Clinical and Radiological Outcomes of Modified Phemister Operation with Coracoclavicular Ligament Augmentation Using Suture Anchor for Acute Acromioclavicular Joint Dislocation

Background Modified Phemister operation has been widely used for the treatment of acute acromioclavicular (AC) joint dislocation. Additionally, the use of suture anchor for coracoclavicular (CC) fixation has been reported to provide CC stability. This study was conducted to evaluate the clinical and radiological results of a modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation. Methods Seventy-four patients underwent the modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation and were followed-up for an average of 12.3 months. The visual analogue scale (VAS), range of motion, Constant score, and Korean shoulder scoring system (KSS) were used for clinical assessment. Acromioclavicular interval (ACI), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were obtained to evaluate the radiological assessments. Results At the last follow-up, the mean VAS Score was 1.7 points, the mean joint range of the forward flexion was 164.6°, external rotation at the side was 61.2°, and internal rotation to the posterior was a level of T12. The mean Constant score and the mean KSS was 82.7 points and 84.2 points, respectively. At the mean ACI, CCD, and ACD, significant differences were found preoperatively and at the last follow-up. When the ACI, CCD, and ACD were compared with the contralateral unaffected shoulder at the last follow-up, the affected shoulders had significantly higher values. Conclusions The modified Phemister operation with CC ligament augmentation using suture anchor is clinically and radiologically effective at acute AC joint dislocation

Isolation and characterization of canine umbilical cord blood-derived mesenchymal stem cells

Human umbilical cord blood-derived mesenchymal stem cells (MSCs) are known to possess the potential for multiple differentiations abilities in vitro and in vivo. In canine system, studying stem cell therapy is important, but so far, stem cells from canine were not identified and characterized. In this study, we successfully isolated and characterized MSCs from the canine umbilical cord and its fetal blood. Canine MSCs (cMSCs) were grown in medium containing low glucose DMEM with 20% FBS. The cMSCs have stem cells expression patterns which are concerned with MSCs surface markers by fluorescence-activated cell sorter analysis. The cMSCs had multipotent abilities. In the neuronal differentiation study, the cMSCs expressed the neuronal markers glial fibrillary acidic protein (GFAP), neuronal class III β tubulin (Tuj-1), neurofilament M (NF160) in the basal culture media. After neuronal differentiation, the cMSCs expressed the neuronal markers Nestin, GFAP, Tuj-1, microtubule-associated protein 2, NF160. In the osteogenic & chondrogenic differentiation studies, cMSCs were stained with alizarin red and toluidine blue staining, respectively. With osteogenic differentiation, the cMSCs presented osteoblastic differentiation genes by RT-PCR. This finding also suggests that cMSCs might have the ability to differentiate multipotentially. It was concluded that isolated MSCs from canine cord blood have multipotential differentiation abilities. Therefore, it is suggested that cMSCs may represent a be a good model system for stem cell biology and could be useful as a therapeutic modality for canine incurable or intractable diseases, including spinal cord injuries in future regenerative medicine studies

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Preparation of Cu2ZnSnS4 thin films via electrochemical deposition and rapid thermal annealing

We fabricated metallic Cu-Zn-Sn (CZT) precursor thin films via electrochemical deposition from aqueous metal salt solution on Mo-coated soda-lime glass substrates, and the influence of the subsequent sulfurization condition on the morphology, composition and structure of the final Cu2ZnSnS4 (CZTS) thin films was investigated. A rapid thermal annealing equipment was used for a systematic control of the sulfurization process parameters. The as-deposited films are composed of binary metallic alloys, which can be converted to the highly crystalline CZTS phase after sulfurization at temperatures above 500 degrees C. The composition of the CZT film barely changes during the sulfurization, and a small amount of CuS-based secondary phases exists even at 550 degrees C. However, a quick post-annealing KCN treatment effectively and selectively removes the secondary phase, evidenced by the Raman spectroscopy and elemental

Amino acid supplementation affects imprinted gene transcription patterns in parthenogenetic porcine blastocysts.

To determine whether exogenous amino acids affect gene transcription patterns in parthenogenetic porcine embryos, we investigated the effects of amino acid mixtures in culture medium. Parthenogenetic embryos were cultured in PZM3 medium under four experimental conditions: 1) control (no amino acids except L-glutamine and taurine); 2) nonessential amino acids (NEAA); 3) essential amino acids (EAA); and 4) NEAA and EAA. The rate of development of embryos to the four-cell stage was not affected by treatment. However, fewer (P<0.05) embryos cultured with EAA (12.8%) reached the blastocyst stage as compared with the control group (25.6%) and NEAA group (30.3%). Based on these findings, we identified genes with altered expression in parthenogenetic embryos exposed to medium with or without EAAs. The results indicated that EAA influenced gene expression patterns, particularly those of imprinted genes (e.g., H19, IGF2R, PEG1, XIST). However, NEAAs did not affect impaired imprinted gene expressions induced by EAA. The results also showed that mechanistic target of rapamycin (MTOR) mRNA expression was significantly increased by EAA alone as compared with control cultures, and that the combined treatment with NEAA and EAA did not differ significantly from those of control cultures. Our results revealed that gene transcription levels in porcine embryos changed differentially depending on the presence of EAA or NEAA. However, the changes in the H19 mRNA observed in the parthenogenetic blastocysts expression level was not related to the DNA methylation status in the IGF2/H19 domain. The addition of exogenous amino acid mixtures affected not only early embryonic development, but also gene transcription levels, particularly those of imprinted genes. However, this study did not reveal how amino acids affect expression of imprinted genes under the culture conditions used. Further studies are thus required to fully evaluate how amino acids affect transcriptional regulation in porcine embryos

Differential mRNA expression patterns for four imprinted genes in parthenogenetic blastocysts cultured with NEAA or EAA or both.

<p>Bars (A) and aligned dot plots (B) represent mRNA transcript levels of the imprinted <i>H19</i>, <i>IGF2R</i>, <i>NNAT</i> and <i>PEG1</i> genes in individual blastocysts after normalization relative to the average of <i>RN18S</i> and <i>ACTB</i> (internal control) genes, were compared to those of control blastocysts cultured in the absence of amino acid mixture, which was set to 1. The aligned dot plots with asterisks indicate significantly different from 1 (*, <i>P</i><0.05; **, <i>P</i><0.001; ***, <i>P</i><0.0001).</p

Real-time PCR analysis of mRNA expression levels in parthenogenetic blastocysts cultured with/without EAAs.

<p>The relative mRNA expression of the selected 15 genes; <i>HKII</i>, <i>ACACA</i>, <i>PCmt</i>, <i>MCT1</i>, <i>SLC3A1</i>, <i>GLUT2</i>, <i>GRB10</i>, <i>H19</i>, <i>IGF2R</i>, <i>NNAT</i>, <i>PEG1</i>, <i>XIST</i>, <i>BEX1</i>, <i>G6PD</i>, and <i>PGK1</i>, in EAA blastocysts (<i>n</i> = 30) after normalization relative to the average of <i>RN18S</i> and <i>ACTB</i> (internal control) gene, were compared to those of the blastocysts cultured in the absence of amino acid mixtures (control) which was set to 1. Bars with asterisks indicate significantly different from the value in the control (*, <i>P</i><0.05). Data is mean ± S.E.M.</p

Total cell numbers of parthenogenetic blastocysts cultured with NEAA or EAA or both.

<p>Scatter dot plots represent average numbers of total cells in control (41.6; <i>n</i> = 48), NEAA (42.2; <i>n</i> = 48), EAA^D3 (32.7 <i>n</i> = 37), EAA^D6 (30.8; <i>n</i> = 36), EAA^half (31.3; <i>n</i> = 41), and NEAA + EAA (40.5; <i>n</i> = 45) blastocysts at Day 6. Cells were counted under UV using a fluorescence microscope with a DAPI fluorescence emission filter in three independent experiments. <i>P</i>-values are derived when treatments are compared to control (*, <i>P</i><0.05, **, <i>P</i><0.001).</p

mRNA expression pattern of <i>H19</i> and <i>IGF2R</i> in individual parthenogenetic blastocysts.

<p>The quantitative data represents the values from transcripts of <i>H19</i> and <i>IGF2R</i> genes in individual mRNA samples (<i>n</i> = 20). Bars with asterisks indicate significantly different from the value in the control (*, <i>P</i><0.05). Data is mean ± S.E.M.</p