An optimal de Quervain's tenosynovitis splint with ergonomic thumb support and evenly distributed pressure.

Splinting is a conventional treatment for de Quervain's tenosynovitis (dQt). However, existing splints have problems such as excessive thermal discomfort and poor fit, which have been pointed out in previous studies. This study proposes a new functional splint consisting of both hard and soft materials with the aim of providing wear comfort with a good fit and sufficient stability of the injured hand. Thumb support of the splint is an important component that controls and protects the affected thumb. To develop an ergonomically shaped thumb support, 16 participants with dQt were recruited for three-dimensional (3D) scanning of their hands. The angles of the wrist and the curvature of the thumb were measured using computer software, and the results were used as a reference for the design of the prototype supports. Excessive pressure on particular regions, such as bony areas, may cause discomfort or pain. To ensure the wear comfort of the proposed splint, a finite element model (FEM) was built to simulate the wear process of the splint and hence to predict the pressure distribution exerted from the splint onto the hand of the wearer. The simulated results show that the pressure is evenly distributed over the hand, indicating that patients are likely to wear the proposed splint comfortably during their treatment period.

Label-free sensing of exosomal MCT1 and CD147 for tracking metabolic reprogramming and malignant progression in glioma.

Malignant glioma is a fatal brain tumor whose pathological progression is closely associated with glycolytic reprogramming, leading to the high expression of monocarboxylate transporter 1 (MCT1) and its ancillary protein, cluster of differentiation 147 (CD147) for enhancing lactate efflux. In particular, malignant glioma cells (GMs) release tremendous number of exosomes, nanovesicles of 30 to 200 nm in size, promoting tumor progression by the transport of pro-oncogenic molecules to neighboring cells. In the present study, we found that hypoxia-induced malignant GMs strongly enhanced MCT1 and CD147 expression, playing a crucial role in promoting calcium-dependent exosome release. Furthermore, it was first identified that hypoxic GMs-derived exosomes contained significantly high levels of MCT1 and CD147, which could be quantitatively detected by noninvasive localized surface plasmon resonance and atomic force microscopy biosensors, demonstrating that they could be precise surrogate biomarkers for tracking parent GMs' metabolic reprogramming and malignant progression as liquid biopsies.

Case study on the effects of fit and material of sports gloves on hand performance.

Active and sports fashion in the high-end market focuses on fit, superior comfort and functional performance for various end-uses. However, the engineering design of sports gloves in relation to hand anthropometry measurements remains unclear. In this study, two types of ready-to-wear sport gloves, namely, war-gaming glove and hiking glove were purchased from the market. The glove dimensions, fabrication properties and the effect of glove fit on hand and finger dexterity were investigated. Thirty female individuals (20-29 years old) participated a series of hand performance tests and subjective perception rating assessments towards the gloves. Results indicated that the active range of motion of fingers, finger tactile sensitivity, gripping strength and ability to handle pegs and marbles decreased with the use of gloves compared with bare hands. The perceptions of comfort and ease of hand motions decreased with the increased of wear time. The glove fit in terms of finger length dimensions was significantly correlated with hand grip force. The glove fit in hand, wrist and finger circumference dimensions had significant impact on the ability to handle small objects. It is suggested that hand length, hand circumference, finger circumference and the ratio of finger length to palm length should be considered in the design and development of gloves to improve hand performance and comfort.

Effects of custom-made textile insoles on plantar pressure distribution and lower limb EMG activity during turning.

BACKGROUND: Turning during locomotion involves considerable changes of the body's center of mass and reduced stability, as well as lower limb kinematics and kinetics. However, many previous studies have been carried out to evaluate the effectiveness and applications of orthotic insoles as well as different types of orthotic materials in various clinical symptoms, which are focused primarily on straight line walking. Hence, the influence of custom-made insoles with the use of advanced three-dimensional spacer fabrics on biomechanics parameters in terms of plantar pressure distribution and lower limb electromyography during turning movement was studied. METHODS: Twelve subjects performed 180-degree turning at a speed 3.07-3.74 km/h for five successful trials under 3 insoles conditions: wearing traditional ethylene vinyl acetate insoles and two different spacer-fabricated insoles, with the plantar pressure and lower limb muscle activity collected simultaneously. Turning movement was broken down into 3 phases for analysis: Turning initiation, turn around and turn termination. RESULTS: There was a statistically significance difference in plantar pressure between the traditional insoles and the insoles made of a spacer fabric as the top layer (p < 0.05). Compared to the traditional insoles, insoles made of a spacer fabric reduced the peak pressure (>12 %) and pressure-time integral (>13 %) in toes, metatarsal head 1 and metatarsal heads 2-3 at turning initiation; (>15 %) and (>17 %) in medial midfoot and medial heel at turn around. Insoles with spacer fabrics on the top and middle layer reduced both pressure parameters (>18 %) in toes and MTH 1 at turn termination. In terms of muscle activities, insoles with two-layer spacer fabrics could lower maximum muscle activities of vastus lateralis (>16 %; p < 0.05) at turn around. CONCLUSIONS: Insoles with different fabrications could offer various pressure offloading patterns across the plantar and muscle activity changes while turning. Insoles with a spacer fabric on the top tend to reduce plantar pressure loading at different regions during turn initiation and turn around phases, while two-layer spacer-fabricated insoles may contribute to reduced vastus lateralis muscle activation during turn around. More importantly, this study provides a new dimension in the potential use of the textile-fabricated insoles which may widen the range of insole materials selection in the design and development of insoles so as to enhance the effectiveness of orthotic treatment.

Effects of indoor slippers on plantar pressure and lower limb EMG activity in older women.

Open-toe mule slippers are popular footwear worn at home especially by older women. However, their biomechanical effects are still poorly understood. The objective of this study is to therefore evaluate the physical properties of two typical types of open-toe mule slippers and the changes in plantar pressure and lower limb muscle activity of older women when wearing these slippers. Five walking trials have been carried out by ten healthy women. The results indicate that compared to barefoot, wearing slippers results in significant increases in the contact area of the mid-foot regions which lead to plantar pressure redistribution from metatarsal heads 2-3 and the lateral heel to the midfoot regions. However, there is no significant difference in the selected muscle activity across all conditions. The findings enhance our understanding of slipper features associated with changes in biomechanical measures thereby providing the basis of slipper designs for better foot protection and comfort.

2D and 3D anatomical analyses of hand dimensions for custom-made gloves.

Measuring hand anthropometric data for the development of good-fitting gloves is crucial. In pursuing higher accuracy in hand anthropometric measurements, scanning of hand surfaces with the aids of image analysis system to acquire measurements is an alternative to the manual methods. This study proposes a new hand measuring approach by using 2D and 3D scanning which are evaluated through comparisons of manual measurements. Thirty-three dimensions are measured by using (1) tape and calliper measurement; (2) 2D image analysis; (3) 3D image analysis based on ten captures; and (4) 3D image analysis based on three captures, respectively. Repeated-measures ANOVA, correlation analysis and RMSE are used to examine the results. The hand dimensions obtained from the four methods are highly linearly correlated. Hand data taken from 3D image analysis has no significant difference compared with manual measurements on hand and wrist circumferences, length and breadth dimension, regardless of the number of captures.

Comparison between mechanical freezer and conventional freezing using liquid nitrogen in normozoospermia.

INTRODUCTION: This study evaluated the effect of human semen cryopreservation using an ultra-low temperature technique with a mechanical freezer at -85°C as an alternative method to the conventional liquid nitrogen technique at -196°C. METHODS: This was a prospective experimental study conducted in the Medically Assisted Conception unit, Department of Obstetrics and Gynaecology, National University Hospital, Malaysia from January 1, 2006 to April 30, 2007. All normozoospermic semen samples were included in the study. The concentration, motility and percentage of intact DNA of each semen sample were assessed before and after freezing and thawing on Days 7 and 30 post freezing. RESULTS: Sperm cryopreservation at -85°C was comparable to the conventional liquid nitrogen technique for a period of up to 30 days in a normozoospermic sample. There was no statistical difference in concentration (Day 7 p-value is 0.1, Day 30 p-value is 0.2), motility (Day 7 p-value is 0.9, Day 30 p-value is 0.5) and proportion of intact DNA (Day 7 p-value is 0.1, Day 30 p-value is 0.2) between the ultra-low temperature technique and conventional liquid nitrogen cryopreservation at Days 7 and 30 post thawing. CONCLUSION: This study clearly demonstrates that short-term storage of sperm at -85°C could be a viable alternative to conventional liquid nitrogen cryopreservation at -196°C due to their comparable post-thaw results.

Coherent polarization locking of a diode emitter array.

We present our work on the coherent combining of an array of diode emitters in a conventional diode bar configuration using the coherent polarization locking technique. An external laser cavity is designed so that the diode emissions from four diode emitters are spatially overlapped and passively phase locked via a series of birefringent walk-off crystals and a polarizing beam splitter. This concept was experimentally demonstrated up to 1030 mW of coherently combined power and was shown to increase the laser brightness of the diode bar by approximately 50 times.

Early life insult from cigarette smoke may be predictive of chronic diseases later in life.

Evidence is rapidly accumulating that links cigarette smoke (CS) exposure in utero with the development of a variety of disease pathologies in the older offspring including, type 2 diabetes, obesity, certain childhood cancers and respiratory disorders. The role that the fetal environment plays in these late-onset outcomes and the underlying cellular/molecular mechanisms by which these CS-induced effects may occur are currently unknown. Although we are becoming more aware of the fact that prenatal insult can underlie childhood/adult diseases, critical knowledge gaps still exist including gene-environment interactions, and how a CS-induced imbalance in immune dynamics (i.e. TH1/TH2) might affect asthma development and/or exacerbation later in life. In this mini-review we introduce the concept of sexual dimorphism in CS-induced late-onset disease outcomes, as well as explore the mechanisms by which CS exposure in utero can lead to cardiovascular, cancer and respiratory abnormalities in the exposed offspring. By addressing such questions using animal models, appropriate intervention strategies can be developed that will help to protect children's health and their long-term quality of life.

GnRH agonist and GnRH antagonist in intracytoplasmic injection cycles.

The long agonistic protocol for controlled ovarian hyperstimulation (COH) is effective and used most often, thus is considered the gold standard. Therefore any new regimen has to be compared in its results with those obtained with the long protocol. This report compares the efficacy of GnRH agonist and antagonist in a retrospective study of IVF/ICSI carried out in a tertiary teaching hospital from 2003 to 2006. Only the first COH cycle followed by IVF-ICSI from 200 couples (agonist = 120 and antagonist = 80) were analysed. The end points studied included the number of oocytes recovered, number of mature (MII) oocytes, fertilization, cleavage, morphology based embryo quality, pregnancy rate, quantity and cost of gonadotrophin. The average age of female subjects was 35.1 +/- 4.7 years with 50% being 35 years and above. Major infertility factors were tubal blockage, male factor and endometriosis altogether comprising 68%. GnRH agonist and antagonist cycle parameters were comparable except lesser amount of gonadotrophin was used with lower resultant costs (both p < 0.0005) in antagonistic regime. Antagonist regime produce somewhat more good quality embryos (p = 0.065), an insignificant difference. A clinical pregnancy rate per embryo transfer of 16.3% in agonist and 20.6% in antagonist regime was achieved respectively. In conclusion, GnRH antagonist protocol produced a COH response, embryonic development and pregnancy rates on par to GnRH agonist regime. Moreover GnRH antagonist protocol required a shorter stimulation period plus fewer complications. Hence GnRH antagonist regime provided means for a friendlier, convenient and cost effective protocol for patients.

Computerized tomography technique for reconstruction of obstructed phase data in shearography.

Shearography is an interferometric method that overcomes several limitations of holography by eliminating the reference beam. It greatly simplifies the optical setup and has much higher tolerance to environmental disturbances. Consequently, the technique has received considerable industrial acceptance, particularly for nondestructive testing. Shearography, however, is generally not applicable to the measurement of an obstructed area, as the area to be measured must be accessible to both illumination and imaging. We present an algorithm based on the principle of tomography that permits the reconstruction of the unavailable phase distribution in an obstructed area from the measured boundary phase distribution. In the process, a set of imaginary rays is projected from many different directions across the area. For each ray, integration of the phase directional derivative along the ray is equal to the phase difference between the boundary points intercepted by the ray. Therefore, a set of linear equations can be established by considering the multiple rays. Each equation expresses the unknown phase derivatives in the obstructed area in terms of the measured boundary phase. Solution of the set of simultaneous equations yields the unknown phase distribution in the blind area. While its applications to shearography are demonstrated, the technique is potentially applicable to all full-field optical measurement techniques such as holography, speckle interferometry, classical interferometry, thermography, moiré, photoelasticity, and speckle correlation techniques.

Squeeze maneuver: an easy way to manage radiological contrast-medium extravasation.

BACKGROUND: Contrast-medium extravasation injuries may be self-limited to catastrophic. Adequate prophylactic measures are enforced when risk factors for extravasation are present, and prompt treatment can avoid serious complications. PURPOSE: To describe the squeeze maneuver, an effective method for the treatment of symptomatic contrast-medium extravasation. MATERIAL AND METHODS: Over a 3-month period, eight patients with >50 ml contrast-medium extravasation resulting in vascular compromise of the fingers were managed with the squeeze maneuver as follows. The intravenous catheter used for contrast-medium injection was removed, and the skin around the insertion site was cleaned with povidone-iodine. An 18-gauge needle was then used to puncture five to eight openings near the catheter insertion site as deeply as possible. We then began squeezing from the periphery of the swelling toward the needle holes. As the contrast medium drained, it was swabbed away with iodine-soaked cotton swabs. RESULTS: In all eight patients, the maneuver was successful with immediate resolution of the vascular compromise. CONCLUSION: The squeeze maneuver provides an easy way to manage radiological contrast-medium extravasation and can be performed immediately in the CT suite.

Sustained elevation of Epstein-Barr virus antibody levels preceding clinical onset of nasopharyngeal carcinoma.

We have monitored Epstein-Barr virus (EBV) IgA antibody levels of 39 nasopharyngeal carcinoma (NPC) cases for up to 15 years before clinical onset of NPC, and assessed preclinical serologic status of another 68 cases. Our results identify a serologic window preceding diagnosis when antibody levels are raised and sustained. This window can persist for as long as 10 years, with a mean duration estimated to as 37+/-28 months. Ninety-seven of these 107 NPC cases exhibited such a window. Cases that did not may reflect individual antibody response to EBV. Serologic screening at enrollment identified those cases who had already entered the window and became clinically manifested earlier (median=28 months) than those who entered the window after enrollment (median=90 months). The former account for 19 of 21 cases diagnosed within 2 years of screening. Nasopharyngeal carcinoma risk levels among seropositive subjects were also highest during this period. Both prediction rates and risk levels declined thereafter; cases detected at later times were composed of increasing proportions of individuals who entered the serological window after screening. Our findings establish EBV antibody as an early marker of NPC and suggest that repeated screening to monitor cases as they enter this window has considerable predictive value, with practical consequences for cancer treatment.

Unbalanced chromosomal translocation: a cause of recurrent spontaneous abortion.

Recurrent spontaneous abortion, defined as three consecutive abortions, occurs in approximately 1% to 2% of couples. Although the cause is unknown in up to 50% of cases, about 5% of these couples are found to be a balanced translocation carrier. We report a case in which the mother was identified to be a translocation carrier following the birth of a baby with multiple congenital abnormalities.

Polarization-resolved study of diode-pumped passively Q-switched Nd:GdVO4 lasers.

By using the natural birefringence of an a-cut Nd:GdVO(4) crystal, we experimentally investigate laser operation under different light polarizations (pi- and sigma-polarized emissions) and compare their performance. The laser performance is further compared with a diode-pumped c-cut Nd:GdVO(4) laser of the same parameters. We show experimentally that the c-cut Nd:GdVO(4) laser could have good passively Q-switched performance in a low-pump-power region but is influenced by other intrinsic laser effects, such as the thermally induced cavity losses; its performance is severely degraded under high pump power. The best passively Q-switched performance obtained in our experiments is from the a-cut pi-polarized laser, which gives the narrowest pulse of 5.4 ns with the highest peak power of 20 kW. Our experimental results show that, to achieve the best performance of the passively Q-switched laser operation, an overall consideration of laser parameters is important.

Predictors of intrauterine insemination success.

Intrauterine insemination (IUI) remains a therapeutic option within means of the majority of infertile couples in Malaysia. Therefore additional information on predictors of IUI success in the local context would provide a more concrete basis for counseling patients on expectations and treatment options. A retrospective analysis of 297 couples who underwent 445 IUI cycles from Jan 2005-Mar 2006 was undertaken. Four fifths were Malay with a mean paternal and maternal age of 35.53 +/- 5.82 (range 24-59) and 33.02 +/- 4.69 (range 21-46) years respectively. Causes of infertility were idiopathic (50%), endometriosis (17%) and anovulation/polycystic ovarian syndrome (15%). Almost 10% were oligoastenoteratozoospermic with another 23% oligozoospermic or astenozoospermic. Combined male and female factors occurred in 26%. A pregnancy rate (PR) of 9.4% per cycle; 14.1% per couple with a cumulative PR of 36.7% per 4 cycles was achieved. Those who became pregnant were significantly younger (31.29 +/- 4.43 vs. 33.21 +/- 4.68 years, p = 0.011) and had more follicles (13.95 +/- 9.72 vs. 11.43 +/- 6.67, p = 0.029) at the time of insemination. PR depreciated with maternal age and semen quality. Maternal and paternal age was inversely correlated to the number of follicles recruited (r = -0.30, p < 0.0005) and progressive sperm motility (r = -0.125, p = 0.013) respectively.

The empty follicle syndrome.

The empty follicle syndrome (EFS) is a rare complication of in vitro fertilization (IVF) treatment, leading to cycle cancellation. Low human chorionic gonadotropin (hCG) bioavailability and ovarian dysfunction have been implicated with this condition. This case report illustrates a typical case of EFS and several strategies suggested to overcome this problem.

Primary Burkitt lymphoma of the ovary.

A 20 year-old woman presented with features of a twisted ovarian cyst and had an emergency laparotomy Intraoperative findings revealed bilateral, solid ovarian tumors and a left oophorectomy with biopsy of the contralateral ovary performed. Histopathology report confirmed Burkitt lymphoma of ovary. There was no other evidence of lymphoma elsewhere. The primary Burkitt lymphoma of the ovaries was successfully managed with six courses of highly toxic chemotherapy (Berlin-Frankfurt- Munster 1986 protocol). The patient has remained disease free for the last 36 months.