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Uncemented acetabular shell primary stability is essential for optimal clinical outcomes. Push-out testing, rotation testing, and lever-out testing are major evaluation methods of primary stability between the shell and bone. However, these test methods do not consider shell loads during daily activity and shell installation angle. This study proposes a novel evaluation method of acetabular shell primary stability considering load during level walking and acetabular installation angles such as inclination and anteversion. To achieve this, a novel primary stability test apparatus was designed with a shell position of 40° acetabular inclination and 20° anteversion. The vertical load, corresponding to walking load, was set to 3 kN according to ISO 14242–1, which is the wear test standard for artificial hip joints. The vertical load was applied by an air cylinder controlled by a pressure-type electro-pneumatic proportional valve, with the vertical load value monitored by a load cell. Torque was measured when angular displacement was applied in the direction of extension during the application of vertical load. For comparison, we also measured torque using the traditional lever-out test. The novel primary stability test yielded significantly higher primary stabilities; 5.4 times greater than the lever-out test results. The novel primary stability test failure mode was more similar to the clinical failure than the traditional lever-out test. It is suggested that this novel primary stability test method, applying physiological walking loads and extension motions to the acetabular shell, better reflects in vivo primary stability than the traditional lever-out test. [ABSTRACT FROM AUTHOR]

We previously reported that a second dose of BNT162b2 was safe and effective for allogeneic hematopoietic stem cell transplantation (HSCT) patients. Here, we investigated the safety and efficacy of a third dose of COVID-19 mRNA vaccine in allogeneic HSCT patients. Antibody titers against the S1 spike protein were measured using the QuaResearch COVID-19 Human IgM IgG ELISA kit. The previous study included 25 allogeneic HSCT patients who received two doses of BNT162b2. Following the exclusion of three patients because of the development of COVID-19 (n = 2) and loss to follow-up (n = 1), the study evaluated 22 allogeneic HSCT patients who received a third dose of COVID-19 mRNA vaccine (BNT162b2 [n = 15] and mRNA-1273 [n = 7]). Median age at the time of the first vaccination was 56 (range, 23–71) years. Five patients were receiving immunosuppressants at the third vaccination, namely calcineurin inhibitors (CI) alone (n = 1), steroids alone (n = 2), or CI combined with steroids (n = 2). Twenty-one patients (95%) seroconverted after the third dose. None of our patients had serious adverse events, new-onset graft-versus-host disease (GVHD), or GVHD exacerbation after vaccination. A third dose of the BNT162b2 and mRNA-1273 COVID-19 vaccines was safe and effective for allogeneic HSCT patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is currently no methodology for evaluating the accuracy of ablation in ablation therapy, and thus normal cells in the surrounding area can be damaged, possibly leading to complications. OBJECTIVE: The aim of this study was to distinguish heat-treated dead cells from viable cells using the electrical impedance-to-frequency ratio as an evaluation index. METHODS: Rat heart striated myocytes were cultured in a monolayer on collagen-coated microelectrodes placed in the center of an electrode-loaded chamber. The cells in the chamber were killed by heat treatment for 5 minutes at 50 °C, and the frequency response of the cell impedance was measured before and after heat treatment. The frequency of the input current was varied from 10 to 100 kHz. The measured electrical impedance at each frequency was divided by the value at 100 kHz, and we refer to the resulting values as the impedance ratio. RESULTS: The impedance ratio was high at low frequencies and low at high frequencies. Furthermore, the impedance ratio was lower at lower frequencies after heat treatment than before heat treatment. CONCLUSIONS: The electrical impedance ratio can be used to distinguish viable and dead cells after heat treatment. [ABSTRACT FROM AUTHOR]

A morphological analysis of ancient human bones is essential for understanding life history, medical history, and genetic characteristics. In addition to external measurements, a three-dimensional structural analysis using CT will provide more detailed information. The present study examined adult male human skeletons excavated from Hegi cave, Nakatsu city, Oita Prefecture. CT images were taken from the femurs of adult males (Initial/Early Jomon Period (n = 10) and Late Jomon Period (n = 5)). Cross-sectional images of the diaphysis from below the lesser trochanter to above the adductor tubercle were obtained using the method established by Imamura et al. (2019) and Imamura et al. (2021). Using Excel formulas and macros, the area of cortical bone, thickness, and degree of curvature were quantitatively analyzed. The results were compared with data on modern Japanese. The maximum thickness of cortical bone in the diaphysis and the degree of the anterior curvature were significantly greater in Late Jomon humans than in the other groups. In contrast to modern humans, the majority of Jomon femurs showed the S-shaped curvature with the medial side at the top position and the lateral side at the lower position. The present results demonstrate that Late Jomon humans had a wider range of activity than the other groups and also provide insights into diseases in the hip and knee joints of Jomon humans. [ABSTRACT FROM AUTHOR]

The article explores Acute myeloid leukemia (AML) with inv(16)(p13q22)/t(16;16) (p13;q22) has distinct clinicopathologic features, including myelomonocytic leukemic cells, abnormal bone marrow eosinophils, and a relatively favorable prognosis.1,2 Most cases are classified as AML M4 with abnormal eosinophils (M4Eo) in the French-AmericanBritish (FAB) classification.

We investigated the efficacy of BNT162b2 mRNA COVID-19 vaccine in patients with B-cell malignancies treated with anti-CD20 antibody. Although T-cell-mediated immune responses were detected even in patients receiving R-CHOP treatment, the S1 antibody titer following BNT162b2 vaccination remained only marginally increased for more than 3 years after the final dose of anti-CD20 antibody. We found no relationship between the percent of B-cells and S1 antibody titer. The duration of this suppression was much longer than we anticipated. Further protection and treatment strategies against COVID-19 for these patients are warranted. [ABSTRACT FROM AUTHOR]

The lubrication ability of a contact lens is one of its most essential properties because high friction on an eyelid causes discomfort during blinking. Friction measurements allow assessment of lubrication ability. So far, several apparatuses have been developed to measure contact lens friction. However, thus far, ocular physiological conditions including sliding speed and area have been imperfectly realised. Herein, a pendulum‐type friction tester was developed for the assessment of contact lenses under physiological conditions. A high sliding speed of 90 mm/s was achieved thanks to the short oscillation period of the small pendulum. Physiologically, the sliding surface on a contact lens was realised at the fulcrum of the pendulum. The coefficient of friction for the interaction between a contact lens and plastic hemisphere was directly calculated from the decay in potential energy during the free libration of the pendulum. Friction coefficient of a commercially available contact lens in saline solution, 0.1% and 0.3% HA solutions were 0.036, 0.039 and 0.050, respectively. These results were reliable because they ranged within the low levels reported by previous studies. It was shown that the present pendulum machine represents a major advancement in the realisation of physiologically realistic contact lens friction measurement. [ABSTRACT FROM AUTHOR]

Excellent primary stability of uncemented acetabular shells is essential to obtain successful clinical outcomes. However, in the case of developmental dysplasia of the hip (DDH), aseptic loosening may be induced by instability due to a decrease of the contact area between the acetabular shell and host bone. The aim of this study was to assess the primary stability of two commercially-available acetabular shells, hemispherical and hemielliptical, in normal and DDH models. Synthetic bone was reamed using appropriate surgical reamers for each reaming condition (normal acetabular model). The normal acetabular model was also cut diagonally at 40° to create a dysplasia model. Stability of the acetabular components was evaluated by the lever-out test. In the normal acetabular model conditions, the maximum primary stabilities of hemispherical and hemielliptical shells were observed in the 1-mm under- and 1-mm over-reamed conditions, respectively, and the resulting stabilities were comparable. The lateral defect in the dysplasia model had an adverse effect on the primary stabilities of the two designs. The lever-out moment of the hemielliptical acetabular shell was 1.4 times greater than that of the hemispherical acetabular shell in the dysplasia model. The hemispherical shell is useful for the normal acetabular condition, and the hemielliptical shell for the severe dysplasia condition, in the context of primary stability. [ABSTRACT FROM AUTHOR]

A 69-year-old woman who had been diagnosed with unresectable papillary thyroid cancer was referred to our hospital. We initially treated her with sorafenib, but she subsequently developed erythema multiforme, which was suspected to be a drug rush due to sorafenib; therefore, sorafenib was discontinued. At the time of discontinuation, immature blast cells were detected in her peripheral blood. Approximately two weeks later, her skin rash improved substantially, but the proportion of blasts in the peripheral blood increased. We performed a bone marrow examination, and she was diagnosed with FLT3-ITD-positive acute myeloid leukemia. FLT3-ITD expression is found in 20–25% of AML and is a known independent poor prognostic factor. To overcome the poor prognosis associated with FLT3-ITD, molecular drugs targeting FLT3-ITD are attracting much attention. Sorafenib, a multi-kinase inhibitor, also has an effect on FLT3-ITD. Although primary disease flares after tyrosine kinase inhibitor discontinuation have been reported, this is the first report to describe discontinuation of sorafenib treatment as a potential trigger of FLT3-ITD-positive acute myeloid leukemia in papillary thyroid cancer. [ABSTRACT FROM AUTHOR]

The present study aimed to develop a denoising convolutional neural network metal artifact reduction hybrid reconstruction (DnCNN-MARHR) algorithm for decreasing metal objects in digital tomosynthesis (DT) for arthroplasty by using projection data. For metal artifact reduction (MAR), we implemented a DnCNN-MARHR algorithm based on a training network (mini-batch stochastic gradient descent algorithm with momentum) to estimate the residual reference (140 keV virtual monochromatic [VM]) and object (70 kV with metal artifacts) images. For this, we used projection data and subtracted the estimated residual images from the object images, involving hybrid and subjectively reconstructed image usage (back projection and maximum likelihood expectation maximization [MLEM]). The DnCNN-MARHR algorithm was compared with the dual-energy material decomposition reconstruction algorithm (DEMDRA), VM, MLEM, established and commonly used filtered back projection (FBP), and a simultaneous algebraic reconstruction technique-total variation (SART-TV) with MAR processing. MAR was compared using artifact index (AI) and texture analysis. Artifact spread functions (ASFs) for images that were out-of-plane and in-focus were evaluated using a prosthesis phantom. The overall performance of the DnCNN-MARHR algorithm was adequate with regard to the ASF, and the derived images showed better results, without being influenced by the metal type (AI was almost equal to the best value for the DEMDRA). In the ASF analysis, the DnCNN-MARHR algorithm generated better MAR compared with that obtained employing usual algorithms for reconstruction using MAR processing. In addition, comparison of the difference (mean square error) between DnCNN-MARHR and the conventional algorithm resulted in the smallest VM. The DnCNN-MARHR algorithm showed the best performance with regard to image homogeneity in the texture analysis. The proposed algorithm is particularly useful for reducing artifacts in the longitudinal direction, and it is not affected by tissue misclassification. [ABSTRACT FROM AUTHOR]

Scopulariopsis alboflavescens is a soil saprophyte that is widely distributed in nature. Recently, there have been increasing number of reports of invasive infections with Scopulariopsis species in immunocompromised patients. In this report, we described an adult woman with acute myeloid leukemia and who developed S. alboflavescens pneumonia. Liposomal amphotericin B and voriconazole combination therapy was unsuccessful and the patient died because of pneumonia. Scopulariopsis is highly resistant to available antifungal agents and almost invariably fatal. This case report should alert clinicians to the importance of listing Scopulariopsis as a pathogenic fungus in immunocompromised patients. [ABSTRACT FROM AUTHOR]

Immune reconstitution affects clinical outcomes after allogeneic hematopoietic stem cell transplantation (HSCT), and it has been suggested that lymphocyte recovery affects survival after HSCT. However, few studies have examined lymphocyte recovery in Asian patients who received mycophenolate mofetil (MMF) prophylaxis for graft-versus-host disease. We retrospectively evaluated early lymphocyte recovery after HSCT among Japanese adults who received MMF prophylaxis. Patients were divided into two groups according to their median absolute lymphocyte count (ALC) on day 28 after HSCT as follows: the "low ALC group" (≤ 0.22 × 109 cells/L) and the "high ALC group" (> 0.22 × 109 cells/L). With a median follow-up of 317 days, the high ALC group showed significantly better overall survival than the low ALC group (at 1 year: 62 vs. 46%, P = 0.02). The high ALC group also tended to have better non-relapse mortality than the low ALC group (at 1 year: 13 vs. 23%, P = 0.08). There was no significant difference in relapse rate between the high and low ALC groups (at 1 year: 29 vs. 35%, P = 0.2). We conclude that among Japanese patients who received MMF prophylaxis, ALC on day 28 after HSCT was effective in predicting overall survival and non-relapse mortality. [ABSTRACT FROM AUTHOR]

Purpose: Mycophenolate mofetil (MMF) is increasingly used among Japanese patients undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT). Because pharmacokinetic data for MMF in the Asian population are limited, we conducted this investigation.Methods: Intravenous MMF (1000 mg/dose) was administered to 10 patients along with cyclosporine or tacrolimus for 10 days after allo-SCT; it was administered every 8 h in peripheral blood stem cell- and bone marrow-transplanted patients, and every 12 h in cord blood-transplanted patients. MMF was administered orally at the same dose from day 11. Plasma concentrations of mycophenolic acid (MPA) were measured by high-performance liquid chromatography.Results: The MPA AUC0 - tau was 31.9 ± 3.4, 26.2 ± 2.4, and 21.0 ± 2.2 µg*h/mL, the mean Ctrough was 0.25, 0.35, and 0.37 µg/mL, and the Cmax was 10.8, 9.2, and 5.5 µg/mL on days 2, 9, and 16, respectively. The AUC0 - tau and Cmax were significantly higher after intravenous MMF dosing than after oral MMF dosing. All patients exhibited successful neutrophil engraftments in a median time of 18 days. Grade II acute graft-versus-host disease (GvHD) of the skin was observed in two patients, and one patient developed limited chronic GvHD. Individual cases of transient and curable grade III oral mucositis and diarrhea were observed; however, MMF was not discontinued. No other severe complications or infections were observed.Conclusions: Intravenously administered MMF was safe and possibly effective in achieving higher MPA plasma concentrations for GvHD prophylaxis after allo-SCT in Japanese patients. [ABSTRACT FROM AUTHOR]

To explore the possibility of decreasing the radiation dose during digital tomosynthesis (DT) for arthroplasty, we compared the image qualities of several reconstruction algorithms, such as filtered back projection (FBP) and two iterative reconstruction (IR), methods maximum likelihood expectation maximization (MLEM) and the simultaneous iterative reconstruction technique (SIRT) under different radiation doses. The three algorithms were implemented using a DT system and experimentally evaluated by contrast-to-noise ratio (CNR), artifact spread function (ASF), and power spectrum measurements on a prosthesis phantom. The CNR and ASF data were statistically analyzed by a one-way analysis of variance. The effectiveness of each technique for enhancing the visibility of the prosthesis phantom was quantified by the CNR (reference dose vs. 20 % reduced dose in FBP, P = 0.62; reference vs. 37 % reduced dose in FBP, P = 0.16; reference vs. 55 % reduced dose in FBP, P < 0.05; reference vs. 20 % reduced dose in IR, P = 0.92; reference vs. 37 % reduced dose in IR, P = 0.40; reference vs. 55 % reduced dose in IR, P < 0.05) and ASF (reference dose vs. 20 % reduced dose in FBP, P = 0.25; reference vs. 37 and 55 % reduced dose in FBP, P < 0.05; reference vs. 20 % reduced dose in IR, P = 0.16; reference vs. 37 and 55 % reduced dose in IR, P < 0.05). The power spectra under the reference and reduced doses are equivalent. In this phantom study, the radiation dose of the reference dose could be decreased by 20 % with FBP and IR for consideration of common factors. [ABSTRACT FROM AUTHOR]

Patients who have undergone hematopoietic stem cell transplantation (HSCT) for hematological disease experience high mortality when infected by coronavirus disease 2019 (COVID-19). However, the safety and efficacy of the COVID-19 vaccine in HSCT patients remain to be investigated. We prospectively evaluated the safety and immunogenicity of the BNT162b2 mRNA COVID-19 vaccine (Pfizer BioNTech) in 25 Japanese allogeneic HSCT patients in comparison with 19 healthy volunteers. While anti-S1 antibody titers in almost all healthy volunteers after the second dose were higher than the cut-off value reported previously, levels in HSCT patients after the second dose were diverse. Nineteen patients (76%) had seroconversion of anti-S1 IgG. The median optical density of antibody levels in HSCT patients with low IgG levels (<600 mg/dL), steroid treatment, or low lymphocytes (<1000/μL) was significantly lower than that in the other HSCT patients. There were no serious adverse events (>Grade 3) and no new development or exacerbation of graft-versus-host disease after vaccination. We concluded that the BNT162b2 mRNA vaccine is safe and effective in Japanese allogeneic HSCT patients. [ABSTRACT FROM AUTHOR]

Adequate fixation at the time of cementless stem implantation depends on the operator's experience. An objective evaluation method to determine whether the stem has been appropriately implanted may be helpful. We studied the relationship between the hammering sound frequency during stem implantation and internal stress in a femoral model, and evaluated the possible usefulness of hammering sound frequency analysis for preventing intraoperative fracture. Three types of cementless stem (BiCONTACT®, SL-PLUS®, and AI-Hip®) were used. Surgeons performed stem insertion using a procedure similar to that employed in a routine operation. Stress was estimated by finite element analysis, the hammering force was measured, and frequency analysis of hammering sound data obtained using a microphone. Finite element analysis showed a decrease in the hammering sound frequency with an increase in the estimated maximum stress. When a decrease in frequency was observed, adequate hammering had occurred, and the continuation of hammering risked fracture. Based on the relationship between stress and frequency, the evaluation of changes in frequency may be useful for preventing the development of intraoperative fractures. Using our method, when a decrease in frequency is observed, the hammering force should be reduced. Hammering sound frequency analysis may allow the prediction of bone fractures that can be visually confirmed, and may be a useful objective evaluation method for the prevention of intraoperative periprosthetic fractures during stem insertion. [ABSTRACT FROM AUTHOR]

During cementless stem fixation, impaction of the stem is occasionally complicated by bony injuries. Small fractures not visible to the eye during surgery or on post-operative radiographs may remain undetected, and the incidence of such injuries may be underestimated. Employing the same techniques as those employed during total hip arthroplasty, we implanted cementless stems into artificial femora, with equivalent mechanical characteristics to living femora. The hammering force applied to the femur and the displacement of the stem and femur were measured using a load sensor and imaging, respectively. The von Mises stress generated in the femur during cementless stem press-fixation was also measured using finite element analysis. Average hammering force under these conditions (9.25 kN) was sufficient to cause damage to the artificial femur. The first two of eight hammer strikes caused most displacement of the stem. The von Mises stresses generated by the first and second hammer strikes were 31 and 68 MPa, respectively. Applying a high average hammering force to the stem after displacement has ceased probably contributes to the generation of intraoperative fractures during cementless stem fixation. Given that two strikes appeared to be sufficient, we believe that hammering force should be reduced to a micro-adjustment level after the second hit. [ABSTRACT FROM AUTHOR]

In this study, a novel combination of hybrid generative adversarial networks (GANs) comprising cycle-consistent GAN, pix2pix, and (mask pyramid network) MPN (CGpM-metal artifact reduction [MAR]), was developed using projection data to reduce metal artifacts and the radiation dose during digital tomosynthesis. The CGpM-MAR algorithm was compared with the conventional filtered back projection (FBP) without MAR, FBP with MAR, and convolutional neural network MAR. The MAR rates were compared using the artifact index (AI) and Gumbel distribution of the largest variation analysis using a prosthesis phantom at various radiation doses. The novel CGpM-MAR yielded an adequately effective overall performance in terms of AI. The resulting images yielded good results independently of the type of metal used in the prosthesis phantom (p < 0.05) and good artifact removal at 55% radiation-dose reduction. Furthermore, the CGpM-MAR represented the minimum in the model with the largest variation at 55% radiation-dose reduction. Regarding the AI and Gumbel distribution analysis, the novel CGpM-MAR yielded superior MAR when compared with the conventional reconstruction algorithms with and without MAR at 55% radiation-dose reduction and presented features most similar to the reference FBP. CGpM-MAR presents a promising method for metal artifact and radiation-dose reduction in clinical practice. [ABSTRACT FROM AUTHOR]