Laboratory-Reported Normal Value Ranges Should Not Be Used to Diagnose Periprosthetic Joint Infection.

Introduction: Clinical laboratories offer several multipurpose tests, such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which are not intended to diagnose any specific disease but are used by clinicians in multiple fields. The results and laboratory interpretation (normal/abnormal) of these multipurpose tests are based on laboratory-reported normal thresholds, which vary across clinical laboratories. In 2018, the International Consensus Meeting on Musculoskeletal Infection (2018 ICM) provided a gold-standard definition to diagnose periprosthetic joint infection (PJI) which included many multipurpose laboratory tests, along with thresholds optimized to diagnose PJI.

Isolated Large Glenoid Fracture in Acute Glenohumeral Dislocation in the Elderly: A Novel Indication for Reverse Shoulder Arthroplasty.

Case: Two elderly males presented with traumatic shoulder dislocation and bony Bankart fracture consisting of greater than 25% of the glenoid width. Due to several concomitant factors such as polytrauma, activity level, rotator cuff pathology, optimization of comorbidities, risk of complications, and potential for revision surgery, the patients were treated with reverse shoulder arthroplasty (RSA).

Conclusion: RSA may be a satisfactory treatment option for isolated, large glenoid fractures associated with anterior glenohumeral instability in the elderly.

Choledochal Malformations: Surgical Implications of Radiologic Findings.

Objective: The purpose of this article is to review the relevant pathophysiologic features, appearances, and surgical implications of choledochal malformations.

Conclusion: Choledochal malformations, colloquially called choledochal cysts, initially described in 1723, have been recategorized multiple times, the most widely accepted being the Todani classification based on morphologic features and location. Although readily applied to imaging findings, this classification system does not correlate well with clinical and surgical management.

hUBC9 associates with MEKK1 and type I TNF-alpha receptor and stimulates NFkappaB activity.

hUBC9, an E2 ubiquitin conjugating enzyme, was identified by yeast two-hybrid screening and coprecipitation studies to interact with MEKK1 and the type I TNF-alpha receptor, respectively. Because both of these proteins regulate NFkappaB activity, the role of hUBC9 in modulating NFkappaB activity was investigated. Overexpression of hUBC9 in HeLa cells stimulated the activity of NFkappaB as determined by NFkappaB reporter and IL-6 secretion assays.