Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

Contralateral development of acute subdural hematoma (SDH) immediately following a burr-hole craniostomy for chronic SDH

Background: Burr-hole trephination is a widely used surgical technique for chronic subdural hematoma (CSDH). Although various postoperative complications following burr-hole craniostomy have been discussed, no contralateral acute SDH (ASDH) immediately after the initial surgery without concurrent hemorrhages has been reported so far; we experienced this very rare complication in a previously healthy 84 year old male. Details of this very rare case are presented in this report. Materials and methods: 87 patients with chronic SDH underwent a burr hole trephination, that is, craniostomy between July 2012 and June 2014; there were 47 male and 40 female patients. 24 of 87 patients harbored bilateral SDHs. 67 of 111 lesions were drained with two catheters and the remaining 44 employed a single catheter. Results: Unsatisfactory results following the craniastomy included recurrence, insufficient drain, aggravated acute SDH and contralateral development of incracranial hemorrhage. Contralateral intracranial hemorrhage occurred to three patients. One died and the other two were discharged without any sequelae. One of the three contralateral hemorrhages was a mere ASDH which was complicated to a previously healthy 84 year old male within less than an hour after the initial surgery. The patient was discharged without sequelae. Conclusion: This report represents a contralateral ASDH that occurred less than an hour after a burr-hole trephination for CSDH. Several hypotheses concerning the etiology of this rare complication, albeit inconclusive, are worth contemplation. Excessive drain of CSDH must be refrained from in order not to encounter any unexpected complications

Sex differences in pedobarographic findings and relationship between radiograph and pedobarograph measurements in young healthy adults

Category: Basic Sciences/Biologics Introduction/Purpose: Although pedobarographic measurement is increasingly used for clinical and research purposes, relatively few published studies have investigated normative data. This study examined pedobarographic findings in young healthy adults with regard to sex-related differences and correlations among measurement indices. Methods: Twenty young healthy adults (mean age 22.4 years, SD 1.2 years; 10 males and 10 females) were included. Weightbearing anteroposterior and lateral foot radiographs were taken, and dynamic pedobarographic data during treadmill walking and maximum ankle dorsiflexion were obtained. AP talo-first metatarsal angle, naviculocuboid overlap, lateral talo-first metatarsal angle, and plantar soft tissue thickness were measured on foot radiographs. Pedobarographic data including peak pressure and pressure-time integral were measured on five plantar segments: medial forefoot (MFF), lateral forefoot (LFF), medial midfoot (MMF), lateral midfoot (LMF), and heel. Results: Male and female subjects significantly differed in BMI (p<0.001), AP talo-first metatarsal angle (p=0.018), soft tissue thickness under the metatarsal head (p=0.04) and calcaneal tuberosity (p<0.001), maximum dorsiflexion during stance phase (p=0.041), peak pressure on the MFF (p=0.005) and LFF (p=0.004), and pressure-time integral on the MFF (p=0.018) and heel (p=0.001). Maximum dorsiflexion demonstrated significant negative correlations with pressure-time integral on the MFF (r=-0.595, p=0.007) and total pressure-time integral (r=-0.492, p=0.032). Pressure-time integral varus/valgus index was significantly correlated with pressure-time integral forefoot/heel index (r=0.472, p=0.036). Conclusion: Sex-related differences in pedobarographic examination were observed. Achilles stretching exercise was considered to reduce foot pressures, and subtalar joint was hypothesized to play an important role in pressure distribution

Short-term outcome of Lisfranc injuries treated with single dorsal plate fixation

Category: Ankle, Trauma Introduction/Purpose: Several methods like cortical screw, Kirschner (K) wire have been used for stabilizing the Lisfranc joint. We performed this study to assess whether single dorsal plating can be used as an alternative treatment method for a Lisfranc injury. Methods: Patients were followed up for more than 1 year after the initial surgery.Following open reduction of the joint with a bone reduction clamp, a single dorsal plate was used to perform Lisfranc joint fixation. The plate was fixed with 2.7-mm locking screws on the first metatarsal, second metatarsal, medial cuneiform, and intermediate cuneiform. Three weeks postoperatively, the cast was removed, and patients progressively advanced to full weight bearing while wearing a postoperative shoe. The plate was removed 3 months postoperatively. One year postoperatively, weight-bearing foot radiographs and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale score were obtained. Results: Eighteen patients with a Lisfranc injury who were treated with open reduction and internal fixation using a single dorsal plate were included. The average AOFAS midfoot score for pain was 35, and the total score was 80.8 (range, 67–95). Six patients (33.3%) had an excellent outcome (score =90); eight (44.4%) had a good outcome (90 > score = 75); and four (22.2%) had a fair outcome (75 > score = 50). Radiographs during the follow-up period showed no loss of reduction or arthritic change. Screw breakage occurred in 3 cases. But the injury ultimately healed anatomically. Conclusion: Single dorsal plating can be an alternative treatment method for a Lisfranc injury, as it provides a good short-term outcome without causing further joint injury

Posterior tibial tendon integrity can be screened using plain anteroposterior foot radiography

Category: Hindfoot Introduction/Purpose: Posterior tibial tendon’s condition has traditionally been evaluated using ultrasonography or magnetic resonance imaging, but recent advancements in radiography have increased the resolution of radiographic soft tissue images. We performed this study to examined whether the posterior tibial tendon could be screened using anteroposterior foot radiographs, based on interobserver agreement and accuracy. Methods: We retrospectively evaluated consecutive patients who underwent weight-bearing foot radiography and ultrasonography based on a suspicion of posterior tibial tendinopathy. The integrity of the posterior tibial tendon was evaluated by two orthopaedic surgeons (8 years and 3 years of experience) using foot radiographs, and scored as having normal or abnormal tendon integrity (Fig). We evaluated interobserver agreement between the two surgeons, and the ultrasonography and radiography findings were compared to evaluate diagnostic accuracy. Results: We included 21 patients with a mean age of 51.5 ± 15.7 years (5 men and 16 women). Ultrasonography revealed 4 patients with normal tendon integrity, 6 patients with tenosynovitis and no tendinopathy, 8 patients with tendinopathy and tendon continuity, and 3 patients with loss of tendon continuity. The surgeons provided consistent radiographic findings for 81.0% of the patients (17/21; kappa = 0.576, p = 0.007). Based on the ultrasonographic findings, the surgeons provided accuracies of 76.2% (16/21) and 61.9% (13/21). Conclusion: The results indicate that weight-bearing anteroposterior foot radiography can be used to evaluate posterior tibial tendon integrity, which may allow physicians to predict the prognosis of patients with PTTD, to determine the extent of surgical treatment, and to evaluate the postoperative tendon integrity

Natural Progression of Radiographic Indices in Juvenile Hallux Valgus Deformity

Category: Bunion, Midfoot/Forefoot Introduction/Purpose: There is a lack of quantitative studies on the progression of juvenile hallux valgus deformity. Therefore, we performed this study to estimate an annual change of radiographic indices for juvenile hallux valgus. Methods: We reviewed medical records of consecutive patients under the age of 15 with juvenile hallux valgus who underwent weight-bearing foot radiographs more than twice, and were followed over a period of one year or more. A total of 133 feet from 69 patients were included. Hallux valgus angle, hallux interphalangeal angle, intermetatarsal angle, metatarsus adductus angle, distal metatarsal articular angle, anteroposterior talo-1st metatarsal angle, anteroposterior talo-2nd metatarsal angle, and lateral talo-1st metatarsal angle were measured and were used as a study criteria. The progression rate of hallux valgus angle was adjusted by multiple factors including the use of a linear mixed model with gender and radiographic measurements as the fixed effects and laterality and each subject as the random effect. Results: Our results demonstrate that the value of hallux valgus angle on the radiographs progressed as the patients grew older. The hallux valgus angle increased by 0.8° per year (p<0.001)(Figure). The distal metatarsal articular angle also increased by 0.8 per year (p=0.003). Conversely, hallux interphalangeal angle decreased by 0.2° per year (p=0.019). Progression of the intermetatarsal angle and metatarsus adductus angle with aging were not statistically significant. There was a difference in progression of radiographic indices between older patients (=10 years) and younger patients (<10 years). The hallux valgus angle increased by 1.5° per year (p<0.001) in younger patients, progression of the hallux valgus angle in older patients was not statistically significant (p=0.869) as children grew up. Conclusion: These results suggest that the hallux valgus angle increased in patients with juvenile hallux valgus under 10 years old, unlike the patients aged 10 or older. We believed that our results can help surgeons to determine a treatment strategy that uses the growth potential to achieve correction of deformity such as lateral hemiepiphyseodesis of the 1st metatarsal to patients with juvenile hallux valgus

Is there a Relationship between Bone Morphology and Injured Ligament on Imaging Studies and Laxity on Ankle Stress Radiographs?

Category: Ankle, Sports Introduction/Purpose: We hypothesized that the bony configuration of the ankle could also be associated with ankle stress radiographs, in addition to ligament injury of the ankle. Therefore, this study aimed to investigate the relationship between bone morphology and injured ligament on imaging studies and laxity on ankle stress radiographs in patients with lateral ankle instability. Methods: In total, 115 patients who had undergone ankle MRI, ankle radiography, and stress radiography were included. Distal tibial articular surface angle, bimalleolar tilt, medial and lateral malleolar relative length, medial malleolar slip angle, anterior inclination of the tibia, and fibular position were measured on ankle radiographs. Tibiotalar tilt angle and anterior translation of the talus were measured on ankle stress radiographs. Degree of ligament injury was evaluated on ankle MRIs. Multiple regression analysis was performed using the following independent variables: age, sex, and factors significantly associated with ankle stress view on univariate linear regression analysis. Results: Age (p = 0.041), sex (p = 0.014), degree of anterior talofibular ligament injury (p < 0.001), and bimalleolar tilt (p = 0.016) were correlated with tibiotalar tilt angle (Table). Younger patients demonstrated a larger tibiotalar tilt angle than older patients, and the angle decreased by 0.07° per year of age. Tibiotalar tilt angle in female patients was 2.2° larger than that in male patients. Fibular position and degree of posterior talofibular ligament injury were factors significantly related to anterior translation of the talus. Conclusion: Differences in patient characteristics might predispose ankle stress radiograph results. Comparison of both ankles on stress radiographs is superior to applying fixed numerical values to the injured side, in order to reduce the influence of patient factors

Abstracts of 2nd International Symposium on Plastic Pollution

This book presents the abstracts of the selected contributions to the Second International Symposium on Plastic Pollution, hosted from 3rd to 4th of November 2022 in hybrid mode by the “Plastic Free” Specialized Graduate School, University of Seoul. The symposium covers “Challenges and Possible Solutions of Plastic Pollution” and “Toxicity Assessment of Plastics”. The symposium was special as it brought together researchers from multidisciplinary fields, bringing new research ideas and creating collaboration in the field of plastic pollution. With 20 experts from 7 countries and two special sessions with different themes, the symposium offered a perfect platform for attendees to share their research ideas. Symposium Title: 2nd International Symposium on Plastic PollutionTheme: SYM-1~2: Challenges and Possible Solutions of Plastic Pollution. SYM-3: Toxicity Assessment of PlasticsSymposium Date: 3-4 November 2022Symposium Location: Hybrid (online and offline – Jeju-Island Pacific, South Korea)Symposium Organizer: Plastic-Free Specialized Graduate School, University of Seoul, South KoreaSymposium Sponsors: Ministry of Environment &amp; KEITI, South Korea Previous Year Abstract Book: Abstracts of 1st International Symposium on Plastic Pollutio