Search

Surgeons should select one side for cervical unilateral open door laminoplasty (UODL). However, few reports suggest proper guidelines for deciding which side to open. The aim of this study is to evaluate the impact of opening side in UODL on dominant cord compressive or symptomatic side. 193 degenerative cervical myeloradiculopathy patients with followed-up more than 2 years were enrolled. In all cases, UODL was performed uniformly on the right side. Patients were sub-grouped based on preoperative dominant 3 characteristics: cord compression, myelopathy symptom and radiculopathy symptom (right, symmetric, left). Pre- and postoperative radiographic and clinical parameters and incidence of postoperative C5 palsy were analyzed and compared among the groups. According to dominant compressive side, there were no significant differences in postoperative radiographic and clinical parameters among three groups. According to dominant myelopathy or radiculopathy symptom side, there were no significant differences of all radiographic and clinical parameters postoperatively, except slightly lower neck VAS in groups of preoperative right dominant myelopathy or radiculopathy symptom side at postoperative 1 month. C5 palsies occurred in twelve patients (6.2%), but the incidences were not different among the groups. Therefore, when performing UODL, the choice of lamina opening side can be left to surgeon’s preference.

This study aimed to investigate the changes in gluteal muscle volume and the effects of such changes in spinal alignment as a result of postoperative gluteal muscle strengthening exercise (GMSE) in patients following long-segment fixation for adult spinal deformity (ASD). Eighty-three consecutive patients (average age, 70.1 years) were analyzed. Three-dimensional CT scans were conducted to obtain serial axial gluteus muscle image slices. The size of each muscle area in every image slice was measured by Computer Aided Design and the sum of each muscle area was calculated. At the last follow-up, the sagittal vertical axis was significantly greater in the basic postoperative exercise group (1.49 mm vs. 17.94 mm), and the percentage of optimal sagittal alignment was significantly higher in the GMSE group (97.8% vs. 84.2%). At the last follow-up, the gluteus maximus volume was significantly higher in the GMSE group (900,107.1 cm3 vs. 825,714.2 cm3, p = 0.036). For the increase in muscle volume after 1 year, gluteus maximus and medius volumes showed a significant intergroup difference (+ 6.8% vs. + 2.4% and + 6.9% vs. + 3.6%). The GMSE protocol developed in this study could effectively increase gluteal muscle volume and maintain the optimal sagittal balance in patients with ASD.

The search continues for improved therapy for acute lymphoblastic leukemia (aLL), the most common malignancy in children. Recently, d,l-methadone was put forth as sensitizer for aLL chemotherapy. However, the specific target of d,l-methadone in leukemic cells and the mechanism by which it induces leukemic cell apoptosis remain to be defined. Here, we demonstrate that d,l-methadone induces leukemic cell apoptosis through activation of the mu1 subtype of opioid receptors (OPRM1). d,l-Methadone evokes IP3R-mediated ER Ca2+ release that is inhibited by OPRM1 loss. In addition, the rate of Ca2+ extrusion following d,l-methadone treatment is reduced, but is accelerated by loss of OPRM1. These d,l-methadone effects cause a lethal rise in [Ca2+]i that is again inhibited by OPRM1 loss, which then prevents d,l-methadone-induced apoptosis that is associated with activation of calpain-1, truncation of Bid, cytochrome C release, and proteolysis of caspase-3/12. Chelating intracellular Ca2+ with BAPTA-AM reverses d,l-methadone-induced apoptosis, establishing a link between the rise in [Ca2+]i and d,l-methadone-induced apoptosis. Altogether, our findings point to OPRM1 as a specific target of d,l-methadone in leukemic cells, and that OPRM1 activation by d,l-methadone disrupts IP3R-mediated ER Ca2+ release and rate of Ca2+ efflux, causing a rise in [Ca2+]i that upregulates the calpain-1-Bid-cytochrome C-caspase-3/12 apoptotic pathway.

Human delta-like 1 (hDlk1) is known to be able to regulate cell fate decisions during hematopoiesis. Mesenchymal stromal cells (MSCs) are known to exhibit potent immunomodulatory roles in a variety of diseases. Herein, we investigated in vivo functions of hDlk1-hMSCs and hDlk1+hMSCs in T cell development and T cell response to viral infection in humanized NOD/SCID/IL-2Rγnull (NSG) mice. Co-injection of hDlk1-hMSC with hCD34+ cord blood (CB) cells into the liver of NSG mice markedly suppressed the development of human T cells. In contrast, co-injection of hDlk1+hMSC with hCD34+ CB cells into the liver of NSG dramatically promoted the development of human T cells. Human T cells developed in humanized NSG mice represent markedly diverse, functionally active, TCR V$$\upbeta $$ β usages, and the restriction to human MHC molecules. Upon challenge with Epstein-Barr virus (EBV), EBV-specific hCD8+ T cells in humanized NSG mice were effectively mounted with phenotypically activated T cells presented as hCD45+hCD3+hCD8+hCD45RO+hHLA-DR+ T cells, suggesting that antigen-specific T cell response was induced in the humanized NSG mice. Taken together, our data suggest that the hDlk1-expressing MSCs can effectively promote the development of human T cells and immune response to exogenous antigen in humanized NSG mice. Thus, the humanized NSG model might have potential advantages for the development of therapeutics targeting infectious diseases in the future.

To date, the effect of adjuvant chemotherapy after curative resection in patients with stage II colon cancer remains controversial. Still, little is known about the effects of adjuvant chemotherapy in patients with stage II colon cancer who are older than 70 years, as most studies did not focus on this population. This study aimed to investigate the oncologic outcomes of elderly patients with stage II colon cancer who underwent curative resection with or without postoperative adjuvant chemotherapy. We retrospectively reviewed medical records of patients older than 70 years who underwent curative resection of stage II primary colon cancer during 2002–2015. Patients were classified into surgery alone (SA) and adjuvant chemotherapy (AC) groups and propensity score-matched at a 1:1 ratio using a logistic regression. The end points were recurrence-free (RFS), cancer-specific (CSS) and overall survival (OS). Of the 623 patients who met the criteria, 145 were assigned to each arm after propensity score matching. The mean ages of the SA and AC groups were 74.3 and 74.0 years, respectively. A log-rank test revealed no significant inter-group differences in RFS (p = 0.202), CSS (p = 0.486) or OS (p = 0.299). In a Cox regression analysis, adjuvant chemotherapy was not found to be an independent factor affecting RFS (p = 0.206), CSS (p = 0.487) or OS (p = 0.301). Adjuvant chemotherapy does not appear to yield survival benefits in elderly patients with stage II colon cancer.

If anastomotic site leakage is expected after laparoscopic low anterior resection (LAR), de-functioning ileostomy is required. However, there is controversy about the consequence of stoma formation via the specimen extraction site (SES). Therefore, we aimed to investigate stoma-related complication according to stoma formation via the SES. We enrolled rectal cancer patients who underwent laparoscopic LAR with temporary ileostomy between January 2013 and December 2017. Patients were divided into two groups: stoma through the SES (SES) and stoma through a new site (NS). The difference in the incidence of stoma-related complications was analysed. In total, 198 patients underwent laparoscopic LAR (SES = 141 patients, NS = 57 patients). The SES group had a shorter operation time (204.7 ± 74.4 min vs 229.5 ± 90.5 min, p = 0.049) and was associated with fewer cases of wound infection (0% vs 7%, p = 0.006) than the NS group. There was no statistically significant difference between the SES group and NS group in all-stoma complications (22.7% vs 12.3%, p = 0.095). The incidence of parastomal hernia also was not significantly different (11.3% vs 5.3%, p = 0.286). Stoma via the SES is feasible after laparoscopic LAR with temporary ileostomy, although stoma-related complication rate was higher, without a significant difference. It can shorten the operation time and reduce wound infection rate.

This study aimed to compare the effects of volatile anesthesia and total intravenous anesthesia (TIVA) on syndecan-1 shedding in patients with gastric cancer undergoing minimally invasive gastrectomy. Patients were randomly assigned to either the Volatile (n = 68) or the TIVA (n = 68) group. Anesthesia was maintained with sevoflurane/remifentanil or propofol/remifentanil in the Volatile and TIVA groups, respectively. Serum syndecan-1 was evaluated at pre-operation, end of operation, and postoperative day (POD) 1. Inflammatory markers including white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP), were also measured at pre-operation, end of operation, and POD 1, 2, 3, and 5. The TIVA group showed significantly lower levels of syndecan-1 at the end of the operation compared to the Volatile group; however, no difference was seen between the groups at POD 1. The WBC count and NLR were significantly lower in the TIVA group at the end of the operation than the Volatile group, but there were no differences between the groups at POD 1, 2, 3, and 5. CRP levels were similar between the groups at all time points. In conclusion, despite TIVA being superior to volatile anesthesia in protecting endothelial glycocalyx during the operation, both did not prevent postoperative syndecan-1 shedding after gastrectomy.Clinical trial registration number: NCT04183296 (ClinicalTrial.gov, 03/12/2019).

We propose a free-space electro-optic transmission modulator based on multiple p-n-junction semiconductor subwavelength gratings. The proposed device operates with a high-Q guided-mode resonance undergoing electro-optic resonance shift due to direct electrical control. Using rigorous electrical and optical modeling methods, we theoretically demonstrate a modulation depth of 84%, on-state efficiency 85%, and on-off extinction ratio of 19 dB at 1,550 nm wavelength under electrical control signals within a favorably low bias voltage range from −4 V to +1 V. This functionality operates in the transmission mode and sustainable in the high-speed operation regime up to a 10-GHz-scale modulation bandwidth in principle. The theoretical performance prediction is remarkably advantageous over plasmonic tunable metasurfaces in the power-efficiency and absolute modulation-depth aspects. Therefore, further experimental study is of great interest for creating practical-level metasurface components in various application areas.

Although volatile organic compounds (VOCs) are becoming increasingly recognized as harmful agents and potential biomarkers, selective detection of the organic targets remains a tremendous challenge. Among the materials being investigated for target recognition, peptides are attractive candidates because of their chemical robustness, divergence and their homology to natural olfactory receptors. Using a combinatorial peptide library and either a graphitic surface or phenyl-terminated self-assembled monolayer as relevant target surfaces, we successfully selected three interesting peptides that differentiate a single carbon deviation among benzene and its analogues. The heterogeneity of the designed target surfaces provided peptides with varying affinity toward targeted molecules and generated a set of selective peptides that complemented each other. Microcantilever sensors conjugated with each peptide quantitated benzene, toluene and xylene to sub-ppm levels in real time. The selection of specific receptors for a group of volatile molecules will provide a strong foundation for general approach to individually monitoring VOCs.