A method to calculate relative spinal motion without digitization

Background contextEuler and projection methods have been used to describe relative spinal motion. In the Eulerian formulation, the exiting method used vector form of Euler angles and only provides an approximation. In the projection method, local coordinate systems constructed with digitization can affect the accuracy of kinematical results. A more consistent data reduction method is desired to calculate relative spinal motion (range of motion) from raw marker data.PurposeTo develop a new data reduction method to calculate relative spinal motion based on arbitrarily oriented local coordinate systems of individual vertebrae, and to simplify experimental procedures in multidirectional testing of spines.Study design/settingThe relative spinal motion was determined from raw marker data using transformation matrices.MethodsIn the Eulerian formulation, the relative motion of a vertebra to its subjacent level was determined using transformation matrices rather than vector operation on Euler angles. In the projection method, the projection axes were determined by tranforming local coordinate systems. Both approaches can be used to analyze raw marker data.ResultsThe new data reduction method was successfully implemented to analyze the raw data acquired on an intact L1–L2 motion segment. There was little difference between the Euler method and projection methods.ConclusionsIn conclusion, an alternative data reduction method in both Euler and projection angles to calculate range of motion for in vitro spine biomechanical studies was presented. The method was validated on a human cadaveric lumbar motion segment under axial torsion, lateral bending, and flexion extension. Because the relative spinal motion does not depend on how local coordinate systems are oriented, the digitization process can be eliminated in most multidirectional flexibility tests. Compared with previous methods, this new method provides more consistent kinematical results and significantly simplifies experimental procedures.     

Comparison of two different oxygen delivery methods in the early postoperative period: randomized trial

Title.  Comparison of two different oxygen delivery methods in the early postoperative period: randomized trial.
Aim.  This paper is a report of a study conducted to compare the effects of two different oxygen delivery methods on both patient peripheral oxygen saturation and patient satisfaction.
Background.  One of the most serious problems encountered in the early postoperative period is hypoxemia. Giving oxygen to patients in the perioperative period reduces the incidence of hypoxemia. Oxygen is generally delivered to patients through oxygen masks or nasal cannulae. Previous studies have shown that face masks and nasal cannulae are effective in the early postoperative period.
Method.  A randomized trial was conducted between 2007 and 2008 with patients undergoing thyroidectomy. In the early postoperative period, 5 L/minute of oxygen was given to patients via an oxygen mask ( n  = 53) or nasal cannulae ( n  = 53). Peripheral oxygen saturation were measured by pulse oxymeter every 5 minutes for a 30-minute period. The Postoperative Nausea Vomiting Scale was used and patient satisfaction was evaluated using a 10-point scale.
Results.  Average peripheral oxygen saturation for the nasal cannulae group was statistically significant higher than that in the mask group. This difference arose from more frequent removal of the oxygen mask than the nasal cannulae by patients and healthcare professionals. Average satisfaction scores for patients in the nasal cannulae group were statistically significantly higher than those in the mask group.
Conclusion.  During the early postoperative period, using nasal cannulae for patients undergoing thyroidectomy increases oxygenation.     

Prognostic and predictive value of vascular endothelial growth factor and its soluble receptors, VEGFR-1 and VEGFR-2 levels in the sera of small cell lung cancer patients

OBJECTIVES: Small cell lung cancer (SCLC) has a rapid growth rate and is characterized by early metastases. Tumor growth is dependent on angiogenesis. Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis. Whether surveillance of pre- and post-treatment serum VEGF and especially its receptors VEGF-1 and VEGF-2 levels in SCLC patients have impact on clinical outcome is unknown. METHODS: From February 2001 to January 2003, 39 consecutive patients with histological proven SCLC were enrolled into the study. Pre-treatment (n: 39) and post-treatment (n: 25) samples of the same patients were collected at the time of their response evaluation. The levels of VEGF and its receptors VEGFR-1 and VEGFR-2 were measured in the serum by quantitative sandwich enzyme immunoassay technique. RESULTS: The median pre-treatment serum VEGF, VEGFR-1, and VEGFR-2 levels which were significantly higher than the normal controls were 1,200 pg/ml (range, 1,414.3 +/- 956.2 pg/ml), 85 pg/ml (range, 97.8 +/- 70.7 pg/ml), and 11,550 pg/ml (range, 14,481 +/- 6,267 pg/ml), respectively. We detected a poor but positive correlation between VEGF and VEGFR-2 (r: 0.46, p: 0.003). Pre-treatment low serum VEGF (<728.5 pg/ml) value (p: 0.02) and good response to treatment (p: 0.008) were found as good prognostic factors by multivariate analysis. CONCLUSIONS: Low serum VEGF concentration is a significant and independent prognostic factor in SCLC patients. Surveillance of VEGF and its receptors to predict chemotherapy response is not useful. Whether the levels of serum VEGF and its receptors VEGFR-1 and VEGFR-2 have value in detecting treatment modalities of SCLC need further studies.     

Synthesis and antimycobacterial activities of some new N-acylhydrazone and thiosemicarbazide derivatives of 6-methyl-4,5-dihydropyridazin-3(2H)-one

In this study, twenty-five new 6-methyl-4,5-dihydropyridazin-3(2H)-one derivatives having N-acylhydrazone and thiosemicarbazide moieties were synthesized. The target compounds were tested for their antimycobacterial activity in vitro against Mycobacterium tuberculosis H₃₇R_v using the agar dilution method. Among the synthesized compounds, N′-(2,4-dichlorobenzylidene)-2-(3-methyl-6-oxo-5,6-dihydropyridazin-1(4H)-yl)acetohydrazide 4g was found to be the most active compound with minimum inhibitory concentration of 0.78?μM and was more potent than ethambutol and ciprofloxacin.     

Orthodontic treatment of transposition of permanent mandibular lateral incisor and left canine in mixed dentition: a case report

The purpose of this study was to present the orthodontic treatment of a unilateral transposition of a permanent mandibular left canine and permanent mandibular lateral incisor during middle transitional dentition in a 10-year-old female. A panoramic radiograph showed the apex of the permanent mandibular left lateral incisor to be resting on the mesial corner of the permanent mandibular left canine crown, which was ectopically erupted in the proximity of the primary mandibular left second molar. A removable appliance was used to upright the permanent mandibular left lateral incisor, after which a utility arch was used until full eruption of the permanent dentition. Treatment continued with a fixed appliance system that included all teeth until the transposition of the canine and lateral incisor was corrected and a Class I occlusion with a favorable smile was obtained (at 36 months).     

Comparison of the effects of sibutramine versus sibutramine plus metformin in obese women

Sibutramine and metformin are drugs commonly used to obtain weight loss. We aimed to compare the effects of sibutramine alone with that of sibutramine plus metformin combination on weight loss, insulin sensitivity, leptin and C reactive protein in obese women. Seventy obese women were included. After a diet period of month (baseline), each individual was randomly assigned to receive 15 mg sibutramine (sibutramine group; n = 36) or 15 mg sibutramine plus 1,700 mg metformin per day (sibutramine plus metformin group; n = 34) during the next 12 months. Body weight, insulin resistance by the homeostasis model assessment model (HOMA-IR), leptin and C reactive protein were measured at baseline, after 3 months and after 12 months. Mean weight losses in sibutramine and sibutramine plus metformin groups were 5.3 ± 4.0% (P < 0.001) and 6.8 ± 3.9% (P < 0.001) after 3 months, and 10.5 ± 4.4% (P < 0.001) and 15.7 ± 4.6% (P = 0.007) after 12 months, respectively. HOMA-IR value also decreased in both sibutramine (P = 0.045 and P = 0.002) and sibutramine plus metformin groups (P = 0.04 and P = 0.015) after 3 and 12 months, respectively. Similarly, serum leptin levels decreased in both sibutramine (P = 0.04, P = 0.01) and sibutramine plus metformin groups (P = 0.023, P = 0.025) after 3 and 12 months, respectively. There was also significant reductions in serum C reactive protein levels in both sibutramine (P = 0.045, P = 0.02) and sibutramine plus metformin groups (P = 0.007, P = 0.001) after 3 and 12 months, respectively. These decrements of body weight, HOMA-IR, serum leptin and C reactive protein levels were not statistical significance between these two groups both after 3 and 12 months (P > 0.05). Combination of sibutramine with metformin did not result in any further effects on weight loss, insulin resistance, leptin and C reactive protein levels when compared to sibutramine alone.     

Functional outcome in stroke patients with atrial fibrillation

OBJECTIVES: To identify the prevalence of atrial fibrillation (AF) in a sample of stroke patients and to evaluate the impact of AF on patient clinical characteristics and functional outcome. DESIGN: A retrospective case-comparison study. SETTING: University-affiliated rehabilitation centers. PARTICIPANTS: One hundred ninety-six of 231 consecutive stroke patients admitted to inpatient rehabilitation units were evaluated during the rehabilitation period. MAIN OUTCOME MEASURES: Characteristics of cerebral lesions, patient demographic features, disease duration, length of hospital stay (LOS), risk factors for stroke, and functional status at admission and at discharge were assessed and compared in patients with and without AF. Functional Independence Measure (FIM) and Adapted Patient Evaluation Conference System (APECS) were used to evaluate functional status. RESULTS: AF was diagnosed in 41 (20.1%) patients. Patients who had AF were more likely to have ischemic cerebral lesions. There were no significant differences between the AF and non-AF groups with regard to mean age, LOS, and disease duration. Ischemic and valvular heart disease were more common in patients with AF. Based on FIM and APECS scores, both initial and discharge disability were more severe in patients with AF. In a multivariate model, AF was a negative prognostic factor for functional outcome in stroke patients. CONCLUSION: AF is not only associated with increased risk of stroke, but also with markedly greater disability in stroke patients. Factors such as size and type of cerebral lesions, stroke severity, comorbid conditions, and impact of AF on systemic and cerebral circulation can influence stroke recovery.