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BACKGROUND: Men with low testosterone levels are at an increased risk of developing metabolic syndrome, irrespective of age or obesity. However, the relationship between metabolic syndrome and testosterone levels in women remains unclear. We compared the total testosterone concentrations between premenopausal obese women with and without metabolic syndrome and identified the factors affecting these concentrations. METHODS: A single-center retrospective analysis was conducted using the medical records of 580 premenopausal women with obesity. The diagnostic criteria for metabolic syndrome were established using the National Cholesterol Education Program Adult Treatment Panel III guidelines. RESULTS: The mean±standard deviation age, weight, and body mass index were 38.8±8.4 years, 78.0±11.8 kg, and 30.0±4.1 kg/m2, respectively. The mean total testosterone concentration was lower in the metabolic syndrome group than in the non-metabolic syndrome group (n=385 vs. n=195; 0.22±0.10 ng/mL vs. 0.24±0.11 ng/mL; P<0.001). In a model adjusted for age, body mass index, skeletal muscle mass, body fat mass, and body fat percentage, the odds ratio for metabolic syndrome with respect to the total testosterone level was 0.128 (P=0.028). Testosterone concentration was negatively correlated with age (r=-0.334), systolic blood pressure (r=-0.084), and triglyceride concentration (r=-0.093) but positively correlated with weight (r=0.144), body mass index (r=0.140), waist circumference (r=0.133), body fat mass (r=0.167), and body fat percentage (r=0.167). Stepwise regression analysis revealed that age (ß=-0.004, P<0.001), body mass index (ß=0.003, P=0.004), and high-density lipoprotein cholesterol concentration (ß=0.001, P=0.019) were independently associated with total testosterone concentration (adjusted R2=12.6%). CONCLUSION: Metabolic syndrome and obesity may be independently associated with testosterone levels in premenopausal women with obesity.
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The causes of carpal tunnel syndrome are complex. However, little is known about the risk factors for carpal tunnel syndrome occurrence on simple radiographic images. To determine the X-ray imaging factors that can predict idiopathic carpal tunnel syndrome occurrence, we compared a group diagnosed with idiopathic carpal tunnel syndrome who received carpal tunnel release with a control group that had no symptoms. The simple wrist X-ray findings of 75 patients diagnosed with idiopathic carpal tunnel syndrome and 87 patients selected for the control group were evaluated. All the carpal tunnel syndrome patients were diagnosed based on clinical symptoms and nerve conduction studies. Anteroposterior and lateral radiographs of the wrists were taken in all the groups. The radial inclination, volar tilt, ulnar variance, radiolunate angle, and lunate-to-axis-of-radius distance were measured. Data were measured using two independent raters. After calculating the average of each value, the two groups were statistically compared. The diagnostic performance of statistically different figures was confirmed by drawing receiver operator characteristic curves. There was a significant difference in the radiolunate angle and lunate-to-axis-of-radius distance between the two groups (p < 0.01 and p = 0.028, respectively). The odd ratios for each parameter were 1.052 and 1.319, respectively. The area under the receiver operator characteristic curves were 0.715 and 0.601, respectively. In this study, radiolunate angle and lunate-to-axis-of-radius distance were useful as radiographic diagnostic tools. In other words, excessive dorsiflexion and volar displacement of the lunate can be considered as risk factors that may cause idiopathic carpal tunnel syndrome in the future.
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The authors would like to make the following corrections about the published paper [...].
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Mixed reality (MR) has recently been suggested as a new educational tool for nursing simulation. However, few studies have assessed the use and evaluation of MR nursing simulations. Therefore, this review identified studies of MR nursing simulations through a scoping review using the framework proposed by Arksey and O'Malley. The studies reviewed were found through DBpia, RISS, PubMed, CINAHL, and Google Scholar. Each study was analyzed, and data were abstracted into publication characteristics, simulation program details, device use, and simulation evaluation. A total of 10 studies were reviewed. Senses that were mainly used in MR nursing simulation included audition and haptics via motion, in addition to visual information. Simulations were evaluated using various outcome variables. Knowledge was most commonly evaluated, followed by clinical performance and satisfaction. This study is significant as it analyzed trends in research on MR nursing simulations in Korea and other countries and suggested directions for the use of MR technology in nursing simulations based on the findings. Additional studies are required to develop scenarios for the effective use of MR in nursing education and to evaluate the effects of MR nursing simulations.
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We report the temperature dependence of the dielectric function ε = ε1 + iε2 and critical point (CP) energies of biaxial α-SnS in the spectral energy region from 0.74 to 6.42 eV and temperatures from 27 to 350 K using spectroscopic ellipsometry. Bulk SnS was grown by temperature gradient method. Dielectric response functions were obtained using multilayer calculations to remove artifacts due to surface roughness. We observe sharpening and blue-shifting of CPs with decreasing temperature. A strong exciton effect is detected only in the armchair direction at low temperature. New CPs are observed at low temperature that cannot be detected at room temperature. The temperature dependences of the CP energies were determined by fitting the data to the phenomenological expression that contains the Bose-Einstein statistical factor and the temperature coefficient for describing the electron-phonon interaction.
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PURPOSE: The purpose of this study was to determine the results of mobile bearing unicompartmental knee arthroplasty (UKA) with an intentionally increased flexion angle of the femoral component in patients requiring high flexion. MATERIALS AND METHODS: We investigated 45 knees treated by UKA. Clinically, we measured the range of motion (ROM) and the American Knee Society (AKS) score preoperatively and at final follow-up and investigated complications. Radiologically, we measured the flexion angle of the femoral component, the posterior slope angle of the tibial component, the femorotibial angle and mechanical axis of the limb postoperatively. RESULTS: The ROM was increased from 123° preoperatively to 139° at the final follow-up. The AKS knee and function scores increased from 59 and 68, respectively, preoperatively to 94 and 96, respectively, at the final follow-up. The flexion angle of the femoral component was 9.1°, and the posterior slope angle of the tibial component was 8.6°. There was one case of bearing dislocation in the largest femoral flexion angle case. CONCLUSIONS: The results might reflect the positive effect of an increased flexion angle of the femoral component up to 10° on ROM in mobile bearing UKA, which would contribute to better quality of life after UKA especially in populations requiring deep knee flexion.
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We aimed to investigate the association between serum 25-hydroxyvitamin D (25[OH]D) and microvascular complications in type 2 diabetes mellitus (T2DM) patients. It was hypothesized that lower 25(OH)D would be associated with increased microvascular complications in T2DM. A total of 257 T2DM patients (111 men, 146 women) who underwent diabetic microvascular complication (peripheral neuropathy, nephropathy, retinopathy) studies were recruited. Patients were categorized into 3 groups according to vitamin D status: vitamin D sufficient (n = 41, 25[OH]D ≥ 20 ng/mL), vitamin D insufficient (n = 132, 10 ≤ 25[OH]D < 20 ng/mL), and vitamin D deficient (n = 84, 25[OH]D < 10 ng/mL). In men, the prevalence of diabetic peripheral neuropathy (DPN) was significantly higher in patients with vitamin D deficiency than in those with insufficiency or sufficiency (38%, 11.7%, and 10%, respectively; P = .005). In addition, the prevalence of diabetic nephropathy (DN) was significantly higher in women with vitamin D deficiency than in the other 2 groups (40%, 20.6%, and 0%; P = .007). Compared with men in the vitamin D-sufficient group (reference), men in the vitamin D-deficient group had an increased risk of DPN after adjusting for confounding factors (odds ratio, 7.79; 95% confidence interval, 1.52-40.05). For women, when the vitamin D-sufficient group was used as a reference, those in the vitamin D-deficient group had an increased risk of DN after adjusting for confounding factors (odds ratio, 4.27; 95% confidence interval, 1.58-11.56). This present study found that a serum 25(OH)D level less than 10 ng/mL is independently associated with increased DPN in male patients and increased DN in female patients with T2DM.
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Diabetes Mellitus Tipo 2/complicações , Angiopatias Diabéticas/etiologia , Estado Nutricional , Deficiência de Vitamina D/fisiopatologia , 25-Hidroxivitamina D 2/sangue , Idoso , Calcifediol/sangue , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Angiopatias Diabéticas/complicações , Angiopatias Diabéticas/epidemiologia , Nefropatias Diabéticas/complicações , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/etiologia , Retinopatia Diabética/complicações , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/etiologia , Feminino , Hospitais Universitários , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Ambulatório Hospitalar , Prevalência , República da Coreia/epidemiologia , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologiaRESUMO
OBJECTIVE: This study evaluates cardiac autonomic neuropathy and heart rate variability according to the vitamin D status in type 2 diabetes mellitus. METHODS: A total of 163 patients were recruited. Cardiac autonomic neuropathy was assessed using five tests according to Ewing's protocol. The time and frequency domains of the heart rate variability were also evaluated. Patients were separated into three groups: vitamin D sufficient [25(OH)D ⩾ 20 ng/mL], vitamin D insufficient [10 ⩽ 25(OH)D < 20] and vitamin D deficiency [25(OH)D < 10] groups. RESULTS: Both standard deviation of normal-to-normal RR intervals and square root of the average of the sum of the squares of the differences between adjacent NN intervals in the supine position were significantly lower in vitamin D deficient group. Low frequency/high frequency ratio in the upright position was significantly higher in the vitamin D deficient group. 25(OH)D levels are positively correlated with standard deviation of normal-to-normal RR intervals in the supine position. In multivariate logistic analysis, patients with vitamin D levels of 10 < 25(OH)D < 20 ng/mL showed borderline significantly lower cardiac autonomic neuropathy risk than those with 25(OH)D levels <10 ng/mL (odds ratio = 0.45 (0.23-1.01), p = 0.051). CONCLUSION: Vitamin D deficiency was significantly correlated with heart rate variability parameters. However, there was only borderline significant association between vitamin D concentration and presence of cardiac autonomic neuropathy. Therefore, future studies are required to establish a relationship between vitamin D levels and cardiac autonomic neuropathy.
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Diabetes Mellitus Tipo 2/metabolismo , Neuropatias Diabéticas/metabolismo , Coração/fisiopatologia , Vitamina D/metabolismo , Adulto , Idoso , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/fisiopatologia , Neuropatias Diabéticas/fisiopatologia , Eletrocardiografia/métodos , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND AND AIMS: We undertook this study to compare the prevalence of coronary artery calcification (CAC) across glycated hemoglobin A1c (HbA1c) in nondiabetic males and to evaluate the impact of insulin resistance on CAC in relation to HbA1c levels. METHODS: A cross-sectional study was performed in 18,504 adult males without diabetes mellitus and cardiovascular disease (CVD). CAC scores were measured by multidetector computed tomography; CAC was defined as a CAC score >0. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). Subjects were grouped by HbA1c quartile (≤5.4%, 5.4-5.6%, 5.7%, 5.8-6.4%). RESULTS: Thirteen percent of subjects (n = 2,406) had a CAC score >0. The prevalence of CAC increased with increasing HbA1c quartile (9.4%, 11.1%, 14.1%, 17.3%). Crude odds ratios (ORs) for CAC were 1.2, 1.58 and 2.01 for the HbA1c quartiles 2, 3, and 4 when compared with the first quartile. Mean HOMA-IR levels were different among HbA1C categories and CAC status. HOMA-IR levels were higher in subjects with CAC than in those without, except in the third HbA1c quartile. Stratification by HbA1c showed a significant association between CAC and insulin resistance only in the first (OR 1.67) and fourth (OR 1.33) HbA1c quartile. After adjustment for CV risk factors, insulin resistance remained an independent predictor of CAC only in the first HbA1c quartile. CONCLUSIONS: Our study demonstrated that not only glucose status represented by HbA1c but also insulin resistance might be associated with CAC in non-diabetic Korean men. The magnitude of association of CAC with insulin resistance was greater in the lowest HbA1c quartile group.
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Doença da Artéria Coronariana/epidemiologia , Hemoglobinas Glicadas/análise , Resistência à Insulina/fisiologia , Calcificação Vascular/epidemiologia , Adulto , Idoso , Estudos Transversais , Diabetes Mellitus/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , República da Coreia , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
Metastasis to the primary thyroid carcinoma is extremely rare. We report here a case of colonic adenocarcinoma metastasis to medullary thyroid carcinoma in a 53-yr old man with a history of colon cancer. He showed a nodular lesion, suggesting malignancy in the thyroid gland, in a follow-up examination after colon cancer surgery. Fine needle aspiration biopsy (FNAB) of the thyroid gland showed tumor cell clusters, which was suspected to be medullary thyroid carcinoma (MTC). The patient underwent a total thyroidectomy. Using several specific immunohistochemical stains, the patient was diagnosed with colonic adenocarcinoma metastasis to MTC. To the best of our knowledge, the present patient is the first case of colonic adenocarcinoma metastasizing to MTC. Although tumor-tumor metastasis to primary thyroid carcinoma is very rare, we still should consider metastasis to the thyroid gland, when a patient with a history of other malignancy presents with a new thyroid finding.
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Carcinoma Medular/secundário , Neoplasias do Colo/patologia , Segunda Neoplasia Primária/diagnóstico , Neoplasias da Glândula Tireoide/secundário , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Biópsia por Agulha Fina , Carcinoma Medular/diagnóstico , Carcinoma Medular/diagnóstico por imagem , Carcinoma Neuroendócrino , Neoplasias do Colo/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnósticoRESUMO
We investigated the association between microalbuminuria and prediabetes in Korean population using data from the KNHANES 2011-2012. Prevalence of microalbuminuria was significantly increased in prediabetes group. However, the odds ratio became insignificant after adjustment for blood pressure, and the prevalence of microalbuminuria was not increased in prediabetic subjects without hypertension.
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Albuminúria/epidemiologia , Inquéritos Nutricionais/métodos , Estado Pré-Diabético/epidemiologia , Adulto , Albuminúria/complicações , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estado Pré-Diabético/complicações , Prevalência , Prognóstico , República da Coreia/epidemiologia , Estudos RetrospectivosRESUMO
Ligands/surfactants play an important role in the synthesis of anisotropic nanomaterials. Other than site specific binding to the crystal plane, they can also undergo complexation with metal ions, altering the nature of the metal complex. The ligand-metal complex formation could be sufficient to modify the reaction kinetics and could affect the size and morphology of the nanostructures. In this article, we investigated such a change in the metal precursor caused by ligands (i.e., alkyl amines) in the hydrothermal synthesis of Cu nanowires in the presence of glucose as a reducing agent. Comparative studies were carried out with other nitrogen-based surfactants such as cetyl trimethyl ammonium bromide and polyvinyl pyrrolodine. Our experimental results confirmed the complex formation of Cu(2+) ions with alkyl amines and its application for nanowire synthesis. Slow reduction of this complex allows for the generation of twinned seeds, which are later grown into nanowires by consuming newly generated seeds in the presence of excess alkyl amine.
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Recently, environmental-friendly, solution-processed, flexible Cu(In,Ga)(S,Se)2 devices have gained significant interest, primarily because the solution deposition method enables large-scale and low-cost production of photovoltaics, and a flexible substrate can be implemented on uneven surfaces in various applications. Here, we suggest a novel green-chemistry aqueous ink that is readily achievable through the incorporation of molecular precursors in an aqueous medium. A copper formate precursor was introduced to lower the fabrication temperature, provide compatibility with a polyimide plastic substrate, and allow for high photovoltaic performance. Through a comparative spectroscopic study on temperature-dependent chemical/crystal structural evolution, the chemical role of copper formate was elucidated, which led to the chalcopyrite framework that was appropriate to low-temperature annealed Cu(In,Ga)S2 absorber layers at 400 °C. This Cu(In,Ga)S2 solar cell exhibited a power conversion efficiency of 7.04% on a rigid substrate and 5.60% on a polymeric substrate. Our cell on the polymeric substrate also demonstrated both acceptable mechanical flexibility and durability throughout a repeated bending test of 200 cycles.
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BACKGROUND: Whereas visceral abdominal adipose tissue (VAT) is associated with cardiometabolic risk, there is debate regarding the role of subcutaneous abdominal adipose tissue (SAT). The aim of this study was to investigate the relationships of subcutaneous and visceral abdominal fat with carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM). METHODS: A total of 234 patients (men 131, women 103, mean age: 53 years) with T2DM were enrolled. Carotid intima-media thickness (CIMT), abdominal subcutaneous fat thickness (SFT) and visceral fat thickness (VFT) were assessed by high-resolution B-mode ultrasonography (US). RESULTS: Compared to women, men had significantly higher VFT and lower SFT (p = 0.002, p = 0.04, respectively). In partial correlation coefficient analyses between CIMT and abdominal fat thickness after adjustment for body mass index (BMI), SFT showed a negative correlation with CIMT in men (r = -0.27, p = 0.03). VFT was not correlated with CIMT in either men or women. In women, SFT was not correlated with CIMT (r = -0.01, p = 0.93). VFT/SFT ratio was not correlated with CIMT in either men or women. In multivariate regression analyses adjusted for BMI and other CVD risk factors, SFT but not VFT was independently inversely associated with CIMT in men but not in women (p < 0.001). CONCLUSIONS: SFT assessed by US was inversely associated with carotid atherosclerosis in patients with T2DM, particularly men. Further research into the different roles of the two types of abdominal adipose tissue in both men and women is warranted.
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Gordura Abdominal/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Diabetes Mellitus Tipo 2/epidemiologia , Gordura Subcutânea/diagnóstico por imagem , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , UltrassonografiaRESUMO
BACKGROUND: We examined the relationship between central blood pressure (BP), brachial BP with carotid atherosclerosis and microvascular complications in type 2 diabetes mellitus (T2DM). METHODS: We recruited 201 patients who were evaluated for central BP, brachial BP, carotid ultrasonography, brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and microvascular complications. Central BP were calculated using a radial automated tonometric system. RESULTS: Agreement between central BP and brachial BP was very strong (concordance correlation coefficient between central and brachial SBP = 0.889, between central and brachial PP = 0.816). Central pulse pressure (PP) was correlated with mean carotid intima-media thickness (CIMT), baPWV and ABI, whereas brachial PP was borderline significantly correlated with CIMT. The prevalence of nephropathy(DN) and retinopathy(DR) according to the brachial PP tertiles increased, the prevalences of microvascular complications were not different across central PP tertiles. In multivariate analysis, the relative risks (RRs) for the presence of DR were 1.2 and 4.6 for the brachial PP tertiles 2 and 3 when compared with the first tertile. Also, the RRs for the presence of DN were 1.02 and 3 for the brachial PP tertiles 2 and 3 when compared with the first tertile. CONCLUSIONS: Agreement of central BP and brachial BP was very strong. Nonetheless, this study showed that higher brachial PP levels are associated with increased probability for the presence of microvascular complications such as DR/DN. However, there are no associations with central SBP and central PP with microvascular complications. Central BP levels than brachial BP are correlated with surrogate marker of macrovascular complications.
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Pressão Arterial , Artéria Braquial/fisiopatologia , Doenças das Artérias Carótidas/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Angiopatias Diabéticas/epidemiologia , Microcirculação , Índice Tornozelo-Braço , Doenças das Artérias Carótidas/diagnóstico , Doenças das Artérias Carótidas/fisiopatologia , Espessura Intima-Media Carotídea , Distribuição de Qui-Quadrado , Estudos Transversais , Diabetes Mellitus Tipo 2/diagnóstico , Angiopatias Diabéticas/diagnóstico , Angiopatias Diabéticas/fisiopatologia , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/fisiopatologia , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/fisiopatologia , Feminino , Humanos , Modelos Logísticos , Masculino , Manometria , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Valor Preditivo dos Testes , Prevalência , Análise de Onda de Pulso , República da Coreia/epidemiologia , Fatores de RiscoRESUMO
Nonlinear multiphoton absorption induced by focusing near infrared (NIR) femtosecond (fs) laser pulses into a transparent cornea allows surgery on neovascular structures with minimal collateral damage. In this report, we introduce an fs laser-based microsurgery for selective treatment of rat corneal neovascularizations (in vivo). Contiguous tissue effects are achieved by scanning a focused laser pulse below the corneal surface with a fluence range of 2.2-8.6 J/cm(2). The minimal visible laser lesion (MVL) threshold determined over the corneal neovascular structures was found to be 4.3 J/cm(2). Histological and optical coherence tomography examinations of the anterior segment after laser irradiations show localized degeneration of neovascular structures without any unexpected change in adjacent tissues. Furthermore, an approximately 30 % reduction in corneal neovascularizations was observed after 5 days of fs laser exposure. The femtosecond laser is thus a promising tool for minimally invasive intrastromal surgery with the aid of a significantly smaller and more deterministic photodisruptive energy threshold for the interaction between the fs laser pulse and corneal neovascular structures.
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Córnea/irrigação sanguínea , Neovascularização da Córnea/cirurgia , Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Animais , Córnea/patologia , Córnea/cirurgia , Microcirurgia , RatosRESUMO
Solution processing of earth-abundant Cu2ZnSn(S1-x,Sex)4 (CZTSSe) absorber materials is an attractive research area in the economical and large-scale deployment of photovoltaics. Here, a band-gap-graded CZTSSe thin-film solar cell with 7.1% efficiency was developed using non-toxic solvent-based ink without the involvement of complex particle synthesis, highly toxic solvents, or organic additives. Despite the high series resistance due to the presence of a thick Mo(S,Se)x layer and Zn(S,Se) aggregates, a high short-circuit current density (JSC) was generated. In addition, there was no significant difference in open circuit voltages (VOC) between CZTS (0.517 V) and CZTSSe (0.505-0.479 V) cells, despite a significant band gap change from 1.51 eV to 1.24 eV. The high JSC and less loss of VOC are attributed to the effect of band gap grading induced by Se grading in the CZTSSe absorber layer. Our environmentally benign ink approach will enable the realization of low-cost, large-area, high-efficiency thin-film solar cells.
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BACKGROUND: It is not clear whether microangiopathies are associated with subclinical atherosclerosis in type 2 diabetes mellitus (T2DM). We investigated the relation of cardiac autonomic neuropathy (CAN) and other microangiopathies with carotid atherosclerosis in T2DM. METHODS: A total of 131 patients with T2DM were stratified by mean carotid intima-media thickness (CIMT) ≥ or <1.0 mm and the number of carotid plaques. CAN was assessed by the five standard cardiovascular reflex tests according to the Ewing's protocol. CAN was defined as the presence of at least two abnormal tests or an autonomic neuropathy points ≥2. Diabetic microangiopathies were assessed. RESULTS: Patients with CAN comprised 77% of the group with mean CIMT ≥1.0 mm, while they were 29% of the group with CIMT <1.0 mm (P=0.016). Patients with diabetic retinopathy (DR) comprised 68% of the group with CIMT ≥1.0 mm, while they were 28% of the group without CIMT thickening (P=0.003). Patients with CAN comprised 51% of the group with ≥2 carotid plaques, while they were 23% of the group with ≤1 carotid plaque (P=0.014). In multivariable adjusted logistic regression analysis, the patients who presented with CAN showed an odds ratio [OR] of 8.6 (95% confidence interval [CI], 1.6 to 44.8) for CIMT thickening and an OR of 2.9 (95% CI, 1.1 to 7.5) for carotid plaques. Furthermore, patients with DR were 3.8 times (95% CI, 1.4 to 10.2) more likely to have CIMT thickening. CONCLUSION: These results suggest that CAN is associated with carotid atherosclerosis, represented as CIMT and plaques, independent of the traditional cardiovascular risk factors in T2DM. CAN or DR may be a determinant of subclinical atherosclerosis in T2DM.
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STUDY DESIGN: A technical note and a retrospective review of cervical osteotomy using an innovative reduction technique. OBJECTIVE: To present the clinical and radiological outcomes and effectiveness of the sterile-freehand reduction technique for cervical osteotomy. SUMMARY OF BACKGROUD DATA: For a successful osteotomy, controlled reduction of deformity after complete release of bony deformity is the most critical step. Conventional "unscrubbed-scrubbed" manual reduction techniques necessitate multiple releases and retightening of the clamp and are inconvenient for the surgeon to control the force and monitor the surgical field closely. METHODS: A total of 7 consecutive patients (5 male and 2 female; mean age, 52.6 yr) who underwent corrective osteotomy of the fixed cervical kyphosis by a single surgeon were enrolled. Radiographically, C2-C7 sagittal and coronal angle, and the chin-brow vertical angle were measured. In the prone position, the entire head and the Gardner-Wells tong were included in the surgical field, and a sterile rope was connected to a weight through a hole made in the surgical drape. After complete release of bony element and fixation of the caudal part of osteotomy with a prebent lordotic rod, the operator held the tong with right hand and gradually reduced the deformity to place the rod within the screw heads on the cranial part of osteotomy under close visual observation, with the support of the caudal part with left hand. RESULTS.: The type of osteotomy performed was pedicle-subtraction osteotomy in 5 cases and anterior-release-posterior osteotomy in 2 cases. The mean correction angle was 39.7° (28°-63°) on the sagittal plane and 9.3° (0°-16°) on the coronal plane. The mean correction of the chin-brow vertical angle was 37.1° (18°-61°). There was no neurovascular complication. CONCLUSION: Using the sterile-freehand reduction technique, the operator can obtain a safe, controlled reduction with close monitoring of the surgical field. The technique is potentially a simple and effective method to provide stable, 3-dimensional reduction for corrective osteotomies of the cervical spine.
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Vértebras Cervicais/cirurgia , Cifose/cirurgia , Osteotomia/métodos , Adulto , Idoso , Parafusos Ósseos , Feminino , Humanos , Fixadores Internos , Masculino , Pessoa de Meia-Idade , Posicionamento do Paciente , Resultado do TratamentoRESUMO
We propose a design for a highly sensitive biosensor based on nanostructured anodized aluminum oxide (AAO) substrates. A gold-deposited AAO substrate exhibits both optical interference and localized surface plasmon resonance (LSPR). In our sensor, application of these disparate optical properties overcomes problems of limited sensitivity, selectivity, and dynamic range seen in similar biosensors. We fabricated uniform periodic nanopore lattice AAO templates by two-step anodizing and assessed their suitability for application in biosensors by characterizing the change in optical response on addition of biomolecules to the AAO template. To determine the suitability of such structures for biosensing applications, we immobilized a layer of C-reactive protein (CRP) antibody on a gold coating atop an AAO template. We then applied a CRP antigen (Ag) atop the immobilized antibody (Ab) layer. The shift in reflectance is interpreted as being caused by the change in refractive index with membrane thickness. Our results confirm that our proposed AAO-based biosensor is highly selective toward detection of CRP antigen, and can measure a change in CRP antigen concentration of 1 fg/ml. This method can provide a simple, fast, and sensitive analysis for protein detection in real-time.