Variation in functional pelvic tilt in patients undergoing total hip arthroplasty with acetabular dysplasia

Purpose: It is important to clarify the link between acetabular dysplasia and pelvic tilt to optimize surgical planning and postoperative outcomes. We sought to investigate functional pelvic tilt in patients undergoing total hip arthroplasty with acetabular dysplasia. Materials & Methods: From 2014 to 2020, pre-operative AP Pelvis X-rays, CT scans, and other patient-specific data such as pelvic tilt, lumbar lordotic angle, etc were collected as part of surgical planning for total hip arthroplasty. From this database, we investigated 678 female patients under the age of 50 that had undergone preoperative standing AP pelvis X-rays. Analysis was performed by investigating how many patients whose hips are dysplastic displayed anterior pelvic tilt. Anterior pelvic tilt was defined in three different positions, sitting/supine/standing. Correlation between the severity of the dysplasia and anterior pelvic tilt was also investigated. Results: Out of the 678 patients, 80.7% had a dysplastic hip. 70.7% displayed an anterior standing pelvic tilt, 89.2% displayed an anterior supine pelvic tilt, and 98.3% displayed a seated anterior pelvic tilt. An observed 81.3% of the patients who have an anterior pelvic tilt have a unilaterally or a bilaterally dysplastic hip. Out of the anterior pelvic tilt group, 63.9% were bilaterally dysplastic hip patients. Conclusion: The majority of the pre-operative patients displayed an anterior pelvic tilt in all 3 positions (standing, supine, seated). Unilaterally or bilaterally dysplastic patients were also more likely to display an anterior pelvic tilt. Within the dysplastic group, bilateral patients were more likely to display anterior pelvic tilt

Tailored stereotactic radiotherapy technique using deep inspiration breath-hold to reduce stomach dose for cardiac radioablation

PURPOSE: To provide a new insight on a novel safe cardiac radioablation using deep inspiration breath-hold (DIBH) to reduce gastrointestinal dose. MATERIALS AND METHODS: For treating incessant ventricular tachycardia (VT) originated from left ventricle inferior scar abutting the stomach, a target delineation and treatment planning for cardiac radioablation was performed. With four different computed tomography (CT) scan protocols-DIBH, full expiration breath-hold, four-dimensional (4D) CT without and with abdominal compression, the distances between the target and the stomach were compared. RESULTS: Among the protocols, the CT scan with DIBH showed largest distance between the target and the stomach and selected for the treatment planning. The prescribed dose was 25 Gy in a single fraction, and satisfactory dosimetric parameters were achieved with the DIBH. The patient was successfully treated with the DIBH, and experienced no acute toxicity. CONCLUSION: To gain the best benefit from cardiac radioablation, understanding the possible toxicity in the adjacent organs is crucial. By moving the heart with thoraco-diaphragmatic movement by DIBH, the target could be physically separated from the stomach

Catechin-capped gold nanoparticles: green synthesis, characterization, and catalytic activity toward 4-nitrophenol reduction

An eco-friendly approach is described for the green synthesis of gold nanoparticles using catechin as a reducing and capping agent. The reaction occurred at room temperature within 1 h without the use of any external energy and an excellent yield (99%) was obtained, as determined by inductively coupled plasma mass spectrometry. Various shapes of gold nanoparticles with an estimated diameter of 16.6 nm were green-synthesized. Notably, the capping of freshly synthesized gold nanoparticles by catechin was clearly visualized with the aid of microscopic techniques, including high-resolution transmission electron microscopy, atomic force microscopy, and field emission scanning electron microscopy. Strong peaks in the X-ray diffraction pattern of the as-prepared gold nanoparticles confirmed their crystalline nature. The catalytic activity of the as-prepared gold nanoparticles was observed in the reduction of 4-nitrophenol to 4-aminophenol in the presence of NaBH(4). The results suggest that the newly prepared gold nanoparticles have potential uses in catalysis

Use of signal sequences as an in situ removable sequence element to stimulate protein synthesis in cell-free extracts

This study developed a method to boost the expression of recombinant proteins in a cell-free protein synthesis system without leaving additional amino acid residues. It was found that the nucleotide sequences of the signal peptides serve as an efficient downstream box to stimulate protein synthesis when they were fused upstream of the target genes. The extent of stimulation was critically affected by the identity of the second codons of the signal sequences. Moreover, the yield of the synthesized protein was enhanced by as much as 10 times in the presence of an optimal second codon. The signal peptides were in situ cleaved and the target proteins were produced in their native sizes by carrying out the cell-free synthesis reactions in the presence of Triton X-100, most likely through the activation of signal peptidase in the S30 extract. The amplification of the template DNA and the addition of the signal sequences were accomplished by PCR. Hence, elevated levels of recombinant proteins were generated within several hours

Pengaruh Ekstrak Jahe Merah (Zingiber Officinale Roscoe Var. Rubrum) Terhadap Kadar Mda Serum Tikus Setelah Terpapar Asap Rokok

Latar Belakang: Asap rokok merupakan salah satu sumber radikal bebas. Kadar radikal bebas yang tinggi dapat menyebabkan terjadinya kondisi stres oksidatif dan memicu terjadinya peroksidasi lipid pada membran sel yang akan menghasilkan Malondialdehyde (MDA). Sebenarnya, tubuh mempunyai sejumlah enzim dan zat yang dapat menetralkan radikal bebas yang disebut antioksidan. Kadar radikal bebas yang tinggi dapat menyebabkan antioksidan endogen tidak mampu untuk menetralisir. Kemampuan jahe sebagai antioksidan alami juga tidak terlepas dari kadar komponen fenolik total yang terkandung di dalamnya sehingga memiliki efek protektif yang tinggi dalam menangkal stres oksidatif. Tujuan: Penelitian ini bertujuan untuk mengetahui pengaruh pemberian ekstrak jahe merah terhadap kadar MDA serum tikus setelah terpapar asap rokok. Metode: Penelitian ini merupakan penelitian true experimental dengan desain pre-post test only control group design pada tikus. Perlakuan yang diberikan yaitu dengan pemberian ekstrak jahe merah (Zingiber officinale var. Rubrum) dan pemberian paparan asap rokok pada tikus, sedangkan keluarannya (outcome) adalah kadar MDA serum tikus. Hasil: Pemberian paparan asap rokok pada kelompok 2 meningkatkan kadar MDA serum dibandingkan dengan kelompok 1. Kelompok 3 yang diberikan ekstrak jahe merah 200 mg/kgBB/hari tidak efektif menurunkan kadar MDA serum. Pemberian ekstrak jahe merah menurunkan kadar MDA serum setelah diberikan paparan asap rokok (K4) jika dibandingkan dengan kelompok yang diberikan jahe merah tanpa diberikan paparan asap rokok (K3), penurunan tersebut tidak bermakna secara statistik. Kelompok 4 meningkatkan kadar MDA serum tikus dibandingkan dengan kelompok 2. Kesimpulan: Tidak terdapat pengaruh yang bermakna dari pemberian jahe merah (Zingiber officinale var. Rubrum) terhadap kadar MDA darah tikus setelah terpapar asap rokok

Artificial intelligence for the detection of sacroiliitis on magnetic resonance imaging in patients with axial spondyloarthritis

BackgroundMagnetic resonance imaging (MRI) is important for the early detection of axial spondyloarthritis (axSpA). We developed an artificial intelligence (AI) model for detecting sacroiliitis in patients with axSpA using MRI.MethodsThis study included MRI examinations of patients who underwent semi-coronal MRI scans of the sacroiliac joints owing to chronic back pain with short tau inversion recovery (STIR) sequences between January 2010 and December 2021. Sacroiliitis was defined as a positive MRI finding according to the ASAS classification criteria for axSpA. We developed a two-stage framework. First, the Faster R-CNN network extracted regions of interest (ROIs) to localize the sacroiliac joints. Maximum intensity projection (MIP) of three consecutive slices was used to mimic the reading of two adjacent slices. Second, the VGG-19 network determined the presence of sacroiliitis in localized ROIs. We augmented the positive dataset six-fold. The sacroiliitis classification performance was measured using the sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC). The prediction models were evaluated using three-round three-fold cross-validation.ResultsA total of 296 participants with 4,746 MRI slices were included in the study. Sacroiliitis was identified in 864 MRI slices of 119 participants. The mean sensitivity, specificity, and AUROC for the detection of sacroiliitis were 0.725 (95% CI, 0.705–0.745), 0.936 (95% CI, 0.924–0.947), and 0.830 (95%CI, 0.792–0.868), respectively, at the image level and 0.947 (95% CI, 0.912–0.982), 0.691 (95% CI, 0.603–0.779), and 0.816 (95% CI, 0.776–0.856), respectively, at the patient level. In the original model, without using MIP and dataset augmentation, the mean sensitivity, specificity, and AUROC were 0.517 (95% CI, 0.493–0.780), 0.944 (95% CI, 0.933–0.955), and 0.731 (95% CI, 0.681–0.780), respectively, at the image level and 0.806 (95% CI, 0.729–0.883), 0.617 (95% CI, 0.523–0.711), and 0.711 (95% CI, 0.660–0.763), respectively, at the patient level. The performance was improved by MIP techniques and data augmentation.ConclusionAn AI model was developed for the detection of sacroiliitis using MRI, compatible with the ASAS criteria for axSpA, with the potential to aid MRI application in a wider clinical setting

Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation and Valvular Heart Disease

Background: There are limited data for non-vitamin K antagonist oral anticoagulants (NOACs) impact on outcomes for patients with atrial fibrillation (AF) and valvular heart diseases (VHDs). Methods: We identified patients with AF and associated Evaluated Heartvalves, Rheumatic or Artificial (EHRA) type 2 VHDs, and who had been naïve from the oral anticoagulants in the Korean National Health Insurance Service database between 2014 and 2016 (warfarin: n = 2671; NOAC: n = 3058). For analyzing the effect of NOAC on primary prevention, we excluded those with a previous history of ischemic stroke, intracranial hemorrhage (ICH), and gastrointestinal (GI) bleeding events. To balance covariates, we used the propensity score weighting method. Ischemic stroke, ICH, GI bleeding, major bleeding, all-cause death, and their composite outcome and fatal clinical events were evaluated. Results: During a follow-up with a mean duration of 1.4 years, NOACs were associated with lower risks of ischemic stroke (hazard ratio (HR): 0.71, 95% confidence interval (CI): 0.53–0.96), GI bleeding (HR: 0.50, 95% CI: 0.35–0.72), fatal ICH (HR: 0.28, 95% CI: 0.07–0.83), and major bleeding (HR: 0.61, 95% CI: 0.45–0.80) compared with warfarin. Overall, NOACs were associated with a lower risk of the composite outcome (HR: 0.68, 95% CI: 0.58–0.80). Conclusions: In this nationwide Asian AF population with EHRA type 2 VHDs, NOAC use was associated with lower risks of ischemic stroke, major bleeding, all-cause death, and the composite outcome compared to warfarin use

Differentiation of the right versus left outflow tract ventricular arrhythmias using local activation time at the His bundle electrogram

Background Although multiple algorithms based on surface electrocardiographic criteria have been introduced to localize idiopathic ventricular arrhythmia (VA) origins from the outflow tract (OT), their diagnostic accuracy and clinical usefulness remain limited. We evaluated whether local activation time of the His bundle region could differentiate left and right ventricular OT VA origins in the early stage of electrophysiology study. Methods We studied 30 patients who underwent catheter ablation for OT VAs with a left bundle branch block pattern and inferior axis QRS morphology. The interval between the local V signal on the mapping catheter placed in the RVOT and His bundle region (V(RVOT)-V(HB) interval) and the interval from QRS complex onset to the local V signal on the His bundle region (QRS-V(HB) interval) were measured during VAs. Results The V(RVOT)-V(HB) and QRS-V(HB) intervals were significantly shorter in patients with LVOT VAs. The area under the curve (AUC) for the V(RVOT)-V(HB) interval by receiver operating characteristic analysis was 0.865. A cutoff value of ≤ 50 ms predicted an LVOT origin of VA with sensitivity, specificity, and positive and negative predictive values of 100%, 62.5%, 40%, and 100%, respectively. The QRS-V(HB) interval showed similar diagnostic accuracy (AUC, 0.840), and a cutoff value of ≤ 15 ms predicted an LVOT origin of VA with a sensitivity, specificity, and positive and negative predictive values of 100%, 70.8%, 45.2%, and 100%, respectively. Conclusion The V(RVOT)-V(HB) and QRS-V(HB) intervals could differentiate left from right OT origins of VA with high sensitivity and negative predictive values