Effect Of Different Procedures Research Articles

How to Confuse Motor Control: Passive Muscle Shortening after Contraction in Lengthened Position Reduces the Muscular Holding Stability in the Sense of Adaptive Force.

Adaptation to external forces relies on a well-functioning proprioceptive system including muscle spindle afferents. Muscle length and tension control in reaction to external forces is most important regarding the Adaptive Force (AF). This study investigated the effect of different procedures, which are assumed to influence the function of muscle spindles, on the AF. Elbow flexors of 12 healthy participants (n = 19 limbs) were assessed by an objectified manual muscle test (MMT) with different procedures: regular MMT, MMT after precontraction (self-estimated 20% MVIC) in lengthened position with passive return to test position (CL), and MMT after CL with a second precontraction in test position (CL-CT). During regular MMTs, muscles maintained their length up to 99.7% ± 1.0% of the maximal AF (AFmax). After CL, muscles started to lengthen at 53.0% ± 22.5% of AFmax. For CL-CT, muscles were again able to maintain the static position up to 98.3% ± 5.5% of AFmax. AFisomax differed highly significantly between CL vs. CL-CT and regular MMT. CL was assumed to generate a slack of muscle spindles, which led to a substantial reduction of the holding capacity. This was immediately erased by a precontraction in the test position. The results substantiate that muscle spindle sensitivity seems to play an important role for neuromuscular functioning and musculoskeletal stability.

A comparison of surgical techniques in the management of patients with choledocholithiasis undergoing laparoscopic cholecystectomy: an Australian experience

Background: Optimal management of patients with gallstones and concomitant choledocholithiasis has been a longstanding dilemma. Advancements in laparoscopic and endoscopic techniques have enabled multiple options for management. This study aims to compare the effectiveness of different procedures for choledocholithiasis in patients requiring laparoscopic cholecystectomy in the emergency setting of a large tertiary Australian hospital.Methods: A retrospective review of patients requiring emergency laparoscopic cholecystectomy who were also treated for choledocholithiasis was conducted at Liverpool Hospital, New South Wales. Patients were allocated into three groups: pre-operative endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecyst-ectomy at index admission, or laparoscopic cholecystectomy with intraoperative biliary stent placement followed by interval ERCP and stent removal, or laparoscopic cholecystectomy with intraoperative bile duct exploration. The primary outcome assessed was bile duct clearance rate. The secondary outcomes included complication rates, number of procedures performed, total operative time, length of stay (LOS) and cost.Results: A total of 96 patients were included. Primary outcome was no different between the three groups and there was no significant difference between post-operative complications. However, LOS was shorter in the laparoscopic cholecystectomy with intraoperative bile duct exploration by three days compared to the other two groups.Conclusions: Laparoscopic cholecystectomy with intraoperative bile duct exploration has similar outcomes and complication rates to other techniques and may be associated with a shorter LOS and lower costs.

The effects of different procedures on pain levels in preterm and term infants in neonatal intensive care unit: a cross-sectional survey of pain assessment in newborns.

Newborns show a series of behavioral and physiological reactions to painful stimuli. The current study aimed to determine the effect of different procedures on the pain levels of newborns in the Neonatal Intensive Care Unit (NICU). One hundred ninety-six newborns with gestational age (GA) of 23-40weeks, birth weight (BW) between 2235 ± 911g were included. Painful procedure (PP) (vascular access (VA), heel prick (HP), umbilical catheter (UC), orogastric catheter (OC), and intubation (I)) were recorded. Pain during the PP was evaluated with Neonatal Infant Pain Scale (NIPS). Pulse and O2 saturation were recorded before (BP), during (DP) and after (AP) procedure. NIPS total scores were found to be significantly higher with term infants (p < 0.05). When NIPS total scores were compared according to the type of PP, significant difference was observed between groups (p = 0.000). Positive correlation was found between birth week (p = 0.000, r = 0.364), BW of infants and NIPS total score (p = 0.000, r = 0.371), pulse values of DP and NIPS total score (p = 0.000, r = 0.386). Negative correlation was found between O2 saturation values DP and the NIPS total scores (p = 0.000, r = -0.405). It is concluded that as GA and BW increase, so do the pain responses of the infant, which showed that the pain thresholds of term-preterm infants are different, and decrease as GA and BW increase.

Vapour fast freezing with low semen volumes can highly improve motility and viability or DNA quality of cryopreserved human spermatozoa.

ObjectivesTo challenge a vapour fast freezing (VFF) cryopreservation procedure (conventional VFF) with several vitrification protocols and VFF conducted with small semen volumes (10 μl, microVFF), in order to implement a procedure for sperm banking in subjects with small sperm number.Materials and methodsConventional VFF was conducted with test yolk buffer (TYB) as freezing medium and 500 μl straws as carriers. MicroVFF was conducted with TYB and using tips or cell sleepers as carriers. Vitrification was performed with TYB or SpermFreeze as freezing medium and with microspheres and tips as carriers. The effect of different procedures on progressive and total motility, viability, oxidative stress and DNA fragmentation of spermatozoa (sDF) was determined. Fresh and thawed samples, the latter after adequate washing/centrifuging, were evaluated. In some experiments, motility and viability recovery was determined in thawed samples, omitting the washing/centrifuging step.ResultsAll the cryopreservation procedures blunted sperm motility and viability and induced increase of oxidative stress and sDF. However, VFF better preserved sperm motility and viability and less induced oxidative stress and sDF than vitrification, independently from the freezing medium and the carriers used in the latter. MicroVFF with cell sleepers resulted in a percentage increase of 57.58 ± 63.63%, 48.82 ± 74.96% and 24.55 ± 39.20% of, respectively, progressive and total motility and viability compared to the conventional VFF. Further, when tips were used, microVFF resulted in a percentage decrease of 15.77 ± 20.77% of sDF with respect to conventional VFF. Finally, omission of washing/centrifuging in post thawed samples, resulted in a much lower negative effect on motility and viability.Discussion and conclusionVFF, and in particular microVFF, better prevents sperm cryodamage than vitrification. Washing/centrifuging step after sample thawing seems to be responsible for a relevant fraction of damage to sperm motility and viability. Overall, our results are promising for developing a novel strategy of sperm banking in subjects with small sperm number, where low semen volumes are mandatory.

Effect of Different Retightening Procedures on Screw Stability in External-Hex and Internal Trichannel Connections: An In Vitro Study.

To evaluate the effect of different abutment screw retightening procedures on the screw stability between the abutment and implant. External hexagon connection (EHC) and internal trichannel connection (ITC) implants were employed in this study. Each abutment screw was used for the following specific applications (n = 5 for each group): group 0 = abutment was tightened and retightened with a 10-minute interval; group 1 = abutment was tightened and retightened with a 10-minute interval, then loaded for 500,000 cycles; group 2 = abutment was loaded for 83,000 cycles during tightening and retightening, then loaded for 500,000 cycles; group 3 = abutment was loaded for 167,000 cycles during tightening and retightening, then loaded for 500,000 cycles; and group 4 = abutment was loaded for 250,000 cycles during tightening and retightening, then loaded for 500,000 cycles. Both tightening and retightening torques were set at 35 Ncm, and dynamic oblique loading between 0 N and 200 N was applied on the abutment in all groups. The settling values of the abutments after retightening and the abutment removal torque values (RTVs) after testing were measured. No significant differences in settling values were found between EHC and ITC. There were significant differences in the RTVs of EHC implants, but ITC implants showed no difference in RTV with different prosthetic retightening applications. The retightening application affected the joint stability of EHC implants but did not affect the settlement and joint stability of ITC implants. Int J Prosthodont 2023;36:181-188. doi: 10.11607/ijp.6863.

Facing one's implicit biases: From awareness to acknowledgment.

Expanding on conflicting theoretical conceptualizations of implicit bias, 6 studies tested the effectiveness of different procedures to increase acknowledgment of harboring biases against minorities. Participants who predicted their responses toward pictures of various minority groups on future implicit association tests (IATs) showed increased alignment between implicit and explicit preferences (Studies 1-3), greater levels of explicit bias (Studies 1-3), and increased self-reported acknowledgment of being racially biased (Studies 4-6). In all studies, effects of IAT score prediction were significant even when participants did not actually complete IATs. Effects of predicting IAT scores were moderated by nonprejudicial goals, in that IAT score prediction increased acknowledgment of bias for participants with strong nonprejudicial goals, but not for participants with weak nonprejudicial goals (Study 4). Mere completion of IATs and feedback on IAT performance had inconsistent effects across studies and criterion measures. Instructions to attend to one's spontaneous affective reactions toward minority group members increased acknowledgment of bias to the same extent as IAT score prediction (Study 6). The findings are consistent with conceptualizations suggesting that (a) implicit evaluations are consciously experienced as spontaneous affective reactions and (b) directing people's attention to their spontaneous affective reactions can increase acknowledgment of bias. Implications for theoretical conceptualizations of implicit bias and interventions that aim to reduce discrimination via increased acknowledgment of bias are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Patient-reported rates of chronic pain and recurrence after groin hernia repair.

The effectiveness of different procedures in routine surgical practice for hernia repair with respect to chronic postoperative pain and reoperation rates is not clear. This was prospective cohort study based on a unique combination of patient-reported outcomes and national registry data. Virtually all patients with a groin hernia repair in Sweden between September 2012 and April 2015 were sent a questionnaire 1 year after surgery. Persistent pain, defined as at least 'pain present, cannot be ignored, and interferes with concentration on everyday activities' in the past week was the primary outcome. Reoperation for recurrence recorded in the register was the secondary outcome. In total, 22 917 patients (response rate 75·5 per cent) who had an elective unilateral groin hernia repair were analysed. Persistent pain present 1 year after hernia repair was reported by 15·2 per cent of patients. The risk was least for endoscopic total extraperitoneal (TEP) repair (adjusted odds ratio (OR) 0·84, 95 per cent c.i. 0·74 to 0·96), compared with open anterior mesh repair. TEP repair had an increased risk of reoperation for recurrence (adjusted OR 2·14, 1·52 to 2·98), as did open preperitoneal mesh repair (adjusted OR 2·34, 1·42 to 3·71) at 2·5-year follow-up. No other methods of repair differed significantly from open anterior mesh repair. The risk of significant pain 1 year after groin hernia repair in routine surgical practice was 15·2 per cent. This figure was lower in patients who had surgery by an endoscopic technique, but at the price of a significantly higher risk of reoperation for recurrence.

Effect of Different Procedures from Blood Cell Separators on Autologous PBSC Collection Efficiency

To observe the efficacy and adverse reactions of autologous PBSC collection when the autoPBSC procedure and MNC procedure of COBE Spectra cell separator and the MNC procedure of Spectra Optia cell separator were used. The autologous perepheral blood hematopoietic stem cells from 41 patients were collected by using autoPBSC procedure and MNC procedure of COBE Spectra blood cell separator and MNC procedure of Spectra Optia blood cell separator. The numbers of MNC and CD34+ cells collected by 3 collected procedure, the difference of hemoglobin (Hb) drop and platelet decrease, and the adverse reaction of patients were observed. When the whole blood processing and the collection time were basically same among these 3 groups, the MNC counts collected by MNC procedure of COBE Spectra and Spectra Optia were higher than that of AutoPBSC procedure of COBE Spctra, but the CD34+ cell count was lower than that collected by AutoPBSC procedure (P< 0.05). The final product volume collected by MNC procedure of COBE Spectra and Spectra Optia was bigger than that collected by AutoPBSC procedure. In comprission with MNC procedure of COBE Spectra cell seperator, the CD34+ count collected by MNC procedure of Spectra Optia Seperator did not show significant difference, but the CD34+ cell count collected by MNC procedure of Spectra Optia was higher than that collected by MNC procedure of COBE Spectra cell separator (P<0.05). The platelet count and hemoglobin level collected by MNC procedure of Spectra Optia were lower than those before collection. The adverse reactions in the 3 procedures were similar, and the patients could tolerate them. The AutoPBSC procedure of COBE Spectra and MNC procedure of Spectra Optia are better than MNC procedure of COBE Spectra for autologous peripheral blood hematopoietic stem cells collection. The loss of blood platelet and hemoglobin after collection is lowest in MNC procedure of Spectra Optia.

Rice seed priming

the priming is a technique that involves the controlled hydration of seeds up to allows the start of germination preparatory processes without permit radicle protrusion. The aim of this study was to evaluate the effect of different procedures of priming on physiological potential of rice seeds. Seeds of rice cultivars Puita Inta Inov CL and CL, each represented by a lot were used. The treatments consisted of: control, hydropriming, priming with Stimulate®, boric acid solution and zinc sulfate solution, with four replications. Prior to priming, the seeds hydration curves were determining. After priming, the seeds evaluated for germination, seedling growth, efficiency of use of the endosperm, germination at lowest temperatures and seedling emergence. Priming procedures used in this study does not improve rice seed physiological potential, of cultivars Puita Inta CL and Inov Cl. Seed priming with boric acid has a negative effect on seed performance.

An Efficient Procedure for Removal and Inactivation of Alpha-Synuclein Assemblies from Laboratory Materials.

Background: Preformed α-synuclein fibrils seed the aggregation of soluble α-synuclein in cultured cells and in vivo. This, and other findings, has kindled the idea that α-synuclein fibrils possess prion-like properties.Objective: As α-synuclein fibrils should not be considered as innocuous, there is a need for decontamination and inactivation procedures for laboratory benches and non-disposable laboratory material.Methods: We assessed the effectiveness of different procedures designed to disassemble α-synuclein fibrils and reduce their infectivity. We examined different commercially available detergents to remove α-synuclein assemblies adsorbed on materials that are not disposable and that are most found in laboratories (e.g. plastic, glass, aluminum or stainless steel surfaces).Results: We show that methods designed to decrease PrP prion infectivity neither effectively remove α-synuclein assemblies adsorbed to different materials commonly used in the laboratory nor disassemble the fibrillar form of the protein with efficiency. In contrast, both commercial detergents and SDS detached α-synuclein assemblies from contaminated surfaces and disassembled the fibrils.Conclusions: We describe three cleaning procedures that effectively remove and disassemble α-synuclein seeds. The methods rely on the use of detergents that are compatible with most non-disposable tools in a laboratory. The procedures are easy to implement and significantly decrease any potential risks associated to handling α-synuclein assemblies.

Cost of external fixation vs external fixation then nailing in bone infection.

To study the cost benefit of external fixation vs external fixation then nailing in treatment of bone infection by segment transfer. Out of 71 patients with infected nonunion tibia treated between 2003 and 2006, 50 patients fitted the inclusion criteria (26 patients were treated by external fixation only, and 24 patients were treated by external fixation early removal after segment transfer and replacement by internal fixation). Cost of inpatient treatment, total cost of inpatient and outpatient treatment till full healing, and the weeks of absence from school or work were calculated and compared between both groups. The cost of hospital stay and surgery in the group of external fixation only was 22.6 ± 3.3 while the cost of hospital stay and surgery in the group of early external fixation removal and replacement by intramedullary nail was 26.0 ± 3.2. The difference was statistically significant regarding the cost of hospital stay and surgery in favor of the group of external fixation only. The total cost of medical care (surgery, hospital stay, treatment outside the hospital including medications, dressing, physical therapy, outpatient laboratory work, etc.) in group of external fixation only was 63.3 ± 15.1, and total absence from work was 38.6 ± 6.6 wk. While the group of early removal of external fixation and replacement by IM nail, total cost of medical care was 38.3 ± 6.4 and total absence from work or school was 22.7 ± 4.1. The difference was statistically significant regarding the total cost and absence from work in favor of the group of early removal and replacement by IM nail. Early removal of external fixation and replacement by intramedullary nail in treatment of infected nonunion showed more cost effectiveness. Orthopaedic society needs to show the cost effectiveness of different procedures to the community, insurance, and health authorities.

Improving ovarian tissue cryopreservation for oncologic patients: slow freezing versus vitrification, effect of different procedures and devices

To compare slow freezing (SF) with four vitrification techniques (VT) for cryopreservation of ovarian tissue (OT) and to evaluate the best protocol for human OT in a xenograft model. Experimental study. University hospital. Patients undergoing fertility preservation. Ovariectomized nude mice. Cryopreservation of bovine OT after SF and four VTs (VT1, VT2, VT3, and VT4) by combining two cryoprotectant vitrification solutions (VS1 and VS2) and two devices (metallic grid and ethyl vinyl acetate bag), after which the cryopreservation of human OT by SF and VT1 and xenograft into nude mice. Follicular densities, proliferation, vascularization, fibrosis, apoptosis, tissue viability. The in vitro study in bovine OT showed a lower percentage of quiescent follicles in the SF group but not in the vitrification groups (VT1-VT4). Apoptosis increased and cell proliferation decreased in all the experimental groups except VT1 (20% ethylene glycol, 20% dimethyl sulfoxide, 0.5 M sucrose, and 20% synthetic serum substitute in HEPES-buffered M199 culture media with Cryotissue metallic grids). Tissue viability was diminished in VT3, and the SF-xenografted human samples showed reduced primordial and secondary densities and unbalanced follicular populations when compared with fresh and VT1 tissue. VT1 offers similar conditions to fresh tissue for follicular density, proliferation, viability, and cell death and preserves a larger population of quiescent follicles than SF after transplantation, thus ensuring the maintenance of graft potential fertility.

Needs Assessment for Cosmetic Dermatologic Surgery

Cosmetic procedures have been an integral part of dermatologic surgery for over half a century, with a more recent proliferation of devices to improve skin color and texture and modify subcutaneous fat. Overall, cosmetic dermatologic procedures are extremely safe. However, detailed information about safety and effectiveness, and especially comparative effectiveness, is not available for many procedures. There are few randomized control trials of comparative effectiveness of different procedures for similar indications. Key comparative effectiveness studies are briefly reviewed, and areas of substantial deficiency in such research are highlighted.

Dentine treatment effects on bonding strength of adhesive resin cements

The aim of this study is to investigate the effect of different procedures applied to the dentine surface on the cement bonding strength of various resins. Improving the bonding strength between dentine and composite resin usually requires increased surface roughness to promote mechanical interlocking. Ninety-six extracted human non-carious incisor teeth were used. Teeth were separated into six groups. In group I, the dentine surfaces were roughened with a diamond bur in a high speed handpiece at 200 000 rev min−1 with air/water coolant. In group II, the dentine surfaces were etched with 37% phosphoric acid gel for 10 s. In group III, the dentine surfaces were air abraded for 7 s with 30 μm aluminium trioxide particles at 3 bar pressure. In group IV, the dentine surfaces were sandblasted with 50 μm aluminium oxide powder using an intraoral sandblasting device. In group V, the samples were irradiated with an Er∶YAG laser with a continuous wavelength of 2940 nm. In group VI, the group served as control. The teeth were then bonded with one of the two resin cements according to each manufacturer’s instructions and stored in distilled water at 37°C for 24 h. The specimens in each group were tested in shear mode in a screw driven universal testing machine at a crosshead speed of 0·5 mm min−1. The treated dentine surfaces were photographed with a scanning electron microscope. Analysis of variance showed that the interaction between surface procedures applied to dentine, resin cement type and resin cement type surface procedure was statistically significant (p<0·001). The lowest bonding resistance was determined in the control group and the highest in the specimens abraded using a bur and cemented with Clearfil SA cement, while similar resistances were determined in the other group specimens. Bur abrasion led to the greatest increase in bonding value, while the best bonding effectiveness was obtained in specimens cemented with Clearfil SA cement.

Great Meaningless Questions in Urology: Which Is Better, Open, Laparoscopic, or Robotic Radical Prostatectomy?

Great Meaningless Questions in Urology: Which Is Better, Open, Laparoscopic, or Robotic Radical Prostatectomy?

Influence of different computational approaches for stent deployment on cerebral aneurysm haemodynamics

Cerebral aneurysms are abnormal focal dilatations of artery walls. The interest in virtual tools to help clinicians to value the effectiveness of different procedures for cerebral aneurysm treatment is constantly growing. This study is focused on the analysis of the influence of different stent deployment approaches on intra-aneurysmal haemodynamics using computational fluid dynamics (CFD). A self-expanding stent was deployed in an idealized aneurysmatic cerebral vessel in two initial positions. Different cases characterized by a progression of simplifications on stent modelling (geometry and material) and vessel material properties were set up, using finite element and fast virtual stenting methods. Then, CFD analysis was performed for untreated and stented vessels. Haemodynamic parameters were analysed qualitatively and quantitatively, comparing the cases and the two initial positions. All the cases predicted a reduction of average wall shear stress and average velocity of almost 50 per cent after stent deployment for both initial positions. Results highlighted that, although some differences in calculated parameters existed across the cases based on the modelling simplifications, all the approaches described the most important effects on intra-aneurysmal haemodynamics. Hence, simpler and faster modelling approaches could be included in clinical workflow and, despite the adopted simplifications, support clinicians in the treatment planning.

Management of prosthetic graft occlusion after lower extremity bypasses

Report the experience of management of graft occlusion in patients with lower extremity bypasses and discuss the appropriate treatment strategy. From Oct. 2004 to Oct. 2009, 104 cases of graft occlusion were treated in 53 patients with lower extremity arterial bypasses, including medical therapy for 10 cases and redo operations for 94 cases: graft thrombectomy alone for 26 cases, redo bypass or extension bypass with prosthetic or autologous vein grafts for 23 cases, graft thrombectomy plus balloon angioplasty for 18 cases, major amputation for 14 cases, graft thrombectomy plus femoral or popliteal artery endarterectomy for 10 cases, removal of occluded graft with infection for 2 case, and autologous stem cell transplantation for 1 case. 77 reconstructive procedures were applied and graft failures recurred in 49 cases (63.6%). One patient died of acute renal failure during peri-operative period and 9 patients died during follow-up; 6 patients were lost to follow-up. The remaining 37 patients were followed: major amputation for 12 patients, patent grafts after reconstruction in 18 patients, and medical therapy after graft occlusion for 7 patients with limb salvage. Kaplan-Meier survival analysis revealed 3-year survival of 77.4%, limb salvage of 64.7%, and graft patency of 45.7%. Effect of different procedures on cumulative patency was of no statistical significance. Graft occlusions after lower extremity bypasses may result in high rate of reocclusion and amputation. Optimal management should be based on a thorough analysis of individual condition.

Application of Kubelka–Munk analysis to the study of translucency in fresh-cut tomato

Abstract In order to assess the development of translucency in fresh-cut tomato (Lycopersicum esculentum cv. Belissimo) during refrigerated storage, two experiments were conducted. In the first one, tomato slices obtained from fruits at breaker and at red stage were stored at 5 ± 0.5 °C and monitored at regular intervals for 9 days. In the second one, slices obtained from fruits at the light-red stage were stored at 5 ± 0.5 °C, 9 ± 0.7 °C and 13 ± 0.7 °C for 4 days. Intact (control) fruits were stored at the same conditions and sliced immediately before the evaluations. In both experiments, translucency was assessed using Kubelka–Munk analysis and through visual evaluation using a scale from 0 to 4. The translucency of cut tomato slices increased during storage in both experiments. Fruits at red stage got translucent faster than fruits at breaker stage and the intensity of translucency was also higher for more ripe fruit. The storage temperature did not influence significantly the development of translucency, indicating that the water soaking of the pericarp tissue is not a result of chilling injury. The K/S (absorption coefficient/scattering coefficient) ratio increased during storage for cut fruits and remained practically constant for intact fruits, reflecting the effects of treatment observed visually. Additional experiments indicated that the removal of the locular gel combined or not with washing and drying the slice cut surface inhibited the development of translucency. Industrial relevance The development of translucency is a common alteration in the appearance of fresh-cut fleshy tissue after processing, which renders the product unappealing for consumption. It is of interest for the fresh-cut industry to be able to assess the development of translucency and then evaluate the effect of different procedures in its occurrence and intensity. This paper presents the use of Kubelka–Munk analysis, a technique of widespread use in other fields like printing and painting, to assess the development of translucency in sliced tomato and to study how this process is affected by storage temperature and maturity stage of the fruit.

Effect of different procedures of ejaculate collection, extenders and packages on DNA integrity of boar spermatozoa following freezing–thawing

Whole ejaculate or sperm-rich fraction, collected from four sexually mature boars, was frozen in an extender containing lactose-hen egg yolk with glycerol (lactose-HEY-G) or extender containing lactose, lyophilized lipoprotein fractions isolated from ostrich egg yolk and glycerol (lactose-LPFo-G), and Orvus Es Paste, respectively. The sperm samples were also frozen in a standard boar semen extender (Kortowo-3), without the addition of cryoprotective substances. Sperm DNA integrity was assessed using a modified neutral comet assay. Sperm characteristics such as motility, plasma membrane integrity (SYBR-14/PI), mitochondrial function (rhodamine 123) and acrosome integrity were monitored. Freezing–thawing caused a significant increase ( P < 0.05) in sperm DNA fragmentation, irrespective of the procedures of ejaculate collection and extender type. Sperm DNA fragmentation was significantly lower ( P < 0.05) in the whole ejaculate compared with the sperm-rich fraction, indicating that spermatozoa maintained in the whole seminal plasma prior to its removal for freezing–thawing procedure were less vulnerable to cryo-induced DNA fragmentation. Furthermore, spermatozoa frozen in lactose-HEY-G or lactose-LPFo-G extender exhibited lower ( P < 0.05) DNA fragmentation than those frozen in the absence of cryoprotective substances. The levels of sperm DNA damage, as expressed by comet tail length and tail moment values, were significantly higher ( P < 0.05) in sperm samples frozen in the absence of cryoprotective substances. The deterioration in post-thaw sperm DNA integrity was concurrent with reduced sperm characteristics. It can be suggested that evaluation of DNA integrity, coupled with different sperm characteristics such as motility, plasma membrane integrity and mitochondrial function, may aid in determining the quality of frozen-thawed boar semen.

Correction of Moderate and Severe Acquired Flexible Flatfoot with Medializing Calcaneal Osteotomy and Flexor Digitorum Longus Transfer

Acquired flexible flatfoot encompasses a wide spectrum of disease, and there is no validated treatment protocol. We hypothesized that a medializing calcaneal osteotomy with a flexor digitorum longus transfer is adequate to correct a less severe acquired flexible flatfoot but not a more severe flatfoot. We also hypothesized that use of an additional procedure would further correct the flatfoot. The study included seven pairs of cadaver specimens, with one side randomly selected for the creation of a mild flatfoot deformity and the other, for the creation of a severe flatfoot deformity. Cyclic axial load was applied to the intact foot, to the flatfoot, after correction with a medializing calcaneal osteotomy and a flexor digitorum longus transfer, and after the addition of a subtalar arthroereisis. Radiographic and pedobarographic data were obtained at each stage. A repeated-measures analysis of variance with post hoc analysis was used to compare all parameters in the intact foot with those in the flatfoot and corrected specimens. A Student t test was used to compare flatfoot severity between the mild and severe models. Compared with the intact foot, the mild and severe flatfoot models showed a significant change in the talar-first metatarsal angle (p = 0.01 and 0.03, respectively), talonavicular angle (p = 0.04 and 0.04), and medial cuneiform height (p = 0.03 and 0.05). The mild and severe models were significantly different from each other with regard to the talar-first metatarsal angle (p = 0.003) and talonavicular angle (p = 0.002). After the osteotomy and tendon transfer in the mild-flatfoot model, the talar-first metatarsal angle and talonavicular angle were not significantly different from those in the intact state. In the severe-flatfoot model, the talar-first metatarsal angle, talonavicular angle, and medial cuneiform height remained significantly undercorrected after the osteotomy and tendon transfer. After the arthroereisis, the talonavicular angle and medial cuneiform height were not significantly different from the values for the intact foot. In a cadaver model, the effectiveness of different procedures on radiographic and pedobarographic parameters varies with the severity of an acquired flatfoot deformity.