The Importance of Apex Location and Proximal Hemi-Curve Morphology for the Surgical Tactic of Significant Convex Coronal Imbalance in Patients with Dystrophic Scoliosis Secondary to Type I Neurofibromatosis: Classification and Management

Fine Tuning ◽

Type I ◽

Coronal Imbalance ◽

Valid Information

Abstract Background. There was a paucity of valid information on how to discriminate between different patterns of convex coronal imbalance (CCI>3cm) in dystrophic scoliosis secondary to Type I neurofibromatosis (DS-NF1), while aggravated postoperative CCI occurred regularly with the causes being insufficiently investigated. We aimed to develop a new classification of CCI in DS-NF1, and to optimize the coronal rebalancing strategies.Methods. NF1-related scoliosis database was reviewed and different types of CCI were identified, and the outcomes of coronal rebalance were analyzed. Results. Two main CCI patterns were defined: thoracic CCI (Type 1) and thoracolumbar/lumbar CCI (Type 2), and were further subtyped by the compensatory behavior of the upper hemi-curve (straight or curved morphology). The incidence of immediate post-op CCI was 0.0% and 63.6% for Type1 and Type 2 groups, respectively. Mismatch of both translation and inclination correction between the upper and lower hemi-curve was significant in the post-op coronal imbalanced group (△Upper Arc Translation/△Lower Arc Translation: 109.6±60.0% vs. 31.8±34.4%, p=0.008; △Upper Arc Inclination/△Lower Arc Inclination: 89.8±36.6% vs. 33.5±37.3%, p=0.012). Multiple linear regression analysis revealed that △UAT/△LAT significantly correlated with the correction of coronal balance distance (β=-21.567; p=0.018). A surgical rebalancing algorithm was proposed to treat each subtype.Conclusion. Thoracolumbar/lumbar CCI in dystrophic scoliosis was prone to suffer high risk of persistent post-op CCI. Satisfying coronal rebalance should rely on maximal translational correction of lower hemi-curve, while the upper hemi-curve played the role of fine-tuning for coronal realignment rather than radical Cobb correction, straight morphology in particular.

The Arterial Supply of the Distal Part of the Pancreas

Surgery Research and Practice ◽

10.1155/2019/5804047 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

S. Covantev ◽

N. Mazuruc ◽

O. Belic

Keyword(s):

Splenic Artery ◽

Distal Part ◽

Type I ◽

Type Iv ◽

Distal Pancreas ◽

Corrosion Cast ◽

Type 3

The pancreatic surgery field has evolved greatly over the previous years. Nevertheless, the vascularization of the pancreas remains a difficult subject and requires further attention. The study was conducted using macroscopical dissection and corrosion cast methods. The total number of organ blocks was 72 (50 for dissection and 22 for corrosion cast). Based on the data obtained by dissection, we can distinguish three major types of vascularization of the distal pancreas. In type one, the pancreas was vascularized only by the short branches of the splenic artery and was encountered in 18 cases (36%). In type two, the pancreas was vascularized by the long and short branches of the splenic artery and was encountered in 20 cases (40%). In type three, the pancreas was vascularized only by the long branches of the splenic artery in 12 cases (24%). Compared to that, the corrosion cast method demonstrated type 1 in 8 cases (36.36%), type 2 in 10 cases (45.46%), and type 3 in 4 cases (18.18%). During the dissection, there were no arteries to the tail of the pancreas in 13 (26%) cases, one artery in 15 (30%) cases, two arteries in 19 (38%), and three arteries in three (6%) cases. The 22 corrosion cast specimens were also evaluated based on the classification of Roman Ramos and coworkers. Type I (small arcades) was in 9 (40.90%) cases, type II (small and large arcades) was in 7 (31.82%) cases, type III (large arcades) was in 5 (22.73%) cases, and type IV (straight branches) was in 1 (4.55%) case. The corrosion cast method allowed us to determine no arteries to the tail in 4 (18.18%) cases, one artery in 6 (27.27%) cases, two arteries in 10 (45.46%) cases and three arteries in two (9.09%) cases. The vascularization of the distal part of the pancreas is highly variable and should be taken into consideration during surgery.

Salvodara Persica As An Oral Aids For Edentulous Patients

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i2.1101 ◽

2017 ◽

Vol 16 (2) ◽

Author(s):

Nusima Mohamed ◽

Norlela Yacob ◽

Wan Nor Syariza Wan Ali ◽

Aida Ali

Keyword(s):

Type I ◽

New Approach ◽

Denture Stomatitis ◽

Edentulous Patients ◽

Type 3 ◽

Dentate Patient ◽

Control Study

Introduction: Salvadora percisa (popularly known as miswak) has been widely used as an aid for oral hygiene in dentate patient. There is no side effect of using miswak stick. A new approach introduced the role of miswak stick in edentulous patient. It may prevent the incidence of denture stomatitis among denture wearer. This study assessed the effectiveness of the miswak stick as an oral aid in edentulous patients as an alternative treatment for denture stomatitis. Materials and Methods: A clinical case control study included patients affected by denture stomatitis. The Miswak stick was introduced to the subjects to use as the oral device to clean the denture and oral mucosal area everyday. Pre- and postoperative assessment (clinical and photographic) were evaluated within 8 to 12 weeks and analysed by comparing the mapping of denture stomatitis inflammation. Results: A total of 11 subjects with denture stomatitis comprised as type 1; n=5 (46%), type 2; n=4 (36%) and type 3; n=2 (18%). 54.5% of subjects showed more than 50% reduction in the mapping of denture stomatitis inflammation (p<0.05) after the use of miswak stick. This study also showed that the use of miswak stick for more than 3 weeks to Type I and II denture stomatitis (54.6%) has successfully reduce the inflammation for more than 50%. 54.5% of the subjects with good denture hygiene has 50% more reduction of denture stomatitis. Conclusion(s): The miswak stick was significantly effective to reduce the denture stomatitis with a regular use and maintenance of good denture hygiene.

Management of autoimmune pancreatitis

Herald of Pancreatic Club ◽

10.33149/vkp.2020.03.02 ◽

2020 ◽

Vol 48 (3) ◽

pp. 13-17

Author(s):

V. S. Akshintala ◽

V. K. Singh

Keyword(s):

Autoimmune Pancreatitis ◽

Pancreatic Disease ◽

Lymphoplasmacytic Sclerosing Pancreatitis ◽

Sclerosing Pancreatitis ◽

Histological Characteristics ◽

Igg4 Level

The article contains modern data on such a chronic pancreatic disease as autoimmune pancreatitis (AIP). Statistical data on the prevalence and incidence of AIP are presented, the current international classification of this pathology is considered, the main features of type 1 AIP (lymphoplasmacytic sclerosing pancreatitis, LPSP) and type 2 AIP (idiopathic duct centric pancreatitis, IDCP) are put forward. The clinical manifestation of these types is different: obstructive jaundice develops more often in patients with LPSP, while patients with IDCP mostly have acute pancreatitis. The presence and variety of extrapancreatic manifestations of the disease with extremely frequent concomitant development of ulcerative colitis is emphasized. The features of serological diagnosis of AIP and the role of IgG4 level in determining the type of disease are considered. The proper techniques of AIP instrumental diagnostics are listed, the typical changes detected during computed tomography and the distinctive histological characteristics of LPSP and IDCP are considered. The feasibility of a differential diagnosis between AIP and pancreatic cancer is indicated by analyzing the results of serological, imaging, and histological studies. The algorithm of management of AIP patients depending on the type of disease is described, as well as the tactics of prescribing corticosteroids, immunomodulators upon LPSP and IDCP. Immunomodulators of choice (mycophenolate mofetil, azathioprine) are indicated, and rituximab administration features are considered. Possible signs of AI recurrence are listed (IgG4-sclerosing cholangitis, high IgE level).

Association of Triglyceride-Glucose Index with the Incidence of Ketoacidosis in Chinese Children with Type 1 Diabetes

10.21203/rs.3.rs-340966/v1 ◽

2021 ◽

Author(s):

Long Gao ◽

Xinhui Wang ◽

Jianbo Shu ◽

Mingying Zhang ◽

Xiufang Zhi ◽

...

Keyword(s):

Positive Impact ◽

Clinical Prognosis ◽

Tyg Index ◽

Index Group ◽

Triglyceride Glucose Index ◽

The Relationship

Abstract Objective: The relationship between triglyceride-glucose index (TyG index) and the prevalence of type 2 diabetes mellitus (T2DM) has been confirmed by former studies. However, it remains uncertain whether TyG index has a predictive value in T1DM patients with diabetic ketoacidosis (DKA).Methods: The study retrospectively enrolled 143 patients ((boys/girls = 60/83) with T1DM in the Endocrine inpatient wards of Tianjin Children’s Hospital from June 2017 to May 2019.TyG index was calculated as follows: ln[fasting triglycerides (mg/dL)×fasting plasma glucose (mg/dL)/2]. These patients stratifed by the optimal cut-off point of TyG index were divided into the lower TyG index group (n=73) and higher TyG index group (n=70).Results: TyG index and related lipid parameters were significantly higher in patients with DKA compared with those without. Compared with patients in lower TyG index group, those with higher TyG index seemed to be younger. Multiple linear regression analysis showed that increase of TC (95%CI: 0.018~0.568, p=0.037) level and decrease of T3(95%CI:-2.314~-0.668,p=0.001) level were associated with the risk of higher TyG index. A linear equation was obtained between TC, T3 and TyG index (TyG index=10.226+0.299*TC-1.384*T3, R2=0.481). Conclusions: Increased TyG index is a significant predictor of DKA in children with T1DM. Higher TC and lower T3 levels were associated with higher TyG index. Further studies need to be conducted to determine whether interventions for TyG index have a positive impact on improving clinical prognosis.

PENGARUH KUALITAS PRODUK DAN RELIGIUSITAS TERHADAP KEPUTUSAN NASABAH PRODUK SIMPANAN PADA BSM CABANG PURWOKERTO

el-jizya Jurnal Ekonomi Islam ◽

10.24090/ej.v4i1.2016.pp189-215 ◽

2017 ◽

Vol 4 (1) ◽

pp. 189-215

Author(s):

Yoiz Shofwa Shafrani

Keyword(s):

Regression Analysis ◽

Product Quality ◽

Analytical Tool ◽

The Other ◽

Financial Assets ◽

Islamic Bank

Perkembangan dunia perbankan syariah tidak lepas dari peran para nasabah yang memberikan kepercayaan terhadap pihak perbankan untuk penyimpanan asset keuangannya. Faktanya banyak kelompok nasabah yang memutuskan untuk menjadi nasabah di perbankan syariah karena faktor religiusitasnya. Faktor lain yang dapat ikut mempengaruhi keputusan nasabah adalah kualitas produk. Di mana kualitas produk merupakan karakteristik yang melekat dari suatu produk. Kemungkinan yang terjadi bahwa kebanyakan nasabah pada perbankan syariah juga masih merupakan nasabah perbankan konvensional.Tujuan yang ingin dicapai dalam penelitian ini adalah untuk mengetahui pengaruh kualitas produk dan tingkat religiusitas nasabah terhadap keputusan nasabah untuk menyimpan dananya atau tidak di BSM Cabang Purwokerto. Alat analisis yang digunakan adalah analisis regresi linier berganda, dengan jumlah sampel 100 nasabah. Diperoleh hasil Y = 5,046 + 0,101X1 + 0,218X2. Berdasarkan uji F yang sudah dilakukan maka dapat diketahui bahwa variabel kualitas produk dan religiusitas secara bersama – sama berpengaruh terhadap keputusan nasabah untuk menyimpan dananya di BSM Cabang Purwokerto. Berdasarkan uji t yang sudah dilakukan dapat diketahui bahwa secara partial baik variabel kualitas produk maupun variabel religiusitas berpengaruh terhadap keputusan nasabah untuk menyimpan dananya di BSM Cabang Purwokerto. The progress of the Islamic bank cannot be separated from the role of its customers who give trust to the bank to deposit their financial assets. It is a fact many groups of customers decide to be the customers of the Islamic bank because of their religiosity. The other influences factor of a customer’s decision is the quality of the product. The aim of this research was to determine the effect of product quality and level of customers’ religiosity towards customers’ decision whether to keep their funds in Syariah Mandiri Bank, Branch of Purwokerto, or not. The analytical tool used was multiple linear regression analysis, with a sample of 100 customers. The results indicate Y = 5,046 + 0,101X1 + 0,218X2. Based on F, it can be seen that both variables of product quality and religiosity simultanously affect the customers’ decision to keep theirfunds in BSM Branch of Purwokerto. Based on t test, it can be seen that independently, either variable of product quality or variables of religiosityinfluences the customers’ decision to keep their funds in BSM Branch of Purwokerto.

Peranan Komisaris dan Direksi Bank Syariah dalam Pengelolaan Dana Zakat dan ISR (Islamic Social Responsibility) di Indonesia

Akuntansi dan Manajemen ◽

10.30630/jakmenpnp.14.2.178 ◽

2019 ◽

Vol 14 (2) ◽

pp. 95

Author(s):

Melia Frastuti ◽

Dimas Pratama Putra ◽

Erfan Effendi

Keyword(s):

Social Responsibility ◽

Commercial Banks ◽

Islamic Banks ◽

The Public ◽

Islamic Bank ◽

Positive Assessment ◽

Nature Preservation

Abstract Almsgiving is one of the pillars supporting the upholding of Islam as the obligation for the adherents to improve horizontal relations between fellow humans and strengthen vertical relations with Allah SWT. The implementation of Islamic Social Responsibility (ISR) of the Islamic Bank gives a positive assessment in sharia agreement, justice and equality, responsibility for work, welfare, guarantee of nature preservation and benevolent assistance that is not profit-oriented.Proper almsgiving management and ISR implementation make Islamic banks trusted by the public in terms of service quality, satisfaction and loyalty of Muzzaki. It reduces bad images, and provides relevant impacts on social welfare and the progress of the era. The data analysis used to test the hypotheses is Multiple Linear Regression analysis. The data is collected by distributing questionnaires to Commissioners and Directors at 14 (fourteen) Islamic Commercial Banks spread throughout Indonesia. The result of this study shows partially prove the role of Islamic bank commissioners in the amsgiving management only, while the importance of the role of directors in Islamic banks in almsgiving management and the implementation of ISR partially. Keywords: Islamic Bank, Commissioners, Directors, Almsgiving and ISR

Regulatory Role of Heat Shock Proteins in the Pathogenesis of Type 1 and Type 2 Diabetes

Current Immunology Reviews ◽

10.2174/1573395513666170606121625 ◽

2017 ◽

Vol 13 (1) ◽

Cited By ~ 1

Author(s):

Christiane Habich ◽

Henrike Sell ◽

Volker Burkart

Keyword(s):

Type 2 Diabetes ◽

Heat Shock ◽

Heat Shock Proteins ◽

Regulatory Role ◽

Shock Proteins

Hormonal characterization and classification of breast cyst fluid in gross cystic mastopathy

Endocrine Related Cancer ◽

10.1677/erc.0.0010049 ◽

1994 ◽

Vol 1 (2) ◽

pp. 49-55 ◽

Cited By ~ 2

Author(s):

I Számel ◽

B Budai ◽

K Daubner ◽

J Kralovánszky ◽

Sz Ottó ◽

...

Keyword(s):

Breast Cancer ◽

Sex Steroids ◽

Cyst Fluid ◽

Type I ◽

Breast Cyst Fluid ◽

Breast Cyst ◽

Apocrine Metaplasia ◽

Endocrine Parameters

ABSTRACT Gross cystic disease (GCD) of the breast may be associated with a higher risk for the development of breast cancer. High levels of sex steroids, steroid hormone precursors, prolactin and cations have been found in breast cyst fluid (BCF) by several investigators. Accordingly, endocrine parameters and the cationic composition of BCF may be considered as useful characteristics to follow patients bearing macrocysts. In this study we have investigated the concentrations of estradiol (E2), progesterone, testosterone, dehydroepiandrosterone (DHA) and DHA-3-sulfate (DHA-S), prolactin, potassium (K+) and sodium (Na+) in BCF aspirated from 99 women. The mean age of the patients was 49.8 years (range 32-58). The hormone levels were measured by RIA methods; K+ and Na+ were determined by flame photometry. Estradiol, progesterone, testosterone, DHA, DHA-S, prolactin and K+ showed significant accumulation in the BCF compared with their respective serum values. The K+/Na+ ratio proved to be useful in dividing cysts into type I (≥1), type II (<1 but ≥0.1) and type III (<0.1) subgroups. For type I BCF, higher DHA, DHA-S and prolactin concentrations were detected. Linear regression analysis established a highly significant (P<0.001) correlation between the concentrations of E2 and DHA-S (r=0.686), and also between testosterone and DHA-S (r=0.711). These findings indicate that type I BCF might be a marker for 'active' GCD of the breast, and suggest that it may be associated with an increased breast cancer risk, since this group of patients is supposed to have cysts with apocrine metaplasia. It is suggested therefore that when BCF is aspirated, sex steroids, steroid precursors and cations should be routinely measured, and women with type I cysts should be regularly examined.

Orexin A Enhances Pro-Opiomelanocortin Transcription Regulated by BMP-4 in Mouse Corticotrope AtT20 Cells

International Journal of Molecular Sciences ◽

10.3390/ijms22094553 ◽

2021 ◽

Vol 22 (9) ◽

pp. 4553

Author(s):

Satoshi Fujisawa ◽

Motoshi Komatsubara ◽

Naoko Tsukamoto-Yamauchi ◽

Nahoko Iwata ◽

Takahiro Nada ◽

...

Keyword(s):

Stress Responses ◽

Endocrine Function ◽

Type I ◽

Orexin A ◽

Protein Levels ◽

Bmp Receptors ◽

Morphogenetic Protein ◽

Crh Receptor Type 1

Orexin is expressed mainly in the hypothalamus and is known to activate the hypothalamic–pituitary–adrenal (HPA) axis that is involved in various stress responses and its resilience. However, the effects of orexin on the endocrine function of pituitary corticotrope cells remain unclear. In this study, we investigated the roles of orexin A in pro-opiomelanocortin (POMC) transcription using mouse corticotrope AtT20 cells, focusing on the bone morphogenetic protein (BMP) system expressed in the pituitary. Regarding the receptors for orexin, type 2 (OXR2) rather than type 1 (OX1R) receptor mRNA was predominantly expressed in AtT20 cells. It was found that orexin A treatment enhanced POMC expression, induced by corticotropin-releasing hormone (CRH) stimulation through upregulation of CRH receptor type-1 (CRHR1). Orexin A had no direct effect on the POMC transcription suppressed by BMP-4 treatment, whereas it suppressed Smad1/5/9 phosphorylation and Id-1 mRNA expression induced by BMP-4. It was further revealed that orexin A had no significant effect on the expression levels of type I and II BMP receptors but upregulated inhibitory Smad6/7 mRNA and protein levels in AtT20 cells. The results demonstrated that orexin A upregulated CRHR signaling and downregulated BMP-Smad signaling, leading to an enhancement of POMC transcription by corticotrope cells.

The challenges of diagnosing diabetes in childhood

Diagnosis ◽

10.1515/dx-2020-0036 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Mairi Pucci ◽

Marco Benati ◽

Claudia Lo Cascio ◽

Martina Montagnana ◽

Giuseppe Lippi

Keyword(s):

Diabetes Mellitus ◽

Children And Young People ◽

Narrative Literature ◽

Diagnosis And Classification ◽

Narrative Literature Review ◽

Optimal Approach ◽

Diagnostic Step

AbstractDiabetes is one of the most prevalent diseases worldwide, whereby type 1 diabetes mellitus (T1DM) alone involves nearly 15 million patients. Although T1DM and type 2 diabetes mellitus (T2DM) are the most common types, there are other forms of diabetes which may remain often under-diagnosed, or that can be misdiagnosed as being T1DM or T2DM. After an initial diagnostic step, the differential diagnosis among T1DM, T2DM, Maturity-Onset Diabetes of the Young (MODY) and others forms has important implication for both therapeutic and behavioral decisions. Although the criteria used for diagnosing diabetes mellitus are well defined by the guidelines of the American Diabetes Association (ADA), no clear indications are provided on the optimal approach to be followed for classifying diabetes, especially in children. In this circumstance, both routine and genetic blood test may play a pivotal role. Therefore, the purpose of this article is to provide, through a narrative literature review, some elements that may aid accurate diagnosis and classification of diabetes in children and young people.