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[Interpretation of the expert consensus on the whole-process management of herpes zoster-associated pain]. ZHONGHUA YI XUE ZA ZHI 2022; 102:3156-3159. [PMID: 36319169 DOI: 10.3760/cma.j.cn112137-20220415-00814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Currently, the diagnosis, treatment and management of herpes zoster-associated pain are not well understood in China. The expert consensus on the whole-process management of herpes zoster-associated pain was focused on the standardization of diagnosis and treatment of herpes zoster-associated pain, such as the time definition of clinical stages, the relevant details of analgesic drugs and minimally invasive interventional therapy, and the value of vaccines in pain management. This article gives a detailed interpretation of the associated content in the consensus.
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[Safety analysis of definitive surgery for chronic radiation intestinal injury]. ZHONGHUA WEI CHANG WAI KE ZA ZHI = CHINESE JOURNAL OF GASTROINTESTINAL SURGERY 2021; 24:969-976. [PMID: 34823297 DOI: 10.3760/cma.j.cn441530-20210814-00330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To investigate the safety of definitive surgery for chronic radiation intestinal injury. Methods: A descriptive case series study was performed. Clinical data of 105 patients who were diagnosed as chronic radiation intestinal injury, had complete data and received definitive surgery (the radiation-induced intestinal segment and digestive tract reconstruction) at Department of Gastrointestinal Surgery of Beijing Tsinghua Changgung Hospital from June 2016 to May 2020 were retrospectively analyzed. There were 30 males (28.6%) and 75 females (71.4%) with the median age of 58 years (P25, P75: 52, 64 years). Patients who had tumor recurrence or refused surgical treatment were excluded. According to the preoperative evaluation and clinical manifestations, to select the resection range. Outcome parameters: (1) preoperative evaluation (nutrition risk assessment and status of obstruction or fistula); (2) clinical manifestations and treatment strategies; (3) details of surgical parameters; (4) postoperative complications, and Clavien-Dindo classification III to V was defined as main moderate-severe complication. Results: (1) Preoperative evaluation: Eighty-eight patients (83.8%) developed symptoms of chronic radiation intestinal injury more than 1 year after the end of radiotherapy. Ninety-eight patients (93.3%) had preoperative NRS-2002 score ≥3, 74 patients (70.5%) received preoperative parenteral nutritional support, and the median time of nutritional support was 10.5 (7.0, 16.0) days. Sixteen patients (15.2%) received small intestinal decompression tube implantation due to severe obstruction. (2) Clinical manifestations and treatment strategies: Among 105 patients, 87 (82.9%) presented with obstruction and received definitive resection of the radiation-induced intestinal segment plus one-stage digestive tract reconstruction; 18 (17.1%) presented with intestinal fistula and all of them received definitive resection of the radiation-induced intestinal segment, intestinal fistula plus one-stage digestive tract reconstruction. Among above 18 patients with fistula, 3 patients with ileorectal stump fistula received pedicled pelvic closure of greater omentum at the same time; 4 patients had ileal vesical fistula, of whom 2 patients received cystectomy and bladder repair due to preoperative nephrostomy decompression, and the other 2 patients received transection of the small intestine proximal and distal to the fistula and anastomosis of the intestinal loop without fistula resection, intestinal fistula or bladder fistula repair. (3) The details of surgical parameters: Median operative time and intraoperative blood loss was 230 (180, 300) minutes and 50 (20, 50) ml respectively. Ninety-two patients (92/105, 87.6%) underwent ileocolonic anastomosis, and anastomosis on the hepatic flexure or splenic flexure colon were performed in 88 (83.8%) and 4 (3.8%) patients respectively. Ileoileal anastomosis was performed in 13 patients (12.4%). The anastomotic site of 92 patients (87.6%) was strictly located in the contralateral quadrant of the radiation field, and the anastomotic site of 13 patients (12.4%) was far from the radiation field. Nine patients (8.6%) had more than one anastomosis, 5 patients (4.8%) had less than 180 cm of residual small intestine, 7 patients (6.7%) underwent retrograde intestinal permutation, 4 patients (3.8%) underwent abdominal wall reconstruction surgery due to abdominal wall defects, and 87 patients (82.9%) had severe abdominal pelvic adhesions (grade 3-4 adhesions). Intraoperative complications occurred in 3 patients (2.9%), which were found in time and handled properly. The median postoperative hospital stay was 13.0 (12.0, 24.5) days, and all the patients had resumed oral feeding upon discharge. (4) Postoperative complications: Fourteen patients (13.3%) had 18 major complications (grade III to V). The incidence of postoperative anastomotic leakage was 5.7% (6/105), and the incidence of anastomotic leakage for ileocolon anastomosis and ileoileal anastomosis was 2.2% (2/92) and 4/13, respectively (χ(2)=17.29, P<0.001). The incidence of postoperative anastomotic leakage of intestinal fistula and intestinal obstruction was 3/18 and 3.4% (3/87), respectively (χ(2)=4.84, P=0.028). The mortality at 30 days after operation was 1.0% (1/105), after abdominal infection and septic shock caused by postoperative anastomotic leakage resulting in multiple organ failure. Conclusion: For chronic radiation intestinal injury patients with obstruction or fistula, definitive surgical treatment is feasible and safe with acceptable major complications.
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[Study on the characteristics of major birth defects in 1.69 million cases of fetus in Guangxi Zhuang Autonomous Region]. ZHONGHUA LIU XING BING XUE ZA ZHI = ZHONGHUA LIUXINGBINGXUE ZAZHI 2020; 40:1554-1559. [PMID: 32062914 DOI: 10.3760/cma.j.issn.0254-6450.2019.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Tracking the information on 1.69 million fetal cases across Guangxi Zhuang Autonomous Region (Guangxi) so as to study the occurrences of total and major birth defects in order to evaluate the ability on related prevention and control programs in Guangxi. Methods: Using the self-developed "Gui Women's System" to establish a database of 1.69 million fetal cases in Guangxi and to analyze the distribution of time, space and population, as well as the outcomes of pregnancy, using the big data. Results: During the 29 months of observation, the overall live birth rate was 99.25%, with stillbirth rate during pregnancy as 0.44%, stillbirth rate during birth as 0.02%, and the 0-6 days mortality rate as 0.14%. The total detection rate on birth defects was 197.63/10 000; the incidence rate was 103.04/10 000, the birth rate was 102.55/10 000. The overall discovery rate of major birth defects was 48.33/10 000, with the incidence rate as 783 000, the birth rate as 0.58/10 000. The discovery rates of major birth defects in 14 cities were between 35 and 68/10 000, and the birth rate dropped significantly to less than 1.00 in 10 000. Nationalities showed that the number of pregnant women with birth defects more than 50 000 would include Hui (9.68/10 000), Yao (9.57/10 000), and Jing (9.37/10 000). With the increasing age of gestation, number of birth defects, incidence of major birth defects also increased. Ninety-five percent of the major birth defects were found within <28 weeks and with the top 5 kinds of major birth defects as complicated congenital heart disease (9.11/10 000), alpha thalassemia (8.36/10 000), and 21-trisomy syndrome (7.85/10 000), beta thalassemia (5.32/10 000) and fetal edema syndrome (4.92/10 000). The top 5 major birth defects appeared as complicated congenital heart disease (9.11/10 000), alpha thalassemia (8.36/10 000), and 21-trisomy syndrome (7.85/10 000), beta thalassemia (5.32/10 000) and fetal edema syndrome (4.92/10 000). Conclusion: Programs leading to increase the rate on discovery of major birth defects were fundamental in effectively reducing the major birth defects.
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Transcriptomic differential lncRNA expression is involved in neuropathic pain in rat dorsal root ganglion after spared sciatic nerve injury. ACTA ACUST UNITED AC 2018; 51:e7113. [PMID: 30066726 PMCID: PMC6065813 DOI: 10.1590/1414-431x20187113] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 06/11/2018] [Indexed: 12/22/2022]
Abstract
Dorsal root ganglia (DRG) neurons regenerate spontaneously after traumatic or surgical injury. Long noncoding RNAs (lncRNAs) are involved in various biological regulation processes. Conditions of lncRNAs in DRG neuron injury deserve to be further investigated. Transcriptomic analysis was performed by high-throughput Illumina HiSeq2500 sequencing to profile the differential genes in L4–L6 DRGs following rat sciatic nerve tying. A total of 1,228 genes were up-regulated and 1,415 down-regulated. By comparing to rat lncRNA database, 86 known and 26 novel lncRNA genes were found to be differential. The 86 known lncRNA genes modulated 866 target genes subject to gene ontology (GO) and KEGG enrichment analysis. The genes involved in the neurotransmitter status of neurons were downregulated and those involved in a neuronal regeneration were upregulated. Known lncRNA gene rno-Cntnap2 was downregulated. There were 13 credible GO terms for the rno-Cntnap2 gene, which had a putative function in cell component of voltage-gated potassium channel complex on the cell surface for neurites. In 26 novel lncRNA genes, 4 were related to 21 mRNA genes. A novel lncRNA gene AC111653.1 improved rno-Hypm synthesizing huntingtin during sciatic nerve regeneration. Real time qPCR results attested the down-regulation of rno-Cntnap lncRNA gene and the upregulation of AC111653.1 lncRNA gene. A total of 26 novel lncRNAs were found. Known lncRNA gene rno-Cntnap2 and novel lncRNA AC111653.1 were involved in neuropathic pain of DRGs after spared sciatic nerve injury. They contributed to peripheral nerve regeneration via the putative mechanisms.
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Switching properties of epitaxial La0.5Sr0.5CoO3/Na0.5Bi0.5TiO3/La0.5Sr0.5CoO3 ferroelectric capacitor. RSC Adv 2018. [DOI: 10.1039/c7ra12575e] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
La0.5Sr0.5CoO3/Na0.5Bi0.5TiO3/La0.5Sr0.5CoO3 (LSCO/NBT/LSCO) ferroelectric capacitors have been successfully fabricated on (001) SrTiO3 substrate, in which the LSCO film is prepared by magnetron sputtering and the NBT film by pulsed laser deposition.
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Difluorobenzothiadiazole based two-dimensional conjugated polymers with triphenylamine substituted moieties as pendants for bulk heterojunction solar cells. EXPRESS POLYM LETT 2017. [DOI: 10.3144/expresspolymlett.2017.87] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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First-principles calculations of oxygen adsorption on the Ti3Al (0001) surface. SURF INTERFACE ANAL 2016. [DOI: 10.1002/sia.6043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
This study was performed in 145 pigs to develop a population pharmacokinetics (PPK) model by i.m. administration of cefquinome (CEQ) at the dose of 2 mg/kg in the neck muscle. Serum physiological and biochemical parameters for each pig were determined before administration. After administration, 2-4 samples were collected at random, with the sampling point evenly distributed in the three periods (<1 h, 1-4 h and >4 h). The plasma concentration of CEQ was determined by high performance liquid chromatography with UV detector. The pharmacostatistical analyses of concentration-time data, weight, age, gender, serum physiological and biochemical parameters were performed with nonlinear mixed effect modeling (NONMEM). A one-compartmental model with first-order absorption and elimination adequately described the data from the study group. The optimal random effect model of pharmacokinetics parameters was of log-normal distribution and the residual errors assumed a mixed-type model (proportional and additive) to best explain intra-individual variability. Covariate analysis showed that body weight is positively correlated with apparent volume of distribution (V/F) and body clearance (CL/F). The typical PPK parameters of Ka , CL, and V were 0.564/h, 5.15 L/h, and 1.36 L, respectively.
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Atomic ordering kinetics of FePt thin films. JOURNAL OF NANOSCIENCE AND NANOTECHNOLOGY 2009; 9:1141-1143. [PMID: 19441473 DOI: 10.1166/jnn.2009.c105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In the present study, the nucleation and growth kinetics of the L1(0) ordered domains in FePt thin films were studied by using X-ray diffraction (XRD) measurements combined with transmission electron microscopy (TEM). A small nucleation activation energy En = (0.5 +/- 0.1) eV and a relatively large growth activation energy Eg = (0.9 +/- 0.1) eV for the L1(0) ordered domains are separately determined. The high ratio Eg/En > 1 yields an understanding of a high L1(0) ordering temperature for the FePt thin films used for magnetic recording media.
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The effect of activation treatments on the development of reconstructed bovine oocytes. Anim Reprod Sci 2007; 106:1-12. [PMID: 17482390 DOI: 10.1016/j.anireprosci.2007.03.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2006] [Revised: 03/12/2007] [Accepted: 03/23/2007] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to investigate the effect of different activation treatments on the development of IVM-derived and cloned bovine embryos. The effect of oocyte age (20h versus 24h after IVM) on the blastocyst rate was also investigated. No differences in the percentage of blastocyst development were observed between the oocytes matured for 20 and 24h (15% versus 27%, p>0.05). Reconstructed oocytes activated 4h after fusion (fusion before activation, FBA) had a higher blastocyst rate than those oocytes activated immediately after electrofusion (fusion and activation simultaneously, FAS) (26% versus 5%, p<0.01). Blastocyst rates were significantly greater (p<0.01) for the reconstructed oocytes activated by calcium ionophore (A23187) combined with 6-dimethylaminopurine (6-DMAP) (51.6%) than for those activated with cycloheximide (CHX) plus cytochalasin B (CB) treatment (1h, 8.2%; 5h, 14.3%). However, the blastocyst rates were similar among reconstructed oocytes activated by electric pulses and A23187 (30.5% versus 42.2%) or by A23187 and ionomycin (36.7% versus 33.3%) combined with 6-DMAP, respectively. Blastocysts that developed from reconstructed oocytes activated by A23187 and 6-DMAP resulted in three pregnancies (3/9) and one live birth from 18 embryos transferred to recipient cows. Genotypic analysis of six bovine microsatellite markers by polymerase chain reaction confirmed that the cloned calf was genetically identical to the nuclear donor. In conclusion, reconstructed oocytes that derived from oocytes exposed to activation treatment 4h after electrofusion are more likely to develop to the blastocyst stage. The best treatment to activate reconstructed bovine oocytes in this study was A23187 combined with 6-DMAP.
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Large anisotropic normal-state magnetoresistance in clean MgB2 thin films. PHYSICAL REVIEW LETTERS 2006; 96:167003. [PMID: 16712262 DOI: 10.1103/physrevlett.96.167003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Indexed: 05/09/2023]
Abstract
We report a large normal-state magnetoresistance with temperature-dependent anisotropy in very clean epitaxial MgB2 thin films (residual resistivity much smaller than 1 microOmega cm) grown by hybrid physical-chemical vapor deposition. The magnetoresistance shows a complex dependence on the orientation of the applied magnetic field, with a large magnetoresistance (Delta(rho)/(rho)0=136%) observed for the field H perpendicular ab plane. The angular dependence changes dramatically as the temperature is increased, and at high temperatures the magnetoresistance maximum changes to H||ab. We attribute the large magnetoresistance and the evolution of its angular dependence with temperature to the multiple bands with different Fermi surface topology in MgB2 and the relative scattering rates of the sigma and pi bands, which vary with temperature due to stronger electron-phonon coupling for the sigma bands.
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New Turbulent Model for Computational Mass Transfer and Its Application to a Commercial-Scale Distillation Column. Ind Eng Chem Res 2005. [DOI: 10.1021/ie049382y] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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The stage-dependent inhibitory effect of porcine follicular cells on the development of preantral follicles. Anim Reprod Sci 2002; 73:73-88. [PMID: 12220820 DOI: 10.1016/s0378-4320(02)00119-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The objective of this study was to examine the effects of follicular cells on the in vitro development of porcine preantral follicles. In Experiment 1, one preantral follicle alone (Trt 1) was cocultured with a follicle of the same size with oocytes (Trt 2) or without oocytes (Trt 3). Preantral follicles cultured alone in vitro for 12 days had greater follicle diameters (1017 +/- 96 microm versus 706 +/- 69 or 793 +/- 72 microm, P < 0.05), growth rates (201 +/- 0.3 versus 103 +/- 0.2 or 128 +/- 0.2, P < 0.05) and oocyte survival rates (73% versus 48, or 25%, P < 0.05) than other groups. The inhibitory effects of follicle cells on the growth of preantral follicles and oocyte survival rates were not enhanced by the addition of oocytectomized preantral follicles (Experiment 2). Follicles were cocultured with different sources of follicular cells in other experiments. Coculture with cumulus cells enhanced oocyte survival compared to the control (without coculture) and mural follicular cell groups (Experiment 3). The growth and survival rates of oocytes collected from the group of follicles cocultured with cumulus cells from large antral follicles (>3 mm) were greater (P < 0.05) than those from small antral follicles (<3 mm), or than the control group (without cumulus cells, experiment 4). No significant differences in the follicular diameters (674 +/- 30 microm versus 638 +/- 33 and 655 +/- 28 microm) and growth rate (105% versus 94 and 105%) were observed among the preantral follicles of the different treatments (P > 0.05). Taken together, coculture with the cells from large antral follicles (>3 mm) exerted a significant positive effect on oocyte survival. The growth and oocyte survival of preantral follicle cocultured with the same size of follicles (with or without oocyte) were inhibited. Growth and survival rates of preantral follicles and oocytes are improved by coculturing them with the cumulus cells derived from larger antral follicles.
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Nanoscale phenomena in synthetic functional oxide heterostructures. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2002; 8:333-349. [PMID: 12533230 DOI: 10.1017/s1431927602020287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This paper reviews nanoscale phenomena such as polarization relaxation dynamics and piezoelectric characterization in model ferroelectric thin films and nanostructures using voltage-modulated scanning force microscopy. Using this technique we show the three-dimensional reconstruction of the polarization vector in lead zirconate titanate (PZT) thin films. Second, the time-dependent relaxation of remanent polarization in epitaxial PZT ferroelectric thin films, containing a uniform two-dimensional grid of 90 degrees domains (c-axis in the plane of the film), has been investigated extensively. The 90 degrees domain walls preferentially nucleate the 180 degrees reverse domains during relaxation. Relaxation occurs through the nucleation and growth of reverse 180 degrees domains, which subsequently coalesce and consume the entire region as a function of relaxation time. In addition we also present results on investigation of the relaxation phenomenon on a very local scale, where pinning and bowing of domain walls has been observed. We also show how this technique is used for obtaining quantitative information on piezoelectric constants and by engineering special structures, and how we realize ultrahigh values of piezoconstants. Last, we also show direct hysteresis measurements on nanoscale capacitors, where there is no observable loss of polarization in capacitors as small as 0.16 microm2 in area.
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Electrical Interaction Energy between Two Charged Entities in an Electrolyte Solution. J Colloid Interface Sci 1999; 217:219-236. [PMID: 10469531 DOI: 10.1006/jcis.1999.6354] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The electrical interaction energy between two charged entities in an electrolyte solution plays a significant role in various phenomena in colloid and interface science. Available methods for the estimation of this energy under the Debye-Huckel condition are discussed briefly, and a systematic approach based on a boundary integral method, which has the potential to yield an approximate analytical expression for various types of surfaces under a general surface condition, is introduced. The linear sizes of the interacting entities can be comparable or one is much larger than the other. A typical example for the former includes, for instance, the interaction between two colloidal particles. The stability behavior of a colloidal dispersion belongs to this category. That for the latter includes the interaction between a particle and a wall. The adsorption of particles to surfaces and the electrophoretic motion of particles near a boundary, for example, belong to this category. Extensions to more complicated cases, for example, multiple particles and arbitrary surfaces, are also discussed. Copyright 1999 Academic Press.
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Electrostatic Potential Distribution for Spheroidal Surfaces in Symmetric Electrolyte Solutions. J Colloid Interface Sci 1997; 192:481-9. [PMID: 9367573 DOI: 10.1006/jcis.1997.5026] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The electrostatic potential distribution for a charged spheroidal surface immersed in a symmetric electrolyte solution is derived. Such surfaces simulate a wide class of dispersed entities. Two types of boundary condition at the solid surface are considered, constant surface potential and constant amount of surface charges; both conductive and nonconductive surfaces are examined for the latter. The present analysis extends the conventional one-dimensional treatment on simple geometries to a two-dimensional space. A perturbation method is adopted to solve the governing Poisson-Boltzmann equation for the case of thin to moderately thick double layers. The classic results for planar and spherical surfaces can be recovered as special cases of the present analysis. The basic thermodynamic properties of the system under consideration, such as Helmholtz free energy, entropy, and surface excess, are derived. We show that using an equivalent sphere to approximate a spheroid can lead to an appreciable deviation in the prediction of the Helmholtz free energy. For a thin double layer, assuming a planar geometry will underestimate the Helmholtz free energy. Copyright 1997Academic Press
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Abstract
The electrostatic interaction between two ion-penetrable, charged spheroidal particles is examined theoretically. These particles can assume different sizes and an arbitrary spatial orientation. The electrical potential distribution is derived analytically under the Debye-Huckle condition. The results for two interaction spheres, one spheroidal particle and a planar surface, and rigid particles covered by an ion-penetrable membrane can be recovered as the special cases of the present general problem. We show that, for a fixed center-to-center distance between two particles, regardless of their relative sizes, the interaction free energy is the greatest if their major axes lie on the same line (head-to-head), and the smallest if their major axes are perpendicular to each other but not on the same plane (perpendicular).
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