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1.
ACS Appl Mater Interfaces ; 16(23): 30371-30384, 2024 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-38815133

RESUMEN

Manganese oxides with porous structure and abundant active sites show potential in degrading sulfur mustard (HD). However, there is an interface effect between the oily liquid HD and nano oxides, and the powder is prone to agglomeration, which leads to incomplete contact and limited degradation ability. Here, we demonstrate a simple hydrothermal method for preparing MnO2/Ti3C2 composites to address this problem. The influence of morphology and crystal structure on performance are examined. Herein, flower-like MnO2 is loaded onto the surface or interlayer of Ti3C2-MXene nanosheets during in situ formation, significantly expanding the specific surface area. It also provides abundant acid-base sites and oxygen vacancies for the degradation of simulants 2-chloro-ethyl-ethyl thioether (2-CEES) without external energy, resulting in a reaction half-life as fast as 12.5 min. The relationship between structure and performance is clearly elaborated through temperature-programmed desorption (TPD), X-ray photoelectron spectroscopy (XPS), and X-ray absorption fine structure (XAFS) analyses. Based on in situ attenuated total reflection-Fourier transform infrared (ATR-FTIR) analysis, gas chromatography-mass spectrometry (GC-MS) analysis, and density functional theory (DFT) calculation, the proposed degradation pathway of the 2-CEES molecule is a synergistic effect of hydrolysis, elimination, and oxidation. Furthermore, the products are nontoxic or low toxic. Metal oxide/MXene composites are first illustrated for their potential use in degrading sulfur mustard, suggesting new insights into these materials as novel decontamination for decomposing chemical warfare agents.

2.
Knee Surg Sports Traumatol Arthrosc ; 32(1): 19-28, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38226671

RESUMEN

PURPOSE: The aim of this study was to evaluate the clinical effect of derotational femoral osteotomy combined with medial patellofemoral ligament reconstruction for patellar dislocation and the effect of the distribution of femoral torsion at different segments on postoperative function. METHODS: Forty-two patients with patellar dislocation who underwent derotational femoral osteotomy from 2017 to 2021 were retrospectively analysed. All patients received computed tomography scans from the hip to the knee to evaluate correction of the femoral anteversion (FA) angle, patellar tilt angle (PTA) and congruence angle (CA) after derotational femoral osteotomy. Subjective scores, such as the Kujala, Lysholm, International Knee Documentation Committee (IKDC), Tegner and visual analog scale (VAS) scores, were used to evaluate knee function before and after the operation. Patients with supracondylar torsion > distal torsion were categorized into the supracondylar torsion group and patients with distal torsion > supracondylar torsion were categorized into the distal torsion group. Subgroup analyses were performed. RESULTS: No presentation of redislocation occurred in these patients at the minimum 2-year follow-up visit. The mean preoperative FA angle in the supracondylar torsion group was 30.2° ± 4.2°, and the mean postoperative FA angle was 14.5° ± 2.5° (p < 0.001). The mean preoperative FA angle was 26.7° ± 1.4° and the mean postoperative FA angle was 14.1° ± 1.4° in the distal torsion group. In addition, postoperative PTA and CA were significantly corrected in both groups (p < 0.001). The postoperative Kujala, Lysholm, IKDC, Tegner and VAS scores were significantly improved in both groups (p < 0.001). Subgroup analyses showed a higher preoperative FA in the supracondylar torsion group and a higher occurrence of high-grade trochlear dysplasia in the distal torsion group. However, there was no significant difference in their postoperative clinical outcomes. CONCLUSION: Through a minimum of 2-year follow-up visits of patients with patellar dislocation and increased FA, it was found that derotational femoral osteotomy could significantly reduce FA and improve subjective knee function. The pattern of torsion distribution did not significantly affect the clinical outcomes of derotational femoral osteotomy. These findings readvised orthopaedic surgeons that derotational femoral osteotomy remains the preferred procedure for correcting rotational malalignment, but that they should be more cautious about its indications. LEVEL OF EVIDENCE: Level IV.


Asunto(s)
Enfermedades Óseas , Inestabilidad de la Articulación , Luxación de la Rótula , Articulación Patelofemoral , Humanos , Luxación de la Rótula/cirugía , Estudios Retrospectivos , Fémur/cirugía , Ligamentos Articulares/cirugía , Osteotomía/métodos , Inestabilidad de la Articulación/cirugía , Articulación Patelofemoral/cirugía
3.
Sci Rep ; 14(1): 86, 2024 01 02.
Artículo en Inglés | MEDLINE | ID: mdl-38168489

RESUMEN

Bone resection is highly valued in total knee arthroplasty (TKA), but how to determine the amount of distal femur resection is still controversial. The purpose of this study was to explore how to use lateral condyle as a reference for distal femoral osteotomy in TKA. Magnetic resonance imaging (MRI) and Radiographic images from 118 nonarthritic subjects and 123 osteoarthritis (OA) subjects were used to assess the cartilage wear pattern of the distal femur in varus knees. Measurements were performed on three-dimensional reconstruction after virtual bone cutting. The difference between the resection amount of distal (0°) and posterior (90°) was calculated when the medial condyle was used as a reference in OA patients. The osteotomy amount on lateral was calculated in nonarthritic subjects when the medial condylar osteotomy was consistent with the thickness of the implants. In 43% of OA patients, there was > 1 mm difference between the 0° and 90° in medial condyle cartilage, and no difference was observed in lateral. When using medial condyle as a reference for osteotomy, there was a difference of 1.3 ± 0.56 mm between the resection amount of 0° and 90°, and the difference was 0.24 ± 0.27 mm when using lateral condyle. Statistical analysis showed that there was a linear correlation between the resection amount of lateral condyle and mechanical lateral distal femoral angle (mLDFA) in nonarthritic subjects (r = 0.845, p < 0.001). Lateral distal femoral condyle has more uniform cartilage wear in varus knee osteoarthritis. Using the lateral condyle as the reference for distal femoral osteotomy is more suitable for the cartilage wear pattern of the varus knee. The position of cutting guide can be adjusted by preoperative measurements of mLDFA.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Cartílago Articular , Osteoartritis de la Rodilla , Humanos , Osteoartritis de la Rodilla/diagnóstico por imagen , Osteoartritis de la Rodilla/cirugía , Osteoartritis de la Rodilla/patología , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/cirugía , Articulación de la Rodilla/patología , Fémur/diagnóstico por imagen , Fémur/cirugía , Fémur/patología , Artroplastia de Reemplazo de Rodilla/métodos , Cartílago Articular/diagnóstico por imagen , Cartílago Articular/cirugía , Cartílago Articular/patología
4.
J Colloid Interface Sci ; 657: 1003-1015, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38141470

RESUMEN

Pelargonic acid vanillylamide (PAVA), a capsaicin-type dacryagogue agent utilized for counter-terrorism and riot control, possesses a low stimulus threshold. This characteristic can lead to environmental contamination following its application and may easily result in secondary stimulation to personnel. Cobalt-doped Ti3C2-MXene nanosheets (Co3O4/Ti3C2@C) were synthesized for the purpose of activating peracetic acid (PAA) and degrading PAVA. A carbon layer was coated on the surface of Ti3C2-MXene nanosheets to address the challenge of poor oxygen resistance in MXenes, thus preventing a significant decline in surface reactivity. The BET surface area of Co3O4/Ti3C2@C was expanded to 149.6 m2/g, significantly exceeding that of Ti3C2 (13.0 m2/g) and Co3O4 (56.4 m2/g). With 0.5 mg/mL of Co3O4/Ti3C2@C and 0.35 mM of PAA, 100 mg/L of PAVA was completely degraded within 60 min. The augmented BET surface area and the presence of more active sites confer remarkable PAA activation and catalytic degradation properties toward PAVA. Parameters such as initial pH, PAVA concentration, catalyst dosage, and PAA concentration on PAVA degradation were systematically assessed. Furthermore, the reusability and stability of the nanocomposite were substantiated through recycling tests. Radical quenching experiments and electron paramagnetic resonance analysis demonstrated the acetylperoxy radical (CH3CO3) as the primary species responsible for PAVA degradation. This research serves as an illustration of the utilization of MXene and transition metal activated PAA in wastewater treatment.

5.
J Orthop Surg Res ; 18(1): 781, 2023 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-37853479

RESUMEN

BACKGROUND: To investigate the differences in postoperative patellofemoral pressures and patellar tracking during at least three years of follow-up in patients using three prostheses of different designs in total knee arthroplasty (TKA) without patellar resurfacing. METHODS: RADIOGRAPHIC INVESTIGATIONS: The study included 401 patients who had a total of 480 knee prostheses implanted without patellar resurfacing. The prostheses used were Genesis II (external rotation design of femoral prosthesis), Triathlon (design with deep trochlear grooves), and Gemini MK II (deepening of trochlear groove and lateral condylar protrusion that closely follows the anatomical shape). The patients' patellar tracking was assessed by measuring patellar tilt and displacement during postoperative follow-up. Furthermore, postoperative knee function and pain were evaluated through range of motion, Knee Society scores (KSS), and Forgotten Joint Score (FJS) to compare the different groups. FINITE ELEMENT ANALYSIS: Constructing a finite element model of the knee joint of a normal volunteer after total knee arthroplasty using different prostheses for nonpatellar replacement. The three models' von Mises stress distribution heat map, peak contact pressure, and patellar transverse displacement were compared at 30°, 60°, and 90°, respectively. RESULTS: RADIOGRAPHIC INVESTIGATIONS: A total of 456 knees of 384 patients were investigated at a 3-year follow-up after TKA without patellar resurfacing. There were no significant differences in patellar tracking between the three groups. Patients with all three prostheses demonstrated favorable clinical outcomes at 3 years postoperatively, with no statistically significant differences in knee scores (91.9 vs 92.3 vs 91.8) or range of motion (127.9° vs 128.5° vs 127.7°) between the groups. However, there was a significant difference between Genesis II and Gemini MK II in the Forgotten Joint Score (59.7 vs 62.4). Patients with persistent postoperative anterior knee pain were present in all three groups (16 vs 12 vs 10), but the incidence was not significantly different. FINITE ELEMENT ANALYSIS: The von Mises stress distribution heat map showed that during flexion, the patellofemoral stresses were mainly concentrated on the lateral side of the prosthesis side, and the contact site gradually shifted downward with increasing flexion angle. At the same time, the peak contact stress of the patellofemoral joint increased with the gradual increase in the flexion angle. Genesis II, with a wider and shallower trochlear groove, showed greater patellofemoral stresses and lateral patellar displacement after TKA without patellar resurfacing. The Gemini MK II with a deeper trochlear groove and slightly protruding lateral condyle is more in line with anatomical design, with smaller patellofemoral joint pressure and better patellar tracking. CONCLUSIONS: In TKA without patellar resurfacing, a prosthesis with a deeper trochlear groove, a slightly higher lateral femoral condyle, and a more anatomically designed knee that better matches the patellar morphology should be a better choice.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla , Articulación Patelofemoral , Humanos , Estudios de Casos y Controles , Estudios de Seguimiento , Articulación de la Rodilla/cirugía , Rótula/diagnóstico por imagen , Rótula/cirugía , Articulación Patelofemoral/diagnóstico por imagen , Articulación Patelofemoral/cirugía , Dolor/cirugía , Diseño de Prótesis , Rango del Movimiento Articular
6.
Knee Surg Sports Traumatol Arthrosc ; 31(11): 4951-4960, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37606638

RESUMEN

PURPOSE: To investigate the growth of the epiphyseal plate in patients with trochlea dysplasia using a 3D computed tomography (CT)-based reconstruction of the bony structure of the distal femur. The epiphysis plate was divided into a medial part and a lateral part to compare their differences in patients with trochlear dysplasia. METHODS: This retrospective study included 50 patients with trochlea dysplasia in the study group and 50 age- and sex-matched patients in the control group. Based on the CT images, MIMICS was used to reconstruct the bony structure of the distal femur. Measurements included the surface area and volume of the growth plate (both medial and lateral), the surface area and capacity of the proximal trochlea, trochlea-physis distance (TPD) (both medial and lateral), and height of the medial and lateral condyle. RESULTS: The surface area of the medial epiphyseal plate (1339.8 ± 202.4 mm2 vs. 1596.6 ± 171.8 mm2), medial TPD (4.9 ± 2.8 mm vs. 10.6 ± 3.0 mm), height of the medial condyle (1.1 ± 2.5 mm vs. 4.9 ± 1.3 mm), and capacity of the proximal trochlear groove (821.7 ± 230.9 mm3 vs. 1520.0 ± 498.0 mm3) was significantly smaller in the study group than in the control group. A significant positive correlation was found among the area of the medial epiphyseal plate, the medial TPD, the height of the medial condyle and the capacity of the proximal trochlear groove (r = 0.502-0.638). CONCLUSION: The medial epiphyseal plate was dysplastic in patients with trochlea dysplasia. There is a significant positive correlation between the surface area of the medial epiphyseal plate, medial TPD, height of the medial condyle and capacity of the proximal trochlear groove, which can be used to evaluate the developmental stage of the trochlea in clinical practice and to guide targeted treatment of trochlear dysplasia. LEVEL OF EVIDENCE: III.

7.
J Orthop Surg Res ; 18(1): 144, 2023 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-36849936

RESUMEN

BACKGROUND: Patellar instability (PI) usually combines with morphological abnormalities of femoral condyles that may affect the morphology of the intercondylar notch and anterior cruciate ligament (ACL), which are important in individualized ACL reconstruction. This study aimed to investigate the morphological characteristics of the intercondylar notch and ACL in patients with PI. METHODS: 80 patients with PI and 160 age- and gender-matched controls from January 2014 to June 2022 were studied. Morphological measurements of the femoral condyles included intercondylar notch height, notch width, medial condylar width, lateral condylar width, bicondylar width, notch width index, notch angle, lateral femoral condyle ratio (LFCR), condyle flexion angle, and posterior tibial slope. Morphological measurements of the ACL included ACL length, inclination angle, and ACL size. The measurements were compared between PI and control groups, and between males and females in PI group. The independent samples t-test was performed to examine differences in continuous variables. The chi-square test was used for comparing categorical variables. RESULTS: The intercondylar notch width, bicondylar width, notch width index, and notch angle were significantly smaller, while the LFCR was significantly larger in PI group than those of control group (p < 0.05). The ACL thickness (0.70 ± 0.16 cm vs 0.80 ± 0.21 cm, p = 0.023) and width (0.54 ± 0.14 cm vs 0.60 ± 0.13 cm, p = 0.029) were significantly smaller in PI group. The notch width was significantly smaller in female patients than males in PI group, but no significant difference was observed in the notch width index and notch angle (p > 0.05). No sex difference related to the morphology of the ACL was found. CONCLUSIONS: The patient with PI had a stenotic intercondylar notch and a thin ACL. No significant sex difference in the intercondylar notch stenosis and ACL size was observed. The morphology of the intercondylar notch and ACL should be taken into consideration when planning individualized ACL reconstruction in the presence of PI.


Asunto(s)
Inestabilidad de la Articulación , Articulación Patelofemoral , Masculino , Humanos , Femenino , Ligamento Cruzado Anterior/diagnóstico por imagen , Constricción Patológica , Inestabilidad de la Articulación/diagnóstico por imagen , Estudios Retrospectivos
8.
BMC Musculoskelet Disord ; 24(1): 90, 2023 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-36732733

RESUMEN

PURPOSE: Distal femoral torsion is a key factor for poor alignment of patellofemoral joint. This study aims to evaluate the correlation between distal femoral torsion and the severity of patellofemoral arthritis, and to analyze the correlation between distal femoral torsion and the morphology of femoral condyle. METHODS: A retrospective analysis was performed on 125 patients awaiting surgical treatment for knee osteoarthritis from January 2021 to March 2022(79 females, 46 males, average age: 65.78 years, SD 6.61). All patients underwent knee joint radiography, lower-limb digital radiography, and knee joint CT scans. The ratio of length of each distal femoral condyle, TT-TG, patellar tilt, DFL-PCL, DFL-TEA, TEA-PCL and TEA-ACL were measured. The Pearson correlation coefficient was used to evaluate the correlation between distal femoral torsion and ratio of distal femoral condyle, TT-TG and patellar tilt. Logistic regression was used to evaluate the correlation between each parameter and the severity of PFOA. RESULTS: With the increased severity of PFOA, TT-TG, patellar tilt, DFL-PCL, DFL-TEA and PCA all tended to increase. Patellar tilt was correlated with DFL-PCL (r = 0.243) and TEA-PCL(r = 0.201), but TT-TG had no evident correlation with distal femoral torsion. Compared with Grade I patients of PFOA, DFL-PCL, DFL-TEA, and TEA-PCL were risk factors for increased severity of patellofemoral arthritis in Grade III patients of PFOA, but there was no significant statistic difference in Grade II patients of PFOA. CONCLUSIONS: Distal femoral torsion correlates with the severity of patellofemoral arthritis. Variation of the femoral transepicondylar axis caused by the change of ratio of the femoral condyle is particularly important in the distal femoral torsion. In patients with severe PFOA, abnormal variation of the femoral condyle axis should be not ignored.


Asunto(s)
Enfermedades Óseas , Inestabilidad de la Articulación , Osteoartritis de la Rodilla , Articulación Patelofemoral , Masculino , Femenino , Humanos , Anciano , Estudios Retrospectivos , Tibia/cirugía , Fémur/diagnóstico por imagen , Fémur/cirugía , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/cirugía , Articulación Patelofemoral/diagnóstico por imagen , Articulación Patelofemoral/cirugía , Osteoartritis de la Rodilla/diagnóstico por imagen , Osteoartritis de la Rodilla/cirugía
9.
Water Sci Technol ; 87(1): 336-346, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36640041

RESUMEN

The peroxide-based decontaminants had attracted great attention for degradation of chemical warfare agents (CWAs) because of their high performance, non-corrosive and environmental-friendly merits. Hydrogen peroxide can be activated by some organic activators to enhance the oxidation ability. In this work, a novel formula based on sodium percarbonate (SPC) complexed with 1-acetylguanidine (ACG) was investigated for decontamination of sulfur mustard (HD) and VX as CWAs. In the experimental results, the active species acetyl peroxide imide acid in the formula aqueous solution was detected in situ by Raman and 13C NMR spectroscopy. The optimized conditions of the decontamination formula (SPC/ACG) were suggested that, the molar ratio of active oxygen and activator ([O]/[ACG]) was 1:1 while the pH value of the formula aqueous solution was about 9. To achieve the decontamination percentage over 99%, the molar ratio of active oxygen to CWA ((O)/(CWA)) needed to be at least 3 for HD and 7 for VX. Meanwhile, the degradation products detected by gas chromatography/mass spectrometry (GC/MS), liquid chromatography/mass spectrometry (LC/MS) and ion chromatography (IC) indicated that the oxidation and elimination reactions should have occurred on HD molecule, while the degradation of VX mainly originate from the nucleophilic substitution and oxidation reactions.


Asunto(s)
Sustancias para la Guerra Química , Gas Mostaza , Gas Mostaza/análisis , Gas Mostaza/química , Descontaminación/métodos , Especies Reactivas de Oxígeno , Sustancias para la Guerra Química/análisis , Sustancias para la Guerra Química/química , Peróxidos , Azufre
10.
Knee Surg Sports Traumatol Arthrosc ; 31(7): 2888-2896, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-36454293

RESUMEN

PURPOSE: The purpose of this study was to evaluate and compare clinical and radiological outcomes between isolated medial patellofemoral ligament reconstruction (MPFLR) and MPFLR combined with derotational distal femoral osteotomy (DDFO) for patellar dislocation with increased femoral anteversion (FA). METHODS: Between 2014 and 2019, 36 patients who underwent isolated MPFLR and 31 patients who underwent MPFLR combined with DDFO were retrospectively included. Clinical outcomes included physical examinations, functional outcomes (Kujala, Lysholm, International Knee Documentation Committee (IKDC), and Banff Patella Instability Instrument (BPII) scores), activity level (Tegner activity score and return to sports), complications, and patellar re-dislocation rate. Radiological outcomes included patella tilt angle, patellar congruence angle, and patella-trochlear groove distance. RESULTS: All clinical outcomes improved significantly in both groups, but the DDFO group had significantly better postoperative scores than the MPFLR group (Kujala: 85.1 ± 7.7 vs. 80.5 ± 8.4, P = 0.023; Lysholm: 86.8 ± 8.2 vs. 81.9 ± 9.1, P = 0.026; IKDC: 86.2 ± 10.0 vs. 81.7 ± 8.1, P = 0.045; and BPII: 68.0 ± 12.5 vs. 62.3 ± 10.0, P = 0.039). Both groups achieved successful return to sports (90.3% vs. 91.7%). No re-dislocation or major complications occurred. Radiological outcomes improved significantly in both groups, but the DDFO group had better outcomes (P < 0.05). The tibial tubercle-trochlear groove distance was only improved after DDFO from 17.0 ± 2.3 mm to 15.1 ± 2.0 mm (P = 0.001). CONCLUSION: Both isolated MPFLR and MPFLR combined with DDFO yielded satisfactory clinical and radiological outcomes in the treatment of patellar dislocation with increased FA. However, combined DDFO had better outcomes and should be considered a priority. LEVEL OF EVIDENCE: Level III.


Asunto(s)
Inestabilidad de la Articulación , Luxación de la Rótula , Articulación Patelofemoral , Humanos , Luxación de la Rótula/diagnóstico por imagen , Luxación de la Rótula/cirugía , Estudios Retrospectivos , Articulación de la Rodilla/cirugía , Ligamentos Articulares/cirugía , Osteotomía/métodos , Inestabilidad de la Articulación/cirugía , Articulación Patelofemoral/diagnóstico por imagen , Articulación Patelofemoral/cirugía
11.
J Orthop Surg Res ; 17(1): 469, 2022 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-36307822

RESUMEN

PURPOSE: To investigate the change of the cross-sectional area (CSA) of vastus medialis oblique (VMO) in patients with recurrent patellar dislocation (RPD) treated by tibial tubercle transfer combined with medial patellofemoral ligament (MPFL) reconstruction by imaging methods, and to guide clinical treatment and rehabilitation. METHODS: From October 2015 to March 2022, 23 patients with RPD who underwent tibial tubercle transfer combined with MPFL reconstruction were retrospectively enrolled. All patients were assessed by CT in the supine position with the knee fully extended and the quadriceps relaxed. The CSA of VMO and the ratio of CSA of VMO to body weight (CSA/BW) were measured at the upper pole of the patella, 5 mm above the upper pole of the patella and 5 mm below the upper pole of patella. The differences of measured parameters were compared before surgery and at follow-up, including CSA of VMO and CSA/BW. Test level α = 0.05. RESULTS: The tibial tubercle-trochlear groove (TT-TG) distance was significantly reduced at follow-up compared with that before surgery (27.91 ± 1.95 mm vs 12.33 ± 1.07 mm, P < 0.001). The CSA of VMO was significantly increased at follow-up compared with that before surgery at 5 mm below the upper pole of the patella (473.06 ± 106.32 mm2 vs 562.97 ± 157.90 mm2, P < 0.001), at the upper pole of the patella (641.23 ± 188.45 mm2 vs 700.23 ± 177.55 mm2, P = 0.029), and at 5 mm above the upper pole of the patella (788.25 ± 238.62 mm2 vs 849.79 ± 180.84 mm2, P = 0.018). The CSA/BW was significantly increased at follow-up compared with that before surgery at 5 mm below the upper pole of the patella (7.83 ± 2.52 mm2/kg vs 9.22 ± 3.54 mm2/kg, P < 0.001), at the upper pole of the patella (10.48 ± 3.62 mm2/kg vs 11.42 ± 4.14 mm2/kg, P = 0.020), and at 5 mm above the upper pole of the patella (12.86 ± 4.65 mm2/kg vs 13.68 ± 3.86 mm2/kg, P = 0.017). CONCLUSION: After tibial tubercle transfer combined with MPFL reconstruction, CSA of VMO increased in patients with RPD, which will help to enhance patellar stability and reduce recurrence.


Asunto(s)
Luxaciones Articulares , Inestabilidad de la Articulación , Luxación de la Rótula , Articulación Patelofemoral , Humanos , Luxación de la Rótula/diagnóstico por imagen , Luxación de la Rótula/cirugía , Articulación Patelofemoral/diagnóstico por imagen , Articulación Patelofemoral/cirugía , Músculo Cuádriceps/diagnóstico por imagen , Músculo Cuádriceps/cirugía , Estudios Retrospectivos , Ligamentos Articulares/cirugía , Tibia/diagnóstico por imagen , Tibia/cirugía , Articulación de la Rodilla/cirugía , Rótula/diagnóstico por imagen , Rótula/cirugía , Tomografía Computarizada por Rayos X , Inestabilidad de la Articulación/cirugía
12.
J Orthop Surg Res ; 17(1): 416, 2022 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-36104806

RESUMEN

BACKGROUND: Because the patients undergoing medial patellofemoral ligament reconstruction (MPFLr) combined with medial tibial tubercle transfer (TTT) procedure are usually young and active, the quality of life (QoL) is also an important prognostic factor for patients with recurrent patellar dislocation. Assessing QoL can provide more useful and accurate evidence for the effects of this procedure. This study aimed to evaluate QoL following MPFLr combined with TTT, compared with isolated MPFLr (iMPFLr). METHODS: Fifty-one patients who underwent iMPFLr + TTT and 48 patients who underwent iMPFLr were included. Clinical evaluation included QoL (EQ-5D-5L and EQ-5D VAS), functional outcomes (Kujala, Lysholm and Tegner activity scores), physical examinations (patellar apprehension test and range of motion) and redislocation rates. Radiological evaluation included patellar tilt angle and bisect offset. These preoperative and postoperative results were compared between groups at baseline and the final follow-up. The paired and independent t tests were used for the data following a normal distribution. Otherwise, the Wilcoxon and Mann-Whitney U tests were used to analyze the differences. Categorical variables were compared by chi-square or Fisher's exact test. RESULTS: All of the QoL (EQ-5D-5L and EQ-5D VAS), clinical results and radiological outcomes significantly improved in both groups at the final follow-up, with no significant differences between groups. There was no significant difference in five dimensions of EQ-5D at the final follow-up, although percentages of people with problems of mobility and pain/discomfort were higher in the MPFLr + TTT group. Female patients had lower EQ-5D index and EQ-5D VAS compared with male patients in both groups at the final follow-up, but there was only a significant difference in the EQ-5D VAS. CONCLUSIONS: Both MPFLr + TTT and iMPFLr groups obtained similar and satisfactory improvements in the QoL, clinical results and radiological outcomes, indicating that MPFLr combined with TTT is a safe and effective procedure, which can significantly improve the QoL for patients with recurrent patellar dislocation in cases of pathologically lateralized TT. However, female patients obtained lower QoL than males.


Asunto(s)
Luxación de la Rótula , Articulación Patelofemoral , Femenino , Humanos , Ligamentos Articulares/cirugía , Masculino , Luxación de la Rótula/diagnóstico por imagen , Luxación de la Rótula/cirugía , Articulación Patelofemoral/diagnóstico por imagen , Articulación Patelofemoral/cirugía , Calidad de Vida , Estudios Retrospectivos
13.
J Orthop Surg Res ; 17(1): 276, 2022 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-35570290

RESUMEN

PURPOSE: To investigate the difference of trochlear width between normal and dysplastic trochlear and to analyze whether the medialization of trochlear groove was correlated with abnormal width of trochlear facets in trochlear dysplasia. METHODS: This study involved CT scans of fifty knees with trochlear dysplasia (TD group) and fifty knees without obvious trochlear dysplasia (Normal group). The linear distance from the medial femoral epicondyle to the various reference points was measured on axial CT images which included the medial edge of medial trochlear facet (dMTE), trochlear groove (dTG), and the lateral edge of lateral trochlear facets (dLTE). The medial and lateral trochlear width was calculated and standardized by the width of the anatomical epicondylar axis. Pearson's correlation analysis was performed between the dTG and the width of the medial and lateral trochlear. RESULTS: The reliability of the results was good. Intraclass correlation coefficient (ICC) ranged from 0.89 to 0.97. The dMTE was significantly greater in the TD group than the normal group (32.7 ± 5.1% vs. 29.6 ± 3.5%, p = 0.009). There was no significant difference in the dLTE between groups. The dTG was reduced in the TD group compared with the normal group (45.2 ± 4.1% vs. 49.1 ± 3.9%, p = 0.019). In the TD group, there was a significant reduction in the medial trochlear width (13.9 ± 4.1% vs. 19.4 ± 2.9%, p < 0.001) and a significant increase in the lateral trochlear width (31.3 ± 4.0% vs. 26.9 ± 3.6%, p < 0.001) compared with the normal group. The dTG was significantly correlated with the lateral trochlear width (r value = - 0.693, p < 0.001) and not correlated with the medial trochlear width (r value = 0.044, p = 0.766) in trochlear dysplasia. CONCLUSIONS: This study demonstrated that dysplasia of trochlear morphology was related to the reduction of medial trochlear width and increase in lateral trochlear width. The medialization of trochlear groove was significantly correlated with the increased lateral trochlear width.


Asunto(s)
Inestabilidad de la Articulación , Luxación de la Rótula , Articulación Patelofemoral , Fémur/diagnóstico por imagen , Humanos , Articulaciones , Imagen por Resonancia Magnética , Reproducibilidad de los Resultados , Tomografía Computarizada por Rayos X
14.
J Hazard Mater ; 407: 124808, 2021 04 05.
Artículo en Inglés | MEDLINE | ID: mdl-33338811

RESUMEN

The degradation process of malathion in the acetyl peroxyborate (APB) solution of different APB/malathion molar ratio and in the carbonate-activated APB (APB/CO32-) solution of different pH was studied by 31P NMR technology. In the APB solution, all malathion could be degraded in 47.5 min when the molar ratio of APB/malathion was 60. CO32- could effectively activate APB to degrade all malathion in 10 min at pH of 10 when APB/malathion was 10, which was obviously higher than in APB solution. 1O2, •O2-, •OH and carbon-centered radicals (RC•) could be produced in the APB/CO32- solution, and the degradation of malathion was mainly affected by RC•. The degradation mechanism of malathion in the APB/CO32- solution was proposed based on the research results of malathion degradation process by 31P NMR and active species quenching test, which involves two steps: the first step is the oxidation of malathion to malaoxon by RC•, and the second step is the hydrolysis of malaoxon to dimethyl phosphate via hydroxyl anions nucleophilic addition.

15.
J Hazard Mater ; 248-249: 435-41, 2013 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-23416488

RESUMEN

Trace detection of cyanide is studied based on the Ag nanoplate-built hollow microsphere array and its surface enhanced Raman scattering (SERS) effect. This array was fabricated based on electro-deposition and template method under a low current density. Due to the special structure, such array is a good SERS substrate with high activity and structural stability, and good reproducibility. Such substrate was used for detection of trace amount of kalium cyanide (KCN) in water based on its SERS effect. It has been shown that the detection limit can be down to the level of 0.1 ppb. There exists a good linear double-logarithm relation between the Raman signal and the KCN concentration in water in the range from 0.1 ppb to 1 ppm. In addition, it has been found that the suitable laser power for Raman excitation is crucial to trace detection of KCN molecules. This work is of importance in the practical application in device-design based on the SERS effect of noble metal micro/nano-structured arrays.


Asunto(s)
Cianuros/análisis , Plata/química , Contaminantes Químicos del Agua/análisis , Microesferas , Nanoestructuras/química , Espectrometría Raman/instrumentación
16.
Environ Sci Technol ; 43(5): 1553-8, 2009 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-19350934

RESUMEN

A study has been done to examine the degradation of sulfur mustard (HD) and sarin (GB) over hardened cement paste (HCP). The HCP behaved as a typical base like CaO and Ca(OH)2. The base sites over the HCP were not entirely poisoned by H2O and CO2 in air, and about 0.47 mmol/g base sites could still be evidenced by chemisorption of CO2. A large amount of water irreversibly adsorbed by HCP was experimentally demonstrated. Ten kinds of products through hydrolysis S(N)1 (C-Cl), elimination E1 or E2 (C-Cl, C-H), and addition-elimination (A-E) under the action of base sites and water from the degradation of HD over HCP were detected and identified by GC-FPD, GC-MS, and NMR approaches. Their distribution and kinds varied with time of degradation and water content Both degradation activity and distribution of products from HD were strongly determined by the strength and density of base sites and the water content in HCP. The molecules of GB adsorbed over HCP in comparison with HD could be more quickly and completely degraded into hydrolyzed products such as isopropyl methylphosphonic acid and methylphosphonic acid by adsorbed water, in comparison with HD.


Asunto(s)
Materiales de Construcción , Restauración y Remediación Ambiental , Dureza , Gas Mostaza/química , Sarín/química , Adsorción , Aire , Dióxido de Carbono/química , Cromatografía de Gases , Cinética , Espectrometría de Masas , Dióxido de Silicio/química , Temperatura , Volatilización
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