Search

Background: Few studies have reported the healing process of anterolateral ligament (ALL) injuries. Purpose/Hypothesis: This study investigated the healing status of ALL injuries after primary anterior cruciate ligament (ACL) reconstruction (ACLR). Additionally, we investigated the association between the healing status of ALL injuries and associated lesions such as osseous lesions and meniscal tears occurring at the time of an ACL rupture. We hypothesized that acute ALL injuries show a high rate (more than two-thirds) of healing at the 1-year follow-up after ACLR and that concomitant lesions observed at the time of an ACL rupture affect the healing status of the ALL. Study Design: Case-control study; Level of evidence, 3. Methods: We retrospectively investigated patients with ALL injuries who underwent primary ACLR between March 2015 and February 2017. Using magnetic resonance imaging (MRI), we evaluated the features of ALL injuries and concomitant lesions, and MRI was performed at the 1-year follow-up to assess the healing status of the ALL. We investigated the association between the healing status of the ALL and concomitant lesions observed at the time of an ACL rupture. A subjective assessment was performed using the Lysholm score, International Knee Documentation Committee subjective score, and Tegner activity scale. Objective tests included an isokinetic strength assessment and functional performance testing. Results: With respect to the severity of ALL injuries, of 54 patients, a complete rupture occurred in 16 (29.6%) of the 54 patients and a partial rupture in 38 (70%). A significant association was observed between the severity of ALL injuries and bone contusions (lateral tibial plateau and medial tibial plateau [MTP]) and meniscus ramp lesions (Fisher exact test: P =.023,.012, and.023, respectively). Good and partial healing of the ALL occurred in 16 (29.6%) and 23 (42.6%) of 54 patients, respectively. Scar formation occurred in 12 (22.2%), and nonvisualization of the ALL was observed in 3 (5.6%) of 54 patients. Poor healing of the ALL was associated with preoperative MTP bone contusions and a high-grade pivot shift. Multivariate analysis showed that an MTP bone contusion was an independent risk factor associated with poor healing of the ALL. Among the functional tests performed, significant differences were observed between the good and poor healing groups with respect to the carioca test (P =.039). The good healing group (n = 16) showed a negative pivot shift at the last follow-up, whereas 5 (13.2%) of the patients from the poor healing group (n = 38) showed a positive pivot shift, including 2 (5.3%) with a high-grade pivot shift. Conclusion: Approximately 70% of acute ALL injuries showed poor healing at the 1-year follow-up. Poor healing of ALL injuries was significantly associated with preoperative MTP bone contusions and a high-grade pivot shift. Therefore, a careful assessment of posteromedial bone contusions at the time of an ACL rupture is warranted, particularly in patients with a high-grade pivot shift. [ABSTRACT FROM AUTHOR]

A retrospective metabolomics approach was utilized as a tool in genomics-assisted selection for forest tree improvement. Key metabolic components were thus correlated with the inherently rapid stem growth of Pinus densiflora Siebold & Zucc. trees, including water soluble metabolites and amino acids found in the inner bark (phloem) of cambial region tissues that were harvested in midsummer (July) from 34-year-old trees. Metabolites were assessed in individual genotypes from seven open-pollinated, half-sibling families. Four of the families were classed as fast growing, and three of the families were significantly slower growing. This metabolomics approach was also used to assess metabolite profiles in similar cambium-phloem region tissues from 4-year-old trees representing 12 unrelated families. Initially by Pearson's correlation analysis, and subsequently by stepwise linear modeling, we assessed the interactions between stem growth parameters (stem diameters and a stem volume index) and metabolite contents, and we did this via a retrospective approach. Among the metabolites identified, inositol was a consistent, positive, and highly significant correlate with the stem growth of P. densiflora trees at two developmental stages (ages 4 and 34 years). Inositol also exhibited these significant correlations in an environment-independent manner, i.e., on two very different field progeny test sites. We conclude that inositol may be a useful metabolic biomarker for early selection of rapid tree stem growth traits of this conifer species. In so doing, it could appreciably enhance the breeding and selection of inherently rapid-growing families of P. densiflora. [ABSTRACT FROM AUTHOR]

Objective: Preoperative percutaneous nephrostomy (PCN) has been commonly performed for patients with urinary stones complicated with pyelonephritis or obstructive uropathy; in fact, a considerable number of patients undergo ureteroscopic removal of stone (URS) in the presence of a PCN. We assessed the effectiveness of PCN during URS in the management of upper ureteral stones. Patients and Methods: We retrospectively analyzed 140 patients who underwent URS for upper ureteral stones between January 2008 and December 2011. All URS were performed by a single experienced surgeon. The subjects were divided into two groups depending on the presence of a PCN at the time of the surgery (PCN group: 42 and non-PCN group: 98). The PCN group was subdivided into two groups depending on the performance of external fluid irrigation through PCN during the surgery (irrigation group: 21 and non-irrigation group: 21). To evaluate operative outcomes, we compared operative times, auxiliary procedures required, and success and complication rates. Results: The PCN group showed significantly better outcomes in terms of the operative time (57.4 minute vs. 68.1 minute) and success rate (92.9% vs. 78.6%) without increasing the complication rate. In the PCN group, the irrigation group showed a shorter operative time compared to the non-irrigation group, although statistical significance was not observed. Other perioperative outcomes, such as the success rate, auxiliary procedures, and complication rates, were not significantly different between the two groups. Conclusion: URS for upper ureteral stones in patients with PCN produced superior surgical outcomes in terms of the success rate, operative time, and auxiliary procedure rate without increasing the complication rate. The presence of PCN with/without external irrigation during URS can be a beneficial factor to produce better outcomes of URS for the management of upper ureteral stones. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the outcomes of topical steroid therapy according to potency as the first-line treatment for boys with symptomatic phimosis.Materials and Methods: From April 2017 to March 2019, we retrospectively reviewed 45 boys with severe phimosis (Kikiros retractability grade 4 or 5) who presented with phimosis-related complications. During the first year of the study period, methylprednisolone aceponate (MPA, Advantan®, potent topical steroid) was administered in 24 boys. Hydrocortisone butyrate (HCB, Bandel®, moderately potent topical steroid) was administered in 21 boys in the subsequent period. Topical steroids were administered for 4-8 weeks in all patients. Success of the therapy was determined by two conditions at 3 months after therapy: achieving Kikiros grade 3 and less with disappearance of symptoms.Results: Of 45 boys, 35 (77.8%) achieved success of the therapy. Mean age was 46.64±22.42 months. Recurrence of phimosis with clinical complications was confirmed in three of 35 patients with initial success (8.6%) during the follow-up period. All boys with recurrence showed remission after additional topical steroid therapy. Success rate of the MPA group was higher than that of the HCB group (91.7% and 61.9% respectively, P = .029). Side effects associated with the topical steroid application were not observed in all children.Conclusion: Topical steroid application is an effective and safe procedure as first-line treatment in symptomatic boys with severe phimosis. Moreover, the potency of topical steroids for the treatment of phimosis is considered a factor affecting the success rate. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate whether preoperative serum albumin-to-globulin ratio (AGR) could predict the prognosis of patients with urothelial bladder cancer (UBC) after radical cystectomy (RC).Materials and Methods: A total of 176 patients with UBC who underwent RC in a tertiary hospital between 2008 and 2019 were retrospectively analyzed. The AGR was calculated as albumin/(total protein - albumin). In addition, the AGR was divided into two groups for the time-dependent receiver operating characteristic curve (ROC) analysis. Survival was estimated using the Kaplan-Meier analysis and compared using the log-rank test. Cox proportional- hazards models were used for multivariate survival analysis.Results: The best cutoff AGR value for metastasis prediction was 1.32 based on the ROC curve analysis. Patients who had lower pretreatment AGR (<1.32) values composed the low-AGR group (n = 57; 32.4%). On the other hand, the remaining patients (n = 119; 67.6%) composed the high-AGR group. The patients in the low-AGR group had more advanced stage tumors compared with the patients in the high-AGR group. The Kaplan-Meier curves revealed that the patients in the low-AGR group had significantly lower rates of metastasis-free survival (MFS) and cancer-specific survival (CSS). The multivariate Cox regression analysis showed that preoperative AGR was an independent prognostic factor for MFS and CSS.Conclusion: In this single-institution retrospective study, lower preoperative AGR values demonstrated a poor prognostic effect on MFS and CSS in patients with UBC who underwent RC. [ABSTRACT FROM AUTHOR]