The Effect of Biopolymer Coatings on Hernia Meshes in a Rat Model

Purpose: To improve biocompatibility and texture of hernia meshes has played a key role in tissue engineering for decades. Biopolymer (Polyethylenimine (PEI) and 3-Glycidoxypropyltrimethoxysilane (GOPS)) coating on Polypropylene (PP) and expanded Polytetrafluoroethylene (ePTFE) mesh showed promising results in fibroblast adhesion and cell growth in an invitro analysis. The objective of this animal study was to evaluate whether this may influence the incorporation into host tissue. Methods: 30 male Lewis rats were divided into 3 groups (n=10): Group 1: ePTFE/PEI, Group 2: ePTFE/GOPS, Group 3: PP/PEI. In each animal, a 3x0.5 cm coated mesh was implanted in the right rectus sheath in sublay position, the uncoated mesh was implanted on the left equally. After 90 days, the rats were sacrificed and each side of the rectus sheath was analyzed separately for adhesions and mechanical strength. Histopathological assessment included Gieson’s stain and haematoxylin-eosin staining. The Wilcoxon test was used for statistical analyses. Results: The GOPS-coated ePTFE tends to cause more adhesions. There was no significant difference in the mechanical strength within and between the groups, but the PEI-coated polypropylene was significantly less extendible (p<0.05) compared to the uncoated PP. In group 2, Gieson’s stain showed a significantly lower surrounding tissue reaction of foreign-body giant cells and scar tissue around the PEI-coated mesh compared to the uncoated ePTFE (p<0.05). Conclusions: It is possible to coat surgical mesh devices with biopolymers. They do not lead to a lack of mechanical strength. The GOPS-coating did not show any general positive effect on the biocompatibility of meshes. The PEIcoating resulted in a lower surrounding tissue reaction and in a less extendible abdominal wall and should therefore be investigated further.

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Can the cytokine adsorber CytoSorb® help to mitigate cytokine storm and reduce mortality in critically ill patients? A propensity score matching analysis

Annals of Intensive Care ◽

10.1186/s13613-021-00905-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Christina Scharf ◽

Ines Schroeder ◽

Michael Paal ◽

Martin Winkels ◽

Michael Irlbeck ◽

...

Keyword(s):

Propensity Score ◽

Critically Ill ◽

Critically Ill Patients ◽

Wilcoxon Test ◽

Relative Reduction ◽

Cytokine Storm ◽

Saps Ii ◽

Significant Difference ◽

Group 2 ◽

Group 1

Abstract Background A cytokine storm is life threatening for critically ill patients and is mainly caused by sepsis or severe trauma. In combination with supportive therapy, the cytokine adsorber Cytosorb® (CS) is increasingly used for the treatment of cytokine storm. However, it is questionable whether its use is actually beneficial in these patients. Methods Patients with an interleukin-6 (IL-6) > 10,000 pg/ml were retrospectively included between October 2014 and May 2020 and were divided into two groups (group 1: CS therapy; group 2: no CS therapy). Inclusion criteria were a regularly measured IL-6 and, for patients allocated to group 1, CS therapy for at least 90 min. A propensity score (PS) matching analysis with significant baseline differences as predictors (Simplified Acute Physiology Score (SAPS) II, extracorporeal membrane oxygenation, renal replacement therapy, IL-6, lactate and norepinephrine demand) was performed to compare both groups (adjustment tolerance: < 0.05; standardization tolerance: < 10%). U-test and Fisher’s-test were used for independent variables and the Wilcoxon test was used for dependent variables. Results In total, 143 patients were included in the initial evaluation (group 1: 38; group 2: 105). Nineteen comparable pairings could be formed (mean initial IL-6: 58,385 vs. 59,812 pg/ml; mean SAPS II: 77 vs. 75). There was a significant reduction in IL-6 in patients with (p < 0.001) and without CS treatment (p = 0.005). However, there was no significant difference (p = 0.708) in the median relative reduction in both groups (89% vs. 80%). Furthermore, there was no significant difference in the relative change in C-reactive protein, lactate, or norepinephrine demand in either group and the in-hospital mortality was similar between groups (73.7%). Conclusion Our study showed no difference in IL-6 reduction, hemodynamic stabilization, or mortality in patients with Cytosorb® treatment compared to a matched patient population.

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EPICARDIAL PACING

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.01.1980 ◽

2010 ◽

Vol 17 (01) ◽

pp. 55-58

Author(s):

ZAHID PARVEZ ◽

FARID AHMAD CHAUDHARY ◽

AJMAL HASAN NAZQVI ◽

Muniza Saeed

Keyword(s):

Cardiac Surgery ◽

Artery Bypass ◽

Left Ventricular ◽

Right Atrial ◽

Routine Practice ◽

Optimum Time ◽

Pacing Threshold ◽

Significant Difference ◽

Group 2 ◽

The Right

Placement of epicardial wires on the right atrial and right ventricle surfaces is a routine practice in cardiac surgery. These pacingelectrodes are used for invasive pacing of the myocardium for a variety of emergent and elective conditions postoperatively. There is uncertaintyin actual practice about the optimum time for their removal, and practice varies widely between different institutions. Objectives: To determine thetime related efficacy of these pacing electrodes after cardiac surgery, to find out the optimum time of their removal. Period: July 2008 toOctober 2008. Patients & Methods: 47 patients those underwent coronary artery bypass surgery were prospectively enrolled and evaluatedwith standard 12 lead ECG and ventricle pacing threshold immediately after surgery and on the 5t h postoperative day. The patients were dividedinto two subgroups according to their left ventricle ejection fraction ( > 40% verses < 40%). Results: There was significant difference in theeffective pacing threshold in groupl and 2 on immediate post operative period and on day 5. (P = 0.002 and P = 0.02 respectively) The sensingthreshold immediately after operation and on 5t h post operative day also differed significantly (P = 0.009 in group 1 and 0.02 in group 2) Theeffective VVI* pacing was lost in 17 patients (40.5%) on the 5t h post operative day and comparison of effective pacing threshold in the twogroups showed no significant difference during the same period of time (P = NS). "Ventrculo-ventrical inhibition. Conclusions: The epicardialpacing wires have little usefulness after the fifth postoperative day and should be removed by this time. In addition postoperative pacingthreshold was not affected by the decreased left ventricular function.

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Pharmacokinetics of a New Pharmaceutical Form of Vitamin D3 100,000 IU in Soft Capsule

Nutrients ◽

10.3390/nu11030703 ◽

2019 ◽

Vol 11 (3) ◽

pp. 703 ◽

Cited By ~ 4

Author(s):

Romuald Mentaverri ◽

Jean-Claude Souberbielle ◽

Gilles Brami ◽

Christelle Daniel ◽

Patrice Fardellone

Keyword(s):

Single Dose ◽

Vitamin D3 ◽

Oral Solution ◽

Wilcoxon Test ◽

Late Winter ◽

Reference Drug ◽

Significant Difference ◽

Group 2 ◽

New Formulation ◽

Group 1

Vitamin D deficiency is frequent in the general population and both subjects and health professionals could benefit from a broader range of vitamin D3 formulations. We conducted a single-dose, open-label, parallel-group, randomized bioequivalence study to compare a single dose of a newly developed vitamin D3 100,000 IU in a soft capsule (Group 1) with the reference drug vitamin D3 100,000 IU oral solution in ampoule (Group 2) in healthy volunteers over a four-month period. The primary endpoint was the area under the curve (AUC) of serum 25-hydroxyvitamin-D (25(OH)D) concentrations on Day 112. This study was conducted in France from February to June 2014 in 53 young adults with a mean age of 26.9 years. At baseline, low mean serum 25(OH)D levels were observed in both groups (10.6 ng/mL in Group 1 and 9.0 ng/mL in Group 2). On Day 112, the AUC of serum 25(OH)D concentration was 2499.4 ± 463.8 nmol/mL (7.8 ± 0.2 for LogAUC) for Group 1 and 2152.3 ± 479.8 nmol/mL (7.6 ± 0.2 for LogAUC) for Group 2. Bioequivalence of the two treatments was not demonstrated. Superiority of vitamin D3 100,000 IU soft capsule was observed with p = 0.029 for AUC and p = 0.03 for LogAUC using a non-parametric Wilcoxon test. The profile of the serum 25(OH)D concentration showed a significant difference in favor of Group 1 on Days 1, 3, 7, 14 and 90. Mean serum 25(OH)D concentrations in Group 1 were between 20 and 30 ng/mL during the four-month period and under 20 ng/mL throughout the study in Group 2, except on Day 112. Mean Cmax for Group 1 was significantly higher (p = 0.002). Fourteen days were needed to reach Tmax by more than half the subjects in Group 1 compared to 45 days in Group 2. Both treatments were well tolerated, with no severe or related adverse events reported. In conclusion, the pharmacokinetic profile of the new formulation of vitamin D3 100,000 IU soft capsule is superior to that of the oral solution in ampoule. The new formulation increased serum 25(OH)D levels to above 20 ng/mL and maintained levels from 20 ng/mL to 30 ng/mL for four months in late winter and spring.

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Venous air embolism in swine: transport of gas bubbles through the pulmonary circulation

Journal of Applied Physiology ◽

10.1152/jappl.1990.69.1.237 ◽

1990 ◽

Vol 69 (1) ◽

pp. 237-244 ◽

Cited By ~ 50

Author(s):

A. Vik ◽

A. O. Brubakk ◽

T. R. Hennessy ◽

B. M. Jenssen ◽

M. Ekker ◽

...

Keyword(s):

Arterial Pressure ◽

Gas Bubbles ◽

Air Embolism ◽

Threshold Value ◽

Maximum Increase ◽

Venous Air Embolism ◽

Mean Pulmonary Arterial Pressure ◽

Significant Difference ◽

Group 2 ◽

The Right

The assumption that the lung is an effective filter for gas bubbles is of importance for certain occupations (e.g., divers, astronauts) as well as in the accomplishment of several medical procedures. The filtering capacity was tested in pigs by use of continuous air infusion into the right ventricle and a transesophageal echocardiographic transducer for detection of air in the left atrium. Twenty pigs, anesthetized with pentobarbital sodium and mechanically ventilated, were divided into groups that received air at infusion rates of 0.05 (group 1a, n = 7), 0.10 (group 2, n = 6), and 0.20 (group 3, n = 5) ml.kg-1.min-1. Two pigs served as controls. The breakthrough incidence was 0, 67, and 100%, respectively. Group 1a received a second infusion of 0.10 ml.kg-1.min-1 (group 1b, n = 7), and spillover of bubbles occurred in only 14% of these pigs. Infusion of gas caused a maximum increase in mean pulmonary arterial pressure (PAP) of 129 +/- 9% to 39.2 +/- 1.3 (SE) mmHg, with no significant difference between the groups. Breakthrough was observed only in animals with a dramatic reduction in mean arterial pressure and a PAP that returned to almost-normal values at spillover time. Our results suggest that the threshold value for breakthrough of air bubbles in pigs is reduced compared with that in dogs. The hemodynamic consequences at a given infusion rate are, however, greatly enhanced.

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The effect of a 6-week land and resistance training of 13-16 years old swimmers groups to lower limb isokinetic strength values and to swimming performance13-16 yaş grubu yüzücülerde 6 haftalık kara ve direnç antrenmanlarının alt ekstremite izokinetik kuvvet performansına ve yüzme derecelerine etkisi

Journal of Human Sciences ◽

10.14687/jhs.v13i3.4158 ◽

2016 ◽

Vol 13 (3) ◽

pp. 5269 ◽

Cited By ~ 2

Author(s):

Ayşegül Yapıcı ◽

Barış Maden ◽

Gülin Fındıkoğlu

Keyword(s):

Resistance Training ◽

Lower Limb ◽

Swimming Performance ◽

Left Knee ◽

Wilcoxon Test ◽

Positive Development ◽

Isokinetic Strength ◽

Significant Difference ◽

Post Test ◽

The Right

The aim of this study is to investigate the effect of a 6-week land and resistance training of 13-16 year old swimmers groups to lower limb isokinetic strength values and to swimming performance. 22 swimmers participated in this study. The subjects were divided into three groups (A-B-C) according to their 50m swimming degrees. 25m underwater,25m,50m,75m and 100m freestyle swimming degrees of swimmers were recorded. As isokinetic measurements was applied at 60°/s,180°/s and 240°/s speed and the right and left knee. Kruskal-Wallis is used the differences between groups, the Mann-Whitney U test is used for which group the difference is caused and group differences were analyzed with the Wilcoxon test. Statistically significant difference was found between pre-test and post-test of 25m underwater,25m,50m,75m and 100m freestyle swimming values (p<0.05). In all groups, at 60°/s,180°/s,240°/s, for the right and left knee flexors and extensor, and freestyle swimming degrees positive development is observed. After 6-weeks training, isokinetic strength and swimming degrees of the group C increased 9.25%, whereas B has increased 8.35%. The pre-test and post-test results in 25m underwater,25m,50m,75m and 100m freestyle swimming values were statistically significant between the groups (p<0.05). In this study, it is possible to say that the land and resistance training can make a significant contribution to the performance of the force in this age group swimmer. ÖzetBu çalışmanın amacı; 13-16 yaş grubu yüzücülerde 6 haftalık kara ve direnç antrenmanlarının alt ekstremite izokinetik kuvvet değerlerine ve yüzme performansına etkisini araştırmaktır. Çalışmaya 22 yüzücü katılmıştır. Denekler 50m yüzme derecelerine göre üç gruba (A-B-C) ayrılmıştır. Yüzücülerin 25m sualtı, 25m, 50m, 75m ve 100m serbest stildeki yüzme dereceleri kayıt edilmiştir. İzokinetik ölçümler 60°/s, 180°/s ve 240°/s hızda sağ ve sol diz için uygulanmıştır. Gruplar arası farka Kruskal Wallis, farkın hangi gruptan kaynaklandığına Mann Whitney U testi, grup içi farklara ise Wilcoxon testi ile bakılmıştır. Ön test ve son test 25m sualtı, 25m, 50m, 75m ve 100m serbest yüzme değerlerinde istatistiksel olarak anlamlı fark bulunmuştur (p<0.05). Tüm grupların, 60º/s, 180º/s ve 240º/s hızda sağ ve sol diz için fleksör ve ektensörlerin tepe tork değerlerinde ve serbest yüzme derecelerinde sayısal olarak pozitif bir gelişim görülmüştür. 6 haftalık antrenman sonunda, C grubunun izokinetik kuvvet ve yüzme derecelerindeki artış (%9.25) iken, B grubunda bu değer (%8.35) çıkmıştır. Yapılan istatistiksel analiz sonucu ön test ve son test 25m sualtı, 25m, 50m, 75m ve 100m serbest yüzme değerlerinde gruplar arasında istatistiksel olarak anlamlı fark bulunmuştur (p<0.05). Bu çalışmada, bu yaş grubu yüzücülerde yapılan kara ve direnç antrenmanlarının kuvvet performansına önemli bir katkı sağlayabileceği söylenebilir.

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P040 INFLAMMATORY REACTION TO ALD COATED POLYPROPYLENE MESHES USED FOR HERNIA REPIAR. AN EXPERIMENTAL STUDY IN ANIMALS

British Journal of Surgery ◽

10.1093/bjs/znab395.038 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Magomed Khamidov ◽

Ragimov Razin ◽

Abay Maksumova ◽

Naida Abdullaeva ◽

Zeinab Gasanbekova ◽

...

Keyword(s):

Inflammatory Reaction ◽

High Performance ◽

Soft Tissues ◽

Atomic Layer ◽

Scar Tissue ◽

Tissue Reaction ◽

Surrounding Tissue ◽

Post Surgery ◽

Bacteria Adhesion ◽

Surface Modified

Abstract Aim The main goal of the present work is to study and ability of Atomic Layer Depostion (ALD) ultra-thin (<100nm) ceramic films on polypropylene (PP) hernia meshes to prevent the mesh-associated infections (post-surgery complications). Material and Methods Three types of ALD nanofilms were examined: Al2O3, TiO2, or TixVyOz. 10 rats and 5 rabbits were used to evaluate the tissue reaction of surface modified PP meshes and for biomechanical (antibacterial, inflammation effect), biocompatibility, and barrier testing of the healed tissue. The ALD coated PP meshes were implanted into rabbits and rats together with uncoated ones. After 10, 20, 30 and 60 days, the hernia meshes with the surrounding soft tissues were removed and fixed for histological and cytological studies. Results The TixVyOz (28nm) film showed enhanced antibacterial activity compare to Al2O3 and TiO2 films. The histology was performed on coated and uncoated PP mesh samples. Conclusions The ALD TixVyOz film helped to avoids formation of rough scar tissue (microscale roughness, which prevents ability biofilm formation) and, reduction of eosinophilic-cell and lymphocytic-cell reactions of the tissues surrounding the mesh, illustrate good integration into the surrounding tissue with minimal inflammatory reaction and minimal adhesions to intra-abdominal structures. The ALD film was highly effective in inhibiting S. aureus and E. coli bacteria adhesion and exhibited excellent biological activity in promoting osteoblastic adhesion. Speculatively, presence of vanadyl (≡V=O:) chemical groups, either on the surface or in the bulk, believe to play a key role in high performance of the TixVyOz compare to TiO2.

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First Case Report of Cholesterol Granuloma of Femur

10.21203/rs.3.rs-954012/v1 ◽

2021 ◽

Author(s):

Shenshen Hao ◽

Shengli Dong ◽

Hongke Li ◽

Shuaizhi Li ◽

Huihui Ren ◽

...

Keyword(s):

Benign Lesion ◽

Giant Cells ◽

Tissue Reaction ◽

Cholesterol Granuloma ◽

Treatment Results ◽

Cholesterol Crystals ◽

First Case ◽

Foreign Body Giant Cells ◽

The Right

Abstract Introduction: Cholesterol granuloma (CG) is a special type of granulation tissue reaction. It is a very rare benign lesion with swelling growth, in which there are a large number of cholesterol crystals and foreign body giant cells. A small amount of literature reports that it occurred in the middle ear or mastoid area. There has been no report of CG of the femur.Methods: A 74-year-old woman suffered from pain and discomfort in the upper right knee for 10 years, which aggravated for 10 days. He was diagnosed with CG of the right femur in our hospital, and was treated with surgery. Results: During the operation, a large amount of yellow-brown oily crystal structure was found, and the pathology after the operation was confirmed as CG. The postoperative follow-up was 3 months, and the treatment effect was satisfactory.Conclusion: CG of the femur is an extremely rare benign lesion, and there is no relevant report. Surgical treatment can remove the diseased tissue and provide effective treatment results.

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ASSOCIATION BETWEEN EMOTIONAL-VOLITIONAL DYSFUNCTION AND FEATURES OF AGGRESSION OR HOSTILITY IN MENS WITH DIFFERENT FORMS OF SUBSTANCE ADDICTIONS: A CROSS-SECTIONAL STUDY

Wiadomości Lekarskie ◽

10.36740/wlek202006109 ◽

2020 ◽

Vol 73 (6) ◽

pp. 1129-1133

Author(s):

Liliia V. Zhyvotovska ◽

Dmytro I. Boiko ◽

Nataliia V. Kadzhaia ◽

Anastasia D. Shkodina ◽

Iryna V. Demianenko ◽

...

Keyword(s):

Physical Aggression ◽

Self Regulation ◽

Cross Sectional Study ◽

Self Control ◽

General Level ◽

Cross Sectional ◽

Significant Difference ◽

Group 2 ◽

The Right ◽

Group 1

The aim: The research aim was to study features of emotional-volitional sphere and its association in mens with different forms of Substance Addictions. Materials and methods: We examined 146 patients with alcohol and drug addictions using Toronto Alexithymia Scale, Zverkov-Eidmann`s questionnaire and Buss-Durkee questionnaire. Results: The study showed an increase in the overall level of alexithymia, a moderate level of aggressiveness and a sufficient level of volitional self-regulation without a significant difference between the groups. The indirect correlation of “persistence” with the “general level of alexithymia”, “difficulty identifying feelings” and “physical aggression” in group 1 and at the same time the indirect correlation between “self-control” and “verbal aggression” and “volitional self-regulation” with “difficulty describing feelings” can be explained by the opposite meaning of these concepts and phenomena themselves.However, it is interesting that the indicators “physical aggression” and “difficulty describing feelings” in group 2 were significantly lower, but at the same time correlated with “general level of alexithymia” and “irritability”, respectively. On other hand in group 1 the indicator “suspiciousness” is directly related to the “general level of alexithymia”, but its level is significantly lower in comparison with group 2. Conclusions: The phenomenon of alexithymia is not only recorded in the clinical picture of patients with various forms of addiction, but can also induce the development of manifestations of aggressiveness and hostility in them. Correction of alexithymia is necessary to understand the emotional state of these patients and choose the right approach to their treatment and rehabilitation.

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Therapeutic trial in experimental tegumentary leishmaniasis caused by Leishmania (Leishmania) amazonensis. A comparative study between mefloquine and aminosidine

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822000000400008 ◽

2000 ◽

Vol 33 (4) ◽

pp. 377-382 ◽

Cited By ~ 4

Author(s):

Letícia Oba Galvão ◽

Sebastião Moreira Júnior ◽

Pedro Medeiros Júnior ◽

Gleiser José Piantino Lemos ◽

Nara Fabiana Cunha ◽

...

Keyword(s):

Treated Group ◽

Leishmania Amazonensis ◽

Control Group ◽

Therapeutic Trial ◽

End Of Treatment ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

The Right ◽

Group 1

One hundred and eighty-two male inbred C57/BL/6 mice were infected with 3 x 106 Leishmania (Leishmania) amazonensis promastigotes of the MHOM/BR/PH8 strain by means of a subcutaneous injection in the right ear. The animals were separated in three groups: 1) oral mefloquine hydrochloride treatment (16mg/kg/day/10 days), 2) intramuscular aminosidine (Paromomycin®) treatment (20mg/kg/20 days) and 3) control. Twenty six mice of each treated group were sacrificed, one at the end of treatment (nine weeks after inoculation), and one six weeks later (fifteen weeks after inoculation). Control Group animals were sacrificed at weeks six, nine and fifteen after inoculation. There was no significant difference between Group 1 (mefloquine) and Group 3 (control) subjects. Group 2 animals (aminosidine) presented the smallest differences of all, both at the end of the treatment and six weeks later. The histopato-logical parameters have shown the following findings: a) there was no significant difference between the mefloquine treated group and the control group; the group treated with aminosidine showed fewer of vacuolated macrophages than the control group, at week 9 (end of treatment). b) both at the end of treatment and six weeks later, evaluation of tissue necrosis and tissue fibrosis revealed no differences between the treated groups. It was found that six weeks after the end of treatment, mice in the control group presented significantly more severe degrees of fibrosis than mice in the other groups. It can be concluded that mefloquine showed limited therapeutic effect in this experimental model, whereas aminosidine had a significant effect. Nevertheless, neither of them resulted in cure of the lesions.

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The effect of rapid maxillary expansion on the upper airway’s aerodynamic characteristics

BMC Oral Health ◽

10.1186/s12903-021-01488-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xin Feng ◽

Yicheng Chen ◽

Kristina Hellén-Halme ◽

Weihua Cai ◽

Xie-Qi Shi

Keyword(s):

Cfd Simulation ◽

Three Dimensional ◽

Upper Airway ◽

3D Models ◽

Aerodynamic Characteristics ◽

Rapid Maxillary Expansion ◽

Wilcoxon Test ◽

Maxillary Expansion ◽

Significant Difference ◽

Group 2

Abstract Background The effect of rapid maxillary expansion (RME) on the upper airway (UA) has been studied earlier but without a consistent conclusion. This study aims to evaluate the outcome of RME on the UA function in terms of aerodynamic characteristics by applying a computational fluid dynamics (CFD) simulation. Methods This retrospective cohort study consists of seventeen cases with two consecutive CBCT scans obtained before (T0) and after (T1) RME. Patients were divided into two groups with respect to patency of the nasopharyngeal airway as expressed in the adenoidal nasopharyngeal ratio (AN): group 1 was comprised of patients with an AN ratio < 0.6 and group 2 encompassing those with an AN ratio ≥ 0.6. CFD simulation at inspiration and expiration were performed based on the three-dimensional (3D) models of the UA segmented from the CBCT images. The aerodynamic characteristics in terms of pressure drop (ΔP), maximum midsagittal velocity (Vms), and maximum wall shear stress (Pws) were compared by paired t-test and Wilcoxon test according to the normality test at T0 and T1. Results The aerodynamic characteristics in UA revealed no statistically significant difference after RME. The maximum Vms (m/s) decreased from 2.79 to 2.28 at expiration after RME (P = 0.057). Conclusion The aerodynamic characteristics were not significantly changed after RME. Further CFD studies with more cases are warranted.

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