We present the case of a 15-year-old girl. Two months after becoming aware of pain, she was diagnosed with a sacral tumor and referred to our department. She was diagnosed with a sacral Ewing’s ...sarcoma; after chemotherapy, it was determined that the tumor could be resected, so surgical treatment was performed. The sacrum and ilium were partially resected at the lower end of S1, and the lumbar vertebrae and pelvis were fixed with a pedicle screw and two iliac screws on each side of L3, and the sacral resection was reconstructed with a tibial strut allograft. No tumor recurrence or metastasis has been observed 1 year postoperatively. She developed bladder and rectal dysfunction, but she remained independent in activities of daily living and her daily life was not limited. The bone fusion in the reconstructed area confirmed the lack of instrumentation looseness. Surgical treatment for sacral Ewing’s sarcoma was performed to cure the patient. We believe that the tibial allograft contributed to the patient’s ability to walk on her own due to its high mechanical stability. Postoperative bone healing was observed with the same material, suggesting that the tibial allograft is useful for similar procedures.
Abstract
Objectives
This study sought to investigate the ability of near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS) to differentiate among plaque rupture (PR), plaque erosion (PE), ...and calcified nodule (CN) in acute myocardial infarction (AMI) using an optical coherence tomography (OCT) diagnosis as a reference standard.
Background
In vivo, precise differentiation among PR, PE and CN is a major challenge for intravascular imaging.
Methods
The study enrolled 156 AMI patients who had a de novo culprit lesion in a native coronary artery. The culprit lesions were assessed by both NIRS-IVUS and OCT.
Results
OCT identified 112 PR, 29 PE, and 15 CN. IVUS-detected plaque ulceration showed a high specificity (100%) to identify OCT-PR although the sensitivity (62%) was intermediate. IVUS-detected convex calcium showed a high sensitivity (93%) and specificity (100%) to identify OCT-CN. In NIRS, the maximum lipid core burden index in 4 mm (maxLCBI4mm) was greatest in OCT-PR (values are median interquartile range) (671 530 to 853), followed by OCT-CN (355 303 to 432) and OCT-PE (283 89 to 357) (p<0.001). MaxLCBI4mm of <422 was the best cut-off to discriminate OCT-PE from OCT-PR and OCT-CN. The NIRS-IVUS classification algorithm using plaque ulceration, convex calcium, and maxLCBI4mm <422 showed a sensitivity and specificity of 96% and 95% for identifying OCT-PR, 93% and 95% for OCT-PE, and 93% and 100% for OCT-CN, respectively.
NIRS-IVUS classification algorism
Conclusion
Lipid component assessed by NIRS-IVUS was different among OCT-PR, OCT-PE and OCT-CN. The NIRS-IVUS classification algorism was highly sensitive and specific for differentiating these unstable lesion types in AMI.
Acknowledgement/Funding
None
Abstract
Background
While plaque rupture (PR) is the leading cause of acute myocardial infarction (AMI), other etiologies are also involved in the onset of AMI. Cholesterol crystals (CCs) are usually ...present abundantly in atherosclerotic plaques, especially in the culprit site of AMI. However, the relationship between in vivo CCs and PR is unclear. Optical coherence tomography (OCT) is a high-resolution imaging technique that allows for the in vivo identification of various plaque characteristics including PR and CCs.
Purpose
The aim of this study was to investigate prevalence and distribution of CCs between patients with AMI with PR, AMI without PR, and SAP.
Method
This study consisted of 146 patients with coronary artery disease (AMI with PR; n=64, AMI without PR; n=41, and SAP; n=41) who underwent OCT prior to percutaneous coronary intervention. Plaque characteristics in OCT images were assessed according to the consensus document. We classified the distribution of CCs as follows; superficial type CCs were defined by any of the CCs invading the fibrous cap and remaining CCs as deep type CCs.
Result
There was no statistical difference in clinical characteristics among the three groups. The % diameter stenosis was significantly smaller in the SAP group than others (AMI with PR 91±12% vs. AMI without PR 86±13% vs. SAP 65±9%, p<0.001). The prevalence of CCs was significantly higher in the AMI with PR group than others (AMI with PR 78% vs. AMI without PR 41% vs. SAP 39%, p<0.001). The prevalence of superficial type CCs was significantly different among the groups (AMI with PR 72% vs. AMI without PR 24% vs. SAP 7%, p<0.001). Multivariable logistic analysis demonstrated that lipid plaque (OR 84.5, 95% CI 6.30–11332.33, p<0.001) and superficial type CC (OR 9.5, 95% CI 2.61–34.89, p<0.001) were independent predictors of PR.
Conclusion
Plaque with CCs invading the fibrous cap is frequently associated with PR in patients with AMI, suggesting. In vivo CC detection is a new morphological feature for plaque rupture.
Acknowledgement/Funding
This study was supported by a grant from JSPS KAKENHI (17K09557).
This study proposes a systematic approach to investigate cloud-radiative feedbacks to climate change induced by an increase of CO₂ concentrations in global climate models (GCMs). Based on two ...versions of the Model for Interdisciplinary Research on Climate (MIROC), which have opposite signs for cloud–shortwave feedback (ΔSWcld) and hence different equilibrium climate sensitivities (ECSs), hybrid models are constructed by replacing one or more parameterization schemes for cumulus convection, cloud, and turbulence between them. An ensemble of climate change simulations using a suite of eight models, called a multiphysics ensemble (MPE), is generated. The MPE provides a range of ECS as wide as the Coupled Model Intercomparison Project phase 3 (CMIP3) multimodel ensemble and reveals a different magnitude and sign of ΔSWcldover the tropics, which is crucial for determining ECS.
It is found that no single process controls ΔSWcld, but that the coupling of two processes does. Namely, changing the cloud and turbulence schemes greatly alters the mean and the response of low clouds, whereas replacing the convection and cloud schemes affects low and middle clouds over the convective region. For each of the circulation regimes, ΔSWcldand cloud changes in the MPE have a nonlinear, but systematic, relationship with the mean cloud amount, which can be constrained from satellite estimates. The analysis suggests a positive feedback over the subsidence regime and a near-neutral or weak negative ΔSWcldover the convective regime in these model configurations, which, however, may not be carried into other models.
Spin currents can exert spin-transfer torques on magnetic systems even in the limit of vanishingly small net magnetization, as recently shown for antiferromagnets. Here, we experimentally show that a ...spin-transfer torque is operative in a macroscopic ensemble of weakly interacting, randomly magnetized Co nanomagnets. We employ element- and time-resolved X-ray ferromagnetic resonance (XFMR) spectroscopy to directly detect subnanosecond dynamics of the Co nanomagnets, excited into precession with cone angle ≳0.003° by an oscillating spin current. XFMR measurements reveal that as the net moment of the ensemble decreases, the strength of the spin-transfer torque increases relative to those of magnetic field torques. Our findings point to spin-transfer torque as an effective way to manipulate the state of nanomagnet ensembles at subnanosecond time scales.
The relation between segmental mobility and degree of lumbar degenerative change is still unknown. This cross-sectional study aimed to elucidate the association between intervertebral disc ...degeneration (IVDD) and segmental mobility in chronic low back pain using magnetic resonance imaging (MRI) T2 mapping.
Subjects comprised 60 patients (29 men, 31 women; mean age, 61.8 ± 1.9 years; range, 41–79 years). T2 values of the anterior annulus fibrosus (AF), the nucleus pulposus (NP) and the posterior AF were evaluated with MRI T2 mapping. Facet joint degeneration was divided into 4 grades using MRI. We analyzed the correlation between segmental mobility and T2 values of anterior AF, NP and posterior AF using multiple linear regression analysis adjusted for age and facet joint degeneration.
The standardized partial regression coefficient of the anterior AF, NP and posterior AF T2 values were 0.125 (p=0.72), 0.499 (p<0.01) and –0.026 (p=0.11), respectively, for the L1-2 level; 0.102 (p=0.27), 0.395 (p<0.01) and –0.094 (p=0.20), respectively, for the L2-3 level; 0.108 (p=0.38), 0.415 (p<0.01) and –0.050 (p=0.51), respectively, for the L3-4 level; 0.124 (p=0.09), 0.396 (p<0.01) and 0.025 (p=0.73), respectively, for the L4-5 level; and 0.011 (p=0.89), 0.443 (p<0.01) and 0.030 (p=0.72), respectively, for the L5-S level. There was a significantly positive correlation between segmental mobility and the T2 values of NP at L1–L2, L2–L3, L3–L4, L4–L5, and L5–S1. No significant correlations arose between segmental mobility and the T2 values of the anterior AF and the posterior AF at L1–L2, L2–L3, L3–L4, L4–L5, and L5–S1.
Characterization of the relationship between NP degeneration and lumbar segmental mobility may enhance our ability to evaluate the changes seen in kinematics of functional spinal unit.
Drosophila calpains, Calpain A and Calpain B, show typical calpain domain structures similar to mammalian calpains. However, the small subunit of mammalian calpains, shown to be essential in both ...genetic and biochemical aspects, is absent in Drosophila calpains and is not required for enzymatic activity. How they compensate for the lack of small subunit is mostly unknown. Here we conducted experiments using recombinant Drosophila Calpain B for further characterization of the enzyme with particular focuses on two issues: possibility of homodimerization and mode of autolysis. The native molecular weight of Calpain B indicates that the active enzyme is primarily monomeric. Co-expression of two recombinant Calpain B proteins each with a unique affinity tag and a subsequent single round of affinity tag purification resulted in isolation of only one recombinant calpain type, suggesting there is no homodimeric interaction. Also the C-termini of Drosophila calpains lack many of the key hydrophobic residues considered to be important in the dimerization of mammalian calpains. Further, initial autolysis of Calpain B seems to occur intramolecularly, which supports the monomeric nature of Drosophila calpains. These results strongly suggest that dimerization is not an essential requirement for Drosophila calpains.
We conducted sensitivity experiments using a coupled atmosphere-ocean general circulation model to examine the asymmetry between the hydrological responses to instantaneous positive and negative CO ...sub(2) forcing and the impact of the CO sub(2) physiological effects (CDPEs) on these responses. This study focuses on the fast response occurring on time scales shorter than 1 year after imposing CO sub(2) forcing. Experiments investigating the CO sub(2) physiological effect show that the fast response of precipitation to positive CO sub(2) forcing is a decrease in the global and annual mean, whereas that of negative forcing is an increase the global and annual mean precipitation. The fast global precipitation response to negative forcing is stronger than the response to positive forcing. In contrast, the experiments without the CDPE reveal similar magnitudes of the fast global precipitation responses to negative and positive CO sub(2) forcing. Significant differences in the magnitudes of the fast precipitation response due to the CDPE are found in tropical regions such as the Amazon Basin, the Maritime Continents, and tropical Africa, where C3-type plants are common. The stomatal conductance of plant leaves is decreased by both positive and negative CO sub(2) forcing, which suppress the transpiration from the leaves. Consequently, the CDPE enhances the asymmetry of the fast precipitation responses to positive and negative CO sub(2) forcing. The asymmetric impact of CDPE requires a careful evaluation of future hydrological changes which is constrained by paleoclimate evidence.
We conducted sensitivity experiments using a coupled atmosphere-ocean general circulation model to examine the asymmetry between the hydrological responses to instantaneous positive and negative ...CO.sub.2 forcing and the impact of the CO.sub.2 physiological effects (CDPEs) on these responses. This study focuses on the fast response occurring on time scales shorter than 1 year after imposing CO.sub.2 forcing. Experiments investigating the CO.sub.2 physiological effect show that the fast response of precipitation to positive CO.sub.2 forcing is a decrease in the global and annual mean, whereas that of negative forcing is an increase the global and annual mean precipitation. The fast global precipitation response to negative forcing is stronger than the response to positive forcing. In contrast, the experiments without the CDPE reveal similar magnitudes of the fast global precipitation responses to negative and positive CO.sub.2 forcing. Significant differences in the magnitudes of the fast precipitation response due to the CDPE are found in tropical regions such as the Amazon Basin, the Maritime Continents, and tropical Africa, where C3-type plants are common. The stomatal conductance of plant leaves is decreased by both positive and negative CO.sub.2 forcing, which suppress the transpiration from the leaves. Consequently, the CDPE enhances the asymmetry of the fast precipitation responses to positive and negative CO.sub.2 forcing. The asymmetric impact of CDPE requires a careful evaluation of future hydrological changes which is constrained by paleoclimate evidence.
Cumulus cells and mural granulosa cells (MGCs) have functionally distinct roles in antral follicles, and comparison of their transcriptomes at a global and systems level can propel future studies on ...mechanisms underlying their functional diversity. These cells were isolated from small and large antral follicles before and after stimulation of immature mice with gonadotropins, respectively. Both cell types underwent dramatic transcriptomic changes, and differences between them increased with follicular growth. Although cumulus cells of both stages of follicular development are competent to undergo expansion in vitro, they were otherwise remarkably dissimilar with transcriptomic changes quantitatively equivalent to those of MGCs. Gene ontology analysis revealed that cumulus cells of small follicles were enriched in transcripts generally associated with catalytic components of metabolic processes, while those from large follicles were involved in regulation of metabolism, cell differentiation, and adhesion. Contrast of cumulus cells versus MGCs revealed that cumulus cells were enriched in transcripts associated with metabolism and cell proliferation while MGCs were enriched for transcripts involved in cell signaling and differentiation. In vitro and in vivo models were used to test the hypothesis that higher levels of transcripts in cumulus cells versus MGCs is the result of stimulation by oocyte-derived paracrine factors (ODPFs). Surprisingly ∼48% of transcripts higher in cumulus cells than MGCs were not stimulated by ODPFs. Those stimulated by ODPFs were mainly associated with cell division, mRNA processing, or the catalytic pathways of metabolism, while those not stimulated by ODPFs were associated with regulatory processes such as signaling, transcription, phosphorylation, or the regulation of metabolism.
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