The effect of humeral tunnel locations on radiographic tunnel changes in baseball players following medial ulnar collateral ligament reconstruction: comparison of anatomic and nonanatomic locations.

BACKGROUND: There has been no study on radiologic changes after medial ulnar collateral ligament (MUCL) reconstruction and related clinical features. METHODS: Data from 39 baseball players who underwent MUCL reconstruction were collected and analyzed. The baseball players were classified into 2 groups according to the starting point of the humeral tunnel: (1) the lower tip of the medial epicondyle (group NA, n = 21) and (2) the remnant of the MUCL (group A, n = 18). Bone tunnel characteristics and changes were evaluated by computed tomography (CT) at 3 and 9 months postoperatively. Outcome measures consisted of the visual analog scale, range of motion (ROM), the Conway scale, and the presence of ulnar nerve irritation postoperatively. RESULTS: The mean diameter of the humeral entry was 4.0 mm (range, 3.4-5.1 mm) on the first CT scan, which increased to 5.5 mm (range, 3.2-7.2 mm) on the follow-up CT scan (P < .001). The mean diameter of the ulnar tunnel was 2.8 mm (range, 1.1-3.3 mm) on the first CT scan, which decreased to 1.6 mm (range, 0-4.3 mm) on the follow-up CT scan (P < .001). The between-group comparison revealed no differences in the changes in the diameter of the humeral and ulnar tunnels. A statistically significant correlation was not found between athletic performance measured by the Conway scale and the radiologic changes on CT evaluation (P = .182). Group A showed improvement in extension from 7° preoperatively to 1° postoperatively (P < .001) and in flexion from 126° preoperatively to 136° postoperatively (P < .001), while group NA did not achieve statistical significance in ROM improvement after the operation. CONCLUSIONS: Humeral tunnel widening was commonly observed, while the ulnar tunnel was maintained or became narrowed conversely. The humeral tunnel placements did not affect tunnel changes after the surgical procedure; however, MUCL reconstruction with the anatomic location of the humeral tunnel yielded substantial improvement in elbow ROM.

Diffusion and perfusion MRI prediction of progression-free survival in patients with hepatocellular carcinoma treated with concurrent chemoradiotherapy.

PURPOSE: To assess whether MR perfusion and diffusion parameters taken before concurrent chemoradiotherapy (CCRT) are useful imaging biomarkers for predicting progression-free survival (PFS) in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Twenty patients with locally advanced HCC who had no treatment before CCRT underwent dynamic contrast-enhanced (DCE) and diffusion-weighted MRI. Mean values of the volume transfer constant (K(trans) ), reflex constant (Kep ), extravascular extracellular volume fraction (Ve ) and the apparent diffusion coefficient (ADC) were estimated on a region of interest. The best cutoff value for each factor was assessed to differentiate between patients who had PFS shorter or longer than the median PFS. Patients were dichotomized in terms of the cutoff value. The survival outcome of the two groups and the predictive ability of each factor on PFS were evaluated. RESULTS: Median time to PFS was 179 days. The best cutoff values for ADC, K(trans) , Kep , and Ve was 1.008 × 10(-3) mm(2) s(-1) , 0.108 min(-1) , 0.570 min(-1) , and 0.298%. Patients with higher ADC had significantly longer PFS than those with lower ADC(P < 0.0001). CONCLUSION: The ADC of HCC acquired before CCRT correlated with PFS and was valuable in the prediction of the clinical outcome of HCC treated with CCRT.

The use of elemental sulfur as an alternative feedstock for polymeric materials.

An excess of elemental sulfur is generated annually from hydrodesulfurization in petroleum refining processes; however, it has a limited number of uses, of which one example is the production of sulfuric acid. Despite this excess, the development of synthetic and processing methods to convert elemental sulfur into useful chemical substances has not been investigated widely. Here we report a facile method (termed 'inverse vulcanization') to prepare chemically stable and processable polymeric materials through the direct copolymerization of elemental sulfur with vinylic monomers. This methodology enabled the modification of sulfur into processable copolymer forms with tunable thermomechanical properties, which leads to well-defined sulfur-rich micropatterned films created by imprint lithography. We also demonstrate that these copolymers exhibit comparable electrochemical properties to elemental sulfur and could serve as the active material in Li-S batteries, exhibiting high specific capacity (823 mA h g(-1) at 100 cycles) and enhanced capacity retention.