We aimed to investigate factors related to the technique of medial opening wedge high tibial osteotomy which might predispose to the development of a lateral hinge fracture.
A total of 71 patients ...with 82 osteotomies were included in the study. Their mean age was 62.9 years (37 to 80). The classification of the type of osteotomy was based on whether it extended beyond the fibular head. The level of the osteotomy was classified according to the height of its endpoint.
At a mean follow-up of 20 months (6 to 52), a total of 15 lateral hinge fractures (18.3%) were identified. A sufficient osteotomy, in which both anterior and posterior tibial cortices were involved with extension into the lateral aspect of the plateau in relation to an anteroposterior line tangential to the medial edge of the fibular head in the CT axial plane, was seen in 48 knees (71.6%) in those without a lateral hinge fracture and in seven (46.7%) in those with a lateral hinge fracture. An osteotomy which ended above the level of the fibular head was seen in nine (13.4%) of the knees without a lateral hinge fracture and seven (46.7%) of the those with a lateral hinge fracture. There was a significant relationship between the absence of a lateral hinge fracture and both a sufficient osteotomy and one whose endpoint was at the level of the fibular head (p = 0.0451 and p = 0.0214, respectively).
A sufficient osteotomy involving both the anterior and posterior cortices, whose endpoint is at the level of the fibular head, should be performed when undertaking a medial opening wedge high tibial osteotomy if a lateral hinge fracture is to be avoided as a complication. Cite this article:
2017;99-B:887-93.
Aim
Phase angle (PhA) can be determined through bioelectrical impedance analysis and is a unique variable for skeletal muscle. The objective of this study was to evaluate the relationship between PhA ...and muscle mass/quality in older adults. In addition, we attempted to determine the cutoff value of PhA for poor muscle function.
Methods
Community-dwelling Japanese older men (n=285, 81.1±7.1 years) and women (n=724, 80.4±6.8 years) participated in this study and were classified into four groups based on the Asian Working Group for Sarcopenia (normal, presarcopenia, dynapenia, and sarcopenia). We measured PhA using bioelectrical impedance analysis, muscle quantity and quality indicators using ultrasonography, muscle strength, and physical performance and compared them in four groups. We also tried to determine the cutoff value of PhA for poor muscle function.
Results
We found a significant difference in PhA among the four groups in men (P<0.05), and the dynapenia (3.61±0.75°) and sarcopenia groups (3.40±0.74°) showed significantly lower values than the normal group (4.50±0.86°) (P<0.05), but not the presarcopenia group (4.12±0.85°). In women, a significant difference was also observed among the four groups (P<0.05), and the dynapenia (3.41±0.65°) and sarcopenia groups (3.31±0.66°) showed significantly lower measures than the normal group (4.14±0.71°) (P<0.05), but not the presarcopenia group (4.07±0.51°). The receiver-operating characteristic curve analysis indicated the best cutoff value of PhA (men: 4.05°, women: 3.55°) to discriminate sarcopenia and dynapenia from normal and presarcopenia.
Conclusion
These findings suggest that PhA is a useful indicator for muscle function.
In this retrospective analysis using the Transplant Registry Unified Management Program, we identified 145 patients with human herpesvirus (HHV)-6 encephalitis among 6593 recipients. The cumulative ...incidences of HHV-6 encephalitis at 100 days after transplantation in all patients, recipients of bone marrow or PBSCs and recipients of cord blood were 2.3%, 1.6% and 5.0%, respectively. Risk factors identified in multivariate analysis were male sex, type of transplanted cells (relative risk in cord blood transplantation, 11.09, P<0.001; relative risk in transplantation from HLA-mismatched unrelated donor, 9.48, P<0.001; vs transplantation from HLA-matched related donor) and GvHD prophylaxis by calcineurin inhibitor alone. At 100 days after transplantation, the overall survival rate was 58.3% and 80.5% among patients with and without HHV-6 encephalitis, respectively (P<0.001). Neuropsychological sequelae remained in 57% of 121 evaluated patients. With both foscarnet and ganciclovir, full-dose therapy (foscarnet ⩾180 mg/kg, ganciclovir ⩾10 mg/kg) was associated with better response rate (foscarnet, 93% vs 74%, P=0.044; ganciclovir, 84% vs 58%, P=0.047). HHV-6 encephalitis is not rare not only in cord blood transplant recipients but also in recipients of HLA-mismatched unrelated donors. In this study, development of HHV-6 encephalitis was associated with a poor survival rate, and neurological sequelae remained in many patients.
Summary
Anti‐microbial peptides or host defence peptides are small molecules that display both anti‐microbial activities and complex immunomodulatory functions to protect against various diseases. ...Among these peptides, the human β‐defensins (hBDs) are localized primarily in epithelial surfaces, including those of the skin, where they contribute to protective barriers. In atopic dermatitis skin lesions, altered skin barrier and immune dysregulation are believed to be responsible for reduced hBD synthesis. Impaired hBD expression in the skin is reportedly the leading cause of increased susceptibility to bacterial and viral infection in patients with atopic dermatitis. Although hBDs have considerable beneficial effects as anti‐microbial agents and immunomodulators and may ameliorate atopic dermatitis clinically, recent evidence has also suggested the negative effects of hBDs in atopic dermatitis development. In the current review, we provide an overview of the regulation of hBDs and their role in the pathogenesis of atopic dermatitis. The efforts to utilize these molecules in clinical applications are also described.
This review focuses on the current knowledge of antimicrobial peptides human beta‐defensins with an emphasis on their regulatory mechanisms in atopic dermatitis, their roles in atopic dermatitis pathogenesis, and their applicability as therapeutic agents for this skin disorder.
Nitrogen isotope analysis of chloropigments provides information on the sources of nitrogenous nutrients assimilated by phytoplankton. The abundant, ubiquitous chlorophyll a records nitrogen isotopic ...compositions (δ15N) of eukaryotic phytoplankton and cyanobacteria, whereas more source‐specific chloropigments, such as the divinylchlorophylls exclusively possessed by the marine picocyanobacterium Prochlorococcus, can potentially resolve isotopic variability within the phytoplankton community. In this study, we analyzed the δ15N of both chlorophyll a and divinylchlorophyll a isolated from suspended particulate material collected at the subsurface chlorophyll maximum (SCM) along a meridional transect at 88°E in the oligotrophic eastern Indian Ocean. The nitrogen isotopic compositions of Prochlorococcus (δ15NPRO) and the combined biomass of eukaryotic phytoplankton and Synechococcus (δ15NEU+SYN) estimated from the δ15N of divinylchlorophyll a and chlorophyll a, respectively, revealed systematic variations that were not apparent from bulk isotope measurements. Whereas consistently low δ15NPRO indicated reliance of Prochlorococcus on regenerated nitrogen throughout the transect, elevation in δ15NEU+SYN values at several stations was interpreted to reflect assimilation of subsurface NO3− by eukaryotic phytoplankton. The δ15N distributions revealed subtle differences in NO3− availability at the SCM along the transect, which were consistently explained by the occurrence of mesoscale eddies in the Bay of Bengal, deepening of the mixed layer induced by a seasonal Wyrtki Jet in the equatorial region, and substantial deepening of the nutricline in the South Indian Ocean gyre. Our results highlight the utility of compound‐specific isotopic measurements of multiple species of chlorophylls in obtaining essential non‐incubation‐based biogeochemical constraints on the primary production in the ocean.
Key Points
We determined nitrogen sources for phytoplankton based on nitrogen isotopic measurements of chlorophyll a and divinylchlorophyll a
Prochlorococcus depended on regenerated nitrogen whereas eukaryotic phytoplankton responded sensitively to the subsurface nitrate supply
Phytoplankton responses were consistently explained by oceanographic conditions along a meridional transect in the eastern Indian Ocean
Summary
We analyzed osteoporosis in 20 HME patients. According to the T-score of BMD, 30% and 67.5% of the patients fell in the range of osteopenia in the lumbar spine and femoral neck. Our results ...indicate HME patients have low bone mass. They do not have abnormal bone metabolism.
Introduction
There are few reports of osteoporosis in hereditary multiple exostoses (HME) patients. Therefore, the purpose of this study was to analyze osteoporosis in HME patients.
Methods
This retrospective cohort study included 20 patients diagnosed with HME. Patients underwent bone mineral density (BMD) measurement of the lumbar spine (
n
= 20) and femoral neck (
n
= 40). Bone metabolic parameters, including serum osteocalcin and urinary cross-linked N-telopeptide of type 1 collagen (NTx), were analyzed in all subjects.
EXT1
and
EXT2
genes were sequenced using genomic DNA. We also examined the correlation between genotype and BMD Z-score and T-score.
Results
The mean BMD values of the lumbar spine were 1.085 ± 0.116 g/cm
2
(
n
= 11) in male and 1.108 ± 0.088 g/cm
2
(
n
= 9) in female. The mean BMD values of the femoral neck area were 0.759 ± 0.125 g/cm
2
(
n
= 22) in male and 0.749 ± 0.115 g/cm
2
(
n
= 18) in female. Z-score of most HME patients show < 0, indicating that these patients tend to have low bone mass compared with the age-matched population. According to the T-score of BMD, 30% (6 of 20) and 67.5% (27 of 40) of the patients fell in the range of osteopenia in the lumbar spine and femoral neck areas, respectively. Serum osteocalcin and urinary NTx were in the normal range in most patients. There was no significant correlation between genotypes and Z-score.
Conclusion
HME patients have low bone mass, especially in the femoral neck area. They do not have abnormal bone metabolism, and there was no correlation between genotypes and Z-score.
The second survey of the molecular clouds in the Large Magellanic Cloud in super(12)CO was carried out by NANTEN. The sensitivity of this survey is twice as high as that of the previous NANTEN ...survey, leading to a detection of molecular clouds with image M sub(image). We identified 272 molecular clouds, 230 of which are detected at three or more observed positions. We derived the physical properties, such as size, line width, and virial mass, of the 164 GMCs that have an extent more than the beam size of NANTEN in both the major and minor axes. The CO luminosity and virial mass of the clouds show a good correlation of image, with a Spearman rank correlation of 0.8, suggesting that the clouds are in nearly virial equilibrium. Assuming the clouds are in virial equilibrium, we derived an X sub(CO)-factor of image cm super(-2) (K km s super(-1)) super(-1). The mass spectrum of the clouds is fitted well by a power law of image above the completeness limit of image M sub(image). The slope of the mass spectrum becomes steeper if we fit only the massive clouds, e.g., image for image M sub(image).
•Ignition control strategy with ozone for gasoline compression ignition (GCI) engines.•Detailed investigations on the effects of ozone concentration.•Investigations on the effects of fuel injection ...parameters.•Combustion regime control from GCI to mixing-controlled combustion with ozone.
To control the ignition timing in a gasoline compression ignition (GCI) engine, ozone (O3) was introduced into the intake air. The O-radicals are decomposed from the O3 above 550 K during the compression stroke, and combine into oxygen (O2) in a very short time. The authors adopted two-stage direct injection to mix the fuel injected into the cylinder at very early timings with the O-radicals, before a reduction of the O-radicals would take place. The ignition timing of the second fuel injection for the main combustion is controlled by the heat release from the first fuel injection. In this paper, engine experiments were performed to examine the feasibility of the ignition control with a primary reference fuel, octane number 90 (PRF90). The O3 concentration, the quantity, and the timing of the first injection were changed as experimental parameters. The results showed that a very small quantity of O3, tens of ppm, is sufficient to promote the heat release of the first injected fuel. The heat release increases with the O3 concentration and the quantity of fuel in the first injection. The addition of O3 has no other impact on the ignition when the first injection timing is retarded to around −40°CA ATDC. In this manner, it is possible to control the ignition delays and to alter the combustion state from typical diesel combustion to premixed compression ignition combustion.
Tropical forests hold large stores of carbon, yet uncertainty remains regarding their quantitative contribution to the global carbon cycle. One approach to quantifying carbon biomass stores consists ...in inferring changes from long-term forest inventory plots. Regression models are used to convert inventory data into an estimate of aboveground biomass (AGB). We provide a critical reassessment of the quality and the robustness of these models across tropical forest types, using a large dataset of 2,410 trees >= 5 cm diameter, directly harvested in 27 study sites across the tropics. Proportional relationships between aboveground biomass and the product of wood density, trunk cross-sectional area, and total height are constructed. We also develop a regression model involving wood density and stem diameter only. Our models were tested for secondary and old-growth forests, for dry, moist and wet forests, for lowland and montane forests, and for mangrove forests. The most important predictors of AGB of a tree were, in decreasing order of importance, its trunk diameter, wood specific gravity, total height, and forest type (dry, moist, or wet). Overestimates prevailed, giving a bias of 0.5-6.5% when errors were averaged across all stands. Our regression models can be used reliably to predict aboveground tree biomass across a broad range of tropical forests. Because they are based on an unprecedented dataset, these models should improve the quality of tropical biomass estimates, and bring consensus about the contribution of the tropical forest biome and tropical deforestation to the global carbon cycle.
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