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Spinal curves showed a significant correlation between bending radiographs and recumbent images (CTS). In our group of patients, a Cobb angle of the minor curve of less than 35 degrees in the CTS indicated that this minor curve was non-structural.
Spinal curves showed a significant correlation between bending radiographs and recumbent images (CTS). In our group of patients, a Cobb angle of the minor curve of less than 35 degrees in the CTS indicated that this minor curve was non-structural.
Previous studies only investigated the simple linear relationships of global tilt (GT) with thoracic kyphosis (TK), lumbar lordosis (LL) and pelvic incidence (PI). This study aimed to establish multiple linear regressions of GT based on individual TK, LL and PI in patients with degenerative spines.
Four hundred sixty-nine adult patients aged older than 35years with various degenerative spinal diseases were enrolled in this two-centre study between January 2017 and December 2020. Full-spine X-rays were performed for all the subjects in a standing position. The following regional and global parameters were measured in the sagittal plane TK, LL, PI, pelvic tilt (PT), sagittal vertical axis (SVA) and GT. The correlations of the GT, PT and SVA with the TK, LL and PI were analysed, and then multiple linear regressions were constructed.
GT was statistically correlated with TK, LL and PI. Additionally, TK, LL and PI were significant predictors for the GT, PT and SVA models. The relevant predictive formulae were as follows GT = -9.60 + 1.09*PI + 0.89*LL + 0.42*TK (R
= 0.935), PT = -4.49 + 0.81*PI + 0.56*LL + 0.24*TK (R
= 0.792) and SVA = -25.68 + 2.98*LL + 2.37*PI + 1.67*TK (R
= 0.416).
The specific sagittal spinopelvic morphology, evaluated by GT parameters, should be determined by individual TK, LL and PI values in the degenerative spine. Surgeons can utilize such predictive models to better understand the degenerative evolution of sagittal alignment and recognize the relationships between regional parameters and global sagittal alignment to customize a precise correction strategy.
The specific sagittal spinopelvic morphology, evaluated by GT parameters, should be determined by individual TK, LL and PI values in the degenerative spine. Surgeons can utilize such predictive models to better understand the degenerative evolution of sagittal alignment and recognize the relationships between regional parameters and global sagittal alignment to customize a precise correction strategy.The family Genomoviridae (phylum Cressdnaviricota, class Repensiviricetes, order Geplafuvirales) includes viruses with circular single-stranded DNA genomes encoding two proteins, the capsid protein and the rolling-circle replication initiation protein. The genomes of the vast majority of members in this family have been sequenced directly from diverse environmental or animal- and plant-associated samples, but two genomoviruses have been identified infecting fungi. Since the last taxonomic update of the Genomoviridae, a number of new members of this family have been sequenced. Here, we report on the most recent taxonomic update, including the creation of one new genus, Gemytripvirus, and classification of ~420 new genomoviruses into 164 new species. We also announce the adoption of the "Genus + freeform epithet" binomial system for the naming of all 236 officially recognized species in the family Genomoviridae. The updated taxonomy presented in this article has been accepted by the International Committee on Taxonomy of Viruses (ICTV).
Laparoscopic anatomic liver resection is technically demanding, given the need to safely isolate the Glissonean pedicles and expose the hepatic veins (HVs) on the liver parenchyma cut surface. Laennec's capsule is observed around the Glissonean pedicles and root of the HVs. However, its existence, particularly on the peripheral side of the HVs, remains controversial. Herein, we describe Laennec's capsule-related histopathological findings around the HVs and a safe laparoscopic left medial sectionectomy utilizing Laennec's capsule.
The extrahepatic Glissonean approach was performed by connecting Gates II and III, in accordance with Sugioka's Gate theory. Liver parenchymal transection commenced along the demarcation line,which is between the medial and lateral sections, and the G4 was dissected during transection. Subsequently, via the outer-Laennec approach, the middle hepatic vein (MHV) was exposed from the root side in cranial view, while Laennec's capsule was preserved. Parenchymal transection was completed while connecting the MHV with the demarcation line. We obtained the membrane surrounding the HVs and performed histopathological examinations.
Six patients underwent laparoscopic left medial sectionectomy from February 2012 to November 2020. There were no cases involving complications (Clavien-Dindo classification; grade II or higher), open-surgery conversion, transfusion, or surgery-related death. The histopathological findings showed Laennec's capsule surrounding both the trunk of the major HVs and the peripheral side of the HVs.
A cranial approach to the major HVs utilizing Laennec's capsule is a feasible and advantageous procedure for laparoscopic left medial sectionectomy. We propose that Laennec's capsule surrounds the entire length of the HVs.
A cranial approach to the major HVs utilizing Laennec's capsule is a feasible and advantageous procedure for laparoscopic left medial sectionectomy. We propose that Laennec's capsule surrounds the entire length of the HVs.We described a technique of a post-process stage to partially remove the poly(vinyl alcohol) (PVA) binder in Poly(lactic-co-glycolic acid) (PLGA) dental scaffolds. The scaffolds were exposed to ultrasonic waves while immersed in an ethanol/acetone solvent mixture that possessed both polar and nonpolar properties. A factorial experiment was conducted in which the scaffolds were treated to three levels of sonication power (pW) 0, 20% (22 W) and 40% (44 W), and soaking duration (t) 5, 15, and 30 min. The treated scaffolds were characterized by FT-IR, optical microscopy, and mechanical (compressive) testing. FT-IR revealed that the amount of PVA decreased with increasing pW and t. Two-way ANOVA revealed that increasing pW and t, respectively, resulted in increasing scaffold surface area to volume (SVR). Sonication and solvent caused structural damage (i.e., unevenness) on the scaffold surface, but the damage was minimal at 20% pW and 30 min. The optimal values of pW and t resulting in enhanced fracture strength, strain and toughness were 20% and 30 min, respectively, which corroborated the findings of minimal structural damage. However, sonication had no significant effects on the scaffold stiffness. Mechanistic analysis of the effects of sonication predicted that the ultrasonic energy absorbed by the scaffold was sufficient to disrupt the van Der Waals bonds between the PVA and PLGA but not high enough to disrupt the covalent bonds within the PLGA. This technique is promising as it can partially remove the PVA from the scaffold, and mitigate problematic issues down the line, such as thermal degradation during sterilization, and undue delay/variability in biodegradation.
Osimertinib, an irreversible third-generation EGFR-TKI, is the standard of care for second-line treatment of T790M-mutant advanced NSCLC patients whose disease progressed after first-line EGFR-TKI therapy. In this multicenter study, we aimed to determine the real-life efficacy and safety of Osimertinib in pretreated advanced NSCLC patients with T790M mutation.
This retrospective trial included advanced T790M-mutant pretreated NSCLC patients who received Osimertinib from 24 different centers in Turkey. Noradrenaline bitartrate monohydrate nmr Primary endpoint was time-to-treatment discontinuation (TTD). Secondary endpoints were objective response rate (ORR), overall survival (OS), and safety.
Of 163 patients, 68.7% had EGFR exon 19 deletion and 22.7% had exon 21 L858R mutation. Osimertinib was given as second-line treatment in 96 patients (58.9%) and third-line in 48 patients (29.4%). After median of 13-month follow-up, median TTD was 21.6months with an 82.2% ORR. Estimated median OS was 32.1months. Grade 3-4 adverse events were seen in 11.7% of the patients.
Osimertinib is a highly effective option in second- or third-line treatment of NSCLC patients with T790M mutation, with a favorable safety profile.
Osimertinib is a highly effective option in second- or third-line treatment of NSCLC patients with T790M mutation, with a favorable safety profile.
The accuracy of preoperative patient-reported weight was never evaluated in patients undergoing lower extremity procedures. The purpose of this study was to (1) compare the disparity between patient-reported and measured weights in patients undergoing lower extremity total joint arthroplasty (LE-TJA) and arthroscopy; and (2) investigate the association between patient-specific factors (patient age, BMI, zip code, and psychiatric comorbidities) and the accuracy of patient-reported weight.
Preoperative self-reported weights were retrospectively compared to measured weights in 400 LE-TJA and 85 control arthroscopy patients. The difference between reported and measured weights was calculated. Additionally, the percent of accurate reporting within 0.5, 1, and 5kg ranges of the measured weight was calculated. Outcomes were compared between surgical modalities as well as between patient-specific factors.
There was low disparity (p = 0.838) between patient-reported and measured weights among LE-TJA (mean difference 0.18 ± 3.63kg; p = 0.446) and that of arthroscopy (0.27 ± 4.08kg; p = 0.129) patients. Additionally, LE-TJA patients were equally likely to report weights accurately within 0.5kg of the measured weight (74% vs. 71.76%; p = 0.908). LE-TJA and arthroscopy patients had similar reporting accuracy within 1 and 5kg of the measured weights (p > 0.05).
Preoperative patient-reported weights demonstrated acceptable accuracy in both LE-TJA and lower extremity arthroscopic orthopaedic patient populations making it a potentially reliable parameter of preoperative assessment.
Preoperative patient-reported weights demonstrated acceptable accuracy in both LE-TJA and lower extremity arthroscopic orthopaedic patient populations making it a potentially reliable parameter of preoperative assessment.
The object of this study was to evaluate the primary stability of tibial interference screw (IFS) fixation in single-stage revision surgery of the anterior cruciate ligament (ACL) in the case of recurrent instability after ACL repair with dynamic intraligamentary stabilization (DIS), dependent on the implant position during DIS.
Tibial aperture fixation in ACL reconstruction (ACL-R) was performed in a porcine knee model using an IFS. Native ACL-R was performed in the control group (n = 15). In the intervention groups DIS and subsequent implant removal were performed prior to single-stage revision ACL-R. A distance of 20mm in group R-DIS1 (n = 15) and 5mm in group R-DIS2 (n = 15) was left between the joint line and the implant during DIS. Specimens were mounted in a material-testing machine and load-to-failure was applied in a worst-case-scenario.
Load to failure was 454 ± 111N in the R-DIS1 group, 154 ± 71N in the R-DIS2 group and 405 ± 105N in the primary ACL-R group. Load-to-failure, stiffness and elongation of the group R-DIS2 were significantly inferior in comparison to R-DIS1 and ACL-R respectively (p < 0.
