A non-invasive acoustical system was developed for the measurement of transmission properties of acoustic waves in the hip joints. The instrumentation consisted of three sub-systems. An excitation system employed a vibratory force at the sacrum of the test subjects. A transduction system included a pair of identical microphones installed in the tubes of two stethoscopes, which were placed at the greater trochanters on both sides for picking up the acoustical signals transmitted across the hip joints. The data acquisition and analysis system was a portable signal analyzer with a program of dual channel digital filter for measuring the power of acoustical signal in 1/3-octave frequency bands. 27 normal adults, 20 normal pre-school children and 40 normal neonates were randomly selected for testing. Coherence function (CF) and discrepancy (D) was measured during the testing. Results from the three groups showed that there was a high coherence of the signals (CF > 0.9) and a small discrepancy (D < 3 dB) between bilateral hips in the frequency range of 200-315 Hz. For normal neonates, there was a wider frequency range of 160-315 Hz in which the acoustical signals maintained a high coherence (CF > 0.93) and a smaller discrepancy (D < 2 dB) was observed. This study showed that the development of the acoustical technique provided a practical method with objective parameters. The results obtained in this study can offer a baseline for further investigation of hip disorders particularly those related to structural abnormalities of the hip.
Acoustic Stimulation/*instrumentation ; Age Factors ; Hip Joint/*anatomy & histology ; Sacrum/anatomy & histology ; Signal Processing, Computer-Assisted/*instrumentation ; Sound/*diagnostic use

Aged ; Carcinoma, Renal Cell ; diagnosis ; diagnostic imaging ; Female ; Humans ; Kidney Neoplasms ; diagnosis ; diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, Emission-Computed ; Ultrasonography

This study aimed to develop a non-invasive diagnostic technique for the measurement of acoustic transmission in hip joints to reflect the dynamic response of the observed structure. This instrument consists of three sub-systems. An stimulation system applied a vibratory force at the sacrum of the test subject. A transduction system included a pair of identical microphones was installed in the tubes of two stethoscopes, which were placed at the greater trochanters on both sides for picking up the acoustic signals transmitting across the hip joints. The data acquisition and analysis system was a portable frequency analyser with a program of dual channel digital filter for measuring the power of acoustic signals in 1/3-octoscn frequency bands. Twenty-seven normal adults, 20 normal pre-school children and 40 normal neonates were recruited for the testing. Coherence function (CF) of the signal and the discrepancy (D) of bilateral hips were measured during the testing. The results from the three groups showed that there was a high coherence of the signals (CF > 0.9) and a small discrepancy (D < 3 dB) between bilateral hips in the frequency range of 200-315 Hz. For normal neonates, the frequency range (160-315 Hz) was wider in which the acoustic signals maintained a high coherence (CF > 0.94) and a smaller discrepancy (D < 2 dB) were observed between bilateral hips. This study has shown that the development of the acoustical diagnostic technique could provide a practical method with objective parameters. The results obtained in this study can offer a base for further investigation of hip disorders, particularly those related to structural abnormalities of hip joints.
Acoustic Stimulation ; instrumentation ; Adult ; Child, Preschool ; Female ; Hip Joint ; anatomy & histology ; Humans ; Infant, Newborn ; Male ; Signal Processing, Computer-Assisted ; instrumentation ; Sound

A non-invasive acoustical system was developed for the measurement of transmission properties of acoustic waves in the hip joints. The instrumentation consisted of three sub-systems. An excitation system employed a vibratory force at the sacrum of the test subjects. A transduction system included a pair of identical microphones installed in the tubes of two stethoscopes, which were placed at the greater trochanters on both sides for picking up the acoustical signals transmitted across the hip joints. The data acquisition and analysis system was a portable signal analyzer with a program of dual channel digital filter for measuring the power of acoustical signal in 1/3-octave frequency bands. 27 normal adults, 20 normal pre-school children and 40 normal neonates were randomly selected for testing. Coherence function (CF) and discrepancy (D) was measured during the testing. Results from the three groups showed that there was a high coherence of the signals (CF > 0.9) and a small discrepancy (D < 3 dB) between bilateral hips in the frequency range of 200-315 Hz. For normal neonates, there was a wider frequency range of 160-315 Hz in which the acoustical signals maintained a high coherence (CF > 0.93) and a smaller discrepancy (D < 2 dB) was observed. This study showed that the development of the acoustical technique provided a practical method with objective parameters. The results obtained in this study can offer a baseline for further investigation of hip disorders particularly those related to structural abnormalities of the hip.
Acoustic Stimulation ; instrumentation ; Adult ; Age Factors ; Child ; Child, Preschool ; Female ; Hip Joint ; anatomy & histology ; Humans ; Infant ; Infant, Newborn ; Male ; Sacrum ; anatomy & histology ; Signal Processing, Computer-Assisted ; instrumentation ; Sound

INTRODUCTIONCultural influences affect attitudes towards cancer screening, diagnosis, treatment and palliation. The objective of this study is to survey the prevailing attitudes towards cancer in a multicultural tertiary outpatient setting.

MATERIALS AND METHODSThis is a cross-sectional study of 300 respondents visiting the Singapore General Hospital (SGH) Urology Centre over a period of 1 month. A questionnaire was developed assessing responses to various facets of cancer management and administered in English, Chinese or Malay to every 10th person visiting the centre. Institutional review board approval was obtained.

RESULTSOf 300 respondents, 57% were Chinese, 17% Malay, 19% Indian, and 7% others. Mean age was 54.3 years. Most respondents were male (68%) and had up to secondary education (56%). Most Chinese were Taoist/Buddhist (42%) or Christian/ Catholic (36%) while Indians were largely Hindu (47%) or Muslim (27%). Thirty-seven percent of respondents had ever participated in cancer screening. Eighty-nine percent of respondents wanted to be the first to know if they had cancer, and 76% found it unacceptable if the diagnosis of cancer was withheld from them. These were irrespective of race, religion or other factors. Forty percent of respondents believed that being diagnosed with cancer was a matter of fate. Sixty percent of respondents would undergo treatment with 50% chance of cure, even if it involved major surgery and adjuvant therapy. Eighty-one percent believed in efficacy of at least 1 form of alternative treatment. Seventy-one percent of respondents preferred to die at home and this was most marked among Malay respondents (90.4%).

CONCLUSIONThis better understanding of patient attitudes will allow us to help patients balance wishes for autonomy versus family involvement in dealing with cancer. This will help us achieve a more holistic and patient-centred approach to cancer care.

Cross-Sectional Studies ; Health Knowledge, Attitudes, Practice ; Humans ; Neoplasms ; Outpatients ; Surveys and Questionnaires

OBJECTIVETo compare the cell viability of chondrocytes between the anterior and the posterior spinal growth plates in adolescent idiopathic scoliosis (AIS) by proliferation and apoptosis labelling.

METHODSSeventeen AIS patients (4 male and 13 female, mean age 13.6 years old, ranged from 10 to 17 years old) were recruited in this study. Growth plates were harvested during anterior and posterior surgery. PCNA (proliferating cell nuclear antigen) and TUNEL (terminal deoxynucleotide transferase-mediated nick end labeling) were used for proliferation and apoptosis labeling on chondrocytes respectively.

RESULTSIn AIS, the distribution of the proliferating nests were denser and more parallel in anterior column than those in posterior under microscope observation. In the proliferative and hypertrophic zone the PCNA index and PCNA/TUNEL ratio were higher in the anterior column than those in the posterior column (P < 0.05 and P < 0.01 respectively). While in resting zone the differences were not so significant.

CONCLUSIONIn adolescent idiopathic scoliosis the growth viability of chondrocytes is more vigorous in anterior spinal column than in the posterior column.

Adolescent ; Apoptosis ; Cell Proliferation ; Cell Survival ; Child ; Chondrocytes ; cytology ; Female ; Growth Plate ; pathology ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Male ; Scoliosis ; pathology ; physiopathology ; Spine ; growth & development ; pathology

OBJECTIVETo evaluate the trabecular bone micro-structure from different sites of spine in adolescent idiopathic scoliosis patients. The target site consisted of the bilateral facet joints from apical vertebrae and from end vertebrae.

METHODSNine AIS patients with mean age 14.9 years (range 12-17 years) and mean Cobb angle 56 degrees (ranged 48 degrees-84 degrees) were recruited into this study. Corrective surgery was indicated to these patients, and facet joint biopsies were collected during decortications for spinal fusion. Biopsy consents were obtained from patients. Bone specimens were fixed with routine histology procedures and scanned by micro computer tomography (muCT40, Scanco Medical, Switzerland). Ten pairs of facet joint were harvested from apical vertebrae and 12 pairs from end vertebrae. Three-dimensional reconstructed images with the resolution of 20 microm were achieved for histomorphometric analysis.

RESULTSThe values of BV/TV (0.268 vs. 0.354, P < 0.05), TbTh (0.20 vs. 0.24, P < 0.05), TbSP (0.66 vs. 0.56, P < 0.05) and BS/BV (12.7 vs. 10.4, P < 0.05) between convex and concave side at the apex area were significantly different. No difference was found in any structural parameters between left and right side at end area, and upper thoracic (T5, 6) and thoracolumbar (T12, L1).

CONCLUSIONDue to asymmetric compression and tension shared between convex and concave side, more bone and thicker and more profound trabecular bones are observed in the concave side than in the convex side, which seems to resist the progression of spinal curvature. This finding suggests that the provocative factors which cause the progression of the curve in certain patients may not lie in the bone component of spine.

Adolescent ; Child ; Female ; Humans ; Scoliosis ; diagnostic imaging ; pathology ; physiopathology ; Tomography, X-Ray Computed ; Zygapophyseal Joint ; pathology ; physiopathology

Objectives: Sarcopenia has emerged as a significant aging-related disease that affects many facets of societal-level and patient-level public health. This study analysed knowledge of sarcopenia and associated socio-demographic factors among the general public of Malaysia in order to effectively improve its prevention and countermeasures. Methods: A cross-sectional online survey was conducted in Selangor, Malaysia, using Google Forms among 202 Malaysian adults from January 1, 2021 to March 31, 2021. Descriptive statistics were used to analyse the socio-demographic characteristics and knowledge scores. The continuous variables were evaluated using the independent t-test, Mann–Whitney test, and one-way analysis of variance test. The Spearman correlation coefficient was employed to determine the correlation between socio-demographic characteristics and knowledge score levels. Results: The final analysis included 202 participants. The mean±standard deviation age was 49.03±12.65. Only 6.9% of participants had good knowledge of sarcopenia and were aware of sarcopenia’s characteristics, consequences, and treatments. Post-hoc comparisons using the Dunnett T3 test showed statistical significance in mean knowledge score and age group (p=0.011) and education level (p≤0.001). The Mann–Whitney test revealed that gender (p=0.026) and current smoking status (p=0.023) significantly influenced knowledge scores. Conclusions The general public’s knowledge of sarcopenia was found to be poor to moderate and associated with age and education status. Therefore, education and interventions by policymakers and healthcare professionals to improve public knowledge of sarcopenia in Malaysia are needed.

BACKGROUNDOff-label application of drug-eluting stents (DES) during percutaneous coronary intervention (PCI) was not uncommon in daily practice, however DES in treating Chinese patients with complex lesion subset was under-investigated. The primary objective of the FIREMAN registry was to evaluate the long term efficacy and safety of the Firebird sirolimus-eluting stent (SES) in treating patients with complex coronary lesions. Here we report the mid-term of one-year clinical outcomes and eight-month angiographic follow-up results of FIREMAN registry.

METHODSThe FIREMAN registry was a prospective multi-center registry, which included 1029 consecutive patients undergoing PCI with Firebird SES implantation between September 2006 and July 2007 in 45 centers in China. The clinical follow-up was designed to be performed at 1, 6, 12, 18, 24, 30 and 36 months post index procedure, and non-mandatory angiographic follow-up at 8 months was planned. One hundred percent site monitoring was conducted.

RESULTSLong lesions (59.2%), multi-vessel disease (50.4%), and small vessel disease (31.6%) were mostly found in angiography. Major adverse cardiac events (MACE) occurred in 51 (5.1%) patients at 1 year clinical follow-up, including cardiac mortality in 6 (0.6%), non-fatal myocardial infarction in 11 (1.1%), and target lesion revascularization in 36 (3.5%) of the patients. Definite and probable stent thrombosis (ST) by Academic Research Consortium (ARC) definition occurred in 12 (1.36%) patients at one-year clinical follow-up. The 8-month binary restenosis rate was 5.7% in-segment and 4.3% in-stent, respectively. Late lumen loss was (0.21 ± 0.40) mm in-segment and (0.23 ± 0.36) mm in-stent, respectively. Furthermore, Cox regression analysis revealed that diabetes, small vessel diameter, and chronic total occlusion were independent predictors of ST.

CONCLUSIONSThe results showed that the Firebird SES was effective and safe in treating Chinese patients with complex coronary lesions and occurrence of ST rate at one-year clinical follow-up was acceptable, however further long-term follow-up was still necessary. (NCT00552656)

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; methods ; Asian Continental Ancestry Group ; Coronary Angiography ; Coronary Disease ; diagnostic imaging ; therapy ; Drug-Eluting Stents ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Sirolimus ; therapeutic use ; Treatment Outcome

Autonomic Nervous System ; physiopathology ; Blood Pressure ; physiology ; Cardiovascular Diseases ; therapy ; Cardiovascular System ; physiopathology ; Diabetic Neuropathies ; therapy ; Humans