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Background: Total knee arthroplasty (TKA) has been known as a definitive treatment of advanced knee osteoarthritis. Both intra- (IM) and extramedullary (EM) tibial guides have been used to restore the desired extremity alignment. However, controversy exists regarding the superiority of either technique. We aimed to compare their functional outcomes and accuracy in providing neutral alignment after TKA. Methods: In a randomized, double-blinded clinical trial, we studied 98 patients undergoing primary TKA in two groups of IM and EM. We measured the medial proximal tibial angle (MPTA), varus angle (VA), and joint-line convergence angle with normal ranges of 90°±3°, 0-2°, and 0±3°, respectively, on a three-joint alignment view after three months. We also assessed functional outcomes at the last follow-up. Finally, we compared these outcomes between groups. Results: Eighty-four patients (IM=42, EM=42) were included in the final analysis (16 males, 68 females; mean age: 63.9±8.6 years; mean follow-up: 27±2.9 months). The mean postoperative alignment angles showed no significant difference, although MPTA outliers were significantly more frequent in the EM group (26.2% vs. 9.5% in IM, P=0.04). None of the functional outcomes showed a significant difference between groups. However, the mean ROM increase was significantly higher in VAs within ±3° of normal than those outside it (30.8 vs. 27.4, respectively; P=0.039). Conclusions: We conclude that both techniques were not different in terms of the mean alignment angles and functional outcomes. However, fewer MPTA outliers can be seen with IM. A postoperative mechanical axis within ±3° of neutral can result in a more ROM increase after one year. Trial registration: IRCT, IRCT20160809029286N5. Registered 21 April 2020, https://www.irct.ir/trial/46976

Introduction: Gastric cancer is the third cause of death in all malignancies and the fifth most common neoplasm resulting from a combination of specific genetic alteration and environmental factors. Chronic stress can also promote brain tumor cell proliferation and leads to brain metastasis highly resistant to chemotherapy. Catecholamines, norepinephrine, and epinephrine impact neurochemistry and endocrine and immune system functions. The present study investigated the effect of different epinephrine concentrations and β-adrenergic receptor antagonists (propranolol) on proliferation, viability, and adhesion of gastric adenocarcinoma and brain glioblastoma cells.Material and methods: The human gastric cancer AGS cells and glioblastoma, U87 cell lines were obtained from the Iranian Biological Resource Center (Tehran, Iran) and cultured in RPMI-1640 culture medium supplements. The studied cells were categorized into the nine groups following treatment with epinephrine and propranolol. Wound healing assay (proliferation), Adhesion assay, and cell viability were performed on each group. Graph Pad Prism 6 was used for the statistical analysis. Results: Proliferation, Viability, cytotoxicity, and adhesion of both cell lines changed under epinephrine agonism in the presence and absence of propranolol (P valueConclusion: Using a combination of epinephrine and chemotherapy agents in the right stage of developing tumors may have more substantial effects on destroying cancer cells, obtaining the patient's recovery with less repetition of chemotherapy sessions, and curing high-grade cancer tumors.