Non-tuberculous mycobacterial (NTM) infection
of the musculoskeletal tissue is a rare disease. An early and accurate diagnosis
is often difficult because of the indolent clinical course and difficulty
of isolating pathogens. Our goal was to determine the clinical features
of musculoskeletal NTM infection and to present the treatment outcomes.
A total of 29 patients (nine females, 20 males between 34 and 85
years old, mean age 61.7 years; 34 to 85) with NTM infection of the
musculoskeletal system between 1998 to 2011 were identified and
their treatment retrospectively analysed. Microbiological studies
demonstrated NTM in 29 patients: the isolates were Cite this article:
RNA-Seq or whole transcriptome shotgun sequencing has been adopted in the last years as a reference technique to determine the presence and the quantity of different species of RNA in determined biological samples, thanks to it allows the identification every single RNA species transcribed from a reference genome. Meta-profiling takes advantage of the public availability of an increasing set of RNA-Seq data produced by different laboratories to summarize the expression levels of the different RNA species of many samples according to their biological context, giving the opportunity to perform comparisons on the gene expression profiles of different tissues by integrating data derived from a high number of studies. By using Genevestigator™; a platform which integrates RNA-Seq data into meta-profiles, we have performed a comparison between the gene expression profiles of bone, cartilage, muscle tendon and skin by means of interrogating its database with different gene sets and families with relevance to the function of the tissues of the
Imaging of the
Osteoarthritis is the most prevalent joint disease, causing severe pain, deformity and a loss of mobility. Low back pain (LBP), frequently associated with degeneration of the intervertebral disc (IVD), is the No.1 cause of Years Lived with Disability. Age is a major risk factor for both conditions. However, the reasons why susceptibility to these conditions increases with age are poorly understood. The circadian (24 hourly) clocks in the brain and periphery direct key aspects of physiology through rhythmic control of tissue-specific sets of downstream genes. Work from our group focuses on the roles of circadian clocks in the articular cartilage and IVD. We show that the daily rhythm in these tissues becomes dampened and out-of-phase during ageing. Further, our data identify circadian clock disruption in cartilage and IVD as a new target of inflammation. Moreover, we show that mice with targeted knockout of an essential clock gene (BMAL1) in chondrocytes and disc cells have profound, yet tissue-specific degeneration in the articular cartilage and IVD. These findings implicate the local skeletal clock as a key regulatory mechanism for tissue homeostasis. This new avenue of research holds potential to better understand, and eventually treat these debilitating conditions.
We reviewed 34 hindquarter amputations performed for malignant tumours around the hip from 1971 to 1988, classifying them as palliative or curative according to the resection margins or the presence of disseminated disease at the time of surgery. There were three peri-operative deaths, 12 palliative and 19 curative procedures. Ten patients died of disseminated disease within a year of surgery, eight of whom had had a palliative operation. Three patients died between one and five years after palliative surgery. One died of unrelated disease at nine years. Seventeen patients are disease free an average of 31 months from surgery, 16 after curative procedures. The median survival after palliative amputations was six months and the 5-year survival rate for curative cases was 83%.
X-ray is the standard method for monitoring fracture healing however it is not ideal; signs of healing are not normally visible on X-ray until around 6–8 weeks post fracture. Ultrasonography allows the detection of both the initial haematoma, usually formed immediately after fracture, and the small calcium deposits laid down between broken bone ends in the first stages of fracture healing. It has been reported that these early indicators of the healing process are visible as early as 1–2 weeks after fracture. We use Freehand 3D Ultrasound to monitor the early stages of fracture healing as both the bone surface and surrounding soft tissues can be imaged simultaneously. The Freehand 3D Ultrasound system consists of a standard Ultrasound machine, a PC running STRAD-WIN (Medical Imaging Group, Cambridge University) 3D software, and an optical tracking devise (NDI Polaris) to record the position and orientation of the Ultrasound probe during scanning. Images are transferred from the Ultrasound machine to the PC using RF capture through out a scan. Calibrating the system matches up the correct image with the correct probe position to produce a 3D dataset. We segment features of interest on the sequence of 2D images to construct a 3D model. These models are rotatable and provide views of the scanned anatomy that are not otherwise achievable using conventional Ultrasound or X-ray. The 3D data set can also be resliced through any plane to provide further views. To conduct a 3D Ultrasound scan takes the same amount of time as a conventional 2D scan. The production of the 3D model takes between 15–60 minutes depending on the level of detail required. Distances are measurable to within ±0.4mm meaning fracture gaps of sub-millimeter width can be resolved. The system has already been evaluated on healthy volunteers and a clinical study currently underway.
Granular Cell Tumours are rare mesenchymal soft tissue tumours that arise throughout the body and are believed to be of neural origin. They often present as an asymptomatic slow-growing benign solitary lesion but may be multifocal. One to two percent of cases are malignant and can metastasise. Described series in the literature are sparse. We examined our database and identified eleven cases in ten patients treated surgically and followed-up for a period of over six years (May 2002 to January 2009) in our regional bone and soft tissue tumour centre. Five tumours were located in the lower limb, four in the upper limb and two in the axial skeleton. Mean patient age was 31.2 years (range 8 to 55 years). Excision was complete in one case, marginal in five cases and intra-lesional in five cases. No specimens showed evidence of malignancy. No patients required postoperative adjuvant treatment. Mean follow-up was 19.3 months (range 1 to 37 months), with no cases of local recurrence. One case was multi-focal. Histopathological examination revealed the classical features of granular cell tumour in all cases. Typically, tumour cells were diffusely and strongly positive for S100 protein by immunohistochemistry, whereas the other markers tested were negative. We believe this case series to be the largest of its type in patients presenting to an orthopaedic soft tissue tumour unit. We present our findings and correlate it with findings of other series in the literature.
Developmental exposure to estrogens has been shown to affect a number of organ systems, including long and short bones. Epigenetic effects of DES exposure have been shown to affect the third generation of progeny. Furthermore, recent studies have shown that environmental exposure to estrogen-like compounds is much higher than originally anticipated. This study aims to discover the effect of in utero exposure to a well-known estrogen agonist, diethylstilbestrol (DES), on lumbar bone, intervertebral disc (IVD), and articular cartilage. Femoral bone was studied to determine the specificity of the effect. C57bl/6n pregnant mice were dosed orally with vehicle (peanut oil) or 0.1, 1.0 and 10 g/kg/day of DES on gestational days 11–14. Male and female pups were allowed to mature without further treatment until 3 months of age, at which point they were divided into swim and sedentary groups. After sacrifice, bone mineral density (BMD), bone mineral content (BMC), bone area (BA), and trabecular bone area (TBA) of the lumbar vertebrae and femur were measured using a PIXImus Bone Densitometer System (GE Medical Systems). Glycosaminoglycan (GAG) content (proteoglycan) was measured by the DMMB assay. Histological analysis of proteoglycan was performed with Safranin O staining. Intervertebral disc height was measured using NDP software (Leeds, UK). Statistical analysis was performed using analysis of variance (ANOVA) followed by Fisher's Protected Least Significant Difference (PLSD). A p-value of < 0.05 was considered statistically significant.Purpose
Method
Imaging can provide valuable information about the function of tissues and organs. The capacity for detecting and measuring imaging biomarkers of biological activities, allows for a better understanding of the pathophysiology of any process in the human body, including the
Aims. Tenosynovial giant cell tumour (TGCT) is a rare benign tumour of the
Our
