Abnormalities of the pericruciate fat pad: Correlations with the location and severity of chondral lesions of the knee.

PURPOSE: The aim of this study was to evaluate the relationship between the grade of signal change of the pericruciate fat pad (PCFP) and the location and severity of cartilage alterations in the knee on magnetic resonance imaging (MRI). MATERIALS AND METHODS: This retrospective study included 234 patients (M:F = 96:138, mean: 51 years) who underwent knee MRI. Two experienced musculoskeletal radiologists assessed any PCFP alterations (as grades 0-3) and chondral lesions using the modified Outerbridge grade (as grades 0-4). Bone marrow lesions (BMLs), meniscal status, anterior cruciate ligament alterations, and effusion-synovitis were also evaluated on the MRI. The relationships between PCFP alteration and MR findings (including the grade of chondral lesion) were evaluated. RESULTS: Signal changes in the PCFP were detected in 150 cases by Reader 1 (grade 0, 67 cases; grade 1, 53 cases; grade 2, 21 cases; grade 3, 9 cases) and in 154 cases by Reader 2 (grade 0, 59 cases; grade 1, 61 cases; grade 2, 24 cases; grade 3, 10 cases). The grade of PCFP signal change was statistically significantly correlated with the grade of the chondral lesion of the medial femoral condyle (MFC) (p = 0.029 and p = 0.003, respectively) and the medial tibial plateau (MTP) (p = 0.045, p = 0.002, Readers 1 and 2, respectively). The grade of PCFP signal change was significantly correlated with the grade of the BMLs of the MFC, MTP, and lateral femoral condyle (p < 0.05) for both readers. PCFP alteration was related to effusion-synovitis and tears of the medial meniscus. CONCLUSIONS: The grade of PCFP signal change was correlated with the severity of the cartilage alteration in the medial compartment of the knee joint and was also correlated with BMLs in the medial compartment, medial meniscal tears, and synovitis. Therefore, signal change in the PFCP seen on MRI can be an additional clue of the presence of osteoarthritis in the knee, particularly in the medial compartment.

The Association of Carbohydrate Antigen (CA) 19-9 Levels and Low Skeletal Muscle Mass in Healthy Adults.

Carbohydrate antigen 19-9 (CA 19-9) is a commonly used tumor marker for pancreatic cancer. However, CA 19-9 can be overexpressed in several benign inflammatory diseases. We investigated the relationship between high CA 19-9 level and low muscle mass (LMM) in healthy adults without cancer. Participants who underwent evaluation of muscle mass and CA 19-9 were included. Exclusion criteria were any malignancy, cardiovascular disease, tuberculosis, and chronic lung/liver disease. Participants were classified into "normal", "mild LMM", and "severe LMM" groups based on the skeletal muscle mass index. Multivariable logistic regression analyses were conducted to assess the association of high CA 19-9 with muscle mass status. A total of 263,061 adults were included. The mean age and SMI were 41.03 years and 7.13 kg/m2. After adjustments for various confounders, high CA 19-9 was independently associated with mild LMM (adjusted odds ratio, 1.677 [95% confidence interval, 1.533-1.834]) and severe LMM (2.651 [2.126-3.306]) compared to the normal group. Furthermore, the association between high CA 19-9 and severe LMM was stronger in men than in women. Elevated CA 19-9 levels were independently associated with a higher prevalence of LMM in healthy adults without cancer. Therefore, increased CA 19-9 could be utilized as a novel biomarker for sarcopenia.

Association of Pulmonary Function with Osteosarcopenic Obesity in Older Adults Aged over 50 Years.

Osteosarcopenic obesity (OSO) is a newly described coexistence of osteopenia/osteoporosis, sarcopenia, and obesity. We examined the association between pulmonary function, OSO, and its composition in adults aged ≥ 50 years. A total of 26,343 participants (8640 men; 17,703 women) were classified into four groups based on the number of abnormal body compositions (osteopenia/osteoporosis, sarcopenia, and obesity): 0 (control), 1+, 2+, and 3+ (OSO) abnormal body compositions. The values of forced volume vital capacity (FVC)%, forced expiratory volume in 1 s (FEV1%), and FEV1/FVC% were significantly decreased by increasing the number of adverse body compositions (p < 0.0001). Although the prevalence of restrictive spirometry pattern (RSP) was positively associated with a higher number of abnormal body composition parameters (p < 0.001), obstructive spirometry pattern (OSP) had no association with adverse body composition. In multivariate analyses, the adjusted odds ratios (ORs) for RSP compared to the control group were 1.36 in 1+, 1.47 in 2+, and 1.64 in 3+ abnormal body compositions (p for trend < 0.001). Multiple abnormal body composition, especially osteosarcopenic obesity, was independently associated with poor lung function showing RSP in older adults over 50 years. The coexistence of these abnormal body compositions may be a predisposing factor for pulmonary function deterioration.

Association between N-Terminal Prohormone Brain Natriuretic Peptide and Decreased Skeletal Muscle Mass in a Healthy Adult Population: A Cross-Sectional Study.

BACKGRUOUND: Although an inverse association between the N-terminal prohormone brain natriuretic peptide (NT-proBNP) and obesity exists, only few major studies have assessed the association between NT-proBNP levels and skeletal muscle mass in asymptomatic healthy adults. Therefore, this cross-sectional study was conducted. METHODS: We assessed participants who underwent health examinations at Kangbuk Samsung Hospital in South Korea from January 2012 to December 2019. Appendicular skeletal muscle mass was measured using a bioelectrical impedance analyzer, and the skeletal muscle mass index (SMI) was calculated. Participants were divided into the control, mildly low skeletal muscle mass (LMM) (-2 standard deviation [SD] < SMI ≤-1 [SD]), and severely LMM groups (SD ≤-2) based on their SMI. The association between elevated NT-proBNP level (≥125 pg/mL) and skeletal muscle mass was assessed using multivariable logistic regression analysis with adjustment for confounding factors. RESULTS: This study enrolled 15,013 participants (mean age, 37.52±9.52; men, 54.24%; control, n=12,827; mildly LMM, n=1,998; severely LMM, n=188). Prevalence of elevated NT-proBNP was higher in mildly and severely LMM groups than in the control group (control, 1.19%; mildly LMM, 1.4%; severely LMM, 4.26%; P=0.001). The adjusted odds ratio (OR) of elevated NT-proBNP was significantly higher in severely LMM (OR, 2.87; 95% confidence interval [CI], 1.3 to 6.37) than in control (OR, 1.00; reference) or mildly LMM groups (OR, 1.24; 95% CI, 0.81 to 1.89). CONCLUSION: Our results showed that NT-proBNP elevation were more prevalent in participants with LMM. In addition, our study showed an association between skeletal muscle mass and NT-proBNP level in a relatively young and healthy adult population.

Sex-specific associations between gut microbiota and skeletal muscle mass in a population-based study.

BACKGROUND: A gut-muscle axis through which the microbiome influences skeletal muscle has been hypothesized. However, sex-specific association between the characteristics of gut microbiota and skeletal muscle mass has not yet been reported. Herein, we performed sex-specific analyses of faecal microbiota composition for the skeletal muscle mass in a population-based cohort. METHODS: We collected faecal samples of 1052 middle-aged participants (621 men and 431 women) who attended health screenings, and we analysed the intestinal microbiota using 16S rRNA gene sequencing. Relative muscle mass was calculated using a bioelectrical impedance analysis and presented as the skeletal muscle mass index [SMI (%) = total appendicular muscle mass (kg)/weight (kg) × 100]. We categorized the subjects into four groups by the quartile of the SMI. Association tests between gut microbiota and SMI were conducted according to the microbial diversity, taxonomic profiling and functional inference in a sex-stratified manner. RESULTS: The mean age and SMI of the total participants were 44.8 years (standard deviation [SD], 8.2) and 41.4% (SD, 3.9), respectively. After adjustments for possible covariates such as age, body mass index and regular physical activity, the highest quartile (Q4) group of SMI had higher alpha diversity than the lowest quartile (Q1) group in male participants (coefficient = 10.79, P < 0.05, linear regression model), whereas there was no difference in diversity among SMI groups in females. At the species level, Haemophilus parainfluenzae (coefficient = 1.910) and Roseburia faecis (coefficient = 1.536) were more abundant in the highest SMI (Q4) group than in the lowest SMI (Q1) group in males. However, no significant taxon was observed along the SMI groups in females. The gut microbiota of the lowest SMI group (Q1) was enriched with genes involved in biosynthesis of amino acids and energy generation compared with that of the highest SMI group (Q4) in both sexes, although the significance of the inferred pathways was weak (P < 0.05 but the false discovery rate q > 0.05). CONCLUSIONS: In this large sample of middle-aged individuals, this study highlights fundamental sex-specific differences in the microbial diversity, composition and metabolic pathways inferred from gut microbiota according to SMI. The gut microbiota may provide novel insights into the potential mechanisms underlying the sex dependence of skeletal muscle mass.

Comparison of methods for evaluation of upper esophageal sphincter (UES) relaxation duration: Videofluoroscopic swallow study versus high-resolution manometry.

This study aims to compare the 2 methods of upper esophageal sphincter (UES) relaxation measurement and determine which method has better diagnostic value in UES relaxation impairment The study included 140 patients with pharyngeal dysphagia who underwent both videofluoroscopic swallow study (VFSS) and high-resolution manometry (HRM). Feeding method was determined to oral or non-oral feeding based on the severity of dysphagia; 103 patients were in oral feeding group and 37 were in non-oral feeding group. UES relaxation duration was measured using VFSS and HRM, respectively. Receiver-operating characteristic curve analysis was conducted to validate the UES relaxation duration in determination of feeding method. UES relaxation duration was more decreased in non-oral feeding group than in oral feeding group on both VFSS and HRM. Receiver-operating characteristic analysis revealed that the optimal cutoff value of UES relaxation duration to determine feeding method (oral or non-oral feeding) was 0.42 seconds on VFSS and 0.44 seconds on HRM. The sensitivity for feeding method was higher in VFSS than HRM (83.5% vs 70.9%), while the specificity was higher in HRM than VFSS (48.6% vs 54.1%). VFSS and HRM have complementary ability in evaluating UES relaxation duration in patients with oropharyngeal dysphagia.

Impact of Low Skeletal Muscle Mass and Obesity on Hearing Loss in Asymptomatic Individuals: A Population-Based Study.

The relationship between low muscle mass (LMM) with obesity and hearing loss has been poorly studied. We aimed to investigate the association of LMM and obesity on hearing loss in the general population. A total of 265,792 adults who underwent a hearing test and body composition analyses were included. Pre-sarcopenia was defined as having an appendicular muscle mass index <5.7 kg/m2 for women and <7.0 kg/m2 for men, and obesity as a body mass index ≥25 kg/m2, while pre-sarcopenic obesity was defined as the co-presence of LMM and obesity. Participants were divided into four groups according to the presence of pre-sarcopenia and/or obesity. The prevalence of hearing loss was 1.8% in the control, 2.5% in the pre-sarcopenia alone, 3.0% in the obesity alone, and 6.2% in the pre-sarcopenic obesity group (p < 0.001). Hearing Thresholds were the highest in the pre-sarcopenic obesity group compared with the other three groups. In multivariable-adjusted models, the risk of hearing loss was the highest in the pre-sarcopenic obesity group (odds ratio: 1.30 [95% confidence interval: 1.10−1.56]), followed by the obesity alone (1.20 [1.12−1.28]) and pre-sarcopenia alone (1.19 [1.06−1.34]) group compared with the control group (p < 0.001). Pre-sarcopenic obesity was independently associated with a higher prevalence of hearing loss, supporting pre-sarcopenic obesity itself as a risk for the decline in hearing function.

Sex-Specific Associations between Serum Ferritin and Osteosarcopenic Obesity in Adults Aged over 50 Years.

We investigated the sex-specific association between ferritin and adverse body composition in adults aged over 50 years in a population-based cohort. A total of 25,546 participants (16,912 women; 8634 men) were stratified into three groups by the tertiles of ferritin. The number of adverse body compositions was categorized as 0 (without osteopenia/osteoporosis, low muscle mass, or obesity), 1 (having one of the components), 2 (two), and 3 (all three; osteosarcopenic obesity). As ferritin tertile increased, the prevalence of one, two, or three simultaneous adverse body compositions increased, significant only in women (p < 0.0001), not in men (p = 0.125). Among women, the prevalence of osteosarcopenic obesity gradually increased from 1.7% in the lowest, to 2.2% in the middle, and 2.5% in the highest tertile. Using multivariate-adjusted analysis, women in the higher tertile had an increased likelihood of having multiple adverse body compositions compared with those in the lowest tertile. Women in the highest tertile had a 1.52 times increased risk of osteosarcopenic obesity than those in the lowest tertile. A high ferritin level was associated with an increased risk of having multiple adverse body compositions, especially for osteosarcopenic obesity in women aged >50 years, suggesting its potential use for detecting osteosarcopenic obesity.

Sex Difference in Cutoff and Prevalence of Sarcopenia among 300,090 Urban Korean Population: Association with Metabolic Syndrome.

Background and Objectives: The study aimed to establish the threshold values and prevalence of sarcopenia and to investigate the association of sarcopenia with metabolic syndrome in an urban Korean population. Materials and Methods: The study included 300,090 adults who underwent anthropometric analyses by bioelectrical impedance analyzer. Sarcopenia was defined as: (1) class I, skeletal muscle mass index (SMI) within −1 to −2 standard deviations (SDs); (2) or class II, <−2 SD of SMI in a young population. Results: Low SMI threshold levels for class I and class II sarcopenia were 39.8 and 36.7% in men, and 35.5 and 32.3% in women. Among all age groups, the prevalence rates of sarcopenia were highest in the age group 80−89 years. Following adjustment for possible confounders including age, sex, height, metabolic and health behavioral factors, adjusted odds ratios (95% confidence intervals) for the risk of metabolic syndrome were 2.43 (2.33−2.54) for class I and 2.69 (2.49−2.91) for class II sarcopenia, compared with the normal reference. Sarcopenia was more strongly associated with metabolic syndrome in women than men (p for interaction < 0.01). The threshold values and prevalence of sarcopenia were demonstrated in a large Korean urban population. Conclusions: This study identified that sarcopenia was associated with increased risk of metabolic syndrome, showing itself to be significantly higher in women than men.

The effects of early exercise in traumatic brain-injured rats with changes in motor ability, brain tissue, and biomarkers.

Traumatic brain injury (TBI) is brain damage which is caused by the impact of external mechanical forces. TBI can lead to the temporary or permanent impairment of physical and cognitive abilities, resulting in abnormal behavior. We recently observed that a single session of early exercise in animals with TBI improved their behavioral performance in the absence of other cognitive abnormalities. In the present study, we investigated the therapeutic effects of continuous exercise during the early stages of TBI in rats. We found that continuous low-intensity exercise in early-stage improves the locomotion recovery in the TBI of animal models; however, it does not significantly enhance short-term memory capabilities. Moreover, continuous early exercise not only reduces the protein expression of cerebral damage-related markers, such as Glial Fibrillary Acid Protein (GFAP), Neuron-Specific Enolase (NSE), S100ß, Protein Gene Products 9.5 (PGP9.5), and Heat Shock Protein 70 (HSP70), but it also decreases the expression of apoptosis-related protein BAX and cleaved caspase 3. Furthermore, exercise training in animals with TBI decreases the microglia activation and the expression of inflammatory cytokines in the serum, such as CCL20, IL-13, IL-1α, and IL-1ß. These findings thus demonstrate that early exercise therapy for TBI may be an effective strategy in improving physiological function, and that serum protein levels are useful biomarkers for the predicition of the effectiveness of early exercise therapy.[BMB Reports 2022; 55(10): 506-511].

Increased Carcinoembryonic Antigen (CEA) Level Is Highly Associated with Low Skeletal Muscle Mass in Asymptomatic Adults: A Population-Based Study.

We investigated the relationship between high carcinoembryonic antigen (CEA) levels and low skeletal muscle mass (LMM) in asymptomatic adults in a population-based study. A total of 202,602 adults (mean age 41.7 years) without malignancy, stroke, cardiovascular disease, or chronic lung/liver disease were included. A high CEA level was defined as ≥5 ng/mL. Skeletal muscle mass index (SMI) was calculated based on appendicular muscle mass (kg)/height (m)2. Participants were classified into three groups based on SMI: "normal", "mild LMM", and "severe LMM." The prevalence of elevated CEA levels was the highest in subjects with severe LMM (4.2%), followed by those with mild LMM (1.6%) and normal muscle mass (1.1%) (p for trend < 0.001). In multivariate logistic regression analysis, high CEA was independently associated with having mild LMM (adjusted odds ratio, 1.139 [95% confidence interval, 1.092−1.188]) and severe LMM (2.611 [2.055−3.319]) compared to normal muscle mass. Furthermore, the association between high CEA and severe LMM was stronger in women than that in men (women, 5.373 [2.705−10.669]; men, 2.273 [1.762−2.933]). Elevated CEA levels were significantly associated with a higher prevalence of LMM. Therefore, increased CEA could be used as a biomarker for detecting LMM in adults without cancer.

A Comparison of the Effect of a 4.4-MHz Radiofrequency Deep Heating Therapy and Ultrasound on Low Back Pain: A Randomized, Double-Blind, Multicenter Trial.

Despite the increasing interest in RF (Radiofrequency) therapy, little is known about its effectiveness for low back pain (LBP). The aim of this study was to investigate the effectiveness of 4.4-MHz RF diathermy compared to ultrasound (US) in patients with LBP. One-hundred-and-eighteen patients with LBP were randomized with RF (n = 62) or US (n = 56). Investigator and subjects were blinded to the treatment group. Either RF (4.4 MHz, 45 W/cm2) or US (1 MHz, 2 W/cm2) was applied for 10 to 15 min, 3 times per week for 4 weeks. The primary outcome was the Oswestry Disability Index (ODI, %). Secondary outcomes were numeric rating scale (NRS), Biering−Sorensen test, up-and-go test, successful pain relief, and successful functional improvement. Clinical outcomes were evaluated prior to intervention (baseline), and at 4 and 12 weeks after treatment. There were no significant differences between the groups regarding baseline demographic and clinical characteristics. Both groups observed a significant improvement of ODI (%), NRS, Biering−Sorensen test, and up-and-go test at 4 and 12 weeks after treatment (p < 0.05); however, no significant differences were found between groups. The RF group showed a higher proportion of successful pain relief at 12 weeks after treatment than the US group (p = 0.048). The RF diathermy showed favorable results in pain reduction, improvement of function, mobility, and back muscle endurance. Compared with US, RF diathermy obtained slightly better perception of patients in pain relief at 12 weeks after treatment. The results from this study indicated that 4.4-MHz RF diathermy can effectively be used as a conservative treatment option for patients with LBP.

Relationship between hyperhomocysteinemia and coexisting obesity with low skeletal muscle mass in asymptomatic adult population.

The relationship between hyperhomocysteinemia (HHcy) and obesity with low skeletal muscle mass (LMM) has not been established. We aim to assess the association between HHcy and the coexistence of obesity and LMM in asymptomatic adult population. We conducted a population-based cross-sectional study among asymptomatic individuals who underwent measurements of plasma homocysteine and body composition analysis. HHcy was defined as > 15 umol/L, obesity as body mass index ≥ 25 (kg/m2), and LMM as skeletal muscle index less than 2 SD below the sex-specific mean of young adults. The participants were classified into 'control', 'obesity alone', 'LMM alone', and 'obesity with LMM'. Among 113,805 participants, the prevalence of HHcy was 8.3% in control, 8.7% in obesity alone, 10.0% in LMM alone, and 13.0% in obesity with LMM (p for trend < 0.001). In a multivariable logistic regression analysis, the associations showed a positive trend for HHcy along the groups from obesity alone, to LMM alone, and to obesity with LMM. HHcy was independently associated with the presence of LMM alone (adjusted odds ratio 1.186 [95% confidence interval 1.117-1.259]) and obesity with LMM (1.424 [1.134-1.788]), respectively. This study demonstrated that HHcys was more strongly associated with coexistence of obesity and LMM than either condition alone in the adult population.

Association between osteosarcopenia and coronary artery calcification in asymptomatic individuals.

Osteoporosis and sarcopenia are substantially interrelated with shared cardiovascular risk factors. However, the relationship between osteosarcopenia and coronary artery disease is largely unexplored. We aimed to investigate the association between osteosarcopenia and coronary artery calcification (CAC) scores in asymptomatic adults. A total of 5969 asymptomatic adults without cardiovascular disease who underwent a health examination including estimation of CAC scores by cardiac tomography were analyzed. Osteoporosis was defined as low bone mineral density T-score ≤ - 2.5 standard deviation, and sarcopenia as appendicular skeletal muscle mass < 5.7 kg/m2 for women and < 7.0 kg/m2 for men, and osteosarcopenia as the copresence of both osteoporosis and sarcopenia. Participants were divided into four groups according to the presence of osteoporosis and/or sarcopenia as control, sarcopenia alone, osteoporosis alone, and osteosarcopenia. Prevalence of CAC was 22.0% in control, 23.6% in sarcopenia alone, 38.5% in osteoporosis alone, and 48.3% in osteosarcopenia group, with the osteosarcopenia group showing the highest (p < 0.0001). After adjustments for possible confounders, mean of log (CAC score + 1) in osteosarcopenia group was higher than other three groups (Bonferroni p < 0.0001). Using multivariate-adjusted analysis, subjects with osteosarcopenia had the highest risk for having CAC > 0 (odds ratio [OR] 2.868; 95% confidence interval [CI] 1.717-4.790). Furthermore, subjects with osteosarcopenia had a significant risk of moderate-to-extensive CAC (CAC score ≥ 100) (OR 2.709; 95% CI 1.128-6.505). We demonstrated that osteosarcopenia was independently associated with a higher prevalence of subclinical coronary atherosclerosis. Our results suggest osteosarcopenia as a predisposing factor for coronary heart disease.

Association between Elevated Plasma Homocysteine and Low Skeletal Muscle Mass in Asymptomatic Adults.

BACKGROUND: Homocysteine has been drawing attention with a closed linkage with skeletal muscle. However, the association of hyperhomocysteinemia with decreased skeletal muscle mass remains unclear. We aimed to investigate the association of hyperhomocysteinemia with low skeletal muscle mass (LMM) in asymptomatic adults. METHODS: This was a cross-sectional study of 114,583 community-dwelling adults without cancer, stroke, or cardiovascular diseases who underwent measurements of plasma homocysteine and body composition analysis from 2012 to 2018. Hyperhomocysteinemia was defined as >15 µmol/L. Skeletal muscle mass index (SMI) was calculated based on appendicular muscle mass (kg)/height (m)2. Participants were classified into three groups based on SMI: "normal," "mildly low," and "severely low." RESULTS: The prevalence of hyperhomocysteinemia was the highest in subjects with severely LMM (12.9%), followed by those with mildly LMM (9.8%), and those with normal muscle mass (8.5%) (P for trend <0.001). In a multivariable logistic regression model, hyperhomocysteinemia was significantly associated with having a mildly LMM (odds ratio [OR], 1.305; 95% confidence interval [CI], 1.224 to 1.392) and severely LMM (OR, 1.958; 95% CI, 1.667 to 2.286), respectively. One unit increment of log-transformed homocysteine was associated with 1.360 and 2.169 times higher risk of having mildly LMM and severely LMM, respectively. CONCLUSION: We demonstrated that elevated homocysteine has an independent association with LMM in asymptomatic adults, supporting that hyperhomocysteinemia itself can be a risk for decline in skeletal musculature.

Protruding anterior medial meniscus and posterior tibial translation as secondary signs of complete and partial posterior cruciate ligament tear.

OBJECTIVE: To evaluate whether measurement of protruding anterior meniscus in the medial compartment (PAMM) and posterior tibial translation (PTT) can be used as a secondary sign of posterior cruciate ligament (PCL) tear for differential diagnosis of partial or complete tear. METHODS: 21 cases with complete PCL tear, 35 cases with partial PCL tear, and 55 normal cases were reviewed in this retrospective study. PTT and PAMM were measured from the MR images associated with each case. Non-parametric data were evaluated using the Kruskal-Wallis test and the Mann-Whitney U-test with Bonferroni correction to compare differences among the three groups: complete tear, partial tear, and controls. RESULTS: There were significant differences in the median values of PAMM among the three groups, and with PAMM increasing as the grade of PCL injury increased. However, there were no significant differences in median PTT among the three groups. Median PAMM in the partial and complete tear groups was significantly higher than in subjects without PCL rupture (adjusted p-value <0.05). Although median PAMM in subjects in the complete tear group tended to be higher than in those with a partial tear, this difference was not statistically significant (adjusted p-values ≥0.418). CONCLUSION: PAMM is more useful finding than PTT and can predict PCL tear with or without posterior instability. However, PAMM cannot differentiate partial tear and complete tear of the PCL. ADVANCES IN KNOWLEDGE: PAMM is more useful finding than PTT and can predict PCL tear with or without posterior instability. However, PAMM cannot differentiate partial tear and complete tear of the PCL.

Preparation of Ligand Brush Nanocapsules for Robust Self-Controlled Antimicrobial Activity with Low Cytotoxicity at Target pH and Humidity.

This study prepared nanocapsules (NCs) with excellent self-controlled antimicrobial activity at pH 6-7 and humidity 45-100%, conditions in which most bacterial and fungal strains thrive. The nanocapsule substrate (NC@SiO2) was 676 nm in diameter, and the ligand-grafted capsule (NC@SiO2-g-MAA) was 888 nm. The large surface area and outer ligand brush of the NCs induced a rapid, self-controlled antibacterial response in the pH and humidity conditions needed for industrial and medical applications. Ligand-brush NCs containing an anionic antimicrobial drug had a rapid release effect because of the repellent electrostatic force and swelling properties of the ligand brushes. Controlled release of the drug was achieved at pH 6 and humidity of 45% and 100%. As many carboxylic acid groups are deprotonated into carboxylic acids at pH 5, the NC@SiO2-g-MAA had a high negative charge density. Carboxylic acid groups are anionized (-COO-) at pH 6 and above and push each other out of the capsule, expanding the outer shell as in a polymer brush to create the release behavior. The surface potential of the NC intermediate (NC@SiO2-MPS) was -23.45 [mV], and the potential of the capsule surface decreased to -36.4 [mV] when the MAA ligand brushes were grafted onto the surface of the capsule intermediate. In an antimicrobial experiment using Escherichia coli, a clear zone of 13-20 mm formed at pH 6, and the E. coli was eradicated completely at pH 6 and pH 7 when the humidity was 100%.

Prevalence and Related Factors for Poststroke Complex Regional Pain Syndrome: A Retrospective Cross-Sectional Cohort Study.

OBJECTIVE: The objective of this study was to evaluate the prevalence of poststroke complex regional pain syndrome (CRPS) to estimate related factors for poststroke CRPS in patients with first-ever stroke. DESIGN: This was a retrospective cross-sectional cohort study of adult patients (age >18y) with stroke who were admitted to rehabilitation unit from December 2014 to May 2018 in Korea. SETTING: Single acute rehabilitation unit of university hospital. PARTICIPANTS: Participants (N=313) diagnosed with first-ever stroke were identified from the stroke rehabilitation registry of our institute. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Prevalence of poststroke CRPS based on clinical features and 3-phase bone scintigraphy and the related factors of poststroke CRPS. RESULTS: A total of 313 records were analyzed, including demographic, clinical characteristics, and functional variables. Poststroke CRPS was found in 8.94% (28 of 313) patients with first-ever stroke. Logistic regression analysis showed that Fugl Meyer Assessment of Upper Extremity (FMA-UE) score was a significant associated factor for the presence of CRPS (odds ratio, 0.96; 95% confidence interval, 0.94-0.98; P=.003). The cutoff value of 76 points for FMA-UE score yielded moderate accuracy in identifying of poststroke CRPS (92.6% sensitivity, 65.8% specificity, and 0.85 area under the curve). CONCLUSIONS: The prevalence of poststroke CRPS was 8.94% in patients with first-ever stroke. The FMA-UE score was associated with the poststroke CRPS. Therefore, in patients with low FMA-UE score, prevention and high suspicion of post-stroke CRPS is necessary.

Postsurgical status of articular cartilage after arthroscopic posterior cruciate ligament reconstruction in patients with or without concomitant meniscal pathology.

PURPOSE: Several factors present at the time of posterior cruciate ligament reconstruction (PCLR) may cause the subsequent progression of articular cartilage lesions. This study aimed to evaluate postsurgical articular cartilage lesions which can be seen on MRI in patients who underwent arthroscopic PCLR with or without concomitant meniscal pathology. MATERIAL AND METHODS: A total of sixty-five patients (mean age 35.8 ± 12.3 years) who underwent arthroscopic PCLR were included in this retrospective study. Patients were divided into two groups: ten patients with concomitant meniscal injuries at the time of PCLR who underwent meniscal surgery and fifty-five patients with intact menisci. The cartilage status of all knees was evaluated by MRI and modified Noyes classification. RESULTS: Cartilage lesions were observed in 18 patients (27.7%) on the last follow-up MRI. The cartilage lesions were more common in the medial (15.4%) and patellofemoral (12.3%) compartments than in the lateral compartment (7.7%). Progression of cartilage lesions was present in 11 patients (16.9%) during follow-up MRI. The majority of cartilage lesions with progression were located in the medial compartment. The meniscal pathology group showed a higher prevalence of articular cartilage lesions on the last follow-up MRI (21.8% versus 60%, p = 0.022). In multivariate Cox regression, concomitant meniscal pathology was significantly associated with progression of articular cartilage lesions (p = 0.044). CONCLUSION: PCLR patients with associated meniscal pathology showed worse cartilage condition and more progression of cartilage lesions than isolated PCLR patients. Attention to this risk factor might provide more applicable treatment options for potential osteoarthritis prevention strategies.

Altered Differentiation of Tendon-Derived Stem Cells in Diabetic Conditions Mediated by Macrophage Migration Inhibitory Factor.

The purpose of our study was to evaluate the role of macrophage migration inhibitory factor (MIF) in the differentiation of tendon-derived stem cells (TdSCs) under hyperglycemic conditions. In the in vivo experiment, rats were classified into diabetic (DM) and non-DM groups depending on the intraperitoneal streptozotocin (STZ) or saline injection. Twelve-week after STZ injection, the supraspinatus tendon was harvested and prepared for histological evaluation and real-time reverse transcription polymerase chain reaction for osteochondrogenic (aggrecan, BMP-2, and Sox9) and tenogenic (Egr1, Mkx, scleraxis, type 1 collagen, and Tnmd) markers. For the in vitro experiment, TdSCs were isolated from healthy rat Achilles tendons. Cultured TdSCs were treated with methylglyoxal and recombinant MIF or MIF gene knockdown to determine the effect of hyperglycemic conditions and MIF on the differentiation function of TdSCs. These conditions were classified into four groups: hyperglycemic-control group, hyperglycemic-recombinant-MIF group, hyperglycemic-knockdown-MIF group, and normal-control group. The mRNA expression of osteochondrogenic and tenogenic markers was compared among the groups. In the in vivo experiment, the mRNA expression of all osteochondrogenic and tenogenic differentiation markers in the DM group was significantly higher and lower than that in the non-DM group, respectively. Similarly, in the in vitro experiments, the expression of all osteochondrogenic and tenogenic differentiation markers was significantly upregulated and downregulated, respectively, in the hyperglycemic-control group compared to that in the normal-control group. The hyperglycemic-knockdown-MIF group demonstrated significantly decreased expression of all osteochondrogenic differentiation markers and increased expression of only some tenogenic differentiation markers compared with the hyperglycemic-control group. In contrast, the hyperglycemic-recombinant-MIF group showed significantly increased expression of all osteochondrogenic differentiation markers, but no significant difference in any tenogenic marker level, compared to the hyperglycemic-control group. These results suggest that tendon homeostasis could be affected by hyperglycemic conditions, and MIF appears to alter the differentiation of TdSCs via enhancement of the osteochondrogenic differentiation in hyperglycemic conditions. These are preliminary findings, and must be confirmed in a further study.