Relationship between radiographic grading of osteoarthritis and the biochemical markers for arthritis in knee osteoarthritis

The aim of this study was to investigate the relationship between the biochemical markers of arthritis and the radiographic grading of osteoarthritis (OA) in knees. Seventy-one women aged 49–85 years with knee OA were studied. Anterior–posterior knee radiographs and hand radiographs were taken in all patients. The radiographic grading of OA in the knee was performed by using the Kellgren–Lawrence criteria and the joint space width. The 71 patients with knee OA were divided into two groups: 37 patients exhibiting generalized osteoarthritis (GOA) and 34 non-GOA patients, according to the grading of their hand radiograph. C-reactive protein (CRP), urinary pyridinoline, YKL-40, plasma matrix metalloproteinase (MMP)-3, MMP-9 and tissue inhibitor of metalloproteinases (TIMP)-1 were measured as the biochemical markers of arthritis. The radiographic grading with the Kellgren–Lawrence scale revealed a significant relationship to the joint space width (P = 0.003): the joint space width decreased with increasing Kellgren–Lawrence grade. All biochemical markers had negative correlations with the joint space width, but only urinary pyridinoline had a significant correlation (P = 0.039). Pyridinoline (P = 0.034) and TIMP-1 (P = 0.017) also exhibited a significant relationship to the Kellgren–Lawrence grade. In GOA evaluations, the joint space width did not differ between GOA and non-GOA patients. CRP, pyridinoline, YKL-40 and MMP-3 levels were significantly greater in GOA patients than in non-GOA patients. CRP, pyridinoline, YKL-40, MMP-3 and TIMP-1 levels each related to at least one of the radiographic gradings. Furthermore, pyridinoline related to every type of radiographic grading examined in the present study

Volumetric Assessment of the Frontal Sinus in Female Adolescents and Its Relationship with Craniofacial Morphology and Orthodontic Treatment : A Pilot Study

The present study aimed to evaluate the correlation between frontal sinus morphology and craniofacial morphology, and to investigate the effects of orthodontic treatment on the development of the frontal sinus in female adolescents (mean age: 13.9 ± 1.3 years). In total, 53 patients were recruited and underwent cephalography and computed tomography before and after orthodontic treatment. Of these patients, most had a bilaterally symmetrical fan-shaped frontal sinus without any fusion. The average size and volume of the frontal sinus before orthodontic treatment were 45.8 ± 12.3 mm in breadth, 29.8 ± 7.3 mm in height, 22.7 ± 5.1 mm in depth, and 5151.6 ± 2711.4 mm2 in volume. Sinus volume in patients with skeletal Class III malocclusion tended to be larger than that in patients with skeletal Class I and II malocclusion. Upon comparison with the pretreatment measurements, the sizes and volumes of the frontal sinus were significantly larger following orthodontic treatment, regardless of the skeletal pattern; however, since these changes were small, the increases in the size and volume of the frontal sinus may have been caused by pubertal growth and not orthodontic treatment. The clinical relevance of the frontal sinus remains controversial

Orthodontic Treatment Does Not Affect Frontal Sinus Development in Female Adults : A Clinical Study

Frontal sinus growth is gradual and lasts until post-puberty. However, the influence of biomechanical stimuli, such as orthodontic treatment, on frontal sinus development after the growth period has ended remains unclear. This study was designed to elucidate the impact of orthodontic treatment on the frontal sinus morphology of adult females. Sixty women were included and divided into three groups, based on the Frankfort mandibular plane angle. All participants underwent computed tomography and lateral cephalometry before and after treatment. Although two participants exhibited frontal sinus agenesis, most exhibited a bilaterally symmetric frontal sinus without fusion. The frontal sinus width and height were almost similar, irrespective of the vertical skeletal pattern, where the frontal sinus depth was significantly larger in the average mandibular plane angle group than in the low- and high-angle groups. Furthermore, the sinus volume in the low-angle group was likely smaller than that in the average and high-angle groups. On comparing pre-treatment and post-treatment measurements, minimal or no changes to the frontal sinus dimension were detected after treatment. In conclusion, orthodontic treatment did not affect frontal sinus development after the end of growth

Fibrin membrane pupillary-block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator: a case report

<p>Abstract</p> <p>Background</p> <p>Fibrin pupillary-block glaucoma is a rare complication after cataract surgery. The treatment for this condition is still controversial, since Nd:YAG laser fibrin membranotomy tends to reocclude and laser peripheral iridotomy entails the risk of damaging the corneal endothelium in the presence of corneal edema associated with elevated intraocular pressure.</p> <p>Case presentation</p> <p>A 62-year-old man with diabetes mellitus developed acute elevation of intraocular pressure with a shallow anterior chamber five days after uneventful cataract surgery. Initially, slit lamp examination provided only limited information due to severe corneal edema. After resolution of corneal edema with systemic glaucoma therapy, a complete fibrin membrane was observed across the pupil by slit lamp examination. Anterior segment optic coherence tomography clearly revealed a thin fibrin membrane covering the entire pupillary space, a shallow anterior chamber, and a deep posterior chamber. The intraocular lens was not observed by anterior segment optic coherence tomography. In contrast, ultrasound biomicroscopy, which has superior penetration depth, was able to visualize the intraocular lens deep in the posterior chamber. Injection of tissue plasminogen activator into the anterior chamber resulted in complete fibrinolysis and released the pupillary block.</p> <p>Conclusion</p> <p>This case suggests that ocular anterior segment imaging modalities, especially ultrasound biomicroscopy, serve as powerful diagnostic tools to identify mechanisms of acute angle closure glaucoma, which is often accompanied by poor intraocular visibility. This is the first reported case of fibrin pupillary-block glaucoma after cataract surgery successfully treated with intracameral tissue plasminogen activator.</p

Longitudinal Morphological Changes in the Adenoids and Tonsils in Japanese School Children

The adenoid (Ad) and tonsil (Ts), located in the upper airway, play an important role in immunological protection. These lymphoid tissues grow rapidly, reach a peak of growth at the age of 6–8 years, and decrease in their size thereafter. However, little information is available on the longitudinal growth patterns of Ad and Ts in the general population. This study aimed to evaluate the individual growth of Ad and Ts during childhood using lateral cephalograms taken longitudinally from the same individuals at the ages of 8–12 years. Our results showed that the cross-sectional areas of the Ad, nasopharynx (Np), and oropharynx (Op) significantly increased with age while small changes in the size of Ts were present throughout the study period. In addition, the values of Ad/Np and Ts/Op decreased significantly with age in the elementary school. Furthermore, there was a strong and significant correlation between the Ad/Np ratio and upper airway resistance, indicating the narrowest distance in the upper airway. In conclusion, the airway occupation in Np and Op increased with age due to the increase in the sizes of Np and Op but not the decrease in the sizes of Ad and Ts

Synchronous improvement in strength and ductility of biomedical Co–Cr–Mo alloys by unique low-temperature heat treatment

The microstructure and tensile properties of Co–27Cr–6Mo (mass%) alloys heat-treated at 673–1373 K were studied. Lower elongation was observed after heat treatment at 1073 K due to formation of carbonitride precipitates. In contrast, when low-temperature heat treatment (LTHT) was applied at 673–873 K, both the ultimate tensile strength and elongation synchronously improved compared with the solution-treated alloy. Electron backscatter diffraction analysis for plastic-strained alloys and in situ X-ray diffraction analysis under stress-induced conditions revealed that the strain-induced martensitic transformation (SIMT) of the γ(fcc)-phase to ε(hcp)-phase during plastic deformation was suppressed by the LTHT. Stacking faults (thin ε-phase) were observed to collide in the LTHT alloys. The following mechanisms for the synchronous improvement in the tensile strength and elongation after LHTH are proposed. First, stacking faults with multiple variants were formed during LTHT. Then, the ε-phase of a single variant formed by SIMT during plastic deformation collides with preexisting multi-variant stacking faults formed during LTHT, increasing the tensile strength. In addition, the SIMT during plastic deformation is suppressed in the high-plastic-strain region by the collision. This decreases the total amount of ε-phase formed during plastic deformation, which improves the ductility. We demonstrated that LTHT of Co–Cr–Mo alloys effectively improves the performance and mechanical safety of spinal fixation implants, which often fracture because of fatigue cracking.Ueki K., Abe M., Ueda K., et al. Synchronous improvement in strength and ductility of biomedical Co–Cr–Mo alloys by unique low-temperature heat treatment. Materials Science and Engineering A, 739, 53. https://doi.org/10.1016/j.msea.2018.10.016