Neuromonitoring in pre-post and intraoperative total hip replacement surgery in type 4 high-riding developmental dysplasia of the hip.

OBJECTIVE: The choice approach to treating congenital dislocation of the hip joint is total hip replacement (THR). One of the severe but uncommon complications of THR is nerve damage. The most common nerve injury associated with total hip arthroplasty (THA) is sciatic nerve palsy, and the second typical nerve damage with THA is femoral nerve paralysis. PATIENTS AND METHODS: In this prospective cohort study, 35 patients with type 4 high riding developmental dysplasia of the hip (DDH) who were candidates for THA were enrolled. The somatosensory evoked potential (SSEP), motor evoked potential (MEP), and electromyography (EMG) were measured pre-post and intraoperatively to check the status of the sciatic and femoral nerves. After collecting the mentioned information, the data was analyzed by SPSS V. 26 software. RESULTS: Out of 35 patients with DDH type 4 who were candidates for THR, nine patients showed a 50 percent decrease in SSEP amplitude, and six patients showed a 10 percent decrease in SSEP latency. One patient during and two patients after the surgery showed more than an 80 percent decrease in MEP amplitude. Meanwhile, 14 patients showed abnormal spikes during and two patients after surgery regarding EMG. All patients with disturbed neurophysiological findings reverted to normal in the further investigation during follow-up. No correlation was found between increasing limb shortness and these modalities. CONCLUSIONS: Using neuromonitoring techniques during Total Hip Arthroplasty (THA) can help identify potential early nerve damage, prevent post-surgical complications, and improve high-riding DDH patient outcomes.

Investigation of theoretical scaling laws using large eddy simulations for airborne spreading of viral contagion from sneezing and coughing.

Using a set of large eddy point-particle simulations, we explore the fluid dynamics of an ejected puff resulting from a cough/sneeze. The ejection contains over 61 000 potentially virus-laden droplets at an injection Reynolds number of about 46 000, comparable to an actual cough/sneeze. We observe that global puff properties, such as centroid, puff volume, momentum, and buoyancy vary little across realizations. Other properties, such as maximum extent, shape, and edge velocity of the puff, may exhibit substantial variation. In many realizations, a portion of the puff splits off and advances along a random direction, while keeping airborne droplet nuclei afloat. This peeled-off portion provides a mechanism for virus-laden droplets to travel over large distances in a short amount of time. We also observe that the vast majority of droplets remain suspended within the puff after all liquid has evaporated. The main objectives of the study are to (i) evaluate assumptions of Balachandar's et al. theory [Int. J. Multiphase Flow 132, 103439 (2020)], which include buoyancy effects, shape of the puff, and droplet evaporation rate, (ii) obtain values of closure parameters, which include location and time of the virtual origin, and puff entrainment and drag coefficients, and (iii) evaluate the accuracy of the theory in predicting the shape, size, and location of the puff, as well as droplet number density long after ejection. The theory adequately predicts global puff properties including size, velocity, and distance traveled, the largest size of droplets that exit the puff due to settling, and the droplet size distribution within the puff long after ejection.

Subcellular fractionation of midgut cells of the sunn pest Eurygaster integriceps (Hemiptera: Scutelleridae): enzyme markers of microvillar and perimicrovillar membranes.

The subcellular distributions of six digestive and non-digestive enzymes (alpha-glucosidase, beta-glucosidase, alkaline phosphatase, acid phosphatase, aminopeptidase and lactate dehydrogenase) of Eurygaster integriceps have been studied. The subcellular distributions of acid phosphatase and alpha-glucosidase are similar and the gradient ultracentrifugation profiles of these two enzymes overlap. Two partially membrane-bound enzymes, alkaline phosphatase and beta-glucosidase have similar distributions in differential centrifugation fractions, which are different from that of alpha-glucosidase. Sucrose gradient ultracentrifugation of membranes from luminal contents showed that beta-glucosidase carrying membranes are heavier. SDS-polyacrylamide gel electrophoresis (SDS-PAGE) revealed that the profile of proteins extracted from beta-glucosidase carrying membranes is different from that of alpha-glucosidase carrying membranes. We conclude that beta-glucosidase and aminopeptidase are markers of microvillar membrane (MM) and perimicrovillar space, respectively, while alpha-glucosidase and acid phosphatase are perimicrovillar markers. In E. integriceps V1 luminal content is a rich source of PMM and MM and that is used to resolve these membranes.

Seven novel point mutations in the F11 gene in Iranian FXI-deficient patients.

Factor XI (FXI) deficiency disorder is caused by defects in the F11 gene. The affected patients may suffer unexpected and major bleeding after trauma. Hence, the aim of this study was to identify the mutations underlying FXI deficiency in Iranian patients. The genetic basis of FXI deficiency was investigated in nine Iranian patients from unrelated families using conformation-sensitive gel electrophoresis (CSGE) and direct sequencing. Nine different mutations were detected among which seven changes were not previously reported. Among the novel mutations, one was a point mutation that interfered with normal splicing of the mRNA; the other six changes were missense mutations that resulted in amino acid substitutions. Five mutations out of nine were heterozygous and were found in moderately affected patients, whereas the other four changes were homozygous among severely affected patients.

Assessment of fetal weight based on ultrasonic femur length after the second trimester.

OBJECTIVE: The ultrasonic measurement of the fetal femur length is a sensitive and precise variable for estimation of fetal growth and development. The objective of this study is to predict fetal weight in fetuses of more than 24 weeks gestation by ultrasound measurement of the femur length. METHOD: In this study, pregnant mothers were identified by the criteria of normalities, such as: well-known LMP, regular menstrual cycles, no use of OCP for the last 3 months, no use of alcohol or cigarettes, no drug abuse, no history of diabetes or chronic HTN. Multiple gestations, congenital anomalies and still-births were excluded. Birth-weight measurements (adjusted for maternal age, baby's sex, parity and week of gestation) were taken immediately after birth. RESULT: The relation between fetal weight and fetal femur length has been determined by cross-sectional analysis of 900 normal fetuses (> or = 25 weeks gestation) using real time ultrasonography. Mathematical modeling of the data has demonstrated that the femur growth curve is non-linear beyond 24 weeks gestation. With the aid of a scientific calculator the data were analyzed and a simple second-grade equation has been derived: EFW (kg) = 0.042FL(2) (cm)+0.32FL-1.36, S.D. approximately +/-235 g (Honarvar's Formula 2). With the use of this data, the error in estimation of EFW given FL is +/-235 g. CONCLUSION: This simple, new and accurate equation appears to be clinically reliable and easy to use and suggests that previous normal ultrasonic fetal femur length curves for another population may underestimate or overestimate normal fetal weight for the Iranian population. Thus, our formula is an excellent means to estimate true fetal weight.

Assessment of gestational age based on ultrasonic femur length after the first trimester: a simple mathematical correlation between gestational age (GA) and femur length (FL).

OBJECTIVE: The ultrasonic measurement of the fetal femur length is a sensitive and precise variable for estimation of fetal growth and development. The objective of this study was to predict gestational age in fetuses more than 13 weeks of gestation by ultrasound measurement of the femur length. METHOD: In this study, pregnant mothers were identified by the criteria of normalities such as: well-known LMP, regular menstrual cycles, no use of OCP for the last 3 months, no smoking, no history of diabetes, etc. RESULT: The relation between gestational age and fetal femur length has been determined by cross-sectional analysis of 900 normal fetuses (> or = 14 weeks of gestation) using real time ultrasonography. Mathematical modeling of the data has demonstrated that the femur growth curve is non-linear beyond 13 weeks of gestation. With the aid of a scientific calculator the data were analyzed and a simple second grade equation has been derived: GA (weeks) = 0.262(2) FL (cm) + 2 FL + 11.5, S.D. approximately +/- 5 days(Honarvar's Formula 3). With the use of this data, the error in the estimation of GA given as FL is +/-5 days. CONCLUSION: This simple, new and accurate equation appears to be clinically reliable and easy to use and suggests that previous normal ultrasonic fetal femur length curves for another population may under- or overestimate normal fetal age for the Iranian population. Thus, our formula is an excellent means of estimating true gestational age.

A simple estimated fetal weight equation for fetuses between 24 and 34 weeks of gestation.

OBJECTIVE: To develop a mathematical equation that is simple, accurate and easy to use when applied to low-birth weight or preterm fetuses (< 35 weeks) and to assess previous normal ultrasonic fetal weight curves and make a comparison with normal fetal delivery weight curves. METHOD: In a large teaching hospital, 269 pregnant mothers were identified by the criteria of normalities, such as: well known LMP, regular menstrual cycles, no use of OCP for the last 3 months, no smoking and no history of diabetes. Birth-weight measurements (adjusted for maternal age, baby's sex, parity and week of gestation) were taken immediately after birth. RESULTS: Mean gestational age and mean birth' weight + S.D. were 29.5 + 3.02 weeks and 1530.238 237.856 g, respectively. With the aid of a scientific calculator the data were analyzed and a simple regression equation has been derived: EFW (kg) = 0.17 (G.A. - 20), S.D. - 235 g (Honarvar's Formula 1). CONCLUSION: For estimating weights of preterm or low-birth weight fetuses of less than 2500 g, this simple equation appears to be clinically reliable and easy to use and suggests that previous normal ultrasonic fetal weight curves may underestimate or overestimate normal fetal delivery weight between the 24th and 34th week of gestation. Our formula approximates actual birth weight better and recommends Ott's ultrasonic weight curve for Iranian population.