•A clinical study assessing the efficacy of HIFU for uterine fibroid or adenomyosis.•A cohort of 618 patients, of which 272 had uterine fibroid and 346 had adenomyosis.•Chongqing Haifu JC Focused ...Ultrasound (USgHIFU) Tumor Therapeutic System was used.•USgHIFU is an effective and safe non-invasive therapy for fibroid and adenomyosis.
This study aimed to assess the therapeutic outcomes of patients with uterine fibroid or adenomyosis treated by ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation at Incheon Christian Hospital, Korea.
This study included 618 patients, of which 272 suffered from uterine fibroid and 346 suffered from adenomyosis. Treatment was administrated using the Model Haifu JC Focused Ultrasound Tumor Therapeutic System (Chongqing Haifu Technology, Chongqing, China) under real-time ultrasound guidance. A follow-up was conducted on volume change as well as on symptom improvement using the Symptom Severity Score (SSS) and Uterine Fibroid Symptom and Quality of Life (UFS–QOL) after treatment.
The uterine fibroid volume reduction rates (%) were 58.08%, 66.18%, and 77.59% at 3, 6, and 12months after treatment, respectively. The SSS reduction rates (%) were 55.58%, 52.76%, and 50.39% by 3, 6, and 12months, respectively. The UFS–QOL score increasing rates (%) were 42.66%, 43.50%, and 43.45% by 3, 6, and 12months, respectively. The uterine volume reduction rates (%) for adenomyosis were 43.99%, 47.01%, and 53.98% by 3, 6, and 12months, respectively. The SSS reduction rates (%) for adenomyosis were 55.61%, 52.38%, and 57.98% by 3, 6, and 12months, respectively. The UFS–QOL score increasing rates (%) for adenomyosis UFS–QOL score were 80.06%, 69.39%, and 85.07% by 3, 6, and 12months, respectively.
We conclude that USgHIFU treatment for uterine fibroid and adenomyosis is an effective non-invasive therapy via the assessment of fibroid volume reduction, symptom improvement, UFS–QOL score increase, and acceptable level of side effects. Although preliminary experience of HIFU is encouraging, well-designed prospective trials and more clinical experiences are needed to ascertain the efficacy and safety of this new treatment.
The hydrophobicity of dissolved organic matter (DOM) affects various aspects of its environmental impacts in terms of water quality, sorption behaviors, interactions with other pollutants, and water ...treatment efficiency. In this study, source tracking of river DOM was conducted separately for hydrophobic acid (HoA-DOM) and hydrophilic (Hi-DOM) fractions using end-member mixing analysis (EMMA) in an agricultural watershed during a storm event. EMMA with optical indices of bulk DOM revealed larger contributions of soil (24 %), compost (28 %), and wastewater effluent (23 %) to riverine DOM under high versus low flow conditions. Molecular level analysis of bulk DOM revealed more dynamic features, showing an abundance of CHO and CHOS formulae in riverine DOM under high- and low flow conditions. CHO formulae originated from soil (78 %) and leaves (75 %) and contributed to the increasing CHO abundance during the storm event, whereas CHOS formulae likely originated from compost (48 %) and wastewater effluent (41 %). The characterization of bulk DOM at the molecular level demonstrated that soil and leaves are the dominant contributors for the high-flow samples. However, in contrast to the results of bulk DOM analysis, EMMA with HoA-DOM and Hi-DOM revealed major contributions from manure (37 %) and leaf DOM (48 %) during storm events, respectively. The results of this study highlight the importance of individual source tracking of HoA-DOM and Hi-DOM for the proper evaluation of the ultimate roles of DOM in affecting river water quality and for a better understanding of DOM dynamics and transformation in natural and engineered systems.
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•Source tracking was separately conducted for HoA- and Hi-DOM during a storm event.•Major sources were different between the HoA- and Hi-DOM in agricultural watershed.•Leaves were the major source contributor to Hi-DOM, whereas manure was to HoA-DOM.
Dietary net endogenous acid production (NEAP), which represents total dietary load of nonvolatile acid, may affect kidney function. Estimated NEAP (eNEAP) is calculated indirectly by the ratio of ...protein and potassium intake. A few studies are available assessing the association between eNEAP and chronic kidney disease (CKD), and its relation to dietary protein and potassium intake in the elderly.
A total 1,369 community-dwelling elderly Koreans in the Kangbuk Samsung Cohort Study (KSCS) were evaluated using a food frequency questionnaire (FFQ) and comprehensive health examination. We evaluated the association between eNEAP and the CKD. We also examined their relation to protein and potassium intake.
eNEAP was correlated with potassium intake (r = -0.410, P < 0.001), but was not correlated with protein intake (r = -0.004, P = 0.879). In a full multivariate adjustment for sociodemographic factors, dietary factors, and comorbidities, the participants with higher eNEAP quartiles (Q2, Q3, Q4) had higher odds of CKD compared to the lowest eNEAP quartile (Q1); OR (95% CI) were 1.47 (0.78-2.72), 1.66 (0.85-3.23), and 2.30 (1.16-4.60) respectively (P for trend = 0.019). The odds of CKD decreased for participants with higher potassium intake quartiles (Q2, Q3, Q4) compared to the lowest potassium intake quartile (Q1); OR (95% CI) were 0.52 (0.28-0.95), 0.50 (0.26-0.96), and 0.50 (0.21-0.99) respectively (P for trend = 0.050). Protein intake was not associated with CKD. The association between eNEAP and CKD was similar in subgroup analysis.
Dietary acid load was associated with CKD. Among the nutrients related to dietary acid load, potassium intake was negatively associated with CKD, but protein intake was not associated with CKD in elderly adults.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Sarcopenia, defined as a significant loss of skeletal muscle mass and function, is suggested to be associated with an increased risk of complications after various surgical interventions. ...However, evidence regarding sarcopenia in microsurgical breast reconstruction has been lacking. The present study was designed to evaluate the association between preoperative sarcopenia and adverse outcomes in deep inferior epigastric perforator (DIEP) flap-based breast reconstruction.
Methods
Patients who underwent breast reconstruction using DIEP flap between 2009 and 2018 were reviewed. Sarcopenia was defined as a skeletal muscle index < 38.5 cm
2
/m
2
, calculated by normalizing the cross-sectional area of the skeletal muscle, measured at the level of the third lumbar vertebra based on preoperative computed tomography angiography, to patient height. Postoperative complication rates were compared between patients with sarcopenia and those without it. Independent association of sarcopenia with complication profiles were evaluated. Further analyses were conducted using propensity score matching.
Results
In total, 557 patients were analyzed, of which 154 (27.6%) had preoperative sarcopenia. The sarcopenia group had a significantly lower body mass index, a lower elevated flap weight, and greater use of bipedicled flaps compared to the nonsarcopenia group. Complications developed in 128 patients (23.0%) and were more prevalent in the sarcopenia group. Preoperative sarcopenia was associated with a significantly higher rate of complications, including breast hematoma, breast wound problems, abdominal functional weakness, and reoperation in the multivariable analyses. Similar associations were observed in the propensity score matching analysis.
Conclusions
Preoperative sarcopenia appears to be associated with adverse outcomes in DIEP flap-based breast reconstruction.
Divalent cations have been reported to develop bridges between anionic polyelectrolytes and negatively-charged colloidal particles, thereby enhancing particle flocculation. However, results from this ...study of kaolinite suspensions dosed with various anionic polyacrylamides (PAMs) reveal that Ca2+ and Mg2+ can lead to colloid stabilization under some conditions. To explain the opposite but coexisting processes of flocculation and stabilization with divalent cations, a conceptual flocculation model with (1) particle-binding divalent cationic bridges between PAM molecules and kaolinite particles and (2) polymer-binding divalent cationic bridges between PAM molecules is proposed. The particle-binding bridges enhanced flocculation and aggregated kaolinite particles in large, easily-settleable flocs whereas the polymer-binding bridges increased steric stabilization by developing polymer layers covering the kaolinite surface. Both the particle-binding and polymer-binding divalent cationic bridges coexist in anionic PAM- and kaolinite-containing suspensions and thus induce the counteracting processes of particle flocculation and stabilization. Therefore, anionic polyelectrolytes in divalent cation-enriched aqueous solutions can sometimes lead to the stabilization of colloidal particles due to the polymer-binding divalent cationic bridges.
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► Effects of divalent cations on kaolinite flocculation and stabilization are compared for different anionic polyacrylamides. ► Particle stabilization results from surface coatings formed via polyelectrolyte-binding divalent cationic bridges. ► Polyelectrolyte-binding divalent cationic bridges inhibit kaolinite flocculation primarily by steric stabilization. ► Competition between particle-binding and polyelectrolyte-binding bridges explains kaolinite flocculation or stabilization.
Among a variety of relevant factors of osteoporosis, the association between alcohol intake and postmenopausal women's bone mineral density (BMD) by using data from the Korean National Health and ...Nutrition Examination Survey was evaluated in this study.
Among a total of 31,596 subjects, males, premenopausal women, participants without BMD data were excluded. Finally, a total number of subjects in the study was 3,312. The frequency and amount of alcohol intake were determined by self-reported questionnaires, and BMD was measured by dual-energy x-ray absorptiometry.
Mean femoral BMD for light drinkers was statistically significantly greater than that for heavy drinkers and non-drinkers. We observed the characteristic trends for BMD by drinking frequency; the mean BMD gradually increased from non-drinkers to the participants who drank 2-3 times per week; these participants exhibited the highest BMD. Participants who drank alcohol greater than 4 times per week showed a lower BMD. In the risk factor analysis, the adjusted odds ratio for osteoporosis (at femoral neck) was 1.68 in non-drinkers and 1.70 in heavy drinkers compared with light drinkers.
Light alcohol intake (2-3 times per week and 1-2 or 5-6 glasses per occasion) in South Korean postmenopausal women was related to high femoral BMD. Non-drinkers and heavy drinkers had approximately a 1.7-times greater risk for osteoporosis than light drinkers.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract Self‐powered electrical bandages (SEBs), integrated with wearable energy harvesters, can provide an effective and autonomous electrical stimulation (ES) solution for rapid and scarless wound ...healing. A continuously operating, wireless, and applicable‐to‐comprehensive‐wound ES device is essential for the quick restoration of wounds and convenience. This work illustrates a SEB powered by body‐coupled energy harvesting. The SEB continuously treats the wound with 60‐Hz sinusoidal electrical potential gained from the coupling of the human body and ambient electrical waves. It is demonstrated that enough level of electrical potential can be applied to the wound, further enhanced by strong capacitive coupling arising from the use of high‐permittivity poly(vinylidene fluoride‐trifluoroethylene):CaCu 3 Ti 4 O 12 (P(VDF‐TrFE):CCTO) nanocomposite. The potential clinical efficacy of the SEB is illustrated by preclinical analysis of human fibroblasts and mouse wound model, thus confirming the successful expedition of wound recovery. This work suggests a new class of wearable devices to provide ES events and its potential for extension to other conventional wound care materials and device technology.
BACKGROUND:The present study aimed to evaluate the influence of vertical location and spacing of perforators within flaps on the outcomes of deep inferior epigastric perforator (DIEP) flap breast ...reconstruction.
METHODS:Patients who underwent unilateral breast reconstruction with unipedicle DIEP flaps were identified. They were categorized into cohorts based on the entry of perforators in the middle third (cohort 1), upper third (cohort 2), and multiple third parts (cohort 3) of the flaps. Perfusion-related complications including fat necrosis diagnosed with ultrasound and donor-site morbidity were compared between the cohorts.
RESULTS:A total of 287 patients were analyzed, including 51 in cohort 1, 75 in cohort 2, and 161 in cohort 3. The cohorts were well matched, except for a greater number of perforators and more frequent harvest of both medial and lateral row perforators in cohort 3. Rates of overall perfusion-related complications and fat necrosis differed significantly between cohorts, with the highest rates in cohort 2. Fat necrosis occurred predominantly in the caudal portion of the flap in cohort 2, whereas it was relatively evenly distributed in the cephalic and caudal portions in cohorts 1 and 3. Rates of donor-site complications were similar across the cohorts. Multivariate analyses demonstrated that vertical spacing of perforators had an independent influence on developing perfusion-related complications and fat necrosis, showing that cohort 2 had significantly higher odds compared with cohorts 1 and 3, respectively.
CONCLUSION:Vertical spacing of perforators might affect the risk of perfusion-related complications in DIEP flap breast reconstruction.
CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, III.
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