Optimized quantification of fatty acids in complex media using advanced analytical techniques.

RATIONALE: Various medium formulations contain essential fatty acids at concentrations ranging from 10 to 100 mg/L. Accurate and precise lipid measurement in media is crucial for monitoring media quality and conducting studies on lipids in the context of cell culture. This study employed two-dimensional gas chromatography (GC × GC) analyses to offer enhanced resolution, sensitivity, and separation performance compared to GC. METHODS: Quantification of fatty acid methyl esters (FAMEs) in a medium was conducted using GC × GC combined with a high-resolution mass spectrometer and flame ionization detector, considering potential interference from nonionic surfactant Tween 80, which was precipitated and removed by optimizing the concentration of cobalt thiocyanate (CTA) solution during pretreatment. This advanced analytical approach enabled identification of cis and trans isomers of identical molecular weights and determination of the location and number of double bonds in the same carbon number structure. RESULTS: Our analysis identified 36 FAMEs within the C6-C24 region, and a 5% CTA solution was optimal for efficient removal of Tween 80 during lipid extraction. Additionally, this advanced method minimized FAME contamination and loss during pretreatment, thereby significantly reducing the sample volume required to detect trace levels of FAMEs. This improvement led to a fatty acid recovery rate of 106% while maintaining the average relative standard deviation for the target FAMEs of about 3%. CONCLUSIONS: Our research paves the way for future investigation into medium quality control and the role of fatty acids in cell culture. This offers the possibility for economical and effective trace quantification of fatty acids in complex media.

The left ventricular assist device: a literature review and guidelines for dental care.

About 6.2 million adults in the United States suffer from heart failure (HF). For patients with advanced HF refractory to medical therapy, an orthotopic heart transplant or a ventricular assist device (VAD) is the only long-term survival option. The most commonly used form of these devices is the left VAD (LVAD), implanted to support the left ventricle. As many as 2754 LVADs were implanted annually between 2006 and 2015, allowing recipients to maintain a relatively normal lifestyle, including both elective and emergency dental care in the ambulatory setting. As more LVADs are implanted, oral healthcare providers (OHCPs) are more likely to encounter these patients in an outpatient clinical setting. This study aims to educate OHCPs on the specific needs of these patients and to begin development of clinical guidelines for their dental management. A literature review using electronic resources was conducted to identify all literature relevant to the clinical topic. Appropriate literature was selected based on established inclusion and exclusion criteria, and 3 articles published between 2015 and 2020 were identified. None offered clinical practice guidelines for the care of patients with implanted LVADs. However, it is known that patients supported by an LVAD are at higher risk of thrombotic complications, which can lead to pump system failure and embolic stroke. To reduce the risk of complications, these patients are treated with anticoagulation therapy. Interruption of these drugs prior to dental treatment is not recommended. Due to the side effects of anticoagulation therapy and acquired coagulopathy, patients with an LVAD are also at increased risk of bleeding events. Thus, perioperative hemorrhagic risk during routine oral surgical procedures must be considered. While most dental care can be done in an outpatient setting, OHCPs should be aware of the special needs of these patients and provide appropriate care through close coordination with the LVAD/transplant team.

Roll-Pressed Silicon Anodes with High Reversible Volumetric Capacity Achieved by Interfacial Stabilization and Mechanical Strengthening of a Silicon/Graphene Hybrid Assembly.

Application of Si anodes is hindered by severe capacity fading due to pulverization of Si particles during the large volume changes of Si during charge/discharge and repeated formation of the solid-electrolyte interphase. To address these issues, considerable efforts have been devoted to the development of Si composites with conductive carbons (Si/C composites). However, Si/C composites with high C content inevitably show low volumetric capacity because of low electrode density. For practical applications, the volumetric capacity of a Si/C composite electrode is more important than gravimetric capacity, but volumetric capacity in pressed electrodes is rarely reported. Herein, a novel synthesis strategy is demonstrate for a compact Si nanoparticle/graphene microspherical assembly with interfacial stability and mechanical strength achieved by consecutively formed chemical bonds using 3-aminopropyltriethoxysilane and sucrose. The unpressed electrode (density: 0.71 g cm-3 ) shows a reversible specific capacity of 1470 mAh g-1 with a high initial coulombic efficiency of 83.7% at a current density of 1 C-rate. The corresponding pressed electrode (density: 1.32 g cm-3 ) exhibits high reversible volumetric capacity of 1405 mAh cm-3 and gravimetric capacity of 1520 mAh g-1 with a high initial coulombic efficiency of 80.4% and excellent cycling stability of 83% over 100 cycles at 1 C-rate.

Correlations of Sesamoid Bone Subluxation with the Radiologic Measures of Hallux Valgus and Its Clinical Implications.

Background and Objectives: Hallux valgus is one of the most common chronic foot complaints, with prevalences of over 23% in adults and up to 35.7% in older adults. However, the prevalence is only 3.5% in adolescents. The pathological causes and pathophysiology of hallux valgus are well-known in various studies and reports. A change in the position of the sesamoid bone under the metatarsal bone of the first toe is known to be the cause of the initial pathophysiology. Purpose: The relationships between the changes in the location of the sesamoid bone and each radiologically measured angle and joint congruency in the hallux valgus remain as yet unknown. Therefore, this study investigated the relationships of sesamoid bone subluxation with the hallux valgus angle, intermetatarsal angle, and metatarsophalangeal joint congruency in hallux valgus patients. The goal is to know the hallux valgus angle, the intermetatarsal angle, and metatarsophalangeal joint congruency's correlation with hallux valgus severity and prognosis by revealing the relationship between each measured value and sesamoid bone subluxation. Materials and Methods: We reviewed 205 hallux valgus patients who underwent radiographic evaluation and subsequent hallux valgus correction surgery in our orthopedic clinic between March 2015 and February 2020. Sesamoid subluxation was assessed using a new five-grade scale on foot radiographs, and other radiologic measurements were assessed, such as hallux valgus angle, the intermetatarsal angle, distal metatarsal articular angle, joint congruency, etc. Conclusions: Measurements of the hallux valgus angle, interphalangeal angle, and joint congruency exhibited high interobserver and intraobserver reliabilities in this study. They also showed correlations with sesamoid subluxation grade.

Efficacy of Silver Nanoparticles-Loaded Bone Cement against an MRSA Induced-Osteomyelitis in a Rat Model.

Background and Objectives: The purpose of this study was to assess the cytotoxicity and antibacterial effects of AgNP-impregnated Tetracalcium phosphate-dicalcium phosphate dihydrate (TTCP-DCPD). Materials and Methods: Using in vitro experiments, the cytotoxicity of AgNP-impregnated TTCP-DCPD against fibroblasts and osteocytes was assessed in terms of cell viability by water-soluble tetrazolium salt assay. To assess antibacterial effects, a disc diffusion test was used; osteomyelitis was induced first in vivo, by injection of methicillin-resistant Staphylococcus aureus into the tibia of rats. AgNP-impregnated TTCP-DCPD bone cement was then applied at various silver concentrations for 3 or 12 weeks. Antibacterial effects were assessed by culturing and reverse transcription-polymerase chain reaction (RT-PCR). For histological observation, the bone tissues were stained using hematoxylin and eosin. Results: Cell viability was decreased by the impregnated bone cement but did not differ according to AgNP concentration. The diameter of the growth-inhibited zone of MRSA was between 4.1 and 13.3 mm on the disks treated with AgNP, indicating antimicrobial effects. In vivo, the numbers of bacterial colonies were reduced in the 12-week treatment groups compared to the 3-week treatment groups. The groups treated with a higher (10×) dose of AgNP (G2-G5) showed a tendency of lower bacterial colony counts compared to the group without AgNP (G1). The PCR analysis results showed a tendency of decreased bacterial gene expression in the AgNP-impregnated TTCP-DCPD groups (G2-G5) compared to the group without AgNP (G1) at 3 and 12 weeks. In the H&E staining, the degree of inflammation and necrosis of the AgNP-impregnated TTCP-DCPD groups (G2-G5) showed a tendency to be lower at 3 and 12 weeks compared to the control group. Our results suggest that AgNP-impregnated TTCP-DCPD cement has antimicrobial effects. Conclusions: This study indicates that AgNP-impregnated TTCP-DCPD bone cement could be considered to treat osteomyelitis.

Association between joint effusions and concomitant structural injuries (tendinitis and structural injury) on MRI in ankle trauma without fracture.

BACKGROUND: The evaluation of correlations among joint effusion, ligament injuries, tenosynovitis and osteochondral lesion of talus (OLT) in the ankle joint is important for developing a treatment plan and predicting prognosis. PURPOSE: To evaluate correlations among tibiotalar (anterior) and talocalcaneal (posterior) joint effusion, tenosynovitis of major flexor tendons, ligaments, and OLT in a group of patients with ankle trauma. MATERIAL AND METHODS: This retrospective study included 101 patients with ankle trauma who underwent magnetic resonance imaging. Two radiologists assessed the presence and amount of effusion in the tibiotalar and talocalcaneal joints from grade 0 to 2, according to the amount of capsular distension. Concomitant structural injuries were assessed in the tibialis posterior (TP), flexor digitorum longus, flexor hallucis longus, and peroneus tendons, and the anterior talofibular ligament, calcaneofibular ligament, anteroinferior tibiofibular ligament, posteroinferior tibiofibular ligament, and OLT. RESULTS: The proportion of anterior and posterior joint effusion according to grade was 67.3% for anterior joint effusion grade 0, 22.8% for grade 1, and 9.9% for grade 2; for posterior joint effusion, grade 0 was 74.2%, grade 1 was 22.8%, and grade 2 was 3.0%. We found statistically significant correlations between posterior joint effusion and tenosynovitis of TP (P < 0.05) and between posterior joint effusion and OLT (P < 0.05). CONCLUSION: Posterior joint effusion is correlated with TP injury and OLT; however, tendon injuries have no correlation with other structural injuries of the ankle joint in a general population with ankle trauma.

In Situ Growth of Novel Graphene Nanostructures in Reduced Graphene Oxide Microspherical Assembly with Restacking-Resistance and Inter-Particle Contacts for Energy Storage Devices.

Graphene is extensively investigated for various energy storage systems. However, the very low density (<0.01 g cm-3 ) of graphene nanosheets has hindered its further applications. To solve this issue, a controlled assembly of 2D graphene building blocks should be developed into graphene microspheres with high packing density, and restacking of graphene should be prevented to ensure an electrochemically accessible surface area during the assembly. Furthermore, graphene microspheres should have multiple 1D external conductive architecture to promote contacts with the neighbors. This study reports in situ growth of novel graphene nanostructures in reduced graphene oxide microspherical assembly (denoted as GT/GnS@rGB) with restacking resistance and interparticle contacts, for electrochemical energy storage. The GT/GnS@rGB showed high gravimetric (231.8 F g-1 ) and volumetric (181.5 F cm-3 ) capacitances at 0.2 A g-1 in organic electrolyte with excellent rate capabilities of 94.3% (@ 0.2 vs 10 Ag-1 ). Furthermore, GT/GnS@rGB exhibited excellent cycling stability (96.1% of the initial capacitance after 100 000 charge/discharge cycles at 2 A g-1 ). As demonstrated in the electrochemical evaluation as electrode materials for electrical double-layer capacitors, unique structural and textural features of the GT/GnS@rGB would be beneficial in the use of graphene assembly for energy storage applications.

Retrograde transvenous obliteration for the prevention of variceal rebleeding in patients with portal vein thrombosis: a multicenter study.

OBJECTIVES: To evaluate the effectiveness of retrograde transvenous obliteration (RTO) for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis (PVT). METHODS: Consecutive cirrhotic patients with PVT who underwent RTO for the prevention of variceal rebleeding between January 2002 and June 2019 were included in this multicenter retrospective study. The primary outcome measure was rebleeding. The secondary outcome measures were survival, other complications of portal hypertension, liver function, and PVT. RESULTS: Forty-five patients (mean age, 66.0 ± 10.6 years; mean Model for End-Stage Liver Disease (MELD) score, 13.9 ± 5.5) were included. The 1-year actuarial probability of remaining free of rebleeding was 92.8 ± 4.0%. The 6-week, 1-year, and 3-year actuarial probabilities of survival were 79.8 ± 6.0%, 48.8 ± 7.7%, and 46.1 ± 7.9%, respectively. MELD score (hazard ratio (HR), 1.09 (95% confidence interval (CI), 1.01-1.17); p = .013) and ascites (HR, 2.84 (95% CI, 1.24-6.55); p = .014) were identified as significant predictors of survival. The 1-year actuarial probabilities of remaining free of new or worsening ascites and esophageal varices were 81.2 ± 8.7% and 89.2 ± 6.0%, respectively. No patients had overt hepatic encephalopathy during follow-up. MELD score significantly increased by a mean of 3.8 (95% CI, 1.7-6.0) at 3 months (p = .001). PVT had improved in 32.0%, worsened in 12.0%, and remained unchanged in 56.0% of patients at 3 months. CONCLUSION: RTO may be effective for the prevention of variceal rebleeding in cirrhotic patients with PVT. KEY POINTS: • Retrograde transvenous obliteration may prevent variceal rebleeding in cirrhotic patients with portal vein thrombosis. • The risks of other complications of portal hypertension may not be high after retrograde transvenous obliteration in cirrhotic patients with portal vein thrombosis. • Portal vein thrombosis may improve in approximately one-third of cirrhotic patients within 3 months after retrograde transvenous obliteration.

Oncostatin M enhances osteogenic differentiation of dental pulp stem cells derived from supernumerary teeth.

Supernumerary tooth (ST) may arise from uncertain developmental abnormalities or underlying genetic causes, and the extraction at the early age is recommended. Dental pulp stem cells (DPSCs) are the valuable resource for the regeneration of tooth and related craniofacial structures. DPSCs isolated from ST (sDPSCs) have not been fully characterized despite the potential in the applications. The objectives of this study are the efficient isolation of sDPSCs and the analysis of the properties as stem cells. sDPSCs were established by hammer-cracking and separation of the intact pulp from ST. sDPSCs in the culture were examined by light microscope and flow cytometer for the morphology and the surface marker expression. sDPSCs exhibited the cellular morphology of typical mesenchymal stem cells and expressed CD44, CD73, CD90, CD105 and CD166, but not CD14, CD34 or CD45. sDPSCs showed the differentiation potential toward osteogenic, chondrogenic and adipogenic lineages. During osteogenic differentiation, the stimulation by Oncostatin M enhanced the differentiation and significantly increased the expression of genes involved in the hard tissue repair, such as BMP2, BMP4, BMP6 and RUNX2. sDPSCs can be effectively derived from ST and displays the characteristics of mesenchymal stem cells in the maintenance and the differentiation. sDPSCs satisfies the quality as DPSCs thus provide the valuable resource to the regenerative therapy.

The increased amount of coffee consumption lowers the incidence of fatty liver disease in Korean men.

BACKGROUND AND AIMS: Coffee is known to have a beneficial effect on various liver diseases. The aim of this retrospective longitudinal study was to investigate an association between the amount of coffee consumption and the incidence of fatty liver disease in Korean adults. METHODS AND RESULTS: Data from a total of 91,436 male and female subjects with the mean follow-up period of 2.8 years were analyzed. The incidence of fatty liver was not associated with the amount of coffee consumption at baseline, but it was associated with the change in the amount of coffee consumption at the follow-up period. Multiple linear regression analyses showed that hazard ratios for incidence of fatty liver disease were significantly low in "increase" group comparing with "no change" group in fully adjusted model. When a subgroup analysis by gender was conducted, similar significant results were observed in male subjects, but not in females. CONCLUSIONS: The increment in the amount of coffee consumption is associated with the lower incidence of fatty liver in Korean men and suggests that increasing the coffee consumption may have a protective effect on fatty liver.

2'-Hydroxycinnamaldehyde inhibits proliferation and induces apoptosis via signal transducer and activator of transcription 3 inactivation and reactive oxygen species generation.

Inhibition of the signal transducer and activator of transcription 3 (STAT3) signaling pathway is a novel therapeutic strategy to treat human cancers with constitutively active STAT3. During the screening of natural products to find STAT3 inhibitors, we identified 2'-hydroxycinnamaldehyde (HCA) as a STAT3 inhibitor, which was isolated from the stem bark of Cinnamomum cassia. In this study, we found that HCA inhibited constitutive and inducible STAT3 activation in STAT3-activated DU145 prostate cancer cells. HCA selectively inhibited the STAT3 activity by direct binding to STAT3, which was confirmed by biochemical methods, including a pull-down assay with biotin-conjugated HCA, a drug affinity responsive target stability (DARTS) experiment and a cellular thermal shift assay (CETSA). HCA inhibited STAT3 phosphorylation at the tyrosine 705 residue, dimer formation, and nuclear translocation in DU145 cells, which led to a downregulation of STAT3 target genes. The downregulation of cell cycle progression and antiapoptosis-related gene expression by HCA induced the accumulation of cells in the G0/G1 phase of the cell cycle and then induced apoptosis. We also found that reactive oxygen species (ROS) were involved in the HCA-induced inhibition of STAT3 activation and cell proliferation because the suppressed p-STAT3 level was rescued by glutathione or N-acetyl-L-cysteine treatment, which are general ROS inhibitors. These results suggest that HCA could be a potent anticancer agent targeting STAT3-activated tumor cells.

Predictive value of lymphoscintigraphy in patients with breast cancer-related lymphedema undergoing complex decongestive therapy.

PURPOSE: We evaluated the prognostic value of lymphoscintigraphy after complex decongestive therapy (CDT) in breast cancer-related secondary lymphedema. METHODS: Prior to CDT, 80 patients with breast cancer-related lymphedema underwent a 99mTc tin-colloid lymphoscintigram. We investigated the uptake patterns of axillary lymph nodes (LNs), main lymphatic vessels, collateral lymphatic vessels, and dermal back flow in the lymphoscintigraphy of the upper extremities. We also compared the above findings with other clinical variables between patients who respond well to CDT (responders) and those who do not (poor responders). We used Pearson's χ2 test and Fisher's exact test to compare the lymphoscintigram findings with the studied variables. RESULTS: There were 50 poor responders and 30 responders 1 year after CDT. There were significant differences between the two groups with regard to compliance (P < 0.05) and visualization of axillary LNs (P < 0.05). In combined results, the odds ratio was 21.33 (2.37-192.03) in the compliance and visible axillary LNs group compared to the poor compliance and invisible axillary LNs group. CONCLUSION: Lymphoscintigraphy of the upper extremities can be a useful tool to predict the prognosis of CDT in breast cancer-related lymphedema patients.

Percutaneous Transcholecystic Removal of Common Bile Duct Stones: Case Series in 114 Patients.

Purpose To evaluate the safety and effectiveness of percutaneous transcholecystic removal of common bile duct (CBD) stones in 114 patients. Materials and Methods This retrospective study was approved by the institutional review board. From September 2011 through February 2017, 114 consecutive patients (68 men, 46 women; mean age, 73 years) underwent percutaneous transcholecystic removal of CBD stones. All patients had acute cholangitis or cholecystitis. Stones were extracted through a 12-F sheath by using a Wittich nitinol stone basket uder fluoroscopic guidance. Technical success rates, complications, and long-term follow-up were evaluated. Results Technical success was achieved in 96 of 114 (84.2%) patients. In 18 patients, stone removal was unsuccessful due to failure of cystic duct cannulation (n = 11), proximal migration of the CBD stone (n = 3), multiple CBD stones (n = 3), and low insertion of the cystic duct (n = 1). No major procedure-related complications were seen. During the mean follow-up of 644 days (range, 11-2206 days), CBD stones recurred in 12 patients after a mean of 884 days (range, 439-1799 days) after the procedure. Conclusion Percutaneous transcholecystic removal of common bile duct stones seems to be a safe and effective method. © RSNA, 2018 Online supplemental material is available for this article . See also the editorial by vanSonnenberg and Panchanathan in this issue.

Efficacy and Safety of Transvenous Embolization of Type II Renal Arteriovenous Malformations with Coils.

PURPOSE: To evaluate the efficacy and safety of transvenous coil embolization of the venous sac for type II renal arteriovenous malformation (AVM). MATERIALS AND METHODS: A retrospective review was conducted of 8 patients (5 women and 3 men; mean age, 57 years; age range, 41-69 years) who underwent transvenous coil embolization for type II congenital renal AVM at 5 different hospitals between 2012 and 2018. Additional intra-arterial ethanol injection was performed if shunt flow persisted after venous sac coiling. Technical success was defined as complete occlusion of shunt flow with coil embolization. Clinical success was defined as no symptom recurrence during the follow-up period. The renal parenchymal infarction rate was measured on computed tomography (CT), and procedure-related complications were reviewed. RESULTS: Nine sessions of embolization were performed for 8 patients. The mean venous sac size was 24 mm (range, 10-39 mm), and a mean of 14 micro and/or micro-detachable coils (range, 3-50) were used. The technical success rate was 88% (7 of 8) using coil embolization. One patient (12%) required additional ethanol injection to complete occlusion of the shunt flow and had a less than 10% parenchymal infarction on follow-up CT. No procedure-related complications or recurrences occurred during a mean clinical follow-up period of 20.8 months (range, 4.7-76.6 months). CONCLUSIONS: Transvenous coil embolization of type II renal AVM showed an 88% technical success rate. One patient (12%) showed less than 10% renal parenchymal infarction after additional ethanol injection. No additional complications or recurrences occurred during the follow-up period.

Efficacy and Safety of AMPLATZER Vascular Plug Type IV for Embolization of Pulmonary Arteriovenous Malformations.

PURPOSE: To assess the efficacy and safety of the AMPLATZER Vascular Plug type IV for pulmonary arteriovenous malformation (PAVM) treatment. MATERIALS AND METHODS: Between June 2013 and January 2018, 13 patients with 26 PAVMs were treated with the type IV AVP. Patients without follow-up computed tomography (CT) were excluded. Technical success was defined as flow occlusion on angiography. Plug-to-sac distance was measured on angiographic images. Feeding artery and venous sac diameter changes were measured on preprocedural and follow-up CT. Successful embolization was defined as > 70% sac size regression. Procedure time, device migration, and complications were evaluated. RESULTS: Nine female patients (mean age, 49 y; range, 40-71 y) with 19 PAVMs were enrolled. Four patients with 7 PAVMs were lost to follow-up. Nineteen PAVMs were treated in 11 sessions, and the mean procedure time was 29 min. The technical success rate was 100%. Mean feeding artery diameter was 3.1 mm ± 0.7 (range, 2.1-4.9 mm). Mean plug-to-sac distance was 5.4 mm ± 4.9 (range, 0-13.3 mm). The mean CT follow-up period was 14 months ± 7 (range, 6-30 mo). Sixteen of 19 PAVMs (84%) were successfully embolized. Minor complications (tachycardia and chest discomfort) arose in 2 of 11 sessions. No device migrations or major complications occurred. CONCLUSIONS: The type IV AVP showed an 84% treatment success rate based on 70% sac size regression criteria in small PAVMs. There were no device migrations or major complications.

Preparation of Silica Microparticles as Volatile Material Carrier and Their Sustained-Release Property.

The aim of this study is to develop an effective delivery system (silica microparticles) encapsulating volatile essential oil (EO) by multiple emulsification process and sol-gel method. Depending on critical materials (Pluronic P123 and HPC) and process parameter (drying temperature), silica microparticles were prepared and evaluated. As results, the amount of EO inside microparticles increased in polymer-dependent manners. On the other hand, the amount of EO was reduced as drying temperature increased. Based on these data, the condition fabricating silica microparticles was optimized: drying temperature (25 °C), Pluronic P123 (1.2%) and HPC (1.2%). The size and morphology of microparticles were observed by scanning electron microscopy. Also, the loadings and release profiles of EO in these particles were quantitatively analyzed by HPLC. Optimized silica microparticles showed the high encapsulation efficiency (32.7%) and sustained-release profiles of EO for 3 days. Taken together, silica microparticles are effective carrier for encapsulating volatile materials and providing sustained-release.

Mid-term follow-up results of calcaneal reconstruction for calcaneal malunion.

BACKGROUND: We hypothesized that calcaneal reconstruction can relieve chronic pain due to calcaneal malunion. We report the mid-term follow-up results of calcaneal reconstruction for calcaneal malunion. METHODS: We reviewed the records of 10 male patients (10 ft) who underwent calcaneal reconstruction for calcaneal malunion between January 2009 and July 2014 at the mid-term follow-up. Talocalcaneal height and angle, calcaneal pitch, calcaneal width, Böhler angle, Stephens classification, and Zwipp classification were evaluated by three orthopedic doctors at each visit (pre-reconstruction, post-reconstruction, and at the last follow-up). RESULTS: The mean follow-up period was 67.1 months (range, 48-101 months). The sites of pain before reconstruction were lateral aspect (4 patients), plantar aspect (3 patients), diffuse pain (2 patients), and anterior aspect (1 patient). There was a significant difference in talocalcaneal height, talocalcaneal angle, calcaneal pitch, calcaneal width, and Böhler angle before and after reconstruction (p < 0.05). There was no significant difference between reconstruction and the last follow-up. Radiological measurement agreement was calculated to be moderate to strong (intraclass correlation coefficient: 0.659-0.988). Mean American Orthopedic Foot & Ankle Society Ankle and Hindfoot score improved from 66.50 ± 9.37 pre-reconstruction to 80.30 ± 8.52 at the last follow-up (p < 0.05). The mean visual analog scale score improved from 8.60 ± 1.43 before reconstruction to 3.40 ± 0.84 at the last follow-up (p < 0.05). Most patients were satisfied with the outcome postoperatively. CONCLUSIONS: Our results showed substantial improvement in the clinical and radiological outcomes after calcaneal reconstruction of calcaneal malunion. This outcome was maintained until the mid-term follow-up. Therefore, calcaneal reconstruction may be a good option for the treatment of chronic pain caused by the malunion of a calcaneal fracture without severe subtalar arthritis. Further prospective studies are needed to test this theory. LEVEL OF EVIDENCE: Level IV, Retrospective Case Series.

Presence of Subfibular Ossicle Does Not Affect the Outcome of Arthroscopic Modified Broström Procedure for Chronic Lateral Ankle Instability.

PURPOSE: To evaluate the clinical and radiological outcomes of the all-inside, arthroscopic, modified Broström procedure (MBP) used to treat chronic lateral ankle instability (CLAI) according to subfibular ossicle (SFO) status. METHODS: Between January 2013 and September 2016, we retrospectively analyzed CLAI patients who underwent the arthroscopic MBP. When performing the arthroscopic MBP, SFO was removed with all inside technique regardless of size. Patients who were not followed for more than a minimum of 12 months after surgery were excluded. The patients were divided into 2 groups: ankles with SFOs were assigned to the SFO group and the others to the non-SFO (NSFO) group. The evaluation tools used included the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score, a pain visual analog scale, and the talar tilt angle. RESULTS: Following the inclusion criteria, we included 125 patients (125 ankles) in this study. The SFO group consisted of 26 patients and the NSFO group consisted of 99 patients. The preoperative scores in the 2 groups shows no significant difference except for AOFAS scores. The final AOFAS scores in both groups improved compared with the preoperative scores (18.4 ± 16.3 and 22.1 ± 21.6 for the SFO and NSFO groups, respectively). The final follow-up visual analog scale scores also improved in both groups (5.0 ± 1.7 and 5.2 ± 1.4, respectively). The mean ± standard deviation talar tilt improved from 8.7 ± 5.0° preoperatively to 4.6 ± 3.6° at the final follow-up in the SFO group, and from 7.3 ± 4.4° preoperatively to 3.2 ± 3.0° at the final follow-up in the NSFO group. Neither the preoperative nor final talar tilt angle differed between the 2 groups (P = .300 and P = .072, respectively). CONCLUSIONS: All-inside arthroscopic MBP after SFO resection was as successful as the same surgery without SFO resection. The clinical outcomes of the SFO and NSFO groups did not differ. Both groups achieved successful radiological outcomes at the last follow-up. All-inside arthroscopic MBP is a reliable treatment for CLAI patients regardless of SFO status. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Methyllucidone inhibits STAT3 activity by regulating the expression of the protein tyrosine phosphatase MEG2 in DU145 prostate carcinoma cells.

During the search for signal transducer and activator of transcription 3 (STAT3) inhibitors from natural products, methyllucidone, isolated from Lindera species (Lauraceae), was identified as a STAT3 inhibitor. Methyllucidone inhibited STAT3 phosphorylation at tyrosine 705 in a dose- and time dependent manner in DU145 prostate cancer cells and suppressed IL-6-induced STAT3 phosphorylation at Tyr-705 in LNCaP cells. Methyllucidone decreased the expression levels of STAT3 target genes, such as cyclin D1, cyclin A, Bcl-2, Mcl-1, and survivin. Methyllucidone inhibited DU145 cell growth and induced apoptosis by arresting the cell cycle at G1 phase. Notably, knockdown of the MEG2 gene by small interfering RNA suppressed the ability of methyllucidone to inhibit STAT3 activation. Methyllucidone regulates STAT3 activity by modulating MEG2 expression, and our results suggest that this compound is a novel inhibitor of the STAT3 pathway and may be a useful lead molecule for the development of a therapeutic STAT3 inhibitor.

Piperlongumine derivative, CG-06, inhibits STAT3 activity by direct binding to STAT3 and regulating the reactive oxygen species in DU145 prostate carcinoma cells.

Piperlongumine (PL), isolated from Piper longum L., is receiving intense interest due to its selectively ability to kill cancer cells but not normal cells. We synthesized a number of analogues by replacing the cyclic amide of PL with aliphatic amides to explore structural diversity. Compound CG-06 had the strongest cytotoxic profile of this series, showing potent effects in human prostate cancer DU-145 cells, in which signal transducer and activator of transcription 3 (STAT3) is constitutively active. CG-06 inhibited STAT3 phosphorylation at tyrosine 705 in a dose- and time dependent manner in DU-145 cells and suppressed IL-6-induced STAT3 phosphorylation at Tyr-705 in DU-145 and LNCaP cell lines. CG-06 decreased the expression levels of STAT3 target genes, such as cyclin A, Bcl-2, and survivin. Notably, we used drug affinity responsive target stability (DARTS) to show that CG-06 binds directly to STAT3, and the reactive oxygen species (ROS) scavenger N-acetyl cysteine (NAC) rescued the CG-06-induced suppression p-STAT3. Our results suggest that CG-06 is a novel inhibitor of STAT3 and may be a useful lead molecule for the development of a therapeutic STAT3 inhibitor.