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Shi Z, Li ZC, Fan MX, Wang QL, Liu B, Lang Z, He D, Tian W. Impact of optical navigation variables on the accuracy of robot-assisted surgery: a study of the TIANJI Robot system. J Robot Surg 2024; 18:36. [PMID: 38231441 DOI: 10.1007/s11701-023-01784-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024]
Abstract
This study aims to explore factors related to optical navigation that interfere with the accuracy of robot-assisted surgery, specifically focusing on the TIANJI Robot system. A measurement model was created to assess the accuracy of the TIANJI Robot system in simulated screw placement. Deviation between actual and planned positions was measured using a three-coordinate machine. Various experiments were conducted to investigate the impact of different optical navigation factors on screw placement accuracy. Deviations were measured at different distances (ranging from 1.2 to 2.2 m) between the optical navigation stereo camera and the tracker, with each distance being tested 50 times. The distance between the optical camera and patient tracker was set at 1.4 m. Deviations were also measured at different angles between the camera and robot tracker, repeated over 25 times for each angle. Data were analyzed using mean and standard deviation, with line charts illustrating deviation changes based on distance and angle details. Within the range of the TIANJI Robot system's optical navigation (1.2-2.2 m), deviation increased as distance increased (χ2 = 479.107, P < 0.001). The robotic system demonstrated high and consistent accuracy (mean deviation: 0.332 mm ± 0.067 mm) when the relative angle between the optical camera and tracker was below 40°. The accuracy of the TIANJI Robot system was found to be influenced by relative distance and angle between the optical camera and tracker during screw placement procedures. Surgeons are recommended to set a relative distance of 1.4-1.5 m between the optical camera and patient tracker, with a relative angle below 40° when placing and adjusting optical tracking devices.
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Affiliation(s)
- Zhan Shi
- Department of Spine Surgery, Beijing Jishuitan Hospital, No. 31, Xinjiekou East St, Xicheng District, Beijing, 100035, China
| | - Zu-Chang Li
- Department of Spine Surgery, Beijing Jishuitan Hospital, No. 31, Xinjiekou East St, Xicheng District, Beijing, 100035, China
| | - Ming-Xing Fan
- Department of Spine Surgery, Beijing Jishuitan Hospital, No. 31, Xinjiekou East St, Xicheng District, Beijing, 100035, China
| | - Qi-Long Wang
- Department of Spine Surgery, Beijing Jishuitan Hospital, No. 31, Xinjiekou East St, Xicheng District, Beijing, 100035, China
| | - Bo Liu
- Department of Spine Surgery, Beijing Jishuitan Hospital, No. 31, Xinjiekou East St, Xicheng District, Beijing, 100035, China
| | - Zhao Lang
- Department of Spine Surgery, Beijing Jishuitan Hospital, No. 31, Xinjiekou East St, Xicheng District, Beijing, 100035, China
| | - Da He
- Department of Spine Surgery, Beijing Jishuitan Hospital, No. 31, Xinjiekou East St, Xicheng District, Beijing, 100035, China.
| | - Wei Tian
- Department of Spine Surgery, Beijing Jishuitan Hospital, No. 31, Xinjiekou East St, Xicheng District, Beijing, 100035, China.
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Aziz M, Abunayan M, El Shazly M, Salman B, Habous M, Almannie R. Medial deviation of the ureter is a new sign that could predict stone impaction: a pilot study. Int Urol Nephrol 2023; 55:3033-3038. [PMID: 37606748 PMCID: PMC10611609 DOI: 10.1007/s11255-023-03744-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/06/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE To assess the value medial deviation of the ureter at site of ureteric stone as a sign of ureteric stone impaction. PATIENTS AND METHODS All cases with medial deviation of the ureter at site of ureteric stones in our department over 4 years were enrolled in this pilot study. All cases were diagnosed with KUB and non-contrast CT (NCCT). Radiological and ureteroscopic findings were recorded. RESULTS A total of 32 patients with a single impacted stone in the proximal and middle third of the ureter were included in the study. Medial deviation of the ureter at the site of the stone was detected in the upper third of the ureter in 24 (75%) cases and in the middle third in 8 (25%) cases. There were mucosal polyps and mucosal erythema (inflammatory changes) seen by ureteroscopy in all cases (100%). Ureteroscopy was successfully completed with stone fragmentation in 23 (71.8%) patients: 8 of them needed ureteric catheter and 15 required JJ stent insertion. Failure of ureteroscopy with insertion of JJ stent was done in 5 (15.6%) patients. Removal of the stent and ureteroscopy was done after 4 weeks. CONCLUSION We conclude from this study that medial deviation of the ureter is a new reliable radiological sign of ureteric stone impaction.
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Affiliation(s)
- Mohammed Aziz
- Urology Department, Menoufia University, Shibin El Kom, Egypt
| | - Mohammed Abunayan
- Urology Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | | | - Baher Salman
- Urology Department, Menoufia University, Shibin El Kom, Egypt
| | - Mohammad Habous
- Urology Department, Menoufia University, Shibin El Kom, Egypt
| | - Raed Almannie
- Urology Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Rak D, Rügamer T, Klann L, Nedopil AJ, Rudert M. Setting the distal and posterior condyle of the femoral component to restore the medial pre-arthritic femoral articular surface results in better outcomes after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2023; 31:5319-5331. [PMID: 37741934 PMCID: PMC10719128 DOI: 10.1007/s00167-023-07576-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/04/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE The present study of total knee arthroplasty (TKA) describes an intra-operative method that determines the direction and quantifies the magnitude of deviation of the distal and the posterior medial and lateral (DM, PM, DL, and PL) condyle of the femoral component relative to the pre-arthritic femoral articular surface. For each femoral condyle, the deviations were categorized, and an analysis determined which had better or worse Forgotten Joint Score (FJS), Oxford Knee Score (OKS), and WOMAC scores at 1-year follow-up. METHODS Four academic arthroplasty surgeons supervised a cemented primary CR TKA (Triathlon, Stryker) on 120 consecutive patients. 103 that completed patient-reported outcome measures (PROMs) were analyzed. The surgeon determined the direction and the magnitude of deviation of the condyle of the femoral component by intraoperatively measuring the thickness of the femoral resection, adding compensations of 1 mm for the saw kerf and 2 mm for worn cartilage, and then subtracting the thickness of the femoral component's condyle. For each femoral condyle, a Kruskal-Wallis test determined the categories of deviation with clinically important and significantly different 1-year PROMs. RESULTS A 1 to 2.5 mm and 3 mm or more proximal deviation of the DM condyle of the femoral component worsened the median FJS by 35 and 40 points, OKS by 9 and 14 points, and WOMAC score by 9 and 17 points, respectively, relative to those with a -0.5 to 0.5 mm deviation (p < 0.01). A 1 to 2.5 mm and 3 mm or more anterior deviation of the PM condyle of the femoral component worsened the FJS by 34 and 48 points, OKS by 7 and 13 points, and WOMAC scores by 8 and 16 points, respectively (p < 0.01). Deviations of the DL and PL condyle of the femoral component did not affect PROMs (p ≥ 0.13). CONCLUSIONS Although many factors can affect PROM, such as patient expectations, the surgeon should understand that setting the DM and the PM condyles of the femoral component within 1 mm of the patient's pre-arthritic femoral articular surface can potentially result in better FJS, OKS, and WOMAC scores at 1 year. LEVEL OF EVIDENCE II, Prospective cohort study.
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Affiliation(s)
- Dominik Rak
- Department of Orthopaedic Surgery, König-Ludwig-Haus, University of Würzburg, Würzburg, Germany
| | - Thorsten Rügamer
- Department of Orthopaedic Surgery, König-Ludwig-Haus, University of Würzburg, Würzburg, Germany
| | - Lukas Klann
- Department of Orthopaedic Surgery, König-Ludwig-Haus, University of Würzburg, Würzburg, Germany
| | - Alexander J Nedopil
- Department of Orthopaedic Surgery, König-Ludwig-Haus, University of Würzburg, Würzburg, Germany.
| | - Maximilian Rudert
- Department of Orthopaedic Surgery, König-Ludwig-Haus, University of Würzburg, Würzburg, Germany
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Abduo J, Lau D. Accuracy of Static Computer- Assisted Implant Placement in Posterior Edentulous Areas with Different Levels of Tooth- Support by Novice Clinicians. Eur J Prosthodont Restor Dent 2023; 31:373-382. [PMID: 37191579 DOI: 10.1922/ejprd_2494abduo10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/21/2023] [Indexed: 05/17/2023]
Abstract
Correct implant placement is necessary for satisfactory implant restoration. Therefore, the use of surgical guide is recommended. This study evaluated the accuracy of implant placement in posterior edentulous areas with different levels of tooth-support by novice clinicians according to fully-guided (FG), pilot-guided (PG), and freehand (FH) placement protocols. A mandibular model with missing first molars was designed. On one side, the model had a bound edentulous area (BEA), and on the other side, a free end edentulous area (FEA). Fourteen clinicians new to implant dentistry participated in the study, and each clinician inserted an implant in the BEA and FEA sites for every placement protocol. Angle, vertical and maximum horizontal platform and apex deviations were measured. The FG placement was more accurate than the PG and FH placements. This was significant for BEA angle deviation, BEA and FEA maximum horizontal platform deviations, and BEA maximum horizontal apex deviation. The PG placement was significantly more accurate than the FH placement for BEA and FEA maximum horizontal platform deviations. FG shows significantly greater angle, maximum horizontal platform and maximum horizontal apex deviations at FEA than BEA. This can be attributed to reduced guide support and the possibility of guide displacement during surgery.
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Affiliation(s)
- J Abduo
- Melbourne Dental School, Melbourne University, 720 Swanston Street, Melbourne, Victoria 3010
| | - D Lau
- Melbourne Dental School, Melbourne University, 720 Swanston Street, Melbourne, Victoria 3010
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Donmez MB, Çakmak G, Dede DÖ, Küçükekenci AS, Lu WE, Schumacher FL, Revilla-León M, Yilmaz B. Effect of scan powder and scanning technology on measured deviations of complete-arch implant supported frameworks digitized with industrial and intraoral scanners. J Dent 2023; 138:104736. [PMID: 37802291 DOI: 10.1016/j.jdent.2023.104736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/08/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023] Open
Abstract
OBJECTIVES To evaluate the suitability of intraoral scanners (IOSs) to analyze the fabrication trueness of titanium complete-arch implant-supported frameworks by comparing with an industrial-grade scanner and investigate how anti-reflective scan powder affects measured deviations. METHODS Ten titanium complete-arch implant-supported frameworks were milled from a reference standard tessellation language (STL) file. An industrial-grade blue light scanner (ATOS Core 80 (AT)) and three IOSs (Primescan (PS), TRIOS T3 (T3), and TRIOS T4 (T4)) with (PS-P, T3-P, and T4-P) or without (PS, T3, and T4) anti-reflective scan powder application were used to generate test STL (TSTL) files of the frameworks. Reference STL and TSTLs were imported into a metrology-grade analysis software (Geomagic Control X) and whole surface root mean square (RMS) values were calculated. Another software (Medit Link v 2.4.4) was used to virtually isolate marginal surfaces of all STL files and marginal RMS values were calculated by using the same metrology-grade analysis software. A linear mixed effects model was used to compare the transformed deviations of the scans performed by using each IOS (with or without powder) with the deviations of those performed by using the reference AT scanner within each surface, where a Box-Cox type transformation was used for variance stability. Bonferroni corrected post-hoc tests were used to compare conditions within each IOS (α=0.05). RESULTS All IOSs had significantly higher whole surface and marginal RMS values than AT, regardless of the condition (P≤.002). However, scan powder application did not affect the whole surface and marginal RMS values in scans of tested IOSs (P≥.054). CONCLUSION Measured whole surface and marginal deviations in all IOS scans performed with or without the use of scan powder were higher than those in AT scans. The application of anti-reflective scan powder did not affect the deviations in scans of tested IOSs. CLINICAL SIGNIFICANCE Even though deviations measured in the scans of tested scanners were significantly different than those in the reference scanner, the maximum raw mean difference was 37.33 µm and the maximum raw confidence interval value of estimated differences was 47.88 µm, which can be considered clinically small taking into account the size of the frameworks tested. Therefore, tested intraoral scanners may be feasible to scan prostheses similar to or smaller than tested frameworks for fabrication trueness analysis, which may facilitate potential clinical adjustments.
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Affiliation(s)
- Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Doğu Ömür Dede
- Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | | | - Wei-En Lu
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Fernanda Lang Schumacher
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Washington, USA; Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
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Yilmaz B, Dede DÖ, Donmez MB, Küçükekenci AS, Lu WE, Schumacher FL, Çakmak G. Comparison of intraoral and laboratory scanners to an industrial-grade scanner while analyzing the fabrication trueness of polymer and titanium complete-arch implant-supported frameworks. J Dent 2023; 138:104697. [PMID: 37696469 DOI: 10.1016/j.jdent.2023.104697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVES To compare the scans of different intraoral scanners (IOSs) and laboratory scanners (LBSs) to those of an industrial-grade optical scanner by measuring deviations of complete-arch implant-supported frameworks from their virtual design file. MATERIAL AND METHODS Ten polyetheretherketone (PEEK) and 10 titanium (Ti) complete-arch implant-supported frameworks were milled from a master standard tessellation language (STL) file. An industrial-grade blue light scanner (AT), 2 LBSs (MT and E4), and 3 IOSs (PS, T3, and T4) were used to generate STL files of these frameworks. All STLs were imported into an analysis software (Geomagic Control X) and overall root mean square (RMS) values were calculated. Marginal surfaces of all STL files were then virtually isolated (Medit Link v 2.4.4) and marginal RMS values were calculated. Deviations in scans of tested scanners were compared with those in scans of AT by using a linear mixed effects model (α = 0.05). RESULTS When the scans of PEEK frameworks were considered, PS and T3 had similar overall RMS to those of AT (p ≥ .076). However, E4 and T4 had higher and MT had lower overall RMS than AT (p ≤ .002) with a maximum estimated mean difference of 13.41 µm. When the scans of Ti frameworks were considered, AT had significantly lower overall RMS than tested scanners (p ≤ .010) with a maximum estimated mean difference of 31.35 µm. Scans of tested scanners led to significantly higher marginal RMS than scans of AT (p ≤ .006) with a maximum estimated mean difference of 53.90 µm for PEEK and 40.50 µm for Ti frameworks. CONCLUSION Only the PEEK framework scans of PS and T3 led to similar overall deviations to those of AT. However, scans of all tested scanners resulted in higher marginal deviations than those of AT scans. CLINICAL SIGNIFICANCE Scans performed by using PS and T3 may be alternatives to those of tested reference industrial scanner AT, for the overall fabrication trueness analysis of complete-arch implant-supported PEEK frameworks.
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Affiliation(s)
- Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, OH, USA
| | - Doğu Ömür Dede
- Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey.
| | | | - Wei-En Lu
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Fernanda Lang Schumacher
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Shi Y, Wang J, Ma C, Shen J, Dong X, Lin D. A systematic review of the accuracy of digital surgical guides for dental implantation. Int J Implant Dent 2023; 9:38. [PMID: 37875645 PMCID: PMC10597938 DOI: 10.1186/s40729-023-00507-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/08/2023] [Indexed: 10/26/2023] Open
Abstract
PURPOSE This review aimed to reveal the influence of implant guides on surgical accuracy with regard to supporting types, manufacturing methods and design (including fixation screws and sleeves). METHODS A literature search related to accuracy of surgical guides for dental implantation was performed in Web of Science and PubMed. Studies with in vivo or in vitro deviation data published in recent 5 years (2018-2022) were included and assessed by Newcastle-Ottawa Scale with regard to risk of bias and reliability degree of clinical studies. Accuracy-related deviation data were summarized as forest plots and normal distributions. RESULTS Forty-one articles were included with high degree of credibility. Data showed that implant surgery accuracy can be achieved with mean distance deviation < 2 mm (most < 1 mm) and angular deviation < 8° (most < 5°). CONCLUSIONS Bilateral tooth-supported guides exhibited highest in vitro accuracy and similar in vivo accuracy to unilateral tooth-supported guides; mucosa-supported guides exhibit lowest in vivo accuracy, while its in vitro data showed low credibility due to mechanical complexity of living mucosa tissue. Milling exhibited higher in vivo accuracy of guides than 3d-printing, though further data support was needed. Design of fixation screws and sleeves of implant guides affected the surgical accuracy and might remain a research focus in near future. However, lack of universal evaluation standards for implantation accuracy remained a major problem in this field. The influence of implant guides on surgical accuracy revealed in this review might shed light on future development of dental implantology.
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Affiliation(s)
- Yiting Shi
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China
| | - JunKai Wang
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China
| | - Chao Ma
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China
| | - Jiayi Shen
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China
| | - Xian Dong
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China.
| | - Dan Lin
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China.
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Çakmak G, Donmez MB, Akay C, de Paula MS, Mangano FG, Abou-Ayash S, Yilmaz B. Effect of measurement techniques and operators on measured deviations in digital implant scans. J Dent 2023; 130:104388. [PMID: 36502966 DOI: 10.1016/j.jdent.2022.104388] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/21/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To evaluate the effect of different measurement techniques and operators on measured deviations in vitro implant scans. METHODS A 2-piece system that comprises a healing abutment (HA) and a scan body (SB) was mounted onto an implant at right first molar site of a polymethylmethacrylate mandibular dentate model. Model was digitized by using an industrial scanner (reference model scan, n = 1) and an intraoral scanner (test scan, n = 20). All standard tessellation language files were imported into a 3-dimensional analysis software and superimposed. Three operators with similar experience performed circle-based and point-based deviation analyses (n = 20). Deviations measured with different techniques were compared with paired samples t-test within each operator, while the reliability of the operators was assessed by using F-tests for both technqiues (α = 0.05). RESULTS Point-based technique resulted in lower deviations than circle-based technique for all operators (P = .001) with to higher reliability among operators (ICC = 0.438, P = .001). The correlation among the operators was nonsignificant when circle-based technique was used (ICC = 0.114, P = .189). CONCLUSION Lower deviations were detected with the point-based technique. In addition, different operators' measurements had higher correlation when point-based technique was used compared with circle-based technique. CLINICAL SIGNIFICANCE Point-based technique may be preferred over circle-based technique for research studies on scan accuracy of implants, given its higher reliability. The accuracy of measured deviations may increase if the number of planes are increased, which can facilitate point generation at different surfaces of the scan body.
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Affiliation(s)
- Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, Istinye University, Faculty of Dentistry, Istanbul, Turkey.
| | - Canan Akay
- Department of Prosthodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey; Translational Medicine Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Marcella Silva de Paula
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Universidade Federal de Goiás, Department of Prevention and Oral Rehabilitation, Goiânia, GO, Brasil
| | - Francesco Guido Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, OH, USA
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Tremp M, Schneider J, Raghu RBN, Goksel A, Saban Y. A Systematic Analysis of the Nasal Septum in Crooked Noses and Suggested Treatment Algorithm According to Preservation Rhinoplasty (PR) Principles. Aesthetic Plast Surg 2023:10.1007/s00266-023-03293-3. [PMID: 36826521 PMCID: PMC10390351 DOI: 10.1007/s00266-023-03293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/28/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND A deviated nose is a common problem among patients for both cosmetic and functional reasons. The correction remains a major challenge for the rhinoplasty surgeon. Unrecognized nasal septal deviations stand as the primary reason for failed rhinoplasty outcomes. There is a paucity of data in the literature about septoplasty classifications and technical details in preservation rhinoplasty (PR) for various crooked noses. MATERIALS AND METHODS The aim of this article is to provide a comprehensive overview of the various septum deviations according to the nasal axis. Moreover, a treatment algorithm is suggested with technical details based on PR principles. RESULTS The directions and curvature of the cartilaginous deviation of crooked nose such as C-shaped, reverse C-shaped, straight axis deviations (I-shaped), and S-shaped are described. According to the deviation, a septoplasty classification (Type 1-Type 4) is suggested. CONCLUSIONS On the basis of septal deviation, different PR techniques are proposed to achieve the desired straight nasal dorsum with an optimal functional outcome. Compared to the classical L-strut concept, the quadrangular cartilage remains preserved in the swinging door technique. The cartilage might be further used in the future for grafting in the hybrid structural/preservation technique if needed, ultimately saving rib cartilage and/or conchal cartilage. Finally, surgery time is reduced, and patient's morbidity remains minimal. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Mathias Tremp
- Faculty of Medicine, University of Basel, Basel, BS, Switzerland. .,Private Practice, Hirslanden Private Hospital Group, Dorfplatz 1, 6330, Cham, Switzerland.
| | - Jonas Schneider
- Faculty of Medicine, University of Basel, Basel, BS, Switzerland
| | | | | | - Yves Saban
- Rhinoplasty Private Practice, Nice, France
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Arokia Femina T, Barghavi V, Archana K, Swethaa NG, Maddaly R. Non-uniformity in in vitro drug-induced cytotoxicity as evidenced by differences in IC 50 values - implications and way forward. J Pharmacol Toxicol Methods 2023; 119:107238. [PMID: 36521817 DOI: 10.1016/j.vascn.2022.107238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
Cell lines have proven indispensable for in vitro experiments and their utility as experimental models range from understanding the fundamental cell functioning to drug discovery. One of the most common utility of cell lines is for in vitro drug testing. Drug testing involves determining the cytotoxic effects of the drugs and such a measurement is expressed as the IC50 values of drugs. Although determination of IC50 values of drugs on cell lines is one of the most common in vitro experimental approaches, a significant amount of variations can be observed in the results obtained from such studies. Although the variations in the IC50 values of a drug on different cells lines can and should vary, the non-uniformity of such results reported from different studies using a particular drug on a specific cell line is a matter of concern. We present the IC50 values of 5 most commonly used drugs 5-fluorouracil, bleomycin, cisplatin, doxorubicin and methotrexate obtained from several in vitro cell line-based studies. Some of the factors which contribute to the non-uniformity of the IC50 values for a particular drug from different studies are discussed as three types of factors, the biological, non-biological and human factors. Also, ways in which such variations can be reduced to obtain universally common, reliable results are presented.
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Affiliation(s)
- T Arokia Femina
- Department of Human Genetics, Faculty of Biomedical Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu 600116, India
| | - V Barghavi
- Department of Human Genetics, Faculty of Biomedical Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu 600116, India
| | - K Archana
- Department of Human Genetics, Faculty of Biomedical Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu 600116, India
| | - N G Swethaa
- Department of Biotechnology, Anna University, Guindy, Chennai 600 025, India
| | - Ravi Maddaly
- Department of Human Genetics, Faculty of Biomedical Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu 600116, India.
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Boviatsis M. Legal assessment of BIMCO's infectious or contagious diseases (IOCD) clauses for voyage and time charter parties. Mar Policy 2022; 144:105206. [PMID: 35911784 PMCID: PMC9306314 DOI: 10.1016/j.marpol.2022.105206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 07/03/2022] [Accepted: 07/10/2022] [Indexed: 05/13/2023]
Abstract
The impact of the Covid-19 pandemic on the shipping industry is still severe, ranging from vessels being denied entrance to ports to crews on board ships being trapped for many months. To counter and regulate those emerging issues, the shipping industry presently incorporated into the charter parties the BIMCO's Disease Clause originated from the 2015 Ebola outbreak, the so-called BIMCO's Infectious or Contagious Diseases (IOCD) Clauses. While proved successful during the Ebola outbreak, those Clauses were inadequate to regulate a global pandemic such as Covid-19 effectively. Specifically, the IOCD Clauses, while they successfully establish the concepts of 'Disease' and 'Affected Area', fail with the allocation of liability, especially when the crew on board is affected by Covid-19 and the ship needs to deviate from course to change the crew. In that instance, the shipowner, provided that he exercised due diligence in proactively avoiding the infection of his crew, is excluded from liability. In contrast, it is deemed that the liability between shipowner and charterer should be at least shared. For voyage charter parties BIMCO's Infectious or Contagious Diseases Clause 2015, applied both to the Ebola and the Covid-19 outbreak, allocates the right of termination and the liability for deviations and excessive costs strictly to charterers. In contrast, for the time charter parties, BIMCO has imposed the 'BIMCO Infectious or Contagious Diseases Clause for Time Charter Parties 2022' amended presently. According to those regulations, the liability can and should be shared between charterers and ship owners. As a result, the shipowner is forced to exercise due diligence more effectively, especially when he is initially liable for the excessive costs.
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Affiliation(s)
- M Boviatsis
- University of Piraeus, Department of Maritime Studies, Greece
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Shan X, Uddin LQ, Xiao J, He C, Ling Z, Li L, Huang X, Chen H, Duan X. Mapping the Heterogeneous Brain Structural Phenotype of Autism Spectrum Disorder Using the Normative Model. Biol Psychiatry 2022; 91:967-976. [PMID: 35367047 DOI: 10.1016/j.biopsych.2022.01.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/28/2021] [Accepted: 01/14/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by substantial clinical and biological heterogeneity. Quantitative and individualized metrics for delineating the heterogeneity of brain structure in ASD are still lacking. Likewise, the extent to which brain structural metrics of ASD deviate from typical development (TD) and whether deviations can be used for parsing brain structural phenotypes of ASD is unclear. METHODS T1-weighted magnetic resonance imaging data from the Autism Brain Imaging Data Exchange (ABIDE) II (nTD = 564) were used to generate a normative model to map brain structure deviations of ABIDE I subjects (nTD = 560, nASD = 496). Voxel-based morphometry was used to compute gray matter volume. Non-negative matrix factorization was employed to decompose the gray matter matrix into 6 factors and weights. These weights were used for normative modeling to estimate the factor deviations. Then, clustering analysis was used to identify ASD subtypes. RESULTS Compared with TD, ASD showed increased weights and deviations in 5 factors. Three subtypes with distinct neuroanatomical deviation patterns were identified. ASD subtype 1 and subtype 3 showed positive deviations, whereas ASD subtype 2 showed negative deviations. Distinct clinical manifestations in social communication deficits were identified among the three subtypes. CONCLUSIONS Our findings suggest that individuals with ASD have heterogeneous deviation patterns in brain structure. The results highlight the need to test for subtypes in neuroimaging studies of ASD. This study also presents a framework for understanding neuroanatomical heterogeneity in this increasingly prevalent neurodevelopmental disorder.
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Affiliation(s)
- Xiaolong Shan
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Ministry of Education Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Lucina Q Uddin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Jinming Xiao
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Ministry of Education Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Changchun He
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Ministry of Education Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Zihan Ling
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Ministry of Education Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Lei Li
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Ministry of Education Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinyue Huang
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Ministry of Education Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Ministry of Education Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Xujun Duan
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Ministry of Education Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China.
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Li Z, Qu B, Wu X, Chen H, Wang J, Zhou L, Wu X, Zhang W. Methodology improvement for network pharmacology to correct the deviation of deduced medicinal constituents and mechanism: Xian-Ling-Gu-Bao as an example. J Ethnopharmacol 2022; 289:115058. [PMID: 35114343 DOI: 10.1016/j.jep.2022.115058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/17/2021] [Accepted: 01/27/2022] [Indexed: 06/14/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Network pharmacology is extremely adaptive for investigating traditional ethnic drugs, especially the herbal medicines. However, challenges still hang over many related studies due to the limitations in the methodology of conventional network pharmacology. AIM OF THE STUDY Our work was aimed to investigate the methodology limitations of conventional network pharmacology with Xian-Ling-Gu-Bao (XLGB) as a representative, meanwhile, propose the strategies for coping with these issues. MATERIALS AND METHODS Predicted phytochemical constituents formed virtual XLGB. The constituents in realistic XLGB samples was detected by liquid chromatography-mass spectrometry (LC-MS) to correct the constituent deviation resulted from virtual prediction. Multivariate statistical analysis of quantitative target data were used to reveal the relation of target profile between drug and disease. The key constituents and targets were screened and compared between virtual and realistic XLGB through network analysis. After enrichment analysis, reversing network pharmacology was performed to exclude weak targets and re-construct the interaction from key pathways to key targets. Finally, the core constituents and action mechanism of XLGB were deduced. RESULTS Significant deviation of phytochemical constituents was found between virtual and realistic XLGB. As expected, this deviation led to a cascade of deviation ranging from deduced key constituents to key targets and key pathways. Moreover, many key KEGG pathways were enriched and screened out, however, they were almost irrelevant to the studied disease. These results systemically illustrated the limitations in the methodology of conventional network pharmacology. Importantly, the strategies for coping with these limitations were proposed, such as high-throughput detection of the realistic samples, multivariate analysis of target profile and combined enrichment analysis. Finally, based on the improved network pharmacology, the medicinal constituents and mechanism of XLGB against osteoarthritis were effectively deduced. CONCLUSIONS Our work highlighted the necessity and proposed the strategies for improving the methodology of conventional network pharmacology. The corrected results from improved network pharmacology provided promising directions for future research on XLGB.
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Affiliation(s)
- Zheng Li
- Jiangsu Engineering Research Center of Cardiovascular Drugs Targeting Endothelial Cells, College of Health Sciences, School of Life Sciences, Jiangsu Normal University, Xuzhou, China; State Key Laboratory of Natural and Biomimetic Drugs, Peking University, Beijing, China.
| | - Biao Qu
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, China
| | - Xiaowen Wu
- Department of Pharmacy, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Hongwei Chen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Jue Wang
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, China
| | - Lei Zhou
- Jiangsu Engineering Research Center of Cardiovascular Drugs Targeting Endothelial Cells, College of Health Sciences, School of Life Sciences, Jiangsu Normal University, Xuzhou, China
| | - Xiaoyi Wu
- Department of Pharmacy, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Wei Zhang
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, China
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Li Z, Lai X, Lai J, Qi M, Yuan L, Zeng X, Ji F. Correction of the Estimated Hearing Level of NB Chirp ABR in Normal Hearing Population. Audiol Neurootol 2022; 27:388-396. [PMID: 35443242 DOI: 10.1159/000523918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/27/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The narrowband chirp (NB Chirp), a frequency-specific sound stimulus signal obtained by limiting the frequency bandwidth based on chirp, is applied to the frequency specified auditory brainstem response (fsABR) increasingly. Although some studies demonstrated that NB Chirp-evoked auditory brainstem response (NB Chirp ABR) causes a better neural response than tone burst-evoked auditory brainstem response and is preferred for fsABR, there is little known about how to better estimate an individual's hearing level through the threshold of NB Chirp ABR. The present study intended to compare the accuracy and deviation of NB Chirp ABR corrected by different approaches in estimating the hearing level of people with normal hearing. METHODS A total of 66 volunteers with normal hearing were randomly divided into a model group (n = 26), test group 1 (n = 20), and test group 2 (n = 20). The model group was used to calculate the threshold difference between NB Chirp ABR and pure-tone audiometry at 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz, as well as the regression equation, providing a reference for the correction of estimated hearing level of NB Chirp ABR. Test group 1 was used to observe the accuracy and deviation of the "noncorrection (N)," "threshold difference (A1)," and "regression equation (A2)" methods in correcting the estimated hearing level of NB Chirp ABR. Test group 2 was used to replicate the analysis of test group 1 to verify the repeatability of the experimental results. All data were analyzed using SPSS 24.0. RESULTS Test group 1 and test group 2 had similar results. First, the accuracy of the estimated hearing level of N was significantly higher than that of A1 or A2. Second, compared with "0," the deviation of the estimated hearing level of N was bigger than that of A1 or A2 at 500 Hz and 1,000 Hz, while similar at 2,000 Hz and 4,000 Hz. Finally, there was no significant difference in the deviation of the estimated hearing level between A1 and A2 at 500 Hz and 1,000 Hz. CONCLUSION Among people with normal hearing, it was necessary to correct NB Chirp ABR at 500 Hz and 1,000 Hz for lower deviation of the estimated hearing level. Both correction approaches based on threshold difference and regression equation can be used.
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Affiliation(s)
- Zhicheng Li
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,
- Department of Otolaryngology-Head & Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China,
| | - Xiaofen Lai
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Department of Otolaryngology-Head & Neck Surgery, He Xian Memorial Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Jinmei Lai
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Department of Otolaryngology-Head & Neck Surgery, Quanzhou Hospital of Traditional Chinese Medicine, Quanzhou, China
| | - Min Qi
- Department of Otolaryngology-Head & Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lianxiong Yuan
- Department of Scientific Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiangli Zeng
- Department of Otolaryngology-Head & Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Fei Ji
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
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Eusemann BK, Ulrich R, Sanchez-Rodriguez E, Benavides-Reyes C, Dominguez-Gasca N, Rodriguez-Navarro AB, Petow S. Bone quality and composition are influenced by egg production, layer line, and estradiol-17ß in laying hens. Avian Pathol 2022; 51:267-282. [PMID: 35261302 DOI: 10.1080/03079457.2022.2050671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Keel bone fractures are a serious animal welfare problem in laying hens. The aim of the current study was to assess the influence of egg production, estradiol-17ß, and selection for high laying performance on bone quality. Hens of two layer lines differing in laying performance (WLA: 320 eggs per year, G11: 200 eggs per year) were allocated to four treatment groups. Group S received a deslorelin acetate implant that suppressed egg production. Group E received an implant with the sexual steroid estradiol-17ß. Group SE received both implants and group C did not receive any implant. In the 63rd week of age, composition and characteristics of the tibiotarsi were assessed using histological analysis, three-point bending test, thermogravimetric analysis, infrared spectroscopy, and two-dimensional X-ray diffraction, respectively. Non-egg laying hens showed a higher total bone area and a higher relative amount of cortical bone compared to egg laying hens. Hens of layer line G11 showed a higher relative amount of medullary bone and a higher degree of mineralization of the cortical bone compared to hens of layer line WLA. These differences in bone composition may explain different susceptibility for keel bone fractures in non-egg laying compared to egg laying hens as well as in hens of layer lines differing in laying performance. The effect of exogenous estradiol-17ß on bone parameters varied between the layer lines indicating a genetic influence on bone physiology and the way it can be modulated by hormone substitution.
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Affiliation(s)
| | - Reiner Ulrich
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler-Institut, Greifswald - Isle of Riems, Germany
| | | | | | | | | | - Stefanie Petow
- Institute of Animal Welfare and Animal Husbandry, Friedrich-Loeffler-Institut, Celle, Germany
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Bailly R, Lempereur M, Thepaut M, Pons C, Houx L, Brochard S. Relationship between 3D lower limb bone morphology and 3D gait variables in children with uni and bilateral Cerebral Palsy. Gait Posture 2022; 92:51-59. [PMID: 34826693 DOI: 10.1016/j.gaitpost.2021.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/27/2021] [Accepted: 11/06/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Medical and surgical interventions to prevent or reduce bone deformities and improve gait in children with cerebral palsy (CP) are based on empirical evidence that there is a relationship between bone deformities and gait deviations. RESEARCH QUESTION What is the relationship between tibial-femoral bone morphology and kinematic gait variables in ambulant children with CP? METHODS A retrospective analysis was conducted on data from 121 children with uni- (n = 64, mean age 9.9 (SD 3.4) years) and bi- lateral (n = 57, mean age 10.4 (SD 3.6) years) CP who had undergone 3D gait analysis and biplanar X-rays (EOS® system). The limbs were split as DIP (the more impaired limb of children with bilateral CP), HEMI (the impaired limb of unilateral CP) and REF (the unimpaired limb of unilateral CP). Multi-variable Linear Regressions were performed between 23 kinematic variables, the Gait Deviation Index (GDI) and a model composed of nine 3D bone variables for each limb type. RESULTS When the whole sample was pooled, 72% of R2 values were poor, 16% were fair, and 12% were moderate. Lower limb bone morphology models explained less than 1% of GDI variability. Correlations between tibial-femoral rotational parameters and hip rotation were mostly poor. Mean foot progression angle was the only kinematic parameter that was fairly to moderately correlated with bone variables in the 3 limb types. A tibial-femoral bone model explained 48% of the variability of mean foot progression angle in the REF limbs, 31% in the HEMI limbs and 25% in the DIP limbs. SIGNIFICANCE Tibial-femoral bone morphology was only weakly related to kinematic gait variables, in contrast with common clinical assumptions. These results suggest that factors other than bone morphology influence gait quality and thus a thorough clinical examination and gait analysis is required prior to making treatment decisions.
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Affiliation(s)
- Rodolphe Bailly
- Fondation Ildys, Brest, France; LATIM, Inserm U1101, Brest, France; Université de Bretagne Occidentale, Brest, France.
| | - Mathieu Lempereur
- LATIM, Inserm U1101, Brest, France; Université de Bretagne Occidentale, Brest, France; Service de Médecine Physique et de Réadaptation, CHRU Brest, France
| | | | - Christelle Pons
- Fondation Ildys, Brest, France; LATIM, Inserm U1101, Brest, France; Université de Bretagne Occidentale, Brest, France; Service de Médecine Physique et de Réadaptation, CHRU Brest, France
| | - Laetitia Houx
- LATIM, Inserm U1101, Brest, France; Université de Bretagne Occidentale, Brest, France; Service de Médecine Physique et de Réadaptation, CHRU Brest, France
| | - Sylvain Brochard
- Fondation Ildys, Brest, France; LATIM, Inserm U1101, Brest, France; Université de Bretagne Occidentale, Brest, France; Service de Médecine Physique et de Réadaptation, CHRU Brest, France
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Elvin Gul E, Azizi Z, Alipour P, Haseeb S, Malcolm R, Terricabras M, Sanchez Somonte P, Tsang B, Khaykin Y, Wulffhart Z, Verma A, Pantano A. Fluoroless Catheter Ablation of Atrial Fibrillation: Integration of Intracardiac Echocardiography and Cartosound Module. J Atr Fibrillation 2021; 14:20200477. [PMID: 34950370 DOI: 10.4022/jafib.20200477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/19/2021] [Accepted: 05/18/2021] [Indexed: 12/18/2022]
Abstract
Objective To evaluate the feasibility, safety, and clinical efficacy of non-fluoroscopic radiofrequency catheter ablation of atrial fibrillation (AF) in comparison to traditional fluoroscopy-guided ablation in a local Canadian community cohort. Methods We retrospectively studied consecutive patients with paroxysmal and persistent AF undergoing pulmonary vein isolation (PVI) guided by intracardiac echocardiography (ICE) and Carto system (CartoSound module). ICE-guided PVI without fluoroscopy (Zero-fluoro group) was performed in 116 patients, and conventional fluoroscopy-guided PVI (Traditional group) was performed in 131 patients. Results Two hundred and forty-seven patients with AF (60.7% male; mean age: 62.2 ± 10.6 years; paroxysmal AF =63.1%) who underwent PVI were studied. Mean procedure times were similar between both groups (136.8±33.4 minutes in the zero-fluoro group vs. 144.3±44.9 minutes in the traditional group; p=0.2). Acute PVI was achieved in all patients. Survival from early AF recurrence was 85% and 81% in the zero-fluoro and traditional groups, respectively (p = 0.06). Survival from late AF recurrence (12-months) between the zero-fluoro and traditional groups was also similar (p=0.1). Moreover, there were no significant differences between complication rates, including hematoma (p = 0.2) and tamponade (p = 1),between both groups. Conclusions Zero-fluoroscopy ICE and CartoSound-guided AF ablation may be safe and feasible in patients undergoing PVI compared to conventional fluoroscopy-guided ablation.
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Affiliation(s)
- Enes Elvin Gul
- Division of Cardiology, Southlake Regional Health Centre, University of Toronto, Toronto, Ontario, Canada.,Contributed equally as first co-authors
| | - Zahra Azizi
- Division of Cardiology, Southlake Regional Health Centre, University of Toronto, Toronto, Ontario, Canada.,Contributed equally as first co-authors
| | - Pouria Alipour
- Division of Cardiology, Southlake Regional Health Centre, University of Toronto, Toronto, Ontario, Canada
| | - Sohaib Haseeb
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Rebecca Malcolm
- Division of Cardiology, Southlake Regional Health Centre, University of Toronto, Toronto, Ontario, Canada
| | - Maria Terricabras
- Division of Cardiology, Southlake Regional Health Centre, University of Toronto, Toronto, Ontario, Canada
| | - Paula Sanchez Somonte
- Division of Cardiology, Southlake Regional Health Centre, University of Toronto, Toronto, Ontario, Canada
| | - Bernice Tsang
- Division of Cardiology, Southlake Regional Health Centre, University of Toronto, Toronto, Ontario, Canada
| | - Yaariv Khaykin
- Division of Cardiology, Southlake Regional Health Centre, University of Toronto, Toronto, Ontario, Canada
| | - Zaev Wulffhart
- Division of Cardiology, Southlake Regional Health Centre, University of Toronto, Toronto, Ontario, Canada
| | - Atul Verma
- Division of Cardiology, Southlake Regional Health Centre, University of Toronto, Toronto, Ontario, Canada
| | - Alfredo Pantano
- Division of Cardiology, Southlake Regional Health Centre, University of Toronto, Toronto, Ontario, Canada
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Khalladi N, Dejean C, Bosset M, Pointreau Y, Kinj R, Racadot S, Castelli J, Huguet F, Renard S, Guihard S, Tao Y, Rouvier JM, Johnson A, Bourhis J, Xu Shan S, Thariat J. A priori quality assurance using a benchmark case of the randomized phase 2 GORTEC 2014-14 in oligometastatic head and neck cancer patients. Cancer Radiother 2021; 25:755-762. [PMID: 34565664 DOI: 10.1016/j.canrad.2021.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/19/2021] [Accepted: 04/28/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE A Benchmark Case (BC) was performed as part of the quality assurance process of the randomized phase 2 GORTEC 2014-14 OMET study, testing the possibility of multisite stereotactic radiation therapy (SBRT) alone in oligometastatic head and neck squamous cell carcinoma (HNSCC) as an alternative to systemic treatment and SBRT. MATERIAL AND METHODS Compliance of the investigating centers with the prescription, delineation, planning and evaluation recommendations available in the research protocol was assessed. In addition, classical dosimetric analysis was supplemented by quantitative geometric analysis using conformation indices. RESULTS Twenty centers participated in the BC analysis. Among them, four major deviations (MaD) were reported in two centers. Two (10%) centers in MaD had omitted the satellite tumor nodule and secondarily validated after revision. Their respective DICE indexes were 0.37 and 0 and use of extracranial SBRT devices suboptimal There were significant residual heterogeneities between participating centers, including those with a similar SBRT equipment, with impact of plan quality using standard indicators and geometric indices. CONCLUSION A priori QA using a BC conditioning the participation of the clinical investigation centers showed deviations from good SBRT practice and led to the exclusion of one out of the twenty participating centers. The majority of centers have demonstrated rigorous compliance with the research protocol. The use of quality indexes adds a complementary approach to improve assessment of plan quality.
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Affiliation(s)
- N Khalladi
- Centre François Baclesse, 3, avenue General Harris, 14076 Caen, France
| | - C Dejean
- Centre Antoine Lacassagne, Nice, France
| | - M Bosset
- Centre Marie Curie, Valence, France
| | | | - R Kinj
- Centre Antoine Lacassagne, Nice, France
| | | | | | - F Huguet
- Centre hospitalier et universitaire Tenon, Paris, France
| | - S Renard
- Institut de Cancérologie de Lorraine, Nancy, France
| | - S Guihard
- Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | - Y Tao
- Institut Gustave Roussy, Villejuif, France
| | - J M Rouvier
- Centre hospitalier régional et universitaire, Besançon-Montbéliard, France
| | - A Johnson
- Centre François Baclesse, 3, avenue General Harris, 14076 Caen, France
| | - J Bourhis
- Centre hospitalier universitaire vaudois, Lausanne, Switzerland
| | - S Xu Shan
- Centre hospitalier universitaire vaudois, Lausanne, Switzerland
| | - J Thariat
- Centre François Baclesse, 3, avenue General Harris, 14076 Caen, France; Corpuscular Physics Laboratory-Normandy University, Caen, France.
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Lemonakis P, Eliou N, Karakasidis T. Investigation of speed and trajectory of motorcycle riders at curved road sections of two-lane rural roads under diverse lighting conditions. J Safety Res 2021; 78:138-145. [PMID: 34399909 DOI: 10.1016/j.jsr.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/15/2021] [Accepted: 05/25/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Vehicular accidents at horizontal curves are over-represented compared to accidents that occur at tangent sections. Investigations have been conducted aimed at identifying the major causes that result in higher accident risk, both in terms of severity and rate, at curved road sections. Excessive or abrupt changes in speeding and improper vertical position are cited as major factors of lane departure, whereas other factors (either human or environmental) have also been documented. However, most research involves 4-wheel vehicles rather than other modes of transport that behave differently. More specifically, while motorcyclist fatalities occur more frequently than passenger vehicles, when accounting for vehicle distance traveled only a limited number of research studies address their behavior at curved road sections. METHOD This paper presents the findings of field operational tests carried out by motorcyclists along two-lane rural roads with a wide range of horizontal curves using an instrumented motorcycle. Key objectives of the research included the conditions under which the motorcyclists differentiate their trajectory in regards to the direction of the horizontal curves, the correlation between the trajectory and the geometry of the road, and the impact of the lighting conditions on riders' behavior. RESULTS The research showed that motorcyclists tend to ride closer to the centerline of the road, neglect the hazards associated with dim lighting conditions, and maintain constant speed in the left hand and the right-hand horizontal curves.
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Affiliation(s)
| | - Nikolaos Eliou
- Department of Civil Engineering, University of Thessaly, Volos, Greece
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20
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Batabyal D, Lord H, Ahlstrom B, Wikström M. Determination of the experimental extinction coefficient of therapeutic proteins using the Edelhoch method. Biologicals 2021; 71:42-47. [PMID: 33875326 DOI: 10.1016/j.biologicals.2021.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/25/2021] [Accepted: 03/31/2021] [Indexed: 11/27/2022] Open
Abstract
The objective of this study was to determine how the theoretical values of the extinction coefficient (EC) compares to the experimentally determined extinction coefficient for a large set of biotherapeutic proteins measured by the Edelhoch method. We have performed extensive analysis based on over 176 observations covering 19 different types of molecules from different structural classes covering mAbs, bispecific antibodies, fusion proteins and BiTE molecules. Precision was measured by assessing the repeatability of the measurements for each molecule and determining the relative standard deviation (%RSD). The maximum RSD observed for any given molecule was 1.7% with an average RSD of 0.9%. Deviation from the theoretical extinction coefficient was determined by calculating the experimental bias first, which is the difference between the mean experimental extinction coefficient and the theoretical extinction coefficient. The percent bias (%bias) was then calculated as (bias ÷ theoretical EC) × 100. The maximum %bias observed for any given molecule was 5.3% with an average %bias of 2.6%. Our results indicate that the Edelhoch method is highly reliable with significant improvement in execution efficiency with reduction in cost, time and improvements in safety when compared to the commonly used methods such as amino acid analysis (AAA) technique.
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Alkasbi J, Mortuaire G, Rysman B, Nicot R, Chevalier D, Mouawad F. Match between therapeutic proposal in multidisciplinary tumor board and actual treatment in head and neck cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:247-252. [PMID: 33257266 DOI: 10.1016/j.anorl.2020.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES There are few published studies evaluating the quality and outcome of multidisciplinary tumor board (MDTB) decisions. The aim of the present study was to evaluate adherence to MDTB recommendations in head and neck cancer and to document reasons in case of discordance. MATERIAL AND METHODS We included all patients with newly diagnosed head and neck cancer presented in our MDTB meetings between January 1st and December 31st, 2018, whatever the tumor site, histology type and TNM classification. MDTB recommendations were compared to actual treatment. Discordance was defined as treatment partially or entirely different from the treatment decision recorded in the MDTB minutes. RESULTS Board decisions were made for 344 new patients. Complete treatment concordance rate was 91.6% (315/344 patients), with deviation in 29 patients. Reasons for deviation were complications of treatment in 10 cases, patient refusal in 8, and physician's decision in 4 cases. Five patients died before therapy initiation. Mean interval from board discussion to treatment was 21 days, and depended on type of treatment (range, 1 to 74 days). CONCLUSION This study shows the importance of evaluating concordance between the protocol proposed in the MDTB and the treatment actually received, to identify factors for deviation and remedy them when possible.
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Affiliation(s)
- J Alkasbi
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Huriez, CHU de Lille, Université de Lille, rue Michel Polonovski, 59037 Lille cedex, France
| | - G Mortuaire
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Huriez, CHU de Lille, Université de Lille, rue Michel Polonovski, 59037 Lille cedex, France
| | - B Rysman
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Huriez, CHU de Lille, Université de Lille, rue Michel Polonovski, 59037 Lille cedex, France
| | - R Nicot
- Service de Stomatologie et de Chirurgie Maxillo-Faciale, Hôpital Roger Salengro, CHU de Lille, Université de Lille, Rue Michel Polonovski, 59037 Lille cedex, France
| | - D Chevalier
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Huriez, CHU de Lille, Université de Lille, rue Michel Polonovski, 59037 Lille cedex, France
| | - F Mouawad
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Huriez, CHU de Lille, Université de Lille, rue Michel Polonovski, 59037 Lille cedex, France; Inserm U 908, Lille Science and Technology University, UFR de Biologie - SN3, 59655 Villeneuve d'Ascq, France.
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Dietzsch S, Braesigk A, Seidel C, Remmele J, Kitzing R, Schlender T, Mynarek M, Geismar D, Jablonska K, Schwarz R, Pazos M, Walser M, Frick S, Gurtner K, Matuschek C, Harrabi SB, Glück A, Lewitzki V, Dieckmann K, Benesch M, Gerber NU, Rutkowski S, Timmermann B, Kortmann RD. Pretreatment central quality control for craniospinal irradiation in non-metastatic medulloblastoma : First experiences of the German radiotherapy quality control panel in the SIOP PNET5 MB trial. Strahlenther Onkol 2020; 197:674-682. [PMID: 33226469 PMCID: PMC8292275 DOI: 10.1007/s00066-020-01707-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/23/2020] [Indexed: 12/13/2022]
Abstract
Purpose Several studies have demonstrated the negative impact of radiotherapy protocol deviations on tumor control in medulloblastoma. In the SIOP PNET5 MB trial, a pretreatment radiotherapy quality control (RT-QC) program was introduced. A first analysis for patients enrolled in Germany, Switzerland and Austria with focus on types of deviations in the initial plan proposals and review criteria for modern radiation technologies was performed. Methods and patients Sixty-nine craniospinal irradiation (CSI) plans were available for detailed analyses. RT-QC was performed according to protocol definitions on dose uniformity. Because of the lack of definitions for high-precision 3D conformal radiotherapy within the protocol, additional criteria for RT-QC on delineation and coverage of clinical target volume (CTV) and planning target volume (PTV) were defined and evaluated. Results Target volume (CTV/PTV) deviations occurred in 49.3% of initial CSI plan proposals (33.3% minor, 15.9% major). Dose uniformity deviations were less frequent (43.5%). Modification of the RT plan was recommended in 43.5% of CSI plans. Unacceptable RT plans were predominantly related to incorrect target delineation rather than dose uniformity. Unacceptable plans were negatively correlated to the number of enrolled patients per institution with a cutoff of 5 patients (p = 0.001). Conclusion This prospective pretreatment individual case review study revealed a high rate of deviations and emphasizes the strong need of pretreatment RT-QC in clinical trials for medulloblastoma. Furthermore, the experiences point out the necessity of new RT-QC criteria for high-precision CSI techniques. Electronic supplementary material The online version of this article (10.1007/s00066-020-01707-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stefan Dietzsch
- Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany.
| | - Annett Braesigk
- Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany
| | - Clemens Seidel
- Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany
| | - Julia Remmele
- Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany
| | - Ralf Kitzing
- Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany
| | - Tina Schlender
- Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany
| | - Martin Mynarek
- Departement of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dirk Geismar
- Clinic for Particle Therapy, West German Proton Therapy Centre, University of Essen, Essen, Germany
| | - Karolina Jablonska
- Faculty of Medicine, Department of Radiation Oncology, University of Cologne, Cologne, Germany
| | - Rudolf Schwarz
- Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Montserrat Pazos
- Department of Radiotherapy and Radiation Oncology, Ludwig Maximilian University Munich, Munich, Germany
| | - Marc Walser
- Center for Protontherapy, Paul Scherrer Institute, Villigen, Switzerland
| | - Silke Frick
- Department of Radiotherapy and Radiation Oncology, Hospital Bremen Mitte, Bremen, Germany
| | - Kristin Gurtner
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Christiane Matuschek
- Department of Radiation Oncology, Medical Faculty Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Semi Ben Harrabi
- Department of Radiation Oncology and Radiotherapy, Heidelberg University Hospital, Heidelberg, Germany
| | - Albrecht Glück
- Radiation Oncology, Munich-Schwabing Municipal Hospital, Munich, Germany
| | - Victor Lewitzki
- Department of Radiotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Karin Dieckmann
- Department of Radiotherapy, Medical University of Vienna, Vienna, Austria
| | - Martin Benesch
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | | | - Stefan Rutkowski
- Departement of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Beate Timmermann
- Clinic for Particle Therapy, West German Proton Therapy Centre, University of Essen, Essen, Germany
| | - Rolf-Dieter Kortmann
- Department for Radiation Oncology, University of Leipzig Medical Center, Stephanstr. 9a, 04103, Leipzig, Germany
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Akay G, Eren İ, Karadag Ö, Güngör K. Nasal septal deviation in the unilateral cleft lip and palate deformities: a three-dimensional analysis. Oral Radiol 2020; 37:567-572. [PMID: 33180266 DOI: 10.1007/s11282-020-00491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Lip and palate deformities are an important craniofacial congenital anomaly that negatively affects the anatomy of the nasal cavity and maxilla. This study aimed to evaluate the nasal septum deviation in individuals with a unilateral cleft lip and palate. METHODS The sample consists of 22 unilateral cleft lip-palate patients and 20 controls with non-cleft skeletal Class III. Maximal septal deviation angle and linear dimension were measured on cone-beam computed tomography images. The localization of maximal septal deviation was determined. The data were analyzed and compared between unilateral cleft lip-palate patients and skeletal Class III individuals. RESULTS For septal deviation, a significant discrepancy between unilateral cleft patients and skeletal Class III subjects was detected at the anterior nasal spine (ANS) level, the posterior nasal spine (PNS) level and the ANS-PNS midpoint level (p < 0.05). The maximum septal deviation angle of individuals with a unilateral cleft was significantly greater than individuals with skeletal Class III (p < 0.05). No statistically significant differences were found in the localization of maximum septal deviation between the unilateral cleft patients and the Class III individuals. CONCLUSION Our results demonstrated that the maximum septal deviation angle and dimension had significant differences in individuals with a unilateral cleft, compared to a skeletal Class III control group. However, no statistically significant discrepancy was observed between three levels (ANS, PNS and ANS-PNS middle levels) in the unilateral cleft patients.
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Affiliation(s)
- Gülsün Akay
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Bişkek street, 82. street No:4, Emek, Ankara, Turkey.
| | - İlkay Eren
- Ministry of Health, Osmanlı Oral and Dental Health Center, Ankara, Turkey
| | - Özge Karadag
- Department of Statistics, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - Kahraman Güngör
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Bişkek street, 82. street No:4, Emek, Ankara, Turkey
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Teo TW, Tan BYQ, Sia CH. 32-year-old with Paroxysmal Atrial Fibrillation after Traumatic Spinal Cord Injury. J Atr Fibrillation 2020; 13:2324. [PMID: 34950294 DOI: 10.4022/jafib.2324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 04/30/2020] [Accepted: 05/02/2020] [Indexed: 11/10/2022]
Abstract
A 32-year-old man presented with sudden loss of consciousness after passing urine with resultant trauma to the back of his neck. There were no palpitations prior. Examination revealed flaccid paralysis of all 4 limbs with priapism. Electrocardiogram demonstrated atrial fibrillation with rapid ventricular response. Laboratory showed normal potassium, magnesium, calcium, thyroid stimulating hormone and troponin I levels. Magnetic resonance imaging of the cervical spine demonstrated left C4 facet dislocation with grade 1 spondylolisthesis of C4 over C5, with moderate to severe narrowing of the spinal canal with cord compression and oedema. Transthoracic echocardiogram demonstrated an ejection fraction of 60% and no valvular abnormalities. Left atrium size was normal. The atrial fibrillation subsequently spontaneously reverted to sinus rhythm without treatment. Clinicians should be aware that atrial fibrillation can occur in the context of traumatic spinal cord injury due to disruption of the autonomic pathways in the cervical spine.
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Affiliation(s)
- Ting-Wei Teo
- Internal Medicine Residency, National University Health System, Singapore
| | - Benjamin Yong-Qiang Tan
- Division of Neurology, Department of Medicine, National University Hospital, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore
| | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore
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Dar T, Murtaza G, Yarlagadda B, Madoukh B, Bravin L, Vuddanda V, Parikh V, Reddy M, Lakkireddy D. Dofetilide Initiation and Implications of Deviation From the Standard Protocol - A Real World Experience. J Atr Fibrillation 2020; 12:2265. [PMID: 32435348 DOI: 10.4022/jafib.2265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/11/2019] [Accepted: 10/12/2019] [Indexed: 11/10/2022]
Abstract
Background Manufacturer/federal drug administration (FDA) recommends inpatient initiation of dofetilide with the manufacturer providing an initiation algorithm. The outcomes of algorithm deviation have not been reported outside of clinical trials. Objective We sought to perform a chart review of all the patients admitted for inpatient initiation of dofetilide to report on the incidence of protocol deviations and their implications. Methods We performed a retrospective review of all patients over a 15-month periodwho were initiated on dofetilide for the very first time or reinitiated on dofetilide after a break of three months or more at our institution. We assessed data about patients who were given dofetilide without adherence to the protocol (i.e. protocol deviation). Results A total of 189 patients were included in the study with a median age of 66 ± 9 years. Mean baseline QTc interval was 436 ± 32 msec, and 61% (116/189) were in atrial fibrillation (AF) at the time of dofetilide initiation. In 9% (17/189) of patients, the drug was discontinued due to intolerance or inefficacy. Therapy in 49% (93/189) of patients was noted to deviate from manufacturer recommended protocol with deviations more than once in some patients during the same hospitalization. Baseline QTc exceeding 440 msec(>500msec in conduction abnormalities) was the most frequent deviation (25%; 47/189).Ventricular tachyarrhythmia occurred in 4% (7/189) of patients, did not differ between patients, and occurred with and without protocol deviations (5% vs 2%; p = 0.27). Conclusions In our retrospective study, there were frequent deviations from the manufacturer-recommended algorithm guidelines for dofetilideinitation, primarily due to prolonged baseline QTc interval. The impact of these protocol deviations on drug discontinuation was uncertain; however, significant adverse events were higher in the deviation group compared to the group that fully adhered to the protocol. Further multicenter studies are warranted to clarify our findings.
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Affiliation(s)
- Tawseef Dar
- Department of Nuclear Cardiology, Massachusetts General Hospital, Boston, MA
| | - Ghulam Murtaza
- Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, KS
| | | | - Bader Madoukh
- Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, KS
| | - Lesley Bravin
- Division of Cardiovascular Diseases, University of Kansas Hospital and Medical Center, Kansas City, KS
| | - Venkat Vuddanda
- Department of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Valay Parikh
- Division of Cardiovascular Diseases, University of Kansas Hospital and Medical Center, Kansas City, KS
| | - Madhu Reddy
- Division of Cardiovascular Diseases, University of Kansas Hospital and Medical Center, Kansas City, KS
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Sperling H. [Reconstructive possibilities for Peyronie's disease]. Urologe A 2020; 59:426-431. [PMID: 32140745 DOI: 10.1007/s00120-020-01154-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The surgical treatment of Peyronie's disease involves a multistage procedure with increasing invasiveness. In addition to precise knowledge about the existing surgical treatment procedures, the indication and the informed consent process of the patient is extremely important. The dissatisfaction with the surgical results for many patients is due to false expectations and positivistic representations. If we can avoid this and make the right decisions during surgery, even these difficult-to-treat patients can be treated successfully.
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Affiliation(s)
- Herbert Sperling
- Urologische Klinik, Kliniken Maria Hilf GmbH, Viersener Str. 450, 41063, Mönchengladbach, Deutschland.
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Abstract
A mucocele is an epithelium-lined, mucus-filled cavity in the paranasal sinuses. Mucocele may develop due to scarring and obstruction of the sinus ostium caused by midface sinus trauma, such as orbital bone fracture or endoscopic sinus surgery. The authors report two cases of orbital mucocele as complications following midface sinus injury (endoscopic sinus surgery in one case, and orbital fracture repair in the other). In both cases, imaging studies showed a large orbital mucocele accompanied by bony erosion and orbital wall remodeling, compressing the ocular muscle. Using an open approach, the lesion was excised and marsupialized. The symptoms resolved, and the postoperative eyeball position was normal. Orbital mucocele may cause serious complications such as ocular symptoms, orbital cellulitis, osteomyelitis, and the formation of an abscess with the potential to invade the brain. Therefore, surgeons should consider the possibility of mucocele as a late complication of surgery and initiate an immediate work-up and surgical treatment if needed.
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Affiliation(s)
- Se Young Oh
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Ji Seon Choi
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jin Soo Lim
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Min Cheol Kim
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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Abstract
How do emotional stimuli influence perception, attention, and ultimately memory? This debate at the cross-section of emotion and cognition research has a long tradition. The emotional oddball paradigm (EOP) has frequently been applied to investigate the detection and processing of (emotional) change detection (Schlüter & Bermeitinger, 2017). However, the EOP has also been used to reveal the effects of emotional deviants on memory for serially presented stimuli. In this integrative article, we review the results of 29 experiments published between the years 2000 and 2017. Based on these data, we provide an overview of how the EOP is applied in the context of memory research. We also review and integrate the empirical evidence for memory effects in the EOP (with a special focus on retrograde and anterograde emotion-induced effects) and present theories of emotional memory as well as their fit with the results obtained by the EOP. Directions for future research are presented that would help to address important issues of the current debate around emotion-induced memory effects.
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Ji N, Xu M, Yu H, Xu J, Yu X. Factors influencing the self-reported sense of deviation in adults with successful surgical outcomes for strabismus. BMC Ophthalmol 2020; 20:9. [PMID: 31906894 DOI: 10.1186/s12886-019-1299-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 12/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To determine whether a sense of deviation remains in adults with successful motor alignment who fulfil diplopia criteria after surgery and to examine the factors associated with this judgement. METHODS This was a retrospective study. Adult patients defined as having a successful outcome based on more than 1 year of post-operative follow-up visits were included in the study. The sense of deviation was determined at the last visit. Pre- and post-operative deviation and characteristics including age, gender, education level, occupation, diagnosis, size of deviation, extraocular movement (EOM), binocular function, and health-related quality of life (HRQOL) were recorded. RESULTS In total, 22 (24%) of the 91 adults with successful surgical outcomes reported a sense of deviation. No significant differences were noted between subjects with and without a sense of deviation regarding patient demographics, pre- and post-operative deviation, changes in deviation, sensory fusion or EOM. Subjects with a sense of deviation had an increased prevalence of and larger post-operative vertical deviation, poorer stereo function, and lower HRQOL scores than those with no sense of deviation. The presence of post-operative vertical deviation was associated with a sense of deviation. CONCLUSIONS Approximately one-fourth (24%) of adults defined as having successful surgical outcomes who still had a sense of deviation exhibited worse stereo function, higher vertical deviation size and lower HRQOL scores. The presence of 3 to 5 prism dioptres(pd) of vertical deviation would be the main factor associated with a sense of deviation post-operatively.
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Yokouchi N, Hashimoto H. Association Between Deviation of Fairness Perceptions from Group Average and Serious Psychological Distress in Japanese Worksites: a Cross-Sectional Study. Int J Behav Med 2019; 26:306-315. [PMID: 30877552 PMCID: PMC6529606 DOI: 10.1007/s12529-019-09781-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Workers with deviating fairness perceptions are likely to be excluded and become isolated at worksites, leading to psychological distress. The study aimed to examine the cross-sectional association between deviation of fairness perception from the group average and serious psychological distress in Japanese worksites. Methods Secondary data analysis of an existing Japanese occupational cohort data using a multilevel logistic regression model was conducted for 8701 workers from 12 companies in Japan who participated in the baseline survey (from April 2010 to March 2012). Individual perception of interactional and procedural fairness was measured with the Japanese version of the Organizational Justice Scale. Group averages were calculated within workers’ reference groups, categorized by company affiliation, age group, gender, and occupational class. Psychological distress was measured using the K6 scale, and serious psychological distress was defined as a total K6 score of 13 or more. Results Both low deviation and high deviation of interactional fairness perception were significantly and positively associated with serious psychological distress (odds ratio (OR) = 1.24, 95% confidence intervals (CI); 1.03–1.49 and OR = 1.57, 95% CI; 1.12–2.19), independently of individual-level fairness perception, group-level mean fairness perception, demographic characteristics, and health-related behaviors. Only high deviation of procedural fairness perception was significantly and positively related to serious psychological distress (OR = 1.51, 95% CI; 1.11–2.06). Conclusions The results indicated that divergent perceptions of fairness at worksites may deserve further exploration for equal achievement of workers’ psychological well-being.
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Affiliation(s)
- Nobutada Yokouchi
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Hideki Hashimoto
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Abstract
Background and Objectives Condylar fractures can be treated with one of the two methods, including the conservative (closed reduction and immobilization) and/or surgical (open reduction and internal fixation) methods. Both these modalities of treatment have their indications and contraindications and merits and demerits. The present study was designed with the purpose of comparing the outcomes of surgical versus conservative management of moderately displaced subcondylar and condylar neck fractures. Materials and Methods The present study included a total of 20 patients with moderately displaced condylar fractures in patients > 18 years of age who were randomly divided into nonsurgical and surgical group and were managed accordingly. In the present study, the outcomes of conservative versus surgical management of subcondylar and condylar neck fractures were discussed in terms of seven parameters, including the maximal interincisal mouth opening, protrusive and lateral excursive movements of the mandible, status of occlusion, deviation of mandible during mouth opening, pain (in terms of visual analog scale) and the height of ascending ramus (radiographically) which were measured and evaluated pre- and post-operatively at different intervals of time. The follow-up was done for a period of up to 6 weeks postoperatively. Statistical Analysis Used Descriptive and analytical statistics were calculated using the Statistical Package for Social Sciences version 19. The Mann-Whitney U-test was used to assess the significance of the difference between the groups, whereas the Wilcoxon signed-rank test was used to assess the significance of the difference between the paired observations in each group. Results Patients treated surgically showed better improvement in maximal interincisal mouth opening, lateral excursions with minimal deviation, early relief from pain, and restoration of height of the ramus with symmetry in comparison with the patients managed conservatively where prolonged periods of pain apart from obvious deviation and minimal restoration of height of the ramus was observed over a follow-up period of 6 weeks postoperatively. The results were also found to be statistically significant with the value of P < 0.05. Interpretation and Conclusion Surgery is inarguably preferred over conservative management of moderately displaced condylar fractures as per the results of the present study. The present study provided valuable information and mandated further studies with larger sample sizes to come to definitive conclusions.
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Affiliation(s)
- Abhishek Karan
- Department of Oral and Maxillofacial Surgery, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
| | - N S Kedarnath
- Department of Oral and Maxillofacial Surgery, Rajarajeswari Dental College and Hospital, Bangalore, Karnataka, India
| | - G Santhosh Reddy
- Department of Oral and Maxillofacial Surgery, Malla Reddy Dental College for Women, Hyderabad, Telangana, India
| | - T V S Harish Kumar
- Department of Oral and Maxillofacial Surgery, Malla Reddy Dental College for Women, Hyderabad, Telangana, India
| | - C Neelima
- Department of Oral and Maxillofacial Surgery, Malla Reddy Dental College for Women, Hyderabad, Telangana, India
| | - M Bhavani
- Department of Oral and Maxillofacial Surgery, Malla Reddy Dental College for Women, Hyderabad, Telangana, India
| | - Abhishek Singh Nayyar
- Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
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Tolbin AY, Pushkarev VE, Sedova MV, Maklakov SS, Tomilova LG. Aggregation of slipped-cofacial phthalocyanine J-type dimers: Spectroscopic and AFM study. Spectrochim Acta A Mol Biomol Spectrosc 2018; 205:335-340. [PMID: 30036802 DOI: 10.1016/j.saa.2018.07.052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 06/08/2023]
Abstract
Direct metallation of 2-hydroxyphthalocyanine J-type slipped-cofacial dimeric ligand by Mg, Zn, Cu, Ni and Co salts has been carried out to obtain corresponding metal complexes selectively without any noticeable dissociation or polymerization of the starting ligand. Integrated analysis of aggregation properties in the synthesized series has been conducted with the involvement of AFM microscopy, UV/Vis spectroscopy and theoretical assessment. As a result, a nonlinear relationship between absorption and concentration was found, with aggregation beginning to appear at concentrations above 3.3 × 10-5 mol L-1 with predominant formation of trimers from the dimeric molecules in THF solutions.
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Affiliation(s)
- Alexander Yu Tolbin
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, 142432 Chernogolovka, Moscow Region, Russian Federation; Department of Chemistry, M. V. Lomonosov Moscow State University, 119991 Moscow, Russian Federation.
| | - Victor E Pushkarev
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, 142432 Chernogolovka, Moscow Region, Russian Federation; Department of Chemistry, M. V. Lomonosov Moscow State University, 119991 Moscow, Russian Federation
| | - Marina V Sedova
- Institute for Theoretical and Applied Electrodynamics RAS (ITAE RAS), Izhorskaya St., 13, 125412 Moscow, Russian Federation
| | - Sergey S Maklakov
- Institute for Theoretical and Applied Electrodynamics RAS (ITAE RAS), Izhorskaya St., 13, 125412 Moscow, Russian Federation
| | - Larisa G Tomilova
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, 142432 Chernogolovka, Moscow Region, Russian Federation; Department of Chemistry, M. V. Lomonosov Moscow State University, 119991 Moscow, Russian Federation
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Liu J, Han J, Zhang Y, Wang H, Kong H, Shi L. Prediction of soil organic carbon with different parent materials development using visible-near infrared spectroscopy. Spectrochim Acta A Mol Biomol Spectrosc 2018; 204:33-39. [PMID: 29902769 DOI: 10.1016/j.saa.2018.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 06/04/2018] [Accepted: 06/04/2018] [Indexed: 06/08/2023]
Abstract
The storage of soil organic carbon (SOC) should improve soil fertility. Conventional determination of SOC is expensive and tedious. Visible-near infrared reflectance spectroscopy is a practical and cost-effective approach that has been successfully used SOC concentration. Soil spectral inversion model could quickly and efficiently determine SOC content. This paper presents a study dealing with SOC estimation through the combination of soil spectroscopy and stepwise multiple linear regression (SMLR), partial least squares regression (PLSR), principal component regression (PCR). Spectral measurements for 106 soil samples were acquired using an ASD FieldSpec 4 standard-res spectroradiometer (350-2500 nm). Six types of transformations and three regression methods were applied to build for the quantification of different parent materials development soil. The results show that (1)the basaltic volcanic clastics development of SOC spectral response bands located in 500 nm, 800 nm; Trachyte spectral response of the soil quality, and the volcanic clastics development at 405 nm, 465 nm, 575 nm, 1105 nm. (2) Basaltic volcanic debris soil development, first deviation of maximum correlation coefficient is 0.8898; thick surface soil of the development of rocky volcanic debris from bottom reflectivity logarithm of first deviation of maximum correlation coefficient is 0.9029. (3) Soil organic matter content of basaltic volcanic clastics development optimal prediction model based on spectral reflectance inverse logarithms of first deviation of SMLR. Independent variable number is 7, Rv2 = 0.9720, RMSEP = 2.0590, sig = 0.003. Trachyte qualitative volcanic clastics developed soil organic matter content of the optimal prediction model based on spectral reflectance inverse logarithms of first deviation of PLSR. Model number of the independent variables Pc = 5, Rc = 0.9872, Rc2 = 0.9745, RMSEC = 0.4821, SEC = 0.4906, forecasts determine coefficient Rv2 = 0.9702, RMSEP = 0.9563, SEP = 0.9711, Bias = 0.0637.
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Affiliation(s)
- Jinbao Liu
- Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Key Laboratory of Degraded and Unused Land Consolidation Engineering, The Ministry of Land and Resources, Xi'an 710075, China; Institute of Land Engineering and Technology, Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Shaanxi Provincial Land Consolidation Engineering Technology Research Center, Xi'an 710075, China
| | - Jichang Han
- Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Key Laboratory of Degraded and Unused Land Consolidation Engineering, The Ministry of Land and Resources, Xi'an 710075, China; Institute of Land Engineering and Technology, Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Shaanxi Provincial Land Consolidation Engineering Technology Research Center, Xi'an 710075, China.
| | - Yang Zhang
- Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Key Laboratory of Degraded and Unused Land Consolidation Engineering, The Ministry of Land and Resources, Xi'an 710075, China; Institute of Land Engineering and Technology, Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Shaanxi Provincial Land Consolidation Engineering Technology Research Center, Xi'an 710075, China
| | - Huanyuan Wang
- Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Key Laboratory of Degraded and Unused Land Consolidation Engineering, The Ministry of Land and Resources, Xi'an 710075, China; Institute of Land Engineering and Technology, Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Shaanxi Provincial Land Consolidation Engineering Technology Research Center, Xi'an 710075, China
| | - Hui Kong
- Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Key Laboratory of Degraded and Unused Land Consolidation Engineering, The Ministry of Land and Resources, Xi'an 710075, China; Institute of Land Engineering and Technology, Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Shaanxi Provincial Land Consolidation Engineering Technology Research Center, Xi'an 710075, China
| | - Lei Shi
- Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Key Laboratory of Degraded and Unused Land Consolidation Engineering, The Ministry of Land and Resources, Xi'an 710075, China; Institute of Land Engineering and Technology, Shaanxi Provincial Land Engineering Construction Group, Xi'an 710075, China; Shaanxi Provincial Land Consolidation Engineering Technology Research Center, Xi'an 710075, China
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Haruta Y, Kawahara S, Tsuchimochi K, Hamasaki A, Hara T. Deviation of femoral intramedullary alignment rod influences coronal and sagittal alignment during total knee arthroplasty. Knee 2018; 25:644-649. [PMID: 29778655 DOI: 10.1016/j.knee.2018.04.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/18/2018] [Accepted: 04/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND An intramedullary (IM) rod is used to resect the distal femur vertically to the femoral mechanical axis in the coronal plane in many cases of total knee arthroplasties (TKA). The valgus angle between the mechanical axis and the anatomical axis of the distal femur is estimated preoperatively. It is known the deviation of the IM rod in the femoral canal could influence the femoral component alignment. However, there is no published data regarding how many degrees of deviation to make with the IM rod. The purpose of this study is to measure each deviation of the IM rod using three-dimensional (3D) computer simulations. METHODS Preoperative CT scans on 30 knees undergoing TKA were studied. The line connecting central points at 10 and 20 cm proximal from the intercondylar notch was defined as the anatomical axis and the point at which the anatomical axis intersects the surface of the distal femur was considered as the entry point of the IM rod. The medio-lateral (ML) and antero-posterior (AP) deviations between the anatomical axis and the IM rod were measured. RESULTS The ML and AP deviations were 0.8 and 1.1° on average. The IM rod was deviated medio-laterally more than 1.0° in three knees (10%). CONCLUSION Surgeons should note the ML difference of the resection thickness of the distal femur for coronal alignment. If the ML difference varies greatly from the preoperative planning, they need to adjust at most 1.0° of valgus angle to achieve the appropriate coronal alignment. Level of evidence III, Therapeutic.
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Affiliation(s)
- Yohei Haruta
- Department of Orthopedic Surgery, Aso-Iizuka Hospital, 3-83 Yoshio-machi, Iizuka-city, Fukuoka 820-8505, Japan
| | - Shinya Kawahara
- Department of Orthopedic Surgery, Aso-Iizuka Hospital, 3-83 Yoshio-machi, Iizuka-city, Fukuoka 820-8505, Japan.
| | - Kanenobu Tsuchimochi
- Department of Orthopedic Surgery, Aso-Iizuka Hospital, 3-83 Yoshio-machi, Iizuka-city, Fukuoka 820-8505, Japan
| | - Akihiko Hamasaki
- Department of Orthopedic Surgery, Aso-Iizuka Hospital, 3-83 Yoshio-machi, Iizuka-city, Fukuoka 820-8505, Japan
| | - Toshihiko Hara
- Department of Orthopedic Surgery, Aso-Iizuka Hospital, 3-83 Yoshio-machi, Iizuka-city, Fukuoka 820-8505, Japan
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Trovato A, El-Rich M, Adeeb S, Dhillon S, Jomha N. Geometric analysis of the talus and development of a generic talar prosthetic. Foot Ankle Surg 2017; 23:89-94. [PMID: 28578800 DOI: 10.1016/j.fas.2016.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 10/05/2016] [Accepted: 12/06/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Trauma to the talus can result in fracture, avascular necrosis and structural collapse. Treatment has been limited to surgical fusion and total ankle arthroplasty. Total ankle arthroplasty may not be an appropriate treatment for avascular necrosis while surgical fusion of the joint limits mobility. Custom-made implants have recently been used to address these limitations but have lengthy delays between injury and surgery and higher associated costs. A generic talar prosthesis available in various sizes may serve as a suitable alternative. METHODS The geometric variation between shapes of individual tali was determined using 3D geometric models of 91 tali created from CT-scan data. Comparisons were done to determine if tali are one shape. The best shape was determined for each sex, and was compared to determine if a unisex implant would be possible. A geometric template for the implant in multiple sizes was created and compared to the models. RESULTS The average of the average deviation between tali after volume scaling was found to be less than 1mm on the main articulating surfaces. One shape group was found for the talus. The female and male tali were found to be similar and a unisex implant template was created. CONCLUSIONS Ten generic talar implant sizes were determined to be sufficient to match the size and shape of the 91 tali examined in this study.
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Affiliation(s)
- Alexandra Trovato
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, Alberta, Canada.
| | - Marwan El-Rich
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, Alberta, Canada; Department of Mechanical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates.
| | - Samer Adeeb
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, Alberta, Canada.
| | - Suki Dhillon
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
| | - Nadr Jomha
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
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Dauendorffer JN, Méria P. [Abnormalities of the male median raphe]. Prog Urol 2016; 26:1146-1149. [PMID: 27816461 DOI: 10.1016/j.purol.2016.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 10/01/2016] [Accepted: 10/09/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Abnormalities of the male median raphe can either be detected during postnatal examination or appear later during childhood or adulthood. They can be isolated or sometimes associated with severe congenital genitourinary malformations. METHODS A literature review was performed on the Medline database, considering the articles listed until April 2015 dealing with abnormalities of the male median raphe using the following keywords: male, median raphe and abnormalities. Papers were selected according to their language (English and French) and their relevance. RESULTS Forty-one articles related to male median raphe abnormalities were listed. Five of them were selected for their relevance. We describe frequent median raphe abnormalities (hyperpigmentation, deviation, division, cyst, canal and sinus), emphasizing the clinical aspects, the explorations, the risk of associated genitourinary abnormalities and the treatment. DISCUSSION Male raphe abnormalities should be known by the urologists since functional, infectious and aesthetic complications could lead patients to consultation.
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Affiliation(s)
- J N Dauendorffer
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - P Méria
- Service d'urologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Carstens P, Stevens P. Paraphilia and sex offending - A South African criminal law perspective. Int J Law Psychiatry 2016; 47:93-101. [PMID: 27182003 DOI: 10.1016/j.ijlp.2016.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Historically, the link between sexual deviance and criminality has been described and documented, asserted by psychiatry, and manifested in law. Laws that have regulated sexual behaviour have referred to terms such as 'sexual deviation', 'sexual perversion' or even archaic moral terms such as 'unnatural acts and unspeakable crimes against nature'. A possible link between sexual perversion, psychopathy, and criminality, specifically manifesting in sexual homicide, has been the subject of remarkable research in forensic psychiatry. This contribution examines the phenomenon of paraphilia with specific reference to its definition, diagnostic classification and characteristics, as well as a few selections of incidences of paraphilia in South African criminal case law. A brief assessment is made of how South African criminal courts have dealt with paraphilia. In this regard, an analysis is made of the criminal liability of the paraphiliac. The South African response to sexual deviation as addressed in the Criminal Law (Sexual Offences and Related Matters) Amendment Act 32 of 2007 will also be addressed with reference to its efficacy in addressing paraphilia within South African criminal law. The interface between criminal law and medical ethics within the context of this theme will also be canvassed. In conclusion, recommendations for possible reform are canvassed.
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Affiliation(s)
- Pieter Carstens
- Department of Public Law, University of Pretoria, South Africa.
| | - Philip Stevens
- Department of Public Law, University of Pretoria, South Africa.
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Uchino T, Miura M, Oyama Y, Matsumoto S, Shingu C, Kitano T. Lateral deviation of four types of epidural catheters from the lumbar epidural space into the intervertebral foramen. J Anesth 2016; 30:583-90. [PMID: 27137846 DOI: 10.1007/s00540-016-2177-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 04/21/2016] [Indexed: 11/28/2022]
Abstract
Background During epidural anesthesia, the catheter tip occasionally deviates from the epidural space into the intervertebral foramen, resulting in inadequate anesthesia. Methods During postoperative plain radiography, iohexol was injected via the epidural catheter to determine its position and to observe the spread of the material. After exclusion of seven patients with catheters that migrated into the subcutaneous area and 25 patients with no evidence of the contrast medium, 415 patients were evaluated. We retrospectively compared patients to determine whether the incidence of deviation into the intervertebral foramen differed between four types of epidural catheters. We also investigated the load applied to the catheter tip using a Shimadzu Autograph AG-X-500 N-111 universal testing machine. Results Deviation of the epidural catheter into the intervertebral foramen was observed in eight and 33 patients in the Hakko and Perifix Soft tip catheter groups, respectively. The incidence of deviation was higher in the Perifix Soft tip catheter group, and lower in the FlexTip Plus and Perifix FX catheter groups. A rapid increase was observed in the force exerted on the tips of the Hakko and Perifix Soft tip catheters, while the force transmitted to the tips of the FlexTip Plus and Perifix FX catheters gradually increased and then reached a plateau at a low level. Conclusions The incidence of deviation was significantly lower with spiral-type catheters than with other types of catheters. This might be attributable to the gradual transmission of a lower level of force to the tip in spiral-type catheters.
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Abstract
There are various indications that may necessitate partial or complete resection of the mandible, from trauma to congenital deformities. However, the most prevalent indication that requires surgical resection of the mandible along with the involved adjacent oral structures is the presence of a locally aggressive neoplastic growth. The resultant continuity defect leads to an alteration in the range and direction of mandibular movement, impedes clear articulation of syllables and cosmetic disfigurement. The role of a prosthodontist is paramount in bringing about the restoration of the esthetic and functional dysfunction. This article discusses a series of hemimandibulectomy cases wherein mandibular deviation was successfully corrected using guide-flange prosthesis.
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Affiliation(s)
- Sushil Kar
- Department of Prosthodontics, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Arvind Tripathi
- Department of Prosthodontics, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Riti Madhok
- Department of Prosthodontics, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
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Kämmerer PW, Schneider D, Pacyna AA, Daubländer M. Movement control during aspiration with different injection systems via video monitoring-an in vitro model. Clin Oral Investig 2016; 21:105-110. [PMID: 26888222 DOI: 10.1007/s00784-016-1756-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 02/12/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of the present study was an evaluation of movement during double aspiration by different manual syringes and one computer-controlled local anesthesia delivery system (C-CLAD). MATERIALS AND METHODS With five different devices (two disposable syringes (2, 5 ml), two aspirating syringes (active, passive), one C-CLAD), simulation of double aspiration in a phantom model was conducted. Two experienced and two inexperienced test persons carried out double aspiration with the injection systems at the right and left phantom mandibles in three different inclination angles (n = 24 × 5 × 2 for each system). 3D divergences of the needle between aspiration procedures (mm) were measured with two video cameras. RESULTS An average movement for the 2-ml disposal syringe of 2.85 mm (SD 1.63), for the 5 ml syringe of 2.36 mm (SD 0.86), for the active-aspirating syringe of 2.45 mm (SD 0.9), for the passive-aspirating syringe of 2.01 mm (SD 0.7), and for the C-CLAD, an average movement of 0.91 mm (SD 0.63) was seen. The movement was significantly less for the C-CLAD compared to the other systems (p < 0.001). The movement of the needle in the soft tissue was significantly less for the C-CLAD compared to the other systems (p < 0.001). CONCLUSIONS A difference in involuntary movement of the syringe could be seen in comparison between manual and C-CLAD systems. Launching the aspiration by a foot pedal in computer-assisted anesthesia leads to a minor movement. CLINICAL RELEVANCE To solve the problem of movement during aspiration with possibly increased false-negative results, a C-CLAD seems to be favorable.
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Affiliation(s)
- P W Kämmerer
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Rostock, Germany.
| | - D Schneider
- Department of Oral and Maxillofacial Surgery, HELIOS Clinics Schwerin, Schwerin, Germany
| | - A A Pacyna
- Private Dental Practice, Alfaz del Pi, Spain
| | - M Daubländer
- Department of Oral Surgery, University Medical Centre Mainz, Mainz, Germany
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Smitha SG, Jagannath B, Mathew AS. Impact of Septal Correction on the Blood Pressure of Hypertensive Patients with Deviated Nasal Septum. Indian J Otolaryngol Head Neck Surg 2016; 68:46-51. [PMID: 27066410 DOI: 10.1007/s12070-015-0840-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 02/04/2015] [Indexed: 10/24/2022] Open
Abstract
This study aims to evaluate the effect of septal correction on the blood pressure (BP) of patients with symptomatic nasal septal deviation and to assess whether a positive association exists between deviated nasal septum and hypertension. A prospective observational clinical study was conducted at Kempegowda Institute of Medical Sciences, Bangalore. Hundred adults, aged 18-40 years, with symptomatic nasal septal deviation, newly detected untreated hypertension (mean BP ≥140/90 mmHg), undergoing submucosal resection of the septum and submucosal diathermy of hypertrophied inferior turbinate (when present), were included. Postoperative follow up for ENT examination and BP measurement was done at 1, 6 and 12 months. Seventy five males and 25 females met the inclusion criteria. 48 % were aged 31-35 years (mean = 31.83 ± 5.19 years). 71 % had anterior septal deviation, 13 % posterior deviation and 16 % a combination of both. Preoperatively, mean systolic blood pressure was 141.82 ± 1.70 mmHg and mean diastolic blood pressure was 91.04 ± 1.21 mmHg, which postoperatively decreased by 10-12 mmHg and 4-5 mmHg respectively. 79 % showed a significant (P < 0.001) decrease in BP postoperatively. 13 % showed no change in BP, of which 53.8 % had posterior deviation, demonstrating a significant association (P < 0.001) between type of deviation and response to surgery. In 8 %, a rise in BP over the follow up period was seen; of these, 62.5 % were aged 36-40 years, indicating a significant association (P < 0.001) between age and BP. Surgical correction of septal deviation is thus effective in controlling the BP of patients with anterior deviation, aged <35 years.
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Howie DF, Love GJ, Deakin AH, Kinninmonth AWG. Intra-operative deviation in limb alignment occurring at implantation in total knee arthroplasty. Knee 2015; 22:47-50. [PMID: 25476128 DOI: 10.1016/j.knee.2014.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 11/07/2014] [Accepted: 11/10/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Long-term survival of knee replacement depends on accurate alignment. Despite improvements in cut accuracy mal-alignment of 3° or more is still seen. All methods share common implantation techniques. This study examines the effect of implantation on overall limb alignment relating it to cut alignment and trial alignment. METHODS A retrospective review of navigated primary knee replacements was undertaken (n=113). Overall coronal limb alignments for the aggregated cuts, trial and final implanted components were examined. RESULTS All 113 knees had coronal aggregated cut alignment within 2° of neutral (range: 2° varus to 2° valgus). With trial components 99 knees (88%) had an overall coronal limb alignment within 2° of neutral (range: 3° varus to 4° valgus). After final implantation 106 knees (94%) were within 2° of neutral (range: 4° varus to 4° valgus). Forty eight knees (42%) showed no alignment deviation occurring between trial and the final implanted prostheses and 16 knees (14%) shoed a deviation of 2° or more. There was a correlation of both aggregated cut (r=0.284, p=0.002) and trial (r=0.794, p<0.001) with final alignment. There was no significant difference between the final alignment and the aggregated cut alignment(mean difference=-0.15°, p=0.254) or trial alignment (mean difference -0.13°, p=0.155). CONCLUSIONS Even when the aggregated alignment produced by the bone cuts is accurate, inaccuracy in final alignment can result from the implantation process. It may be productive for surgeons to concentrate on the implantation process to improve alignment and reduce outliers.
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Affiliation(s)
- D F Howie
- Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, United Kingdom.
| | - G J Love
- Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, United Kingdom
| | - A H Deakin
- Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, United Kingdom
| | - A W G Kinninmonth
- Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, United Kingdom
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Aydın S, Taskin U, Orhan I, Altas B, Oktay MF, Toksöz M, Albayrak R. The analysis of the maxillary sinus volumes and the nasal septal deviation in patients with antrochoanal polyps. Eur Arch Otorhinolaryngol 2014; 272:3347-52. [PMID: 25534286 DOI: 10.1007/s00405-014-3460-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
Abstract
The aim of this study was to evaluate the relationship between the maxillary sinus volumes and the nasal septal deviation angles in patients with antrochoanal polyps (ACP). 76 patients who underwent ACP surgery were included in the study. Of those 36 patients who had multislice computed tomography (MSCT) were evaluated to calculate maxillary sinus volume. The records of paranasal MSCT of 36 healthy people without any paranasal sinus diseases or surgery constituted age- and gender-matched healthy controls. Maxillary sinüs volumes and septal deviation angles were calculated using the paranasal MSCT volume-rendering technique. Thirty-six patients in the ACP group were compared with 36 polyp side-matched healthy people. The mean age was 16.6 ± 6.7 years in both groups. Statistically, the mean value of the maxillary sinus volume was significantly higher in the ACP group compared with the ACP side-matched control group (15.1 ± 4.6 versus 12.0 ± 3.5 mm(3)) (p = 0.002). Furthermore, the mean value of the maxillary sinus volume in the non-polyp side (14.2 ± 4.7 mm(3)) was statistically higher in the ACP group compared with the side-matched control group volume (11.9 ± 3.8 mm(3)) (p = 0.024). In addition, Fifty-three of 76 ACP patients had septal deviation. While the septal deviation was on the same side with the ACP in 17 patients, it was on the opposite side in 36 patients. In conclusion, the maxillary sinus volumes increased in ACP patients compared with the healthy control group. Many patients had nasal septal deviation on the opposite side of the ACP.
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Affiliation(s)
- Salih Aydın
- Otorhinolaryngology Department, Bagcilar Education and Research Hospital, Merkez mah. Mimar sinan cad no: 6 Güngören, Istanbul, Turkey.
| | - Umit Taskin
- Otorhinolaryngology Department, Bagcilar Education and Research Hospital, Merkez mah. Mimar sinan cad no: 6 Güngören, Istanbul, Turkey
| | - Israfil Orhan
- Otorhinolaryngology Department, Sütçü İmam Medical Faculty, Kahramanmaraş, Turkey
| | - Bengül Altas
- Otorhinolaryngology Department, Bagcilar Education and Research Hospital, Merkez mah. Mimar sinan cad no: 6 Güngören, Istanbul, Turkey
| | - Mehmet Faruk Oktay
- Otorhinolaryngology Department, Bagcilar Education and Research Hospital, Merkez mah. Mimar sinan cad no: 6 Güngören, Istanbul, Turkey
| | - Mehmet Toksöz
- Radiology Department, Bagcilar Education and Research Hospital, Istanbul, Turkey
| | - Ramazan Albayrak
- Radiology Department, Bagcilar Education and Research Hospital, Istanbul, Turkey
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Abstract
Introduction and Objectives: Hypospadias is the most common congenital abnormality of the penis, and is most commonly diagnosed during the postnatal physical examination. However, milder forms of the condition can be difficult to detect, leading to delayed referral to specialist teams. We aim to determine whether there is an association between hypospadias and the position of the penoscrotal raphe. Materials and Methods: A case — control study was performed where clinical photographs from children undergoing hypospadias correction were compared with a control group of children without the condition. The position of the penoscrotal raphe was documented as midline, left or right. Pearson's chi squared test was used to determine significance. Results: Images for 80 children undergoing hypospadias correction were compared with 80 normal children in the maternity ward. 88.8% of the children with hypospadias had a penoscrotal raphe deviated from the midline compared with only 13.8% in the control group (P < 0.0003). Conclusions: Our study demonstrates a significant association between hypospadias and deviation of the penoscrotal raphe from the midline. Consideration should be given to whether to include this finding within the spectrum of abnormalities seen in hypospadias. Examination of the penoscrotal raphe is simple to perform and could aid in the early diagnosis in children with milder forms of the condition.
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Affiliation(s)
- Arvind Mohan
- Department of Plastic Surgery, Royal Preston Hospital, Plastic Surgery Department, Lancashire, UK
| | - Laura Ashton
- Department of Plastic Surgery, Royal Preston Hospital, Plastic Surgery Department, Lancashire, UK
| | - Milind Dalal
- Department of Plastic Surgery, Royal Preston Hospital, Plastic Surgery Department, Lancashire, UK
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Hassanpour SE, Moosavizadeh SM, Fadaei Araghi M, Eshraghi B. Pulmonary artery pressure in patients with markedly deviated septum candidate for septorhinoplasty. World J Plast Surg 2014; 3:119-21. [PMID: 25489535 PMCID: PMC4236997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 03/12/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The nasal septal deviation (NSD) is one of the major causes of nasal obstruction. This condition increases upper airway resistance. In This study we evaluated the mean pulmonary artery pressure (MPAP) in patients with markedly deviated septum. METHODS Sixty two patients with NSD (Age range: 26-45 years, 34 men and 28 women) were included in the study. Mean pulmonary artery pressure was measured in preoperative period by Doppler echocardiography with the assistance of an expert cardiologist. RESULTS The mean preoperative MPAP value (22.5 mmHg in men and 20.03 mmHg in women) of the patients in this study was higher than normal population (20 mmHg). The MPAP of nine patients (14.5%) was greater than 25 mmHg. This value was significantly higher than values for normal population. CONCLUSION Markedly deviated septum had improper effects in cardiovascular system due to increase in MPAP.
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Affiliation(s)
- Seyed Esmail Hassanpour
- Department of Plastic and Reconstructive Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran;,Correspondence Author: Seyed Esmail Hassanpour, MD; Professor and Chairman of Department of Plastic and Reconstructive Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Tel: +98-21-88901108 , Fax: +98-21-88909193, E-mail:
| | - Seyed Mehdi Moosavizadeh
- Department of Plastic and Reconstructive Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Fadaei Araghi
- Department of Plastic and Reconstructive Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Eshraghi
- Department of Cardiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lundh D, Coleman S, Riad J. Movement deviation and asymmetry assessment with three dimensional gait analysis of both upper- and lower extremity results in four different clinical relevant subgroups in unilateral cerebral palsy. Clin Biomech (Bristol, Avon) 2014; 29:381-6. [PMID: 24670612 DOI: 10.1016/j.clinbiomech.2014.02.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 01/22/2014] [Accepted: 02/27/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND In unilateral cerebral palsy, movement pattern can be difficult to define and quantify. The aim was to assess the degree of deviation and asymmetry in upper and lower extremities during walking. METHODS Forty-seven patients, 45 Gross Motor Function Classification Scale (GMFCS) I and 2 patients GMFCS II, mean age 17.1 years (range 13.1 to 24.0) and 15 matched controls were evaluated. Gait profile score (GPS) and arm posture score (APS) were calculated from three-dimensional gait analysis (GA). Asymmetry was the calculated difference in deviation between affected and unaffected sides. FINDINGS The GPS was significantly increased compared to the control group on the affected side (6.93 (2.08) versus 4.23 (1.11) degrees) and on the unaffected side (6.67 (2.14)). The APS was also significantly increased on the affected side (10.39 (5.01) versus 5.52 (1.71) degrees) and on the unaffected side (7.13 (2.23)). The lower extremity asymmetry increased (significantly) in comparison with the control group (7.89 (3.82) versus 3.90 (1.01)) and correspondingly in the upper extremity (9.75 (4.62) versus 5.72 (1.84)). The GPS was not different between affected and unaffected sides, however the APS was different (statistically significant). INTERPRETATION We calculated deviation and asymmetry of movement during walking in unilateral CP, identifying four important clinical groups: close to normal, deviations mainly in the leg, deviations mainly in the arm and those with deviation in the arm and leg. This method can be applied to any patient group, and aid in diagnosing, planning treatment, and prognosis.
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Affiliation(s)
- Dan Lundh
- University of Skövde, Box 408, 541 28 Skövde, Sweden.
| | - Scott Coleman
- Motion and Sports Lab, Baylor University Medical Center, 411 N. Washington Ave Suite 2100, Dallas, TX 752 46, USA
| | - Jacques Riad
- Orthopaedic Department, Skaraborg Hospital Skövde, 541 85 Skövde, Sweden; Women's and Children's Health, Karolinska Institute, 171 76 Stockholm, Sweden
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Lee JE, Jung HJ, Chang M, Jin HR. A novel wedge technique to correct the curved deviation of the cartilaginous nasal septum. Auris Nasus Larynx 2013; 41:190-4. [PMID: 24206828 DOI: 10.1016/j.anl.2013.07.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 07/23/2013] [Accepted: 09/20/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To introduce a novel wedge technique in endonasal septoplasty to correct the curved deviation of the cartilaginous septum and describe the surgical procedure and results. METHODS A retrospective analysis was performed on 17 patients who had septoplasty using the wedge technique to correct the curved deviation of their cartilaginous septum. A 2-2.5-cm-long wedge made of either septal cartilage or ethmoid/vomer bone was inserted through an incision located 1.5-2 cm caudal to the bony-cartilaginous junction near the dorsum. Materials used for the wedge, objective evaluation of the surgical results, subjective symptom improvement and surgical complications were investigated. RESULTS The degree of deviation was moderate to severe in all patients. Bony septum was used as the wedge material in 9 patients and septal cartilage in 8 patients. Among 17 patients, 15 had a completely straight septum while 2 had a minimal curvature remaining. Subjective symptoms of nasal obstruction evaluated by the Visual Analog Scale score and Nasal Obstructive Symptom Evaluation scale improved in all patients. In acoustic rhinometry, minimal cross-sectional area and nasal volume change showed some improvement without statistical significance. There were no major complications including saddle nose and revision surgery. CONCLUSION Our novel wedge technique can be an effective and safe technique to straighten the curved deviations of the cartilaginous septum in selected patients.
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Affiliation(s)
- Ji-Eun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chosun University Hospital, Gwangju, Republic of Korea
| | - Hahn Jin Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Munyoung Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Hong Ryul Jin
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
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