BACKGROUND To treat flexor pollicis longus(FPL)muscle function loss,the 4th flexor digitorum superficialis(FDS)to the FPL tendon transfer is preferred as a reconstruction method.Various complications can occur during ...BACKGROUND To treat flexor pollicis longus(FPL)muscle function loss,the 4th flexor digitorum superficialis(FDS)to the FPL tendon transfer is preferred as a reconstruction method.Various complications can occur during transfer.However,median nerve neuropathy has not been reported yet.We present a case of median nerve neuropathy caused by irritation of suture knots of the 4th FDS to the FPL tendon transfer with a review of the literature.CASE SUMMARY A 52-year-old male patient presented with paresthesia along median nerve distribution of right hand after tendon transfer.He complained of right thumb flexion limitation due to FPL function loss so authors performed the 4th FDS to FPL transfer using Pulvertaft weave technique.FPL function loss was due to adhesion resulting from repeated surgery of radius shaft.He had a history of radius shaft open fracture 9 years ago and nonunion 7 years ago.During surgery,FPL muscle was severely adhered and indistinguishable.However,tendon continuity remained intact.After tendon transfer,he experienced paresthesia along median nerve distribution upon movement of thumb.He was diagnosed with median nerve neuropathy caused by irritation of tendon suture knots.Exploration was then performed.The median nerve was irritated by suture knots of transferred tendon.Thus,knots were removed.Twelve months later,he demonstrated thumb flexion of 80°.Additionally,median nerve neuropathy symptoms fully resolved.CONCLUSION Median nerve neuropathy can occur after tendon transfer from irritation of suture knots.Covering knots using surrounding tissue is recommended.展开更多
To mitigate the sand burial of highways in sandy regions,a separated subgrade design was widely adopted in the embankments of high-grade highways,but the problem of sand deposition on subgrade slopes and pavements sti...To mitigate the sand burial of highways in sandy regions,a separated subgrade design was widely adopted in the embankments of high-grade highways,but the problem of sand deposition on subgrade slopes and pavements still happens frequently.Based on the theory of wind-sand two-phase flow,this paper constructed a three-dimensional model of the separated subgrade,the wind-sand flow transport law around the subgrade with varying median strip widths and concave depths was simulated by Fluent software.After comparison and analysis of seven subgrade models,the flow field distribution,wind speed horizontal variation,and erosion-deposition characteristics were investigated.The findings are as follows:(1)The width of the median strip in the separated subgrade had significant influences on the wind-sand flow.The smooth passage of wind-sand flow over the road surface was facilitated with the increase of the median strip width.However,sand deposition in the median strip happened.It can lead to secondary sand damage of downwind subgrade and increase the work load of road sand removal for subsequent maintenance.(2)The obstruction to airflow and sand accumulation was aggravated with greater concave depth of the median strip.Therefore,it is advisable to minimize the concave depth of the median strip in case of more sand damage.(3)A median strip width exceeding 12 m(possibly without guardrails)for an integral embankment without enough road land is recommended.Conversely,median strip width of over 40 m for separate subgrade with unrestricted land is suggested.(4)In the case of sand deposition in the existing separated subgrade,the median strip can be filled by sand deposition or other materials,then was covered with gravel to form a flat ground like Gobi smooth surface,which can let the wind-blown sand flow pass through the subgrade section without sand deposition.展开更多
BACKGROUND A 56-year-old female presented with acute abdominal pain due to a ruptured pseudoaneurysm associated with median arcuate ligament syndrome(MALS),a rare condition caused by the compression of the celiac arte...BACKGROUND A 56-year-old female presented with acute abdominal pain due to a ruptured pseudoaneurysm associated with median arcuate ligament syndrome(MALS),a rare condition caused by the compression of the celiac artery by the median arcuate ligament(MAL),potentially leading to ischemia,aneurysm formation,and rupture.CASE SUMMARY Computed tomography revealed a retroperitoneal hematoma,celiac artery stenosis,and two aneurysms in the inferior pancreaticoduodenal artery.Hemo-stasis was achieved using transcatheter arterial embolization.However,15 days after embolization,the patient developed duodenal stenosis,manifesting as gastric distension and nausea without abdominal pain.Endoscopy revealed mucosal edema and luminal narrowing of the duodenum.Conservative treatment was ineffective,and the patient underwent MAL transection and gastrojejun-ostomy.She recovered uneventfully,and follow-up at 4 months showed complete resolution of duodenal stenosis and no recurrence.CONCLUSION This case highlights the importance of the early diagnosis and multidisciplinary management of MALS.展开更多
Background:Hypertrophic scars and keloids,common complications following median sternotomy for cardiac surgery,significantly impact patient quality of life due to their aesthetic and symptomatic burden.Recent advanceme...Background:Hypertrophic scars and keloids,common complications following median sternotomy for cardiac surgery,significantly impact patient quality of life due to their aesthetic and symptomatic burden.Recent advancements in laser therapy have made it a prominent option for managing these complex scars,yet a com-prehensive understanding of its efficacy is lacking.The aim of this scoping review is to explore the effects of laser therapy in managing hypertrophic scars and keloids after median sternotomy.Methods:This scoping review ana-lyzed studies up to February 2024 from databases including PubMed,EMBASE,CINAHL,Scopus,Web of Science,and the Cochrane Library.We included any study that assessed laser therapy’s effects on hypertrophic scars and keloids following median sternotomy.Studies were selected based on predefined inclusion criteria with-out publication year,design,or origin restrictions.Results:Six studies met the inclusion criteria,involving a total offive RCTs and one review.These studies primarily tested 585 and 595-nm pulsed dye laser(PDL)treatments,focusing on scar appearance,patient symptoms,and treatment satisfaction.Most studies reported significant improvements in scar height reduction and patient symptom relief after treatment,with mixed results for scar erythema and elasticity.Adverse events were generally mild and transient.Conclusions:Laser therapy offers a beneficial approach for improving the appearance and symptoms of hypertrophic scars and keloids post-median sternotomy.However,further research is necessary to optimize treatment parameters and explore the long-term psychosocial impacts of this therapy.This review highlights the need for more comprehensive studies to establish standardized treatment protocols and evaluate their effectiveness.展开更多
Background: Left atrial myxoma (LAM) is the most common heart tumor in adults, requiring prompt surgical removal to prevent complications like valvular obstruction or embolization. Objectives: This study aimed to comp...Background: Left atrial myxoma (LAM) is the most common heart tumor in adults, requiring prompt surgical removal to prevent complications like valvular obstruction or embolization. Objectives: This study aimed to compare early postoperative outcomes between two surgical approaches—right mini-thoracotomy and median sternotomy—for the removal of isolated left atrial myxoma. Methods: We conducted a prospective observational study at the Department of Cardiac Surgery, National Heart Foundation Hospital & Research Institute (NHFH&RI), Mirpur, Dhaka, from March 2017 to August 2019. Twenty-eight patients undergoing surgery for isolated left atrial myxoma were included. The surgical approach was determined by the operating surgeon. We analyzed outcomes like intubation time, Intensive Care Unit (ICU) stay, pain levels (Visual Analogue Scale score), and overall hospital stay using SPSS. Statistical significance was set at p Results: Patients in the right mini-thoracotomy group had longer mean intubation times (11.43 vs. 5.93 hours, p Conclusion: Despite longer intubation and ICU times, the right mini-thoracotomy approach offers a minimally invasive alternative for isolated left atrial myxoma excision, with favorable outcomes overall.展开更多
Median arcuate ligament syndrome (MALS), is a rare abdominal vascular compression syndrome caused by the compression of the proximal celiac trunk by the median arcuate ligament. According to many authors, a low insert...Median arcuate ligament syndrome (MALS), is a rare abdominal vascular compression syndrome caused by the compression of the proximal celiac trunk by the median arcuate ligament. According to many authors, a low insertion of the diaphragmatic crura or an abnormally high origin of the celiac trunk from the aorta can cause compression of the celiac artery. Usually, patients with MALS are asymptomatic. Computed tomography (CT) angiography of the abdomen is the main imaging modality to confirm the diagnosis. The coexistence of celiac trunk and superior mesenteric artery compression by the median arcuate ligament is rarely described in the literature. To our knowledge, until now, a simultaneous combination of three abdominal vascular compressions by the median arcuate ligament has never been described. From this case, we report a simultaneous compression of the celiac trunk, superior mesenteric artery, and renal arteries by the median arcuate ligament.展开更多
Attenuating the noises plays an essential role in the image processing. Almost all the traditional median filters concern the removal of impulse noise having a single layer, whose noise gray level value is constant. I...Attenuating the noises plays an essential role in the image processing. Almost all the traditional median filters concern the removal of impulse noise having a single layer, whose noise gray level value is constant. In this paper, a new adaptive median filter is proposed to handle those images corrupted not only by single layer noise. The adaptive threshold median filter （ATMF） has been developed by combining the adaptive median filter （AMF） and two dynamic thresholds. Because of the dynamic threshold being used, the ATMF is able to balance the removal of the multiple-impulse noise and the quality of image. Comparison of the proposed method with traditional median filters is provided. Some visual examples are given to demonstrate the performance of the proposed filter.展开更多
Objective This study aimed to investigate the possible role of Orphanin FQ(OFQ) in the regulation of hypothalamic gonadotropin-releasing hormone(GnRH) secretion. Methods The method of push-pull perfusion and radioimmu...Objective This study aimed to investigate the possible role of Orphanin FQ(OFQ) in the regulation of hypothalamic gonadotropin-releasing hormone(GnRH) secretion. Methods The method of push-pull perfusion and radioimmunoassay(RIA) were adopted to examine the secretory profile of GnRH in the median eminence(ME) in freely moving ovariectomized(OVX) rats after intracerebroventricular(icv) injection of OFQ and/or [Nphe1]NC(1-13)NH2(NC13),a competitive antagonists of the opioid receptor-like 1 receptor(ORL1 recep...展开更多
For direct sequence spread spectrum （DSSS） receivers, the capability of rejecting narrow-band interference can be significantly improved by a process of frequency-domain interference suppression （FDIS）. The key is...For direct sequence spread spectrum （DSSS） receivers, the capability of rejecting narrow-band interference can be significantly improved by a process of frequency-domain interference suppression （FDIS）. The key issue of this process is how to determine a threshold to eliminate interference in the frequency domain, which has been extensively studied. However, these previous methods are tedious or very complex. A simple and ef- ficient algorithm based on medians is proposed. The elimination threshold is only related to the median by a scale factor, which can be obtained by the numerical analysis. Simulation results show that the algorithm provides excellent narrow-band interfer- ence suppression while only slightly degrading the signal-to-noise ratio （SNR）. A one-pass algorithm using logarithmic segmentation is further derived to estimate medians with low computational complexity. Finally, the FDIS is implemented in a field programmable gate array （FPGA） of Xilinx. Experiments are carried out by connecting the FDIS FPGA to a DSSS receiver, and the results show that the receiver has an effective countermeasure for a 60 dB interference-to-signal ratio （ISR）.展开更多
文摘BACKGROUND To treat flexor pollicis longus(FPL)muscle function loss,the 4th flexor digitorum superficialis(FDS)to the FPL tendon transfer is preferred as a reconstruction method.Various complications can occur during transfer.However,median nerve neuropathy has not been reported yet.We present a case of median nerve neuropathy caused by irritation of suture knots of the 4th FDS to the FPL tendon transfer with a review of the literature.CASE SUMMARY A 52-year-old male patient presented with paresthesia along median nerve distribution of right hand after tendon transfer.He complained of right thumb flexion limitation due to FPL function loss so authors performed the 4th FDS to FPL transfer using Pulvertaft weave technique.FPL function loss was due to adhesion resulting from repeated surgery of radius shaft.He had a history of radius shaft open fracture 9 years ago and nonunion 7 years ago.During surgery,FPL muscle was severely adhered and indistinguishable.However,tendon continuity remained intact.After tendon transfer,he experienced paresthesia along median nerve distribution upon movement of thumb.He was diagnosed with median nerve neuropathy caused by irritation of tendon suture knots.Exploration was then performed.The median nerve was irritated by suture knots of transferred tendon.Thus,knots were removed.Twelve months later,he demonstrated thumb flexion of 80°.Additionally,median nerve neuropathy symptoms fully resolved.CONCLUSION Median nerve neuropathy can occur after tendon transfer from irritation of suture knots.Covering knots using surrounding tissue is recommended.
基金supported by the Third Xinjiang Scientific Expedition and Research Program-Investigation and Risk Assessment of Drought and Aeolian Disasters in Tarim River Basin(No.2021xjkk0300)the National Natural Science Foundation of China(No.62466056)the subject of'the technical scheme and application demonstration of sand disaster prevention and control of Xinjiang expressway to engineering practice,Xinjiang Transportation Investment(Group)Co.,Ltd.(No.XJJTZKX-FWCG-202401-0043).
文摘To mitigate the sand burial of highways in sandy regions,a separated subgrade design was widely adopted in the embankments of high-grade highways,but the problem of sand deposition on subgrade slopes and pavements still happens frequently.Based on the theory of wind-sand two-phase flow,this paper constructed a three-dimensional model of the separated subgrade,the wind-sand flow transport law around the subgrade with varying median strip widths and concave depths was simulated by Fluent software.After comparison and analysis of seven subgrade models,the flow field distribution,wind speed horizontal variation,and erosion-deposition characteristics were investigated.The findings are as follows:(1)The width of the median strip in the separated subgrade had significant influences on the wind-sand flow.The smooth passage of wind-sand flow over the road surface was facilitated with the increase of the median strip width.However,sand deposition in the median strip happened.It can lead to secondary sand damage of downwind subgrade and increase the work load of road sand removal for subsequent maintenance.(2)The obstruction to airflow and sand accumulation was aggravated with greater concave depth of the median strip.Therefore,it is advisable to minimize the concave depth of the median strip in case of more sand damage.(3)A median strip width exceeding 12 m(possibly without guardrails)for an integral embankment without enough road land is recommended.Conversely,median strip width of over 40 m for separate subgrade with unrestricted land is suggested.(4)In the case of sand deposition in the existing separated subgrade,the median strip can be filled by sand deposition or other materials,then was covered with gravel to form a flat ground like Gobi smooth surface,which can let the wind-blown sand flow pass through the subgrade section without sand deposition.
文摘BACKGROUND A 56-year-old female presented with acute abdominal pain due to a ruptured pseudoaneurysm associated with median arcuate ligament syndrome(MALS),a rare condition caused by the compression of the celiac artery by the median arcuate ligament(MAL),potentially leading to ischemia,aneurysm formation,and rupture.CASE SUMMARY Computed tomography revealed a retroperitoneal hematoma,celiac artery stenosis,and two aneurysms in the inferior pancreaticoduodenal artery.Hemo-stasis was achieved using transcatheter arterial embolization.However,15 days after embolization,the patient developed duodenal stenosis,manifesting as gastric distension and nausea without abdominal pain.Endoscopy revealed mucosal edema and luminal narrowing of the duodenum.Conservative treatment was ineffective,and the patient underwent MAL transection and gastrojejun-ostomy.She recovered uneventfully,and follow-up at 4 months showed complete resolution of duodenal stenosis and no recurrence.CONCLUSION This case highlights the importance of the early diagnosis and multidisciplinary management of MALS.
文摘Background:Hypertrophic scars and keloids,common complications following median sternotomy for cardiac surgery,significantly impact patient quality of life due to their aesthetic and symptomatic burden.Recent advancements in laser therapy have made it a prominent option for managing these complex scars,yet a com-prehensive understanding of its efficacy is lacking.The aim of this scoping review is to explore the effects of laser therapy in managing hypertrophic scars and keloids after median sternotomy.Methods:This scoping review ana-lyzed studies up to February 2024 from databases including PubMed,EMBASE,CINAHL,Scopus,Web of Science,and the Cochrane Library.We included any study that assessed laser therapy’s effects on hypertrophic scars and keloids following median sternotomy.Studies were selected based on predefined inclusion criteria with-out publication year,design,or origin restrictions.Results:Six studies met the inclusion criteria,involving a total offive RCTs and one review.These studies primarily tested 585 and 595-nm pulsed dye laser(PDL)treatments,focusing on scar appearance,patient symptoms,and treatment satisfaction.Most studies reported significant improvements in scar height reduction and patient symptom relief after treatment,with mixed results for scar erythema and elasticity.Adverse events were generally mild and transient.Conclusions:Laser therapy offers a beneficial approach for improving the appearance and symptoms of hypertrophic scars and keloids post-median sternotomy.However,further research is necessary to optimize treatment parameters and explore the long-term psychosocial impacts of this therapy.This review highlights the need for more comprehensive studies to establish standardized treatment protocols and evaluate their effectiveness.
文摘Background: Left atrial myxoma (LAM) is the most common heart tumor in adults, requiring prompt surgical removal to prevent complications like valvular obstruction or embolization. Objectives: This study aimed to compare early postoperative outcomes between two surgical approaches—right mini-thoracotomy and median sternotomy—for the removal of isolated left atrial myxoma. Methods: We conducted a prospective observational study at the Department of Cardiac Surgery, National Heart Foundation Hospital & Research Institute (NHFH&RI), Mirpur, Dhaka, from March 2017 to August 2019. Twenty-eight patients undergoing surgery for isolated left atrial myxoma were included. The surgical approach was determined by the operating surgeon. We analyzed outcomes like intubation time, Intensive Care Unit (ICU) stay, pain levels (Visual Analogue Scale score), and overall hospital stay using SPSS. Statistical significance was set at p Results: Patients in the right mini-thoracotomy group had longer mean intubation times (11.43 vs. 5.93 hours, p Conclusion: Despite longer intubation and ICU times, the right mini-thoracotomy approach offers a minimally invasive alternative for isolated left atrial myxoma excision, with favorable outcomes overall.
文摘Median arcuate ligament syndrome (MALS), is a rare abdominal vascular compression syndrome caused by the compression of the proximal celiac trunk by the median arcuate ligament. According to many authors, a low insertion of the diaphragmatic crura or an abnormally high origin of the celiac trunk from the aorta can cause compression of the celiac artery. Usually, patients with MALS are asymptomatic. Computed tomography (CT) angiography of the abdomen is the main imaging modality to confirm the diagnosis. The coexistence of celiac trunk and superior mesenteric artery compression by the median arcuate ligament is rarely described in the literature. To our knowledge, until now, a simultaneous combination of three abdominal vascular compressions by the median arcuate ligament has never been described. From this case, we report a simultaneous compression of the celiac trunk, superior mesenteric artery, and renal arteries by the median arcuate ligament.
文摘Attenuating the noises plays an essential role in the image processing. Almost all the traditional median filters concern the removal of impulse noise having a single layer, whose noise gray level value is constant. In this paper, a new adaptive median filter is proposed to handle those images corrupted not only by single layer noise. The adaptive threshold median filter （ATMF） has been developed by combining the adaptive median filter （AMF） and two dynamic thresholds. Because of the dynamic threshold being used, the ATMF is able to balance the removal of the multiple-impulse noise and the quality of image. Comparison of the proposed method with traditional median filters is provided. Some visual examples are given to demonstrate the performance of the proposed filter.
基金supported by the National Natural Science Foundation of China (No. 39870914)the Key Project on Traditional Chinese Medicine of Shanghai Medical Health Bureau (No. 20003).
文摘Objective This study aimed to investigate the possible role of Orphanin FQ(OFQ) in the regulation of hypothalamic gonadotropin-releasing hormone(GnRH) secretion. Methods The method of push-pull perfusion and radioimmunoassay(RIA) were adopted to examine the secretory profile of GnRH in the median eminence(ME) in freely moving ovariectomized(OVX) rats after intracerebroventricular(icv) injection of OFQ and/or [Nphe1]NC(1-13)NH2(NC13),a competitive antagonists of the opioid receptor-like 1 receptor(ORL1 recep...
基金supported by the National Natural Science Foundation of China(60904090)
文摘For direct sequence spread spectrum （DSSS） receivers, the capability of rejecting narrow-band interference can be significantly improved by a process of frequency-domain interference suppression （FDIS）. The key issue of this process is how to determine a threshold to eliminate interference in the frequency domain, which has been extensively studied. However, these previous methods are tedious or very complex. A simple and ef- ficient algorithm based on medians is proposed. The elimination threshold is only related to the median by a scale factor, which can be obtained by the numerical analysis. Simulation results show that the algorithm provides excellent narrow-band interfer- ence suppression while only slightly degrading the signal-to-noise ratio （SNR）. A one-pass algorithm using logarithmic segmentation is further derived to estimate medians with low computational complexity. Finally, the FDIS is implemented in a field programmable gate array （FPGA） of Xilinx. Experiments are carried out by connecting the FDIS FPGA to a DSSS receiver, and the results show that the receiver has an effective countermeasure for a 60 dB interference-to-signal ratio （ISR）.
