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Background: The morphology of the suprascapular notch (SSN) and the ossification of the superior transverse suprascapular ligament (STSL) are risk factors for injury of the suprascapular nerve (SN) during arthroscopic shoulder procedures. The purpose of the current study was to compare preoperative clinical and radiologic characteristics between patients with and without STSL ossification and to evaluate SSN morphology in patients who underwent arthroscopic rotator cuff repair using a 3-dimensional (3D) reconstructed model. Methods: Patients who underwent arthroscopic rotator cuff repair and were given a computed tomography (CT) scan from March 2018 to August 2019 were included in this study. Patients were divided into 2 groups: those without STSL ossification (group I) and those with STSL ossification (group II). Tear size of the rotator cuff and fatty infiltration of rotator cuff muscles were assessed in preoperative magnetic resonance imaging. The morphology of the SSN was classified following Rengachary's classification. The transverse and vertical diameters of the SSN and the distances from anatomical landmarks to the STSL were measured. All measurements were completed using a 3D CT reconstructed scapula model. Results: A total of 200 patients were included in this study. One hundred seventy-eight patients (89.0%) without STSL ossification were included in group I, and 22 patients (11.0%) with STSL ossification were included in group II. Group II showed a significantly advanced age (61.0 ± 7.4 vs. 71.0 ± 7.3 years, p < 0.001) and a shorter transverse diameter of SSN (10.7 ± 3.1 mm vs. 6.1 ± 3.7 mm, p < 0.001) than group I. In the logistic regression analysis, age was an independent prognostic factor for STSL ossification (odds ratio, 1.201; 95% confidence interval, 1.112-1.296; p < 0.001). Patients in type VI showed significantly shorter transverse diameters than other types (p < 0.001). The patient with type I showed a significantly shorter distance from the articular surface of the glenoid to the SSN than those with other types (p < 0.001). Conclusions: In the 3D morphological analysis, age was the independent factor associated with STSL ossification in patients who underwent arthroscopic rotator cuff repair. Type VI showed significantly shorter transverse diameters than other types. Type I showed a significantly shorter distance from the articular surface of the glenoid to the SSN than other types.
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Artroscopia , Imageamento Tridimensional , Lesões do Manguito Rotador , Tomografia Computadorizada por Raios X , Humanos , Artroscopia/métodos , Feminino , Masculino , Pessoa de Meia-Idade , Lesões do Manguito Rotador/cirurgia , Lesões do Manguito Rotador/diagnóstico por imagem , Idoso , Estudos Retrospectivos , Ossificação Heterotópica/diagnóstico por imagem , Ossificação Heterotópica/cirurgia , Manguito Rotador/cirurgia , Manguito Rotador/diagnóstico por imagem , Escápula/diagnóstico por imagem , Escápula/cirurgia , Ligamentos Articulares/cirurgia , Ligamentos Articulares/diagnóstico por imagem , AdultoRESUMO
BACKGROUND: In previous studies, denosumab, a RANKL human monoclonal antibody used in osteoporosis treatment, has shown efficacy in tendon healing after rotator cuff repair. This prospective study investigated the effects of denosumab on tendon healing, re-tear rates, and clinical outcomes post rotator cuff repair in women with osteoporosis. METHOD: This was a prospective, observational study, employing propensity score matching for the control group. From March 2018 to March 2023, female patients over the age of 60 with normal bone density undergoing arthroscopic rotator cuff repair were selected as controls through propensity score matching (PSM) and compared with female patients of the same age group with osteoporosis who were receiving denosumab treatment. The control group was matched using 1-to-2 propensity score matching. Radiological examinations and functional outcomes were assessed preoperatively and at 6 months postoperatively. RESULTS: In the final analysis, the study comprised 34 patients in the denosumab treatment group (Group 1) and 68 patients in the control group (Group 2). The functional scores showed significant improvement at 6 months post-surgery in both groups. No significant difference in the functional scores was observed among the groups. The re-tear rate, defined according to Sugaya's classification (types IV and V) as re-tear, was slightly higher in Group 1 at 16.7% (6 of 34) compared to Group 2 at 11.7% (8 of 68), but the difference was not statistically significant (p = 0.469). The re-tear patterns, classified according to Rhee's classification, also showed no significant difference among the groups (Group 1: 2/4 of 6; Group 2: 4/4 of 8; p = 0.571). The occurrence of type I re-tear exhibited no significant difference between the two groups (5.9% vs. 5.9%; p = 1.000). CONCLUSIONS: The administration of denosumab following arthroscopic rotator cuff repair in women aged 60 and over with osteoporosis resulted in a re-tear rate that was similar to that observed in patients without osteoporosis. This result suggests that denosumab administration might be beneficial for rotator cuff healing, particularly in the context of osteoporosis, a known risk factor for increased retear rates. Therefore, comprehensive osteoporosis screening and treatment should be considered in conjunction with rotator cuff repair surgery in middle-aged women.
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Introduction: In patients with idiopathic normal pressure hydrocephalus (iNPH), the characteristics of balance disturbance are not as well understood as those related to gait. This study examined changes in postural stability in quiet standing after the cerebrospinal fluid tap test (CSFTT) in these patients. Furthermore, the study explored the relationship between the amount of spontaneous body sway and both gait and executive function. Materials and methods: All patients diagnosed with iNPH underwent CSFTT. We evaluated their center of pressure (COP) measurements on a force plate during quiet standing, both pre- and post-CSFTT. Following the COP measurements, we calculated COP parameters using time and frequency domain analysis and assessed changes in these parameters after CSFTT. At pre-CSFTT, we assessed the Timed Up and Go (TUG) and the Frontal Assessment Battery (FAB). We investigated the relationship between COP parameters and the TUG and FAB scores at pre-CSFTT. Results: A total of 72 patients with iNPH were initially enrolled, and 56 patients who responded positively to CSFTT were finally included. Post-CSFTT, significant improvements were observed in COP parameters through time domain analysis. These included the velocity of COP (vCOP), root-mean-square of COP (rmsCOP), turn index, torque, and base of support (BOS), compared to the pre-CSFTT values (p < 0.05). In the frequency domain analysis of COP parameters post-CSFTT, there was a decrease in both the peak and average of power spectral density (PSD) values in both the anteroposterior (AP) and mediolateral (ML) directions below 0.5 Hz (p < 0.05). In addition, the TUG scores showed a positive correlation with vCOP, rmsCOP, turn index, torque, BOS, and both the peak and average PSD values in the AP and ML directions below 0.5 Hz (p < 0.05). The FAB scores demonstrated a negative correlation with vCOP, rmsCOP, turns index, BOS, and both peak and average PSD values in the AP direction below 0.5 Hz (p < 0.05). Conclusion: In patients with iNPH who responded to CSFTT, there was an improvement in spontaneous body sway during quiet standing after CSFTT. Increased spontaneous sway is associated with impaired gait and frontal lobe function. This may be linked to impaired cortico-cortical and cortico-subcortical circuits in patients with iNPH.
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Posttranslational modifications regulate the properties and abundance of synaptic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors that mediate fast excitatory synaptic transmission and synaptic plasticity in the central nervous system. During long-term depression (LTD), protein tyrosine phosphatases (PTPs) dephosphorylate tyrosine residues in the C-terminal tail of AMPA receptor GluA2 subunit, which is essential for GluA2 endocytosis and group I metabotropic glutamate receptor (mGluR)-dependent LTD. However, as a selective downstream effector of mGluRs, the mGluR-dependent PTP responsible for GluA2 tyrosine dephosphorylation remains elusive at Schaffer collateral (SC)-CA1 synapses. In the present study, we find that mGluR5 stimulation activates Src homology 2 (SH2) domain-containing phosphatase 2 (SHP2) by increasing phospho-Y542 levels in SHP2. Under steady-state conditions, SHP2 plays a protective role in stabilizing phospho-Y869 of GluA2 by directly interacting with GluA2 phosphorylated at Y869, without affecting GluA2 phospho-Y876 levels. Upon mGluR5 stimulation, SHP2 dephosphorylates GluA2 at Y869 and Y876, resulting in GluA2 endocytosis and mGluR-LTD. Our results establish SHP2 as a downstream effector of mGluR5 and indicate a dual action of SHP2 in regulating GluA2 tyrosine phosphorylation and function. Given the implications of mGluR5 and SHP2 in synaptic pathophysiology, we propose SHP2 as a promising therapeutic target for neurodevelopmental and autism spectrum disorders.
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Endocitose , Depressão Sináptica de Longo Prazo , Proteína Tirosina Fosfatase não Receptora Tipo 11 , Receptores de AMPA , Receptores de Glutamato Metabotrópico , Receptores de AMPA/metabolismo , Animais , Fosforilação , Endocitose/fisiologia , Depressão Sináptica de Longo Prazo/fisiologia , Receptores de Glutamato Metabotrópico/metabolismo , Proteína Tirosina Fosfatase não Receptora Tipo 11/metabolismo , Proteína Tirosina Fosfatase não Receptora Tipo 11/genética , Ratos , Tirosina/metabolismo , Receptor de Glutamato Metabotrópico 5/metabolismo , Sinapses/metabolismo , Camundongos , Humanos , Neurônios/metabolismoRESUMO
The purpose of this study was to investigate the fracture morphology of distal radius fractures (DRFs) with the status of triangular fibrocartilage complex (TFCC) foveal insertion in patients with or without osteoporosis and to identify the relationship between osteoporosis and foveal tear. Seventy-five patients who underwent surgery for DRF from January 2021 to September 2023 were included. All patients were evaluated by standard radiography and dual-energy X-ray absorptiometry and underwent a 3.0 T magnetic-resonance imaging examination of the involved wrist to identify TFCC foveal tear. Patients were allocated into two groups according to the presence of osteoporosis: patients with osteoporosis (group I) and those without osteoporosis (group II). Group I showed a significantly larger displacement of fractures compared to group II (radial inclination; 13.7 ± 5.4 vs. 17.9 ± 4.2; p < 0.001, dorsal angulation; 22.2 ± 12.1 vs. 16.5 ± 9.4; p = 0.024, ulnar variance; 4.15 ± 2.1 vs. 2.2 ± 1.9; p < 0.001). Dorsal angulation and ulnar variance were found to be independent prognostic factors for TFCC foveal tear in logistic regression analysis. Displacement of fractures was related to osteoporosis, and dorsal angulation and ulnar variance were independent prognostic factors for TFCC foveal tear. However, osteoporosis was not identified as a factor associated with TFCC foveal tears.
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Biogenic amines are produced during fermentation and can act as harmful substances. Strains related to the fermentation of maesil extract were identified and Clavispora lusitaniae and Pichia kluyveri were selected to investigate the relationship between biogenic amines and precursors, NaCl or ethanol. Biogenic amines were analyzed by high-performance liquid chromatography. Among precursors added, arginine was most effective for the biogenic amines formation. After 24 h incubation, the content of total biogenic amines increased from 37.60 to 51.75 mL/L for C. lusitaniae and from 2.60 to 33.30 mL/L for P. kluyveri in arginine-added medium. The number of yeast decreased in both NaCl- and ethanol-YM broth added with arginine, but there was no correlation between the number of yeast and biogenic amines. These results suggested that the formation of biogenic amines by yeast was affected by various factors and their interactions rather than a single factor, such as decarboxylase activity and stress factor. Supplementary Information: The online version contains supplementary material available at 10.1007/s10068-023-01328-8.
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PURPOSE: To evaluate whether postoperative graft volume reduction is associated with clinical outcomes after superior capsule reconstruction (SCR) and to identify factors related to graft volume change. METHODS: Between May 2018 and June 2021, patients who underwent SCR with acellular dermal matrix allograft for irreparable rotator cuff tear with a minimum 1-year follow-up and who had intact graft continuity in postoperative 6-month magnetic resonance imaging were retrospectively reviewed. The lateral half to the medial half of the graft volume ratio was defined as lateral half graft volume ratio. The difference between the preoperative and postoperative lateral half graft volume ratio was defined as lateral half graft volume change. Patients were divided into 2 groups: those with preserved graft volume (group I) and those with reduced graft volume (group II). Intergroup differences in clinical and radiological characteristics were analyzed. RESULTS: A total of 81 patients were included, with 47 (58.0%) in group I and 34 (42.0%) in group II. Group I showed significantly lower lateral half graft volume change (0.018 ± 0.064 vs 0.370 ± 0.177; P < .001) than group II. Group II showed significantly greater preoperative Hamada grade (1.3 ± 0.5 vs 2.2 ± 0.6, P < .001), an anteroposterior distance of the graft at the greater tuberosity (APGT) (30.3 ± 4.8 vs 35.2 ± 3.8, P < .001), and fatty infiltration of infraspinatus (2.3 ± 0.9 vs 3.1 ± 0.8, P < .001) and subscapularis (0.9 ± 0.9 vs 1.6 ± 1.3, P = .009) than group I. Group II had a significantly lower proportion of patients achieving MIC in Constant score than group I (70.2% vs 47.1%, P = .035). The Hamada grade, APGT, and fatty infiltration of infraspinatus and subscapularis were independent factors of graft volume change. CONCLUSIONS: Although SCR improved pain and shoulder function, postoperative graft volume reduction was related to a lower rate of minimal important change achievement in the Constant score compared with preserved graft volume. The preoperative Hamada grade, APGT, and fatty infiltration of infraspinatus and subscapularis were associated with graft volume reduction. LEVEL OF EVIDENCE: Level III, retrospective case-control study.
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Derme Acelular , Lesões do Manguito Rotador , Articulação do Ombro , Humanos , Articulação do Ombro/cirurgia , Estudos Retrospectivos , Estudos de Casos e Controles , Amplitude de Movimento Articular , Lesões do Manguito Rotador/cirurgia , Aloenxertos , Resultado do Tratamento , Artroscopia/métodosRESUMO
Atomically thin 2D transition metal dichalcogenides (TMDs) have recently been spotlighted for next-generation electronic and photoelectric device applications. TMD materials with high carrier mobility have superior electronic properties different from bulk semiconductor materials. 0D quantum dots (QDs) possess the ability to tune their bandgap by composition, diameter, and morphology, which allows for a control of their light absorbance and emission wavelength. However, QDs exhibit a low charge carrier mobility and the presence of surface trap states, making it difficult to apply them to electronic and optoelectronic devices. Accordingly, 0D/2D hybrid structures are considered as functional materials with complementary advantages that may not be realized with a single component. Such advantages allow them to be used as both transport and active layers in next-generation optoelectronic applications such as photodetectors, image sensors, solar cells, and light-emitting diodes. Here, recent discoveries related to multicomponent hybrid materials are highlighted. Research trends in electronic and optoelectronic devices based on hybrid heterogeneous materials are also introduced and the issues to be solved from the perspective of the materials and devices are discussed.
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As point-of-care testing (POCT) is becoming the new paradigm of medical diagnostics, there is a growing need to develop reliable POCT devices that can be conveniently operated in a minimally invasive manner. However, the clinical potential of POCT diagnostics is yet to be realized, mainly due to the limited and inconsistent amount of collected samples on these devices, undermining their accuracy. This study proposes a new biosensing platform modified with a functional polysuccinimide (PSI)-silica nanoparticle (SNP) composite system that can substantially increase the protein conjugation efficiency by modulating physicochemical interaction with proteins by several hundred percent from an unmodified device. The efficacy of this PSI-SNP system is further validated by applying it on the surface of a microneedle array (MN), which has emerged as a promising POCT device capable of accessing interstitial fluid through minimal penetration of the skin. This PSI-SNP MN is demonstrated to detect a wide array of proteins with high sensitivity on par with conventional whole serum analysis, validated by in vivo animal testing, effectively displaying broad applicability in biomedical engineering.
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Técnicas Biossensoriais , Nanocompostos , Animais , Dióxido de Silício/química , Pele , AgulhasRESUMO
BACKGROUND: There is no practical consensus on managing cholesterol in patients with rotator cuff repair despite hyperlipidemia and statin therapy being well-known factors in rotator cuff healing. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk score is a commonly used guideline to determine statin administration for hyperlipidemia. PURPOSE: To identify the relationship between retear and preoperative factors, including 10-year ASCVD risk score and statin administration status, and to compare clinical outcomes and retear rates between patients who are taking and not taking statins. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: This study enrolled 182 patients with a symptomatic full-thickness rotator cuff tear who underwent arthroscopic repair. Serum lipid profile, 10-year ASCVD risk score, statin eligibility, and statin administration status were assessed. Patients were categorized into 2 groups based on magnetic resonance imaging to evaluate cuff integrity at postoperative 6 months: a healed group and a retear group. Radiographic and intraoperative factors related to retear were analyzed. Multiple regression analysis was performed to evaluate factors related to rotator cuff retear. For the subgroup analysis, patients eligible for statin therapy were divided into 2 subgroups according to administration status. RESULTS: There were 149 (81.9%) patients in the healed group and 33 (18.1%) in the retear group. In the multiple regression analysis, missed statin therapy, 10-year ASCVD risk score, and fatty infiltration of the infraspinatus muscle were the independent factors related to retear. The cutoff value for 10-year ASCVD risk score was 11.85%, with a sensitivity of 0.75 and a specificity of 0.62. In the subgroup analysis of 104 patients eligible for statin therapy, 66 (63.5%; group 1) received statin therapy and 38 (36.5%; group 2) missed it. Group 2 showed a significantly higher retear rate than group 1 (36.8% vs 13.6%; P = .006). CONCLUSION: Missed statin therapy, 10-year ASCVD risk score, and fatty infiltration of the infraspinatus were the independent factors associated with rotator cuff retear. Patients who missed statin therapy showed a higher retear rate than patients receiving statin therapy. Optimal statin therapy for patients who undergo arthroscopic rotator cuff repair might improve repair integrity.
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Doenças Cardiovasculares , Inibidores de Hidroximetilglutaril-CoA Redutases , Hiperlipidemias , Lesões do Manguito Rotador , Humanos , Manguito Rotador/cirurgia , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Estudos de Casos e Controles , Doenças Cardiovasculares/tratamento farmacológico , Resultado do Tratamento , Lesões do Manguito Rotador/tratamento farmacológico , Lesões do Manguito Rotador/cirurgia , Artroscopia/métodos , Imageamento por Ressonância Magnética , Hiperlipidemias/tratamento farmacológico , Fatores de Risco , Estudos RetrospectivosRESUMO
Thermometry, the process of measuring temperature, is one of the most fundamental tasks not only for understanding the thermodynamics of basic physical, chemical, and biological processes but also for thermal management of microelectronics. However, it is a challenge to acquire microscale temperature fields in both space and time. Here, a 3D printed micro-thermoelectric device that enables direct 4D (3D Space + Time) thermometry at the microscale is reported. The device is composed of freestanding thermocouple probe networks, fabricated by bi-metal 3D printing with an outstanding spatial resolution of a few µm. It shows that the developed 4D thermometry can explore dynamics of Joule heating or evaporative cooling on microscale subjects of interest such as a microelectrode or a water meniscus. The utilization of 3D printing further opens up the possibility to freely realize a wide range of on-chip, freestanding microsensors or microelectronic devices without the design restrictions by manufacturing processes.
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Recently, one of the primary concerns in e-textile-based healthcare monitoring systems for chronic illness patients has been reducing wasted power consumption, as the system should be always-on to capture diverse biochemical and physiological characteristics. However, the general conductive fibers, a major component of the existing wearable monitoring systems, have a positive gauge-factor (GF) that increases electrical resistance when stretched, so that the systems have no choice but to consume power continuously. Herein, a twisted conductive-fiber-based negatively responsive switch-type (NRS) strain-sensor with an extremely high negative GF (resistance change ratio ≈ 3.9 × 108 ) that can significantly increase its conductivity from insulating to conducting properties is developed. To this end, a precision cracking technology is devised, which could induce a difference in the Young's modulus of the encapsulated layer on the fiber through selective ultraviolet-irradiation treatment. Owing to this technology, the NRS strain-sensors can allow for effective regulation of the mutual contact resistance under tensile strain while maintaining superior durability for over 5000 stretching cycles. For further practical demonstrations, three healthcare monitoring systems (E-fitness pants, smart-masks, and posture correction T-shirts) with near-zero standby power are also developed, which opens up advancements in electronic textiles by expanding the utilization range of fiber strain-sensors.
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Dispositivos Eletrônicos Vestíveis , Humanos , Têxteis , Eletrônica , Módulo de Elasticidade , Atenção à SaúdeRESUMO
Graft fixation sites on the greater tuberosity and the superior glenoid for superior capsule reconstruction (SCR) are prone to graft failure. The graft fixation procedure on the superior glenoid is challenging due to the limited working space, narrow graft attachment site, and difficulties in suture management. This technical note introduces the surgical technique of SCR using an acellular dermal matrix allograft combined with remnant tendon augmentation to enhance graft healing and the suture management technique to prevent suture tangling for the treatment of irreparable rotator cuff tear.
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Based on their high applicability to wearable electronics, fiber-based stretchable electronics have been developed via different strategies. However, the electrical conductivity of a fiber electrode is severely degraded, following deformation upon stretching. Despite the introduction of conductive buckled structures to resolve this issue, there still exist limitations regarding the simultaneous realizations of high conductivity and stretchability. Here, we exploit the dense distribution of the Ag nanoparticle (AgNP) network in polyurethane (PU) to fabricate a strain-insensitive stretchable fiber conductor comprising highly conductive buckled shells via a facile chemical process. These buckled AgNPs/PU fibers exhibit stable and reliable electrical responses across a wide range (tensile strain = â¼200%), in addition to their high electrical conductivity (26,128 S/m) and quality factor (Q = 2.29). Particularly, the negligible electrical hysteresis and excellent durability (>10,000 stretching-releasing cycles) of the fibers demonstrate their high applicability to wearable electronics. Furthermore, we develop buckled fiber-based pH sensors exhibiting stable, repeatable, and highly distinguishable responses (changing pH is from 4 to 8, response time is 5-6 s) even under 100% tensile strain. The buckled AgNPs/PU fibers represent a facile strategy for maintaining the stable electrical performances of fiber electrodes across the strain range of human motion for wearable applications.
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A circular active noise barrier using a theoretically calculated control filter without real-time adaptation was proposed for noise reduction in a specific outdoor space. A compact circular barrier is used for the movable system to cope with changes in the location of the workspace, and noise in a wide frequency band can be reduced by conducting active noise control through control speakers arranged around a barrier. However, there was a significant performance gap compared with the maximum performance achieved by using the experimental fixed filter due to an extremely simplified theoretical model which ignores the interaction between the control speakers and the barrier. Therefore, this study tried to minimize the performance degradation when applying the theoretically calculated control filter. Another theoretical model is introduced to improve the noise reduction performance by considering the interaction between the control speaker and the barrier. Through experiment, it is confirmed that noise reduction performance is improved by about 2.6 dB in the frequency of interest.
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Neddylation is a cellular process in which the neural precursor cell expressed, developmentally down-regulated 8 (NEDD8) is conjugated to the lysine residue of target proteins via serial enzymatic cascades. Recently, it has been demonstrated that neddylation is required for synaptic clustering of metabotropic glutamate receptor 7 (mGlu7) and postsynaptic density protein 95 (PSD-95), and the inhibition of neddylation impairs neurite outgrowth and excitatory synaptic maturation. Similar to the balanced role of deubiquitylating enzymes (DUBs) in the ubiquitination process, we hypothesized that deneddylating enzymes can regulate neuronal development by counteracting the process of neddylation. We find that the SUMO peptidase family member, NEDD8 specific (SENP8) acts as a key neuronal deneddylase targeting the global neuronal substrates in primary rat cultured neurons. We demonstrate that SENP8 expression levels are developmentally regulated, peaking around the first postnatal week and gradually diminishing in mature brain and neurons. We find that SENP8 negatively regulates neurite outgrowth through multiple pathways, including actin dynamics, Wnt/ß-catenin signaling, and autophagic processes. Alterations in neurite outgrowth by SENP8 subsequently result in the impairment of excitatory synapse maturation. Our data indicate that SENP8 plays an essential role in neuronal development and is a promising therapeutic target for neurodevelopmental disorders.
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Endopeptidases , Neurogênese , Animais , Ratos , Proteína 4 Homóloga a Disks-Large , Neurônios , Sinapses/fisiologia , Ubiquitinação , Endopeptidases/metabolismoRESUMO
PURPOSE: This study aimed to compare clinical and radiologic outcomes between single- and double-bundle arthroscopic-assisted coracoclavicular (CC) ligament reconstruction using cortical fixation buttons with suture tapes for acute acromioclavicular (AC) joint dislocation. METHODS: Patients who underwent arthroscopic-assisted CC ligament reconstruction using cortical fixation buttons with suture tapes for acute AC joint dislocation from July 2014 to March 2019 were identified. This study included patients treated for acute AC joint dislocation within 2 weeks after an injury, with a Rockwood classification of III or V and at least 2 years of follow-up. Patients were divided into 2 groups based on the reconstruction technique: group I (single-bundle technique) and group II (double-bundle technique). The clinical outcomes were compared using the American Shoulder Elbow Surgeons (ASES) score, Constant score, and visual analog scale for pain score between the 2 groups. On the plain radiograph, the CC interval ratio (CCIR) was measured to evaluate maintenance of CC interval fixation. Postoperative complications, including reduction failure, were also documented. RESULTS: Fifty-eight patients (26 in group I, 32 in group II) were enrolled. There were no significant differences in CCIR between the 2 groups preoperatively and 3 months postoperatively. However, the CCIR of group I was significantly greater than that of group II 6 months postoperatively (group I: 160.5% ± 48.5%, group II: 125.4% ± 38.9% at 6 months postoperatively, P = .01; group I: 164.0% ± 57.3%, group II: 123.2% ± 35.9% at the last visit, P = .01). Despite radiologic differences, the clinical outcomes demonstrated no significant differences between 2 the groups (ASES score: 93.5 ± 5.2 in group I, 94.4 ± 4.5 in group II, P = .54; Constant score: 92.9 ± 5.3 in group I, 94.8 ± 4.3 in group II, P = .16). Reduction failure occurred in 4 patients (15.3%) in group I and in 1 patient (3.2%) in group II (P = .16). CONCLUSIONS: Arthroscopic-assisted double-bundle CC ligament reconstruction using cortical fixation buttons with suture tapes provided superior vertical stability than the single-bundle technique. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
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Articulação Acromioclavicular , Luxações Articulares , Luxação do Ombro , Humanos , Luxações Articulares/cirurgia , Articulação Acromioclavicular/cirurgia , Articulação Acromioclavicular/lesões , Estudos Retrospectivos , Resultado do Tratamento , Luxação do Ombro/cirurgia , Ligamentos Articulares/cirurgia , SuturasRESUMO
PURPOSE: Large retracted anterior L-shaped tear characterized by a retracted supraspinatus tendon to the glenoid level combined with a relatively preserved infraspinatus tendon is one of the challenging tear patterns in achieving complete repair to the anatomic footprint. The purpose of this study was to evaluate clinical outcomes and tendon integrity of rotator cuff repair combined with anterior cable reconstruction using the proximal biceps tendon in patients with large retracted anterior L-shaped rotator cuff tear. METHODS: This study prospectively enrolled patients who underwent arthroscopic anterior cable reconstruction using the proximal biceps tendon for large retracted anterior L-shaped rotator cuff tears between 2018 and 2020 with a minimum 2-year follow-up. The anterior portion of the rotator cable was reconstructed using tenotomized proximal biceps tendon fixed with two suture anchors at the footprint. The retracted supraspinatus tendon was repaired on the biceps tendon without undue tension. The proximal portion of the infraspinatus tendon was repaired with the biceps tendon-supraspinatus tendon complex. Clinical outcomes was assessed during the follow-up period. Tendon integrity and retear size were evaluated by postoperative MRI. RESULTS: A total of 32 consecutive patients were included. The ASES score was significantly improved from 66.6 ± 16.6 preoperatively to 94.1 ± 6.1 postoperatively (P < 0.001), and the VAS for pain was significantly relieved from 2.8 ± 1.9 preoperatively to 0.5 ± 0.4 postoperatively (P < 0.001). All patients were satisfied postoperatively regardless of tendon integrity (P = 0.015). Postoperative ROM was increased continuously during the follow-up period (P < 0.001). The Popeye sign was found in 4 patients (12.5%). Six patients (18.7%) had rotator cuff retears. However, the ASES score of patients with retear was significantly improved from 72.8 ± 13.3 preoperatively to 91.1 ± 6.7 postoperatively (P < 0.001). Relative changes in the retear size compared with the primary tear size were -56.8 ± 14.4% for the anteroposterior diameter and - 70.6 ± 6.1% for the mediolateral diameter. CONCLUSIONS: Rotator cuff repair combined with anterior cable reconstruction using the proximal biceps tendon provided satisfactory clinical and radiological outcomes for large retracted anterior L-shaped tears. Anterior cable reconstruction using the proximal biceps tendon is a sound surgical option for the patients with large retracted anterior rotator cuff tear. LEVEL OF EVIDENCE: IV.
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Lesões do Manguito Rotador , Humanos , Lesões do Manguito Rotador/cirurgia , Resultado do Tratamento , Tendões/cirurgia , Manguito Rotador/cirurgia , Ruptura/cirurgiaRESUMO
Controlling the contact properties of a copper (Cu) electrode is an important process for improving the performance of an amorphous indium-gallium-zinc oxide (a-IGZO) thin-film transistor (TFT) for high-speed applications, owing to the low resistance-capacitance product constant of Cu. One of the many challenges in Cu application to a-IGZO is inhibiting high diffusivity, which causes degradation in the performance of a-IGZO TFT by forming electron trap states. A self-assembled monolayer (SAM) can perfectly act as a Cu diffusion barrier (DB) and passivation layer that prevents moisture and oxygen, which can deteriorate the TFT on-off performance. However, traditional SAM materials have high contact resistance and low mechanical-adhesion properties. In this study, we demonstrate that tailoring the SAM using the chemical coupling method can enhance the electrical and mechanical properties of a-IGZO TFTs. The doping effects from the dipole moment of the tailored SAMs enhance the electrical properties of a-IGZO TFTs, resulting in a field-effect mobility of 13.87 cm2/V·s, an on-off ratio above 107, and a low contact resistance of 612 Ω. Because of the high electrical performance of tailored SAMs, they function as a Cu DB and a passivation layer. Moreover, a selectively tailored functional group can improve the adhesion properties between Cu and a-IGZO. These multifunctionally tailored SAMs can be a promising candidate for a very thin Cu DB in future electronic technology.
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A chemically revertible bioconjugation strategy featuring a new bioorthogonal dissociative reaction employing enamine N-oxides is described. The reaction is rapid, complete, directional, traceless, and displays a broad substrate scope. Reaction rates for cleavage of fluorophores from proteins are on the order of 82 M-1s-1, and the reaction is relatively insensitive to common aqueous buffers and pHs between 4 and 10. Diboron reagents with bidentate and tridentate ligands also effectively reduce the enamine N-oxide to induce dissociation and compound release. This reaction can be paired with the corresponding bioorthogonal hydroamination reaction to afford an integrated system of bioorthogonal click and release via an enamine N-oxide linchpin with a minimal footprint. The tandem associative and dissociative reactions are useful for the transient attachment of proteins and small molecules with access to a discrete, isolable intermediate. We demonstrate the effectiveness of this revertible transformation on cells using chemically cleavable antibody-drug conjugates.