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Sagittal computed tomography evaluation of osteochondritis dissecans of the capitellum correlates with clinical outcomes of arthroscopic debridement in adolescent baseball players
Get PDFObjectives: To investigate the relationship between the size and location of osteochondral defects in capitellar osteochondritis dissecans (OCD) measured on coronal and sagittal reconstructed computed tomography (CT) images and the clinical outcomes of arthroscopic debridement in adolescent baseball players.
Methods: This retrospective study investigated the clinical outcomes of arthroscopic debridement for capitellar OCD in adolescent baseball players with ≥24 months of follow-up after surgery between 2008 and 2020. On preoperative coronal CT images, medial and lateral distance (%) were used to evaluate the location of the defect. Defect size (%) was also evaluated. On preoperative sagittal CT images, superior and inferior angles (deg) were used to evaluate the location of the defect. The size of the defect was evaluated using the defect angle (deg). Outcome measures were determined using the Timmerman–Andrews score at the latest follow-up. Spearman’s rank correlation coefficient was used to examine relationships between these parameters and the Timmerman–Andrews score. Statistical significance was set at p < 0.05.
Results: Thirty players [mean age, 14 (range, 11–16) years] underwent arthroscopic debridement: 5 were pitchers, 7 were catchers, 13 were infielders, and 5 were outfielders. Mean follow-up duration was 26 (range, 24–66) months. The median Timmerman–Andrews score at the latest follow-up was 193 [interquartile range (IQR), 181–200] points. Inferior angle showed statistically significant positive correlations with Timmerman–Andrews score (rs = 0.520, p < 0.01), pain (rs = 0.478, p < 0.01), and sagittal arc of motion (rs = 0.409, p = 0.025). Defect angle showed statistically significant negative correlations with Timmerman–Andrews score (rs = −0.462, p = 0.010) and flexion contracture (rs = -0.424, p = 0.020). Medial distance, lateral distance, defect size, and superior angle were not correlated with the Timmerman–Andrews score or any of its subscores.
Conclusion: Posterior or large osteochondral defects of the humeral capitellum on preoperative sagittal CT images affected the outcomes of arthroscopic debridement for capitellar OCD in adolescent baseball players.
Level of evidence: Level V, case series.journal articl
Online training program maintains motor functions and quality of life in patients with Parkinson’s disease
Get PDFObjective: Several systematic reviews have shown that physical exercise positively affects motor function (MF) and quality of life (QoL) in patients with Parkinson’s disease (PD). After the coronavirus disease (COVID-19) pandemic, numerous studies were conducted to reveal the effects of telerehabilitation for patients with PD. However, only a few empirical results of online programs for PD patients have been reported. Therefore, this study aimed to determine the effects of an online physical and cognitive training program on MF and QoL in patients with PD.
Methods: We evaluated the impact of our online program on the QoL and MF of patients with PD by comparing data at baseline and after six months of intervention. For the QoL assessment, we used the Schwab and England Activities of Daily Living scale and Parkinson’s Disease Questionnaire (PDQ-39), whereas, for MF, we measured movement status using the modified 20-m walk test and timed up-and-go (TUG) test.
Results: We enrolled 20 patients for QoL and 19 for MF in this study. For PDQ- 39, social support (p = 0.046, δ = 0.320) and cognitions (p = 0.028, δ = 0.268) significantly improved. Additionally, cadence (p = 0.032, g = −0.377) in the modified 20-m walk and exam duration (p = 0.003, δ = 0.296) and forward gait (p = 0.003, δ = 0.341) in the TUG test showed significant differences before and after the intervention.
Conclusion: Our results suggest that online physical and cognitive training programs positively affect MF and QoL in individuals with PD.doctoral thesi
MR Imaging Findings of Uterine Adenomatoid Tumors
Get PDFPurpose: Adenomatoid tumor is a rare benign genital tract neoplasm of mesothelial origin. Uterine adenomatoid tumors occur in the outer myometrium and may mimic leiomyomas. Because hormonal treatment is not applicable to adenomatoid tumors and laparoscopic enucleation is not easy as myomectomy, it is important to differentiate adenomatoid tumors from leiomyomas for the adequate treatment. The purpose of this study is to evaluate the MRI findings of adenomatoid tumor for the differentiation from leiomyoma.
Methods: MRI findings of surgically proven 10 uterine adenomatoid tumors in 9 women were retrospectively evaluated with correlation to histopathological findings.
Results: All 10 tumors appeared as solid myometrial masses and showed heterogeneous signal intensity with admixture of partially ill-defined slight high-intensity areas containing abundant tubular tumor cells and well-defined myoma-like low-intensity areas reflecting smooth muscle hypertrophy on T2WI including 4 lesions with peripheral ring-like high intensity. High-intensity areas on T2WI tended to show high intensity on diffusion-weighted imaging (DWI) with relatively high apparent diffusion coefficient (ADC), suggesting T2 shine-through effect due to abundant tubules. Intra-tumoral hemorrhage revealed on MRI was rare. Early intense contrast-enhanced areas on dynamic contrast-enhanced study were observed dominantly within the high-intensity areas but rarely within the low-intensity areas on T2WI.
Conclusion: The outer myometrial mass with the admixture of well-defined low- and ill-defined high-intensity areas on T2WI may be suggestive of adenomatoid tumor. Peripheral ring-like high intensity on T2WI and DWI may also be suggestive. Dynamic contrast-enhanced MR study may be helpful for the differentiation from leiomyoma.journal articl
Anticancer approach by targeted activation of a global inhibitor of sialyltransferases with acrolein
Get PDFCells are covered with a thick layer of sugar molecules known as glycans. Abnormal glycosylation is a hallmark of cancer, and hypersialylation increases tumor metastasis by promoting immune evasion and inducing tumor cell invasion and migration. Inhibiting sialylation is thus a potential anticancer treatment strategy. However, targeting sialic acids is difficult because of the lack of selective delivery tools. Here, we present a prodrug strategy for selectively releasing the global inhibitor of sialylation peracetylated 3Fax-Neu5Ac (PFN) in cancer cells using the reaction between phenyl azide and endogenous acrolein, which is overproduced in most cancer cells. The prodrug significantly suppressed tumor growth in mice as effectively as PFN without causing kidney dysfunction, which is associated with PFN. The use of sialylated glycans as immune checkpoints is gaining increasing attention, and the proposed method for precisely targeting aberrant sialylation provides a novel avenue for expanding current cancer treatments.journal articl
The Utility of Urinary Titin to Diagnose and Predict the Prognosis of Acute Myocardial Infarction
Get PDFEarly detection and management are crucial for better prognosis in acute myocardial infarction (AMI). Serum titin, a component of the sarcomere in cardiac and skeletal muscle, was associated with AMI. Thus, we hypothesized that urinary N-fragment titin may be a biomarker for its diagnosis and prognosis. Between January 2021 and November 2021, we prospectively enrolled 83 patients with suspected AMI. Their urinary N-fragment titin, serum high-sensitivity troponin I (hsTnI), creatine kinase (CK), and creatine kinase-MB (CK-MB) were measured on admission. Then, urinary titin was assessed as diagnostic and prognostic biomarker in AMI. Among 83 enrolled patients, 51 patients were diagnosed as AMI. In AMI patients who were admitted as early as 3 h or longer after symptom onset, their urinary titin levels were significantly higher than non-AMI patients who are also admitted 3 h or longer after symptom onset (12.76 [IQR 5.87–16.68] pmol/mgCr (creatinine) and 5.13 [IQR 3.93–11.25] pmol/mgCr, p = 0.045, respectively). Moreover, the urinary titin levels in patients who died during hospitalization were incredibly higher than in those who were discharged (15.90 [IQR 13.46–22.61] pmol/mgCr and 4.90 [IQR 3.55–11.95] pmol/mgCr, p = 0.023). Urinary N-fragment titin can be used as non-invasive early diagnostic biomarker in AMI. Furthermore, it associates with hospital discharge disposition, providing prognostic utility.journal articl
Combination treatment with hyaluronic acid synthesis and Bcl-2 inhibitors induces senolytic elimination of oral squamous cell carcinoma cells in vitro
Get PDFObjective: Hyaluronic acid (HA) is a major glycosaminoglycan in the extracellular matrix and plays a vital role in cancer progression. HA interacts with cell membrane receptors, such as receptor for HA-mediated motility (RHAMM), to regulate the cell cycle and cell division. 4-Methylumbelliferone (4-MU) is a well-known HA synthesis inhibitor and a promising cancer therapy alternative. 4-MU is a coumarin derivative with no obvious side effects and has been studied in several cancers. However, little is known about its use in oral squamous cell carcinoma (OSCC). In this study, we evaluated the antitumor effects of 4-MU on OSCC cells.
Methods: The effects of 4-MU on HAS gene and HA-related protein expression were evaluated with RT-qPCR and Western blotting. The effects on HA secretion was confirmed by ELISA. The effects on cell proliferation were confirmed by MTS assay. Trypan blue exclusion assay was used for cell viability assay. Cell cycle analysis, cell-clock cell cycle assay, and apoptosis assay were used to determine the effects on cell cycle and apoptosis. SA-β-gal staining was used to evaluate senescence.
Results: 4-MU induced senescence change in OSCC cells by overexpression of the anti-apoptotic protein Bcl-2 and markedly suppressed their proliferation. Furthermore, following administration of Bcl-2 inhibitor, ABT-263 known as a senescent cell eliminator can specifically induce apoptosis and eliminate the senescent OSCC cells.
Conclusions: These findings highlight the potential use of 4-MU in OSCC chemotherapy as a senescence-inducing agent that not only potently suppresses OSCC cell proliferation but also enhances the efficacy of Bcl-2 inhibitor.doctoral thesi
Pulmonary pressure-flow responses to exercise in heart failure treated with angiotensin receptor neprilysin inhibitor
Get PDFBackground: The role of the angiotensin receptor neprilysin inhibitor (ARNI) in cardiac function, particularly its impact on pulmonary circulation, remains underexplored. Recent studies have described abnormal mean pulmonary artery pressure (mPAP)-cardiac output (CO) responses as having the potential to assess the disease state. The aim of this study was to assess the effects of ARNI on pulmonary circulation in heart failure. We measured echocardiographic parameters post 6-minute walk (6MW) and compared the changes with baseline and follow-up. Our hypothesis was that pulmonary pressure-flow relationship of the pulmonary circulation obtained by 6MW stress echocardiography would be improved with treatment.
Methods: We prospectively enrolled 39 heart failure patients and conducted the 6MW test indoors. Post-6MW echocardiography measured echocardiographic variables, and CO was derived from electric cardiometry. Individualized ARNI doses were optimized, with follow-up echocardiographic evaluations after 1 year.
Results: Left ventricular (LV) volume were significantly reduced (160.7±49.6ml vs 136.0±54.3ml, P<0.001), and LV ejection fraction was significantly improved (37.6±11.3% vs 44.9±11.5%, P<0.001). Among the 31 patients who underwent 6MW stress echocardiographic study at baseline and 1 year later, 6MW distance increased after treatment (380m vs 430m, P=0.003). The ΔmPAP/ΔCO by 6MW stress decreased with treatment (6.9mmHg/L/min vs 2.8mmHg/L/min, P=0.002). The left atrial volume index was associated with the response group receiving ARNI treatment for pulmonary circulation.
Conclusions: Initiation of ARNI was associated with improvement of left ventricular size and LVEF. Additionally, the 6MW distance increased and the ΔmPAP/ΔCO was improved to within normal range with treatment.journal articl
Twist angle dependence of graphene-stacked junction characteristics
Get PDFVertically stacked graphene diodes are fabricated using epitaxially grown graphene with twist angles ranging from 0° to 30°. Their switching behavior and negative differential conductance are observed at all the measured angles. The junction conductance in the initial state does not indicate clear angle dependence and is almost constant, i.e., 231 μS for all devices. The junction conductance in the high-bias region exhibits a steep peak at 12°. The on/off ratio of the stacked junction diode indicates a maximum value of 142 at 12°. Therefore, the fabricated stacked graphene device with a simple structure exhibits strong nonlinear electrical properties and negative differential conductance at all twist angles. The on/off ratio of the stacked junction diodes is controlled by the twist angle between two single-crystal graphene layers.journal articl