Membrane depolarization mediates both the inhibition of neural activity and cell-type-differences in response to high-frequency stimulation.

Neuromodulation using high frequency (>1 kHz) electric stimulation (HFS) enables preferential activation or inhibition of individual neural types, offering the possibility of more effective treatments across a broad spectrum of neurological diseases. To improve effectiveness, it is important to better understand the mechanisms governing activation and inhibition with HFS so that selectivity can be optimized. In this study, we measure the membrane potential (Vm) and spiking responses of ON and OFF α-sustained retinal ganglion cells (RGCs) to a wide range of stimulus frequencies (100-2500 Hz) and amplitudes (10-100 µA). Our findings indicate that HFS induces shifts in Vm, with both the strength and polarity of the shifts dependent on the stimulus conditions. Spiking responses in each cell directly correlate with the shifts in Vm, where strong depolarization leads to spiking suppression. Comparisons between the two cell types reveal that ON cells are more depolarized by a given amplitude of HFS than OFF cells-this sensitivity difference enables the selective targeting. Computational modeling indicates that ion-channel dynamics largely account for the shifts in Vm, suggesting that a better understanding of the differences in ion-channel properties across cell types may improve the selectivity and ultimately, enhance HFS-based neurostimulation strategies.

Airborne survival and stress response in Listeria monocytogenes across different growth temperatures.

In the food industry, ensuring food safety during transportation and storage is vital, with temperature regulation preventing spoilage. However, airborne contamination through foodborne pathogens remains a concern. Listeria monocytogenes, a psychrotolerant foodborne pathogen, has been linked to various foodborne outbreaks. Therefore, understanding how its airborne characteristics depend on the growth temperature is imperative. As a result, when the L. monocytogenes was floated in air for 30 and 60 min, the surviving population of 15 °C-grown L. monocytogenes that was suspended in air and attached on the surface was significantly higher than L. monocytogenes grown at 25°C and 37 °C. The fatty acid analysis revealed a significantly higher proportion of shorter chain fatty acids in L. monocytogenes grown at 15 °C compared to those grown at 37 °C. Under aerosolization, L. monocytogenes encountered osmotic and cold stresses regardless of their growth temperature. Transcriptomic analysis showed that stress response related genes, such as oxidative and cold stress response, as well as PTS system related genes were upregulated at 15 °C, resulting in the enhanced resistance to various stresses during aerosolization. These results provide insights into the different responses of aerosolized L. monocytogenes according to the different growth temperatures, highlighting a critical factor in preventing airborne cross-contamination.

Neural activity of retinal ganglion cells under continuous, dynamically-modulated high frequency electrical stimulation.

Objective.Current retinal prosthetics are limited in their ability to precisely control firing patterns of functionally distinct retinal ganglion cell (RGC) types. The aim of this study was to characterise RGC responses to continuous, kilohertz-frequency-varying stimulation to assess its utility in controlling RGC activity.Approach.We usedin vitropatch-clamp experiments to assess electrically-evoked ON and OFF RGC responses to frequency-varying pulse train sequences. In each sequence, the stimulation amplitude was kept constant while the stimulation frequency (0.5-10 kHz) was changed every 40 ms, in either a linearly increasing, linearly decreasing or randomised manner. The stimulation amplitude across sequences was increased from 10 to 300µA.Main results.We found that continuous stimulation without rest periods caused complex and irreproducible stimulus-response relationships, primarily due to strong stimulus-induced response adaptation and influence of the preceding stimulus frequency on the response to a subsequent stimulus. In addition, ON and OFF populations showed different sensitivities to continuous, frequency-varying pulse trains, with OFF cells generally exhibiting more dependency on frequency changes within a sequence. Finally, the ability to maintain spiking behaviour to continuous stimulation in RGCs significantly reduced over longer stimulation durations irrespective of the frequency order.Significance.This study represents an important step in advancing and understanding the utility of continuous frequency modulation in controlling functionally distinct RGCs. Our results indicate that continuous, kHz-frequency-varying stimulation sequences provide very limited control of RGC firing patterns due to inter-dependency between adjacent frequencies and generally, different RGC types do not display different frequency preferences under such stimulation conditions. For future stimulation strategies using kHz frequencies, careful consideration must be given to design appropriate pauses in stimulation, stimulation frequency order and the length of continuous stimulation duration.

Effective Enhancement of Energy Density of Zinc-Polyiodide Flow Batteries by Organic/Penta-iodide Complexation.

Based on the ambipolar characteristics and high solubility of ZnI2, zinc-polyiodide flow batteries (ZIFB) have attracted attention as high-energy density flow batteries. However, due to the various oxidation products of iodide (I-) and the formation of iodine (I2) solid precipitates at the positive electrode, the limiting state-of-charge (SoC) of ZIFB has not been clearly defined. Herein, a clear definition of SoC in ZIFBs is given based on the thermodynamic relationship among I-(aq), I3-(aq), I5-(aq), and I2(aq) in the electrolyte. Conventional ZIFBs are limited by their maximum attainable SoC of 87%, at which the fully charged catholyte includes I-, I3-, and I5- ions at molar ratios of 49.6, 32.2, and 18.1%, respectively. Furthermore, two effective strategies to extend the maximum SoC are suggested: (1) increasing the formation constant (Keq) of I3- can raise the availability of I- for electrooxidation by suppressing I2 precipitation, and (2) promoting the production of higher-order polyiodides such as I5- can increase the oxidation state of the charged electrolyte. The addition of 5 vol % triethylene glycol (tri-EG) to the electrolyte increased Keq from 710 to 1123 L mol-1; this increase was confirmed spectrophotometrically. Tri-EG stabilized I5- ions in the form of the I5-/tri-EG complex, thereby converting the main oxidation product from I3- to I5-. The preferred electrochemical production of I5- in the tri-EG electrolyte was observed by electrochemical and computational analyses. As a result, the maximum attainable SoC was enhanced remarkably to 116%, yielding molar ratios of I-, I3-, and I5- ions of 9.1, 11.2, and 79.7%, respectively. This SoC extension effect was confirmed in the ZIFB flow cell with stable charge-discharge cycling at the SoC 120% limit, demonstrating the highest energy density, 249.9 Wh L-1, among all reported ZIFBs.

Characteristics of Staphylococcus aureus biofilm matured in tryptic soy broth, low-fat milk, or whole milk samples along with inactivation by 405 nm light combined with folic acid.

In the present study, the characteristics of Staphylococcus aureus biofilms matured in tryptic soy broth (TSB), low-fat milk, or whole milk samples were identified along with their resistance to 405 nm light with or without folic acid. Phenotypic properties of carbohydrate and protein contents in extracellular polymeric substance (EPS) of S. aureus biofilms matured in different conditions were identified. The carbohydrate content was higher in the biofilm matured in low-fat milk (1.27) than the samples matured in whole milk (0.58) and TSB (0.10). Protein content in the EPS of biofilm was higher in the sample matured in whole milk (6.59) than the samples matured in low-fat milk (3.24) and TSB (2.08). Moreover, the maturation condition had a significant effect on the membrane lipid composition of the biofilm, producing more unsaturated fatty acids in biofilm matured in milk samples. These changes in biofilm matured in milk samples increased the resistance of S. aureus to 405 nm light in the presence of folic acid (LFA). Additionally, transcriptomic analysis was conducted to identify the response of S. aureus biofilm to LFA treatment. Several genes related to DNA and protein protection from oxidative stress along with biofilm accumulation were overexpressed in the LFA-treated biofilms. These results indicate the maturation of S. aureus biofilm in various samples and the biofilms responses to bactericidal treatments.

Bacterial composition of refrigerators in households and inactivation of airborne Staphylococcus aureus using a TiO2-UVLED module in a 512 L aerobiology chamber.

This study aimed to investigate the microbiota in the air and on the surface of a refrigerator and to inactivate aerosolized Staphylococcus aureus using a TiO2-UVLED module. A total of 100 L of the air and 5000 cm2 surfaces in seven household refrigerators were collected using an air sampler and a swab, respectively. Samples were subjected to microbiota analysis as well as quantitative analyses of aerobic or anaerobic bacteria. The level of airborne aerobic bacteria was 4.26 log CFU/vol (100 L), while that of surface aerobic bacteria was 5.27 log CFU/surface (5000 cm2). PCoA based on the Bray-Curtis metric revealed that the bacterial composition differed between samples collected from refrigerators with and without a vegetable drawer. Moreover, pathogenic bacteria containing genera and order from each sample were found, such as Enterobacaterales, Pseudomonas, Staphylococcus, Listeria, and Bacillus. Among them, Staphylococcus aureus was determined to be a core hazardous pathogen in air. Therefore, three S. aureus strains isolated from the air in refrigerators, as well as a reference strain of S. aureus (ATCC 6538P), were inactivated by a TiO2-UVLED module in a 512 L aerobiology chamber. All aerosolized S. aureus were reduced over 1.6 log CFU/vol after treatment with TiO2 under UVA (365 nm) light at 40 J/cm2. These findings suggest that TiO2-UVLED modules have the potential to be used to control airborne bacteria in household refrigerators.

Mechanically resilient, alumina-reinforced carbon nanotube arrays for in-plane shock absorption in micromechanical devices.

Microelectromechanical systems (MEMS) are of considerable interest due to their compact size and low power consumption when used in modern electronics. MEMS devices intrinsically incorporate three-dimensional (3D) microstructures for their intended operations; however, these microstructures are easily broken by mechanical shocks accompanying high-magnitude transient acceleration, inducing device malfunction. Although various structural designs and materials have been proposed to overcome this limit, developing a shock absorber for easy integration into existing MEMS structures that effectively dissipates impact energy remains challenging. Here, a vertically aligned 3D nanocomposite based on ceramic-reinforced carbon nanotube (CNT) arrays is presented for in-plane shock-absorbing and energy dissipation around MEMS devices. This geometrically aligned composite consists of regionally-selective integrated CNT arrays and a subsequent atomically thick alumina layer coating, which serve as structural and reinforcing materials, respectively. The nanocomposite is integrated with the microstructure through a batch-fabrication process and remarkably improves the in-plane shock reliability of a designed movable structure over a wide acceleration range (0-12,000g). In addition, the enhanced shock reliability through the nanocomposite was experimentally verified through comparison with various control devices.

Simultaneous vacuum ultra violet-amalgam lamp radiation and near-infrared radiation heating for a synergistic bactericidal effect against Escherichia coli O157:H7 and Salmonella enterica serovar Typhimurium in black peppercorn.

This study evaluated the effect of simultaneous irradiation with vacuum ultraviolet (VUV)-amalgam lamp and near-infrared radiation (NIR) to inactivate foodborne pathogens in black peppercorn (Piper nigrum) while monitoring its piperine content and color. NIR treatment for 20 min caused an increase in black peppercorn temperature to 70 °C, and its bactericidal effect showed only 3.14 and 1.88 log reductions of Escherichia coli O157:H7 and Salmonella Typhimurium respectively. Single treatment with a VUV-amalgam lamp for 20 min achieved 2.26 and 1.55 log reductions of E. coli O157:H7 and S. Typhimurium, respectively. However, simultaneous treatment for 15 min produces a greater than 5-log reduction of both foodborne pathogens without changes of black peppercorn quality. The underlying bactericidal mechanism of the VUV-amalgam lamp is 254 nm irradiation with ozone generated by 185 nm irradiation. The ozone concentration was maintained with VUV-amalgam lamp single treatment but decreased during simultaneous treatment. In contrast, due to the drying effect of NIR irradiation, water vapor reacts with 185 nm irradiation or ozone to produce a variety of reactive oxygen species (ROS) such as hydrogen peroxide and hydroxyl radical during simultaneous treatment. The hydrogen peroxide concentration measured by Gastec increased during simultaneous treatment. We also investigated various generated types of ROS that can contribute to a synergistic bactericidal effect. We compared the bactericidal effect of sequential and simultaneous treatments with NIR and VUV-amalgam lamps to black peppercorn. Although sequential treatment showed additional inactivation efficacy, reductions of pathogens were significantly lower than with simultaneous treatment. These findings suggest that simultaneous VUV-amalgam lamp and NIR irradiation treatment via generation of ROS can increase bacterial inactivation efficacy of foodborne pathogens in black peppercorns without quality changes.

Gerstmann Syndrome as a Disconnection Syndrome: A Single Case Diffusion Tensor Imaging Study.

Gerstmann syndrome (GS) is a rare syndrome that occurs when there is a lesion of the dominant inferior parietal lobule (IPL), causing agraphia, acalculia, finger agnosia, and right-left disorientation. A 49-year-old right-handed male was diagnosed as GS after left parieto-occipital lobe hemorrhage. The patient showed mild anomic aphasia with agraphia in the language test and the neuropsychological test revealed acalculia, impaired right-left discrimination, and finger agnosia. In diffusion tensor tractography, the tracts of left superior longitudinal fasciculus (SLF), middle longitudinal fasciculus, U-fibers and posterior corpus callosum (CC) were disrupted around the left IPL. In addition, fractional anisotropy (FA) values were markedly decreased in left SLF, and posterior CC when compared to twelve healthy control subjects. Our clinical and neuroimaging findings support that GS is a disconnection syndrome caused by lesion in the white matter pathway surrounding IPL. In future, more studies of the correlation between the white matter disconnection and the development of GS including high quality imaging technique are needed.

Prediction of progression rate and fate of osteoarthritis: Comparison of machine learning algorithms.

Appropriate prediction models can assist healthcare systems in delaying or reversing osteoarthritis (OA) progression. We aimed to identify a reliable algorithm for predicting the progression rate and fate of OA based on patient-specific information. From May 2003 to 2019, 83,280 knees were collected. Age, sex, body mass index, bone mineral density, physical demands for occupation, comorbidities, and initial Kellgren-Lawrence (K-L) grade were used as variables for the prediction models. The prediction targets were divided into dichotomous groups for even distribution. We compared the performances of logistic regression (LR), random forest (RF), and extreme gradient boost (XGB) algorithms. Each algorithm had the best precision when the model used all variables. XGB showed the best results in accuracy, recall, F1 score, specificity, and error rates (progression rate/fate of OA: 0.710/0.877, 0.542/0.637, 0.637/0.758, 0.859/0.981, and 0.290/0.123, respectively). The feature importance of RF and XGB had the same order up to the top six for each prediction target. Age and initial K-L grade had the highest feature importance in RF and XGB for the progression rate and fate of OA, respectively. The XGB and RF machine learning algorithms showed better performance than conventional LR in predicting the progression rate and fate of OA. The best performance was obtained when all variables were combined using the XGB algorithm. For each algorithm, the initial K-L grade and physical demand for occupation were the greatest contributors with superior feature importance compared with the others.

Effects of storage temperature on microbiota shifts in raw milk biofilm developed on stainless steel.

This study aimed to investigate the microbiota in raw milk and the influence of storage temperature on the microbiota shift after biofilm formation. Raw milk stored at 4 °C and biofilms developed in raw milk incubated at 4 °C or 25 °C for 7 days were subjected to microbiota analysis as well as quantitative analyses of aerobic or anaerobic bacteria. The levels of aerobic bacteria increased during biofilm formation, while no significant changes were observed within anaerobic bacteria. In addition, there was a difference between aerobic and anaerobic bacterial counts in raw milk and biofilm stored for 7 days. The pattern of microbial composition differed by temperature. In addition, the genus Pseudomonas (53-71%) occupied a high proportion in raw milk, and the raw milk biofilm developed at 4 °C, while the genus Lactobacillus (75-83%) was predominant in biofilms developed at 25 °C. Intriguingly, bacterial richness was higher in raw milk on day 0 and biofilm developed at 4 °C than raw milk after 7 days of storage at 4 °C. These findings suggest that temperature critically affects the bacterial composition of both raw milk and its associated biofilm.

TiO2-based photocatalyst Generated Reactive Oxygen Species cause cell membrane disruption of Staphylococcus aureus and Escherichia coli O157:H7.

Photocatalysts, including titanium dioxide (TiO2), have attracted much attention in food safety for controlling foodborne pathogens. However, the study of the photocatalytic activity on various food-surrounding media and the factors that affect the efficacy of photocatalytic inactivation is incomplete. In this study, to inactivate foodborne pathogens in food-surrounding environments, TiO2-based photocatalysts with ultraviolet A (UVA, 365 nm) and visible light (VIS, 405 nm) were employed. Three TiO2-based photocatalysts, namely, Degussa P25 TiO2, carbon-modified KRONOClean 7000® (C-TiO2), and Pt-doped Ishihara-Sangyo MPT-623 (Pt-TiO2) inactivated Staphylococcus aureus and Escherichia coli O157:H7 exposed to UVA and VIS light in both water and air samples. Among them, Degussa P25 under UVA showed the highest bactericidal effects in both water and air treatments, which induced 5.19 log reductions in S. aureus when treated for 11.68 J/cm2, and E. coli O157:H7 was reduced by more than 6.21 log for 1.32 J/cm2 in the water sample. For air treatment, the combination of Degussa P25 and UVA achieved 3.45 and 3.28 log reductions for Staphylococcus aureus and E. coli O157:H7, respectively, in a developed laboratory-scale chamber for 1 h and 20.02 J/cm2. Scavenger assays showed that regardless of the photocatalyst and wavelength used, reactive oxygen species (ROS) generation causes cell membrane disruption of foodborne pathogens. However, the types of ROS that are generated vary among the photocatalysts and are related to different bactericidal efficacies. These results indicated that TiO2-based photocatalytic activity can be used to control microbiological hazards in various environments in the food industry.

Stress response of Salmonella Montevideo adapted to red pepper powders at various humidities and resistance to near-infrared heating.

In the present study, the stress responses of Salmonella Montevideo adapted to red pepper powder with various humidities were investigated. The resistance of S. Montevideo to near-infrared heating increased significantly when adapted to red pepper powder. Moreover, the pathogen turned to a viable but noncultureable (VBNC) state after storage in red pepper powder at 30 °C with 40 % relative humidity (RH). Therefore, transcriptomic analysis was conducted for pathogens adapted to red pepper powder at 30 °C and 40 % RH for 4 h (VBNC transformation starting point). Compared to the transcriptome from the pathogen grown in tryptic soy broth at 37 °C, a total of 1,268 differentially expressed genes (DEGs) were observed with the criteria of ΙlogFCΙ ≥ 2 and false discovery rate ≤ 0.05, including 229 upregulated and 1,039 downregulated genes. It was confirmed that heat shock protein-related genes such as dnaK and dnaJ were highly overexpressed in the pathogen adapted to red pepper powder. Moreover, genes contributing to the invasion and internalization of S. Montevideo to red pepper powder were upregulated. Finally, higher gene expression levels of the type III secretion system (ssaS, ssaL, sseG, and pipB) with lower sample humidity were observed with quantitative real-time PCR. These results indicated that genomic changes contribute to phenotypic changes, such as heat resistance changes and transformation to the VBNC state.

The combined effect of folic acid and 365-405 nm light emitting diode for inactivation of foodborne pathogens and its bactericidal mechanisms.

The inactivation of Escherichia coli O157:H7 ATCC 35150 and methicillin-resistant S. aureus ATCC 33591 by a light emitting diode (LED) was investigated in the present study. Various wavelengths of LEDs (365, 385, and 405 nm) were used individually or combined with folic acid (LEDF), and inactivation curves were analyzed using the Weibull model to compare the bactericidal effects. Reduction levels of pathogens by combination treatment of LED and 100 µM folic acid were significantly higher than those by individual LED treatment for the wavelength used in this study. It was confirmed that the reactive oxygen species produced by folic acid degradation accelerated the bactericidal effect of LEDs. When applied in apple juice, the same trend was observed by 405 nm treatment, although the inactivation rates were higher than those of buffer due to the low pH of apple juice. Moreover, injured cells were not observed except 30 J/cm2 LED, LEDF and 36 J/cm2 LEDF treatments. Mode of inactivation by LEDF was suggested as DNA damage along with membrane damages. Moreover, it was validated that genes related to antimicrobial resistance would be mutated by LEDF treatment. Therefore, LEDF can be used effectively to control foodborne pathogens in apple juice.

Magnetic stimulation allows focal activation of the mouse cochlea.

Cochlear implants (CIs) provide sound and speech sensations for patients with severe to profound hearing loss by electrically stimulating the auditory nerve. While most CI users achieve some degree of open set word recognition under quiet conditions, hearing that utilizes complex neural coding (e.g., appreciating music) has proved elusive, probably because of the inability of CIs to create narrow regions of spectral activation. Several novel approaches have recently shown promise for improving spatial selectivity, but substantial design differences from conventional CIs will necessitate much additional safety and efficacy testing before clinical viability is established. Outside the cochlea, magnetic stimulation from small coils (micro-coils) has been shown to confine activation more narrowly than that from conventional microelectrodes, raising the possibility that coil-based stimulation of the cochlea could improve the spectral resolution of CIs. To explore this, we delivered magnetic stimulation from micro-coils to multiple locations of the cochlea and measured the spread of activation utilizing a multielectrode array inserted into the inferior colliculus; responses to magnetic stimulation were compared to analogous experiments with conventional microelectrodes as well as to responses when presenting auditory monotones. Encouragingly, the extent of activation with micro-coils was ~60% narrower compared to electric stimulation and largely similar to the spread arising from acoustic stimulation. The dynamic range of coils was more than three times larger than that of electrodes, further supporting a smaller spread of activation. While much additional testing is required, these results support the notion that magnetic micro-coil CIs can produce a larger number of independent spectral channels and may therefore improve auditory outcomes. Further, because coil-based devices are structurally similar to existing CIs, fewer impediments to clinical translational are likely to arise.

Market weight, slaughter age, and yield grade to determine economic carcass traits and primal cuts yield of Hanwoo beef.

This study was conducted to evaluate the relationship among market weight, slaughter age, yield grade, and primal cut yield in Hanwoo. A total of 403 Hanwoo (Korean native cattle) was assessed for carcass traits such as carcass cold weight, backfat thickness, ribeye area, dressing percentage, yield index, and marbling score. The production yield of the individual major primal cuts of Hanwoo beef was also measured. Carcass cold weight, ribeye area, and backfat thickness, which affect meat quality increased with increased market weight (p < 0.05). The production yield of the ten major primal cuts also increased with increased market weight (p < 0.05). In terms of slaughter age, carcass cold weight, ribeye area, and backfat thickness all increased from 25 months to 28-29 months, and the production yield of all prime cuts also increased with increasing slaughter age. According to the meat yield grade, carcass cold weight and backfat thickness increased from grade A to grade C, although the ribeye area was not affected. The combined findings of the study suggest that slaughtering Hanwoo at the weight of 651-700 kg and 701-750 and age of 28.23 and 29.83 months could be desirable to achieve the best quality and quantity grade of Hanwoo beef. However, the positive correlation of carcass cold weight and backfat thickness, and the negative correlation of the yield index according to primal cuts yield indicated that it is necessary to couple the slaughtering management of cattle with improved genetic and breeding method of Hanwoo to increase the production yield of the major prime cuts of Hanwoo beef.

Tumour-infiltrating bystander CD8+ T cells activated by IL-15 contribute to tumour control in non-small cell lung cancer.

BACKGROUND: Tumour-unrelated, virus-specific bystander CD8+ T cells were recently shown to be abundant among tumour-infiltrating lymphocytes (TILs). However, their roles in tumour immunity have not been elucidated yet. METHODS: We studied the characteristics of bystander CD8+ TILs from non-small cell lung cancer (NSCLC) tissues (N=66) and their activation by interleukin (IL)-15 to repurpose them for tumour immunotherapy. RESULTS: We show that bystander CD8+ TILs specific to various viruses are present in human NSCLC tissues. We stimulated CD8+ TILs ex vivo using IL-15 without cognate antigens and found that IL-15 treatment upregulated NKG2D expression on CD8+ TILs, resulting in NKG2D-dependent production of interferon (IFN)-γ (p=0.0006). Finally, we tested whether IL-15 treatment can control tumour growth in a murine NSCLC model with or without a history of murine cytomegalovirus (MCMV) infection. IL-15 treatment reduced the number of tumour nodules in the lung only in mice with MCMV infection (p=0.0037). We confirmed that MCMV-specific bystander CD8+ TILs produced interferon (IFN)-γ after IL-15 treatment, and that IL-15 treatment in MCMV-infected mice upregulated tumour necrosis factor-α and IFN-γ responsive genes in tumour microenvironment. CONCLUSION: Thus, the study demonstrates that bystander CD8+ TILs can be repurposed by IL-15 for tumour immunotherapy.

Effect of Isolated Medial Patellofemoral Ligament Reconstruction in Patellofemoral Instability Regardless of Predisposing Factors.

The purpose of this study was to evaluate the outcomes of isolated medial patellofemoral ligament (MPFL) reconstruction, regardless of the presence of predisposing factors. A total of 21 knees that underwent isolated MPFL reconstruction from March 2014 to August 2017 were included in this retrospective series. Radiographs of the series of the knee at flexion angles of 20, 40, and 60 degrees were acquired. The patellar position was evaluated using the patellar tilt angle, sulcus angle, congruence angle (CA), and Caton-Deschamps and Blackburne-Peel ratios. To evaluate the clinical outcome, the preoperative and postoperative International Knee Documentation Committee (IKDC) and Lysholm knee scoring scales were analyzed. To evaluate the postoperative outcomes based on the predisposing factors, the results were separately analyzed for each group. Regarding radiologic outcomes, 20-degree CA was significantly reduced from 10.37 ± 5.96° preoperatively to -0.94 ± 4.11° postoperatively (p = 0.001). In addition, regardless of the predisposing factors, delta values of pre- and postoperation of 20-degree CA were not significantly different in both groups. The IKDC score improved from 53.71 (range: 18-74) preoperatively to 94.71 (range: 86-100) at the last follow-up (p = 0.004), and the Lysholm score improved from 54.28 (range: 10-81) preoperatively to 94.14 (range: 86-100) at the last follow-up (p = 0.010). Isolated MPFL reconstruction provides a safe and effective treatment for patellofemoral instability, even in the presence of mild predisposing factors, such as trochlear dysplasia, increased patella height, increased TT-TG distance, or valgus alignment. This is a Level 4, case series study.

Comparison of the Radiologic, Morphometric, and Clinical Outcomes between Kinematically and Mechanically Aligned Total Knee Arthroplasty: A Propensity Matching Study.

The purpose of this study was to compare radiologic, morphometric, and clinical outcomes between kinematically aligned (KA) and mechanically aligned (MA) total knee arthroplasty (TKA) in Korean patients. Overall, 168 patients who underwent primary TKA were retrospectively reviewed, and propensity matching (age, sex, and body mass index) was performed as 1:3 ration (KA TKAs [n = 42]: MA TKAs [n = 126]). Joint-line orientation angle (JLOA), coronal and axial alignments of implants, hip-knee-ankle (HKA) angle, and patellar tilt angle were assessed using full-length standing radiograph, axial computed tomography (CT) scan, and plain radiographs. Morphometric assessment was performed by analyzing the intraoperative measurement of the femoral cut surface and femoral components fitting in five zones. Clinical outcomes more than 2 years of follow-up were evaluated with the Knee Society (KS) knee and functional scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and the Short-Form Health Survey (SF-36). In radiologic results, JLOA was more parallel to the floor in KA TKAs (KA: medial tilt 0.9 ± 1.5 degrees; MA: lateral tilt 1.7 ± 1.5 degrees, p < 0.05), and patellar tilt angle was closer to preoperative status after KA TKA (KA: 2.0 ± 1.6 degrees; MA;0.3 ± 1.2 degrees, p < 0.05). HKA angle and rotational mismatch were similar between two groups. In morphometric analysis, entire overhang of anterior femoral cutting surface was reduced in KA TKA compared with MA TKA (KA: 11.7 ± 6.2 mm; MA: 14.4 ± 5.9 mm, p < 0.05). However, both of MA and KA TKAs showed underhang in mediolateral dimension without difference. There were no significant differences in clinical scores between two groups. KA TKA showed more parallel JLOA to floor, closer patellar tilt to preoperative status, and better anterior flange fitting that can reproduce more natural knee kinematics compared with MA TKA. Although clinical outcomes assessed by conventional evaluating tools were similar between two groups, further evaluation focusing on the patellofemoral symptoms or unawareness of TKA is necessary to clarify the clinical benefit of KA TKA.

The Relationship Between Visuoconstructive Abilities and Language Performance in Patients With Aphasia After Stroke.

This study aimed to investigate the visuoconstructive abilities and the relationship between visuoconstructive function and language performance in aphasic patients. Right-handed 24 aphasic patients (males 14, females 10) with at least 3 months post-stroke and 32 age-matched healthy controls participated in this study. Visuoconstructive function was assessed by 3 levels of task difficulty: simple (drawing objects), intermediate (clock drawing), and complex (copy subtest of Rey complex figure test and block construction). Aphasic patients were divided into 3 sub-groups (mild, moderate to severe, and very severe group) according to severity of aphasia and compared with the control group, respectively. We analyzed the relation all levels of visuoconstructive tasks to aphasia quotient (AQ) and sub-domain scores of K-WAB. Moderate to severe aphasia group demonstrated no significant differences in scores of simple drawing objects compared to controls, but clock drawing, Rey complex figure copy and block design showed significantly decreased scores. Very severe group showed significantly lower scores in all levels of visuoconstructive tasks than the control. Correlation between all levels of visuoconstructive tasks except drawing objects and AQ were found to be statistically significant. Among the tasks, the clock drawing test revealed the highest correlation with language performance. Visuoconstructive abilities varied according to the severity of aphasia and the level of visuoconstructive tasks. Therefore, a thorough individual assessment of visuoconstructive function is needed to plan and predict the treatment and prognosis of aphasia and the clock drawing test may be a useful screening tool to evaluate this function.