A 55-year-old man was admitted for ongoing gross hematuria and bladder tamponade. Computed tomography revealed a mass near the right sidewall of the bladder, along with massive blood clots. The ...patient was diagnosed as having bladder cancer based on laboratory findings and emergency clinical symptoms. Thus, emergency transurethral resection of the bladder tumor was performed. Pathological examination revealed an inflammatory myofibroblastic tumor (IMT). No tumor progression was observed during the 6-month follow-up period. Owing to its rarity, IMT has not been well characterized clinically and radiologically, and thus, it is very difficult to diagnose IMT accurately without pathological examinations.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background:
Autologous osteochondral mosaicplasty (ie, mosaicplasty) results in satisfactory clinical outcomes and reliable return to play for patients with large or unstable lesions due to ...osteochondritis dissecans (OCD) of the humeral capitellum. However, the association between the healing of the reconstructed cartilage and clinical outcomes remains unclear.
Purpose:
To evaluate the efficacy of mosaicplasty in teenage athletes through use of clinical scores and imaging. The secondary purpose was to compare the clinical outcomes with images of centrally and laterally located lesions.
Study Design:
Case series; Level of evidence, 4.
Methods:
This study analyzed 22 elbows (all male patients; mean age, 13.5 ± 1.2 years) with capitellar OCD managed with mosaicplasty. Patients were divided into 2 groups according to the location of the lesions: central (10 patients) and lateral (12 patients). Evaluation was performed through use of the clinical rating system of Timmerman and Andrews, plain radiographs, and magnetic resonance imaging (MRI; the cartilage repair monitoring system of Roberts). The mean follow-up period was 27.5 months (range, 24-48 months).
Results:
Lateral lesions were significantly larger than central lesions (147.1 ± 51.9 mm2 vs 95.5 ± 27.4 mm2, P = .01). No other significant differences were found between central and lateral lesions. Timmerman and Andrews scores for both central and lateral lesions improved significantly from 125.0 ± 30.1 points and 138.3 ± 34.5 points preoperatively to 193.5 ± 11.3 points and 186.7 ± 18.1 points, respectively, at final follow-up (P < .0001, P < .0001). Radiography identified complete graft incorporation in all cases and the absence of severe osteoarthritic changes or displaced osteochondral fragments. In the lateral group, the radial head ratio at final follow-up (1.83 ± 0.23) was significantly larger than the preoperative findings (1.75 ± 0.14, P = .049). The quality of joint surface reconstruction was found to be acceptable for central and lateral lesions on MRI evaluation.
Conclusion:
Mosaicplasty resulted in satisfactory clinical outcomes and smooth cartilage surface integrity in teenage athletes with OCD on their return to competition-level sports activities irrespective of lesion location.
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FSPLJ, NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Abstract
We aimed to clarify the effects of morphological patterns of the trapezium and first metacarpal on the distribution of subchondral bone density across the articular surface of the ...trapeziometacarpal (TMC) joint using computed tomography osteoabsorptiometry. Thirty-three patients with normal TMC joints were evaluated. The percentages of the high-density areas in the radial-dorsal and ulnar-volar regions of the trapezium were significantly higher than that in the ulnar-dorsal region, and that of the ulnar-dorsal region of the first metacarpal was significantly lower than in the other three regions. The percentage of the high-density area of the radial-dorsal region of the trapezium and trapezial inclination (TI) showed a significant positive correlation, and the percentages of the high-density areas in the ulnar-dorsal and ulnar-volar regions had significant negative correlations with TI at the articular surface of the first metacarpal. These results indicate that bony morphologic differences in the trapezium affect the distribution pattern of subchondral bone density through the TMC joint.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The M-type phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A (THSD7A) were identified as intrinsic antigens in primary membranous nephropathy (MN). Complement ...activation via the lectin pathway in intrinsic antigen-related MN is still unclear.
We retrospectively enrolled 60 primary Japanese MN patients and detected activated complement pathways by staining complement proteins in glomerular deposition. According to the findings of PLA2R and THSD7A staining in glomeruli, they were classified into intrinsic antigen-related or -unrelated MN. We evaluated clinicopathological characteristics and predictors of clinical outcomes in intrinsic antigen-related MN.
Thirty-nine (65%) patients had PLA2R in glomerular deposits and two (3.3%) patients had THSD7A. One of them had both PLA2R and THSD7A (double positive). Forty patients were classified into the intrinsic antigen-related group. The other 20 patients were negative for both antigens (unrelated group). The prevalence and staining intensity of mannose-binding lectin (MBL) deposits were much higher in the intrinsic antigen-related group 55% versus 20%, P < 0.010, 1.0 (interquartile range 1.0-2.0) versus 1.0 (0.0-1.0), P = 0.01, respectively. The staining intensity of MBL in glomeruli also correlated with the IgG4 staining intensity. In intrinsic antigen-related MN, MBL staining intensity was an unfavorable predictor for remission of proteinuria hazard ratio (HR) 0.40, P < 0.01 and renal dysfunction (HR 3.81, P = 0.01) in Cox proportional hazards analysis. Moreover, the glomerular MBL-positive group showed more severe interstitial fibrosis and worse clinical outcomes.
Intrinsic antigen-related MN was more strongly associated with complement activation by the lectin pathway, which may contribute to a less favorable clinical outcome.
The aim of this study was to evaluate the joint contact area of the dominant side and that of the non-dominant side without valgus instability in symptomatic pitchers. Ten symptomatic elbow medial ...ulnar collateral ligament (UCL) deficient baseball pitchers participated in this study. Computed tomography (CT) data from the dominant and non-dominant elbows were obtained with and without elbow valgus stress. The CT imaging data of each elbow joint were reconstructed using a 3D reconstruction software package, and the radiocapitellar and ulnohumeral joint contact areas were calculated. The center of the contact area and the translation from the position without stress to the position with valgus stress were also calculated. With elbow valgus stress, the contact area changed, and the center of the radiocapitellar joint contact area translated significantly more laterally in the dominant elbow than in the non-dominant elbow (p = 0.0361). In addition, the center of the ulnohumeral joint contact area translated significantly more posteriorly in the dominant elbow than in the non-dominant elbow (p = 0.0413). These changes in contact areas could be the reason for cartilage injury at the posterior trochlea in pitchers with UCL deficiency.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Elucidating the taste sensing systems in chickens will enhance our understanding of poultry nutrition and improve the feeding strategies used in poultry farming. It is known that chickens lack the ...sweet taste receptor subunit, taste receptor type 1 member 2 (T1R2), in their genome. Thus, the present study investigated T1R2-independent sweet-sensing pathways in chickens. RT-PCR analysis revealed that glucose transporters known to play an important role in T1R2-independent sweet sensing in mammals—namely sodium-glucose cotransporter 1 (SGLT1) and ATP-gated K+ channel subunits—are expressed in the palate, the main taste organ in chickens. In behavioral tests, chickens slightly preferred glucose, galactose, sucrose, maltose, lactose, and stevioside, while high doses of sucrose and fructose were rejected. Chickens did not show any preference for noncaloric sweeteners or sugar alcohol, such as acesulfame K, aspartame, saccharin, sucralose, or sorbitol. The preference for galactose was inhibited by an inhibitor of SGLT1 in a dose-dependent manner. In addition, we found that glucagon-like peptide 1 (GLP-1) and mRNA of the GLP-1 receptor, which are involved specifically in sweet transmission in mice, are also present in the oral tissues of chickens. The present results imply that chickens can sense various sweet compounds via T1R2-independent pathways in oral tissues.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Light Detection and Ranging (LiDAR) is a widespread technique for 3D ranging and has widespread use in most automated systems that must interact with the external environment, for instance in ...industrial and security applications. In this work, we study a novel architecture for Single Photon Avalanche Diode (SPAD) arrays suitable for handheld single point rangefinders, which is aimed at the identification of the objects' position in the presence of strong ambient background illumination. The system will be developed for an industrial environment, and the array targets a distance range of about 1 m and a precision of few centimeters. Since the laser spot illuminates only a small portion of the array, while all pixels are exposed to background illumination, we propose and validate through Monte Carlo simulations a novel architecture for the identification of the pixels illuminated by the laser spot to perform an adaptive laser spot tracking and a smart sharing of the timing electronics, thus significantly improving the accuracy of the distance measurement. Such a novel architecture represents a robust and effective approach to develop SPAD arrays for industrial applications with extremely high background illumination.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
A 72-year-old man presented with severe pulmonary contusions and multiple traumas, including aortic injury, pelvic fracture, and renal injury. The patient required multidisciplinary treatment, ...including transcatheter arterial embolization, thoracic endovascular aortic repair, right lung upper lobe partial resection, and massive transfusion. During the initial treatment, the patient experienced respiratory failure due to endotracheal bleeding, and we attempted isolated lung ventilation with a 37 Fr double-lumen endotracheal intubation tube. Although drainage by suction and protection of the healthy lung was vital, the patient was unable to maintain ventilation volume because of poor drainage. Additionally, the respiratory status deteriorated. To resolve the situation, a tracheotomy was performed and two endotracheal intubation tubes (6.0 mm inner diameter, and 9.0 mm outer diameter) were inserted through a large U-shaped tracheal hole 18 hours after admission. The respiratory status of the patient gradually improved after the procedure. There were two advantages of this method of respiratory management. Firstly, each of the two endotracheal tubes had a separate cuff, allowing more reliable separation of the healthy lung from the injured lung. Secondly, bronchoscopes of sufficient diameter (4.9 mm outer diameter ) were used bilaterally, allowing sufficient drainage of viscous airway secretions mixed with hematoma and improving atelectasis. Although venovenous extracorporeal membrane oxygenation is a crucial support tool when the respiratory status deteriorates due to severe pulmonary contusions, our method of airway management may be attempted in patients with multiple traumatic injuries with coagulopathy.
Let b ≥ 2 and n ≥ 2 be integers. For a b-adic n-digit integer x, let A (resp. B) be the b-adic n-digit integer obtained by rearranging the numbers of all digits of x in descending (resp. ascending) ...order. Then, we define the Kaprekar transformation T ( b , n ) ( x ) : = A - B . If T ( b , n ) ( x ) = x , then x is called a b-adicn-digit Kaprekar constant. Moreover, we say that a b-adic n-digit Kaprekar constant x is regular when the numbers of all digits of x are distinct. In this article, we obtain some formulas for regular and non-regular Kaprekar constants, respectively. As an application of these formulas, we then see that for any integer b ≥ 2 , the number of b-adic odd-digit regular Kaprekar constants is greater than or equal to the number of all non-trivial divisors of b. Kaprekar constants have the symmetric property that they are fixed points for recursive number theoretical functions T ( b , n ) .
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Recently, three-dimensional (3D) planning, patient-specific instruments, and navigation system have been developed to improve the accuracy of baseplate placement in reverse shoulder arthroplasty ...(RSA). The purpose of this study was to evaluate baseplate placement using the navigation system. Sixty-four shoulders in 63 patients who underwent RSA for rotator cuff tear arthropathy or irreparable rotator cuff tears were enrolled. Conventional RSA was performed in 31 shoulders and navigated RSA using pre-operative planning software was performed in 33 shoulders. The use of augmented baseplates, the version and inclination of the baseplate, and screw length were compared between conventional RSA and navigated RSA. Augmented baseplates were used more frequently in navigated RSA than in conventional RSA (20 vs 9 shoulders, p = 0.014). Baseplate alignment was 1.0° (SD 5.1) of retroversion and 2.4° (SD 6.8) of superior inclination in conventional RSA and 0.2° (SD 1.9) of anteversion and 0.3° (SD 1.7) of superior inclination in navigated RSA. Compared with conventional RSA, precision of baseplate version and inclination were higher in navigated RSA (both p < 0.001). Superior, inferior, and posteroinferior screws were significantly longer in navigated RSA than in conventional RSA (p = 0.021, 0.001 and < 0.001, respectively). Precision of superior and inferior screw lengths was significantly higher in navigated RSA than in conventional RSA (both p = 0.001). Our results suggest that adoption of pre-operative planning software increased augmented baseplate use to minimize the glenoid reaming. The navigation system allows placement of the baseplate accurately, according to the pre-operative plan. Furthermore, the navigation system enables monitoring of screw length and direction in real time.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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