Is Surgical Treatment Necessary for the Treatment of a Jones Fracture?: A Retrospective Study.

Background: Jones fractures are common injuries that can be treated conservatively or surgically. However, the optimal treatment approach remains controversial. This study aimed to compare the clinical outcomes of conservative and operative treatments for Jones fractures and determine whether surgical treatment is necessary. Methods: A retrospective study was conducted on 69 patients with Jones fractures treated at our hospital. The patients were divided into 2 groups: conservative (C group; n = 46) and operative (O group; n = 23) treatments. Patients were followed up after 2, 6, and 12 weeks, and every 3 months thereafter. However, outpatient follow-ups were conducted between 8 and 10 weeks as needed. The mean follow-up period was 14.5 weeks (range, 12-24 weeks). In group C, the patients were treated with a non-weight-bearing cast for 4-6 weeks, followed by additional weight-bearing boot immobilization before returning to exercise. In group O, patients were treated surgically using a bicortical screw or intramedullary internal fixation. Time to radiologic union, clinical union, return to sports, visual analog scale (VAS), Foot Function Index-Revised Short Form (FFI-RS), and American Orthopedic Foot and Ankle Society (AOFAS) scores were evaluated. Results: Sixty-nine patients were included in the analysis. There were statistically significant differences in the time to radiologic union and return to sports, VAS score in the second week, and FFI-RS score in the 12th week. In group C, favorable outcomes were observed in terms of the time to return to sports, VAS score in the second week, and FFI-RS score in the 12th week. Contrastingly, in group O, better results were observed in time to radiologic union. The AOFAS score was excellent at the final follow-up, with no significant differences between groups. Complication rates were 10.8% and 13% in groups C and O, respectively. Conclusions: Surgical treatment is sometimes necessary for Jones fractures, but conservative treatment should also be considered because of the favorable outcomes. Conservative treatment can be a good option for patients who are risk-averse and place a high value on fracture healing without surgery.

Anti-Osteoarthritic Effects of Cartilage-Derived Extracellular Matrix in a Rat Osteoarthritis Model.

BACKGROUND: The extracellular matrix (ECM) has many functions, such as segregating tissues, providing support, and regulating intercellular communication. Cartilage-derived ECM (CECM) can be prepared via consecutive processes of chemical decellularization and enzyme treatment. The purpose of this study was to improve and treat osteoarthritis (OA) using porcine knee articular CECM. METHODS: We assessed the rheological characteristics and pH of CECM solutions. Furthermore, we determined the effects of CECM on cell proliferation and cytotoxicity in the chondrocytes of New Zealand rabbits. The inhibitory effect of CECM on tumor necrosis factor (TNF)-α-induced cellular apoptosis was assessed using New Zealand rabbit chondrocytes and human synoviocytes. Finally, we examined the in vivo effects of CECM on inflammation control and cartilage degradation in an experimental OA-induced rat model. The rat model of OA was established by injecting monosodium iodoacetate into the intra-articular knee joint. The rats were then injected with CECM solution. Inflammation control and cartilage degradation were assessed by measuring the serum levels of proinflammatory cytokines and C-telopeptide of type II collagen and performing a histomorphological analysis. RESULTS: CECM was found to be biocompatible and non-immunogenic, and could improve cell proliferation without inducing a toxic reaction. CECM significantly reduced cellular apoptosis due to TNF-α, significantly improved the survival of cells in inflammatory environments, and exerted anti-inflammatory effects. CONCLUSION: Our findings suggest that CECM is an appropriate injectable material that mediates OA-induced inflammation.

The Progress of Stem Cell Therapy in Myocardial-Infarcted Heart Regeneration: Cell Sheet Technology.

Various tissues, including the heart, cornea, bone, esophagus, bladder and liver, have been vascularized using the cell sheet technique. It overcomes the limitations of existing techniques by allowing small layers of the cell sheet to generate capillaries on their own, and it can also be used to vascularize tissue-engineered transplants. Cell sheets eliminate the need for traditional tissue engineering procedures such as isolated cell injections and scaffold-based technologies, which have limited applicability. While cell sheet engineering can eliminate many of the drawbacks, there are still a few challenges that need to be addressed. The number of cell sheets that can be layered without triggering core ischemia or hypoxia is limited. Even when scaffold-based technologies are disregarded, strategies to tackle this problem remain a substantial impediment to the efficient regeneration of thick, living three-dimensional cell sheets. In this review, we summarize the cell sheet technology in myocardial infarcted tissue regeneration.

Comparison of actual amount of movement with surgical treatment objective in the orthognathic maxillary repositioning.

OBJECTIVE: To compare the postoperative position of the maxilla with the surgical treatment objectives (STO) in bimaxillary orthognathic surgery for evaluating the surgical accuracy and investigating the pattern and cause of the discrepancy. METHODS: Patients undergoing conventional bimaxillary orthognathic surgery by a single oral and maxillofacial surgeon were enrolled. Utilizing the superimposition of preoperative and postoperative computed tomography images, the actual amounts of positional change of both the maxillary central incisor and first molars were compared with those of STO. All the patients were divided into two groups according to the actual discrepancy between STO and the postoperative position and factors that may affect surgical accuracy were analyzed. RESULTS: In 62 cases, the absolute mean value of the positional difference between STO and the actual outcome was 2.20 mm (X-axis, 0.93 mm; Y-axis, 1.31 mm; and Z-axis, 1.09 mm) in the maxillary central incisor. The signed mean value of the central incisor was -0.07 mm, 0.79 mm, and -0.57 mm in the X-, Y-, and Z-axes, respectively, and the value in the Y- and Z-axes showed a statistically significant difference in comparison with STO (P<0.01). Age, sex, skeletal Angle classification, maxillary and mandibular profile, use of 3D virtual surgery, facial asymmetry, and yawing correction did not show a statistically significant correlation with surgical accuracy at the central incisor. CONCLUSION: There was an acceptable range of discrepancy between postoperative maxillary position and STO after orthognathic surgery; however, there was a tendency for posterior and downward movement in the maxillary anterior teeth.

Characterization of Marine Organism Extracellular Matrix-Anchored Extracellular Vesicles and Their Biological Effect on the Alleviation of Pro-Inflammatory Cytokines.

Representative marine materials such as biopolymers and bioceramics contain bioactive properties and are applied in regenerative medicine and tissue engineering. The marine organism-derived extracellular matrix (ECM), which consists of structural and functional molecules, has been studied as a biomaterial. It has been used to reconstruct tissues and improve biological functions. However, research on marine-derived extracellular vesicles (EVs) among marine functional materials is limited. Recent studies on marine-derived EVs were limited to eco-system studies using bacteria-released EVs. We aimed to expand the range of representative marine organisms such as fish, crustaceans, and echinoderms; establish the extraction process; and study the bioactivity capability of marine EVs. Results confirmed that marine organism ECM-anchored EVs (mEVs) have a similar morphology and cargos to those of EVs in land animals. To investigate physiological effects, lipopolysaccharide (LPS)-infected macrophages were treated with EVs derived from sea cucumber, fish, and shrimp. A comparison of the expression levels of inflammatory cytokine genes revealed that all types of mEVs alleviated pro-inflammatory cytokines, although to different degrees. Among them, the sea cucumber-derived EVs showed the strongest suppression ability. This study showed that research on EVs derived from various types of marine animals can lead to the development of high value-added therapeutics from discarded marine wastes.

Three-Dimensional Convolutional Neural Network for Prostate MRI Segmentation and Comparison of Prostate Volume Measurements by Use of Artificial Neural Network and Ellipsoid Formula.

OBJECTIVE. The purposes of this study were to assess the performance of a 3D convolutional neural network (CNN) for automatic segmentation of prostates on MR images and to compare the volume estimates from the 3D CNN with those of the ellipsoid formula. MATERIALS AND METHODS. The study included 330 MR image sets that were divided into 260 training sets and 70 test sets for automated segmentation of the entire prostate. Among these, 162 training sets and 50 test sets were used for transition zone segmentation. Assisted by manual segmentation by two radiologists, the following values were obtained: estimates of ground-truth volume (VGT), software-derived volume (VSW), mean of VGT and VSW (VAV), and automatically generated volume from the 3D CNN (VNET). These values were compared with the volume calculated with the ellipsoid formula (VEL). RESULTS. The Dice similarity coefficient for the entire prostate was 87.12% and for the transition zone was 76.48%. There was no significant difference between VNET and VAV (p = 0.689) in the test sets of the entire prostate, whereas a significant difference was found between VEL and VAV (p < 0.001). No significant difference was found among the volume estimates in the test sets of the transition zone. Overall intraclass correlation coefficients between the volume estimates were excellent (0.887-0.995). In the test sets of entire prostate, the mean error between VGT and VNET (2.5) was smaller than that between VGT and VEL (3.3). CONCLUSION. The fully automated network studied provides reliable volume estimates of the entire prostate compared with those obtained with the ellipsoid formula. Fast and accurate volume measurement by use of the 3D CNN may help clinicians evaluate prostate disease.

Photodynamic therapy (PDT) resistance by PARP1 regulation on PDT-induced apoptosis with autophagy in head and neck cancer cells.

BACKGROUND: Photodynamic therapy (PDT) is an anticancer treatment that generates excessive reactive oxygen species after photosensitizer treatments following specific wavelength irradiation. In another reports, PDT was regulated with autophagic cell death and apoptotic cell death. However, the mechanism of PDT resistance in PDT-stimulated cell death is unclear. In this study, we determined PDT resistance by autophagy and apoptosis in HP-PDT-treated oral cancer cells. MATERIALS & METHODS: Cells were treated hematoporphyrin and then irradiation with or without inhibitor. Cell lysates were checked protein expression with specific antibody. PDT resistance cells were generated with PDT repeated treatments. RESULTS: In HP-PDT, PDT induced autophagy through mTOR, ATG5, and LC3 in dose-dependent manners. Also, PDT at high dose induced apoptosis through caspase activation and PARP-1. Moreover, PARP-1 inhibitor protected cells against HP-PDT-induced cell death, but not by caspase inhibitor. At low dose of HP, autophagy inhibitor partially protected from HP-PDT-induced cell death. In autophagy phases, at low doses, HP-PDT regulated autophagic cell death through the inhibition of LC3II. Although autophagy inhibitor did not alter cell death directly, autophagy has associated with HP-PDT-induced apoptotic cell death by PARP-1 regulation. CONCLUSION: Taken together, HP-PDT induces apoptotic cell death with autophagy in oral cancer cells. PDT resistance is related to autophagy by PARP-1 regulation in oral cancer cells.

In vitro bactericidal effects of 625, 525, and 425 nm wavelength (red, green, and blue) light-emitting diode irradiation.

OBJECTIVE: The purpose of this study was to evaluate the relationship of 625, 525, and 425 nm wavelengths, providing average power output and effects on three common pathogenic bacteria. BACKGROUND DATA: Ultraviolet (UV) light kills bacteria, but the bactericidal effects of UV may not be unique, as 425 nm produces a similar effect. The bactericidal effects of light-emitting diode (LED) wavelengths such as 625 and 525 nm have not been described. Before conducting clinical trials, the appropriate wavelength with reasonable dose and exposure time should be established. MATERIALS AND METHODS: The bactericidal effects of 625, 525, and 425 nm wavelength LED irradiation were investigated in vitro for the anaerobic bacterium Porphyromonas gingivalis and two aerobes (Staphylococcus aureus and Escherichia coli DH5α). Average power output was 6 mW/cm(2) for 1 h. The bacteria were exposed to LED irradiation for 1, 2, 4, and 8 h (21.6, 43.2, 86.4, and 172.8 J/cm(2), respectively). LED irradiation was performed during growth on agar and in broth. Control bacteria were incubated without LED irradiation. Bacterial growth was expressed in colony-forming units (CFU) and at an optical density at 600 nm in agar and broth. RESULTS: The bactericidal effect of LED phototherapy depended upon wavelength, power density, bacterial viable number, and bacteria species. The bactericidal effect of 425 and 525 nm irradiation varied depending upon the bacterial inoculation, compared with unirradiated samples and samples irradiated with red light. Especially, P. gingivalis and E. coli DH5α were killed by 425 nm, and S. aureus growth was inhibited by 525 nm. However, the wavelength of 625 nm was not bactericidal for P. gingivalis, E. coli DH5α, or S. aureus. CONCLUSIONS: Irradiation at 625 nm light was not bactericidal to S. aureus, E. coli, and P. gingivalis, whereas wavelengths of 425 and 525 nm had bactericidal effects. S. aureus was also killed at 525 nm.

Role of interferon-γ-producing t cells in the pathogenesis of chronic rhinosinusitis with nasal polyps associated with staphylococcal superantigen.

OBJECTIVES: The major aims of this study were to characterize the varieties of T-cell infiltrates in tissue collected from patients with chronic rhinosinusitis with nasal polyps (CRSwNP), analyze the cytokine profiles of these infiltrating T cells, and determine whether infiltrating T lymphocytes are specific for superantigens (SAGs). METHODS: Anterior ethmoid sinus mucosa and polyp tissue were collected from 23 patients with CRSwNP, and control anterior ethmoid sinus mucosa were obtained from 20 patients without CRS. Infiltrating cells were isolated from tissue samples and analyzed using flow cytometry, enzyme-linked immunosorbent assay, reverse transcriptase-polymerase chain reaction, and in vitro T-lymphocyte stimulation with Staphylococcus aureus. RESULTS: The mean total numbers and proportions of CD3+, CD4+, and CD8+ T cells were significantly higher in the mucosa and polyp tissue of patients with CRSwNP than in the control group. Most infiltrating T cells in patients with CRSwNP were activated CD45RO+ memory T cells. Furthermore, interferon-γ (IFN-γ) expression was significantly higher than interleukin (IL)-10 and IL-4 expression in infiltrating T cells isolated from both the mucosa and the polyp tissue. IFN-γ also showed significantly greater increases in expression compared to IL-4 and IL-10 when isolated T cells were stimulated with SAGs in vitro. CONCLUSION: IFN-γ-producing T cells could play an important role in CRSwNP when sinonasal chronic inflammation is induced by SAGs.