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Two-dimensional van der Waals heterostructures (2D-vdWHs) based on transition metal dichalcogenides (TMDs) provide unparalleled control over electronic properties. However, the interlayer coupling is challenged by the interfacial misalignment and defects, which hinders a comprehensive understanding of the intertwined electronic orders, especially superconductivity and charge density wave (CDW). Here, by using pressure to regulate the interlayer coupling of non-centrosymmetric 6R-TaS2 vdWHs, we observe an unprecedented phase diagram in TMDs. This phase diagram encompasses successive suppression of the original CDW states from alternating H-layer and T-layer configurations, the emergence and disappearance of a new CDW-like state, and a double superconducting dome induced by different interlayer coupling effects. These results not only illuminate the crucial role of interlayer coupling in shaping the complex phase diagram of TMD systems but also pave a new avenue for the creation of a novel family of bulk heterostructures with customized 2D properties.
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Primary hepatocytes are valuable for studying liver diseases, drug-induced liver injury, and drug metabolism. However, when cultured in a two-dimensional (2D) environment, primary hepatocytes undergo rapid dedifferentiation via an epithelial-mesenchymal transition (EMT) and lose their liver-specific functions. On the other hand, a three-dimensional (3D) culture of primary hepatocyte organoids presents challenges for analyzing cellular functions and molecular behaviors due to strong cell-cell adhesion among heterogeneous cells. In this study, we developed a novel dispersion culture method of hepatocytes within a dome-shaped collagen matrix, overcoming conventional limitations. The expression levels of EMT-related genes were lower in rat primary hepatocytes cultured using this method for 4 d than in cells cultured using the 2D method. Furthermore, albumin production, a marker of liver function, declined sharply in rat primary hepatocytes cultured in two dimensions from 6.40 µg/mL/48 h on day 4 to 1.35 µg/mL/48 h on day 8, and declined gradually from 4.92 µg/mL/48 h on day 8 to 3.89 µg/mL/48 h on day 14 in rat primary hepatocytes cultured using our new method. These findings indicate that the newly developed culture method can suppress EMT and maintain liver functions for 14 d in rat primary hepatocytes, potentially expanding the utility of primary hepatocyte cultured by using conventional 3D methods.
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Colágeno , Transição Epitelial-Mesenquimal , Hepatócitos , Fígado , Animais , Hepatócitos/metabolismo , Transição Epitelial-Mesenquimal/efeitos dos fármacos , Transição Epitelial-Mesenquimal/fisiologia , Células Cultivadas , Colágeno/metabolismo , Masculino , Fígado/metabolismo , Fígado/citologia , Ratos , Técnicas de Cultura de Células/métodos , Ratos Sprague-Dawley , Albuminas/metabolismoRESUMO
PURPOSE: The aim of this study was to investigate the microcirculatory characteristics of the dome-shaped macula (DSM), its complications in highly myopic eyes and to explore the factors associated with a DSM. METHODS: This cross-sectional case-control study included a total of 98 subjects (98 eyes): 49 eyes with DSM and 49 eyes without DSM. The axial length (AL) of the myopic eyes was matched 1:1 to eliminate the effect of AL differences on the results. Choroidal (CT) and scleral thickness (ST) and other structural parameters were assessed by swept-source optical coherence tomography (SS-OCT). OCT angiography was used to measure microcirculatory parameters in highly myopic eyes. RESULTS: Subjects with DSM had thinner subfoveal choroidal thickness (46.01 ± 13.25 vs. 81.62 ± 48.26 µm; p < 0.001), thicker subfoveal scleral thickness (SFST; 331.93 ± 79.87 vs. 238.74 ± 70.96 µm; p < 0.001) and thinner foveal CT (66.86 ± 24.65 vs. 107.85 ± 52.65 µm; p < 0.001) compared to subjects without DSM. The foveal choroidal perfusion area (0.72 ± 0.04 vs. 0.76 ± 0.04 mm2; p < 0.001) and foveal choroidal vascularity index (0.15 ± 0.04 vs. 0.33 ± 0.14; p < 0.001) were significantly lower in eyes with DSM. Retinoschisis (81.6% vs. 38.8%; p < 0.001) was more common in eyes with DSM. Eyes with horizontal DSM had worse best-corrected logMAR visual acuity than eyes with round DSM (0.34 ± 0.22 vs. 0.23 ± 0.22; p = 0.03). DSM height (98.95 ± 65.17 vs. 104.63 ± 44.62 µm; p = 0.05) was lower in the horizontal DSM. SFST (OR = 1.06, p = 0.04) and foveal choroidal vascularity index (OR = 0.711, p = 0.02) were significantly associated with DSM. DSM width (p < 0.001), foveal choroidal perfusion area (p = 0.01), foveal choriocapillaris perfusion area (p = 0.02) and parafoveal choroidal vascularity index (p = 0.03) were the most significantly associated factors with DSM height. CONCLUSIONS: The microcirculatory characteristics of eyes with DSM differed from those without DSM. Microcirculatory abnormalities were significantly associated with a DSM. The height of the DSM was associated with decreased blood perfusion.
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Angiofluoresceinografia , Macula Lutea , Microcirculação , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Masculino , Feminino , Estudos Transversais , Macula Lutea/irrigação sanguínea , Macula Lutea/diagnóstico por imagem , Macula Lutea/patologia , Microcirculação/fisiologia , Estudos de Casos e Controles , Pessoa de Meia-Idade , Adulto , Angiofluoresceinografia/métodos , Acuidade Visual/fisiologia , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/fisiopatologia , Vasos Retinianos/patologia , Miopia Degenerativa/fisiopatologia , Miopia Degenerativa/diagnóstico , Corioide/irrigação sanguínea , Corioide/diagnóstico por imagem , Fundo de OlhoRESUMO
OBJECTIVE: The C3 & C7 dome-hybrid open-door laminoplasty was proven to be an effective treatment for multi-levels cervical spondylotic myelopathy (CSM). However, its superiority over traditional unilateral open-door laminoplasty (UOLP) remains questionable, and no studies have compared the efficacy of this technique with traditional UOLP. This study aimed to compare the effectiveness of C3 & C7 dome-hybrid open-door laminoplasty with traditional UOLP in treating multi-levels CSM. METHODS: A retrospective study of multi-levels CSM with laminoplasty was performed, including 35 cases of traditional UOLP and 27 cases of C3 & C7 dome-hybrid open-door laminoplasty. Radiographic evaluation parameters and clinical outcomes were recorded to evaluate the surgical effectiveness. RESULTS: There was no significant difference in demographic baseline parameters. At the final follow-up, the C2-C7 Cobb angle of the modified group was significantly greater than that of the traditional group (p = 0.026). Meanwhile, the C2-C7 SVA of the modified group was significantly smaller than that of the traditional group (p = 0.009). Clinical outcomes such as VAS, NDI, and SF-12 scores, improved significantly in the modified group compared to the traditional group, while the JOA scores had no significant difference in both groups. There was no significant difference in the overall rate of complications between the two groups. CONCLUSION: Both techniques have satisfactory outcomes in treating multi-levels CSM. Comparing with traditional UOLP, C3 & C7 dome-hybrid open-door laminoplasty has a greater superiority in reducing postoperative neck pain and maintaining the cervical sagittal alignment. It is proven to be a feasible management for patients with multi-levels CSM.
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Laminoplastia , Doenças da Medula Espinal , Humanos , Laminoplastia/métodos , Estudos Retrospectivos , Doenças da Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/cirurgia , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: A successful outcome after total knee arthroplasty (TKA) includes the restoration of patellofemoral function. Modern patella component designs in TKA include a medialized dome and more recently, an anatomic design. There is a paucity of literature comparing these 2 implants. METHODS: This prospective nonrandomized study examined 544 consecutive TKAs with patella resurfacing using a posterior-stabilized, rotating platform knee prothesis performed by a single surgeon. A medialized dome patella design was used in the first 323 cases and an anatomic design in the subsequent 221 cases. Patients were assessed preoperatively, at 4 weeks and 1-year post-TKA for Oxford Knee Score (OKS) (total, pain, and kneeling components) and range of movement (ROM). Radiolucent lines (RLLs), patellar tilts and displacements, as well as reoperations were assessed at 1-year post-TKA. RESULTS: At 1-year post-TKA, both groups demonstrated similar improvements in ROM, OKS, pain, and kneeling scores, and had a similar incidence of fixed-flexion deformity (all P > .05). Radiographically, there was no clinically significant difference in the incidence of RLLs, patellar tilts, and displacements. The prevalence of reoperations (1.8 versus 3.2%, P = .526) was similar between the designs with no patella-related complications. CONCLUSION: Both medialized dome and anatomic patella designs result in improved ROM and OKS with no patella-related complications. However, our study showed no differences between the designs at 1 year.
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Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Humanos , Patela/cirurgia , Estudos Prospectivos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Dor/cirurgia , Resultado do Tratamento , Osteoartrite do Joelho/cirurgiaRESUMO
BACKGROUND: Anatomic patellar components for total knee arthroplasty (TKA) have demonstrated favorable in vivo kinematics. A novel failure mechanism in TKA patients with an anatomic patellar component was observed prompting an investigation to identify patient- and implant-related factors associated with suboptimal performance. METHODS: A retrospective evaluation was performed comparing 100 TKA patients with an anatomic patellar component to 100 gender-, age-, and body mass index-matched patients with a medialized dome component. All surgeries were performed with the same posterior-stabilized TKA system with minimum of 1-year follow-up. Several radiographic parameters were assessed. A separate computational evaluation was performed using finite-element analysis, comparing bone strain energy density through the patella bone remnant. RESULTS: Patients with an anatomic patellar component had significantly higher rates of anterior knee pain (18 versus 2%, P < .001), chronic effusions (18 versus 2%, P < .001), and superior patellar pole fragmentation (36 versus 13%, P < .001) compared to those with a dome component. Radiographically, the anatomic group demonstrated more lateral patellar subluxation (2.3 versus 1.1 mm, P < .001) and lateral tilt (5.4 versus 4.0 mm, P = .013). Furthermore, there were more revisions in the anatomic group (7 versus 3, P = .331). On computational evaluation, all simulations demonstrated increased bone strain energy density at the superior patellar pole with the anatomic patella. Resection thickness <13 mm resulted in over 2-fold higher strain energy density, and negative resection angle of 7° resulted in 6-fold higher superior pole strain energy. CONCLUSIONS: Patients with an anatomic patellar component showed higher rates of anterior knee pain, chronic effusion, and superior pole fragmentation compared to patients with a dome patella, with higher superior patellar pole strain energy confirmed on computational evaluation. Avoiding higher resection angles and excessive patellar resection may improve the performance and survivorship of the anatomic patella.
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Artroplastia do Joelho , Prótese do Joelho , Patela , Humanos , Feminino , Masculino , Artroplastia do Joelho/métodos , Estudos Retrospectivos , Idoso , Patela/cirurgia , Patela/diagnóstico por imagem , Pessoa de Meia-Idade , Radiografia , Fenômenos Biomecânicos , Análise de Elementos Finitos , Articulação do Joelho/cirurgia , Articulação do Joelho/diagnóstico por imagem , Desenho de Prótese , Falha de PróteseRESUMO
The focal dome osteotomy allows deformity correction through frontal plane rotation, and if needed, anterior or posterior translation. This percutaneous technique allows extracapsular ankle realignment with minimal soft tissue dissection. While circumventing a standard anterior incision, this technique encounters soft tissue structures that must be considered. Focal dome osteotomies were simulated on 10 fresh-frozen below the knee cadavers. Centered proximal to the tibial plafond at the physeal scar, a radial arm using a 4-hole Rancho cube was used to map the dome. Medial, lateral, and central incisions were made to allow access for drilling and measured to nearby anatomic structures. Among 10 cadavers, the age and weight were 70 ± 7.96 years and 134.7 ± 30.8 pounds, respectively. In all cadavers, the hole below the most proximal posthole provided the ideal position for the creation of the osteotomy. The medial and central incisions were closest to the tibialis anterior tendon measuring 3.37 ± 2.48 mm and 0.43 ± 0.9 mm, respectively. The lateral incision and half-pin used to create the distal axis of rotation were closest to the extensor hallucis longus tendon, measuring 1.97 ± 1.92 mm and 1.27 ± 1.5 mm, respectively. Drilling the second hole from the top on a 4-hole Rancho cube, forming a 2.50 cm radial arm, created the ideal osteotomy arc. Though neurovascular structures were further away from respective incision and half-pin sites compared to tendons, in several specimens, anatomic variations held them closer, warranting preoperative handheld Doppler and mapping. Care should be taken to protect anterior ankle anatomy during dissection, drilling, and completing the osteotomy.
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Articulação do Joelho , Joelho , Humanos , Articulação do Joelho/cirurgia , Joelho/cirurgia , Tíbia/cirurgia , Osteotomia/métodos , CadáverRESUMO
Biowaste generation is considerably increasing multiple times recently due to various social and environmental changes like population growth, economic prosperity, globalisation etc. they contain different composition and generated at different stages of their life cycle. Though studies reported for recycle, reproduce and reuse of them, this investigation is unique by focussing to investigate the ideal circumstances for the production of biogas and methane from anaerobic digestion of vegetable waste using response surface methods and artificial neural networks with thermophilic temperature range. Thermophilic temperature of 20.78, organic loading rate of 0.2, pH of 8.81, agitation time of 5.8 and hydro retention time of 3 are the ideal input parameter values for the generation of biogas 3.03 m3 and methane% 186.08 with a desirability of 1. The Response surface model was surpassed by the Artificial Neural Network model.
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Biocombustíveis , Metano , Anaerobiose , Temperatura , Redes Neurais de Computação , Reatores BiológicosRESUMO
PURPOSE: To evaluate the characteristics of dome-shaped macula (DSM) in children aged 4-6 years with normal visual acuity using optical coherence tomography angiography. METHOD: This is a cross-sectional study. A total of 19 children aged 4-6 years were included. The results of optical coherence tomography angiography images were analysed to identify and quantify retinal structural and vascular parameters in DSM children. The dome height, dome base, and sub-dome choroidal thickness were manually measured. Participants with DSM and those without DSM from our previous study were compared on these parameters. RESULTS: Nineteen eyes of the preschool subjects with normal visual acuity showed horizontal DSM on optical coherence tomography (OCT). The DSM was significantly smooth and low in the children, and we did not observe differences between sex and age. Compared to the children without DSM, the average axial length was longer, and the average macular vessel density was lower in the DSM group, especially in the deep retinal vascular density. Additionally, the dome height was positively correlated with the sub-dome choroidal thickness. When the dome base/height was increased, the fovea avascular zone (FAZ) area was larger. CONCLUSION: Dome-shaped macula was detected in the preschool children in the process of the emmetropization with normal visual acuity. The changes in macular structure and vasculature provide new ideas for further investigation into the characteristics of DSM formation.
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Macula Lutea , Tomografia de Coerência Óptica , Humanos , Pré-Escolar , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Estudos Transversais , População do Leste Asiático , Estudos Retrospectivos , Angiofluoresceinografia/métodosRESUMO
INTRODUCTION: The aim of this study was to analyze the atrophic, tractional, and neovascular (ATN) components grading in highly myopic patients with dome-shaped macula (DSM) and ridge-shaped macula (RSM). METHODS: This was a cross-sectional, noninterventional study. 57 eyes of 38 different patients were included. They were classified as DSM or RSM based on the number of radial scans that showed an inward protrusion ≥50 µm in the swept-source optical coherence tomography (SS-OCT) (12 = DSM; <12 = RSM). All patients underwent a complete ophthalmological examination in addition to SS-OCT. They were graded using the ATN system for myopic maculopathy by 2 masked retina specialists that assessed the atrophic (A), tractional (T), and neovascular (N) components in order to analyze the differences between the groups. As complementary measurements, age, axial length, and best-corrected visual acuity were collected. Height and orientation of the macular bulge and the presence of Bruch's membrane defects, scleral perforating vessels, and staphyloma were recorded. RESULTS: Out of total 57 eyes, 13 eyes (22.8%) were classified as DSM. Regarding the atrophic component (A), there were statistically significant differences between groups, with DSM group showing a greater stage of atrophy (predominantly stage A3 in 69.2% of the sample) compared to the RSM group (predominantly stage A2 in 61.3% of the sample) (p < 0.05). For the T and N components, there were no significant differences between groups. The presence of Bruch's membrane defects was more frequently seen in DSM (p < 0.05). CONCLUSIONS: DSM group showed more Bruch's membrane defects and a greater stage of the atrophy component, based on the ATN grading system, compared with RSM group. As Bruch's membrane may have biomechanical properties in terms of strength, the defects found around the macula, added to the major atrophic component, may be a cause of a local relaxation that induce a central bulge forming the dome.
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Macula Lutea , Miopia Degenerativa , Miopia , Doenças Retinianas , Humanos , Estudos Transversais , Estudos Retrospectivos , Miopia/diagnóstico , Miopia/patologia , Doenças Retinianas/diagnóstico , Macula Lutea/patologia , Tomografia de Coerência Óptica/métodos , Atrofia , Miopia Degenerativa/complicações , Miopia Degenerativa/diagnósticoRESUMO
BACKGROUND: Acetabular dome impaction fractures (ADIF) are difficult to reduce and have a high failure rate. Consistency between the acetabulum and the femoral head is usually assessed using intraoperative X-ray fluoroscopy to evaluate the quality of fracture reduction. This study examines the effects of intraoperative mobile 2D/3DX imaging system (O-arm) on the reduction quality and functional recovery of ADIF. METHODS: We retrospectively analysed the data of 48 patients with ADIF treated at Honghui Hospital between October 2018 and October 2021.The patients were divided into the X-ray and O-arm groups. The residual step-off and gap displacements in the acetabular dome region were measured, and fracture reduction quality was evaluated. Hip function was evaluated using the modified Merle d'Aubigné and Postel scoring systems. RESULTS: There were no significant intergroup differences in the preoperative general data (p > 0.05). The mean residual average step displacement in the acetabular dome region was 3.48 ± 2.43 mm and 1.61 ± 1.16 mm (p < 0.05), while the mean gap displacement was 6.72 ± 3.69 mm and 3.83 ± 1.67 mm (p < 0.05) in the X-ray and the O-arm groups, respectively. In the X-ray group, according to the fracture reduction criteria described by Verbeek and Moed et al., one case was excellent, 13 cases were good, 11 cases were poor; 56% were excellent or good. In the O-arm group, seven cases were excellent, 12 cases were good, and four cases were poor; overall in this group, 82.6% were excellent or good (p < 0.05). A total of 46 patients achieved fracture healing at the last follow-up. In the X-ray group, according to the modified Merle d'Aubigné and Postel function score, three cases were excellent,12 cases were good, six cases were middle, three cases were poor; 62.5% were excellent or good, In the O-arm group, 15 cases were excellent, four cases were good, two cases were middle, one case was poor; 86.4% were excellent or good (p < 0.05). CONCLUSIONS: The application of O-arm in ADIF can improve fracture reduction quality and functional recovery.
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Fraturas Ósseas , Fraturas do Quadril , Fraturas da Coluna Vertebral , Cirurgia Assistida por Computador , Humanos , Estudos Retrospectivos , Imageamento Tridimensional , Resultado do Tratamento , Tomografia Computadorizada por Raios X , Fraturas do Quadril/cirurgia , Acetábulo/diagnóstico por imagem , Acetábulo/cirurgia , Acetábulo/lesões , Fraturas Ósseas/cirurgia , Fixação Interna de Fraturas/métodosRESUMO
BACKGROUND: Various patellar designs are used in total knee arthroplasty (TKA) for optimal management of patellofemoral pain. The aim of this study was to compare postoperative 2-year clinical outcomes of 3 patellar designs: medialized anatomic (MA), medialized dome (MD), and Gaussian dome (GD). METHODS: In this randomized controlled trial, 153 patients undergoing primary TKA from 2015 to 2019 were enrolled. Patients were allocated to 3 groups (MA, MD, and GD). Demographic characteristics, clinical variables including knee flexion angle and patient-reported outcome measures (Kujala score, Knee Society Scores, the Hospital for Special Surgery score, and The Western Ontario and McMaster Universities Arthritis Index), and complications were collected. Radiologic parameters including Blackburne-Peel ratio and patellar tilt angle (PTA) were measured. A total of 139 patients who completed postoperative follow-up for 2 years were analyzed. RESULTS: Knee flexion angle and patient-reported outcome measures did not statistically differ among the 3 groups (MA, MD, and GD). There were no extensor mechanism-related complications at any group. Group MA showed significantly higher mean values of postoperative PTA than group GD (0.1 ± 3.2 versus -1.8 ± 3.4, P = .011). Group GD (20.8%) had a tendency to have more outliers (over 5 degrees) in PTA than groups MA (10.6%) and MD (4.5%), although the differences were not statistically significant (P = .092). CONCLUSION: Anatomic patellar design was not clinically superior over dome design in TKA, showing comparable results in terms of clinical scores, complications, and radiographic indices.
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Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Humanos , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/métodos , Articulação do Joelho/cirurgia , Resultado do Tratamento , Patela/cirurgia , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento ArticularRESUMO
Volcanism is an important geological evolutionary process on the Moon. The study of lunar volcanic features is of great significance and value to understanding the geological evolution of the Moon better. Lunar domes are one of the essential volcanic features of the Moon. However, the existing lunar dome detection methods are still traditional manual or semiautomatic identification approaches that require extensive prior knowledge and have a complex identification process. Therefore, this paper proposes an automatic detection method based on improved YOLOv7 for lunar dome detection. First, a new lunar dome dataset was created by digital elevation model (DEM) data, and the effective squeeze and excitation (ESE) attention mechanism module was added to the backbone and neck sections to reduce information loss in the feature map and enhance network expressiveness. Then, a new SPPCSPC-RFE module was proposed by adding the receptive field enhancement (RFE) module into the neck section, which can adapt to dome feature maps of different shapes and sizes. Finally, the bounding box regression loss function complete IOU (CIOU) was replaced by wise IOU (WIOU). The WIOU loss function improved the model's performance for the dome detection effect. Furthermore, this study combined several data enhancement strategies to improve the robustness of the network. To evaluate the performance of the proposed model, we conducted several experiments using the dome dataset developed in this study. The experimental results indicate that the improved method outperforms related methods with a mean average precision (mAP@0.5) value of 88.7%, precision (P) value of 85.6%, and recall (R) value of 86.4%. This study provides an effective solution for lunar dome detection.
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We used an ultrasensitive, broadband optomechanical ultrasound sensor to study the acoustic signals produced by pressurized nitrogen escaping from a variety of small syringes. Harmonically related jet tones extending into the MHz region were observed for a certain range of flow (i.e., Reynolds number), which is in qualitative agreement with historical studies on gas jets emitted from pipes and orifices of much larger dimensions. For higher turbulent flow rates, we observed broadband ultrasonic emission in the ~0-5 MHz range, which was likely limited on the upper end due to attenuation in air. These observations are made possible by the broadband, ultrasensitive response (for air-coupled ultrasound) of our optomechanical devices. Aside from being of theoretical interest, our results could have practical implications for the non-contact monitoring and detection of early-stage leaks in pressured fluid systems.
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Seringas , Ultrassom , UltrassonografiaRESUMO
The results of conventional corrective procedures remain suboptimal for severe cubitus varus deformities (> 30°) in children. We present the results of shortening dome osteotomy for the correction of such deformities. PATIENTS AND METHODS: We present retrospective review of prospectively collected data of 18 patients (11 boys and 7 girls) who underwent shortening dome osteotomy between January 2011 and December 2019 for severe cubitus varus deformities (> 30°) secondary to malunited supracondylar fracture. The procedure involved the removal of convexo-concave bone (5-8 mm wide) between the two domes. Humero-ulnar angles, lateral condylar prominence index (LCPI), and elbow range of movements were recorded preoperatively and postoperatively. RESULTS: Mean age was 7.5 years (range 5 years-11 years). Indication for surgery was poor cosmesis in all the patients and tardy ulnar nerve symptoms in three patients. Mean preoperative humero-ulnar angle was 26.1° varus (range 22°-34°), while it was 7.1° valgus (range 0°-12°) for contralateral normal elbow. They were followed for a mean duration of 2.2 years (range 12 months-5.8 years). The mean postoperative valgus angle achieved was 7.3° (range 2°-12°) as total angular correction achieved was 34.4° (range 30°-44°) (p < 0.001). Radiological healing was observed in all the patients at mean duration of 7.1 weeks (range 5 weeks-9 weeks). Mean preoperative and postoperative LCPI were - 2.4 (range +4.7 to - 10.5) and - 1.7 (range +4.5 to - 5.1), respectively (p = 0.595). Three patients had pin tract infections and two of them responded to aseptic dressings and oral antibiotics, while another required early pin removal and additional protection in splint. All patients regained preoperative arc of motion within 6 months after the procedure. CONCLUSION: Shortening dome osteotomy is a safe and effective method for correcting severe cubitus varus deformities (> 30°) secondary to malunited supracondylar fracture in children.
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Articulação do Cotovelo , Fraturas Mal-Unidas , Fraturas do Úmero , Deformidades Articulares Adquiridas , Masculino , Feminino , Humanos , Criança , Pré-Escolar , Fraturas do Úmero/cirurgia , Resultado do Tratamento , Deformidades Articulares Adquiridas/complicações , Deformidades Articulares Adquiridas/cirurgia , Amplitude de Movimento Articular/fisiologia , Articulação do Cotovelo/cirurgia , Osteotomia/métodos , Fraturas Mal-Unidas/diagnósticoRESUMO
BACKGROUND: Dome-shaped supramalleolar osteotomies are a well-established treatment option for correcting ankle deformity. However, the procedure remains technically demanding and is limited by a two-dimensional (2D) radiographic planning of a three-dimensional (3D) deformity. Therefore, we implemented a weight-bearing CT (WBCT) to plan a 3D deformity correction using patient-specific guides. METHODS: A 3D-guided dome-shaped supramalleolar osteotomy was performed to correct ankle varus deformity in a case series of five patients with a mean age of 53.8 years (range 47-58). WBCT images were obtained to generate 3D models, which enabled a deformity correction using patient-specific guides. These technical steps are outlined and associated with a retrospective analysis of the clinical outcome using the EFAS score, Foot and Ankle Outcome Score (FAOS) and visual analog pain scale (VAS). Radiographic assessment was performed using the tibial anterior surface angle (TAS), tibiotalar angle (TTS), talar tilt angle (TTA), hindfoot angle (HA), tibial lateral surface angle (TLS) and tibial rotation angle (TRA). RESULTS: The mean follow-up was 40.8 months (range 8-65) and all patients showed improvements in the EFAS score, FAOS and VAS (p < 0.05). A 3-month postoperative WBCT confirmed healing of the osteotomy site and radiographic improvement of the TAS, TTS and HA (p < 0.05), but the TTA and TRA did not change significantly (p > 0.05). CONCLUSION: Dome-shaped supramalleolar osteotomies using 3D-printed guides designed on WBCT are a valuable option in correcting ankle varus deformity and have the potential to mitigate the technical drawbacks of free-hand osteotomies. LEVEL OF EVIDENCE: Level 5 case series.
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At the initial stage of carcinogenesis, oncogenic transformation occurs in single cells within epithelial layers. However, the behavior and fate of the newly emerging transformed cells remain enigmatic. Here, using originally established mouse models, we investigate the fate of RasV12-transformed cells that appear in a mosaic manner within epithelial tissues. In the lung bronchial epithelium, most majority of RasV12-transformed cells are apically extruded, whereas noneliminated RasV12 cells are often basally delaminated leading to various noncell-autonomous changes in surrounding environments; macrophages and activated fibroblasts are accumulated, and normal epithelial cells overlying RasV12 cells overproliferate and form a convex multilayer, which is termed a 'dome-like structure'. In addition, basally extruded RasV12 cells acquire certain features of epithelial-mesenchymal transition (EMT). Furthermore, the expression of COX-2 is profoundly elevated in RasV12 cells in dome-like structures, and treatment with the COX inhibitor ibuprofen suppresses the recruitment of activated fibroblasts and moderately diminishes the formation of dome-like structures. Therefore, basal extrusion of single-oncogenic mutant cells can induce a tumor microenvironment and EMT and generate characteristic precancerous lesions, providing molecular insights into the earlier steps of cancer development.
Assuntos
Transformação Celular Neoplásica , Células Epiteliais , Cães , Camundongos , Animais , Células Madin Darby de Rim Canino , Células Epiteliais/patologia , Transformação Celular Neoplásica/metabolismo , Epitélio/metabolismo , Oncogenes , Microambiente TumoralRESUMO
OBJECTIVE: Tarsal coalition is known to cause abnormal talocrural stress, hindfoot malalignment, and ankle sprains. These can all be associated with osteochondritis dissecans (OCD) of the talar dome. We present the first detailed description of a series of talar OCDs occurring in patients with tarsal coalition, with the goal of determining whether there is an increased prevalence of OCDs among patients with tarsal coalition. MATERIALS AND METHODS: We studied ankle MRIs in 57 patients with tarsal coalitions, excluding those with a reported inciting traumatic event. The MRIs were performed on magnetic field strengths ranging from 0.3 to 1.5 T and included axial, coronal, and sagittal T1 and T2 or PD fat-suppressed sequences. We evaluated the morphology and location of classically described OCDs in these patients, type and location of concomitant tarsal coalition, and, when available, the presence of pes planus and hindfoot valgus on weight-bearing radiographs. Chi-squared analysis was used to compare categorical variables and a Student's t test was used for parametric continuous variables. Additionally, logistic regression was used to compute the odds ratio of talar OCD associated with patient age, gender, laterality, pes planus status, hindfoot valgus status, and coalition type. RESULTS: Eighty-nine percent of tarsal coalitions were non-osseous coalitions and the calcaneonavicular space was the most common site of abnormal tarsal connection (54.4%). In the 29 patients with tarsal coalitions and talar OCDs, OCDs commonly occurred medially (75.9%). In the sagittal plane, talar OCDs occurred centrally, with only one case sparing the central talar dome. The mean surface area of the 29 OCDs was 89.7 mm2. Both osseous coalition and hindfoot valgus were associated with smaller talar OCD mean surface area (p = 0.015 and p = 0.0001, respectively). There was no association between depth and surface area of talar OCD with either coalition location or presence of pes planus (coalition location: p = 0.455 for depth and p = 0.295 for surface area; presence of pes planus: p = 0.593 for depth and p = 0.367 for surface area). CONCLUSION: Talar OCD prevalence is higher in patients with tarsal coalition than that reported for the general population. This occurrence may relate to altered biomechanics and repetitive talocrural stress owing to altered subtalar motion, particularly given the findings of increased odds of talar OCD in older patients, as well as weak associations between OCD surface area and both non-osseous coalition and hindfoot alignment. However, we did not find any specific OCD morphologic features attributable to the precise location of the tarsal coalition.
Assuntos
Pé Chato , Osteocondrite Dissecante , Ossos do Tarso , Coalizão Tarsal , Idoso , Pé Chato/diagnóstico por imagem , Pé Chato/epidemiologia , Humanos , Imageamento por Ressonância Magnética , Osteocondrite Dissecante/diagnóstico por imagem , Osteocondrite Dissecante/epidemiologia , Radiografia , Ossos do Tarso/diagnóstico por imagem , Coalizão Tarsal/diagnóstico por imagemRESUMO
The main geological structures in the Dammam Dome are defined by integrating geophysical measurements and applying new methodological approaches. Dammam Dome is characterized by a well-developed fracture/joints system; thus, high complexity of the subsurface is expected. Direct Current Resistivity (DCR) and Seismic Refraction (SR) geophysical survey aimed to map the Dammam Dome's near-surface features. The geophysical data were acquired along two profiles in the northern part of Dammam Dome. To maximize the results from conducting DCR and SR measurements over a complex area, a combined local and global optimization algorithm was used to obtain high-resolution near-surface images in resistivity and velocity models. The local optimization technique involves individual and joint inversion of the DCR and SR data incorporating appropriate regularization parameters, while the global optimization uses single and multi-objective genetic algorithms in model parameter estimation. The combined algorithm uses the output from the local optimization method to define a search space for the global optimization algorithm. The results show that the local optimization produces satisfactory inverted models, and that the global optimization algorithm improves the local optimization results. The joint inversion and processing of the acquired data identified two major faults and a deformed zone with an almost N-S direction that corresponds with an outcrop were mapped in profile one, while profile two shows similar anomalies in both the resistivity and velocity models with the main E-W direction. This study not only demonstrates the capability of using the combined local and global optimization multi-objectives techniques to estimate model parameters of large datasets (i.e., 2D DCR and SR data), but also provides high-resolution subsurface images that can be used to study structural features of the Dammam Dome.
Assuntos
Fraturas Ósseas , Refração Ocular , Humanos , Eletricidade , Algoritmos , GeologiaRESUMO
The objective of this study is to design the hull-mounted sonar dome of a ship. The goal is to reduce the ship total resistance and improve the flow field around the sonar dome for the ship design speed. OpenFOAM 6 was applied to analyze the viscous flow around the ship bow and then optimize the sonar dome geometry. The length, width and depth of the original geometry were maintained. Only the local geometry was fine-tuned considering the back slope and front tip by using Rhinoceros 6. The verification and validation was performed for the original hull form against towing tank resistance data. The grid independence was checked for the optimal design in different design stages. To ensure less influence on the interior equipment installation and to be able to re-use the non-steel dome part, the best resistance reduction is almost 2%. With a larger allowance of shape deformation, the maximal reduction could reach slightly higher than 3%. The flow field is improved for smaller flow separation and vortex, and less fluid nose in sonar detection is expected. The main reason of the resistance reduction is the decrease of the pressure component. In conclusion, a sonar dome design procedure is proposed, and an optimal geometry is suggested.