Histopathologic characteristics of chronic sinusitis with bronchial asthma

Although tympanic-membrane (TM) perforations are common sequelae of middle-ear disease, the hearing losses they cause have not been accurately determined, largely because additional pathological conditions occur in these ears. Our measurements of acoustic transmission before and after making controlled perforations in cadaver ears show that perforations cause frequency-dependent loss that: (1) is largest at low frequencies; (2) increases as perforation size increases; and (3) does not depend on perforation location. The dominant loss mechanism is the reduction in sound-pressure difference across the TM. Measurements of middle-ear air-space sound pressures show that transmission via direct acoustic stimulation of the oval and round windows is generally negligible. A quantitative model predicts the influence of middle-ear air-space volume on loss; with larger volumes, loss is smaller.     

Analysis of the pathological severity degree of aortic stenosis (AS) and mitral stenosis (MS) using the discrete wavelet transform (DWT)

The heart is the principal organ that circulates blood. In normal conditions it produces four sounds for each cardiac cycle. However, most often only two sounds appear essential: S1 and S2. Two other sounds: S3 and S4, with lower amplitude than S1 or S2, appear occasionally in the cardiac cycle by the effect of disease or age. The presence of abnormal sounds in one cardiac cycle provide valuable information on various diseases. The aortic stenosis (AS), as being a valvular pathology, is characterized by a systolic murmur due to a narrowing of the aortic valve. The mitral stenosis (MS) is characterized by a diastolic murmur due to a reduction in the mitral valve. Early screening of these diseases is necessary; it’s done by a simple technique known as: phonocardiography. Analysis of phonocardiograms signals using signal processing techniques can provide for clinicians useful information considered as a platform for significant decisions in their medical diagnosis. In this work two types of diseases were studied: aortic stenosis (AS) and mitral stenosis (MS). Each one presents six different cases. The application of the discrete wavelet transform (DWT) to analyse pathological severity of the (AS and MS was presented. Then, the calculation of various parameters was performed for each patient. This study examines the possibility of using the DWT in the analysis of pathological severity of AS and MS.     

Fetal Growth in Women Using Low-Dose Aspirin for the Prevention of Preeclampsia: Effect of Maternal Size

We wanted to determine whether low-dose aspirin has an effect on birthweight in a low-risk population and to evaluate the interaction between aspirin and maternal risk factors in relationship to their effect on birthweight. We also wanted to determine the specific fetal ultrasound measurements affected by low-dose aspirin and the gestational age at which this effect becomes apparent.

The women studied were derived from a population of 606 nulliparous women who participated in a randomized trial of low dose aspirin to reduce the incidence of preeclampsia. This analysis included only women who remained normotensive and delivered live horn singletons at term. There were 254 women in the group randomized to 60 mg of aspirin daily from 24 weeks onward, and 248 who received a daily placebo.

The mean birthweight was 3,353 g in the aspirin versus 3,282 g in the control group, a difference of 71 g (P = 0.08). In a regression analysis controlling for race, height, weight, smoking, and infant sex, the use of aspirin was associated with an 88-g increase in birthweight (P = 0.04). The effect of aspirin on birthweight in black and white infants and male and female infants was not significantly different. However, when the study population was divided at the median by height and weight, virtually the entire increase in birthweight associated with low-dose aspirin was found in the short and thin women, with birthweight increases in these groups of approximately 140 g (P ≤ 0.02). Sequential fetal ultrasound measurements in thin women revealed significant changes in the abdominal circumference (P < 0.001) at 27 weeks and above associated with aspirin use, but no differences in femur length or head circumference.

Low-dose aspirin has a significant impact on birthweight in a low-risk nulliparous population, which is most marked in thin and/or short women. The effect is related predominantly to an increase in the fetal abdominal circumference. These results are compatible with current knowledge about the mechanism of action of low dose aspirin, and the etiology of decreased birthweight in thin women.     

ESB clinical biomechanics award 2008: Complete data of total knee replacement loading for level walking and stair climbing measured in vivo with a follow-up of 6–10 months

Background

Detailed information about the loading of the knee joint is required for various investigations in total knee replacement. Up to now, gait analysis plus analytical musculo-skeletal models were used to calculate the forces and moments acting in the knee joint. Currently, all experimental and numerical pre-clinical tests rely on these indirect measurements which have limitations. The validation of these methods requires in vivo data; therefore, the purpose of this study was to provide in vivo loading data of the knee joint.

Methods

A custom-made telemetric tibial tray was used to measure the three forces and three moments acting in the implant. This prosthesis was implanted into two subjects and measurements were obtained for a follow-up of 6 and 10 months, respectively.Subjects performed level walking and going up and down stairs using a self-selected comfortable speed. The subjects’ activities were captured simultaneously with the load data on a digital video tape. Customized software enabled the display of all information in one video sequence.

Findings

The highest mean values of the peak load components from the two subjects were as follows: during level walking the forces were 276 %BW (percent body weight) in axial direction, 21 %BW (medio-lateral), and 29 %BW (antero-posterior). The moments were 1.8 %BW*m in the sagittal plane, 4.3 %BW*m (frontal plane) and 1.0 %BW*m (transversal plane). During stair climbing the axial force increased to 306 %BW, while the shear forces changed only slightly. The sagittal plane moment increased to 2.4 %BW*m, while the frontal and transversal plane moments decreased slightly. Stair descending produced the highest forces of 352 %BW (axial), 35 %BW (medio-lateral), and 36 %BW (antero-posterior). The sagittal and frontal plane moments increased to 2.8 %BW*m and 4.6 %BW*m, respectively, while the transversal plane moment changed only slightly.

Interpretation

Using the data obtained, mechanical simulators can be programmed according to realistic load profiles. Furthermore, musculo-skeletal models can be validated, which until now often lacked the ability to predict properly the non-sagittal load values, e.g. varus–valgus and internal–external moments.     

Radiation dose and image information in computed radiography. A phantom study of angle measurements in the weight-bearing knee

Purpose: To establish a correlation between radiation dose and diagnostic accuracy when employing a new digital method for angle determinations. The specific intention was to determine how far the radiation dose can be reduced without losing measuring accuracy and to compare this radiation dose with that employed with our conventional method.Material and Methods: An image succession of an anthropomorphic phantom was generated with a computed radiography (CR) system, by reducing the exposure stepwise. The images were archived and transferred to a workstation for evaluation. The intraobserver variation of two angle determinations was used as an indicator of the evaluation accuracy. Patient radiation doses were measured with thermoluminescent dosimeters. The energy imparted, indicating the relative risk associated with exposure to ionising radiation, and the effective dose, which determines the absolute risk, were calculated.Results and Conclusion: No significant correlation was found between patient dose and measuring accuracy within the evaluated exposure interval. At the lowest exposure of the CR system, the energy imparted to the patient was 30 μJ. Compared with our conventional analogue method this is a reduction by 98%. The effective dose was as low as 1.5 μSv. The CR technique creates possibilities to adapt exposure parameters, and thus the radiation dose to the patient, according to the purpose of the investigation.     

Distal femur morphometry: a gender and bilateral comparative study using magnetic resonance imaging

Among the anthropometric factors to be considered, anatomic differences in the distal femur and intercondylar notch have been implicated as a cause of the different rates of anterior cruciate ligament (ACL) rupture between men and women; therefore, in this study our aim was to evaluate a number of morphometric measurements in the distal part of the femur. Two hundred knee MRI examinations were analyzed: 56 male right, 44 male left, 42 female right and 58 female left. Measurements of the intercondylar height (ICH), intercondylar width (ICW), medial condylar width (MCW), lateral condylar width (LCW) and epicondylar width (EW) were obtained. The notch shape index (NSI) was also calculated. Statistical analysis for comparisons was done by Students t-test. Correlations between the parameters studied were calculated by Pearson correlation coefficients. Significant bilateral differences were not found (p>0.05). In all measurements, males showed significantly greater values than females (p<0.001). No difference was seen in the NSI between males and females (p>0.05). Conversely a significant association was obtained between age and all parameters. We conclude that the results of this study may be useful for anatomic evaluation of the distal femur region prior to orthopaedic operations.     

生物学年龄评价方法进展

利用生物学年龄衡量个体的衰老进程,可以弥补实足年龄难以解释同龄个体间健康水平差异的缺陷。近年来,涌现出多种基于临床或表型、分子生物学指标或复合型指标的生物学年龄测量方法。本文对一些常见的生物学年龄评价指标进行概述,并比较这些评价指标的效度。     

The value of retropharyngeal soft tissue measurements in trauma of the adult cervical spine

Widening of the retropharyngeal soft tissue space (RSTS) has been interpreted as a sign of cervical spine trauma. Widely differing measurements are reported in the literature. However it is clear that, using the currently acceptable limits of normal, a large number of patients without spinal injury are subjected to further tests. The RSTS on lateral cervical spine radiographs of 318 patients with a history of cervical spine trauma were measured at the C2–C4 level. The values for patients found to be normal or with fractures/dislocations were evaluated. Statistical analysis of the results demonstrates a considerable overlap in the RSTS of normal and abnormal patients. Therefore we suggest that RSTS measurements are of limited diagnostic value. Using the statistical probability of abnormality, guidelines that indicate which patients may require additional study are suggested.     

乳腺癌患者生存质量的测量量表及其研究进展

乳腺癌是女性最常见的恶性肿瘤，目前人类尚未彻底了解乳腺癌的病因及寻找出有效的预防乳腺癌的手段。因此在我国及世界许多国家乳腺癌发病率仍呈逐渐上升的趋势。在过去30年里随着临床治疗手段及早期诊断技术的进步，其死亡率已呈现下降的趋势。越来越多的乳腺癌患者将保持长期带瘤生存状态．乳腺癌如何影响患者的健康及生活已成为人们关注的主要问题。因此，生存质量（HRQOL）这一概念也就应运而生。鉴于生存质量的研究在我国尚处于起步阶段，本文就肿瘤目前常用的生存质量的测量手段加以介绍。