Alterations of 3D acetabular and lower limb parameters in adolescent idiopathic scoliosis

European Spine Journal - To evaluate the 3D deformity of the acetabula and lower limbs in subjects with adolescent idiopathic scoliosis (AIS) and their relationship with spino-pelvic alignment. Two...     

The importance of submalleolar deformity in determining leg length discrepancy

Background and purposeThe association of leg length discrepancy (LLD) with a number of clinical disorders has made its determination a significant part of the physical examination. We believe that submalleolar causes of LLD may be under-acknowledged. The most common clinical method used to measure LLD is by tape from the anterior superior iliac spine (ASIS) to medial malleolus which disregards the potential for LLD arising from asymmetry in the foot distal to the tibiotalar joint.MethodsThe present pilot study involves a group of 5 volunteers (experimental group) and a group of 3 patients with flexible flat feet (clinical study). The differences in tibial tubercle height from the ground between full pronation and full supination were measured using the CODA MPX 30^® system (Charnwood Dynamics Limited, Leicestershire, England). Correlations of the patterns within each group were produced.ResultsA significant relationship with leg lengths was found in the experimental group when they induced maximum pronation (R-squared = 0.62, p = 0.007) while an inverse relationship occurred with supination, although marginally significant (R-squared = 0.37, p = 0.064).ConclusionsWe have demonstrated that significant leg length discrepancy can occur in patients who do not have obvious deformity when non weight bearing. We recommend using the blocks method routinely. Appropriately measuring LLD is of vital importance to properly diagnosing and treating patients with unequal leg lengths or related symptoms.     

Progesterone in transient ischemic stroke: a dose–response study

Rationale

Previous studies demonstrate the neuroprotective effects of progesterone in numerous animal injury models, but a systematic dose–response study in a transient ischemic stroke model is lacking.

Objectives

We investigated the effects of progesterone at different doses on post-stroke brain infarction and functional deficits in middle-aged rats.

Methods

Cerebral ischemia was induced in 13-month-old male Sprague–Dawley rats by right middle cerebral artery occlusion for 2 h followed by reperfusion. Rats received intraperitoneal injections of 8, 16, or 32 mg/kg of progesterone (P8, P16, P32) or vehicle at 2 h post-occlusion followed by subcutaneous injections at 6 h and every 24 h post-injury for 7 days. Functional recovery was evaluated at intervals over 22 days using motor, sensory, and cognitive tests. Infarct size was evaluated at 22 days post-stroke.

Results

Repeated-measures ANOVA showed significant group effects on grip strength, rotarod, and sensory neglect. All progesterone-treated groups had improved (p?p?Conclusions Although all doses were somewhat effective, progesterone given at 8 mg/kg led to the most consistent improvements across a panel of behavioral/functional tests and reduced the severity of ischemic infarct injury.     

Alterations in cytochrome P450-derived arachidonic acid metabolism during pressure overload-induced cardiac hypertrophy

Cardiac hypertrophy is a major risk factor for many serious heart diseases. Recent data demonstrated the role of cytochrome P450 (CYP)-derived arachidonic acid (AA) metabolites in cardiovascular pathophysiology. In the current study our aim was to determine the aberrations in CYP-mediated AA metabolism in the heart during cardiac hypertrophy. Pressure overload cardiac hypertrophy was induced in Sprague Dawley rats using the descending aortic constriction procedure. Five weeks post-surgery, the cardiac levels of AA metabolites were determined in hypertrophied and normal hearts. In addition, the formation rate of AA metabolites, as well as, CYP expression in cardiac microsomal fraction was also determined. AA metabolites were measured by liquid chromatography–electrospray ionization-mass spectroscopy, whereas, the expression of CYPs was determined by Western blot analysis. Non-parametric analysis was performed to examine the association between metabolites formation and CYP expressions. Our results showed that 5,6-, 8,9-, 11,12-, and 14,15-epoxyeicosatrienoic acids (EETs), and 5-, 12-, 15-, and 20-hydroxyeicosatetraenoic acids (HETEs) levels were increased, whereas, 19-HETE formation was decreased in hypertrophied hearts. The increase in EETs was linked to CYP2B2. On the other hand, CYP1B1 and CYP2J3 were involved in mid-chain HETE metabolism, whereas, CYP4A2/3 inhibition was involved in the decrease in 19-HETE formation in hypertrophied hearts. In conclusion, CYP1B1 played cardiotoxic role, whereas, CYP2B2, CYP2J3 and CYP4A2/3 played cardioprotective roles during pressure overload-induced cardiac hypertrophy. These CYP can be valid targets for the development of drugs to treat and prevent cardiac hypertrophy and heart failure.     

Characteristics of Entrained Air Voids in Hardened Concrete with the Method of Digital Image Analysis Coupled with Schwartz-Saltykov Conversion

This paper presents the characteristics of air void systems in hardened concrete with the method of digital image analysis (DIA) coupled with Schwartz-Saltykov (SS) conversion. The results indicate that the DIA method coupled with SS conversion estimates the air content with more accuracy than it would without SS conversion; the correlation between air content obtained from the DIA method, and that from the thin section (TS) method is as good as the correlation observed between the pressure saturation (PS) method and the TS method. It was also found that the DIA method shows a better correlation with the TS method when the spacing factor without SS conversion is considered, while both methods show poor correlations when the corresponding specific surface is considered. In addition, it indicates that the peak of three-dimensional size distribution (3-DSD) of air voids after SS conversion falls in smaller voids, and 3-DSD of air voids shifts to a narrow size range, in comparison with the 2-DSD without SS conversion; the shape of the 3-DSD air voids remains constant irrespective of the class widths. Increasing the number of classes can minimise the standard deviation in the estimation, however, it also results in a leap in voids volume density, which will influence the estimation of air content.     

Minimally invasive tricuspid valve surgery

Tricuspid valve disease carries a very unfavorable prognosis when medically treated. Despite that, surgical intervention is still underperformed for tricuspid valve disease due to the reported high morbidity and mortality from a sternotomy approach. This had led to a shift towards maximizing medical therapy for right ventricular failure and, as a result, a more significant delay in surgical referrals with surgical risks when patients are finally referred. Tricuspid valve patients usually have other co-morbidities resulting from their systemic venous congestion and low flow cardiac output. Minimally invasive tricuspid valve surgery provides less tissue injury and, as a result, less trauma during surgery. This provides a hope for both patients and treating doctors to be more open for providing this procedure with less complications. Isolated minimally invasive tricuspid valve surgery is still not performed as widely as expected. This can be partly due to the adverse outcomes historically labelled to tricuspid valve surgery or by the long journey of learning the surgical team would need to commit to with a minimal access approach. In this article we will review the perioperative pathway, and outcomes of isolated minimally invasive tricuspid valve surgery in the available English literature.     

Detection of tetracosactide in plasma by enzyme‐linked immunosorbent assay (ELISA)

As a synthetic analogue of adrenocorticotropic hormone (ACTH), tetracosactide is prohibited in sport by the World Anti‐Doping Agency (WADA). An enzyme‐linked immunosorbent assay (ELISA) method is proposed for detection of this drug in plasma. Since its structure corresponds to the 24 N‐terminal of the 39 amino acids of the natural endogenous peptide ACTH, tetracosactide can be detected with a commercial ELISA kit for ACTH that uses antibodies, the epitopes of which are located in the 1?24 part of ACTH. However, an essential condition for detection specificity is the preliminary total clearance of endogenous ACTH in the plasma samples. This is achieved by a preparative step based on cation‐exchange chromatography before ELISA. The method is specific and sensitive (LOD: 30 pg/mL) and may be used as a screening analysis in anti‐doping control. The pre‐analytical conditions are shown to be of the upmost importance and recommendations for blood collection (EDTA tubes), sample transport (4 °C) and plasma sample storage (‐20 °C) are presented. Copyright © 2014 John Wiley & Sons, Ltd.