Fixation of an Anatomically Designed Cementless Stem in Total Hip Arthroplasty

Purpose. The Anatomic Fiber Metal plus stem (Zimmer) is one of the anatomically designed cementless stems to achieve stable fixation by metaphyseal fit. We studied outcomes of cementless total hip arthroplasty using this stem and possible effects of metaphyseal fit on outcomes. Methods. The cementless total hip arthroplasty using this stem was performed for 155 hips. One hundred and thirty-seven hips of 122 patients were followed for 5 to 16 (mean, 9.7) years and entered into the study. The metaphyseal fit was defined as good or poor in an anteroposterior radiograph after surgery. We studied the fixation of the stem and bone reaction on an anteroposterior radiograph at the final followup. Results. Twelve hips had revision, six acetabular components and six acetabular liners. No stem was revised. The biological fixation of the stem was bone ingrown fixation for 136 hips and unstable for one. The metaphyseal fit was good for 83 hips and poor for 54 hips. There were no differences for stem fixation and bone reaction between the two groups. Conclusions. The fixation of the stem was stable at a mean followup of 9.7 years independently from metaphyseal fit

Ambegaokar-Baratoff relations of Josephson critical current in heterojunctions with multi-gap superconductors

An extension of the Ambegaokar-Baratoff relation to a superconductor-insulator-superconductor (SIS) Josephson junction with multiple tunneling channels is derived. Appling the resultant relation to a SIS Josephson junction formed by an iron-based (five-band) and a single-band Bardeen-Cooper-Schrieffer (BCS) type superconductors, a theoretical bound of the Josephson critical current ($I_{\rm c}$) multiplied by the resistance of the junction ($R_{\rm n}$) is given. We reveal that such a bound is useful for identifying the pairing symmetry of iron-pnictide superconductors. One finds that if a measured value of $I_{\rm c}R_{\rm n}$ is smaller than the bound then the symmetry is $\pm s$-wave, and otherwise $s$-wave without any sign changes. In addition, we stress that temperature dependence of $I_{\rm c}R_{\rm n}$ is sensitive to the difference of the gap functions from the BCS type gap formula in the above heterojunction.Comment: 7 pages, 6 figure

The Effects of Self-directed Home Exercise with Serial Telephone Contacts on Physical Functions and Quality of Life in Elderly People at High Risk of Locomotor Dysfunction

Exercise is essential for maintaining quality of life (QOL) in elderly individuals. However, adherence to exercise programs is low. Here, we assessed the effectiveness of a self-directed home exercise program with serial telephone contacts to encourage exercise adherence among elderly individuals at high risk of locomotor dysfunction. We recruited community-dwelling adults (ｧ65 years) in Niigata, Japan, who were targets of the long-term care prevention project for locomotor dysfunction but did not participate in the government-sponsored prevention programs. The study was conducted from November 2011 to October 2012. Participants received exercise instruction and performed exercises independently for 3 months with serial telephone contacts. The single-leg stance and five-times sit-to-stand tests were used to assess physical function. The SF-8 was used to measure health-related QOL. Ninety-seven participants were enrolled in the study, representing 2.5ｵ of eligible people;87 completed the intervention. Scores from physical function tests were significantly improved by the intervention, as were 7 of eight SF-8 subscales. Adherence was 85.4ｵ for the single-leg standing exercise and 82.1ｵ for squatting. Thus, self-directed home exercise with serial telephone contacts improved physical function and health-related QOL, representing a promising model for preventing the need for long-term care due to locomotor dysfunction

Systemic AA Amyloidosis Secondary to Metastatic Renal Cell Carcinoma in a Hemodialysis Patient with Intractable Diarrhea

We describe an autopsied case of systemic AA amyloidosis secondary to metastatic renal cell carcinoma presenting intractable diarrhea. Severe diarrhea was the major symptom for the diagnosis of AA amyloidosis. No renal symptoms which are common in AA amyloidosis secondary to renal cell carcinoma were shown because hemodialysis following bilateral nephrectomy had already been started 9 years before. Treatment against metastatic tumors as a solution of AA amyloidosis could not be performed because of bad performance status and the patient died 5 months after the diagnosis. Autopsy findings revealed that AA amyloid deposition was seen in multi-organs including the intestine. The metastatic tumors were histologically compatible as metastasis of renal cell carcinoma. There was no other cause of chronic inflammation such as inflammatory arthritis. We concluded that chronic inflammation provoked by the metastatic tumors of renal cell carcinoma was a major cause of systemic AA amyloidosis. Intestinal AA amyloidosis with malabsorption was the cause of death. Clinicians should keep it in mind that solid organ malignancy can be a cause of AA amyloidosis and renal cell carcinoma is the most common carcinomatous cause. This case is particularly instructive in that progression of amyloidosis may be missed in hemodialysis patients with anuria and that gastrointestinal symptoms can be the primary indicators of systemic amyloidosis. Endoscopic examination including biopsy is important for the diagnosis and early treatment of amyloidosis

Phenethyl iosothiocyanate activates leptin signaling

Obesity, a principal risk factor for the development of diabetes mellitus, heart disease, and hypertension, is a growing and serious health problem all over the world. Leptin is a weight-reducing hormone produced by adipose tissue, which decreases food intake via hypothalamic leptin receptors (Ob-Rb) and the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway. Protein tyrosine phosphatase 1B (PTP1B) negatively regulates leptin signaling by dephosphorylating JAK2, and the increased activity of PTP1B is implicated in the pathogenesis of obesity. Hence, inhibition of PTP1B may help prevent and reduce obesity. In this study, we revealed that phenethyl isothiocyanate (PEITC), a naturally occurring isothiocyanate in certain cruciferous vegetables, potently inhibits recombinant PTP1B by binding to the reactive cysteinyl thiol. Moreover, we found that PEITC causes the ligand-independent phosphorylation of Ob-Rb, JAK2, and STAT3 by inhibiting cellular PTP1B in differentiated human SH-SY5Y neuronal cells. PEITC treatment also induced nuclear accumulation of phosphorylated STAT3, resulting in enhanced anorexigenic POMC expression and suppressed orexigenic NPY/AGRP expression. We demonstrated that oral administration of PEITC to mice significantly reduces food intake, and stimulates hypothalamic leptin signaling. Our results suggest that PEITC might help prevent and improve obesity

The Incidence of Hyperuricemia and Correlated Factors in Middle-Aged Japanese Men

hyperuricemia-free (less than 7.5 mg/dl of SUA and no medication for hyperuricemia or hypertension) Japanese male office workers aged 30 to 53 yr were followed up for seven successive years with annual examinations, with an average period of observation of 6.4 yr with a standard deviation of 1.6 yr. Subjects who were found to have become hyperuricemic (SUA levels of 7.5 mg/dl or more) or who started medication for hyperuricemia during repeat survey were defined as incidence cases. An analysis by means of the Kaplan-Meier method showed that the incidence of hyperuricemia increased significantly with increases in the body mass index (BMI), systolic blood pressure, diastolic blood pressure, triglyceride level, SUA level, total protein level, white blood cell level, and alcohol intake. From the age-adjusted analysis with the Cox proportional hazards model, the total cholesterol level and hemoglobin A 1c (HbA 1c ) level emerged as significant positive and negative factors for the incidence of hyperuricemia, respectively. Multivariate analysis, excluding the SUA level as a factor in the Cox proportional hazards model, indicated that the BMI, Log triglyceride level, white blood cell level, and alcohol intake were significantly positively associated with the incidence of hyperuricemia. On the other hand, age and the HbA 1c level were significantly inversely associated with the incidence of hyperuricemia. When the SUA level was included as a factor in the model, BMI and alcohol intake remained as independent Received Apr 26, 1999; Accepted Aug 2, 1999 Correspondence to: N. Nakanishi, Department of Social and Environmental Medicine, Course of Social Medicine, Osaka University Graduate School of Medicine F2, 2-2 Yamada-oka, Suita-shi, Osaka 565-0871, Japan factors. Furthermore, the white blood cell level was identified as marginally significant for the incidence of hyperuricemia (p=0.064). In conclusion, obesity and alcohol intake were determined to be independent predictors for the development of hyperuricemia. In addition, the white blood cell level may be a contributory factor. (J Occup Health 2000; 42: 1-7

Three-dimensional observation and analysis of remineralization in dentinal caries lesions

The remineralization mechanism in dental caries lesions is not completely understood. This study reports on ultrastructural and chemical changes observed within arrested caries lesions. Carious human teeth were observed using scanning electron microscopy (SEM) and focused-ion-beam (FIB)-SEM. The crystals detected in the caries lesions were characterized by transmission electron microscopy (TEM), along with chemical element mapping using energy-dispersive spectroscopy (EDS)-STEM. FIB-SEM 3D reconstructions revealed a severely damaged dentin surface abundantly covered by bacteria. Although the dentin tubules were clogged up to a depth of 100 mu m, bacterial invasion into dentin tubules was not observed. TEM crystal analysis and EDS-STEM revealed the presence of Ca and P, as well as of Mg within the HAp crystals deposited inside the dentin tubules. It was concluded that extensive remineralization with deposition of Mg-HAp crystals had occurred in dentin tubules of caries-arrested dentin. Understanding the natural remineralization process is thought to be helpful for developing clinical biomimetic remineralization protocols

Visual Grounding of Whole Radiology Reports for 3D CT Images

Building a large-scale training dataset is an essential problem in the development of medical image recognition systems. Visual grounding techniques, which automatically associate objects in images with corresponding descriptions, can facilitate labeling of large number of images. However, visual grounding of radiology reports for CT images remains challenging, because so many kinds of anomalies are detectable via CT imaging, and resulting report descriptions are long and complex. In this paper, we present the first visual grounding framework designed for CT image and report pairs covering various body parts and diverse anomaly types. Our framework combines two components of 1) anatomical segmentation of images, and 2) report structuring. The anatomical segmentation provides multiple organ masks of given CT images, and helps the grounding model recognize detailed anatomies. The report structuring helps to accurately extract information regarding the presence, location, and type of each anomaly described in corresponding reports. Given the two additional image/report features, the grounding model can achieve better localization. In the verification process, we constructed a large-scale dataset with region-description correspondence annotations for 10,410 studies of 7,321 unique patients. We evaluated our framework using grounding accuracy, the percentage of correctly localized anomalies, as a metric and demonstrated that the combination of the anatomical segmentation and the report structuring improves the performance with a large margin over the baseline model (66.0% vs 77.8%). Comparison with the prior techniques also showed higher performance of our method.Comment: 14 pages, 7 figures. Accepted at MICCAI 202