Aflatoxin B1 and viruses' combined pathogenesis: A mini systematics review of invitro and invivo studies.

INTRODUCTION: The combined pathogenesis of Aflatoxin B1 (AFB1) and several viruses such as HBV, EBV and influenza virus have been investigated yet the molecular mechanism of their interaction and possible synergistic effects is not fully understood. OBJECTIVES: The aim of the current systematic review was to review in-vitro and in-vivo studies investigating the combined pathogenesis of aflatoxins and viruses. METHODS: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. PECO (Population, Exposure, Comparator, and Outcome) criteria for invitro and invivo studies were used to evaluate the eligibility of the studies for systematic review. RESULTS: 21 studies were eligible for qualitative analysis based on the inclusion criteria. Of all the included studies, 9 (42.9 %) were invivo, 7 (33.3 %) were invitro-invivo and 5(23.8) articles conducted only invitro assay. Furthermore 14 (66.6 %) article explored hepatitis B virus (HBV) combination with AFB1, 4 (19 %) studied influenza A virus (SIV), 2 (9.7 %) were about Epstein-Barr virus (EBV) and only 1 (4.7 %) included hepatitis C virus (HCV). CONCLUSION: The limited collected evidence suggests that AFB1 enhanced EBV and influenza virus pathogenesis. AFB1 also operated as a cofactor for HBV and EBV-mediated carcinogenesis. On the other hand HBV and HCV also induced AFB-1 carcinogenesis. Due to the limited amount of included studies and the inconsistency of their results further studies especially on HBV and SIV are essential for better understanding of their combined mechanisms.

Investigation of cocoa and cinnamon effect on acrylamide formation in cakes production using GC/MS method: A risk assessment study.

This study was conducted with the aim of investigating the effect of cinnamon and cocoa on the formation of acrylamide in cake samples and their carcinogenic and non-carcinogenic risks. The cake samples were prepared using alkaline extraction, xanthidrol derivative and micro-extraction, then injected into a gas chromatography-mass spectrometry (GC-MS) to identify acrylamide. The maximum and minimum mean concentration of acrylamide among samples was related to the cinnamon cakes (212.28 ng/g) and the cocoa cake samples (10.14 ng/g), respectively. Acrylamide concentration for unflavored samples, cinnamon cake samples and cocoa cake samples were 61.86 ng/g, 169.38-212.28 ng/g and 10.14-44.64 ng/g, respectively. Human health risk assessment based on Monte Carlo simulation (MCS) indicated that the target hazard quotient and incremental lifetime cancer due to ingestion of acrylamide formation in cake samples for adults and children were in the acceptable limits (THQ > 1 and CR > 1E-4). In conclusion, cocoa flavor was able to decrease the concentration of acrylamide in cakes. According to the results, it is necessary to measure the amount of acrylamide in consumer cakes by regulatory organizations.

Hypochondroplasia and temporal lobe epilepsy - A series of 4 cases.

Hypochondroplasia is a skeletal dysplasia syndrome with an autosomal dominant inheritance. It may be associated with temporal lobe epilepsy. We present a series of four patients (two female, two male) with hypochondroplasia who presented at our center with drug refractory epilepsy. Clinical details and EEG and MRI findings led to a diagnosis of temporal lobe epilepsy in all four cases. The MRI findings indicate the epilepsy in hypochondroplasia may be associated with bilateral temporal lobe dysgenesis.

The Role of Recombinant Fibroblast Growth Factor 1 in Enhancing the Angiogenesis in Random Cutaneous Flaps in Animal Model of Rat.

BACKGROUND: Randomized skin flaps have been used as a basic treatment modality for covering skin defects for a long time but they have always been in the risk of an inherent ischemia. Fibroblast growth factor 1 is a known angiogenic factor in in vitro studies which has shown conflicting results in in vivo investigation. We aimed to determine the effect of recombinant fibroblast growth factor on the angiogenesis rate of random cutaneous flap in animal model of rats. METHODS: This experimental study was conducted on 24 adult male rats randomized to 2 groups. In the first group FGF1 was injected subdermally in equally divided doses and distances of random flap surface in days 1, 3 and 5. In second group, normal saline was injected as control. Flap surgery was done on day 21 after first injection. The extent of necrosis and angiogenesis (mean vessel density) were assessed in day 14 after surgery. RESULTS: The mean percentage of clinically apparent necrosis was 35.2% (±10.5) in intervention (FGF1) group and 38.1% (±8.7) in control (normal saline), respectively. Mean vessel density was 86.20±5.6/mm2 in control group and 90.17±5.5/mm2 in intervention group, which showed no statistically significant difference. CONCLUSION: Mean vessel density and mean percentage of clinically apparent necrosis area were similar in 2 groups of rats with random cutaneous flaps receiving FGF1 or normal saline.

Relationship between urinary heavy metals with metabolic syndrome and its components in population from Hoveyzeh cohort study: A case-control study in Iran.

BACKGROUND: The incidence of Metabolic Syndrome (MetS) has been growing rapidly and is rising to pandemic proportions. Although obesity is a primary risk factor for the enhancement of these conditions, not all obese individuals develop metabolic syndrome, indicating that the risk for developing MetS is impacted by other genetic and/or environmental factors such as heavy metals. Therefore, the present study focused on the association between exposures to heavy metal and MetS. METHODS: Urine samples were collected from 150 participants (75 patients with MetS and 75 healthy participants), which were used from Hoveyzeh Cohort center. To make a quantitative comparison between the two groups, Man-Whitney nonparametric test was used. The logistic regression was performed adjusted for age, demographic, lifestyle factor, physical activity, occupational history and urine creatinine. RESULTS: The results of logistic regression showed that OR and 95 % CI for Cd, Pb, Sr, As and Fe concentration were still significant after adjusting for urine creatinine. Moreover, there was a relationship between Cd and Pb levels and waist circumstance (WC). After adjusting for urine creatinine, age, sex, occupation, smoking status, education and place of residence, only Pb concentration was showed a significant association with systolic blood pressure (SBP). The subjects with high urine level of Cd had the high odds (OR: 6.273; 95 % Cl: 1.783-22.070) of MetS and low high-density lipoprotein (HDL-C). The relationship between As concentration and high fasting blood sugars confirmed the previous evidence suggesting that high As level can cause diabetes. CONCLUSION: These results indicated that outbreak of MetS and its component are associated with heavy metal concentrations in urine.

Metal(loid)s urinary level among workers of gas refinery and petrochemical companies: Health risk assessment of metal(loid)s in drinking water and dust.

BACKGROUND: Asalouyeh (southern Iran) contains many pollution sources like petrochemical and gas refinery companies. Few studies were conducted on the body burden of metal(loid)s in occupationally exposed workers of the companies in this area. OBJECTIVES: The urine concentration of metal(loid)s in workers of gas refinery and petrochemical companies in Asalouyeh (who have been worked as "two weeks work-two weeks rest" schedule) was evaluated during a before-and-after observational study. The risks of metal(loid)s in drinking water and dust particles in the studied area were also assessed. METHODS: Urinary samples (n = 179) were gathered at the first day of two weeks of work (before) and at the end of two weeks of work (after). The concentration of V, Ni, Mn, Cd, and As was measured using a graphite furnace atomic absorption spectrometry. The health hazards of metal(loid)s in the air dust and drinking water of workers were also evaluated. RESULTS: The median concentration of metal(loid)s for workers of gas refinery and petrochemical companies for before and after two weeks of work was measured, respectively, as: As (11.44 and 9.31 µg/L), Ni (1.06 and 0.51 µg/L), Cd (0.36 and 0.31 µg/L), Mn (0.29 and 0.24 µg/L), and V (0.08 and 0.05 µg/L). After two weeks work, the median of all metal(loid)s in the urine of petrochemical and gas refinery workers was significantly increased. The non-cancer risk due to intake metal(loid)s from drinking water was more than the threshold value and the cancer risk from drinking water and inhaled air dust was less than the threshold. CONCLUSION: Our results revealed the effect of gas refinery and petrochemical activities on increasing the metal(loid)s concentration of the worker's body and the necessity to protect this group. Additionally, the metal(loid)s intake from drinking water and inhaled dust posed no cancer risk to the workers.

Data on photo-catalytic degradation of 4- chlorophenol from aqueous solution using UV/ZnO/persulfate.

The presence of chlorinated aromatic pollutants like 4- chlorophenol (4CP), even at low concentrations, in the wastewater should be controlled urgently, because of their high toxicity, carcinogenic potential and poor biodegradability. This dataset reveals the effectiveness of an advanced oxidation process (AOP) for attenuating of 4 CP. The AOP of UV/ZnO/persulfate and the influence of various parameters like pH, persulfate dosage and ZnO dosage were studied and the optimum removal conditions could be easily implied by readerships. The efficiency of > 90% was attained for degrading of 4CP by UV/ZnO/persulfate system at the experimental conditions of pH of 7, persulfate dosage of 11 mg/L, 4CP concentration of 10 mg/L, and ZnO dosage of 1 g/L. The data had a good agreement with pseudo first-order kinetic model. Thus, the UV/ZnO/persulfate system is an efficient method for decreasing 4CP from aqueous solution.

The possible DNA damage induced by environmental organic compounds: The case of Nonylphenol.

Human impact on the environment leads to the release of many pollutants that produce artificial compounds, which can have harmful effects on the body's endocrine system; these are known as endocrine disruptors (EDs). Nonylphenol (NP) is a chemical compound with a nonyl group that is attached to a phenol ring. NP-induced H2AX is a sensitive genotoxic biomarker for detecting possible DNA damage; it also causes male infertility and carcinogenesis. We attempt to comprehensively review all the available evidence about the different ways with descriptive mechanisms for explaining the possible DNA damage that is induced by NP. We systematically searched several databases, including PubMed, Scopus, Web of Science, and gray literature, such as Google Scholar by using medical subheading (MeSH) terms and various combinations of selected keywords from January 1970 to August 2017. The initial search identified 62,737 potentially eligible studies; of these studies, 33 were included according to the established inclusion criteria. Thirty-three selected studies, include the topics of animal model (n = 21), cell line (n = 6), human model (n = 4), microorganisms (n = 1), solid DNA (n = 1), infertility (n = 4), apoptosis (n = 6), and carcinogenesis (n = 3). This review highlighted the possible deleterious effects of NP on DNA damage through the ability to produce ROS/RNS. Finally, it is significant to observe caution at this stage with the continued use of environmental pollutants such as NP, which may induce DNA damage and apoptosis.

Photodegradation of Acid red 18 dye by BiOI/ZnO nanocomposite: A dataset.

Dyes are one of the most important existing pollutants in textile industrial wastewater. These compounds are often toxic, carcinogenic, and mutagenic to living organisms, chemically and photochemically stable, and non-biodegradable. Acid red 18 is one of the azo dyes that are currently used in the textile industries. Photocatalytic degradation offers a great potential as an advanced oxidation process, in this study photocatalytic degradation of Acid red 18 by using BiOI/ZnO nanocomposite was evaluated under visible light irradiation. The influence of most essential parameters such as pH and BiOI/ZnO dosage were studied for optimum conditions. The dye removal efficiency was 85.1% at optimum experimental conditions of pH of 7, and BiOI/ZnO dosage of 1.5 g/L. The data had a good agreement with pseudo first-order kinetic model. Thus, the BiOI/ZnO/UV is an efficient process for dye degradation.

Urinary arsenic, cadmium, manganese, nickel, and vanadium levels of schoolchildren in the vicinity of the industrialised area of Asaluyeh, Iran.

Asaluyeh is one of the most heavily industrialised areas in the world where gas, petrochemical, and many downstream industries are located. This study aims to survey the biomonitoring of four metals and one metalloid in children living in the vicinity of Asaluyeh area. To do this, we analysed the creatinine-adjusted urinary levels of arsenic (As), cadmium (Cd), vanadium (V), manganese (Mn), and nickel (Ni) in 184 elementary schoolchildren (99 boys and 85 girls) living in Asaluyeh and compared them with a reference population. The comparisons were done for two seasons (spring and fall). The results showed that in the case area (Asaluyeh), the levels of As, V, Mn, and Ni were significantly higher and that of Cd was not significantly higher than the reference city for both seasons. The mean concentration of metal(loid)s in Asaluyeh (case) and Sadabad (reference) area as µg g-1 creatinine was As 2.90 and 2.24, V 0.06 and 0.03, Mn 0.28 and 0.25, Ni 0.54 and 0.29, and Cd 0.31 and 0.28 in spring and As 3.08 and 2.28, V 0.07 and 0.03, Mn 0.30 and 0.26, Ni 0.91 and 0.30, and Cd 0.36 and 0.31 in the fall. Seasonal variations played a key role in determining urinary metal(loid) concentration, as we saw the significant level of As, Cd, V, and Ni in fall than in spring. With regard to the impact of gender on the absorption and accumulation of urinary metal(loid)s, boys showed higher levels of the studied elements, especially for As, than girls as outdoor activities are more popular among boys. Due to the values being lower than those reported in literature, more research is needed on various population groups and other exposure sources in order to judge whether living in the vicinity of the gas and petrochemical industries in Asaluyeh is a threat to nearby residents.

Determination of nickel and thallium concentration in Cynoglossus arel fish in Musa estuary, Persian Gulf, Iran.

Heavy metals with high bioaccumulation capacity are considered as important contaminants and may be available in high concentrations in environment and biota samples. The main aim of this study was to determine the concentration of nickel and thallium in Cynoglossus arel fish in Musa estuary. Sixty-seven fish samples were collected from Musa estuary during five intervals of 15 days in summer 2013. After biometric measurements, the concentrations of nickel and thallium were measured by graphite furnace atomic absorption spectrophotometer. The mean concentration of nickel and thallium in muscle tissue of fish samples was 2.458 ± 0.910 and 0.781 ± 1.754 mg kg-1/ww, respectively. The GLM analysis showed a significant negative relationship between nickel concentration and length. In addition, there was a significant positive relationship between thallium concentration and fish length. Nickel concentration exceeded the allowable standards of WHO and FDA in Cynoglossus arel. Therefore, regarding with high consumption of seafood in this region, it is recommended that these fishes should be consumed under a nutritionist counseling.

Catalytic degradation of 2,4-dichlorophenoxyacetic acid (2,4-D) by nano-Fe2O3 activated peroxymonosulfate: Influential factors and mechanism determination.

2,4-Dichlorophenoxyacetic acid (2,4-D) is one of the most applicable herbicides in the world. Therefore, its residue in aquatic environment threatens the human health and ecosystems. In this study, Fe2O3 (hematite) nanoparticles (HNPs) were synthesized, and the characteristics of the obtained HNPs were determined using X-ray powder diffraction (XRD), field emission scanning electron microscopy (FESEM), Fourier transform infrared spectroscopy (FTIR), Brunauer-Emmett-Teller (BET) technique, and particle size analyzer (PSA). The catalytic activity of HNPs was evaluated for the activation of peroxymonosulfate (PMS) for the degradation of 2,4-D. The effects of the operating parameters were studied for the PMS/HNPs system. The results showed that the acidic condition provided higher efficiency, while overdosing of PMS had a scavenging effect. The PMS/HNPs showed high efficiency in comparison with the homogeneous forms of iron (Fe2+ and Fe3+). Reusability of HNPs was studied in five consequent usages. The presence of the anions (chloride, nitrate, and hydrogen phosphate) reduced the 2,4-D degradation. Moreover, the catalytic activity of HNPs was also investigated in the presence of other oxidants. UV irradiation increased the function of PMS/HNPs and its mechanism was described. The order of 2,4-D removal for the oxidants was PMS > persulfate > H2O2 > percarbonate. A total of 29.7% of 2,4-D chlorine content was released during the destruction of 2,4-D. The quenching study showed that sulfate radical was the major agent in the degradation of 2,4-D.

Taguchi optimization approach for metronidazole removal from aqueous solutions by using graphene oxide functionalized ß-cyclodextrin/Ag nanocomposite.

Metronidazole (MNZ) is a major threat to the ecosystems and human health, due to its toxicity and carcinogenic nature. The main aim of this study was to evaluate the efficiency of graphene oxide functionalized ß-cyclodextrin/Ag nanocomposite (GO/ß-CD/Ag) for MNZ removal from aqueous solution. The effect of operational parameters such as solution pH (2-5), adsorbent dosages (0.2-1 g/L), contact time (10-80 min), initial MNZ concentrations (0.25-10 mg/L) and ionic strength (0.001-0.1 mol/L) was studied using Taguchi experimental design. The maximum removal efficiency of 93.5% was observed for optimum conditions. The optimum values of contact time, the initial MNZ concentration, the ionic strength, the adsorbent dosage and solution pH were found to be 20 min, 0.25 ppm, 0.01 mol/L, 0.4 g/L and 2, respectively. Freundlich and Dubinin-Radushkevich isotherm models were best-fitted with experimental data. Pseudo-first order and type 1 pseudo-second order kinetic models showed the maximum correlation with the experimental data. Adsorption experiments with real samples indicated that the adsorptive removal of MNZ from a hospital wastewater was 72%. Desorption studies showed maximum recovery of GO/ß-CD/Ag nanocomposite during three cycles. According to the obtained results, it can be concluded that the application of carbon adsorbents such as GO/ß-CD/Ag can be considered an efficient method for final treatment of effluents containing antibiotics.

Optimizing COD removal from greywater by photoelectro-persulfate process using Box-Behnken design: assessment of effluent quality and electrical energy consumption.

Greywater (GW) is a potential source for water reuse in various applications. However, GW treatment is still a vital issue in water reuse in cases of environmental standards and risk to public health. This study investigates optimization and modeling of a hybrid process for COD removal from GW. Persulfate (PS) was simultaneously activated by electrogenerated ferrous ion (EC) and UV to generate sulfate radical. Photoelectro-persulfate (PEPS) was optimized by Box-Behnken design and the effects of four variables (pH, PS dosage, current density, and electrolysis time) were evaluated on COD removal. The results and several coefficients showed that the obtained model was acceptable for predicting the COD removal. Moreover, under optimum conditions (pH = 6.9, PS = 8.8 mM, current density = 2.0 mA/cm(2), and 49.3 min electrolysis time), BOD5, turbidity, TSS, phosphate, and UV254 were effectively removed and COD and BOD5 values reached to discharge standards. Different configurations of the processes were assessed for COD removal. The order of COD removal efficiency followed: PS < Fe(II) < UV/PS ≤ Fe(II)/PS < Fe(II)/PS/UV < electrocoagulation ≤ electrocoagulation/UV < electro-PS < PEPS. The monitoring PS concentration during 60 min reaction time in the aforesaid processes indicated that PEPS could remarkably activate PS. The solution pH was also monitored and related results revealed that the presence of PS during the 10 min first time decreased pH value while production of hydroxide ion at cathode increased pH significantly. Finally, the contribution of electrochemical process in the electrical energy consumption was far less than that of photolysis process in hybrid PEPS process.

Trihalomethanes formation in Iranian water supply systems: predicting and modeling.

Trihalomethanes (THMs) were the first disinfection by-products discovered in drinking water and are classified as probable carcinogens. This study measures and models THMs formation at two drinking water distribution systems (WDS1 and WDS2) in Ahvaz City, Iran. The investigation was based on field-scale investigations and an intensive 36-week sampling program, from January to September 2011. The results showed total THM concentrations in the range 17.4-174.8 µg/L and 18.9-99.5 µg/L in WDS1 and WDS2, respectively. Except in a few cases, the THM concentrations in WDS1 and WDS2 were lower than the maximum contaminant level values. Using two-tailed Pearson correlation test, the water temperature, dissolved organic carbon, UV254, bromide ion (Br-), free residual chlorine, and chlorine dose were identified as the significant parameters for THMs formation in WDS2. Water temperature was the only significant parameter for THMs formation in WDS1. Based on the correlation results, a predictive model for THMs formation was developed using a multiple regression approach. A multiple linear regression model showed the best fit according to the coefficients of determination (R2) obtained for WDS1 (R2=0.47) and WDS2 (R2=0.54). Further correlation studies and analysis focusing on THMs formation are necessary to assess THMs concentration using the predictive models.

Constructing an atomic-resolution model of human P2X7 receptor followed by pharmacophore modeling to identify potential inhibitors.

The P2X purinoceptor 7 (P2X7R) is a trimeric ATP-activated ion channel gated by extracellular ATP. P2X7R has important role in numerous diseases including pain, neurodegeneration, and inflammatory diseases such as rheumatoid arthritis and osteoarthritis. In this prospective, the discovery of small-molecule inhibitors for P2X7R as a novel therapeutic target has received considerable attention in recent years. At first, 3D structure of P2X7R was built by using homology modeling (HM) and a 50ns molecular dynamics simulation (MDS). Ligand-based quantitative pharmacophore modeling methodology of P2X7R antagonists were developed based on training set of 49 compounds. The best four-feature pharmacophore model, includes two hydrophobic aromatic, one hydrophobic and one aromatic ring features, has the highest correlation coefficient (0.874), cost difference (368.677), low RMSD (2.876), as well as it shows a high goodness of fit and enrichment factor. Consequently, some hit compounds were introduced as final candidates by employing virtual screening and molecular docking procedure simultaneously. Among these compounds, six potential molecule were identified as potential virtual leads which, as such or upon further optimization, can be used to design novel P2X7R inhibitors.

Investigation of antibacterial effect of Cadmium Oxide nanoparticles on Staphylococcus Aureus bacteria.

BACKGROUND: Inorganic antibacterial factors provide high bacterial resistance and thermal stability. Inorganic nanomaterial consists of modern formulation, biological, chemical, and physical properties produced on the basis of their function and influenced by their nano scales, the reason for which they have become very popular. The antibacterial effect of Cadmium Oxide Nanoparticles on Staphylococcus Aureus has been studied for the first time in this research because of their resistance to antibiotics. MATERIALS AND METHODS: Different concentrations consist of 10 µg/ml, 15 µg/ml, and 20 µg/ml have been provided and their effects were studied in the agar and broth against the foregoing bacteria. Needless to say, the optimization of their non-microbial effect in variable times, pH, and temperatures of exposure was analyzed. RESULTS: The results represented that there is a direct association between the nanoparticles applied dosage and the restrain effect augmentation of applied dosage results in increase in restrain effect. In the study of environmental factors (pH and temperature), the results are in line with the inherent physiology of the bacteria; however, there was a significant decline in the number of analyzed bacteria cells due to the "Double Effect" of nanoparticle-pH variations as well as nanoparticle-temperature variables. In the very study, the promotion of Cadmium Oxide nanoparticles concentration leads to the elevation of antimicrobial feature and the reduction of bacteria growth rate is consistent with the other surveys about the nanoparticles effects on microorganisms to be more specific, one can come to this conclusion that the presence of nanoparticles prompts cellular destruction. CONCLUSION: In the recent study, by elevation in Cadmium Oxide nanoparticles concentration, the antimicrobial property augments and the bacteria growth rate declines, that are in line with other researches about the nanoparticles effect on microorganisms.

Measurements of Young's and shear moduli of rail steel at elevated temperatures.

The design and modelling of the buckling effect of Continuous Welded Rail (CWR) requires accurate material constants, especially at elevated temperatures. However, such material constants have rarely been found in literature. In this article, the Young's moduli and shear moduli of rail steel at elevated temperatures are determined by a new sonic resonance method developed in our group. A network analyser is used to excite a sample hanged inside a furnace through a simple tweeter type speaker. The vibration signal is picked up by a Polytec OFV-5000 Laser Vibrometer and then transferred back to the network analyser. Resonance frequencies in both the flexural and torsional modes are measured, and the Young's moduli and shear moduli are determined through the measured resonant frequencies. To validate the measured elastic constants, the measurements have been repeated by using the classic sonic resonance method. The comparisons of obtained moduli from the two methods show an excellent consistency of the results. In addition, the material elastic constants measured are validated by an ultrasound test based on a pulse-echo method and compared with previous published results at room temperature. The measured material data provides an invaluable reference for the design of CWR to avoid detrimental buckling failure.

Comparison of the postural control between football players following ACL reconstruction and healthy subjects.

BACKGROUND: Rupture of the Anterior Cruciate Ligment (ACL) is a common knee injury. The purpose of this study was to determine the balance control in football players with and without ACL reconstruction in posture of injury. METHODS: Sway of the center of gravity of 15 patients with ACL reconstruction was compared with 15 healthy, age and sex-matched subjects as the control group. All tests were done unilaterally in the posture of injury, using a kistler force plate with the open and -closed eye conditions. RESULTS: The knee of the operated side of the case group showed more displacement of the center of gravity when compared to the non-operated side in the same subject for all variables of the force plate. The operated side of the case group showed more displacement of the center of gravity for all variables of the force plate in comparison with the dominant side of knees in control group. There were significant differences between the non-operated side in the case group and the dominant side of the control group. CONCLUSION: All together, postural control in the operated side of the case group was weaker than the nonoperated side of the same group and the dominant limb of the control group, which might have resulted from poor proprioception. The postural control was even weaker in the non-operated side of the case group as compared with the dominant limb of the control group, which can justify the hypo mobility of limb for several months after the surgery.