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Background: The cause of early graft failure within 1 year of meniscal allograft transplantation (MAT) remains unclear. The association of early failure with a nonanatomic horn position of the allograft after lateral MAT with the keyhole technique has never been evaluated. Hypothesis: A nonanatomic horn position of an allograft would be a significant risk factor for a premature graft tear as compared with an anatomically positioned allograft. Study Design: Cohort study; Level of evidence, 3. Methods: From October 2007 to October 2016, 208 patients (214 knees) with primary isolated lateral MAT in a single center were enrolled. A >5-mm or 10% discrepancy between pre- and postoperative horn position was defined as "nonanatomic," and the early failure rate was compared. Among 214 cases of lateral MAT, 54 were nonanatomically positioned, and 160 were anatomically positioned. The early failures (within 1 year after MAT) were defined as (1) grade 3 signal intensities (tears) over one-third of the allograft on magnetic resonance image or (2) removal of more than one-third of the allograft because of tears. Results: Among the early failure cases, 6 were in the nonanatomic group and 5 in the anatomic group. The failure rate was 11.1% (6 of 54) in the nonanatomic group and 3.1% (5 of 160) in the anatomic group, with a 5.1% (11 of 214) overall early failure rate. The nonanatomic horn position group had an increased risk of early graft failure as compared with the anatomically positioned group (odds ratio = 3.88; 95% CI, 1.13-13.26). Anteriorized and lateralized horn position was identified in the nonanatomic group as compared with the anatomic group. Differences in patient age, sex, body mass index, involved knee, cartilage status, alignment of lower extremity, and joint space width were not statistically significant between the groups. Conclusion: Horn position discrepancy was associated with an increased risk of early graft failures. Meticulous insertion of a bone bridge is needed to ensure anatomically correct horn positioning to avoid early graft failure in lateral MAT with the keyhole technique. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study is to evaluate mid-to-long-term clinical and radiological outcomes after an arthroscopic partial meniscectomy for symptomatic discoid lateral meniscus (DLM) in young patients and to determine whether degeneration of the residual meniscus and articular cartilage progresses during the follow-up period using magnetic resonance imaging (MRI).Materials and Methods: We retrospectively reviewed patients aged ≤ 40 years at surgery who underwent arthroscopic partial meniscectomy for symptomatic DLM and were followed up for ≥ 5 years. Lysholm knee scores and reoperation rates were assessed as clinical outcomes. Factors that affect clinical outcomes were evaluated. Tapper-Hoover classification and femorotibial angle were used for radiological assessment. The degree of degeneration of articular cartilages and residual meniscus was evaluated using preoperative and follow-up MRIs.Results: A total of 73 knees (66 patients) were enrolled. The mean follow-up period was 10.0 years. The mean follow-up Lysholm knee score was 84.2 ± 14.5, and the reoperation rate was 32.9%. Follow-up Lysholm knee scores were related to duration of symptoms prior to surgery (β = - 0.129, P = 0.003) and femorotibial angle at the last follow-up (β = 1.362, P = 0.045). On simple radiographs, progression of arthritis of the lateral compartment was observed in 68.5% (49 knees). In MRI analyses, degeneration of the residual meniscus progressed in 52.9% (34 knees) (P < 0.001), and significant changes in modified Yulish scores were observed in both lateral femoral and tibial condyles (P < 0.001, both condyles).Conclusions: After an arthroscopic partial meniscectomy for symptomatic DLM, unfavorable clinical outcomes were shown in > 30% of the patients during a mean follow-up of 10.0 years. Clinical outcomes based on the patient-reported outcome measures were related to durations of symptoms prior to surgery and alignment at the last follow-up. In radiological and MRI assessments, progression of degeneration of articular cartilages in the lateral compartments of the knees and residual menisci was observed. [ABSTRACT FROM AUTHOR]

Background: Meniscal extrusion is related to degeneration of the native knee joint. However, the clinical effect of the phenomenon after meniscal allograft transplantation (MAT) has not been clearly identified. Purpose/Hypothesis: The purpose of this study was to evaluate the change in meniscal extrusion in both the coronal and sagittal planes after lateral MAT through the midterm follow-up period. We hypothesized that meniscal extrusion does not progress during the midterm follow-up period. Study Design: Case series; Level of evidence, 4. Methods: A total of 46 patients with a mean follow-up of 51.1 ± 7.1 months were included in the study. The patients underwent lateral MAT using the keyhole technique. Postoperative magnetic resonance imaging (MRI) was performed at 6-week, 1-year, and midterm (3- to 5-year) follow-up. In the coronal plane, the absolute value of meniscal subluxation and the relative percentage of extrusion (RPE) were measured. In the sagittal plane, meniscal subluxation was measured as the absolute and relative anterior cartilage meniscal distance (ACMD) and posterior cartilage meniscal distance (PCMD). The joint-space width (JSW) on weightbearing radiographs with 2 different knee positions was measured preoperatively and at 1-year and midterm follow-up. The Lysholm score was assessed at the same time points. Results: In the coronal plane, the mean absolute meniscal extrusion at 6-week, 1-year, and final follow-up was 2.90 ± 0.94, 2.85 ± 0.97, and 2.83 ± 0.89 mm, respectively, and the mean RPE was 27.0% ± 9.4%, 27.1% ± 10.1%, and 27.8% ± 9.7%, respectively. There were no statistically significant differences in absolute and relative coronal extrusion among the 3 time periods (P > .05). The percentage of patients with meniscal extrusion (≥3 mm) was 37.0% at 6-week follow-up and 34.8% at 1-year and final follow-up. In the sagittal plane, the mean absolute ACMD was 2.59 ± 1.75, 2.58 ± 1.85, and 2.37 ± 1.60 mm, respectively, and the mean relative ACMD was 20.7% ± 13.1%, 20.6% ± 13.8%, and 19.0% ± 12.2%, respectively, at the 3 follow-up time points. The mean absolute PCMD was −1.23 ± 3.34, −1.28 ± 3.08, and −1.42 ± 2.77 mm, respectively, and the mean relative PCMD was −10.3% ± 25.9%, −11.0% ± 24.6%, and −12.2% ± 23.2%, respectively, at the same time points. Sagittal extrusion was not significantly different between the time points (P > .05). The mean JSW at 2 days preoperatively, 1 year postoperatively, and midterm follow-up was 5.40 ± 1.07, 5.44 ± 1.04, and 5.43 ± 0.98 mm, respectively, on anterior-posterior radiographs with full extension, and it was 4.90 ± 0.94, 4.94 ± 0.98, and 4.89 ± 0.96 mm, respectively, on posterior-anterior radiographs with 45° of flexion. The mean JSW values were not significantly different between the 3 different time points (P > .05). The mean preoperative Lysholm score was 58. 9 ± 8.3; the score increased to 90.4 ± 9.7 at 1 year postoperatively and 90.5 ± 10.1 at final follow-up, which is a significant improvement compared with the preoperative status (P < .05). There was no statistically significant difference between the scores at the 2 postoperative time points (P > .05). Conclusion: This study demonstrated that extrusion of the meniscal allograft did not significantly progress either in the coronal or sagittal plane after lateral MAT during the midterm follow-up period. [ABSTRACT FROM AUTHOR]

Background: It is important to restore the normal anatomy of the native meniscus in meniscal allograft transplantation (MAT) for successful surgical results. Purpose/Hypothesis: The purpose of this study was to compare the anatomic positions of the anterior horn (AH) and posterior horn (PH) between the preoperative lateral meniscus and postoperative meniscal allograft after lateral MAT using the keyhole technique. We hypothesized that the keyhole technique could restore the preoperative anatomy of the native lateral meniscus. Study Design: Case series; Level of evidence, 4. Methods: Between December 2012 and December 2014, a total of 70 patients underwent lateral MAT using the keyhole technique. The anatomic positions of both horns of the native lateral meniscus and the meniscal allograft were measured on magnetic resonance imaging (MRI). Preoperative MRI was performed 1 day before lateral MAT, while postoperative MRI was performed 2 days after lateral MAT. A percentage reference method was used to measure the location of both horns. Results: For the AH, the mean delta value of the absolute position was 0.7 ± 1.8 mm (95% CI, 0.3-1.1 mm) in the coronal plane and 0.5 ± 1.6 mm (95% CI, 0.2-0.9 mm) in the sagittal plane, and the mean delta value of the relative position was 1.0% ± 2.3% (95% CI, 0.5%-1.6%) in the coronal plane and 1.1% ± 3.3% (95% CI, 0.2%-1.8%) in the sagittal plane. For the PH, the mean delta value of the absolute position was 2.4 ± 2.6 mm (95% CI, 1.8 to 3.1 mm) in the coronal plane and −0.1 ± 2.1 mm (95% CI, −0.6 to 0.4 mm) in the sagittal plane, and the mean delta value of the relative position was 3.3% ± 3.5% (95% CI, 2.5% to 4.2%) in the coronal plane and −0.3% ± 4.4% (95% CI, –1.3% to 0.8%) in the sagittal plane. Therefore, the AH moved by a mean of 0.7 mm laterally and 0.5 mm anteriorly (absolute values) and 1.0% laterally and 1.1% anteriorly (relative values) compared with the preoperative position. The PH moved by a mean of 2.4 mm laterally and 0.1 mm posteriorly (absolute values) and 3.3% laterally and 0.3% posteriorly (relative values) compared with the preoperative position. For the AH, the proportion of patients with an absolute delta value of ≥5 mm was 4.3% in the coronal plane and 2.9% in the sagittal plane. For the PH, the proportion of patients with an absolute delta value of ≥5 mm was 18.6% in the coronal plane and 4.3% in the sagittal plane. Conclusion: When comparing the position of the horns preoperatively and postoperatively, both horns showed mean relative postoperative positional changes of <5% of relative values and <5 mm of absolute values in both the coronal and sagittal planes. The keyhole technique in lateral MAT can reconstruct the lateral meniscus close to its native anatomic position by avoiding displacement of >5 mm in both the coronal and sagittal planes. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to evaluate clinical and radiological outcomes after arthroscopically assisted coracoclavicular (CC) fixation using a single adjustable–loop-length suspensory fixation device for acute acromioclavicular dislocation and to report intraoperative and postoperative complications. Methods Eighteen consecutive patients with acute acromioclavicular dislocation underwent arthroscopically assisted CC fixation using a single TightRope (Arthrex, Naples, FL). Using the Rockwood classification, 3 patients had grade III dislocations, one patient had a grade IV dislocation, and 14 patients had grade V dislocations. Results The preoperative CC distance of the injured shoulder was 16.1 ± 2.7 mm (range, 11.2 to 21.0 mm), and it increased by 99% ± 36% (range, 17% to 153%) on average compared with the contralateral shoulder. The average CC distance was 10.5 ± 2.5 mm (range, 7.7 to 15.5 mm), and it increased by 30% ± 30% (range, −9.4% to 90%) at the final follow-up. Compared with immediate postoperative radiographs, the CC distance was maintained in 12 patients, increased between 50% and 100% in 4 patients, and increased more than 100% in 2 patients at final follow-up. However, there was no statistical difference in Constant scores between 6 patients with reduction loss (95.6 ± 4.5) and 12 patients with reduction maintenance (98.4 ± 2.5; P = .17). Perioperative complications occurred in 8 patients, including one case of acromioclavicular arthritis, one case of delayed distal clavicular fracture at the clavicular hole of the device, 3 cases of clavicular or coracoid button failures, and 3 cases of clavicular bony erosion. Conclusions Satisfactory clinical outcomes were obtained after CC fixation using the single adjustable–loop-length suspensory fixation device for acute acromioclavicular joint dislocation. However, CC fixation failure of greater than 50% of the unaffected side in radiological examinations occurred in 33% of the patients within 3 months after the operation. Additionally, 8 patients (44%) had complications associated with the adjustable–loop-length suspensory fixation device and surgical technical problems. Despite acceptable shoulder function restoration, adequate care should be exercised in surgical treatment of acute acromioclavicular dislocation with a single adjustable–loop-length suspensory fixation device for optimal radiological outcomes. Level of Evidence Level IV, therapeutic case series. [ABSTRACT FROM AUTHOR]

Ten consecutive patients with digital enchondroma were treated by curettage and calcium phosphate bone cement (CPC) injection under digital nerve block. Mean patient age at surgery was 39 years old (range, 26-54), and the mean follow-up period was 19 months (range, 12-31). Two patients had a pathologic fracture at the first visit. Active finger motion was allowed at three days postoperatively and all patients returned to work within four weeks of surgery. The surgical procedures were uneventful in all patients, and no complications were encountered during follow-up. The mean total arc of motion of the PIP joints and MP joints of the affected fingers was 93% of and 99%, respectively, of the arcs of the corresponding joints of the contralateral unaffected fingers at final follow-up. CPC injection is a good option for the treatment of enchondroma of the finger. [ABSTRACT FROM AUTHOR]

Mild cognitive impairment (MCI) is considered as a transitional stage between aging and Alzheimer's disease. In the present study, we examined the protective effect of Schisandra chinensis (SC) and Ribes fasciculatum (RF) on neuronal cell death in vitro and scopolamine-induced cognitive impairment in Sprague Dawley® rats in vivo. A mixture of SC and RF extracts (SC+RF) significantly protected against hydrogen peroxide-induced PC12 neuronal cell death. The neuroprotective effect of SC+RF on scopolamine-induced memory impairment in rats was evaluated using the passive avoidance test and the Morris water maze test. In the passive avoidance test, SC+RF-treated rats showed an increased latency to escape, compared to the scopolamine-treated rats. Moreover, SC+RF treatment significantly reduced escape latency in water maze test, compared to treatment with scopolamine alone. To verify the long-term memory, we performed probe test of water maze test. As a result, rat treated with SC+RF spent more time in the target quadrant. Consistent with enhancement of memory function, the brain derived neurotrophic factor (BDNF) and its downstream molecules (pERK, pATK, and pCREB) are increased in SC+RF treatment in hippocampal area compared with scopolamine treated group. These results suggest that a mixture of SC and RF extracts may be a good therapeutic candidate for preventing mild cognitive impairment. [ABSTRACT FROM AUTHOR]

Abstract: One of the most important aspects in designing production systems is implementing an adequate inspection procedure to ensure the product quality. Our literature study indicates that two important questions still remain unanswered. First, most of the previous studies on inspection procedures are mainly concerned with how to evaluate and analyze the adequacy of inspection procedures during a production stage. Although the issue of the adequacy of inspection procedures at this point is clearly important, many production processes may better benefit from designing enhanced inspection procedures during an early design stage. Second, the majority of previous studies do not incorporate possible economic impacts of measurement errors when inspection procedures need to be designed. More extensive efforts in designing inspection procedures need to be investigated based on economic considerations. Two approaches, the use of guard band and the selection of inspection precision level, are simultaneously examined for designing economic inspection procedures. By incorporating these two approaches, this paper proposes an optimization scheme for economic design of inspection procedures. A numerical example along with sensitivity analysis demonstrates the applicability of the proposed model. [Copyright &y& Elsevier]

Abstract: In this work, it was investigated the effect of solubility in supercritical CO2 on the nickel-electroplating characteristics. The plating characteristics could be controlled by electric resistance and dispersion in emulsion as well. CO2 concentration had better be controlled at lower concentration than 50 CO2 wt% to decrease electric resistance since supercritical CO2 is non-polar material. Non-ionic surfactant with EO/PO block copolymer was more efficient than any other surfactant and the dispersion at 0.2 surfactant wt% was better than at any surfactant concentration and over-added surfactant concentration over 0.2 wt% brought to the decrease of dispersion properties. Electric resistance was constant at 20Ω in ranging from pH 2.2 to pH 3.5 and increased slowly to 50Ω at pH 4 and rapidly to 400Ω at pH 5. Characteristics of nickel film has a close relation with solubility in supercritical CO2 and solubility is dependent on pressure and temperature. Solubility at 16 MPa was higher than that any other at pressure and at constant pressure of 16 MPa, solubility in supercritical CO2 increased with an increasing temperature from 31 to 45°C and decreased over 45°C. [Copyright &y& Elsevier]