Clinical decision-making for the management of foot deformities in children is primarily based upon the analysis of weight-bearing radiographs of the foot and ankle. However, a comprehensive quantitative technique for the analysis of such radiographs has not been described. Ten radiographic measurements were developed and applied to the foot and ankle radiographs of a normal foot and ankle in 60 children (mean age 10 years, range 5-17 years). Intraobserver variability and interobserver variability were determined for 10 cases. Mean values for the 10 measurements were calculated from the entire study group. Intraobserver variability was excellent, with correlation coefficients for the 10 measurements ranging from 0.89 to 0.99. The absolute value of the mean differences in angular measurements ranged from 0.8 to 2.5 degrees. Interobserver variability was also excellent, with correlation coefficients ranging from 0.86 to 0.99. The absolute value of the mean differences in angular measurements ranged from 0.5 to 3.2 degrees. The mean values, standard deviations, and ranges for the 10 radiographic parameters from the 60 normal feet have been determined. Clinically acceptable variability of 10 selected radiographic measurements of the foot and ankle was achieved, and normal values and ranges for these measurements were determined. Quantitative segmental analysis of foot and ankle alignment, using these 10 radiographic measurements, can be used to describe common malalignment patterns, and this may assist in clinical decision-making and assessment of outcome.
BackgroundMesenchymal stromal cells (MSC) hold promise for both cell replacement and immune modulation strategies owing to their progenitor and non-progenitor functions, respectively. Characterization of MSC from different sources is an important and necessary step before clinical use of these cells is widely adopted. Little is known about the biology and function of canine MSC compared to their mouse or human counterparts. This knowledge-gap impedes development of canine evidence-based MSC technologies.Hypothesis and ObjectivesWe hypothesized that canine adipose tissue (AT) and bone marrow (BM) MSC (derived from the same dogs) will have similar differentiation and immune modulatory profiles. Our objectives were to evaluate progenitor and non-progenitor functions as well as other characteristics of AT- and BM-MSC including 1) proliferation rate, 2) cell surface marker expression, 3) DNA methylation levels, 4) potential for trilineage differentiation towards osteogenic, adipogenic, and chondrogenic cell fates, and 5) immunomodulatory potency in vitro.Results1) AT-MSC proliferated at more than double the rate of BM-MSC (population doubling times in days) for passage (P) 2, AT: 1.69, BM: 3.81; P3, AT: 1.80, BM: 4.06; P4, AT: 2.37, BM: 5.34; P5, AT: 3.20, BM: 7.21). 2) Canine MSC, regardless of source, strongly expressed cell surface markers MHC I, CD29, CD44, and CD90, and were negative for MHC II and CD45. They also showed moderate expression of CD8 and CD73 and mild expression of CD14. Minor differences were found in expression of CD4 and CD34. 3) Global DNA methylation levels were significantly lower in BM-MSC compared to AT-MSC. 4) Little difference was found between AT- and BM-MSC in their potential for adipogenesis and osteogenesis. Chondrogenesis was poor to absent for both sources in spite of adding varying levels of bone-morphogenic protein to our standard transforming growth factor (TGF-β3)-based induction medium. 5) Immunomodulatory capacity was equal regardless of cell source when tested in mitogen-stimulated lymphocyte reactions. Priming of MSC with pro-inflammatory factors interferon-gamma and/or tumour necrosis factor did not increase the lymphocyte suppressive properties of the MSC compared to untreated MSC.Conclusions/SignificanceNo significant differences were found between AT- and BM-MSC with regard to their immunophenotype, progenitor, and non-progenitor functions. Both MSC populations showed strong adipogenic and osteogenic potential and poor chondrogenic potential. Both significantly suppressed stimulated peripheral blood mononuclear cells. The most significant differences found were the higher isolation success and proliferation rate of AT-MSC, which could be realized as notable benefits of their use over BM-MSC.
Results in 68 dogs and cats that underwent surgery within 24 hours of admission suggested that early surgical intervention for acute diaphragmatic hernia was associated with good perioperative survival rates.
There is a high incidence of unrecognized glove perforations in small animal surgery.
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