Suppressors of cytokine signaling (SOCS) have emerged as potential regulators of macrophage function. We have investigated mechanisms of SOCS3 action on type 2 macrophage (M2) differentiation induced by glucocorticoid using human monocytic cell lines and mouse bone marrow-derived macrophages. Treatment of THP1 monocytic cells with dexamethasone (Dex) induced ROS generation and M2 polarization promoting IL-10 and TGF-β production, while suppressing IL-1β, TNF-α and IL-6 production. SOCS3 over-expression reduced, whereas SOCS3 ablation enhanced IL-10 and TGF-β induction with concomitant regulation of ROS. As a mediator of M2 differentiation, glucocorticoidinduced leucine zipper (GILZ) was down-regulated by SOCS3 and up-regulated by shSOCS3. The induction of GILZ and IL-10 by Dex was dependent on ROS and p38 MAPK activity. Importantly, GILZ ablation led to the inhibition of ROS generation and anti-inflammatory cytokine induction by Dex. Moreover, GILZ knock-down negated the up-regulation of IL-10 production induced by shSOCS3 transduction. Our data suggest that SOCS3 targets ROS- and p38-dependent GILZ expression to suppress Dex-induced M2 polarization.

Ambulatory Care ; COVID-19 ; Health Facility Planning ; Hospital Bed Capacity ; Hospitals, Rehabilitation ; Humans ; Infection Control ; Rehabilitation ; Remote Consultation ; SARS-CoV-2 ; Singapore ; Telerehabilitation ; Triage

Introduction: Prediabetes, typically defined as blood glucose levels above normal but below diabetes thresholds, denotes a risk state that confers a high chance of developing diabetes. Asians, particularly the Southeast Asian population, may have a higher genetic predisposition to diabetes and increased exposure to environmental and social risk factors. Malaysia alone was home to 3.4 million people with diabetes in 2017; the figure is estimated to reach 6.1 million by 2045. Developing strategies for early interventions to treat prediabetes and preventing the development of overt diabetes and subsequent cardiovascular and microvascular complications are therefore important. Methods: An expert panel comprising regional experts was convened in Kuala Lumpur, for a one-day meeting, to develop a document on prediabetes management in Malaysia. The expert panel comprised renowned subject-matter experts and specialists in diabetes and endocrinology, primary-care physicians, as well as academicians with relevant expertise. Results: Fifteen key clinical statements were proposed. The expert panel reached agreements on several important issues related to the management of prediabetes providing recommendations on the screening, diagnosis, lifestyle and pharmacological management of prediabetes. The expert panel also proposed changes in forthcoming clinical practice guidelines and suggested that the government should advocate early screening, detection, and intensive management of prediabetes. Conclusion: This document provides a comprehensive approach to the management of prediabetes in Malaysia in their daily activities and offer help in improving government policies and the decision-making process.

OBJECTIVES: To determine the relationship between lumbar disc degeneration and back muscle degeneration.SUMMARY OF LITERATURE REVIEW: In the degenerative cascade of the spine described by Kirkaldy-Willis, degeneration of the disc and of the facet joint co-occur with aging. However, the muscles of the back are not included in this model. Several studies have reported significant correlations between back muscle degeneration and facet joint arthritis. The purpose of our study was to evaluate relationships between lumbar disc degeneration and fatty degeneration of the back muscles. MATERIALS AND METHODS: In this study, 65 patients over the age of 50 years who had undergone lumbar spine MRI in our orthopaedic clinic were recruited. Fatty degeneration of the back muscles was qualitatively graded from I to III by the degree of the fat signal in the muscle layer, including both the multifidus and erector spinae. Lumbar disc degeneration was graded from I to V according to the Pfirrmann grade. Correlations between the back muscle degeneration grade and radiological parameters were analyzed. RESULTS: The degeneration grade of the multifidus correlated positively with age and the grade of disc degeneration. Correlations with other radiologic parameters were not significant. The degeneration grade of the erector spinae correlated positively with age. Other radiologic parameters were not significant. CONCLUSIONS There was a significant correlation between lumbar disc degeneration and multifidus degeneration. Erector spinae degeneration was correlated with age, but not with lumbar disc degeneration. The degenerative cascade of the spine was accompanied by fatty changes of the multifidus with aging.

PURPOSE: To analyze the correlation between a rupture of the hypovascular zone and early single heel raising after Achilles tendon repair. MATERIALS AND METHODS: From January 2012 to August 2015, 68 patients, who underwent surgical treatment for a Achilles tendon rupture using Krackow method, were analyzed retrospectively. The patients were divided into two groups according to possibility of single heel raises within 3 months postoperatively. During the periodic outpatient observations, the visual analogue scale, Achilles tendon total rupture score (ATRS), and timing capable single heel raises were evaluated. In addition, the preoperative defect size and distance between the calcaneal osteotendinous junction and the rupture site were measured by ultrasound in all cases. RESULTS: Twenty-three patients could perform a single heel raise within 3 months after surgery (early single heel raise group), and forty-five patients could perform a single heel raise after 3 month postoperatively. The age, gender, body mass index, smoking, and operation delay were similar in the two groups. In addition, the defect size and distance between the calcaneal osteotendinous junction and rupture site as measured by preoperative ultrasound were similar (p=0.379 and p=0.631, respectively). On the other hand, when the rupture site was divided into the hypovascular zone (4~7 cm from calcaneal osteotendinous junction) and non-hypovascular zone, the hypovascular zone rupture rate was significantly lower in the early single heel raise group (60.9%, 14/23; 91.1%, 41/45; p=0.003). In logistic regression analysis, the odds of the hypovascular zone rupture group being capable of early single heel raise were 0.189 (p=0.017). The ATRS score at 3 months and 1 year after surgery were significantly higher in the early single heel raise group (p < 0.001). CONCLUSION: Achilles tendon rupture at the hypovascular zone is a poor prognostic factor for early single heel raise and might affect the prognosis significantly after an Achilles tendon rupture operation.
Achilles Tendon* ; Body Mass Index ; Hand ; Heel* ; Humans ; Logistic Models ; Methods ; Outpatients ; Prognosis ; Retrospective Studies ; Rupture* ; Smoke ; Smoking ; Ultrasonography

STUDY DESIGN: Retrospective evaluation. OBJECTIVES: To determine the relationship between lumbar disc degeneration and back muscle degeneration. SUMMARY OF LITERATURE REVIEW: In the degenerative cascade of the spine described by Kirkaldy-Willis, degeneration of the disc and of the facet joint co-occur with aging. However, the muscles of the back are not included in this model. Several studies have reported significant correlations between back muscle degeneration and facet joint arthritis. The purpose of our study was to evaluate relationships between lumbar disc degeneration and fatty degeneration of the back muscles. MATERIALS AND METHODS: In this study, 65 patients over the age of 50 years who had undergone lumbar spine MRI in our orthopaedic clinic were recruited. Fatty degeneration of the back muscles was qualitatively graded from I to III by the degree of the fat signal in the muscle layer, including both the multifidus and erector spinae. Lumbar disc degeneration was graded from I to V according to the Pfirrmann grade. Correlations between the back muscle degeneration grade and radiological parameters were analyzed. RESULTS: The degeneration grade of the multifidus correlated positively with age and the grade of disc degeneration. Correlations with other radiologic parameters were not significant. The degeneration grade of the erector spinae correlated positively with age. Other radiologic parameters were not significant. CONCLUSIONS: There was a significant correlation between lumbar disc degeneration and multifidus degeneration. Erector spinae degeneration was correlated with age, but not with lumbar disc degeneration. The degenerative cascade of the spine was accompanied by fatty changes of the multifidus with aging.
Aging ; Arthritis ; Back Muscles ; Humans ; Intervertebral Disc Degeneration ; Magnetic Resonance Imaging ; Muscles ; Paraspinal Muscles ; Retrospective Studies ; Spine ; Zygapophyseal Joint

PURPOSE: This study introduces a reading chart application for the iPad tablet in the Korean language and investigates the reading speed in a normal-sighted population according to age group. METHODS: Sixty-three Korean sentences were selected from textbooks for second grade elementary school students. A commonly used typeface in everyday printed material, “BatangChe,” was used. Letter size was presented in logarithm of the minimum angle of resolution (logMAR) 0.0 to 1.0 at 0.1 logMAR steps at a reading distance of 40 cm. A third generation retina display iPad was used to present the chart, and the sentences were presented randomly for each size of letter. The subjects repeated the test silently (reading only) and out loud (reading and speaking) to prevent them from skipping reading words. Pilot testing followed in 65 normal vision adults under 60 years of age. RESULTS: The mean reading only speed for logMAR 0.5 optotype (point 10) was 121.1 ± 47.2 words per minute (wpm) for people in their 20s (n=21), 116.5 ± 38.3 in their 30s (n=27), 93.8 ± 12.6 in their 40s (n=9), and 56.5 ± 42.7 (n=8) in their 50s. There was a significant correlation between age and reading and speaking speed (r=−0.48, p<0.001). The mean reading only speed for logMAR 0.5 optotype (point 10) was 202.3 ± 88.4 wpm and the mean reading and speaking speed was 129.7 ± 25.9 wpm, with significantly different (p<0.001). CONCLUSIONS: This Korean reading chart application could present a new standard when checking reading speed according to age groups.
Adult ; Humans ; Retina

Many cellular structures directly imply specific biological functions. For example, normal slit diaphragm structures that extend from podocyte foot processes ensure the filtering function of renal glomeruli. These slits are covered by a number of surface proteins, such as nephrin, podocin, podocalyxin and CD2AP. Here we report a human patient presenting with congenital nephrotic syndrome, omphalocele and microcoria due to two loss-of-function mutations in PODXL, which encodes podocalyxin, inherited from each parent. This set of symptoms strikingly mimics previously reported mouse Podxl(−/−) embryos, emphasizing the essential function of PODXL in mammalian kidney development and highlighting this patient as a human PODXL-null model. The results underscore the utility of current genomics approaches to provide insights into the genetic mechanisms of human disease traits through molecular diagnosis.

Arthroscopic treatment has been reported to provide effective improvement of ankle function when used in treatment of small osteochondral lesion of talus; however, favorable long-term results have been less predictable for large osteochondral lesion of talus. In cases in which primary arthroscopic treatment fails, the decision regarding which subsequent technique to choose has become increasingly difficult, as good clinical outcomes may be unlikely for such patients irrespective of the surgical technique used. Redomicrofracture should be used judiciously for treatment of osteochondral lesion of talus in which arthroscopic treatment has failed.
Ankle ; Humans ; Talus*

PURPOSE: The purpose of this study is to evaluate the efficacy of mesenchymal stem cell (MSC) isolation by the magnetic-activated cell sorting (MACS) method in tendon tissue-derived cells compared to the colony picking method for isolation of MSCs by picking colonyforming cells. MATERIALS AND METHODS: Human tendon-derived cells were isolated by enzyme digestion using normal tendon tissues from three donors. We used the magnetic kit and well-known MSC markers (CD90 or CD105) to isolate MSCs in tendon-derived cells using MACS. Cloning cylinders were used to isolate colony-forming cells having MSC characteristics in tendon-derived cells. Colony-forming unitfibroblast (CFU-F) assay was used to evaluate the self-renewal capacity of cells isolated using the colony picking method or MACS. For comparison of differentiation potentials into osteogenic or adipogenic lineage between two groups, alizarin red S and oil red O staining were performed at 14 days after induction of differentiation in vitro. RESULTS: Flow cytometry results showed that early passage tendon-derived cells expressed CD44 in 99.13%, CD90 in 56.51%, and CD105 in 86.19%. In the CFU-F assay, CD90+ or CD105+ cells isolated with MACS showed larger colony formation in size than cells isolated using the colony picking method. We also observed that CD90+ or CD105+ cells were constantly differentiated into both osteogenic and adipogenic lineages in cells from all donors, whereas cells isolated using the colony picking method were heterogeneous in differentiation potentials to the osteogenic and adipogenic lineages. CONCLUSION: CD90+ or CD105+ cells isolated using MACS showed superior MSC characteristics in the self-renewal and multi-differentiation capacities compared with cells isolated using the colony picking method.
Clone Cells ; Cloning, Organism ; Digestion ; Flow Cytometry ; Humans ; Mesenchymal Stromal Cells* ; Tendons ; Tissue Donors