Remodeling Pattern of Spinal Canal after Full Endoscopic Uniportal Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression: One Year Repetitive MRI and Clinical Follow-Up Evaluation

Objective: There is limited literature on repetitive postoperative MRI and clinical evaluation after Uniportal Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression. Methods: Clinical visual analog scale, Oswestry Disability Index, McNab's criteria evaluation and MRI evaluation of the axial cut spinal canal area of the upper end plate, mid disc and lower end plate were performed for patients who underwent single-level Uniportal Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression. From the evaluation of the axial cut MRI, four types of patterns of remodeling were identified: type A: continuous expanded spinal canal, type B: restenosis with delayed expansion, type C: progressive expansion and type D: restenosis. Result: A total of 126 patients with single-level Uniportal Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression were recruited with a minimum follow-up of 26 months. Thirty-six type A, fifty type B, thirty type C and ten type D patterns of spinal canal remodeling were observed. All four types of patterns of remodeling had statistically significant improvement in VAS at final follow-up compared to the preoperative state with type A (5.59 +/- 1.58), B (5.58 +/- 1.71), C (5.58 +/- 1.71) and D (5.27 +/- 1.68), p < 0.05. ODI was significantly improved at final follow-up with type A (49.19 +/- 10.51), B (50.00 +/- 11.29), C (45.60 +/- 10.58) and D (45.60 +/- 10.58), p < 0.05. A significant MRI axial cut increment of the spinal canal area was found at the upper endplate at postoperative day one and one year with type A (39.16 +/- 22.73; 28.00 +/- 42.57) mm(2), B (47.42 +/- 18.77; 42.38 +/- 19.29) mm(2), C (51.45 +/- 18.16; 49.49 +/- 18.41) mm(2) and D (49.10 +/- 23.05; 38.18 +/- 18.94) mm(2), respectively, p < 0.05. Similar significant increment was found at the mid-disc at postoperative day one, 6 months and one year with type A (55.16 +/- 27.51; 37.23 +/- 25.88; 44.86 +/- 25.73) mm(2), B (72.83 +/- 23.87; 49.79 +/- 21.93; 62.94 +/- 24.43) mm(2), C (66.85 +/- 34.48; 54.92 +/- 30.70; 64.33 +/- 31.82) mm(2) and D (71.65 +/- 16.87; 41.55 +/- 12.92; 49.83 +/- 13.31) mm(2) and the lower endplate at postoperative day one and one year with type A (49.89 +/- 34.50; 41.04 +/- 28.56) mm(2), B (63.63 +/- 23.70; 54.72 +/- 24.29) mm(2), C (58.50 +/- 24.27; 55.32 +/- 22.49) mm(2) and D (81.43 +/- 16.81; 58.40 +/- 18.05) mm(2) at postoperative day one and one year, respectively, p < 0.05. Conclusions: After full endoscopic lumbar decompression, despite achieving sufficient decompression immediately postoperatively, varying severity of asymptomatic restenosis was found in postoperative six months MRI without clinical significance. Further remodeling with a varying degree of increment of the spinal canal area occurs at postoperative one year with overall good clinical outcomes

The impact of non-pharmaceutical interventions on premature births during the COVID-19 pandemic: a nationwide observational study in Korea

BackgroundNon-pharmaceutical interventions (NPIs), such as social distancing and hand washing, have been associated with a decline in the preterm birth rate worldwide. We aimed to evaluate whether the preterm birth rate in Korea during the coronavirus disease 2019 lockdown has changed compared to that in previous years.MethodA birth registry from the Korea Statistical Information Service, which is a nationwide official database, was used to include all births claimed to have occurred between 2011 and 2020. Newborns with gestational age (GA) less than 22 weeks and birth weight less than 220 g were excluded. The pre-NPI period was designated as January 2011 to January 2020, and the NPI period was defined as February 2020 to December 2020. We assessed the effect of NPI on the incidence of prematurity per 100 births using an interrupted time-series quasi-experimental design and implementing an autoregressive integrated moving average (ARIMA) model.ResultsFrom 2011 to 2020, a total of 3,931,974 live births were registered, among which 11,416 were excluded. Consequently, the final study population included 3,920,558 live births (both singleton and multiple births) among which 275,009 (7.0%) were preterm. The preterm birth rate was significantly higher during the NPI period (8.68%) compared to that in the pre-NPI period (6.92%) (P < 0.001). The ARIMA model showed that in all singleton and multiple births, except those in July (observed 9.24, expected 8.54, [95% prediction interval {PI} 8.13–8.96], percent difference 7.81%), September (observed 7.89, expected 8.35, [95% PI 7.93–8.76], percent difference −5.66%), and December (observed 9.90, expected 9.40, [95% PI 8.98–9.82], percent difference 5.2%), most observed values were within the 95% PI of the expected values and showed an increasing trend.ConclusionIn this nationwide observational study, the trend in premature birth rate did not significantly change due to NPI implementation in Korea, as it had been increasing since 2011. The trend of Korea's birth rate appears to be unaffected by the implementation of NPIs; however, further studies with a longer follow-up period are needed

Understanding the Role of Electronic Effects in CO on the Pt-Sn Alloy Surface via Band Structure Measurements

Using angle-resolved photoemission spectroscopy, we show direct evidence for charge transfer between adsorbed molecules and metal substrates, i.e., chemisorption of CO on Pt(111) and Pt-Sn/Pt(111) 2 x 2 surfaces. The observed band structures show a unique signature of charge transfer as CO atoms are adsorbed, revealing the roles of specific orbital characters participating in the chemisorption process. As the coverage of CO increases, the degree of charge transfer between CO and Pt shows a clear difference to that of Pt-Sn. With comparison to density functional theory calculation results, the observed distinct features in the band structure are interpreted as back-donation bonding states formed between the Pt molecular orbital and the 2 pi orbital of CO. Furthermore, the change in the surface charge concentration, measured from the Fermi surface area, shows that the Pt surface has a larger charge concentration change than the Pt-Sn surface upon CO adsorption. The differences between Pt and Pt-Sn surfaces are due to the effect of Pt-Sn intermetallic bonding on the interaction of CO with the surface

Effect of Neutrophil Adhesion on the Mechanical Properties of Lung Microvascular Endothelial Cells

Neutrophil adhesion to pulmonary microvascular endothelial cells (ECs) initiates intracellular signaling, resulting in remodeling of F-actin cytoskeletal structure of ECs. The present study determined the mechanical properties of ECs and the changes induced by neutrophil adhesion by atomic force microscopy. The elastic moduli of ECs were compared before neutrophils were present, as soon as neutrophil adhesion was detected, and 1 minute later. ECs that were adjacent to those with adherent neutrophils were also evaluated. Neutrophil adhesion induced a decrease in the elastic moduli in the 6.25-μm rim of ECs surrounding adherent neutrophils as soon as firmly adherent neutrophils were detected, which was transient and lasted less than 1 minute. Adjacent ECs developed an increase in stiffness that was significant in the central regions of these cells. Intercellular adhesion molecule–1 crosslinking did not induce significant changes in the elastic modulus of ECs in either region, suggesting that crosslinking intercellular adhesion molecule–1 is not sufficient to induce the observed changes. Our results demonstrate that neutrophil adhesion induces regional changes in the stiffness of ECs

Serum amyloid A–containing HDL binds adipocyte-derived versican and macrophage-derived biglycan, reducing its antiinflammatory properties

The ability of HDL to inhibit inflammation in adipocytes and adipose tissue is reduced when HDL contains serum amyloid A (SAA) that is trapped by proteoglycans at the adipocyte surface. Because we recently found that the major extracellular matrix proteoglycan produced by hypertrophic adipocytes is versican, whereas activated adipose tissue macrophages produce mainly biglycan, we further investigated the role of proteoglycans in determining the antiinflammatory properties of HDL. The distributions of versican, biglycan, apolipoprotein A1 (the major apolipoprotein of HDL), and SAA were similar in adipose tissue from obese mice and obese human subjects. Colocalization of SAA-enriched HDL with versican and biglycan at the cell surface of adipocyte and peritoneal macrophages, respectively, was blocked by silencing these proteoglycans, which also restored the antiinflammatory property of SAA-enriched HDL despite the presence of SAA. Similar to adipocytes, normal HDL exerted its antiinflammatory function in macrophages by reducing lipid rafts, reactive oxygen species generation, and translocation of Toll-like receptor 4 and NADPH oxidase 2 into lipid rafts, effects that were not observed with SAA-enriched HDL. These findings imply that SAA present in HDL can be trapped by adipocyte-derived versican and macrophage-derived biglycan, thereby blunting HDL’s antiinflammatory properties

Risks of NTM-PD measured by age and sex for matched cohorts.

Risks of NTM-PD measured by age and sex for matched cohorts.</p

Cumulative incidence of NTM in the depression group and non-depression group for matched cohorts.

Cumulative incidence of NTM in the depression group and non-depression group for matched cohorts.</p