Does Size Really Matter? Analysis of the Effect of Large Fibroids and Uterine Volumes on Complication Rates of Uterine Artery Embolisation

The purpose of this study was to determine whether there is a correlation between large uterine fibroid diameter, uterine volume, number of vials of embolic agent used and risk of complications from uterine artery embolisation (UAE). This was a prospective study involving 121 patients undergoing UAE embolisation for symptomatic uterine fibroids at a single institution. Patients were grouped according to diameter of largest fibroid and uterine volume. Results were also stratified according to the number of vials of embolic agent used and rate of complications. No statistical difference in complication rate was demonstrated between the two groups according to diameter of the largest fibroid (large fibroids were classified as ≥10 cm; Fisher’s exact test P = 1.00), and no statistical difference in complication rate was demonstrated according to uterine volume (large uterine volume was defined as ≥750 cm³; Fisher’s exact test P = 0.70). 84 of the 121 patients had documentation of the number of vials used during the procedure. Patients were divided into two groups, with ≥4 used defined as a large number of embolic agent. There was no statistical difference between these two groups and no associated increased risk of developing complications. This study showed no increased incidence of complications in women with large-diameter fibroids or uterine volumes as defined. In addition, there was no evidence of increased complications according to quantity of embolic material used. Therefore, UAE should be offered to women with large fibroids and uterine volumes.     

Effect of repeated freezing–thawing on the Achilles tendon of rabbits

The increased use of allograft tissue in the reconstruction of anterior cruciate ligament has brought more focus to the effect of storage and treatment on allograft. The purpose of this study was to observe the effect of histology and biomechanics on Achilles tendon in rabbits through repeated freezing–thawing before allograft tendon transplantation. Rabbit Achilles tendons were harvested and processed according to the manufacture’s protocol of tissue bank, and freezing–thawing was repeated three times (group 1) and ten times (group 2). Those received only one cycle were used as controls. Then, tendons in each group were selected randomly to make for histological observations and biomechanics test. Histological observation showed that the following changes happened as the number of freezing–thawing increased: the arrangement of tendon bundles and collagen fibrils became disordered until ruptured, cells disrupted and apparent gaps appeared between tendon bundle because the formation of ice crystals. There were significant differences between the experimental and control groups in the values of maximum load, energy of maximum load and maximum stress, whereas no significant differences existed in other values such as stiffness, maximum strain, elastic modulus, and energy density. Therefore, repeated freezing–thawing had histological and biomechanical effect on Achilles tendon in rabbits before allograft tendon transplantation. This indicates that cautions should be taken in the repeated freezing–thawing preparation of allograft tendons in clinical application.     

Influence of magnesium chloride on the dose–response of polyacrylamide-type gel dosimeters

We investigated the effect of magnesium chloride (MgCl₂) on the nuclear magnetic resonance dose–response of polyacrylamide-type (PAGAT, NIPAM, and VIPET) gel dosimeters containing acrylamide, N-isopropylacrylamide, and N-vinylpyrrolidone as a monomer, respectively. The dose-transverse relaxation rates (1/T₂?=?R₂) obtained from magnetic resonance imaging data revealed that a substantial increase in the dose–R₂ response occurred as the concentration of MgCl₂ in the gel dosimeters increased. The sensitivity of the PAGAT gel with 1.0 M MgCl₂ was found to be approximately one order higher than that of the same gel without MgCl₂. In addition, the water equivalences of the gels with MgCl₂ were evaluated over a wide range of photon energies. The results indicated that MgCl₂ acts as a powerful sensitizer to radiation-induced free-radical polymerization in polyacrylamide-type gel dosimeters, but does not interfere with the desirable properties of basic polyacrylamide-type gel dosimeters (i.e., the dose rate and dose integration).     

Influence of sex on the “Athlete's Heart” in trained cyclists

Compared to females, male endurance athletes have generally been considered to demonstrate greater values of cardiac mass and volume (the “athlete's heart”). However, studies addressing this issue have frequently failed to match training volumes between groups or provided inadequate adjustment of variables for body size and composition. This study compared echocardiographic anatomic features in 8 female and 8 male competitive cyclists with a similar training history. Conforming to most previous reports, left ventricular mass and end diastolic dimension, adjusted for fat free body mass and body surface area, respectively, were greater in the males (3.56 ± 0.83 g kg^?1 versus 2.50 ± 0.38 g kg^?1; 41.7 ± 2.2 mm and 37.4 ± 2.5 mm per BSA^0.5). This study indicated that when training volume as well as body size and composition are considered, male endurance athletes exhibit greater cardiac dimensions and mass compared to their female counterparts.     

No cash no whiplash?: Influence of the legal system on the incidence of whiplash injury

Whiplash injury has been a continuous source of controversy due to its association with litigation. We studied the incidence of whiplash associated disorder (WAD) in two similar socioeconomic areas and carried out a retrospective study based on the hypothesis that the Spanish law 30/1995 might have an affect on the incidence and duration of cervical symptoms and the persistence of impairment. More than 10,000 patients injured in traffic accidents were studied over a period three years. Of these, only patients with an initial diagnosis of whiplash injury were included in the study. Patients with other injuries were excluded. The patients were classified into two groups: Galicia-Spain and North-Central Portugal (depending on where the accident took place and the medico-legal evaluation procedure in force). Statistical analysis was made using SPSS 13.0 and Statistix 8.0. We found a statistically significant difference between Spain and Portugal in the incidence of WAD and in the duration of symptoms. The incongruities caused by the compulsory application of Spanish law arise from the fact that evaluation on a points scale of impairment does not always reflect the functional state of the injured person.     

Influence of the irradiation of high dose γ-rays on the track development properties of soda lime glass detectors

The influence of high γ-ray flux in the range of 3.727 × 10¹⁰ radiations cm⁻² to 0.9939 × 10¹² radiations cm⁻² has been studied on the track development properties of soda lime glass detectors. The etchpit diameters of fission fragment tracks of ²⁵²Cf are found to decrease with an increase exposure of γ-rays. A decrease in the value of bulk etch rate has also been reported.     

Leiomyoma Infarction after Uterine Artery Embolization: Influence of Embolic Agent and Leiomyoma Size and Location on Outcome

Purpose

To study the factors that might impact infarction of individual uterine leiomyomas and total tumor burden after uterine artery embolization (UAE).

Influence of the anterior–posterior femoral translation on the range of motion in cruciate-retaining total knee arthroplasty

Purpose

The purpose of this study is to evaluate the post-operative range of motion (ROM) of the knee related to the anterior–posterior femoral translation on the tibia observed during surgery in cruciate-retaining total knee arthroplasty (TKA) using a navigation system. Our hypothesis is that the intraoperative anterior–posterior femoral translation is correlated with the post-operative ROM in patients undergoing cruciate-retaining TKA.

Methods

The subjects were 20 patients involving 23 joints. The passive maximum ROM was measured before and 1 year after surgery. In addition, we evaluated the intraoperative anterior–posterior femoral translation that was measured after inserting a tensor device from 10° to 120° of knee flexion. The starting point of the anterior–posterior femoral translation was defined as when the femur started to move posteriorly. The anterior–posterior femoral translation 120 was set as the amount of femoral movement from 10° to 120°.

Results

The subjects were divided into those with an increased or maintained ROM (group A) and those with a decreased ROM (group B). There were no significant differences between the two groups in terms of the age or pre-operative ROM. The starting point of the anterior–posterior femoral translation was significantly earlier in group B (58.0 ± 5.7° for group A, 48.7 ± 3.2° for group B) (P < 0.05). Regarding the anterior–posterior femoral translation 120, Group B showed a larger amount of femoral movement posteriorly than group A (13.0 ± 6.5 mm for group A, 19.0 ± 6.2 mm for group B) (P < 0.05).

Conclusions

The present study shows that intraoperative anterior–posterior femoral translation has a significant correlation with the post-operative ROM in patients undergoing cruciate-retaining TKA. If the starting point of the anterior–posterior femoral translation is early and the anterior–posterior femoral translation 120 is large, there is likely to be a decrease in the post-operative ROM.

Level of evidence

III.     

Evaluation of the Early Access STR Kit v1 on the Ion Torrent PGM™ platform

The Early Access STR Kit v1 is designed to detect 25-plex loci with next generation sequencing (NGS) technology on the Ion Torrent PGM™ platform, including 16 of 20 expanded Combined DNA Index System (CODIS) core loci (CSF1PO, D1S1656, D2S1338, D2S441, D3S1358, D5S818, D7S820, D8S1179, D10S1248, D13S317, D16S539, D19S433, D21S11, TH01, TPOX and vWA), 8 non-CODIS core loci (D1S1677, D2S1776, D4S2408, D5S2500.AC008791, D6S1043, D6S474, D9S2157 and D14S1434) and Amelogenin. In this study, we compared the Early Access STR Kit v1 with the Ion Torrent™ HID STR 10-plex to find out its improvements and explored an appropriate analytical threshold to enhance the performance. In addition, seven experiments were conducted to evaluate the Early Access STR Kit v1 such as studies of repeatability, concordance, sensitivity, mixtures, degraded samples, case-type samples and pedigrees. Other than a little discordance (0.95%) with CE-STR results observed at D21S11, NGS-STR results correctly reflected the sample being tested. Repeatable results were obtained from both initial PCRs and emPCRs aside from a few variations of allele coverage. Full profiles could be obtained from 100 pg input DNA and >48.84% profiles from 10 pg input DNA. Mixtures were easily detected at 9:1 and 1:9 ratios. This system could be adapted to case-type samples and degraded samples. As a whole, the Early Access STR Kit v1 is a robust, reliable and reproducible assay for NGS-STR typing and a potential tool for human identification.     

Positioning of the pH-probe by manometry or radiography for monitoring of the esophagus. Influence on diagnostic results?

PURPOSE: To correlate gastroesophageal reflux (GER), demonstrated by radiography using bread and barium, with 24-h pH monitoring in the esophagus, with the pH-probe positioned by manometry or radiology. MATERIAL AND METHODS: In all, 146 patients, 41 females and 105 males, with a median age of 47 years, suspected of GER were examined. Radiography was performed with the patient in the supine right oblique position during mastication and swallowing a piece of rye bread with liver paté and barium. The test was positive if barium was observed more than 5 cm proximal to the gastroesophageal junction (GEJ). An antimony pH-probe was placed 5 cm above the lower esophageal sphincter determined by manometry, or 5 cm above the GEJ determined by radiography. The total time of esophageal pH <4 exceeding 5% was considered pathological. RESULTS: The radiological method had a specificity of 100% and a sensitivity of 52% compared to 24-h pH monitoring with the pH-probe positioned manometrically, and a specificity of 100% and sensitivity of 67% with the pH-probe positioned by radiography, with no significant difference between the two positionings. CONCLUSION: In 146 patients submitted to 24-h pH monitoring, the pH-probe could be placed as safely by radiography as by manometry.     

Effect of bracing on the prevention of anterior knee pain—a prospective randomized study

There have been numerous reports about the use of knee braces to prevent traumatic knee injuries. Despite the frequent use of braces, very few prospective studies have been performed to study the effect of knee braces for preventing anterior knee pain syndrome (AKPS). The purpose of this study was to assess the effectiveness of a dynamic patellofemoral brace (On-Track System, dj Orthopedics) in the prevention of AKPS. 167 military recruits without history of knee pain were randomized into two groups prior to the start of their 6-week basic military training (BMT) program. The first group (brace group) consisted of 54 recruits who wore the braces for all physical activities during these 6 weeks. 113 recruits served as a control group, and followed the same 6-week strenuous training program. Chi square statistics (Fisher exact test) were used to compare the number of AKPS patients in the brace group and in the non-brace group. Our results indicated that recruits in the brace group appeared to develop significantly less anterior knee pain compared to the recruits in the control group (p =0.020). Out of the 54 recruits in the brace group, ten (18.5%) developed anterior knee pain during this study. In the control group (n =113), 42 recruits (37%) developed anterior knee pain. We conclude that the result of the present study suggests that the use of a dynamic patellofemoral brace is an effective way to prevent the development of anterior knee pain in persons undergoing a strenuous training program.The views expressed in this article are those of the author and do not reflect the official policy or position of the Belgian Department of Defense     

Effect of Reducing Chemotherapy Drug Doses on the Level of Index of Liver Fibrosis 、TGF-β1 and Recent Curative Effect of HPC

目的 探索减少经导管动脉化疗栓塞术(TACE)中化疗药剂量对原发性肝癌(PHC)患者肝纤维化指标、血清转化生长因子-β1( TGF-β1)水平及短期疗效的影响.资料与方法 36例不可手术切除的PHC患者接受超选择性TACE,按入选标准随机分为两组,A组(n=15,小剂量组)给予小剂量化疗药物;B组(n=21,常规剂量组)给予常规剂量化疗药物.结果 两组患者治疗前后血清学指标比较,常规剂量组术后三项纤维化指标透明质酸(HA)、人Ⅲ型前胶原(hPC-Ⅲ)、Ⅳ-C型胶原(Ⅳ-C)及TGF-β1水平均明显高于手术前(P＜0.01),层粘连蛋白(LN)水平较术前升高(P＜0.05);小剂量组术后四项肝纤维化指标较术前无显著性差异(P＞0.05),TGF-β1水平较术前升高(P＜0.05);近期疗效比较两组无显著性差异(P＞0.05).结论 TACE治疗PHC,适当减少化疗药物剂量可减轻肝纤维化的发生,有利于保护肝功能,而并不影响到患者近期疗效.     

Influence of age and sex on signal intensities of the posterior lobe of the pituitary gland on T1-weighted images from 3 T MRI

Purpose

To elucidate the influence of age and sex on the signal intensity (SI) of the posterior lobe of the pituitary gland (PPG) on T1-weighted images (T1WI) from 3 T MRI.

Materials and methods

Sagittal T1WI acquired from three-dimensional fast spoiled gradient recalled acquisition in the steady state in 1,634 subjects without conditions affecting antidiuretic hormone were evaluated retrospectively. The presence or absence of a bright signal in the PPG was assessed qualitatively. The SI ratio of the PPG to the pons (SIR) was obtained from quantitative measurements. We statistically analyzed these data, creating 14 subject groups categorized according to age and sex, and applied a Poisson generalized linear model to the SIR data.

Results

The characteristic bright signal was absent in 47 subjects (2.8 %), with no significant difference in incidence among the groups. The SIR was inversely related to age in both males (r > 0.7) and females (r > 0.9), and was significantly higher in females in the third to the eighth decades (p < 0.05). Analysis of the whole SIR dataset using a generalized linear model showed that the estimated SIR decreased by 1.7 % per decade and is higher in females.

Conclusion

Age and sex influence the SI of the PPG on T1WI. These findings may aid the recognition of PPG signal abnormalities on T1WI.     

Effect of amifostine (Ethyol®) on the development of extraembryonic blood vessels in chick embryos

Aim

Systemic and local side effects can limit radioas well as chemotherapy in patients suffering from neoplastic discaccs One possibility to reduce the therapy-dependent side effects is to attenuate radical induced alterations of normal healthy tissue by application of antioxidants. Preclinical and clinical studies demonstrated the ability of amifostine to protect normal, but not neoplastic, tissues from cytotoxic effects of chemotherapy or irradiation. The purpose of the present study was to establish whether amifostine (Ethyol®) can affect microvessel density in vivo.

Material and Methods

For this study fertilized crossbred ldWhite-Plymouth-Rocks x Sussexrd eggs were used. After 48 hours of incubation 0.05 ml solution containing 25.7 μg (approximately 120 μM) amifostine were injected next to the germ disc. Taking into account the mean surface area of the area vasculosa and the embryo, this corresponds to a dose of 26 μg/cm². As controls, the area vasculosa of eggs treated with 0.05 ml NaCl 0.9% were used. Twenty-four and 48 hours after injection of amifostine or NaCl photographs and video microscopic pictures from treated areas and controls were taken and evaluated for vascular density. Results of vascular density are given as vascular intersections per mm² (VIS/mm²).

Results

There was a significant (p < 0.001) difference in vascular density with a mean microvessel count of 30.40 (± 12.84 SD) VIS/mm² in the NaCl control and 53.69 (±24.56 SD) VIS/mm² in the amifostine-treated area vasculosa.

Conclusion

The results show that amifostine induced an increase in vascular density in the rapidly proliferating area vasculosa of the early chick embryo.     

Effect of geometry on mass attenuation coefficient of β-particles

The mass attenuation coefficient of β-particles in aluminum is determined for five different β-emitters covering the end-point energy range from 0.4 to 2.3 MeV adopting two extreme geometries, namely the good geometry setup and the 2π geometry setup. The experimental and estimated values obtained using these geometries are compared with those values obtained using an intermediate geometry by Nathuram et al.,⁽¹⁾ and Gleason et al.⁽⁵⁾ The effect of geometry on μ/ϱ values is discussed.