Authors: Abdulaziz Almaawi, Fahad S AlAbdullatif, Abdullah H AlOmar...

Background Various studies have described the restoration of the neutral mechanical alignment of the lower limb in total knee replacement (TKR) as a key factor of knee implant durability. Mechanical alignment of the knee requires that the tibial and femoral cuts are perpendicular to the mechanical axis of each bone in the coronal plane. Objectives The aim of this study is to investigate mechanical knee alignment and the prevalence of constitutional varus knee among the Saudi population at a single tertiary center with no history of musculoskeletal abnormalities. Methodology This is a retrospective cross-sectional study involving patients with no musculoskeletal abnormality who had their lower limb X-ray Centigram using the universal viewer zero footprint system made between 2015 and 2021. The study took place at King Saud University Medical City. The X-rays were obtained from patients' electronic medical records retrospectively. A total of 728 knees of 370 males and 358 females were included in this study. Results The results showed that 165 male knees (44.4%) and 218 female knees (60%) had constitutional varus alignment with the hip-knee-ankle (HKA) angle of ≤3° or less. The average HKA angle was smaller in males than in females: -3.69° versus -1.98°, respectively. Conclusion We have identified variables and factors that can help surgeons detect the constitutional varus on a full leg radiograph preoperatively at the time of TKA, regardless of the osteoarthritic changes of the knee. We encourage the scientific community to look for causes and risk factors for developing constitutional varus.

PubMed: 37575843
DOI: 10.7759/cureus.41753

Authors: Abdulaziz Ajlan M Al Salloom

Intracystic papillary carcinoma (IPC) in men is an extremely rare disease that accounts for less than 1% of all malignancies with only a few case presentations published so far. This report presents a case of 53-year-old male, who presented a painless swelling of his left breast. The left breast mass was 6 cm maximally and was found to be non-invasive IPC. The tumour is consistently positive for GCDFP-15, ER or PR and negative for HER-2. It consists of predominantly fibrovascular stromal lined by monotonous epithelial cells retaining intermediate to high histological grade with a high nuclear cytoplasmic ratio. In addition, increased numbers of mitotic figures were also seen. Chest X-ray, liver ultrasound and bone centigram showed no evidence of distant metastases. In short, this is the first case report from Saudi Arabia of a male having IPC, with increased number of mitotic figures and high nuclear grades.

PubMed: 26435954
DOI: 10.7860/JCDR/2015/13909.6299

Authors: L L Matz, T C Beaman, P Gerhardt...

Homogeneous fragments of exosporium were extricated in centigram amounts from dormant spores of Bacillus cereus and analyzed for intrinsic constituents. The membrane proved to be chemically complex but not unique, consisting mainly of protein (52%), amino and neutral polysaccharides (20%), lipids (18%), and ash (4%). Seventeen common amino acids were identified by chromatography, and were present in usual proportions except for low levels of cystine-cysteine, methionine, tyrosine, and histidine. Glucosamine was the only amino sugar, and glucose and rhamnose were the principal neutral sugars. The lipid fraction contained 5.5% cardiolipin as the only phospholipid, 12.5% neutral lipids, and at least 19 fatty acids, among which normal C(16) and C(18) ones predominated. Calcium and phosphorus occurred in the ash. Small amounts of teichoic, ribonucleic, and dipicolinic acids were believed to represent contamination.

Topics: Amino Acids; Bacillus cereus; Calcium; Cell Membrane; Chemical Phenomena; Chemistry; Chromatography; Cysteine; Cystine; Fatty Acids; Histidine; Lipids; Methionine; Phospholipids; Phosphorus; Polysaccharides; Proteins; Spores; Tyrosine

PubMed: 4983648
DOI: 10.1128/jb.101.1.196-201.1970