ABSTRACT
Purpose: This study aimed to confirm the synergy effect of these two materials by evaluating osteoblast and antibacterial activity by applying a double-layered hydroxyapatite(HA) zirconium oxide(ZrO2) coating to titanium. Methods: The specimens used in this study were divided into four groups: a control group (polished titanium; group T) and three experimental groups: Group TH (RF magnetron sputtered HA deposited titanium), Group Z (ZrO2 ALD deposited titanium), and Group ZH (RF magnetron sputtered HA and ZrO2 ALD deposited titanium). The adhesion of Streptococcus mutans (S.mutans) to the surface was assessed using a crystal violet assay. The adhesion, proliferation, and differentiation of MC3T3-E1 cells, a mouse osteoblastic cell line, were assessed through a WST-8 assay and ALP assay. Results: Group Z showed a decrease in the adhesion of S. mutans (p < 0.05) and an improvement in osteoblastic viability (p < 0.0083). Group TH and ZH showed a decrease in adhesion of S. mutans (p < 0.05) and an increase in osteoblastic cell proliferation and cell differentiation (p < 0.0083). Group ZH exhibited the highest antibacterial and osteoblastic differentiation. Conclusion: In conclusion double-layered HA and ZrO2 deposited on titanium were shown to be more effective in inhibiting the adhesion of S. mutans, which induced biofilm formation, and increasing osteoblastic differentiation involved in osseointegration by the synergistic effect of the two materials.
Subject(s)
Bacterial Adhesion , Cell Differentiation , Cell Proliferation , Coated Materials, Biocompatible , Durapatite , Osteoblasts , Streptococcus mutans , Surface Properties , Titanium , Zirconium , Zirconium/chemistry , Zirconium/pharmacology , Titanium/chemistry , Titanium/pharmacology , Streptococcus mutans/drug effects , Animals , Mice , Durapatite/chemistry , Durapatite/pharmacology , Osteoblasts/drug effects , Osteoblasts/cytology , Cell Proliferation/drug effects , Cell Differentiation/drug effects , Bacterial Adhesion/drug effects , Coated Materials, Biocompatible/chemistry , Coated Materials, Biocompatible/pharmacology , Cell Line , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/chemistry , Cell Adhesion/drug effects , Cell Survival/drug effectsABSTRACT
Purpose: Atomic layer deposition (ALD) is a method that can deposit zirconia uniformly on an atomic basis. The effect of deposited zirconia on titanium implants using ALD was evaluated in vivo. Methods: Machined titanium implants (MTIs) were used as the Control. MTIs treated by sandblasting with large grit and acid etching (SA) and MTIs deposited with zirconia using ALD are referred to as Groups S and Z, respectively. Twelve implants were prepared for each group. Six rabbits were used as experimental animals. To evaluate the osteogenesis and osteocyte aspects around the implants, radiological and histological analyses were performed. The bone-to-implant contact (BIC) ratio was measured and statistically analyzed to evaluate the osseointegration capabilities. Results: In the micro-CT analysis, more radiopaque bone tissues were observed around the implants in Groups S and Z. Histological observation found that Groups S and Z had more and denser mature bone tissues around the implants in the cortical bone area. Many new and mature bone tissues were also observed in the medullary cavity area. For the BIC ratio, Groups S and Z were significantly higher than the Control in the cortical bone area (P < 0.017), but there was no significant difference between Groups S and Z. Conclusion: MTIs deposited with zirconia using ALD (Group Z) radiologically and histologically showed more mature bone formation and activated osteocytes compared with MTIs (Control). Group Z also had a significantly higher BIC ratio than the Control. Within the limitations of this study, depositing zirconia on the surface of MTIs using ALD can improve osseointegration in vivo.
Subject(s)
Osseointegration , Titanium , Zirconium , Animals , Zirconium/chemistry , Zirconium/pharmacology , Rabbits , Titanium/chemistry , Titanium/pharmacology , Osseointegration/drug effects , Surface Properties , X-Ray Microtomography , Coated Materials, Biocompatible/chemistry , Coated Materials, Biocompatible/pharmacology , Bone-Implant Interface , Osteogenesis/drug effects , Dental Implants , Prostheses and ImplantsABSTRACT
To evaluate pre- and postoperative changes in the subjective awareness of exodeviation in patients with intermittent exotropia and compare pediatric and adult patients. This retrospective study included pediatric (6-17 years) and adult patients (≥18 years) with intermittent exotropia who underwent surgery. Patients with subjective awareness of exodeviation associated with exotropia were included. Postoperative improvement was defined as a decrease in the subjective awareness of exodeviation and alleviation of associated symptoms after surgery. Changes in subjective awareness of exodeviation after surgery were evaluated and compared between pediatric and adult patients. Clinical factors associated with postoperative improvement in subjective awareness of exodeviation were analyzed. A total of 195 patients (159 pediatric and 36 adult) were included. Among the included patients, 145 (74.4%, 145/195) reported postoperative improvements in their subjective awareness of exodeviation. A lower percentage of adult patients (15/36, 41.7%) showed postoperative improvement in subjective awareness of exodeviation than that of pediatric patients (130/159, 81.8%, Pâ <â .001). The level of distant control was significantly associated with postoperative improvement in subjective awareness of exodeviation in adult patients (odds ratio, 1.151; 95% confidence interval, 0.030-0.758; Pâ =â .022). There was a significant difference in the postoperative change in the subjective awareness of exodeviation between pediatric and adult patients with intermittent exotropia. Adult patients are less likely to exhibit postoperative improvement in subjective awareness of exodeviation than pediatric patients. Adult patients with a better level of distant control are more likely to show postoperative improvement in their subjective awareness of exodeviation.
Subject(s)
Exotropia , Humans , Exotropia/surgery , Exotropia/physiopathology , Retrospective Studies , Male , Female , Adolescent , Child , Adult , Postoperative Period , Middle Aged , Ophthalmologic Surgical Procedures/methods , Awareness , Age Factors , Young Adult , Treatment OutcomeABSTRACT
The effects of TiO2 nanotube (TNT) and reduced graphene oxide (rGO) deposition onto titanium, which is widely used in dental implants, on Streptococcus mutans (S. mutans) and preosteoblastic cells were evaluated. TNTs were formed through anodic oxidation on pure titanium, and rGO was deposited using an atmospheric plasma generator. The specimens used were divided into a control group of titanium specimens and three experimental groups: Group N (specimens with TNT formation), Group G (rGO-deposited specimens), and Group NG (specimens under rGO deposition after TNT formation). Adhesion of S. mutans to the surface was assessed after 24 h of culture using a crystal violet assay, while adhesion and proliferation of MC3T3-E1 cells, a mouse preosteoblastic cell line, were evaluated after 24 and 72 h through a water-soluble tetrazolium salt assay. TNT formation and rGO deposition on titanium decreased S. mutans adhesion (p < 0.05) and increased MC3T3-E1 cell adhesion and proliferation (p < 0.0083). In Group NG, S. mutans adhesion was the lowest (p < 0.05), while MC3T3-E1 cell proliferation was the highest (p < 0.0083). In this study, TNT formation and rGO deposition on a pure titanium surface inhibited the adhesion of S. mutans at an early stage and increased the initial adhesion and proliferation of preosteoblastic cells.
Subject(s)
Graphite , Nanotubes , Streptococcus mutans , Mice , Animals , Titanium/pharmacology , Titanium/chemistry , Surface Properties , Nanotubes/chemistryABSTRACT
This study aimed to evaluate changes in the number and clinical characteristics of patients with acute acquired concomitant esotropia (AACE) over the course of 8 years. This retrospective study enrolled patients with AACE who visited our clinic between July 2014 and June 2022. The total study period was divided into 4 periods in chronological order. The number of patients who initially visited the clinic and underwent surgery was compared over time by dividing the time period into 8 quarters (quarters, 2 years). Clinical factors were analyzed between patients with and without surgery. Ninety-seven patients were enrolled (mean age, 29.5 years; 43 females). Among these, 65 patients (67.0%) underwent surgery. The number of patients with AACE increased steadily throughout the study period. The number of patients who underwent surgery was the highest during the 2020 Q3 to 2022 Q2. There was an increasing trend in patients with large ocular deviation (≥30 prism diopters) over time among patients with AACE who underwent surgical treatment (P = .037). Mean ocular deviation at the initial visit was greater in patients who underwent surgery than in those who did not (P < .001). The mean age of patients who underwent surgery was lower than that of patients who did not (P = .005). The number of patients with AACE has been increasing over time. Patients who underwent surgical treatment showed more ocular deviation and were younger at the initial visit than patients who did not.
Subject(s)
Esotropia , Female , Humans , Adult , Esotropia/surgery , Retrospective Studies , Acute Disease , Ambulatory Care Facilities , Face , Oculomotor Muscles/surgery , Treatment OutcomeABSTRACT
BACKGROUND/AIMS: We evaluate the clinical characteristics of intermittent exotropia with controllability and compare surgical outcomes between patients with and without controllability. METHODS: We reviewed the medical records of patients aged 6-18 years with intermittent exotropia who underwent surgery between September 2015 and September 2021. Controllability was defined as the patient's subjective awareness of exotropia or diplopia associated with the presence of exotropia and ability to instinctively correct the ocular exodeviation. Surgical outcomes were compared between patients with and without controllability, with a favorable surgical outcome defined as an ocular deviation between ≤ 10 PD of exotropia and ≤ 4 PD of esotropia at distance and near. RESULTS: Among 521 patients, 130 (25%, 130/521) had controllability. The mean age of onset (7.7 years) and surgery (9.9 years) were higher in patients with controllability than in those without controllability (p < 0.001). The mean control scores of patients with controllability (distance: 1.9, near: 1.5) were lower compared with patients without controllability (distance: 3.0, near: 2.2), reflecting a better level of control. Patients with controllability had a better surgical outcome than those without controllability, as analyzed by log-rank test (p < 0.001). Larger preoperative ocular exodeviation at distance (hazard ratio [HR] = 1.083, confidence interval [CI] = 1.018-1.151, p = 0.012) and near (HR = 1.102, CI = 1.037-1.172, p = 0.002) were significantly related to recurrence in patients with controllability. CONCLUSIONS: Patients with controllability showed better surgical outcomes, later exotropia onset, and better level of control than patients without controllability. Preoperative ocular exodeviation was a significant factor influencing favorable outcomes in patients with controllable exotropia.
Subject(s)
Exotropia , Humans , Child , Exotropia/surgery , Treatment Outcome , Ophthalmologic Surgical Procedures , Oculomotor Muscles/surgery , Retrospective Studies , Follow-Up Studies , Vision, BinocularABSTRACT
PURPOSE: To describe clinical manifestations and short-term prognosis of ocular motility disorders following coronavirus disease-2019 (COVID-19) vaccination. METHODS: Ocular motility disorders were diagnosed by clinical assessment, high-resolution magnetic resonance imaging, and laboratory testing. Clinical manifestations, short-term prognosis, and rate of complete recovery were analyzed. RESULTS: Sixty-three patients (37 males, 26 females) with a mean age of 61.6 ± 13.3 years (range, 22-81 years) were included in this study. Among 61 applicable patients with sufficient information regarding medical histories, 38 (62.3%) had one or more significant underlying past medical histories including vasculopathic risk factors. The interval between initial symptoms and vaccination was 8.6 ± 8.2 (range, 0-28) days. Forty-two (66.7%), 14 (22.2%), and 7 (11.1%) patients developed symptoms after the first, second, and third vaccinations, respectively. One case of internuclear ophthalmoplegia, 52 cases of cranial nerve palsy, two cases of myasthenia gravis, six cases of orbital diseases (such as myositis, thyroid eye disease, and IgG-related orbital myopathy), and two cases of comitant vertical strabismus with acute onset diplopia were found. Among 42 patients with follow-up data (duration: 62.1 ± 40.3 days), complete improvement, partial improvement, no improvement, and exacerbation were shown in 20, 15, 3, and 4 patients, respectively. CONCLUSION: This study provided various clinical features of ocular motility disorders following COVID-19 vaccination. The majority of cases had a mild clinical course while some cases showed a progressive nature. Close follow-up and further studies are needed to elucidate the underlying mechanisms and long-term prognosis.
Subject(s)
COVID-19 Vaccines , COVID-19 , Myasthenia Gravis , Ocular Motility Disorders , Strabismus , Aged , Female , Humans , Male , Middle Aged , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Vaccines/adverse effects , Ocular Motility Disorders/diagnosis , Ocular Motility Disorders/etiology , Strabismus/diagnosisABSTRACT
BACKGROUND: Accumulating evidence suggests that alterations in inflammatory biomarkers are important in depression. However, previous meta-analyses disagree on these associations, and errors in data extraction may account for these discrepancies. METHODS: PubMed/MEDLINE, Embase, PsycINFO, and the Cochrane Library were searched from database inception to 14 January 2020. Meta-analyses of observational studies examining the association between depression and levels of tumor necrosis factor-α (TNF-α), interleukin 1-ß (IL-1ß), interleukin-6 (IL-6), and C-reactive protein (CRP) were eligible. Errors were classified as follows: incorrect sample sizes, incorrectly used standard deviation, incorrect participant inclusion, calculation error, or analysis with insufficient data. We determined their impact on the results after correction thereof. RESULTS: Errors were noted in 14 of the 15 meta-analyses included. Across 521 primary studies, 118 (22.6%) showed the following errors: incorrect sample sizes (20 studies, 16.9%), incorrect use of standard deviation (35 studies, 29.7%), incorrect participant inclusion (7 studies, 5.9%), calculation errors (33 studies, 28.0%), and analysis with insufficient data (23 studies, 19.5%). After correcting these errors, 11 (29.7%) out of 37 pooled effect sizes changed by a magnitude of more than 0.1, ranging from 0.11 to 1.15. The updated meta-analyses showed that elevated levels of TNF- α, IL-6, CRP, but not IL-1ß, are associated with depression. CONCLUSIONS: These findings show that data extraction errors in meta-analyses can impact findings. Efforts to reduce such errors are important in studies of the association between depression and peripheral inflammatory biomarkers, for which high heterogeneity and conflicting results have been continuously reported.
Subject(s)
Depression , Interleukin-6 , Humans , Depression/epidemiology , Inflammation/metabolism , Biomarkers , C-Reactive Protein , Tumor Necrosis Factor-alphaABSTRACT
BACKGROUND: Several vaccines against the severe acute respiratory syndrome coronavirus 2 have been approved and widely distributed, raising public concerns regarding the side effects of immunization, as the incidence of ease. Although many adverse events following the coronavirus disease 2019 (COVID-19) vaccine have been reported, neurological complications are relatively uncommon. Herein, we report a rare case of multiple cranial palsies following COVID-19 vaccination in an adolescent patient. CASE SUMMARY: A previously healthy, 14-year-old Asian girl with facial palsy presented to the emergency department with inability to close the right eye or wrinkle right side of the forehead, and pain in the right cheek. She had received second dose of the COVID-19 mRNA vaccine (Pfizer-BioNTech) 18 days before onset of symptoms. She was diagnosed with Bell's palsy and prescribed a steroid (1 mg/kg/day methylprednisolone) based on symptoms and magnetic resonance imaging findings. However, the next day, all sense of taste was lost with inability to swallow solid food; the gag reflex was absent. Horizontal diplopia was also present. Due to worsening of her condition, she was given high-dose steroids (1 g/day methylprednisolone) for 3 days and then discharged with oral steroids. Improvement in the symptoms was noted 4 days post steroid treatment completion. At the most recent follow-up, her general condition was good with no symptoms except diplopia; ocular motility disturbances were noted. Hence, prism glasses were prescribed for diplopia relief. CONCLUSION: Small-angle exotropia was observed in the facial, trigeminal, and glossopharyngeal nerve palsies, in our patient. The etiology of this adverse effect following vaccination was thought to be immunological.
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PURPOSE: We investigated the association between the level of control and exodeviation after the monocular occlusion test (MO) in pediatric patients with intermittent exotropia. METHODS: We retrospectively reviewed the records of pediatric patients with intermittent exotropia who visited Yeungnam University Hospital between September 2015 and December 2020. The largest exodeviation obtained before and after 1 hour of MO were compared. The LACTOSE (Look And Cover, then Ten seconds of Observation Scale for Exotropia) control scoring system was used to measure the level of control. Controllability was defined when the patient had the subjective awareness of exotropia and the instinctive ability to correct ocular deviation. RESULTS: Five hundred and three consecutive patients (260 male and 243 female patients; mean age, 7.8 years) were included. In all control scores, exodeviation significantly increased after the MO (p < 0.001). However, the patients with an increase in exodeviation ≥5 prism diopters (PD) after the test did not show any significant association with the control scores. The presence of controllability was significantly associated with an increase of ≥5 PD at near (p = 0.034). CONCLUSIONS: Exodeviation showed significant increase after the MO, regardless of the level of control, in pediatric patients with intermittent exotropia. There was no significant association between the control scores and an increase of ≥5 PD after the MO. Patients with controllability were more likely to show increase in exodeviation after the MO.
Subject(s)
Exotropia , Child , Chronic Disease , Exotropia/diagnosis , Exotropia/surgery , Eye , Female , Follow-Up Studies , Humans , Male , Oculomotor Muscles , Ophthalmologic Surgical Procedures , Retrospective Studies , Treatment Outcome , Vision, BinocularABSTRACT
Hypoxia-induced neuroinflammation in stroke, neonatal hypoxic encephalopathy, and other diseases subsequently contributes to neurological damage and neuronal diseases. Microglia are the primary neuroimmune cells that play a crucial role in cerebral inflammation. Epigallocatechin gallate (EGCG) has a protective antioxidant and anti-inflammatory effects against neuroinflammation. However, the effects of EGCG on hypoxia-induced inflammation in microglia and the underlying mechanism remain unclear. In this study, we investigated whether EGCG might have a protective effect against hypoxia injury in microglia by treatment with CoCl2 to establish a hypoxic model of BV2 microglia cells following EGCG pre-treatment. An exposure of cells to CoCl2 caused an increase in inflammatory mediator interleukin (IL)-6, inducible nitric oxide synthase (iNOS), and cyclooxygenase (COX)-2 expression, which were significantly ameliorated by EGCG via inhibition of NF-κB pathway. In addition, EGCG attenuated the expression of hypoxia-inducible factor (HIF)-1α and the generation of ROS in hypoxic BV2 cells. Furthermore, the suppression of hypoxia-induced IL-6 production by EGCG was mediated via the inhibition of HIF-1α expression and the suppression of ROS generation in BV2 cells. Notably, EGCG increased the Nrf-2 levels and HO-1 levels in the presence of CoCl2. Additionally, EGCG suppressed hypoxia-induced apoptosis of BV2 microglia with cleavage of poly (ADP-ribose) polymerase (PARP) and caspase-3. In summary, EGCG protects microglia from hypoxia-induced inflammation and oxidative stress via abrogating the NF-κB pathway as well as activating the Nrf-2/HO-1 pathway.
Subject(s)
Catechin , Hypoxia, Brain , Microglia , Humans , Catechin/analogs & derivatives , Catechin/pharmacology , Cyclooxygenase 2/metabolism , Hypoxia, Brain/metabolism , Inflammation/drug therapy , Inflammation/metabolism , Interleukin-6/metabolism , Lipopolysaccharides , Microglia/metabolism , NF-kappa B/metabolism , Reactive Oxygen Species/metabolismABSTRACT
BACKGROUND/AIMS: To investigate the sequential change in intraocular pressure (IOP) during strabismus surgery in patients with thyroid eye disease (TED). METHODS: This prospective study included patients with TED who underwent strabismus surgery (medial rectus [MR], inferior rectus [IR], and superior rectus [SR] recession) between March 2018 and December 2020. The IOP was measured six times during surgery (5 min after intubation, after isolation of the muscle using a hook and dissection of the surrounding tissue, immediately before muscle detachment, immediately after muscle detachment, after reattachment of the muscle, and after closure of the conjunctiva). RESULTS: Thirty-five eyes of 18 patients were included. The mean IOP at first was 21.1 mmHg, which significantly increased to 28.6 mmHg after muscle isolation. The IOP significantly decreased to 15.5 mmHg after muscle detachment. This increased to 19.1 mmHg after muscle reattachment. The last IOP was 18.9 mmHg. There were similar patterns of sequential change in the IOP among the three muscles. The MR showed the highest increase in IOP. The IR showed the lowest mean IOP compared with the other two muscles. CONCLUSIONS: The IOP was elevated during the isolation and dissection of the surrounding muscle tissue, especially in the MR. The IOP significantly decreased after muscle detachment and was maintained until the last measurement, even after muscle reattachment. IR showed the lowest IOP among the three muscles during surgery.
Subject(s)
Graves Ophthalmopathy , Strabismus , Graves Ophthalmopathy/complications , Graves Ophthalmopathy/surgery , Humans , Intraocular Pressure , Oculomotor Muscles/surgery , Prospective Studies , Strabismus/surgeryABSTRACT
Toll-like receptors (TLRs) make a crucial contribution to the innate immune response. TLR5 was expressed in embryoid body derived from mouse embryonic stem cells (mESCs) and ßIII-tubulin-positive cells under all-trans retinoic acid-treated condition. TLR5 was upregulated during neural differentiation from mESCs and augmented the neural differentiation of mESCs via nuclear factor-κB and interleukin 6/CREB pathways. Besides, TLR5 was expressed in SOX2- or doublecortin-positive cells in the subgranular zone of the hippocampal dentate gyrus where adult neurogenesis occurs. TLR5 inhibited the proliferation of adult hippocampal neural stem cells (NSCs) by regulating the cell cycle and facilitated the neural differentiation from the adult hippocampal NSCs via JNK pathway. Also, TLR5 deficiency impaired fear memory performance in mice. Our data suggest that TLR5 is a crucial modulator of neurogenesis from mESCs and adult hippocampal NSCs in mice and represents a new therapeutic target in neurological disorders related to cognitive function.
Subject(s)
Neural Stem Cells , Toll-Like Receptor 5 , Animals , Cell Proliferation , Embryonic Stem Cells/metabolism , Hippocampus , Mice , Mice, Inbred C57BL , Neural Stem Cells/metabolism , Neurogenesis/physiology , Toll-Like Receptor 5/metabolismABSTRACT
To optimize the reproduction of Jeju black cattle (JBC), freezing conditions for sperm were established and sperm motility, vitality, morphology, and fertility were evaluated to select the optimal bull for breeding. Semen samples from five JBC bulls were individually mixed with freezing medium at a final concentration of 1 × 108 sperm/mL and frozen in liquid nitrogen vapor at a height of 3 or 7 cm (referred to as 3 cm sperm and 7 cm sperm, respectively). When the freezing conditions were compared, the motility of 7 cm sperm was significantly higher than that of 3 cm sperm for the JBC-A bull. The motility, curvilinear velocity, straight-line velocity, and average path velocity of fresh and frozen-thawed sperm were the highest for the JBC-A bull. The vitalities of fresh and frozen-thawed sperm were the highest for the JBC-A/E and JBC-A bulls, respectively. The percentage of normal cells in fresh sperm was the highest for the JBC-D bull. The rates of the normal formation of two pronuclei and total sperm penetration were the highest in zygotes fertilized with sperm from the JBC-A bull. The sperm from the JBC-A bull had superior qualities and are thus the most appropriate choice for the preservation and reproduction of these endangered cattle.
ABSTRACT
BACKGROUND/PURPOSE: Autophagy is involved in controlling differentiation of various cell types. The present study aimed to investigate the mechanism related to autophagy in regulating odontogenic differentiation of dental pulp cells. MATERIALS AND METHODS: Human dental pulp cells (HDPCs) were cultured in differentiation inductive medium (DM) and odontoblastic differentiation and mineralization were evaluated by alkaline phosphatase (ALP) staining and Alizarin red S staining, respectively. Tooth cavity preparation was made on the mesial surface of lower first molars in rat. The expression of autophagy-related signal molecules was detected using Western blot analysis and Immunohistochemistry. RESULTS: HDPCs cultured in DM showed increased autophagic flux and declined phosphorylation of phosphoinositide 3-kinases (PI3K), protein kinase B (Akt), and mTOR. Dentin matrix protein-1 (DMP-1) and dentin sialoprotein (DSP), markers of odontoblastic differentiation, were upregulated and autophagic activation showing increased LC3-II and decreased p62 levels was observed during odontogenic differentiation of HDPCs. However, PI3K blocker 3-methyladenine (3MA), lentiviral shLC3 and Akt activator SC79 attenuated the expression of LC3II as well as DMP-1, ALP activity and mineralization enhanced in HDPCs under DM condition. In addition, 3MA, shLC3 and SC79 recovered the expression of pluripotency factor CD146, Oct4 and Nanog downregulated in DM condition. In rat tooth cavity preparation model, the expression of LC3B and DMP-1 was elevated near odontoblast-dentin layer during reparative dentin formation, whereas 3MA significantly reduced the expression of LC3B and DMP-1. CONCLUSION: These findings indicated autophagy promotes the odontogenic differentiation of dental pulp cells modulating stemness via PI3K/Akt inactivation and the repair of pulp.
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PURPOSE: This study evaluated the prognosis of patients with traumatic unilateral superior oblique palsy (SOP) and clinical factors associated with spontaneous resolution. METHODS: Medical records of patients with traumatic unilateral SOP who visited two hospitals (Yeungnam University Hospital and Daegu Catholic University Medical Center) between January 2015 and June 2020 were reviewed retrospectively. When traumatic unilateral SOP did not recover within at least 1 year of follow-up, no spontaneous resolution was considered. Both traumatic and ocular factors were evaluated to evaluate their association with spontaneous recovery. RESULTS: Fifty-nine patients (mean age, 52.6 years; 48 male patients) were enrolled in this study. The mean interval from trauma to initial presentation was 3.9 months. The mean vertical deviation at initial presentation was 6.34 ± 5.22 prism diopters (PD) (range, 0-25 PD). During the mean 24.1-month follow-up period, 28 patients (47.5%) achieved spontaneous resolution of SOP. Thirteen patients underwent surgical treatment for SOP. Vertical deviation <6 PD at the initial visit and low fundus torsion in the nonparetic eye and both eyes were significantly associated with spontaneous recovery (p < 0.05, logistic regression analysis). Traumatic factors, including the trauma type, presence of intracranial lesion, loss of consciousness, and Glasgow Coma Scale score, were not associated with spontaneous recovery. CONCLUSIONS: In this multicenter study, spontaneously recovery was achieved in 47.5% patients with traumatic unilateral SOP. Even mild head trauma can lead to permanent SOP. Ocular factors, including the angle of deviation and fundus torsion, may better predict spontaneous resolution than traumatic factors in patients with traumatic unilateral SOP.
Subject(s)
Strabismus , Trochlear Nerve Diseases , Fundus Oculi , Humans , Male , Middle Aged , Oculomotor Muscles/pathology , Oculomotor Muscles/surgery , Paralysis/pathology , Prognosis , Retrospective Studies , Strabismus/surgery , Trochlear Nerve Diseases/diagnosis , Trochlear Nerve Diseases/surgeryABSTRACT
BACKGROUND: During high tibial osteotomy (HTO), the superficial medial collateral ligament (sMCL) is cut or released at any degree to expose the osteotomy site and achieve the targeted alignment correction according to the surgeon's preference. However, it is still unclear whether transection of sMCL increases valgus laxity. PURPOSE: We aimed to assess the outcomes and safety of sMCL transection, especially focusing on iatrogenic valgus instability. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Seventy-two patients (89 knees) who underwent medial open wedge HTO (MOWHTO) with transection of the sMCL between October 2013 and September 2018 were retrospectively investigated. Clinical evaluations, including the International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner and Lysholm scores, were performed preoperatively and at 2 years postoperatively. The radiographic parameters hip-knee-ankle (HKA) angle, joint line convergence angle on standing radiographs (standing JLCA), and weightbearing line (WBL) ratio were assessed preoperatively and at 3 months, 6 months, 1 year, and 2 years postoperatively. To evaluate valgus laxity, we assessed the valgus JLCA and medial joint opening (MJO) at the aforementioned time points using valgus stress radiographs. RESULTS: All clinical results at the 2-year follow-up were significantly improved compared with those obtained at the preoperative assessment (P < .001). The postoperative HKA angle significantly differed from the preoperative one, and no significant valgus progression was observed during follow-up (preoperative, 8.5°± 2.7°; 3 months, -3.5°± 2.0°; 6 months, -3.2°± 2.3°; 1 year, -3.1°± 2.3°; 2 years, -2.9°± 2.5°; P < .001) The mean WBL ratio was 62.5% ± 9.0% at 2 years postoperatively. The postoperative valgus JLCA at all follow-up points did not significantly change compared with the preoperative valgus JLCA (preoperative, -0.1°± 2.1°; 3 months, -0.2°± 2.4°; 6 months, -0.1°± 2.5°; 1 year, 0.1°± 2.5°; 2 years, 0.2°± 2.2°) The postoperative MJO at all follow-up points did not significantly change compared with the preoperative MJO (preoperative, 7.1 ± 1.7 mm; 3 months, 7.0 ± 1.7 mm; 6 months, 6.9 ± 1.9 mm; 1 year, 6.7 ± 1.8 mm; 2 years, 6.8 ± 1.8 mm). CONCLUSION: Transection of the sMCL during MOWHTO does not increase valgus laxity and could yield desirable clinical and radiographic results.
Subject(s)
Joint Instability , Osteoarthritis, Knee , Humans , Joint Instability/surgery , Knee Joint , Osteotomy , Retrospective Studies , Tibia/surgeryABSTRACT
PURPOSE: A few studies have focused on factors predisposing to retear after arthroscopic revision rotator cuff repair (ARRCR). This study aimed to retrospectively evaluate (1) the structural and clinical outcomes of ARRCR and (2) pre- and intraoperative factors affecting the integrity of the rotator cuff (RC) tendon by focusing on preoperative RC tendon integrity, tear size, muscle hypotrophy and fatty infiltration. METHODS: Patients who underwent ARRCR between 2006 and 2016 were reviewed. Preoperative variables included demographic data, RC tendon integrity, tear size, and muscle hypotrophy and fatty infiltration on preoperative magnetic resonance imaging (MRI). Intraoperative variables included repair technique and completeness of repair. The visual analog scale for pain (PVAS), functional VAS (FVAS), American Shoulder and Elbow Surgeons scores, and shoulder range of motion (ROM) were assessed. Postoperative tendon integrity was evaluated using over 6-month follow-up MRI. Patients were classified into groups A (healed) and B (retear), and their variables were compared. RESULTS: Overall 65 patients with a mean follow-up of 49.5 ± 30.2 (range, 24.0-148.9) months were analyzed. Fifty-six of 65 (86.2%) patients underwent MRI at 9.1 ± 9.7 (range, 4.4-40.2) months after ARRCR, and 20 of 56 (35.7%) patients (group B) exhibited retear. Group A (36/56, 64.3%) showed higher functional scores and ROMs than group B at the final follow-up, with significant differences in the FVAS scores (Group A versus B: FVAS, 7.6 ± 1.8 versus 6.4 ± 1.9, p = 0.036). Intraoperative variables, including preoperative tendon integrity (p = 0.021), tear size (p = 0.007), supraspinatus and infraspinatus muscle hypotrophy and fatty infiltration (p < 0.001 and p = 0.046), and completeness of repair (p = 0.030), differed significantly between the groups. Multivariate analysis revealed that preoperative supraspinatus muscle hypotrophy and fatty infiltration were independent predisposing factors for retear after ARRCR [odds ratio = 7.5, 95% confidence interval (CI) 1.1-55.8, p = 0.048]. CONCLUSION: The retear was found in 20/56 patients (35.7%) after ARRCR for less than massive rotator cuff tears in this limited study population. Preoperative tendon integrity, tear size, supraspinatus and infraspinatus muscle hypotrophy and fatty infiltration, and completeness of repair was revealed to be associated with tendon integrity following ARRCR. Among them, preoperative supraspinatus muscle atrophy and fatty infiltration were the independent factors for retear after ARRCR, although generalization is limited. LEVEL OF EVIDENCE: IV.
Subject(s)
Rotator Cuff Injuries , Rotator Cuff , Arthroscopy/methods , Humans , Magnetic Resonance Imaging , Muscular Atrophy/etiology , Retrospective Studies , Rotator Cuff/diagnostic imaging , Rotator Cuff/surgery , Rotator Cuff Injuries/surgery , Rupture/surgery , Tendons , Treatment OutcomeABSTRACT
BACKGROUND: Periodontitis is an inflammatory disease caused by multiple disease-associated bacterial species in periodontal tissues. Autophagy is known to modulate various inflammation-driven diseases and inflammatory responses, but the role of autophagy related to the pathogenesis of periodontitis is not fully established. We investigated whether autophagic flux regulated the expression of inflammatory cytokines in the gingiva of periodontitis patients and lipopolysaccharide (LPS)-stimulated human gingival fibroblasts (HGFs) and the underlying mechanism. METHODS: The mRNA and protein expression of proinflammatory cytokines was assessed in human gingival tissues collected from patients with periodontitis and HGFs treated with LPS. The expression of signaling molecules related to autophagy was evaluated by immunofluorescence and Western blot analyses. RESULTS: The expression of interleukin (IL)-6, tumor necrosis factor-α (TNF-α), cyclooxygenase-2 (COX-2), and intercellular adhesion molecule-1 (ICAM-1) was increased in the gingival tissues of patients with periodontitis. LC3B-positive cells, a typical autophagic marker, were increased in the gingival tissues of periodontitis patients and LPS-treated HGFs. The conversion ratio of LC3-I to LC3-II was higher in the gingival tissues associated with periodontitis and LPS-treated HGFs compared to the controls. The autophagy inhibitor 3-methyladenine (3MA) significantly abrogated the LPS-sustained inflammatory effect by reducing the expression of IL-6, TNF-α, COX-2, and ICAM-1 in HGFs. The phosphorylation of protein kinase B (AKT) and protein S6K1 (S6), signals involved in the mTOR-dependent mechanism, was decreased in gingiva derived from periodontitis patients and LPS-treated HGFs. CONCLUSIONS: Autophagy augmented the production of inflammatory cytokines by mTOR inactivation via the AKT signaling pathway in the gingival tissues of patients with periodontitis and LPS-stimulated HGFs. These findings would provide a better understanding of the mechanism by which autophagy regulates the inflammatory response associated with periodontal pathogenesis.
Subject(s)
Gingiva , Periodontitis , Autophagy , Cells, Cultured , Cyclooxygenase 2/metabolism , Cyclooxygenase 2/pharmacology , Cytokines/metabolism , Fibroblasts , Humans , Intercellular Adhesion Molecule-1/metabolism , Interleukin-6/metabolism , Lipopolysaccharides/metabolism , Lipopolysaccharides/pharmacology , Periodontitis/metabolism , Proto-Oncogene Proteins c-akt/metabolism , Proto-Oncogene Proteins c-akt/pharmacology , TOR Serine-Threonine Kinases/metabolism , TOR Serine-Threonine Kinases/pharmacology , Tumor Necrosis Factor-alpha/metabolismABSTRACT
OBJECTIVE: Relationship between hair cortisol concentration (HCC) and stress-related psychological measures are inconclusive, possibly due to overlooked heterogeneity regarding childhood trauma and a lack of comprehensive research on stress-related psychological factors. This study aims to compare young adults without history of childhood trauma to young adults who experienced childhood trauma using HCC and various stress-related psychological factors, as well as investigate the impacts of childhood trauma on the association between HCC and stress-related psychological measures. METHODS: A total of 206 young, healthy adults were recruited. We divided participants into two groups depending on whether or not they had suffered moderate-to-severe childhood trauma (CT+ and CT-) and compared HCC and various stress-related psychological measures between groups. Using multiple linear regression analyses, we assessed the associations between HCC and stress-related psychological measures for each group. RESULTS: We found no difference between the groups in HCC or the reported number of stressful life events in the past year; however, CT+ individuals reported higher stress perception, more depressive and anxiety-related symptoms, and more difficulties in emotion regulation than CT- individuals. HCC was associated with emotion dysregulation among the CT- individuals, but not among the CT+ individuals. CONCLUSION: These findings suggest that history of childhood trauma should be considered in studies using HCC as a biomarker for stress in young adults. Furthermore, HCC might be a useful biomarker of stress and stress-related emotion dysregulation in individuals without moderate-to-severe childhood trauma.