Germinal centers (GC) are critically important for the maturation of the antibody response and the generation of memory B cells, which are the basis for long-term protection from pathogens. Germinal centers only occur in lymphoid tissue, such as lymph nodes, and are not present in blood. Therefore, cells of the germinal center, including GC B cells and GC T follicular helper (TFH) cells, are not well-studied in humans under normal healthy conditions, due to the limited availability of healthy lymph node samples. We used a minimally invasive, routine clinical procedure, lymph node fine needle aspirations (LN FNAs), to obtain lymph node cells from healthy human subjects to establish benchmarks of GC cells under noninflammatory conditions. This study of 50 lymph nodes demonstrates that human LN FNAs are a safe and feasible technique for immunological research, and defines benchmarks for human GC biology. The findings indicate that assessment of the GC response via LN FNAs will have application to the study of human vaccination, allergy, and autoimmune disease..
Objective
The aim of this study was to determine the correlations between objective performance-based physical function, self-reported physical function, quality of life, and gait function at 1 mo after unilateral total knee arthroplasty.
Design
Cross-sectional data from 195 patients who underwent unilateral primary total knee arthroplasty were analyzed. The isometric knee extensor and flexor strength of both knees, gait parameters, 6-min walk test, timed up-and-go test, timed stair-climbing test, knee flexion and extension range of motion of surgical knee, Western Ontario McMaster Universities Osteoarthritis Index pain, stiffness, and functional levels, EuroQol five-dimensions questionnaire, and visual analog scale for knee pain were assessed.
Results
In bivariate analyses, both postoperative gait speed and gait endurance had significant positive correlations with postoperative peak torque of the extensor and flexor of both knees, cadence, stride length, and significant negative correlation with timed up-and-go, stair-climbing test ascent, stair-climbing test descent, visual analog scale, Western Ontario McMaster Universities Osteoarthritis Index pain, stiffness, and function levels. In the linear regression analyses, postoperative peak torque of the extensors of both knees and VAS for knee pain were factors correlated with postoperative gait speed and gait endurance.
Conclusions
Quadriceps muscle strength of both knees and knee pain were important factors correlated with gait function early after total knee arthroplasty.
Germinal centers (GC) are critically important for the maturation of the antibody response and the generation of memory B cells, which are the basis for long-term protection from pathogens. Germinal centers only occur in lymphoid tissue, such as lymph nodes, and are not present in blood. Therefore, cells of the germinal center, including GC B cells and GC T follicular helper (TFH) cells, are not well-studied in humans under normal healthy conditions, due to the limited availability of healthy lymph node samples. We used a minimally invasive, routine clinical procedure, lymph node fine needle aspirations (LN FNAs), to obtain lymph node cells from healthy human subjects to establish benchmarks of GC cells under noninflammatory conditions. This study of 50 lymph nodes demonstrates that human LN FNAs are a safe and feasible technique for immunological research, and defines benchmarks for human GC biology. The findings indicate that assessment of the GC response via LN FNAs will have application to the study of human vaccination, allergy, and autoimmune disease.
ObjectiveTo investigate the effects of early combined eccentric-concentric (ECC-CON) or concentric (CON) resistance training following total knee arthroplasty (TKA).MethodsPatients who underwent a primary TKA were randomly assigned to an ECC-CON group (n=16) or a CON group (n=18). All patients received early, progressive resistance training with five sessions per week for 2 weeks starting 2 weeks after TKA. Isometric knee flexor and extensor strength of the surgical and non-surgical knees, instrumental gait analysis for spatiotemporal parameters, 6-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Timed Stair Climbing Test (SCT) were used to evaluate performance-based physical function. The Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and EuroQOL five dimensions (EQ-5D) questionnaire were used to evaluate self-reported physical function and self-reported quality of life. All patients underwent these evaluations before and 1 month after TKA.ResultsThe ECC-CON group showed clinically meaningful improvements in extensor peak torque (PT) of the non-surgical knee, gait speed, and 6MWT from preoperative values. The CON group had an increase in H/Q ratio of the surgical knee and improvement in SCT-ascent postoperatively. Both groups showed significant improvements in WOMAC-Pain, function, and EQ-5D scores. Although extensor PT of the surgical knee did not reach the preoperative level in either group, the postoperative change was significantly less in the ECC-CON group than the CON group.ConclusionEarly combined ECC-CON resistance training minimizes the loss in quadriceps strength of the surgical knee and improves endurance and gait speed after TKA.
Background: The purpose of this study was to investigate the effectiveness of a home-based fragility fracture integrated rehabilitation management (H-FIRM) program following an inpatient FIRM (I-FIRM) program in patients surgically treated for hip fracture. Methods: This nonrandomized controlled trial included 32 patients who underwent hip surgery for a fragility hip fracture. The patients were divided into two groups: a prospective intervention group (n = 16) and a historical control group (n = 16). The intervention group performed a nine-week H-FIRM program combined with the I-FIRM program. The historical control group performed the I-FIRM program only. Functional outcomes included Koval’s grade, Functional Ambulatory Category (FAC), Functional Independence Measure (FIM) locomotion, Modified Rivermead Mobility Index (MRMI), 4 m walking speed test (4MWT), and the Korean version of Modified Barthel Index (K-MBI). All functional outcomes were assessed one week (before I-FIRM), three weeks (before I-FIRM), and three months (after H-FIRM) after surgery. Results: Both groups showed significant and clinically meaningful improvements in functional outcomes over time. Compared with the control group, the intervention group showed clinically meaningful improvements in Koval’s grade, FAC, FIM locomotion, MRMI, 4MWT, and K-MBI from baseline to three months. Conclusion: H-FIRM may be an effective intervention for improving functional outcomes in older people after fragility hip fractures.
Type 2 superior labral anterior to posterior (SLAP) lesion is a common cause of shoulder pain requiring surgical operation. SLAP tears are often associated with paralabral cysts, but they rarely cause nerve compression. However, we experienced two cases of type 2 SLAP-related paralabral cysts at the spinoglenoid notch which were confirmed as isolated nerve entrapment of the infraspinatus branch of the suprascapular nerve by electrodiagnostic assessment and magnetic resonance imaging. In these pathological conditions, comprehensive electrodiagnostic evaluation is warranted for confirmation of neuropathy, while surgical decompression of the paralabral cyst combined with SLAP repair is recommended.
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