Conservative Management of Spontaneous Isolated Dissection of the Superior Mesenteric Artery

Purpose. We report the clinical outcomes of patients with spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) who were treated conservatively. Materials and Methods. A retrospective review was performed in 14 patients from 2006 to 2016 with SIDSMA. Their clinical features and computed tomographic angiography (CTA) characteristics, treatment methods, and clinical outcomes were analyzed. The mean age was 53.6 (range, 41–73) years, and the mean follow-up duration was 20.6 (range, 1–54) months. Conservative management was the primary treatment if no bowel ischemia or arterial rupture was noted. Results. The mean initial abdominal visual analog pain score was 7 (range, 5–9) in seven patients. The mean total duration of abdominal pain was 10.2 days (range, 2–42 days) in 10 patients. The mean percentage stenosis of the dissected SMA at the initial presentation was 78.8% in 14 patients. Complete obstruction of the SMA at the initial presentation was evident in 4 of the 14 patients (28.6%). Conservative management was successful in all 14 patients. None of the 14 patients developed bowel ischemia or an infarction. Abdominal pain did not recur in any patient during follow-up (mean, 20.6 months; range, 1–54 months). Conclusion. Conservative management was successful for all SIDSMA patients, even those with severe compression of the true lumen or complete obstruction of the dissected SMA

Equivalent Modal Damping of Short-Span Bridges Subjected to Strong Motion

In this paper four different methods are investigated for estimating the equivalent modal damping ratios of a short-span bridge under strong ground motion by considering the energy dissipation at the boundary. The Painter Street Overcrossing (PSO) is investigated because of seismic data availability. Computed responses using the response-spectrum method with the equivalent damping ratios estimates are compared with the recorded responses. The results show that the four methods provide reasonable estimation of equivalent modal damping ratios and that neglecting off-diagonal elements in the damping matrix is the most efficient and practical method. The equivalent damping ratio of the PSO was nearly 25% under an earthquake with peak ground acceleration of 0.55g, which is much higher than the conventional assumption of 5%

The Singer's Formant and Speaker's Ring Resonance: A Long-Term Average Spectrum Analysis

ObjectivesWe previously showed that a trained tenor's voice has the conventional singer's formant at the region of 3 kHz and another energy peak at 8-9 kHz. Singers in other operatic voice ranges are assumed to have the same peak in their singing and speaking voice. However, to date, no specific measurement of this has been made.MethodsTenors, baritones, sopranos and mezzo sopranos were chosen to participate in this study of the singer's formant and the speaker's ring resonance. Untrained males (n=15) and females (n=15) were included in the control group. Each subject was asked to produce successive /a/ vowel sounds in their singing and speaking voice. For singing, the low pitch was produced in the chest register and the high notes in the head register. We collected the data on the long-term average spectra of the speaking and singing voices of the trained singers and the control groups.ResultsFor the sounds produced from the head register, a significant energy concentration was seen in both 2.2-3.4 kHz and 7.5-8.4 kHz regions (except for the voices of the mezzo sopranos) in the trained singer group when compared to the control groups. Also, the chest register had a significant energy concentration in the 4 trained singer groups at the 2.2-3.1 kHz and 7.8-8.4 kHz. For speaking sound, all trained singers had a significant energy concentration at 2.2-5.3 kHz and sopranos had another energy concentration at 9-10 kHz.ConclusionThe results of this study suggest that opera singers have more energy concentration in the singer's formant/speaker's ring region, in both singing and speaking voices. Furthermore, another region of energy concentration was identified in opera singer's singing sound and in sopranos' speaking sound at 8-9 kHz. The authors believe that these energy concentrations may contribute to the rich voice of trained singers

Adenosine A2A Receptor Agonist, Polydeoxyribonucleotide Treatment Improves Locomotor Function and Thermal Hyperalgesia Following Neuropathic Pain in Rats

Purpose Lithotomy position has been widely used in the various urologic surgery. Occasionally sensory and motor problems of the lower extremities are occurred due to the lithotomy position and these deficits may be related with sciatic nerve injury (SNI). Inflammatory process is a factor to induce functional impairment after SNI. Therefore, we evaluated the role of adenosine A2A receptor agonists, polydeoxyribonucleotide (PDRN) showing anti-inflammatory effect on locomotor function following SNI in rats. Methods Sciatic nerve was compressed with surgical clips for 1 minute after exposing of right sciatic nerve. After 3 days of SNI, PDRN (2, 4, and 8 mg/kg) was applied to the damaged area of sciatic nerve once daily for 10 days. Walking track analysis was conducted for locomotor function and plantar test was performed for thermal pain sensitivity. Level of cyclic adenosine-3´,5´-monophosphate (cAMP) were measured using enzyme-linked immunosorbent assay. Western blot analysis was performed for tumor necrosis factor (TNF)-α, interleukin (IL)-1β, cAMP response element binding protein (CREP), vascular endothelial growth factor (VEGF). Immunofluorescence for neurofilament was also conducted. Results Locomotor function was decreased and thermal pain sensitivity was increased by SNI. SNI enhanced proinflammatory cytokines’ production, such as TNF-α and IL-1β, while suppressed CREP phosphorylation and cAMP level. SNI also reduced the expression of VEGF and neurofilaments. However, treatment with PDRN inhibited proinflammatory cytokines’ production and upregulated CREP phosphorylation and cAMP expression. PDRN also enhanced the expression of VEGF and neurofilaments. As a result, PDRN improved locomotor function and alleviated thermal hyperalgesia after SNI. Conclusions PDRN has shown potential to be used as an effective treatment for neuropathic pain

Dual Effect of Chrysanthemum indicum

The risk of bone-related diseases increases due to the imbalance between bone resorption and bone formation by osteoclasts and osteoblasts, respectively. The goal in the development of antiosteoporotic treatments is an agent that will improve bone through simultaneous osteoblast stimulation and osteoclast inhibition without undesirable side effects. To achieve this goal, numerous studies have been performed to identify novel approaches using natural oriental herbs to treat bone metabolic diseases. In the present study, we investigated the effect of Chrysanthemum indicum extract (CIE) on the differentiation of osteoclastic and osteoblastic cells. CIE inhibited the formation of TRAP-positive mature osteoclasts and of filamentous-actin rings and disrupted the bone-resorbing activity of mature osteoclasts in a dose-dependent manner. CIE strongly inhibited Akt, GSK3β, and IκB phosphorylation in RANKL-stimulated bone marrow macrophages and did not show any effects on MAP kinases, including p38, ERK, and JNK. Interestingly, CIE also enhanced primary osteoblast differentiation via upregulation of the expression of alkaline phosphatase and the level of extracellular calcium concentrations during the early and terminal stages of differentiation, respectively. Our results revealed that CIE could have a potential therapeutic role in bone-related disorders through its dual effects on osteoclast and osteoblast differentiation

Association between Choroidal Thickness and Ocular Perfusion Pressure in Young, Healthy Subjects: Enhanced Depth Imaging Optical Coherence Tomography Study

PURPOSE. To investigate the correlation of choroidal thickness (CT) with ocular perfusion pressure (OPP) in young, healthy subjects using enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS. A single horizontal section and a single vertical section of EDI-OCT scans in each eye of 69 young, healthy subjects were obtained at the macula. CT was measured at the fovea, and up to 3 mm, at intervals of 0.5 mm, away from the fovea in the superior, inferior, nasal, and temporal choroid. Univariable and multivariable analyses were performed to assess the association of CT with OPP while axial length (AL), refractive error (RE), sex, and/or body mass index (BMI), were taken into consideration. RESULTS. Mean subfoveal CT was 307.03 6 91.27 lm (mean age, 22.3 6 3 years; mean axial length, 25.35 6 1.14 mm; mean refractive error, À3.89 6 2.02 diopters; mean OPP, 44.18 6 5.49 mm Hg). Multivariable regression analysis showed that in eyes with <6 diopters of myopia, subfoveal CT (325.92 6 88.46 lm) changed most significantly in association with RE and mean OPP (b ¼ 25.941, P < 0.001; b ¼À3.551, P ¼ 0.042, respectively; adjusted R 2 ¼ 0.249). In subjects with myopia of >6 diopters, subfoveal CT (225.17 6 49.37 lm) was significantly thinner (P < 0.0001), and a significant correlation with OPP was not observed (P > 0.05). CONCLUSIONS. In vivo subfoveal CT as measured by EDI-OCT was significantly associated with OPP in young, healthy subjects when adjusted for RE, suggesting that subfoveal CT may be indirectly indicative of subfoveal ocular perfusion status. This association was not observed in subjects with high myopia. (Invest Ophthalmol Vis Sci. 2012;53:7710-7717