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RSC Chemical Biology Jun 2021Proximal multi-site phosphorylation is a critical post-translational modification in protein biology. The additive effects of multiple phosphosite clusters in close... (Review)
Review
Proximal multi-site phosphorylation is a critical post-translational modification in protein biology. The additive effects of multiple phosphosite clusters in close spatial proximity triggers integrative and cooperative effects on protein conformation and activity. Proximal phosphorylation has been shown to modulate signal transduction pathways and gene expression, and as a result, is implicated in a broad range of disease states through altered protein function and/or localization including enzyme overactivation or protein aggregation. The role of proximal multi-phosphorylation events is becoming increasingly recognized as mechanistically important, although breakthroughs are limited due to a lack of detection technologies. To date, there is a limited selection of facile and robust sensing tools for proximal phosphorylation. Nonetheless, there have been considerable efforts in developing optical chemosensors for the detection of proximal phosphorylation motifs on peptides and proteins in recent years. This review provides a comprehensive overview of optical chemosensors for proximal phosphorylation, with the majority of work being reported in the past two decades. Optical sensors, in the form of fluorescent and luminescent chemosensors, hybrid biosensors, and inorganic nanoparticles, are described. Emphasis is placed on the rationale behind sensor scaffolds, relevant protein motifs, and applications in protein biology.
PubMed: 34458812
DOI: 10.1039/d1cb00055a -
Journal of Wrist Surgery Oct 2023The scaphotrapeziotrapezoidal (STT) joint transfers forces to the proximal carpal row from the thumb and fingers. Clinically, STT joint osteoarthritis is frequently...
The scaphotrapeziotrapezoidal (STT) joint transfers forces to the proximal carpal row from the thumb and fingers. Clinically, STT joint osteoarthritis is frequently observed on plain radiographs though its role in the mechanics of the wrist joint remains unclear. Our purpose was to use a model of normal wrist types, to predict STT motion upon load. Five normal computed tomography scans of a wrist type 1 and five wrist type 2 were used to model the wrist. A 200-N force was split and applied to the trapezoid and capitate to replicate forces during a knuckle pushup. The bony movement was predicted by the model as bony movement using finite element analysis. We found differences in force transfer through the STT joint between the two wrist types when loading the index and middle fingers. Type 1 wrists moved quantitatively more anterior-posterior, type 2 wrists moved more medially-laterally and more proximally-distally. The trapezium in type 1 wrists moved more in the coronal plane than in type 2 wrists. The trapezoid moved more from distal to proximal in a type 2 wrist, = 0.03. This study found differences in motion upon loading through the STT joint between type 1 and 2 wrists. Type 2 wrists moved more radially toward the proximal scaphoid and scapholunate ligament. This study may provide a mechanical basis for degenerative configurations. By linking observed patterns of degeneration to their mechanical causes we can aid in prevention of arthritis.
PubMed: 37841353
DOI: 10.1055/s-0043-1761287 -
Folia Morphologica 2023The sternocleidomastoid muscles (SCM) are prominent paired muscles of the neck connecting proximally the manubrium sterni and the clavicle to the mastoid process and the... (Review)
Review
The sternocleidomastoid muscles (SCM) are prominent paired muscles of the neck connecting proximally the manubrium sterni and the clavicle to the mastoid process and the occipital bone distally. Following their points of attachment sternomastoid, sternooccipital, cleidomastoid and cleidooccipital portions of this muscle have been described. Altogether 23 case reports from year 2000 till 2020 with 29 subjects related to the SCM supernumerary variations were searched and analysed where parameters such as supernumerary proximal variation types (sternal vs. clavicular), insertional variation, unilaterality/bilaterality of the variation, study type, reported gender of the subjects and the country of research were extracted. The research shows that 48.3% of the subjects had bilateral presentation of SCM variations. If present unilaterally, three quarters of the cases were on the left side. The most frequent variation is located at the clavicular side of the proximal SCM head whereas isolated sternal sided proximal head variation or an insertional variation alone are very rare. Interestingly, with 96.6%, most of cases in the literature were discovered in cadavers during anatomical dissections. Male gender represented with 82.8% higher prevalence than females. The higher male prevalence in the body donor system, predominantly in the Asian continent could play a decisive role in the outcome as more than half of the reported cases stemmed from India in this period. Importantly, the knowledge of different anatomical variations of the SCM is highly relevant for surgical, clinical or radiological approaches in the neck.
Topics: Female; Humans; Male; Neck Muscles; Neck; Dissection; Sternum; Clavicle
PubMed: 35607877
DOI: 10.5603/FM.a2022.0045 -
Operative Orthopadie Und Traumatologie Jun 2022Proximal femoral replacement (PFR) is a salvage procedure originally developed for reconstruction after resection of sarcomas and metastatic cancer. These techniques... (Review)
Review
OBJECTIVE
Proximal femoral replacement (PFR) is a salvage procedure originally developed for reconstruction after resection of sarcomas and metastatic cancer. These techniques can also be adapted for the treatment of non-oncologic reconstruction for cases involving massive proximal bone loss. The direct anterior approach (DAA) is readily utilized for revision total hip arthroplasty (THA), but there have been few reports of its use for proximal femoral replacement.
INDICATIONS
Aseptic, septic femoral implant loosening, periprosthetic femoral fracture, oncologic lesions of the proximal femur. The most common indication for non-oncologic proximal femoral placement is a severe femoral defect Paprosky IIIB or IV.
CONTRAINDICATIONS
Infection.
SURGICAL TECHNIQUE
In contrast to conventional DAA approaches and extensions, we recommend starting the approach 3 cm lateral to the anterior superior iliac spine and performing a straight incision directed towards the fibular head. After identification and incision of the tensor fasciae lata proximally and the lateral mobilization of the iliotibial tract distally, the vastus lateralis muscle can be retracted medially as far as needed. Special care should be taken to avoid injuries to the branches of the femoral nerve innervating the vastus lateralis muscle. If required, the distal extension of the DAA can continue all the way to the knee to allow implantation of a total femoral replacement. The level of the femoral resection is detected with an x‑ray. In accordance with preoperative planning, the proximal femur is resected. Ream and broach the distal femoral fragment to the femoral canal. With trial implants in place, leg length, anteversion of the implant and hip stability are evaluated. It is crucial to provide robust reattachment of the abductor muscles to the PFR prosthesis. Mesh reinforcement can be used to reinforce the muscular attachment if necessary.
POSTOPERATIVE MANAGEMENT
We typically use no hip precautions other than to limit combined external rotation and extension for 6 weeks. In most cases, full weight bearing is possible after surgery.
RESULTS
A PFR was performed in 16 patients (mean age: 55.1 years; range 17-84 years) using an extension of the DAA. The indication was primary bone sarcoma in 7 patients, metastatic lesion in 6 patients and massive periprosthetic femoral bone loss in 3 patients. Complications related to the surgery occurred in 2 patients (both were dislocation). Overall, 1 patient required reoperation and 1 patient died because of his disease. Mean follow-up was 34.5 months.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip; Femur; Hip Prosthesis; Humans; Middle Aged; Prosthesis Failure; Reoperation; Treatment Outcome; Young Adult
PubMed: 35641789
DOI: 10.1007/s00064-022-00770-x -
European Cardiology Feb 2021Myocardial bridging occurs when coronary arteries run intramurally. Episodes of tachycardia can cause a dynamic obstruction that extends into diastole, compromising... (Review)
Review
Myocardial bridging occurs when coronary arteries run intramurally. Episodes of tachycardia can cause a dynamic obstruction that extends into diastole, compromising coronary filling time, and subsequently leading to ischaemia. Myocardial ischaemia, acute coronary syndrome, coronary spasm, myocardial stunning, arrhythmia, takotsubo cardiomyopathy, and sudden cardiac death have all been reported with bridging. Atherosclerotic plaques develop proximally in the bridge due to low shear stress and high oscillatory wall-flow. Factors affecting atherosclerotic build-up include disrupted flow patterns (particularly flow recirculation, which exacerbates LDL internalisation), cell adhesion and monocyte adhesion to the endothelium. Endothelial health depends on arterial flow patterns, given that the vessel reacts differently to various flow types, as confirmed in 3D simulations. Medication is the first-line therapy, while surgical de-roofing and coronary bypass are reserved for severe stenosis. Distinguishing physiological arterial compression from pathological stenosis is essential. Deeper bridges correlating with recurrent angina with an instantaneous wave-free ratio ≤0.89 or fractional flow reserve ≤0.80 are treated.
PubMed: 33737959
DOI: 10.15420/ecr.2020.33 -
Ultrasound in Obstetrics & Gynecology :... Oct 2021Obstetric anal sphincter injury (OASI) is a common preventable cause of anal incontinence. Both diagnosis and primary repair of OASI are often suboptimal, partly owing...
OBJECTIVE
Obstetric anal sphincter injury (OASI) is a common preventable cause of anal incontinence. Both diagnosis and primary repair of OASI are often suboptimal, partly owing to the absence of effective clinical audit. The aim of this study was to evaluate the location of scars or defects of the external anal sphincter (EAS), diagnosed by translabial ultrasound (TLUS), following primary OASI repair.
METHODS
This was a retrospective analysis of 309 women who were seen at a tertiary obstetric unit after primary repair of OASI between June 2012 and May 2019. All women underwent a standardized interview, including St Mark's incontinence score, followed by clinical examination and TLUS assessment within 2-9 months after OASI repair. Postprocessing of TLUS volume datasets was performed by an investigator who was blinded to all other information. Tomographic ultrasound imaging was used to evaluate the presence of a scar or defect in the proximal and distal parts of the EAS. Women were classified into four groups according to the imaging findings: (1) no visible defect or distortion (likely false positive); (2) only proximal OASI; (3) only distal OASI; and (4) both proximal and distal OASI.
RESULTS
Of the 309 women seen during the study period, 34 were excluded because they were referred for reasons other than recent (< 1 year) OASI, 16 owing to missing data and four owing to poor image quality, leaving 255 patients for analysis. Women were seen on average 0.25 ± 0.1 years after the index birth, and their mean age at delivery was 29.1 ± 4.6 years. Anal incontinence was reported by 97 (38.0%) women. A scar or defect was seen only in the proximal part of the EAS in 64 (25.1%) women and only in the distal part in 19 (7.5%) (P < 0.001). In 165 (64.7%) women, the damage affected both the proximal and distal EAS.
CONCLUSIONS
EAS scars after primary OASI repair commonly affect the entire length of the EAS; however, partial tears seem to be more likely to occur proximally. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
Topics: Adult; Anal Canal; Cicatrix; Delivery, Obstetric; Fecal Incontinence; Female; Humans; Pregnancy; Retrospective Studies; Single-Blind Method; Tomography, X-Ray Computed; Ultrasonography; Vulva
PubMed: 34170050
DOI: 10.1002/uog.23719 -
Indian Journal of Plastic Surgery :... Feb 2023The axial vessels like the anterior and posterior tibial emerge as the first choice of recipient vessels, in free flaps for lower limb trauma. When the defects are...
The axial vessels like the anterior and posterior tibial emerge as the first choice of recipient vessels, in free flaps for lower limb trauma. When the defects are located more proximally in the leg, the deeper course of the axial vessels makes the dissection more tedious. Alternative vessels like the descending genicular, medial genicular, and distal end of the descending branch of the lateral circumflex femoral can be used for an end-to-end anastomosis, well away from the zone of trauma. The objective of this study was to define the indications and technique of the use of the sural vessels as the recipient pedicle for proximal and middle third leg defects. For the period 2006 to 2022, 18 leg defects following road traffic accidents were covered with latissimus dorsi muscle flap using sural vessels as the recipient pedicle. Among 18 patients, 8 patients had defect in proximal third, 8 had a combined defect in proximal and middle third leg, and 2 had defect in middle third leg. Two patients developed arterial thrombosis and one patient had venous thrombosis for which re-exploration was performed. Two flaps were lost and sixteen had successful wound coverage. The sural vessels as recipient pedicle are easier to access and can be considered as a reliable option for free flaps in limb defects of proximal and middle third leg. Using the submuscular part of the vessel ensures a better distal reach of the flap.
PubMed: 36998928
DOI: 10.1055/s-0042-1760094 -
Journal of Anatomy Aug 2021Morphological variation in the hominoid capitate has been linked to differences in habitual locomotor activity due to its importance in movement and load transfer at the...
Morphological variation in the hominoid capitate has been linked to differences in habitual locomotor activity due to its importance in movement and load transfer at the midcarpal joint proximally and carpometacarpal joints distally. Although the shape of bones and their articulations are linked to joint mobility, the internal structure of bones has been shown experimentally to reflect, at least in part, the loading direction and magnitude experienced by the bone. To date, it is uncertain whether locomotor differences among hominoids are reflected in the bone microarchitecture of the capitate. Here, we apply a whole-bone methodology to quantify the cortical and trabecular architecture (separately and combined) of the capitate across bipedal (modern Homo sapiens), knuckle-walking (Pan paniscus, Pan troglodytes, Gorilla sp.), and suspensory (Pongo sp.) hominoids (n = 69). It is hypothesized that variation in bone microarchitecture will differentiate these locomotor groups, reflecting differences in habitual postures and presumed loading force and direction. Additionally, it is hypothesized that trabecular and cortical architecture in the proximal and distal regions, as a result of being part of mechanically divergent joints proximally and distally, will differ across these portions of the capitate. Results indicate that the capitate of knuckle-walking and suspensory hominoids is differentiated from bipedal Homo primarily by significantly thicker distal cortical bone. Knuckle-walking taxa are further differentiated from suspensory and bipedal taxa by more isotropic trabeculae in the proximal capitate. An allometric analysis indicates that size is not a significant determinate of bone variation across hominoids, although sexual dimorphism may influence some parameters within Gorilla. Results suggest that internal trabecular and cortical bone is subjected to different forces and functional adaptation responses across the capitate (and possibly other short bones). Additionally, while separating trabecular and cortical bone is normal protocol of current whole-bone methodologies, this study shows that when applied to carpals, removing or studying the cortical bone separately potentially obfuscates functionally relevant signals in bone structure.
Topics: Animals; Anisotropy; Biometry; Cancellous Bone; Capitate Bone; Cortical Bone; Hominidae; Humans; X-Ray Microtomography
PubMed: 33942895
DOI: 10.1111/joa.13437 -
Medicina (Kaunas, Lithuania) Feb 2023: Proximal humerus fractures (PHFs) are common in the elderly, but the treatment results are often poor. A clear understanding of fracture morphology and distribution of...
: Proximal humerus fractures (PHFs) are common in the elderly, but the treatment results are often poor. A clear understanding of fracture morphology and distribution of cortical bone loss is important for improved surgical decision making, operative considerations, and new implant designs. The aim of this study was to develop a 3D segmentation fracture mapping technique to create a statistical description of the spatial pattern and cortical bone loss of complex PHFs. : Fifty clinical computed tomography (CT) scans of complex PHFs and their contralateral intact shoulders were collected. In-house software was developed for semi-automated segmentation and fracture line detection and was combined with manual fracture reduction to the contralateral template in a commercial software. A statistical mean model of these cases was built and used to describe probability maps of the fracture lines and cortical fragments. : The fracture lines predominantly passed through the surgical neck and between the tuberosities and tendon insertions. The superior aspects of the tuberosities were constant fragments where comminution was less likely. Some fracture lines passed through the bicipital sulcus, but predominantly at its edges and curving around the tuberosities proximally and distally. : A comprehensive and systematic approach was developed for processing clinical CT images of complex fractures into fracture morphology and fragment probability maps and applied on PHFs. This information creates an important basis for better understanding of fracture morphology that could be utilized in future studies for surgical training and implant design.
Topics: Humans; Aged; Fracture Fixation, Internal; Shoulder Fractures; Tomography, X-Ray Computed; Treatment Outcome; Fractures, Comminuted; Bone Diseases, Metabolic
PubMed: 36837571
DOI: 10.3390/medicina59020370 -
World Journal of Orthopedics Nov 2020Scaphoid fractures, particularly those that occur more proximally, are unreliable in achieving union due to the retrograde blood supply of the scaphoid bone. Vascular... (Review)
Review
Scaphoid fractures, particularly those that occur more proximally, are unreliable in achieving union due to the retrograde blood supply of the scaphoid bone. Vascular compromise is associated with the development of nonunions and avascular necrosis of the proximal pole. Due to the tenuous blood supply of the scaphoid, it is imperative that the vascularity be assessed when creating diagnostic and treatment strategies. Early detection of vascular compromise imaging may signal impending nonunion and allow clinicians to perform interventions that aid in restoring perfusion to the scaphoid. Vascular compromise in the scaphoid presents a diagnostic challenge, in part due to the non-specific findings on plain radiographs and computed tomography. Magnetic resonance imaging techniques have dramatically improved our ability to assess the blood supply to the scaphoid and improve time to intervention. This review aims to summarize these advances and highlights the importance of imaging in assessing vascular compromise in scaphoid nonunion and in reperfusion following surgical intervention.
PubMed: 33269213
DOI: 10.5312/wjo.v11.i11.475