Robot-Assisted Total Knee Arthroplasty Does Not Improve Long-Term Clinical and Radiologic Outcomes

BackgroundWhether robot-assisted total knee arthroplasty (TKA) improves the accuracy of radiographic alignment leading to improved patient satisfaction and implant survivorship in the long term has thus far been inconclusive.MethodsWe retrospectively compared the long-term clinical and radiological outcomes of 84 knees that had undergone robot-assisted TKA using ROBODOC vs 79 knees that had undergone conventional TKA. The mean duration of the follow-up period was 129.1 months (range: 108-147 months). Clinical outcomes were evaluated using the Knee Society Score and 36-item Short Form Survey, as well as by assessing the range of motion, operation time, and complications. Radiologic outcomes were evaluated by assessing the hip-knee-ankle angle, coronal and sagittal alignments of the femoral and tibial components, and any radiologic abnormalities such as loosening or osteolysis.ResultsThere was no significant difference in clinical outcomes between the two groups. The prevalence of an outlier for the hip-knee-ankle angle in the robot-assisted group was 10.7%, whereas it was 16.5% in the conventional group (P = .172). The other component alignments (α°, β°, γ°, δ°) revealed a tendency toward a lower rate of outliers in the robot-assisted group, but without statistical significance (P > .05). In addition, there was no significant difference in complications, including revision surgery, between both groups.ConclusionRobot-assisted TKA does not improve long-term clinical or radiologic outcomes compared with conventional TKA.     

Schizonepeta tenuifolia inhibits collagen stimulated platelet function via suppressing MAPK and Akt signaling

The prevalence of cardiovascular diseases (CVDs) is increasing at a rapid pace in developed countries, and CVDs are the leading cause of morbidity and mortality. Natural products and ethnomedicine have been shown to reduce the risk of CVDs. Schizonepeta (S.) tenuifolia is a medicinal plant widely used in China, Korea, and Japan and is known to exhibit anti-inflammatory, antioxidant, and immunomodulatory activities. We hypothesized that given herbal plant exhibit pharmacological activities against CVDs, we specifically explored its effects on platelet function. Platelet aggregation was evaluated using standard light transmission aggregometry. Intracellular calcium mobilization was assessed using Fura-2/AM, and granule secretion (ATP release) was measured in a luminometer. Fibrinogen binding to integrin α_Ⅱbβ₃, was assessed using flow cytometry. Phosphorylation of mitogen-activated protein kinase (MAPK) signaling molecules and activation of the protein kinase B (Akt) was assessed using Western blot assays. S. tenuifolia, extract potently and significantly inhibited platelet aggregation, calcium mobilization, granule secretion, and fibrinogen binding to integrin α_Ⅱbβ₃. Moreover, all extracts significantly inhibited MAPK and Akt phosphorylation. S. tenuifolia extract inhibited platelet aggregation and granule secretion, and attenuated collagen mediated GPVI downstream signaling, indicating the potential therapeutic effects of these plant extracts on the cardiovascular system and platelet function. We suggest that S. tenuifolia extract may be a potent candidate to treat platelet-related CVDs and to be used as an antiplatelet and antithrombotic agent.     

Intra-arterial thrombectomy for acute ischaemic stroke patients with active cancer

Journal of Neurology - This study aimed to evaluate the efficacy of intra-arterial thrombectomy (IAT) and prognosis for acute ischaemic stroke patients with active cancer. We retrospectively...     

Mass mortality in Korean bay scallop (Argopecten irradians) associated with Ostreid Herpesvirus‐1 μVar

Since November 2017, mass mortalities of larvae of bay scallop (Argopecten irradians) were reported in hatcheries located at the southern area of Republic of Korea. Over 90% of larvae aged 5–10 days sank to the bottom of the tank and died. The hatcheries could not produce spat, and thus artificial seed production industry incurred huge losses. We identified Ostreid Herpesvirus‐1 μVar (OsHV‐1 μVar) associated with mass mortality by PCR, sequencing and transmission electron microscopy (TEM). All the samples were positive for OsHV‐1 μVar with 99% sequence identity to previously reported OsHV‐1 μVar sequences. Partial sequence of ORF‐4 of OsHV‐1 detected in this study was more closely related to sequences isolated from Europe. This is the first report to confirm the mortality caused by an OsHV‐1 infection in the bay scallop.     

Novel Predictive Models of Early Death Less Than 1 Year in Patients With Metastatic Renal Cell Carcinoma After Treatment With First-line Tyrosine Kinase Inhibitors

BackgroundWe aimed to develop a modified International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model that can predict early death less than 1 year in patients with metastatic renal cell carcinoma (mRCC) after receiving first-line tyrosine kinase inhibitors (TKIs).Patients and MethodsWe retrospectively reviewed records of patients with mRCC treated with first-line TKIs at our institution between 2007 and 2012. The primary endpoint was the rate of early death within 1 year after first-line TKI administration. We determined statistically significant factors predicting early death by performing multiple logistic regression. The modified IMDC model 1 was developed using new variables in addition to the risk criteria of the IMDC model, and model 2 was developed using new variables irrespective of the risk classification of IMDC model.ResultsEarly mortality within 1 year of first-line TKI treatment was 19.7% (n = 98) in 462 patients. Although the C-index of the IMDC model for early death was 0.655, the C-index of model 1, which includes 5 variables (previous nephrectomy, body mass index, multiple metastases, previous metastasectomy, and serum albumin level) in addition to the Heng criteria, was 0.823. The C-index of model 2, which includes 7 variables (hemoglobin, neutrophil level, and the 5 variables of model 1) was 0.822. Of note, there was no significant difference in net reclassification index between the 2 models.ConclusionThis is the first study suggesting novel prediction models for early death less than 1 year in patients with mRCC treated with first-line TKI.     

Predicting neo‐adjuvant chemotherapy response and progression‐free survival of locally advanced breast cancer using textural features of intratumoral heterogeneity on F‐18 FDG PET/CT and diffusion‐weighted MR imaging

Predicting response to neo‐adjuvant chemotherapy (NAC) and survival in locally advanced breast cancer (LABC) is important. This study investigated the prognostic value of tumor heterogeneity evaluated with textural analysis through F‐18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and diffusion‐weighted imaging (DWI). We enrolled 83 patients with LABC who had completed NAC and curative surgery. Tumor texture indices from pretreatment FDG PET and DWI were extracted from histogram analysis and 7 different parent matrices: co‐occurrence matrix, the voxel‐alignment matrix, neighborhood intensity difference matrix, intensity size‐zone matrix (ISZM), normalized gray‐level co‐occurrence matrix (NGLCM), neighboring gray‐level dependence matrix (NGLDM), and texture spectrum matrix. The predictive values of textural features were tested regarding both pathologic NAC response and progression‐free survival. Among 83 patients, 46 were pathologic responders, while 37 were nonresponders. The PET texture indices from 7 parent matrices, DWI texture indices from histogram, and 1 parent matrix (NGLCM) showed significant differences according to NAC response. On multivariable analysis, number nonuniformity of PET extracted from the NGLDM was an independent predictor of pathologic response (P = .009). During a median follow‐up period of 17.3 months, 14 patients experienced recurrence. High‐intensity zone emphasis (HIZE) and high‐intensity short‐zone emphasis (HISZE) from PET extracted from ISZM were significant textural predictors (P = .011 and P = .033). On Cox regression analysis, only HIZE was a significant predictor of recurrence (P = .027), while HISZE showed borderline significance (P = .107). Tumor texture indices are useful for NAC response prediction in LABC. Moreover, PET texture indices can help to predict disease recurrence.