Self-reported outcomes are associated with knee strength and functional symmetry in individuals who have undergone anterior cruciate ligament reconstruction with hamstring tendon autograft

Background

The aim of this study was to investigate the relationship between self-reported knee outcomes and limb symmetry indices (LSIs) for hip and knee strength, postural control and single-leg hop distance in individuals who had undergone an anterior cruciate ligament (ACL) reconstruction via hamstring tendon autograft (HTG).

Endothelial,platelet, and macrophage microparticle levels do not change acutely following transcatheter aortic valve replacement

Background

Patients with severe aortic stenosis have increased levels of prothrombotic and proinflammatory microparticles (MP), and MPs actively regulate pathological processes that lead to atherothrombotic cardiovascular events. Shear stress is a validated stimulus of MP production, and abnormal shear stress in aortic stenosis increases MP release in ex-vivo studies. We hypothesized that in patients with severe aortic stenosis, percutaneous replacement of the aortic valve (TAVR) would reduce abnormal shear stress and would decrease levels of circulating MPs.

Findings

The experimental protocol utilized flow cytometry (FC) and nanoparticle tracking analysis (NTA) to quantify circulating plasma MP levels in aortic stenosis patients at baseline and 5 days after TAVR. The baseline and 5 day MP counts measured by FC were 6.10?10⁵?±?1.21?10⁵ MP/μL and 5.74?10⁵?±?9.54?10⁴ MP/μL, respectively (p?=?0.91). The baseline and 5 day MP counts measured by NTA were 9.29?10¹³?±?1.66?10¹³ MP/μL and 3.95?10¹⁴?±?3.11?10¹⁴ MP/μL, respectively (p?=?0.91). When MPs were stratified by cell source, there was no difference in pre/post TAVR endothelial, platelet, or leukocyte MP levels.

Conclusion

Levels of circulating MPs do not change acutely following TAVR therapy for aortic stenosis.Trial registered at clinicaltrials.gov NCT02193035 on July 11, 2014.

     

Single-leg vertical jump test as a functional test after anterior cruciate ligament reconstruction

Background

The aim of this study was to identify the correlations between the single-leg vertical jump (SLVJ) test and subjective and objective tests which were used widely for determining return-to-sports (RTS) after anterior cruciate ligament reconstruction (ACLR).

Histopathological changes in the infrapatellar fat pad in an experimental rabbit model of early patellofemoral osteoarthritis

Background

The purpose of this study was to characterise the histopathological changes in the infrapatellar fat pad (IPFP) in the early stage of patellofemoral osteoarthritis (PFOA).

Middle patellar tendon to posterior cruciate ligament (PT–PCL) and normalized PT–PCL: New magnetic resonance indices for tibial tubercle position in patients with patellar instability

Background

To demonstrate whether the distance between the middle point of the patellar tendon and posterior cruciate ligament (PT–PCL) calculated on a single axial MR image could be an alternative measure to tibial tubercle–PCL (TT–PCL) distance for TT lateralization without the need of imaging processing. To show that normalization of PT–PCL (nPT-PCL) against the maximum diameter of the tibial plateau may help to identify patients with patellar instability (PI).

The role of meniscal tears and meniscectomy in the mechanical stability of the anterior cruciate ligament deficient knee

Background

The role of an intact meniscus in providing mechanical stability to the knee of anterior cruciate ligament (ACL) deficient and ACL reconstructed patients has not been well studied.

Topical ocular dexamethasone decreases intraocular pressure and body weight in rats

Background

Recently, topical dexamethasone-induced ocular hypertension and a consequent loss of retinal ganglion cells (RGCs) have been described in mice. This has been proposed as a model of steroid-induced glaucoma. In this study, we set up and evaluated a similar model in rats.

Results

Ten-week old Sprague Dawley (SD) rats (N?=?12) were used to evaluate the effect of topical 0.1 % dexamethasone (50 μl) administered 3 times daily for 4 weeks. Sodium chloride (0.9 %) was used in another group of rats (N?=?12) that served as the controls. After 1 week, we observed a progressive decrease in body weight in the dexamethasone-treated rats compared both to the pre-treatment baseline and the vehicle-treated rats. In contrast to earlier work that showed elevated Intraocular pressure (IOP) following dexamethasone instillation in mice, IOP in the rats unexpectedly fell to 11.3?±?1.3 mmHg in the treated eyes, compared to 14.8?±?2.4 mmHg in the untreated eyes, after 3 weeks of topical dexamethasone (P?=?0.032). Blood tests performed after 4 weeks of treatment showed a 3.3-fold increase in both plasma cholesterol (P?<?0.001) and alanine transaminase (P?=?0.019) in the dexamethasone-treated rats compared to the control rats. Meanwhile, topical steroid did not induce changes in either plasma blood glucose or glycated hemoglobin (HbA1c). We also did not detect changes in the expression of RGC markers (with real-time PCR) following the treatment.

Conclusions

In contrast to mice, which previously showed increased IOP following the topical administration of dexamethasone, the rats displayed a paradoxical reduction in IOP following a similar treatment. This was accompanied by a loss of body weight without affecting the level of blood glucose.

     

Evaluation of hepatic markers and body weight gain in growing and finishing steers

Background

The liver plays an important role in nutrient metabolism, in detoxification and excretion of hydrophobic metabolites, and in the synthesis of most circulating proteins. Thus, enhanced knowledge of the processes that regulate liver function in beef cattle production stages can lead to significant improvements in their management.

Aims

The authors studied the levels of some serum liver parameters during growing and finishing stages of steers.

Methods

Blood samples were collected from (n?=?60) steers at day 1 and at day 21 and 42 days after the start of the growing (group 1 n?=?30: mean body weight (BW) 430?±?5.8 Kg) or finishing (group 2 n?=?30: mean BW 591?±?5.3 Kg) phases. Steers from both groups were separated into two subgroups (A and B, respectively) according to the percentage of body weight gain (%WG). Subgroup A steers had a lower mean %WG than subgroup B steers. Serum total proteins (TP), albumin, globulins, serum urea nitrogen (SUN), total and conjugated bilirubin (TB, CB), aspartate amino transferase (AST), and gamma-glutamyltransferase (GGT) were assessed in order to evaluate significant differences between groups and subgroups.

Results

All parameters showed significant differences between the phases and between groups with the exception of AST and GGT. Mean?±?S.D. of %WG was 11.07?±?1.95 for group 1 and 9.84?±?0.77 % for group 2. For group 1 steers, there was a significant difference on SUN concentration and GGT activity between subgroup A and subgroup B.

Conclusions

These findings suggest that hepatic markers in steers are influenced by production stages and improve the knowledge about the effect of growing and finishing phases on their hepatic markers. Furthermore, it underlies the importance of monitoring body weight gain in order to obtain a maximizing profitability.

     

Screw oversizing for anterior cruciate ligament graft fixation in primary and enlarged tibial tunnels: A biomechanical study in a porcine model

Background

Ideal diameter for tibial interference screw fixation of the anterior cruciate ligament (ACL) graft remains controversial. Tibial graft fixation with screws matching the tunnel diameter vs. one-millimetre oversized screws were compared.

MRI assessment of aortic flow in patients with pulmonary arterial hypertension in response to exercise

Background

While primarily a right heart disease, pulmonary arterial hypertension (PAH) can impact left heart function and aortic flow through a shifted interventricular septum from right ventricular pressure overload and reduced left ventricular preload, among other mechanisms. In this study, we used phase contrast (PC) MRI and a modest exercise challenge to examine the effects of PAH on systemic circulation. While exercise challenges are typically performed with ultrasound in the clinic, MRI exercise studies allow for more reproducible image alignment, more accurate flow quantification, and improved tissue contrast.

Methods

Six PAH patients and fifteen healthy controls (8 older age-matched, 7 younger) exercised in the magnet bore with an MRI-compatible exercise device that allowed for scanning immediately following cessation of exercise. PC scans were performed in the ascending aorta during a breath hold immediately after modest exercise to non-invasively measure stroke volume (SV), cardiac output (CO), aortic peak systolic flow (PSF), and aortic wall stiffness via relative area change (RAC).

Results

Images following exercise showed mild blurring, but were high enough quality to allow for segmentation of the aorta. While SV was approximately 30% lower in PAH patients (SV_PAH,rest?=?67?±?16?mL; SV_PAH,stress?=?90?±?42?mL) than age-matched controls (SV_,older,rest?=?93?±?16?mL; SV_older,stress?=?133?±?40?mL) at both rest and following exercise, CO was similar for both groups following exercise (CO_PAH,stress?=?10.8?±?5.7?L/min; CO_older,stress?=?11.8?±?5.0?L/min). This was achieved through a compensatory increase in heart rate in the PAH subjects (74% increase as compared to 29% in age-matched controls). The PAH subjects also demonstrated reduced aortic peak systolic flow relative to the healthy controls (PSF_PAH,_rest?=?309?±?52?mL/s; PSF_older,_rest?=?416?±?114?mL/s; PSF_PAH,_stress?=?388?±?113?mL/s; PSF_older,_stress?=?462?±?176?mL/s). PAH patients and older controls demonstrated stiffer aortic walls when compared to younger controls (RAC_PAH,rest?=?0.15?±?0.05; RAC_older,rest?=?0.17?±?0.05; RAC_young,rest?=?0.28?±?0.08).

Conclusions

PC MRI following a modest exercise challenge was capable of detecting differences in left heart dynamics likely induced from PAH. These results demonstrated that PAH can have a significant influence on systemic flow, even when the patient has no prior left heart disease. Image quantification following exercise could likely be improved in future studies through the implementation of free-breathing or real-time MRI acquisitions.

Trial registration

Retrospectively registered on 02/26/2018 (TRN:NCT03523910).

     

The association of urinary interferon-gamma inducible protein-10 (IP10/CXCL10) levels with kidney allograft rejection

Background

Interferon-gamma inducible protein-10 (IP-10/CXCL10) is a chemokine involved in the alloimmune response against kidney allograft. We aimed to investigate the association of urinary CXCL10 protein levels with rejection in renal transplant patients.

Methods

A total of 273 urine samples from (biopsy-proven) rejection and non-rejection patients and controls were included in this study. CXCL10 levels were analyzed for association with rejection.

Results

The data showed statistically significant differences in the CXCL10 levels between rejection vs. non-rejection (p?<?0.001). Among the rejection groups, statistically significant differences for CXCL10 levels were found between ACR vs. NAD (p?<?0.001), ACR vs. BLR (p?=?0.019) and AVR vs. NAD (p?=?0.009). Receiver Operating Characteristic (ROC) curve analysis of CXCL10 showed an area under the curve (AUC) of 0.74 with 72% sensitivity and 71% specificity at 27.5 pg/ml between rejection and non-rejection group. Kaplan–Meier curve analysis among different levels of CXCL10 showed a better rejection-free graft survival in patients with <100 pg/ml when compared to >200 pg/ml (38?±?6 vs. 12?±?1.0 weeks; log-rank p?<?0.001) and 100–200 pg/ml (38?±?6 vs. 22?±?9 weeks; log-rank p?=?0.442) concentration.

Conclusion

The results indicate significantly increased levels of CXCL10 protein in the urine at the time of allograft rejection. This association of urinary CXCL10 protein levels with rejection could provide an additional tool for the non-invasive monitoring of allograft rejection.

     

Body Image in Patients with Systemic Lupus Erythematosus

Background

Systemic lupus erythematosus (SLE), a multisystemic disease of young women may be disfiguring and affect physical and emotional health. Body image literature in SLE is scant and controversial.

Purpose

We compared body image-related quality of life in subjects with (n?=?87) and without (n?=?78) SLE and determined its correlates using the body image quality of life inventory (BIQLI).

Method

The tool was self-administered to consenting individuals. Demographic information along with disease activity and damage assessments for SLE patients were obtained. T test, chi square test, correlational, and regression analyses were used to make comparisons.

Results

Mean age (±SD) were 42.4?±?13.1 and 38.7?±?13.2?years for SLE and non-SLE subjects, respectively. Mean (±SD) BIQLI scores were significantly worse in SLE than non-SLE subjects: 19.9?±?33.2 and 41.6?±?24.8 (p?=?0.001). In SLE, BIQLI scores correlated inversely with overall damage, irreversible cutaneous damage, alopecia, and self-reported depression, and directly with age and health status.

Conclusion

Body image in SLE is poor, and effective interventions may be directed at cutaneous disease activity, damage, and depression.     

Electroacupuncture at the ST36 acupoint increases interleukin-4 responsiveness in macrophages, generation of alternatively activated macrophages and susceptibility to Leishmania major infection

Background

Electroacupuncture (EA) has been used to treat inflammatory diseases. Alternatively activated macrophages (AAMo) stimulated by cytokines such as interleukin (IL)-4, IL-10 and IL-13 are anti-inflammatory and mildly microbicidal. This study aimed to evaluate whether EA at the Zusanli acupoint (ST36) would change the profile of healthy murine macrophages, particularly the generation of AAMo and susceptibility to Leishmania major infection.

Methods

BALB/c mice were treated with EA (15/30?Hz) at the ST36 acupoint for 20?min/d for 5 d. After the final EA session, the mice were euthanized and their peritoneal cells were harvested and counted for determination of arginase activity, nitric oxide (NO) production and microbicidal activity after culture in the presence or absence of IL-4, interferon-?? (IFN??) or lipopolysaccharide (LPS) or both IFN?? and LPS. Twelve mice were infected with L. major promastigotes into the footpads after the final EA session and the infection course was monitored.

Results

Peritoneal cells freshly obtained from EA-treated mice had similar arginase and microbicidal activities to cells from sham-treated mice. After culture with IL-4, cells from EA-treated mice exhibited significant increases in the arginase activity (sham: 58?±?11.3 vs. EA: 80.7?±?4.6%, P?=?0.025) and number of parasites/infected cell (sham: 2.5?±?0.4 vs. EA: 4.3?±?0.8 cells, P?=?0.007). The NO production was lower in cells from EA-treated mice cultured in the presence of a combination of IFN?? and LPS (sham: 31.6?±?6.5 vs. EA: 22.3?±?2.1???M, P?=?0.025). The lesion size in mice infected with L. major promastigotes was larger in EA-treated mice (sham: 3.26?±?0.29 vs. EA: 2.23?±?0.4?mm, P?=?0.039).

Conclusion

EA at the ST36 acupoint increases IL-4 responsiveness in macrophages, Generation of AAMo and susceptibility to L. major infection     

Radial scars/complex sclerosing lesions of the breast: radiologic and clinicopathologic correlation

Background

We investigated the radiologic and clinical findings of radial scar and complex sclerosing lesions, and evaluated the rate of pathologic upgrade and predicting factors.

Methods

From review of our institution’s database from January 2006 to December 2012, we enrolled 82 radial scars/complex sclerosing lesions in 80 women; 51 by ultrasound guided core needle biopsy, 1 by mammography-guided stereotactic biopsy, and 38 by surgical excision. The initial biopsy pathology revealed that 53 lesions were without high risk lesions and 29 were with high risk lesions. Radiologic, clinical and pathological results were analyzed statistically and upgrade rates were calculated.

Results

Of the 82 lesions, 64 (78.0%) were surgically excised. After surgical excision, two were upgraded to DCIS and two were upgraded to lesions with high risk lesions. The rate of radial scar with high risk lesions was significantly higher in the surgical excision group (11.1% vs. 42.2%, p?=?0.015), which also demonstrated larger lesion size (10.7?±?6.5 vs. 7.1?±?2.6 mm, p?=?0.001). The diagnoses with high risk lesions on final pathological results showed older age (52.9?±?6.0 years vs. 48.4?±?6.7 years, p?=?0.018).

Conclusions

Radial scars with and without high risk lesions showed no statistically significant differences in imaging, and gave relatively low cancer upgrade rates.

     

Asthma and Hypogammaglobulinemia: an Asthma Phenotype with Low Type 2 Inflammation

Purpose

Little is known about hypogammaglobulinemia (HGG) in asthma patients. No data are available on the characteristics of adult patients with asthma and HGG.

Methods

We conducted a retrospective monocentric study between January 2006 and December 2012. Asthma patients with a serum immunoglobulin (Ig) quantitative analysis were included and classified into two groups depending on their serum IgG concentration: presence or absence of HGG. Clinical, biological, functional, and radiologic characteristics were compared in univariate and multivariate analysis, using a logistic regression model.

Results

In univariate analysis, asthma patients with HGG (n?=?25) were older (58 years old?±?18 vs 49?±?18, p?=?0.04) and more frequently active or former smokers as compared to patients with normoglobulinemia (n?=?80) (56.0 vs 35.0 %, p?=?0.01). Total IgE?<?30 kUI/L was more frequently observed in patients with HGG (53.0 vs 18.3 %, p?=?0.01). HGG asthma patients had lower fraction of exhaled nitric oxide (p?=?0.02), blood eosinophilia (p?=?0.0009), and presented with more severe composite score for bronchiectasis (p?=?0.01). In multivariate analysis, asthma patients with HGG had increased risk of being smokers [OR?=?6.11 (IC 95 %?=?1.16–32.04)], having total IgE concentration?<?30 kUI/L [OR?=?12.87 (IC 95 %?=?2.30–72.15)], and a more severe composite score of bronchiectasis [OR?=?20.65 (IC 95 %?=?2.13–199.74)].

Conclusion

Asthma patients with HGG are older and more often tobacco smoker than asthma patients without HGG. These patients have low type-2 inflammation markers.

     

前稳定型垫片在全膝关节置换术中的早期临床研究

目的探讨全膝关节置换术(TKA)中应用前稳定型(AS)垫片的临床效果。方法 2018年1月至2018年12月选取北京大学人民医院收治的107例终末期骨性关节炎行全膝关节置换患者,术中采用邦美公司提供的后交叉韧带保留型(CR)Vanguard膝关节假体,其中使用AS垫片组45例,CR垫片组62例。统计全部患者的手术时间,术后伤口引流量,感染并发症,术前、术后膝关节活动度和膝关节协会评分,比较AS垫片组和CR垫片组之间的差异。结果全部病例均获得随访,随访时间为12~24个月,平均(20.3±2.8)个月。术前AS垫片组、CR垫片组膝关节活动度分别为平均90.2°±17.4°、92.7°±18.6°,术后末次随访时AS垫片组、CR垫片组分别为平均108.5°±22.3°、110.6°±19.3°。膝关节协会评分术前AS垫片组为临床评分(50±15)分、功能评分(52±21)分,CR垫片组为临床评分(49±13)分,功能评分(52±19)分;术后末次随访时AS垫片组临床评分(80±16)分、功能评分(82±20)分;CR垫片组临床评分(82±15)分、功能评分(83±22)分。上述各评价指标、手术时间、术后伤口引流量两组间差异均无统计学意义。所有病例均未出现感染并发症。结论 TKA术中应用AS垫片术后早期膝关节活动度、膝关节协会评分结果良好,与CR垫片相比较效果相当。     

2D/3D CMR tissue tracking versus CMR tagging in the assessment of spontaneous T2DM rhesus monkeys with isolated diastolic dysfunction

Background

Spontaneous T2DM in rhesus monkeys manifests as isolated diastolic dysfunction in the early stage of diabetic cardiomyopathy, similar to humans. Myocardial deformation measurements have emerged as a superior way to measure left ventricular (LV) function in the early stage of cardiac dysfunction, making it possible to further evaluate early-stage LV dysfunction in spontaneous T2DM rhesus monkeys.

Methods

Spontaneous T2DM rhesus monkeys with isolated diastolic dysfunction (T2DM-DD, n?=?10) and corresponding nondiabetic healthy animals (ND, n?=?9) were prospectively scanned for a CMR study. Circumferential and longitudinal peak systolic strain (Ecc, Ell), time to peak strain (tEcc, tEll) and peak diastolic strain rate (CSR, LSR) obtained from 2D/3D CMR-TT were compared with those obtained from CMR tagging separately. In addition, all CMR imaging protocols were performed twice in 9 ND animals to assess test-retest reproducibility.

Results

Compared with the ND group, the T2DM-DD monkeys demonstrated significantly impaired LV Ecc (??10.63?±?3.23 vs ??14.18?±?3.19, p?<?0.05), CSR (65.50?±?14.48 vs 65.50?±?14.48, p?<?0.01), Ell (??9.11?±?2.59 vs ??14.17?±?1.68, p?<?0.05), and LSR (59.43?±?19.17 vs 108.46?±?22.33, p?<?0.01) with the tagging. Only Ecc (??13.10?±?2.47 vs ??19.03?±?3.69, p?<?0.01) and CSR (148.90?±?31.27 vs 202.00?±?51.88, p?<?0.01) were significantly reduced with 2D CMR-TT, and only Ecc (??13.77?±?1.98 vs ??17.26?±?3.78, p?<?0.05) was significantly reduced with 3D CMR-TT. Moreover, 2D/3D CMR-TT-derived Ecc and CSR correlated with the corresponding tagging values collectively, with a statistically significant ICC value (p?<?0.05). Test-retest repeatability analysis showed that most tagging-derived biomarkers had acceptable repeatability (p?<?0.01). In addition, 2D CMR-TT-derived indicators were poorer than those derived from the tagging method but better than those obtained using the 3D method, with larger ICCs except for tEcc (p?<?0.05).

Conclusions

LV systolic and diastolic deformations were impaired in spontaneous T2DM rhesus monkeys previously diagnosed with isolated diastolic dysfunction by echocardiography. The 2D CMR-TT-derived Ecc and CSR were effective in the evaluation of the myocardial systolic and diastolic functions of early-diabetic cardiomyopathy, with relatively higher test-retest reproducibility and acceptable correlation with the tagging method compared with the 3D CMR-TT method.

     

Ultrasound point shear wave elastography of the pancreas: comparison of patients with type 1 diabetes and healthy volunteers – results from a pilot study

Background

The aims of this study were to establish shear wave elastography of the pancreas by comparing measurements in patients with type 1 diabetes (T1D) and healthy volunteers and to consider whether this method could contribute to the screening or prevention of T1D.

Methods

This pilot study included 15 patients with T1D (10 men, 5 women) and 15 healthy volunteers (10 men, 5 women) as controls. Measurements were performed with a Siemens Acuson S3000 (Siemens Healthcare, Erlangen, Germany) using a 6C1 convex transducer and the Virtual Touch? tissue quantification (VTQ) method.

Results

The mean shear wave velocity of the head of the pancreas was 1.0?±?0.2?m/s (median: 1.1?m/s) for the study group and likewise 1.0?±?0.2?m/s (median: 0.9?m/s) for the control group. Velocities of 1.2?±?0.2?m/s (median: 1.2?m/s) were measured in the body of the pancreas in both groups. There was a significant difference between the values obtained in the tail of the pancreas: patients 1.1?±?0.1?m/s (median: 1.0?m/s) versus controls 0.9?±?0.1?m/s (median: 0.8?m/s) (p?=?0.0474). The mean value in the whole pancreas of the study group was not significantly above that of the control group: 1.1?±?0.1?m/s (median: 1.0?m/s) versus 1.0?±?0.1?m/s (median: 1.0?m/s) (p?=?0.2453).

Conclusions

Sonoelastography of the pancreas revealed no overall difference between patients with T1D and healthy volunteers. Patients with T1D showed higher values only in the tail segment. Future studies need to determine whether specific regional differences can be found in a larger study population.

     

The relationship between anteroposterior stability and medial–lateral stability of the bi-cruciate stabilized total knee arthroplasty

Background

Acquisition of appropriate anteroposterior (AP) stability depends on the prosthetic design and intraoperative soft tissue handling. A bi-cruciate stabilized (BCS) total knee arthroplasty (TKA) has a two cam-post mechanism, which substitutes for the anterior cruciate ligament and posterior cruciate ligament (PCL). Therefore, appropriate AP stability is expected. Because the PCL is sacrificed during BCS TKA, medial stability and lateral stability are thought to be important factors to determine AP stability. However, no previous study has reported AP stability after BCS TKA and the relationship between AP and medial–lateral stability.