Analysis of tendon tension and hysteresis by tendon twisting and development of anti‐twist tendon mechanism of robotic surgical instruments

xlomafota13 shared this article with you from Inoreader Analysis of tendon tension and hysteresis by tendon twisting and development of anti‐twist tendon mechanism of robotic surgical instruments Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Control of the joints of robotic surgical instruments is difficult owing to hysteresis, and tendon twisting due to axial rotation of surgical tools also causes hysteresis. Therefore, a new mechanism is needed to prevent tendon twisting. Methods Tendon tension and hysteresis change were analyzed by observing the movement of the joint depending on whether the tendons twisted for the same input signal. An anti-twist tendon mechanism to prevent twisting was developed. A 3-mm needle driver applied with the proposed mechanism was manufactured. Results The anti-twist mechanism makes no tension change because of twisting or friction between the tendon and the system, i.e., the operating performance was the same regardless of rotation. Conclusion The proposed mechanism has been verified and can be applied to small surgical instruments 3 mm in size. These findings can be applied in the development of instruments for precise surgeries such as microsurgery. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pathological diagnosis, differential diagnosis and origin investigation of easily misdiagnosed adult gastric duplication cysts

xlomafota13 shared this article with you from Inoreader Pathological diagnosis, differential diagnosis and origin investigation of easily misdiagnosed adult gastric duplication cysts Via Cellular and Molecular Biology Histol Histopathol. 2021 Dec 29:18417. doi: 10.14670/HH-18-417. Online ahead of print. ABSTRACT OBJECTIVES: To study diagnosis, differential diagnosis, and origin of easily misdiagnosed adult gastric duplication cysts. METHODS: Six cases with GDCs were studied using immunohistochemical methods to research the expression of tumor markers. RESULTS: Most GDCs were located in the abdominal cavity outside the digestive organs. The cyst wall tissues included a repetition of the full-thickness structure of the stomach wall that was lined by a variety of different epithelia. The expression of CK7 was positive in all epithelia (6/6), while CK7 expression was positive in cardia glands in 5/5 and positive in fundus glands in 1/5. CK 20 was 100% (4/4) positively expressed in the SCE, 100% (3/3) negative in the CCE, and in the SE. It was also expressed positively 100% (5/5) in fundus glands and 80% (4/5) in cardia glands. Both CK7 and C K20 were negatively expressed in the pyloric glands in case 3. The expression of MUC1 was positive in all epithelia and glands, whereas MUC2 expression was negative. MUC5AC was expressed differently in epithelia and glands. CONCLUSIONS: GDCs can originate from the antrum or the fundus of the stomach. Tumor markers can help diagnosis and differential diagnosis. This study may help to improve clinical precision treatment. PMID:34964481 | DOI:10.14670/HH-18-417 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characteristics and function of resident macrophages in stria vascularis

xlomafota13 shared this article with you from Inoreader Characteristics and function of resident macrophages in stria vascularis Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1365-1370. doi: 10.3760/cma.j.cn115330-20210119-00027. NO ABSTRACT PMID:34963230 | DOI:10.3760/cma.j.cn115330-20210119-00027 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bilateral Sensorineural Hearing Loss in the Setting of Acute Methamphetamine Overdose

xlomafota13 shared this article with you from Inoreader Bilateral Sensorineural Hearing Loss in the Setting of Acute Methamphetamine Overdose Via ear nose throat Ear Nose Throat J. 2021 Dec 29:1455613211069353. doi: 10.1177/01455613211069353. Online ahead of print. ABSTRACT Substance abuse is a rare but known cause of sensorineural hearing loss (SNHL). We report a case of acute SNHL in a 28-year-old man following an overdose of methamphetamine and incidental ingestion of fentanyl. On initial encounter, he had moderate-to-severe hearing loss in the right ear and severe-to-profound hearing loss in the left ear in addition to acute kidn ey injury, liver failure, and lactic acidosis. The patient was treated with a two-week course of high-dose steroids and expressed a subjective improvement in hearing. This case highlights the importance of auditory testing following a drug overdose and is one of the only documented cases of hearing loss following methamphetamine use in recent years. There is a paucity of literature regarding the mechanism causing acute SNHL secondary to methamphetamines. Proposed etiologies include neurotransmitter depletion or reduced cochlear blood flow as possible causes of ototoxicity. PMID:34965172 | DOI:10.1177/01455613211069353 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS):a multicenter randomized controlled trial

xlomafota13 shared this article with you from Inoreader Efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS):a multicenter randomized controlled trial Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1248-1255. doi: 10.3760/cma.j.cn115330-20210429-00237. ABSTRACT Objective: To compare the therapeutic efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: This is a multicenter randomized controlled trial. From March 2017 to July 2019, moderate to severe OSAHS patients from three clinical center in Shanghai who were intolerant to continuous positive airway pressure (CPAP) and with velopharyngeal and glossopharyngeal plane obstruction were enrolled in this study. According to the surgical type, they were 1∶1 randomized to HUPPP plus radiofrequency ablation of tongue base group (Ablation group) or HUPPP plus traction of tongue base group (Traction group). All patients completed over-night standard Polysomnography (PSG), upper-airway assessment (Friedman classification, Müller test, CT and cephalometric examination), preoperative routine examination, Epworth Sleepiness Scale (ESS) and Quebec sleep questionnaire (QSQ). Six to 12 months after operation, all the above-mentioned examinations were repeatedly performed. Changes of aforementioned variables before and after operation were assessed. Results: A total of 43 patients with moderate to severe OSAHS were enrolled in this study. One patient lost to follow-up, the remaining 21 were allocated to Ablation group and 21 were allocated to Traction group. The total therapeutic efficacy of all patients was 69.05% (61.90% in Ablation group and 76.19% in Traction group), but there was no statistical significance between the two groups (P= 0.317). The value of sleep scale score (ESS and QSQ), objective sleep variables (apnea-hypopnea index, oxygen saturation, percentage of time with blood oxygen less than 90% in total sleep time, oxygen desaturation index and micro-arousals) and upper airway cross-sectional area (palatopharyngeal and retrolingual area) of the two groups were improved (P<0.05), but the differences between the two groups were not statistically significant (P>0.05). Conclusion: For moderate to severe OSAHS who had glossopharyngeal plane obstruction, both HUPPP plus radiofrequency ablation of tongue base or HUPPP plus traction of tongue base are effective treatment for OSAHS, and the curative effect is similar. The choice of surgical type could be selected according to patient's or surgical conditions. PMID:34963211 | DOI:10.3760/cma.j.cn115330-20210429-00237 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Obstructive sleep apnea and metabolic syndrome: an association study based on a large sample clinical database

xlomafota13 shared this article with you from Inoreader Obstructive sleep apnea and metabolic syndrome: an association study based on a large sample clinical database Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1263-1269. doi: 10.3760/cma.j.cn115330-20210531-00314. ABSTRACT Objective: To investigate the prevalence and associated risk factors of metabolic syndrome (MS) in patients with obstructive sleep apnea (OSA). Methods: From July 2007 to June 2017, a total of 8 155 adult subjects, including 6 484 males and 1 671 females, aged 18-90 (43.13±12.28), body mass index 14.61~59.56 (25.59±3.98) kg/m2,who were admitted to the Department of Otorhinolaryngology head and Neck surgery of The Sixth People's Hospital affiliated to Shanghai Jiao Tong University, were retrospectively analyzed. All patients underwent polysomnography and biochemical tests. Subjects were divided into four groups (non-OSA, mild OSA, moderate OSA, and severe OSA) according to OSA severity. The prevalence of MS was expressed as percentage, and the correlation between OSA and MS and its c haracteristic pathophysiological indicators was evaluated by logistic regression model after adjusting for factors such as gender, age, BMI, neck circumference, hip circumference, smoking and alcohol consumption, and was expressed by odds ratio (OR). SPSS 25.0 software was used for statistical analysis. Results: The overall prevalence of MS was 43.6%, and that of non-/mild/moderate/severe OSA group was 18.6%, 30.4%, 43.8%, 57.1%.Logistic regression showed that patients with mild/moderate/severe OSA had an increased risk of MS compared with non-OSA patients, with adjusted OR values and confidence intervals of 1.27 (1.05-1.54), 1.84 (1.53-2.22), and 2.08 (1.76-2.46), respectively (P<0.01).In addition, indicators of OSA anoxic burden [oxygen drop index(Toxygen=7.1), minimum blood oxygen(Tminimum=56.3), blood oxygen saturation below 90% cumulative time ratio (TCT90=10.6) ]were closely associated with MS disease(P<0.01), but sle ep fragmentation index (arousals index) was not significantly associated with MS disease. Conclusion: The risk of MS gradually increases with the severity of OSA, and the indicators reflecting OSA hypoxia burden are closely related to MS disease. PMID:34963213 | DOI:10.3760/cma.j.cn115330-20210531-00314 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of COL1A1 gene variation and clinical prevention and treatment in patients with Van der Hoeve syndrome

xlomafota13 shared this article with you from Inoreader Analysis of <em>COL1A1</em> gene variation and clinical prevention and treatment in patients with Van der Hoeve syndrome Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1292-1299. doi: 10.3760/cma.j.cn115330-20210110-00014. ABSTRACT Objective: To investigate the clinical phenotype, treatment and prevention of Van der Hoeve syndrome, and analyze the variation characteristics of its related gene COL1A1. Methods: Hearing and sequencing data of syndromic deafness patients who had undergone genetic testing for deafness at the Chinese People's Liberation Army General Hospital since January 2008 to October 2020 were retrospectively reviewed. The variation of the COL1A1 gene and return visits to traceable patients and families were summarized, the disease progress and clinical treatment effects were analyzed, and the prevention strategies were discussed. Results: A total of 7 patients with COL1A1 gene mutation underwent clinical intervention. The mutation sites were c.1342A>T (p.Lys448*), c.124C>T (p.Gln42*), c.249insG(p.Ala84*), c.668insC(p.Gly224*), c.2829+1G>C, c.1081C>T (p.Arg361*), c.1792C>T (p.Arg598*), of which c.1081C>T and c.1792C>T had been previously reported, and the remaining 5 were novo mutations that have not been reported. All the 7 probands underwent stapes implantation and received genetic counseling and prevention guidance. Conclusions: Van der Hoeve syndrome belongs to osteogenesis imperfecta type Ⅰ. The disease has high penetrance. Timely surgical intervention for hearing loss can improve the life quality in patients. Accurate genetic counseling and preimplantation genetic diagnosis can achieve the primary prevention for the disease. PMID:34963217 | DOI:10.3760/cma.j.cn115330-20210110-00014 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of relocation and expansion pharyngoplasty by suspension sutures in the treatment of OSAHS with soft palate oropharyngeal obstruction

xlomafota13 shared this article with you from Inoreader Efficacy of relocation and expansion pharyngoplasty by suspension sutures in the treatment of OSAHS with soft palate oropharyngeal obstruction Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1270-1276. doi: 10.3760/cma.j.cn115330-20210707-00436. ABSTRACT Objective: To explore the efficacy of relocation and expansion pharyngoplasty by suspension sutures in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Seventy-three patients(including 60 males and 13 females) with OSAHS admitted to the department of otorhinolaryngology of our hospital in recent two years were retrospectively analyzed. All the patients had velopharyngeal obstructionevaluated by electronic endoscopic Müller test and were divided into control group (34 cases) and observation group (39 cases). The patients in the control group were performed modified uvulopalatopharyngoplasty, while those in the observation group were performed relocation and expansion pharyngoplasty by suspension sutures.The scores of ESS, AHI and LSaO2 before and after trea tment were collected and compared. Results: The total effective rate of the observation group was 94.87%, which was significantly higher than 79.41% of the control group. The AHI was lower and LSaO2 value was higher (χ2=-1. 896,-1. 968,P<0.05)in the observation group. The sleeping symptoms and quality of life of the two groups were significantly improved. The ESS score of the observation group was decreased more significantly than that of the control group after treatment, and the difference was statistically significant (χ2=-1.451,P<0.05). The incidence of foreign body sensation in pharynx of the observation group (89.74%) was higher than that of the control group (55.88%), and the postoperative bleeding and postoperative recurrence rate (0.00%, 2.56%) was lower than that of the control group (8.82%, 14.70%)with statistical significance (χ2=4.738,4.249,4.119,P<0.05).The incidence of transient nasoph aryngeal reflux in both groups was low and statistically insignificant (χ2=0.629,P>0.05). Conclusions: Preoperative strict screening of indications plays an important role in the selection of palatopharyngeal surgery methods and curative effect. Relocation and expansion pharyngoplasty by suspension sutures can improve the clinical efficacy of OSAHS with better safety and less recurrence. PMID:34963214 | DOI:10.3760/cma.j.cn115330-20210707-00436 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mini-incision with endoscope-assisted surgery for bilateral congenital second branchial cleft fistula and a pedigree report

xlomafota13 shared this article with you from Inoreader Mini-incision with endoscope-assisted surgery for bilateral congenital second branchial cleft fistula and a pedigree report Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1313-1318. doi: 10.3760/cma.j.cn115330-20201225-00952. ABSTRACT Objective: To investigate the feasibility and efficacy of mini-incision with endoscope-assisted resection for bilateral congenital second branchial cleft fistula, and to report on a rare pedigree. Methods: The clinical data of 5 patients with bilateral congenital second branchial fistula admitted in Fujian Provincial Hospital from April 2007 to December 2018 were retrospectively reviewed, including 2 males and 3 females, aged from 3 to 31 years old. The surgical strateges and clinical experience of single mini-incision with endoscope-assisted fistulectomy were summarized, and a rare pedigree was reported. Results: In five patients, Case 1 to Case 4 were treated with bilateral endoscopic-assisted fistula high ligation with titanium clips and removal through a single small incision under ge neral anesthesia. No obvious complications occurred after the operation. The patients were followed up for 40-164 months with no fistula recurrence. Case 5 gave up surgical resection and was followed up for 24 months with acute infection attack once. Case 2 and Case 4 came from the same family. In this family, 7 out of 31 members of four generations had second branchial cleft fistulas, of which 4 were bilateral and 3 were right. Pedigree analysis was consistent with autosomal dominant inheritance. No deafness, preauricular tag, external and middle ear deformity and kidney malformation were found in the family members. Conclusions: Bilateral congenital second branchial cleft fistula is rare. Surgical resection is the preferred treatment. Mini-incision with endoscopic-assisted fistula high ligation with titanium clip and resection has clear operative field, ideal cosmetic effect and definite curative effect. PMID:34963220 | DOI:10.3760/cma.j.cn115330-20201225-00952 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neuroimaging of the endolymphatic hydrops of the labyrinth in severe and moderately severe Meniere's disease

xlomafota13 shared this article with you from Inoreader Neuroimaging of the endolymphatic hydrops of the labyrinth in severe and moderately severe Meniere's disease Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):4-9. doi: 10.17116/otorino2021860614. ABSTRACT The results of magnetic resonance imaging (MRI) of the inner ear 24 hours after intratympanic administration of 1 ml of diluted (1:7) contrast substance for gadolinium-based MRI in 43 patients with moderate and severe Meniere's disease course are presented. It has been revealed that in case of severe and moderate course of Meniere's disease endolymphatic hydrops is presented in all departments of labyrinth: cochlea, vestibule, semicircular canals, but is most pronounced in vestibular department of labyrinth: horizontal semicircular canal and vestibule. The neuroimaging method according to the presented protocol is safe and can be applied in a wide practice both to assess the presence and localization, and the degree of expression of the endolymphatic hydrops. PMID:34964321 | DOI:10.17116/otorino2021860614 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Features of the clinic, diagnosis and treatment of parapharyngeal abscesses in children: analysis of 121 observations

xlomafota13 shared this article with you from Inoreader Features of the clinic, diagnosis and treatment of parapharyngeal abscesses in children: analysis of 121 observations Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):62-68. doi: 10.17116/otorino20218606162. ABSTRACT Parapharyngeal and retropharyngeal abscesses (PPA) in children are a rare pathology, for the diagnosis of which it is necessary to use additional instrumental examination methods. The tactics of treating patients remains a subject of discussion. OBJECTIVE: To analyze the features of the clinic, diagnosis and treatment of PPA in children. MATERIAL AND METHODS: According to the hospital database, a retrospective analysis of the medical histories of children discharged from the clinic with a diagnosis of "J39.0 Retropharyngeal and parapharyngeal abscess" was carried out in the period from 01.01.14 to 31.12.19. In all cases, the diagnosis was confirmed by computed tomography (CT) data with contrast enhancement. Complaints at the time of treatment, anamnesis and instrumental diagnosis data, clinical features of the course of the disease and the e ffectiveness of treatment were analyzed. RESULTS: 121 children were treated for PPA (average age 73±41 months; Me=52.5 months), which is 0.4% of all hospitalized in the otorhinolaryngological department, 0.7% of the number of emergency hospitalizations, 0.8% of the number of hospitalized children with pharyngeal diseases, and 8.3% of the number of patients with pharyngeal abscess. Abscesses were more often localized in the upper pharynx, at the level of the I-II cervical vertebrae (49.6% of all observations); abscesses were found least often in the pharyngeal space (5.8%), there was no statistically significant difference between the right-sided and left-sided location: 47.9% and 46.2%, respectively. Surgical treatment was performed in 98 (81%) patients in the presence of an abscess capsule or an abscess diameter of more than 2 cm according to CT; the remaining 23 (19%) children were treated conservatively. The opening of the abscess was performed endopharyngeal, in the case of a pronounced deep lateral location of the abscess and its proximity to large blood vessels - with access through the tonsillar niche after preliminary tonsillectomy (19.4% of those operated). CONCLUSION: The final diagnosis of parapharyngeal and retropharyngeal abscess can be established by contrast-enhanced computed tomography. Conservative treatment is indicated for a limited group of patients at the initial stages of the disease, most patients need surgical treatment. PMID:34964332 | DOI:10.17116/otorino20218606162 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.