Mechanical load assisted dissolution response of biomedical cobalt–chromium and titanium metallic alloys: influence of in-plane stress and chemical environment

Mechanical load-assisted dissolution is identified as one of the key mechanisms governing material removal in fretting and crevice corrosion of biomedical implants. In the current study, material removal on a stressed surface of cobalt–chromium–molybdenum (CoCrMo) and titanium (Ti64) alloys subjected to single asperity contact is investigated to identify the influence of contact loads and in-plane stress state on surface damage mechanisms. The experiments were conducted in three different aqueous environments—phosphate-buffered saline (PBS) at pH 7.4, PBS at pH 4.1, and high chloride solutions at pH 2.0. The tip of an atomic force microscope is used as a well-characterized “asperity” to apply controlled contact forces and mechanically stimulate the loaded specimen surface in different aqueous environments from passivating to corroding. The volume of the material removed is measured to determine the influence of contact loads, in-plane stresses, and the environment on the material dissolution rate. Experimental results indicate that surface damage is initiated at all the contact loads studied and as expected in a wear situation, removal rate increases with increase in contact loads. For both alloys, removal rates display a complex dependence on residual stresses and the environment. In a passivating environment, the material removal rate is linearly dependent on the stress state such that surface damage is accelerated under compressive stresses and suppressed under tensile stresses. In a corrosive environment, the dissolution rate demonstrates a quadratic dependence on stress, with both compressive and tensile stresses accelerating material dissolution. The material removal rates are found to be consistently larger for CoCrMo in comparison to Ti64 surfaces under the same mechanical and electrochemical stimuli, despite the higher hardness of CoCrMo surfaces. A surface damage mechanism based on stress-assisted dissolution is proposed to elucidate the experimental observations

GAIT ASYMMETRY IN CHILDREN WITH DOWN SYNDROME

It has been reported that approximately 80% of children with Down syndrome (OS) exhibit gait problems (Matteo, 2002), characterized by flat-footed contact with no heel-strike, excessive abduction of the leg in the swing phase, and abnormal knee and hip f1exions throughout the gait cycle (Parker et aI., 1986). Due to muscle hypotonia, muscle weakness, !igamentous laXity, and other orthopedic abnormalities, different gait characteristics exist. The purpose of this study was to investigate the gait (walking and running) asymmetry in children with OS

Development of a Watershed-Scale Long-Term Hydrologic Impact Assessment Model with the Asymptotic Curve Number Regression Equation

In this study, 52 asymptotic Curve Number (CN) regression equations were developed for combinations of representative land covers and hydrologic soil groups. In addition, to overcome the limitations of the original Long-term Hydrologic Impact Assessment (L-THIA) model when it is applied to larger watersheds, a watershed-scale L-THIA Asymptotic CN (ACN) regression equation model (watershed-scale L-THIA ACN model) was developed by integrating the asymptotic CN regressions and various modules for direct runoff/baseflow/channel routing. The watershed-scale L-THIA ACN model was applied to four watersheds in South Korea to evaluate the accuracy of its streamflow prediction. The coefficient of determination (R2) and Nash–Sutcliffe Efficiency (NSE) values for observed versus simulated streamflows over intervals of eight days were greater than 0.6 for all four of the watersheds. The watershed-scale L-THIA ACN model, including the asymptotic CN regression equation method, can simulate long-term streamflow sufficiently well with the ten parameters that have been added for the characterization of streamflow

Decreased DBC1 Expression Is Associated With Poor Prognosis in Patients With Non-Muscle-Invasive Bladder Cancer

Purpose The deleted in bladder cancer 1 (DBC1) gene is located within chromosome 9 (9q32-33), a chromosomal region that frequently shows loss of heterozygosity in bladder cancer (BC). It is suspected that it acts as a tumor suppressor gene, but its prognostic value remains unclear. The aim of the present study was to investigate the value of DBC1 as a prognostic marker in BC. Materials and Methods The expression of DBC1 was determined by real-time polymerase chain reaction analysis in 344 patients with BC (220 non-muscle-invasive BC [NMIBC] and 124 muscle-invasive BC [MIBC]) and in 34 patients with normal bladder mucosa. The results were compared with clinicopathologic parameters, and the prognostic value of DBC1 was evaluated by Kaplan-Meier analysis and a multivariate Cox regression model. Results: DBC1 expression was significantly decreased in patients with MIBC compared with those diagnosed with NMIBC (p=0.010). Patients with aggressive tumor characteristics had lower DBC1 expression levels in NMIBC (each, p<0.05). By multivariate Cox regression analysis, low DBC1 expression was a predictor of progression to MIBC (hazard ratio, 7.104; p=0.013). Kaplan-Meier estimates revealed a significant difference in tumor recurrence, progression to MIBC, and cancer-specific survival depending on the level of DBC1 expression in NMIBC (log-rank test, each, p<0.05). Conclusions: The expression of DBC1 was associated with tumor aggressiveness, progression to MIBC, and survival in NMIBC. Our results suggest that DBC1 expression can be a useful prognostic marker for patients with NMIBC

Pure Sensory Deficit at the T4 Sensory Level as an Isolated Manifestation of Lateral Medullary Infarction

In rare cases restricted sensory deficits along the somatotopic topography of the spinothalamic tract can develop from a lateral medullary infarction. To our knowledge, isolated dermatomal sensory deficit as a single manifestation of a lateral medullary infarction has not been reported previously. A 58-year-old man presenting with sudden left-sided paresthesia complained of sensory deficit of pain and temperature below the left T4 sensory level without other neurologic deficits. Diffuse- and T2-weighted magnetic resonance imaging (MRI) of the brain showed high signal intensities in the right lower medulla oblongata, whereas thoracic-spine MRI and somatosensory evoked potentials produced normal findings

Observation of the Far-ultraviolet Continuum Background with SPEAR/FIMS

We present the general properties of the far-ultraviolet (FUV; 1370-1720A) continuum background over most of the sky, obtained with the Spectroscopy of Plasma Evolution from Astrophysical Radiation instrument (SPEAR, also known as FIMS), flown aboard the STSAT-1 satellite mission. We find that the diffuse FUV continuum intensity is well correlated with N_{HI}, 100 $\mu$m, and H-alpha intensities but anti-correlated with soft X-ray. The correlation of the diffuse background with the direct stellar flux is weaker than the correlation with other parameters. The continuum spectra are relatively flat. However, a weak softening of the FUV spectra toward some sight lines, mostly at high Galactic latitudes, is found not only in direct-stellar but also in diffuse background spectra. The diffuse background is relatively softer that the direct stellar spectrum. We also find that the diffuse FUV background averaged over the sky has about the same level as the direct-stellar radiation field in the statistical sense and a bit softer spectrum compared to direct stellar radiation. A map of the ratio of 1400-1510A to 1560-1660A shows that the sky is divided into roughly two parts. However, this map shows a lot of patchy structures on small scales. The spatial variation of the hardness ratio seems to be largely determined by the longitudinal distribution of spectral types of stars in the Galactic plane. A correlation of the hardness ratio with the FUV intensity at high intensities is found but an anti-correlation at low intensities. We also find evidence that the FUV intensity distribution is log-normal in nature.Comment: 39 pages, 26 figures, accepted for publication in ApJ

Clinical Implications of Mandible and Neck Measurements in Non-Obese Asian Snorers: Ansan City General Population-Based Study

ObjectivesAnthropometric abnormalities of the mandible and neck may contribute to snoring in non-obese Asians. The study evaluated the clinical implications of mandible and neck measurements in non-obese Asian snorers.MethodsThe external mandible and neck measurements (neck circumference, two lengths of neck, mandibular body angle, and lengths of mandibular ramus and body) were compared between snorers and non-snorers in a sample of 2,778 non-obese Koreans (1,389 males, 1,389 females) aged 40 to 69 years (mean, 48.47±7.72 years).ResultsThe overall prevalence of snoring was 64.7% (899/1,389) and 48.3% (671/1,389) in non-obese male and female subjects, respectively. In non-obese males, snorers had significantly a greater neck circumference (P<0.0001) and shorter mandibular body length (P=0.0126) than non-snorers. In non-obese females, snorers had significantly greater neck circumferences (P=0.0165), compared with non-snorers. However, there were no statistically significant differences in other variables between non-snorers and snorers.ConclusionAnthropometric abnormalities of the mandible and neck, including thick neck circumference in both genders and small mandible size in males, may be relevant contributing factors to snoring in non-obese Asian snorers

Characteristics, Outcomes and Predictors of Long-Term Mortality for Patients Hospitalized for Acute Heart Failure: A Report From the Korean Heart Failure Registry

BACKGROUND AND OBJECTIVES: Acute heart failure (AHF) is associated with a poor prognosis and it requires repeated hospitalizations. However, there are few studies on the characteristics, treatment and prognostic factors of AHF. The aims of this study were to describe the clinical characteristics, management and outcomes of the patients hospitalized for AHF in Korea. SUBJECTS AND METHODS: We analyzed the clinical data of 3,200 hospitalization episodes that were recorded between June 2004 and April 2009 from the Korean Heart Failure (KorHF) Registry database. The mean age was 67.6±14.3 years and 50% of the patients were female. RESULTS: Twenty-nine point six percent (29.6%) of the patients had a history of previous HF and 52.3% of the patients had ischemic heart disease. Left ventricular ejection fraction (LVEF) was reported for 89% of the patients. The mean LVEF was 38.5±15.7% and 26.1% of the patients had preserved systolic function (LVEF ≥50%), which was more prevalent in the females (34.0% vs. 18.4%, respectively, p<0.001). At discharge, 58.6% of the patients received beta-blockers (BB), 53.7% received either angiotensin converting enzyme-inhibitors or angiotensin receptor blockers (ACEi/ARB), and 58.4% received both BB and ACEi/ARB. The 1-, 2-, 3- and 4-year mortality rates were 15%, 21%, 26% and 30%, respectively. Multivariate analysis revealed that advanced age {hazard ratio: 1.023 (95% confidence interval: 1.004-1.042); p=0.020}, a previous history of heart failure {1.735 (1.150-2.618); p=0.009}, anemia {1.973 (1.271-3.063); p=0.002}, hyponatremia {1.861 (1.184-2.926); p=0.007}, a high level of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) {3.152 (1.450-6.849); p=0.004} and the use of BB at discharge {0.599 (0.360-0.997); p=0.490} were significantly associated with total death. CONCLUSION: We present here the characteristics and prognosis of an unselected population of AHF patients in Korea. The long-term mortality rate was comparable to that reported in other countries. The independent clinical risk factors included age, a previous history of heart failure, anemia, hyponatremia, a high NT-proBNP level and taking BB at discharge.ope

Perinatal Outcome in Twin Pregnancies Complicated by Gestational Diabetes Mellitus: A Comparative Study

The purpose of this study is to compare perinatal outcomes of twin pregnancies complicated by gestational diabetes (GDM) with those unaffected by GDM. A total of 1,154 twin pregnancies who delivered at Cheil General Hospital, between January 1998 and December 2002 were recruited to participate in a retrospective analysis. Out of these twin pregnancies, 37 women were had GDM. Four pregnancies exposed to GDM were excluded due to the loss of medical records; therefore 33 twin pregnancies exposed to GDM were enrolled. We matched the GDM pregnancies with pregnancies unaffected by GDM in a 1:2 ratio; therefore there were 33 GDM/66 without GDM who delivered during the study period. Our findings show that there were no significant differences including birth weight, Apgar score, respiratory distress syndrome, meconium aspiration pneumonia, transient tachypnea of new born, hyperbilirubinemia, hypoglycemia, hypocalcemia and congenital anomalies. Therefore, well controlled GDM may not increase perinatal complications in twin pregnancies. Careful pregnancy management and fetal surveillance in twin pregnancies is important to decrease perinatal complications and maintain a sound pregnancy and healthy offspring