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BACKGROUND The authors noticed that ankle joint osteoarthritis was not uncommon when lower extremity malalignment, such as a knee varus deformity, was present as a result of severe osteoarthritis of the knee. The purpose of this study was to analyze radiologic changes of the ankle joint after total knee arthroplasty. METHODS This study included 142 cases in 110 patients who underwent total knee arthroplasty and were followed for at least 3 years. The varus knee group included 128 cases and the valgus knee group included 14 cases. On anteroposterior standing lower extremity radiographs, varus and valgus angles of the knee were measured preoperatively and at the last follow-up. The angle between the ground surface and the distal tibial plafond as well as the upper talus was also measured. In addition, tibial anterior surface angle, talar tilt, space between the medial malleolar distal tip and the medial articular surface of the talus, and medial tibiotalar joint space of the ankle joint were measured. RESULTS Out of 142 cases, 50 (35.2%) had arthritis in the ankle before total knee arthroplasty and 31 (21.8%) had newly developed or progressive arthritis after surgery. In particular, the varus knee group demonstrated statistically significant differences in preoperative varus deformity, preoperative talar tilt, and postoperative correction angle between the cases that developed or had progressive arthritis and those that did not show any changes (p

Nahid Kondori1,*, Marcel Erhard2, Christina Welinder-Olsson1, Marizeth Groenewald3, Gerard Verkley3 and Edward R. B. Moore1,41Department of Infectious Diseases, Sahlgrenska Academy of the University of Gothenburg, SE-40234 Gothenburg, Sweden2RIPAC-LABOR GmbH, D-14476 Potsdam, Germany3Centraalbureau voor Schimmelcultures (CBS), CBS-KNAW Fungal Biodiversity Centre, 3584 CT Utrecht, Netherlands4Culture Collection University of Gothenburg, Sahlgrenska Academy of the University of Gothenburg, SE-40234 Gothenburg, Sweden↵*Corresponding author: Department of Infectious Diseases, University of Gothenburg, Box 7193, 40234 Gothenburg, Sweden. Tel: +46-31-342-4226; Fax: +46-31-342-4975; E-mail: nahid.kondori{at}microbio.gu.seRevision received July 8, 2014.Accepted November 3, 2014.AbstractConventional mycological identifications based on the recognition of morphological characteristics can be problematic. A relatively new methodology applicable for the identification of microorganisms is based on the exploitation of taxon- specific mass patterns recorded from abundant cell proteins directly from whole-cell preparations, using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). This study reports the application of MALDI-TOF MS for the differentiation and identifications of black yeasts, isolated from the respiratory tracts of patients with cystic fibrosis (CF). Initial phenotypic and DNA sequence-based analyses identified these isolates to be Exophiala dermatitidis. The type strains of E. dermatitidis (CBS 207.35T) and other species of Exophiala were included in the MALDI-TOF MS analyses to establish the references for comparing the mass spectra of the clinical isolates of Exophiala. MALDI-TOF MS analyses exhibited extremely close relationships among the clinical isolates and with the spectra generated from the type strain of E. dermatitidis. The relationships observed between the E. dermatitidis strains from the MALDI-TOF MS profiling analyses were supported by DNA sequence-based analyses of the rRNA ITS1 and ITS2 regions. These data demonstrated the applicability of MALDI-TOF MS as a reliable, rapid and cost-effective method for the identification of isolates of E. dermatitidis and other clinically relevant fungi and yeasts that typically are difficult to identify by conventional methods.Exophiala dermatitidisfungiMALDI-TOF MSwhole-cell protein profiling© FEMS 2014. All rights reserved. For permissions, please e-mail: journals.permissions{at}oup.com

Deep Candida infections (DCI) in patients who are immunocompromised or in intensive care units present both diagnostic and therapeutic problems. Serological tests for diagnosis of invasive fungal infections are used with varying results. Moreover, long term therapies with antifungal agents have led to the emergence of resistant Candida strains. Our aim was to investigate cell wall components of Candida albicans in order to find antigenic markers of DCI, and to explore the anti-fungal activity of peptide fragments of the innate defense factor lactoferrin (LF).The relative ability of antibodies to specifically recognize C. albicans cell wall components, such as native cell wall fragments (CW), phosphopeptidomannan (PPM), and b(1-6)(1-3)glucan was evaluated in ELISA by using serum from C. albicans-immunized rabbits and serum from patients with DCI. It was found that PPM is the dominant antigen in the cell wall of C. albicans. Moreover, analysis of DCI patients for IgG subclass antibodies against the above antigens showed that IgG2 anti- PPM and IgG1 anti-CW antibodies were highly discriminatory for recognition of DCI when compared with two control groups consisting of women with suspected superficial Candida infection of the nipples and healthy blood donors. Determination of circulating Candida cell wall material in the very same patients and control groups revealed that b(1-6)(1-3)glucan, as determined by a commercially available biochemical assay based on a coagulation cascade in the cell lysate of hemocytes from the Limulus crab, was detectable in high concentrations in the serum of all patients, but not in any of the controls. Polyclonal and monoclonal (Mab) antibodies against b(1-3) glucans were produced. One novel Mab recognized not only an epitope in the free form of b(1-6)(1-3)glucan, but uniquely also on the cell surface of C. albicans, C. krusei, C. glabrata, C. parapsilosis and Cryptococcus neoformans as revealed by immunofluorescence. Antibodies with high specificity against b(1-3) glucans might become useful tools in the serodignosis of DCI, but also for investigations regarding the localization of b(1-3) glucans in the cell wall of Candida.Lactoferrin (LF)-derived synthetic fragments (12-, 23-, and 25 amino acid long peptide sequences) homologous to the antimicrobial, surface-exposed a-helix and b-sheet region from the N terminal end of the human LF exerted fungicidal activity against C. albicans, C. krusei, C. kefyr, C. parapsilosis and Cryptococcus neoformans analysed by a microplate assay. C. glabrata was, however, resistant. The killing of yeast cells by the peptides was accompanied by cytoplasmic and mitochondrial permeabilization as analysed by propidium iodide staining and rhodamine 123-loaded mitochondria in yeast cells. By peroral treatment with each of the two longer LF peptides (23 and 25 a.a.) of mice with gastric colonization of C. albicans the yeast cells were significantly reduced. In conclusion, two IgG subclass antibodies and circulating b(1-3)glucan seem to be promising early specific markers in the laboratory diagnosis of DCI. Complementary studies on patients followed prospectively will provide definite information to their future usefulness. The novel Mab and polyclonal antibodies to b(1-3)glucans might become useful tools in the serodiagnosis of DCI by improving the precision of the glucan determination. Colonization by Candida species increases the risk of DCI in immunocompromised patients, thus antifungal peptide fragments derived from antimicrobial proteins of the host such as lactoferrin might be of prophylactic and therapeutic use.