Evaluation of articular cartilage degeneration in patients with osteonecrosis of the femoral head using T2 mapping magnetic resonance imaging.

OBJECTIVES: To evaluate and characterise articular cartilage degeneration in patients with osteonecrosis of the femoral head (ONFH) using T2 mapping magnetic resonance imaging (MRI). METHODS: We reviewed 35 patients with ONFH (20 males and 15 females, mean age 45.7±12.9 years) without obvious cartilage abnormalities on plain MRI (ONFH group) and 25 healthy volunteers (9 males and 16 females, mean age 42.9±5.8 years) (control group). All patients underwent T2 mapping MRI after ONFH onset. The region of interest was defined as the weight-bearing portion of the articular cartilage in the femoral head and acetabulum in the coronal view. RESULTS: The T2 values of the articular cartilage of the acetabulum and femoral head, including necrotic and normal regions, were significantly higher in the ONFH group than those in the control group. These T2 values of the acetabulum and femoral head in stages 3A and 2 were significantly higher in the ONFH group than those in the control group. CONCLUSIONS: The articular cartilage of the acetabulum and femoral head can deteriorate after the onset of ONFH, which may affect the natural history of ONFH and ONFH treatment. Our findings suggest the need for early intervention in joint preservation surgery.

Transportation-induced nausea-like behavior in goats and the effects of anti-motion sickness medication.

This study investigated the nausea-like behavior induced by road transportation in goats, and the effects of an anti-motion sickness (MS) medication on this behavior. In the first experiment, 11 adult Shiba goats were road transported twice with either a saline (control) or a commercial anti-MS medication (Travelmin) injection at the first or second transportation. Almost all goats showed nausea-like behavior, which was defined as pointing their heads downward, closing their eyes, and staying relatively still. These goats did not respond when they were touched during blood collection. The anti-MS medication significantly reduced the total time spent in nausea-like behavior (P < 0.05) and tended to increase the frequency of escape attempts during blood collection (P < 0.1). In a second experiment, the effects of the anti-MS medication were examined in goats held under normal housing. The anti-MS medication increased the time spent feeding (P < 0.01) and reduced the time spent in rumination (P < 0.05) but did not change the frequency of lying down nor plasma cortisol concentrations. Our results indicate that the nausea-like behavior in transported goats might be induced, at least in part, by regulatory mechanisms similar to the MS.

Evaluation of the long-term patient-reported outcomes after hip arthroplasty or joint preserving with Sugioka femoral osteotomy in patients with femoral head osteonecrosis.

PURPOSE: This study retrospectively evaluated long-term clinical outcomes and patient-reported outcome measures (PROMs) in patients with osteonecrosis of the femoral head (ONFH) who underwent transtrochanteric rotational osteotomy (TRO), curved varus osteotomy (CVO), and total hip arthroplasty (THA). METHODS: We retrospectively reviewed the 109 hips in 96 patients (46 men, 50 women) who underwent CVO, TRO, or THA for ONFH treatment. The mean follow-up period for the TRO, CVO, and THA groups was 14.8, 11.5, and 13.3 years, respectively. RESULTS: The THA conversion rate of the TRO patients was significantly higher than that of the patients with CVO, and the final clinical scores in the patients with TRO did not improve compared with preoperative scores. Postoperative PROMs showed that the total and pain scores of the patients with THA were significantly higher than those of patients with TRO and CVO, while the PROM score did not change between patients with TRO and CVO. The analysis further showed that the preoperative type C2, stage 3A, or postoperative type C1 and C2 were significant predictors of decreased final PROM scores. CONCLUSION: This study found that CVO and THA are clinically effective treatments for ONFH, with significant improvements compared with preoperative scores. However, THA was associated with significantly higher PROMs and pain scores than those of CVO and TRO in long-term follow-up. Furthermore, our results suggest that postoperative PROMs depend mainly on the preoperative level of collapse and postoperative transposed intact ratio of the articular surface of the femoral head.

A Multielectrode Array-Based Recording System for Analyzing Ultrasound-Driven Neural Responses in Brain Slices in vitro.

Ultrasound stimulation is expected to be useful for transcranial local and deep stimulation of the brain, which is difficult to achieve using conventional electromagnetic stimulation methods. Previous ultrasound stimulation experiments have used various types of acute in vitro preparations, including hippocampus slices from rodents and Caenorhabditis elegans tissue. For in vivo preparations, researchers have used the cortices of rodents as targets for transcranial ultrasound stimulation. However, no previous studies have used in vitro ultrasound stimulation in rodent cortical slices to examine the mechanisms of ultrasound-driven central neural circuits. Here we demonstrate the optimal experimental conditions for an in vitro ultrasound stimulation system for measuring activity in brain slices using a multielectrode array substrate. We found that the peak amplitudes of the ultrasound-evoked cortical responses in the brain slices depend on the intensities and durations of the ultrasound stimulation parameters. Thus, our findings provide a new in vitro experimental setup that enables activation of a brain slice via ultrasound stimulation. Accordingly, our results indicate that choosing the appropriate ultrasound waveguide structure and stimulation parameters is important for producing the desired intensity distribution in a localized area within a brain slice. We expect that this experimental setup will facilitate future exploration of the mechanisms of ultrasound-driven neural activity.

Lateral wall fixation with bone pegs for advanced osteochondritis dissecans of the humeral capitellum.

BACKGROUND AND HYPOTHESIS: It is generally considered that fragment fixation with bone pegs (FFBP) for osteochondritis dissecans (OCD) of the humeral capitellum can be indicated for stages I and II according to the International Cartilage Repair Society (ICRS) classification of OCD and it is difficult to obtain complete bone union for advanced lesions. However, the clinical and radiologic results of FFBP with cancellous bone graft for ICRS-OCD stage III with lateral wall involvement have not been described in detail. Good bone union can be achieved with the lateral wall fragment of the capitellum by FFBP in combination with refreshing the sclerotic surface at the base of the lesion and cancellous bone grafting even in ICRS-OCD stage III lesions. METHODS: In total, 10 adolescent baseball players with a diagnosis of OCD, a median age of 13.5 years at the time of surgery, and 26.7 months of postoperative follow-up were included. Preoperative imaging showed that all patients had lesions in the late detached stage and of the lateral-widespread type based on the site of the focal lesion. The intraoperative ICRS-OCD classification was stage III. We aimed to preserve and fix the lateral wall fragment with cancellous bone grafting if the condition of the articular cartilage was good and the size and thickness of the segment could withstand fixation. RESULTS: Bone union of the lateral wall fragment was achieved in all cases. The elbow extension range of motion was -3.9° ± 9.7° before surgery and was eventually -0.4° ± 6.7° at the final assessment. Flexion range of motion ranged from 138.1° ± 10.5° to 142.4° ± 6.2°. The Timmerman and Andrews score significantly improved from 165.5 ± 10.9 points before surgery to 197.0 ± 6.3 points after surgery, demonstrating excellent results in all patients. All patients were able to return to competitive baseball. CONCLUSION: The radiographic and clinical outcomes of FFBP for lateral wall fragments with cancellous bone graft were satisfactory, showing that the indications for this procedure could be extended to ICRS-OCD stage III.