The effects of microRNA on the absorption, distribution, metabolism and excretion of drugs

The importance of genetic factors (e.g. sequence variation) in the absorption, distribution, metabolism, excretion (ADME) and overall efficacy of therapeutic agents is well established. Our ability to identify, interpret and utilize these factors is the subject of much clinical investigation and therapeutic development. However, drug ADME and efficacy are also heavily influenced by epigenetic factors such as DNA/histone methylation and non-coding RNAs [especially microRNAs (miRNAs)]. Results from studies using tools, such as in silico miRNA target prediction, in vitro functional assays, nucleic acid profiling/sequencing and high-throughput proteomics, are rapidly expanding our knowledge of these factors and their effects on drug metabolism. Although these studies reveal a complex regulation of drug ADME, an increased understanding of the molecular interplay between the genome, epigenome and transcriptome has the potential to provide practically useful strategies to facilitate drug development, optimize therapeutic efficacy, circumvent adverse effects, yield novel diagnostics and ultimately become an integral component of personalized medicine.

Effects of Palonosetron on Perioperative Cardiovascular Complications in Patients Undergoing Noncardiac Surgery With General Anesthesia: A Retrospective Cohort Study

We retrospectively investigated whether palonosetron administered during the induction of general anesthesia is associated with an increased risk of perioperative cardiovascular complications in a single tertiary center cohort consisting of 4,517 palonosetron-exposed patients and 4,517 propensity score-matched patients without palonosetron exposure. The primary endpoint was a composite of perioperative cardiovascular complications, including intraoperative cardiac arrhythmia, intraoperative cardiac death, and myocardial injury within the first postoperative week, and there was no significant difference between the groups (odds ratio [OR] = 1.04; 95% confidence interval [CI] = 0.92-1.19). As secondary endpoints, intraoperative cardioversion, cardiac compression, use of cardiovascular drugs, postoperative hospital stay, and in-hospital mortality showed no differences between the groups. However, the palonosetron group showed decreased intraoperative hypotension (OR = 0.88; 95% CI = 0.79-0.97) and length of postoperative intensive care unit (ICU) stay (4.26 ± 9.86 vs. 6.14 ± 16.75; P = 0.026). Palonosetron did not increase the rate of perioperative cardiovascular complications, and can therefore be used safely during anesthetic induction.

Changes of knee joint and ankle joint orientations after high tibial osteotomy

OBJECTIVE

We sought to determine (1) whether change in the tibial plateau inclination (TPI) after high tibial osteotomy (HTO) is different from change in the knee joint line orientation (KJLO) relative to the ground; (2) whether, in varus knee OA patients before and after HTO, these radiographic measures are different from those in normal control; and (3) whether the postoperative values of the TPI and KJLO relative to the ground are associated with short term clinical outcome scores after HTO.

DESIGN

Fifty patients who underwent HTO and 75 normal controls were assessed with four radiographic measures. We compared the measures before HTO with those after HTO and with those of the normal controls, then examined associations between the postoperative radiographic measures and clinical outcome scores 1-year after HTO.

RESULTS

After HTO, TPI increased 9.0°, whereas KJLO relative to the ground only increased 4.1°, with a compensatory change of the ankle joint line orientation. However, the postoperative KJLO relative to the ground in the HTO group was significantly different from that of the normal controls (mean difference, 4.9°; P < 0.001). In the multiple regression analyses, the postoperative radiographic measures were not associated with outcome clinical scores 1 year after HTO.

CONCLUSION

After HTO the relative KJLO changed significantly less than did the anatomical geometry of the proximal tibia. Although the KJLO after the HTO was still significantly different from that of normal knees, its value did not adversely affect clinical outcome scores 1 year after HTO.

Coherent quasiparticles with a small fermi surface in lightly doped Sr(3)Ir(2)O(7)

We characterize the electron doping evolution of (Sr_{1-x}La_{x})_{3}Ir_{2}O_{7} by means of angle-resolved photoemission. Concomitant with the metal insulator transition around x≈0.05 we find the emergence of coherent quasiparticle states forming a closed small Fermi surface of volume 3x/2, where x is the independently measured La concentration. The quasiparticle weight Z remains large along the entire Fermi surface, consistent with the moderate renormalization of the low-energy dispersion, and no pseudogap is observed. This indicates a conventional, weakly correlated Fermi liquid state with a momentum independent residue Z≈0.5 in lightly doped Sr_{3}Ir_{2}O_{7}.

The role of melanogenesis in regulation of melanoma behavior: melanogenesis leads to stimulation of HIF-1α expression and HIF-dependent attendant pathways

To study the effect of melanogenesis on HIF-1α expression and attendant pathways, we used stable human and hamster melanoma cell lines in which the amelanotic vs. melanotic phenotypes are dependent upon the concentration of melanogenesis precursors in the culture media. The induction of melanin pigmentation led to significant up-regulation of HIF-1α, but not HIF-2α, protein in melanized cells for both lines. Similar upregulation of nuclear HIF-1α was observed in excisions of advanced melanotic vs. amelanotic melanomas. In cultured cells, melanogenesis also significantly stimulated expression of classical HIF-1-dependent target genes involved in angiogenesis and cellular metabolism, including glucose metabolism and stimulation of activity of key enzymes in the glycolytic pathway. Several other stress related genes containing putative HRE consensus sites were also upregulated by melanogenesis, concurrently with modulation of expression of HIF-1-independent genes encoding for steroidogenic enzymes, cytokines and growth factors. Immunohistochemical studies using a large panel of pigmented lesions revealed that higher levels of HIF-1α and GLUT-1 were detected in advanced melanomas in comparison to melanocytic nevi or thin melanomas localized to the skin. However, the effects on overall or disease free survival in melanoma patients were modest or absent for GLUT-1 or for HIF-1α, respectively. In conclusion, induction of the melanogenic pathway leads to robust upregulation of HIF-1-dependent and independent pathways in cultured melanoma cells, suggesting a key role for melanogenesis in regulation of cellular metabolism.

Control of a two-dimensional electron gas on SrTiO₃(111) by atomic oxygen

We report on the formation of a two-dimensional electron gas (2DEG) at the bare surface of (111) oriented SrTiO3. Angle resolved photoemission experiments reveal highly itinerant carriers with a sixfold symmetric Fermi surface and strongly anisotropic effective masses. The electronic structure of the 2DEG is in good agreement with self-consistent tight-binding supercell calculations that incorporate a confinement potential due to surface band bending. We further demonstrate that alternate exposure of the surface to ultraviolet light and atomic oxygen allows tuning of the carrier density and the complete suppression of the 2DEG.

Determination of SK3497 in rat plasma and its application in a pharmacokinetic study of SK3497

In this study, a sensitive and reliable method for the quantitation of SK3497 in rat plasma was developed and validated using high performance liquid chromatography. The plasma samples were prepared by deproteinization, and sildenafil was used as an internal standard. Chromatographic separation was achieved using a reversed-phase (C18) column. The mobile phase, 0.02 M ammonium acetate buffer:acetonitrile (45:55, v/v), was run at a flow rate of 1.0 mL/min, and the column eluent was monitored using an ultraviolet detector at 254 nm at room temperature. The retention times of sildenafil (an internal standard), and SK3497 were approximately 5.6 and 8.3 min, respectively. The detection limit of SK3497 in rat plasma was 0.03 μg/mL. Pharmacokinetic parameters of SK3497 was evaluated after intravenous (i. v.; at doses of 15 mg/kg) and oral (p.o.; at doses of 30 mg/kg) administration of SK3497 in rats. After p.o. administration (30 mg/kg) of SK3497, F-value was approximately 53.0%. The protein binding of SK3497 to 4% human serum albumin were also described.

Relationship between early postoperative C-reactive protein elevation and long-term postoperative major adverse cardiovascular and cerebral events in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study

BACKGROUND

Inflammation plays a key role in the pathogenesis of vascular occlusive diseases, such as myocardial infarction and stroke. Additionally, these conditions are predicted by C-reactive protein (CRP), a general inflammation marker. We hypothesized that the inflammation induced by surgery itself augments vascular occlusive disease. We retrospectively evaluated the relationship between postoperative CRP elevation and postoperative major adverse cardiovascular and cerebral events (MACCE) in patients undergoing off-pump coronary artery bypass surgery (OPCAB).

METHODS

The electronic medical records of 1046 patients who underwent OPCAB were reviewed retrospectively. The relationship between postoperative serum CRP and long-term postoperative MACCE (median follow-up 28 months) was investigated.

RESULTS

Patients were divided into quartiles according to maximum postoperative CRP levels (<18, 18-22, 22-27, ≥27 mg dl(-1)). The adjusted hazard ratios (HRs) were 2.15, 2.45, and 2.81, respectively (P=0.004), compared with the lowest quartile (<18 mg dl(-1)). In the multivariate analysis, the postoperative CRP quartile (HR 2.81; P=0.004), postoperative non-use of statins (HR 1.86; P=0.003), and postoperative maximum troponin I (HR 1.02; P<0.001) independently predicted postoperative MACCE, while preoperative CRP did not (P=0.203). Several parameters were correlated with postoperative maximum CRP level: body temperature (P=0.001) and heart rate (P<0.001) at the end of surgery; intraoperative last lactate (P<0.001) and base excess (P<0.001); and red blood cell transfusion (P=0.019).

CONCLUSIONS

Postoperative CRP elevation was associated with long-term postoperative MACCE in OPCAB patients. This was mitigated by postoperative statin medication. Furthermore, postoperative CRP elevation was associated with intraoperative parameters reflecting hypoperfusion and inflammation.

Osteophyte excision without cyst excision for a mucous cyst of the finger

Osteophyte excision is a mainstay of treatment for mucous cyst combined with Heberden's node in a distal interphalangeal joint or in an interphalangeal joint of the thumb. The aim of this study was to evaluate the results of osteophyte excision without cyst excision for the treatment of a mucous cyst combined with Heberden's node. The medical records of 37 patients (42 cases) with a mucous cyst with Heberden's node were retrospectively reviewed. Thirty-eight of 40 cases with available pre-operative simple radiographs showed evidence of joint arthrosis. A T-shaped skin incision of the joint capsule between the extensor tendon and lateral collateral ligament was used. Osteophyte excision without cyst excision was performed. All cysts, except one, regressed without recurrence or a skin complication after osteophyte excision, but eight cases showed post-operative pain and loss of range of motion. Osteophyte excision without cyst excision may be a good treatment choice for mucous cyst of the finger.

Asian venous thromboembolism guidelines: prevention of venous thromboembolism

Venous thromboembolism (VTE) prophylaxis is under-utilized in Asia because of the misconception that its incidence is lower in Asians as compared to the Caucasians. The available data on VTE in Asia is limited due to the lack of well-designed multicenter randomized controlled trials as well as non-standardized research designs, making data comparison difficult. Emerging data indicates that the VTE incidence is not low in Asia, and is comparable to that reported in the Western literature in some instances. There is also a trend towards increasing incidence of VTE, as demonstrated by a number of hospital-based studies in Asia. This could be attributed to lifestyle changes, ageing population, increasing awareness of VTE and wider availability of Duplex ultrasound. The risk of VTE in hospitalized patients remain the same in Asians and Caucasians, even though there may be factors that are inherent to patients in Asia that influence the slight variation in incidence. The utilization rate of VTE prophylaxis remains suboptimal in Asia. The Asian Venous Thrombosis Forum (AVTF) comprises participants from various countries such as China, Hong Kong, India, Indonesia, Korea, Malaysia, Philippines, Singapore, Taiwan, Thailand and experts from Australia and Europe. The forum evaluated the available data on VTE from the Asian region and formulated guidelines tailored to meet the needs of the region. We recommend that serious considerations are given to VTE prophylaxis especially in the at-risk group and a formal hospital policy be established to facilitate the implementation. On admission to the hospital, we recommend assessing the patients for both VTE and bleeding risk. We recommend mechanical prophylaxis for patients at increased risk of bleeding and utilizing it as an adjunctive measure in combination with pharmacological prophylaxis in patients with high risk of VTE. For patients undergoing general or gynecological surgery and with moderate risk for VTE, we recommend prophylaxis with one of the following: low dose unfractionated heparin (LDUH), low molecular weight heparin (LMWH), fondaparinux or intermittent pneumatic compression (IPC). For the same group of patients at high risk of VTE, we recommend pharmacological or combination of pharmacological and mechanical prophylaxis. For patients undergoing major orthopedic surgeries like total hip replacement, total knee replacement and proximal hip fracture surgery, we recommend using one of the following: LMWH, fondaparinux, rivaroxaban, apixaban, edoxaban, dabigatran, warfarin or aspirin with IPC. For patients admitted to the hospital with acute medical illness and has moderate risk of VTE, we recommend prophylaxis with LDUH, LMWH or Fondaparinux. For the same group at high risk of VTE, we recommend combination of pharmacological and mechanical prophylaxis.

Comparison of the predictive power of the LODS and APACHE II scoring systems in a neurological intensive care unit

OBJECTIVE

A prospective study to compare the power of the Logistic Organ Dysfunction System (LODS) and the Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring systems to predict survival, in patients admitted to the neurological intensive care unit (NICU).

METHODS

Clinical data from 521 consecutive NICU patients were collected during the first 24 h of admission and were used to compare the predictive power of both scoring systems.

RESULTS

The observed mortality rate was 10.0% compared with predicted mortality rates of 7.2% and 4.8% according to LODS and APACHE II, respectively. Both scoring systems had excellent discrimination but LODS had superior calibration.

CONCLUSION

The LODS scoring system was more stable than the APACHE II scoring system in the NICU setting.

Effects of 12 weeks of aerobic exercise on body composition and vascular compliance in obese boys

AIM

This study tested the hypothesis that 12 weeks of air board exercise would enhance cardiorespiratory fitness and vascular compliance and reduce % body fat in obese Korean boys.

METHODS

Twenty-two obese boys (>30% body fat) were studied. They were divided into 2 groups- an aerobic exercise group (N.=12), which trained 3 days/week, 50 min/day for 12 weeks, and a control group (N.=10). Control subjects only performed activities involved in their physical education classes. Body composition, cardiovascular fitness (20 m multistage endurance test performance) and vascular compliance were assessed before and after the completion of exercise training.

RESULTS

The % changes in body fat (-4.6±0.9 vs. -1.5±1.0%), fat mass (-5.4±1.5 vs. -0.1±1.6%) and performance on the cardiovascular fitness test (14.3±2.5 vs. 3.7±1.6%) were greater in the exercise group than in the controls Compared to controls, % increases in vascular compliance were greater in the arms and legs of the exercise group (left arm: 2.8±0.5 vs. 2.0±2.9%; left leg: 2.6±1.2 vs. -0.5±2.0%; right arm: 2.9±0.9 vs. 0.3±2.9%; right leg: 4.8±1.8 vs. 1.5±2.0%).

CONCLUSION

Results suggest that exercise training can reduce % body fat and enhance vascular compliance in obese male adolescents; changes that may reduce the risk for later development of cardiovascular disease.

Comparative protein binding of taxotere and SID530, a new docetaxel formulation with hydroxypropyl-beta-cyclodextrin, in human plasma in vitro

The purpose of this study was to evaluate the plasma-protein binding of docetaxel in two different formulations, Taxotere and SID530, a new docetaxel formulation with hydroxypropyl-beta-cyclodextrin (HP-beta-CD), in human plasma in vitro, using equilibrium dialysis. Unbound docetaxel concentration in the human plasma was determined by LC-MS/MS analysis. SID530 showed a plasma-protein binding profile comparable to that of Taxotere in the clinically relevant concentration range of docetaxel. In both formulations, the unbound fraction of docetaxel increased in a concentration-dependent biphasic manner. The resulting data indicate that the excipient used in SID530, HP-beta-CD, generates similar effects as polysorbate 80 of Taxotere in terms of plasma-protein binding of docetaxel.

Validated LC-MS/MS method for the determination of mirodenafil in rat plasma and its application to a comparative pharmacokinetic study of the free base and hydrochloride salt forms of mirodenafil

In this study, the pharmacokinetics of 2 forms of mirodenafil, namely the base form and the hydrochloride salt form, were investigated in rats. The 2 forms were orally administered to rats and the plasma concentrations of mirodenafil were determined using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The mirodenafil base and hydrochloride salt forms showed similar pharmacokinetic profiles in terms of their maximum plasma concentration (Cmax) and area under the concentration-time curve (AUC). The time to peak concentration (Tmax) of the base form was slightly greater than that of the salt form, but this difference was not statistically significant. These results suggest that the mirodenafil base and hydrochloride forms are pharmacokinetically equivalent in rats, and thus the base form could be used in various mirodenafil formulations as a substitute for the existing mirodenafil hydrochloride form.

Ir(111) surface state with giant Rashba splitting persists under graphene in air

We reveal a giant Rashba effect (α(R)≈1.3  eV Å) on a surface state of Ir(111) by angle-resolved photoemission and by density functional theory. It is demonstrated that the existence of the surface state, its spin polarization, and the size of its Rashba-type spin-orbit splitting remain unaffected when Ir is covered with graphene. The graphene protection is, in turn, sufficient for the spin-split surface state to survive in ambient atmosphere. We discuss this result along with indications for a topological protection of the surface state.

Electronic confinement and ordering instabilities in colossal magnetoresistive bilayer manganites

We present angle-resolved photoemission studies of (La{1-z}Pr{z}){2-2x}Sr{1+2x}Mn{2}O{7} with x=0.4 and z=0.1, 0.2, and 0.4 along with density functional theory calculations and x-ray scattering data. Our results show that the bilayer splitting in the ferromagnetic metallic phase of these materials is small, if not completely absent. The charge carriers are therefore confined to a single MnO{2} layer, which in turn results in a strongly nested Fermi surface. In addition to this, the spectral function also displays clear signatures of an electronic ordering instability well below the Fermi level. The increase of the corresponding interaction strength with z and its magnitude of ∼400  meV make the coupling to a bare phonon highly unlikely. Instead we conclude that fluctuating order, involving electronic and lattice degrees of freedom, causes the observed renormalization of the spectral features.

High basal NF-κB activity in nonpigmented melanoma cells is associated with an enhanced sensitivity to vitamin D3 derivatives

Background:

Melanoma is highly resistant to current modalities of therapy, with the extent of pigmentation playing an important role in therapeutic resistance. Nuclear factor-κB (NF-κB) is constitutively activated in melanoma and can serve as a molecular target for cancer therapy and steroid/secosteroid action.

Methods:

Cultured melanoma cells were used for mechanistic studies on NF-κB activity, utilising immunofluorescence, western blotting, EMSA, ELISA, gene reporter, and estimated DNA synthesis assays. Formalin-fixed, paraffin-embedded specimens from melanoma patients were used for immunocytochemical analysis of NF-κB activity in situ.

Results:

Novel 20-hydroxyvitamin (20(OH)D₃) and classical 1α,25-dihydroxyvitamin D₃ (1,25(OH)₂D₃) secosteroids inhibited melanoma cell proliferation. Active forms of vitamin D were found to inhibit NF-κB activity in nonpigmented cells, while having no effect on pigmented cells. Treatment of nonpigmented cells with vitamin D3 derivatives inhibited NF-κB DNA binding and NF-κB-dependent reporter assays, as well as inhibited the nuclear translocation of the p65 NF-κB subunit and its accumulation in the cytoplasm. Moreover, analysis of biopsies of melanoma patients showed that nonpigmented and slightly pigmented melanomas displayed higher nuclear NF-κB p65 expression than highly pigmented melanomas.

Conclusion:

Classical 1,25(OH)₂D₃ and novel 20(OH)D₃ hydroxyderivatives of vitamin D3 can target NF-κB and regulate melanoma progression in nonpigmented melanoma cells. Melanin pigmentation is associated with the resistance of melanomas to 20(OH)D₃ and 1,25(OH)₂D₃ treatment.

k Dependence of the crystal-field splittings of 4f states in rare-earth systems

The occupation, energy separation, and order of the crystal-field-split 4f states are crucial for the understanding of the magnetic properties of rare-earth systems. We provide the experimental evidence that crystal-field-split 4f states exhibit energy dispersion in momentum space leading to variations of energy spacings between them and even of their energy sequence across the Brillouin zone. These observations were made by performing angle-resolved photoemission experiments on YbRh(2)Si(2) and properly simulated within a simple model based on results obtained by inelastic neutron scattering experiments and band structure calculations. Our findings should be generally applicable to rare-earth systems and have considerable impact on the understanding of magnetism and related phenomena.

Superconductivity without nesting in LiFeAs

We have studied the electronic structure of the nonmagnetic LiFeAs (T(c)∼18  K) superconductor using angle-resolved photoemission spectroscopy. We find a notable absence of the Fermi surface nesting, strong renormalization of the conduction bands by a factor of 3, high density of states at the Fermi level caused by a van Hove singularity, and no evidence for either a static or a fluctuating order except superconductivity with in-plane isotropic energy gaps. Our observations suggest that these electronic properties capture the majority of ingredients necessary for the superconductivity in iron pnictides.

Weak superconducting pairing and a single isotropic energy gap in stoichiometric LiFeAs

We report superconducting (SC) properties of stoichiometric LiFeAs (T(c)=17 K) studied by small-angle neutron scattering (SANS) and angle-resolved photoemission (ARPES). Although the vortex lattice exhibits no long-range order, well-defined SANS rocking curves indicate better ordering than in chemically doped 122 compounds. The London penetration depth lambda(ab)(0)=210+/-20 nm, determined from the magnetic field dependence of the form factor, is compared to that calculated from the ARPES band structure with no adjustable parameters. The temperature dependence of lambda(ab) is best described by a single isotropic SC gap Delta(0)=3.0+/-0.2 meV, which agrees with the ARPES value of Delta(0)(ARPES)=3.1+/-0.3 meV and corresponds to the ratio 2Delta/k(B)T(c)=4.1+/-0.3, approaching the weak-coupling limit predicted by the BCS theory. This classifies LiFeAs as a weakly coupled single-gap superconductor.

What should be considered in using standard knee radiographs to estimate mechanical alignment of the knee?

OBJECTIVE

Anatomical tibiofemoral angle (anatomical TFA) of the knee measured on standard knee radiographs is still widely used as proxy for mechanical tibiofemoral angle (mechanical TFA), because of the practical and economic limitations in using full-limb radiographs. However, reported differences between anatomical and mechanical TFAs show wide variations. The first aim of this study was to determine whether gender, the presence of advanced osteoarthritis (OA), and history of total knee arthroplasty (TKA) influence the differences between anatomical and mechanical TFAs. The second aim was to identify anatomical features that cause divergences between anatomical and mechanical TFAs, and the final aim was to determine whether anatomical TFA measured using reference points more distant from the knee provides more accurate estimates of mechanical TFA.

DESIGN

In 102 knees with advanced OA before and after TKAs and 99 control knees with no/minimal OA, we assessed the differences between two anatomical TFAs, namely, anatomical TFA1 and anatomical TFA2, which were based on conventional or more distant proximal and distal reference points on standard knee radiographs, respectively, and the mechanical TFA measured on full-limb radiographs. These differences were investigated for women vs men, no/minimal OA vs advanced OA, and for knees before vs after TKA. Regression analyses were performed to determine associations between femoral and tibial anatomical characteristics and the differences between mechanical and anatomical TFAs.

RESULTS

The OA group showed significantly greater differences between mechanical and anatomical TFAs than the control group for both genders. In OA and TKA group, women were more likely to have greater mean differences between mechanical and anatomical TFAs than men. However, TKA did not significantly affect these differences. Femoral and tibial bowing angles, particularly of the femur, were found to be the major contributors to divergences between mechanical and two anatomical TFAs. Furthermore, anatomical TFA2 was found to provide more accurate estimates of mechanical TFA.

CONCLUSIONS

We found that the differences between mechanical and anatomical TFAs depend on gender and the presence of advanced OA, but not on a history of TKA. These findings indicate that prediction of mechanical TFA based on anatomical TFA is dependent on study population characteristics. This study also shows that the presence of lateral bowing of the femur is a major cause of mechanical TFA to anatomical TFA variations associated with gender and advanced OA. To reduce the adverse effects of anatomical variations on estimations of mechanical TFA based on an anatomical TFA method, more distant proximal and distal reference points are recommended to determine anatomical TFA value on standard knee radiographs.

CeFePO: f-d hybridization and quenching of superconductivity

As a homologue to the new, Fe-based type of high-temperature superconductors, the electronic structure of the heavy-fermion compound CeFePO was studied by means of angle-resolved resonant photoemission. It was experimentally found-and later on confirmed by local-density approximation (LDA) as well as dynamical mean-field theory (DMFT) calculations-that the Ce 4f states hybridize to the Fe 3d states of d{3z{2}-r{2}} symmetry near the Fermi level that discloses their participation in the occurring electron-correlation phenomena and provides insight into mechanism of superconductivity in oxopnictides.

Treatment of infraorbital dark circles by autologous fat transplantation: a pilot study

BACKGROUND

Infraorbital dark circles are a cosmetic concern for a large number of individuals. However, the exact definition and precise cause has not been elucidated clearly. In our experience infraorbital dark circles due to thin and translucent lower eyelid skin overlying the orbicularis oculi muscle can be treated successfully with autologous fat transplantation.

OBJECTIVES

This study was conducted to clarify the nature of dark circles under the eyes and determine the efficacy of autologous fat transplantation.

PATIENTS AND METHODS

Ten patients with dark circles due to increased vascularity and translucency of the skin were included. They received at least one autologous fat transplantation and follow-up evaluations were conducted at least 3 months after the last treatment.

RESULTS

An average of 1.6 autologous fat transplantations were done in both infraorbital areas. Patients showed an average of 78% improvement (average grading scale: 2.6 out of 4). Most of the patients showed improvement in the infraorbital darkening and contour of the lower eyelids.

CONCLUSIONS

Autologous fat transplantation is an effective method for the treatment of infraorbital dark circles due to thin and translucent lower eyelid skin overlying the orbicularis oculi muscle.

Evaluations of radiographic joint space--do they adequately predict cartilage conditions in the patellofemoral joint of the patients undergoing total knee arthroplasty for advanced knee osteoarthritis?

OBJECTIVE

To determine whether assessments of patellofemoral (PF) joint space reliably predict the cartilage conditions in the PF joint of the patients undergoing total knee arthroplasty (TKA) for advanced knee osteoarthritis.

METHODS

Radiographic joint spaces and gross cartilage conditions in the PF joint were assessed in 151 osteoarthritic knees undergoing TKA. Minimum joint space widths (MJSWs) in the medial and lateral compartments of the PF joint were measured separately on Merchant radiographs. Degrees of joint space were graded as normal, narrowed and obliterated, and expected locations of significant cartilage lesions were classified as medial, lateral, and global. Cartilage lesions were grossly assessed in terms of their severity (depth and size) and location. Cross-table analyses and kappa statistics were used to determine the level of agreements between radiographic and gross assessments and the diagnostic accuracies of the radiographic assessments.

RESULTS

The agreements between the radiographic assessments and the gross assessments on the lesion severities and locations were only fair [kappa coefficient (k)=0.288 and 0.211, respectively]. The cross-table analyses demonstrated that 45 (47.4%) of 95 knees with a normal radiographic joint space had moderate or severe cartilage degeneration of the PF joint identified with gross assessments. In the radiographic assessments, the lateral compartment of the PF joint was the most frequent location of joint space narrowing (71.4%) whereas in the gross assessments, the medial compartment of the PF joint was the most frequent location of significant cartilage lesion (48.1%). Diagnostic accuracies on the lesion severities and locations were generally poor.

CONCLUSION

This study demonstrates that prediction of the cartilage conditions of the PF joint by the radiographic joint space can be inaccurate.

Hepatic perfusion imaging using factor analysis of contrast enhanced ultrasound

Contrast enhanced ultrasound imaging provides a real-time tool for evaluating vasculature in the liver. Primary liver cancer is known to be perfused exclusively by blood from the hepatic artery, whereas normal liver is also supplied by the portal vein. Visual separation of two different phases of enhancement from the independent feeding vessels is important for diagnosis but remains a challenge. This paper presents a method of using factor analysis for extracting distinct time-intensity curves. A key component to this extraction is the clustering of measured bolus curves and their projection onto a positivity domain to obtain nonnegative curves. This technique provides complementary images representing spatial loadings on each curve. As little as 1% of the data is required to contain unmixed signals to extract time-intensity curves that correlate well with true curves. A method of combining this information to display a regional hepatic perfusion image is proposed, and results are tested on a set of 10 patients. Region of interest analysis suggests it is possible to detect changes in the hepatic perfusion index of liver lesions relative to normal liver parenchyma using contrast ultrasound.