This study investigated a novel coronary knobby scoring balloon through finite element analysis (FEA) and in vitro anti-slippage testing, evaluating its dilation process under various vascular conditions and comparing it with other balloons. The FEA results indicated that in the cases of healthy artery and diseased artery with different stenosis rates, the stress on the vessels caused by the knobby scoring balloon was significantly smaller than that of the scoring balloon, and was close to that of the plain balloon. In vitro anti-slippage testing showed that the slippage distance of a plain balloon was 0.11±0.06 mm, and there was no slippage for knobby scoring balloon under nominal pressure. Knobby scoring balloon can effectively expand calcified lesion while providing anti-slippage function, and has a lower risk of vascular injury.
Finite Element Analysis ; Humans ; Angioplasty, Balloon, Coronary/instrumentation* ; Equipment Design ; Biomechanical Phenomena ; Coronary Vessels

Introduction: Minimally invasive percutaneous osteosynthesis (MIPO) plating techniques have demonstrated good outcomes in the treatment of distal tibia fractures. Early arthritis and functional impairment may occur if length and rotation are not restored. This study aims to determine the incidence and severity of tibia malrotation following MIPO plating of isolated unilateral distal tibia fractures, defined as torsional difference of greater than 10° as compared to the contralateral limb and whether the degree of malrotation affects functional outcomes scores. Materials and methods: This was a level 2 prospective cohort study. All patients with fractures of the distal tibia who underwent surgical fixation with the exclusion of patients with polytrauma, neurovascular injuries or preexisting disabilities were recruited. Patients underwent MIPO plating followed by a post-operative Computed Tomography (CT) scan of bilateral lower limbs. AOFAS ankle-hindfoot score was recorded at six months and one year follow-up. Results: A total of 24 patients (28 to 83 years old) were recruited. Nineteen patients obtained CT scans. Nine of the 19 patients (47.3%) had tibia malrotation. The mean tibia malrotation angle was 10.3° (0° - 45°). The average AOFAS scores was 82.4 and 84.3 at 6 months and 1 year follow-up. Degree of CT malrotation was not significantly associated with AOFAS scores at 6 month (spearman rho -0.386) and 1 year (spearman rho -0.343). Conclusions: Tibia malrotation following MIPO plating of distal tibia fractures is common, with an incidence of 47.3% and an average malrotation angle of 10.3°. The degree of malrotation does not appear to have significant mid-term functional impact on the patient.

Introduction: Non-union of long bones is a common challenge in the treatment of fractures. Bone grafting is commonly used to treat atrophic non-union, but mechanical displacement of the graft may occur, resulting in delay or failure of treatment. Fibrin glue has demonstrated positive results in management of bone defects in neurosurgery and oromaxillary facial surgery, however, there has yet to be any study on its use in long bone fractures. Materials and methods: We conducted a prospective randomised controlled trial at a single tertiary centre involving adult patients with long bone fractures that had undergone non-union and requiring bone grafting only. Autologous iliac crest bone graft was applied to the debrided non-union site, with additional fibrin glue applied for the intervention arm. Patients were followed-up with serial radiographs until clinical and radiographical union. Results: Ten patients (3 male, 7 female), of mean age 41.7 (19 – 63) were recruited over five years, with one drop out. Eight out of nine fractures united after treatment. One patient underwent hypertrophic non-union requiring re-fixation and bone grafting. There was no difference in the time to union for patients in the fibrin glue group (19.5 weeks) versus the control group (18.75 weeks) (p=0.86). There were no complications sustained from usage of fibrin glue. Conclusions: Fibrin glue appears to be a safe adjunct for treatment of non-union of long bone fractures across varying fracture sites by holding the bone graft in place despite not demonstrating a faster time to union.

Purpose: The aim of this study was to evaluate the feasibility and satisfaction of an online global health education course for medical students in comparison with an in-person of the course and to assess students’ preferences regarding online methods of delivery. Methods: Second-year medical students enrolled in this course in 2019 (in-person) and 2020 (online). The attendance rate, satisfaction in the course evaluation survey, and academic achievement on the written final examination were utilized to compare the two different methods of course delivery. The medical students who took the online course were also asked about their preferences regarding the method of course delivery and the advantages and drawbacks of each method of online lectures. Results: There was no significant difference in the attendance rate and overall satisfaction between the two groups. The mean score on the written examination of the online course (84.1±19.6) showed comparable effects to the in-person course (78.0±18.3). The percentages of students who achieved high performance (55.5%) and the achieved minimum requirement (95.9%) were also maintained compared to the in-person course (14.6% and 93.6%, respectively). Medical students preferred the online course to the in-person course; in particular, they preferred prerecorded videos over live streaming online lectures. Conclusion The participation, satisfaction, and the academic achievement of the online course were comparable to those of the in-person course. However, the greatest drawback of the online course was the lack of interaction between peer learners. Therefore, diverse methods for online education should be considered to increase students’ sense of belonging to a learning community.

Purpose: The aim of this study was to evaluate the feasibility and satisfaction of an online global health education course for medical students in comparison with an in-person of the course and to assess students’ preferences regarding online methods of delivery. Methods: Second-year medical students enrolled in this course in 2019 (in-person) and 2020 (online). The attendance rate, satisfaction in the course evaluation survey, and academic achievement on the written final examination were utilized to compare the two different methods of course delivery. The medical students who took the online course were also asked about their preferences regarding the method of course delivery and the advantages and drawbacks of each method of online lectures. Results: There was no significant difference in the attendance rate and overall satisfaction between the two groups. The mean score on the written examination of the online course (84.1±19.6) showed comparable effects to the in-person course (78.0±18.3). The percentages of students who achieved high performance (55.5%) and the achieved minimum requirement (95.9%) were also maintained compared to the in-person course (14.6% and 93.6%, respectively). Medical students preferred the online course to the in-person course; in particular, they preferred prerecorded videos over live streaming online lectures. Conclusion The participation, satisfaction, and the academic achievement of the online course were comparable to those of the in-person course. However, the greatest drawback of the online course was the lack of interaction between peer learners. Therefore, diverse methods for online education should be considered to increase students’ sense of belonging to a learning community.

The primary procedural components of deviated nose correction are as follows: osteotomy to correct bony deviation, septal deviation correction, manipulation of the dorsal septum to correct upper lateral cartilage deviation, and correction of functional problems (manipulation for correction of internal valve collapse and hypertrophy of the inferior turbinate). The correction of tip and nostril asymmetry cannot be overemphasized, because if tip and nostril asymmetry is not corrected, patients are unlikely to provide favorable evaluations from an aesthetic standpoint. Tip asymmetry, deviated columella, and resulting nostril asymmetry are primarily caused by lower lateral cartilage problems, which include deviation of the medial crura, discrepancy in the height of the medial crura, and asymmetry or deformity of the lateral crura. However, caudal and dorsal septal deviation, which is a more important etiology, should also be corrected. A columellar strut graft, correction of any discrepancy in the height of the medial crura, or lateral crural correction is needed to correct lower lateral cartilage deformation depending on the type. In order to correct caudal septal deviation, caudal septal shortening, repositioning, or the cut-and-suture technique are used. Surgery to correct dorsal septal deviation is performed by combining a scoring and splinting graft, a spreader graft, and/or the clocking suture technique. Moreover, when correcting a deviated nose, correction of asymmetry of the alar rim and alar base should not be overlooked to achieve tip and nostril symmetry.

OBJECTIVE: To investigate the efficacy of motion-correction algorithm (MCA) in improving coronary artery image quality and measurement accuracy using an anthropomorphic dynamic heart phantom and 256-detector row computed tomography (CT) scanner. MATERIALS AND METHODS: An anthropomorphic dynamic heart phantom was scanned under a static condition and under heart rate (HR) simulation of 50–120 beats per minute (bpm), and the obtained images were reconstructed using conventional algorithm (CA) and MCA. We compared the subjective image quality of coronary arteries using a four-point scale (1, excellent; 2, good; 3, fair; 4, poor) and measurement accuracy using measurement errors of the minimal luminal diameter (MLD) and minimal luminal area (MLA). RESULTS: Compared with CA, MCA significantly improved the subjective image quality at HRs of 110 bpm (1.3 ± 0.3 vs. 1.9 ± 0.8, p = 0.003) and 120 bpm (1.7 ± 0.7 vs. 2.3 ± 0.6, p = 0.006). The measurement error of MLD significantly decreased on using MCA at 110 bpm (11.7 ± 5.9% vs. 18.4 ± 9.4%, p = 0.013) and 120 bpm (10.0 ± 7.3% vs. 25.0 ± 16.5%, p = 0.013). The measurement error of the MLA was also reduced using MCA at 110 bpm (19.2 ± 28.1% vs. 26.4 ± 21.6%, p = 0.028) and 120 bpm (17.9 ± 17.7% vs. 34.8 ± 19.6%, p = 0.018). CONCLUSION: Motion-correction algorithm can improve the coronary artery image quality and measurement accuracy at a high HR using an anthropomorphic dynamic heart phantom and 256-detector row CT scanner.
Coronary Vessels* ; Heart Rate* ; Heart* ; Phenobarbital

Objective: To evaluate the antioxidant activity of extracts and fractions from Stachys sieboldii Miq., and to examine its effect on the cellular reactive oxygen species (ROS) and glutathione (GSH) production and genomic DNA oxidation in HT-1080 cells.Methods: The ROS generation induced by H2O2 was measured by the dichlorofluorescein-diacetate assay. GSH levels were measured using a fluorescent method with mBBr. Genomic DNA oxidative damage was measured with levels of oxidative DNA induced by the reaction of ferritin with H2O2.Results: Then-hexane, 85％ aqueous methanol andn-butanol fractions (0.05 mg/mL concentrations) inhibited H2O2-induced ROS generation by 63％, 35％ and 45％, respectively. GSH levels were significantly increased in both acetone+methylene chloride and methanol extracts (P<0.05). Supplementation of cells withn-hexane significantly increased GSH levels at concentrations of 0.05 mg/mL (P<0.05). Both the acetone+methylene chloride and methanol extracts, as well as all fractions significantly inhibited oxidative DNA damage (P<0.05). Conclusions: These results indicate that cellular oxidation was inhibited by then-hexane fraction and this fraction may contain valuable active compounds.

Deviated nose deformities have always been a surgical challenge, and it is essential to achieve both functional and esthetic improvements. Various techniques have evolved over time to correct deviated noses but no one method applies in all cases. Successful correction requires a complete understanding of the various surgical techniques and concepts, including the three-dimensional nasal structure and the time-related changes to surgically-treated noses.
Congenital Abnormalities ; Methods ; Nasal Septum ; Nose Deformities, Acquired ; Nose* ; Rhinoplasty

OBJECTIVE: To develop a population pharmacokinetics (PK)/pharmacodynamics (PD) model for alcohol in healthy volunteers and to elucidate individual characteristics to affects alcohol's PK or PD including dissolved oxygen. METHODS: Following multiple intakes of total 540 mL alcohol (19.42 v/v%) to healthy volunteer, blood alcohol concentration was measured using a Breathe alcohol analyser (Lion SD-400 Alcolmeter®). A sequential population PK/PD modeling was performed using NONMEM (ver 7.3). RESULTS: Eighteen healthy volunteer were included in the study. PK model of alcohol was well explained by one-compartment model with first-order absorption and Michaelis-Menten elimination kinetics. K(a), V/F, V(max), K(m) is 8.1 hr⁻¹, 73.7 L, 9.65 g/hr, 0.041 g/L, respectively. Covariate analysis revealed that gender significantly influenced V(max) (Male vs Female, 9.65 g/hr vs 7.38 g/hr). PD model of temporary systolic blood pressure decreasing effect of alcohol was explained by biophase model with inhibitory E(max) model. K(e0), I(max), E(0), IC(50) were 0.23 hr⁻¹, 44.9 mmHg, 138 mmHg, 0.693 g/L, respectively. CONCLUSION: Model evaluation results suggested that this PK/PD model was robust and has good precision.