform medical decision-making and aid in risk stratification of publicly reported outcomes. Therefore, we conducted a nationwide population-based study to identify the disease-related risk factors and construct a risk score nomogram to predict revision surgery. Methods Records of all 68,030 femoral neck fracture patients receiving partial hemiarthroplasty (HA) in 2000–2010, with no total hip arthroplasty (THA) or revision HA history, were collected from the National Health Insurance Research Database. Cox proportional hazard regression was used to estimate the risk of revision hip replacement (RHA). The score of each risk factor was the quotient of the regression coefficient of the variable by the regression coefficient for a 10-year increase in age. The predictive accuracy was tested using the area under the receiver operating characteristic curve (AUROC). Results The revision risk for hemiarthroplasty increased in male, those with schizophrenia and end-stage renal disease patients had 1.58-, 1.88-, and 1.74-fold revision HA risk (95 % confidence interval (CI) = 1.40–1.78, 1.26–2.79, and 1.29–2.34, respectively). In a predictive model, the cumulative risk score ranged from 0 to 13 with a 5.08 to 91.82 % 10-year predicted RHA risk. The percentage of AUROC for 10-year RHA risk in nomogram was 61.9 (95 % CI = 60.0–63.4). Conclusions Males, schizophrenia and end-stage renal disease patients have higher risk of revision surgery after hemiarthroplasty for femoral neck fracture.

This study aims at developing lightweight and high performance composite bipolar plates for use in polymer electrolyte membrane fuel cells (PEMFCs). The thin polymer composite bipolar plates (the thickness M w ) of poly(oxypropylene)-backboned diamine intercalating agents. Results indicate that the basal spacing and content of MMT varied with M w of POP-diamines are critical in determining the resultant mechanical properties for bipolar plates. Flexural strength of MMT composite plates was increased from 30.21 to 45.66 MPa by adding 2 phr of MMT. The flexural strength of the plate was also ca. 38% higher than the pristine graphite plate as the basal spacing of MMT was increased from 1.71 to 5.43 nm. Meanwhile, the unnotched impact strength of the composite plates was increased from 58.11 to 80.21 J m −1 . The unnotched impact strength of the plate was ca. 30% higher than that of the original graphite plates as the basal spacing of MMT was increased from 1.71 to 5.43 nm. The limiting oxygen index (LOI) and the UL-94 test revealed that the bipolar plate possesses excellent flame retardant with LOI >50 and UL-94-V0. The thermal decomposition temperature of each MMT composite plate is also higher than 250 °C. In addition, the bulk electrical conductivity of the bipolar plate with different MMT contents and basal spacing of MMT is higher than 100 S cm −1 . The corrosion current is less than 10 −7 A cm −2 . Results confirm that the addition of MMT leads to a significant improvement on the performance of the composite bipolar plate.

The α2,6-sialyltransferase from Photobacterium damsela was applied for the enzymatic sialylation of the T N glycopeptide (APGSTA) with GalNAc α-linked to either the serine or threonine residue in the sequence. The enzyme preparation and reaction conditions were optimized prior to the application. In contrast to the mammalian sialyltransferases which recognize the moiety'of GalNAcα(1,1)Thr only, this bacterial enzyme can accept GalNA-cα(1,1)Thr as well as GalNAcα(1,1)Ser. Our study also introduced a 4-dimethylaminoazobenzene-4'-sulfonyl (dabsyl) chromophore to the N-terminus of the peptide backbone, which is suitable for glyco-conjugate substrates without affecting the binding affinity.

Malate dehydrogenase (MDH) has been used as a conjugate for enzyme immunoassay of a wide variety of compounds, such as drugs of abuse, drugs used in repetitive therapeutic application and hormones. In consideration of the various biotechnological applications of MDH, investigations of MDH from Thermus thermophilus were carried out to further understand the properties of this enzyme. The DNA fragment containing the open reading frame of mdh was amplified from the genomic DNA of T. thermophilus and cloned into the expression vector pET21b(+). The protein was expressed in a soluble form in Escherichia coli strain BL21(DE3). Homogeneous protein was obtained using a three-step procedure consisting of thermal treatment, Ni(2+)-chelating chromatography and size-exclusion chromatography. The purified MDH was crystallized and the crystals diffracted to a resolution of 1.80 Å on the BL13C1 beamline of the National Synchrotron Radiation Research Center (NSRRC), Taiwan. The crystals belonged to the orthorhombic space group P2(1)2(1)2(1), with unit-cell parameters a = 71.3, b = 86.1, c = 118.2 Å. The unit-cell volume of the crystal is compatible with the presence of two monomers in the asymmetric unit, with a corresponding Matthews coefficient VM of 2.52 Å(3) Da(-1) and a solvent content of 51.2%. The crystal structure of MDH has been solved by molecular replacement and is currently under refinement.

This study evaluates the safety and effectiveness of computed tomography- (CT-) assisted endoscopic surgery in the treatment of infectious spondylodiscitis of the thoracic and upper lumbar spine in immunocompromised patients. From October 2006 to March 2014, a total of 41 patients with infectious spondylodiscitis underwent percutaneous endoscopic surgery under local anesthesia, and 13 lesions from 13 patients on the thoracic or upper lumbar spine were selected for evaluation. A CT-guided catheter was placed before percutaneous endoscopic surgery as a guide to avoid injury to visceral organs, major vessels, and the spinal cord. All 13 patients had quick pain relief after endoscopic surgery without complications. The bacterial culture rate was 77%. Inflammatory parameters returned to normal after adequate antibiotic treatment. Postoperative radiographs showed no significant kyphotic deformity when compared with preoperative films. As of the last follow-up visit, no recurrent infections were noted. Traditional transthoracic or diaphragmatic surgery with or without posterior instrumentation is associated with high rates of morbidity and mortality, especially in elderly patients, patients with multiple comorbidities, or immunocompromised patients. Percutaneous endoscopic surgery assisted by a CT-guided catheter provides a safe and effective alternative treatment for infectious spondylodiscitis of the thoracic and upper lumbar spine.

A fungal immunomodulatory protein (Fip-gts) was purified from Ganoderma tsugae. The DNA encoding Fip-gts was isolated from a cDNA library of G. tsugae by reverse transcriptase-polymerase chain reaction. The complete amino acid sequence of Fip-gts, deduced from the nucleotide sequence of the cDNA, was the same as LZ-8 isolated from Ganodermn lucidum. Recombinant Fip-gts was expressed as a glutathione S-transferase fusion protein in Escherichia coli with a yield of 20 mg/liter of culture. Recombinant Fip-gts, purified to homogeneity, had the same blast formation stimulatory activity to human peripheral blood lymphocytes as native Fip-gts. The yeast two-hybrid system and site-directed mutagenesis were used to determine whether dimerization of Fip-gts occurred. Deletion analysis of the N-terminal amphipathic alpha-helix domain of Fip-gts identified a sequence of about 10 amino acids responsible for inducing immunomodulatory activity. Non-functional Fip-gts deletion mutants did not form dimers, whereas wild type Fip-gts did as determined by gel filtration. A mutant with deletions at Leu-5, Phe-7, and Leu-9 lost the amphipathic characteristics of the N-terminal domain and the ability to form dimers as well as its immunomodulatory activity. Fusion of Fip-gts with the DNA binding and the transactivation domains of GAL4 resulted in the activation of the lacZ activator gene, indicating the interaction of Fip-gts with it itself. The dimerization domain was further defined by analyzing the ability of the N-terminal 13 amino acids or Leu-5, Phe-7, and Leu-9 deletion mutants of Fip-gts to interact with the wild type Fip-gts. These experiments confirmed the N-terminal amphipathic alpha-helix as the dimerization domain and suggest that the dimerization of Fip-gts may play an important role in Fip-gts immunomodulatory activity.

Acute traumatic patellar dislocation is a common injury in the active and young adult populations. MRI of the knee is recommended in all patients who present with acute patellar dislocation. Numerous operative and non-operative methods have been described to treat the injuries; however, the ideal management of the acute traumatic patellar dislocation in young adults is still in debate. This article is intended to review the studies to the subjects of epidemiology, initial examination and management.

DNAs encoding of three abrin A-chains were obtained from the cDNA library of Abrus precatorius by polymerase chain reaction and ligated into the expression vector, pGEX-2T. The mature A-chains of abrins a, b and d have been expressed in the cytoplasm of Escherichia coli, and the yield of the soluble recombinant proteins was 7 mg/l induced culture. Three recombinant abrin A-chains were purified to be homogeneity and their N-glycosidase ability to inhibit protein biosynthesis in a cell-free system and to depurinate 28S rRNA in rat liver ribosomes was demonstrated in vitro. The recombinant abrin-a A-chain had the highest N-glycosidase activity among three recombinant abrin A-chains while the recombinant abrin-b A-chain, the least. Three mutants, glutamic-acid-to-alanine replacement (E164A), arginine to leucine (R167L) or double mutation (E164A and R167L) were constructed and expressed. The protein-biosynthesis-inhibitory activity of mutant (E164A), mutant (R167L) and the double mutant was found to be 25-fold, 625-fold and 1250-fold lower than that of wild type, respectively. The results indicated that Arg167 was essential for abrin toxin A-chain catalysis.

Degenerate primers were designed based on all possible sequences of the N-terminal and C-terminal regions of Delonix regia trypsin inhibitor (DrTI). Five hundred sixty-one bp of polymerase chain reaction (PCR) product was amplified using the above degenerate primers and genomic DNA and cDNA of Delonix regia as a template. The amplified PCR products were cloned and sequenced. DNA sequence analysis of cDNA and genomic clones of DrTI have the same nucleotide sequence in the coding region, and manifested a genomic clone without intervening sequences in the coding region. The amino acid sequence deduced from the DrTI genomic and cDNA clones agreed with that identified via amino acid sequencing analysis, except that two amino acid residues, Ser and Lys, existed between residues Lys141 and Ser142. DrTI open reading frame was then amplified and cloned in-frame with GST in pGEX4T-1 and overexpressed in Escherichia coli to yield a glutathione S-transferase (GST)-fusion protein with a calculated molecular mass of about 45 kDa. The recombinant DrTI (reDrTI) was derived by treating the GST-DrTI fusion protein with thrombin. Both the reDrTI and GST-DrTI fusion protein exhibited a strong identical inhibitory effect on trypsin activity.

Native Acacia confusa trypsin inhibitor (ACTI) contains two disulphide bonds; one is an intrachain disulphide bond (Cys40-Cys86), located in the A-chain, while the other is an interchain disulphide bond (Cys133-Cys141) connecting the A- and B-chain; the inhibitor consists of 175 amino acid residues, 136 residues in the A-chain and 39 residues in the B-chain. The putative reactive site of ACTI is located at Lys64, while for all other Kunitz family trypsin inhibitors it is at Arg64. When the Lys64 residue of ACTI was converted into Ile or Arg by site-specific mutagenesis, the K64I mutant completely lost its inhibitory activity but the K64R mutant retained most of its inhibitory activity. The C133G mutant lost its inhibitory activity while the C40G mutant did not. This suggests that the interchain disulphide bond (Cys133-Cys141) linking two β-strands of the six-strand β-barrel is essential for ACTI inhibitory activity, while the intrachain disulphide bond (Cys40-Cys86) connecting the two loops is non-essential.

Sialic acid synthase encoded by the neuB gene of Escherichia coli catalyzes the condensation of N -acetylmannosamine and phosphoenolpyruvate to form N -acetylneuraminic acid. This report demonstrates the first structural information on sialic acid synthase by CD, MALDI-TOF, and chemical cross-linking studies. Also, a specific cleavage by endogenous protease(s) has been identified at Lys 280 of the enzyme (40 kDa) by LC-MS and N-terminal sequencing analyses. The cleavage results in the formation of two inactive fragments of 33 and 7 kDa. The structural analysis indicates that the fragmentation is associated with a significant change of the enzyme from a tetrameric to trimeric form, and alterations in both secondary and native quaternary structures.

Dementia is among various diseases affecting the elderly, who is also at a high risk for fractures. This study aimed to evaluate the association between fracture history and sequential risk of dementia in Taiwan. A retrospective cohort study was designed using the claims data of the entire insured residents covered by Taiwan's universal health insurance from 1998 to 2010. A total of 66,797 patients with fractures and 133,594 control subjects without fractures were matched in terms of age (±5 years), sex, and index year and then recruited. Fractures and dementia were defined in accordance with the International Classification of Diseases, 9th Revision, Clinical Modification. The influence of fractures on the risk of dementia was analyzed using a Cox proportional hazards model. After a 12-year follow-up period, 2775 and 3991 incident cases of dementia were reported in exposed and unexposed cohorts, respectively. The overall incidence rate of dementia in individuals with fractures was 41% higher than that in individuals without fractures (6.05 vs 4.30 per 1000 person-years) at an adjusted hazard ratio of 1.38 (95% confidence interval 1.32–1.45) after age, sex, urbanization, and individual disorders or comorbidities were adjusted. Considering fracture location, we found that patients with hip fractures were at a slightly high risk for dementia. The occurrence of multiple fractures at a single visit was also significantly associated with an increased risk of dementia. Fracture history is regarded as an independent risk factor of dementia in individuals aged ≥65 years, particularly those who suffered from multiple fractures and/or fractures located in the hip. Further studies are needed to support an independent role of fracture in dementia considering the clinical information and other comorbidities.

Abrin A-chain (ABRA) inhibits protein synthesis by its N-glycosidase activity as well as induces apoptosis, but the molecular mechanism of ABRA-induced cell death has been obscure. Using an ABRA mutant that lacks N-glycosidase activity as bait in a yeast two-hybrid system, a 30-kDa antioxidant protein-1 (AOP-1) was found to be an ABRA(E164Q)-interacting protein. The interaction was further confirmed in vitro by a glutathione S-transferase pull-down assay. The colocalization of endogenous AOP-1 and exogenous ABR proteins in the cell was demonstrated by confocal immunofluorescence. We also demonstrated that ABRA attenuates AOP-1 antioxidant activity in a dose-dependent manner and the intracellular level of reactive oxygen species (ROS) increases in ABR-treated cells. Moreover, ROS scavengers N-acetylcysteine and 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl delayed programmed cell death. This indicates that ROS are important mediators of ABR-induced apoptosis. When ectopically expressed, AOP-1 blocked the release of cytochrome c and prevented apoptosis in ABR-treated cells. These findings suggest that the binding of ABRA to AOP-1 promotes apoptosis by inhibiting the mitochondrial antioxidant protein AOP-1, resulting in the increase of intracellular ROS and the release of cytochrome c from the mitochondria to the cytosol, which activates caspase-9 and caspase-3.

Objective The purpose of this study is to compare glenopolar angle (GPA) and the functional outcomes of fixation of both the clavicle and the scapular neck, fixation of the clavicle alone, and conservative treatment for floating-shoulder injuries. Methods A prospective stratified randomized study was performed in 39 adult patients who suffered floating-shoulder injuries and underwent fixation of both the clavicle and the scapular neck (group A), or fixation of the clavicle alone (group B), or conservative treatment (group C) between January 2005 and September 2011. The GPA, Disabilities of the Arm, Shoulder and Hand (DASH) score, and Constant-Murley Shoulder Outcome (Constant) score were compared between the three groups. Results All 39 patients were followed up for more than 2 years. GPA after bony consolidation was significantly better in group A than in groups B and C (p = 0.015). Functional outcomes measured by DASH and Constant scores were significantly better in group A at final follow-up (p = 0.008 and 0.002, respectively). Both DASH and Constant scores were highly correlated with GPA after consolidation (p