Rib Cage Research Articles

Effect of different observations on evaluation of cosmetic shoulder balance in adolescent idiopathic scoliosis patients with thoracic curve

Objective: To investigate the correlations between cosmetic and radiographic parameters of shoulder balance, as well as the variations in cosmetic shoulder balance observed from different perspectives, among patients with adolescent idiopathic scoliosis (AIS) characterized by thoracic curves. Methods: A total of 43 patients with thoracic curves treated from July to October in 2022 in Nanjing Drum Tower Hospital were recruited in this study. There were 9 males and 34 females with a mean age of (14.3±1.5) years. All participants underwent comprehensive radiographic assessments and were photographed both from posterior and anterior views, focusing on the shoulder region as well as a higher level (maintaining a consistent vertical distance of 180 cm from the ground). Six cosmetic parameters were measured on the photographs: shoulder angle(α1), axilla angle(α2), shoulder area index 1(SAI1), shoulder area index 2 (SAI2), inner shoulder height (SHi) and outer shoulder height (SHo). Eight radiographic parameters were measured on the radiographs: radiographic shoulder height difference (RSHD), first rib angle (FRA), clavicle-rib cage intersection (CRCI), coracoid process height (CPH), T1 tilt, clavicle angle(CA), clavicle chest cage angle difference (CCAD) and Cobb angle. Differences among bilateral cosmetic indicators from different perspectives were analyzed and compared, and their correlation with bilateral radiographic indicators was studied. Results: There was no significant differences between anterior cosmetic parameters and posterior cosmetic parameters at the same level of observation(all P>0.05). However, when observing SHi, SHo, α1, and α2 at the shoulder level, it became evident that they exhibited significantly higher values compared to the corresponding higher level on the same side of the patients' bodies. This contrast was observed in both the dorsal [SHo: (0.11±1.20) cm vs (-0.44±1.39) cm, P=0.005; SHi: (0.64±0.86) cm vs (0.32±0.56) cm, P=0.003; α1:-0.47°±2.27° vs -0.77°±2.49°, P=0.014; α2:-3.06°±3.23° vs -2.21°±3.03°, P=0.034] and ventral [SHo: (0.12±1.29) cm vs (-0.48±1.35) cm, P=0.007; SHi: (0.61±0.88) cm vs (0.30±0.59) cm, P=0.006; α1:-0.46°±2.18° vs -0.69°±2.35°, P=0.018; α2:-3.26°±3.12° vs -2.05°±2.97°, P=0.029] aspects of the patients. SHi and SHo were more sensitive to this difference of height. The correlation coefficients between radiographic parameters and cosmetic aspects at the shoulder level varied from 0.374 to 0.767. Similarly, the correlation coefficients between radiographic parameters and cosmetic factors at the higher level ranged from 0.273 to 0.579 (all P<0.05). Conclusions: The cosmetic parameters had significant difference between different perspective of observation, the cosmetic parameters are needed to be observed at the shoulder level in the evaluation of patients' shoulder balance.

A COMPARATIVE STUDY OF CHANNEL COOLING ENHANCEMENT BY ANGLED, PARALLEL BROKEN, AND RHOMBUS PATTERNED RIBS

Heating and cooling of fluids play an important role in energy engineering, such as solar air heaters and the internal cooling of gas turbine blades. Heat transfer in the heat exchanger channels can be enhanced by ribs, which will also result in a significant decrease in coolant pressure. In our previous work, a novel bioinspired rib design with a rhombus-shaped pattern was proposed to enhance the channel cooling. The Nusselt numbers and flow characteristics are further compared to angled and parallel broken ribs in this work. It is interesting to find that the proposed channel with decreasing-height rhombus-shaped patterned ribs exhibits the best heat transfer performance. At the same time, the Nusselt number and friction factor are related to the Reynolds number in the studied range. The surface with rhombus-shaped patterned ribs shows greater thermal performance factors than that with angled ribs, while the surface with a decreasing-height rib arrangement has the highest thermal performance factor due to a better Coanda effect. This work confirms that the proposed ribs with decreasing height rhombus-shaped patterns are effective for enhancing the internal cooling of the channel.

Hox genes and patterning the vertebrate body.

The diversity of vertebrate body plans is dizzying, yet stunning for the many things they have in common. Vertebrates have inhabited virtually every part of the earth from its coldest to warmest climates. They locomote by swimming, flying, walking, slithering, or climbing, or combinations of these behaviors. And they exist in many different sizes, from the smallest of frogs, fish and lizards to giraffes, elephants, and blue whales. Despite these differences, vertebrates follow a remarkably similar blueprint for the establishment of their body plan. Within the relatively small amount of time required to complete gastrulation, the process through which the three germ layers, ectoderm, mesoderm, and endoderm are created, the embryo also generates its body axis and is simultaneously patterned. For the length of this axis, the genes that distinguish the neck from the rib cage or the trunk from the sacrum are the Hox genes. In vertebrates, there was evolutionary pressure to maintain this set of genes in the organism. Over the past decades, much has been learned regarding the regulatory mechanisms that ensure the appropriate expression of these genes along the main body axes. Genetic functions continue to be explored though much has been learned. Much less has been discerned on the identity of co-factors used by Hox proteins for the specificity of transcriptional regulation or what downstream targets and pathways are critical for patterning events, though there are notable exceptions. Current work in the field is demonstrating that Hox genes continue to function in many organs long after directing early patterning events. It is hopeful continued research will shed light on remaining questions regarding mechanisms used by this important and conserved set of transcriptional regulators.

Rib cage contributions to inspiratory capacity in patients with cervical spinal cord injury

BackgroundCervical spinal cord injury (CSI) often leads to impaired respiratory function, affecting the overall well-being of patients. This study aimed to investigate the influence of rib cage motion on inspiratory capacity in CSI patients. MethodsWe conducted a study with 11 CSI patients, utilising respiratory inductance plethysmography (RIP). We measured ventilatory volume by spirometry concurrently with RIP. Participants were instructed to perform maximal inspiratory efforts. Inspiratory capacity (IC) was calculated from spirometry waveforms. We converted the respiratory waveforms of the chest and abdomen into inspiratory volume measured by a spirometer. The inspiratory volume measured by the chest sensor was defined as VRIP-rib cage (VRIP-rc), and the inspiratory volume measured by the abdominal sensor was defined as VRIP-abdomen (VRIP-ab). Subsequently, the relationships of IC with VRIP-rc and VRIPab were assessed. ResultsThe mean IC was 1.828 ± 0.459 L, with the mean VRIP-rc at 1.343 ± 0.568 L and the mean VRIP-ab at 0.485 ± 0.427 L. A significant correlation was observed between IC and VRIP-rc (r = 0.67, p = 0.02), indicating that rib cage motion significantly influences IC in CSI patients. ConclusionThis study highlights the importance of rib cage motion in assessing inspiratory capacity in patients with CSI.

Thoracic Cage Deformity Correction in Patients with Lenke Type 1 Adolescent Idiopathic Scoliosis.

Whether the thoracic cage deformity in adolescent idiopathic scoliosis (AIS) can be sufficiently treated with vertebral derotation alone, has been quite controversial. Our aim is to control the hypothesis that the rib cage deformity (RCD) may be adequately corrected when only vertebral derotation is applied. We studied retrospectively patients treated for AIS with posterior spinal fusion without costoplasty. The RCD was assessed on lateral radiographs by rib index (RI). The correction of RI after surgery was calculated. Of the 103 patients that were finally included in our study, 29 patients (22 females and 7 males; mean age, 14.5 ± 2.1 years) represented Group A (Harrington rod instrumentation - no derotation), while 74 patients (61 females and 13 males; mean age, 14.1 ± 2.4 years) were operated with either a full pedicle screw system or a hybrid construct with hooks and pedicle screws (Group B-derotation). RI was significantly corrected after surgery in both groups. RI was significantly greater in Group A after surgery. Whatsoever, the correction of RI, thereby the RCD correction, did not significantly differ among groups. In conclusion, it cannot be suggested by the present study that vertebral derotation alone can offer an absolute correction of the deformity of the thoracic cage in patients with Lenke Type 1 AIS, and it seems also that the development of RCD may not exclusively result from the spinal deformity, thus questions can be further raised regarding scoliogeny per se.

Thoracic trauma in children.

Isolated thoracic trauma is rare in children. Because of their small body size, the trauma often also affects other spaces, such as the abdomen and head, and these coexistences significantly increase the rate of mortality. However, in isolated thoracic traumas, the children can quickly recover if they can survive the initial period of trauma. Pediatric thoracic trauma cases can have a different clinical course compared to adults due to the unique anatomic and physiologic properties of children's thoracic cages. Their ribs are nonossified and are very elastic, and therefore, as their ribs can sustain significant deformation without breaking, some significant intrathoracic injuries can be overlooked. In this review, the most common thoracic injuries, including pulmonary contusion, hemopneumothorax, pulmonary laceration, rib fractures, flail chest, tracheobronchial injuries, traumatic asphyxia, and other less common mediastinal injuries are discussed in detail in regard of clinical presentation and management.

Suture-anchored cutaneous tension induces persistent hypertrophic scarring in a novel murine model.

Hypertrophic scars cause impaired skin appearance and function, seriously affecting physical and mental health. Due to medical ethics and clinical accessibility, the collection of human scar specimens is frequently restricted, and the establishment of scar experimental animal models for scientific research is urgently needed. The four most commonly used animal models of hypertrophic scars have the following drawbacks: the rabbit ear model takes a long time to construct; the immunodeficient mouse hypertrophic scar model necessitates careful feeding and experimental operations; female Duroc pigs are expensive to purchase and maintain, and their large size makes it difficult to produce a significant number of models; and mouse scar models that rely on tension require special skin stretch devices, which are often damaged and shed, resulting in unstable model establishment. Our group overcame the shortcomings of previous scar animal models and created a new mouse model of hypertrophic scarring induced by suture anchoring at the wound edge. We utilized suture anchoring of incisional wounds to impose directional tension throughout the healing process, restrain wound contraction, and generate granulation tissue, thus inducing scar formation. Dorsal paired incisions were generated in mice, with wound edges on the upper back sutured to the rib cage and the wound edges on the lower back relaxed as a control. Macroscopic manifestation, microscopic histological analysis, mRNA sequencing, bioinformatics, and in vitro cell assays were also conducted to verify the reliability of this method. Compared with those in relaxed controls, the fibrotic changes in stretched wounds were more profound. Histologically, the stretched scars were hypercellular, hypervascular, and hyperproliferative with disorganized extracellular matrix deposition, and displayed molecular hallmarks of hypertrophic fibrosis. In addition, the stretched scars exhibited transcriptional overlap with mechanically stretched scars, and human hypertrophic and keloid scars. Phosphatidylinositol 3-kinase-serine/threonine-protein kinase B signaling was implicated as a profibrotic mediator of apoptosis resistance under suture-induced tension. This straightforward murine model successfully induces cardinal molecular and histological features of pathological hypertrophic scarring through localized suture tension to inhibit wound contraction. The model enables us to interrogate the mechanisms of tension-induced fibrosis and evaluate anti-scarring therapies.

Extracorporeal Closed-Loop Respiratory Regulation for Patients With Respiratory Difficulty Using a Soft Bionic Robot.

Respiratory regulation is critical for patients with respiratory dysfunction. Clinically used ventilators can lead to long-term dependence and injury. Extracorporeal assistance approaches such as iron-lung devices provide a noninvasive alternative, however, artificial actuator counterparts have not achieved marvelous biomimetic ventilation as human respiratory muscles. Here, we propose a bionic soft exoskeleton robot that can achieve extracorporeal closed-loop respiratory regulation by emulating natural human breath. For inspiration, a soft vacuum chamber is actuated to produce negative thoracic pressure and thus expand lung volume by pulling the rib cage up and outward through use of external negative pressure. For expiration, a soft origami array under positive pressure pushes the abdominal muscles inward and the diaphragm upward. To achieve in vitro measurement of respiratory profile, we describe a wireless respiratory monitoring device to measure respiratory profiles with high accuracy, validated by quantitative comparisons with spirometer as gold-standard reference. By constructing a human-robot coupled respiratory mechanical model, a model-based proportional controller is designed for continuous tracking of the target respiratory profile. In experiments with ten healthy participants and ten patients with respiratory difficulty, the robot can adjust its assistive forces in real time and drive human-robot coupling respiratory system to track the target profile. The biomimetic robot can achieve extracorporeal closed-loop respiratory regulation for a diverse population. The soft robot has important potential to assist respiration for people with respiratory difficulty, whether in a hospital or a home setting.

Real-time changes in rib cage expansion and use of abdominal mechanical stimulation in newborns: a quasi-experimental study.

To assess the rib cage expansion and respiratory rate in newborns using an abdominal stabilization band. The study included 32 newborns of both genders, with gestational age between 35 and 41 weeks. The abdominal stabilization band was used for 15 minutes between the xiphoid process and the anterosuperior iliac crest, with an abdominal contention 0.5cm smaller than the abdominal circumference. The rib cage expansion was evaluated by a breathing transducer (Pneumotrace II™) three minutes before using the band, during the use (15 minutes), and ten minutes after removing the band. The Shapiro-Wilk test verified data normality, and the Wilcoxon test compared the variables considering rib cage expansion and respiratory rate. Significance was set to p<0.05. There was an increase in respiratory rate when comparing before and ten minutes after removing (p=0.008) the abdominal stabilization band, as well as when comparing during its use and ten minutes after its removal (p=0.001). There was also an increase in rib cage expansion when comparing before and during the use of the abdominal stabilization band (p=0.005). The use of the abdominal stabilization band promoted an increase in the rib cage expansion and respiratory rate in the assessed newborns and may be a viable option to improve the respiratory kinematics of this population.

The length of scoliosis instrumentation affects the adjacent segmental flexibility and the lumbar intradiscal pressure: An in vitro study using entire thoracolumbar spine and rib cage specimens

The length of scoliosis instrumentation affects the adjacent segmental flexibility and the lumbar intradiscal pressure: An in vitro study using entire thoracolumbar spine and rib cage specimens

To study the effect of obesity on pulmonary functions in adults

Background: Obesity is defined as an excessive accumulation of fat in the body, resulting in adverse effects on the health of the individual. Obesity alters the relationship between the lungs, chest wall, and diaphragm. So, it has been expected to alter respiratory function. Aims and Objectives: The aim of the present study was to conduct a study of pulmonary function in obese (study group) and non-obese (control group) healthy college students. Materials and Methods: The present study involved 100 subjects in the age group of 18–25 years, both obese and non-obese, recruited from various colleges. Out of a total of 100 subjects, 50 were obese (study group) and 50 were non-obese (control group) subjects. Data were statistically analyzed using an unpaired Student “t” test; P &lt; 0.05 was considered statistically significant. Results: In this study, pulmonary functions such as peak expiratory flow rate and maximum voluntary ventilation decreased significantly (&lt;0.05) in obese people when compared with non-obese people. forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) decreased in obese people when compared with non-obese people, but the results were not significant (&gt;0.05). There was no change in FEV1/FVC%. Conclusion: Obesity can cause various deleterious effects on respiratory function. These changes in lung function are caused by extra adipose tissue in the chest wall and abdominal cavity compressing the thoracic cage, diaphragm, and lungs.

Full-thickness chest wall reconstruction after resection of recurrent desmoid-type fibromatosis

Introduction. Desmoid-type fibromatosis (DF) is a benign but locally infiltrative soft tissue tumor that develops from fascia and musculoaponeurotic tissue with high local recurrence rate. The aim of this article was to present a case of recurrent DF of the chest wall and chest wall reconstruction after tumor resection. Case outline. A 62-year-old man came for an examination due to a tumor localized on the right anterior chest wall. The previous year, the patient had undergone surgical excision of DF of the abdominal wall. Physical examination found a firm and painless 6?7 cm mass on the right side of the chest wall with no swelling of superficial lymph nodes. A computed tomography scan revealed a homogenous mass of soft tissue density, measuring 7.12 ? 4.23 cm, arising from right anterolateral wall of thoracic cage with adjoining ribs destruction. The patient was taken to surgery, and right thoracotomy was done with excision of tumor along with resection of the eighth, nineth and tenth rib. The results of pathological examination were consistent with the frozen section, and the patient was diagnosed with DF. Despite the absence of postoperative radiotherapy, there was no evidence of local recurrence two years later. Conclusion. Surgical treatment of recurrent DF of the chest wall requires a wide resection with negative margins. Multidisciplinary approach in case of full-thickness defect of the chest wall and combination of pedicled muscle flap and polypropylene mesh are important to provide chest wall stability.

Trapped Lung as a Sequela of Dramatic Tumor Shrinkage of Lung Cancer.

Herein, we report a case of 72-year-old man who had L858R EGFR-mutated lung adenocarcinoma. Chest computed tomography revealed a large lung mass that had completely replaced the right upper lobe. Although the mass dramatically shrank after initiating chemotherapy, non-malignant pleural effusion appeared. Because diffuse pleural thickening and shrinking of the thoracic cage gradually became apparent, the patient was diagnosed with trapped lung. Despite the stabilization of his lung cancer, he experienced severe dyspnea and significant weight loss, ultimately leading to a decreased performance status. Chest physicians should recognize that trapped lung can develop as a sequela of dramatic tumor shrinkage in lung cancer.

Research on Meso‐Damage Experiment and Simulation in the Anchorage Bonding Interface Between Rock Bolt and Rock Mass

Anchorage failure occurs mostly at the anchorage interface, and the mechanical mechanism of the anchorage interface is the key point and difficulty in the analysis and research of anchorage. In order to study the mechanics and failure mechanism of the anchorage interface, the shear failure characteristics of the anchorage interface and the deformation rule of the anchored rock under different rib spacings were analyzed through the indoor plane anchorage pull‐out test. Reasonable rib spacing can significantly improve the shear strength of the anchored solid. Finite element software ABAQUS was used to create an axisymmetric plane model of rock bolt pull‐out under different rib conditions to simulate the whole process of rock bolt pull‐out and anchorage interface failure. The results show that during the pull‐out process of anchorage rock mass, stress concentration zones occur at rib corners, and peak shear stress moves to the depths of the anchorage section. As the load increases, cracks emerge from the top of the rib and the edge of the rib angle of the rock bolt and propagate to the deep anchorage along the edge of the costal angle, resulting in damage at the rock mass interface. Load–displacement curves of different transverse rib shapes, heights, widths, and spacings indicate that rib changes affect the anchor‐bearing limit. The anchoring failure mode changes from rib wear and spreading slip, rib shear convex body propagation to interfacial crack propagation, and rib causes varying degrees of damage to the surrounding rock mass. Therefore, reasonable rib parameter improvements can enhance anchoring force performance.

Uncertainty analysis method for the output force vector control on the rib of the orienter in coiled tubing drilling

This work addresses the uncertainty associated with downhole parameters in coiled tubing drilling and proposes a new method for controlling the output force vector on the ribs of the orienter, enabling more precise control of the actual wellbore trajectory. Based on the principles of longitudinal and transverse bending beams, we construct a 3D mechanical model of the Bottom Hole Assembly (BHA) used in coiled tubing drilling. We then analyze the spatial geometry relating the force direction on the orienter's rib and the tool face angle, establishing a comprehensive steering resultant force vector model. Applying the principle of minimum energy, we explore traditional control schemes for the output force on each rib and reveal its intricate variation patterns. We conduct a statistical analysis to investigate the randomness distribution state and sensitivity of the experimental parameters, allowing us to derive the probability density and cumulative probability functions for the two-dimensional random variables linked to the output force on the ribs. Confidence interval models are constructed to predict the output forces with a predetermined level of certainty. Finally, we experimentally verify the proposed uncertainty control method in real-world coiled tubing drilling. Our results show that the randomness of weight on bit (WOB) and the tool face angle of rib 1# are the main factors influencing the uncertainty of the output force control. When the output forces vector on the ribs exceeds the uncertainty confidence interval, the actual wellbore trajectory significantly deviates from the designed one. Conversely, when the output forces vector falls within the confidence interval, the error between the actual and designed wellbore trajectories is significantly smaller. This validates the rationality and effectiveness of the proposed uncertainty analysis method, providing valuable guidance for implementing wellbore trajectory control in coiled tubing drilling.

Invention of Device for Measuring Cardiac Compression Rates and the Depth for the Cardio-Pulmonary Resuscitation Manikin

Manikins that simulate cardiopulmonary resuscitation (CPR) are used to teach personnel how to execute it. Modern cardiac resuscitation manikins are still low-fidelity designs in terms of anatomy and physiology. Designing a manikin with a cardiac and respiratory system, as well as integrated flow sensors to track cardiac output and air displacement in response to cardiopulmonary resuscitation, was the main goal of this research. A polyoxy-methylene rib cage joined to a vertebral column from an anatomical female model was used to create this manikin in line with anatomical proportions. The respiratory system was made up of a polyvinyl chloride bronchus, a latex trachea, and silicon-coated memory foam that mimicked lungs. The pulmonary and aortic arteries were represented by two sets of latex tubing, while the ventricles and aggregated abdominal volumes were represented by latex balloons, respectively. These components made up the cardiovascular system. These balloons were inserted into polyether foam and filled with blood from a life/form simulation. Flow sensors were installed in the respiratory and cardiovascular systems to collect data in reaction to chest compressions. On this manikin, three non-medical individuals applied chest compressions that produced data proportional to force-displacement while the flow sensors supplied feedback. The force-displacement experiments performed on this manikin demonstrate an advantageous nonlinear behavior that mimics the chest compressions used during cardiopulmonary resuscitation in humans. A considerable amount of information on the internal effects of cardiopulmonary resuscitation is also provided by the flow sensors. To sum up, scientifically developed and anatomically accurate designs of cardiopulmonary resuscitation manikins that incorporate flow sensors can enhance physiological fidelity and offer helpful feedback data.

Microwave absorption behaviour of novel rib cage structured piper betel leaves: Effect of drying and sintering processes

This paper focuses on a simple and cost−effective technique to explore the impact of the drying and sintering process on the microwave absorption behavior of piper betel leaves. The microwave absorption behavior of dried leaves and leaves sintered at 800 ℃ for 3 h was examined. X − Ray Diffraction (XRD) study confirms the presence of elemental composites such as sucrose, cellulose, hemicellulose, and lignin in the dried sample, while sintered betel powder exhibited crystalline phases of CaSiO5, SiO2, Mg2P2O7, CaO, KPO3, Na2K(P3O9) K2CO3, and CaCO3. Microstructure study showed a unique rib cage and nanorod strand structure in the dried leaves and a porous structure in the sintered leaves. Spectroscopy analysis confirmed the occurrence of chemical composites in both dried and sintered betel leaves. The optical band gap of the sintered and dried leaves was 2.7 and 2 eV, respectively. Dielectric loss and loss mechanism in the betel leaf were studied using the DAK 3.5 kit. Results of the microwave absorption studies revealed that dried betel leaves with a thickness of 9 mm exhibited a high Reflection Loss (RLmax) of − 22.69 dB at 11.37 GHz. Also, the same thickness has an effective absorption bandwidth (EAB) of 3.69 GHz, 87.8% of the X band frequency. On the other hand, sintered betel leaves with a thickness of 9 mm have a reflection loss (RLmax) of − 48.57 dB at 10.52 GHz, with an effective absorption bandwidth (EAB) of 2.88 GHz, covering 68.5% of the X band frequency.

Acute effect of scapular mobilization with associated myofascial release on butterfly performance: Randomized clinical trial

IntroductionTo evaluate the acute effect of scapular mobilization with associated myofascial release compared to scapular mobilization without myofascial release on butterfly stroke sports performance. Design: Randomized clinical trial. MethodPilot study that non-probabilistically convenience sampling that selected butterfly swimmers who were simply randomized into three groups to receive the standard protocol (scapular mobilization with release of the subscapularis muscle by the lateral edge of the scapula and rib cage detachment) in intervention group (IG), sham group (SG) (scapular mobilization without subscapularis muscle release and without rib cage detachment) or no intervention in control group (CG). We evaluated the stroke frequency, length, and average speed of 30 swimmers using the 8.15 Kinovea® motion analysis system. ResultsThe findings showed that, compared to the CG and IG, the SG showed a significant reduction in mean velocity (p = 0.002; p = 0.02, respectively), stroke frequency (p = 0.002; p = 0.003, respectively), and stroke length (p = 0.01; p = 0.05, respectively). DiscussionThe results showed that manual therapy through scapular mobilization without associated myofascial release with detachment of the scapula from the rib cage worsened the swimming efficiency indicators even after 30 min of application of the technique. The limitations of the studies are related to the sample size, the risk of non-probabilistic contraction bias and the lack of blinding of the evaluators. Thus, the results of this study should be evaluated with caution.

Comparison of breathing pattern and diaphragmatic motion in patients with unilateral cervical radiculopathy and asymptomatic group

BackgroundThe associations between neck pain and respiratory dysfunction were clarified in patients with neck pain. There is dearth of evidence on pulmonary dysfunction and diaphragmatic excursion in patients with unilateral cervical radiculopathy (CR). The purpose of this study was to compare the breathing pattern and diaphragmatic excursion in patients with unilateral CR with those in an asymptomatic group.MethodsTwenty-five patients with unilateral CR and 25 asymptomatic individuals aged between 30 and 55 participated in this study. Diaphragmatic motion, breathing pattern, active cervical range of motion and kinesiophobia were investigated in both groups by using fluoroscopy, manual assessment of respiratory motion (MARM), cervical range of motion device, and Tampa scale of kinesiophobia. Statistical significance was set at 0.05.ResultsNo statistically significant differences were found between the two groups with regard to sex, age and body mass index. The mean excursion of the hemi diaphragm on the involved side (the side of CR) was significantly lower than that on the uninvolved side in patients with unilateral CR with a large effect size. The excursion of the involved hemi diaphragm in patients was reduced compared to the matched hemi diaphragm in the control group. There was no significant difference between the hemi diaphragms excursion in the control group. The results of the MARM variables showed that the volume of breathing and the percentage rib cage motion in normal and deep breathing were significantly different between the two groups, but there was no significant difference in the balance of breathing between the two groups. Additionally, the active cervical range of motion was reduced in these patients in comparison to the control group, and it was less on the involved side than on the uninvolved side.ConclusionThe results of this study revealed a dysfunctional breathing pattern in normal and deep breathing and a unilateral reduction in diaphragmatic excursion on the side of radiculopathy in patients with unilateral CR compared to the control group.

Remaining microtia tissue as a source for 3D bioprinted elastic cartilage tissue constructs, potential use for surgical microtia reconstruction.

The absence of ears in children is a global problem. An implant made of costal cartilage is the standard procedure for ear reconstruction; however, side effects such as pneumothorax, loss of thoracic cage shape, and respiratory complications have been documented. Three-dimensional (3D) printing allows the generation of biocompatible scaffolds that mimic the shape, mechanical strength, and architecture of the native extracellular matrix necessary to promote new elastic cartilage formation. We report the potential use of a 3D-bioprinted poly-ε-caprolactone (3D-PCL) auricle-shaped framework seeded with remaining human microtia chondrocytes for the development of elastic cartilage for autologous microtia ear reconstruction. An in vivo assay of the neo-tissue formed revealed the generation of a 3D pinna-shaped neo-tissue, and confirmed the formation of elastic cartilage by the presence of type II collagen and elastin with histological features and a protein composition consistent with normal elastic cartilage. According to our results, a combination of 3D-PCL auricle frameworks and autologous microtia remnant tissue generates a suitable pinna structure for autologous ear reconstruction.