Prevalence of Adrenal Insufficiency in Korean Patients undergoing Total Knee Arthroplasty

Background This study investigated the prevalence of adrenal insufficiency among patients admitted for total knee arthroplasty (TKA) due to osteoarthritis and identified factors contributing to adrenal insufficiency. Methods We divided the patients into two groups based on the results of preoperative standard-dose short synchronous stimulation tests: group 1 (adrenal insufficiency) and group 2 (normal adrenal function). We also assessed the prevalence of adrenal insufficiency and compared the numbers of patients who received oral steroids, the frequency of previous steroid injection use, and the frequency of systemic symptoms of steroid depletion such as fatigue and loss of appetite between the two groups. Multiple regression analysis was performed to identify factors related to adrenal insufficiency. Results The prevalence of adrenal insufficiency was 60.0% (120/200). Group 1 had higher numbers of previous steroid injections (12.8±10.2 vs. 6.8±7.9) and patients taking oral steroids (18/120 vs. 3/80) (p<0.001 and p=0.011, respectively). The frequency of systemic symptoms of steroid depletion, such as fatigue and loss of appetite, was also higher in group 1 (94/120 vs. 42/80, p<0.001). Recent steroid injections and loss of appetite were associated with adrenal insufficiency (p=0.002 and p=0.009, respectively). Conclusions The results of this study revealed a high prevalence of adrenal insufficiency in Korean patients hospitalized for TKA due to end-stage osteoarthritis. Recent steroid injections were causally related to the development of adrenal insufficiency. Therefore, adrenal function should be assessed preoperatively to prevent postoperative complications related to adrenal insufficiency

Using the redundant convolutional encoder–decoder to denoise QRS complexes in ECG signals recorded with an armband wearable device

Long-term electrocardiogram (ECG) recordings while performing normal daily routines are often corrupted with motion artifacts, which in turn, can result in the incorrect calculation of heart rates. Heart rates are important clinical information, as they can be used for analysis of heart-rate variability and detection of cardiac arrhythmias. In this study, we present an algorithm for denoising ECG signals acquired with a wearable armband device. The armband was worn on the upper left arm by one male participant, and we simultaneously recorded three ECG channels for 24 h. We extracted 10-s sequences from armband recordings corrupted with added noise and motion artifacts. Denoising was performed using the redundant convolutional encoder–decoder (R-CED), a fully convolutional network. We measured the performance by detecting R-peaks in clean, noisy, and denoised sequences and by calculating signal quality indices: signal-to-noise ratio (SNR), ratio of power, and cross-correlation with respect to the clean sequences. The percent of correctly detected R-peaks in denoised sequences was higher than in sequences corrupted with either added noise (70–100% vs. 34–97%) or motion artifacts (91.86% vs. 61.16%). There was notable improvement in SNR values after denoising for signals with noise added (7–19 dB), and when sequences were corrupted with motion artifacts (0.39 dB). The ratio of power for noisy sequences was significantly lower when compared to both clean and denoised sequences. Similarly, cross-correlation between noisy and clean sequences was significantly lower than between denoised and clean sequences. Moreover, we tested our denoising algorithm on 60-s sequences extracted from recordings from the Massachusetts Institute of Technology-Beth Israel Hospital (MIT-BIH) arrhythmia database and obtained improvement in SNR values of 7.08 ± 0.25 dB (mean ± standard deviation (sd)). These results from a diverse set of data suggest that the proposed denoising algorithm improves the quality of the signal and can potentially be applied to most ECG measurement devices

An improved algorithm for respiration signal extraction from electrocardiogram measured by conductive textile electrodes using instantaneous frequency estimation

In this paper, an improved algorithm for the extraction of respiration signal from the electrocardiogram (ECG) in home healthcare is proposed. The whole system consists of two-lead electrocardiogram acquisition using conductive textile electrodes located in bed, baseline fluctuation elimination, R-wave detection, adjustment of sudden change in R-wave area using moving average, and optimal lead selection. In order to solve the problems of previous algorithms for the ECG-derived respiration (EDR) signal acquisition, we are proposing a method for the optimal lead selection. An optimal EDR signal among the three EDR signals derived from each lead (and arctangent of their ratio) is selected by estimating the instantaneous frequency using the Hilbert transform, and then choosing the signal with minimum variation of the instantaneous frequency. The proposed algorithm was tested on 15 male subjects, and we obtained satisfactory respiration signals that showed high correlation (r2 > 0.8) with the signal acquired from the chest-belt respiration sensor

Innate antiviral responses against Shaan virus infection in HEK293, A549 and MARC-145 cells and limited role of viperin against Shaan virus replication

The Shaan virus is a new paramyxovirus species recently isolated from an insectivorous bat. Therefore, its replication characteristics remain unclear. We used transcriptome analysis and molecular experiments to examine host cell responses in human A549, HEK293, and monkey MARC-145 cell lines infected with the Shaan virus (ShaV/B16-40). Transcriptome data showed that Shaan virus infection induced innate immune responses associated with defense mechanisms against viral infection in all infected host cells. In real-time RT-PCR, IFN-α, -β and -λ1 were significantly upregulated in response to infection with Shaan virus in A549 and HEK-293 cells. However, the expression of IFN-α and -λ1 did not change in MARC-145 infected cells, while IFN-β significantly increased compared to the control in all the infected cell lines. In DEG analysis, the viperin expression pattern by Shaan virus infection varied depending on the host cell types or their origins. Viperin was highly induced at the RNA level by Shaan virus infection, and viperin protein expression was detected by western blotting. Although viperin, an ISG, has broad inhibitory effects on a range of viral pathogens, viperin knockdown or knock-in in the infected cells indicated that this protein did not markedly affect Shaan virus replication. Interestingly, these effects were independent of CMPK2 expression, which is beneficial for the antiviral effects of viperin. Therefore, the present results suggest that Shaan virus might have a strategy to evade the antiviral effect of viperin or not be significantly affected by viperin

Thermal radical initiator derivatives based on O-imino-isourea: Synthesis, polymerization, and characterization

The new thermal radical initiators (TRIs) with linear and cyclic type groups based on derivatives of O-imino-isourea have been designed and synthesized. The radical polymerization property of the synthesized TRI derivatives as a radical initiator in n-butyl acrylate was monitored by differential scanning calorimetry analysis. TRI derivatives with linear type groups, such as 3-PenDCC, 3-HexDCC, and 4-HepDCC, showed peak temperatures (T-peak) of 80-84 degrees C, whereas those with cyclic type groups, such as C-PenDCC, C-HexDCC, and C-HepDCC, exhibited a wide T-peak distribution in the 74-87 degrees C range. The polymerization efficiency using new TRIs in n-butyl acrylate was elaborately identified from the molecular weights and conversion obtained using gel permeation chromatography analysis and NMR spectroscopy. To consider their possible application to automotive clearcoats, the real-time evolution of the rheological properties of clearcoat resins during the crosslinking process with newly synthesized TRI derivatives was measured, confirming the different crosslinking kinetics of TRI derivatives in real thermal curing process. The results were found to be well correlated with data from the radical polymerization experiments of TRIs.clos