Validity of measurement of femoral anteversion angle using FEMORA® software based on two-dimensional radiographic imaging examination femur in children with cerebral palsy in Indonesia.

Introduction: Children with spastic cerebral palsy (CP) often show an increase in femoral anteversion angle (FAA). Computed tomography (CT) scan is the main modality for evaluating FAA in these patients, however, due to significant radiation exposure, it carries a high carcinogenic risk. FEMORA® software is expected to be able to accurately assess FAA even with conventional X-ray images that only require low radiation exposure. However, its validity has not been tested in various populations or CT devices. This study aimed to validate the FEMORA® software by comparing it to CT scans done on an Indonesian population. Material and methods: All spastic CP patients of the outpatient clinic at Dr. Soetomo Hospital between March and November 2022, were included. The FEMORA® Software evaluation was performed by three examiners. The calculation results were averaged and compared with those of the CT scan. Intraclass correlation coefficient (ICC), reliability, and correlation were be assessed. Results: There were 36 patients included in this study. Most were female (n = 22; 61,1 %) and the average age was 7,28 years old. Interobserver preoperative analysis using ICC showed good outcomes (p = 0.918; 95 % CI, 0.858-0.955). FAA measurement results using FEMORA® and CT scans were 41,71 ± 12,90 and 32,68 ± 11,85, respectively. Correlation coefficient between the two values is 0.634 (p < 0.001). Conclusion: FEMORA® software demonstrates a good and significant correlation with FAA measurement using CT scan.

The enhancement apoptosis of osteosarcoma mesenchymal stem cells co-cultivation with peripheral blood mononuclear cells sensitized by secretome and granulocyte macrophage colony-stimulating factor.

The advanced, metastasis, and reccurent of osteosarcoma (OS) patients have a poor prognosis postaggresive surgery and chemotherapy. Peripheral blood mononuclear cells (PBMCs) as cell-based immunotherapy may successful in the OS treatment. To investigate the enhancement apoptosis of OS-mesenchymal stem cells (OS-MSCs) co-cultivated with PBMCs sensitized using the secretome and granulocyte macrophage colony-stimulating factor (GMCSF). This true experimental study with posttest only control group design and in vitro study. The sample was cultured OS-MSCs which confirmed by Cluster of Differentiation-133 using immunocytochemistry (ICC) and histopathology analysis. The sample divided into six groups accordingly: OS-MSC, OS-MSC + PMBC, OS-MSC + PMBC + Secretome, OS-MSC + PMBC + GMCSF, OS-MSC + PBMC + Secretome + GMCSF (n = 5/N = 30). The enhancement of OS-MSCs apoptosis was analyzed through Interleukin-2 (IL-2) level through the Enyzme-Linked Immunosorbent Assay examination, expression of Signal Transducers and Activators of Transcription (STAT)-3 and caspase-3 by ICC. One-way analysis of variance test and Tukey Honestly Significant Difference to analyze the difference between the groups (P < 0.05). The highest of IL-2 level was found in the PBMC + Secretome + GMCSF group. The highest expression of caspase-3 was found in OS-MSC + PBMC + Secretome + GMCSF group with significant different between groups (P < 0.05). There was insignificant difference of STAT-3 epxression and IL-2 level between groups (P > 0.05). The co-cultivation of OS-MSCs and PBMSCs activated using secretome and GMCSF has a great ability to enhance OS-MSCs apoptosis.