Low Neutralizing Activities to the Omicron Subvariants BN.1 and XBB.1.5 of Sera From the Individuals Vaccinated With a BA.4/5-Containing Bivalent mRNA Vaccine.

The continuous emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants has provided insights for updating current coronavirus disease 2019 (COVID-19) vaccines. We examined the neutralizing activity of Abs induced by a BA.4/5-containing bivalent mRNA vaccine against Omicron subvariants BN.1 and XBB.1.5. We recruited 40 individuals who had received a monovalent COVID-19 booster dose after a primary series of COVID-19 vaccinations and will be vaccinated with a BA.4/5-containing bivalent vaccine. Sera were collected before vaccination, one month after, and three months after a bivalent booster. Neutralizing Ab (nAb) titers were measured against ancestral SARS-CoV-2 and Omicron subvariants BA.5, BN.1, and XBB.1.5. BA.4/5-containing bivalent vaccination significantly boosted nAb levels against both ancestral SARS-CoV-2 and Omicron subvariants. Participants with a history of SARS-CoV-2 infection had higher nAb titers against all examined strains than the infection-naïve group. NAb titers against BN.1 and XBB.1.5 were lower than those against the ancestral SARS-CoV-2 and BA.5 strains. These results suggest that COVID-19 vaccinations specifically targeting emerging Omicron subvariants, such as XBB.1.5, may be required to ensure better protection against SARS-CoV-2 infection, especially in high-risk groups.

Is Mobile-Bearing Medial Unicompartmental Knee Arthroplasty Appropriate for Asian Patients With the Risk of Bearing Dislocation?

BACKGROUND: Mobile-bearing unicompartmental knee arthroplasty (UKA) is an attractive operation for medial unicompartmental knee arthritis, but unexpected bearing dislocation is a drawback. Bearing dislocation occurs more frequently in Asians, whose lifestyle involves deeper knee flexion than Westerners. This study investigated whether mobile-bearing medial UKA is appropriate for Asians by analyzing (1) the rate of bearing dislocation and (2) the results of patients with bearing dislocation. METHODS: We retrospectively reviewed 531 consecutive mobile-bearing medial UKA in the previous 15 years, including 22 patients with bearing dislocation who had at least 2 years of follow-up. The entire patient cohort was divided into 2 groups: the symmetrical bearing (187 knees) and the anatomic bearing (344 knees) groups. In the anatomic bearing group, patients who underwent surgery using the conventional phase III (283 knees) vs the Microplasty (61 knees) instrumentation systems were compared. RESULTS: The overall incidence of bearing dislocation was 4.1% (22/531). Patients with the symmetrical bearing displayed a relatively high dislocation rate of 9.6% (18/187), which significantly decreased to 1.1% (4/344) after changing to the anatomic bearing (P < .001). In the anatomic bearing group, the dislocation rate with the conventional phase III system was 1.4% (4/283). There were no bearing dislocations in the Microplasty system group (0%, 0/61) after at least 2 years of follow-up. CONCLUSION: Although mobile-bearing medial UKA was reported to have a high incidence of bearing dislocation in Asians, this frequency of dislocation is drastically decreased by bearing design and implantation system improvements. We consider mobile-bearing medial UKA appropriate for Asians.

Dislocation Structure in Hot Deformed Al-Zn-Mg Alloy by X-ray Line Profile Analysis.

The microstructure of extruded Cu-free Al-Zn-Mg alloy is studied. Hot torsion tests are performed on a Cu-free Al-Zn-Mg alloy to investigate the effect of large strain deformation on the dislocation behavior. The dislocation structure is characterized by X-ray diffraction profile analysis, and the effective stress-strain curves are obtained by hot torsion tests. The dislocation density at low deformation temperature is found to be higher than that at high deformation temperature. The dislocation density of the alloy increases gradually up to ε = 1 with increasing strain and does not change significantly during further deformation.

Late Mobile-Bearing Dislocation in Unicompartmental Knee Arthroplasty.

The authors present 2 cases of late mobile-bearing dislocation after unicompartmental knee arthroplasty with long-term follow-up. Patients had anterior bearing dislocation more than 10 years after primary unicompartmental knee arthroplasty. Retrieved mobile bearings showed severe erosion on the posterior lip, suggesting frequent deep knee flexion as the cause of wear. Bearing dislocation is known to occur in the early postoperative phase. However, for Asians with a lifestyle that requires high knee flexion, dislocation might occur in the late postoperative phase. Such late bearing dislocation has a mechanism different from those reported in previous studies. Loss of bump in the posterior lip was found to be the cause. After late bearing dislocation, conversion to total knee arthroplasty is unnecessary because a simple bearing exchange will suffice. [Orthopedics. 2019; 42(1):e124-e127.].

Total Knee Arthroplasty for Severe Flexion Contracture in Rheumatoid Arthritis Knees.

Flexion contracture deformities, as well as severe varus and valgus deformities of the knee joint, accompany osteoarthritis or rheumatoid arthritis (RA). In particular, severe flexion contracture deformity of the knee joint is often found in patients with RA, which renders them nonambulatory. This report describes a 26-year-old female patient diagnosed with RA 10 years ago. She had chronic joint pain, severe flexion contracture, valgus deformity in both knees, and limited range of motion in both knees and became nonambulatory. She underwent a total knee arthroplasty (TKA) and serial casting and physical therapy to restore stable joint movement and correct knee joint deformity. Her pain was successfully relieved, and she was able to walk after surgery. Here, we report the excellent results of TKA in this RA patient with severe flexion contracture of both knees.

Short-Term Results of Total Knee Arthroplasty with Anterior-Posterior Glide LCS Mobile-Bearing System.

PURPOSE: To evaluate the clinical and radiological results of total knee arthroplasty (TKA) using the anterior-posterior glide (APG) low contact stress (LCS) mobile-bearing system. MATERIALS AND METHODS: We evaluated 130 knees in 117 patients who had undergone TKA with APG LCS mobile-bearing system between September 2005 and July 2007 and could be followed over 5 years. The mean follow-up period was 68 months. The clinical and radiological results were evaluated using the American Knee Society Scoring System, Oxford knee score and the American Knee Society Roentgenographic Evaluation and Scoring System. And we analyzed short-term postoperative complications. RESULTS: The average range of motion of the knee joint was 107.9° (range, 70° to 135°) preoperatively and 125.2° (range, 90° to 135°) at the last follow-up. The average knee and functional scores were improved from 39.1 and 42.0 to 71.2 and 75.6, respectively, between the preoperative and last follow-up evaluation. The Oxford knee score was decreased from 42.9 preoperatively to 23.1 at the last follow-up. The femoro-tibial angle (anatomical axis) changed from 10.1° varus preoperatively to 3.3° valgus at the last follow-up. Radiolucency was observed in 14% of all cases. There were 1 case of traumatic dislocation of the polyethylene liner, 1 case of aseptic loosening and 6 cases of posterior instability because of posterior cruciate ligament (PCL) insufficiency. CONCLUSIONS: TKA with APG LCS mobile-bearing system demonstrated relatively good short-term clinical and radiological results. However, further considerations for posterior instability associated with PCL insufficiency are needed.

Microstructure and properties of cross-roll rolled and heat treated metastable TiNbSn alloy.

A (Ti-35mass%Nb)-4mass%Sn alloy was cross-roll rolled with a reduction ratio of 70% in which the roll axes are tilted by ± 5 degrees away from the transverse direction of the rolled sample and then aged at 250 degrees C for 2 h. Cross-roll rolling was found to increase yield strength and Young's modulus, simultaneously. Yield strength was higher in cross-roll rolled than in conventionally rolled at same reduction ratio. Yield and tensile strength further increased by a low temperature ageing by ψ precipitation hardening and microstructure refinement. Yield and tensile strength of the aged 70% cross-roll rolled sample were higher than those of the aged 70% conventionally rolled one.

Adenomyoepithelioma located over the tibial tuberosity.

Adenomyoepithelioma is a rarely occurring tumor and its generation in the limbs is extremely rare. We report a case of an adenomyoepithelioma over the proximal tibial tuberosity that was treated without any complications after an excisional biopsy with a literature review.

Characteristics of tin oxide-based thin film transistors prepared by DC magnetron sputtering.

Here we demonstrate the fabrication of SnO(x) thin-film transistors (TFTs), where SnO(x) thin films are deposited as an active channel layer by DC magnetron sputtering. We analyzed the effects of the oxygen partial pressure ratio and post-deposition heat treatment (PDHT) on the characteristics of the SnO(x) thin films. We found improved performance of the TFTs obtained by using interface modification with the optimized deposition condition of SnO(x) thin films. These results are helpful for fabricating oxide-TFTs, including simple binary oxide semiconductors, as an active channel layer.

Effect of hydroxyapatite on bone integration in a rabbit tibial defect model.

BACKGROUND: The aim of the present study was to prepare hydroxyapatite (HA) and then characterize its effect on bone integration in a rabbit tibial defect model. The bone formation with different designs of HA was compared and the bony integration of several graft materials was investigated qualitatively by radiologic and histologic study. METHODS: Ten rabbits were included in this study; two holes were drilled bilaterally across the near cortex and the four holes in each rabbit were divided into four treatment groups (HAP, hydroxyapatite powder; HAC, hydroxyapatite cylinder; HA/TCP, hydroxyapatite/tri-calcium phosphate cylinder, and titanium cylinder). The volume of bone ingrowth and the change of bone mineral density were statistically calculated by computed tomography five times for each treatment group at 0, 2, 4, 6, and 8 weeks after grafting. Histologic analysis was performed at 8 weeks after grafting. RESULTS: The HAP group showed the most pronounced effect on the bone ingrowth surface area, which seen at 4, 6, and 8 weeks after graft (p < 0.05). On comparing the change of bone mineral density the bone ingrowth surface area among the 4 groups, there were no statistically significant differences among the groups found for any period (p > 0.05). On histological examination, the HAP group revealed well-recovered cortical bone, but the bone was irregularly thickened and haphazardly admixed with powder. The HAC group showed similar histological features to those of the HA/TCP group; the cortical surface of the newly developed bone was smooth and the bone matrix on the surface of the cylinder was regularly arranged. CONCLUSIONS: We concluded that both the hydroxyapatite powder and cylinder models investigated in our study may be suitable as a bone substitute in the rabbit tibial defect model, but their characteristic properties are quite different. In contrast to hydroxyapatite powder, which showed better results for the bone ingrowth surface, the hydroxyapatite cylinder showed better results for the sustained morphology.

Cilostazol protects rat chondrocytes against nitric oxide-induced apoptosis in vitro and prevents cartilage destruction in a rat model of osteoarthritis.

OBJECTIVE: To examine whether cilostazol, a selective phosphodiesterase type III inhibitor, protects rat articular chondrocytes against nitric oxide (NO)-induced apoptosis and prevents cartilage destruction in mono-iodoacetate-induced osteoarthritis (OA) in a rat model in which inducible nitric oxide synthase (iNOS) is expressed. METHODS: The NO donor sodium nitroprusside was administered to rat articular chondrocytes that had been pretreated with cilostazol. Induction of apoptosis was evaluated by DNA electrophoresis and pulsed-field gel electrophoresis. The expression level and the subcellular location of apoptosis-associated factors were examined by Western blot analysis and confocal microscopy, respectively. Protein kinase CK2 (PKCK2) activity was also assayed. To examine whether orally administered cilostazol prevents cartilage destruction in vivo, cartilage samples obtained from rats with experimentally induced OA were subjected to hematoxylin and eosin, Safranin O, and TUNEL staining and immunohistochemical analysis of iNOS expression. RESULTS: Cilostazol prevented NO-induced reduction in viability, in a dose-dependent manner. It also prevented the up-regulation of phosphorylated p53 and p38, the down-regulation of heme oxygenase 1, the subcellular translocation of apoptosis-inducing factor and cytochrome c, and the activation of caspases 3, 7, and 8 induced by NO treatment, indicating that cilostazol prevented NO-induced cell death by blocking apoptosis. In addition, cilostazol prevented NO-induced translocation of cleaved Bid onto mitochondria, and caused phosphorylated Bid to accumulate in the nucleus and cytosol. Cilostazol prevented the down-regulation of PKCK2 and the reduction in PKCK2 activity induced by NO, indicating that its apoptosis-preventing activity was mediated via PKCK2. It also prevented chondrocyte apoptosis and cartilage destruction in a rat model of experimentally induced OA. CONCLUSION: Our findings indicate that cilostazol prevents NO-induced apoptosis of chondrocytes via PKCK2 in vitro and prevents cartilage destruction in a rat model of OA.

A purified extract from Clematis mandshurica prevents staurosporin-induced downregulation of 14-3-3 and subsequent apoptosis on rat chondrocytes.

OBJECTIVE: To dissect the mechanism of the protection of staurosporin-induced apoptosis on rat chondrocytes by a purified extract from Clematis mandshurica. DESIGN: Primary cultured rat articular chondrocytes as well as RCJ3.1C.18 cells were incubated with 1 microM staurosporin and 300 microg/ml purified extract from Clematis mandshurica. Western blot assay, silencing 14-3-3 gene and immunoprecipitation were conducted. RESULTS: Clematis mandshurica prevented staurosporin-induced downregulation of several antiapoptotic bcl-2 family proteins Bcl-xL and Bcl-2, and staurosporin-induced upregulation of an apoptotic bcl-2 family protein Bax. Clematis mandshurica also prevented staurosporin-induced downregulation of a premitochondrial antiapoptotic protein 14-3-3. It is noticeable that siRNA to 14-3-3 abolished the prevention of caspase-3 activation by Clematis mandshurica. Furthermore viability assay corroborated that silencing of 14-3-3 gene abolished this apoptosis protection efficacy by Clematis mandshurica. Immunoprecipitation assay elucidated that Clematis mandshurica prevented the staurosporin-induced reduction of the interactions between 14-3-3 with phospho-ser112-Bad and Bcl-xL to phospho-ser155-Bad. CONCLUSIONS: Clematis mandshurica prevents staurosporin-induced apoptosis of rat chondrocytes via 14-3-3.

TRAIL induces apoptosis of chondrocytes and influences the pathogenesis of experimentally induced rat osteoarthritis.

OBJECTIVE: To investigate whether TRAIL influences the pathogenesis of osteoarthritis (OA). METHODS: A recombinant adenoviral vector system (Ad-TRAIL) was used. Expression of TRAIL in a rat chondrocyte cell line (RCJ3.1C.18) and alterations in the expression of death and decoy receptors after Ad-TRAIL infection were measured by Western blot assay. To explore the underlying mechanism, Western blot assays (to detect caspase 8, poly[ADP-ribose] polymerase [PARP], and caspase 3 activation), mitochondrial membrane potential (DeltaPsim) measurement, Hoechst staining, and DNA electrophoresis were conducted. Next, expression of TRAIL and death and decoy receptors was examined by immunochemistry in primary cultured chondrocytes and on cartilage obtained from rats with experimentally induced OA. RESULTS: Ad-TRAIL infection induced expression of TRAIL in RCJ3.1C.18 cells, increased expression of death receptor 4 (DR4), and decreased expression of DR5 and decoy receptor 1 (DcR1). Ad-TRAIL, at doses of 10 and 100 multiplicities of infection, decreased the viability of chondrocytes 4 days after infection. Reduction of DeltaPsim, cytochrome c release, nuclear condensation, activation of caspase 3 and PARP, and DNA fragmentation proved the induction of apoptosis. Activation of caspase 8 was also observed. Ad-TRAIL also induced apoptosis in primary cultured chondrocytes, in which alterations in expression of TRAIL and death receptors were similar to those observed in RCJ3.1C.18 cells. Cartilage obtained from rats with experimentally induced OA showed increased expression of TRAIL and DR4 and decreased expression of DR5 and DcR1 compared with control cartilage. CONCLUSION: TRAIL induces chondrocyte apoptosis, and TRAIL-induced chondrocyte apoptosis may play a role in the pathogenesis of OA.

Ganglion cysts of the posterior cruciate ligament.

Ganglion cysts arising from the posterior cruciate ligament (PCL) of the knee are rare. Thirteen cases have been reported with detailed description in the English literature. In this study, 3 cases of ganglion cyst arising from the PCL of the knee are described and comparatively reviewed with the literature. This case report draws attention to clinical symptoms and signs. We presume that rather than mechanical block, it is changes in the shape and dimension of the ganglion cyst with knee motion and posture that stimulate nerve endings in the synovial membrane, causing the development of knee pain and the limitation of knee motion.