Case Report Common Peroneal Nerve Palsy with Multiple-Ligament Knee Injury and Distal Avulsion of the Biceps Femoris Tendon

A multiple-ligament knee injury that includes posterolateral corner (PLC) disruption often causes palsy of the common peroneal nerve (CPN), which occurs in 44% of cases with PLC injury and biceps femoris tendon rupture or avulsion of the fibular head. Approximately half of these cases do not show functional recovery. This case report aims to present a criteria-based approach to the operation and postoperative management of CPN palsy that resulted from a multiple-ligament knee injury in a 22-year-old man that occurred during judo. We performed a two-staged surgery. The first stage was to repair the injuries to the PLC and biceps femoris. The second stage involved anterior cruciate ligament reconstruction. The outcomes were excellent, with a stable knee, excellent range of motion, and improvement in the palsy. The patient was able to return to judo competition 27 weeks after the injury. To the best of our knowledge, this is the first case report describing a return to sports following CPN palsy with multiple-ligament knee injury

Ultrasonography imaging of the anterolateral ligament using real-time virtual sonography

Background: The anterolateral ligament (ALL) functions as a stabilizer in the internal rotation of the knee. Previous studies have reported the ALL can be identified using magnetic resonance imaging (MRI); however, there are no reports on using ultrasonography (US) for this purpose. Real-time virtual sonography (RVS) uses magnetic navigation and computer software for the synchronized display of real-time US and multiplanar reconstruction MRI images. This study investigated the ability of using US with RVS to evaluate the ALL. Methods: Nine healthy subjects were enrolled. The Digital Imaging Communications in Medicine MRI dataset was loaded into the Hitachi Aloka Preirus, and US images were displayed on the same monitor. When the ALL was identified using MRI, the monitor was frozen to evaluate the ALL. The ALL was divided into the femoral, meniscal, and tibial portions. The portions and thickness of the ALLs and the lateral inferior genicular artery (LIGA), a landmark for the ALL, were evaluated. Results: All portions of the ALL could be identified using MRI. Using US, the tibial portion of the ALL was detected in all subjects and the femoral portion was detected in seven subjects; however, the meniscal portions could not be identified. The average ALL thickness as measured by US was 1.3 ± 0.1 mm and the LIGA was identified in all cases. Conclusions: Most portions of the ALL can be identified using US. As most ALL injuries occur at the femoral or tibial portion, US may be useful as a diagnostic tool for ALL injury.Level of Evidence: 4. © 2015 Elsevier B.V.Embargo Period 12 month

Distorted antibody repertoire developed in the absence of pre-B cell receptor formation

The pre-B cell receptor (pre-BCR), consisting of the μ heavy chain (μHC) and the surrogate light chain (SLC, Vpre-B and λ5), plays important roles during B cell development. The formation of the pre-BCR, which enables the nascent immunoglobulin HC to associate with the SLC, is considered a prerequisite for B cell development. However, a significant number of peripheral mature (leaky) B cells exist in SLC-deficient mice. These leaky B cells develop in the absence of pre-BCR and do not undergo the pre-BCR checkpoint. The antibody repertoires of leaky B cells thus reflect the absence of pre-BCR function. To investigate how the absence of the pre-BCR is circumvented by these leaky-B cells and examine the effect of the pre-BCR checkpoint on the antibody system, we analyzed the antibody repertoires of λ5-deficient (λ5−/−) mice using next-generation sequencing. In λ5−/− mice, spleen B cells displayed different patterns of VDJ-usage, relative to those in wild-type (WT) mice. Moreover, leaky B cells were neither derived from unusual B2 cells, characterized by particular LC gene rearrangements in the absence of pre-BCR signaling, nor from B1 cells, originating from different B cell progenitors. Analysis of the CDR-H3 amino acid sequences of μ-chain repertoires revealed that certain bone marrow B cells with particular CDR-H3 profiles undergo clonal expansion in λ5−/− mice. Part of these CDR-H3s contain arginine(s) in the middle of the CDR-H3 loop in λ5−/− mice, whereas few arginine(s) exist in this middle loop in WT CDR-H3s in the absence of clonal expansion. This CDR-H3 feature in λ5−/− mice presumably reflects the role of the pre-BCR in autoantibody regulation, since arginine(s) are often found in the antigen-binding site of autoantibodies. Here, we present a unique viewpoint on the role of pre-BCR, by assessing the whole antibody repertoire formed in SLC-deficient mice

Precise risk factors for Osgood–Schlatter disease

Introduction: A number of studies have examined the risk factors for Osgood–Schlatter disease (OSD). Studies on risk factors have not necessarily accurately demonstrated the risk factors of this disease because they were not prospective cohort studies or the populations in the studies were not categorized by the skeletal maturation of the tibial tuberosity. We can identify the precise risk factors for OSD by performing a prospective cohort study of a group of asymptomatic patients in particular times of adolescent using ultrasonography. In the present study, we aimed to investigate the precise risk factors for OSD. Methods: For all examinations, we used a 3-stage classification for tibial tuberosity development observed on ultrasonography: sonolucent (stage S), individual (stage I), and connective stages (stage C). Among 150 players with 300 knees, we included 37 male players with 70 knees at asymptomatic stage I on the first examination. We re-examined the included knees 1 year after the first examination and compared 10 knees with OSD (OSD group) and 60 knees without OSD (control group). Height, body weight, body mass index, tightness of the quadriceps femoris and hamstring muscles, muscle strength during knee extension, and flexion were assessed during the first medical examination. Results: The incidence of OSD was 14.3 % in this 1-year cohort study. A significant difference was found in body weight, quadriceps muscle tightness, and muscle tightness and strength during knee extension between the 2 groups. The precise risk factors for OSD were increased, namely the quadriceps femoris muscle tightness and strength during knee extension and flexibility of the hamstring muscles, using logistic regression analysis. Conclusions: This information may be useful for teaching quadriceps stretching in preadolescent male football players with stage I. © 2015 Springer-Verlag Berlin Heidelber

Attachment Disorder and Early Media Exposure

Many studies have reported many adverse effects of children’s use of media. These effects include reduced cognitive development and hyperactivity and attention disorders. Although it has been recommended that child be kept away from the media during the early developmental period, many modern parents use the media as a way to calm their children. Consequently, these children lack the opportunity to form selective attachments by reduced social engagement. These children’s symptoms occasionally mimic autism spectrum disorder (ASD). However, few studies have examined the symptoms children develop with early media exposure. Here, we present a boy exposed to the media during his early development who was diagnosed with attachment disorder. He was unable to make eye contact and was hyperactive and had delayed language development, like children with ASD. His symptoms improved dramatically after he was prevented from using all media and encouraged to play in other ways. After this treatment, he would make eye contact, and talked about playing with their parents. Simply avoiding the media and playing with others can change the behavior of a child with ASD-like symptoms. It is important to understand the symptoms caused by attachment disorder and early media exposure

Technique of anatomical single bundle ACL reconstruction with rounded rectangle femoral dilator

Background: This study aimed to present a new technique for anatomical single bundle anterior cruciate ligament (ACL) reconstruction. We developed an original rounded rectangular dilator set to create rounded rectangular femoral tunnels. This technique can increase the femoral tunnel size without roof impingement, and has the potential to reduce the graft failure rate. We investigated the tunnel position and the incidence of intraoperative complications. Method: The presented technique is anatomical single bundle ACL reconstruction using a semitendinosus graft (with or without the gracilis tendon). The tunnel was drilled via an additional medial portal. Rounded rectangular tunnels were created using a special dilator. Tibial tunnels were created using conventional rounded tunnels. Fixation was achieved using a suspensory device on the femoral side and a plate and screw on the tibial side. Patients: Fifty patients underwent this surgery, and intraoperative complications were investigated. The femoral tunnel positions were documented postoperatively from computed tomography scans using the quadrant method. The tibial tunnel positions (anterior-to-posterior, medial-to-lateral) were documented using intraoperative X-ray scans. Results: Only one patient had a partial posterior tunnel wall blowout. The femoral tunnel length varied between 30 and 40 mm (mean, 34.9 ± 3.3 mm). All femoral and tibial tunnels were located within the area of the anatomical ACL insertions. Conclusion: We did not experience any serious intraoperative complications during anatomical single bundle ACL reconstruction using a rounded rectangle dilator, and the resulting locations of the femoral and tibial tunnels were within the anatomical ACL footprint. Level of evidence: Level IV. © 2015 Elsevier B.V..Embargo Period 12 month

Changes in muscle activity after performing the FIFA 11+ programme part 2 for 4 weeks

Changes in muscle activity were evaluated by positron emission tomography–computed tomography (PET–CT) after performing part 2 of the Fédération Internationale de Football Association’s 11+ programme (11+) for 4 weeks. Eleven males performed part 2 of the 11+ for 20 min before and after 37 MBq of 18F-fluorodeoxyglucose (FDG) was injected intravenously. PET–CT images were obtained 50 min after FDG injection. The participants were then instructed to perform part 2 of the 11+ 3 times per week for 4 consecutive weeks, after which another set of PET–CT images was obtained following the same procedure. Regions of interest were defined within 30 muscles. The standardised uptake value (SUV) of FDG by muscle tissue per unit volume was calculated, and FDG accumulation was compared between pre- and post-training PET–CT results. Performing part 2 of the 11+ for 4 weeks increased mean SUV in the sartorius, semimembranosus, biceps femoris, abductor hallucis, and flexor hallucis brevis muscles (P < 0.05). In conclusion, routinely performing part 2 of the 11+ for 4 weeks increased glucose uptake related to muscle activity in the hamstrings and hallux muscles. We speculate that there is some possibility of this change of muscle activity contributing to a decrease in sports-related injuries. © 2016 Taylor & FrancisEmbargo Period 18 month

The Japanese space gravitational wave antenna; DECIGO

DECi-hertz Interferometer Gravitational wave Observatory (DECIGO) is the future Japanese space gravitational wave antenna. DECIGO is expected to open a new window of observation for gravitational wave astronomy especially between 0.1 Hz and 10 Hz, revealing various mysteries of the universe such as dark energy, formation mechanism of supermassive black holes, and inflation of the universe. The pre-conceptual design of DECIGO consists of three drag-free spacecraft, whose relative displacements are measured by a differential Fabry– Perot Michelson interferometer. We plan to launch two missions, DECIGO pathfinder and pre- DECIGO first and finally DECIGO in 2024

Interferon signaling and hypercytokinemia-related gene expression in the blood of antidepressant non-responders

Only 50% of patients with depression respond to the first antidepressant drug administered. Thus, biomarkers for prediction of antidepressant responses are needed, as predicting which patients will not respond to antidepressants can optimize selection of alternative therapies. We aimed to identify biomarkers that could predict antidepressant responsiveness using a novel data-driven approach based on statistical pattern recognition. We retrospectively divided patients with major depressive disorder into antidepressant responder and non-responder groups. Comprehensive gene expression analysis was performed using peripheral blood without narrowing the genes. We designed a classifier according to our own discrete Bayes decision rule that can handle categorical data. Nineteen genes showed differential expression in the antidepressant non-responder group (n = 15) compared to the antidepressant responder group (n = 15). In the training sample of 30 individuals, eight candidate genes had significantly altered expression according to quantitative real-time polymerase chain reaction. The expression of these genes was examined in an independent test sample of antidepressant responders (n = 22) and non-responders (n = 12). Using the discrete Bayes classifier with the HERC5, IFI6, and IFI44 genes identified in the training set yielded 85% discrimination accuracy for antidepressant responsiveness in the 34 test samples. Pathway analysis of the RNA sequencing data for antidepressant responsiveness identified that hypercytokinemia- and interferon-related genes were increased in non-responders. Disease and biofunction analysis identified changes in genes related to inflammatory and infectious diseases, including coronavirus disease. These results strongly suggest an association between antidepressant responsiveness and inflammation, which may be useful for future treatment strategies for depression