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BACKGROUND Postoperative nausea and vomiting (PONV) is one of the major concerns after anesthesia and surgery, and it may be more frequent in orthopedic patients receiving patient-controlled epidural analgesia (PCEA). The purpose of this study was to compare the effect of palonosetron and dexamethasone on the prevention of PONV in patients undergoing total joint arthroplasty and receiving PCEA. METHODS Patients scheduled for total hip or knee arthroplasty under spinal anesthesia/PCEA were randomly allocated to receive either intravenous palonosetron (0.075 mg, n = 50) or dexamethasone (5 mg, n = 50). Treatments were administered intravenously to the patients 30 min before the beginning of surgery. The total incidence of PONV and incidence in each time period, severity of nausea, need for rescue anti-emetics, pain score, and adverse effects during the first 48 h postoperatively were evaluated. RESULTS The total incidence of PONV was lower in the palonosetron group compared with the dexamethasone group (18.4% vs. 36.7%, P = 0.042), but there were no statistically significant differences in incidence between the groups at all time points. No significant intergroup differences were observed in the severity of nausea, use of rescue anti-emetics, pain score, and adverse effects. CONCLUSIONS Although there were no significant differences in the incidence of PONV between the treatment groups at all time points, intravenous palonosetron reduced the total incidence of PONV in orthopedic patients receiving PCEA compared with dexamethasone.

A non-fullerene small molecule acceptor, SF-HR composed of 3D-shaped spirobifluorene and hexyl rhodanine, was synthesized for use in bulk heterojunction organic solar cells (OSCs). It possesses harmonious molecular aggregation between the donor and acceptor, due to the interesting diagonal molecular shape of SF-HR. Furthermore, the energy level of SF-HR matches well with that of the donor polymer, poly(3-hexyl thiophene) (P3HT) in this system which can affect efficient charge transfer and transport properties. As a result, OSCs made from a P3HT:SF-HR photoactive layer exhibited a power conversion efficiency rate of 4.01% with a high VOC of 1.00 V, a JSC value of 8.23 mA cm−2, and a FF value of 49%. Moreover, the P3HT:SF-HR film showed superior thermal and photo-stability to P3HT:PC71BM. These results indicate that SF-HR is specialized as a non-fullerene acceptor for use in high-performance OSCs.

Two benzo[1,2-b:4,5-b’]dithiophene (BDT)-based copolymers, poly[4,8-bis(5-(2-ethylhexyl) thiophene-2-yl)benzo[1,2-b:4,5-b’]dithiophene-alt-5,8-(2,3-bis(4-octyloxy)phenyl)quinoxaline] (P1) and poly[4,8-bis(5-(2-ethylhexyl)thiophene-2-yl)benzo[1,2-b:4,5-b’]dithiophene-alt-5,7-(2,3-bis(4- octyloxy)phenyl)thieno[3,4-b]pyrazine] (P2), are synthesized and used as donor materials in polymer solar cells (PSCs). To obtain a low band gap polymer, we use a copolymerized donor-acceptor structure. The optical, electrochemical, and photovoltaic properties of the copolymers are investigated. The results indicate that the acceptor units in the copolymers influenced the band gap, electronic energy levels, and photovoltaic properties of the copolymers significantly. The band gaps of the copolymers are in the range 1.34 − 1.75 eV. Under optimized conditions, the BDT-based polymers showed power conversion efficiencies (PCEs) for the PSCs in the range 1.46 − 2.05% under AM 1.5 illumination (100 mW/cm2).

Background: Coccygodynia is a pain in the region of the coccyx that radiates to the sacral, perineal area. The cause of the pain is often unknown. Coccygodynia is diagnosed through the patient's past history, a physical examination, and dynamic radiographic study, but the injection of local anesthetics or a diagnostic nerve blockade are needed to distinguish between somatic, neuropathic, and combined pain. Ganglion impar is a single retroperitoneal structure made of both paravertebral sympathetic ganglions. Although there are no standard guidelines for the treatment of coccygodynia, ganglion impar blockade is one of the effective options for treatment. Methods: Here, we report a 42-year-old female patient presenting with severe pain in the coccygeal area after spinal arachnoid cyst removal. Results: Treatment involved neurolysis with absolute alcohol on the ganglion impar through the transsacrococcygeal junction. Pain was relieved without any complications. Conclusion: Our case report offers the ganglion impar blockade using the transsacrococcygeal approach with absolute alcohol can improve intractable coccydynia.

Hyperlipidemia and marrow fat are associated with lowering bone density in vivo, suggesting that lipid contributes to bone loss. Using bone marrow-derived macrophages, we investigated the effect of saturated fatty acids (SFA) on osteoclastogenesis. The level of free fatty acids and adiposity in bone marrow was significantly elevated in obese mice. SFA increased osteoclast (OC) survival by preventing apoptosis. SFA caused the production of MIP-1alpha and led to activation of nuclear factor (NF)-kappaB in the OC. The absence of Toll-like receptor 4 (TLR4) or myeloid differentiation factor 88 (MyD88) abolished the survival effect of SFA on OC.

Ovariectomy (OVX)-induced estrogen withdrawal resulted in both bone loss and an increase in fat. We observed elevated osteoclast (OC) formation by bone marrow-derived macrophages treated with medium conditioned by fats from OVX mice, but not from sham-operated mice. Fats from OVX mice expressed and secreted higher levels of monocyte chemoattractant protein-1 (MCP-1) than those from sham-operated mice. Increased fat resulting from estrogen deficiency is thus responsible for bone loss due to enhanced OC formation, which is, at least partly, a consequence of elevated MCP-1 production.

Curcumin (diferuloylmethane), a pigment derived from turmeric, has anti-oxidant and anti-inflammatory activities. Accumulating evidence points to a biochemical link between increased oxidative stress and reduced bone density. Osteoclast formation was evaluated in co-cultures of bone marrow stromal cells (BMSC) and whole bone marrow cells (BMC). Expression of receptor activator of nuclear factor-kappaB ligand (RANKL) was analyzed at the mRNA and protein levels. Exposure to curcumin led to dose-dependent suppression of osteoclastogenesis in the coculture system, and to reduced expression of RANKL in IL-1alpha-stimulated BMSCs. Addition of RANKL abolished the inhibition of osteoclastogenesis by curcumin, whereas the addition of prostaglandin E2(PGE2) did not. The decreased osteoclastogenesis induced by curcumin may reduce bone loss and be of potential benefit in preventing and/or attenuating osteoporosis.