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Background: The medial ulnar collateral ligament (UCL) of the elbow joint is the primary restraint to valgus stress during the throwing motion. The flexor pronator muscles (FPMs) also stabilize the elbow joint against valgus forces; however, assessment of FPM stiffness in baseball players has been limited. Purpose: To use ultrasound shear wave elastography (USWE) to evaluate the change in tissue elasticity of the FPMs due to pitching. Study Designs: Descriptive laboratory study. Methods: Included were 14 healthy male amateur baseball players (mean age, 28.0 ± 2.6 years) who had played intermediate-level high school or college baseball. The tissue elasticity of the flexor digitorum superficialis (FDS) in the superficial layer of the FPMs and the flexor digitorum profundus (FDP) in the deep layer of the FPMs were measured using USWE before, immediately after, and 24 hours after a throwing session of 100 pitches. The intra- and interrater reliability of the measurements were evaluated using the Pearson correlation coefficient and intraclass correlation coefficient (ICC). The elasticity of each muscle was analyzed using repeated-measures analysis of variance followed by post hoc analysis. Results: Reliability of the USWE measurements was good to excellent (intrarater ICCs, 0.78-0.94; interrater ICCs, 0.85-0.96). The mean tissue elasticity values before, immediately after, and 24 hours after pitching were 22.3 ± 4.4, 41.0 ± 13.8, and 38.3 ± 11.2 kPa, respectively, for the FDS and 27.1 ± 5.8, 48.0 ± 22.3, and 29.6 ± 11.5 kPa, respectively, for the FDP. For both the FDS and FDP, elasticity was significantly higher immediately after pitching than before pitching (P <.001 and P =.0027, respectively). While the elasticity of the FDS at 24 hours after pitching remained significantly higher compared with before pitching (P =.0011), the elasticity of the FDP at 24 hours decreased to the same level as before pitching (P =.91). Conclusion: Results using USWE indicated that the elasticity of the FDS did not decrease 24 hours after pitching and remained significantly higher than before pitching, suggesting that it may not be fully functioning as a dynamic stabilizer during this period. Clinical Relevance: Pitching in such a condition may result in greater stress on the UCL and increase the risk of UCL injury. [ABSTRACT FROM AUTHOR]

Air voids remaining on the concrete surface are detrimental to the durability. Surface voids also affect the esthetics of concrete structures. In this study, the method of reducing the surface voids caused by entrapped air of fresh concrete was verified using 122 cases of vibration box tests with different materials, mix proportions, vibration frequencies, and amplitudes. The surface void area ratio (SVAR) decreased when the acceleration of the vibration box was increased regardless of the type of concrete. The relationship between SVAR and acceleration can be expressed through a power function. However, a segregation was observed in medium‐fluidity concrete when the acceleration exceeded 4.0 Gal (hereinafter referred to as G). In addition, the SVAR correlated with the mortar rheological constant was measured using a steel ball pull‐up test. An equation using mortar rheological constants, which can be estimated using a concrete slump, was proposed to predict the SVAR‐acceleration relationship. [ABSTRACT FROM AUTHOR]

Background: A link between tendinopathy and oxidative stress has been recently reported. Nicotinamide mononucleotide (NMN) is a precursor of nicotinamide adenine dinucleotide, which plays an important role in cell redox homeostasis. The aim of this study was to evaluate the antioxidant effect of NMN on tendinopathy in vitro and in vivo. Methods: Tenocytes from healthy Sprague-Dawley rats were cultured in regular glucose (RG) and high-glucose (HG) conditions with or without NMN, and were divided into four groups: RG NMN(−), RG NMN(+), HG NMN(−), and HG NMN(+). Cell viability, reactive oxygen species (ROS) accumulation, apoptotic rate, and mRNA expression of nicotinamide adenine dinucleotide phosphate oxidase (NOX)1, NOX4, interleukin (IL)6, sirtuin (SIRT)1, and SIRT6 were investigated. In addition, rats with collagenase-induced tendinopathy were treated with or without NMN. Immunostaining of NOX1 and NOX4; mRNA expression of SIRT1, SIRT6, and IL6; and superoxide dismutase (SOD) activity measurements in the Achilles tendon were performed. Results: NMN increased the expression of SIRT1 and SIRT6 in rat tenocytes, but decreased the levels of NOX1, NOX4, IL6, ROS, and apoptosis. In Achilles tendons with collagenase-induced tendinopathy, NMN increased the mRNA expression of SIRT1 and SIRT6, as well as SOD activity; while suppressing protein expression of NOX1 and NOX4, and mRNA expression of IL6. Conclusion: The in vitro and in vivo results of this study show that NMN exerts an antioxidant effect on tendinopathy by promoting the expression of SIRT while inhibiting that of NOX. [ABSTRACT FROM AUTHOR]

Background: A link between tendinopathy and oxidative stress has been recently reported. Nicotinamide mononucleotide (NMN) is a precursor of nicotinamide adenine dinucleotide, which plays an important role in cell redox homeostasis. The aim of this study was to evaluate the antioxidant effect of NMN on tendinopathy in vitro and in vivo.Methods: Tenocytes from healthy Sprague-Dawley rats were cultured in regular glucose (RG) and high-glucose (HG) conditions with or without NMN, and were divided into four groups: RG NMN(-), RG NMN(+), HG NMN(-), and HG NMN(+). Cell viability, reactive oxygen species (ROS) accumulation, apoptotic rate, and mRNA expression of nicotinamide adenine dinucleotide phosphate oxidase (NOX)1, NOX4, interleukin (IL)6, sirtuin (SIRT)1, and SIRT6 were investigated. In addition, rats with collagenase-induced tendinopathy were treated with or without NMN. Immunostaining of NOX1 and NOX4; mRNA expression of SIRT1, SIRT6, and IL6; and superoxide dismutase (SOD) activity measurements in the Achilles tendon were performed.Results: NMN increased the expression of SIRT1 and SIRT6 in rat tenocytes, but decreased the levels of NOX1, NOX4, IL6, ROS, and apoptosis. In Achilles tendons with collagenase-induced tendinopathy, NMN increased the mRNA expression of SIRT1 and SIRT6, as well as SOD activity; while suppressing protein expression of NOX1 and NOX4, and mRNA expression of IL6.Conclusion: The in vitro and in vivo results of this study show that NMN exerts an antioxidant effect on tendinopathy by promoting the expression of SIRT while inhibiting that of NOX. [ABSTRACT FROM AUTHOR]

Background: While the precise measurement of the range of motion (ROM) of the elbow joint is important for clinical assessment and rehabilitation, problems include low accuracy and reproducibility in goniometer measurements due to the influence of soft tissue. The purpose of this study was to validate elbow joint motion analysis using a three-dimensional electromagnetic sensor system (EMS). Methods: The accuracy and reproducibility of the EMS system were evaluated at four angles (0°, 45°, 90°, and 135°) using a model bone of the humerus and forearm. In addition, the maximum extension and maximum flexion of six elbows of six healthy volunteers were assessed by radiographic and EMS measurements. Accuracy was assessed by calculating the mean value of the measurement angle, standard deviation, Pearson's correlation coefficient, and the Bland–Altman method. Reproducibility was assessed by calculating the intra-rater and inter-rater reliabilities using intraclass correlation coefficients. Results: In the model bone evaluation, the mean angles of the EMS measurement were 1.2° ± 2.0°, 45.4° ± 2.1°, 91.7° ± 2.4°, and 134.6° ± 2.7° at 0°, 45°, 90°, and 135°, respectively. In the in vivo evaluation, the elbow angles at the maximum extension with the EMS and radiographic angles were 4.7° ± 3.0° and 2.7° ± 2.0°, respectively, and the angles at maximum flexion were 131.8° ± 13.0° and 130.8° ± 4.5°, respectively. There were statistically significant correlations between the EMS and radiographic measurements; the Bland–Altman plots indicated that the two methods were almost in agreement for both extension and flexion. Conclusions: This method of measuring ROM of the elbow joint using EMS showed high accuracy, reliability, and reproducibility. The current results demonstrated the possibility of using the electromagnetic system to provide an accurate evaluation of the elbow joint in clinical settings. [ABSTRACT FROM AUTHOR]

Introduction: Excellent outcomes of arthroscopic rotator cuff repair for small and medium tears have been recently reported. However, re-tears after surgery have been a common complication after surgical repair of large and massive rotator cuff tears and often occur in early postoperative phase. It was previously reported that basic fibroblast growth factor and platelet-rich plasma enhanced rotator cuff tear healing. We hypothesized that this combined therapy could enhance rotator cuff healing after rotator cuff repair in a rat model. This study aimed to evaluate the efficacy of combined therapy of platelet-rich plasma and basic fibroblast growth factor with gelatin-hydrogel sheet. Methods: To create a rotator cuff defect, the infraspinatus tendon of Sprague Dawley rat was resected from the greater tuberosity. The infraspinatus tendons were repaired and covered with gelatin-hydrogel sheet impregnated with PBS (control group), basic fibroblast growth factor (bFGF group), platelet-rich plasma (PRP group), or both basic fibroblast growth factor and platelet-rich plasma (combined group). Histological examinations were conducted using hematoxylin and eosin, safranin O, and immunofluorescence staining, such as Isolectin B4, type II collagen at 2 weeks postoperatively. For mechanical analysis, ultimate failure load of the tendon-humeral head complex was evaluated at 6 weeks postoperatively. Results: In the hematoxylin and eosin staining, the tendon maturing score of the combined group was higher than that of the control group at postoperative 2 weeks. In the safranin O staining, stronger proteoglycan staining was observed in the combined group compared with the other groups at postoperative 2 weeks. Vascular staining with isolectin B4 in 3 treatment groups was significantly higher than that in the control group. Type II collagen expression in the combined group was significantly higher than those in the other groups. The ultimate failure load of the combined group was significantly higher than that of the control group. Conclusion: Combined therapy of basic fibroblast growth factor and platelet-rich plasma promoted angiogenesis, tendon maturing and fibrocartilage regeneration at the enthesis, which could enhance the mechanical strength. It was suggested that combined basic fibroblast growth factor and platelet-rich plasma might enhance both tendon and bone–tendon junction healing, and basic fibroblast growth factor and platelet-rich plasma might be synergistic. [ABSTRACT FROM AUTHOR]

Background: Improvements in ultrasound diagnostic equipment and techniques can enable muscle stiffness to be measured quantitatively as muscle elasticity using ultrasound shear wave elastography (USWE), where high muscle elasticity values represent muscle stiffness. Purpose: To use USWE to analyze the sequential changes in muscle elasticity in the posterior shoulder before and after pitching. Study Design: Descriptive laboratory study. Methods: The authors evaluated 14 baseball players who had played in high school or college at an intermediate level. The elasticity of the supraspinatus, infraspinatus (ISP), middle trapezius, lower trapezius (LT), rhomboideus, and serratus anterior muscles of the throwing shoulder was measured using USWE at 3 time points: before, immediately after, and 24 hours after a throwing session of 100 pitches. The authors analyzed the sequential changes in the mean elasticity values of the respective muscles at the 3 time points. Results: The mean elasticity values before, immediately after, and 24 hours after throwing were as follows: supraspinatus: 32.9, 53.4, 43.8 kPa; ISP: 22.7, 44.8, 43.7 kPa; middle trapezius: 45.1, 70.3, 59.9 kPa; LT: 32.8, 45.5, 46.5 kPa; rhomboideus: 29.1, 47.5, 38.8 kPa; and serratus anterior: 19.2, 36.9, 26.5 kPa, respectively. The mean elasticity values for all tested muscles were significantly higher immediately after throwing compared with before throwing (P ≤.0086 for all), and elasticity values in the ISP and LT remained significantly higher 24 hours after throwing compared with before throwing (P ≤.019 for both). Conclusion: The study results indicated that pitching significantly increased ISP and LT muscle elasticity even after 24 hours. [ABSTRACT FROM AUTHOR]

Background: The accurate assessment of distal radioulnar joint (DRUJ) instability is still challenging as there is no established objective evaluation method. This study aimed to develop a noninvasive measurement method using a three-dimensional electromagnetic sensor system (EMS) to quantitatively assess and characterize the normal DRUJ movement in healthy volunteers. Methods: The DRUJ movement was mimicked using both a block model and saw bone. Movement of the models was measured by EMS, and the accuracy and reproducibility of the measurements were assessed. In vivo measurement was performed in a sitting position with the elbow flexed and the forearm pronated. One sensor each was attached to the distal radial shaft and the ulnar head. The examiners fixed the distal radius and the carpal bones, moved the ulnar head from the dorsal to the volar side and measured the dorsovolar translation. The volar translation was measured by EMS and ultrasonography, and the correlation coefficient was calculated. The dorsovolar translation was evaluated in 14 healthy volunteers (7 men and 7 women) by three hand surgeons. The intraclass and inter-rater correlation coefficients (ICCs), the differences between the dominant and non-dominant sides and between men and women were assessed. Results: The accuracy and reproducibility assessment results of the EMS showed high accuracy and reproducibility. In the comparison between EMS and ultrasonography, the correlation coefficient was 0.920 (p = 0.16 × 10-3). The ICC (1,5) for the intra-rater reliability was 0.856, and the ICC (2,5) for inter-rater reliability was 0.868. The mean ulnar head translation and difference between dominant and non-dominant sides were 6.00 ± 1.16 mm (mean ± SD) and − 0.12 ± 0.40 mm, respectively. There were no significant differences between any of the parameters. Conclusions: A new measurement method using EMS could evaluate DRUJ movement with high accuracy, reproducibility, and intra- and inter-rater reliability. In healthy volunteers, the dorsovolar ulnar head translation was 6.00 mm. The difference between the dominant and non-dominant sides was < 1.0 mm with no significant difference. EMS provided an objective, non-invasive, real-time assessment of dynamic changes in the DRUJ. These findings could be useful in the treatment of patients with DRUJ instability. [ABSTRACT FROM AUTHOR]

Background: Dehydroepiandrosterone (DHEA), an adrenal steroid, has a protective role against diabetes. This study aimed to investigate the in vitro and in vivo protective effects of DHEA against high glucose-induced oxidative stress in tenocytes and tendons.Methods: Tenocytes from normal Sprague-Dawley rats were cultured in low-glucose (LG) or high-glucose (HG) medium with or without DHEA. The experimental groups were: control group (LG without DHEA), LG with DHEA, HG without DHEA, and HG with DHEA. Reactive oxygen species (ROS) production, apoptosis, and messenger RNA (mRNA) expression of NADPH oxidase (NOX) 1 and 4, and interleukin-6 (IL-6) were determined. Further, diabetic rats were divided into a control group and a DHEA-injected group (DHEA group). NOX1 and NOX4 protein expression and mRNA expression of NOX1, NOX4, IL-6, matrix metalloproteinase (MMP)-2, tissue inhibitors of matrix metalloproteinase (TIMP)-2, and type I and III collagens in the Achilles tendon were determined.Results: In rat tenocytes, DHEA decreased the expression of NOX1 and IL-6, ROS accumulation, and apoptotic cells. In the diabetic rat Achilles tendon, NOX1 protein expression and mRNA expression of NOX1, IL-6, MMP-2, TIMP-2, and type III collagen were significantly lower while type I collagen expression was significantly higher in the DHEA group than in the control group.Conclusions: DHEA showed antioxidant and anti-inflammatory effects both in vitro and in vivo. Moreover, DHEA improved tendon matrix synthesis and turnover, which are affected by hyperglycemic conditions. DHEA is a potential preventive drug for diabetic tendinopathy. [ABSTRACT FROM AUTHOR]

Efficacy of cholangioscopy‐assisted lithotripsy for difficult stones such as huge stones, multiple large stones and an impacted stone in patients with non‐altered anatomy has been reported. Herein, we describe peroral direct digital cholangioscopy (PDCS)‐assisted electrohydraulic lithotripsy (EHL) with a new technique in patients with surgically altered anatomy. Five patients received PDCS‐assisted EHL with the monorail technique due to failed conventional stone extraction. Balloon enteroscope was removed, leaving the stiff guidewire in the bile duct and an overtube with inflated balloons. The cholangioscope was then inserted into the bile duct over the wire through the overtube. After direct visualization of the stone, PDCS‐assisted EHL was carried out. This technique was named the 'monorail technique'. Complete removal of biliary stones in one session was accomplished in four patients and only one case required two sessions. There was no adverse event in any of the cases. PDCS‐assisted EHL using the monorail technique was effective and safe for difficult biliary stones in patients with surgically altered anatomy. [ABSTRACT FROM AUTHOR]

Background and Aim: Endoscopic papillectomy (EP) has been attempted not only for benign lesions but also for early ampullary carcinoma (AC). However, there is still no sufficient evidence or consensus regarding the effectiveness of EP for early AC. Herein, we evaluated the expanding indication of EP for early AC. Methods: Between May 1999 and December 2016, 177 patients were diagnosed with ampullary tumor before undergoing EP, and their clinical and histopathological data were analyzed retrospectively. Results: There were 27 Tis‐T1a AC patients and four T1b AC patients who underwent EP. Mean tumor size was 14.1 mm for Tis‐T1a AC and 17.0 mm for T1b AC. For the histological grade, 50% (2/4) of T1b AC were moderately differentiated, whereas 96.3% (26/27) of Tis‐T1a AC were well differentiated and papillary. For lymphovascular invasion, one (25%) occurred in T1b AC but none occurred in Tis‐T1a AC. There was no AC recurrence from the date of EP until a maximum of 5 years (Tis‐T1a: mean period 48.5 months [5–60]; T1b: mean period 26.5 months [3–60]). Conclusions: Endoscopic papillectomy is useful and reliable for the curative treatment of T1a AC. Large‐scale prospective studies with long‐term follow up are needed. [ABSTRACT FROM AUTHOR]

Background and Aims: Endoscopic ultrasound (EUS)‐guided transmural drainage using a covered biflanged metal stent (CBFMS) and a conventional tubular biliary covered self‐expandable metal stent (CSEMS) has recently been performed by EUS experts. However, appropriate traction force of the sheath to prevent the migration during stent deployment is well unknown. Herein, we assessed the anchoring force (AF) of the distal flange in CBFMSs and CSEMSs. Methods: The AFs of four CBFMSs (Stents AX, NG, PL, and SX) and six CSEMSs (Stents BF, BP, EG, HN, SP, and WF) were compared in an ex vivo setting. We assessed the AF produced by each stent using an EUS‐guided transmural drainage model and an EUS‐guided hepaticogastrostomy model consisting of sheet‐shaped specimens of the stomach, gelatin gel, and gelatin tubes. Results: For CBFMSs, the maximum AF of Stent AX was significantly higher than those of Stents PL and SX (P < 0.05) in the porcine model. In the gelatin series, all stents except Stent NG showed a nearly similar AF. For CSEMSs, Stents HN, EG, BF, and WF showed gradual AF elevation in the porcine stomach. Stents SP and BP showed a lower AF than the other four stents. For the gelatin setting, the maximum AF of Stents HN, EG, and WF was higher than those of the other stents regardless of the type of specimens. Conclusions: The significance of the AF and traction distance according to the property of various CBFMSs and CSEMSs could be elucidated using ex vivo models. [ABSTRACT FROM AUTHOR]

Olecranon apophyseal nonunion is an elbow injury from overuse that affects adolescent athletes such as baseball pitchers who participate in overhead throwing sports. However, such injury is rare in collision sports. Here, we report two patients with this condition who are Judo athletes. The purpose of this report was to describe three elbows with olecranon apophyseal nonunion in two adolescent patients participating in Judo. This is a case series; the level of evidence is 4. Two 15-year-old patients were evaluated. One suffered from unilateral and the other from bilateral chronic posterior elbow pain. They were diagnosed with olecranon apophyseal nonunion, which was treated using internal fixation and bone grafting. Radiographic evidence of the apophyseal union was observed four months postsurgery. Two elbows were treated with tension band wiring, then they underwent hardware removal six months postsurgery. Both patients returned to their previous levels of activities six months postsurgery. Internal fixation using autologous bone grafting was a useful treatment for these Judo athletes with olecranon apophyseal nonunion. [ABSTRACT FROM AUTHOR]

Detection of pancreatic cancer (PC) at a resectable stage is still difficult because of the lack of accurate detection tests. The development of accurate biomarkers in low or non-invasive biofluids is essential to enable frequent tests, which would help increase the opportunity of PC detection in early stages. Polyamines have been reported as possible biomarkers in urine and saliva samples in various cancers. Here, we analyzed salivary metabolites, including polyamines, using capillary electrophoresis-mass spectrometry. Salivary samples were collected from patients with PC (n = 39), those with chronic pancreatitis (CP, n = 14), and controls (C, n = 26). Polyamines, such as spermine, N1-acetylspermidine, and N1-acetylspermine, showed a significant difference between patients with PC and those with C, and the combination of four metabolites including N1-acetylspermidine showed high accuracy in discriminating PC from the other two groups. These data show the potential of saliva as a source for tests screening for PC. [ABSTRACT FROM AUTHOR]

B Correction: BMC Musculoskelet Disord 23, 249 (2022) b B https://doi.org/10.1186/s12891-022-05205-z b Following the publication of the original article [[1]] the author noticed that the published Fig. The expression of IL6 was significantly suppressed in the NMN group compared to the control group, whereas the expression of SIRT1 and SIRT6 was significantly increased in the NMN group compared to the control group. Quantitative RT-PCR results showing the mRNA expression of SIRT1, SIRT6, and IL6 in an in vivo collagenase-induced tendinopathy model. [Extracted from the article]

In order to improve docking score correction, we developed several structure-based quantitative structure activity relationship (QSAR) models by protein-drug docking simulations and applied these models to public affinity data. The prediction models used descriptor-based regression, and the compound descriptor was a set of docking scores against multiple (∼600) proteins including nontargets. The binding free energy that corresponded to the docking score was approximated by a weighted average of docking scores for multiple proteins, and we tried linear, weighted linear and polynomial regression models considering the compound similarities. In addition, we tried a combination of these regression models for individual data sets such as IC50, Ki, and %inhibition values. The cross-validation results showed that the weighted linear model was more accurate than the simple linear regression model. Thus, the QSAR approaches based on the affinity data of public databases should improve docking scores. [ABSTRACT FROM AUTHOR]

The C-terminal domain (CTD) of tumor suppressor protein p53 is an intrinsically disordered region that binds to various partner proteins, where lysine of CTD is acetylated/nonacetylated and histidine neutralized/non-neutralized. Because of the flexibility of the unbound CTD, a free-energy landscape (FEL) is a useful quantity for determining its statistical properties. We conducted enhanced conformational sampling of CTD in the unbound state via virtual system coupled multicanonical molecular dynamics, in which the lysine was acetylated or nonacetylated and histidine was charged or neutralized. The fragments were expressed by an all-atom model and were immersed in an explicit solvent. The acetylation and charge-neutralization varied FEL greatly, which might be convenient to exert a hub property. The acetylation slightly enhanced alpha-helix structures that are more compact than sheet/loop conformations. The charge-neutralization produced hairpins. Additionally, circular dichroism experiments confirmed the computational results. We propose possible binding mechanisms of CTD to partners by investigating FEL. © 2016 The Authors. Journal of Computational Chemistry Published by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Medium-chain fatty acids (MCFAs) consisting of 8 to 12 carbons are knowns exhibit antimicrobial activity against bacteria and gut protozoa. However, little information is available on their effect in helminthes. The effect of MCFA on an intestinal nematode (Nematodirus sp.) was therefore evaluated in four calves (4 to 11 month old). Edible fat containing MCFA was administered into the abomasum of the calves by practical stimulation of the reticular groove reflex for 5 days, and the resulting fecal egg shedding was examined. Although MCFA had a weak effect on fecal egg number of Nematodirus sp., morphologically anomalous eggs were observed. Anomalies manifested as degenerated eggs with ova granulation or shell rupture, irregular monocellular egg, and disproportional cleavage at the 2-, 4-cell and subsequent stages, despite normal shedding at 8- or 16-cell stages inmost cases. Thus, MCFA administration brought cleavage disturbance and degeneration of Nematodirus sp. eggs. [ABSTRACT FROM AUTHOR]

Background. We have reported that proton radiotherapy for hepatocellular carcinoma (HCC) is a safe and effective therapeutic option. However, it is difficult to evaluate its effect in certain cases. Recently, it has been reported that the usage of contrast-enhanced color Doppler ultrasonography (CECDU) can improve diagnostic accuracy, both in terms of the presence of hepatic tumor and in the evaluation of treatment. The aim of this study was to determine the usefulness of CECDU in assessing the therapeutic response of HCC treated with proton radiotherapy. Methods. Twenty-two patients treated with the proton radiotherapy were studied. We inspected HCC lesions by CECDU, before and after the irradiation, over time. The magnitude of blood flow in the HCC was quantified on still images by CECDU. The ratio of the number of color pixels against that of the total number of pixels in the tumor area was defined as the tumor blood flow ratio (TBFR). Results. Immediately after the proton treatment, a transient increase of blood flow in the tumor was recognized in more than half of the patients, while the TBFR was unchanged or decreased in the remaining patients. At longer periods after irradiation, the TBFR in all HCCs gradually decreased, and this reduction of TBFR was statistically significant from 9 months after irradiation. These findings are consistent with those obtained previously by computed tomography (CT) as well as magnetic resonance imaging (MRI). Conclusions. We propose CECDU as a useful diagnostic option for the evaluation of HCC treated with proton radiotherapy. [ABSTRACT FROM AUTHOR]

Although Spy DS (SpyGlass DS Direct Visualization System) is considered to be useful for the diagnosis of bile duct strictures and the treatment of bile duct stones, there is limited data to date validating its efficacy. We hence retrospectively evaluated the clinical outcomes of the use of Spy DS in a large number of patients. A total of 183 patients who underwent Spy DS-guided procedures for indeterminate bile duct strictures (n = 93) and bile duct stones (n = 90) were analyzed retrospectively. All patients (93/93) with bile duct strictures successfully underwent visual observation, and 95.7% (89/93) of these patients successfully underwent direct biopsy. The sensitivity, specificity, and overall accuracy were 94.7%, 83.3%, and 90.3%, respectively, for visual impression; 80.9%, 100%, and 89.2%, respectively, for histopathological analysis of a direct biopsy; and 96.5%, 91.7%, and 94.6%, respectively, for visual impression combined with biopsy. Successful visualization of the stones was achieved in 98.9% (89/90) of the patients, and complete stone removal was achieved in 92.2% (83/90) of the patients, with an average of 3.3 procedures. The adverse events rate was 17.5% (32/183; cholangitis in 15 patients, fever the following day in 25, pancreatitis in 1, hemorrhage in 1, and gastrointestinal perforation in 1). No administration of antibiotics before the procedure was found to be a statistically significant risk factor for the development of fever after the procedure (p < 0.01). Spy DS-guided procedures are effective for the diagnosis and treatment of bile duct lesions and can be performed with a low risk of serious adverse events. [ABSTRACT FROM AUTHOR]

Membrane permeability is an important property of drugs in adsorption. Many prediction methods work well for small molecules, but the prediction of middle‐molecule permeability is still difficult. In the present study, we modified a classical permeability model based on Fick's law to study passive membrane permeability. The model consisted of the distribution of solute from water to membrane and the diffusion of solute in each solvent. The diffusion coefficient is the inverse of the resistance, and we examined the inertial resistance in addition to the viscous resistance, the latter of which has been widely used in permeability prediction. Also, we examined three models changing the balance between the diffusion of solute in membrane and the conformational change of solute. The inertial resistance improved the prediction results in addition to the viscous resistance. The models worked well not only for small molecules but also for middle molecules, whose structures have more conformational freedom. [ABSTRACT FROM AUTHOR]

Background: Aging impairs tendon healing and is a potential risk factor for chronic tendinitis. During normal aging, tendons undergo structural and biomechanical degenerative changes, accompanied by a reduction in the number of tenocytes and changes to their properties. However, molecular changes in aged tendons under inflammatory conditions are not well understood. The present study analyzed the molecular changes in collagenase induced acute tendon injury using a senescence-accelerated mouse (SAM) model.Methods: SAMP6 mice were used as an aging animal model and SAMR1 mice were used as a control to represent a senescence-resistant inbred strain. All the mice used in the study were 40 weeks old. Collagenase I from Clostridium histolyticum (20 μL) was injected percutaneously to the tendon-bone junction of the Achilles tendon. Two weeks after treatment, the Achilles tendons were harvested and stained using Picrosirius Red to determine collagen expression. Real-time PCR was performed to analyze gene expression of IL-6, tenomodulin, type I and type II collagen, MMP-9, TIMP-1, and TIMP-2.Results: Collagenase injection resulted in significantly higher gene expression of IL-6 but significantly lower tenomodulin expression compared with the control in SAMP6 and SAMR1 mice. In SAMP6 mice, gene expression of type III collagen and MMP-9 was significantly higher in the collagenase-injected group compared with the control group. SAMP6 mice also showed lower expression of type I collagen, TIMP-1, and TIMP-2 in the collagenase-injected group compared with the control group. Picrosirius Red staining showed the highest expression of type III collagen in the collagenase-injected SAMP6 group compared with the other groups.Conclusions: The collagenase-injected SAMP6 group showed higher expression of IL-6, MMP-9, and type III collagen and lower expression of type I collagen, TIMP-1, and TIMP-2, which are known to suppress metalloproteinases. The results indicate that aging may lead to dysfunction of the tendon healing process after acute tendon injury. [ABSTRACT FROM AUTHOR]

Background: Fascia lata augmentation of massive rotator cuff tears has shown good clinical results. However, its biological effect during the early healing process is not clearly understood. The purpose of the study was to evaluate the biological efficacy of fascia lata augmentation during the early healing process of rotator cuff tears using a rabbit rotator cuff defect model. Methods: The infraspinatus tendon was resected from the greater tuberosity of a rabbit to create a rotator cuff tear. The tendon edge was directly sutured to the humeral head. The rotator cuff repaired site was augmented with a fascia lata autograft (augmentation group, group A). The rotator cuff defect in the contralateral shoulder was repaired without augmentation (reattachment group, group R). A group with intact rotator cuff was set as the control group. Histological examinations and mechanical analysis were conducted 4 and 8 weeks postoperatively. Results: In the HE staining, the tendon maturing score of group A was higher than that of group R at 4 weeks postoperatively. In the safranin O staining, proteoglycan staining at the repaired enthesis in group A at 4 weeks postoperatively was stronger than that in group R. Picrosirius red staining showed that type III and type I collagen in group A was more strongly expressed than that in group R at 4 weeks postoperatively. The ultimate failure load of the infraspinatus tendon–humeral head complex in group A was statistically higher than that in group R at 4 weeks postoperatively. The ultimate failure load of group A was similar to that of the control group. Conclusion: The biological and mechanical contribution of fascia lata augmentation for massive rotator cuff tears was analyzed in this study. Type III collagen was reported to be expressed during the tendon healing process. Although the biological action similar to natural ligament healing occurred around the fascia lata grafts, type III collagen was gradually replaced by type I collagen as the tissue matured. Our results suggest that fascia lata augmentation could stimulate biological healing and provide initial fixation strength of the repaired rotator cuff. [ABSTRACT FROM AUTHOR]

We have improved the accuracy of the laser separation of stems from raisin samples on the basis of the degree of polarization of scattered light from raisins and stems. The specular reflection from wet raisins was minimized by regulating the degree of polarization of their scattered emissions. Wet and dry raisins were therefore judged as the same samples. Using these polarization characteristics, wet or dry raisins were separated from their stems in our laser inspection system. The detection error was reduced from 25 to 7% in our system. [ABSTRACT FROM AUTHOR]