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Osteotomies are the established surgical procedure for the deformity of the lower limb induced by osteoarthritis (OA) of the knee and ankle. Closed-wedge (CW) and open-wedge (OW) high tibial osteotomy (HTO) are extra-articular surgery, which aim to shift the mechanical axis from medial to slightly lateral and reduce the overload in the medial compartment of the varus deformed knee by extra-articular correction. However, varus deformity of the knee with the teeter effect, which could be accompanied with subluxation and thrust due to the medial-lateral soft tissue imbalance, is not resolved only by the shift of mechanical axis. The depression of the medial tibia plateau, so-called pagoda deformity, is the intra-articular deformity, which could potentially cause the teeter effect and involves intra-articular incongruency. In such case, the osteotomy with novel concept should be developed to overcome the issues, both the imbalance of soft tissue and intra-articular deformity. Tibial condylar valgus osteotomy (TCVO) is an intra-articular osteotomy, which improves the joint congruency of the medial-compartment knee OA with subluxation and/or intra-articular deformity and also provides better joint stability. A similar argument is raised in the treatment of the ankle OA. Low tibial osteotomy (LTO) is an extra-articular surgery to correct malalignment of lower leg. Distal tibial oblique osteotomy (DTOO) is a novel surgery to improve the bony congruency of the ankle OA. In DTOO, the distal tibia is cut obliquely from the proximal medial to the distal lateral in the coronal plane and towards the center of the tibiofibular joint to improve the bony congruency of the ankle joint. Tibial condylar valgus osteotomy (TCVO) and distal tibial oblique osteotomy (DTOO) can correct intra-articular deformity of knee and ankle, respectively. The rationale and indication of TCVO and DTOO for the treatment of the lower limb by reconstructing the joint congruency are discussed.

Background: Severe ankle osteoarthritis was treated total joint replacement and the ankle fusion. The clinical results of total joint replacement was unstable and the ankle fusion lost all function of the ankle joint. Severe ankle osteoarthritis, for example stage 3 and 4 was treated Distal Tibial [for full text, please go to the a.m. URL], Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016)

Objectives: Total knee arthroplasty (TKA) or Hemiarthroplasty (HA) is mainly used for moderate or severe medial knee osteoarthritis, and High tibial osteotomy (HTO) is used only for mild cases. Because HTO, which is an extra-articular osteotomy, cannot improve the congruency of knee joints. Tibial Condylar[for full text, please go to the a.m. URL], Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016)

Two-dimensional electronic-vibrational spectroscopy was used to investigate the ultrafast photoinduced dynamics of betaine-30 in methanol-d4 solution. Our study reveals three vibrational modes (1330, 1350 and 1370 cm-1) are strongly coupled to the back charge transfer process.

We have successfully determined the internuclear distance of I2 molecules in an alignment laser field by applying our molecular structure determination methodology to an I 2p X-ray photoelectron diffraction profile observed with femtosecond X-ray free electron laser pulses. Using this methodology, we have found that the internuclear distance of the sample I2 molecules in an alignment Nd:YAG laser field of 6 × 10^11 W/cm2 is elongated by from 0.18 to 0.30 Å “in average” relatively to the equilibrium internuclear distance of 2.666 Å. Thus, the present experiment constitutes a critical step towards the goal of femtosecond imaging of chemical reactions and opens a new direction for the study of ultrafast chemical reaction in the gas phase.

A new experimental approach for determining the photoionization matrix elements with the use of multi-coincidence velocity-map imaging spectrometry is presented for the case of C1s photoionization of CO2 molecule over the energy region of a shape resonance. Our experimental results provide the complete information on the shape resonance mechanism and clearly demonstrate the inadequacy of presently available theoretical calculations for this system.

With the full use of the experimental data obtained by multi- coincidence velocity- map imaging spectrometry, we have determined the dipole amplitudes and their relative phases that describe the C 1s photoionization dynamics in CS2. It has been found that the sigma shape resonance at about 15 eV above the C 1s ionization threshold appears only in the dipole amplitude d(f sigma). We have also carried out time- dependent density functional theory calculations so as to better understand the photoemission dynamics and shape resonances in the C 1s photoionization of CS2 molecules with heavy atoms ( sulfur) having 3p valence orbitals, which distinguish the present work from well- studied works such as on CO and CO2 molecules.

The pathogenic mechanisms of atopic dermatitis (AD) and recurrent wheezing (RW) during infancy are not fully understood.We evaluated immunological markers associated with AD and RW during infancy.We followed a cohort (n = 314) from birth to 14 months of age. Some of the participants underwent a physical examination and blood test at 6 and 14 months of age. Univariate and multivariate logistic regression analysis and receiver operating characteristic curve analysis were performed to find which immunological markers could be risk factors for AD and RW.Of 16 immunological markers found in cord blood, only immunoglobulin (Ig) E was associated with AD at 6 months of age (adjusted OR [aOR], 1.607). None of the markers was associated with AD or RW at 14 months of age. Of 23 immunological markers at 6 months of age, total IgE (aOR, 1.018) and sensitization to egg white (aOR, 23.246) were associated with AD at 14 months of age. Phytohemagglutinin (PHA)-induced production of interleukin (IL) 4 from peripheral blood mononuclear cells (PBMCs) (aOR, 1.043) was associated with RW at 14 months of age.Cord blood IgE was a risk factor for AD at 6 months of age. Total IgE and sensitization to egg white at 6 months of age were risk factors for AD at 14 months of age. PHA-induced IL-4 production in PBMCs at 6 months of age was a risk factor for RW at 14 months of age.

The photoelectron angular distribution asymmetry parameters β of the Xe 3d subshell were investigated using an x-ray free-electron laser (XFEL) at photon energies of 750 and 800 eV. Owing to the perfect polarization of the XFEL and two-dimensional momentum imaging capability of our velocity map imaging spectrometer, we determined the β values with high accuracy. The β values were also investigated based on relativistic time-dependent density functional theory calculations of up to 900 eV of photon energies. By comparing all the available experimental results including our data with the most reliable theories on the photon energy dependence of the β parameters, serious differences are noted between the experiments and theories. Further studies on resolving this difference will provide new insight into the photoionization processes of the deep inner shells.

Reducing low-density lipoprotein cholesterol (LDL-C) levels using statins is associated with significant reductions in cardiovascular (CV) events in a wide range of patient populations. Although statins are generally considered to be safe, recent studies suggest they are associated with an increased risk of developing Type 2 diabetes (T2D). This led the US Food and Drug Administration (FDA) to change their labelling requirements for statins to include a warning about the possibility of increased blood sugar and HbA1c levels and the European Medicines Agency (EMA) to issue guidance on a small increased risk of T2D with the statin class. This review examines the evidence leading to these claims and provides practical guidance for primary care physicians on the use of statins in people with or at risk of developing T2D. Overall, evidence suggests that the benefits of statins for the reduction of CV risk far outweigh the risk of developing T2D, especially in individuals with higher CV risk. To reduce the risk of developing T2D, physicians should assess all patients for T2D risk prior to starting statin therapy, educate patients about their risks, and encourage risk-reduction through lifestyle changes. Whether some statins are more diabetogenic than others requires further study. Statin-treated patients at high risk of developing T2D should regularly be monitored for changes in blood glucose or HbA1c levels, and the risk of conversion from pre-diabetes to T2D should be reduced by intensifying lifestyle changes. Should a patient develop T2D during statin treatment, physicians should continue with statin therapy and manage T2D in accordance with relevant national guidelines. (C) 2014 Published by Elsevier Ireland Ltd.

3D O 1s photoelectron angular distributions from a fixed-in-space H2O molecule have been observed for the first time by quadruple coincidence measurements of photoelectron−O+−H+−H+. Obtained results for the non-axially symmetric molecules reveal the symmetry-imposed restrictions of the C2v symmetry group on the angular distributions and their strong orientation. Characteristic features of the angular distributions are explained with full quantum mechanical calculations and also in terms of Huygens' approach on electron de Broglie waves.