Poly-L-lactic acid(PLLA)has become a popular treatment for body skin laxity,especially in female patients;however,research on its use in male patients remains limited,particularly in addressing changes in the gluteal ...Poly-L-lactic acid(PLLA)has become a popular treatment for body skin laxity,especially in female patients;however,research on its use in male patients remains limited,particularly in addressing changes in the gluteal region due to aging.This case report investigates the efficacy of PLLA in treating skin laxity in the gluteal area of three male patients aged 36,41,and 50 years who were treated at the Antony Barbosa Institute between May 2023 and June 2024.The Male Gluteal Contour Method^(TM):C-Tech Collagen Boost was employed using a C-shaped injection technique with an 18G×70 mm cannula.Patients underwent four sessions of PLLA injections,reconstituted with bacteriostatic sterile water and lidocaine,at 4–6-week intervals.Improvements in the gluteal contour and skin laxity were noted in all patients,with increased collagen production contributing to enhanced muscle definition and firmness.Minimal side effects such as mild bruising,swelling,and tenderness were reported,and no nodules were observed.This study highlights the importance of tailored treatment plans that cater to the specific needs of middle-age and older men.The C-shaped injection technique allowed for an even distribution of the biostimulator while respecting male anatomy.PLLA is a promising nonsurgical solution for improving male gluteal contour and skin quality,although further research with larger groups is warranted to establish more definitive guidelines for its use in male gluteal augmentation.展开更多
AIM:To evaluate the importance of sphincter of Oddi laxity (SOL) in hepatolithiasis (HL).METHODS:Subjects included 98 patients diagnosed with HL between 2002 and 2007. Detailed histories were taken and the subjects we...AIM:To evaluate the importance of sphincter of Oddi laxity (SOL) in hepatolithiasis (HL).METHODS:Subjects included 98 patients diagnosed with HL between 2002 and 2007. Detailed histories were taken and the subjects were monitored until July 2008. HL patients were divided into two groups:Group included 45 patients with SOL,and Group included 53 patients without. Recurrence and reoperation indices of both groups were calculated and compared.RESULTS:The recurrence index was 0.135 in Group and 0.018 in Group fldex was 0.070 in Group and 0.010 in Group (P <0.001). The mean frequency of biliary operation was 2.07in Group (P = 0.001). Differences between the two groups are significant.CONCLUSION:HL patients with SOL tend to have a higher risk of recurrence and a larger demand for re-operation than those without this condition.展开更多
Objectives: The basic mechanisms of cervical incompetence remain unknown although preliminary histological, biochemical and DNA studies suggest connective tissue pathology may be a contributing factor. Certain connect...Objectives: The basic mechanisms of cervical incompetence remain unknown although preliminary histological, biochemical and DNA studies suggest connective tissue pathology may be a contributing factor. Certain connective tissue disorders are known to be associated with obstetric complications. Utilising a standardised established scoring system for connective tissue laxity, this study aimed to test the relationship between clinical evidence of connective tissue laxity and cervical incompetence. Methods: This case-control study involved pregnant and non-pregnant women with a history of mid-trimester pregnancy loss in the absence of major bleeding, infection and uterine abnormalities and a control group of women with uncomplicated obstetric histories. Relevant medical details were obtained. Connective tissue laxity was assessed utilizing the Beighton scoring system. Potential confounding factors, including age, pregnancy and gestation were explored. Results: The frequency of connective tissue laxity between the cases [n = 29] was not statistically different from the controls [n = 58] [p = 0.391] suggesting a lack of association between cervical incompetence and clinical evidence of connective tissue laxity. Conclusion: Although no clear evidence of connective tissue laxity was demonstrated, it is possible that cervical incompetence is associated with abnormal connective tissue. But this abnormality is different from the defect that underlies joint hypermobility and skin elasticity.展开更多
AIM To compare the measurements of knee rotation laxity by non-invasive skin pointer with a knee rotation jig in cadaveric knees against a skeletally mounted marker. METHODS Six pairs of cadaveric legs were mounted on...AIM To compare the measurements of knee rotation laxity by non-invasive skin pointer with a knee rotation jig in cadaveric knees against a skeletally mounted marker. METHODS Six pairs of cadaveric legs were mounted on a knee rotation jig. One Kirscher wire was driven into the tibial tubercle as a bone marker and a skin pointer was attached. Rotational forces of 3, 6 and 9 nm applied at 0°, 30°, 45°, 60° and 90° of knee flexion were analysed using the Pearson correlation coefficient and paired t-test. RESULTS Total rotation recorded with the skin pointer significantly correlated with the bone marker at 3 nm at 0°(skin pointer 23.9 ± 26.0° vs bone marker 16.3 ± 17.3°, r = 0.92; P = 0.0), 30°(41.7 ± 15.5° vs 33.1 ± 14.7°, r = 0.63; P = 0.037), 45°(49.0 ± 17.0° vs 40.3 ± 11.2°, r = 0.81; P = 0.002), 60°(45.7 ± 17.5° vs 34.7 ± 9.5°, r = 0.86; P = 0.001) and 90°(29.2 ± 10.9° vs 21.2 ± 6.8°, r = 0.69; P = 0.019) of knee flexion and 6 nm at 0°(51.1 ± 37.7° vs 38.6 ± 30.1°, r = 0.90; P = 0.0), 30°(64.6 ± 21.6° vs 54.3 ± 15.1°, r = 0.73; P = 0.011), 45°(67.7 ± 20.6° vs 55.5 ± 9.5°, r = 0.65; P = 0.029), 60°(62.9 ± 22.4° vs 45.8 ± 13.1°,r = 0.65; P = 0.031) and 90°(43.6 ± 17.6° vs 31.0 ± 6.3°, r = 0.62; P = 0.043) of knee flexion and at 9 nm at 0°(69.7 ± 40.0° vs 55.6 ± 30.6°, r = 0.86; P = 0.001) and 60°(74.5 ± 27.6° vs 57.1 ± 11.5°, r = 0.77; P = 0.006). No statistically significant correlation with 9 nm at 30°(79.2 ± 25.1° vs 66.9 ± 15.4°, r = 0.59; P = 0.055), 45°(80.7 ± 24.7° vs 65.5 ± 11.2°, r = 0.51; P = 0.11) and 90°(54.7 ± 21.1° vs 39.4 ± 8.2°, r = 0.55; P = 0.079). We recognize that 9 nm of torque may be not tolerated in vivo due to pain. Knee rotation was at its maximum at 45° of knee flexion and increased with increasing torque.CONCLUSION The skin pointer and knee rotation jig can be a reliable and simple means of quantifying knee rotational laxity with future clinical application.展开更多
The authors reviewed 200 normal children and 225 cases of congenitaldislocation of the hip (CDH), all below 5 years of age. These cases were checked at thehip, ankle, elbow, wrist and knee for hyper-extension and thum...The authors reviewed 200 normal children and 225 cases of congenitaldislocation of the hip (CDH), all below 5 years of age. These cases were checked at thehip, ankle, elbow, wrist and knee for hyper-extension and thumb-radius angle at the wrist.From the values of 200 normal cases, SD was derived. Joint laxity was graded by the fol-lowing method (Wynne Davies, Tsuyama). SD±2=2 points, SD±1=1 point,【SD=0point. The result showed that in the normal group there were 8-12% of joint laxity,whereas in the CDH group there were 34-46%. Dividing the CDH and normal groups in-to boys and girls, and those below 2 and those aged 2-5 years group (50 each), itshowed a P value of 【0.01, 【0.02, 【0.01 and 【0.001 respectively. The authors believedthat CDH has a congenital fibrous tissue defect, probably associated with abnormality ofthe collagen fibres. The authors discuss this with clinical problems.展开更多
Findings in 1656 patients referred for evaluation of Ehlers-Danlos syndrome, 710 evaluated systematically using novel history and physical forms, defined a characteristic clinical pattern termed arthritis-adrenaline d...Findings in 1656 patients referred for evaluation of Ehlers-Danlos syndrome, 710 evaluated systematically using novel history and physical forms, defined a characteristic clinical pattern termed arthritis-adrenaline disorder, a genus that provides immediate therapy while delineation of particular tissue laxity/dysautonomia species is underway. Preliminary diagnoses, clinical findings, and laboratory results were entered into an MS Excel? database with IRB approval and correlations or statistical significance analyzed using Excel? functions. Frequencies of 80 findings by history and 40 on physical were similar among EDS groups, females paralleling males with more total history (35 versus 23) and physical (18 versus 15) findings. Finding frequencies in joint-skeletal (6.2 of 15) and dysautonomia (11 of 20) subcategories were substantial regardless of age, EDS diagnosis, or referral source, the latter was shown by 6.4 and 13 average findings for cardiology, 5.3 and 8.3 for orthopedic referrals. Early affliction evidenced by history findings averaging 19.5 in those under 12 increased dramatically to 25 for teens and 32 for adults with plateauing at older ages arguing against degenerative disease. Frequent neuromuscular symptoms in females emphasize surrounding muscle support and protection of joint-connective tissue as a key factor in decreased male severity. The congruent clinical profile suggests operation of an articulo-autonomic dysplasia cycle where lax vessels and lower body pooling elicit sympathetic response, autonomic imbalance in turn affecting small nerve fibers and enhancing connective tissue laxity. Recognition of this arthritis-adrenalin disorder can guide management strategies while underlying causes are pursued, among them, physical therapy, exercise, and vitamin D to build muscle/bone strength;lower gluten/dairy and antihistamine protocols for low bowel motility/mast-cell activation;hydration, salt, and exercise for postural orthostatic tachycardia syndrome.展开更多
Constituting the reasonable control models of the wrinkle limit blank holder forces is the sticking point of the processes of the deep drawing with variable blank-holder forces, especially in the square-box forming. T...Constituting the reasonable control models of the wrinkle limit blank holder forces is the sticking point of the processes of the deep drawing with variable blank-holder forces, especially in the square-box forming. To begin with, a mode of segmenting flange of the square-box into eight zones is put forward according to the fact that the uniformity of flange deforming can be improved by control-ling segment blank-holders. Considering the integral influence of shear stress, a new concept, strain relaxation factor is defined. Hereby, the law of distribution of stress and stain in the deforming flange of square-box is achieved. Then based on these mechanical analysis models and the energy principle, the wrinkling flexivity functions of the straight flange and the circle flange are given, and the corresponding formulae of wrinkling limit blank-holder force in these two situations are also educed. In these processes, ply-anisotropy, strain hardening, thickness and friction are considered. In the end, a calculating example is designed to validate the rationality of the formulae of wrinkling limit blank-holder force, at the same time, the influences of the ply-anisotropy exponent and the strain hardening exponent on the wrinkle limit blank holder forces are also analyzed.展开更多
Background: Radiofrequency has been proven to penetrate deeper than optical light sources independent of skin color allowing a safer treatment for the Asian skin type. Many studies have indicated the efficacy of vario...Background: Radiofrequency has been proven to penetrate deeper than optical light sources independent of skin color allowing a safer treatment for the Asian skin type. Many studies have indicated the efficacy of various types of devices, but have not included a sufficient objective evaluation. Multisource radiofrequency uses multiple phase controlled radiofrequency generators with real time impedance control, allowing painless, deeper dermal heating with better adaptation to differences in individual skin impedance. In this study we used three-dimensional imaging for the objective evaluation of facial skin tightening by multisource phase-controlled radiofrequency. Methods: Twenty Japanese patients were treated with a multisource phase-controlled radiofrequency device. Three-dimensional imaging was performed with a Canfield Scientific Vectra camera and software, and quantitative volume measurements were taken to evaluate the change in the post-treatment volume. The patients then provided subjective assessments. Results: Objective assessments of the treated cheek volume evaluated by a three-dimensional color schematic representation with quantitative volume measurements showed significant improvement three months after the final treatment. The mean volume reduction at the last post-treatment visit was 3.878 ± 2.86 mL. The post-treatment volume was significantly reduced compared to the pretreatment volume in all of the volunteers (P = 0.0007). Ninety-five percent of volunteers reported satisfaction with the improvement of skin laxity, and ninety percent of volunteers reported satisfaction with the improvement of wrinkles, such as the nasolabial folds. Conclusions: The advantages of these multisource phase-controlled radiofrequency treatments are its high efficacy for skin tightening associated with minimal level of discomfort, minimal side effects, and low cost. Taken together, these characteristics facilitate the ability to give repeated treatments as a stand alone treatment or adjunct to surgery. This study provides for the first time a qualitative and quantitative volumetric assessment, proving the ability of the technology to reduce the volume through non invasive skin tightening.展开更多
The problem of scheduling real time and non real time traffic in an ATM switch multiplexor when bursts of either type of traffic occur is studied. The scheduling algorithms studied are: Queue Length Threshold (QLT) an...The problem of scheduling real time and non real time traffic in an ATM switch multiplexor when bursts of either type of traffic occur is studied. The scheduling algorithms studied are: Queue Length Threshold (QLT) and Minimum Laxity Threshold (MLT). Analytic results based on Markov Chains are used. In addition the results are compared with an optimal (but impractical) scheduling determined via dynamic programming. Dynamic programming is used in this paper to show that MLT gives a near optimal performance trade off between real time and non real time traffic for constant arrival rates. The trade off QLT allows is not close to optimal. For non real time bursts MLT still gives a close to optimal trade off. For real time bursts the trade off MLT allows between real time and non real time traffic is not as close to optimal, but even where the MLT trade off is not near optimal, the QLT trade off is much worse than the MLT trade off.展开更多
Background: As the population of people aged 65 and older increases, greater attention is being paid to issues surrounding skin aging. This study was conducted to evaluate the efficacy of an oral unhydrolyzed eggshell...Background: As the population of people aged 65 and older increases, greater attention is being paid to issues surrounding skin aging. This study was conducted to evaluate the efficacy of an oral unhydrolyzed eggshell membrane (ESM) ingredient (branded Ovolux™) versus placebo on both objective and subjective markers of skin aging in middle-aged and senior adults, and also to assess the possible benefits of Ovolux™ on the health of hair and fingernails. Methods: Sixty-three healthy, men and women (aged 35 - 66) were randomly assigned to receive either oral ESM 300 mg (n = 32) or placebo (n = 31) once daily for 12 weeks. The primary endpoint was any statistically significant improvement in skin elasticity in the anterior region of the temporal fossa of the face versus placebo evaluated at 12 weeks of treatment based upon measurements taken with the Cutometer® MPA 580 multi-probe system. Secondary endpoints were improvement in skin firmness, viscoelasticity, hydration, or trans-epidermal water loss versus placebo. Additional secondary endpoints were any improvement in skin, hair, or fingernail subjective parameters versus placebo as determined via Patient’s Assessments. Results: Supplementation with Ovolux™ ESM produced a significant absolute treatment effect (TEabs) versus placebo after both six weeks (TEabs +8.4%, p = 0.019) and twelve weeks of treatment (TEabs +12.2%, p = 0.002) for the primary outcome measure total elasticity (R2). There were also significant treatment responses versus placebo for the objective measures of firmness (R0), net elasticity (R5), and viscoelasticity (R6) at both timepoints (R0: Week 6, −23.9%;Week 12, −16.8%) (R5: Week 6, +9.5%;Week 12, +10.6%) (R6: Week 6, −17.9%;Week 12, −17.7%), as well as for skin hydration versus placebo at both 6 weeks (+8.3%) and 12 weeks (+8.6%) of treatment. There were also significant improvements in the ESM treatment group versus placebo in the subjective measures of skin appearance, skin texture, overall skin health, hair texture, and overall hair health as determined by patient assessments. Conclusions: Ovolux™ provided significant broad-based improvements in critical biomechanical skin properties versus placebo, including elasticity, firmness, and viscoelasticity. These effects, along with improvement in skin hydration, were observed as early as 6 weeks and continued through the end of the 12-week study. Treatment with ESM was reported to be well-tolerated. Ovolux™ ESM appears to be a natural solution to help skin to resist the epidermal thickening, the dermal thinning, and the skin laxity and elastosis found in intrinsically aging skin. The Clinical Trial Registration number is: NCT06148337.展开更多
Osteogenesis imperfecta(OI)is mainly characterized by bone fragility and Ehlers-Danlos syndrome(EDS)by connective tissue defects.Mutations in COL1A1 or COL1A2 can lead to both syndromes.OI/EDS overlap syndrome is most...Osteogenesis imperfecta(OI)is mainly characterized by bone fragility and Ehlers-Danlos syndrome(EDS)by connective tissue defects.Mutations in COL1A1 or COL1A2 can lead to both syndromes.OI/EDS overlap syndrome is mostly caused by helical mutations near the amino-proteinase cleavage site of type Ⅰ procollagen.In this study,we identified a Thai patient having OI type Ⅲ,EDS,brachydactyly,and dentinogenesis imperfecta.His dentition showed delayed eruption,early exfoliation,and severe malocclusion.For the first time,ultrastructural analysis of the tooth affected with OI/EDS showed that the tooth had enamel inversion,bonelike dentin,loss of dentinal tubules,and reduction in hardness and elasticity,suggesting severe developmental disturbance.These severe dental defects have never been reported in OI or EDS.Exome sequencing identified a novel de novo heterozygous glycine substitution,c.3296G>A,p.Gly1099Glu,in exon 49 of COL1A2.Three patients with mutations in the exon 49 of COL1A2 were previously reported to have OI with brachydactyly and intracranial hemorrhage.Notably,two of these three patients did not show hyperextensible joints and hypermobile skin,while our patient at the age of 5 years had not developed intracranial hemorrhage.Here,we demonstrate that the novel glycine substitution in the carboxyl region of alpha2(Ⅰ)collagen triple helix leads to OI/EDS with brachydactyly and severe tooth defects,expanding the genotypic and phenotypic spectra of OI/EDS overlap syndrome.展开更多
Sagittal knee laxity is often quantified using arthrometers. Adding rotational laxity and compliance measurementsis relatively new and could bring new information for anterior cruciate ligament (ACL) injury diagnosis....Sagittal knee laxity is often quantified using arthrometers. Adding rotational laxity and compliance measurementsis relatively new and could bring new information for anterior cruciate ligament (ACL) injury diagnosis. TheDYNEELAX® is a new knee arthrometer able to evaluate simultaneously tibial translation and rotation. Thepurpose is to assess the sensitivity, reproducibility and repeatability of the DYNEELAX® with a prototype leg toprovide accurate instructions before using it in clinical practice. Sensitivity is studied by varying 7 parameters(positioning and sensors), and reproducibility by repeating measurement series with a group of two experiencedoperators and a group of two non-experienced operators. Repeatability is assessed throughout the study. Theresults showed that DYNEELAX® is poorly sensitive to the angle and the position of the displacement sensor, andthe angle of the rotation sensor. It is a bit sensitive to positioning of patella and ankle supports. It is very sensitiveto the tightening of the patella and ankle supports. It exists a significant difference only between groups (p <0.001), but there is no significant difference between the two experienced operators (p > 0.215), or between thetwo non-experienced operators (p > 0.229). Variation coefficients for intra-series are on average inferior to 5% fortranslation and rotation tests. Then, the DYNEELAX® presented encouraging results with a good accuracy and agood reliability but operators must be careful about positioning.展开更多
文摘Poly-L-lactic acid(PLLA)has become a popular treatment for body skin laxity,especially in female patients;however,research on its use in male patients remains limited,particularly in addressing changes in the gluteal region due to aging.This case report investigates the efficacy of PLLA in treating skin laxity in the gluteal area of three male patients aged 36,41,and 50 years who were treated at the Antony Barbosa Institute between May 2023 and June 2024.The Male Gluteal Contour Method^(TM):C-Tech Collagen Boost was employed using a C-shaped injection technique with an 18G×70 mm cannula.Patients underwent four sessions of PLLA injections,reconstituted with bacteriostatic sterile water and lidocaine,at 4–6-week intervals.Improvements in the gluteal contour and skin laxity were noted in all patients,with increased collagen production contributing to enhanced muscle definition and firmness.Minimal side effects such as mild bruising,swelling,and tenderness were reported,and no nodules were observed.This study highlights the importance of tailored treatment plans that cater to the specific needs of middle-age and older men.The C-shaped injection technique allowed for an even distribution of the biostimulator while respecting male anatomy.PLLA is a promising nonsurgical solution for improving male gluteal contour and skin quality,although further research with larger groups is warranted to establish more definitive guidelines for its use in male gluteal augmentation.
基金Supported by Grants from National Natural Science Funds for Distinguished Young Scholars, No. 30925033Science and Technology Planning Project of Zhejiang Province, China, No. 2007C24001
文摘AIM:To evaluate the importance of sphincter of Oddi laxity (SOL) in hepatolithiasis (HL).METHODS:Subjects included 98 patients diagnosed with HL between 2002 and 2007. Detailed histories were taken and the subjects were monitored until July 2008. HL patients were divided into two groups:Group included 45 patients with SOL,and Group included 53 patients without. Recurrence and reoperation indices of both groups were calculated and compared.RESULTS:The recurrence index was 0.135 in Group and 0.018 in Group fldex was 0.070 in Group and 0.010 in Group (P <0.001). The mean frequency of biliary operation was 2.07in Group (P = 0.001). Differences between the two groups are significant.CONCLUSION:HL patients with SOL tend to have a higher risk of recurrence and a larger demand for re-operation than those without this condition.
文摘Objectives: The basic mechanisms of cervical incompetence remain unknown although preliminary histological, biochemical and DNA studies suggest connective tissue pathology may be a contributing factor. Certain connective tissue disorders are known to be associated with obstetric complications. Utilising a standardised established scoring system for connective tissue laxity, this study aimed to test the relationship between clinical evidence of connective tissue laxity and cervical incompetence. Methods: This case-control study involved pregnant and non-pregnant women with a history of mid-trimester pregnancy loss in the absence of major bleeding, infection and uterine abnormalities and a control group of women with uncomplicated obstetric histories. Relevant medical details were obtained. Connective tissue laxity was assessed utilizing the Beighton scoring system. Potential confounding factors, including age, pregnancy and gestation were explored. Results: The frequency of connective tissue laxity between the cases [n = 29] was not statistically different from the controls [n = 58] [p = 0.391] suggesting a lack of association between cervical incompetence and clinical evidence of connective tissue laxity. Conclusion: Although no clear evidence of connective tissue laxity was demonstrated, it is possible that cervical incompetence is associated with abnormal connective tissue. But this abnormality is different from the defect that underlies joint hypermobility and skin elasticity.
文摘AIM To compare the measurements of knee rotation laxity by non-invasive skin pointer with a knee rotation jig in cadaveric knees against a skeletally mounted marker. METHODS Six pairs of cadaveric legs were mounted on a knee rotation jig. One Kirscher wire was driven into the tibial tubercle as a bone marker and a skin pointer was attached. Rotational forces of 3, 6 and 9 nm applied at 0°, 30°, 45°, 60° and 90° of knee flexion were analysed using the Pearson correlation coefficient and paired t-test. RESULTS Total rotation recorded with the skin pointer significantly correlated with the bone marker at 3 nm at 0°(skin pointer 23.9 ± 26.0° vs bone marker 16.3 ± 17.3°, r = 0.92; P = 0.0), 30°(41.7 ± 15.5° vs 33.1 ± 14.7°, r = 0.63; P = 0.037), 45°(49.0 ± 17.0° vs 40.3 ± 11.2°, r = 0.81; P = 0.002), 60°(45.7 ± 17.5° vs 34.7 ± 9.5°, r = 0.86; P = 0.001) and 90°(29.2 ± 10.9° vs 21.2 ± 6.8°, r = 0.69; P = 0.019) of knee flexion and 6 nm at 0°(51.1 ± 37.7° vs 38.6 ± 30.1°, r = 0.90; P = 0.0), 30°(64.6 ± 21.6° vs 54.3 ± 15.1°, r = 0.73; P = 0.011), 45°(67.7 ± 20.6° vs 55.5 ± 9.5°, r = 0.65; P = 0.029), 60°(62.9 ± 22.4° vs 45.8 ± 13.1°,r = 0.65; P = 0.031) and 90°(43.6 ± 17.6° vs 31.0 ± 6.3°, r = 0.62; P = 0.043) of knee flexion and at 9 nm at 0°(69.7 ± 40.0° vs 55.6 ± 30.6°, r = 0.86; P = 0.001) and 60°(74.5 ± 27.6° vs 57.1 ± 11.5°, r = 0.77; P = 0.006). No statistically significant correlation with 9 nm at 30°(79.2 ± 25.1° vs 66.9 ± 15.4°, r = 0.59; P = 0.055), 45°(80.7 ± 24.7° vs 65.5 ± 11.2°, r = 0.51; P = 0.11) and 90°(54.7 ± 21.1° vs 39.4 ± 8.2°, r = 0.55; P = 0.079). We recognize that 9 nm of torque may be not tolerated in vivo due to pain. Knee rotation was at its maximum at 45° of knee flexion and increased with increasing torque.CONCLUSION The skin pointer and knee rotation jig can be a reliable and simple means of quantifying knee rotational laxity with future clinical application.
文摘The authors reviewed 200 normal children and 225 cases of congenitaldislocation of the hip (CDH), all below 5 years of age. These cases were checked at thehip, ankle, elbow, wrist and knee for hyper-extension and thumb-radius angle at the wrist.From the values of 200 normal cases, SD was derived. Joint laxity was graded by the fol-lowing method (Wynne Davies, Tsuyama). SD±2=2 points, SD±1=1 point,【SD=0point. The result showed that in the normal group there were 8-12% of joint laxity,whereas in the CDH group there were 34-46%. Dividing the CDH and normal groups in-to boys and girls, and those below 2 and those aged 2-5 years group (50 each), itshowed a P value of 【0.01, 【0.02, 【0.01 and 【0.001 respectively. The authors believedthat CDH has a congenital fibrous tissue defect, probably associated with abnormality ofthe collagen fibres. The authors discuss this with clinical problems.
文摘Findings in 1656 patients referred for evaluation of Ehlers-Danlos syndrome, 710 evaluated systematically using novel history and physical forms, defined a characteristic clinical pattern termed arthritis-adrenaline disorder, a genus that provides immediate therapy while delineation of particular tissue laxity/dysautonomia species is underway. Preliminary diagnoses, clinical findings, and laboratory results were entered into an MS Excel? database with IRB approval and correlations or statistical significance analyzed using Excel? functions. Frequencies of 80 findings by history and 40 on physical were similar among EDS groups, females paralleling males with more total history (35 versus 23) and physical (18 versus 15) findings. Finding frequencies in joint-skeletal (6.2 of 15) and dysautonomia (11 of 20) subcategories were substantial regardless of age, EDS diagnosis, or referral source, the latter was shown by 6.4 and 13 average findings for cardiology, 5.3 and 8.3 for orthopedic referrals. Early affliction evidenced by history findings averaging 19.5 in those under 12 increased dramatically to 25 for teens and 32 for adults with plateauing at older ages arguing against degenerative disease. Frequent neuromuscular symptoms in females emphasize surrounding muscle support and protection of joint-connective tissue as a key factor in decreased male severity. The congruent clinical profile suggests operation of an articulo-autonomic dysplasia cycle where lax vessels and lower body pooling elicit sympathetic response, autonomic imbalance in turn affecting small nerve fibers and enhancing connective tissue laxity. Recognition of this arthritis-adrenalin disorder can guide management strategies while underlying causes are pursued, among them, physical therapy, exercise, and vitamin D to build muscle/bone strength;lower gluten/dairy and antihistamine protocols for low bowel motility/mast-cell activation;hydration, salt, and exercise for postural orthostatic tachycardia syndrome.
文摘Constituting the reasonable control models of the wrinkle limit blank holder forces is the sticking point of the processes of the deep drawing with variable blank-holder forces, especially in the square-box forming. To begin with, a mode of segmenting flange of the square-box into eight zones is put forward according to the fact that the uniformity of flange deforming can be improved by control-ling segment blank-holders. Considering the integral influence of shear stress, a new concept, strain relaxation factor is defined. Hereby, the law of distribution of stress and stain in the deforming flange of square-box is achieved. Then based on these mechanical analysis models and the energy principle, the wrinkling flexivity functions of the straight flange and the circle flange are given, and the corresponding formulae of wrinkling limit blank-holder force in these two situations are also educed. In these processes, ply-anisotropy, strain hardening, thickness and friction are considered. In the end, a calculating example is designed to validate the rationality of the formulae of wrinkling limit blank-holder force, at the same time, the influences of the ply-anisotropy exponent and the strain hardening exponent on the wrinkle limit blank holder forces are also analyzed.
文摘Background: Radiofrequency has been proven to penetrate deeper than optical light sources independent of skin color allowing a safer treatment for the Asian skin type. Many studies have indicated the efficacy of various types of devices, but have not included a sufficient objective evaluation. Multisource radiofrequency uses multiple phase controlled radiofrequency generators with real time impedance control, allowing painless, deeper dermal heating with better adaptation to differences in individual skin impedance. In this study we used three-dimensional imaging for the objective evaluation of facial skin tightening by multisource phase-controlled radiofrequency. Methods: Twenty Japanese patients were treated with a multisource phase-controlled radiofrequency device. Three-dimensional imaging was performed with a Canfield Scientific Vectra camera and software, and quantitative volume measurements were taken to evaluate the change in the post-treatment volume. The patients then provided subjective assessments. Results: Objective assessments of the treated cheek volume evaluated by a three-dimensional color schematic representation with quantitative volume measurements showed significant improvement three months after the final treatment. The mean volume reduction at the last post-treatment visit was 3.878 ± 2.86 mL. The post-treatment volume was significantly reduced compared to the pretreatment volume in all of the volunteers (P = 0.0007). Ninety-five percent of volunteers reported satisfaction with the improvement of skin laxity, and ninety percent of volunteers reported satisfaction with the improvement of wrinkles, such as the nasolabial folds. Conclusions: The advantages of these multisource phase-controlled radiofrequency treatments are its high efficacy for skin tightening associated with minimal level of discomfort, minimal side effects, and low cost. Taken together, these characteristics facilitate the ability to give repeated treatments as a stand alone treatment or adjunct to surgery. This study provides for the first time a qualitative and quantitative volumetric assessment, proving the ability of the technology to reduce the volume through non invasive skin tightening.
文摘The problem of scheduling real time and non real time traffic in an ATM switch multiplexor when bursts of either type of traffic occur is studied. The scheduling algorithms studied are: Queue Length Threshold (QLT) and Minimum Laxity Threshold (MLT). Analytic results based on Markov Chains are used. In addition the results are compared with an optimal (but impractical) scheduling determined via dynamic programming. Dynamic programming is used in this paper to show that MLT gives a near optimal performance trade off between real time and non real time traffic for constant arrival rates. The trade off QLT allows is not close to optimal. For non real time bursts MLT still gives a close to optimal trade off. For real time bursts the trade off MLT allows between real time and non real time traffic is not as close to optimal, but even where the MLT trade off is not near optimal, the QLT trade off is much worse than the MLT trade off.
文摘Background: As the population of people aged 65 and older increases, greater attention is being paid to issues surrounding skin aging. This study was conducted to evaluate the efficacy of an oral unhydrolyzed eggshell membrane (ESM) ingredient (branded Ovolux™) versus placebo on both objective and subjective markers of skin aging in middle-aged and senior adults, and also to assess the possible benefits of Ovolux™ on the health of hair and fingernails. Methods: Sixty-three healthy, men and women (aged 35 - 66) were randomly assigned to receive either oral ESM 300 mg (n = 32) or placebo (n = 31) once daily for 12 weeks. The primary endpoint was any statistically significant improvement in skin elasticity in the anterior region of the temporal fossa of the face versus placebo evaluated at 12 weeks of treatment based upon measurements taken with the Cutometer® MPA 580 multi-probe system. Secondary endpoints were improvement in skin firmness, viscoelasticity, hydration, or trans-epidermal water loss versus placebo. Additional secondary endpoints were any improvement in skin, hair, or fingernail subjective parameters versus placebo as determined via Patient’s Assessments. Results: Supplementation with Ovolux™ ESM produced a significant absolute treatment effect (TEabs) versus placebo after both six weeks (TEabs +8.4%, p = 0.019) and twelve weeks of treatment (TEabs +12.2%, p = 0.002) for the primary outcome measure total elasticity (R2). There were also significant treatment responses versus placebo for the objective measures of firmness (R0), net elasticity (R5), and viscoelasticity (R6) at both timepoints (R0: Week 6, −23.9%;Week 12, −16.8%) (R5: Week 6, +9.5%;Week 12, +10.6%) (R6: Week 6, −17.9%;Week 12, −17.7%), as well as for skin hydration versus placebo at both 6 weeks (+8.3%) and 12 weeks (+8.6%) of treatment. There were also significant improvements in the ESM treatment group versus placebo in the subjective measures of skin appearance, skin texture, overall skin health, hair texture, and overall hair health as determined by patient assessments. Conclusions: Ovolux™ provided significant broad-based improvements in critical biomechanical skin properties versus placebo, including elasticity, firmness, and viscoelasticity. These effects, along with improvement in skin hydration, were observed as early as 6 weeks and continued through the end of the 12-week study. Treatment with ESM was reported to be well-tolerated. Ovolux™ ESM appears to be a natural solution to help skin to resist the epidermal thickening, the dermal thinning, and the skin laxity and elastosis found in intrinsically aging skin. The Clinical Trial Registration number is: NCT06148337.
基金supported by the 90th Anniversary of Chulalongkorn University,Rachadapisek Sompote FundFaculty of Dentistry(DFR62003),Chulalongkorn University+3 种基金Chulalongkorn Academic Advancement Into Its 2nd Century ProjectNewton FundThailand Research Fund(RSA6280001,DPG6180001)supported by Ratchadapisek Somphot Fund for Postdoctoral Fellowship,Chulalongkorn University,Thailand。
文摘Osteogenesis imperfecta(OI)is mainly characterized by bone fragility and Ehlers-Danlos syndrome(EDS)by connective tissue defects.Mutations in COL1A1 or COL1A2 can lead to both syndromes.OI/EDS overlap syndrome is mostly caused by helical mutations near the amino-proteinase cleavage site of type Ⅰ procollagen.In this study,we identified a Thai patient having OI type Ⅲ,EDS,brachydactyly,and dentinogenesis imperfecta.His dentition showed delayed eruption,early exfoliation,and severe malocclusion.For the first time,ultrastructural analysis of the tooth affected with OI/EDS showed that the tooth had enamel inversion,bonelike dentin,loss of dentinal tubules,and reduction in hardness and elasticity,suggesting severe developmental disturbance.These severe dental defects have never been reported in OI or EDS.Exome sequencing identified a novel de novo heterozygous glycine substitution,c.3296G>A,p.Gly1099Glu,in exon 49 of COL1A2.Three patients with mutations in the exon 49 of COL1A2 were previously reported to have OI with brachydactyly and intracranial hemorrhage.Notably,two of these three patients did not show hyperextensible joints and hypermobile skin,while our patient at the age of 5 years had not developed intracranial hemorrhage.Here,we demonstrate that the novel glycine substitution in the carboxyl region of alpha2(Ⅰ)collagen triple helix leads to OI/EDS with brachydactyly and severe tooth defects,expanding the genotypic and phenotypic spectra of OI/EDS overlap syndrome.
基金The ethics committee of our institution approved our study protocol and amendments(n°22.04729.000226).
文摘Sagittal knee laxity is often quantified using arthrometers. Adding rotational laxity and compliance measurementsis relatively new and could bring new information for anterior cruciate ligament (ACL) injury diagnosis. TheDYNEELAX® is a new knee arthrometer able to evaluate simultaneously tibial translation and rotation. Thepurpose is to assess the sensitivity, reproducibility and repeatability of the DYNEELAX® with a prototype leg toprovide accurate instructions before using it in clinical practice. Sensitivity is studied by varying 7 parameters(positioning and sensors), and reproducibility by repeating measurement series with a group of two experiencedoperators and a group of two non-experienced operators. Repeatability is assessed throughout the study. Theresults showed that DYNEELAX® is poorly sensitive to the angle and the position of the displacement sensor, andthe angle of the rotation sensor. It is a bit sensitive to positioning of patella and ankle supports. It is very sensitiveto the tightening of the patella and ankle supports. It exists a significant difference only between groups (p <0.001), but there is no significant difference between the two experienced operators (p > 0.215), or between thetwo non-experienced operators (p > 0.229). Variation coefficients for intra-series are on average inferior to 5% fortranslation and rotation tests. Then, the DYNEELAX® presented encouraging results with a good accuracy and agood reliability but operators must be careful about positioning.
