Basilar Invagination and Atlantoaxial Dislocation: Reduction, Deformity Correction and Realignment Using the DCER (Distraction, Compression, Extension, and Reduction) Technique With Customized Instrumentation and Implants

P. Sarat Chandra,Jitin Bajaj,Pankaj Kumar Singh,Kanwaljeet Garg,Deepak Agarwal 대한척추신경외과학회 2019 Neurospine Vol.16 No.2

Objective: The technique of distraction, compression, extension, and reduction (DCER) is effective to reduce, realign, and relieve cranio-spinal compression through posterior only approach. Methods: Study included all patients with atlantoaxial dislocation and basilar invagination (BI) with occipitalized C1 arch. Study techniques included Nurick grading, computed tomography scan to study atlanto-dental interval, BI, hyper-lordosis, and neck tilt. Sagittal inclination (SI), coronal inclination (CI), cranio-cervical tilt, presence of pseudo-joints, and anomalous vertebral artery were also noted. Patients underwent DCER with/without joint remodeling or extra-articular distraction (EAD) based on the SI being <100°, 100°–160°, or >160° respectively. In cases with pseudo-joints, joint remodeling was performed in type I and EAD in type II. Customized ‘bullet shaped’ PSC spacers (n=124) and prototype of the universal craniovertebral junction reducer (UCVJR, n=36) were useful. Results: A total of 148 patients with average age 27.25±17.43 years, ranging from 3 to 71 years (87 males) were operated. Nurick’s grading improved from 3.14±1.872 to 1.22±1.17 (p<0.0001). Fifty-two percent of total joints (n=154/296 joints) were either type I (19%)/type II (33%) pseudo-j oints. All traditional indices such as Chamberlein line, McRae line, atlanto-dental interval, and Ranawat line improved (p<at least 0.001). BI, SI, and CI values correlated with type of pseudo-joints (p<0.0001). Side of neck tilt correlated with the type of pseudo-joint (p<0.0001). Cervical hyperlordosis improved significantly (p<0.0001). Conclusion: Occipito-C2 pseudo-joints are important in determining the severity of BI. Asymmetrical pseudo-joint causes coronal/neck tilt. Type of pseudo-joint can strategize by DCER. Customized instruments and implants make technique safe, effective and easier.

A Nationwide Analysis Evaluating the Safety of Using Acellular Dermal Matrix with Tissue Expander-Based Breast Reconstruction

Jessica Luo,Whitney D. Moss,Giovanna R. Pires,Irfan A. Rhemtulla,Megan Rosales,Gregory J. Stoddard,Jayant P. Agarwal,Alvin C. Kwok 대한성형외과학회 2022 Archives of Plastic Surgery Vol.49 No.6

Background In March 2021, the United States Food and Drug Administration (FDA) safety communication cautioned against the use of acellular dermal matrix (ADM) products in breast reconstruction and reiterated that the FDA does not approve ADM use in breast surgery. This study aims to assess the safety of ADM use in breast reconstruction. Methods Women who underwent ADM and non-ADM assisted tissue expander (TE)- based breast reconstruction were identified using the National Surgical Quality Improvement Program database (2012–2019). Trends of ADM use over time, and 30-day outcomes of surgical site infection (SSI), dehiscence, and unplanned reoperation were assessed. Results Of the 49,049 TE-based breast reconstructive cases, 42.4% were ADM assisted and 57.6% non-ADM assisted. From 2012 to 2019, the use of ADM increased from 26.1 to 55.6% (relative risk [RR] ¼1.10; p<0.01). Higher rates of SSI (3.9 vs. 3.4%; p¼0.003) and reoperation (7.4 vs. 6.0%; p<0.001) were seen in the ADM cohort. There was no significant difference seen in dehiscence rates (0.7 vs. 0.7%; p¼0.73). The most common reoperation within 30 days for the ADM group (17.6%) was removal of TE without insertion of implant (current procedural terminology: 11,971). ADM-assisted breast reconstruction was associated with increased relative risk of SSI by 10% (RR¼1.10, confidence interval [CI]: 1.01–1.21; p¼0.03) and reoperation by 15% (RR¼1.15, CI: 1.08–1.23; p<0.001). Conclusions ADM-assisted breast reconstruction more than doubled from 2012 to 2019. There are statistically higher complication rates of SSI (0.5%) and reoperation (1.4%) with ADM use in TE-based breast reconstruction, suggesting that reconstruction without ADM is safe when comparing immediate postoperative outcomes.

In vitro Methanogenesis, Microbial Profile and Fermentation of Green Forages with Buffalo Rumen Liquor as Influenced by 2-Bromoethanesulphonic Acid

Agarwal, Neeta,Kamra, D.N.,Chatterjee, P.N.,Kumar, Ravindra,Chaudhary, L.C. Asian Australasian Association of Animal Productio 2008 Animal Bioscience Vol.21 No.6

The interaction of fibre degrading microbes and methanogens was studied using two forages, lucerne (Medicago sativa) hay and maize (Zea mays) hay, as substrate and 2-bromoethanesulphonic acid (BES) as an additive in an in vitro gas production test. Gas and methane production (ml/g dry matter) were significantly higher (p<0.05) on lucerne as compared to maize hay. Inclusion of BES in the incubation medium significantly suppressed methane emission irrespective of substrate. The population density of total bacteria, fungi, Ruminococcus flavefaciens and Fibrobacter succinogenes was higher, whereas that of methanogens was lower with maize hay as compared to lucerne as substrate. BES suppressed methanogen population by 7 fold on lucerene and by 8.5 fold on maize at 24 h incubation as estimated by real time-PCR. This suppression was accompanied by almost complete (>98% of control) inhibition of methanogenesis. The proportion of acetate decreased, whereas that of propionate increased significantly by inclusion of BES, resulting in narrowing of acetate to propionate ratio. In vitro true digestibility (IVTD) of lucerne was significantly higher as compared to maize but BES inclusion did not affect IVTD.

High risk of tuberculosis during infliximab therapy despite tuberculosis screening in inflammatory bowel disease patients in India

( Ashish Agarwal ),( Saurabh Kedia ),( Saransh Jain ),( Vipin Gupta ),( Sawan Bopanna ),( Dawesh P Yadav ),( Sandeep Goyal ),( Venigalla Pratap Mouli ),( Rajan Dhingra ),( Govind Makharia ),( Vineet A 대한장연구학회 2018 Intestinal Research Vol.16 No.4

Background/Aims: The data on the risk of tuberculosis (TB) reactivation with infliximab (IFX) in patients with inflammatory bowel disease (IBD) from TB endemic countries, like India, is limited. The risk of TB reactivation on IFX and its predictors in patients with IBD was assessed. Methods: This retrospective review included consecutive patients with IBD who received IFX, and were on follow-up from January 2005 to November 2017. The data was recorded on age/disease duration, indications for IFX, screening for latent tuberculosis (LTB) before IFX, response to IFX, incidence and duration when TB developed after IFX, and type of TB (pulmonary [PTB]/extra-pulmonary [EPTB]/disseminated). Results: Of 69 patients (22 ulcerative colitis/47 Crohn’s disease; mean age, 35.6±14.5 years; 50.7% males; median follow-up duration after IFX, 19 months [interquartile range, 5.5-48.7 months]), primary non-response at 8 weeks and secondary loss of response at 26 and 52 weeks were seen in 14.5%, 6% and 15% patients respectively. Prior to IFX, all patients were screened for LTB, 8 (11.6%) developed active TB (disseminated, 62.5%; EPTB, 25%; PTB, 12.5%) after a median of 19 weeks (interquartile range, 14.0-84.5 weeks) of IFX. Of these 8 patients’ none had LTB, even when 7 of 8 were additionally screened with contrast-enhanced chest tomography. Though not statistically significant, more patients with Crohn’s disease than ulcerative colitis (14.9% vs. 4.5%, P=0.21), and those with past history of TB (25% vs. 9.8%, P=0.21), developed TB. Age, gender, disease duration, or extraintestinal manifestations could not predict TB reactivation. Conclusions: There is an extremely high rate of TB with IFX in Indian patients with IBD. Current screening techniques are ineffective and it is difficult to predict TB after IFX. (Intest Res 2018;16:588-598)

Effect of Dietary L-ascorbic Acid (L-AA) on Production Performance, Egg Quality Traits and Fertility in Japanese Quail (Coturnix japonica) at Low Ambient Temperature

Shit, N.,Singh, R.P.,Sastry, K.V.H.,Agarwal, R.,Singh, R.,Pandey, N.K.,Mohan, J. Asian Australasian Association of Animal Productio 2012 Animal Bioscience Vol.25 No.7

Environmental stress boosts the levels of stress hormones and accelerates energy expenditure which subsequently imbalance the body's homeostasis. L-ascorbic acid (L-AA) has been recognized to mitigate the negative impact of environmental stress on production performances in birds. The present investigation was carried out to elucidate the effect of different dietary levels of L-AA on production performance, egg quality traits and fertility in Japanese quail at low ambient temperature. Sixty matured females (15 wks) were equally divided into three groups (20/group) based on the different dietary levels of L-AA (0, 250 and 500 ppm) and coupled with an equal number of males (1:1) obtained from the same hatch. They were managed in uniform husbandry conditions without restriction of feed and water at 14 h photo-schedule. Except for feed efficiency, body weight change, feed consumption and hen-day egg production were recorded highest in 500 ppm L-AA supplemented groups. Among the all egg quality traits studied, only specific gravity, shell weight and thickness differed significantly (p<0.05) in the present study. Fertility was improved significantly ($p{\leq}0.01$) to a dose dependent manner of L-AA. The findings of the present study concluded that dietary L-AA can be a caring management practice at least in part to alleviate the adverse effect of cold induced stress on production performance in Japanese quail.

Coincidence and fixed points for multi-valued mappings and its application to nonconvex integral inclusions

Pathak, H.K.,Agarwal, R.P.,Cho, Y.J. Koninklijke Vlaamse Ingenieursvereniging ; Elsevie 2015 Journal of computational and applied mathematics Vol.283 No.-

In this paper, we consider some problems on coincidence point and fixed point theorems for multi-valued mappings. Applying the characterizations of P-functions, we establish some new existence theorems for coincidence point and fixed point distinct from Nadler's fixed point theorem, Berinde-Berinde's fixed point theorem, Mizoguchi-Takahashi's fixed point theorem and Du's fixed point theorem for nonlinear multi-valued contractive mappings in complete metric spaces. Our results compliment and extend the main results given by some authors in the literature. In the sequel, we consider a nonconvex integral inclusion and prove the Filippov type existence theorem by using an appropriate norm on the space of selection of a multi-function and a multi-valued contraction for set-valued mappings.

Estrogen receptor-α, progesterone receptor, and c-erbB/HER-family receptor mRNA detection and phenotype analysis in spontaneous canine models of breast cancer

Farruk M. Lutful Kabir,Patricia DeInnocentes,Payal Agarwal,Christopher P. Mill,David J. Riese 2nd,R. Curtis Bird 대한수의학회 2017 Journal of Veterinary Science Vol.18 No.2

Well characterized, stable, p16-defective canine mammary cancer (CMT) cell lines and normal canine mammary epithelial cells were used to investigate expression of the major breast cancer-specific hormone receptors estrogen receptor alpha (ER1) and progesterone receptor (PR) as well as luminal epithelial-specific proto-oncogenes encoding c-erbB-1 (epidermal growth factor receptor/EGFr), c-erbB-2/HER2, c-erbB-3, and c-erbB-4 receptors. The investigation developed and validated quantitative reverse transcriptase polymerase chain reaction assays for each transcript to provide rapid assessment of breast cancer phenotypes for canine cancers, based on ER1, PR, and c-erbB-2/HER2 expressions, similar to those in human disease. Roles for relatively underexplored c-erbB-3 and c-erbB-4 receptor expressions in each of these breast cancer phenotypes were also evaluated. Each quantitative assay was validated by assessment of amplicon size and DNA sequencing following amplification. Differential expression of ER1, PR, and c-erbB-2 in CMT cell lines clearly defined distinct human-like breast cancer phenotypes for a selection of CMT-derived cell lines. Expression profiles for EGFr family genes c-erbB-3 and c-erbB-4 in CMT models also provided an enriched classification of canine breast cancer identifying new extended phenotypes beyond the conventional luminal-basal characterization used in human breast cancer.

VLS-like growth and characterizations of dense ZnO nanorods grown by e-beam process

Agarwal, D C,Chauhan, R S,Avasthi, D K,Sulania, I,Kabiraj, D,Thakur, P,Chae, K H,Chawla, Amit,Chandra, R,Ogale, S B,Pellegrini, G,Mazzoldi, P Institute of Physics [etc.] 2009 Journal of Physics. D, Applied Physics Vol.42 No.3

<P>We present a new approach to produce ZnO nanorods in a reproducible manner at a temperature lower than other physical vapour deposition techniques, such as the vapour–liquid–solid mechanism. Arrays of well-aligned ZnO nanorods of uniform diameter have been synthesized on the Si substrate precoated with Au, using a simple electron beam evaporation method without the flow of any carrier gas. Scanning electron microscopy and atomic force microscopy characterizations show that as-grown nanorods are well aligned and uniform in diameter. X-ray diffraction measurements and clear lattice fringes in high-resolution transmission electron microscopy image show the growth of good quality polycrystalline hexagonal ZnO nanorods and a ⟨0 0 2⟩ growth direction. The polarization-dependent studies of near edge x-ray absorption fine structure (NEXAFS) are performed to investigate the electronic structure of the zinc and oxygen ions. The analysis of NEXAFS spectra at different angles of incidence of photon flux indicates the formation of ZnO nanorods having anisotropic behaviour of O and Zn states. The photoluminescence spectrum exhibits strong ultraviolet emission at 385 nm and the UV–visible spectrum also shows a band-gap transition around 390 nm indicating the good quality of nanorods. The catalytic growth mechanism of the ZnO nanorods is discussed on the basis of experimental results in this work.</P>

Search for Post-merger Gravitational Waves from the Remnant of the Binary Neutron Star Merger GW170817

Abbott, B. P.,Abbott, R.,Abbott, T. D.,Acernese, F.,Ackley, K.,Adams, C.,Adams, T.,Addesso, P.,Adhikari, R. X.,Adya, V. B.,Affeldt, C.,Afrough, M.,Agarwal, B.,Agathos, M.,Agatsuma, K.,Aggarwal, N.,Agu American Astronomical Society 2017 ASTROPHYSICAL JOURNAL LETTERS - Vol.851 No.1

<P>The first observation of a binary neutron star (NS) coalescence by the Advanced LIGO and Advanced Virgo gravitational-wave (GW) detectors offers an unprecedented opportunity to study matter under the most extreme conditions. After such a merger, a compact remnant is left over whose nature depends primarily on the masses of the inspiraling objects and on the equation of state of nuclear matter. This could be either a black hole (BH) or an NS, with the latter being either long-lived or too massive for stability implying delayed collapse to a BH. Here, we present a search for GWs from the remnant of the binary NS merger GW170817 using data from Advanced LIGO and Advanced Virgo. We search for short-(less than or similar to 1 s) and intermediate-duration (less than or similar to 500 s) signals, which include GW emission from a hypermassive NS or supramassive NS, respectively. We find no signal from the post-merger remnant. Our derived strain upper limits are more than an order of magnitude larger than those predicted by most models. For short signals, our best upper limit on the root sum square of the GW strain emitted from 1-4 kHz is h(rss)(50%) = 2.1 x 10(-22) Hz(-1/2) detection efficiency. For intermediate-duration signals, our best upper limit at 50% detection efficiency is h(rss) (50%) = 8.4 x 10(-22) Hz(-1/2) for a millisecond magnetar model, and h(rss)(50%) = 5.9 x 10(-22) Hz(-1/2) for a bar-mode model. These results indicate that post-merger emission from a similar event may be detectable when advanced detectors reach design sensitivity or with next-generation detectors.</P>

Search for intermediate mass black hole binaries in the first observing run of Advanced LIGO

Abbott, B. P.,Abbott, R.,Abbott, T. D.,Acernese, F.,Ackley, K.,Adams, C.,Adams, T.,Addesso, P.,Adhikari, R. X.,Adya, V. B.,Affeldt, C.,Afrough, M.,Agarwal, B.,Agatsuma, K.,Aggarwal, N.,Aguiar, O. D.,A American Physical Society 2017 Physical Review D Vol.96 No.2

<P>During their first observational run, the two Advanced LIGO detectors attained an unprecedented sensitivity, resulting in the first direct detections of gravitational-wave signals produced by stellar-mass binary black hole systems. This paper reports on an all-sky search for gravitational waves (GWs) from merging intermediate mass black hole binaries (IMBHBs). The combined results from two independent search techniques were used in this study: the first employs a matched-filter algorithm that uses a bank of filters covering the GW signal parameter space, while the second is a generic search for GW transients (bursts). No GWs from IMBHBs were detected; therefore, we constrain the rate of several classes of IMBHB mergers. The most stringent limit is obtained for black holes of individual mass 100 M-circle dot, with spins aligned with the binary orbital angular momentum. For such systems, the merger rate is constrained to be less than 0.93 Gpc(-3) yr(-1) in comoving units at the 90% confidence level, an improvement of nearly 2 orders of magnitude over previous upper limits.</P>