Arthroscopic Reduction and Internal Fixation in Patients with Acetabular Posterior Wall Fractures.

Background: This study aimed to access the radiologic and clinical outcomes after arthroscopic reduction and internal fixation with screws in patients with posterior wall fractures of the acetabulum. Methods: From May 2013 to December 2019, 13 patients (11 men and 2 women) with posterior wall fractures of the acetabulum were treated with arthroscopic reduction and internal fixation with screws at two medical centers. The mean age at the index operation was 39 years (range, 22-58 years). The mean duration of follow-up was 23 months (range, 12-46 months). Clinical assessment was performed using the modified Merle d'Aubigné and Postel functional scoring system. The maximum displacement of acetabular or femoral head fragments detected on radiographs was used as radiographic results. Secondary osteoarthritis, osteonecrosis, or heterotrophic ossification was assessed at the latest follow-up. Results: Bony union was shown at 12 weeks of follow-up in all patients. The radiologic outcomes showed an anatomical reduction in 11 patients and a satisfactory reduction in 2 patients. The modified Merle d'Aubigné and Postel functional score was excellent in 7 patients, good in 5 patients, and fair in 1 patient. Two patients had transient pudendal nerve palsy after hip arthroscopy. However, no sciatic nerve palsy occurred. At the latest follow-up, there was no heterotopic ossification, osteonecrosis of the femoral head, or posttraumatic osteoarthritis. Conclusions: Arthroscopic reduction and internal fixation with cannulated screws can be good alternative options with good radiographic and clinical outcomes, convenient removal of intra-articular loose body, and low complication rates.

Topical Tranexamic Acid Can Be Used Safely Even in High Risk Patients: Deep Vein Thrombosis Examination Using Routine Ultrasonography of 510 Patients.

Background and Objectives: Previous studies regarding tranexamic acid (TXA) in total knee arthroplasty (TKA) investigated only symptomatic deep vein thrombosis (DVT), or did not include high risk patients. The incidence of DVT including both symptomatic and asymptomatic complications after applying topical TXA has not been evaluated using ultrasonography. Materials and Methods: The medical records of 510 patients who underwent primary unilateral TKA between July 2014 and December 2017 were retrospectively reviewed. Because TXA was routinely applied through the topical route, those who had a history of venous thromboembolism, myocardial infarction, or cerebral vascular occlusive disease, were not excluded. Regardless of symptom manifestation, DVT was examined at 1 week postoperatively for all patients using ultrasonography, and the postoperative transfusion rate was investigated. The study population was divided according to the use of topical TXA. After the two groups were matched based on the propensity scores, the incidence of DVT and the transfusion rate were compared between the groups. Results: Of the 510 patients, comprising 298 patients in the TXA group and 212 patients in the control group, DVT was noted in 22 (4.3%) patients. Two patients had DVT proximal to the popliteal vein. After propensity score matching (PSM), 168 patients were allocated to each group. In all, 11 patients in the TXA group and seven patients in the control group were diagnosed with DVT, which did not show a significant difference (p = 0.721). However, the two groups differ significantly in the transfusion rate (p < 0.001, 50.0% in the TXA group, 91.7% in the control group). Conclusions: The incidence of DVT, whether symptomatic or asymptomatic, was not affected by the use of topical TXA. The postoperative transfusion rate was reduced in the TXA group. Topical TXA could be applied safely even in patients who had been known to be at high risk.

Elimination of irreducible intercalary fragment and fixation using locking plate for Mayo type IIB olecranon fracture-outcomes compared with type IIA.

BACKGROUND: We hypothesized that the outcomes of articular reduction with elimination of irreducible articular intercalary fragments for Mayo type IIB fractures fixed using olecranon locking plates would be as satisfactory as those of noncomminuted fractures. METHODS: A total of 65 patients were enrolled from among 92 who had undergone operative treatment for olecranon fractures between March 2008 and February 2015. Patients with fragments that were eliminated because they were too comminuted to be fixed during surgery (type IIB) were included in group 1. Patients without intraarticular comminuted fragments (type IIA) or with very few fragments were assigned to group 2. In group 1, articular congruency and reduction status were confirmed by direct visualization. The fracture was then fixed with a locking plate and irreducible intercalary fragments were eliminated. RESULTS: There were no significant differences in demographic characteristics, such as age and gender, between the two groups. Both groups achieved bony union within the approximately 6-year follow-up period and there were no serious complications in either group. The grades of heterotrophic ossification and ulnohumeral arthritis were not significantly different between the groups. The mean flexion-extension and pronation-supination arcs were similarly satisfactory in both groups (127.35° and 134.39° vs. 129.69° and 133.75° in groups 1 and 2°, respectively). Clinical outcomes including visual analog scale pain scores, as well as the Mayo Elbow Performance scores (87.73 vs. 88.28 in groups 1 and 2, respectively), were also similarly satisfactory in both groups. CONCLUSIONS: Locking plate fixation under direct visualization (to reduce the articular surface in Mayo type IIB fractures) and elimination of articular intercalary fragments resulted in satisfactory radiologic and clinical outcomes, similar to those of noncomminuted fractures also treated using a locking plate. LEVEL OF EVIDENCE: Level IV, Retrospective therapeutic study.

Antegrade intramedullary nailing in comminuted, open metacarpal bone fracture: maintenance of the length.

PURPOSE: The purpose of this study was to evaluate the radiological and clinical outcomes of treatment of comminuted open fractures of the metacarpal bone (MCB) with associated injuries to soft tissues, tendons, and neurovascular structures using antegrade intramedullary nailing (AIN) at least 2 years postoperatively. METHODS: Between January 2008 and December 2017, a total of 27 patients who met the inclusion/exclusion criteria were included in this study. The inclusion criterion was open and comminuted fracture (with/without segmental bone defects). We evaluated simple radiograph and computed tomography (CT) findings and clinical conditions (visual analog scale [VAS] pain score and Disabilities of the Arm, Shoulder, and Hand [DASH] score), including active range of motion (ROM) at metacarpophalangeal joint (MP) and grip strength at final follow-up. RESULTS: The mean preoperative angulation was 29.63° ± 7.59° and the mean shortening was 9.30 ± 2.38 mm. Union was achieved at mean 12.3 weeks postoperatively, without any complications due to operative treatment. The dorsal angulation measured on the CT scans, shortening on simple radiographs was significantly improved (10.26 °± 3.19°, 0.52 ± 1.05 mm, respectively). The final VAS and DASH scores were 0.41 ± 0.64 and 3.6 ± 2.47, respectively, indicating satisfactory outcomes. The final ROM was 85.0° ± 3.67°. The mean final grip strength was 89.56 ± 5.69% relative to the normal side. A mean extension lag at the MP joint of 12° was noted in three patients; however, it was resolved by additional tenolysis. CONCLUSIONS: AIN is a simple method for fixation of open comminuted metacarpal fractures accompanied by soft tissue injury. The simplicity of the method is beneficial for repairing associated injured structures and healing soft tissue. Minimized additional damage around the MCB during surgery and good stability resulted in satisfactory bony union with minimal angulation, shortening, and rotation. LEVEL OF EVIDENCE: Level IV, Retrospective case series.

Identification and analysis of a differentially expressed wheat RING-type E3 ligase in spike primordia development during post-vernalization.

KEY MESSAGE: We identified a RING-type E3 ligase (TaBAH1) protein in winter wheat that targets TaSAHH1 for degradation and might be involved in primordia development by regulating targeted protein degradation. Grain yield per spike in wheat (Triticum aestivum), is mainly determined prior to flowering during mature primordia development; however, the genes involved in primordia development have yet to be characterized. In this study, we demonstrated that, after vernalization for 50 days at 4 °C, there was a rapid acceleration in primordia development to the mature stages in the winter wheat cultivars Keumgang and Yeongkwang compared with the Chinese Spring cultivar. Although Yeongkwang flowers later than Keumgang under normal condition, it has the same heading time and reaches the WS9 stage of floral development after vernalization for 50 days. Using RNA sequencing, we identified candidate genes associated with primordia development in cvs. Keumgang and Yeongkwang, that are differentially expressed during wheat reproductive stages. Among these, the RING-type E3 ligase TaBAH1 (TraesCS5B01G373000) was transcriptionally upregulated between the double-ridge (WS2.5) stage and later stages of floret primordia development (WS10) after vernalization. Transient expression analysis indicated that TaBAH1 was localized to the plasma membrane and nucleus and was characterized by self-ubiquitination activity. Furthermore, we found that TaBAH1 interacts with TaSAHH1 to mediate its polyubiquitination and degradation through a 26S proteasomal pathway. Collectively, the findings of this study indicate that TaBAH1 might play a prominent role in post-vernalization floret primordia development.

A comparative study of innovative percutaneous repair and open repair for acute Achilles tendon rupture: Innovative usage of intraoperative ultrasonography.

PURPOSE: There is no definitive consensus on the optimal treatment of Achilles tendon rupture. We comparatively analyzed the clinical outcomes of two types of repair surgeries in treating Achilles tendon rupture. METHODS: This retrospective study included 12 patients of Achilles tendon rupture (group A) treated with ultrasound-guided percutaneous repair and 18 patients (group B) treated with open repair. Clinical evaluation was performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles Tendon Total Rupture score (ATRS), visual analog scale, time to single heel raise, bilateral calf circumferences, recovery of athletic ability, and other complications. RESULTS: While the Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, time point when single heel raise was possible, differences in bilateral calf circumference, and recovery of athletic ability compared to pre-rupture level were not significantly different between the two groups (p = 0.999, 0.235, 0.357, 0.645, 0.497, and 0.881, respectively), overall and aesthetic satisfaction levels were higher in the group treated with percutaneous repair under ultrasonography guidance (p = 0.035 and 0.001, respectively). Overall, there were no cases involving sural nerve injury in either group. CONCLUSION: Innovative percutaneous repair provides not only similar clinical outcomes but also greater overall and aesthetic satisfaction levels of operative outcomes and minimal complications (i.e. sural nerve injury) compared to open repair surgeries. Therefore, percutaneous repair may be a useful technique in the treatment of Achilles tendon rupture.

Accuracy of new implant impression technique using dual arch tray and bite impression coping.

PURPOSE: The purpose of this in vitro study was to evaluate the accuracy of a new implant impression technique using bite impression coping and a dual arch tray. MATERIALS AND METHODS: Two implant fixtures were placed on maxillary left second premolar and first molar area in dentoform model. The model with two fixtures was used as the reference. The impression was divided into 2 groups, n=10 each. In group 1, heavy/light body silicone impression was made with pick up impression copings and open tray. In group 2, putty/light body silicone impression was made with bite impression copings and dual arch tray. The reference model and the master casts with implant scan bodies were scanned by a laboratory scanner. Surface tessellation language (STL) datasets from test groups was superimposed with STL dataset of reference model using inspection software. The three-dimensional deviation between the reference model and impression models was calculated and illustrated as a color-map. Data was analyzed by independent samples T-test of variance at α=.05. RESULTS: The mean 3D implant deviations of pick up impression group (group 1) and dual arch impression group (group 2) were 0.029 mm and 0.034 mm, respectively. The difference in 3D deviations between groups 1 and 2 was not statistically significant (P=.075). CONCLUSION: Within limitations of this study, the accuracy of implant impression using a bite impression coping and dual arch tray is comparable to that of conventional pick-up impression.

Physicochemical Properties of Meat Batter Added with Edible Silkworm Pupae (Bombyx mori) and Transglutaminase.

This study was conducted to investigate the physicochemical properties of meat batters prepared with fresh pork meat, back fat, water, and salt and formulated with three different amounts (5%, 10%, and 15%) of silkworm pupae (Bombyx mori) powder and transglutaminase (TG). Meat batters formulated with silkworm pupae powder showed significantly higher contents of protein and ash than control batter. Addition of silkworm pupae to batter also showed significantly lower cooking loss than the control. Moreover, meat batter containing 15% silkworm pupae showed no significant difference in redness value compared to the control. In addition, pH, viscosity, hardness, gumminess, and chewiness were improved after the addition of silkworm pupae. Furthermore, meat batter formulated with TG and silkworm pupae showed improved hardness, gumminess, chewiness and viscosity compared to control batter. Addition of 1% TG with 15% silkworm pupae to meat batter resulted in significantly higher pH, textures, and viscosity. Our data suggest that both silkworm pupae and TG can be added to meat batter to improve its physicochemical properties. Therefore, combination of silkworm pupae and TG could be a new nutritional and functional source for meat products.

Effect of Swiss Chard (Beta vulgaris var. cicla) as Nitrite Replacement on Color Stability and Shelf-Life of Cooked Pork Patties during Refrigerated Storage.

In this study, the effects of pre-converted nitrite from Swiss chard powder (PS) on the color stability and shelf-life of cooked pork patties during refrigerated storage for 28 d were investigated. Nitrite was added at a concentration of approximately 120 ppm. Five treatments were formulated as follows: Control (120 ppm nitrite), T1 (2% PS), T2 (2% pre-converted nitrite from celery powder; PC), T3 (1% PS + 60 ppm nitrite), and NC (nitrite-free). The T1 and T3 samples had higher nitrosoheme pigment contents, which were associated with the redness of the samples (p<0.05). T1 resulted in the highest redness value (p<0.05). The redness and yellowness of the cooked pork patties increased with increasing PS levels. The pH of the samples subjected to all treatments decreased with progress of the storage period (p<0.05). The pH of the T1 and T3 samples treated with PS was lower (p<0.05) than that obtained with other treatments, as PS has a lower pH value. The treatments in which PS was added were most effective for reducing the level of thiobarbituric acid reactive substances (TBARS) and the residual nitrite content relative to the control. T1 resulted in the highest flavor, off-flavor, and overall acceptability scores during storage (p<0.05). The total viable bacterial count for all treatments was below 1 Log CFU/g, and E. coli and coliform bacteria were not detected during storage. Therefore, these results suggested that pre-converted nitrite from Swiss chard powder is a potential replacement for nitrite in meat products.

Combined Effects of Wheat Sprout and Isolated Soy Protein on Quality Properties of Breakfast Sausage.

The objective of this study was to investigate the effects of different concentrations of WSP (wheat sprout powder) and ISP (isolated soy protein) on the quality of breakfast sausage. Treatments were formulated as follows: Control, T1 (2.0% ISP), T2 (1.5% ISP + 0.5% WSP), T3 (1.0% ISP + 1.0% WSP), T4 (0.5% ISP + 1.5% WSP) and T5 (2.0% WSP). The treatments were analyzed for color, pH, cooking loss, emulsion stability, protein solubility, viscosity, texture properties and sensory evaluation. Lightness and redness were reduced and yellowness was increased as increased level of WSP, due to the dark green color of WSP (p<0.05). The pH values of all samples were affected by WSP which has lower pH (p<0.05). The emulsion stability and cooking loss of treatments were improved with increasing level of WSP (p<0.05). The protein solubility, viscosity and overall texture properties of the sausage indicated significant differences in relation to the level of WSP and ISP (p<0.05). The sensory evaluation indicated that the greatest flavor and overall acceptability in sausage was achieved at WSP 1% combination with ISP 1% (T3) (p<0.05). Therefore, these results indicate that breakfast sausage containing 1% WSP and 1% ISP is the optimal formulation, taking into consideration the overall physico-chemical properties and sensory evaluation.

ESP-102, a Combined Herbal Extract of Angelica gigas, Saururus chinensis, and Schisandra chinensis, Changes Synaptic Plasticity and Attenuates Scopolamine-Induced Memory Impairment in Rat Hippocampus Tissue.

ESP-102, an extract from Angelica gigas, Saururus chinensis, and Schisandra chinensis, has been used as herbal medicine and dietary supplement in Korea. Despite the numerous bioactivities in vitro and in vivo studies, its effects on neuronal networks remain elusive. To address the neuronal effect, we examined synaptic plasticity in organotypic hippocampal slice culture with multielectrode array. Our results showed an increase in excitatory postsynaptic potential (EPSP), indicating the induction of long-term potentiation (LTP), in the presence of ESP-102. In addition, the neuroprotective effect of ESP-102 was also tested by application of scopolamine to the hippocampal slice. Interestingly, ESP-102 competitively antagonized the preventative LTP effect induced by scopolamine. The scopolamine-induced reduction in brain-derived neurotrophic factor (BDNF) and GluR-2 expression was also rescued by ESP-102. In terms of mode of action, ESP-102 appears to act on the presynaptic region independent of AMPA/NMDA receptors. Based on these findings, ESP-102 can be suggested as a novel herbal ingredient with memory enhancing as well as neuroprotective effects.

Quality and Sensory Characteristics of Reduced-fat Chicken Patties with Pork Back Fat Replaced by Dietary Fiber from Wheat Sprout.

The effects of reducing pork fat levels from 20% to 15% or 10% by partially substituting pork back fat with wheat sprout fiber in reduced-fat chicken patties were investigated. Approximate composition, energy value, pH, color, cooking loss, reduction in diameter, reduction in thickness, shear force, and sensory properties were determined. Moisture content, ash contents, yellowness of uncooked and cooked reduced-fat chicken patties with wheat sprout were higher than those in the control, while displaying fat content, calorie content, and pH of uncooked and cooked lower in reduced-fat chicken patties than in the control. Cooking loss, reduction in diameter, and reduction in thickness were the highest in the reduced-fat chicken patties with 10% fat level. Cooking loss, reduction in diameter, and reduction in thickness were decreased when fat levels and wheat sprout levels were increased. Control samples without wheat sprout dietary fiber had significantly (p<0.05) higher color and flavor scores compared to reduced-fat chicken patties containing wheat sprout dietary fiber. The overall acceptability of the control and treatment with 15% fat and 2% wheat sprout dietary fiber (T3) was the highest. Therefore, 15% fat level in reduced-fat chicken patties with the addition of 2% wheat sprout dietary fiber can be used to improve the quality and sensory characteristics of regular-fat chicken patties containing 20% fat level.

Effect of estrogen on the expression of cytokines of the temporomandibular joint cartilage cells of the mouse.

PURPOSE: The purpose of this study was to evaluate the effect of estrogen on the synthesis of cytokines of the temporomandibular joint cells. METHODS: Mandibular condyles of 10 mice were resected. Twenty of these condylar cartilages were removed and placed in organ culture for 24 hours with media containing different concentrations of 17beta-estradiol. The chondroblasts from the mandibular condyles of 3 mice were cultured with different concentrations of 17beta-estradiol the same as above. Cytokine concentrations were measured by ELISA. RESULTS: The expression and concentration of IL-1 beta, IL-6, and IL-8 were increased with increasing concentration of 17beta-estradiol. The expression and concentration of IL-4 and IL-10 were not different from the control and experimental group. CONCLUSIONS: These findings suggest that estrogen has the potential to cause temporomandibular joint disease with induction of the proinflammatory cytokines, IL-1 beta, IL-6, and IL-8.

Effects of anodized oxidation or turned implants on bone healing after using conventional drilling or trabecular compaction technique: histomorphometric analysis and RFA.

OBJECTIVES: The aim of this study was to compare the bone healing characteristics adjacent to anodic oxidation and turned surfaces after implant installation using the trabecular compaction technique or the conventional drilling technique in the soft bone area. MATERIAL AND METHODS: A total of 72 implants (36 anodic oxidation surface and 36 turned surface implants) were inserted into the distal end of the femur head of 12 dogs by two different surgical techniques. There were four experimental groups: (1) DT group; drilling+turned, (2) DO group; drilling+oxidation, (3) CT group; compaction+turned, and (4) CO group; compaction+oxidation. The resonance frequency was measured and six specimens/treatment group were obtained at 0, 3 and 8 weeks, postoperatively. Undecalcified ground sections were prepared for histologic and histomorphometric examinations. RESULTS: At week 0, the trabecular compaction groups showed a higher bone to implant contact ratio (BIC) than the conventional drilling groups, regardless of surface types. The CT group showed a higher implant stability quotient (ISQ) than the DT group. At week 3, the oxidation groups showed a higher BIC than the turned groups regardless of the surgical technique used. The CO group showed higher ISQ than the CT group. At week 8, there was no statistically significant difference in BIC and ISQ between the groups. CONCLUSIONS: Surgical technique and implant surface state have an effect on the initial bone response to two-stage implants inserted into trabecular bone regions.