Early and Delayed Postoperative Rehabilitation after Arthroscopic Rotator Cuff Repair: A Comparative Study of Clinical Outcomes.

BACKGROUND: The duration of immobilization after arthroscopic rotator cuff repair and the optimal time to commence rehabilitation are still the subject of ongoing debates. This study was undertaken to evaluate the functional outcome and rotator cuff healing status after arthroscopic rotator cuff repair by comparing early and delayed rehabilitation. METHODS: Totally, 76 patients with small, medium, and large sized rotator cuff tears underwent arthroscopic repair using the suture-bridge technique. In early rehabilitation group, 38 patients commenced passive range of motion at postoperative day 2 whereas 38 patients assigned to the delayed rehabilitation group commenced passive range of motion at postoperative week 3. At the end of the study period, clinical and functional evaluations (Constant score, the University of California, Los Angeles [UCLA] shoulder score) were carried out, subsequent to measuring the range of motion, visual analogue scale for pain, and isokinetic dynamometer test. Rotator cuff healing was confirmed by magnetic resonance imaging at least 6 months after surgery. RESULTS: No significant difference was obtained in range of motion and visual analogue scale between both groups. Functional outcomes showed similar improvements in the Constant score (early: 67.0-88.0; delayed: 66.9-91.0; p<0.001) and the UCLA shoulder score (early: 20.3-32.3; delayed: 20.4-32.4; p<0.001). Furthermore, rotator cuff healing showed no significant differences between the groups (range, 6-15 months; average, 10.4 months). CONCLUSIONS: Delayed passive rehabilitation does not bring about superior outcomes. Therefore, early rehabilitation would be useful to help patients resume their daily lives.

Radix Polygalae Extract Attenuates PTSD-like Symptoms in a Mouse Model of Single Prolonged Stress and Conditioned Fear Possibly by Reversing BAG1.

Radix Polygalae (RP) has been used to relieve psychological stress in traditional oriental medicine. Recently, cell protective, antiamnestic and antidepressant-like effects were disclosed but the possible application of RP to post-traumatic stress disorder, in which exaggerated fear memory persists, has not yet been explored. For this purpose, the effects of RP on fear behavior was examined in a mouse model of single prolonged stress and conditioned fear (SPS-CF), previously shown to mimic key symptoms of post-traumatic stress disorder. Male mice received daily oral dose of RP extract or vehicle during the SPS-CF procedure. Then fear-related memory (cohort 1, n=25), non-fear-related memory (cohort 2, n=38) and concentration-dependent effects of RP on fear memory (cohort 3, n=41) were measured in 3 separate cohort of animals. Also working memory and anxiety-like behaviors were measured in cohort 1. RP-treated SPS-CF mice exhibited attenuated contextual but not cued freezing and no impairments in the working memory and spatial reference memory performances relative to vehicle-treated SPS-CF controls. RP-treated SPS-CF and naive mice also demonstrated no difference in anxiety-like behavior levels relative to vehicle-treated SPS-CF and naive controls, respectively. In the hippocampus of SPS-CF mice, expression of BAG1, which regulates the activity of GR, was decreased, whereas RP increased expression of BAG1 in naïve and SPS-CF mice. These results suggest that RP exerts some symptomatic relief in a mouse with exaggerated fear response. RP and its molecular components may thus constitute valuable research targets in the development of novel therapeutics for stress-related psychological disorders.

Endosomal acidic pH-induced conformational changes of a cytosol-penetrating antibody mediate endosomal escape.

Endosomal escape after endocytosis is a critical step for protein-based agents to exhibit their effects in the cytosol of cells. However, antibodies internalized into cells by endocytosis cannot reach the cytosol due to their inability to escape from endosomes. Here, we report a unique endosomal escape mechanism of the IgG-format TMab4 antibody, which can reach the cytosol of living cells after internalization. Dissociation of TMab4 from its cell surface receptor heparan sulfate proteoglycan by activated heparanase in acidified early endosomes and then local structural changes of the endosomal escape motif of TMab4 in response to the acidified endosomal pH were critical for the formation of membrane pores through which TMab4 escaped into the cytosol. Identification of structural determinants of endosomal escape led us to generate a TMab4 variant with ~3-fold improved endosomal escape efficiency. Our finding of the endosomal escape mechanism of the cytosol-penetrating antibody and its improvement will establish a platform technology that enables a full-length IgG antibody to directly target cytosolic proteins.

A general strategy for generating intact, full-length IgG antibodies that penetrate into the cytosol of living cells.

Full-length IgG antibodies cannot cross cell membranes of living cells; this limits their use for direct targeting of cytosolic proteins. Here, we describe a general strategy for the generation of intact, full-length IgG antibodies, herein called cytotransmabs, which internalize into living cells and localize in the cytosol. We first generated a humanized light chain variable domain (VL) that could penetrate into the cytosol of living cells and was engineered for association with various subtypes of human heavy chain variable domains (VHs). When light chains with humanized VL were co-expressed with 3 heavy chains (HCs), including 2 HCs of the clinically approved adalimumab (Humira®) and bevacizumab (Avastin®), all 3 purified IgG antibodies were internalized into the cytoplasm of living cells. Cytotransmabs primarily internalized into living cells by the clathrin-mediated endocytic pathway through interactions with heparin sulfate proteoglycan that was expressed on the cell surface. The cytotransmabs escaped into the cytosol from early endosomes without being further transported into other cellular compartments, like the lysosomes, endoplasmic reticulum, Golgi apparatus, and nucleus. Furthermore, we generated a cytotransmab that co-localized with the targeted cytosolic protein when it was incubated with living cells, demonstrating that the cytotransmab can directly target cytosolic proteins. Internalized cytotransmabs did not show any noticeable cytotoxicity and remained in the cytosol for more than 6 h before being degraded by proteosomes. These results suggest that cytotransmabs, which efficiently enter living cells and reach the cytosolic space, will find widespread uses as research, diagnostic, and therapeutic agents.

Imidazolium-salt-functionalized ionic-CNT-supported Ru-carbene/palladium nanoparticles for recyclable tandem metathesis/hydrogenation reactions in ionic liquids.

NP and tuck: Two different catalysts, a Ru-carbene complex and palladium nanoparticles, were immobilized onto the same imidazolium-salt-functionalized ionic CNTs. These supported dual-function catalysts showed excellent catalytic activity in tandem metathesis/hydrogenation reactions in an ionic liquid and could be recovered and reused four times. RCM = ring-closing metathesis.

Insight into the origin of the positive effects of imidazolium salt on electrocatalytic activity: ionic carbon nanotubes as metal-free electrocatalysts for oxygen reduction reaction.

We report remarkable metal-free electrocatalytic activities of the imidazolium salt-functionalized ionic multi-walled carbon nanotubes (IM-f-MWCNTs) in the oxygen reduction reaction (ORR). The electrocatalytic activity can be attributed to the induced polarization of the π-electrons of CNTs, thus accelerating interfacial electron transfer. The zwitterionic MWCNTs functionalized with poly(vinylimidazolium sulfonate) have a more positive surface charge and exhibit a better electrocatalytic activity than the poly(vinylbutylimidazolium chloride)-functionalized MWCNTs. The IM-f-MWCNTs showed better fuel selectivity than the commercial Pt/C electrocatalyst.

High-density assembly of gold nanoparticles with zwitterionic carbon nanotubes and their electrocatalytic activity in oxygen reduction reaction.

Gold nanoparticles (AuNPs) were assembled with high density onto multi-walled carbon nanotubes, which were functionalized with zwitterionic poly(imidazoliumsulfonate). The AuNP/zwitterionic CNT hybrids exhibited decent electrocatalytic activity in oxygen reduction reaction as the AuNP-based catalysts.

Impact of anions on electrocatalytic activity in palladium nanoparticles supported on ionic liquid-carbon nanotube hybrids for the oxygen reduction reaction.

A series of palladium nanoparticles supported on carbon nanotubes (CNTs), which were functionalized covalently with imidazolium polymer salts with different anions, Pd/polyIL(X)-CNTs (IL=ionic liquid; X=Cl, Br, I, ClO(4), BF(4), PF(6)), were prepared to investigate the influence of imidazolim salt anions on electrocatalytic activity in the oxygen reduction reaction (ORR). The anions of the imidazolium moiety significantly impacted on the ORR kinetics in a 0.1 M solution of HClO(4). The electronically active surface area results are in good agreement with the order of the ORR kinetic activity of the supported Pd/polyIL(X)-CNTs (X: Cl>ClO(4)>BF(4)>Br≈PF(6)≫I). In contrast, owing to the facile anion exchange of halide anions with hydroxide anions, anion-dependent catalytic activity has not been observed in 0.1 M NaOH. Iterative ORR experiments in acid-base solutions demonstrated anion exchange on the electrode. These results indicate that subtly varied structures of the IL moiety profoundly influence the performance of IL-CNT hybrid materials and molecular-level control of interfacial interactions between the support material, catalysts, and electrolytes is important in the design of supported metal nanoparticle catalysts for fuel cells.

Toward understanding the origin of positive effects of ionic liquids on catalysis: formation of more reactive catalysts and stabilization of reactive intermediates and transition states in ionic liquids.

Over the past decade, ionic liquids have received a great deal of attention as a new means for catalyst immobilization. Large numbers of catalysts having polar or ionic character have been successfully immobilized in ionic liquids, thus allowing their recovery and recycling. However, catalyst immobilization is not the only benefit of ionic liquids in catalysis, of greater importance are the positive effects of ionic liquids on catalytic rates. In this Account, we highlight our work in elucidating the origin of the accelerating effects of ionic liquids in a range of catalytic reactions. Lewis acidic metal triflates often become much more reactive in ionic liquids containing noncoordinating anions as a result of "anion exchange." Consequently, the more electrophilic Lewis acidic species generated in situ accelerate the catalytic reactions dramatically. In some cases, highly reactive intermediates, such as vinyl cations, arenium cations, oxygen radical anions, and so forth, can be stabilized in the presence of ionic liquids, thus increasing the reactivity and selectivity of the reactions. Concerted processes such as S(N)2 and Diels-Alder reactions can also be accelerated through the cooperative activation of both the nucleophile and the electrophile by ionic liquids. In transition metal-catalyzed reactions, certain catalytically active oxidation states can be stabilized in ionic liquids against deactivation to catalytically inactive species. Thus it is clear that gaining an understanding of the origin of these "positive ionic liquid effects" is highly important, not only for predicting the effects of ionic liquids on other organic reactions but also for designing new catalytic reactions. Ionic liquids, by virtue of (typically) having a synthetically accessible carbon backbone, are amenable to tailoring by the organic chemist. Accordingly, their molecular structures can be subtly varied to give "tunable" properties, which can then be used to rationally examine the fundamental reasons that they accelerate catalyzed reactions. Although the origins of enhanced catalytic rates by ionic liquids have been elucidated in many areas, other undiscovered ionic liquid phenomena remain to be unearthed. Developing a better understanding of these modularly tunable liquid salts will foster new discoveries of catalytic reactions that are accelerated by ionic liquids as solvents or additives.

Palladium nanoparticles supported onto ionic carbon nanotubes as robust recyclable catalysts in an ionic liquid.

Palladium nanoparticles have been deposited onto imidazolium bromide-functionalized ionic MWCNTs through hydrogen reduction of Na2PdCl4 in water without aid of surfactants under extremely mild conditions, and combined with an ionic liquid to create a new recyclable ionic liquid-based catalytic system allowing up to 50 times recycling.

Palladium nanoparticles captured onto spherical silica particles using a urea cross-linked imidazolium molecular band.

Palladium nanoparticles were captured onto spherical silica particles using a molecular band composed of imidazolium chloride and urea moieties to form raspberry-like Pd@SiO2 composites, which can be recovered and reused without any loss of catalytic activity in Suzuki-Miyaura coupling.