Effect of foot progression angle on lower extremity kinetics of knee osteoarthritis patients of different ages:a systematic review and meta-analysis / 中国组织工程研究

OBJECTIVE:Knee adduction moment and knee adduction angular impulse enlargement is the main biomechanical risk factor of knee osteoarthritis.According to the survey,a change in the foot progression angle could effectively change the motion mode of patients with knee osteoarthritis.However,the impact of toe-in and toe-out on knee adduction moment and knee adduction angular impulse in young and elderly patients did not reach a consensus.Therefore,this study comprehensively discussed the effect of foot progression angle on knee adduction moment and knee adduction angular impulse in different populations through meta-analysis and provided a reference for the treatment of knee osteoarthritis. METHODS:By June 2022,searches were conducted on Web of Science,EBSCO,PubMed and CNKI databases using"foot progression angle,knee adduction moment,knee adduction angular impulse,gait"as Chinese and English search terms.Self-controlled randomized controlled studies analyzing the effects of toe-in and toe-out on knee adduction moment bimodality and knee adduction angular impulse were included.The cochrane bias risk assessment tool was utilized to make a quality evaluation of the literature.Stata 15.1 software was used for subgroup analysis to determine the effect of foot progression angle on knee adduction moment and knee adduction angular impulse.Meta-regression analysis was used to further determine characteristics of outcome indicators(knee adduction moment,knee adduction angular impulse)changing with foot progression angle. RESULTS:(1)A total of 15 self-control trials and 2 randomized controlled trials(455 subjects)were included in the meta-analysis.All of the included articles were of medium to high quality.(2)The meta-analysis results showed that the toe-in gait could reduce the first peak of knee adduction moment(SMD=-0.380,95%CI:-0.710 to-0.060,P=0.022)and knee adduction angular impulse(SMD=-1.470,95%CI:-2.160 to-0.770,P<0.001)in young patients.The toe-out gait reduced the second peak of knee adduction moment(SMD=-0.720,95%CI:-1.010 to-1.440,P<0.001)in young patients.In addition,toe-in gait could reduce the first peak of knee adduction moment in elder patients(SMD=-0.550,95%CI:-0.800 to-0.300,P<0.001),but increase the second peak knee adduction moment of elderly(SMD=0.280,95%CI:-0.010 to 0.560,P=0.047).The toe-out gait could decrease the second peak knee adduction moment in this population(SMD=-0.510,95%CI:-0.830 to-0.190,P=0.002).(3)Meta-regression showed that the greater the toe-out in elderly patients,the lower the second peak knee adduction moment. CONCLUSION:(1)Toe-in reduced the first peak knee adduction moment and knee adduction angular impulse in young knee osteoarthritis patients aged 18 to 34 years.Since knee adduction moment and knee adduction angular impulse were associated with medial knee loading and knee osteoarthritis incidence,toe-in gait intervention may be a suitable rehabilitation strategy for young patients.(2)Toe-in increased the second peak of knee adduction moment in older knee osteoarthritis patients over 60 years of age,which may exacerbate knee osteoarthritis in this population.However,the second peak of knee adduction moment during walking in this population decreases as the toe-out increases,contributing to a reduction in medial knee loading,suggesting that older patients may consider using toe-out gait during walking.

Application of subcutaneous asymmetric tension reduction combined with dermal buried angular mattress suture in surgical treatment of benign pigmented facial lesions in infants and preschoolers / 中华皮肤科杂志

Objective:To investigate the clinical efficacy of subcutaneous asymmetric tension reduction combined with dermal buried angular mattress suture in surgical treatment of benign pigmented facial lesions in infants and preschoolers.Methods:Totally, 100 infants and preschoolers with pigmented facial lesions were enrolled from the Department of Dermatology, Hanzhong Central Hospital and the Second Affiliated Hospital of Xi′an Jiaotong University from January 2018 to January 2019, and their clinical data were analyzed retrospectively. Among these patients, there were 59 males and 41 females, and their age ranged from 3 months to 5 years, with an average age of 15 months. All patients underwent outpatient surgery under local anesthesia, and sedative drugs were used before operation. The skin lesions were excised once or in stages according to their areas, and incisions were closed by using a subcutaneous asymmetric suture-based tension reduction technique, followed by dermal buried angular mattress sutures. After surgery, medical silicone gels and tension reduction devices were used for 6 months to 1 year, and postoperative follow-up was performed.Results:All patients were followed up for more than 1 year after surgery. Four patients showed suture rejection reaction within two months after surgery, and the incisions completely healed after the suture knots were discharged; cat′s ear-shaped scars were formed at the upper and lower ends of the incisions in 3 cases when the sutures were removed 1 week after surgery, no treatment was given, and the cat′s ear-shaped scars gradually became flat after 1 year of follow-up; fat liquefaction occurred in 1 case 4 days after surgery, re-suturing of the incision was done 1 week after the removal of internal sutures and drainage, and the incision healed well; 1 case developed infection 3 days after surgery, and then received the removal of internal sutures, drainage, and anti-infection treatment, re-suturing was performed after complete regression of the incision swelling, and the incisions healed well; scar hyperplasia occurred in 4 cases 3 to 6 months after surgery, and the scars became flat after the local injection of triamcinolone acetonide. In the remaining children, fine white linear scars were formed after the healing of incisions, the depressions and ridges at both ends of the incisions became flat, and there was no obvious pulling sensation in facial organs or formation of cat′s ear-shaped scars.Conclusions:Subcutaneous asymmetric tension reduction combined with dermal buried angular mattress suture can effectively reduce tension twice during delicate facial surgery in infants and preschoolers, and help to avoid incision widening and scar hyperplasia. The follow-up showed favorable long-term efficacy and aesthetic effect.

Gonioscopia diagnóstica e cirúrgica. Atualidades e perspectivas / Diagnostic and surgical gonioscopy. Recent advances and perspective

RESUMO O presente artigo é uma atualização sobre os principais conceitos, as técnicas, os equipamentos, as lentes e as utilidades do exame de gonioscopia, com foco principal na sua importância para as novas terapias antiglaucomatosas: trabeculoplastia seletiva a laser e cirurgias angulares. Se faz necessária esta revisão e atualização por se tratar de um exame imprescindível para a prática diária do oftalmologista, consolidando o conhecimento necessário para realizá-lo e pelo crescente uso da gonioscopia nas novas terapias antiaglaucomatosas.

ABSTRACT This article is an update on the main concepts, techniques, equipment, lenses, and uses of the gonioscopy exam, with a main focus on its importance for new antiglaucoma therapies: selective laser trabeculoplasty and angular surgeries. This review and update is necessary because it is an essential exam for the daily practice of ophthalmologists, consolidating the knowledge necessary to perform it and because of the increasing use of gonioscopy in new anti-aglaucomatous therapies.

Angle Evaluation of Possible Routes that Can Be Used to Reach the Foramen Ovale in the Anterior Approach / Evaluación Angular de Posibles Rutas que se Pueden Utilizar para Alcanzar el Foramen Oval en el Abordaje Anterior

SUMMARY: For the treatment of trigeminal neuralgia, the foramen ovale is reached by entering the cheek with a needle. Thermocoagulation is performed with balloon compression, administration of alcohol or radiofrequency. Apart from the classical method, it is theoretically possible to reach the foramen ovale through the mouth with the anterior approach. In our study, it was aimed to examine horizontally and vertically the angular values that must be given to the needle to reach the foramen ovale in the anterior approach. Three landmark points were determined on both right and left sides of 25 dry skulls. A rod was inserted starting from these landmark points and passing through the center of the foramen ovale. The vertical and horizontal angular values of this bar were measured. For each foramen ovale, 3 vertical angles, 3 horizontal angles and 4 distance measurements were made. There was a significant difference between the right and left sides in terms of horizontal angular values. Average values of horizontal angles (in degrees); on the right, 7.29 for H1, 12.15 for H2, 32.29 for H3; 1.26 for H1, 9.46 for H2, and 30.56 for H3 on the left side (p<0.005). The angle value was measured as 0 or negative value in 5 (20 %) of the H1 angle measurements made on the right side and 14 (56 %) on the left side. The H2 angle value was found to be smaller than the H1 angle in the skull 2 (8 %) on the right and 3 (12 %) on the left. There was no difference between the right and left sides in terms of vertical angular values. A significant difference was found between the right and left sides in the D1, D2, D4 distances (p<0.005). Six important anatomical features affecting angular values were encountered.

Para el tratamiento de la neuralgia del trigémino, se alcanza el foramen oval introduciendo una aguja en la mejilla. La termocoagulación se realiza con compresión con balón, administración de alcohol o radiofrecuencia. Aparte del método clásico, en teoría es posible alcanzar el foramen oval a través de la cavidad oral mediante el abordaje anterior. En nuestro estudio se tuvo como objetivo examinar horizontal y verticalmente los valores angulares que se deben dar a la aguja para alcanzar el foramen oval en el abordaje anterior. Se determinaron tres puntos de referencia en los lados derecho e izquierdo de 25 cráneos secos. Se insertó una varilla comenzando desde estos puntos de referencia y pasando por el centro del foramen oval. Se midieron los valores angulares verticales y horizontales de esta barra. Para cada foramen oval se realizaron mediciones de 3 ángulos verticales, 3 ángulos horizontales y 4 distancias. Hubo una diferencia significativa entre los lados derecho e izquierdo en términos de valores angulares horizontales. Valores medios de ángulos horizontales (en grados); a la derecha, 7,29 para H1, 12,15 para H2, 32,29 para H3; 1,26 para H1, 9,46 para H2 y 30,56 para H3 en el lado izquierdo (p<0,005). El valor del ángulo se midió como 0 o valor negativo en 5 (20 %) de las mediciones del ángulo H1 realizadas en el lado derecho y 14 (56 %) en el lado izquierdo. Se encontró que el valor del ángulo H2 era menor que el ángulo H1 en el cráneo 2 (8 %) a la derecha y 3 (12 %) a la izquierda. No hubo diferencia entre los lados derecho e izquierdo en términos de valores angulares verticales. Se encontró diferencia significativa entre el lado derecho e izquierdo en las distancias D1, D2, D4 (p<0,005). Se encontraron seis características anatómicas importantes que afectan los valores angulares.

An image classification method for arrhythmias based on Gramian angular summation field and improved Inception-ResNet-v2 / 生物医学工程学杂志

Arrhythmia is a significant cardiovascular disease that poses a threat to human health, and its primary diagnosis relies on electrocardiogram (ECG). Implementing computer technology to achieve automatic classification of arrhythmia can effectively avoid human error, improve diagnostic efficiency, and reduce costs. However, most automatic arrhythmia classification algorithms focus on one-dimensional temporal signals, which lack robustness. Therefore, this study proposed an arrhythmia image classification method based on Gramian angular summation field (GASF) and an improved Inception-ResNet-v2 network. Firstly, the data was preprocessed using variational mode decomposition, and data augmentation was performed using a deep convolutional generative adversarial network. Then, GASF was used to transform one-dimensional ECG signals into two-dimensional images, and an improved Inception-ResNet-v2 network was utilized to implement the five arrhythmia classifications recommended by the AAMI (N, V, S, F, and Q). The experimental results on the MIT-BIH Arrhythmia Database showed that the proposed method achieved an overall classification accuracy of 99.52% and 95.48% under the intra-patient and inter-patient paradigms, respectively. The arrhythmia classification performance of the improved Inception-ResNet-v2 network in this study outperforms other methods, providing a new approach for deep learning-based automatic arrhythmia classification.

An EHG-based Preterm Delivery Prediction Algorithm via Convolution Neural Network / 中国医疗器械杂志

Premature delivery is one of the direct factors that affect the early development and safety of infants. Its direct clinical manifestation is the change of uterine contraction intensity and frequency. Uterine Electrohysterography(EHG) signal collected from the abdomen of pregnant women can accurately and effectively reflect the uterine contraction, which has higher clinical application value than invasive monitoring technology such as intrauterine pressure catheter. Therefore, the research of fetal preterm birth recognition algorithm based on EHG is particularly important for perinatal fetal monitoring. We proposed a convolution neural network(CNN) based on EHG fetal preterm birth recognition algorithm, and a deep CNN model was constructed by combining the Gramian angular difference field(GADF) with the transfer learning technology. The structure of the model was optimized using the clinical measured term-preterm EHG database. The classification accuracy of 94.38% and F1 value of 97.11% were achieved. The experimental results showed that the model constructed in this paper has a certain auxiliary diagnostic value for clinical prediction of premature delivery.

Study on surface electromyography characteristics of erector spinae muscles at different spinal anteversion angles of the scrapers / 中华劳动卫生职业病杂志

Objective: To simulate and evaluate the scraping and grinding work of workers with different spinal anteversion angles, and to explore the effects of different anteversion angles on the erector spinae muscles of scrapers. Methods: In November 2019, 16 male college student volunteers were recruited to simulate workers' scraping and grinding work. The parameters were 25°, 15 times/min, 15°, 30 times/min, 5°, 60 times/min respectively. The surface electromyography (sEMG) was used to collect the electromyographic signals of the erector spinae muscles, and the surface electromyographic characteristics of the erector spinae muscles were evaluated with Borg Scale. Results: There were significant differences between the maximum voluntary contraction percentage (MVE%) of the left and right erector spinae muscles groups in the three groups with different spinal anteversion angles (F(left)=13.41, P(left)<0.001; F(right)=4.74, P(right)=0.005) , and the EMG amplitude was higher at 25°, 15 times/min. At 15°, 30 times/min, MVE% of the left side was significantly higher than that of the right side (t=2.58, P=0.021) . There was significant difference in the mean power frequency (MPF) of the right erector spinae muscle in the three groups (F=9.42, P<0.001) , but there was no significant difference in the MPF of the left erector spinae muscle (F=0.30, P=0.823) . The fitting line showed that the left erector spinae muscle showed a downward trend at 5°, 60 times/min (t=-5.39, P=0.012) . Conclusion: Scrapers are less likely to be fatigued when the posture is 15°, 30 times/min, but they are more likely to be fatigued when working at 5°, 60 times/min.

Estudio comparativo entre fijador externo versus placa volar de estabilidad angular en las fracturas de radio distal / External fixator versus angular stability volar plates in distal radius fractures. A comparative study

Las fracturas del radio distal están entre las patologías más comunes en el área de la emergencia, actualmente los tratamientos más utilizados son la fijación con alambres de Kirschner y fijador externo (AKFE), o la osteosíntesis con placas volares de estabilidad angular (PVEA), realizamos un estudio comparativo de los resultados a corto plazo entre ambos métodos. Se realizó un estudio transversal, retrospectivo y descriptivo desde el 2005 al 2019, donde se revisaron las historias de los pacientes con fracturas de radio distal tratados con AKFE o PVEA, evaluando el alta después de la medición de la amplitud de movimiento articular funcional. Se incluyeron 68 pacientes, 47(69,11%) pacientes tratados con PVEA y 21(30,88%) con AKFE, la edad promedio fue de 53,07 años, la causa más común fue la caída de su altura en 60,29% casos, el alta médica por mejoría se realizó a las 15,95 semanas para AKFE y a las 9,86 semanas para PVEA (<0.05). La osteosíntesis con PVEA evidenció un menor tiempo de recuperación de la amplitud de movimiento articular con respecto a los pacientes tratados con AKFE(AU)

Fractures of the distal radius are among the most common pathologies in the emergency area, currently the treatment more frequently used are fixation with Kirschner wires and external fixator (KWEF), or osteosynthesis with angular stability volar plates (FAVP), we carried out a comparative study of the short-term results between both methods. This is a cross-sectional, retrospective and descriptive study from 2005 to 2019, where the histories of patients with distal radius fractures treated with KWEF or FAVP revised, evaluated, evaluating at discharge after functional joint range of motion was measured.68 patients were evaluated, 47 patients treated with FAVP and 21 with KWEF, average age of 53.07 years, the most common cause was the fall from his height with 60.29%, the medical discharge was made at 15,95 weeks for KWEF and 9,86 weeks for FAVP; with a t student<0.05 between them. Osteosynthesis with FAVP evidenced a shorter recovery time for joint range of motion compared to patients treated with KWEF(AU)

Cerebral Responses to Stationary Emotional Stimuli Measured by fMRI in Women with Persistent Postural-Perceptual Dizziness

Abstract Introduction Persistent postural-perceptual dizziness (PPPD) is a functional vestibular disorder characterized by chronic dizziness, unsteadiness, and hypersensitivity to motion. Preexisting anxiety disorders and neurotic personality traits confer vulnerability to PPPD. High anxiety during acute vertigo or dizziness incites it. A functional magnetic resonance imaging (fMRI) study of chronic subjective dizziness found unexpectedly hypoactive responses to vestibular stimulation in cortical regions that integrate threat assessment and spatial perception. Objective This fMRI study used non-moving, but emotionally charged visual stimuli to investigate the brain's activity of PPPD patients and control subjects. Methods The participants included 16 women with PPPD and 16 age-matched women who recovered completely from acute episodes of vertigo or dizziness capable of triggering PPPD. Brain responses to positive, neutral, and negative figures from the International Affective Picture System were measured with fMRI and compared between the groups. Dizziness handicap, anxiety, and depression were assessed with validated questionnaires. Results Between group analyses: Participants with PPPD showed reduced activity in anterior cingulate cortex and increased activity in left angular gyrus in response to negative versus positive stimuli, which was not observed in recovered individuals. Within group analyses: Participants with PPPD had increased activity in visuospatial areas (parahippocampal gyrus, intraparietal sulcus) in negative versus positive and negative versus neutral contrasts, whereas recovered individuals had increased activity in anxiety regions (amygdala, orbitofrontal cortex). Conclusion Patients with PPPD may be more attuned to spatial elements than to the content of emotionally charged visual stimuli.

Presión intraocular preoperatoria en el control del cierre angular primario tratado con extracción del cristalino / Preoperative intraocular pressure for the control of primary angle closure treated with clear lens extraction

Introducción: la extracción del cristalino transparente en pacientes con cierre angular primario se plantea si existe presión intraocular mayor o igual que 30 mm Hg o daño por glaucoma. En ojos con elevación moderada de la presión intraocular se desconocen los resultados. Objetivo: evaluar la influencia de la presión intraocular preoperatoria en el control del cierre angular primario tratado con extracción del cristalino transparente. Material y Métodos: se realizó un estudio pre-experimental, entre enero de 2013 y enero de 2020, incluyó 78 ojos de 78 pacientes con cierre angular primario tratados con extracción del cristalino transparente; divididos en dos grupos según presión intraocular preoperatoria. Para el análisis estadístico se empleó chi cuadrado de independencia, probabilidad exacta de Fisher, prueba t para muestras independientes y análisis de varianza de medidas repetidas; con significación estadística del 95 por ciento. Resultados: hubo diferencias significativas entre ambos grupos para longitud axial (p=0,003), grosor del cristalino (p<0,001) y espesor corneal central (p=0,016). La presión intraocular y número de colirios, variaron de forma muy significativa (p<0,001) entre el pre y posoperatorio, y entre ambos grupos en los diferentes momentos analizados. En el grupo A el 94,4 por ciento de los ojos mostró control absoluto posoperatorio invariable en el tiempo, en el grupo B la mayoría de los ojos tuvo control relativo con diferencias muy significativas (p<0,001) entre ambos. Conclusiones: la presión intraocular preoperatoria influye en el control del cierre angular primario tratado con extracción del cristalino transparente; valores previos menores que 30 mm Hg, propician mejor control posoperatorio(AU)

Introduction: Clear lens extraction is considered in patients older than 50 years with primary angle closure and intraocular pressure greater than or equal to 30 mm Hg or damage due to glaucoma. The results are unknown in eyes with a moderate elevation of intraocular pressure. Objective: To evaluate the influence of preoperative intraocular pressure in the control of the primary angle closure treated with clear lens extraction. Material and Methods: A pre-experimental study was conducted between January 2013 and January 2020. It included a total of 78 eyes of 78 patients with primary angle closure treated with clear lens extraction. They were divided into two groups according to preoperative intraocular pressure. For statistical analysis, Chi-square test, Fisher's exact probability test, and t test were used for independent samples and analysis of variance with repeated measurements; with 95 percent statistical significance. Results: There were significant differences in axial length (p=0,003), lens thickness (p<0,001) and central corneal thickness (p=0,016) between both groups. Intraocular pressure and the number of eye drops varied very significantly (p<0,001) between the pre-and postoperative periods and between both groups at the different moments analyzed. In group A, 94,4 percent of the eyes showed absolute postoperative control, which remained unchanged over time. In group B, most eyes had relative control. There were very significant differences (p<0,001) between both groups. Conclusions: Preoperative intraocular pressure influences the control of primary angle closure treated with clear lens extraction; previous values less than 30 mm Hg favor better postoperative control(AU)

Bridge plating for simple tibial fractures treated by minimally invasive plate osteosynthesis / [Estabilização em ponte de fraturas tibiais simples por osteossíntese minimamente invasiva com placa]

This study aimed to evaluate the effectiveness of bridge plating of simple tibial fractures in dogs by minimally invasive plate osteosynthesis (MIPO). Medical and radiographic records of twenty-nine dogs with simple tibial fractures that underwent bridge fixation by MIPO were retrospectively evaluated. The clinical outcome was classified considering the presence of lameness at the end of the treatment. The tibial mechanical joint angles were measured and compared with the values described in the literature. Additionally, fragment apposition and implant disposition were evaluated. Based on the modified Radiographic Union Scale for Tibial fractures, the moment of clinical union was determined. Clinically, at the end of treatment, only one patient presented lameness at a trot. While there was no significant difference between the bone alignment in the frontal plane values and the values described in the literature (P>0.05), the caudal proximal tibial angle was significantly higher (P=0.001). The median fragment apposition was considered acceptable. The average bridge plate ratio, plate working length, and plate screw density were 0.8, 0.57, and 0.48, respectively. The median time to clinical union was 30 days. Bridge plating in simple tibial fractures resulted in fast healing and low complication rates.(AU)

Objetivou-se avaliar a efetividade da estabilização em ponte de fraturas tibiais simples em cães utilizando-se a técnica de osteossíntese minimamente invasiva com placa (MIPO). Registros médicos e radiográficos de 29 cães com fraturas simples de tíbia, fixadas em ponte por meio da MIPO, foram retrospectivamente avaliados. O resultado clínico foi classificado com base na deambulação ao final do tratamento. Os ângulos articulares mecânicos da tíbia foram aferidos e comparados aos valores descritos na literatura. Adicionalmente, foram avaliadas a aposição dos fragmentos e a disposição dos implantes. Por meio da escala modificada de união radiográfica para fraturas de tíbia, determinou-se o momento de união clínica. Clinicamente, ao final do tratamento, apenas um animal apresentou claudicação ao trote. Não houve diferença significativa entre o alinhamento ósseo no plano frontal quando comparado com dados da literatura (P>0,05), enquanto, no plano sagital, o ângulo mecânico caudal proximal da tíbia foi significativamente maior (P=0,001). A mediana para aposição dos fragmentos foi considerada aceitável. As médias para relação placa em ponte, comprimento de trabalho da placa e densidade de parafusos da placa foram, respectivamente, 0,8; 0,57 e 0,48. A mediana para união clínica foi de 30 dias. A estabilização em ponte de fraturas tibiais simples resultou em rápida consolidação óssea, com baixas taxas de complicação.(AU)

Angular dependence of the optically stimulated luminescent dosimeter / 中国辐射卫生

0bjective To study the angular dependence of optically stimulated luminescent dosimeter (OSLD) with solid phantoms under SSDL radiation level 60Co radiation field, and to discuss the possibility of OSLD in volumetric modulated arc therapy (VMAT) and other rotating irradiation dose audit. Methods OSLDs were embedded in the two phantoms with the same size and material, respectively. The phantom 1 was set to make the first OSLD perpendicular to the beam, and the phantom 2 was set to make the second OSLD parallel to the beam. The OSLDs were irradiated at 8 angles: 0°, 45°, 90°, 135°, 180°, −45°, −90, −135°. The counts of the OSLSs were read and the response of each angle which normalized to 0° were calculated. Results When the OSLDs are perpendicular to the beam, the angular response is between −6.76% ～ +1.5%, with the maximum angular dependence at 90° and −90°. When the OSLDs are parallel to the beam, the angular response is between −1.74%～+1.67%, below 2%. Conclusion It is better to correct the sensitivity of dosimeters by Element Correction Factors (ECF) for dose audit. Under the condition of rotating irradiation, OSLD shoud be set parallel to the beam, which can better reduce the influence of angular dependence and facilitate further application research of VMAT dose audit.

Bone alignment after minimally invasive plate osteosynthesis of the tibia in dogs / Avaliação do alinhamento ósseo após osteossíntese minimamente invasiva com placa de tíbia em cães

ABSTRACT: This study assessed radiographically changes in tibial alignment in the frontal and sagittal planes in dogs that underwent minimally invasive plate osteosynthesis (MIPO) without the aid of image intensifiers. Radiographs of dogs with complete non-articular tibial fractures submitted to MIPO were included and evaluated, without the aid of a transoperative image intensifier and / or an association of implants. The tibial mechanical angles (mMPTA, mMDTA, mCaPTA and mCrDTA) were measured by three evaluators. The data obtained were compared with results from previously published studies. Twenty-seven animals were included in the study. The mean and standard deviation of the angular changes were as follows: mMPTA, 2.54° ± 3.10 (-1.1º to 8.7º); mMDTA, 0.03º ± 0.16 (-3.44º to 0.79º); mCaPTA, 37º ± 4.29 (-6.23º to 14.87º); and mCrDTA, 8.25° ± 5.53 (-0.2º to 17.28º). There was a negative correlation between "mCaPTA" and "mCrDTA". MIPO of the tibia without using image intensifiers and implant association can potentially cause angular changes, which can lead to clinically relevant deformities after bone healing.

RESUMO: Este estudo teve como objetivo avaliar radiograficamente as alterações no alinhamento da tíbia nos planos frontal e sagital em cães submetidos à osteossíntese minimamente invasiva com placa (MIPO) sem o auxílio de intensificadores de imagem. Foram incluídas e avaliadas radiografias de cães com fraturas completas da tíbia não articulares submetidos a MIPO, sem o auxílio de intensificador de imagem transoperatório e/ou associação de implantes. Os ângulos mecânicos tibiais (mMPTA, mMDTA, mCaPTA e mCrDTA) foram mensurados por três avaliadores. Os dados obtidos pela média de todas as avaliações foram comparados com resultados de estudos previamente publicados. Vinte e sete animais foram incluídos no estudo. A média e desvio padrão das alterações angulares foram os seguintes: mMPTA= 2,54° ± 3,10 (-1,1º a 8,7º); mMDTA= 0,03º ± 0,16 (-3,44º a 0,79º); mCaPTA= 37º ± 4,29 (-6,23º a 14,87º); e mCrDTA= 8,25 ° ± 5,53 (-0,2º a 17,28º). Houve uma correlação negativa entre "mCaPTA" e "mCrDTA". A realização de MIPO em tíbia sem o uso de intensificadores de imagem e associação de implantes pode causar alterações angulares, o que pode levar a deformidades clinicamente relevantes após a cicatrização óssea.

Modified Oregonator: an Approach from the Complex Networks Theory / Oregonador Modificado: un Enfoque desde la Teoría de Redes Complejas

Abstract: Within the framework of Systems Biology, this paper proposes the complex network theory as a fundamental tool for determining the most critical dynamic variables in complex biochemical mechanisms. The Belousov-Zhabotinsky reaction is proposed as a study model and as a complex bipartite network. By determining the structural property authority, the most relevant dynamic variables are specified, and a mathematical model of the Belousov-Zhabotinsky reaction is obtained. The bidirectional coupling of the proposed model was made with other models associated with biological processes, finding synchronization phenomena when varying the coupling parameter. The time series obtained from the numerical solution of the coupled models were used to construct their images using the Gramian Angular Field technique. In the end, a supervised learning tool is proposed for the classification of the type of coupling by analyzing the images, obtaining score percentages above 94%. The hereby proposed methodology could be extended to the experimental field in order to determine anomalies in the coupling and synchronization of different physiological oscillators.

Resumen: En el marco de la Biología de sistemas, se propone en el presente trabajo a la teoría de redes complejas como una herramienta fundamental para la determinación de las variables dinámicas más importantes en mecanismos bioquímicos complejos. Se emplea como modelo de estudio la reacción de Belousov-Zhabotinsky y se plantea como una red compleja bipartita. Mediante la determinación de la propiedad estructural autoridad, se determinan las variables dinámicas con mayor relevancia y se obtiene un modelo matemático de la reacción de Belousov-Zhabotinsky. Se realizó el acoplamiento bidireccional del modelo planteado con otros modelos asociados a procesos biológicos, encontrándose fenómenos de sincronización al variar el parámetro de acoplamiento. Las series de tiempo obtenidas de la solución numérica de los modelos acoplados se emplearon para construir sus respectivas imágenes mediante la técnica de campo angular gramiano. Finalmente, se propone una herramienta de aprendizaje supervisado para la clasificación del tipo de acoplamiento mediante el análisis de las imágenes, obteniéndose porcentajes de exactitud por encima del 94%. La metodología propuesta en el presente trabajo podría extenderse y trasladarse al campo experimental con la finalidad de determinar anomalías en el acoplamiento y sincronización de distintos osciladores fisiológicos.

Angular Photogrammetric Comparison of the Craniofacial Soft-tissue Profile of Three Ethnic Groups in Southern Nigeria

Aim:The aim of this study was to determine the angular craniofacial soft tissue profile of adult southern Nigerian males of Igbo, Ijaw and Yoruba extractions. Methodology:The study made use of a total number of one thousand two hundred (1200) subjects divided into four hundred (400) subjects each from the Igbo, Yoruba and Ijaw ethnic groups of southern Nigeria whose ages ranged between 21 to 40 years. Determination of minimum sample size was done using the Taro-Yamane’s formula. The study employed the use of photogrammetry. Standardized photographic record of the 1200adults were taken in the natural head position. Photographs were analysed using a software tool (WinImager). Data generated were subjected to statistical analysis using SPSS version 25.0 and Microsoft Excel 2019. Results:Results showed ethnic variations across the different ethnic groups. Age related changes were also observed. On comparison with other racialpopulations, marked differences were observed Conclusion:These anthropometric values define the facial soft tissue norm of southern Nigeria and could be useful in anthropometric studies, orofacial, orthodontic and maxillofacial surgeries, and forensics

O papel da ressonância magnética na distinção das gestações intersticial, cornual e angular / The role of magnetic resonance imaging in distinguishing interstitial, cornual and angular pregnancies

Apesar da melhora no diagnóstico e tratamento, a gravidez ectópica ainda é a principal causa de mortalidade materna no primeiro trimestre da gravidez. Formas raras podem apresentar um desafio diagnóstico e, sem um diagnóstico adequado, a incidência de complicações e a mortalidade materna estão relacionadas a aumento de seus índices. Os termos "gravidez cornual" e "gravidez intersticial" têm sido utilizados de forma inconsistente na literatura, sendo frequentemente usados como sinônimos do termo "gravidez angular". Uma distinção estrita entre essas entidades pode ter implicações clínicas importantes, porque o curso natural, a propedêutica e os resultados diferem entre eles. A ressonância magnética não é o padrão-ouro para o diagnóstico de gravidez ectópica, no entanto possui relevância significativa no diagnóstico de possíveis complicações decorrentes dessa afecção. Nesse contexto, esta revisão aborda a importância da ressonância magnética na distinção dos tipos de gravidez mencionados, ilustrados por meio de casos do nosso serviço.(AU)

Despite the improvement in diagnostics and treatment, ectopic pregnancies are still the main cause of maternal mortality in the first trimester of pregnancy. Rare forms may present a diagnostic challenge and without adequate diagnosis, the incidence of complications and maternal mortality is greatly increased. The terms "cornual pregnancy" and "interstitial pregnancy" have been used inconsistently in the literature, frequently been used as synonyms and even used interchangeably with the term "angular pregnancy". A strict distinction among these entities can have important clinical implications because the natural course, management and outcomes differ among them. Magnetic resonance imaging is not the gold standard for the diagnosis of ectopic pregnancy, however, it can be useful in the diagnosis of complicated presentations of such ailment. In this context, this review highlights the importance of MRI in distinguishing the aforementioned types of pregnancies, illustrated with few cases from our service.(AU)

Diagnostic dilemmas of an eccentrically located gestation sac: role of 3D ultrasound

Background: Differential diagnosis of an eccentrically located sac includes interstitial pregnancy, true cornual pregnancy and angular pregnancy which may all look similar on 2D (two dimensional) ultrasound. Interstitial pregnancy is associated with a higher maternal mortality and needs to be differentiated from true cornual pregnancy and angular pregnancy. This paper is an illustration of the role of 3D (three dimensional) ultrasound in differential diagnosis and management of the three entities.Methods: 2D and 3D ultrasound findings were analyzed in 10 cases of eccentrically located sac. The role of 3D ultrasound in differentiating the three entities had been evaluated.Results: The presence of an eccentrically located gestation sac with incomplete or asymmetric myometrial tissue less than 5 mm in thickness on 2D and the coronal sections obtained from 3D scans were used for diagnosis of interstitial pregnancy in three cases. 2 cases of angular pregnancy were diagnosed based on the finding of sac located in one of the lateral angles of the uterus with broad based connection to the endometrium. 2 cases of cornual pregnancy one intrauterine in a bicornuate uterus and the other in a rudimentary horn has been described. One heterotopic pregnancy and two other cases where a cornual fibroid mimics interstitial pregnancy is also illustrated.Conclusions: The role of 3D ultrasound in differentiating the three entities and the key findings in obtaining the precise diagnosis are emphasized. Routine usage of 3D ultrasound in all cases of eccentrically located gestational sac is recommended.

Efficacy of superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis in treatment of moyamoya disease / 中华神经医学杂志

Objective:To investigate the clinical efficacy of superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis in the treatment of Moyamoya disease.Methods:A total of 42 patients with moyamoya disease, admitted to our hospital from January 2016 to January 2019, were selected and divided into observation group and control group according to surgical management. The patients in the observation group were treated with superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis, and the patients in the control group were treated with superficial temporal artery-angular gyrus artery bypass combined with encephalo-duro-arterio-synangiosis. The clinical data of these patients were analyzed retrospectively, and the differences of efficacy and safety between the two groups were compared.Results:There was no significant difference in operation time between the two groups ([189.16±21.23] min vs. [179.46±16.95] min, P>0.05). One d after the operation, the patients in both groups were re-examined with CT angiography, and the anastomotic vessels were unobligated. Two patients in the observation group had cerebral infarction in the operative region and one patient in the control group had cerebral infarction in the operative region; no significant difference was noted in the incidence of postoperative complications between the two groups ( P>0.05). The modified Rankin scale (mRS) scores in both groups one month after surgery were significantly decreased as compared with those one d before surgery ( P<0.05); one month after surgery, the mRS scores in observation group (0.13±0.346) were significantly lower than those in the control group (0.42±0.515, P<0.05). Conclusion:The superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis has definite clinical efficacy in the treatment of moyamoya disease.

Misdiagnosis of interstitial pregnancy followed by circlage operation and failed induced midtrimester abortion: a case report

Interstitial pregnancy is rare form of ectopic pregnancy that can expand up to 18 weeks leads to massive haemoperitoneum hence early diagnosis is imperative to decrease mortality and morbidity. Present case diagnosed as interstitial pregnancy at laparotomy when she had taken for hysterotomy after two failed courses of medical abortion. Clinicians should bear in mind the limitations of various investigations and should have a higher degree of suspicion for interstitial pregnancy Any deviation from normal response to administration of medical abortificient, such as failure to abort, should instigate the diagnosis of ectopic (interstitial) pregnancy by expert radiologist.

An anatomical study of the facial artery / Un estudio anatómico de la arteria facial

The facial artery (a branch of the external carotid artery) is the main artery of the face. It gives rise to seven branches viz. inferior labial, superior labial, inferior alar, superior alar, lateral nasal and angular arteries, which are variable. This study included a dissection of twenty embalmed adult cadaveric head and neck specimens. The parameters of origin, branching patterns, termination and variations were analysed and compared with sex and laterality. The facial artery followed the standard anatomical description of origin in 84.62 % of the sample. Variations: (i) origin as a linguofacial trunk in 12.82 % and (ii) high origin in 2.56 % was observed. Male specimens displayed a higher number of linguofacial trunk origins (7.69 %). The branching patterns of the facial artery was classified into six types, with subtypes for Types 1 and 2. Subtype 1-A (standard anatomical description with early termination) occurred in most of the sample (46.15 %). Males were found to have more variations in branching patterns than females (48.72 % and 41.03 % respectively). Termination of the facial artery was as follows: inferior labial artery (5.13 %), superior labial artery (10.26 %), inferior alar artery (10.26 %), superior alar artery (46.15 %), lateral nasal artery (5.13 %), and angular artery (20.51 %). A single case (2.56 %) of an abortive artery was noted. Statistical analysis showed that sex was independent of each parameter observed in this study. Anatomical knowledge of the facial artery is of importance to clinicians and surgeons during procedures such as musculomucosal, island flaps and aesthetic dermatology.

La arteria facial (una rama de la arteria carótida externa) es la arteria principal de la cara. Da lugar a siete ramas: labial inferior, labial superior, alar inferior, alar superior, arterias nasales y angulares laterales, además de ramas pequeñas variables. Este estudio incluyó una disección de veinte muestras de cabeza y cuello de cadáveres adultos fijados. Los parámetros de origen, patrones de ramificación, terminación y variaciones fueron analizados y comparados con el sexo y la lateralidad. La arteria facial se originó de manera normal en el 84,62 % de la muestra. Variaciones: (i) origen como tronco linguofacial en 12.82 % y (ii) se observó un origen alto en 2,56 %. Las muestras en los hombres mostraron un mayor número de orígenes del tronco linguofacial (7,69 %). Los patrones de ramificación de la arteria facial se clasificaron en seis tipos, con subtipos para los Tipos 1 y 2. El subtipo 1-A (descripción anatómica normal con terminación temprana) se observó en (46,15 %) de la muestra. Las muestras de varones tenían una mayor variación en los patrones de ramificación que las muestras de mujeres, 48,72 % y 41,03 % respectivamente. La terminación de la arteria facial fue la siguiente: arteria labial inferior (5,13 %), arteria labial superior (10,26 %), arteria alar inferior (10,26 %), arteria alar superior (46,15 %), arteria nasal lateral (5,13 %) y arteria angular (20,51 %). Se observó un solo caso (2,56 %) de una arteria abortiva. El análisis estadístico mostró que el sexo era independiente de cada parámetro observado en este estudio. El conocimiento anatómico de la arteria facial es importante para los médicos y cirujanos durante procedimientos como colgajos musculomucosal y en la dermatología estética.