Effect of Nanosheet Surface Structure of Titanium Alloys on Cell Differentiation

Titanium alloys are the most frequently used dental implants partly because of the protective oxide coating that spontaneously forms on their surface. We fabricated titania nanosheet (TNS) structures on titanium surfaces by NaOH treatment to improve bone differentiation on titanium alloy implants. The cellular response to TNSs on Ti6Al4V alloy was investigated, and the ability of the modified surfaces to affect osteogenic differentiation of rat bone marrow cells and increase the success rate of titanium implants was evaluated. The nanoscale network structures formed by alkali etching markedly enhanced the functions of cell adhesion and osteogenesis-related gene expression of rat bone marrow cells. Other cell behaviors, such as proliferation, alkaline phosphatase activity, osteocalcin deposition, and mineralization, were also markedly increased in TNS-modified Ti6Al4V. Our results suggest that titanium implants modified with nanostructures promote osteogenic differentiation, which may improve the biointegration of these implants into the alveolar bone

A randomized phase III study of short-course radiotherapy combined with Temozolomide in elderly patients with newly diagnosed glioblastoma; Japan clinical oncology group study JCOG1910 (AgedGlio-PIII)

BACKGROUND: The current standard treatment for elderly patients with newly diagnosed glioblastoma is surgery followed by short-course radiotherapy with temozolomide. In recent studies, 40 Gy in 15 fractions vs. 60 Gy in 30 fractions, 34 Gy in 10 fractions vs. 60 Gy in 30 fractions, and 40 Gy in 15 fractions vs. 25 Gy in 5 fractions have been reported as non-inferior. The addition of temozolomide increased the survival benefit of radiotherapy with 40 Gy in 15 fractions. However, the optimal regimen for radiotherapy plus concomitant temozolomide remains unresolved. METHODS: This multi-institutional randomized phase III trial was commenced to confirm the non-inferiority of radiotherapy comprising 25 Gy in 5 fractions with concomitant (150 mg/m2/day, 5 days) and adjuvant temozolomide over 40 Gy in 15 fractions with concomitant (75 mg/m2/day, every day from first to last day of radiation) and adjuvant temozolomide in terms of overall survival (OS) in elderly patients with newly diagnosed glioblastoma. A total of 270 patients will be accrued from 51 Japanese institutions in 4 years and follow-up will last 2 years. Patients 71 years of age or older, or 71-75 years old with resection of less than 90% of the contrast-enhanced region, will be registered and randomly assigned to each group with 1:1 allocation. The primary endpoint is OS, and the secondary endpoints are progression-free survival, frequency of adverse events, proportion of Karnofsky performance status preservation, and proportion of health-related quality of life preservation. The Japan Clinical Oncology Group Protocol Review Committee approved this study protocol in April 2020. Ethics approval was granted by the National Cancer Center Hospital Certified Review Board. Patient enrollment began in August 2020. DISCUSSION: If the primary endpoint is met, short-course radiotherapy comprising 25 Gy in 5 fractions with concomitant and adjuvant temozolomide will be a standard of care for elderly patients with newly diagnosed glioblastoma. TRIAL REGISTRATION: Registry number: jRCTs031200099 . Date of Registration: 27/Aug/2020. Date of First Participant Enrollment: 4/Sep/2020

Removal of a catheter mount and heat-and-moisture exchanger improves hypercapnia in patients with acute respiratory distress syndrome

To avoid ventilator-associated lung injury in acute respiratory distress syndrome (ARDS) treatment, respiratory management should be performed at a low tidal volume of 6 to 8 mL/kg and plateau pressure of ≤30 cmH2O. However, such lung-protective ventilation often results in hypercapnia, which is a risk factor for poor outcomes. The purpose of this study was to retrospectively evaluate the effectiveness and safety of the removal of a catheter mount (CM) and using heated humidifiers (HH) instead of a heat-and-moisture exchanger (HME) for reducing the mechanical dead space created by the CM and HME, which may improve hypercapnia in patients with ARDS.This retrospective observational study included adult patients with ARDS, who developed hypercapnia (PaCO2 > 45 mm Hg) during mechanical ventilation, with target tidal volumes between 6 and 8 mL/kg and a plateau pressure of ≤30 cmH2O, and underwent stepwise removal of CM and HME (replaced with HH). The PaCO2 values were measured at 3 points: ventilator circuit with CM and HME (CM + HME) use, with HME (HME), and with HH (HH), and the overall number of accidental extubations was evaluated. Ventilator values (tidal volume, respiratory rate, minutes volume) were evaluated at the same points.A total of 21 patients with mild-to-moderate ARDS who were treated under deep sedation were included. The values of PaCO2 at HME (52.7 ± 7.4 mm Hg, P < .0001) and HH (46.3 ± 6.8 mm Hg, P < .0001) were significantly lower than those at CM + HME (55.9 ± 7.9 mm Hg). Measured ventilator values were similar at CM + HME, HME, and HH. There were no cases of reintubation due to accidental extubation after the removal of CM.The removal of CM and HME reduced PaCO2 values without changing the ventilator settings in deeply sedated patients with mild-to-moderate ARDS on lung-protective ventilation. Caution should be exercised, as the removal of a CM may result in circuit disconnection or accidental extubation. Nevertheless, this intervention may improve hypercapnia and promote lung-protective ventilation

Lesions of supramammillary nucleus decreae self-grooming behavior of rats placed in an open field

Aim : Although subcortical regions send numerous efferent fibers to the hippocampus, their involvement in hippocampal functions has not been fu11y elucidated. The aim of this study was to determine the efTect of the supram ammillary nucleus (SuM) on the hippocampus. Methods : Neurons within the SuM of rats were destroyed by local injections of an excitotoxin, ibotenic acid, and the efTects of the SuM-lesion on behaviors in an open field were investigated. Results: SuM lesions increased distance traveled, movement time and latency to start grooming, while they decreased time spent grooming. SuM lesions had no efTect on rearing frequency or immobility time. Conclusion : Prolonged exploration and decrease in the total time spent grooming observed in the SuM-lesioned rats were consistent with the beh avi oral characteri stics of hippocamp al -lesioned rats of the previ ous report s, suggesting that the SuM is involved in the establishment of spatial memory by hippocampus during the initial exploration of a novel environment. In addition, the reduction of grooming in the SuM-lesioned animal suggests that SuM may be involved in emotion, such as anxiety. The results ofthis study show the involvement ofthe SuM in hippocampal function and in anxiety perceived in anovel environment