This study aimed to evaluate bone union of the tibial tuberosity in patients undergoing medial opening wedge distal tibial tuberosity osteotomy (OWDTO). It was hypothesized that bone union of the ...tibial tuberosity could be associated with lateral hinge fractures (LHFs), but not thickness of the tibial tuberosity osteotomy.
Data of 61 consecutive patients who underwent OWDTO were retrospectively reviewed. Radiographic parameters of the lower limb and LHFs were evaluated. Thickness of the tibial tuberosity osteotomy and bone union of the tibial tuberosity were assessed at 1, 2, 3, 4, and 5 cm distal to the most proximal part of the tibial tuberosity on computed tomography. Bone union was assessed. Factors related to bone union of the tibial tuberosity were analyzed.
There were 13 postoperative onset LHFs: all healed with conservative treatments within 6 months after surgery. The total score of bone union of the tibial tuberosity was 8.4 ± 2.1 points, which correlated with age, postoperative medial proximal tibial angle (MPTA), correction angle, and postoperative onset LHF (r = 0.307, 0.388, 0.275, and −0.624, respectively; p = 0.016, 0.002, 0.033, and <0.001, respectively). Regression coefficient for postoperative onset LHF, postoperative MPTA, and body mass index were −0.619 (p < 0.001), 0.285 (p = 0.003), and −0.227 (p = 0.021), respectively.
Postoperative onset LHFs, but not thickness of the tibial tuberosity osteotomy, were a risk factor for delayed union of the tibial tuberosity following OWDTO. Furthermore, to prevent delayed union of the tibial tuberosity, postoperative onset LHFs should be prevented.
LEVEL III, Case-control study.
Animals’ rhythmic movements, such as locomotion, are considered to be controlled by neural circuits called central pattern generators (CPGs), which generate oscillatory signals. Motivated by this ...biological mechanism, studies have been conducted on the rhythmic movements controlled by CPG. As an autonomous learning framework for a CPG controller, we propose in this article a reinforcement learning method we call the “CPG-actor-critic” method. This method introduces a new architecture to the actor, and its training is roughly based on a stochastic policy gradient algorithm presented recently. We apply this method to an automatic acquisition problem of control for a biped robot. Computer simulations show that training of the CPG can be successfully performed by our method, thus allowing the biped robot to not only walk stably but also adapt to environmental changes.
Introduction: Locomotive syndrome (LS) is a condition of reduced mobility due to the impairment of locomotive organs. The LS risk test is a comprehensive evaluation index of mobility and ...health-related quality of life (HRQOL). Spinopelvic abnormalities cause worsening in HRQOL. One of the causes of LS is osteoporosis. The purpose of this study was to clarify the relationship between spinopelvic parameters and LS in patients with osteoporosis.Methods: A total of 198 primary osteoporosis patients who visited the outpatient osteoporosis clinic at Higashi saitama general hospital underwent standing whole-spine sagittal X-rays and an LS risk test. Physical parameters, including age, height, weight, body mass index, and bone density of the lumbar spine were measured, and the patients were categorized by the LS risk test into four groups: LS1, LS2, LS3, and non-LS. Spinopelvic parameters, including thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), sagittal vertical axis (SVA), and pelvic incidence-lumbar lordosis (PI-LL) were measured on X-ray. The relationships between LS risk and spinopelvic parameters were analyzed.Results: In total, 84 patients were diagnosed as LS1, 46 were diagnosed as LS2, 51 were diagnosed as LS3, and 17 were diagnosed as non-LS. Spearman's rank correlation coefficient showed a significant correlation with LS risk for TLK (r = 0.23, p = 0.001), LL (r = −0.29, p < 0.001), SS (r = −0.26, p < 0.001), PT (r= 0.20, p = 0.004), SVA (r = 0.25, p < 0.001), and PI-LL (r = 0.26, p < 0.001). Stepwise multiple regression analysis showed that LL (odds ratio OR: 0.97, 95% confidence interval CI 0.95-0.98, p = 0.001) and age (OR: 1.08, 95% CI 1.03-1.13, p < 0.001) were related to LS risk.Conclusions: The present study demonstrated that older age and spinopelvic parameters abnormalities influence LS in osteoporosis patients. Hence, the spinopelvic parameters of LL are factors related to LS.
Microfold (M) cells residing in the follicle-associated epithelium of mucosa-associated lymphoid tissues are specialized for sampling luminal antigens to initiate mucosal immune responses. In the ...past decade, glycoprotein 2 (GP2) and Tnfaip2 were identified as reliable markers for M cells in the Peyer's patches of the intestine. Furthermore, RANKL-RANK signaling, as well as the canonical and non-canonical NFκB pathways downstream, is essential for M-cell differentiation from the intestinal stem cells. However, the molecular characterization and differentiation mechanisms of M cells in the lower respiratory tract, where organized lymphoid tissues exist rarely, remain to be fully elucidated. Therefore, this study aimed to explore M cells in the lower respiratory tract in terms of their specific molecular markers, differentiation mechanism, and functions. Immunofluorescence analysis revealed a small number of M cells expressing GP2, Tnfaip2, and RANK is present in the lower respiratory tract of healthy mice. The intraperitoneal administration of RANKL in mice effectively induced M cells, which have a high capacity to take up luminal substrates, in the lower respiratory epithelium. The airway M cells associated with lymphoid follicles were frequently detected in the pathologically induced bronchus-associated lymphoid tissue (iBALT) in the murine models of autoimmune disease as well as pulmonary emphysema. These findings demonstrate that RANKL is a common inducer of M cells in the airway and digestive tracts and that M cells are associated with the respiratory disease. We also established a two-dimensional culture method for airway M cells from the tracheal epithelium in the presence of RANKL successfully. This model may be useful for functional studies of M cells in the sampling of antigens at airway mucosal surfaces.
The purpose of this study was to assess the correlation between tissue volume and blood flow of the flap in an animal model. Using animal model, tissue volume can be attenuated, and precise change of ...blood flow could be evaluated. We further investigate the relationship between blood flow and vascular density in the tissue. In this study, we assessed flap conductance (ml/min/mm Hg) as to evaluate the conductivity of blood flow into the flap. Japanese white rabbit was used (n = 7) for this study. The amount of blood flow of jejunal and latissimus dorsi muscle (LD) flaps was measured while removing the distal portion of the flap sequentially. Conductance at each time was calculated from blood pressure and blood flow volume. The tissue volume at each time was also measured. The correlation between conductance and volume was analyzed using a linear mixed model. Immunohistochemical evaluation of microvessel densities (MVD) in these tissues was also performed for CD31/PECAM1 positive area. Conductance and tissue volume were significantly correlated in both jejunal and LD flaps. As the volume increases by 1 cm
, the conductance increased significantly by 0.012 ml/min/mm Hg in jejunum, and by 0.0047 ml/min/mm Hg in LD. Mean MVD was 1.15 ± 0.52% in the jejunum and 0.37 ± 0.29% in the LD muscle. In this study, we revealed that flap conductance is proportional to volume and proportional constant is different between the type of tissue. It suggests that the difference of MVD creates the unique conductance of each tissue.
Single nucleotide polymorphisms (SNPs) in
-
(
) are associated with bronchial severity and pulmonary function. CHI3L1 proteins are involved in both innate and adaptive immune responses; however, to ...date, the correlation of these SNPs and their age of onset of bronchial asthma has not been demonstrated.
To address the role of these genetic variations, 390 patients with well-controlled bronchial asthma and living in Japan were recruited, genotyped, and had a pulmonary function test performed on them in this study. To analyze the concentration levels of CHI3L1 protein, bronchial lavage fluids were examined.
Forced expiratory volume in one second, %predicted (%FEV1), was significantly decreased in homozygotes of rs1214194 compared to heterozygotes and wild type. The age of onset of adult bronchial asthma was significantly younger in GG homozygotes of rs4950928 and AA homozygotes of rs1214194 than in the other two genotypes. The concentration of CHI3L1 protein in bronchial lavage fluid increased in both homozygotes of rs4950928 and rs1214194.
Our study demonstrated that the homozygotes of rs4950928 and rs1214194 of
might predict an early onset of bronchial asthma and have the propensity to promote airway remodeling.
JMA-IIA00045 remodeling-ICS.
Dear Editor Serum periostin has recently emerged as a novel and useful biomarker for bronchial asthma. Serum periostin is a surrogate biomarker reflecting type 2 immune responses because periostin is ...a downstream molecule of interleukin-4 (IL-4) or IL-13, the signature cytokines of type 2 immune responses. This characteristic of periostin can potentially be applied to predict the efficacy of antagonists such as anti-IL-13 or anti-IgE antibodies against type 2 immune responses. Furthermore, we have recently found that since periostin reflects tissue remodeling or fibrosis in bronchial asthma, it can predict hypo-responsiveness to inhaled corticosteroids in asthma patients, particularly in those who are late-onset and eosinophil-dominant. In spite of the usefulness of periostin as a biomarker for bronchial asthma, serum periostin can be affected by periostin produced in sites other than lung tissues, particularly bones. Therefore, it would be of great benefit in caring for and treating asthma patients if periostin in lung tissues could be specifically detected.
Introduction
The purpose of this retrospective study was to clarify the incidence of non-traumatic vertebral fracture among outpatient women with osteoporosis and to determine whether the stand-up ...test predicted the occurrence of non-traumatic vertebral fracture.
Materials and methods
A total of 242 postmenopausal women over 60 years of age who received outpatient osteoporosis treatment at our hospital between November 2013 and July 2020 were longitudinally evaluated in this study. We obtained medical information and radiographic parameters, including sagittal vertical axis, thoracic kyphosis, pelvic incidence, lumbar lordosis, pelvic tilt, and sacral slope at baseline. Additionally, we measured physical parameters, including height, weight, body mass index, lumbar bone mineral density, visual analog scale score for pain, and the stand-up test.
Results
Vertebral fractures occurred in 20 of 242 participants (8.3%), and accounted for 48.8% the 41 total fractures in the study group. Among vertebral fractures, eight (40.0%) were traumatic, resulting from falls, and 12 (60.0%) were non-traumatic. Cox multivariate logistic regression analysis adjusted for age, body mass index, lumbar bone mineral density, and the time to non-traumatic vertebral fracture showed that the sagittal vertical axis (HR = 1.013, 95% CI 1.001–1.026), stand-up test score (HR = 3.977, 95% CI 1.156–13.683), and presence of difficulty with standing from a 20-cm-high seat using both legs (HR = 3.329, 95% CI 1.625–6.82) were independent risk factors for the occurrence of non-traumatic vertebral fracture.
Conclusion
The stand-up test may be useful as a simple screening tool for non-traumatic vertebral fracture in patients with osteoporosis.
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