Clinical and Radiographic Outcomes of Total Hip Arthroplasty With a Specific Liner in Small Asian Patients: Influence of Patient-Related,Implant-Related,and Surgical Factors on Femoral Head Penetration

Background

We evaluated the clinical and radiographic outcomes, including femoral head penetration, of total hip arthroplasty performed using a specific polyethylene (PE) liner in small Asian patients at 10 years after the index surgery. In addition, we investigated whether femoral head penetration was affected by patient-related, implant-related, and surgical factors.

Surgical treatment of coarctation of the aorta concomitant with left main coronary stenosis; report of a case

A 60-year-old male was referred to our institution for investigation of intractable hypertension. Coarctation of the aorta was detected by computed tomography (CT). Bilateral internal thoracic arteries played an important role as a collateral source to the lower extremity. Coronary angiography showed stenosis at the ostium of left main trunk. Ascending aorta to bilateral external iliac artery bypass grafting and off-pump coronary artery bypass grafting (OPCAB) was done simultaneously, this is because we had to harvest left internal thoracic artery as a conduit for coronary artery bypass grafting(CABG).Postoperative course was uneventful. The patient was discharged 10 days after the operation. We could perform less-invasive surgery despite the simultaneous operations.     

Relationships between nasal obstruction, observed apnea, and daytime sleepiness.

OBJECTIVE: We administered a questionnaire survey to a working population in an attempt to clarify the relationships between self-reported nasal obstruction, observed apnea during sleep, and daytime sleepiness. STUDY DESIGN: A total of 7980 daytime workers were asked to complete questionnaires about nasal obstruction, apnea during sleep, and daytime sleepiness. Of the 7702 responses, the data from 4818 subjects were analyzed. Nasal obstruction and observed apnea were graded into 3 categories. Daytime sleepiness was assessed by the Epworth Sleepiness Scale. RESULTS: Subjects with chronic nasal obstruction had 5.22 and 2.17 times higher odds for having habitual observed apnea and excessive daytime sleepiness (EDS), respectively, compared with those without nasal obstruction (P < 0.001). After adjusting for 3 potential confounding factors (age, sex, and body mass index) and the presence of habitual observed apnea, odds ratios for having EDS decreased, but still remained significant. CONCLUSION: Nasal obstruction is likely to cause daytime sleepiness, at least in part, by causing sleep-disordered breathing including apnea during sleep.     

Hsl7p, a negative regulator of Ste20p protein kinase in the Saccharomyces cerevisiae filamentous growth-signaling pathway

In the budding yeast, Saccharomyces cerevisiae, protein kinases Ste20p (p21(Cdc42p/Rac)-activated kinase), Ste11p [mitogen-activated protein kinase (MAPK) kinase kinase], Ste7p (MAPK kinase), Fus3p, and Kss1p (MAPKs) are utilized for haploid mating, invasive growth, and diploid filamentous growth. Members of the highly conserved Ste20p/p65(PAK) protein kinase family regulate MAPK signal transduction pathways from yeast to man. We describe here a potent negative regulator of Ste20p in the yeast filamentous growth-signaling pathway. We identified a mutant, hsl7, that exhibits filamentous growth on rich medium. Hsl7p belongs to a highly conserved protein family in eukaryotes. Hsl7p associates with the noncatalytic region within the amino-terminal half of Ste20p as well as Cdc42p. Deletions of HSL7 in haploid and diploid strains led to cell elongation and enhancement of both haploid invasive growth and diploid pseudohyphal growth. However, deletions of STE20 in haploid and diploid greatly diminished these hsl7-associated phenotypes. In addition, overexpression of HSL7 inhibited pseudohyphal growth. Thus, Hsl7p may inhibit the activity of Ste20p in the S. cerevisiae filamentous growth-signaling pathway. Our genetic analyses suggest the possibility that Cdc42p and Hsl7p compete for binding to Ste20p for pseudohyphal development when starved for nitrogen.     

Pronounced antibody elevation after SARS‐CoV‐2 BNT162b2 mRNA booster vaccination in nursing home residents

BackgroundInfection control during COVID‐19 outbreaks in nursing facilities is a critical public health issue. Antibody responses before and after the third (booster) dose of SARS‐CoV‐2 vaccination in nursing home residents have not been fully characterized.MethodsThis study included 117 individuals: 54 nursing home residents (mean age, 83.8 years; 39 SARS‐CoV‐2‐naive and 15 previously infected) and 63 healthcare workers (mean age, 45.8 years; 32 SARS‐CoV‐2‐naive and 31 previously infected). Anti‐spike (receptor‐binding domain [RBD]) and anti‐nucleocapsid antibody responses to BNT162b2 mRNA vaccination and their related factors were evaluated using pre‐ (shortly and 6 months after the second dose) and post‐booster vaccination samples.ResultsThe median anti‐spike (RBD) IgG level in SARS‐CoV‐2‐naive residents 6 months after the second dose was the lowest among the four groups, with a decreasing rate of over 90%. The median rate of increase before and after the third dose in SARS‐CoV‐2‐naive residents was significantly higher than that in SARS‐CoV‐2‐naive healthcare workers (64.1‐ vs. 37.0‐fold, P = 0.003), with the highest level among the groups. The IgG ratio of SARS‐CoV‐2‐naive residents to healthcare workers after the second and third doses changed from one‐fifth (20%) to one‐half (50%). The rate of increase after the third dose in previously infected individuals was three‐ to fourfold, regardless of residents or healthcare workers.ConclusionsAdvanced aged nursing home residents, poor responders in the initial SARS‐CoV‐2 vaccine series, could obtain sufficient antibody responses with the additional booster dose, despite more than 6 months after the second.     

Evaluation of quality of life in patients with allergic rhinitis

Nasal symptoms of allergic rhinitis, such as watery rhinorrhea, sneezing and nasal obstruction, are thought to result in reduction in quality of life (QOL). In this study, we evaluated the QOL scores of patients suffering from allergic rhinitis, using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and the Short Form-36 (SF-36). One hundred twenty six patients with allergic rhinitis who visited the department of otolaryngology of UOEH and affiliated hospitals from April, 2003 to March, 2004 were enrolled in this study. Each symptom of allergic rhinitis was shown to degrade the RQLQ scores. In particular, nasal obstruction and severity of the disease strongly related to the RQLQ scores. All the SF-36 scores of allergic rhinitis patients were lower than those of standard Japanese. Nasal obstruction was severer, and ocular symptoms were milder in the perennial group than in the seasonal group. The QOL scores of emotional aspects were significantly different between generations. The QOL score of social functioning increased, and that of mental health decreased with age. These results clearly indicate that nasal symptoms of allergic rhinitis cause degradation of QOL in daily and social lives. It would be interesting and necessary to evaluate QOL disturbance and loss of working efficiency in workers with allergic rhinitis in further studies.     

Should gastric cancer patients more than 80 years of age undergo surgery? Comparison with patients not treated surgically concerning prognosis and quality of life

This study investigated the performance status, mental status, and prognosis of 24 patients older than 80 years whose gastric cancer had been managed surgically during the past 6 years, and 21 patients who were observed conservatively. The advantages and disadvantages of surgery for elderly patients with gastric cancer is discussed. The 3-year survival rate for patients with advanced gastric cancer was 31% for those surgically treated and 0% for those observed conservatively. The difference is statistically significant. The survival rate for patients with early gastric cancer was 62.5% in the surgical treatment group and 33.3% in the conservative observation group, a difference that is not significant. Decline in performance status and deterioration of mental status after open surgery were slight, and the survival rate for patients treated surgically was significantly higher than for conservatively observed patients, regardless of performance status and whether mental status had deteriorated. On univariate and multivariate analyses, the presence or absence of open surgery and macroscopic classification were the only significant prognostic factors, whereas performance status and the presence or absence of mental deterioration were not significant prognostic factors. These results suggest that surgical treatment should not be discouraged even for patients older than 80 years.     

Zinc transporters ZnT3 and ZnT6 are downregulated in the spinal cords of patients with sporadic amyotrophic lateral sclerosis

The loss of homeostasis of essential metals is associated with various diseases, including neurodegenerative diseases. Previous studies have shown that the levels of zinc (Zn) are significantly higher in the cerebrospinal fluid of patients with amyotrophic lateral sclerosis (ALS). Zn transporters and metallothioneins tightly control intracellular and extracellular Zn levels. This study investigated the protein levels of ZnT, a Zn transporter family, in ALS patients and model mice. The mRNA expression of ZnT1, −3, −4, −5, −6, −7, and −10 was assessed in the spinal cords of human control subjects. ZnT3 and ZnT6 protein levels were significantly diminished in the spinal cords of sporadic ALS patients compared with controls. Furthermore, immunohistochemical staining demonstrated decreased ZnT3 and ZnT6 immunoreactivity in the ventral horn of the spinal cords in ALS patients. Moreover, immunohistochemical analysis revealed that all ZnTs expressed in the spinal cords were localized in a distinct subset of motor neurons. In addition, ZnT3 and ZnT6 protein levels were not altered in SOD1 (G93A) mutant transgenic mice before or after the onset of ALS symptoms compared with controls. These results suggest that ZnT3 and ZnT6 protein levels are decreased in the spinal cords of sporadic ALS patients; however, this did not occur merely via loss of motor neurons. © 2014 Wiley Periodicals, Inc.