Background:
It is still debated whether a degenerative horizontal tear of the medial meniscus should be treated with surgery.
Hypothesis:
The clinical outcomes of arthroscopic meniscectomy will be ...better than those of nonoperative treatment for a degenerative horizontal tear of the medial meniscus.
Study Design:
Randomized controlled trial; Level of evidence, 1.
Methods:
A total of 102 patients with knee pain and a degenerative horizontal tear of the posterior horn of the medial meniscus on magnetic resonance imaging were included in this study between January 2007 and July 2009. The study included 81 female and 21 male patients with an average age of 53.8 years (range, 43-62 years). Fifty patients underwent arthroscopic meniscectomy (meniscectomy group), and 52 patients underwent nonoperative treatment with strengthening exercises (nonoperative group). Functional outcomes were compared using a visual analog scale (VAS) for pain, Lysholm knee score, Tegner activity scale, and patient subjective knee pain and satisfaction. Radiological evaluations were performed using the Kellgren-Lawrence classification to evaluate osteoarthritic changes.
Results:
In terms of clinical outcomes, meniscectomy did not provide better functional improvement than nonoperative treatment. At the final follow-up, the average VAS scores were 1.8 (range, 1-5) in the meniscectomy group and 1.7 (range, 1-4) in the nonoperative group (P = .675). The average Lysholm knee scores at 2-year follow-up were 83.2 (range, 52-100) and 84.3 (range, 58-100) in the meniscectomy and nonoperative groups, respectively (P = .237). In addition, the average Tegner activity scale and subjective satisfaction scores were not significantly different between the 2 groups. Although most patients initially had intense knee pain with mechanical symptoms, both groups reported a relief in knee pain, improved knee function, and a high level of satisfaction with treatment (P < .05 for all values). Two patients in the meniscectomy group and 3 in the nonoperative group with Kellgren-Lawrence grade 1 progressed to grade 2 at the 2-year follow-up.
Conclusion:
There were no significant differences between arthroscopic meniscectomy and nonoperative management with strengthening exercises in terms of relief in knee pain, improved knee function, or increased satisfaction in patients after 2 years of follow-up.
Global plastic use has increased rapidly, and environmental pollution associated with nanoplastics (NPs) has been a growing concern recently. However, the impact and biological mechanism of NPs on ...the cardiovascular system are not well characterized. This study aimed to assess the possibility that NPs exposure promotes premature endothelial cell (EC) senescence in porcine coronary artery ECs and, if so, to elucidate the underlying mechanism. Treatment of ECs with NPs promoted the acquisition of senescence markers, senescence-associated β-galactosidase activity, and p53, p21, and p16 protein expression, resulting in the inhibition of proliferation. In addition, NPs impaired endothelium-dependent vasorelaxation associated with decreased endothelial nitric oxide synthase (eNOS) expression. NPs enhanced reactive oxygen species formation in ECs, and increased oxidative stress levels were associated with the induction of NADPH oxidases expression, followed by the subsequent downregulation of Sirt1 expression. The characteristics of EC senescence and dysfunction caused by NPs are prevented by an antioxidant (N-acetylcysteine), an NADPH oxidase inhibitor (apocynin), and a Sirt1 activator (resveratrol). These findings indicate that NPs induced premature EC senescence, at least in part, through the redox-sensitive eNOS/Sirt1 signaling pathway. This study suggested the effects and underlying mechanism of NPs on the cardiovascular system, which may provide pharmacological targets to prevent NPs-associated cardiovascular diseases.
Purpose
The objectives of this study were to compare the clinical outcomes of the two common bone marrow stimulation techniques such as subchondral drilling and microfracture for symptomatic ...osteochondral lesions of the talus and to evaluate prognostic factors affecting the outcomes.
Methods
Ninety patients (90 ankles) who underwent arthroscopic bone marrow stimulation for small- to mid-sized osteochondral lesions of the talus constituted the study cohort. The 90 ankles were divided into two groups: a drilling group (40 ankles) and a microfracture group (50 ankles). Each group was matched for age and gender, and both groups had characteristics similar to those obtained from pre-operative demographic data. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the ankle activity score (AAS) were used to compare clinical outcomes, during a mean follow-up period of 43 months.
Results
The median AOFAS scores were 66.0 points (51–80) in drilling group and 66.5 points (45–81) in microfracture group pre-operatively, and these improved to 89.4 points (77–100) and 90.1 points (69–100) at the final follow-up, respectively. The median VAS scores improved at the final follow-up compared with the pre-operative condition. The median AAS for the drilling group improved from 4.5 (1–6) pre-operatively to 6.0 (1–8) at the final follow-up, while those for the microfracture group improved from 3.0 (2–8) to 6.0 (3–9). No significant differences were observed between the two groups in terms of the AOFAS scores, VAS, and AAS.
Conclusions
The arthroscopic subchondral drilling and microfracture techniques that were used to stimulate bone marrow showed similar clinical outcomes. The results of this study suggest that both techniques are effective and reliable in treating small- to mid-sized osteochondral lesions of the talus, regardless of which of the two techniques is used.
Level of evidence
Level III, retrospective comparative study.
Developing contrast-associated acute kidney injury (CA-AKI) following percutaneous coronary intervention (PCI) is closely related to patient-related risk factors as well as contrast administration. ...The diagnostic and prognostic roles of neutrophil gelatinase-associated lipocalin (NGAL) in CA-AKI following PCI are not well established.
Consecutive patients undergoing PCI were enrolled prospectively. CA-AKI was defined as an increase in the serum creatinine level ≥0.3 mg/dL within 48 hours or ≥1.5 times the baseline within 7 days after PCI. Serum NGAL concentrations were determined immediately before and 6 hours after PCI. The participants were classified into four NGAL groups according to the pre- and post-PCI NGAL values at 75th percentile.
CA-AKI occurred in 38 (6.4%) of 590 patients. With chronic kidney disease status (hazard ratio HR 1.63, 95% confidence interval CI: 1.06-2.52), NGAL groups defined by the combination of pre- and 6 h post-PCI values were independently associated with the occurrence of CA-AKI (HR 1.69, 95% CI: 1.16-2.45). All-cause mortality for 29-month follow-ups was different among NGAL groups (log-rank p<0.001). Pre-PCI NGAL levels significantly correlated with baseline cardiac, inflammatory, and renal markers. Although post-PCI NGAL levels increased in patients with larger contrast administration, contrast media made a relatively limited contribution to the development of CA-AKI.
In patients undergoing PCI, the combination of pre- and post-PCI NGAL values may be a useful adjunct to current risk-stratification of CA-AKI and long-term mortality. CA-AKI is likely caused by systemic reserve deficiency rather than contrast administration itself.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Cold atmospheric plasma (CAP) has been incorporated into various fields, including promotion of cutaneous wound healing. Atopic dermatitis (AD) is a chronic cutaneous condition characterized ...by inflammation-induced skin wounds and impaired skin barrier function. To investigate whether CAP may improve AD using an animal model.
Dermatophagoides farinae
extracts (DFE)-induced murine models of AD were used in this study. The plasma-treated group received a total of 6 CAP treatments during 2 weeks, while the control group did not receive any treatment. Differences in dermatitis severity, transepidermal water loss (TEWL), serum level of immunoglobulin (Ig) E and epidermal thickness were evaluated in both groups. The dermatitis severity was significantly improved by CAP treatment. TEWL was lower in the plasma-treated group compared with the non-treated control group. Serum Ig E dropped significantly after treatment with CAP. Difference in epidermal thickness of the ear skin was not significant between the plasma-treated and non-treated groups. Localized treatment of AD with CAP decreases dermatitis severity, TEWL, and serum Ig E level. These results show CAP’s potentials as a novel therapeutic modality for AD.
This study proposes a novel type of macroporous ceramic scaffolds, which are comprised of hollow tubular filaments with a highly microporous structure, using 3-dimensional ceramic/camphene-based ...co-extrusion (3D-CoEx). The use of an initial feedrod, comprised of a camphene core and an alumina/camphene shell, enabled the construction of hollow tubular frameworks and micropores through the removal of the camphene phase. The produced scaffolds showed 3-dimensionally interconnected macropores with dimensions of ∼250–300μm×400–550μm, which were surrounded by hollow alumina filaments (∼500μm in diameter) featuring a number of micropores (several tens of microns in size). This unique macro/micro-porous structure could achieve a combination of both the reasonably high compressive strength of ∼5.4MPa and very high porosity of 86vol%. In addition, the final mechanical properties and overall porosity of the porous alumina scaffolds could be fine-tuned by adjusting initial alumina content in the alumina/camphene.
This study proposes an innovative way of creating porous ceramics with a unique gradient porous structure using three‐dimensional extrusion of a multilayered ceramic/camphene feed rod, denoted as ...“3D‐Exm”. This 3D‐Exm technique utilizes the wall slip phenomenon during the extrusion process, which can create a gradient core/shell structure with a gradual change in the core/shell thickness ratio. In addition, the microstructure of ceramic filaments can be tuned through the use of the camphene as a pore‐forming agent. Porous alumina ceramics produced using a bilayered feed rod comprised of the alumina/camphene mixtures with the relatively high (ϕH = 40 vol%) and low ceramic contents (ϕL = 10 vol%) showed a gradual change in porosity in the intermediate region between the relatively dense (porosity = ~3 vol%) and highly porous regions (porosity = ~85 vol%).
Abstract
Heart failure (HF) is a frequent consequence of myocardial infarction (MI). Identification of the precise, time-dependent composition of inflammatory cells may provide clues for the ...establishment of new biomarkers and therapeutic approaches targeting post-MI HF. Here, we investigate the spatiotemporal dynamics of MI-associated immune cells in a mouse model of MI using spatial transcriptomics and single-cell RNA-sequencing (scRNA-seq). We identify twelve major immune cell populations; their proportions dynamically change after MI. Macrophages are the most abundant population at all-time points (>60%), except for day 1 post-MI. Trajectory inference analysis shows upregulation of
Trem2
expression in macrophages during the late phase post-MI. In vivo injection of soluble Trem2 leads to significant functional and structural improvements in infarcted hearts. Our data contribute to a better understanding of MI-driven immune responses and further investigation to determine the regulatory factors of the Trem2 signaling pathway will aid the development of novel therapeutic strategies for post-MI HF.
In the present study, the experimental Raman spectrum of niobium‐selenide nanowires (Nb2Se9) is reported for the first time followed by an analysis of the Raman spectrum using the density functional ...theory (DFT). According to the group‐theoretical analysis, 33 Ag modes were identified as Raman active modes. In the experimental spectrum, 19 well‐resolved Raman modes were observed: 13 modes in the low‐wavenumber range (50–200 cm−1) and six modes in the high‐wavenumber range (220–340 cm−1). The DFT calculations were performed using the local‐density approximation (LDA) functional and generalized gradient approximation (GGA) functional of Perdew–Burke–Ernzerhof (PBE) with van der Waals corrections (PBE‐D3). PBE‐D3 showed better compatibility with the experimental data for the high‐wavenumber range. Our results provide an essential reference for the Raman scattering of newly synthesized Nb2Se9 nanowires and nanodevices in the future.
The true one‐dimensional van der Waals material, Nb2Se9 nanowire, was synthesized successfully. We measured the Raman spectra on Nb2Se9 and assigned with simulated Spectra with DFT. This will give useful reference for the studies of lattice dynamics of Nb2Se9 nanowires and one‐dimensional nanomaterials.
Ticagrelor-based dual antiplatelet therapy (DAPT) provides potent antiplatelet inhibition but may increase the bleeding risk in Asian populations. We investigated the influence of early ticagrelor ...dose reduction (120 mg) on clinical outcomes in Korean patients undergoing percutaneous coronary intervention (PCI). A multicenter prospective clinical cohort study was conducted with patients who received standard-dose ticagrelor-based DAPT (180 mg) after PCI for complex lesions. Major adverse cardiovascular event (MACE: a composite of cardiovascular death, myocardial infarction, stroke, and repeat revascularization), bleeding, and net adverse clinical events (NACE: a composite of MACE and bleeding) were assessed. Among the 772 patients on standard-dose ticagrelor-based DAPT, 115 (14.8%) switched to low-dose ticagrelor-based DAPT (120 mg) within 6 months. Common reasons for the regimen changes were switching as planned (38.8%), dyspnea (25.5%), and bleeding (23.6%). A multivariable Cox proportional hazard model (CPH) showed that the risks of MACE, bleeding, and NACE were not different between the low-dose and standard-dose groups throughout the entire follow-up period and the period beyond 6 months post-PCI. Time-varying multivariable CPH models of the ticagrelor dose reduction yielded similar results. A reduction of the ticagrelor dose within 6 months after PCI is feasible and safe even in patients with complex lesions harboring a high ischemic event risk.
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