Application of iodinated starch powder using an atomizer spray gun - a new and effective tool to evaluate hypohidrosis.

BACKGROUND: Hypohidrosis is defined as diminished sweating in response to an appropriate thermal or sympathetic stimulus. When encountered in a clinical setting, it necessitates an accurate documentation of its pattern and extent to prognosticate the risk of associated heat-related illnesses. This can be achieved by thermoregulatory sweat testing which includes a starch-iodine sweat test that can be administered via various methods. OBJECTIVE: To describe and evaluate the effectiveness and safety of a novel method of using an atomizer spray gun in administering the starch-iodine test. METHODS: We describe the administration of the starch-iodine test via an atomizer spray gun (Series 700 Lab Model; Mitsuba Systems, Mumbai, India). The method was utilized for the evaluation of 30 individuals who presented with symptoms of hypohidrosis. RESULTS: Application of iodinated starch powder prepared in-house with the atomizer spray gun achieved a lightweight and homogeneous coat on our patients' skin which allowed for clear visualization of the sweating pattern in areas of anhidrosis. The sharp demarcation of the pathological regions enabled the precise calculation of the affected body surface area of impaired sweating. Unlike the starch-iodine tests using the Minor and Wada methods, neither staining of the skin nor irritation was detected in this method. CONCLUSION: We report a novel method of using an atomizer spray gun to perform the starch-iodine test in a rapid, reproducible, effective, and safe manner suitable for use in the clinical evaluation of hypohidrosis.

Crosstalk analysis in homogeneous multi-core two-mode fiber under bent condition.

We analyze the inter-core crosstalk in homogeneous multi-core two-mode fibers (MC-TMFs) under bent condition by using the coupled-mode equations. In particular, we investigate the effects of the intra-core mode coupling on the inter-core crosstalk for two different types of MC-TMFs at various bending radii. The results show that the inter-core homo-mode crosstalk of LP(11) mode is dominant under the gentle fiber bending condition due to its large effective area. However, as the fiber bending becomes tight, the intra-core mode coupling is significantly enhanced and consequently makes all the inter-core crosstalk levels comparable to each other regardless of the mode. A similar tendency is observed at a reduced bending radius when the difference in the propagation constants between modes is large and core pitch is small.

Low pulmonary function is related with a high risk of sarcopenia in community-dwelling older adults: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2011.

UNLABELLED: Sarcopenia is the age-related reduction of skeletal muscle mass in older individuals. Respiratory muscle strength may be related to skeletal muscle mass and, thus, the present study attempted to estimate the risk of sarcopenia relative to decreased pulmonary function. The present findings demonstrated that low pulmonary function was associated with low muscle mass in community-dwelling older adults. INTRODUCTION: Lean body mass is related to pulmonary function in patients with chronic obstructive pulmonary disease (COPD). However, the relationship between muscle mass and pulmonary function in healthy older adults has yet to be clarified. Thus, the present study investigated the association of pulmonary function with muscle mass in an older community-dwelling Korean population. METHODS: This study included 463 disease-free subjects over 65 years of age who underwent anthropometric measurements, laboratory tests, spirometry, and the estimation of appendicular skeletal muscle (ASM) mass in the 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES). Low muscle mass was defined as the value of ASM divided by height squared (ASM/height(2)) that was less than two standard deviations (SD) below the sex-specific mean of the young reference group. RESULTS: Forced expiratory volume in 1 s (FEV1[L]) and forced vital capacity (FVC[L]) were positively correlated with ASM/height(2) in males (p < 0.001 and p = 0.001, respectively) but not in females (p = 0.360 and p = 0.779, respectively). A univariate logistic regression analysis revealed that males with low FEV1 or FVC were more likely to have low muscle mass (odds ratio [OR] = 3.11, 95% confidence interval [CI] 1.62-5.99 for FEV1; OR = 1.99, 95% CI 1.13-3.53 for FVC); similar results were found for females, but the significance was lower (OR = 11.37, 95% CI 0.97-132.91 for FEV1; OR = 7.31, 95% CI 1.25-42.74 for FVC). After adjusting for age, smoking, and moderate physical activity, a low FEV1 value was associated with low muscle mass in both males (OR = 2.90, 95% CI 1.50-5.63) and females (OR = 9.15, 95% CI 1.53-54.77). CONCLUSIONS: Using nationally representative data from the 2008-2011 KNHANES, low pulmonary function was found to be associated with low muscle mass in community-dwelling older Korean adults.

Correlation of diffusion tensor imaging and phase-contrast MR with clinical parameters of cervical spinal cord injuries.

STUDY DESIGN: This is a cross-sectional study. OBJECTIVES: The goal of this study was to characterize the diffusion properties across segments of the spinal cord and peak cerebrospinal fluid (CSF) velocities in the stenotic spinal canal, and to determine the correlation between these properties and clinical and electrophysiological parameters in patients with cervical spinal cord injury (SCI). SETTING: This study was conducted in the University teaching hospital. METHODS: The study involved 17 patients with cervical SCI. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of the spinal cord and peak systolic and diastolic velocities of CSF were measured at the level of maximum compression (region 1) and at the levels above (region 2) and below (region 3) the level of injury with no signal change in conventional magnetic resonance imaging. Neurological and electrophysiological parameters were measured, including American Spinal Injury Association (ASIA) Impairment Scale (AIS), ASIA motor score, ASIA sensory score, Modified Barthel Index, Spinal Cord Independence Measure III (SCIM III), somatosensory evoked potentials (SSEP) and motor evoked potentials (MEP). RESULTS: The ADC was significantly higher and the FA was significantly lower in regions 1, 2 and 3 of the SCI patients than in the normal controls (P<0.05 each). FA of the level below correlated with AIS, ASIA sensory score and SCIM III score, and FA of the level above correlated with SSEP latencies and MEP amplitudes (P<0.05 each). The reductions in FA correlated with CSF flow, functional measurements and evoked potentials. CONCLUSIONS: Diffusion tensor imaging can be used to quantify the proximal and distal extents of spinal cord damage. Reductions in FA were correlated with CSF flow, functional measurements and evoked potentials.

Role of second-look ultrasound examinations for MR-detected lesions in patients with breast cancer.

PURPOSE: To assess the clinical value of second-look ultrasound (US) examination for the evaluation of additional enhancing lesions detected on magnetic resonance (MR) imaging. MATERIALS AND METHODS: Between May 2008 and February 2011, 794 consecutive patients with histologically confirmed breast cancer underwent breast MR imaging. We included 101 patients with 132 additional enhancing breast lesions detected on MR imaging who underwent second-look US.  The imaging features and lesion category according to the Breast Imaging and Reporting and Data System (BI-RADS) were assessed with MR and US imaging, respectively. RESULTS: According to the BI-RADS system, 67 lesions (50.8 %) were classified as category 0, 33 lesions (25.0 %) as category 3, and 32 lesions (24.2 %) as category 4. Of the 67 indeterminate lesions on MR imaging, 34 (50.7 %) were demonstrated on second-look US. 11 of these 34 lesions showed suspicious sonographic features, including 1 lesion that showed malignancy (9.1 %, 1/11). Most of the suspicious lesions on MR imaging (26 of 32 BI-RADS category 4 lesions, 81.3 %) were demonstrated on second-look US, and 17 were malignant (65.4 %, 17/26). Of the 6 BI-RADS category 4 lesions without sonographic correlation, 1 was malignant (16.7 %, 1/6). CONCLUSION: Second-look US examination was useful for evaluating MR-detected lesions in patients with breast cancer.

Hypoxia inducible factor 2α/insulin-like growth factor receptor signal loop supports the proliferation and Oct-4 maintenance of mouse germline stem cells.

Hypoxia inducible factor 2α (HIF-2α) is critical for primordial germ cell (PGC) survival as knockout of HIF-2α (HIF-2α(-/-)) decreases both expression of Oct-4 and PGC number in genital ridge. Hypoxia is known to stabilize HIF-2α protein from proteasomal degradation. However, little is known about the hypoxia-associated endocrinal signaling in HIF-2α expression. The current work demonstrates a role for an endocrine insulin-like growth factor-I receptor (IGF-IR)-PI3K/Akt-mTOR-HIF-2α regulatory loop in the proliferation and Oct-4 maintenance of PGC-like alkaline phosphatase positive mouse germline stem cells (AP(+)GSCs). We found that hypoxia greatly increased the cell proliferation and the levels of nuclear Oct-4/HIF-2α protein of AP(+)GSCs. The hypoxic-AP(+)GSCs presented stronger stemness ability for germ cell differentiation than normoxic, with expressions of c-KIT (differentiation germ cell marker), VASA (differentiation germ cell marker) and SCP3 (meiotic marker) using a renal capsule transplantation assay. Meanwhile, hypoxia significantly increased the expression levels of secreted-IGF-I and IGF-IR. The IGF-I dose dependently increased the HIF-2α expression levels in AP(+)GSCs; and, the inhibition of IGF-IR by RNA interference (shIGF-IR) or LY294002 (PI3K inhibitor)/Rapamycin (mTOR inhibitor) effectively suppressed the IGF-I- and/or hypoxia-induced HIF-2α and Oct-4 expression, suggesting that the IGF-IR and its downstream Akt/mTOR signaling are involved in the IGF-I/hypoxia effects. Additionally, knockdown of HIF-2α dramatically suppressed Oct-4 and IGF-IR protein levels in AP(+)GSC cells. In conclusion, the present study demonstrates a regulatory loop of IGF-IR-PI3K/Akt-mTOR-HIF-2α in proliferation and Oct-4 maintenance of PGC-like AP(+)GSCs under hypoxia. This finding provides insights into the niche endocrinology underlying early germ cell development.

Optical performance monitoring technique using software-based synchronous amplitude histograms.

We propose and demonstrate a simple technique to monitor both the optical signal-to-noise ratio (OSNR) and chromatic dispersion (CD) by using the software-based synchronous amplitude histogram (SAH) analysis. We exploit the software-based synchronization technique to construct SAHs from the asynchronously sampled intensities of the signal. The use of SAHs facilitates the accurate extraction of the monitoring parameters at the center of the symbol. Thus, unlike in the case of using the technique based on the asynchronous amplitude histogram (AAH), this technique is not affected by the transient characteristics of the modulated signals. The performance of the proposed monitoring technique is evaluated experimentally by using 10-Gbaud quadrature phase-shift keying (QPSK) and quadrature amplitude modulation (QAM) signals over wide ranges of OSNR and CD. We also evaluate the robustness of the proposed technique to the signal's transient characteristics.

Gender flip-flop association between genetic variations of NEDD4L and metabolic syndrome in the Kazakh general population.

Genetic variation is thought to contribute to etiology of metabolic syndrome (MS). Neural precursor cell expressed developmentally downregulated 4-like gene (NEDD4L) is a candidate gene for MS. This study investigated the relationship between variations of NEDD4L and MS in the Kazakh, which is an ideal population to study the genetic mechanisms of complex diseases such as MS. We screened the promoter and exons of NEDD4L in 48 Kazakh individuals with MS to identify representative variations. By genotyping the representative variations [271420T>C (rs2288774), 271454A>G (rs2288775), and 296921-296923delTTG] in the Kazakh general population, we conducted a case-control study. In female subjects, the distribution of genotypes and alleles of rs2288775 and 296921-296923delTTG differed significantly between the MS pacients and controls. In male subjects, the genotype distributions of 296921-296923delTTG were significantly different between the MS pacients and controls in the dominant model (P = 0.047). After adjustment for age, smoking, and drinking, multivariate logistic regression analysis showed that rs2288775 was significantly associated with MS [for the A/A genotype, odds ratio (OR) = 3.296, P = 0.011] in female subjects. For 296921-296923delTTG, the I/D+D/D genotype was the high-risk genotype for MS in female subjects (OR = 2.791, P = 0.035) and was a protective factor for MS in male subjects (OR = 0.580, P = 0.045). The 296921-296923delTTG variation of NEDD4L is a gender flip-flop associated with MS in Kazakh individuals. The A allele of rs2288775 may be an independent risk factor for MS in Kazakh women. The results suggest that the genetic variations of NEDD4L might be involved in the pathogenesis of MS.

Artificial Space Weathering to Mimic Solar Wind Enhances the Toxicity of Lunar Dust Simulants in Human Lung Cells.

During NASA's Apollo missions, inhalation of dust particles from lunar regolith was identified as a potential occupational hazard for astronauts. These fine particles adhered tightly to spacesuits and were unavoidably brought into the living areas of the spacecraft. Apollo astronauts reported that exposure to the dust caused intense respiratory and ocular irritation. This problem is a potential challenge for the Artemis Program, which aims to return humans to the Moon for extended stays in this decade. Since lunar dust is "weathered" by space radiation, solar wind, and the incessant bombardment of micrometeorites, we investigated whether treatment of lunar regolith simulants to mimic space weathering enhanced their toxicity. Two such simulants were employed in this research, Lunar Mare Simulant-1 (LMS-1), and Lunar Highlands Simulant-1 (LHS-1), which were added to cultures of human lung epithelial cells (A549) to simulate lung exposure to the dusts. In addition to pulverization, previously shown to increase dust toxicity sharply, the simulants were exposed to hydrogen gas at high temperature as a proxy for solar wind exposure. This treatment further increased the toxicity of both simulants, as measured by the disruption of mitochondrial function, and damage to DNA both in mitochondria and in the nucleus. By testing the effects of supplementing the cells with an antioxidant (N-acetylcysteine), we showed that a substantial component of this toxicity arises from free radicals. It remains to be determined to what extent the radicals arise from the dust itself, as opposed to their active generation by inflammatory processes in the treated cells.

Achievable capacity improvement by using multi-level modulation format in trench-assisted multi-core fiber system.

We evaluate the impacts of using multi-level modulation formats on the transmission capacity of the multi-core fiber (MCF) having trench-assisted index profile and hexagonal layout. For this evaluation, we utilize the spectral efficiency per unit area, defined as the spatial spectral efficiency (SSE). The results show that the SSE improvement achievable by using the higher-level modulation format can be reduced due to its lower tolerance to the inter-core crosstalk. We also evaluate the effects of using large effective area on the transmission capacity of the trench-assisted MCF. The results show that the use of large effective area can decrease this capacity due to the increased inter-core crosstalk and lengthened cable cutoff wavelength, although it can help increase the transmission distance. Thus, it is necessary to optimize the effective area of MCF by considering both the SSE and transmission distance. However, the results indicate that the effect of using different effective areas on the SSE-distance product is not significant, and it is not useful to increase the effective area of the trench-assisted MCF to be larger than ~110 µm(2).

Factors associated with early onset post-traumatic syringomyelia.

STUDY DESIGN: Retrospective study. OBJECTIVES: To identify factors associated with the development of early onset post-traumatic syringomyelia within 5 years of spinal cord injury. SETTING: Department of Rehabilitation Medicine, Pusan National University School of Medicine, Korea. METHODS: We retrospectively examined the records of 502 patients with traumatic cervical or thoracic spinal cord injury who underwent follow-up magnetic resonance imaging (MRI) examinations more than once a year for at least 5 years. Patients were assessed in terms of the neurological level of injury, the severity of initial spinal cord injury, the use of surgery and the extent of spinal canal involvement. The latter was evaluated by calculating the shortest antero-posterior diameter of the injured vertebral canal and the spinal reserve capacity as shown on MRI at the time of trauma onset and at the time of diagnosis of syringomyelia. RESULTS: Syringomyelia developed within 5 years in 37 (7.3%) of the 502 patients. The mean age of these 37 patients was 44.6 years (range, 17-67 years) and the mean interval from spinal cord injury to onset of syringomyelia was 38.8 months (range, 2-54 months). The development of post-traumatic syringomyelia within 5 years was not significantly related to the severity or level of injury, the use of spinal surgery or the extent of spinal canal encroachment (P≥0.05 for each comparison). CONCLUSION: Early onset syringomyelia occurring within 5 years after spinal cord injury was not associated with neurological injury level, severity of injury, the use of spinal surgery or canal encroachment.

Peripheral compressing artifacts in brain tissue from stereotactic biopsy with sidecutting biopsy needle: a pitfall for adequate glioma grading.

AIMS: The stereotactic brain biopsy is an essential diagnostic procedure in modern neurologic patient management. A side-cutting biopsy needle is one of the most widely used needle types. Recently we found a characteristic tissue artifact named "peripheral compressing artifact" in the brain tissues biopsied using a side-cutting needle of Leksell's system. We investigate prevalence, possible cause and its clinical implication of this type of artifact. MATERIALS AND METHODS: We examined the biopsies from 80 patients (44 cases of gliomas, 13 lymphomas, 7 germ cell tumors, 2 other tumors, 1 metastatic carcinoma, 4 non-tumorous conditions such as demyelinating disease and 8 non-diagnostic) in the stereotactic biopsy group with a suspected brain tumor, who underwent a stereotactic brain biopsy using side-cutting needle of Leksell's system. We also evaluated 16 cases of open brain biopsies without Leksell's system as a control group. RESULTS: The artifact is a semi-circular or band-like tissue compression in the periphery of the biopsied tissue. This artifact was found in 30 (37.5%) out of 80 cases and 57 (11.9%) out of 477 biopsied pieces. It might be produced during rotating of the inner cannula of the biopsy needle. Histologically, it might be misinterpreted as "hypercellular", "spindle", "well circumscribed", or rarely as "pseudopalisading" especially in glioma. CONCLUSIONS: Awareness of this artifact would help making the appropriate pathological diagnosis for glioma.

MRI Features May Predict Molecular Features of Glioblastoma in Isocitrate Dehydrogenase Wild-Type Lower-Grade Gliomas.

BACKGROUND AND PURPOSE: Isocitrate dehydrogenase (IDH) wild-type lower-grade gliomas (histologic grades II and III) with epidermal growth factor receptor (EGFR) amplification or telomerase reverse transcriptase (TERT) promoter mutation are reported to behave similar to glioblastoma. We aimed to evaluate whether MR imaging features could identify a subset of IDH wild-type lower-grade gliomas that carry molecular features of glioblastoma. MATERIALS AND METHODS: In this multi-institutional retrospective study, pathologically confirmed IDH wild-type lower-grade gliomas from 2 tertiary institutions and The Cancer Genome Atlas constituted the training set (institution 1 and The Cancer Genome Atlas, 64 patients) and the independent test set (institution 2, 57 patients). Preoperative MRIs were analyzed using the Visually AcceSAble Rembrandt Images and radiomics. The molecular glioblastoma status was determined on the basis of the presence of EGFR amplification and TERT promoter mutation. Molecular glioblastoma was present in 73.4% and 56.1% in the training and test sets, respectively. Models using clinical, Visually AcceSAble Rembrandt Images, and radiomic features were built to predict the molecular glioblastoma status in the training set; then they were validated in the test set. RESULTS: In the test set, a model using both Visually AcceSAble Rembrandt Images and radiomic features showed superior predictive performance (area under the curve = 0.854) than that with only clinical features or Visually AcceSAble Rembrandt Images (areas under the curve = 0.514 and 0.648, respectively; P < . 001, both). When both Visually AcceSAble Rembrandt Images and radiomics were added to clinical features, the predictive performance significantly increased (areas under the curve = 0.514 versus 0.863, P < .001). CONCLUSIONS: MR imaging features integrated with machine learning classifiers may predict a subset of IDH wild-type lower-grade gliomas that carry molecular features of glioblastoma.

Probiotic characteristics of lactic acid bacteria isolated from kimchi.

AIMS: The present work was aimed at identifying strains of lactic acid bacteria (LAB) from kimchi, with properties suitable for use as starter cultures in yogurt fermentation. METHODS AND RESULTS: A total of 2344 LAB strains were obtained from two different sources, one group consisted of commercial LAB strains from kimchi, and the second group consisted of those strains isolated from various types of kimchi. The LAB strains from both groups were screened for resistance to biological barriers (acid and bile salts), and the four most promising strains were selected. Further analysis revealed that KFRI342 of the four selected strains displayed the greatest ability to reduce the growth of the cancer cells, SNU-C4. The in vivo efficacy of strains in quinone reductase induction assay was evaluated, and the extent of DNA strand breakage in individual cells was investigated using the comet assay. Strain KFRI342 was identified as Lactobacillus acidophilus by 16S rRNA sequence analysis, showed protection against tumour initiation and imparted immunostimulation as well as protection against DNA damage. CONCLUSIONS: Strain KFRI342, which showed probiotic characteristics reducing cancer cell growth, could be a suitable starter culture for yogurt fermentation because of its strong acid production and high acid tolerance. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report to describe a bacterium, isolated from kimchi, Lact. acidophilus KFRI342 which has the probiotic characteristics and the acid tolerance needed for its use as a starter culture in yogurt fermentation.

Limitations in fields of vision for simulated young farm tractor operators.

Farm tractors account for the majority of deaths and injuries among youths working on North American farms. A vehicle operator's field of vision is an important operational aspect for safe driving. However, very little is known about visual limitations of young tractor operators compared to adult operators. The main purpose of this study was to quantify limitations in fields of vision of children with different anthropometry. The study was based on assessment of 42 farm tractors in popular use in the USA. The results showed that youth operators typically had diminished fields of vision compared to the average adult operator. The degree of visual limitation is greatest for objects at close distances and when objects are straight in front of the operator/tractor. This has serious implications in terms of risks for runovers, rollovers and collisions. Study findings may help illuminate the development of policies and guidelines in tractor-related jobs for children. STATEMENT OF RELEVANCE: This study provides an ergonomic approach for evaluation of children's visual limitations in tractor operations. This approach could be used in other related cases, where children are allowed to operate vehicles.

c-Src regulates the simultaneous rearrangement of actin cytoskeleton, p190RhoGAP, and p120RasGAP following epidermal growth factor stimulation.

Analysis of C3H10T1/2 murine fibroblasts overexpressing wild type and dominant negative variants of c-Src has demonstrated a requirement for c-Src in EGF-induced mitogenesis. Correlating with the ability of c-Src variants to potentiate or inhibit EGF-dependent DNA synthesis is the phosphotyrosine content of multiple cellular proteins, including p190-RhoGAP, a protein thought to regulate growth factor-induced actin cytoskeleton remodeling by modulating the activity of the small GTP binding protein, Rho. Because the in vivo phosphotyrosine content of p190 varies with the level of active c-Src and not with EGF treatment, p190 is considered to be a preferred substrate of c-Src. To determine whether tyrosyl phosphorylation of p190 (by c-Src) could influence EGF-dependent actin remodeling, we used conventional and confocal immunofluorescence microscopy to examine the intracellular distribution of p190, actin, and p120RasGAP in EGF-stimulated or unstimulated 10T1/2 Neo control cells and cells that stably overexpress wild-type (K+) or kinase-defective (K-) c-Src. We found that in all cell lines, EGF induced a rapid and transient condensation of p190 and RasGAP into cytoplasmic, arclike structures. However, in K+ cells the rate of appearance and number of cells exhibiting arcs increased when compared with control cells. Conversely, K- cells exhibited delayed arc formation and a reduction in number of cells forming arcs. EGF-induced actin stress fiber disassembly and reassembly occurred with the same kinetics and frequency as did p190 and RasGAP rearrangements in all three cell lines. These results, together with the documented Rho-GAP activity intrinsic to p190 and the ability of Rho to modulate actin stress fiber formation, suggest that c-Src regulates EGF-dependent actin cytoskeleton reorganization through phosphorylation of p190.

Apicidin, the histone deacetylase inhibitor, suppresses Th1 polarization of murine bone marrow-derived dendritic cells.

Apicidin is a fungal metabolite shown to exhibit anti-proliferative, anti-invasive, and anti-inflammatory properties by the inhibition of histone deacetylase (HDAC). However, the effects of apicidin on the maturation and immunostimulatory function of dendritic cells (DCs) remain unknown. In this study, we investigated whether apicidin modulates surface molecule expression, cytokine production, endocytosis capacity, and underlying signaling pathways in murine bone marrow-derived DCs. We observed that apicidin significantly attenuated surface molecule expression in LPS-stimulated DCs, suppressed production of interleukin (IL)-12 and proinflammatory cytokines (IL-6 and TNF-alpha) by DCs, and reduced IFN-gama production by T cells. The apicidin-treated DCs were found to be highly efficient in antigen capture via mannose receptor-mediated endocytosis. Apicidin also inhibited LPS-induced MAPK activation and NF-kB nuclear translocation in DCs. Moreover, the apicidin-treated DCs were incapable of inducing Th1 responses and normal cell-mediated immune responses. These novel findings not only provide new insights into the immunopharmacological role of apicidin in terms of its effects on DCs, but also broaden current perspectives of the immunopharmacological functions of apicidin, and have implications for the development of therapeutic adjuvants for the treatment of DC-related acute and chronic diseases.

Dose versus diagnosis: iatrogenic radiation exposure by multidetector computerised tomography in an academic emergency department with measurement of clinically actionable results and emergently treatable findings.

AIM: To determine the iatrogenic absorbed dosage of radiation of the patient in milligray (mGy) computerised tomography dose index volume (CTDIvol) when tested with multidetector computerised tomography (MDCT) in the emergency department (ED) setting and calculate the absorbed dosage of radiation per clinically actionable result and emergently treatable finding (ETF). SETTING: The University of Texas Medical Branch (UTMB) ED located in Galveston, Texas, USA, is a level 1 trauma and tertiary referral centre treating 70,000 patients per annum. METHOD: A retrospective cross-sectional data analysis of 770 emergency patients investigated by MDCT in July 2007. The presence of actionable results and ETF were determined by chart review. RESULTS: A total of 5320 emergency patients was treated in the UTMB ED in July 2007. This included 4508 medical and 812 trauma patients. A total of 1094 MDCT studies was performed, of which complete data were available on 1046. A total of 770 patients was investigated by MDCT, representing 14.47% of all emergency patients. This included 33.99% of trauma patients and 10.96% of medical patients. Actionable results were found in 341 studies and ETF in 105 studies. The mean radiation was 163.27 and 530.23 mGy CTDIvol for actionable results and ETF, respectively, for all studies. The mean radiation was 53.27 and 106.36 mGy CTDIvol for medical and trauma patients, respectively. CONCLUSIONS: The absorbed dosage of radiation of patients investigated by MDCT is clinically significant. The actionable results and ETF in our study demonstrate considerable opportunity for improvement in the utilisation of this technology by physicians.

Jar-opening challenges. Part 1: an apparatus for assessing hand and finger torques and forces in a jar-opening activity.

A simulated jar apparatus was developed to record hand kinetics and torque contribution of a digit during jar-opening activities. The design of the apparatus, namely a jar body and a lid, is similar to a commercial jam jar that is regularly seen in daily living. One six-axis force-torque transducer and a torque cell were mounted inside the jar lid to detect the external force exerted from the digit and fixed on to the jar body to record the overall torque generated by the hand and wrist respectively. The applications of the apparatus were used to test the twisting torque of the hand and to measure the applied forces of the digit, which are both important factors in opening a jar. The contribution of each digit relative to the total twisting torque of the hand could be obtained via the apparatus. The intraclass correlation coefficient of the repeated measurements of the obtained forces and moments for different counterweights was approximately 0.96-1.00, which indicates that the reliability of the measured components of the apparatus is high. The high coefficient of determination (r2 > 0.99) indicates high accuracy of prediction of the measured values with respect to the expected loads. The validation outcomes support the design rationale and actual body part of the simulated jar. In addition, understanding the contribution of a single digit in opening a jar was also achieved via the apparatus and model.

Jar-opening challenges. Part 2: estimating the force-generating capacity of thumb muscles in healthy young adults during jar-opening tasks.

This study discusses the force-generating capacity of thumb muscles during jar-opening tasks using two grip patterns: the power grip and the precision grip. This study develops a three-dimensional biomechanical model of the thumb to predict muscle forces in jar-opening activities based on external forces measured by a custom-designed jar device. Ten healthy subjects participated in the study. Each participant turned a jar lid of 66 mm diameter counterclockwise with maximal effort and preferred speed using both grip patterns. The average normal and tangential forces applied by the thumb to the jar lid show that the normal force is the primary contributive force for opening a jar. This normal force is approximately three times the tangential force. Muscular force-generating capacity measurements show that the major active muscles during a jar-opening activity for both grips include the flexor pollicis longus, flexor pollicis brevis, abductor pollicis brevis, adductor pollicis, and opponens pollicis. The total muscle force ratios for the precision grip and power grip with respect to externally applied forces are 5.6 and 4.7 respectively. These ratios indicate that the power grip pattern produces less muscle force per unit of external applied load. The technique proposed in this study provides a proper apparatus and model for measuring three-dimensional loads and estimating the force-generating capacity of each muscle and tendon of the thumb during jar-opening tasks.