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Sample records for holy nail siena

  1. SIENA Customer Problem Statement and Requirements

    SciTech Connect

    L. Sauer; R. Clay; C. Adams; H. Walther; B. Allan; R. Mariano; C. Poore; B. Whiteside; B. Boughton; J. Dike; E. Hoffman; R. Hogan; C. LeGall

    2000-08-01

    This document describes the problem domain and functional requirements of the SIENA framework. The software requirements and system architecture of SIENA are specified in separate documents (called SIENA Software Requirement Specification and SIENA Software Architecture, respectively). While currently this version of the document describes the problems and captures the requirements within the Analysis domain (concentrating on finite element models), it is our intention to subsequent y expand this document to describe problems and capture requirements from the Design and Manufacturing domains. In addition, SIENA is designed to be extendible to support and integrate elements from the other domains (see SIENA Software Architecture document).

  2. Nailing Pompeii

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    Roman hihstorian Pliny the Younger noted that Mount Vesuvius blew its top and destroyed Pompeii in the early afternoon of August 24, 1,918 years ago. Now, a team of scientists, tempted by the certainty of that record, has confirmed the eruption to within 7 years. The team developed and used an improved radioactive argon-argon dating technique, which they say can reliably establish the age of rocks as old as the solar system or as recent as 1,000 years old.“We nailed the date to 5% on our first attempt, so we could probably get the error down to 1% or less,” says Paul Renne, adjunct associate professor of geology and geophysics at the University of California at Berkeley and director of the private Berkeley Geochronology Center. “Dating things that are really young has always been the Holy Grail of potassium-argon [an earlier method] and argonargon dating.”

  3. Your Nails

    MedlinePlus

    ... under the surface. Nails start in the nail root , hidden under the cuticle. When cells at the root of the nail grow, the new nail cells ... nail as it grows out from the nail root. The lunula (say: LOON-yuh-luh) — which comes ...

  4. Siena, 1794: History's Most Consequential Meteorite Fall

    NASA Astrophysics Data System (ADS)

    Marvin, U. B.

    1995-09-01

    In the mythos of meteoritics, the fall of stones at L'Aigle in Normandy at 1 p. m. on April 26, 1803, is commonly regarded as the event that turned skeptics into believers and opened the way for the new science. A strong case can be made, however, that the fall of stones at Siena at 7:00 p.m. on June 16, 1794, established the authenticity of meteorite falls and set in motion the reexaminations of entrenched beliefs that led to the founding of the new science. The Siena fall was heralded by the appearance of an extraordinarily high, dark cloud emitting smoke, sparks like rockets, and bolts of unusually slow-moving red lightning. With a tremendous explosion a shower of stones, ranging in weight from a few milligrams to 3 kg, fell southeast of Siena. This was the first meteorite fall to occur in the vicinity of a sizeable European city and the first to be witnessed by so many people, including English visitors, that the fall of the stones from the sky could not be denied. It also was the first fall to be seriously investigated by scholars, at several universities in Italy, who collected eye-witness reports and specimens and formulated hypotheses of origin. Their task was greatly complicated by the timing of the fall which occurred 18 hours after Mt. Vesuvius sprang into full eruption. Some believed that the two events were entirely coincidental; others thought that the stones either were ejecta from the volcano (which lay about 320 km to the southeast of Siena) or had consolidated in the fiery masses of dust and ash expelled by the mountain. No explanations seemed entirely satisfactory, but, in an age when the very possibility of falling stones had been decisively ruled out by savants of the Enlightenment, the well-observed fall at Siena opened a new dialog on this subject. The Siena fall occurred only two months after the publication in Riga and Leipzig of Ernst F. F. Chladni's book On the Origin of Ironmasses in which he concluded from historical records that

  5. Nail cosmetics.

    PubMed

    Madnani, Nina A; Khan, Kaleem J

    2012-01-01

    The nail as an anatomic structure protects the terminal phalanx of the digit from injury. Historically, it has served as a tool for protection and for survival. As civilizations developed, it attained the additional function of adornment. Nail beautification is a big industry today, with various nail cosmetics available, ranging from nail hardeners, polishes, extensions, artificial/sculpted nails, and nail decorations. Adverse events may occur either during the nail-grooming procedure or as a reaction to the individual components of the nail cosmetics. This holds true for both the client and the nail technician. Typically, any of the procedures involves several steps and a series of products. Separate "nail-bars" have been set up dedicated to serve women and men interested in nail beautification. This article attempts to comprehensively inform and educate the dermatologist on the services offered, the products used, and the possible/potential adverse effects related to nail-grooming and nail cosmetics.

  6. Nail abnormalities

    MedlinePlus

    Beau's lines; Fingernail abnormalities; Spoon nails; Onycholysis; Leukonychia; Koilonychia; Brittle nails ... 2012:chap 71. Zaiac MN, Walker A. Nail abnormalities associated with systemic pathologies. Clin Dermatol . 2013;31: ...

  7. Nail Fungus

    MedlinePlus

    ... nail polish daily for a year. Medicated nail cream. Your doctor may prescribe an antifungal cream, which you rub into your infected nails after soaking. These creams may work better if you first thin the ...

  8. Nail cosmetics in nail disorders.

    PubMed

    Iorizzo, Matilde; Piraccini, Bianca Maria; Tosti, Antonella

    2007-03-01

    The clinical features of nail dystrophies depend on the part of the nail that has been damaged. Due to the important functions of fingernails and toenails, any abnormality of the nail causes impaired function of the hand or foot. Moreover, the aesthetic aspect of the nail may affect employability, self-esteem, and interaction with other people. Because the nails are often difficult to treat, cosmetology may be an effective support to medical treatment. Nail cosmetics may help the patient to cope with his or her nail dystrophy while waiting for treatment to show its efficacy. It may also be the only choice to hide nail dystrophy where the nail is irreversibly damaged. Nail cosmetics may also function at treatment for onychtillomania, nail biting, and nail ingrowing.

  9. Nail biology and nail science.

    PubMed

    de Berker, D A R; André, J; Baran, R

    2007-08-01

    The nail plate is the permanent product of the nail matrix. Its normal appearance and growth depend on the integrity of several components: the surrounding tissues or perionychium and the bony phalanx that are contributing to the nail apparatus or nail unit. The nail is inserted proximally in an invagination practically parallel to the upper surface of the skin and laterally in the lateral nail grooves. This pocket-like invagination has a roof, the proximal nail fold and a floor, the matrix from which the nail is derived. The germinal matrix forms the bulk of the nail plate. The proximal element forms the superficial third of the nail whereas the distal element provides its inferior two-thirds. The ventral surface of the proximal nail fold adheres closely to the nail for a short distance and forms a gradually desquamating tissue, the cuticle, made of the stratum corneum of both the dorsal and the ventral side of the proximal nail fold. The cuticle seals and therefore protects the ungual cul-de-sac. The nail plate is bordered by the proximal nail fold which is continuous with the similarly structured lateral nail fold on each side. The nail bed extends from the lunula to the hyponychium. It presents with parallel longitudinal rete ridges. This area, by contrast to the matrix has a firm attachment to the nail plate and nail avulsion produces a denudation of the nail bed. Colourless, but translucent, the highly vascular connective tissue containing glomus organs transmits a pink colour through the nail. Among its multiple functions, the nail provides counterpressure to the pulp that is essential to the tactile sensation involving the fingers and to the prevention of the hypertrophy of the distal wall tissue, produced after nail loss of the great toe nail.

  10. Your Nails

    MedlinePlus

    ... luh) — which comes from the Latin word for "moon" — is that pale half circle just above the ... Problems Most of the time, your nails are pink and healthy, but sometimes nails have problems. Some ...

  11. Quiz: Nails

    MedlinePlus

    ... de los dientes Video: Getting an X-ray Quiz: Nails KidsHealth > For Kids > Quiz: Nails Print A A A How much do ... about your nails? Find out by taking this quiz! About KidsHealth Nemours.org Reading BrightStart! Contact Us ...

  12. Nail anatomy.

    PubMed

    de Berker, David

    2013-01-01

    The nail unit comprises the nail plate, the surrounding soft tissues, and their vasculature and innervation based upon the distal phalanx. The nail plate is a laminated keratinized structure lying on the nail matrix (15-25%), the nail bed with its distal onychodermal band (75-85%), and the hyponychium at its free edge. The distal part of the matrix, the lunula characterized by its half-moon shape, can be observed in some digits. The nail plate is embedded by the proximal and lateral folds. From the proximal nail fold, the cuticle (also known as the eponychium), adheres to the superficial surface of the proximal nail plate. The nail unit possesses a complex and abundant vascular network to ensure adequate blood supply. Finally, both the periungual soft tissues and the nail folds are innervated. The shapes, structure, and inter-relationships of these tissues are factors in the way nails present with disease and how we understand and manage those diseases. In particular, an understanding of the surgical anatomy is important for those undertaking diagnostic or curative operations on the nail. With this knowledge, the most appropriate surgery can be planned and the patient can be provided with accurate and clear guidance to enable informed consent.

  13. Nail histopathology.

    PubMed

    Martin, B

    2013-09-01

    The structure of the nail unit is complex and many dermatologists and dermatopathologists have an incomplete understanding of it. Familiarity with the anatomy and histology of this unit, however, is a key factor in improving the diagnostic yield of nail biopsy. Inflammatory or infectious conditions that affect the nail can have a marked impact on a patient's quality of life. A wide-ranging variety of tumors can also develop in this region and they may be life-threatening or require surgery that will result in functional defects. The author reviews the anatomy and histology of the nail unit as well as the basic histopathologic findings in the most common conditions affecting the nails.

  14. Embryology in Holy Bible.

    PubMed

    Subhaktha, P K

    1996-01-01

    The knowledge of Embryology and its existence dates back to the remote antiquity of mankind. The theory of maternal impressions on Embryo has its sanction in the Holy Bible. Apart from this it is remarkable to find artificial incubation of the eggs of birds practised 'probably' as far back as about 3000 B.C. Other than these, the existence of midwives, cases of premature births, deliveries of the women of advanced age and the obstetric chair etc. are the expositions of the science of medicine in the Holy Bible.

  15. Holy springs and holy water: underestimated sources of illness?

    PubMed

    Kirschner, Alexander K T; Atteneder, Michael; Schmidhuber, Angelika; Knetsch, Sonja; Farnleitner, Andreas H; Sommer, Regina

    2012-09-01

    Use of holy springs and holy water is inherent in religious activities. Holy spring water is also used extensively for personal drinking water, although not assessed according to drinking water standards. Holy water in churches and chapels may cause infections via wetting of lips and sprinkling on persons. Our aim was to assess the microbiological and chemical water quality of holy springs and holy water in churches and hospital chapels. Of the holy springs investigated, only 14% met the microbiological and chemical requirements of national drinking water regulations. Considering results from sanitary inspections of the water catchments, no spring was assessed as a reliable drinking water source. All holy water samples from churches and hospital chapels showed extremely high concentrations of HPC; fecal indicators, Pseudomonas aeruginosa and Staphylococcus aureus occurred only in the most frequently visited churches. We conclude that it is highly necessary to include holy springs in programs for assessment and management of water quality. Public awareness has to be raised to perceive holy springs as potential sources of illness. Holy water can be another source of infection, especially in hospital chapels and frequently visited churches. Recommendations are made for proper water quality management of both water types.

  16. The social impact of dizziness in London and Siena.

    PubMed

    Bronstein, Adolfo M; Golding, John F; Gresty, Michael A; Mandalà, Marco; Nuti, Daniele; Shetye, Anu; Silove, Yvonne

    2010-02-01

    Although dizziness is a common presenting symptom in general and hospital practice, its social cost is not known. We assessed the social and work life impact of dizziness on patients in two contrasting European cities, Siena and London. First, we developed the 'Social life & Work Impact of Dizziness questionnaire' (SWID), which was validated by administering it to 43 patients with dizziness and 45 normal controls and by correlating the results with the EQ-5D (Europe quality of life) questionnaire. The SWID and EQ-5D scores were worse in patients than controls (p < 0.001) and the two correlated significantly (r = 0.50 p < 0.001). Then two hundred consecutive patients per city attending tertiary specialised 'dizzy patient' clinics, one in London led by a neurologist, one in Siena led by an ear, nose and throat specialist (ENT), were investigated with SWID. Amongst the 400 patients, 27% reported changing their jobs and 21% giving up work as a result of the dizziness. Over 50% of patients felt that their efficiency at work had dropped considerably. The mean number of days off work attributed to the dizziness in the previous 6 months was 7.15 days. Social life was disrupted in 57% of all 400 patients. Factor analysis identified that detrimental effects on work, travel, social and family life combine to create a single factor accounting for much of the overall impact of their dizziness. Significant differences in some measures of handicap between London and Siena emerged, with London patients often faring worse. Reasons for these location differences include, as expected, a higher proportion of neurological patients in London than in Siena. However, factors related to city demographics and social cohesion may also modulate the impact on quality of life and working practice. Regardless of inter-city differences, these findings highlight the high social and economic impact of dizziness.

  17. Matricectomy and nail ablation.

    PubMed

    Baran, Robert; Haneke, Eckart

    2002-11-01

    Matricectomy refers to the complete extirpation of the nail matrix, resulting in permanent nail loss. Usually however, matricectomy is only partial, restricted to one or both lateral horns of the matrix. Nail ablation is the definitive removal of the entire nail organ. The most important common denominator in the successful matricectomy is the total removal or destruction of the matrix tissue. Matricectomy may be indicated for the management of onychauxis, onychogryphosis, congenital nail dystrophies, and chronic painful nail, such as recalcitrant ingrown toenail or split within the medial or lateral one-third of the nail.

  18. [Nail diseases in cosmetology].

    PubMed

    Maleszka, Romuald; Ratajczak-Stefańska, Violetta; Boer, Magdalena; Kiedrowicz, Magdalena

    2010-01-01

    Clinical symptoms attributed to the nail apparatus and observed in cosmetology include atrophic or hypertrophic lesions, pathologic nail coloration, abnormalities of the nail surface, and disorders of the nail plate and bed junction. These symptoms may reflect pathologic processes limited to the nail apparatus or may be the consequence of a dermal or systemic disease. Even though the etiology of nail lesions is variegated, diseases of the nails are simply classified as infectious or non-infectious. The aim of this work was to present the most common diseases of the nail apparatus encountered in cosmetology. Often, nail diseases worsen the quality of life of the patient. In addition, the variegated symptomatology demonstrates that nail lesions should be viewed in a wider perspective because they often are important signs of pathologic processes taking place in the organism of the patient.

  19. Update: nail unit dermatopathology.

    PubMed

    Stewart, Campbell L; Rubin, Adam I

    2012-01-01

    Nail unit dermatopathology is a growing field filled with many challenges. Many advances in this field have been made in the last 5 years. This review article provides an update on new information and studies published in that period of time. We divided these works into different sections, including clinical and pathologic challenges in diagnosis and treatment of nail disorders, nail unit biopsy and processing techniques, normal nail unit histology, nail plate structural and growth pathology, metabolic disease, inflammatory conditions, onychomycosis, benign growths, malignant growths, and dyschromias. Specific highlights include advances in the marking and orientation of nail unit biopsies for improved histologic interpretation, improved nail plate softening techniques, new methods for histologic evaluation of onychomycosis, descriptions of newly described benign growths unique to the nail unit, and the morphologic and immunohistochemical distinction between benign and malignant pigmented lesions of the nail unit.

  20. Fungal nail infection

    MedlinePlus

    ... Common fungal infections include: Athlete's foot Jock itch Ringworm on the skin of the body or head ... fungal infection. Alternative Names Nails - fungal infection; Onychomycosis; Tinea unguium Images Nail infection, candidal Yeast and mold ...

  1. Nail Problems (Toenails)

    MedlinePlus

    ... perform a procedure to permanently excessive perspiration. prevent ingrown nails. The corner of the nail that ingrows, along with the matrix or root of Prevention that piece of nail, are removed by use of a ◆ Proper hygiene and regular inspec- chemical, a laser, or by other methods. tion of the feet ...

  2. Demarkuota Valstybės Siena su Baltarusijos Respublika

    NASA Astrophysics Data System (ADS)

    Sližienė, Gražina

    2008-06-01

    Valstybės siena tarp Lietuvos Respublikos ir Baltarusijos Respublikos yra išorinės Europos Sąjungos sienos dalis, todėl jos demarkavimas yra itin svarbus žingsnis, leidžiantis tinkamai taikyti išorinės sienos apsaugos režimą. Šios sienos demarkavimas truko dešimtį metų - nuo Sutarties dėl valstybės sienos tarp Lietuvos Respublikos ir Baltarusijos Respublikos demarkavimo, kurią pasirašė Lietuvos Respublikos ir Baltarusijos Respublikos Prezidentai, o Lietuvos Respublikos Seimas 1996 m. ratifikavo, iki 2006 metų, kai Mišri demarkacijos komisija pasirašė galutinius šios valstybių sienos demarkacijos dokumentus. Vykstant demarkavimo darbams šalys tarpusavyje derino įvairius juridinius, techninius, praktinius klausimus, susijusius su valstybės sienos ženklinimu, geodeziniais-kartografiniais darbais, pasienio juostos įrengimu, tarpvalstybine darbų kontrole, galutinių sienos demarkacijos dokumentų sudarymu ir kt. Iki šiol Lietuvos rytinė siena niekada nebuvo demarkuota, todėl atliekant delimitavimo darbus sienai nustatyti buvo panaudota nelygiavertė ar nekokybi\\vska kartografinė medžiaga, valstybės siena buvo tapdinama su neai\\vskiais arba nery\\vskiais vietovės kontūrais, kartais ji ėjo vingiuotais lauko ar mi\\vsko keliukais. Žymint valstybės sieną vietovėje kilo korektūros būtinybė. Pakoregavus sumažėjo sienos ženklų statymo ir pasienio juostos įrengimo išlaidų, išvengta nesisteminių sienos linijos vingių, išlinkių, įtraukta natūralios ribos (upės, kanalai, proskynos ir pan.), buvo išsaugoti inžineriniai-techniniai statiniai ir komunikacinė infrastruktūra bei jos priežiūros statiniai, siena sutrumpėjo, tačiau išliko perskirstomų plotų balansas. Pagal šalių suderintą valstybės sienos ženklų išdėstymo projektą vietovėje siena buvo paženklinta laikinaisiais sienos ženklais, vėliau jie pakeisti patvirtintos konstrukcijos nuostoviaisiais ženklais: centriniu (poligonometriniu

  3. Astronomical Knowledge from Holy Books

    NASA Astrophysics Data System (ADS)

    Farmanyan, Sona V.; Devrikyan, Vardan G.; Mickaelian, Areg M.

    2016-10-01

    We investigate religious myths related to astronomy from different cultures in an attempt to identify common subjects and characteristics. The paper focuses on astronomy in religion. The initial review covers records from Holy books about sky related superstitious beliefs and cosmological understanding. The purpose of this study is to introduce sky related religious and national traditions (particularly based on different calendars; Solar or Lunar). We carried out a comparative study of astronomical issues contained in a number of Holy books. We come to the conclusion that the perception of celestial objects varies from culture to culture, and from religion to religion and preastronomical views had a significant impact on humankind, particularly on religious diversities. We prove that Astronomy is the basis of cultures, and that national identity and mythology and religion were formed due to the special understanding of celestial objects.

  4. The greenhouse gas balance of the Province of Siena.

    PubMed

    Ridolfi, R; Kneller, M; Donati, A; Pulselli, R M

    2008-01-01

    There is a profound debate over how to assign greenhouse gas (GHG) responsibilities; therefore, we have decided to follow IPCC guidelines, as they offer the only standardized method. We have identified each type of greenhouse emission and its level of absorption. We have studied the province and its districts and municipalities. We have determined that the energy sector is that with the highest level of emissions, even if the per capita emissions of the Province of Siena are very low. This is caused by a very low level of industrialization and the presence of a local geothermal production of energy. In order to highlight this aspect, we have considered scenarios both with and without geothermal production. Our research was then focused on single districts (groups of homogenous municipalities) and municipalities, where we found great differences among the greenhouse emissions of the areas. We have constructed a map of the greenhouse emissions of the whole province. It has been interesting to note that there are 14 municipalities with net negative emissions, seven with low positive emissions, 12 with medium positive emissions and three with elevated positive emissions. These latter correspond to the main city and to two of the most industrialized municipalities.

  5. [Cosmetology and brittle nails].

    PubMed

    Abimelec, P

    2000-12-15

    The knowledge of manicure techniques and nail cosmetics compositions are a prerequisite to the understanding of their potential side effects. The brittle nail syndrome is a common problem that roughly affect 20% of women. We will review the etiologic hypothesis, describe the various presentations, and suggest a treatment for this perplexing problem.

  6. Nail Fungal Infections

    MedlinePlus

    ... Are treatments usually effective?Are there any side effects of the treatment?If my treatment works, will my nail grow back normally?If I've had one fungal nail infection, am I likely to get another?What kinds of shoes should I wear?Should I wear gloves when ...

  7. Advanced Nail Surgery

    PubMed Central

    Haneke, Eckart

    2011-01-01

    Six techniques not yet widely known or used in the dermatologic surgery of the nails are briefly described. Small-to-medium-sized tumours of the proximal nail fold (PNF) can be excised and the defect repaired with advancement or rotation flaps. A superficial biopsy technique of the matrix for the diagnosis of longitudinal brown streaks in the nail, which allows rapid histological diagnosis of the melanocyte focus to be performed, is described here. Because the excision is very shallow and leaves the morphogenetic connective tissue of the matrix intact, the defect heals without scarring. Laterally positioned nail tumours can be excised in the manner of a wide lateral longitudinal nail biopsy. The defect repair is performed with a bipedicled flap from the lateral aspect of the distal phalanx. Malignant tumours of the nail organ often require its complete ablation. These defects can be covered by a full-thickness skin graft, reversed dermal graft, or cross-finger flap. The surgical correction of a split nail is often difficult. The cicatricial tissue of the matrix and PNF have to be excised and the re-attachment of these wounds prevented. The matrix defect has to be excised and sutured or covered with a free matrix graft taken either from the neighbouring area or from the big toe nail. PMID:22279381

  8. Astronomical Knowledge in Holy Books

    NASA Astrophysics Data System (ADS)

    Farmanyan, Sona V.; Mickaelian, Areg M.

    2015-08-01

    We investigate religious myths related to astronomy from different cultures in an attempt to identify common subjects and characteristics. The paper focuses on astronomy in religion. The initial review covers records from Holy books about sky related superstitious beliefs and cosmological understanding. The purpose of this study is to introduce sky related religious and national traditions (particularly based on different calendars; Solar or Lunar). We carried out a comparative study of astronomical issues contained in a number of Holy books: Ancient Egyptian Religion (Pyramid Texts), Zoroastrianism (Avesta), Hinduism (Vedas), Buddhism (Tipitaka), Confucianism (Five Classics), Sikhism (Guru Granth Sahib), Christianity (Bible), Islam (Quran), Druidism (Mabinogion) and Maya Religion (Popol Vuh). These books include various information on the creation of the Universe, Sun and Moon, the age of the Universe, Cosmic sizes, understanding about the planets, stars, Milky Way and description of the Heavens in different religions. We come to the conclusion that the perception of celestial objects varies from culture to culture, and from religion to religion and preastronomical views had a significant impact on humankind, particularly on religious diversities. We prove that Astronomy is the basis of cultures, and that national identity and mythology and religion were formed due to the special understanding of celestial objects.

  9. Nail stem cells.

    PubMed

    Sellheyer, Klaus

    2013-03-01

    Our knowledge on stem cells of the hair follicle has increased exponentially after the bulge was characterized as the stem cell niche two decades ago. In contrast, little is known about stem cells in the nail unit. Whereas hair follicles are plentiful and easy to access, the human body has only twenty nails and they are rarely biopsied. Therefore, examining fetal material offers unique advantages. In the following mini-review, our current knowledge on nail stem cells is summarized and analogies to the hair follicle stem cells are drawn.

  10. Capillary nail refill test

    MedlinePlus

    ... may indicate: Dehydration Shock Peripheral vascular disease (PVD) Hypothermia Alternative Names Nail blanch test; Capillary refill time ... Elsevier Saunders; 2016:chap 79. Read More Dehydration Hypothermia Peripheral artery disease - legs Shock Review Date 4/ ...

  11. Skin or nail culture

    MedlinePlus

    Mucosal culture; Culture - skin; Culture - mucosal; Nail culture; Culture - fingernail; Fingernail culture ... There, it is placed in a special dish (culture). It is then watched to see if bacteria, ...

  12. Nail Care Products

    MedlinePlus

    ... Acrylics") Artificial nails are composed primarily of acrylic polymers and are made by reacting together acrylic monomers, such as ethyl methacrylate monomer, with acrylic polymers, such as polymethylmethacrylate. When the reaction is completed, ...

  13. Diagnostic applications of nail clippings.

    PubMed

    Stephen, Sasha; Tosti, Antonella; Rubin, Adam I

    2015-04-01

    "Nail clipping is a simple technique for diagnosis of several nail unit dermatoses. This article summarizes the practical approach, utility, and histologic findings of a nail clipping in evaluation of onychomycosis, nail unit psoriasis, onychomatricoma, subungual hematoma, melanonychia, and nail cosmetics, and the forensic applications of this easily obtained specimen. It reviews important considerations in optimizing specimen collection, processing methods, and efficacy of special stains in several clinical contexts. Readers will develop a greater understanding and ease of application of this indispensable procedure in assessing nail unit dermatoses."

  14. Nail involvement in pemphigus vulgaris.

    PubMed

    Engineer, L; Norton, L A; Ahmed, A R

    2000-09-01

    Nail involvement in pemphigus vulgaris is relatively rare. We describe a case of severe pemphigus involving both the skin and oral mucosa in which an acute exacerbation was preceded by the onset of nail involvement of all 4 extremities. Nail involvement occurred in the form of hemorrhagic paronychia of multiple digits. Oral, cutaneous, and nail manifestations of the disease were all well controlled by systemic therapy. A review of the literature on nail involvement in pemphigus reveals that this involvement may be manifested in multiple ways, with chronic paronychia and onychomadesis being the most common. Involvement of the nail occurs most frequently either as part of the initial presentation, or just before or concurrent with a flare of pre-existing disease. Nail involvement, when it occurs, is usually present when the disease is severe. Topical therapy is insufficient, and systemic therapy is warranted. In the majority of cases, nail recovery is complete, with no residual damage.

  15. Histopathology of the nail unit.

    PubMed

    Fernandez-Flores, Angel; Saeb-Lima, Marcela; Martínez-Nova, Alfonso

    2014-01-01

    In this report, we review several inflammatory infectious and tumoral conditions of the nail unit. We emphasize the anatomic peculiarities of such pathologies of the nail unit and provide some required diagnostic criteria.

  16. Nails: diagnostic clue to genodermatoses.

    PubMed

    Inamadar, Arun C; Palit, Aparna

    2012-01-01

    Nails are cutaneous appendages mostly involved in mechanical functions. However, nails may reflect presence of various systemic disorders evidenced by alteration of their shape, size, color or texture. Genodermatoses are multisystem disorders with cutaneous involvement. Many of the genodermatoses present with nail changes and some of these may be the clinical pointers to the diagnosis. Diagnostic clues to various genodermatoses derived from nail findings have been discussed.

  17. Nail care for newborns

    MedlinePlus

    ... MedlinePlus GO GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Nail care for newborns URL of this page: //medlineplus.gov/ ...

  18. Anatomy of the nail unit and the nail biopsy.

    PubMed

    Haneke, Eckart

    2015-06-01

    The nail unit is the largest and a rather complex skin appendage. It is located on the dorsal aspect of the tips of fingers and toes and has important protective and sensory functions. Development begins in utero between weeks 7 and 8 and is fully formed at birth. For its correct development, a great number of signals are necessary. Anatomically, it consists of 4 epithelial components: the matrix that forms the nail plate; the nail bed that firmly attaches the plate to the distal phalanx; the hyponychium that forms a natural barrier at the physiological point of separation of the nail from the bed; and the eponychium that represents the undersurface of the proximal nail fold which is responsible for the formation of the cuticle. The connective tissue components of the matrix and nail bed dermis are located between the corresponding epithelia and the bone of the distal phalanx. Characteristics of the connective tissue include: a morphogenetic potency for the regeneration of their epithelia; the lateral and proximal nail folds form a distally open frame for the growing nail; and the tip of the digit has rich sensible and sensory innervation. The blood supply is provided by the paired volar and dorsal digital arteries. Veins and lymphatic vessels are less well defined. The microscopic anatomy varies from nail subregion to subregion. Several different biopsy techniques are available for the histopathological evaluation of nail alterations.

  19. 28 CFR 548.18 - Observance of religious holy days.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Observance of religious holy days. 548.18... holy days. Consistent with maintaining security, safety, and good order in the institution, the Warden shall endeavor to facilitate the observance of important religious holy days which involve special...

  20. 28 CFR 548.18 - Observance of religious holy days.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Observance of religious holy days. 548.18... holy days. Consistent with maintaining security, safety, and good order in the institution, the Warden shall endeavor to facilitate the observance of important religious holy days which involve special...

  1. 28 CFR 548.18 - Observance of religious holy days.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Observance of religious holy days. 548.18... holy days. Consistent with maintaining security, safety, and good order in the institution, the Warden shall endeavor to facilitate the observance of important religious holy days which involve special...

  2. Morphopathological aspects of healthy nails and nails affected by onychomycosis.

    PubMed

    Zaikovska, Olga; Pilmane, Mara; Kisis, Janis

    2014-09-01

    Patients of onychomycosis are common in the dermatology practice. Contemporary morphology creates opportunities to study the functional units of the nail when such infections occur from morphopathological point of view. There were 22 nails biopsies from onychomycosis patients taken for the research of morphopathological changes in the thickened nail plate affected by onychomycosis. Samples of cadaverous' nails were used as a control material. The material was stained with haematoxylin and eosin and immunohistochemical methods. Terminal deoxynucleotidyl transferase dUTP nick end labelling reaction and periodic acid-Schiff reaction were also performed. We found patchy hypertrophy in the granulose layer of the epidermis, with focal acanthosis. In the horn layer, we identified nests of parakeratosis of various sizes, with incorporations of homogenous and eosinophil masses. We found high levels of interleukin 6 and interleukin 10 positive cells in the nail bed and in the bloodstream. Interleukin 1, however, was not a part of any of the functional units of any of the nails. Significant amount of fibres containing human beta defensin-2 were found in the bed and plate of the nail. Therefore one can conclude that as regards the nails affected by onychomycosis, the most effective morphopathogenical processes include cytokine and defensin excretion occurrence in the nail bed.

  3. Nail clipping in onychomycosis*

    PubMed Central

    Bertanha, Laura; Chiacchio, Nilton Di

    2016-01-01

    Onychomycosis is the most prevalent onychopathy and it requires a correct early diagnosis. Currently, the diagnostic gold standard is the association of direct mycological test with culture; however, it shows variable sensitivity. The histopathological examination of the distal nail plate, called clipping, has shown to be an adjuvant in diagnosing onychomycosis. This is an easy-to-perform, relatively cheap examination that is little dependent of the examiner, rapidly provides results, has high sensitivity, and for patients it is painless and harmless. PMID:27828655

  4. Teaching Your Child Healthy Nail Care

    MedlinePlus

    ... aad", "size=300x250", "vpos=t", "hpos=r", "zone=public", "mcat1=de12", ]; for (var c = 0; c Teaching your child healthy nail care Nails take a ... by wearing flip-flops or shower sandals in public places, such as beaches, ... nails are usually healthy, but teaching them to check their nails at a young ...

  5. Bisogni linguistici dei discenti di italiano alla scuola di lingua e cultura italiana per stranieri di Siena (Linguistic Needs of Students of Italian at the School of Italian Language and Culture for Foreigners of Siena).

    ERIC Educational Resources Information Center

    Maggini, Massimo; Parigi, Valerio

    1986-01-01

    Presents the results of a questionnaire administered to students of Italian at the School for Foreigners of Siena to determine the following: (1) student characteristics; (2) student motivations for studying Italian; (3) student interests; (4) student linguistic needs; and (5) student evaluation of the program. (CFM)

  6. Pemphigus vulgaris affecting 19 nails.

    PubMed

    Patsatsi, A; Sotiriou, E; Devliotou-Panagiotidou, D; Sotiriadis, D

    2009-03-01

    A 60-year-old woman presented with painful erosions in the oral mucosa, pharynx, perineum and perianal area, and multiple plaques with thick adherent crusts on the scalp. Most (nine) of the patient's fingernails had alterations in colour, affecting more than half of the nail plate, and all the toenails had severe inflammation of the nail folds, haemorrhagic paronychia and subungual or intraungual haemorrhage. A diagnosis of pemphigus vulgaris (PV) was made based on histology and on direct and indirect immunofluorescence findings. Groups of acantholytic cells were also observed in a Tzanck smear obtained from a subungual lesion. Onychomadesis in most of the fingernails and in all the toenails developed gradually. The patient was hospitalized and treated with oral corticosteroids. Complete recovery without residual damage to the nails and persistent remission was achieved. Nail involvement in PV is rarely described and is always of interest, as its presentation varies widely.

  7. 28 CFR 548.18 - Observance of religious holy days.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... RELIGIOUS PROGRAMS Religious Beliefs and Practices of Committed Offenders § 548.18 Observance of religious... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Observance of religious holy days. 548.18... shall endeavor to facilitate the observance of important religious holy days which involve special...

  8. Revisiting Pneumatic Nail Gun Trigger Recommendations

    PubMed Central

    Albers, James; Lipscomb, Hester; Hudock, Stephen; Dement, John; Evanoff, Bradley; Fullen, Mark; Gillen, Matt; Kaskutas, Vicki; Nolan, James; Patterson, Dennis; Platner, James; Pompeii, Lisa; Schoenfisch, Ashley

    2015-01-01

    Summary Use of a pneumatic nail gun with a sequential actuation trigger (SAT) significantly diminishes the risk for acute traumatic injury compared to use of a contact actuation trigger (CAT) nail gun. A theoretically-based increased risk of work-related musculoskeletal disorders from use of a SAT nail gun, relative to CAT, appears unlikely and remains unproven. Based on current knowledge, the use of CAT nail guns cannot be justified as a safe alternative to SAT nail guns. This letter provides a perspective of ergonomists and occupational safety researchers recommending the use of the sequential actuation trigger for all nail gun tasks in the construction industry. PMID:26366020

  9. Revisiting Pneumatic Nail Gun Trigger Recommendations.

    PubMed

    Albers, James; Lowe, Brian; Lipscomb, Hester; Hudock, Stephen; Dement, John; Evanoff, Bradley; Fullen, Mark; Gillen, Matt; Kaskutas, Vicki; Nolan, James; Patterson, Dennis; Platner, James; Pompeii, Lisa; Schoenfisch, Ashley

    2015-03-01

    Use of a pneumatic nail gun with a sequential actuation trigger (SAT) significantly diminishes the risk for acute traumatic injury compared to use of a contact actuation trigger (CAT) nail gun. A theoretically-based increased risk of work-related musculoskeletal disorders from use of a SAT nail gun, relative to CAT, appears unlikely and remains unproven. Based on current knowledge, the use of CAT nail guns cannot be justified as a safe alternative to SAT nail guns. This letter provides a perspective of ergonomists and occupational safety researchers recommending the use of the sequential actuation trigger for all nail gun tasks in the construction industry.

  10. Physics of nail conditions: why do ingrown nails always happen in the big toes?

    PubMed

    Rauch, Cyril; Cherkaoui-Rbati, Mohammed

    2014-10-16

    Although surgical treatment of nail conditions can be traced back centuries to the writings of Paul Aegineta (625-690 AC), little is known about the physical laws governing nail growth. Such a poor understanding together with the increasing number of nail salons in the high street should raise legitimate concerns regarding the different procedures applied to nails. An understanding of the physics of nail growth is therefore essential to engage with human medicine and to understand the aetiology of nail conditions. In this context, a theory of nail plate adhesion, including a physical description of nail growth can be used to determine the transverse and longitudinal curvatures of the nail plate that are so important in the physical diagnosis of some nail conditions. As a result physics sheds light on: (a) why/how nails/hooves adhere strongly, yet grow smoothly; (b) why hoof/claw/nail growth rates are similar across species; (c) potential nail damage incurred by poor trimming; (d) the connection between three previously unrelated nail conditions, i.e. spoon-shaped, pincer and ingrown nails and; last but not least, (e) why ingrown nails occur preferentially in the big toes.

  11. Nail psoriasis: a review of the literature*

    PubMed Central

    Schons, Karen Regina Rosso; Knob, Cristiane Faccin; Murussi, Nádia; Beber, André Avelino Costa; Neumaier, Walter; Monticielo, Odirlei André

    2014-01-01

    Nails are considered epidermal appendages, and as such, are commonly affected in patients with psoriasis, 80% of whom are likely to develop nail psoriasis as a result of their condition. Two patterns of nail disorders have been shown to be caused by psoriasis. Nail matrix involvement can result in features such as leukonychia, pitting (punctures or cupuliform depressions), red spots in the lunula and crumbling. Nail bed involvement, on the other hand, can cause onycholysis, salmon or oil-drop patches, subungual hyperkeratosis and splinter hemorrhages. Nail disease causes aesthetic and functional impairment, and is indicative of more severe forms of psoriasis as well as of joint involvement. The treatment for nail psoriasis involves behavioral interventions, topical medications, or systemic therapy in case of extensive skin or joint involvement. This article presents a review of the main features of nail psoriasis, its clinical presentation, diagnostic and assessment methods, clinical repercussions, and of its available treatment options. PMID:24770509

  12. Nail psoriasis: a review of the literature.

    PubMed

    Schons, Karen Regina Rosso; Knob, Cristiane Faccin; Murussi, Nádia; Beber, André Avelino Costa; Neumaier, Walter; Monticielo, Odirlei André

    2014-01-01

    Nails are considered epidermal appendages, and as such, are commonly affected in patients with psoriasis, 80% of whom are likely to develop nail psoriasis as a result of their condition. Two patterns of nail disorders have been shown to be caused by psoriasis. Nail matrix involvement can result in features such as leukonychia, pitting (punctures or cupuliform depressions), red spots in the lunula and crumbling. Nail bed involvement, on the other hand, can cause onycholysis, salmon or oil-drop patches, subungual hyperkeratosis and splinter hemorrhages. Nail disease causes aesthetic and functional impairment, and is indicative of more severe forms of psoriasis as well as of joint involvement. The treatment for nail psoriasis involves behavioral interventions, topical medications, or systemic therapy in case of extensive skin or joint involvement. This article presents a review of the main features of nail psoriasis, its clinical presentation, diagnostic and assessment methods, clinical repercussions, and of its available treatment options.

  13. Nail fragility syndrome and its treatment.

    PubMed

    Baran, R; Schoon, D

    2004-07-01

    For reasons of clarity, definitions are offered for strength, hardness, flexibility, brittleness and toughness of the nails. Six clinical types of nail fragility are delineated: longitudinal furrows and splitting (onychorrhexis), single longitudinal splitting, multiple crenellated splitting, lamellar splitting (onychoschizia), transverse splitting and nail friability. Changes may be observed in the keratin structure of fragile nails. Nail brittleness is usually 'environmental' in origin, but sometimes may be part of a nail dystrophy. Household daily chores are particularly damaging. Among the acquired general causes, hypochromic anaemia and sideropaenia, arthritic deformities of the distal joints, peripheral vascular impairment and endocrinopathies are the best known. Useful therapeutic approaches are updated. They entail protection with plastic gloves worn over light cotton glove linings, the use of nail hardeners composed of two main types of products: a modified nail varnish that functions as a base coat or a hardener, such as dimethyl urea, which overcomes the objections related to formaldehyde; a systemic drug, biotine, is still useful.

  14. Understanding the formidable nail barrier: A review of the nail microstructure, composition and diseases.

    PubMed

    Baswan, Sudhir; Kasting, Gerald B; Li, S Kevin; Wickett, Randy; Adams, Brian; Eurich, Sean; Schamper, Ryan

    2017-05-01

    The topical treatment of nail fungal infections has been a focal point of nail research in the past few decades as it offers a much safer and focused alternative to conventional oral therapy. Although the current focus remains on exploring the ways of enhancing permeation through the formidable nail barrier, the understanding of the nail microstructure and composition is far from complete. This article reviews our current understanding of the nail microstructure, composition and diseases. A few of the parameters affecting the nail permeability and potential causes of the recurrence of fungal nail infection are also discussed.

  15. Nail abnormalities in patients with vitiligo*

    PubMed Central

    Topal, Ilteris Oguz; Gungor, Sule; Kocaturk, Ozgur Emek; Duman, Hatice; Durmuscan, Mustafa

    2016-01-01

    Background Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. Methods This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. Results Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). Conclusions Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study. PMID:27579738

  16. Integrating methods for the environmental sustainability: the SPIn-Eco Project in the Province of Siena (Italy).

    PubMed

    Pulselli, Federico M; Ciampalini, Francesca; Leipert, Christian; Tiezzi, Enzo

    2008-01-01

    This paper shows how different methods can be integrated in order to provide an organic evaluation of the environmental sustainability at the territorial level. A territory is a complex, dynamic and open system where a population develops, uses resources, produces goods and services, consumes, depletes and finally obtains economic results. All these elements characterise human behaviour, which can be monitored, measured and compared to the capacity of the environment to sustain it in the long run. The SPIn-Eco Project for the Province of Siena (Italy) is described as an example of an environmental sustainability assessment of an area, and its methods (Ecological Footprint, Greenhouse Gas Inventory, Extended Exergy Analysis, Emergy Evaluation, Life Cycle Assessment (LCA) and Remote Sensing) are briefly introduced. This Project has been proposed and funded by the most important provincial administrative and financial institutions in the territory (the Administration of the Province of Siena and the Monte dei Paschi Foundation, respectively), and was designed and realised in 4 years (2001-2004) by a research team coordinated by the University of Siena.

  17. Ecological footprint analysis applied to a sub-national area: the case of the Province of Siena (Italy).

    PubMed

    Bagliani, Marco; Galli, Alessandro; Niccolucci, Valentina; Marchettini, Nadia

    2008-01-01

    This work is part of a larger project, which aims at investigating the environmental sustainability of the Province of Siena and of its communes, by means of different indicators and methods of analysis. The research presented in this article uses ecological footprint and biocapacity as indicators to monitor the environmental conditions of the area of Siena, thus complementing previous studies carried out using Emergy, greenhouse gases balance and other methods. The calculations have been performed in such a way as to enable a disaggregation of the final results according to the classical categories of ecologically productive land and of consumption, but also according to citizen's and public administration's areas of influence. This information allows us to investigate in detail the socio-economic aspects of environmental resource use. Among the notable results, the Siena territory is characterized by a nearly breakeven total ecological balance, a result contrasting with the national average and most of the other Italian provinces. Furthermore, the analysis has been carried out at different spatial scales (province, districts and communes), highlighting an inhomogeneous territorial structure consisting of subareas in ecological deficit compensated by zones in ecological surplus.

  18. Consensus on melanonychia nail plate dermoscopy*

    PubMed Central

    Chiacchio, Nilton Di; de Farias, Débora Cadore; Piraccini, Bianca Maria; Hirata, Sergio Henrique; Richert, Bertrand; Zaiac, Martin; Daniel, Ralph; Fanti, Pier Alessandro; Andre, Josette; Ruben, Beth S; Fleckman, Philip; Rich, Phoebe; Haneke, Eckart; Chang, Patricia; Cherit, Judith Dominguez; Scher, Richard; Tosti, Antonella

    2013-01-01

    This statement, focused on melanonychia and nail plate dermoscopy, is intended to guide medical professionals working with melanonychia and to assist choosing appropriate management for melanonychia patients. The International Study Group on Melanonychia was founded in 2007 and currently has 30 members, including nail experts and dermatopathologists with special expertise in nails. The need for common definitions of nail plate dermoscopy was addressed during the Second Meeting of this Group held in February 2008. Prior to this meeting and to date (2010) there have been no evidence-based guidelines on the use of dermoscopy in the management of nail pigmentation. PMID:23739699

  19. How to submit a nail specimen.

    PubMed

    Reinig, Erica; Rich, Phoebe; Thompson, Curtis T

    2015-04-01

    The scarcity of specific submission protocols for nail unit biopsies presents many challenges for appropriate specimen processing. Many nail biopsies are received fragmented or without orientation, often resulting in less-than-ideal tissue embedding and poor histologic sections, which are difficult to interpret. Methods are described for proper nail matrix/bed biopsy and plate submission that incorporate aspects of previous submission protocols and include inking the biopsy specimen along with submitting the tissue on a drawing of the nail. Also described is a technique for maintaining adherence of nail plate to glass slides, a chronic challenge in the laboratory.

  20. Nail Psoriasis: The Journey So Far

    PubMed Central

    Dogra, Alka; Arora, Amanjot Kaur

    2014-01-01

    Nail involvement is an extremely common feature of psoriasis and affects approximately 10-78% of psoriasis patients with 5-10% of patients having isolated nail psoriasis. However, it is often an overlooked feature in the management of nail psoriasis, despite the significant burden it places on the patients as a result of functional impairment of manual dexterity, pain, and psychological stress. Affected nail plates often thicken and crumble, and because they are very visible, patients tend to avoid normal day-to-day activities and social interactions. Importantly, 70-80% of patients with psoriatic arthritis have nail psoriasis. In this overview, we review the clinical manifestations of psoriasis affecting the nails, the common differential diagnosis of nail psoriasis, Nail Psoriasis Severity Index and the various diagnostic aids for diagnosing nail psoriasis especially, the cases with isolated nail involvement. We have also discussed the available treatment options, including the topical, physical, systemic, and biological modalities, in great detail in order to equip the present day dermatologist in dealing with a big clinical challenge, that is, management of nail psoriasis. PMID:25071247

  1. [The use of nails to diagnosis diseases].

    PubMed

    Baran, Robert

    2014-11-01

    For those interested in nails, a fairly good knowledge of the anatomy of the nail unit is indispensable. But nothing will replace a careful, clinical examination of the nail apparatus. The shape of the nail, surface abnormalities and coloration, with or without a magnifying glass, may well provide a medical diagnosis not only in dermatology but also for medicine in general. Pits on the surface of the nail plate may be enough to diagnose psoriasis on a limited area of scalp dandruff. Even partial detachment of the nail apparatus might lead to the suspicion of psoriatic arthritis. A triangular lunula is associated with the absence of patellas. Finally, no pulmonary examination of a smoker is complete without looking for clubbing. It is high time to pay tribute to the nail.

  2. Church or state? The Holy See at the United Nations.

    PubMed

    Rahman, A

    1999-01-01

    This article provides an information on the role and position of the Roman Catholic Church in the UN. The Roman Catholic Church was elected to participate in the UN as the "Holy See". The "Holy See" is the supreme organ of government of the Catholic Church with the pope designated as its head under the Code of Canon Law, with the Vatican City regarded as its "vassal" territory. Unlike any other modern nation, the Vatican City does not support its citizen; rather it provides a base for the central administration of the Roman Catholic Church. The "Holy See" was regarded as a "nonmember state" in the UN. Pope Paul VI established the first Holy See "permanent observer mission" on March 21, 1964. When the Holy See was admitted as a nonmember state permanent observer, it maintained delegates at specialized agencies such as the International Atomic Energy Agency and the Council for Cultural Cooperation of the Council of Europe. The status of the Holy See as a state under the International Law was uncertain because it has not satisfied the modern definition of a nation, which has: 1) a permanent population; 2) a defined territory; 3) a government; and 4) the capacity to enter into relations with the other states.

  3. Adaptive environmental management of tourism in the Province of Siena, Italy using the ecological footprint.

    PubMed

    Patterson, Trista M; Niccolucci, Valentina; Marchettini, Nadia

    2008-01-01

    Adaptive management as applied to tourism policy treats management policies as experiments that probe the responses of the system as human behavior changes. We present a conceptual systems model that incorporates the gap between observed and desired levels of the ecological footprint with respect to biocapacity. Addressing this gap (or 'overshoot') can inform strategies to increase or decrease visitation or its associated consumption in the coming years. The feedback mechanism in this conceptual model incorporates a gap between observed and desired ecological footprint levels of tourists and residents. The work is based on longer-term and ongoing study of tourism impacts and ecological footprint assessments from the SPIN-Eco Project. We present historical tourism and environmental data from the province of Siena, Italy and discuss the use of discrete, static environmental indicators as part of an iterative feedback process to manage tourism within biophysical limits. We discuss a necessary shift of emphasis from certain and static numbers to a process-based management model that can reflect slow changes to biophysical resources. As underscored by ecological footprint analysis, the energy and material use associated with tourism and local activity can erode natural capital foundations if that use exceeds the area's biological capacity to support it. The dynamic, and iterative process of using such indicators as management feedback allows us to view sustainability more accurately as a transition and journey, rather than a static destination to which management must arrive.

  4. Biagio Bartalini's "Catalogo dei corpi marini fossili che se trovano intorno a Siena" (1776).

    PubMed

    Manganelli, Giuseppe; Benocci, Andrea; Spadini, Valeriano

    2011-01-01

    In 1776, the Sienese botanist Biagio Bartalini (1750-1822) published a catalogue of wild plants growing around Siena, adding an appendix on fossils found in the same area, that is the first monograph on Sienese fossils and one of the first works of its kind in Italy. This paper provides tentative identifications of the species and an analysis of the value and meaning of Bartalini's work. The catalogue reports 72 species, each denoted by a list of names applied to analogous living taxa. Identification of single entities is extremely problematical because it can only be attempted through analysis of the literature, since the original material cannot be traced. The most interesting report is the first record of a Euro-Mediterranean Pliocene species of Sthenorytis (Gastropoda, Epitoniidae). Though important, the catalogue is incomplete, with oversights and mistakes, suggesting little familiarity with the subject. Shortcomings include some inconsistencies in the species sequence, the report of giant clams and the absence of molluscs ubiquitous in the Sienese Pliocene and sharks. Nor is it true that it is the first Italian palaeontological work in which binomial nomenclature was used, as sometimes claimed.

  5. Comparative anatomy of mouse and human nail units.

    PubMed

    Fleckman, Philip; Jaeger, Karin; Silva, Kathleen A; Sundberg, John P

    2013-03-01

    Recent studies of mice with hair defects have resulted in major contributions to the understanding of hair disorders. To use mouse models as a tool to study nail diseases, a basic understanding of the similarities and differences between the human and mouse nail unit is required. In this study we compare the human and mouse nail unit at the macroscopic and microscopic level and use immunohistochemistry to determine the keratin expression patterns in the mouse nail unit. Both species have a proximal nail fold, cuticle, nail matrix, nail bed, nail plate, and hyponychium. Distinguishing features are the shape of the nail and the presence of an extended hyponychium in the mouse. Expression patterns of most keratins are similar. These findings indicate that the mouse nail unit shares major characteristics with the human nail unit and overall represents a very similar structure, useful for the investigation of nail diseases and nail biology.

  6. Drug reactions affecting the nail unit: diagnosis and management.

    PubMed

    Piraccini, Bianca Maria; Iorizzo, Matilde

    2007-04-01

    Several drugs may be responsible for the development of nail abnormalities, but only a few classes are consistently associated with nail symptoms. Drug-induced nail abnormalities result from toxicity to the matrix, the nail bed, the periungual tissues, or the digit blood vessels. Pharmacologic agents that most frequently produce nail abnormalities include retinoids, indinavir, and cancer chemotherapeutic agents.

  7. Immunohistochemical study of specialized nail mesenchyme containing onychofibroblasts in transverse sections of the nail unit.

    PubMed

    Lee, Dong-Youn; Yang, Jun-Mo; Mun, Goo-Hyun; Jang, Kee-Taek; Cho, Kwang-Hyun

    2011-05-01

    In the frozen longitudinal section of the nail unit, CD10 was previously found in nail mesenchymal cells beneath nail matrix, and we proposed calling the nail mesenchymal cells onychofibroblasts. In this study, to further characterize nail mesenchyme containing onychofibroblasts, we examined the expression of several mesenchymal markers immunohistochemically in transverse paraffin sections of the nail unit. CD10 was strongly expressed in the nail mesenchyme containing onychofibroblasts beneath the nail matrix. However, CD10 was not observed in dermal fibroblasts and surrounding extracellular matrix of the lateral nail fold (LNF), except around blood vessels and eccrine structures. In addition, versican was expressed diffusely in the nail mesenchyme containing onychofibroblasts in contrast to the dermis of LNF. Fibrillin, which is a major component of elastic fiber in the dermis, was expressed very weakly on the nail mesenchyme below the nail matrix but was expressed strongly in the dermis of LNF. These findings support the existence of specialized nail mesenchyme containing onychofibroblasts that is distinguished from the dermis of LNF.

  8. Itraconazole penetrates the nail via the nail matrix and the nail bed--an investigation in onychomycosis.

    PubMed

    Matthieu, L; De Doncker, P; Cauwenbergh, G; Woestenborghs, R; van de Velde, V; Janssen, P A; Dockx, P

    1991-09-01

    Nail-matrix kinetics were studied in 21 patients (19 with onychomycosis, two with tinea corporis) as soon as taking itraconazole (Sporanox) 100 mg daily for up to 7 months. Itraconazole was detected in the distal nail as soon as 1 month after the start of therapy (42 ng/g in fingernails and 16 ng/g in toenails). During the course of treatment, this concentration rose and reached a mean of 160 ng/g in fingernail clippings and 197 ng/g in toenail clippings. Moreover, in fingernails of 12 out of 21 patients and in toenails of six out of 20 patients, itraconazole was detected in the distal nail clippings before full outgrowth of the fastest-growing nail. In most patients, itraconazole was detected in the distal nail clippings earlier than would be expected if the drug were incorporated only via the nail matrix, indicating that in addition to the nail matrix, a second route of penetration into the nail exists, i.e. the nail bed.

  9. [Black nails caused by Proteus mirabilis].

    PubMed

    Qadripur, S A; Schauder, S; Schwartz, P

    2001-07-01

    Black nails caused by Proteus mirabilis were seen in a motor mechanic and in a petrol pump attendant. Proteus mirabilis is a gram-negative bacillus that generates hydrogen sulfide. This compound reacts with traces of metals in the nail plate such as zinc, nickel, cobalt, iron, manganese, tin, copper and lead. Metal sulfides blacken the nail plate. The protracted course of the discoloration over months corresponds to the slow reactions of metals with hydrogen sulfide. The disappearance of the blackening after topical treatment with chinosol, tincture of iodine and chloramphenicol solution supports the etiologic connection between black nails and Proteus mirabilis. Wet and dirty work encourages the colonisation of Proteus mirabilis between nail fold and nail plate.

  10. Genetics Home Reference: nonsyndromic congenital nail disorder 10

    MedlinePlus

    ... congenital nail disorder 10 nonsyndromic congenital nail disorder 10 Enable Javascript to view the expand/collapse boxes. ... All Close All Description Nonsyndromic congenital nail disorder 10 is a condition that affects the fingernails and ...

  11. Assessment of cryopreserved donor skin viability: the experience of the regional tissue bank of Siena.

    PubMed

    Pianigiani, E; Tognetti, L; Ierardi, F; Mariotti, G; Rubegni, P; Cevenini, G; Perotti, R; Fimiani, M

    2016-06-01

    Skin allografts from cadaver donors are an important resource for treating extensive burns, slow-healing wounds and chronic ulcers. A high level of cell viability of cryopreserved allografts is often required, especially in burn surgery, in Italy. Thus, we aimed to determine which conditions enable procurement of highly viable skin in our Regional Skin Bank of Siena. For this purpose, we assessed cell viability of cryopreserved skin allografts procured between 2011 and 2013 from 127 consecutive skin donors, before and after freezing (at day 15, 180, and 365). For each skin donor, we collected data concerning clinical history (age, sex, smoking, phototype, dyslipidemia, diabetes, cause of death), donation process (multi-tissue or multi-organ) and timing of skin procurement (assessment of intervals such as death-harvesting, harvesting-banking, death-banking). All these variables were analysed in the whole case study (127 donors) and in different groups (e.g. multi-organ donors, non refrigerated multi-tissue donors, refrigerated multi-tissue donors) for correlations with cell viability. Our results indicated that cryopreserved skin allografts with higher cell viability were obtained from female, non smoker, heartbeating donors died of cerebral haemorrhage, and were harvested within 2 h of aortic clamping and banked within 12 h of harvesting (13-14 h from clamping). Age, cause of death and dyslipidaemia or diabetes did not appear to influence cell viability. To maintain acceptable cell viability, our skin bank needs to reduce the time interval between harvesting and banking, especially for refrigerated donors.

  12. Yellow nail syndrome: a review.

    PubMed

    Vignes, Stéphane; Baran, Robert

    2017-02-27

    Yellow nail syndrome (YNS; OMIM 153300, ORPHA662) is a very rare disorder that almost always occurs after 50 years of age but a juvenile or familial form has also been observed. YNS is diagnosed based on a triad associating yellow nail discoloration, pulmonary manifestations (chronic cough, bronchiectasia, pleural effusion) and lower limb lymphedema. Chronic sinusitis is frequently associated with the triad. YNS etiology remains unknown but a role of lymphatic impairment is usually evoked. YNS is more frequently isolated but may be associated in rare cases with autoimmune diseases, other clinical manifestations implicating lymphatic functions or cancer and, hence, is also considered a paraneoplastic syndrome. YNS management is symptomatic and not codified. YNS can resolve spontaneously. Oral vitamin E alone or even better when associated with triazole antifungals may achieve partial or total disappearance of nail discoloration. Pleural effusion can be treated surgically, with decortication/pleurectomy or pleurodesis. Antibiotic prophylaxis is prescribed for bronchiectasia with chronic sputum production. Lymphedema treatment is based on low-stretch bandages and the wearing of elastic compression garments combined with skin care, exercises and, as needed, manual lymph drainage.

  13. Investigation of Human Nail Microstructure with Ultrasound

    NASA Astrophysics Data System (ADS)

    Maeva, A. R.; Bakulin, E. Y.; Denisova, L. A.; Maev, R. Gr.

    Investigation of a human fingernail and the extraction of the data on its microstructure and elastic properties is important in three main aspects. First of all, various diseases of the nail can be differentiated more precisely; second of all, it is possible to non-invasively track during time the effects of a cosmetic product upon the nail; third of all, because various processes in the organism have a strong influence upon the nail plate growth, the monitoring of the nail morphology and its mechanical properties may be used as additional information for the diagnosis of a number of medical disorders, such as systemic sclerosis, psoriasis, chronic hand eczema, anemia etc. The aim of the present study was to carry out a detailed ultrasound investigation in the high-frequency range (25-50 MHz) of a human nail including micro-anatomical structure imaging and ultrasound velocity evaluation, using B-scans obtained with a scanning acoustic microscope. On the images, exact topology of the nail, nail matrix and the underlying bone have been revealed. Additionally, a certain type of inclined internal layering along the nails of some individuals has been found, which was not reported in previous ultrasonic studies of the nail.

  14. Functional analysis and treatment of nail biting.

    PubMed

    Dufrene, Brad A; Steuart Watson, T; Kazmerski, Jennifer S

    2008-11-01

    This study applied functional analysis methodology to nail biting exhibited by a 24-year-old female graduate student. Results from the brief functional analysis indicated variability in nail biting across assessment conditions. Functional analysis data were then used to guide treatment development and implementation. Treatment included a simplified habit reversal package that was modified based on results of the functional analysis. Following treatment implementation, nail biting decreased as evidenced by consistent nail growth and participant self-recorded data. Results are discussed in terms of treatment utility of functional analysis methodology for novel populations and response topographies.

  15. Congenital onychoheterotopia involving multiple toe nails.

    PubMed

    Yadav, Savita; Khullar, Geeti; Dogra, Sunil

    2013-01-01

    Onychoheterotopia is an uncommon condition in which nail tissue is found beyond the common nail unit of the digits of the hands and feet, most often on the fifth digit of the hand. It represents an extra and independent nail that can be present either congenitally, or more commonly, acquired following trauma. The exact pathogenesis of the congenital type is undetermined. We report a 25-year-old male with multiple congenital ectopic nails of the toes since birth, which has not been reported before.

  16. Vascular Features of Nail Psoriasis Using Dynamic Optical Coherence Tomography

    PubMed Central

    Aldahan, Adam S.; Chen, Lucy L.; Fertig, Raymond M.; Holmes, Jon; Shah, Vidhi V.; Mlacker, Stephanie; Hsu, Vincent M.; Nouri, Keyvan; Tosti, Antonella

    2017-01-01

    Background Nail psoriasis is a painful and disfiguring nail disease that often leads to invasive biopsies. Dermoscopy of the hyponychium can be useful in the diagnosis showing twisted coiled vessels. Structural features of nail psoriasis have been described with optical coherence tomography (OCT). Objectives To investigate vascular features of nail psoriasis using dynamic OCT. Methods This was an observational, prospective, controlled study in which psoriasis patients with psoriatic nail changes and healthy control patients underwent OCT imaging of the distal nail plate and proximal nail fold. Vertical and horizontal OCT images were analyzed to describe structural and vascular features and to quantify blood flow at depth. Results Sixteen psoriatic nails and 16 control nails were included. Psoriatic nails had significantly increased blood flow in the proximal nail fold at depths of 0.72 mm (p = 0.035) and 0.76 mm (p = 0.027). Nail thickness was significantly greater in psoriatic nails compared to control nails (p = 0.0016). Compared to control nails, psoriatic nails had dilated, disorganized blood vessels superficially in the proximal nail fold. Limitations The main limitation of our study is the relatively small sample size. Conclusions OCT can identify structural and vascular features specific to nail psoriasis. PMID:28232916

  17. Influence of nail prominence and insertion point on anterior knee pain after tibial intramedullary nailing.

    PubMed

    Chen, Chun-Yu; Lin, Kai-Cheng; Yang, Shan-Wei; Tarng, Yih-Wen; Hsu, Chien-Jen; Renn, Jenn-Huei

    2014-03-01

    Chronic anterior knee pain is the most common complication after tibial nail insertion. Its etiology remains unknown, and multifactorial sources have been suggested. The authors believe that nail prominence and the insertion point of the nail are important in the development of anterior knee pain. The purpose of this retrospective study was to evaluate the roles of the insertion point and nail prominence in anterior knee pain after tibial intramedullary nailing using a transtendinous approach and a common nail type. A total of 108 patients with tibial shaft fractures underwent reamed intramedullary nailing using a transtendinous approach between 2006 and 2009. Mean follow-up was 26.8±5.0 months. A visual analog scale (0-100) was used to estimate anterior knee pain severity while patients performed 7 activities retrospectively. Radiographic assessments, including nail prominence and insertion point, were performed. Sixty (55.6%) patients experienced knee pain (group P) and 48 (44.4%) did not (group N). Significant differences were not found between the groups with respect to demographics, nail diameters, or fracture classifications. Less superior and more anterior nail prominences in radiographic assessments were significantly associated with anterior knee pain. When the insertion point was over the bottom half of the anterior cortex, the influence of anterior nail prominence was more obvious. Nail removal resulted in diminished pain during the 7 assessed activities. Nail insertion should be over the bottom half of the anterior cortex, with minimal anterior nail prominence. If anterior knee pain occurs, removal of the nail should be considered.

  18. Cosmetically Induced Disorders of the Nail with Update on Contemporary Nail Manicures

    PubMed Central

    Tosti, Antonella

    2016-01-01

    The nail carries a significant cosmetic impact and plays an integral role in the multi-billion dollar salon industry. This review focuses on nail disorders that are induced by nail cosmetics via procedures, equipment, or materials that are intended to beautify or adorn the nail. The authors give specific attention to clinical presentations that are common, novel, and underreported, but may be misdiagnosed easily by the competent dermatologist. They also provide an update on the controversies surrounding contemporary nail cosmetic procedures, such as acrylic and gel manicures. PMID:27462387

  19. Nail tic disorders: Manifestations, pathogenesis and management.

    PubMed

    Singal, Archana; Daulatabad, Deepashree

    2017-01-01

    Nail tic disorders are classic examples of overlap between the domains of dermatology and psychiatry. They are examples of body-focused repetitive behaviors in which there is an irresistible urge or impulse to perform a certain behavior. The behavior is reinforced as it results in some degree of relief and pleasure. Nail tic disorders are common, yet poorly studied and understood. The literature on nail tic disorders is relatively scarce. Common nail tics include nail biting or onychophagia, onychotillomania and the habit tic deformity. Some uncommon and rare nail tic disorders are onychoteiromania, onychotemnomania, onychodaknomania and bidet nails. Onychophagia is chronic nail biting behavior which usually starts during childhood. It is often regarded as a tension reducing measure. Onychotillomania is recurrent picking and manicuring of the fingernails and/or toenails. In severe cases, it may lead to onychoatrophy due to irreversible scarring of the nail matrix. Very often, they occur in psychologically normal children but may sometimes be associated with anxiety. In severe cases, onychotillomania may be an expression of obsessive-compulsive disorders. Management of nail tic disorders is challenging. Frequent applications of distasteful topical preparations on the nail and periungual skin can discourage patients from biting and chewing their fingernails. Habit-tic deformity can be helped by bandaging the digit daily with permeable adhesive tape. Fluoxetine in high doses can be helpful in interrupting these compulsive disorders in adults. For a complete diagnosis and accurate management, it is imperative to assess the patient's mental health and simultaneously treat the underlying psychiatric comorbidity, if any.

  20. Intramedullary locking femoral nails. Experience with the AO nail.

    PubMed Central

    Fogarty, A. B.; Yeates, H. A.

    1991-01-01

    The AO interlocking nail was introduced to the Ulster Hospital, Dundonald in 1988 and since then has been used in over 50 patients with femoral shaft fractures. We have reviewed 45 patients with 46 femoral shaft fractures treated between June 1988 and April 1990. These included four compound fractures and 13 comminuted fractures. The results compare favourably with other series. The union rate was 98% and there were no instances of deep infection. The alternative treatment methods available are discussed along with a review of the relevant literature. Images Fig 3 Fig 5 PMID:1785145

  1. Functional Analysis and Treatment of Nail Biting

    ERIC Educational Resources Information Center

    Dufrene, Brad A.; Watson, T. Steuart; Kazmerski, Jennifer S.

    2008-01-01

    This study applied functional analysis methodology to nail biting exhibited by a 24-year-old female graduate student. Results from the brief functional analysis indicated variability in nail biting across assessment conditions. Functional analysis data were then used to guide treatment development and implementation. Treatment included a…

  2. Mycobacteria in nail salon whirlpool footbaths, California.

    PubMed

    Vugia, Duc J; Jang, Yvonne; Zizek, Candi; Ely, Janet; Winthrop, Kevin L; Desmond, Edward

    2005-04-01

    In 2000, an outbreak of Mycobacterium fortuitum furunculosis affected customers using whirlpool footbaths at a nail salon. We swabbed 30 footbaths in 18 nail salons from 5 California counties and found mycobacteria in 29 (97%); M. fortuitum was the most common. Mycobacteria may pose an infectious risk for pedicure customers.

  3. Mycobacteria in Nail Salon Whirlpool Footbaths, California

    PubMed Central

    Jang, Yvonne; Zizek, Candi; Ely, Janet; Winthrop, Kevin L.; Desmond, Edward

    2005-01-01

    In 2000, an outbreak of Mycobacterium fortuitum furunculosis affected customers using whirlpool footbaths at a nail salon. We swabbed 30 footbaths in 18 nail salons from 5 California counties and found mycobacteria in 29 (97%); M. fortuitum was the most common. Mycobacteria may pose an infectious risk for pedicure customers. PMID:15829204

  4. Microstructure of Horseshoe Nails Using Neutron Diffraction

    NASA Astrophysics Data System (ADS)

    Goossens, D. J.; Studer, A. J.; Stachurski, Z. H.

    2010-04-01

    Neutron diffraction allows nondestructive testing of the bulk microstructure of mechanical components. The microstructures of horseshoe nails made through three different processes have been explored as a function of position along the nail. Despite all nails being made of similar plain low-carbon steel and being process annealed after manufacture, the microstructures are far from the same. Nails made from strip, using a cold forging stamping process, show narrower diffraction peaks indicating a narrower distribution of lattice parameters and also show diffraction peak intensity ratios closer to those expected for unstrained steel. Thus, the distribution of the orientation of grains in these nails is closer to that of undistorted steel compared to nails made through the other two processes considered—one a drawing from wire and the other a combination of rolling and cold forging. The blades of the drawn nails showed little preferred orientation but the converse was true in the heads. Differing patterns of preferred orientation suggest that the various manufacturing approaches result in substantially different mechanical advantages for the three types of nails, a result in accord with mechanical testing.

  5. 28 CFR 548.18 - Observance of religious holy days.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., dietary regulations, worship, or work proscription. The inmate must submit a written request to the chaplain for time off from work to observe a religious holy day. The Warden may request the chaplain to consult with community representatives of the inmate's faith group and/or other appropriate sources...

  6. Holy Cards/Immaginette: The Extraordinary Literacy of Vernacular Religion

    ERIC Educational Resources Information Center

    George, Diana; Salvatori, Mariolina Rizzi

    2008-01-01

    Like other seemingly ordinary materials (cookbooks, street art, scrapbooks, etc.) the subject of our investigation--holy cards or (in Italian) "immaginette"--often function as rich repositories of personal and cultural memory as well as indicators of popular literacy practices. But to relegate them to the category of ephemera, as is customary with…

  7. Maps and Meaning: Reading the Map of the Holy Land

    ERIC Educational Resources Information Center

    Collins-Kreiner, Noga

    2005-01-01

    The research methods of hermeneutics and semiotics were used to analyse maps of the Holy Land. The main conclusion of this study is how those methods could help us to read and understand maps. Other issues of concern are which religious elements actually appear and their form of representation in the range of maps. Narratives identified on the…

  8. The Inculturation of Holy Child Education: Actions Not Words.

    ERIC Educational Resources Information Center

    Bowman, Lorna M. A.

    1996-01-01

    Discusses the educational philosophy of the Society of the Holy Child Jesus and its impact upon the women of Nigeria and Ghana. This religious instruction allowed them to attain a liberated means of self-expression and leadership faithful to their cultural heritage as African women and their formation as Christians. (MJP)

  9. The 2 clinical subbands of the distal nail unit and the nail isthmus. Anatomical explanation and new physiological observations in relation to the nail growth.

    PubMed

    Perrin, Christophe

    2008-06-01

    The distal region of the nail unit, which marks the transition of the nail bed to the hyponychium, is known clinically as the onychodermal band (ODB). For several authors, the ODB is described as 2 subbands of tonal values: slightly milky and pink from proximal to distal. However, its 2 subbands show individual variation and are often scarcely visible. It has been stated that the proximal subband, that is, the white band of Pinkus, corresponds histologically to the attachment of the compact orthokeratotic layer of the hyponychium to the nail plate. In 2 studies, I have individualized a transitional zone between the nail bed and the hyponychium: the nail isthmus. In these previous studies, the ODB was not visible. The purpose of this article is to analyze the anatomo-clinical correlations between the nail isthmus and the ODB and to highlight some new physiological information concerning the nail growth. A case showing clearly the 2 clinical subbands of ODB was investigated. In addition, all the longitudinal sections of the 5 normal nail unit specimens, used in the 2 previous studies, were reviewed to analyze the ventral surface of the nail plate in longitudinal planes. The nail isthmus can be described synthetically by 2 features: (1) a stair-like appearance of the epithelium of the distal nail bed with a marked depression of the epithelium below the inferior surface of the nail plate (2) a specialized mode of attachment of its horny layer to nail plate via a horizontal mode of differentiation. The white band of Pinkus corresponded histologically to the nail isthmus. Its white color was caused by alteration in light diffraction in the thin compartment of pale parakeratotic corneocytes squeezed between the nail plate and the epithelium of the nail isthmus. The pink middle band corresponded to the 2 horny layers surmounting the epidermis of the hyponychium: the compact horny layer of the hyponychium and the thin pale "tongue-like" parakeratotic extension of the nail

  10. Application of Hansen Solubility Parameters to predict drug-nail interactions, which can assist the design of nail medicines.

    PubMed

    Hossin, B; Rizi, K; Murdan, S

    2016-05-01

    We hypothesised that Hansen Solubility Parameters (HSPs) can be used to predict drug-nail affinities. Our aims were to: (i) determine the HSPs (δD, δP, δH) of the nail plate, the hoof membrane (a model for the nail plate), and of the drugs terbinafine HCl, amorolfine HCl, ciclopirox olamine and efinaconazole, by measuring their swelling/solubility in organic liquids, (ii) predict nail-drug interactions by comparing drug and nail HSPs, and (iii) evaluate the accuracy of these predictions using literature reports of experimentally-determined affinities of these drugs for keratin, the main constituent of the nail plate and hoof. Many solvents caused no change in the mass of nail plates, a few solvents deswelled the nail, while others swelled the nail to varying extents. Fingernail and toenail HSPs were almost the same, while hoof HSPs were similar, except for a slightly lower δP. High nail-terbinafine HCl, nail-amorolfine HCl and nail-ciclopirox olamine affinities, and low nail-efinaconazole affinities were then predicted, and found to accurately match experimental reports of these drugs' affinities to keratin. We therefore propose that drug and nail Hansen Solubility Parameters may be used to predict drug-nail interactions, and that these results can assist in the design of drugs for the treatment of nail diseases, such as onychomycosis and psoriasis. To our knowledge, this is the first report of the application of HSPs in ungual research.

  11. Ultrasound-mediated nail drug delivery system.

    PubMed

    Abadi, Danielle; Zderic, Vesna

    2011-12-01

    A novel ultrasound-mediated drug delivery system has been developed for treatment of a nail fungal disorder (onychomycosis) by improving delivery to the nail bed using ultrasound to increase the permeability of the nail. The slip-in device consists of ultrasound transducers and drug delivery compartments above each toenail. The device is connected to a computer, where a software interface allows users to select their preferred course of treatment. In in vitro testing, canine nails were exposed to 3 energy levels (acoustic power of 1.2 W and exposure durations of 30, 60, and 120 seconds). A stereo -microscope was used to determine how much of a drug-mimicking compound was delivered through the nail layers by measuring brightness on the cross section of each nail tested at each condition, where brightness level decreases coincide with increases in permeability. Each of the 3 energy levels tested showed statistical significance when compared to the control (P < .05) with a permeability factor of 1.3 after 30 seconds of exposure, 1.3 after 60 seconds, and 1.5 after 120 seconds, where a permeability factor of 1 shows no increase in permeability. Current treatments for onychomycosis include systemic, topical, and surgical. Even when used all together, these treatments typically take a long time to result in nail healing, thus making this ultrasound-mediated device a promising alternative.

  12. Octyl-2-Cyanoacrylate adhesive for rapid nail plate restoration.

    PubMed

    Hallock, G G; Lutz, D A

    2000-09-01

    Following nail bed repair, returning the nail plate as a conforming stent or splint is a common technique. Especially when split, the nail plate fragments can very readily be pieced together and bonded to the nail bed using the tissue adhesive Octyl-2-Cyanoacrylate. This new formulation can expedite this maneuver, and has shown no signs of histotoxicity or adverse effect on nail plate regeneration.

  13. Splitting of the Proximal Femur With a New Femoral Nail

    DTIC Science & Technology

    2010-04-01

    offset from the top of this particular nail to its long axis. Key Words: lateral entry, trochanteric nail , intramedullary nailing , femur, complication...trochanteric intramedullary femoral nailing . J Orthop Trauma. 2005;19:681–686. 8. McConnell T, Tornetta P III, Benson E, et al. Gluteus medius tendon injury...Germany: Stryker Trauma; 2006: 191–199. 11. Gerhard Küntscher. Practice of Intramedullary Nailing . Translated by Herman Rinne. Springfield, IL: Thomas

  14. The 'PDA nail': traumatic nail dystrophy in habitual users of personal digital assistants.

    PubMed

    Olszewska, Malgorzata; Wu, John Z; Slowinska, Monika; Rudnicka, Lidia

    2009-01-01

    All-in-one devices with mobile phone, web browser, and organizer are now owned by over 6 million people and their popularity is increasing. These devices are often called personal digital assistants (PDAs) or 'BlackBerry(R)' devices, after a popular brand name of these appliances. The use of PDAs is associated with exposure of distal thumbs and nails to repeated pressure with a frequency of up to a few thousand times per hour and several tens of thousands of times per day. We describe two cases of traumatic thumb nail dystrophy associated with using a PDA keyboard for several hours per day. Both patients developed median nail plate dystrophy after 4-8 months of habitual PDA use. One patient also developed thumb nail psoriasis and paronychia. All symptoms resolved a few months after discontinuing PDA use. Analysis of nail biomechanics, performed by using a finite element fingertip model, showed that maximal stress reaches approximately 3 MPa and appears near the root on the internal surface of the nail, while it reaches approximately 2 MPa and appears around one-third from the root on the outside surface. In conclusion, biomechanical stress resulting from overuse of PDAs may result in various types of nail dystrophy. We suggest the general term 'PDA nails' for these nail abnormalities.

  15. Nails

    MedlinePlus

    ... 2017 American Academy of Dermatology. All rights reserved. Reproduction or republication strictly prohibited without prior written permission. ... 2017 American Academy of Dermatology. All rights reserved. Reproduction or republication strictly prohibited without prior written permission.

  16. Late Quaternary tectonics in the inner Northern Apennines (Siena Basin, southern Tuscany, Italy) and their seismotectonic implication

    NASA Astrophysics Data System (ADS)

    Brogi, Andrea; Capezzuoli, Enrico; Martini, Ivan; Picozzi, Matteo; Sandrelli, Fabio

    2014-05-01

    Defining the most recent Quaternary tectonics represents a challenging task for neotectonic, palaeoseismological and seismotectonic studies. This paper focuses on an integrated approach to reconstructing the latest Quaternary deformation affecting the northern part of the Siena Basin (inner Northern Apennines, i.e., southern Tuscany, Italy) near the town of Siena, and to discuss the seismological implications. Field work and structural and stratigraphic analyses, coupled with the interpretation of reflection seismic lines, have been combined to define the geometry, kinematics and age of mesoscopic to map-scale faults which have affected the mainly Quaternary continental and Pliocene marine deposits. The resulting dataset describes a tectonic setting characterized by coeval SW- and NW-trending transtensional and normal faults, respectively, dissecting alluvial sediments younger than 23.9 ± 0.23 ka. Seismic interpretation sheds light on the geometrical setting of the faults at deeper levels, down to 1-2 km, and provides support for the presence of a wide brittle shear zone defined by conjugated fault segments, locally giving rise to an asymmetrical negative flower-like structure. Faults and their damage zones have controlled (and still control) the discharge of gas vents (mainly CO2 and H2S) and hydrothermal circulation (which deposits travertine) since at least 23.216 ± 0.124 ka. The resulting complete data set provides support for our description of the Neogene-Quaternary tectonics which were active until the late Quaternary, providing additional information about the seismotectonic framework of an area characterized by low seismicity and generally low-magnitude earthquakes (M < 4), but having experienced significant seismic events over the last few centuries.

  17. Femoral lengthening with a motorized intramedullary nail

    PubMed Central

    Horn, Joachim; Grimsrud, Øyvind; Dagsgard, Anita Hoddevik; Huhnstock, Stefan; Steen, Harald

    2015-01-01

    Purpose We assessed whether an intramedullary lengthening device would reduce the problems normally associated with the external fixation technique. We also wanted to determine whether it is a reliable construct for limb lengthening and deformity correction in the femur. Patients and methods We conducted a matched-pair comparison of 30 femoral lengthenings, 15 with a motorized intramedullary nail (the nail group) and 15 lengthenings with an external ring fixator (the fixator group). The patients were matched based on age, sex, amount of lengthening, and the etiology of leg length discrepancy. Mean lengthening was 35 (25–55) mm in the nail group and 38 (15–75) mm in the fixator group. Outcome measures were: lengthening and alignment achieved, consolidation index, knee range of motion (ROM), and complications. Results The pairs in this matched-pair study were similar in terms of age, sex, diagnosis, and amount of lengthening. The planned amount of lengthening was achieved in all patients in both groups and axis correction was considered sufficient. The mean radiographic consolidation index in the nail group, at 1.5 (0.9–3.0) months/cm, was better than the mean value for the fixator group (1.9 (0.9–3.4) months/cm) (p = 0.01). Knee ROM was better in the nail group during the lengthening, 6 weeks after lengthening was completed, and 6 months after lengthening was completed (p < 0.001). A larger number of complications were observed in the fixator group than in the nail group. Interpretation A lengthening nail may be superior to external fixation in femoral lengthening, when the anatomical conditions and the complexity of the deformity allow the use of an intramedullary nail. PMID:25191936

  18. Utility of Gel Nails in Improving the Appearance of Cosmetically Disfigured Nails: Experience with 25 Cases

    PubMed Central

    Nanda, Soni; Grover, Chander

    2014-01-01

    Background: Gel nails are a commonly used cosmetic procedure, though their use by dermatologists has not been evaluated. These can be used to improve the appearance of cosmetically disfigured nails where other treatment options have failed; the condition is self-limiting or irreversible; or to camouflage the dystrophy until healing. Materials and Methods: A prospective, uncontrolled, open-label study on 25 participants presenting with cosmetically disfigured nails was undertaken. Mycologically negative, consenting patients with various nail plate surface abnormalities like trachyonychia (n =8); superficial pitting (n =6); onychorrhexis (n =4); superficial pitting with onychoschizia (n =3); Beau's lines (n =3) and pterygium (n =1) were included. The patients received gel nail application using Ranara gel nail kit®. Extra care was taken to avoid any damage to cuticle. Standard pre- and post-treatment photographs were taken to assess improvement. Patient satisfaction score (1-10); Global assessment score of improvement (no improvement to excellent improvement) and any side effects reported were recorded. Results: The average age of treated patients was 30.44±11.39 years (range 18-60 years). A total of 69 nails were treated (average of 2.76 per patient). Post-procedure, the average patient satisfaction score was 9.08 ± 0.86 (range 7-10). The Global assessment showed excellent improvement (40% cases); good improvement (56% cases) and mild improvement in the single case of pterygium treated. Conclusions: The use of Gel nails in patients with cosmetically disfiguring nail plate surface abnormalities (like trachyonychia, onychoschizia, pitting, etc.) was found to produce good to excellent improvement in most of the cases. The patient satisfaction with the procedure was rated as high. This, coupled with absence of side effects, make gel nails a valuable tool in improving cosmesis and satisfaction among patients presenting with nail plate surface abnormalities. Further

  19. Heat profiles of laser-irradiated nails

    NASA Astrophysics Data System (ADS)

    Paasch, Uwe; Nenoff, Pietro; Seitz, Anna-Theresa; Wagner, Justinus A.; Kendler, Michael; Simon, Jan C.; Grunewald, Sonja

    2014-01-01

    Onychomycosis is a worldwide problem with no tendency for self-healing, and existing systemic treatments achieve disease-free nails in only 35 to 76% of cases. Recently, treatment of nail fungus with a near-infrared laser has been introduced. It is assumed that fungal eradication is mediated by local heat. To investigate if laser treatment has the potential to eradicate fungal hyphae and arthrospores, laser heat application and propagation needs to be studied in detail. This study aimed to measure nail temperatures using real-time videothermography during laser irradiation. Treatment was performed using 808- and 980-nm linear scanning diode lasers developed for hair removal, enabling contact-free homogeneous irradiation of a human nail plate in one pass. Average and peak temperatures increased pass by pass, while the laser beam moved along the nail plates. The achieved mean peak temperatures (808 nm: 74.1 to 112.4°C, 980 nm: 45.8 to 53.5°C), as well as the elevation of average temperatures (808 nm: 29.5 to 38.2°C, 980 nm: 27.1 to 32.6°C) were associated with pain that was equivalent to that of hair removal procedures and was not significantly different for various wavelengths. The linear scanning laser devices provide the benefits of contact-free homogeneous heating of the human nail while ensuring adequate temperature rises.

  20. Lateral drug diffusion in human nails.

    PubMed

    Palliyil, Biji B; Li, Cong; Owaisat, Suzan; Lebo, David B

    2014-12-01

    The main objective of the current work is to demonstrate the process of passive lateral diffusion in the human nail plate and its effect on the passive transungual permeation of antifungal drug ciclopirox olamine (CPO). A water soluble dye, methyl red sodium salt (MR) was used to visualize the process of lateral diffusion using a novel suspended nail experiment. The decline in concentration of CPO correlates with that of concentration of MR from the proximal to the distal end of the nail in suspended nail study. Three toenails each were trimmed to 5 mm × 5 mm (25 mm(2)), 7 mm × 7 mm (49 mm(2)), and 9 mm × 9 mm (81 mm(2)) to study the extent and effect of lateral diffusion of the CPO on its in vitro transungual permeation. The permeation flux of CPO decreased as the surface area of the toenail increased. There was a positive correlation between the concentrations of CPO and MR in the area of application and in the peripheral area of the toenails of the three surface areas, confirming the findings in the suspended nail experiment. Profound lateral diffusion of CPO was demonstrated and shown to reduce the in vitro passive transungual drug permeation and prolong the lag-time in human toenails. The study data implies that during passive in vitro transungual permeation experiments, the peripheral nail around the area of drug application has to be kept to a minimum, in order to get reliable data which mimics the in vivo situation.

  1. Heat profiles of laser-irradiated nails.

    PubMed

    Paasch, Uwe; Nenoff, Pietro; Seitz, Anna-Theresa; Wagner, Justinus A; Kendler, Michael; Simon, Jan C; Grunewald, Sonja

    2014-01-01

    Onychomycosis is a worldwide problem with no tendency for self-healing, and existing systemic treatments achieve disease-free nails in only 35 to 76% of cases. Recently, treatment of nail fungus with a near-infrared laser has been introduced. It is assumed that fungal eradication is mediated by local heat. To investigate if laser treatment has the potential to eradicate fungal hyphae and arthrospores, laser heat application and propagation needs to be studied in detail. This study aimed to measure nail temperatures using real-time videothermography during laser irradiation. Treatment was performed using 808- and 980-nm linear scanning diode lasers developed for hair removal, enabling contact-free homogeneous irradiation of a human nail plate in one pass. Average and peak temperatures increased pass by pass, while the laser beam moved along the nail plates. The achieved mean peak temperatures (808 nm: 74.1 to 112.4°C, 980 nm: 45.8 to 53.5°C), as well as the elevation of average temperatures (808 nm: 29.5 to 38.2°C, 980 nm: 27.1 to 32.6°C) were associated with pain that was equivalent to that of hair removal procedures and was not significantly different for various wavelengths. The linear scanning laser devices provide the benefits of contact-free homogeneous heating of the human nail while ensuring adequate temperature rises.

  2. Flora of the Holy Bible part I - fruits.

    PubMed

    Joseph, G V R

    2002-01-01

    Holy Bible described several plants and the authentication of certain Biblical flora is still in debate. In this present paper, attempts are being made to workout the correct botanical identity of certain plants based on the description mentioned in the Bible. Bible is a genuinely documented book everything mentioned in the Bible has a great significance. Present study is undertaken with a view to evaluate the biblical flora in correlation with the present day knowledge especially with the Ayurvedic system of medicine.

  3. Transungual delivery of terbinafine by iontophoresis in onychomycotic nails.

    PubMed

    Nair, Anroop B; Vaka, Siva Ram Kiran; Murthy, S Narasimha

    2011-10-01

    Trans-nail permeability is limited due to the innate nature of the nail plate and the recent investigations indicated the potential of iontophoresis in enhancing the transungual drug delivery in normal nails. However, the onychomycotic nails differ from the normal nails with respect to the anatomical and biological features. The current study investigated the effect of iontophoresis (0.5 mA/cm(2) for 1 h) on the transungual delivery of terbinafine in onychomycotic finger and toe nails. The presence of fungi in the onychomycotic nails was diagnosed by potassium hydroxide (KOH) microscopy. Passive and iontophoretic delivery of terbinafine across the infected nail was studied in Franz diffusion cell. Further, the release profile of terbinafine from the drug-loaded nails was investigated by agar diffusion method. KOH microscopy confirmed the presence of fungi in all the nails used. The amount of drug permeated across the nail plate was enhanced significantly during iontophoresis over passive delivery, that is, by 21-fold in case of finger and 37-fold in case of toe nails. Further, the total drug load in the onychomycotic nail was enhanced by ~12-fold (in both finger and toe nails) due to iontophoresis. Release of terbinafine from the iontophoresis-loaded nails into agar plates exhibited two phases, a rapid phase followed by a steady release, which extended >2 months. This study concluded that the drug delivery in onychomycotic nails did not differ significantly when compared with normal nails, although the extent of drug permeation and drug load differs between finger and toe nails.

  4. In vitro permeation of several drugs through the human nail plate: relationship between physicochemical properties and nail permeability of drugs.

    PubMed

    Kobayashi, Yoichi; Komatsu, Tsunehisa; Sumi, Machiko; Numajiri, Sachihiko; Miyamoto, Misao; Kobayashi, Daisuke; Sugibayashi, Kenji; Morimoto, Yasunori

    2004-03-01

    The objectives of the present study are to clarify the relationship between the physicochemical properties and the nail permeability of drugs through human nail plates. Homologous p-hydroxybenzoic acid esters were used to investigate the relationship between the octanol/water partition coefficient and the permeability coefficient of several drugs. The nail permeability was found to be independent of the lipophilicity of a penetrating drug. However, the nail permeability of several model drugs was found to markedly decrease as their molecular weights increased. The nail permeability of an ionic drug was found to be significantly lower than that of a non-ionic drug, and the nail permeability of these drugs markedly decreased as their molecular weights increased. The permeation of a model drug, 5-fluorouracil (5-FU), through healthy nail plates was also determined and compared with that through nail plates with fungal infections. The drug permeation through a nail plate decreased with an increase in nail plate thickness. Nail plates with fungal infections exhibited approximately the same 5-FU permeation as healthy nail plates. We suggest that the permeability of a drug is mainly influenced by its molecular weight and permeability through nails with fungal infection can be estimated from data on healthy nail permeability.

  5. Iontophoresis across the proximal nail fold to target drugs to the nail matrix.

    PubMed

    Manda, Prashanth; Sammeta, Srinivasa M; Repka, Michael A; Murthy, S Narasimha

    2012-07-01

    The main objective of the present study was to investigate the plausibility of iontophoretic delivery of drugs to the nail matrix via proximal nail fold. The in vitro drug transport studies were performed in Franz diffusion cells across folded epidermis, which is used as a model for the proximal nail fold. The amount of drug transported into the receiver compartment following iontophoresis for 3 h at 0.5 mA/cm(2) was 150-fold higher than the control (0.008 ± 0.002 μg/cm(2)). The amount of drug present in the skin after iontophoresis (0.45 ± 0.12 μg/mg) was approximately fivefold higher as compared with that of the control (0.08 ± 0.01 μg/mg). Iontophoresis of terbinafine across the proximal nail fold was assessed using excised cadaver toe model as well. A custom-designed foam-pad-type patch system was used for iontophoresis in cadaver toes. The amount of the drug delivered into the nail matrix following iontophoresis for 3 h was significantly higher than the minimum inhibition concentration of terbinafine. However, on the contrary, passive delivery for about 24 h did not result in any detectable drug levels in the nail matrix. Iontophoresis across the proximal nail fold could be developed as a potential method to target drugs to nail matrix.

  6. Nail position has an influence on anterior knee pain after tibial intramedullary nailing.

    PubMed

    Darabos, Nikica; Bajs, Ivana Dovzak; Rutić, Zeljko; Darabos, Anela; Poljak, Damir; Dobsa, Jasminka

    2011-09-01

    Our aim was to determine the possible relationship between anterior knee pain (AKP) and nail position marked as a distance from tip of nail to tibial plateau (NP) and to the tuberositas tibiae (NT). Nail position has an influence on anterior knee pain after tibial intramedullary nailing. We evaluated postoperative outcome results of 50 patients in the last 3 years with healed fractures initially treated with intramedullary (IM) reamed nails with 2 or 3 interlocking screws on both parts of the nail and with the use of medial paratendinous incision for nail entry portal. Patients marked a point on the visual analog scale (VAS) that corresponded to the level of postoperative AKP felt. Two groups of patients were formed on the basis of AKP (pain level was neglected): groups A and B, with and without pain, respectively. The difference between the two groups concerning NP measurements was statistically significant (p < 0.05), but not concerning NT measurements at the p < 0.05 level. Patients were classified by pain with high accuracy (98%) according to a classification tree. Symptoms of AKP did not appear if the tip of the nail position was more than 6.0 mm from the NP and more than 2.6 mm from the NT. However, for better evaluation of these results it will be necessary to examine a larger number of postoperative patients with AKP.

  7. [Anatomy, biology, physiology and basic pathology of the nail organ].

    PubMed

    Haneke, E

    2014-04-01

    The nail is the largest skin appendage. It grows continuously through life in a non-cyclical manner; its growth is not hormone-dependent. The nail of the middle finger of the dominant hand grows fastest with approximately 0.1 mm/day, whereas the big toe nail grows only 0.03-0.05 mm/d. The nails' size and shape vary characteristically from finger to finger and from toe to toe, for which the size and shape of the bone of the terminal phalanx is responsible. The nail apparatus consists of both epithelial and connective tissue components. The matrix epithelium is responsible for the production of the nail plate whereas the nail bed epithelium mediates firm attachment. The hyponychium is a specialized structure sealing the subungual space and allowing the nail plate to physiologically detach from the nail bed. The proximal nail fold covers most of the matrix. Its free end forms the cuticle which seals the nail pocket or cul-de-sac. The dermis of the matrix and nail bed is specialized with a morphogenetic potency. The proximal and lateral nail folds form a frame on three sides giving the nail stability and allowing it to grow out. The nail protects the distal phalanx, is an extremely versatile tool for defense and dexterity and increases the sensitivity of the tip of the finger. Nail apparatus, finger tip, tendons and ligaments of the distal interphalangeal joint form a functional unit and cannot be seen independently. The nail organ has only a certain number of reaction patterns that differ in many respects from hairy and palmoplantar skin.

  8. Drug delivery to the nail following topical application.

    PubMed

    Murdan, Sudaxshina

    2002-04-02

    The absorption of drugs into the nail unit, following topical application to the nail plate, is highly desirable to treat nail disorders, such as onychomycosis (fungal infections of the nail). Nail permeability is however quite low and limits topical therapy to early/mild disease states. In this paper, the recent research into ungual drug delivery is reviewed. The nail unit and the two most common diseases affecting the nail--onychomycosis and nail psoriasis--are briefly described to set the scene and to give an overview of the nature and scope of the problem. The factors, which affect drug uptake and permeation through the nail plate such as solute molecular size, hydrophilicity/hydrophobicity, charge, and the nature of the vehicle, are then discussed, followed by ways of enhancing drug transport into and through the nail plate. Finally, drug-containing nail lacquers which, like cosmetic varnish, are brushed onto the nail plates to form a film, and from which drug is released and penetrates into the nail, are reviewed.

  9. Routes of drug delivery into the nail apparatus: Implications for the efficacy of topical nail solutions in onychomycosis.

    PubMed

    Gupta, Aditya K; Simpson, Fiona C

    2016-01-01

    The route of antifungal drug entry into the nail plate and the underlying nail bed plays an important role in determining the efficacy of therapy. Oral antifungal agents reach the nail bed and nail plate by being ingested and achieving antifungal levels in the blood stream that are well in excess of the minimum inhibitory concentration. The reticular circulation at the distal end of the digit enables the drug to reach the nail bed, the proximal matrix and the lateral nail folds. The drug then diffuses into the proximal, ventral and lateral nail plate. The primary route of drug delivery for topical lacquers is transungual, with drug applied to the dorsal aspect of the nail plate and penetrating to the underlying nail bed. The new topical agents approved in the US for the treatment of onychomycosis are solutions with lower viscosity and increased nail penetration characteristics; therefore, these agents penetrate through the transungual route, but also through the space between the nail plate and the nail bed. This subungual route is an important method of drug delivery and is able to in part circumvent the thickness of the nail plate.

  10. Nail psoriasis - what a rheumatologist should know about.

    PubMed

    Nieradko-Iwanicka, Barbara

    2017-01-01

    Psoriasis is a chronic recurrent inflammatory skin disease with prevalence of 1-3%. Nail psoriasis affects 10-90% of patients with plaque psoriasis. The aim of the article is to review the literature for the correlation between nail psoriasis and psoriatic arthritis (PsA) to provide rheumatologists a short review on features of nail psoriasis, methods of their assessment and possible clinical repercussions. The PubMed database was searched using the key words 'nail psoriasis' and 'psoriatic arthritis'. Psoriasis involving the nail matrix shows up as changes such as pitting, Beau lines, leukonychia, red spots in the lunula, or nail plate crumbling. Nail bed psoriasis manifests as onycholysis, oil drops (or salmon patches), dyschromia, splinter hemorrhages, or subungual hyperkeratosis. Nail psoriasis and psoriatic lesions in the gluteal cleft and on the scalp usually accompany PsA, especially in adult men.

  11. 42. INTERIOR VIEW OF THE NAIL HARDENER USED TO HARDEN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    42. INTERIOR VIEW OF THE NAIL HARDENER USED TO HARDEN AND TEMPER THE NAILS; WEST TUBES IN FOREGRPUND AND DRAWBACK TUBE IN THE CENTER - LaBelle Iron Works, Thirtieth & Wood Streets, Wheeling, Ohio County, WV

  12. Transonychial water loss in healthy and diseased nails.

    PubMed

    Krönauer, C; Gfesser, M; Ring, J; Abeck, D

    2001-01-01

    The objective of this study was to determine the transonychial water loss (TOWL) in both healthy and affected nails in different diseases and to compare it with the transepidermal water loss (TEWL). TOWL was measured by a new evaporimetric method: Plasticine was used to fix the protection cover of the evaporimeter probe to the nails. The TOWL behaved contrary to the TEWL. Affected nails in patients with atopic eczema (p <0.01), psoriasis (p<0.05) and onychomycosis (p<0.001) showed a significantly lower TOWL than did nails of healthy test subjects. The decrease in TOWL in diseased nails in comparison to healthy nails could be due to the formation of a stratum granulosum in atopic, psoriatic or fungus-affected nails, as this layer is normally absent in healthy nails.

  13. Nail psoriasis – what a rheumatologist should know about

    PubMed Central

    2017-01-01

    Psoriasis is a chronic recurrent inflammatory skin disease with prevalence of 1–3%. Nail psoriasis affects 10–90% of patients with plaque psoriasis. The aim of the article is to review the literature for the correlation between nail psoriasis and psoriatic arthritis (PsA) to provide rheumatologists a short review on features of nail psoriasis, methods of their assessment and possible clinical repercussions. The PubMed database was searched using the key words ‘nail psoriasis’ and ‘psoriatic arthritis’. Psoriasis involving the nail matrix shows up as changes such as pitting, Beau lines, leukonychia, red spots in the lunula, or nail plate crumbling. Nail bed psoriasis manifests as onycholysis, oil drops (or salmon patches), dyschromia, splinter hemorrhages, or subungual hyperkeratosis. Nail psoriasis and psoriatic lesions in the gluteal cleft and on the scalp usually accompany PsA, especially in adult men. PMID:28386142

  14. Nail disorders as signs of pediatric systemic disease.

    PubMed

    Shah, Kara N; Rubin, Adam I

    2012-09-01

    Herein, we describe some of the more common changes in the nail unit that can be seen in systemic diseases in children. Changes that can be seen are not limited to those discussed in the following pages. The presence of changes on multiple nails is suggestive of a systemic cause in an ill child. However, multiple nails can also be affected in primary inflammatory disorders and infections of the nail unit. When evaluating a pediatric patient with a nail disorder, it is important to perform a complete physical examination of the skin and oral mucosa, as other clues to the diagnosis of the nail problem may be found. A comprehensive family history is also important to uncover possible syndromic associations with nail disease or diseases that can manifest with nail changes.

  15. Subtrochanteric fractures after retrograde femoral nailing

    PubMed Central

    Mounasamy, Varatharaj; Mallu, Sathya; Khanna, Vishesh; Sambandam, Senthil

    2015-01-01

    Secondary fractures around femoral nails placed for the management of hip fractures are well known. We report, two cases of a fracture of the femur at the interlocking screw site in the subtrochanteric area after retrograde femoral nailing of a femoral shaft fracture. Only a few reports in the existing literature have described these fractures. Two young men after sustaining a fall presented to us with pain, swelling and deformity in the upper thigh region. On enquiring, examining and radiographing them, peri-implant fractures of subtrochanteric nature through the distal interlocking screws were revealed in both patients who also had histories of previous falls for which retrograde intramedullary nailing was performed for their respective femora. Both patients were managed with similar surgical routines including removal of the existing hardware, open reduction and ace cephallomedullary antegrade nailing. The second case did show evidence of delayed healing and was additionally stabilized with cerclage wires. Both patients had uneventful postoperative outcomes and union was evident at the end of 6 mo postoperatively with a good range of motion at the hip and knee. Our report suggests that though seldom reported, peri-implant fractures around the subtrochanteric region can occur and pose a challenge to the treating orthopaedic surgeon. We suggest these be managed, after initial stabilization and resuscitation, by implant removal, open reduction and interlocking intramedullary antegrade nailing. Good results and progression to union can be expected in these patients by adhering to basic principles of osteosynthesis. PMID:26495251

  16. Guidance on maintaining personal hygiene in nail care.

    PubMed

    Malkin, Bridget; Berridge, Pat

    Nail care is important in the maintenance of personal hygiene and is an essential aspect of patient care. Confusion about who should perform nail care for patients has resulted in poor practice and cycles of non-activity. This article provides guidance for nurses on performing routine nail care.

  17. 78 FR 78382 - Steel Nails From China; Determination

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ... COMMISSION Steel Nails From China; Determination On the basis of the record \\1\\ developed in the subject five... order on steel nails from China would be likely to lead to continuation or recurrence of material injury... contained in USITC Publication 4442 (December 2013), entitled Steel Nails from China: Investigation No....

  18. Unusual manifestation of the yellow nail syndrome - Case report*

    PubMed Central

    Papaiordanou, Francine; Epstein, Marina Gabrielle; Miyaoka, Mariana Yumi; Yang, Jeane Jeong Hoon; Pires, Mario Cezar

    2014-01-01

    The yellow nail syndrome is a rare disorder characterized by the classic triad of yellow and dystrophic nails, lymphedema and pleural effusion. We report in this paper a case of yellow nail syndrome, presenting the classic triad of the disease, associated with an unusual lymph accumulation in the abdomen region. PMID:24937826

  19. Portable x-ray fluorescence for the analysis of chromium in nail and nail clippings.

    PubMed

    Fleming, David E B; Ware, Chris S

    2017-03-01

    Assessment of chromium content in human nail or nail clippings could serve as an effective biomarker of chromium status. The feasibility of a new portable x-ray fluorescence (XRF) approach to chromium measurement was investigated through analysis of nail and nail clipping phantoms. Five measurements of 180s (real time) duration were first performed on six whole nail phantoms having chromium concentrations of 0, 2, 5, 10, 15, and 20µg/g. Using nail clippers, these phantoms were then converted to nail clippings, and assembled into different mass groups of 20, 40, 60, 80, and 100mg for additional measurements. The amplitude of the chromium Kα characteristic x-ray energy peak was examined as a function of phantom concentration for all measurement conditions to create a series of calibration lines. The minimum detection limit (MDL) for chromium was also calculated for each case. The chromium MDL determined from the whole nail intact phantoms was 0.88±0.03µg/g. For the clipping phantoms, the MDL ranged from 1.2 to 3.3µg/g, depending on the mass group analyzed. For the 40mg clipping group, the MDL was 1.2±0.1µg/g, and higher mass collections did not improve upon this result. This MDL is comparable to chromium concentration levels seen in various studies involving human nail clippings. Further improvements to the portable XRF technique would be required to detect chromium levels expected from the lower end of a typical population.

  20. [Retrograde nailing in a tibial fracture].

    PubMed

    Valls-Mellado, M; Martí-Garín, D; Fillat-Gomà, F; Marcano-Fernández, F A; González-Vargas, J A

    2014-01-01

    We describe a case of a severely comminuted type iiia open tibial fracture, with distal loss of bone stock (7 cm), total involvement of the tibial joint surface, and severe instability of the fibular-talar joint. The treatment performed consisted of thorough cleansing, placing a retrograde reamed calcaneal-talar-tibial nail with proximal and distal blockage, as well as a fibular-talar Kirschner nail. Primary closure of the skin was achieved. After 3 weeks, an autologous iliac crest bone graft was performed to fill the bone defect, and the endomedullary nail, which had protruded distally was reimpacted and dynamized distally. The bone defect was eventually consolidated after 16 weeks. Currently, the patient can walk without pain the tibial-astragal arthrodesis is consolidated.

  1. Influence of Holy Month Ramadan on Alcohol Consumption in Turkey.

    PubMed

    Çelen, Aydın

    2015-12-01

    This study utilizes a balanced panel data set covering 50 monthly observations regarding the brewery products to examine the impact of holy month Ramadan on alcohol consumption in Turkey. In addition to the Ramadan, temperature, prices of the products and disposable income are other demand factors which are taken into account in this study. As expected, the Ramadan has been found to be associated with lower alcohol usage. As price of alcoholic drinks increases, the alcohol consumption decreases significantly. In addition, alcohol consumption rises with the enhancements in the disposable income. However, surprisingly, the temperature has not any significant effect on alcohol consumption in Turkey.

  2. The Contribution of the Society of the Holy Child Jesus to Catholic Education in West Africa

    ERIC Educational Resources Information Center

    Aidoo, Philomena

    2016-01-01

    This article discusses the extent to which the charism and the philosophy of education of Venerable Cornelia Connelly founder of the Society of the Holy Child Jesus are being maintained in the twenty-first century in West Africa (Nigeria and Ghana). Using data gathered from Sisters and former students of Holy Child schools as evidence it seeks to…

  3. Are biologics useful for nail psoriasis?

    PubMed

    Antúnez-Lay, Andrea; Cabrolier, Jorge; Andino-Navarrete, Romina

    2016-01-11

    Apart from involving skin, psoriasis can compromise the nails and adjacent structures. Even though there are multiple therapeutic alternatives, there is great interest in biological therapy, but no consensus on its role exists. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including three randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded it is not clear whether biological therapy is superior to placebo in the treatment of nail psoriasis because the certainty of the evidence is very low.

  4. Controversies in the Treatment of Ingrown Nails

    PubMed Central

    Haneke, Eckart

    2012-01-01

    Ingrown toenails are one of the most frequent nail disorders of young persons. They may negatively influence daily activities, cause discomfort and pain. Since more than 1000 years, many different treatments have been proposed. Today, conservative and surgical methods are available, which, when carried out with expertise, are able to cure the disease. Packing, taping, gutter treatment, and nail braces are options for relatively mild cases whereas surgery is exclusively done by physicians. Phenolisation of the lateral matrix horn is now the safest, simplest, and most commonly performed method with the lowest recurrence rate. Wedge excisions can no longer be recommended PMID:22675345

  5. Basal cell carcinoma of the nail unit.

    PubMed

    Forman, Seth B; Ferringer, Tammie C; Garrett, Algin B

    2007-05-01

    We report a case of a 70-year-old white male with a basal cell carcinoma of the left thumb nail unit. Excision of the tumor via Mohs micrographic surgery was completed in 2 stages. The defect was repaired with a full thickness skin graft. Five months later the nail unit healed without complications. Prior to this report, 21 cases of basal cell carcinoma have been reported in the world literature. This case, as well as the prior reports, are reviewed with a focus on time to diagnosis, location, excisional technique, and method of repair.

  6. Chemical and biological methods to evaluate the availability of heavy metals in soils of the Siena urban area (Italy).

    PubMed

    Nannoni, Francesco; Protano, Giuseppe

    2016-10-15

    A biogeochemistry field study was conducted in the Siena urban area (Italy) with the main objective of establishing the relationship between available amounts of heavy metals in soil assessed by a chemical method (soil fractionation) and bioavailability assessed by a biological method (bioaccumulation in earthworm tissues). The total content of traffic-related (Cd, Cu, Pb, Sb, Zn) and geogenic (Co, Cr, Ni, U) heavy metals in uncontaminated and contaminated soils and their concentrations in soil fractions and earthworms were used for this purpose. The bioavailability of heavy metals assessed by earthworms did not always match the availability defined by soil fractionation. Earthworms were a good indicator to assess the bioavailability of Pb and Sb in soil, while due to physiological mechanisms of regulation and excretion, Cd, Cu and Zn tissue levels in these invertebrates gave misleading estimates of their bioavailable pool. No relationship was identified between chemical and biological availability for the geogenic heavy metals, characterized by a narrow range of total contents in soil. The study highlighted that chemical and biological methods should be combined to provide more complete information about heavy element bioavailability in soils.

  7. A Content Analysis on the Recognition of the Educational Ministry of the Holy Spirit in Christian Education Textbooks

    ERIC Educational Resources Information Center

    Lindsay, Larry A., II

    2013-01-01

    The ultimate goal of Christian education is spiritual formation, which requires transforming the minds of believers. However, since man's mind is impacted by sin, the work of the Holy Spirit is necessary to transform those minds. Since the Holy Spirit and Christian educators are striving for the same goal, one can state that the Holy Spirit has an…

  8. A simple procedure with nail preservation for ingrowing toe-nails.

    PubMed Central

    Tweedie, J H; Ranger, I

    1985-01-01

    The numerous methods used for treating ingrowing toe-nails are testimony to the lack of a generally acceptable procedure with a low failure rate. A simple procedure with nail preservation is described, and the results of treatment assessed. The procedure consists of making a transposition flap of the nail wall after preliminary curettage of the granulation tissue in the nail groove. A total of 82 patients were treated by this method over a 3-year period, and the results in 63 patients were assessed between 18 months and 3 years after surgery. A total of 120 operations were carried out and 110 (92%) were successful. The treatment is effective, well tolerated, not technically difficult, and should be considered as an alternative to current methods of treatment. Images Fig. 3 PMID:4052211

  9. The effect of nail polish and acrylic nails on pulse oximetry reading using the Lifebox oximeter in Nigeria.

    PubMed

    Desalu, I; Diakparomre, O I; Salami, A O; Abiola, A O

    2013-12-01

    AIMS AND OBJECTIVES - Pulse oximetry is mandatory during anaesthesia, sedation and transfer of critically ill patients. The effect of nail polish and acrylic nails on the accuracy of saturation reading is inconsistent. The Lifebox pulse oximeter is reliable and recommended for low and middle income countries. We investigated its accuracy in the presence of 4 nail colours and acrylic nails SUBJECTS AND METHODS Fifty non-smoking volunteers had their fingers numbered from right to left (little finger of right hand =1 and little finger of left hand =10). Alternate fingers were nails painted with clear, red, brown and black nail polish and the 5th finger had acrylic nail applied. The corresponding finger on the other hand acted as control. The oxygen saturation was determined using the Lifebox pulse oximeter. Results All fingers (100%) with clear nail polish, red nail polish and acrylic nails recorded a saturation value. Each of the mean saturation value for clear nail polish, red nail polish and acrylic nails was not significantly different from the control mean (p= 0.378, 0.427 and 0.921). Only 12% and 64% of nails polished black and brown respectively recorded a saturation value. The mean SpO- for black and brown polish were significantly different from their control mean (p<0.001). CONCLUSION Black and brown polish resulted in a significant decrease in SpO with the Lifebox oximeter. Dark coloured nail polish should be removed prior to SpO2 determination to ensure that accurate readings can be obtained.

  10. In vitro human nail penetration and kinetics of panthenol.

    PubMed

    Hui, X; Hornby, S B; Wester, R C; Barbadillo, S; Appa, Y; Maibach, H

    2007-08-01

    The in vitro absorption of panthenol into and through the human nail was examined in this study. Panthenol, the alcohol form of pantothenic acid (vitamin B5), is believed to act as a humectant and improve the flexibility and strength of nails. A liquid nail treatment formulated with panthenol (2%) was compared to a solution of panthenol (2%) in water. Fingernail specimens were dosed daily for 7 days with either the nail treatment (non-lacquer film forming) formulation or aqueous solution with sampling performed every 24 h. Panthenol concentrations were determined in the dorsal surface, interior (by drilling and removal) and in the supporting bed under the human nail. Panthenol levels in the dorsal nail (R(2) = 0.87; P < 0.001), nail interior (R(2) = 0.94; P < 0.001) and nail supporting bed (R(2) = 0.79; P < 0.003) showed a significant linear increase with each day of dosing. Significantly more panthenol was delivered into the interior nail and supporting bed by a nail treatment formulation than from an aqueous solution. The film acts not only as a reservoir of panthenol, but also acts to increase the hydration of the nail and the thermodynamic activity of panthenol as well, thereby enhancing diffusion.

  11. 1st meeting on topical drug delivery to the nail.

    PubMed

    Murdan, Sudaxshina

    2007-07-01

    The first ever symposium dedicated solely to drug delivery to the nail following topical application was held on the 2nd April 2007, in London, UK, organised by Dr Clive Roper (Charles River Laboratories, Scotland) and Dr Sudaxshina Murdan (School of Pharmacy, University of London, UK), under the auspices of Skin Forum. The 1-day meeting was attended by approximately 35 delegates from industry, academia and hospitals, and provided a much-needed forum for the presentation and discussion of research and problems in this emerging field. Topical drug delivery is especially suitable for onychomycosis (fungal infections of the nail plate and/or nail bed) and nail psoriasis, which affect 2 - 13 and 1 - 3% of the general population, respectively, and make up the bulk of nail disorders. Topical therapy would avoid the adverse events and drug interactions of systemic antifungal agents and the pain of injection when antipsoriatic agents are injected into affected nail folds. However, successful topical therapy is extremely challenging due to the very low permeability of the nail plate. Five speakers spoke about various aspects of topical drug delivery to the nail, including review of the nail plate structure, function, diseases, their existing therapies (systemic and topical), limitations and global sales. The need for effective topical drug delivery to the nail to overcome the problems associated with present treatment, and the fact that there are few topical formulations available for the treatment of nail fungal infections and psoriasis, and the even fewer effective formulations, was highlighted.

  12. Onychomycosis: Potential of Nail Lacquers in Transungual Delivery of Antifungals

    PubMed Central

    Sharma, Hemlata; Pathak, Kamla

    2016-01-01

    Onychomycosis constitutes the most common fungal infection of the nail (skin beneath the nail bed) that affects the finger as well as toe nails. It is an infection that is initiated by yeasts, dermatophytes, and nondermatophyte molds. Nail lacquers are topical solutions intended only for use on fingernails as well as toenails and have been found to be useful in the treatment of onychomycosis. Thus, in the present review an attempt has been made to focus on the treatment aspects of onychomycosis and the ungual delivery of antifungals via nail lacquer. Several patents issued on nail lacquer till date have also been discussed. Penetration efficiency was assessed by several researchers across the human nail plate to investigate the potentiality of nail lacquer based formulations. Various clinical trials have also been conducted in order to evaluate the safety and efficacy of nail lacquers in delivering antifungal agents. Thus, it can be concluded that nail lacquer based preparations are efficacious and stable formulations. These possess tremendous potential for clinical topical application to the nail bed in the treatment of onychomycosis. PMID:27123362

  13. Matrix based system of isotretinoin as nail lacquer to enhance transungal delivery across human nail plate.

    PubMed

    Joshi, Monika; Sharma, Vijay; Pathak, Kamla

    2015-01-15

    The project was aimed at development of isotretinoin nail lacquer and assessment of its penetration efficiency across human nail plate. Preliminary studies (hydration enhancement factor and SEM) aided the selection of thioglycolic acid as permeation and eugenol was selected as local anesthetic in the formulation. The nail lacquer was optimized by 3(2) factorial design and a total of nine formulations were prepared and screened. In vitro adhesion and ex vivo permeation (cumulative drug permeation per unit area (CDP/A) = 6.61 ± 0.57 mg/cm(2)) across bovine hoof guided the selection of F3 as optimized formulation that was improvised. Viscosity adjustments to improve handling characteristics were affected by incorporation of ethyl cellulose (6%; F3M1) that scaled the viscosity to 312.681 cp and insignificantly (p > 0.05) affected CDP/A (6.32 ± 0.45 mg/cm(2)). In comparison to marketed preparation (Retino-A cream) F3M1 afforded two fold increase in CDP/A. The permeation characteristics were defined by Higuchi model (r(2) = 0.964) and flux value of 176 μg/cm(2)/h. Confocal laser scanning microscopy, after 72 h of nail lacquer application, revealed extensive distribution of the fluorescent tracer across the human nail plate in comparison to control that was confined to the top layer. Conclusively, an efficacious and stable nail lacquer of isotretinoin was developed for potential clinical topical use to target the drug to nail bed in treatment of nail psoriasis.

  14. Treatment of Nail Psoriasis: Common Concepts and New Trends

    PubMed Central

    Oram, Yasemin; Akkaya, A. Deniz

    2013-01-01

    The lifetime incidence of nail involvement in psoriatic patients is estimated to be 80–90%, and the nails can be affected in 10% to 55% of psoriatic patients. Psoriasis may also solely involve the nails, without any other skin findings, in which the treatment can be more challenging. Nail psoriasis may lead to considerable impairment in quality of life due to aesthetic concerns and more importantly limitations in daily activities resulting from the associated pain, which may be overlooked by the physicians. Several topical and systemic treatment modalities, as well as radiation and light systems, have been used in the treatment of nail psoriasis. In the last decade, the introduction of biologic agents and the utilization of laser systems have brought a new insight into the treatment of nail psoriasis. This paper focuses on the recent advances, as well as the conventional methods, in treating nail psoriasis in adults and children, in reference to an extensive literature search. PMID:23762032

  15. Twenty-Nail Dystrophy and Darier's (Darier-White) Disease.

    PubMed

    Sehgal, Virendra N; Chatterjee, Kingshuk; Chaudhuri, Anita; Verma, Prashant; Sharma, Sonal

    2015-01-01

    A 35-year-old married man presented with progressive distortion of all the nails of the hands and toes for the past 30 years. Initially, his parents noticed yellowish discoloration and roughness of the thumb nail at the age of 5 years. Since then, the changes have been insidious to involve the other nails. Currently, the nails are lusterless, rough, ridged, and difficult to trim. In addition, the patient has had dark, dirty-looking raised eruptions over the skin, attended by generalized itching, corresponding to the onset of the nail lesions. His mother experienced similar disease. Examination of the nails was marked by alternating elevation and depression (ridging) and/or pitting, lack of luster, roughening, sandpaper texture, and splitting, along with muddy, grayish white discoloration. Dystrophy of the nails was prominent. The changes were bilateral and symmetrical, affecting all 10 fingers and 10 toes (Figure 1).

  16. Non-Melanoma-Associated Dyschromia of the Proximal Nail Fold

    PubMed Central

    Cohen, Philip R

    2016-01-01

    Subungual melanoma with pigmentation beneath the nail that extends to involve the proximal nail fold is referred to as Hutchinson’s sign. Black or brown subungual discoloration involving the proximal nail fold secondary to other etiologies has been referred to as pseudo-Hutchinson’s sign. Three patients with nail discoloration and concurrent dyschromia of the proximal nail fold are described: a female with a chronic subungual hematoma and pseudo-Hutchinson’s sign, a male with culture-confirmed Pseudomonas aeruginosa (P. aeruginosa) of the nail with green discoloration involving the proximal nail fold, and a male with an acute subungual hematoma with red-purple subungual discoloration affecting the proximal nail fold. PubMed was searched for the following: black, brown, chloronychia, discoloration, dyschromia, green, hematoma, Hutchinson’s sign, nail, nail fold, proximal, pseudo-Hutchinson’s sign, red, subungual melanoma, syndrome. The papers were reviewed and appropriate references evaluated. In conclusion, melanoma-associated black proximal nail fold pigmentation is referred to as Hutchinson’s sign, and non-melanoma-associated black pigmentation has been designated as pseudo-Hutchinson’s sign. Subungual nail plate discoloration extending to involve the proximal nail fold may be black, green, or red-purple in patients with melanocytic and non-melanocytic lesions, bacterial infection (Pseudomonas), and acute subungual hematoma, respectively. Instead of creating a new terminology, we suggest that non-black subungual discoloration (green or red-purple) extending to involve the proximal nail fold be referred to as pseudo pseudo-Hutchinson’s sign. PMID:28090415

  17. A Clinical Study of 35 Cases of Pincer Nails

    PubMed Central

    Lee, Jae In; Lee, Young Bok; Oh, Shin Tack; Cho, Baik Kee

    2011-01-01

    Background Pincer nail is a nail deformity characterized by transverse overcurvature of the nail plate. Pincer nail can affect a patient's quality of life due to its chronic, recurrent course; however, there have been no clinical studies on the pincer nail condition in Korean patients. Objective The purpose of this study was to characterize the clinical findings and treatment of pincer nail. In addition, possible etiological factors were considered, and treatment efficacy was evaluated. Methods The medical records and clinical photographs of 35 patients (12 males, 23 females) who were diagnosed with pincer nail between August 1, 2005 and July 31, 2009 were studied. Results Patient age ranged from 10 to 77 (52.09±17.26) years, and there was a predominance of female (23 out of 35 patients, F:M=2:1). The mean duration of the disorder was 7.45 years (range 0.25~40); 85% had pincer nail for at least 1 year. In addition, 40% had a history of previous treatment and recurrence. There were 82.8% patients with the common type of pincer nails. The most commonly involved nails were both great toenails. Among 35 patients, nail grinding was started in 30 patients, and 25 patients showed clinical improvement with nail grinding. The width index increased and the height index decreased after treatment. The mean follow up period was 8.42 months (range 1~27), and 7 patients showed recurrence after 8.8 months (range 2~20). Among 35 patients, 5 patients were treated with nail extraction with matricectomy, and the symptoms resolved immediately. The mean follow up period was 7.6 months (range 0~19), and recurrence was not observed. Onychomycosis was also present in 37.1% of patients, and itraconazole pulse therapy for 3 months was added. Conclusion The results of this study demonstrate the clinical features of pincer nail in Korean patients. The findings show that the common type of pincer nail was most common, and nail grinding as a conservative treatment greatly improved pincer nails

  18. Short-term isotretinoin-induced elkonyxis and median nail dystrophy.

    PubMed

    Alli, Nuran; Dogan, Sibel

    2016-03-01

    Elkonyxis and median nail distrophy are very rare nail fold disorders due to the damage in nail matrix and proximal nail fold. Herein, we report a patient with both elkonyxis and median nail distrophy occured two months into a treatment course of isotretinoin that is to our knowledge for the first time.

  19. [Three cases of removal of intrabronchial metal nails].

    PubMed

    Nohara, Jun; Lee, Synnum; Noguchi, Tetsuo; Sakaguchi, Yasuto; Kono, Tomoya; Terada, Yasuji

    2009-12-01

    We describe the successful extraction from an airway of foreign bodies metal nails in three cases. They were all carpenters, and often held nails between their lips. Case 1: a 72-year-old man had aspirated a nail three months earlier, but did not seek medical assistance at the time. A chest X-ray film and CT examination revealed a nail in the peripheral S7 region of the right lower lobe. The nail could not be extracted with forceps via bronchoscopy, so video-assisted thoracic surgery was performed. During surgery, the nail moved to the truncus intermedius, then it was extracted using bronchoscopy forceps. The extracted nail was rust-proof, and no rust was observed. Case 2 : a 76-year-old man visited our hospital with a history bloody sputum with a slightly dry cough for two months. A chest X-ray film showed a nail in the right hilum. Bronchoscopy revealed the nail covered with mucinous secretion in the right B7, and it was extracted by forceps. It was a rust-proof type nail, and no granulation tissue was observed in the bronchus. Case 3: a 74-year-old man visited our hospital because of dry cough for two months. A chest X-ray revealed a nail in the right hilus and bronchoscopy showed the nail was buried in reactive granulation tissue in the right middle lobe bronchus and could not be observed from the surface. Tranilast (n-[3,4-dimethoxycinnamoyl] anthranilic acid) at 300 mg/day and Methylprednisolone at 250 mg/day were prescribed for 4 days, followed by a reduction of the corticosteroid to 40 mg/day for 3 days. Seven days later, the granulation tissue and mucosal edema had diminished, and the nail was successfully extracted. The extracted nail was not rust-proof and had swollen with rust. These nails were found a few months after aspiration. The reason why these were not defected was possibly that the long and narrow shape did not obstruct the segmental bronchus and the symptoms can be less severe compared with other foreign bodies. The rust-proof nails were

  20. [Biomechanical analysis of the medullary bone nail and its locking].

    PubMed

    Teubner, E

    1985-07-01

    By mechanical definition an intramedullary nail is not a nail but rather a bendable feather, subject to longitudinal tension and to a lesser degree to transverse pressure. Reaming the medullary canal is necessary for centralization of the nail as well as to increase the area of contact with the bone. However, this procedure is detrimental to the bone metabolism and reduces its elasticity against torsional forces. The dynamic locking nail-system is more biologic than conventional nailing and it reduces rotatory instability with the help of additional components, such as transverse screws. Only static locking allows true static weight bearing with crutches, but not dynamic mobilisation. Nails with conventional strength and in leaf of trefoil formation are superior to other designs. However, an improved angle in the proximal locking is suggested, as this would allow for a three to four times greater weight bearing.

  1. New developments in magnetic resonance imaging of the nail unit.

    PubMed

    Soscia, Ernesto; Sirignano, Cesare; Catalano, Onofrio; Atteno, Mariangela; Costa, Luisa; Caso, Francesco; Peluso, Rosario; Bruner, Vincenzo; Aquino, Maria Maddalena; Del Puente, Antonio; Salvatore, Marco; Scarpa, Raffaele

    2012-07-01

    The evolution of dedicated magnetic resonance imaging (MRI) musculoskeletal equipment allows new sequences and better images of the nail unit. The use of MRI has modified the imaging strategies used in treating inflammatory arthritis. In the case of psoriatic arthritis (PsA), the MRI study of the nail unit identifies nail involvement, which appears as an initial lesion for the induction of distal phalanx damage and consequently of distal interphalangeal joint arthritis. All patients with psoriasis, even in the absence of a clinically evident onychopathy, show characteristic MRI changes in the nail. This evidence could have a practical diagnostic value, because MRI study of the nail could document diagnosis in patients with undifferentiated spondyloarthropathies who have a barely evident psoriasis. We discuss the advantages and problems related to the use of low-field and high-field MRI in the study of the nail unit of patients with PsA.

  2. Computational comparison of reamed versus unreamed intramedullary tibial nails.

    PubMed

    Gómez-Benito, María José; Fornells, Pere; García-Aznar, José Manuel; Seral, Belén; Seral-Iñnigo, Fernando; Doblaré, Manuel

    2007-02-01

    We compared, via a computational model, the biomechanical performance of reamed versus unreamed intramedullary tibial nails to treat fractures in three different locations: proximal, mid-diaphyseal, and distal. Two finite element models were analyzed for the two nail types and the three kinds of fractures. Several biomechanical variables were determined: interfragmentary strains in the fracture site, von Mises stresses in nails and bolts, and strain distributions in the tibia and fibula. Although good mechanical stabilization was achieved in all the simulated fractures, the best results were obtained in the proximal fracture for the unreamed nail and in the mid-diaphyseal and distal fractures for the reamed nail. The interlocking bolts, in general, were subjected to higher stresses in the unreamed tibial nail than in the reamed one; thus the former stabilization technique is more likely to fail due to fatigue.

  3. Msx2 and Foxn1 regulate nail homeostasis.

    PubMed

    Cai, Jing; Ma, Liang

    2011-06-01

    Epithelial-mesenchymal interactions underlie the foundation for ectodermal appendage formation. Signal molecules such as BMPs and WNTs mediate crosstalk between the two tissue layers and coordinate both the induction and morphogenesis of ectodermal appendages. Here, we analyzed the function of two BMP downstream transcription factors, Msx2 and Foxn1, in nail differentiation. First, we show that Msx2 function is required during onychocyte (nail cell) terminal differentiation. Second, the Msx2/Foxn1/hair keratin pathway controlling hair differentiation is also conserved during onychocyte differentiation. Finally, the Msx2-/-; Foxn1-/- double-mutant nails exhibit a more severe phenotype than either single mutant including nail bed hyperplasia. Together, our data implicate important functions for Msx2 and Foxn1 in regulating differentiation of the keratogenous zone, proliferation of distal nail matrix cells, and organization of the nail bed.

  4. Relapse of Yellow Nail Syndrome with Pulmonary Lymphedema.

    PubMed

    Morimoto, Kozo; Saraya, Takeshi; Kurosaki, Atsuko; Yano, Ryozo; Sasaki, Yuka; Osawa, Takeshi; Kudoh, Shoji; Goto, Hajime

    2016-01-01

    Yellow nail syndrome (YNS) is a rare disorder characterized by the triad of yellow, thickened nails, lymphedema, and respiratory manifestations such as pleural effusions, bronchiectasis, and recurrent lower respiratory tract infections. We report a case of YNS showing pulmonary interlobular septal thickening on thoracic computed tomography, implying the presence of lymphatic edema. The patient showed both the remission and relapse of yellow nail with different lung treatments over a long clinical course.

  5. Retrograde tibial nail: anatomical implantation and surgical feasibility study.

    PubMed

    Kuhn, S; Appelmann, P; Pairon, P; Gruszka, D; Rommens, P M

    2015-01-01

    PURPOSE OF THE STUDY The treatment of distal tibial fractures requires a stable fixation while minimizing the secondary trauma to the soft tissues by the surgical approach and implant. The experimental Retrograde Tibial Nail is currently investigated as a minimally invasive alternative to plating and antegrade nailing. The purpose of this study was to evaluate the surgical feasibility in a cadaver model for all distal tibial fracture types generally considered treatable by nailing. MATERIAL AND METHODS Five different fracture types (AO/OTA 43-A1/A2/A3 and 43-C1/C2) were created on separate cadaveric limbs. In simple fractures (AO/OTA 43-A1/A2/A3) primary nailing was performed. In intraarticular fractures (AO/OTA 43-C1/2) reduction of the articular block and lag screw fixation was performed before nailing. Intraoperative complications, quality of reduction, fluoroscopy duration and operative time were evaluated. RESULTS Retrograde intramedullary nailing is feasible in simple fracture types by closed manual reduction and percutaneous reduction forceps. Retrograde nailing is possible in fractures with simple intraarticular involvement after primary lag screw fixation. The duration of surgery averaged 51.8 minutes (range 40-62 min). No major complications occurred during nailing. CONCLUSIONS The minimally invasive retrograde nail combines a minimally invasive local osteosynthesis with the ability to adequately fix extraarticular and simple intraarticular distal tibial fractures. The results suggests that retrograde tibia nailing is a promising new concept for the treatment of distal tibia fractures. Key words: minimally invasive surgery, tibia, metaphyseal fractures, intramedullary nailing, retrograde nailing.

  6. OSTEOSYNTHESIS WITH INTRAMEDULLARY NAILS IN CHILDREN

    PubMed Central

    Alvachian Fernandes, Helio Jorge; Saad, Eduardo Abdalla; Reis, Fernando Baldy dos

    2015-01-01

    The authors present a comprehensive review of the literature emphasizing the use of flexible intramedullary nails in the treatment of fractures in children, focusing the treatment of femoral shaft and forearm fractures and emphasizing the importance of the non-surgical approach. Children's age and weight threshold are not well defined for the use of the method. The removal of implants is a controversial matter in the literature, with a trend towards keeping the implants. PMID:27004183

  7. OSTEOSYNTHESIS WITH INTRAMEDULLARY NAILS IN CHILDREN.

    PubMed

    Alvachian Fernandes, Helio Jorge; Saad, Eduardo Abdalla; Reis, Fernando Baldy Dos

    2009-01-01

    The authors present a comprehensive review of the literature emphasizing the use of flexible intramedullary nails in the treatment of fractures in children, focusing the treatment of femoral shaft and forearm fractures and emphasizing the importance of the non-surgical approach. Children's age and weight threshold are not well defined for the use of the method. The removal of implants is a controversial matter in the literature, with a trend towards keeping the implants.

  8. Art, Technology, and the Holy: Reflections on the Work of J. M. W. Turner

    ERIC Educational Resources Information Center

    Murray, Michael

    1974-01-01

    The following reflections focus on one of the late works by Turner, Rain, Steam, and Speed: The Great Western Railway (1844), and its possible bearing on the three-fold theme of art, technology, and the holy. (Author)

  9. Bilateral periorbital necrotizing fasciitis following exposure to Holi colors: A case report

    PubMed Central

    Arora, Ritu; Das, Sima; Shroff, Daraius; Narula, Ritesh

    2007-01-01

    Holi festival is celebrated in India traditionally by applying colors on one another. Various ocular adverse effects of these colors have been reported including conjunctivitis and corneal abrasion. We report a case of bilateral periorbital necrotizing fasciitis, following exposure to Holi colors. General physicians might encounter more such cases after exposure to Holi colors. In India, these colors are prepared on a small scale and lack any quality checks. Use of such toxic colors should be discouraged, and all doctors should caution people against using synthetic dyes. This case report highlights the need to put manufacturing of Holi colors under guidelines of the Food and Drug Cosmetic Act and the Bureau of Indian Standards. PMID:17699947

  10. Prophylactic intramedullary nailing in monostotic fibrous dysplasia.

    PubMed

    Demiralp, Bahtiyar; Ozturk, Cagatay; Ozturan, Kutay; Sanisoglu, Yavuz S; Cicek, Ilker E; Erler, Kaan

    2008-06-01

    Fibrous dysplasia of bone is an enigma with no known cure. Treatment currently consists of curettage and bone-grafting in an attempt to eradicate the lesion and to prevent progressive deformity. This study presents the results of prophylactic intramedullary nailing in 10 patients with monostotic fibrous dysplasia, pain increasing with movement, and scintigraphically established activity. Ten patients with monostotic fibrous dysplasia in their upper or lower extremities treated between 2001 and 2003 were included in the study. Seven patients were male and 3 were female; their mean age was 26.9 years. The mean duration of follow-up was 33.5 months. Closed intramedullary nail without reaming was used in all cases. Bone grafting was not performed. Patients were allowed full weight bearing on the affected extremities on the second postoperative day. Mean VAS for functional pain was 5.33 +/- 0.65 preoperatively and 2.26 +/- 0.57 at final follow-up (p < 0.05). Radiographs showed no changes in lesion size, and the intramedullary fixation appeared to be stable. Prophylactic intramedullary nailing appeared to be beneficial in monostotic fibrous dysplasia with scintigraphically proven activity and functional pain. It also avoids problems that may occur following pathological fracture.

  11. Interlocking Intramedullary Nails in Fracture Treatment.

    PubMed

    Ouyang, Xiao; Wang, Jing Rong; Hong, Shi Dong; Xin, Feng; Wang, Lin; Yang, Xiao Wei; Wang, Jian

    2015-09-01

    The aim of this study is to evaluate interlocking intramedullary nails in the treatment of fractures. We retrospectively reviewed 68 adult patients (for a total of 95 fractures) with isolated long-bone fractures who were treated with interlocking intramedullary nails between January 2010 and January 2012. The patients were followed for 18 months to observe the healing of the fracture, time, and the occurrence of complications in the shoulder, knee, and hip joint functions. After about a follow-up period of 26.2 months (range 18-39 months), all cases obtained bony union. The mean time to fracture union was 5.2 months. Cases of knees and hip joint functions of the femoral or tibial fracture and shoulder functions of the humeral fractures were observed. The interlocking intramedullary nails may be considered as an alternative method for isolated diaphyseal fractures of the extremities. The advantages of this method include small operative scars, reliable fixations, better fracture healings, and fewer complications.

  12. Radiographic findings in the nail-patella syndrome

    PubMed Central

    Louis, Thomas H.

    2015-01-01

    Nail-patella syndrome is a rare disorder characterized classically by the tetrad of nail hypoplasia or aplasia, aplastic or hypoplastic patellae, elbow dysplasia, and the presence of iliac horns. Iliac horns are considered pathognomonic, and the presence of hypoplastic or aplastic patellae in conjunction with nail abnormalities is a cardinal feature of diagnosis. Elbow dysplasia is present in most cases and can exhibit features typical of the syndrome. Herein we present the radiographic findings of the elbows, knees, and pelvis of a woman with nail-patella syndrome. PMID:26130880

  13. Optimization of intramedullary nailing by numerical simulation of fracture healing.

    PubMed

    Wehner, Tim; Claes, Lutz; Ignatius, Anita; Simon, Ulrich

    2012-04-01

    Due to the annular gap between intramedullary (IM) nails and the endosteal surface, high interfragmentary movement can occur under loading. This could prolong the healing time, particularly for thin IM nails that are often used for unreamed IM nailing. The aims of our study were to determine the influence of the nail diameter on the healing time of human tibial shaft fractures and to investigate whether the healing time could be shortened by increasing the stiffness of the implant material. Therefore, a corroborated numerical model for simulating the fracture healing process in humans was used to simulate the healing process of human tibial fractures treated with IM nails. The calculated healing time (up to 71 weeks) was longest for transverse fractures treated with thin IM nails made of titanium. That the healing time was disproportionately long depended on the nail diameter, and could be greatly reduced by using a thicker nail or using steel instead of titanium. To avoid a prolonged healing time, the nail should be thick, and the annular gap should be as narrow as possible. Alternatively, using steel instead of titanium may also help to avoid a prolonged healing time.

  14. Yellow nail syndrome: does protein leakage play a role?

    PubMed

    D'Alessandro, A; Muzi, G; Monaco, A; Filiberto, S; Barboni, A; Abbritti, G

    2001-01-01

    Yellow nail syndrome is characterized by primary lymphoedema, recurrent pleural effusion and yellow discoloration of the nails. Although mechanical lymphatic obstruction is assumed to be the underlying pathology, it cannot explain the common finding of high albumin concentration in the pleural space. This paper describes a case of yellow nail syndrome presenting with the classical triad of lymphoedema, recurrent pleural effusion and yellow discoloration of the nails, associated with persistent hypoalbuminaemia and increased enteric loss of albumin. Based on the findings in this case and those in the literature, it is speculated that increased microvascular permeability may contribute to the pathogenesis of this syndrome.

  15. Insights into drug delivery across the nail plate barrier.

    PubMed

    Saner, Manish V; Kulkarni, Abhijeet D; Pardeshi, Chandrakantsing V

    2014-11-01

    Topical therapy is at the forefront in treating nail ailments (especially onychomycosis and nail psoriasis) due to its local effects, which circumvents systemic adverse events, improves patient compliance and reduces treatment cost. However, the success of topical therapy has been hindered due to poor penetration of topical therapeutics across densely keratinized nail plate barrier. For effective topical therapy across nail plate, ungual drug permeation must be enhanced. Present review is designed to provide an insight into prime aspects of transungual drug delivery viz. nail structure and physiology, various onychopathies, techniques of nail permeation enhancement and in vitro models for trans-nail drug permeation studies. Updated list of drug molecules studied across the nail plate and key commercial products have been furnished with sufficient depth. Patents pertinent to, and current clinical status of transungual drug delivery have also been comprehensively reviewed. This is the first systematic critique encompassing the detailed aspects of transungual drug delivery. In our opinion, transungual drug delivery is a promising avenue for researchers to develop novel formulations, augmenting pharmaceutical industries to commercialize the products for nail disorders.

  16. Allergic contact dermatitis from acrylic nails in a flamenco guitarist.

    PubMed

    Alcántara-Nicolás, F A; Pastor-Nieto, M A; Sánchez-Herreros, C; Pérez-Mesonero, R; Melgar-Molero, V; Ballano, A; De-Eusebio, E

    2016-12-01

    Acrylates are molecules that are well known for their strong sensitizing properties. Historically, many beauticians and individuals using store-bought artificial nail products have developed allergic contact dermatitis from acrylates. More recently, the use of acrylic nails among flamenco guitarists to strengthen their nails has become very popular. A 40-year-old non-atopic male patient working as a flamenco guitarist developed dystrophy, onycholysis and paronychia involving the first four nails of his right hand. The lesions were confined to the fingers where acrylic materials were used in order to strengthen his nails to play the guitar. He noticed improvement whenever he stopped using these materials and intense itching and worsening when he began reusing them. Patch tests were performed and positive results obtained with 2-hydroxyethyl methacrylate (2-HEMA), 2-hydroxyethyl acrylate (2-HEA), ethyleneglycol-dimethacrylate (EGDMA) and 2-hydroxypropyl methacrylate (2-HPMA). The patient was diagnosed with occupational allergic contact dermatitis likely caused by acrylic nails. Artificial nails can contain many kinds of acrylic monomers but most cases of contact dermatitis are induced by 2-HEMA, 2-HPMA and EGDMA. This is the first reported case of occupational allergic contact dermatitis from acrylates in artificial nails in a professional flamenco guitar player. Since the practice of self-applying acrylic nail products is becoming very popular within flamenco musicians, we believe that dermatology and occupational medicine specialists should be made aware of the potentially increasing risk of sensitization from acrylates in this setting.

  17. Drugs in nails: physiology, pharmacokinetics and forensic toxicology.

    PubMed

    Palmeri, A; Pichini, S; Pacifici, R; Zuccaro, P; Lopez, A

    2000-02-01

    In recent years, drug analysis in keratinised matrices, such as hair and nails, has received considerable attention because of several advantages over drug testing methodologies employing body fluids, such as urine or serum. For example, keratinic matrices, such as finger- and toenails, can accumulate drugs during long term exposure. Drugs are incorporated into nails by a double mechanism: (i) deposition into the root of the growing nail via the blood flow in the nail matrix; and (ii) incorporation via the nail bed during growth from the lunula to the beginning of the free margin. Together, these account for a wide retrospective window of drug detection. Nails can provide a good forensic matrix for the detection of drugs of abuse. Indeed, the international literature has reported the use of nail analysis in postmortem detection of drugs of abuse, drug testing in the workplace and drug screening to detect prenatal exposure, even though further studies are needed for correct interpretation of the data obtained. Another application of drug analysis in nails consists of the possibility of detecting the presence of an antimycotic at the site of action during antifungal therapy for patients with onychomycosis. When available, this evidence has permitted drug treatment of a shorter duration and reduced toxicity. However, so far the potential of drug monitoring in nails still lacks harmonisation and validation of analytical methodologies and a better comprehension of the possible correlation between drug concentrations in the matrix and period of exposure.

  18. Holy Jerusalem: The Key to Lasting Peace in the Middle East

    DTIC Science & Technology

    2009-05-01

    their respective religions. The desire to control Jerusalem that 6 Joshua, Saladin and King Richard I displayed still pertains to and materially...less than a century. In 1187, Saladin successfully reclaimed Jerusalem from Christianity. 69 Christians would retain a foothold in the holy land in...own holy war to reclaim it. 89 His nephew, Saladin , succeeded him after another bloody civil war and in 1187 entered Jerusalem as its conqueror

  19. Nutritional Concepts and Frequency of Foodstuffs Mentioned in the Holy Quran.

    PubMed

    Tarighat-Esfanjani, Ali; Namazi, Nazli

    2016-06-01

    The Holy Quran is a religious book of Muslims. In many verses of Quran, various foods are discussed. It seems that limited studies were performed on identification the nutritional verses and their frequencies in the Holy Quran. Therefore, the aims of present study were to establish a numerical model system for studying nutritional verses of Quran, determination of verses with nutritional concepts and frequency of foodstuffs in the Holy Quran. In this descriptive analytical study, "Ghamoos e Quran" and "Vazheyab" online softwares were used to determine the nutritional keywords in Quran. For searching, translating, and interpretation of verses, "Noor-e-Jami Tafasir version 2.1"; "Zekr" and "Pars Quran"softwares were applied. Sixty-four nutritional keywords and 257 nutritional verses were identified. Findings indicated that aliment/foods, eating, water/drinking words, and their derivatives are repeated 171, 109, and 131 times in the Holy Quran, respectively. According to the Holy Quran, except Haram foods (pork meat, wine, carrion meat, blood, and meat of animals not slaughtered properly in the Islamic manner), all foods are tayyeb (lawful). The Holy Quran contains many foodstuffs and verses with nutritional concepts and it recommends eating varied and balanced diet.

  20. The antioxidative properties of Holy basil and Galangal in cooked ground pork.

    PubMed

    Juntachote, T; Berghofer, E; Siebenhandl, S; Bauer, F

    2006-03-01

    The ethanolic extracts from Holy basil and Galangal were examined for their extraction yield, total phenolic content, antioxidant activity against a β-carotene-linoleic acid emulsion system, DPPH scavenging activity and reducing power. Ethanolic extracts of Holy basil exhibited higher extraction yield, total phenolic content, antioxidant activity, DPPH scavenging activity and reducing power than ethanolic extracts of Galangal. Antioxidative efficiency to inhibit lipid oxidation of dried Holy basil and dried Galangal powder, ethanolic extracts of Galangal and Holy basil and commercial antioxidant mixture in cooked ground pork was investigated during refrigerated storage at 5°C for 14 days. The quantitative measurements of thiobarbituric acid reactive substances (TBARS), conjugated diene, peroxide value (POV) and hexanal content were used as indicators of lipid oxidation. Increased levels of TBARS value, POV and hexanal content were noticed in all meat samples during storage, however most marked in cooked ground pork without antioxidants, whereas conjugated diene tended to decrease with increasing storage time. Ranking of the treatment in order of their antioxidant effectiveness showed that commercial antioxidant mixture (0.3% citric acid+0.5% ascorbic acid+0.02% α-tocopherol)>dried Galangal powder>dried Holy basil powder>ethanolic extracts of Galangal>ethanolic extracts of Holy basil>control. Furthermore, in cooked ground pork samples a high correlation between TBARS value and hexanal contents was obtained.

  1. Ingrown nails: a comparison of the nail matrix phenolization method with the elevation of the nail bed-periosteal flap procedure.

    PubMed

    Mori, H; Umeda, T; Nishioka, K; Iida, H; Aoki, K; Yokoyama, A

    1998-01-01

    Seventy-five procedures were performed on 62 patients with ingrown nails from 1992 to 1996. Those consisted of 51 nail matrix phenolization methods (NMP) and 24 elevation of the nail bed-periosteal flap procedures (ENF). Ingrown nails were classified into type A (normal nail plate) and type B (incurved nail plate). The duration and intensity of postoperative pain were assessed, and the recurrence rate was monitered. The recurrence rate was 3.9% in the NMP group and 4.1% in the ENF group. Concerning the recurrence rate, there was no statistical significance between ENF and NMP in both types. Postoperative pain intensity was less in the NMP group than in the ENF group in both types (P < 0.01). The same tendency was seen in postoperative pain duration. However, the NMP group had longer duration of wound healing compared with the ENF group in type A (P < 0.01). We conclude that NMP is a recommendable treatment for most ingrown nails.

  2. Recovery of nail dystrophy potential new therapeutic indication of tofacitinib.

    PubMed

    Jaller, Jose A; Jaller, Juan J; Jaller, Antonio M; Jaller-Char, Juan J; Ferreira, Sineida Berbert; Ferreira, Rachel; Scheinberg, Morton

    2017-04-01

    Nail dystrophy is a heterogeneous skin condition and in some subtypes, is associated with autoimmune diseases in particular psoriasis and psoriatic arthritis. In this report, we show that tofacitinib, a novel therapy for rheumatoid arthritis, appears to be beneficial in patients with nail disease refractory to other conventional modes of therapy.

  3. Development of ciclopirox nail lacquer with enhanced permeation and retention.

    PubMed

    Thapa, Raj Kumar; Choi, Ju Yeon; Go, Toe Gyung; Kang, Min Hyung; Han, Sang Duk; Jun, Joon-Ho; Son, Mi Won; Yong, Chul Soon; Kim, Jong Oh

    2016-07-01

    Onychomycosis is a prevailing disease caused by fungal infection of nails that mostly affects athletes and the elderly. Ciclopirox is approved by the US Food and Drug Administration for the topical treatment of onychomycosis. However, the desired penetration of ciclopirox into the nail bed has not been achieved via topical application for efficient treatment. Therefore, the main aim of this study was to enhance ciclopirox permeation and retention in nail by the development of a new nail lacquer formulation. We screened the effects of different solvents, alkalizing agents, and permeation enhancers on the permeation of bovine hooves by ciclopirox and its retention in human nail clippings. The results suggest that isopropyl alcohol, potassium hydroxide, and urea as the solvent, alkalizing agent, and permeation enhancer, respectively, improved the permeation of the ciclopirox nail lacquer formulation the most with high flux rates. Comparison of the final formulation and marketed product revealed enhanced retention of ciclopirox from our developed formulation in human nail clippings. Therefore, our newly developed nail lacquer may be a potentially effective formulation for the treatment of onychomycosis in humans.

  4. Iontophoretically enhanced ciclopirox delivery into and across human nail plate.

    PubMed

    Hao, Jinsong; Smith, Kelly A; Li, S Kevin

    2009-10-01

    Transungual delivery of antifungal drugs is hindered by the low permeability of human nail plates, and as such, repeated dosing over a long period of time is necessary for effective treatment. The objectives of this study were to explore the possibilities of (a) enhancing the delivery of ciclopirox (CIC) across human nail plates and (b) sustaining CIC delivery from the larger resultant drug depot in the nail plates with constant voltage iontophoresis. In vitro passive and 9 V cathodal iontophoretic transport experiments of CIC across human nails were performed. Transungual CIC delivery with Penlac was the control. The amounts of CIC released from and deposited in the nails were determined in drug release and extraction experiments, respectively. Iontophoresis increased the flux of CIC permeated across the nail approximately 10 times compared to passive delivery from the same formulation or from Penlac. A significant amount of CIC was loaded into and released from the nails; the CIC concentrations were estimated to be above the minimum inhibitory concentrations of CIC for dermatophytic molds. The apparent transport lag time decreased in iontophoretic transport. The results demonstrate that iontophoresis was able to deliver an effective amount of CIC into and across the nails, and this suggests the feasibility of a constant voltage battery-powered transungual iontophoretic device.

  5. Do fungi play a role in psoriatic nails?

    PubMed

    Szepietowski, Jacek C; Salomon, Joanna

    2007-11-01

    Onychomycosis is the most common disease of the nails and constitutes about a half of all nail abnormalities. Some factors like increasing age, male sex, repeated nail damage, genetic predispositions and underlying conditions, such as diabetes, immunodeficiency or peripheral arterial disease may predispose to develop onychomycosis. It is also suggested that abnormalities in nail morphology are the predisposing factors to onychomycosis. Psoriasis is one of the most common reasons of disturbed nail morphology and the spectrum of nail changes in psoriasis is very wide. Thus, there were suggestions that dystrophic nails in psoriatic patients lose their natural preventing barrier and therefore are more predisposed to fungal infection. This paper summarizes the knowledge about prevalence of onychomycosis among psoriatic patients and contains a literature review concerning this problem. Most authors report that the prevalence of onychomycosis in psoriatic patients is not higher than that in control population. However, especially yeasts and maybe moulds, probably as concomitant pathogens, are more often isolated from psoriatic patients than from non-psoriatic population. In reasonable cases, the mycological examination is required, especially when the clinical picture of the nails suggests the presence of fungal infection. In these cases, antifungal treatment may be beneficial for psoriatic patients.

  6. An unusual foreign body in urethra: nail clippers.

    PubMed

    Hatipoglu, Namik; Yucel, Mehmet; Hatipoglu, Nebahat; Yentur, Serhat; Semercioz, Attila

    2011-01-01

    A 37-year-old mentally retarded male patient complained of voiding difficulties. Physical examination revealed a foreign body in the urethra. The foreign body was found to be nail clippers and was removed with open surgery. This case of self-inserted nail clippers in the urethra by the patient is the first published report to our knowledge.

  7. Did You Know Biting Your Nails Can Make You Sick?

    MedlinePlus

    ... symptoms of an infection called paronychia include a red, swollen area around the nail. If the infection is bacterial, you may develop pus-filled blisters. Nail biting is bad for your smile. The habit can cause your teeth to shift out of place or cause them to chip ...

  8. Evaluating a county-based Healthy nail Salon Recognition Program

    EPA Science Inventory

    To determine whether nail solons that participate in the SF recognition program have reduced measured levels of toluene, methyl methacrylate (MMA), and total volatile organic compounds (TVOC)as compared to nail salons that do not participate. We also evaluated changes in worker ...

  9. Rosa damascena as holy ancient herb with novel applications

    PubMed Central

    Mahboubi, Mohaddese

    2015-01-01

    Rosa damascena as an ornamental plant is commonly known as “Gole Mohammadi” in Iran. Iranian people have been called this plant, the flower of Prophet “Mohammad”. R. damascena is traditionally used for treatment of abdominal and chest pains, strengthening the heart, menstrual bleeding, digestive problems and constipation. This paper reviews the ethnopharmacology, phytochemistry and pharmaceutical investigations on R. damascena. All relevant databases and local books on ethnopharmacology of R. damascena were probed without limitation up to 31st March 2015 and the results of these studies were collected and reviewed. R. damascena has an important position in Iranian traditional medicine. It is economically a valuable plant with therapeutic applications in modern medicine. The antimicrobial, antioxidant, analgesic, anti-inflammatory, anti-diabetic and anti-depressant properties of R. damascena have been confirmed. Citronellol and geraniol as the main components of R. damascena essential oil are responsible for pharmacological activities. Overall, R. damascena as holy ancient plant with modern pharmacological investigations should be more investigated as traditional uses in large preclinical and clinical studies. PMID:26870673

  10. The continuing quest for the 'Holy Braille' of tactile displays

    NASA Astrophysics Data System (ADS)

    Runyan, Noel H.; Blazie, Deane B.

    2011-10-01

    The Boston-based National Braille Press has established a Center for Braille Innovation (CBI), whose mission is to research and develop affordable braille literacy products. The primary focus has been to facilitate the development of dramatically lower cost electronic braille display devices, and the much-sought-after "Holy Braille" of a full-page electronic braille display. Developing affordable new braille technologies is crucial to improving the extremely low braille literacy rate (around 12%) of blind students. Our CBI team is working to aid developers of braille technology by focusing attention and resources on the development of the underlying braille actuator technologies. We are also developing braille-related information resources to aid braille display developers. The CBI braille requirements summary (available through the NBP website (http://www.nbp.org) is one of these resources. The braille specifications include braille dot dimensions, spacing, displacement, lifting force, and response time requirements. In addition, mentoring, helping to evaluate new braille display ideas, and openly sharing braille display technology are all part of the activities of the NBP braille innovation team. NBP has expanded the CBI project with domestic and international partners including the China Braille Press, World Braille Foundation, National Federation of the Blind, American Printing House for the Blind, American Foundation for the Blind, and many university and research partners.

  11. In Search of the Holy Grail of Antifungal Therapy

    PubMed Central

    Chapman, Stanley W.; Sullivan, Donna C.; Cleary, John D.

    2008-01-01

    The ideal antifungal agent remains an elusive goal for treatment of life-threatening systemic fungal infections. Such an agent would have broad antifungal activity, low rates of resistance, flexible routes of administration, few associated adverse events, and limited drug-drug interactions. Only three of the seven classes of antifungal agents currently available are suitable for treatment of systemic infection: the polyenes, the azoles, and the echinocandins. None match all the characteristics of an ideal agent, the Holy Grail of antifungal therapy. Academia and industry need to collaborate in the search for new lead antifungal compounds using traditional screening methods as well as the new pharmacogenomics methods. Enhancing efficacy and reducing toxicity of the currently available therapeutic agents is also another important avenue of study. As an example, the Mycosis Research Center at the University of Mississippi Medical Center has identified pyogenic polyenes in commercial preparations of amphotericin B deoxycholate which correlate with infusion related toxicities. A highly purified formulation of amphotericin B appears promising, with a better therapeutic index compared to its parent compound as evidenced by results of in vitro and in vivo studies reviewed in this presentation. PMID:18596853

  12. Neonatal pain management: still in search for the Holy Grail.

    PubMed

    Allegaert, Karel; van den Anker, John N

    2016-07-01

    Inadequate pain management but also inappropriate use of analgesics in early infancy has negative effects on neurodevelopmental outcome. As a consequence, neonatal pain management is still in search for the Holy Grail. At best, effective pain management is based on prevention, assessment, and treatment followed by a re-assessment of the pain to determine if additional treatment is still necessary. Unfortunately, epidemiological observations suggest that neonates are undergoing painful procedures very frequently, unveiling the need for effective preventive, non-pharmacological strategies. In addition, assessment is still based on validated, multimodal, but subjective pain assessment tools. Finally, in neonatal intensive care units, there is a shift in clinical practices (e.g., shorter intubation and ventilation), and this necessitates the development and validation of new pharmacological treatment modalities. To illustrate this, a shift in the use of opioids to paracetamol has occurred and short-acting agents (remifentanil, propofol) are more commonly administered to neonates. In addition to these new modalities and as part of a more advanced approach of the developmental pharmacology of analgesics, pharmacogenetics also emerged as a tool for precision medicine in neonates. To assure further improvement of neonatal pain management the integration of pharmacogenetics with the usual covariates like weight, age and/or disease characteristics is needed.

  13. Drug delivery into microneedle-porated nails from nanoparticle reservoirs.

    PubMed

    Chiu, Wing Sin; Belsey, Natalie A; Garrett, Natalie L; Moger, Julian; Price, Gareth J; Delgado-Charro, M Begoña; Guy, Richard H

    2015-12-28

    This study demonstrates the potential of polymeric nanoparticles as drug reservoirs for sustained topical drug delivery into microneedle-treated human nail. Laser scanning confocal microscopy was used to image the delivery of a fluorescent model compound from nanoparticles into the nail. A label-free imaging technique, stimulated Raman scattering microscopy, was applied, in conjunction with two-photon fluorescence imaging, to probe the disposition of nanoparticles and an associated lipophilic 'active' in a microneedle-porated nail. The results provide clear evidence that the nanoparticles function as immobile reservoirs, sequestered on the nail surface and in the microneedle-generated pores, from which the active payload can be released and diffuse laterally into the nail over an extended period of time.

  14. Magnetic resonance imaging of nail unit in psoriatic arthritis.

    PubMed

    Soscia, Ernesto; Scarpa, Raffaele; Cimmino, Marco Amedeo; Atteno, Mariangela; Peluso, Rosario; Sirignano, Cesare; Costa, Luisa; Iervolino, Salvatore; Caso, Francesco; Del Puente, Antonio; Salvatore, Marco; Soricelli, Andrea

    2009-08-01

    The use of magnetic resonance imaging (MRI) has modified the imaging strategies of inflammatory arthritides. In psoriatic arthritis (PsA), MRI study of the nail unit identifies nail involvement that appears as the initial lesion for induction of distal phalanx damage and consequently of distal interphalangeal joint arthritis. All psoriatic patients, also in the absence of a clinically evident onychopathy, show characteristic MRI changes of the nail. This evidence could have practical diagnostic value because MRI study of the nail could document diagnosis in patients with undifferentiated spondyloarthropathies who have barely evident psoriasis. We discuss the advantages and problems related to the use of low- and high-field MRI in the study of the nail unit of patients with PsA.

  15. Expandable intramedullary nails for fixation of tibial shaft fractures.

    PubMed

    Ghafil, Dior; Ackerman, Pieter; Baillon, Renaud; Verdonk, Rene; Delince, Philippe

    2012-12-01

    Interlocking intramedullary nailing is currently the preferred treatment for most tibial fractures requiring operative treatment, with good results and a relatively low complication rate as reported in large clinical series. However, vascular and neurological complications caused by interlocking screws have been reported. In addition, insertion of distal interlocking screws can be technically demanding and may entail substantial exposure. We present the results with an expandable self-locking nail in the management of 52 AO type A and B tibial shaft fractures. The mean time to union was 15.8 weeks and the rate of union was 98%. The average surgical time was 60 minutes. Complications were those usually seen in diaphysis nailing and no complication was noted during nail expansion. Interlocking screws are not necessary, which reduces the risk of iatrogenic lesions. The expandable nail allows effective management of AO type A and B diaphyseal fractures of the tibia, a lower radiation exposure and shorter operative time.

  16. Safe surgical technique: intramedullary nail fixation of tibial shaft fractures.

    PubMed

    Zelle, Boris A; Boni, Guilherme

    2015-01-01

    Statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Establishing an appropriate starting point is a crucial part of the surgical procedure. Recently, suprapatellar nailing in the semi-extended position has been suggested as a safe and effective surgical technique. Numerous reduction techiques are available to achieve an anatomic fracture alignment and the treating surgeon should be familiar with these maneuvers. Open reduction techniques should be considered if anatomic fracture alignment cannot be achieved by closed means. Favorable union rates above 90 % can be achieved by both reamed and unreamed intramedullary nailing. Despite favorable union rates, patients continue to have functional long-term impairments. In particular, anterior knee pain remains a common complaint following intramedullary tibial nailing. Malrotation remains a commonly reported complication after tibial nailing. The effect of postoperative tibial malalignment on the clinical and radiographic outcome requires further investigation.

  17. Onychophagia (Nail biting), anxiety, and malocclusion.

    PubMed

    Sachan, Avesh; Chaturvedi, T P

    2012-01-01

    Nail biting is a stress removing habit adopted by many children and adults. People usually do it when they are nervous, stressed, hungry, or bored. All of these situations are having a common phenomenon between them is anxiety. Onychophagia is also a sign of other emotional or mental disorders. It is a habit that is not easy to quit and reflection of extreme nervousness or inability to handle stressful conditions. This abnormal habit may cause various malocclusions associated with dentoalveolar segment of the oral cavity. Crowding and rotations of incisors are common with this habit.

  18. [Distribution of Luliconazole in Nail Plate by In Vitro Permeation and Efficacy by Zone of Inhibition Test after Treatment of Luliconazole Nail Solution].

    PubMed

    Shimamura, Tsuyoshi; Miyamae, Akiko; Arai, Masakazu; Minemura, Aya; Nozawa, Akira; Kubota, Nobuo

    2016-01-01

    To clarify the character of luliconazole nail solution we have developed, we investigated luliconazole distribution and antifungal activity in nail plate. An in vitro permeation study which measured luliconazole concentration of sliced nail in the transverse direction after treatment of luliconazole nail solution was conducted to investigate for concentration dependency and the influences of nail thickness and treatment duration. When 0.2, 1, 3, 5, and 7.5% luliconazole nail solutions were used, luliconazole was detected in the all the layers of nail and there was a concentration gradient from the dorsal side to deep nail layers. The luliconazole concentration was almost same after 14-day treatment with 5% luliconazole nail solution when using nails of different thicknesses. And we confirmed that concentration of luliconazole into the nail was increased depending on the treatment duration. In zone of inhibition test after 14-day treatment, 5% luliconazole nail solution showed statistically high formation rate of zones of inhibition compared to 8% ciclopirox nail lacquer. Above all, these data suggested that 5% luliconazole nail solution has the potential to show high therapeutic effect for onychomycosis.

  19. Nail DNA and Possible Biomarkers: A Pilot Study

    PubMed Central

    Park, Joshua; Liang, Debbie; Kim, Jung Woo; Luo, Yongjun; Huang, Taesheng; Kim, Soo-Young

    2012-01-01

    Objectives Nail has been a substitute DNA source for genotyping. To investigate the integrity and consistency of nail DNA amplification for biomarker study, nail clippings from 12 subjects were collected at monthly intervals. The possibility of longer amplification and existence of GAPDH RNA/protein, were also investigated with three nail samples. Methods Three primer sets were designed for quantitative amplification of nuclear and mitochondrial genes and analysis of their consistency. The mean threshold cycles in amplification of the target genes were compared to test the consistency of polymerase chain reaction (PCR) performance among individual factors including age groups, sex, family, the nail source, and by the size of the amplification segments. Results The amplification of the target genes from nail DNA showed similar integrity and consistency between the nail sources, and among the serial collections. However, nail DNA from those in their forties showed earlier threshold cycles in amplification than those in their teens or seventies. Mitochondrial DNA (mtDNA) showed better DNA integrity and consistency in amplification of all three targets than did nuclear DNA (nucDNA). Over 9 kb of mtDNA was successfully amplified, and nested quantitative PCR showed reliable copy numbers (%) between the two loci. Reverse transcription PCR for mRNA and immunoblotting for GAPDH protein successfully reflected their corresponding amounts. Regarding the existence of RNA and protein in nails, more effective extraction and detection methods need to be set up to validate the feasibility in biomarker study. Conclusions Nail DNA might be a feasible intra-individual monitoring biomarker. Considering integrity and consistency in target amplification, mtDNA would be a better target for biomarker research than nucDNA. PMID:22880155

  20. Report: pipeline transport of solid waste in the Grand Holy Mosque in Makkah.

    PubMed

    Al-Ghamdi, Abdullah Saeed; Abu-Rizaiza, Asad Seraj

    2003-10-01

    The Grand Holy Mosque, located in the Holy City of Makkah in Saudi Arabia, attracts millions of Muslim visitors from all over the world, especially during the pilgrimage season. The daily amount of refuse generated in the Grand Holy Mosque and surrounding plazas reached a maximum value of 192.8 tons/day in 1998. Collection and transport of the solid waste generated during the peak times present a challenge to the Makkan authorities. The congested streets and high population density in the Holy Mosque and its surrounding plazas make the traditional methods of collecting and transporting solid waste impractical. This paper presents an alternative system for the collection and transport of solid waste generated in and around the Grand Holy Mosque in Makkah. The proposed system is based on a pneumatic transport technique, by which the waste is collected and transported in underground pipelines. A conceptual layout of the proposed system in the Mosque area is presented, and the merits of the suggested system are discussed.

  1. Is there a bone-nail specific entry point? Automated fit quantification of tibial nail designs during the insertion for six different nail entry points.

    PubMed

    Amarathunga, J P; Schuetz, M A; Yarlagadda, K V D; Schmutz, B

    2015-04-01

    Intramedullary nailing is the standard fixation method for displaced diaphyseal fractures of tibia. Selection of the correct nail insertion point is important for axial alignment of bone fragments and to avoid iatrogenic fractures. However, the standard entry point (SEP) may not always optimise the bone-nail fit due to geometric variations of bones. This study aimed to investigate the optimal entry for a given bone-nail pair using the fit quantification software tool previously developed by the authors. The misfit was quantified for 20 bones with two nail designs (ETN and ETN-Proximal Bend) related to the SEP and 5 entry points which were 5 mm and 10 mm away from the SEP. The SEP was the optimal entry point for 50% of the bones used. For the remaining bones, the optimal entry point was located 5 mm away from the SEP, which improved the overall fit by 40% on average. However, entry points 10 mm away from the SEP doubled the misfit. The optimised bone-nail fit can be achieved through the SEP and within the range of a 5 mm radius, except posteriorly. The study results suggest that the optimal entry point should be selected by considering the fit during insertion and not only at the final position.

  2. Nail Biting; Etiology, Consequences and Management

    PubMed Central

    Ghanizadeh, Ahmad

    2011-01-01

    Nail biting (NB) is a common, but unresolved, problem in psychiatry, psychology, medicine and dentistry. While it seems that NB is a simple behavior that can be stopped easily, many of the children with NB have already tried to stop it, but they have not been successful. The frustrations due to failed attempt involve others such as parents and siblings. The present review aims at providing an overview of prevalence, co-morbidities, education and counseling, and management for NB. Overall, the reviewed literatures suggest that co-morbidities of psychiatric disorders and other stereotypic behaviors in clinical sample of children with NB is more than 80%, and more than half of the parents suffer from psychiatric disorders mainly depression. Treatment of NB, however, is not as easy as it seems. The management of NB is much more complicated than just focusing on stopping it. Nail biting cannot be managed without considering its co-morbidities, antecedents and consequences. It might be concluded form the reviewed literature that children with NB, parents, siblings, and teachers should be educated about what to do and what not to do about NB. Punishment is not effective. Moreover, clinical randomized controlled trials are required to make available evidence-based behavioral and pharmacologic treatment protocols. PMID:23358880

  3. Sustainable urban development in Brisbane City--the Holy Grail?

    PubMed

    Rahman, K; Weber, T

    2003-01-01

    Impacts from urban stormwater runoff on receiving environments have been well documented, particularly through specific regional scientific studies. Using various local government planning and management elements, urban developments in Brisbane City are now able to address stormwater management in an increasingly holistic context. One key initiative includes facilitating Water Sensitive Urban Design (WSUD) components within an Integrated Water Management Strategy that looks at policy formation, planning strategies, design option, community marketing and acceptance, maintenance programs and finally evaluation of various WSUD approaches. These can include the use of Natural Channel Designs, grassed swales, bio-filtration systems, porous pavements and roofwater tanks in several economic combinations. By linking with the Cooperative Research Centre for Catchment Hydrology, Brisbane City Council has influenced the design of WSUD planning tools and benefited the city with academic inputs into extensive evaluation programs. As well, it has also contributed to the Cooperative Research Centre's research outcomes. These evaluation programs are increasingly providing better understanding of various stormwater quality best management practices throughout Australia. As part of the overall implementation process, active involvement by a range of stakeholders has been crucial. These stakeholders have included internal planning, development assessment and design staff, external consultants, developers, and other local and state government agencies. The latter two groups are assisting in the important task of "regionalisation" of Brisbane City Council's policies and guidelines. Implementation of WSUD initiatives and stormwater re-use strategies under Council's new "Integrated Water Management" agenda are showing some excellent results, suggesting that sustainable urban development is no longer like the search for the Holy Grail.

  4. Enhancing the nail permeability of topically applied drugs.

    PubMed

    Murdan, Sudaxshina

    2008-11-01

    The topical therapy of nail diseases, especially of onychomycosis, and to a smaller extent, of nail psoriasis, is desirable to avoid the side effects associated with their systemic therapy, to increase patient compliance and reduce the cost of treatment. Systemic therapy is however the mainstay of treatment due to the poor permeability of the nail plate to topically applied drugs. For effective topical therapy, ungual drug permeation must be enhanced. This can be achieved by disrupting the nail plate using physical techniques or chemical agents. Alternatively, drug permeation into the intact nail plate may be encouraged, for example, by iontophoresis or by formulating the drug within a vehicle which enables high drug partition out of the vehicle and into the nail plate. The physical techniques (manual and electrical nail abrasion, acid etching, ablation by lasers, microporation, application of low-frequency ultrasound and electric currents) and chemicals (thiols, sulphites, hydrogen peroxide, urea, water, enzymes) that have shown ungual enhancer activity are discussed in this review. Optimal drug formulation, while crucial to ungual drug delivery, is only briefly reviewed due to the limited literature.

  5. A Technical Note for Extracting an Incarcerated Femoral Kuntscher Nail

    PubMed Central

    Marí, R; Vilamala, D Valverde; García, A León; Guirro, P; López, F Marqués

    2016-01-01

    Introduction: The use of the Kuntscher nail has been the most important advancement in trauma surgery. One of the problems is the difficulty to remove it. A new extraction technique is described in the present case report. Case Report: A 46-year-old man was referred for hip osteoarthritis. He had an acetabulum fracture and a femoral shaft fracture treated 30 years ago with a reamed Kuntscher femoral nail. Lateral hip approach was performed and after attempting to remove the nail with the specific tools being unsuccessful we decided to be more aggressive. Firstly, we performed a simple unicortical osteotomy on the lateral side from the proximal part to below the callus in order to decompress the femoral canal without success. Secondly, a trench in the greater trochanter around the proximal hole was performed to hit the nail from below which was still insufficient and furthermore, the hole broke when hitting the nail so we needed to drill a new hole distally. Finally, the Kuntscher nail was removed. Several cerclages closed the osteotomy and a bone graft was used to close the trench. The patient had a good evolution at one year of follow-up. Conclusion: With this case report, we present a new salvage technique to remove an incarcerated Kuntscher nail when all the described methods have failed. PMID:28116256

  6. Early 20th Century Education in the United States: The Role of the Brothers of Holy Cross

    ERIC Educational Resources Information Center

    Armstrong, Philip C.

    2007-01-01

    The French Revolution bears an ironic responsibility for generating works of charity. To counteract the devastating social effects of that late 18th century uprising, numerous religious communities were founded in France, among them the Congregation of Holy Cross. The Congregation of Holy Cross, the founding religious community behind the…

  7. Ultrasound anatomy of normal nails unit with 18 mhz linear transducer.

    PubMed

    Cecchini, Andrea; Montella, Andrea; Ena, Pasquale; Meloni, Giovanni Battista; Mazzarello, Vittorio

    2009-01-01

    Interest is growing in non-invasive diagnostic methods for nails in dermatological pathology. Currently, nail disease diagnosis is based mostly on clinical evaluation; instrumental examination, traditionally, has been performed by magnetic resonance. Ultrasound (US) can be proposed as an easier and more available method for the study of the nail apparatus. In this study, the nail unit normal ultrasound anatomy was investigated to obtain data on adult normal parameters. On 35 healthy volunteers (20 women and 15 men--average age of 27 years) we performed an ultrasonographic study on the nail plate (dorsal and ventral), nail matrix and nail bed of all fingers of the hands using a 18 MHz linear transducer with Esaote Mylab 50. A thick gel layer allowed for appropriate transmission of ultrasound without any additional device. Macroscopic nail features were studied by clinical examination and photographic analysis. The following ultrasound parameters were investigated: nail thickness; nail bed thickness; matrix lenght; matrix-bone distance. Blood flow was studied with the use of colour and power colour Doppler. The nail apparatus echographic anatomy consists in: (a) nail plate, represented by two hyperechoic bands (dorsal and ventral) with an hypoechoic or anechoic space between them; (b) nail bed, represented by an area of dys-homogeneous hypo-echogeneity; (c) nail matrix, represented by a markedly hypoechoic area corresponding to the region under the nail sulcus; (d) ligaments, sometimes well detectable and formed by a specialized connective tissue; and (e) vessels, well evaluable through doppler examination.

  8. Antifungal activity, experimental infections and nail permeation of an innovative ciclopirox nail lacquer based on a water-soluble biopolymer.

    PubMed

    Togni, Giuseppe; Mailland, Federico

    2010-05-01

    P-3051 is an innovative 8% ciclopirox nail lacquer, based on hydroxypropyl chitosan (HPCH) as a film-forming agent. The authors' aim was to investigate P-3051's in vitro antifungal activity, as well as its in vitro and in vivo nail permeation. The dilution susceptibility tests performed for Trichophyton rubrum (T. rubrum) and Candida parapsilosis (C. parapsilosis) showed that the minimum inhibitory concentrations (MICs) of P-3051, as percent of ciclopirox, was for both fungi < or = 0.0015% (equivalent to a concentration of 15.6 mg/ ml). In the biological assay of in vitro nail permeation and fungal inhibition, the authors observed that P-3051 permeated well through bovine hoof membranes and produced dose-dependent inhibitory effects on dermatophyte, yeast and mold strains. Moreover, the inhibition effects were higher than those obtained by equal amounts of the ciclopirox reference nail lacquer. P-3051 and the reference showed the same protective activity in experimental infections with strains of dermatophytes isolated from clinical samples. The amount of ciclopirox remained in cut fingernails washed six hours after in vivo application of P-3051 ranged between 18 and 35% of the applied dose. After in vitro application to cut human nails, 40-50% of the applied ciclopirox penetrated during the first six hours, independent of nails being infected or uninfected, intact or filed. In both experiments, the concentration of ciclopirox is largely higher (three to four orders of magnitude) than the MICs for nail pathogens.

  9. Ciclopirox vs amorolfine: in vitro penetration into and permeation through human healthy nails of commercial nail lacquers.

    PubMed

    Monti, Daniela; Tampucci, Silvia; Chetoni, Patrizia; Burgalassi, Susi; Mailland, Federico

    2014-02-01

    One of the pre-requisite for a successful topical antifungal drug indicated for onychomycosis is its bioavailability into the nail unit for achieving fungal eradication and clinical benefit. The aim of this study was to compare in vitro permeation/penetration through and into human nails of amorolfine (MRF) from a 5% anhydrous commercial formulation (Loceryl®) and ciclopirox (CPX) from the 8% aqueous formulation in hydroxypropyl chitosan (HPCH) technology (Onytec®). The ability of the active ingredient to reach efficacious concentrations to inhibit nail pathogens was also evaluated. The amounts of drug permeated and retained in human healthy nails were determined using a suitably modified diffusion apparatus. HPLC analysis of the samples was performed. The HPCH-based CPX formulation demonstrated an efficient penetration into and permeation through the nail plates. Conversely, Loceryl® produced an amount of MRF permeated through and penetrated into the human toenails significantly lower than CPX. The evaluation of the efficacy index showed a higher potential efficacy of Onytec® with respect to Loceryl® on nail pathogens. The present work not only reinforced the previous results on different experimental substrates, but pointed out the superiority of HPCH-based Onytec® formulation containing CPX with respect to Loceryl® commercial product with MRF, both in terms of higher permeation through and penetration into the human nail, and for the efficacy towards the most common ungual pathogens.

  10. 6. REMAINS OF PLANK WALL NAILED TO POSTS WITHIN CANAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. REMAINS OF PLANK WALL NAILED TO POSTS WITHIN CANAL CONSTRUCTED TO PROTECT OUTSIDE CANAL BANK. VIEW IS TO THE WEST. - Snake River Ditch, Headgate on north bank of Snake River, Dillon, Summit County, CO

  11. Nail Biting: Does It Cause Long-Term Damage?

    MedlinePlus

    ... healthy ways, such as physical activity, to manage stress and anxiety Keeping your nails neatly trimmed or manicured Occupying your hands or mouth with alternate activities, such as playing a musical ...

  12. Coexistence of nail lichen planus and lichen planus pigmentosus*

    PubMed Central

    Lemes, Luciana Rodino; Verde, Renata Brandão Villa; Durães, Sandra Maria Barbosa; Araripe Junior, Adolpho de Alencar; Pantaleão, Luciana

    2016-01-01

    We describe a fifty-six-year old, Afro-descendent female patient showing dystrophy of her twenty nails and hyperchromic, asymptomatic macule on her face. Histopathological examination of the macule showed vacuolization of the basal layer, melanophages in the superficial dermis and lymphoplasmocytic inflammatory infiltrate. Nail biopsy revealed orthokeratotic hyperkeratosis and lichenoid inflammatory infiltrate. Lichen planus pigmentosus is an uncommon variety of lichen planus. It is characterized by typical hyperpigmented macules on the face and neck. Nail changes might be present in 10% of lichen planus cases, but no associations with lichen planus pigmentosus have been described. We report a case of lichen planus in twenty nails associated with lichen planus pigmentosus on the patient's face. PMID:28300883

  13. Coexistence of nail lichen planus and lichen planus pigmentosus.

    PubMed

    Lemes, Luciana Rodino; Verde, Renata Brandão Villa; Durães, Sandra Maria Barbosa; Araripe, Adolpho de Alencar; Pantaleão, Luciana

    2016-01-01

    We describe a fifty-six-year old, Afro-descendent female patient showing dystrophy of her twenty nails and hyperchromic, asymptomatic macule on her face. Histopathological examination of the macule showed vacuolization of the basal layer, melanophages in the superficial dermis and lymphoplasmocytic inflammatory infiltrate. Nail biopsy revealed orthokeratotic hyperkeratosis and lichenoid inflammatory infiltrate. Lichen planus pigmentosus is an uncommon variety of lichen planus. It is characterized by typical hyperpigmented macules on the face and neck. Nail changes might be present in 10% of lichen planus cases, but no associations with lichen planus pigmentosus have been described. We report a case of lichen planus in twenty nails associated with lichen planus pigmentosus on the patient's face.

  14. 14. Detail view of the old rotating nail case and ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. Detail view of the old rotating nail case and glass display cases now located in the second floor meeting room; looking southeast. - Horsepasture Store, U.S. Route 58 & State Route 687, Horse Pasture, Henry County, VA

  15. Fingernails: Do's and Don'ts for Healthy Nails

    MedlinePlus

    ... under your fingernails. Repeated or prolonged contact with water can contribute to split fingernails. Wear cotton-lined rubber gloves when washing dishes, cleaning or using harsh chemicals. Practice good nail hygiene. ...

  16. Development of a locking femur nail for mice.

    PubMed

    Holstein, J H; Menger, M D; Culemann, U; Meier, C; Pohlemann, T

    2007-01-01

    We herein report on a novel locking intramedullary nail system in a murine closed femur fracture model. The nail system consists of a modified 24-gauge injection needle and a 0.1-mm-diameter tungsten guide wire. Rotation stability was accomplished by flattening the proximal and distal end of the needle. Torsional mechanical testing of the implants in osteotomized cadaveric femora revealed a superiority of the locking nail (3.9+/-1.0 degrees rotation at a torque of 0.9 Nmm, n=10) compared to the unmodified injection needle (conventional nail; 52.4+/-3.2 degrees, n=10, p<0.05). None of the implants, however, achieved the rotation stability of unfractured femora (0.3+/-0.5 degrees, n=10). In a second step, we tested the feasibility of the in vivo application of the locking nail to stabilize a closed femoral midshaft fracture in C57BL/6 mice. Of interest, none of the 10 animals showed a dislocation of the locking nail over a 5-week period, while 3 of 4 animals with conventional nail fracture stabilization showed a significant pin dislocation within the first 3 days (p<0.05). Mechanical testing after 5-weeks stabilization with the locking nail revealed an appropriate bone healing with a torque at failure of 71.6+/-3.4% and a peak rotation before failure of 68.4+/-5.3% relative to the unfractured contralateral femur. With the advantage that closed fractures can be fixed with rotation stability, the herein introduced model may represent an ideal tool to study bone healing in transgenic and knockout mice.

  17. Nail surgery: best way to obtain effective anesthesia.

    PubMed

    Jellinek, Nathaniel J; Vélez, Nicole F

    2015-04-01

    Nail procedures require an effective and reliable approach to anesthesia of the distal digit. Several techniques have been described in the literature. Herein, the relevant anatomy of the nail unit, pain pathways, anesthetic options, and several injection approaches to achieve complete anesthesia are reviewed. Also considered are the potential pitfalls and complications and their management. Ultimately, the physician's approach must be individualized to the patient, procedure, and setting.

  18. White Nail Radio Transmitter: Billion Dollar Savings through Energy Efficiency

    DTIC Science & Technology

    2011-05-10

    energy consumption ashore by 50 percent CNO, Navy Energy Vision, P 10 White Nail Vision Your Cell Phone Cell ...Greenhouse Gas Power 4 1 Energy Navy Use 7.3 Billion kWh White Nail Cell Phone Savings 11 Billion kWh One and a half times!!! Saves the output of four of...Estimated Total Number of transmitters 3,000,000 Estimated total power saved Watt 1,250,000,000 Cell Phone Transmitter Efficiency 1.25 Gigawatts

  19. The functional results of tibial shaft fractures treated with intramedullary nail compressed by proximal tube.

    PubMed

    Karaarslan, Ahmet Adnan; Acar, Nihat; Aycan, Hakan; Sesli, Erhan

    2016-04-01

    Nailing of tibial shaft fractures is considered the gold standard surgical method by many surgeons. The aim of this retrospective study was to investigate and compare the clinical outcome of tibial shaft fractures treated with intramedullary nails compressed by proximal tube and conventional intramedullary interlocking nails. Fifty-seven patients with tibial shaft fractures, treated with intramedullary nails compressed by proximal tube (n = 32) and the conventional interlocking nails (n = 25), were reviewed. All fractures except for one were united without any additional surgical intervention in the proximal compression tube nail group, whereas in the conventional interlocking nail group, six patients needed dynamization surgery (p = 0.005) and three cases of nonunion were recorded. In the proximal compression tube nail group, faster union occurred in 20 ± 2 (16-24) weeks (mean ± SD; range) without failure of locking screws and proximal nail migration, whereas in the conventional interlocking nail group, union occurred in 22 ± 2.5 (17-27) weeks (p = 0.001) with two failures of locking screws and two proximal nail migration. The proximal compression tube nail system is safer than the conventional nailing methods for the treatment for transverse and oblique tibial shaft fractures with a less rate of nonunion, proximal locking screw failure and proximal nail migration.

  20. Nail polish as a source of exposure to triphenyl phosphate.

    PubMed

    Mendelsohn, Emma; Hagopian, Audrey; Hoffman, Kate; Butt, Craig M; Lorenzo, Amelia; Congleton, Johanna; Webster, Thomas F; Stapleton, Heather M

    2016-01-01

    Triphenyl phosphate (TPHP) is primarily used as either a flame retardant or plasticizer, and is listed as an ingredient in nail polishes. However, the concentration of TPHP in nail polish and the extent of human exposure following applications have not been previously studied. We measured TPHP in ten different nail polish samples purchased from department stores and pharmacies in 2013-2014. Concentrations up to 1.68% TPHP by weight were detected in eight samples, including two that did not list TPHP as an ingredient. Two cohorts (n=26 participants) were recruited to assess fingernail painting as a pathway of TPHP exposure. Participants provided urine samples before and after applying one brand of polish containing 0.97% TPHP by weight. Diphenyl phosphate (DPHP), a TPHP metabolite, was then measured in urine samples (n=411) and found to increase nearly seven-fold 10-14h after fingernail painting (p<0.001). To determine relative contributions of inhalation and dermal exposure, ten participants also painted their nails and painted synthetic nails adhered to gloves on two separate occasions, and collected urine for 24h following applications. Urinary DPHP was significantly diminished when wearing gloves, suggesting that the primary exposure route is dermal. Our results indicate that nail polish may be a significant source of short-term TPHP exposure and a source of chronic exposure for frequent users or those occupationally exposed.

  1. Nail Polish as a Source of Exposure to Triphenyl Phosphate

    PubMed Central

    Mendelsohn, Emma; Hagopian, Audrey; Hoffman, Kate; Butt, Craig M.; Lorenzo, Amelia; Congleton, Johanna; Webster, Thomas F.; Stapleton, Heather M.

    2015-01-01

    Triphenyl phosphate (TPHP) is primarily used as either a flame retardant or plasticizer, and is listed as an ingredient in nail polishes. However, the concentration of TPHP in nail polish and the extent of human exposure following applications have not been previously studied. We measured TPHP in ten different nail polish samples purchased from department stores and pharmacies in 2013–2014. Concentrations up to 1.68% TPHP by weight were detected in eight samples, including two that did not list TPHP as an ingredient. Two cohorts (n=26 participants) were recruited to assess fingernail painting as a pathway of TPHP exposure. Participants provided urine samples before and after applying one brand of polish containing 0.97% TPHP by weight. Diphenyl phosphate (DPHP), a TPHP metabolite, was then measured in urine samples (n=411) and found to increase nearly seven-fold 10–14 hours after fingernail painting (p<0.001). To determine relative contributions of inhalation and dermal exposure, ten participants also painted their nails and painted synthetic nails adhered to gloves on two separate occasions, and collected urine for 24 hours following applications. Urinary DPHP was significantly diminished when wearing gloves, suggesting that the primary exposure route is dermal. Our results indicate that nail polish may be a significant source of short-term TPHP exposure and a source of chronic exposure for frequent users or those occupationally exposed. PMID:26485058

  2. Prevalence and nature of nail alterations in pediatric patients.

    PubMed

    Iglesias, A; Tamayo, L; Sosa-de-Martínez, C; Durán-McKinster, C; Orozco-Covarrubias, L; Ruiz-Maldonado, R

    2001-01-01

    The purpose of this investigation was to explore the frequency and nature of ungual alterations in patients of a pediatric dermatology department at a third-level pediatric hospital. The first 20 patients with nail alterations seen each year during a 5-year period from 1992 through 1996 were included, totaling 100 patients. The rate of nail alterations was 11% (1/9) in pediatric dermatology patients. There were 5 infants, 19 preschoolers (2- to 5-year-olds), 38 school children (6- to 11-year-olds), and 38 adolescents (12- to 17-year-olds). The most frequent diagnoses were onychomycosis (23), nail alterations in a genodermatosis (23), nail alterations associated with dermatoses (16), onychocryptosis (11), and paronychia (10). Toenails were involved in 54 patients, fingernails in 25, and both in 21 patients. Twenty nails were involved in 21 patients. A high prevalence of nail alterations was found in pediatric dermatology patients, some of which were nonspecific, while others provided important diagnostic clues.

  3. A study of dermoscopic features of nail psoriasis

    PubMed Central

    Artuz, Ferda

    2017-01-01

    Introduction Dermoscopy is a non-invasive imaging method that enables the evaluation of pigmented and non-pigmented skin lesions. More recently, dermoscopy has been recognized as an effective tool in the diagnosis of nail diseases. Aim To evaluate the dermoscopic features of nail psoriasis and to assess the relationship between these features and disease severity. Material and methods A total of 67 patients with clinically evident nail psoriasis (14 women, 53 men) were prospectively enrolled. Following a thorough clinical examination, patients were graded according to the Nail Psoriasis Severity Index and physician’s global assessment score. A dermoscopic examination of all fingernails and toenails was performed using a videodermatoscope. Mann-Whitney U and χ2 tests were used for statistical analysis, with a significance threshold of p < 0.05. Results The most frequently observed dermoscopic features were splinter haemorrhage (73.1%), pitting (58.2%), distal onycholysis (55.2%), dilated hyponychial capillaries (35.8%) and the pseudo-fiber sign (34.3%). The pseudo-fiber sign, dilated hyponychial capillaries, nail plate thickening and crumbling, subungual hyperkeratosis, transverse grooves, trachyonychia, pitting and salmon patches were positively associated with disease severity. Conclusions The pseudo-fiber sign described in this study appears to be a novel dermoscopic feature of nail psoriasis. We have demonstrated positive associations between a number of dermoscopic manifestations and disease severity. Further studies are required to support the present findings. PMID:28286468

  4. Tumors of the nail unit. A review. Part I: acquired localized longitudinal melanonychia and erythronychia.

    PubMed

    Perrin, Christophe

    2013-08-01

    The article aims to be a guide to the interpretation of tumors specific to the nail, that is, tumors presenting peculiar histological features linked specifically to the nail unit. Therefore, the classical epithelial, fibroepithelial, and fibrous skin tumors occurring in the nail region are not analyzed. The interpretation of nail biopsies requires the identification and integration of the 2 main clinical modes of presentation of nail tumors, the acquired localized (monodactylous) longitudinal (ALL) band pattern, and the "masked" nail tumor. The ALL band pattern often allows the recognition of a nail tumor in its early phase of progression, with a limited differential diagnosis. The masked nail tumor mimics an inflammatory nail process, as a clinically misleading reactive benign lesion, which delays diagnosis with the subsequent development of partial nail loss and a locally destructive evolution. ALL band pattern appears as a longitudinal band starting at the matrix and extending to the tip of the nail plate. The band is usually single, rarely bifid. This clinical pattern can divided into 2 presentations. The generic term of ALL maculonychia could be proposed to define the macular aspect of the colored band of the nail plate. It encompasses 3 syndromes: longitudinal melanonychia, longitudinal erythronychia, and longitudinal leukonychia. ALL pachyonychia is a rare presentation. Pachyonychia indicates a localized thickening of the nail plate specific to the matrical nail tumor. In this group, there is differentiation toward cells of the nail matrix. The prototype tumor is the onychomatricoma, which present classically with a yellow (xantholeukonychia) band pattern. Recently, a new clinical band pattern has been described as longitudinal pachymelanonychia with 2 etiologies: pigmented onychomatricoma and onychocytic matricoma. The first part of this review delineate, in the first section, the distinctive microanatomical features of the nail unit and the second is

  5. Laugh and Smile upon the Holy Quran: The Study of Analytical Objectivities

    ERIC Educational Resources Information Center

    al-Domi, Mohammad Mahmoud

    2015-01-01

    This study aims to examine the positive impact of The Holy Quran based on the laugh and smile. This kind of derivatives in which context of praise, expression the feeling of happiness and joyful in the positive senses. Everyone needs to relieve his heart so that happiness and joy on their faces can be seen. Laughter also are some of attribute…

  6. Fostering Community through the House System at Most Holy Trinity Catholic School

    ERIC Educational Resources Information Center

    Brennan, Michael C.

    2012-01-01

    Most Holy Trinity Catholic School in Phoenix, Arizona, has experienced a decrease in student enrollment over the last decade, resulting in a reduction to a single class per grade across the PreK-8 community. Recent concerns have surfaced regarding student and teacher isolation, marginalization, and their effects on the broader relationships within…

  7. Called to Be Holy: The Transformative Potential of Christian Service Programmes in Catholic Schools

    ERIC Educational Resources Information Center

    Engebretson, Kath

    2009-01-01

    This is the second in a series of four papers which seeks to articulate theologically and practically the consequences of the ecclesial identity of the Catholic school. The series is based on the principle that the "marks" of the Church--one, holy, catholic, and apostolic--are also marks of the Catholic school, since the Catholic school is within…

  8. E-Halagat: An E-Learning System for Teaching the Holy Quran

    ERIC Educational Resources Information Center

    Elhadj, Yahya O. Mohamed

    2010-01-01

    Recently, there has been a great interest in Islamic software that try to harness computer to serve the religion. This brought about some applications and programs for the Holy Quran and its sciences, Hadith "[image omitted]" (Prophet's Tradition) and its methodology, Fiqh "[image omitted]" (Islamic jurisdiction), and Islamic law in general.…

  9. The Qur'an and the Academic Library: Circulation and Storage Issues with Holy Books

    ERIC Educational Resources Information Center

    Long, Dallas

    2010-01-01

    This article addresses concerns raised by members of the local Muslim community regarding copies of the Qur'an in the circulating collections at Milner Library, Illinois State University. The librarians conducted an analysis of the collection of holy books and investigated the rules and traditions of the Islamic faith that govern the care and…

  10. Black Elk Speaks. Being the Life Story of a Holy Man of the Oglala Sioux.

    ERIC Educational Resources Information Center

    Neihardt, John G.

    This classic book describes the life experiences and "great vision" of Black Elk, a holy man of the Oglala Sioux. Black Elk imparted these things to John Neihardt so that he might save them for future generations. Black Elk's power-vision occurred when he was 9 years old during a sickness. The lengthy vision contained profound symbolism…

  11. The Cry in the Holy Quran and the Effect on the Human Behavior

    ERIC Educational Resources Information Center

    al-Domi, Mohammad Mahmoud

    2015-01-01

    This study aims that cry is the ideal way to release the negative emotions distress, sorrow, and sadness. Which sometimes is also a way to express situations of joy and pleasure of humans. The Almighty Allah also said about cry in The Holy Quran. The prophet pbuh also cry for the expressions of reverence and fear of Allah in perhaps the sort of…

  12. Nail apparatus melanoma initially diagnosed as nail matrix blue nevus: a case report with dermatoscopy and dermatopathology

    PubMed Central

    Akay, Bengu Nisa; Heper, Aylin Okcu; Thomas, Luc; Balme, Brigitte; Clark, Simon; Rosendahl, Cliff

    2017-01-01

    We present a case of nail apparatus melanoma in a 50-year-old woman presenting as new and changing longitudinal melanonychia of the right thumb. Very heavy melanin pigmentation involving both the epidermis and dermis interfered with dermatopathological assessment, which initially leads to a diagnosis of nail matrix blue nevus. After consultation with a specialist multidisciplinary clinic the diagnosis was revised to invasive melanoma, a diagnosis consistent with the clinical and dermatoscopic assessment. PMID:28243499

  13. Chloronychia: green nail syndrome caused by Pseudomonas aeruginosa in elderly persons.

    PubMed

    Chiriac, Anca; Brzezinski, Piotr; Foia, Liliana; Marincu, Iosif

    2015-01-01

    Green nails, also known as chloronychia or green nail syndrome, are characterized by green discoloration of the nail plate (greenish-yellow, greenish-brown, greenish-black), proximal chronic non-tender paronychia, and distolateral onycholysis. The cause is Pseudomonas aeruginosa infection of the nail plate in persons whose hands are constantly exposed to water, soaps, and detergents or are subject to mechanical trauma, especially in the elderly. Green or black coloration of the nails should raise suspicion for Pseudomonas infection and be treated with an oral quinolone (ciprofloxacin), particularly in aged patients. We present three cases of green nails in elderly persons.

  14. Fixator-assisted nailing and consecutive lengthening over an intramedullary nail for the correction of tibial deformity.

    PubMed

    Bilen, F E; Kocaoglu, M; Eralp, L; Balci, H I

    2010-01-01

    We report the results of using a combination of fixator-assisted nailing with lengthening over an intramedullary nail in patients with tibial deformity and shortening. Between 1997 and 2007, 13 tibiae in nine patients with a mean age of 25.4 years (17 to 34) were treated with a unilateral external fixator for acute correction of deformity, followed by lengthening over an intramedullary nail with a circular external fixator applied at the same operating session. At the end of the distraction period locking screws were inserted through the intramedullary nail and the external fixator was removed. The mean amount of lengthening was 5.9 cm (2 to 8). The mean time of external fixation was 90 days (38 to 265). The mean external fixation index was 15.8 days/cm (8.9 to 33.1) and the mean bone healing index was 38 days/cm (30 to 60). One patient developed an equinus deformity which responded to stretching and bracing. Another developed a drop foot due to a compartment syndrome, which was treated by fasciotomy. It recovered in three months. Two patients required bone grafting for poor callus formation. We conclude that the combination of fixator-assisted nailing with lengthening over an intramedullary nail can reduce the overall external fixation time and prevent fractures and deformity of the regenerated bone.

  15. Reconstruction of large area defect of the nail bed by cross finger fascial flap combined with split-thickness toe nail bed graft: A new surgical method.

    PubMed

    Yang, Jianyun; Wang, Tao; Yu, Cong; Gu, Yudong; Jia, Xiaotian

    2017-02-01

    Fingertip injury commonly results in avulsion of the nail bed. For large area defects of the nail bed with distal phalanx exposure, methods for reconstruction of soft tissue defects are scarcely mentioned in the literature.From May 2014 to January 2016, 6 patients with large area defects of the nail bed with distal phalanx exposure were enrolled. A new surgical method, cross finger fascial flap combined with thin split-thickness toe nail bed graft, was applied in all patients.All the 6 patients were followed-up at least 3 months. Good blood supply and no infections were observed. The lengths of the thumb or fingers were preserved. Acceptable appearance and nail bed growth were noted. The donor sites showed no dysfunction or deformity.Cross finger fascial flap combined with thin split-thickness toe nail bed graft is a new and rewarding surgical method to reconstruct large area defect of the nail bed with distal phalanx exposure.

  16. Reconstruction of large area defect of the nail bed by cross finger fascial flap combined with split-thickness toe nail bed graft

    PubMed Central

    Yang, Jianyun; Wang, Tao; Yu, Cong; Gu, Yudong; Jia, Xiaotian

    2017-01-01

    Abstract Fingertip injury commonly results in avulsion of the nail bed. For large area defects of the nail bed with distal phalanx exposure, methods for reconstruction of soft tissue defects are scarcely mentioned in the literature. From May 2014 to January 2016, 6 patients with large area defects of the nail bed with distal phalanx exposure were enrolled. A new surgical method, cross finger fascial flap combined with thin split-thickness toe nail bed graft, was applied in all patients. All the 6 patients were followed-up at least 3 months. Good blood supply and no infections were observed. The lengths of the thumb or fingers were preserved. Acceptable appearance and nail bed growth were noted. The donor sites showed no dysfunction or deformity. Cross finger fascial flap combined with thin split-thickness toe nail bed graft is a new and rewarding surgical method to reconstruct large area defect of the nail bed with distal phalanx exposure. PMID:28178151

  17. Exploring the biology of the nail: An intriguing but less-investigated skin appendage.

    PubMed

    Saito, Masataka; Ohyama, Manabu; Amagai, Masayuki

    2015-09-01

    The nail is a highly keratinized structure covering the tip of the digit, and considered to have several important functions in our daily life. In recent years, as biological aspects of the nail organ have been characterized, we realize that the nail unit and the hair follicle share various biological and immunological features. In particular, development and homeostasis of the nail unit also requires intimate epithelial-mesenchymal interactions that involve signaling pathways such as Wnt. There is also a striking immunological resemblance between both appendages, since the nail matrix, like the anagen hair bulb and the bulge, was shown to present unique characteristics of an immune privileged site. On the other hand, considerable progress in identifying nail stem cells has succeeded in locating putative stem cell niches in the nail unit. In this context, it is intriguing that nail stem cells residing in the nail matrix were recently shown to possess the ability to organize the process leading to digit regeneration. Further elucidation of signaling pathways governing epithelial-mesenchymal interactions in the nail unit seems to be a key to develop a novel therapeutic tool to treat amputees using nail epithelium. However, it is at least certain that the nail unit has a promising potential for the future of regenerative medicine. This review explores the biology of the nail organ by focusing on intriguing knowledge gained from recent studies.

  18. Intramedullary leg lengthening with a motorized nail

    PubMed Central

    2011-01-01

    Background and purpose In the last decade, intramedullary limb lengthening has become a viable alternative to traditional external systems. We retrospectively analyzed the use of an intramedullary motorized nail (Fitbone) in a consecutive series of 32 patients. Patients and methods During the period September 2006 to December 2008, 32 consecutive patients with a median age of 17 (IQR: 15–19) years were treated with a fully implantable, motorized intramedullary lengthening device (Fitbone). The median leg length discrepancy was 35 (IQR: 30–44) mm at the femur (n = 21) and 28 (IQR: 25–30) mm at the tibia (n = 11). Results Leg lengthening was successful in 30 of 32 cases, with no residual relevant discrepancy (± 5 mm). No intraoperative complications were observed. The consolidation index was significantly different (p = 0.04) between femoral lengthening (mean 35 days/cm) and tibial lengthening (mean 48 days/cm) but did not depend on age older/younger than 16 or previous operations at the affected site. 3 problems, 3 obstacles, and 4 complications (3 minor, 1 major) were encountered in 8 patients, 5 of which were implant-associated. Interpretation This technique even allows correction in patients with multiplanar deformities. Compared to external devices, intramedullary systems provide comfort and reduce complication rates, give improved cosmetic results, and lead to fast rehabilitation since percutaneous, transmuscular fixation is prevented. This results in reasonable overall treatment costs despite the relatively high costs of implants. PMID:21561309

  19. Computed modeling of humeral mid-shaft fracture treated by bundle nailing.

    PubMed

    Obruba, Petr; Capek, Lukas; Henys, Petr; Kopp, Lubomir

    2016-10-01

    Elastic bundle nailing is a method for simple humeral mid-shaft fracture osteosynthesis. The aim of our subsequent numerical simulations was to find out torsional and bending stiffness of an elastic bundle nailed humerus. Parametrical 3D numerical model was developed. The diameter of nails was the varying parameter of 1.8, 2.5, 3 and 4 mm. From our results can be seen that the bending stiffness in bundle nailing technique does not depend on nail diameter. On the contrary the torsional stiffness does highly depend on nail diameter. The dependency of the maximal stress on a nail diameter during bending and torsion of the humerus is non-linear. It can be seen that the higher diameter is used the higher stress occurs. Achieved results allow us for the recommendation of optimal nail diameter for this method, which lies between 2 and 3 mm.

  20. Enhancing transungual delivery and spreading of efinaconazole under the nail plate through a unique formulation approach.

    PubMed

    Kircik, Leon H

    2014-12-01

    Onychomycosis is a very common nail disorder seen in dermatological practice. It is difficult to treat successfully for a multitude of reasons, and although topical antifungal therapy might be considered ideal for mild to moderate onychomycosis, efficacy has been limited by poor nail penetration of active ingredient through the nail plate into the nail bed and nail matrix to the site of infection. The intrinsic properties of an antifungal and its vehicle formulation are both considered important contributors to effective treatment. Here we review the formulation approach to efinaconazole topical solution, 10% an effective and well-tolerated treatment for onychomycosis. We demonstrate that the low surface tension formulation affords better penetration of efinaconazole through the nail plate, and also to the site of infection by spreading into the space between the nail and nail bed.

  1. 76 FR 23559 - Certain Steel Nails From the United Arab Emirates: Initiation of Antidumping Duty Investigation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-27

    ... steel nails from the United Arab Emirates (UAE) filed in proper form by Mid Continent Nail Corporation... petitioner made adjustments for foreign inland freight, foreign port expenses, ocean freight, U.S....

  2. Limb Lengthening Using the PRECICETM Nail System: Complications and Results

    PubMed Central

    Wiebking, Ulrich; Liodakis, Emmanouil; Kenawey, Mohamed; Krettek, Christian

    2016-01-01

    Background Three types of telescopic nails are mainly used for intramedullary limb lengthening nowadays. Despite some important advantages of this new technology (e.g. controlled distraction rate, not restricted availability, possibility to perform accordion maneuvers), few articles exist on clinical results and complications after lengthening with the PRECICETM nail (Ellipse, USA). Objectives The aim of the current study was to describe and analyze the complications associated with lengthening with the PRECICETM nail. Are the problems preventable when using the PRECICE, related to the distraction rate control, the lengthening goals and technique and handling? Methods We retrospectively reviewed the charts of 9 patients operated between 2012 and 2013 with a PRECICETM nail for a leg length discrepancy (LLD). The mean age of the patients was 32 years (range, 17 - 48 years). There were 5 femoral and 4 tibial procedures. The causes of LLD were posttraumatic (n = 5) and congenital (n = 4). The mean LLD was 36.4 ± 11.4 mm. The minimum follow-ups were 2 months (average, 5 months; range, 2 - 9 months). Results The mean distraction rate was 0.5 ± 0.1 mm/day. We observed in 7 patients differences in achieving the lengthening goals (average, 1.6 mm; range, -20.0 - 5.0 mm). Average lengthening was 34.7 ± 10.7 mm. All patients reached normal alignment and normal joint orientation. An unintentional loss of the achieved length during the consolidation phase was noticed in patients with delayed bone healing in two cases. In the first case (loss of 20mm distraction) the nail could be redistracted and the goal length was achieved. In the second case (loss of 10mm distraction) the nail broke shortly after the diagnosis and the nail was exchanged. Conclusions We report of loss of achieved length after lengthening with a telescopic nail. Weight bearing before complete consolidation of the regenerate might be a risk factor for that. Thorough examination of the limb length and careful

  3. Patterns of clinical nail appearances in patients with cutaneous psoriasis

    PubMed Central

    MARINA, ELENA MIHAELA; BOTAR-JID, CAROLINA; BOLBOACA, SORANA DANIELA; ROMAN, IULIA IOANA; SENILA, CORINA SIMONA; MIHU, CARMEN MIHAELA; TATARU, DUMITRU ALEXANDRU

    2017-01-01

    Background and aim Nail manifestations are often an overlooked aspect in psoriatic disease, cutaneous and joint involvement being far more often reported and investigated. The reported prevalence of nail changes varies in literature, specific fingernail clinical features having different degrees of occurrence. The aim of this study was to describe specific clinical patterns of fingernail alterations in adult patients with plaque-type psoriasis in a university hospital in the North-West of Romania. Methods Clinical data of 35 patients with fingernail psoriasis were collected and analyzed. Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) scores were used to quantify disease extension in each patient. Results PASI score proved linearly correlated with NAPSI score (p<0.05). The age of onset of fingernail psoriasis was positively correlated with age of onset cutaneous psoriasis (p<0.0001). Furthermore, the duration of cutaneous involvement and NAPSI proved significantly related (p<0.05). The third fingernail in the right hand and first fingernail in the left hand were in most of the cases severely affected. The most common observed nail pattern was pitting, followed by salmon patches and subungual hyperkeratosis. Conclusion Important nail changes appear even in moderate forms of cutaneous psoriasis. Particular localization of specific fingernail psoriasis pattern enables the possibility of detecting early stage disease. PMID:28246493

  4. Comparative study of nail sampling techniques in onychomycosis.

    PubMed

    Shemer, Avner; Davidovici, Batya; Grunwald, Marcelo H; Trau, Henri; Amichai, Boaz

    2009-07-01

    Onychomycosis is a common problem. Obtaining accurate laboratory test results before treatment is important in clinical practice. The purpose of this study was to compare results of curettage and drilling techniques of nail sampling in the diagnosis of onychomycosis, and to establish the best technique and location of sampling. We evaluated 60 patients suffering from distal and lateral subungual onychomycosis and lateral subungual onychomycosis using curettage and vertical and horizontal drilling sampling techniques from three different sites of the infected nail. KOH examination and fungal culture were used for detection and identification of fungal infection. At each sample site, the horizontal drilling technique has a better culture sensitivity than curettage. Trichophyton rubrum was by far the most common pathogen detected by both techniques from all sampling sites. The drilling technique was found to be statistically better than curettage at each site of sampling, furthermore vertical drilling from the proximal part of the affected nail was found to be the best procedure for nail sampling. With each technique we found that the culture sensitivity improved as the location of the sample was more proximal. More types of pathogens were detected in samples taken by both methods from proximal parts of the affected nails.

  5. Frizzled6 deficiency disrupts the differentiation process of nail development

    PubMed Central

    Cui, Chang-Yi; Klar, Joakim; Georgii-Heming, Patrik; Fröjmark, Anne-Sophie; Baig, Shahid M.; Schlessinger, David; Dahl’, Niklas

    2013-01-01

    Nails protect the soft tissue of the tips of digits. The molecular mechanism of nail (and claw) development is largely unknown, but we have recently identified a Wnt receptor gene, Frizzled6 (Fzd6) that is mutated in a human autosomal-recessive nail dysplasia. To investigate the action of Fzd6 in claw development at the molecular level, we compared gene expression profiles of digit tips of wild-type and Fzd6−/− mice, and show that Fzd6 regulates the transcription of a striking number of epidermal differentiation-related genes. Sixty-three genes encoding keratins, keratin associated proteins, and transglutaminases and their substrates were significantly down-regulated in the knockout mice. Among them, four hard keratins, Krt86, Krt81, Krt34 and Krt31; two epithelial keratins, Krt6a and Krt6b; and transglutaminase1 were already known to be involved in nail abnormalities when dysregulated. Immunohistochemical studies revealed decreased expression of Krt86, Krt6b and involucrin in the epidermal portion of the claw field in the knockout embryos. We further showed that Dkk4, a Wnt antagonist, was significantly down-regulated in Fzd6−/− mice along with Wnt, Bmp and Hh family genes; and Dkk4 transgenic mice showed a subtly but appreciably modified claw phenotype. Thus, Fzd6-mediated Wnt signaling likely regulates the overall differentiation process of nail/claw formation. PMID:23439395

  6. Diffusion of uncharged solutes through human nail plate.

    PubMed

    Baswan, Sudhir M; Li, S Kevin; Kasting, Gerald B

    2016-01-01

    Passive diffusion data for uncharged solutes in hydrated human nail plate are collected and compared to the predictions of two theories for diffusion of uncharged solutes in dense keratin matrices. Quantitative agreement between the experimental data and the theories examined is poor. Concerns with both the experiments and the theories are identified and discussed. It is evident from the analysis that magnitude of the experimental nail permeability data may be questioned, as may the extrapolation procedures used to estimate the properties of dense fiber arrays from more dilute systems. Despite these caveats, it can be inferred that the microstructure of the nail plate is more complex than that assumed in the described models. The influence of residual lipids is implicated. More rigorous experiments and theoretical analysis of mass transport in the nail plate system are warranted. Successful completion of these tasks could lead not only to better predictions of transungual drug delivery, but also to better models of skin permeability, if hydrated nail plate can indeed serve as a model for the corneocyte phase of (partially hydrated) stratum corneum.

  7. A practical method to detect mycoses of the nails.

    PubMed

    Goihman-Yahr, Mauricio; Franco-Arcia, Francisco; Maldonado, Carlota

    2015-01-01

    The authors present a method that allows for reliable identification of fungal structures in nails with suspected colonization by fungi. The method is based on the well-known technique of heating nail fragments in 20% potassium hydroxide, but its details allow for reliable and quick processing of samples, when convenient. The method requires simple equipment and is designed for individual practices but might be employed as is or with minor technical improvements by a dermatology department. Minor changes will make it feasible to simultaneously process several samples. The results that were obtained show that while experienced clinicians achieve positive clinical diagnoses in the majority of instances, inaccuracies occur in a sizable proportion of cases. In addition, the varied combination of yeasts and hyphae that were found, bolster the view that microscopic examination is necessary to justify and optimize systemic treatment of mycoses of the nails. Our technique permits the processing and observation of the totality of samples obtained from a single nail or several nails.

  8. Nail psoriasis successfully treated with intralesional methotrexate: case report.

    PubMed

    Sarıcaoglu, Hayriye; Oz, Arife; Turan, Hakan

    2011-02-01

    Psoriasis is a common, chronic disease which affects nearly 3% of the population. The lifetime incidence of nail involvement increases up to 80-90% for psoriatic patients. Nail psoriasis is considered a significant social problem. Many topical agents have been used for psoriatic nails with various side effects and some benefits; management is currently inconclusive. Methotrexate (MTX) is a folic acid analog, which irreversibly binds to dehydrofolate reductase and blocks deoxyribonucleic acid synthesis. It is considered a potential treatment option for rapidly growing cells and has an anti-inflammatory effect through inhibition of the polyamine pathway in autoimmune diseases. Intralesional MTX has been used successfully for various indications. We present a case successfully treated with low-dose intralesional MTX with no observed side effects in a 26-year-old female psoriatic patient suffering from nail dystrophy. In contrast, conventional topical and systemic therapies have various side effects, which limit their use. We conclude that intralesional MTX injection seems to be a safe and effective treatment option for nail psoriasis; however, large controlled studies are needed.

  9. Pigmented lesions of the nail unit: clinical and histopathologic features.

    PubMed

    Ruben, Beth S

    2010-09-01

    Probably the most common reason to perform biopsy of the nail unit is for the evaluation of irregular pigmentation, especially longitudinal melanonychia or pigmented bands. When narrow and solitary, these are usually the product of melanocytic activation/hypermelanosis, lentigines, or melanocytic nevi. Multiple pigmented bands are generally a benign finding, the result of melanocytic activation, as seen in racial pigmentation in darker-skinned patients, for example. In the context of an irregular, broad, heterogeneous or "streaky" band, the chief concern is the exclusion of subungual melanoma. Before assessing the histologic features of any such entities, it is important to understand the normal nail anatomy and melanocytic density of nail unit epithelium, as well as the type of specimen submitted, and whether it is adequate to undertake a proper histologic evaluation. The criteria for diagnosis and prognosis of melanoma of the nail unit are still evolving, and a variety of factors must be weighed in the balance to make a correct diagnosis. The importance of the clinical context cannot be overemphasized. There are also nonmelanocytic conditions to be considered that may produce worrisome nail discoloration, such as subungual hemorrhage, squamous cell carcinoma, and pigmented onychomycosis.

  10. Deep intramedullary infection in tibial lengthening over an intramedullary nail.

    PubMed

    Kim, Seung-Ju; Cielo Balce, Gracia; Huh, Young-Jae; Song, Sang-Yoon; Song, Hae-Ryong; Kim, Seung-Ju

    2011-08-01

    Tibial lengthening over an intramedullary (IM) device is associated with a risk of deep intramedullary infection; there is so far no guideline for decision making between early removal and delayed removal of the nail. Tibial lengthening over an intramedullary nail/Rush pin was performed in 118 limb segments (63 patients) from 2004 to 2008 in our institution. Fifty five patients had bilateral tibial lengthening. Ninety nine of the 118 segments went on to healing without infection, while 13 segments developed superficial infection and 6 segments developed deep infection. Among 6 patients with deep infection, 4 patients underwent early removal of the nail when deep infection signs and symptoms occurred and 2 patients underwent delayed removal of the nail at 11 months. The 6 segments with deep infection differed significantly with respect t to the callus pattern (p < 0.05) and density (p = 0.0001) from those without infection and with superficial infection. In this small sugroup, removal of the nail was delayed in two patients as there was visible callus bridging at more than one cortex, and deep infection subsided after local drainage.

  11. 78 FR 40172 - Steel Nails From China; Institution of a Five-Year Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-03

    ... COMMISSION Steel Nails From China; Institution of a Five-Year Review AGENCY: United States International... whether revocation of the antidumping duty order on steel nails from China would be likely to lead to... duty order on imports of steel nails from China (73 FR 44961). The Commission is conducting a review...

  12. 77 FR 27080 - Certain Steel Nails From the United Arab Emirates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-08

    ... COMMISSION Certain Steel Nails From the United Arab Emirates Determination On the basis of the record \\1... certain steel nails, provided for in subheadings 7317.00.55, 7317.00.65, and 7317.00.75 of the Harmonized... that imports of certain steel nails from the United Arab Emirates were being sold at LTFV within...

  13. 76 FR 29266 - Certain Steel Nails From the United Arab Emirates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-20

    ... COMMISSION Certain Steel Nails From the United Arab Emirates Determination On the basis of the record \\1... imports from the United Arab Emirates of certain steel nails, provided for in subheadings 7317.00.55, 7317... steel nails from the United Arab Emirates. Accordingly, effective March 31, 2011, the...

  14. Road Nail: Experimental Solar Powered Intelligent Road Marking System

    NASA Astrophysics Data System (ADS)

    Samardžija, Dragan; Teslić, Nikola; Todorović, Branislav M.; Kovač, Erne; Isailović, Đorđe; Miladinović, Bojan

    2012-03-01

    Driving in low visibility conditions (night time, fog or heavy precipitation) is particularly challenging task with an increased probability of traffic accidents and possible injuries. Road Nail is a solar powered intelligent road marking system of wirelessly networked signaling devices that improve driver safety in low visibility conditions along hazardous roadways. Nails or signaling devices are autonomous nodes with capability to accumulate energy, exchange wireless messages, detect approaching vehicles and emit signalization light. We have built an experimental test-bed that consists of 20 nodes and a cellular gateway. Implementation details of the above system, including extensive measurements and performance evaluations in realistic field deployments are presented. A novel distributed network topology discovery scheme is proposed which integrates both sensor and wireless communication aspects, where nodes act autonomously. Finally, integration of the Road Nail system with the cellular network and the Internet is described.

  15. Application of Nail Polish During Topical Management of Onychomycosis

    PubMed Central

    Del Rosso, James Q.

    2016-01-01

    Topical antifungal management of toenail onychomycosis has been fraught with several therapeutic challenges including difficulty gaining access to the site of infection and the need for prolonged durations of therapy. In addition, there has been a marked lack of information on the impact of toenail polish application on drug penetration after application. This article reviews available data from studies evaluating the effect of nail polish on antifungal drag penetration using ex vivo laboratory models with cadaver fingernail plates with both tavaborole 5% solution and efinaconazole 10% solution. In addition, changes in nail polish appearance and color transfer to applicators are also discussed, with changes noted with topical efinaconazole. Importantly, there are no data on whether or not nail polish application alters the efficacy of these topical agents. PMID:27672416

  16. The Chinese Nail Murders: forensic medicine in Imperial China.

    PubMed

    Summers, W C

    1999-01-01

    Robert van Gulik was a respected Dutch sinologist and author who first translated a collection of traditional Chinese detective stories into English and then created additional fictional stories based on the same characters and setting in the Tang dynasty. One of these stories, The Chinese Nail Murders, draws on van Gulik's professional interest in law and his knowledge of early Chinese works on forensic medicine. This novel develops a common theme in Chinese detective fiction, murder by a nail wound to the head. The difficulty in detection of this mode of violence posed a particular problem for the examining magistrate because postmortem examination was mostly limited to external observations. This essay compares the development of Chinese and Western forensic medicine in the context of the nail murder motif.

  17. Surgical treatment of nail bed subungual exostosis

    PubMed Central

    Malkoc, Melih; Korkmaz, Ozgur; Keskinbora, Mert; Seker, Ali; Oltulu, Ismail; Bulbul, Ahmet Murat; Say, Ferhat; Cakir, Aslı

    2016-01-01

    INTRODUCTION A subungual exostosis (SE) is a bony overgrowth that is permanently attached to the tip of the distal phalanx. Its pathology differs from osteocartilaginous exostoses in that it mainly involves the overgrowth of normal bone, which may present beneath the toenail or on the sides of the toe. This retrospective study aimed to report the results of surgical treatment when the diagnosis of SE was delayed; the condition was initially considered to be another pathology affecting a different nail or the terminal toe. METHODS A total of 17 patients (12 female, five male) were included in the study. All surgical resections were performed by the same surgeon using the same surgical technique, with the patient under digital anaesthesia. The patients were evaluated pre- and postoperatively (on Weeks 1 and 6, the first year, and the last follow-up visit) using the American Orthopaedic Foot and Ankle Society questionnaire and the Visual Analogue Scale score. RESULTS The patients underwent surgery for SE removal between December 2009 and October 2012. Their mean age was 21.3 ± 4.4 (range 14–29) years and the mean follow-up period was 27.1 ± 7.8 (range 18–45) months. Clinical or radiological recurrence was not observed in any of the patients during the follow-up period. Four patients had superficial infections, which were treated using appropriate antibiotic therapies. CONCLUSION As SE is an uncommon benign lesion, its diagnosis may be delayed. Radiography may be useful in obtaining a differential diagnosis. PMID:26778465

  18. The human nail--barrier characterisation and permeation enhancement.

    PubMed

    Walters, Kenneth A; Abdalghafor, Haydar M; Lane, Majella E

    2012-10-01

    The human nail remains one of the most challenging membranes for formulation scientists to target and for clinicians to heal. Its formidable barrier properties are the primary reason that oral therapy remains the primary approach to manage ungual infections. This article considers the major structural properties underlying the excellent barrier function of the nail, with particular emphasis on the role of biophysical methods in advancing our knowledge of this appendage. Formulations currently available for management of ungual disease are discussed and their therapeutic efficacy is assessed. Finally, experimental strategies to enhance ungual permeation are reviewed and prospects for future developments in the field are considered.

  19. Management of gamma nail breakage with bipolar hemi-arthroplasty.

    PubMed

    Wee, J L H; Sathappan, S S; Yeo, M S W; Low, Y P

    2009-01-01

    Gamma nail breakage is an uncommon occurrence that often arises from fatigue failure of the implant, with a reported incidence ranging from 0.2 to 5.7 percent. We report a 73-year-old woman with a three-part intertrochanteric fracture and who presented two years postoperatively with gamma nail failure secondary to fracture non-union. This patient underwent a revision long-stem bipolar hemi-arthroplasty and has been followed-up for 24 months, with good functional and radiological results.

  20. The Holy See on sexual and reproductive health rights: conservative in position, dynamic in response.

    PubMed

    Coates, Amy L; Hill, Peter S; Rushton, Simon; Balen, Julie

    2014-11-01

    The Holy See has engaged extensively in United Nations negotiations on issues concerning sexual and reproductive health rights as they have emerged and evolved in a dynamic global agenda over the past two decades. A meta-narrative review of the mission's official statements was conducted to examine the positions, discourses and tensions across the broad range of agendas. The Holy See represents a fundamentally conservative and stable position on a range of sexual and reproductive health rights concerns. However, the mission has been dynamic in the ways in which it has forwarded its arguments, increasingly relying upon secularised technical claims and empirical evidence; strategically interpreting human rights norms in ways consistent with its own position; and framing sexuality and reproduction in the context of "the family". Seen in the broader context of a "religious resurgence" in international relations, and in light of the fact that the Holy See has frequently sought to form alliances with conservative State and non-State actors, these findings make an important contribution to understanding the slow progress as well as the potential obstacles that lie ahead in the battle to realise sexual and reproductive health rights in a changing global political environment.

  1. A biomechanical comparison of the antegrade inserted universal femoral nail with the retrograde inserted universal tibial nail for use in femoral shaft fractures.

    PubMed

    Frankle, M; Cordey, J; Sanders, R W; Koval, K; Perren, S M

    1999-01-01

    Femoral shaft fractures with and without bony contact were simulated in cadaver specimens fixed with one of two different types of intramedullary locked nail systems; conventional antegrade nail fixation of the femur with the universal AO femoral nail or retrograde insertion in the femur with the universal tibial nail (a smaller diameter slotted nail) were utilized. Mechanical testing simulated one leg stance, and resultant deformation was measured in bending, torsion, and shortening. In stable fractures, fracture stability was similar to both devices, while in unstable fractures, the larger femoral nail was more stable. Furthermore, the simulation of single leg stance led to a coupled deformation of varus bending, axial shortening, and external rotation, which was dependent on bone geometry.

  2. 76 FR 23279 - Certain Steel Nails From the People's Republic of China: Amended Final Results of the First...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-26

    ... Works/Stanley Fastening Systems LP, and an unaffiliated wire drawing subcontractor are collectively..., nails made of round wire and nails that are cut. Certain steel nails may be of one piece construction or... such as plastic, paper, or wire. Certain steel nails subject to this proceeding are...

  3. 77 FR 24462 - Certain Steel Nails From the People's Republic of China: Amended Final Results of the Second...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-24

    ... International Trade Administration Certain Steel Nails From the People's Republic of China: Amended Final... the antidumping duty order on certain steel nails (``steel nails'') from the People's Republic of... Department's final margin calculations. \\1\\ See Certain Steel Nails from the People's Republic of...

  4. Vascularized nail transfer from non-replantable digit: a case report.

    PubMed

    Zemirline, Ahmed; Taleb, Chihab; Goukodadja, Oswald; Liverneaux, Philippe

    2014-01-01

    We report the case of a traumatic amputation by circular saw of the ring and small fingers, associated with middle finger nail matrix loss and tendon, bone and joint exposure. The replantation was not attempted with patient's consent. Since the nail unit from the ring finger was intact, we decided to harvest the ring finger nail unit for major finger reconstruction. Although the principle of vascularized transfer from a severely damaged finger is widely recognized and the vascularized nail transfer from toe is a relatively common procedure, there is no description of a vascularized nail transfer from a non-replantable digit in the literature.

  5. Treatment of ingrown nail with a special device composed of shape-memory alloy.

    PubMed

    Park, Se-Won; Park, Ji-Ho; Lee, Jong-Hee; Lee, Dong-Youn; Lee, Joo-Heung; Yang, Jun-Mo

    2014-04-01

    Ingrown nail is a common nail problem resulting in pain and disability in daily life. Recently, a new treatment modality for an ingrown nail was reported that used a device composed of shape-memory alloy, K-D. The aim of the present study was to determine the efficacy, recurrence rate and complications of K-D. Between June 2010 and September 2012, 24 patients (31 nails) underwent treatment of symptomatic incurved nails with a K-D. Patients were evaluated at pretreatment and during every visit. The mean age of the patients involved was 43.4 years. The mean period of follow up was 161 days. The mean maintenance period was 41 days. The right first toenail was the most common site. Almost ingrown nails healed and the nail deformity was corrected after the procedure. Among the 31 nails, seven of the ingrown nails recurred during follow up (22.6% recurrence rate). The recurrence rate of the patients with stage 1, 2 and 3 ingrown nails was 22.2%, 33.3% and 14.2%, respectively. The majority of patients were very satisfied. There were no side-effects in most patients except loss of nail in one patient. K-D has some advantages such as simple application steps, no deformity after the procedure, high patient satisfaction and obvious effect compared to other non-invasive and invasive methods.

  6. Influence of type of medullary nail on the development of local infection. An experimental study of solid and slotted nails in rabbits.

    PubMed

    Melcher, G A; Claudi, B; Schlegel, U; Perren, S M; Printzen, G; Munzinger, J

    1994-11-01

    Any operation involving the implantation of a foreign body increases the risk of infection. The implant material and its surface, the dead space, and any necrosis or vascular changes play a significant role in susceptibility to infection. We investigated the effect of the dead space in an intramedullary nail on the rate of local infection. We inoculated the intramedullary cavities of rabbit tibiae with various concentrations of a human pathogen, of Staphylococcus aureus strain, and then inserted either a solid or a hollow slotted stainless-steel nail. We found a significantly higher rate of infection after use of the slotted nail (59%) than after the solid nail (27%) (p < 0.05).

  7. Lichen nitidus presenting with nail changes--case report and review of the literature.

    PubMed

    Tay, Evelyn Yuxin; Ho, Madeline Sheun Ling; Chandran, Nisha Suyien; Lee, Joyce Siong-See; Heng, Yee Kiat

    2015-01-01

    Lichen nitidus of the nail is rare and can precede the onset of skin lesions. Delayed diagnosis is common. We present an unusual case of lichen nitidus-associated nail changes that preceded the onset of skin lesions in a 4-year-old Indian girl. We also conduct a review of six other cases of lichen nitidus with nail involvement from the English-language literature. Clues to the diagnosis of lichen nitidus include violaceous or pigmentary changes of the nail fold and subtle lichenoid papules on the affected digits. Lichen nitidus of the nails appears to be less severe than nail changes of lichen planus and is generally self-limiting. Understanding the natural history of lichen nitidus of the nails will help physicians better counsel patients and their families.

  8. In Vitro penetration of a novel oxaborole antifungal (AN2690) into the human nail plate.

    PubMed

    Hui, Xiaoying; Baker, Stephen J; Wester, Ronald C; Barbadillo, Sherry; Cashmore, Anne K; Sanders, Virginia; Hold, Karin M; Akama, Tsutomu; Zhang, Yong-Kang; Plattner, Jacob J; Maibach, Howard I

    2007-10-01

    Onychomycosis is a challenging fungal infection to treat topically, likely due to the unique properties of the nail plate. This seemingly impenetrable barrier has high resistance to the passage of antifungal drugs in sufficient concentrations to kill the causative fungi deep in the nail bed. Recently, a new class of antifungal agent was described, termed oxaboroles, which have broad-spectrum activity. These oxaboroles were designed with properties believed to be required to allow for easier transit through the nail plate. Herein, we report (i) the nail penetration results of four oxaboroles that led to the selection of AN2690, (ii) the results of the nail penetration of AN2690 from four vehicles, and (iii) the nail penetration of AN2690 in its chosen vehicle compared to a commercial control, ciclopirox. AN2690 has superior penetration compared to ciclopirox, and achieves levels within and under the nail plate that suggest it has the potential to be an effective topical treatment for onychomycosis.

  9. Brushes and picks used on nails during the surgical scrub to reduce bacteria: a randomised trial.

    PubMed

    Tanner, J; Khan, D; Walsh, S; Chernova, J; Lamont, S; Laurent, T

    2009-03-01

    Though brushes are no longer used on the hands and forearms during the surgical scrub, they are still widely used on the nails. The aim of this study was to determine whether nail picks and nail brushes are effective in providing additional decontamination during a surgical hand scrub. A total of 164 operating department staff were randomised to undertake one of the following three surgical hand-scrub protocols: chlorhexidine only; chlorhexidine and a nail pick; or chlorhexidine and a nail brush. Bacterial hand sampling was conducted before and 1h after scrubbing using a modified version of the glove juice method. No statistically significant differences in bacterial numbers were found between any two of the three intervention groups. Nail brushes and nail picks used during surgical hand scrubs do not decrease bacterial numbers and are unnecessary.

  10. Removal of a bent tibial intramedullary nail: a rare case report and review of the literature.

    PubMed

    Aggerwal, Sameer; Soni, Ashwani; Saini, Uttam-C; Gahlot, Nitesh

    2011-04-01

    Intramedullary interlocking nailing is a gold standard for treatment of tibial shaft fractures. Bending of a nail secondary to trauma is a rare complication, which may be encountered in healed or unhealed tibial shaft fractures. Removal of such bent nail is always a challenge. We reported this case to discuss various techniques for removal of bent nails and to share our experience in removing a bent tibial intramedullary nail in a 30-year-old man, who was admitted in our department with re-fracture of the right tibial shaft due to a roadside accident two years after the initial surgical treatment. The intramedullary nail, bent by 30 degrees and visible on anterioposterior as well as on lateral radiographs, was firstly weakened by partially cutting the convex wall, then straightened by applying external force, and finally removed by using the standard nail removal method.

  11. Managing Chemotherapy Side Effects: Skin and Nail Changes

    MedlinePlus

    ... better.” Let your doctor or nurse know if: l Your skin is itchy, dry, red, or hurts l Your nails are dark, yellow, or cracked For ... Be careful what you put on your skin. l Use only mild soaps that are gentle on ...

  12. The isolation of Botryodiplodia theobromae from a nail lesion.

    PubMed

    Restrepo, A; Arango, M; Velez, H; Uribe, L

    1976-03-01

    Botryodiplodia theobromae not known to produce onychomycosis was repeatedly recovered from a healthy woman with evident lesions in a toe nail. Mycelial fragments were observed in the scales and the fungus was isolated in cycloheximide-free culture media. The report indicates that many fungi, hitherto considered non-pathogens, may still be able to colonize a vaiety of human tissues.

  13. Osteosynthesis of the proximal femur anchorage of a cervical nail.

    PubMed

    el Banna, S; Burny, F; Bourgois, R; Donkerwolcke, M; Moulart, F

    1994-01-01

    One of the factors determining the stability of osteosynthesis is the mechanical strength of the bone fragments required for the anchorage of the implant. The aim is to study the driving of a Thornton nail in the proximal epiphysis of a human femur as a way to measure the strength of the trabecular bone and to predict the stability of the implanted system.

  14. The SIGN nail for knee fusion: technique and clinical results

    PubMed Central

    Anderson, Duane Ray; Anderson, Lucas Aaron; Haller, Justin M.; Feyissa, Abebe Chala

    2016-01-01

    Purpose: Evaluate the efficacy of using the SIGN nail for instrumented knee fusion. Methods: Six consecutive patients (seven knees, three males) with an average age of 30.5 years (range, 18–50 years) underwent a knee arthrodesis with SIGN nail (mean follow-up 10.7 months; range, 8–14 months). Diagnoses included tuberculosis (two knees), congenital knee dislocation in two knees (one patient), bacterial septic arthritis (one knee), malunited spontaneous fusion (one knee), and severe gout with 90° flexion contracture (one knee). The nail was inserted through an anteromedial entry point on the femur and full weightbearing was permitted immediately. Results: All knees had clinical and radiographic evidence of fusion at final follow-up and none required further surgery. Four of six patients ambulated without assistive device, and all patients reported improved overall physical function. There were no post-operative complications. Conclusion: The technique described utilizing the SIGN nail is both safe and effective for knee arthrodesis and useful for austere environments with limited fluoroscopy and implant options. PMID:27163095

  15. An electrochemical modeling of lithium-ion battery nail penetration

    NASA Astrophysics Data System (ADS)

    Chiu, Kuan-Cheng; Lin, Chi-Hao; Yeh, Sheng-Fa; Lin, Yu-Han; Chen, Kuo-Ching

    2014-04-01

    Nail penetration into a battery pack, resulting in a state of short-circuit and thus burning, is likely to occur in electric car collisions. To demonstrate the behavior of a specific battery when subject to such incidents, a standard nail penetration test is usually performed; however, conducting such an experiment is money consuming. The purpose of this study is to propose a numerical electrochemical model that can simulate the test accurately. This simulation makes two accurate predictions. First, we are able to model short-circuited lithium-ion batteries (LIBs) via electrochemical governing equations so that the mass and charge transfer effect could be considered. Second, the temperature variation of the cell during and after nail penetration is accurately predicted with the help of simulating the temperature distribution of thermal runaway cells by thermal abuse equations. According to this nail penetration model, both the onset of battery thermal runaway and the cell temperature profile of the test are obtained, both of which are well fitted with our experimental results.

  16. Probabilistic assessment of exposure to nail cosmetics in French consumers.

    PubMed

    Ficheux, A S; Morisset, T; Chevillotte, G; Postic, C; Roudot, A C

    2014-04-01

    The aim of this study was to assess probabilistic exposure to nail cosmetics in French consumers. The exposure assessment was performed with base coat, polish, top coat and remover. This work was done for adult and child consumers. Dermal, inhalation and oral routes were taken into account for varnishes. Exposure evaluation was performed for the inhalation route with polish remover. The main route of exposure to varnishes was the ungual route. Inhalation was the secondary route of exposure, followed by dermal and oral routes. Polish contributed most to exposure, regardless of the route of exposure. For this nail product, P50 and P95 values by ungual route were respectively equal to 1.74 mg(kg bw week)(-1) and 8.55 mg(kg bw week)(-1) for women aged 18-34 years. Exposure to polish by inhalation route was equal to 0.70 mg(kg bw week)(-1) (P50) and 5.27 mg(kg bw week)(-1) (P95). P50 and P95 values by inhalation route were respectively equal to 0.08 mg(kg bw week)(-1) and 1.14 mg(kg bw week)(-1) for consumers aged 18-34 years exposed to polish remover. This work provided current exposure data for nail cosmetics, and a basis for future toxicological studies of the uptake of substances contained in nail cosmetics in order to assess systemic exposure.

  17. Early experience with titanium elastic nails in a trauma unit.

    PubMed

    Shah, M H; Heffernan, G; McGuinness, A J

    2003-01-01

    The Titanium Elastic Nail (TEN) offers a number of potential advantages over traditional ways of treating long bone fractures particularly in the paediatric population. These advantages include earlier mobilisation and shorter hospital stay and less risk of loss of fracture position. These advantages are most apparent and significant when treating femoral fractures in children where the length of hospital stay is reduced from several weeks to a typical period of 5 to 8 days. We have reviewed our early experience of using these implants over the past 2 years. Patients were assessed clinically and radiologically. 13 patients were treated using the TEN during this period. There were 2 femoral fractures, 4 humeral fractures, 1 tibial and 6 forearm fractures treated using the Titanium Elastic Nail. All fractures united during the study period. However 1 humeral fracture required a secondary bone grafting and plating for delayed union and 1 fracture lost position during follow-up. Insertion point pain was a problem in 4 patients but this resolved after nail removal in all. There was 1 superficial wound infection which resolved with antibiotics and 1 superficial wound infection of an open fracture wound which resolved following nail removal and antibiotics. There were no cases of deep infection. There were no limb length discrepancy or rotational or angular malalignment problems. Biomechanical principles and technical aspects of this type of fixation are discussed.

  18. Comparative microscopic analysis of nail clippings from patients with cutaneous psoriasis and psoriatic arthritis*

    PubMed Central

    Fonseca, Gabriela Poglia; Werner, Betina; Seidel, Gabriela; Staub, Henrique Luiz

    2017-01-01

    BACKGROUND The nail involvement in psoriasis is related to psoriatic arthritis and may represent a predictor of the disease. OBJECTIVES To analyze, through nail clipping, clinically normal and dystrophic nails of patients with cutaneous psoriasis and psoriatic arthritis. METHODS This is a cross-sectional multicenter study, conducted between August 2011 and March 2012. Patients were divided into four groups: patients with cutaneous psoriasis and onychodystrophy, patients with cutaneous psoriasis and clinically normal nails, patients with psoriatic arthritis and onychodystrophy and patients with psoriatic arthritis and clinically normal nails. We calculated NAPSI (Nail Psoriasis Severity Index) of the nail with more clinically noticeable change. After collection and preparation of the nail clipping, the following microscopic parameters were evaluated: thickness of the nail plate and subungual region, presence or absence of parakeratosis, serous lakes, blood, and fungi. RESULTS There were more layers of parakeratosis (p=0.001) and a greater thickness of the subungual region in patients with cutaneous psoriasis and onychodystrophy (p=0.002). Serous lakes were also more present in the same group (p=0.008) and in patients with psoriatic arthritis and normal nails (p=0.047). The other microscopic parameters showed no significant difference between normal and dystrophic nails or between patients with psoriatic arthritis or cutaneous psoriasis. STUDY LIMITATIONS Small sample size and use of medications. CONCLUSIONS Nail clipping is a simple and quick method to assess the nails of patients with nail psoriasis although does not demonstrate difference between those with joint changes or exclusively cutaneous psoriasis. PMID:28225951

  19. Drug permeation through the three layers of the human nail plate.

    PubMed

    Kobayashi, Y; Miyamoto, M; Sugibayashi, K; Morimoto, Y

    1999-03-01

    The in-vitro permeation characteristics of a water soluble model drug, 5-fluorouracil, and a poorly water soluble model drug, flurbiprofen, were investigated through three layers of the human nail plate (namely, the dorsal, intermediate and ventral nail plates), using a modified side-by-side diffusion cell. The dorsal-filed nail plate, the ventral-filed nail plate and the dorsal-and-ventral-filed nail plate were prepared to known thicknesses and then used with the full-thickness nail plate to investigate the permeation characteristics of each single layer. Most of the lipids in the human nail plate were found in the dorsal and ventral layers. The rank orders of the permeation fluxes for 5-fluorouracil and flurbiprofen were both: dorsal-and-ventral-filed nail plate > dorsal-filed nail plate > ventral-filed nail plate > full-thickness nail plate. With respect to 5-fluorouracil permeation through each single layer, the permeability coefficient of the intermediate layer was higher than those of other single layers. However in the case of flurbiprofen, the permeability coefficient of the ventral layer was higher than other single layers. The diffusion coefficients of 5-fluorouracil and flurbiprofen in the dorsal layer were the lowest of any single layer. The drug concentration in each layer was estimated using each respective permeation parameter. The drug concentration in the nail plate was observed to be dependent on the solubility and the flux of the drug. From these findings, we suggest that the human nail plate behaves like a hydrophilic gel membrane rather than a lipophilic partition membrane and that the upper layer functions as the main nail barrier to drug permeation through its low diffusivity against the drugs.

  20. Detection of Drugs in Nails: Three Year Experience.

    PubMed

    Shu, Irene; Jones, Joseph; Jones, Mary; Lewis, Douglas; Negrusz, Adam

    2015-10-01

    Nails (fingernails and toenails) are made of keratin. As the nail grows, substances incorporate into the keratin fibers where they can be detected 3-6 months after use. Samples are collected by clipping of 2-3 mm of nail from all fingers (100 mg). We present drug testing results from 10,349 nail samples collected from high-risk cases during a 3-year period of time. Samples were analyzed by validated analytical methods. The initial testing was performed mostly using enzyme-linked immunosorbent assay, but by liquid chromatography-tandem mass spectrometry (LC-MS-MS) as well. Presumptive positive samples were subjected to confirmatory testing with sample preparation procedures including washing, pulverizing, digestion and extraction optimized for each drug class. The total of 7,799 samples was analyzed for amphetamines. The concentrations ranged from 40 to 572,865 pg/mg (median, 100-3,687) for all amphetamine analytes. Amphetamine and methamphetamine were present in 14% of the samples, 22 samples were positive for 3,4-methylenedioxymethamphetamine (0.3%), 7 for methylenedioxyamphetamine (0.09%) and 4 for 3,4-methylenedioxy-N-ethylamphetamine (0.05%). Cocaine and related analytes were found in 5% samples (7,787 total), and the concentration range was 20-265,063 pg/mg (median 84-1,768). Opioids overall ranged from 40 to 118,229 pg/mg (median 123-830). The most prevalent opioid was oxycodone (15.1%) and hydrocodone (11.4%) compared with 1.0-3.6% for the others, including morphine, codeine, hydromorphone, methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine and oxymorphone. Carboxy-Δ-9-tetrahydrocannabinol positivity rate was 18.1% (0.04-262 pg/mg, median 6.41). Out of 3,039 samples, 756 were positive (24.9%) for ethyl glucuronide (20-3,754 pg/mg, median 88). Other drugs found in nails included barbiturates, benzodiazepines, ketamine, meperidine, tramadol, zolpidem, propoxyphene, naltrexone and buprenorphine. Nail analyses have become a reliable way of determining

  1. Anti-infective efficacy of antiseptic-coated intramedullary nails.

    PubMed

    Darouiche, R O; Farmer, J; Chaput, C; Mansouri, M; Saleh, G; Landon, G C

    1998-09-01

    The coating of medical devices with antimicrobial agents has recently emerged as a potentially effective method for the prevention of device-related infections. We examined the anti-infective efficacy of intramedullary nails coated with an antiseptic combination of chlorhexidine and chloroxylenol in a rabbit model of device-related infection after fixation of an open tibial fracture. The rabbits were randomized to receive 2.8-by-100-millimeter stainless-steel tibial intramedullary nails that either were uncoated or were coated with antiseptic. After administration of anesthesia and preoperative antibiotic prophylaxis, a tibial fracture was created and then reduced with insertion of the intramedullary nail. A bacterial inoculum of 10(6) colony-forming units of Staphylococcus aureus was injected into the intramedullary canal, and the wound was sutured. Radiographs of the tibiae were made postoperatively, and the rabbits were monitored daily. They were killed at six weeks, or earlier if there was dehiscence of the wound, the fracture became grossly unstable, or the rabbit failed to thrive. The use of the antiseptic-coated nails was associated with a significantly lower rate of device-related osteomyelitis (two of twenty-two; 9 per cent) than the use of the uncoated nails (thirteen of twenty-one; 62 per cent) (p = 0.0003). The radiographic and histopathological findings were generally similar in the two groups of rabbits. Antiseptic agents were not detected in serum. The results suggest that antiseptic-coated fracture-fixation devices provide significant local protection against Staphylococcus aureus, which is the most common cause of infections related to orthopaedic devices.

  2. Treatment of humeral shaft fractures with antegrade intramedullary locking nail.

    PubMed

    Tsourvakas, Stefanos; Alexandropoulos, Christos; Papachristos, Ioannis; Tsakoumis, Grigorios; Ameridis, Nikolaos

    2011-12-01

    Antegrade interlocked humeral nailing for stabilization of humeral fractures was introduced many years ago, and studies on this method in the orthopedic literature have shown mixed results. The purpose of this investigation was to document the clinical outcome and complications associated with the use of an antegrade intramedullary nail (T2, Stryker) for the humeral fractures. Between 2005 and 2008, 52 fractures of the humeral shaft were treated operatively with this intramedullary nail in our department. Eight patients were polytraumatized, and four patients had an open fracture. The mean age of patients was 51.7 years. Forty-eight patients had an adequate duration of clinical follow-up (a mean of 18 months) for analysis. Complications were recorded, and the time to union was measured. Shoulder and elbow functions were assessed using the Constant Score and the Morrey Score, respectively. Forty-six fractures healed, with a mean time to clinical union of 10.3 weeks. Two patients developed pseudarthroses. There were four adverse events: two proximal screws backed out, one superficial infection at the insertion point, and one fracture at the distal end of the nail. Ninety-one percentage of patients had an excellent or good shoulder function. Five further operations were necessary: two for treatment of pseudarthroses, two for removal the backed out proximal screws, and one wound debridement for superficial infection. Antegrade humeral nailing is a valid therapeutic option for stabilization of humeral shaft fractures. By strictly adhering to the operation technique, the number and the severity of complications can be reduced. When good fracture alignment and stability are obtained, uneventful bone healing with good functional results is the rule.

  3. Clinical Evidence for the Relationship between Nail Configuration and Mechanical Forces

    PubMed Central

    Ogawa, Rei

    2014-01-01

    Summary: Mechanobiology is an emerging field of science that focuses on the way physical forces and changes in cell or tissue mechanics contribute to development, physiology, and disease. As nails are always exposed to physical stimulation, mechanical forces may have a particularly pronounced effect on nail configuration and could be involved in the development of nail deformities. However, the role of mechanobiology in nail configuration and deformities has rarely been assessed. This review describes what is currently understood regarding the effect of mechanical force on nail configuration and deformities. On the basis of these observations, we hypothesize that nails have an automatic curvature function that allows them to adapt to the daily upward mechanical forces. Under normal conditions, the upward daily mechanical force and the automatic curvature force are well balanced. However, an imbalance between these 2 forces may cause nail deformation. For example, pincer nails may be caused by the absence of upward mechanical forces or a genetic propensity increase in the automatic curvature force, whereas koilonychias may occur when the upward mechanical force exceeds the automatic curvature force, thereby causing the nail to curve outward. This hypothesis is a new concept that could aid the development of innovative methods to prevent and treat nail deformities. PMID:25289309

  4. Common nail changes and disorders in older people: Diagnosis and management.

    PubMed

    Abdullah, Lina; Abbas, Ossama

    2011-02-01

    Objective To present family physicians with common nail alterations and disorders occurring in the elderly population and their management options. Quality of evidence The evidence relating to different nail conditions is mostly derived from randomized controlled trials, meta-analyses, and review articles. However, given the scarcity of evidence on some conditions, articles with weaker levels of evidence were also included in our review. Main message Given the growing elderly population and the associated demographic changes and longer lifespans, geriatric care is becoming more of a complicated and multidisciplinary effort in which the role of the family physician is increasingly important. Although common among the elderly, nail changes are often not brought to the attention of primary caregivers and are thus overlooked. These nail changes can affect various components of the nail unit and might represent normal age-related nail alterations or nail abnormalities that require immediate intervention. Knowledge and familiarity with these common nail abnormalities and their underlying causes is important for the family practitioner in order to effectively reach an accurate diagnosis and provide better care of this large and growing elderly population. Conclusion Nail changes are common in the elderly, and family physicians are best placed to diagnose and treat these common problems. It is important that family physicians also recognize less common but more serious nail problems that require immediate treatment.

  5. Automated fit quantification of tibial nail designs during the insertion using computer three-dimensional modelling.

    PubMed

    Amarathunga, Jayani P; Schuetz, Michael A; Yarlagadda, Prasad Kvd; Schmutz, Beat

    2014-12-01

    Intramedullary nailing is the standard fixation method for displaced diaphyseal fractures of the tibia. An optimal nail design should both facilitate insertion and anatomically fit the bone geometry at its final position in order to reduce the risk of stress fractures and malalignments. Due to the nonexistence of suitable commercial software, we developed a software tool for the automated fit assessment of nail designs. Furthermore, we demonstrated that an optimised nail, which fits better at the final position, is also easier to insert. Three-dimensional models of two nail designs and 20 tibiae were used. The fitting was quantified in terms of surface area, maximum distance, sum of surface areas and sum of maximum distances by which the nail was protruding into the cortex. The software was programmed to insert the nail into the bone model and to quantify the fit at defined increment levels. On average, the misfit during the insertion in terms of the four fitting parameters was smaller for the Expert Tibial Nail Proximal bend (476.3 mm(2), 1.5 mm, 2029.8 mm(2), 6.5 mm) than the Expert Tibial Nail (736.7 mm(2), 2.2 mm, 2491.4 mm(2), 8.0 mm). The differences were statistically significant (p ≤ 0.05). The software could be used by nail implant manufacturers for the purpose of implant design validation.

  6. An investigation of how fungal infection influences drug penetration through onychomycosis patient’s nail plates

    PubMed Central

    McAuley, W.J.; Jones, S.A.; Traynor, M.J.; Guesné, S.; Murdan, S.; Brown, M.B.

    2016-01-01

    The treatment of onychomycosis remains problematic even though there are several potent antifungal agents available for patient use. The aim of this investigation was to understand whether the structural modifications that arise when a patient’s nail become infected plates influences the permeation of drugs into the nail following topical application. It was hoped that through improving understanding of the nail barrier in the diseased state, the development of more effective topical treatments for onychomycosis could be facilitated. The permeation of three compounds with differing hydrophobicities, caffeine, terbinafine and amorolfine (clog D at pH 7.4 of −0.55, 3.72 and 4.49 respectively), was assessed across both healthy and onychomycosis infected, full thickness, human nail plate sections. Transonychial water loss (TOWL) measurements performed on the healthy and diseased nails supported previous observations that the nail behaves like a porous barrier given the lack of correlation between TOWL values with the thicker, diseased nails. The flux of the more hydrophilic caffeine was twofold greater across diseased in comparison with the healthy nails, whilst the hydrophobic molecules terbinafine and amorolfine showed no statistically significant change in their nail penetration rates. Caffeine flux across the nail was found to correlate with the TOWL measurements, though no correlation existed for the more hydrophobic drugs. These data supported the notion that the nail pores, opened up by the infection, facilitated the passage of hydrophilic molecules, whilst the keratin binding of hydrophobic molecules meant that their transport through the nail plate was unchanged. Therefore, in order to exploit the structural changes induced by nail fungal infection it would be beneficial to develop a small molecular weight, hydrophilic antifungal agent, which exhibits low levels of keratin binding. PMID:26969264

  7. An investigation of how fungal infection influences drug penetration through onychomycosis patient's nail plates.

    PubMed

    McAuley, W J; Jones, S A; Traynor, M J; Guesné, S; Murdan, S; Brown, M B

    2016-05-01

    The treatment of onychomycosis remains problematic even though there are several potent antifungal agents available for patient use. The aim of this investigation was to understand whether the structural modifications that arise when a patient's nail become infected plates influences the permeation of drugs into the nail following topical application. It was hoped that through improving understanding of the nail barrier in the diseased state, the development of more effective topical treatments for onychomycosis could be facilitated. The permeation of three compounds with differing hydrophobicities, caffeine, terbinafine and amorolfine (clogD at pH 7.4 of -0.55, 3.72 and 4.49 respectively), was assessed across both healthy and onychomycosis infected, full thickness, human nail plate sections. Transonychial water loss (TOWL) measurements performed on the healthy and diseased nails supported previous observations that the nail behaves like a porous barrier given the lack of correlation between TOWL values with the thicker, diseased nails. The flux of the more hydrophilic caffeine was twofold greater across diseased in comparison with the healthy nails, whilst the hydrophobic molecules terbinafine and amorolfine showed no statistically significant change in their nail penetration rates. Caffeine flux across the nail was found to correlate with the TOWL measurements, though no correlation existed for the more hydrophobic drugs. These data supported the notion that the nail pores, opened up by the infection, facilitated the passage of hydrophilic molecules, whilst the keratin binding of hydrophobic molecules meant that their transport through the nail plate was unchanged. Therefore, in order to exploit the structural changes induced by nail fungal infection it would be beneficial to develop a small molecular weight, hydrophilic antifungal agent, which exhibits low levels of keratin binding.

  8. Biomechanical investigation of titanium elastic nail prebending for treating diaphyseal long bone fractures.

    PubMed

    Chen, Yen-Nien; Lee, Pei-Yuan; Chang, Chih-Wei; Ho, Yi-Hung; Peng, Yao-Te; Chang, Chih-Han; Li, Chun-Ting

    2016-12-02

    This study numerically investigated the deformation of titanium elastic nails prebent at various degrees during implantation into the intramedullary canal of fractured bones and the mechanism by which this prebending influenced the stability of the fractured bone. Three degrees of prebending the implanted portions of the nails were used: equal to, two times, and three times the diameter of the intramedullary canal. Furthermore, a simulated diaphyseal fracture with a 5-mm gap was created in the middle shaft portion of the bone fixed with two elastic nails in a double C-type configuration. End caps were simulated using a constraint equation. To confirm that the simulation process is able to present the mechanical response of the nail inside the intramedullary, an experiment was conducted by using sawbone for validation. The results indicated that increasing the degrees of nail prebending facilitated straightening the nails against the inner aspect of canal after implantation, with increase in stability under torsion. Furthermore, reducing nail prebending caused a larger portion of the nails to move closer to the loading site and center of bone after implantation; the use of end caps prevented the nail tips from collapsing and increased axial stability. End cap use was critical for preventing the nail tips from collapsing and for increasing the stability of the nails prebent at a degree equal to the diameter of the canal with insufficient frictional force between the nail and canal. Therefore, titanium elastic nail prebending in a double C-type configuration with a degree three times the diameter of the canal represents a superior solution for treating transverse fractures without a gap, whereas that with a degree equal to the diameter of the intramedullary canal and combined with end cap use represents an advanced solution for treating comminuted fractures in a diaphyseal long bone fracture.

  9. Onychomatricoma in the light of the microanatomy of the normal nail unit.

    PubMed

    Perrin, Christophe; Langbein, Lutz; Schweizer, Jürgen; Cannata, Giuseppe Emilio; Balaguer, Thierry; Chignon-Sicart, Bérangère; Garzon, Jean-Marc; Benchetrit, Maxime; Michiels, Jean-François

    2011-04-01

    Onychomatricoma (OM) is an uncommon benign tumor of the nail thought to exhibit differentiation limited toward the nail matrix. Four recent articles from our laboratory have shown, in some respect, a morphological and immunohistochemical homology between the nail unit and the hair follicle at the level of the matrix and isthmus. The purposes of this article are as follows: to investigate whether the sequential pattern of hair keratin expression in the normal nail matrix is maintained in OM, to compare and contrast follicular tumors with matrix differentiation in OM, and to furnish morphological and immunohistochemical markers of the onychogenic capacity of OM. Formalin-fixed paraffin sections from 6 OM were examined using specific keratin (K) antibodies for the matrix, nail bed, and nail isthmus. Hair keratins were expressed in a sequential pattern similar to normal nail matrix. In 3 cases where the cavities were completely lined by the fibroepithelial projections, the morphological aspect and the pattern of expression of K5, K17, K6, K16, and K75 suggested a differentiation toward the nail bed and the nail isthmus. This study shows for the first time that OM can recapitulate the entire nail unit with differentiation toward the nail bed and the nail isthmus. We have identified new histopathological and immunohistochemical features in OM, and we have abridged the diversity of its histological presentation in 2 main patterns: a lobulated or foliated pattern, observed principally on transverse section, and a "glove-finger" mono- or multidigitate pattern, observed mainly on longitudinal section. We have also concluded that OM is not a nail variant of trichoblastoma, pilomatricoma, or other pilar tumors. The concept of epithelial onychogenic tumor with onychogenic mesenchyme could shed more light about the true nature of this peculiar mixed tumor. However, the term OM is short and sanctioned by usage, which justifies keeping it.

  10. Consensus of the 'Malasars' traditional aboriginal knowledge of medicinal plants in the Velliangiri holy hills, India

    PubMed Central

    Ragupathy, Subramanyam; Steven, Newmaster G; Maruthakkutti, Murugesan; Velusamy, Balasubramaniam; Ul-Huda, Muneer M

    2008-01-01

    There are many vanishing cultures that possess a wealth of knowledge on the medicinal utility of plants. The Malasars of Dravidian Tamils are an indigenous society occupying the forests of the Western Ghats, South India. They are known to be exceptional healers and keepers of traditional aboriginal knowledge (TAK) of the flora in the Velliangiri holy hills. In fact, their expertise is well known throughout India as evidenced by the thousands of pilgrims that go to the Velliangiri holy hills for healing every year. Our research is the first detailed study of medicinal plants in India that considers variation in TAK among informants using a quantitative consensus analysis. A total of 95 species belonging to 50 families were identified for medicinal and general health purposes. For each species the botanical name, family, local name, parts used, summary of mode of preparation, administration and curing are provided. The consensus analysis revealed a high level of agreement among the informants usage of a particular plant at a local scale. The average consensus index value of an informant was FIC > 0.71, and over 0.80 for some ailments such as respiratory and jaundice. Some of the more common problems faced by the Malasars were gastrointestinal disorders, respiratory illness, dermatological problems and simple illness such as fever, cough, cold, wounds and bites from poisonous animals. We also discovered several new ethnotaxa that have considerable medicinal utility. This study supports claims that the Malasars possess a rich TAK of medicinal plants and that many aboriginals and mainstream people (pilgrims) utilize medicinal plants of the Velliangiri holy hills. Unfortunately, the younger generation of Malasars are not embracing TAK as they tend to migrate towards lucrative jobs in more developed urban areas. Our research sheds some light on a traditional culture that believes that a healthy lifestyle is founded on a healthy environment and we suggest that TAK such as

  11. Fatigue strength of common tibial intramedullary nail distal locking screws

    PubMed Central

    Griffin, Lanny V; Harris, Robert M; Zubak, Joseph J

    2009-01-01

    Background Premature failure of either the nail and/or locking screws with unstable fracture patterns may lead to angulation, shortening, malunion, and IM nail migration. Up to thirty percent of all unreamed nail locking screws can break after initial weight bearing is allowed at 8–10 weeks if union has not occurred. The primary problem this presents is hardware removal during revision surgery. The purposes of our study was to evaluate the relative fatigue resistance of distal locking screws and bolts from representative manufacturers of tibial IM nail systems, and develop a relative risk assessment of screws and materials used. Evaluations included quantitative and qualitative measures of the relative performance of these screws. Methods Fatigue tests were conducted to simulate a comminuted fracture that was treated by IM nailing assuming that all load was carried by the screws. Each screw type was tested ten times in a single screw configuration. One screw type was tested an additional ten times in a two-screw parallel configuration. Fatigue tests were performed using a servohydraulic materials testing system and custom fixturing that simulated screws placed in the distal region of an appropriately sized tibial IM nail. Fatigue loads were estimated based on a seventy-five kilogram individual at full weight bearing. The test duration was one million cycles (roughly one year), or screw fracture, whichever occurred first. Failure analysis of a representative sample of titanium alloy and stainless steel screws included scanning electron microscopy (SEM) and quantitative metallography. Results The average fatigue life of a single screw with a diameter of 4.0 mm was 1200 cycles, which would correspond roughly to half a day of full weight bearing. Single screws with a diameter of 4.5 mm or larger have approximately a 50 percent probability of withstanding a week of weight bearing, whereas a single 5.0 mm diameter screw has greater than 90 percent probability of

  12. John Punch, Scotist Holy War, and the Irish Catholic Revolutionary Tradition in the Seventeenth Century.

    PubMed

    Campbell, Ian W

    2016-07-01

    During the 1640s, the Irish Franciscan theologian John Punch taught his theology students in Rome that war against Protestants was made just by their religion alone. Jesuits like Luis de Molina identified the holy war tradition in which Punch stood as a Scotist one, and insisted that the Scotists had confused the natural and supernatural spheres. Among Irishmen, Punch was unusual. The main Irish Catholic revolutionary tradition employed Jesuit and Thomist theory. They argued that the Stuarts had lost the right to rule Ireland for natural reasons, not supernatural ones; because the Stuarts were tyrants, not because they were Protestants.

  13. EAP actuators aid the quest for the 'Holy Braille' of tactile displays

    NASA Astrophysics Data System (ADS)

    Runyan, Noel; Blazie, Deane

    2010-04-01

    The authors present the worldwide need for electronic Braille displays to promote literacy among the blind. The use of of EAP's to produce Braille displays is encouraged and detailed descriptions of the technology of Braille are presented. Prior art is covered since the early 1950's through present day displays based mostly on piezoelectric technologies. EAP's offer the promise of the "Holy Braille", the ability to display a full page of Braille electronically. Details on "how not to make a Braille display" are covered in prior art.

  14. Effect of plat diversity on a set of soil characteristics relevant to soil erosion processes: an example from a biancana badland site (Siena Province, Central Italy)

    NASA Astrophysics Data System (ADS)

    Bacaro, Giovanni; Santi, Elisa; Vergari, Francesca; Maccherini, Simona; Rossi, Mauro; Del Monte, Maurizio; Torri, Dino

    2015-04-01

    A study on the influence of vegetation (grassland) on the evolution of a set of soil characteristics was carried out in a protected area (Site of Community Importance, Natura 2000 Network) where there are some residual areas of biancana badlands. This site, named "Crete di Camposodo e Leonina" is located in the Province of Siena, Tuscany, central Italy. Following geomorphological zonation in the badlands, the areas where firstly classified in a series of different classes where erosion is or was active and where sedimentation is or was active. Secondly, for each "erosion class" as determined before, another classification criterion based on the type of vegetation cover was given. Random plots were than sampled on the basis of these classifications until 22 plots where chosen for analyses. In each plot, vegetation was described in a squared sampling unit (40*40cm), and, after description, it was cut, dried and weighted. A functional matrix, based on plant functional traits, was created and Functional Diversity indices, as well as other classic biodiversity metrics (such as Shannon, Simpson, etc) were obtained. On the same sampling area, 4 randomly selected soil carrots (each with a depth of 20cm) were extracted and used for laboratory analysis while undrained soil shear strength at saturation (U4S) was measured using a pocket torvane. Electrical conductivity, pH, and U4S where then compared with several of the vegetation features, including epi- and ipo-gean biomass, vegetation cover and biodiversity indices. Our results clearly identify the relationships which attribute to vegetation (as representative of the ecosystem they shelter) the main role in modifying the soil from bare rock to a well developed surface horizon: while vegetation changes soil attributes, the changed soil attributes make the niche suitable to other plants, with a modification of the composition of the grassland. Finally, we also demonstrated that plant functional dissimilarity represents one

  15. Habit tic nail deformity - a rare presentation in an 8 year old boy.

    PubMed

    El-Heis, S; Abadie, Al

    2016-11-15

    Habit tic nail deformity is a nail dystrophy resulting from habitual, repetitive trauma to the nail. It is usually acquired in adulthood, however, we report a case of habit tic nail deformity in an 8 year old boy. The diagnosis was made clinically with further history revealing that the boy repeatedly rubbed his thumbnails and pushed the cuticles. Emollient cream (Balneum®) was recommended twice daily and both the patient and his mother were educated on the behavioral nature of this condition. There was marked improvement at 6 months of treatment and further improvement at 12 months.We note that habit tic nail deformity is not exclusive to adults. Diagnosis can be made clinically. History and physical examination provide valuable clues and psychosocial links must be explored and addressed. Management is challenging and compliance with treatment is variable. Patient education, barrier methods, and behavioral therapy can be helpful in preventing further trauma to the nails.

  16. Post-Traumatic Ectopic Nail: A Case Report and Review of Literature

    PubMed Central

    Mishra, Tushar Subhadarshan; Sasmal, Prakash Kumar; Rout, Bikram; Sharma, Rakesh

    2016-01-01

    Ectopic nail or Onychoheterotopia is an uncommon clinical entity. They are usually congenital; the acquired variety is very rare. The exact pathogenesis of the disease is not clear. They present as a nail like outgrowth, distinct from the classic nail units which is usually asymptomatic. The dorsal aspect of fingers and toes are mostly affected. We present a case of a 24-year-old male with post-traumatic ectopic nail of right middle finger. Complete surgical excision of the ectopic nail was done with its germinal matrix. The patient didn’t have any evidence of recurrence after one year of follow-up, with satisfactory cosmetic outcome. This article highlights the classic presentation of a case of ectopic nail with its surgical management and brief review of literature. PMID:28050430

  17. Artificial nails: are they putting patients at risk? A review of the research.

    PubMed

    Toles, Angela

    2002-01-01

    The use of artificial nails has become a popular fashion trend, and many health care workers are following this trend. There is debate whether artificial nails are putting patients at risk of nosocomial infections. Researchers have shown that the colony counts on artificial nails are greater than the colony counts on native nails. Artificial nails have also been linked to poor hand washing practices and more tears in gloves. These factors lead to an increased risk of transmitting bacteria to patients. This transmission could greatly affect patients because the hospitalized patient's risk of nosocomial infection is high. The purpose of this article is to review the data related to the bacterial and fungal contamination of artificial nails and their implications for health care workers. Most of the review describes findings of studies of surgical patients and health care workers who work in surgery departments, but the research applies to any area where there is a risk of transferring potential pathogens to immunocompromised patients.

  18. Full thickness burns caused by cyanoacrylate nail glue: A case series.

    PubMed

    Kelemen, Noemi; Karagergou, Eleni; Jones, Sarah L; Morritt, Andrew N

    2016-06-01

    Artificial (acrylic) nails are popular cosmetic enhancements that provide the user with the appearance of manicured nails, do not chip or crack, and are generally considered very safe to apply. We report three cases where full thickness thermal burns were sustained from nail glue adhesive (cyanoacrylate) during the application of artificial nails. All three cases underwent surgical debridement and split skin graft reconstruction. We carried out an experiment to characterize the exothermic reaction between nail glue and cotton leggings. The average high temperature produced was 68°C which was sustained for 12.2s which is more than sufficient to cause full thickness burns on skin. We report these cases to increase both professional and public awareness of this serious potential complication associated with the application of artificial nails.

  19. Intramedullary Tibial Nail Fixation of Simple Intraarticular Distal Tibia Fractures.

    PubMed

    Scolaro, John A; Broghammer, Francis H; Donegan, Derek J

    2016-11-01

    The optimal treatment strategy for distal tibia fractures, especially those with intraarticular extension, remains controversial. Although open reduction and internal fixation with a plate and screw device is commonly performed for these injuries, the risk of soft tissue complications using this approach is significant. Staged treatment protocols and alternative means of fixation have been proposed to address these undesired events. Although potentially more technically demanding than fixation of diaphyseal or extraarticular tibial fractures, intramedullary nail (IMN) fixation of simple intraarticular distal tibia fractures is a viable treatment alternative with unique advantages. This article presents a review of the literature and rationale for intramedullary tibial nail fixation of simple intraarticular distal tibia fractures and a surgical approach commonly utilized for successful implementation.

  20. Nail Sarcoidosis with and without Systemic Involvement: Report of Two Cases.

    PubMed

    Noriega, Leandro; Criado, Paulo; Gabbi, Tatiana; Avancini, João; Di Chiacchio, Nilton

    2015-09-01

    The most commonly seen nail change in sarcoidosis, often associated with chronic systemic disease, is onychodystrophy. Imaging of hands, feet and chest is of paramount importance when nail sarcoidosis is suspected, for evaluation of bone cysts and pulmonary involvement, respectively. We report 2 cases of sarcoidosis that developed nail involvement - one with pulmonary disease, and the other without any evidence of systemic involvement, which is very rare.

  1. Nail Sarcoidosis with and without Systemic Involvement: Report of Two Cases

    PubMed Central

    Noriega, Leandro; Criado, Paulo; Gabbi, Tatiana; Avancini, João; Di Chiacchio, Nilton

    2015-01-01

    The most commonly seen nail change in sarcoidosis, often associated with chronic systemic disease, is onychodystrophy. Imaging of hands, feet and chest is of paramount importance when nail sarcoidosis is suspected, for evaluation of bone cysts and pulmonary involvement, respectively. We report 2 cases of sarcoidosis that developed nail involvement – one with pulmonary disease, and the other without any evidence of systemic involvement, which is very rare. PMID:27170939

  2. Dermoscopy of the nail bed and matrix to assess melanonychia striata.

    PubMed

    Hirata, Sergio H; Yamada, Sergio; Almeida, Fernando A; Tomomori-Yamashita, Jane; Enokihara, Mauro Y; Paschoal, Francisco M; Enokihara, Milvia M; Outi, Cinthia M; Michalany, Nilceo S

    2005-11-01

    Melanonychia striata represents a diagnostic dilemma for dermatologists. The use of dermoscopy to assess the nail has advantages over clinical examination. However, when compared to skin lesions, it gives fewer details. We describe two cases of melanonychia striata submitted to dermoscopic examination of the nail bed and matrix. This is a new procedure that enables observing dermoscopic characteristics that are not visualized in the nail plate, thus, providing additional information.

  3. Estimating uptake of phthalate ester metabolites into the human nail plate using pharmacokinetic modelling.

    PubMed

    Bui, Thuy T; Alves, Andreia; Palm-Cousins, Anna; Voorspoels, Stefan; Covaci, Adrian; Cousins, Ian T

    2017-03-01

    There is a lack of knowledge regarding uptake of phthalate esters (PEs) and other chemicals into the human nail plate and thus, clarity concerning the suitability of human nails as a valid alternative matrix for monitoring long-term exposure. In particular, the relative importance of internal uptake of phthalate metabolites (from e.g. blood) compared to external uptake pathways is unknown. This study provides first insights into the partitioning of phthalate-metabolites between blood and nail using pharmacokinetic (PK) modelling and biomonitoring data from a Norwegian cohort. A previously published PK model (Lorber PK model) was used in combination with measured urine data to predict serum concentrations of DEHP and DnBP/DiBP metabolites at steady state. Then, partitioning between blood and nail was assessed assuming equilibrium conditions and treating the nail plate as a tissue, assuming a fixed lipid and water content. Although calculated as a worst-case scenario at equilibrium, the predicted nail concentrations of metabolites were lower than the biomonitoring data by factors of 44 to 1300 depending on the metabolite. It is therefore concluded that internal uptake of phthalate metabolites from blood into nail is a negligible pathway and does not explain the observed nail concentrations. Instead, external uptake pathways are more likely to dominate, possibly through deposition of phthalates onto the skin/nail and subsequent metabolism. Modelling gaseous diffusive uptake of PEs from air to nail revealed that this pathway is unlikely to be important. Experimental quantification of internal and external uptake pathways of phthalates and their metabolites into the human nail plate is needed to verify these modelling results. However, based on this model, human nails are not a good indicator of internal human exposure for the phthalate esters studied.

  4. Two synchronous periungual BCC treated with Mohs surgery. Nail polish related?

    PubMed

    Dika, Emi; Patrizi, Annalisa; Fanti, Pier Alessandro; Alessandrini, Aurora; Sorci, Rita; Piraccini, Bianca Maria; Vaccari, Sabina; Misciali, Cosimo; Maibach, Howard I

    2013-06-01

    Basal cell carcinoma (BCC), the most frequent malignant skin tumor observed in Caucasian adults, especially males, occurs mainly in sun-exposed areas of the body. BCC in the periungual tissues, such as proximal nail fold, nail matrix, nail bed and hyponychium, is rarely reported. We report a patient with two synchronous BCC of the periungual tissue localized in the IV and V fingernail, effectively treated with Mohs micrographic surgery.

  5. When all you have is a dermatoscope- start looking at the nails.

    PubMed

    Haenssle, Holger A; Blum, Andreas; Hofmann-Wellenhof, Rainer; Kreusch, Juergen; Stolz, Wilhelm; Argenziano, Giuseppe; Zalaudek, Iris; Brehmer, Franziska

    2014-10-01

    Pigmented and non-pigmented nail alterations are a frequent challenge for dermatologists. A profound knowledge of clinical and dermatoscopic features of nail disorders is crucial because a range of differential diagnoses and even potentially life-threatening diseases are possible underlying causes. Nail matrix melanocytes of unaffected individuals are in a dormant state, and, therefore, fingernails and toenails physiologically are non-pigmented. The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma). In general, non-continuous nail alterations, affecting only limited parts of the nail apparatus, are most frequently of non-melanocytic origin. Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis. In addition, foreign bodies, bacterial infections, traumatic injuries, or artificial discolorations of the nail unit may less frequently cause non-continuous nail alterations. Many systemic diseases that may also show involvement of the nails (e.g., psoriasis, atopic dermatitis, lichen planus, alopecia areata) tend to induce alterations in numerous if not all nails of the hands and feet. A similar extensive and generalized alteration of nails has been reported after treatment with a number of systemic drugs, especially antibiotics and cytostatics. Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen's disease, squamous cell carcinoma, and rare collision tumors. This review aims to assist clinicians in correctly evaluating and diagnosing nail disorders with the help of dermatoscopy.

  6. Biomechanical effects of angular stable locking in intramedullary nails for the fixation of distal tibia fractures.

    PubMed

    Augat, Peter; Hoegel, Florian; Stephan, Daniel; Hoffmann, Stephanie; Buehren, Volker

    2016-11-01

    Treatment of distal tibia shaft fractures using intramedullary nailing requires stable fixation of the distal fragment to prevent malunion. Angular stable locking for intramedullary nails pledge to provide increased mechanical stability. This study tested the hypothesis that intramedullary nails with angular stable interlocking screws would have increased construct stiffness, reduced fracture gap movement and enhanced fatigue failure compared to nails with conventional locking having the same diameter. Biomechanical experiments were performed on 24 human cadaveric tibiae which obtained a distal fracture and were fixed by three different techniques: conventional locking with 8- and 10-mm-diameter nails and angular stable locking with 8-mm nails. Stiffness of the implant-bone construct and movement of the fragments were tested under axial loading and torsion. The constructs were tested to failure under cyclic fatigue loading. Analysis of variance and Kaplan-Meier survival analysis were used for statistical assessment. Axial stiffness of the 10-mm nail was about 50% larger compared to both 8-mm nail constructs independent of the type of locking mode (p < 0.01). No differences were found in axial performance between angular stable and conventional locking neither under static nor under cyclic testing conditions (p > 0.5). Angular stability significantly decreased the clearance under torsional load by more than 50% compared to both conventionally locked constructs (p = 0.03). However, due to the larger nail diameter, the total interfragmentary motion was still smallest for the 10-mm nail construct (p < 0.01). Although the 10-mm nail constructs survived slightly longer, differences between groups were minor and not statistically significant (p = 0.4). Our hypothesis that angular stable interlocking of intramedullary nails would improve mechanical performance of distal tibia fracture fixation was not confirmed in a physiologically realistic loading

  7. Intramedullary Nailing for Pathological Fractures of the Proximal Humerus

    PubMed Central

    Choi, Eun-Seok; Han, Ilkyu; Cho, Hwan Seong; Park, In Woong; Park, Jong Woong

    2016-01-01

    Background Endoprosthetic reconstruction is widely applied for pathological fractures of the proximal humerus; however, functional impairment is usually unsatisfactory. The aims of the current study are to evaluate the reliability of interlocking intramedullary (IM) nailing with cement augmentation as a fixation method in proximal humeral lesions and to assess functional outcomes. Methods We reviewed 32 patients with pathological fractures of the proximal humerus who underwent interlocking IM nailing and cement augmentation. Functional scores and pain relief were assessed as outcomes. Results The mean follow-up period was 14.2 months. The mean Musculoskeletal Tumor Society functional score and Karnofsky performance status scale score were 27.7 and 75.6, respectively. Improvement of pain assessed using the visual analogue scale was 6.2 on average. Thirty-one patients (97%) experienced no pain after surgery. The mean ranges of forward flexion and abduction were 115° and 112.6°, respectively. All patients achieved stability and had no local recurrence without failure of fixation until the last follow-up. Conclusions Proximal interlocking IM nailing with cement augmentation appears to be a reliable treatment option for pathological or impending fractures of the proximal humerus in selected patients with metastatic tumors, even with extensive bone destruction. PMID:27904730

  8. Radiation exposure to the surgeon during closed interlocking intramedullary nailing

    SciTech Connect

    Levin, P.E.; Schoen, R.W. Jr.; Browner, B.D.

    1987-06-01

    During interlocking intramedullary nailing of twenty-five femoral and five tibial fractures, the primary surgeon wore both a universal film badge on the collar of the lead apron and a thermoluminescent dosimeter ring on the dominant hand to quantify the radiation that he or she received. When distal interlocking was performed, the first ring was removed and a second ring was used so that a separate recording could be made for this portion of the procedure. At the conclusion of the study, all of the recorded doses of radiation were averaged. The average amount of radiation to the head and neck during the entire procedure was 7.0 millirems of deep exposure and 8.0 millirems of shallow exposure. The average dose of radiation to the dominant hand during insertion of the intramedullary nail and the proximal interlocking screw was 13.0 millirems, while the average amount during insertion of the distal interlocking nail was 12.0 millirems. Both of these averages are well within the government guidelines for allowable exposure to radiation during one-quarter (three months) of a year. Precautions that are to be observed during this procedure are recommended.

  9. Trachyonychia and Twenty-Nail Dystrophy: A Comprehensive Review and Discussion of Diagnostic Accuracy

    PubMed Central

    Jacobsen, Audrey A.; Tosti, Antonella

    2016-01-01

    Background/Aims The term trachyonychia, also known as twenty-nail dystrophy, is used to describe thin, brittle nails with excessive longitudinal ridging. The term twenty-nail dystrophy has been incorrectly applied to other conditions that can affect all twenty nails. Therefore, we have conducted a comprehensive review of the clinical features of trachyonychia and have included a discussion regarding the diagnostic accuracy of this condition in the literature. Methods In November and December 2015, we conducted a thorough literature search using the following search terms: ‘trachyonychia', ‘twenty nail dystrophy’, and ‘sandpaper nails’. Articles that reported the epidemiology, disease associations, clinical presentation, histopathology, and treatment options for trachyonychia were included. Particular attention was given to case reports to identify misdiagnosed cases of twenty-nail dystrophy. Results Our preliminary search yielded 184 results with 72 unique articles ultimately selected for review. Excluded articles included 27 articles in languages other than English, 18 commentaries or reviews, and 67 irrelevant articles. Twelve additional articles described nail abnormalities clinically different from trachyonychia. Conclusion Many other conditions can cause widespread nail dystrophy. The specific characteristics of trachyonychia need to be considered to make the diagnosis of twenty-nail dystrophy. PMID:27843915

  10. Effects of organic solvents on the barrier properties of human nail.

    PubMed

    Smith, Kelly A; Hao, Jinsong; Li, S Kevin

    2011-10-01

    The effects of organic solvent systems on nail hydration and permeability have not been well studied. The objectives of the present study were to investigate the effects of binary aqueous organic solvent systems of ethanol (EtOH), propylene glycol (PPG), and polyethylene glycol 400 (PEG) on the barrier properties of nail plates. (3) H-water, (14) C-urea, and (14) C-tetraethylammonium ions were the probes in the nail uptake and transport experiments to study the effect(s) of organic solvents on nail hydration and permeability. Gravimetric studies were also performed as a secondary method to study nail hydration and the reversibility of the nail after organic solvent treatments. Both ungual uptake and transport were directly related to the concentration of the organic solvent in the binary systems. Partitioning of the probes into and transport across the nail decreased with an increase in the organic solvent concentration. These changes corresponded to the changes in solution viscosity and the barrier properties of the nail. In general, the effects for PPG and PEG were more pronounced than those for EtOH. Practically, these results suggest that organic solvents in formulations can increase nail barrier resistivity.

  11. Incidence of dermatophytes and cyclohexamide resistant fungi on healthy children hairs and nails in nurseries.

    PubMed

    Maghazy, S M

    2002-01-01

    In order to estimate the prevalence of dermatophytes and other fungi on healthy children hairs and nails, 92 hair samples and 85 nail samples (groups of 10 finger nails from each child) were collected from 5 nurseries (children aged 9 months up to 4 years) in Assiut city. From hair samples 22 species were collected, Trichophyton (2 species) and Microsporum (2 species) were the only recovered dermatophytes in addition to well known keratinophilic genus Chrysosporium (4 species). From nail samples, 18 species were identified, Trichophyton was represented by 4 species, Microsporum, 2 species and Chrysosporium, 4 species. Also, several other saprophytes and cycloheximide resistant fungi were isolated.

  12. Habit Reversal versus Object Manipulation Training for Treating Nail Biting: A Randomized Controlled Clinical Trial

    PubMed Central

    Ghanizadeh, Ahmad; Bazrafshan, Amir; Dehbozorgi, Gholamreza

    2013-01-01

    Objective This is a parallel, three group, randomized, controlled clinical trial, with outcomes evaluated up to three months after randomization for children and adolescents with chronic nail biting. The current study investigates the efficacy of habit reversal training (HRT) and compares its effect with object manipulation training (OMT) considering the limitations of the current literature. Method Ninety one children and adolescents with nail biting were randomly allocated to one of the three groups. The three groups were HRT (n = 30), OMT (n = 30), and wait-list or control group (n = 31). The mean length of nail was considered as the main outcome. Results The mean length of the nails after one month in HRT and OMT groups increased compared to the waiting list group (P < 0.001, P < 0.001, respectively). In long term, both OMT and HRT increased the mean length of nails (P < 0.01), but HRT was more effective than OMT (P < 0.021). The parent-reported frequency of nail biting did show similar results as to the mean length of nails assessment in long term. The number of children who completely stopped nail biting in HRT and OMT groups during three months was 8 and 7, respectively. This number was zero during one month for the wait-list group. Conclusion This trial showed that HRT is more effective than wait-list and OMT in increasing the mean length of nails of children and adolescents in long terms. PMID:24130603

  13. Lengthening over nails using the double plate system ONAS-DPS

    PubMed Central

    Antolič, Vane

    2016-01-01

    Stable insertion of large Schanz screws behind an intramedullary (IM) nail when lengthening over nails (LON) may be difficult due to the limited bone stock. Additionally, the highly probable contact between the screws and IM nail (which is difficult to avoid) increases the likelihood of infection spreading from the skin via Schanz screws directly to the IM nail. A new device for LON has been developed. Instead of inserting Schanz screws from the external fixator beside the IM nail (as in standard LON), a system of two overlaying plates was constructed. Schanz screws can be fixed to the plates without entering the bone. The plates are fixed to the bone using four angle stability screws. The holes in the plates offer stabile fixation for a chosen angle under which the screw is positioned through the cortical bone. Using the new system there is no need to place Schanz screws behind the IM nail. Instead, Schanz screws pass to the plate and not through the bone. The new system for elongation over IM nail is called “Over Nail Angle Stability-Double Plate System” (ONAS-DPS) [Antolič V (2013) Modular side device with an intramedullary nail for guiding a bone during its lengthening. World Intellectual Property Organization. International Publication number: WO 2013/176632 A1]. PMID:27163094

  14. Insertion of intramedullary nails from the suprapatellar pouch for proximal tibial shaft fractures. A technical note.

    PubMed

    Jakma, Tijs; Reynders-Frederix, Peter; Rajmohan, Rai

    2011-12-01

    Intramedullary nailing of proximal tibial fractures can be difficult when using the standard entry portal. We evaluated the suprapatellar portal, using a midline quadriceps tendon incision, to perform intramedullary nailing of the tibia. Seven patients were treated with this adaptation of the standard intramedullary nailing procedure. An arthroscopy was done before and after the nailing procedure. No special equipment was used to perform the intramedullary nailing. We evaluated the handling and necessary modifications of the standard intramedullary technique to introduce the locked tibial nail through the suprapatellar approach. We found this technique not necessarily more difficult than the standard intramedullary nailing of the tibia through the infrapatellar entry portal. Although the patients did not complain of patellofemoral discomfort after the suprapatellar nailing, definitive scuffing of the cartilage in the lower part of the femoral trochlea was visible. Introduction of a locked tibial nail via the suprapatellar approach was found to be possible and even advantageous for some complex upper tibial shaft fractures in compromised limbs. Some possible downsides of this approach need to be taken into account but, in some cases, they can be outweighed by the benefits.

  15. Histopathological analysis of the progression pattern of subungual melanoma: late tendency of dermal invasion in the nail matrix area.

    PubMed

    Shin, Hyun-Tae; Jang, Kee-Taek; Mun, Goo-Hyun; Lee, Dong-Youn; Lee, Jason B

    2014-11-01

    Subungual melanoma is a rare subtype of melanoma that usually originates and spreads from the nail matrix. Because of its poor prognosis and short matrix-to-bone distance, amputation has been traditionally performed. Recently, conservative surgery has been attempted for early subungual melanoma, but the evidence supporting this practice is sparse. As little is known about the progression pattern of subungual melanoma, further advances on the subject may provide better guidance on the optimal surgical approach. Histopathology slides, clinical records, and photographs of 23 cases of subungual melanoma were reviewed. For all cases, each area of the nail unit-proximal nail fold, nail matrix, nail bed, and/or hyponychium-in longitudinal sections was available for histological examination. Growth pattern, dermal invasion, and thickness were assessed in each area of the nail unit. There were five cases of melanoma in situ. Eighteen cases showed dermal invasion in at least one area of the nail unit. There were no cases showing dermal invasion in the nail matrix area only. In four cases, dermal invasion involved areas of the nail unit other than the nail matrix. In 14 cases, dermal invasion involved the nail matrix area as well as other areas of the nail unit. Except for one case, the nail matrix area showed thinner dermal invasion compared with dermal invasion in other areas of the nail unit. In conclusion, dermal invasion of subungual melanoma in the nail matrix area tends to occur later than other areas of the nail unit. Longitudinal incisional biopsy is necessary to accurately evaluate melanoma invasion. The findings of this study suggest that conservative surgical treatment for early subungual melanoma may be justified as the nail matrix area, an area of thin dermis and close proximity to the underlying bone, appears to be more resistant to invasion.

  16. Alteration of the diffusional barrier property of the nail leads to greater terbinafine drug loading and permeation.

    PubMed

    Nair, Anroop B; Sammeta, Srinivasa M; Kim, Hyun D; Chakraborty, Bireswar; Friden, Phillip M; Murthy, S Narasimha

    2009-06-22

    The diffusional barrier property of biological systems varies with ultrastructural organization of the tissues and/or cells, and often plays an important role in drug delivery. The nail plate is a thick, hard and impermeable membrane which makes topical nail drug delivery challenging. The current study investigated the effect of physical and chemical alteration of the nail on the trans-ungual drug delivery of terbinafine hydrochloride (TH) under both passive and iontophoretic conditions. Physical alterations were carried out by dorsal or ventral nail layer abrasion, while chemical alterations were performed by defatting or keratolysis or ionto-keratolysis of the nails. Terbinafine permeation into and across the nail plate following various nail treatments showed similar trends in both passive and iontophoretic delivery, although the extent of drug delivery varied with treatment. Application of iontophoresis to the abraded nails significantly improved (P<0.05) TH permeation and loading compared to abraded nails without iontophoresis or normal nails with iontophoresis. Drug permeation was not enhanced when the nail plate was defatted. Keratolysis moderately enhanced the permeation but not the drug load. Ionto-keratolysis enhanced TH permeation and drug load significantly (P<0.05) during passive and iontophoretic delivery as compared to untreated nails. Ionto-keratolysis may be more efficient in permeabilization of nail plates than long term exposure to keratolysing agents.

  17. Iontophoresis for drug delivery into the nail apparatus: exploring hyponychium as the site of delivery.

    PubMed

    Kushwaha, Avadhesh; Shivakumar, H N; Murthy, S Narasimha

    2016-10-01

    In present studies, a hyponychium pathway (from ventral side of the nail plate) was investigated as a potential route of drug delivery into the nail apparatus using iontophoresis as an active physical method. In vitro transport studies were performed across the human nail plate using sodium fluorescein as a marker substrate for 24 h. After transport studies, the amount of sodium fluorescein extracted from an active diffusion area of the nail plate in case of iontophoresis was found to be ∼54-folds more to that of passive. The amount of sodium fluorescein retained in the peripheral area of the nail plate after application of iontophoresis was found to be ∼30-folds more relative to passive. Ex vivo transport studies were performed on excised human cadaver toe using terbinafine hydrochloride as a model drug for three days (8 h/day). The amount of terbinafine retained in the nail plate after application of iontophoresis (3.43 ± 1.34 µg/mg) was ∼20-folds more when compared with passive (0.17 ± 0.10 µg/mg). The amount of drug extracted from the nail bed and nail matrix was 1.73 ± 0.12 µg/mg and 0.55 ± 0.22 µg/mg, respectively. On the other hand, there was no detectable amount of terbinafine found in the nail bed and nail matrix in case of control (passive delivery). These studies show that the iontophoretic drug delivery through hyponychium region to other parts of the nail apparatus could be a potential way of onychomycosis treatment.

  18. Evaluation of the SMALL nail: Drive technology and behavior in situ.

    PubMed

    Dünnweber, L H; Rödl, R; Gosheger, G; Schiedel, F M

    2016-12-01

    Although clear advances have been made during the last 5 years, practical difficulties persist for patients and surgeons in procedures for intramedullary lengthening of long bones. In particular, precise adjustment of the desired amount of lengthening and technically reliable checking of the length actually achieved are problematic. An intramedullary nail with a new type of drive that exploits the shape memory effect has been constructed. The drive technology and the behavior of the intramedullary nail in situ were evaluated in a cadaver experiment. Three shape memory alloy limb lengthening (SMALL) nails were implanted in a body donor. The SMALL nail contains a spring coupled to a shape memory element consisting of a nickel-titanium alloy. This shape memory element "remembers" its initial state before the lengthening through the spring and can return to it when it is warmed. A cartridge heater inside the lengthening nail is warmed using transcutaneous induction with high-frequency energy via a subcutaneously implanted coil. For evaluation, two SMALL nails were implanted into the femora (antegrade on the left and retrograde on the right) and one SMALL nail was implanted into the left tibia. Lengthening by 50mm was attempted using repeated activation of the drive mechanism. At the same time, test parameters for temperature increases and cooling periods were continually monitored and the data were subsequently analyzed. The nail's mechanism worked in principle, but was inadequate in view of success rates (number of lengthening steps attempted versus number of lengthening steps achieved) of 21% for the SMALL nail in the tibia and left femur and 14% for the nail in the right femur. The temperature values measured during the distraction experiments show that high-frequency energy induction in the SMALL nail gives no cause for concern for patients.

  19. The Contribution of the Holy Ghost Congregation to the Educational Development of Nigeria: Historical and Contemporary Reflections

    ERIC Educational Resources Information Center

    Amadi, Anthony

    2016-01-01

    This article is a historical narrative about the contribution the Holy Ghost Congregation made in the educational development of Nigeria. It is narrative because it highlights the events and the work of the early Spiritan missionaries that brought education and its benefits to Nigerians. It is pedagogic because it describes the methods these Holy…

  20. Effect of Vocalization of the Holy Quran With and Without Translation on Pregnancy Outcomes: A Randomized Clinical Trial

    PubMed Central

    Mirghafourvand, Mojgan; Sehhati Shafaie, Fahimeh; Mohammad-Alizadeh-Charandabi, Sakineh; Jabbari, Batoul

    2016-01-01

    Background During recent decades, research in Iran in the area of the Quran and medical science has been seriously engaged in. With respect to the tendency toward spirituality and alternative medicine, we tried to find other aspects of the influence of the Quran. Objectives This study aimed to determine the effect of vocalizations of the Holy Quran with and without translation on the consequences of pregnancy (the prevalence of preterm delivery, caesarean delivery, and neonatal anthropometric indices) in women admitted to health care centers in Urmia, Iran. Materials and Methods This was a three-armed parallel-group randomized clinical trial in which 168 pregnant women (25-28 weeks) in their first and second pregnancies were divided into three groups of 56 (Holy Quran with translation, Holy Quran without translation, and control group) by randomized blocking. The intervention was implemented once a week for three weeks in the health center, and on other days of the week, the participants listened at home to a CD they were given. The intervention and the control groups all received routine pregnancy care once a week. These mothers were tracked during their labor. Outcomes including gestational age at delivery, delivery type, and neonatal anthropometric indices were recorded based on the mother’s records. Results There was no statistically significant difference between the groups in terms of demographic and obstetric characteristics before the intervention. In comparison with the control group, the probability of preterm delivery was lower in the Holy Quran with translation group (odds ratio: 0.3, CI 95%: 0.1-1.2) and in the Holy Quran without translation group (0.6, 0.2-1.9) as compared to the control group. However, this difference was not statistically significant. Similarly, the probability of caesarean delivery was lower in the Holy Quran with translation group (0.6, 0.3-1.4) and the Holy Quran without translation group (0.5, 0.2-1.2) as compared to the

  1. The cosmic statements in the Holy Quran as introduction to the public understanding of space science in the Islamic countries

    NASA Astrophysics Data System (ADS)

    Mosalam Shaltout, M. A.

    The Holy Quran contains more than 800 cosmic statements speak about: sun, moon, planets, stars, Sirius, zodiac, day, night, twilights, position of stars, navigation, blue sky, night sky, dawn, noon, sunrise and sunset, eclipses, lunar months, release to the sky, landing to the earth, and so on. Due to the new discoveries in the 19th and 20th centuries in astronomy and space sciences, some of the Arabian-Islamic scientists and astronomers wished to find the significance of the cosmic statements in the Holy Quran on the light of these new discoveries. This current started at the end of the 19th century, and was growing through the 20th century. Hundreds of the articles published in the Daily news, and in the Weekly, Monthly, Quarterly, Annually Journals. Also, tens of the books published for different authors, from different Arabian and Islamic countries about the significance of the cosmic statements in the Holy Quran on the light of modern astronomy and Space sciences. Also, Radio and TV play an important role in this field, specially after the releasing of the Human kind to the space in the second half of the 20th century. This activity led to construct the International Commission on Scientific Signs in the Holy Quran and the Sunnah, which follow to the Muslim World League in Makkah Al-Mukarramah in Saudi Arabia. Where, there is a Quarterly Journal for this purpose, and periodic International conference for the same purpose, the seventh conference was held in February 2004. This paper speak about the activity of the different Arabian-Islamic Scientists and Astronomers in the field of interpretations of the cosmic statements in the Holy Quran on the light of modern astronomy and space science, and their role of increasing the public understanding of space science in the Arabian and Islamic countries.

  2. Seismic analysis of nailed vertical excavation using pseudo-dynamic approach

    NASA Astrophysics Data System (ADS)

    Sarangi, Piyush; Ghosh, Priyanka

    2016-12-01

    An attempt has been made to study the behavior of nailed vertical excavations in medium dense to dense cohesionless soil under seismic conditions using a pseudo-dynamic approach. The effect of several parameters such as angle of internal friction of soil ( ϕ), horizontal ( k h) and vertical ( k v) earthquake acceleration coefficients, amplification factor ( f a), length of nails ( L), angle of nail inclination ( α) and vertical spacing of nails ( S v) on the stability of nailed vertical excavations has been explored. The limit equilibrium method along with a planar failure surface is used to derive the formulation involved with the pseudo-dynamic approach, considering axial pullout of the installed nails. A comparison of the pseudo-static and pseudo-dynamic approaches has been established in order to explore the effectiveness of the pseudo-dynamic approach over pseudo-static analysis, since most of the seismic stability studies on nailed vertical excavations are based on the latter. The results are expressed in terms of the global factor of safety (FOS). Seismic stability, i.e., the FOS of nailed vertical excavations is found to decrease with increase in the horizontal and vertical earthquake forces. The present values of FOS are compared with those available in the literature.

  3. Size and Charge Dependence of Ion Transport in Human Nail Plate.

    PubMed

    Baswan, Sudhir M; Li, S Kevin; LaCount, Terri D; Kasting, Gerald B

    2016-03-01

    The electrical properties of human nail plate are poorly characterized yet are a key determinate of the potential to treat nail diseases, such as onychomycosis, using iontophoresis. To address this deficiency, molar conductivities of 17 electrolytes comprising 12 ionic species were determined in hydrated human nail plate in vitro. Cation transport numbers across the nail for 11 of these electrolytes were determined by the electromotive force method. Effective ionic mobilities and diffusivities at infinite dilution for all ionic species were determined by regression analysis. The ratios of diffusivities in nail to those in solution were found to correlate inversely with the hydrodynamic radii of the ions according to a power law relationship having an exponent of -1.75 ± 0.27, a substantially steeper size dependence than observed for similar experiments in skin. Effective diffusivities of cations in nail were 3-fold higher than those of comparably sized anions. These results reflect the strong size and charge selectivity of the nail plate for ionic conduction and diffusion. The analysis implies that efficient transungual iontophoretic delivery of ionized drugs having radii upward of 5 Å (molecular weight, ca. ≥ 340 Da) will require chemical or mechanical alteration of the nail plate.

  4. Size and Charge Dependence of Ion Transport in Human Nail Plate

    PubMed Central

    Baswan, Sudhir M.; Li, S. Kevin; LaCount, Terri D.; Kasting, Gerald B.

    2016-01-01

    The electrical properties of human nail plate are poorly characterized, yet are a key determinate of the potential to treat nail diseases such as onychomycosis using iontophoresis. In order to address this deficiency, molar conductivities of 17 electrolytes comprising 12 ionic species were determined in hydrated human nail plate in vitro. Cation transport numbers across the nail for 11 of these electrolytes were determined by the electromotive force method. Effective ionic mobilities and diffusivities at infinite dilution for all ionic species were determined by regression analysis. The ratios of diffusivities in nail to those in solution were found to correlate inversely with the hydrodynamic radii of the ions according to a power law relationship having an exponent of −1.75 ± 0.27, a substantially steeper size dependence than observed for similar experiments in skin. Effective diffusivities of cations in nail were three-fold higher than those of comparably sized anions. These results reflect the strong size and charge selectivity of the nail plate for ionic conduction and diffusion. The analysis implies that efficient transungual iontophoretic delivery of ionized drugs having radii upwards of 5 Å (approximately MW ≥ 340 Da) will require chemical or mechanical alteration of the nail plate. PMID:26886342

  5. 76 FR 19124 - Certain Steel Nails From the United Arab Emirates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-06

    ... From the Federal Register Online via the Government Publishing Office INTERNATIONAL TRADE COMMISSION Certain Steel Nails From the United Arab Emirates AGENCY: United States International Trade... from The United Arab Emirates of certain steel nails, provided for in subheadings 7317.00.55,...

  6. New Polyurethane Nail Lacquers for the Delivery of Terbinafine: Formulation and Antifungal Activity Evaluation.

    PubMed

    Gregorí Valdes, Barbara S; Serro, Ana Paula; Gordo, Paulo M; Silva, Alexandra; Gonçalves, Lídia; Salgado, Ana; Marto, Joana; Baltazar, Diogo; Dos Santos, Rui Galhano; Bordado, João Moura; Ribeiro, Helena Margarida

    2017-03-03

    Onychomycosis is a fungal nail infection. The development of new topical antifungal agents for the treatment of onychomycosis has focused on formulation enhancements that optimize the pharmacological characteristics required for its effective treatment. Polyurethanes (PUs) have never been used in therapeutic nail lacquers. The aim of this work has been the development of new PU-based nail lacquers with antifungal activity containing 1.0% (wt/wt) of terbinafine hydrochloride. The biocompatibility, wettability, and the prediction of the free volume in the polymeric matrix were assessed using a human keratinocytes cell line, contact angle, and Positron Annihilation Lifetime Spectroscopy determinations, respectively. The morphology of the films obtained was confirmed by scanning electron microscopy, while the nail lacquers' bioadhesion to nails was determined by mechanical tests. Viscosity, in vitro release profiles, and antifungal activity were also assessed. This study demonstrated that PU-terbinafine-based nail lacquers have good keratinocyte compatibility, good wettability properties, and adequate free volume. They formed a homogenous film after application, with suitable adhesion to the nail plate. Furthermore, the antifungal test results demonstrated that the terbinafine released from the nail lacquer Formulation A PU 19 showed activity against dermatophytes, namely Trichophyton rubrum.

  7. Background values for essential and toxic elements in children's nails and correlation with hair levels.

    PubMed

    Carneiro, Maria Fernanda Hornos; Grotto, Denise; Batista, Bruno Lemos; Rhoden, Claudia Ramos; Barbosa, Fernando

    2011-12-01

    Human nails are an attractive matrix for assessing environmental exposures to toxic elements as well as the deficiency of essential elements since it is noninvasively collected and can be stored at room temperature. However, reference or baseline levels in nonexposed and healthy populations are not yet established. Then, the aims of this study were (a) to estimate background values for essential and toxic elements in nails from a healthy young population in southern Brazil and (b) to evaluate possible correlations between essential and toxic elements in nails. Furthermore, this report took part of a recent study of background values in the hair of a young population. Thus, correlations between chemical elements in nails and hair were also evaluated. Nails were collected from healthy children (n = 126), and element concentrations were determined by inductively coupled plasma mass spectrometry. This study provides new and reliable reference concentrations for toxic and essential elements in children's nails. The results can be used as reference values for epidemiological or clinical investigations based on trace elements in nails. Additionally, we also showed weak to strong correlations between Cu, Mg, Mn, Se, and Zn levels in nails and hair.

  8. Deformation monitoring of long GFRP bar soil nails using distributed optical fiber sensing technology

    NASA Astrophysics Data System (ADS)

    Hong, Cheng-Yu; Yin, Jian-Hua; Zhang, Yi-Fan

    2016-08-01

    This paper introduces a new measurement technology characterized by the use of distributed optical fiber sensor (OFSs) for monitoring the strain and temperature distribution of glass fiber reinforced polymer (GFRP) bar soil nails. Laboratory tension tests were used to verify the performance of the OFSs for strain and elongation monitoring of GFRP bars. The measured strain data from the OFSs agree fairly well with the data from strain gauges in calibration tests. In field monitoring tests, two GFRP bar soil nails were installed with OFSs and pure strain data were used to evaluate the performance of GFRP bar soil nails after installation in a practical slope. Both the strain and temperature distributions measured by the OFSs show symmetric features. A Brillouin optical time domain analysis (BOTDA) measurement unit was used to collect temperature and strain data from the OFSs. The monitoring data show that the accumulative elongations of the soil nails present a continuous but limited increase with time in the field. The achieved maximum elongations of soil nails were less than 0.4 mm. The measured axial elongations of the soil nails were also validated using corresponding data predicted by a theoretical model. The test results from the present study prove that BOTDA based sensors are useful for the investigation of the average strain distributions (or elongation) of long soil nails and these data are useful for the estimation of the potential sliding surface of the entire soil nailing system.

  9. Application of soil nails to the stability of mine waste slopes

    SciTech Connect

    Tant, C.R.; Drumm, E.C.; Mauldon, M.; Berry, R.M.

    1996-12-31

    The traditional soil nailed structure incorporates grouted or driven nails, and a wire mesh reinforced shotcrete facing to increase the stability of a slope or wall. This paper describes the construction and monitoring of a full-scale demonstration of nailing to stabilize coal mine spoil. The purpose of the investigation is to evaluate the performance of nailed slopes in mine spoil using methods proven for the stabilization of soil walls and slopes. The site in eastern Tennessee is a 12 meter high slope of dumped fill, composed of weathered shale chips, sandstone, and coal. The slope was formed by {open_quotes}pre-regulatory{close_quotes} contour surface mining operations and served as a work bench during mining. The material varies in size from silt to boulders, and has a small amount of cohesion. Portions of the mine spoil slope have experienced slope instability and erosion which have hampered subsequent reclamation activities. Three different nail spacings and three different nail lengths were used in the design. The 12 meter high structure is instrumented to permit measurement of nail strain, and vertical inclinometer readings and survey measurements will be used for the detection of ground movement. The results of this study will aid in the development of design recommendations and construction guidelines for the application of soil nailing to stabilize mine spoil.

  10. The spotted lunula. A neglected nail sign associated with alopecia areata.

    PubMed

    Shelley, W B

    1980-05-01

    Three patients with alopecia areata were observed to have spotty absence of t4e whiteness of the lunulae of their nails. This was ascribed to defects in the tongue of matrical epithelium which lies under the nail plate and accounts for the lunula. An analogy is drawn with Wickham's striae.

  11. Understanding Habits: A Preliminary Investigation of Nail Biting Function in Children.

    ERIC Educational Resources Information Center

    Woods, Douglas W.; Fuqua, R. Wayne; Siah, Adelene; Murray, Laura K.; Welch, Matthew; Blackman, Edward; Seif, Tory

    2001-01-01

    Traditional functional analysis procedures were combined with a functional assessment interview and etiological theories to evaluate functions of nail biting in six children. Environmental restriction in combination with other variables appeared to control nail biting. A habit reversal intervention was generally effective but was less effective…

  12. 76 FR 47146 - Certain Steel Nails From the Peoples' Republic of China: Notice of Extension of Time Limits for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-04

    ... International Trade Administration Certain Steel Nails From the Peoples' Republic of China: Notice of Extension... review on the antidumping order on certain steel nails from the People's Republic of China (``PRC'') for..., the Department initiated the first antidumping duty administrative review on certain steel nails...

  13. 75 FR 17125 - Certain Steel Nails from the People's Republic of China: Extension of Time Limit for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-05

    ... International Trade Administration Certain Steel Nails from the People's Republic of China: Extension of Time... order on certain steel nails from the People's Republic of China (``PRC'') was published in the Federal Register on August 1, 2008. See Notice of Antidumping Duty Order: Certain Steel Nails From the...

  14. 78 FR 68472 - Steel Nails From China; Scheduling of an Expedited Five-Year Review Concerning the Antidumping...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-14

    ... COMMISSION Steel Nails From China; Scheduling of an Expedited Five-Year Review Concerning the Antidumping Duty Order on Steel Nails From China AGENCY: United States International Trade Commission. ACTION... revocation of the antidumping duty order on steel nails from China would be likely to lead to continuation...

  15. Tolerance in heart transplantation: the Holy Grail, or an attainable goal?

    PubMed

    Pierson, Richard N

    2007-01-01

    The father of cardiac transplantation, Norman Shumway, famously predicted that tolerance was the future of the field, and always would be. Although his prediction remains true to date, significant progress has been made toward this goal, the "Holy Grail" for transplant clinicians. Current efforts are fueled by disappointing long-term outcomes associated with chronic immunosuppression, and the promise that partial or complete tolerance will impact long-term results favorably. This article provides a clinical definition of tolerance primarily based on lessons learned from animal heart allograft models. It reviews several promising strategies for inducing tolerance and detecting its presence through the use of biomarkers in peripheral blood or the graft, and outlines a possible path toward making this vision a clinical reality.

  16. Optimisation of microencapsulation of holy basil essential oil in gelatin by response surface methodology.

    PubMed

    Sutaphanit, Polin; Chitprasert, Pakamon

    2014-05-01

    To protect holy basil essential oil (HBEO) from volatilisation and oxidation, microencapsulation by simple coacervation of gelatin was developed. An optimal encapsulating condition obtained from response surface methodology (RSM) was a gelatin concentration of 11.75% (w/v) and an HBEO amount of 31ml, which provided the greatest yield, oil content, and encapsulation efficiency of 98.80%, 66.50%, and 95.41%, respectively. Scanning electron microscope (SEM) revealed that the internal surface of the microcapsule was honeycomb-like networks containing nonhomogeneous distributions of HBEO. Fourier transform infrared spectroscopy (FTIR) indicated that there was no significant interaction between the HBEO and gelatin. Under storage conditions at 60°C for 49days equivalent to 25°C for 18months, small decreases in the HBEO retention rate and the antioxidant activity were observed. Thus, the microencapsulated formulation has potential to be applied to other volatile compounds.

  17. Antioxidant Activity of The Ancient Herb, Holy Basil in CCl4-Induced Liver Injury in Rats

    PubMed Central

    Ponnusam, Yuvaraj; Louis, Therasilin; Madhavachandran, V; Kumar, Suresh; Thoprani, Neelam; Hamblin, Michael R; Lakshmanan, Shanmugamurthy

    2015-01-01

    An herbal preparation called “holy basil plus herbal powder” (HBPP) containing Ocimum santum, Withania somnifera, Pongamia pinnata, Plumbago indica, Emblica officinalis and Curcuma longa was investigated as an antioxidant and hepatoprotective agent. The antioxidant activity of HBPP was investigated in rats with liver injury induced by oral administration of carbon tetrachloride:olive oil (1:1). HBPP was administered orally at 500 mg/kg daily for 7 days before. HBPP exhibited statistically significant antioxidant activity, as shown by increased levels of glutathione peroxidase (GPX), glutathione S-transferase (GST), glutathione reductase (GRD), superoxide dismutase (SOD) and catalase (CAT) and decreased level of lipid peroxidation (LPO). HBPP performed equally well as silymarin, a well-established antioxidant preparation used to protect against liver injury. PMID:26925464

  18. Witkop tooth and nail syndrome: a report of three cases in a family.

    PubMed

    Memarpour, Mahtab; Shafiei, Fereshteh

    2011-01-01

    Witkop tooth and nail syndrome is a rare autosomal dominant ectodermal dysplasia manifested by hypodontia and nail dysplasia. Tooth shape may vary, and conical and narrow crowns are common. Mandibular incisors, second molars, and maxillary canines are the most frequently missing teeth. Nail dysplasia affects the fingernails and especially the toenails and is often more severe in childhood. Nails may be spoon-shaped, ridged, slow-growing, and easily broken. We examined an Eastern Mediterranean family in which three siblings (two girls, one boy) had this syndrome. The severity of finger and toenail anomalies varied. The children's mother had no Witkop-related abnormalities, but their father was reported to have dental and nail anomalies. Early intervention is recommended to manage orofacial disfigurement and avoid negative social consequences for these children.

  19. Self-inflicted Cardiac Injury with Nail Gun Without Hemodynamic Compromise: A Case Report

    PubMed Central

    Ho, Simon; Feranec, Nicholas

    2017-01-01

    Pneumatically powered nail guns have been used in construction since 1959. Penetrating injuries to the heart with nail guns have a wide range of presentations from asymptomatic to cardiac tamponade and exsanguination. Mortality related to cardiac nail gun injuries is similar to knife injuries, estimated at 25%. Surgical exploration is the treatment of choice. We describe a case of self-inflicted nail gun injury to the chest without hemodynamic compromise in a 51-year-old man. Computed tomography (CT) imaging confirmed nail penetrating the right ventricle, with the tip adjacent to but not violating the abdominal aorta. The patient was successfully treated with thoracotomy and foreign body removal. PMID:28191375

  20. Preliminary studies of the use of nail as a material for reconstructive or cosmetic surgery.

    PubMed

    Taylor, P; Kaakedjian, G

    1998-04-01

    The purpose of this study was to assess the biocompatibility and stability of implanted nail as a preliminary step in the assessment of its potential as a material for small scale reconstructive or cosmetic surgery. Rat nails were placed subcutaneously in the back of 12 Lewis rats, which were then sacrificed in groups of 4 at 4, 8, and 12 months for macroscopic and microscopic examination of the implants. A layer of strongly adherent connective tissue, containing inflammatory cells, had formed around the nails at 4 months, but by 8 to 12 months this reaction had subsided, leaving the nails imbedded in connective tissue adhering to the dermal wall, with no evidence of implant rejection, granuloma formation, or degradation. The results suggest that nail merits further study as a surgical implant material, because of its staying power and lack of immunogenicity.

  1. In vitro nail invasion by pathogenic and non-pathogenic fungi under different culture conditions.

    PubMed

    Baudraz-Rosselet, F; Frenk, E

    1990-01-01

    Data from the literature suggest that the nutritional environment can modify major metabolic functions of fungi and possibly their aggressivity towards keratinous structures. Trichophyton rubrum (TR), Microsporum canis (MC), Scopulariopsis brevicaulis (SB), Aspergillus fumigatus (AF) and Penicillium spec. (P) were inoculated on media of different nutritional value, in presence of nail fragments. The activity of the fungi was evaluated at two and four weeks for intensity and depth of invasion of nail samples. Nail invasion was most pronounced by MC, especially when grown on rice agar or peptone agar. Nail invasion by the other fungi tested was less important, Sabourand glucose and rice agar were most favorable. Our results indicate that nutritional factors can, at least in some fungus species, alter their rate of nail invasion.

  2. Antegrade versus retrograde nailing techniques and trochanteric versus piriformis intramedullary nailing entry points for femoral shaft fractures: a systematic review and meta-analysis

    PubMed Central

    Hussain, Nasir; Hussain, Farrah Naz; Sermer, Corey; Kamdar, Hera; Schemitsch, Emil H.; Sternheim, Amir; Kuzyk, Paul

    2017-01-01

    Background There are several different techniques commonly used to perform intramedullary (IM) nailing of the femur to fix femoral fractures. We sought to identify significant differences in outcomes of studies comparing 1) trochanteric and piriformis entry and 2) antegrade and retrograde entry in IM nailing of the femur. Methods We searched MEDLINE, Cochrane and Embase databases and the Orthopaedic Trauma Association and American Academy of Orthopaedic Surgeons websites for comparative studies published from inception to November 2015. Criteria used to select articles for detailed review included use of antegrade and retrograde entry point or use of trochanteric and piriformis entry point for IM nailing of the femur in adult patients. Functional and technical outcomes were extracted from accepted studies. Results We identified 483 potential studies, of which 52 were eligible. Of these, we included 13 publications and 2 abstracts (2 level I, 7 level II and 6 level III studies). Trochanteric entry significantly reduced operative duration by 14 min compared with piriformis entry (p = 0.030). Retrograde nailing had a greater risk of postoperative knee pain than antegrade nailing (p = 0.05). On the other hand, antegrade nailing had significantly more postoperative hip pain (p = 0.003) and heterotopic ossification (p < 0.001) than retrograde nailing. No significant differences in functional outcomes were observed. Conclusion Although some significant differences were found, the varying quality of studies made recommendation difficult. Our meta-analysis did not confirm superiority of either antegrade over retrograde or trochanteric over piriformis entry for IM nailing of the femur. Level of evidence Level III therapeutic. PMID:28234586

  3. Nail-like targets for laser plasma interaction experiments

    SciTech Connect

    Pasley, J; Wei, M; Shipton, E; Chen, S; Ma, T; Beg, F N; Alexander, N; Stephens, R B; MacPhee, A G; Hey, D; Pape, S L; Patel, P; Mackinnon, A J; Key, M H; Offermann, D; Link, A; Chowdhury, E; Van-Woerkom, L D; Freeman, R R

    2007-12-18

    The interaction of ultra-high power picosecond laser pulses with solid targets is of interest both for benchmarking the results of hybrid particle in cell (PIC) codes and also for applications to re-entrant cone guided fast ignition. We describe the construction of novel targets in which copper/titanium wires are formed into 'nail-like' objects by a process of melting and micromachining, so that energy can be reliably coupled to a 24 {micro}m diameter wire. An extreme-ultraviolet image of the interaction of the Titan laser with such a target is shown.

  4. Fatigue load of current tibial intramedullary nail designs: a simulated study.

    PubMed

    Wagner, Mark; Liu, Qi; Ellis, Thomas J

    2011-06-14

    Comminuted tibial shaft fractures are traditionally treated with statically locked intramedullary nailing and protected weight bearing until fracture callous is evident. The purpose of this study was to demonstrate that a simulation of immediate full weight bearing following intramedullary nailing of these fractures does not result in implant failure.A comminuted fracture model was created using 2 pieces of polyvinyl chloride (PVC) pipe. Ten-millimeter-diameter tibial nails (Synthes, Paoli, Pennsylvania; Styker, Mahwah, New Jersey; Zimmer, Warsaw, Indiana; Smith & Nephew, Memphis, Tennessee) were inserted within the PVC pipe and secured proximally and distally with 2 or 3 locking bolts. The constructs were cycled in axial compression for 500,000 cycles or until implant failure. The tests were conducted using a modified staircase method (200 N per step), and the fatigue strength was identified for each of the tibial nail designs. When 2 interlocking bolts were placed proximally and distally, the fatigue strength was between 900 and 1100 N for the Stryker nail, 1100 and 1300 N for the Zimmer nail, 1200 and 1400 N for the Synthes nail, and 1400 and 1600 N for the Smith & Nephew nail. Adding a third interlocking bolt proximally and distally to the Smith & Nephew nail increased the fatigue strength by 13% to between 1700 and 1900 N. In all cases, implant failures occurred through the proximal or distal interlocking bolts.Biomechanical tests suggest that current tibial nail designs may permit immediate full weight bearing of comminuted tibial shaft fractures with minimal risk of implant failure. This may facilitate mobilization in the early postoperative period, especially in the multiply injured patient.

  5. Enhanced econazole penetration into human nail by 2-n-nonyl-1,3-dioxolane.

    PubMed

    Hui, Xiaoying; Chan, Thomas C K; Barbadillo, Sherry; Lee, Christine; Maibach, Howard I; Wester, Ronald C

    2003-01-01

    This study determines the enhancing effects of 2-n-nonyl-1,3-dioxolane on the penetration of econazole, an antifungal drug, into the deeper layers of the human nail where fungal infection resides. Aliquots (10 microL) of Econail lacquer formulation containing 0.45 mg of [(14)C]-econazole with 18% 2-n-nonyl-1,3-dioxolane (test group) or without 2-n-nonyl-1,3-dioxolane (control group) were applied twice daily for 14 days to human nails that had been washed with ethanol before each morning's application. The hydration of the nail sample was well controlled to simulate normal physiological conditions. After 14 days of dosing, the inner ventral section of the nail plate was assayed for absorbed drug content, using a micrometer-controlled drilling and nail powder removal system. The mass balance values of [(14)C]-econazole in this study were 90.8 and 96.4% for the test and control groups, respectively. The weight-normalized econazole content in the ventral/intermediate nail plate center in the test group was 6-fold greater than that in the control (p = 0.008). The total econazole absorbed into the supporting bed cotton ball in the test group was nearly 200-fold greater than that in the control group (p = 0.008) over the 14-day period. The amount of econazole after dosing in the inner part of the human nail (potential diseased area) was 11.1 +/- 2.6 (SD) microg/mg of nail powder with 2-n-nonyl-1,3-dioxolane in the lacquer and 1.78 +/- 0.32 microg/mg without 2-n-nonyl-1,3-dioxolane (p = 0.008). The surface nail contained more econazole (p = 0.004), that is, nonabsorbed drug, where 2-n-nonyl-1,3-dioxolane was not part of the dosing solution. Econazole in the support bed under the nail (the total absorbed dose) was 47.5 +/- 22.0 mg in the lacquer with 2-n-nonyl-1,3-dioxolane and 0.2 +/- 0.1 mg in the lacquer without 2-n-nonyl-1,3-dioxolane (p = 0.008). Moreover the concentration in the deep nail layer in the test group is 14,000 times higher than minimum inhibitory

  6. Linkage analysis of the Nail-patella syndrome

    SciTech Connect

    Campeau, E.; Watkins, D.; Rouleau, G.A.; Babul, R.; Der Kaloustian, V.M.; Buchanan, J.A.; Meschino, W.

    1995-01-01

    Nail-patella syndrome (NPS) is an autosomal dominant disorder characterized by dysplasia of nails and patella, decreased mobility of the elbow, iliac horns, and, in some cases, nephropathy. The disorder has been mapped to the long arm of chromosome 9, but the precise localization and identity of the NPS gene are unknown. Linkage analysis in three NPS families, using highly informative dinucleotide repeat polymorphisms on 9q33-q34, confirmed linkage of NPS to this chromosome. Recombinations were detected, by two-point linkage analysis, between NPS and the centromeric markers D9S60 and the gelsolin gene and the telomeric markers D9S64 and D9S66, in one of the families. Haplotype analysis suggested an additional recombination between NPS and the argininosuccinate synthetase (ASS) gene. These results localize the NPS gene to an interval on 9q34.1, distal to D9S60 an proximal to ASS, comprising a genetic distance of {approximately}9 cM. This represents a significant refinement in the localization of the NPS gene. 25 refs., 2 figs., 1 tab.

  7. Analysis of human nails by laser-induced breakdown spectroscopy

    NASA Astrophysics Data System (ADS)

    Hosseinimakarem, Zahra; Tavassoli, Seyed Hassan

    2011-05-01

    Laser-induced breakdown spectroscopy (LIBS) is applied to analyze human fingernails using nanosecond laser pulses. Measurements on 45 nail samples are carried out and 14 key species are identified. The elements detected with the present system are: Al, C, Ca, Fe, H, K, Mg, N, Na, O, Si, Sr, Ti as well as CN molecule. Sixty three emission lines have been identified in the spectrum that are dominated by calcium lines. A discriminant function analysis is used to discriminate among different genders and age groups. This analysis demonstrates efficient discrimination among these groups. The mean concentration of each element is compared between different groups. Correlation between concentrations of elements in fingernails is calculated. A strong correlation is found between sodium and potassium while calcium and magnesium levels are inversely correlated. A case report on high levels of sodium and potassium in patients with hyperthyroidism is presented. It is shown that LIBS could be a promising technique for the analysis of nails and therefore identification of health problems.

  8. Nail Damage (Severe Onychodystrophy) Induced by Acrylate Glue: Scanning Electron Microscopy and Energy Dispersive X-Ray Investigations

    PubMed Central

    Pinteala, Tudor; Chiriac, Anca Eduard; Rosca, Irina; Larese Filon, Francesca; Pinteala, Mariana; Chiriac, Anca; Podoleanu, Cristian; Stolnicu, Simona; Coros, Marius Florin; Coroaba, Adina

    2017-01-01

    Background Scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) techniques have been used in various fields of medical research, including different pathologies of the nails; however, no studies have focused on obtaining high-resolution microscopic images and elemental analysis of disorders caused by synthetic nails and acrylic adhesives. Methods Damaged/injured fingernails caused by the use of acrylate glue and synthetic nails were investigated using SEM and EDX methods. Results SEM and EDX proved that synthetic nails, acrylic glue, and nails damaged by contact with acrylate glue have a different morphology and different composition compared to healthy human nails. Conclusions SEM and EDX analysis can give useful information about the aspects of topography (surface sample), morphology (shape and size), hardness or reflectivity, and the elemental composition of nails. PMID:28232921

  9. Infection resistance of unreamed solid, hollow slotted and cannulated intramedullary nails: an in-vivo experimental comparison.

    PubMed

    Horn, J; Schlegel, U; Krettek, C; Ito, K

    2005-07-01

    Infection continues to be a problematic complication of fracture treatment, particularly in severe open fractures. The implant design and material as well as implantation technique play an important role in the pathogenesis of local infection. The aim of our study was to determine if the local resistance to infection of a cannulated IM nail is less than that of a solid nail and more similar to that of a hollow nail. In 65 female White Zealand rabbits, the intramedullary cavity was inoculated with matching concentrations of Staphylococcus aureus, and one of the three nails was inserted. The solid nail had a greater than twofold higher resistance to infection (23%) compared to that of the other two nails (hollow, 65%; cannulated, 61%) which was statistically significant (p<0.02). No difference in infection resistance was detected between the hollow slotted and cannulated nail designs (p=1). Although these experimental results may be clinically considered, direct extrapolation to clinical infection rates is ill advised.

  10. Lgr6 marks nail stem cells and is required for digit tip regeneration

    PubMed Central

    Lehoczky, Jessica A.; Tabin, Clifford J.

    2015-01-01

    The tips of the digits of some mammals, including human infants and mice, are capable of complete regeneration after injury. This process is reliant on the presence of the overlaying nail organ and is mediated by a proliferative blastema. Epithelial Wnt/β-catenin signaling has been shown to be necessary for mouse digit tip regeneration. Here, we report on Lgr5 and Lgr6 (leucine-rich repeat-containing G protein-coupled receptor 5 and 6), two important agonists of the Wnt pathway that are known to be markers of several epithelial stem cell populations. We find that Lgr5 is expressed in a dermal population of cells adjacent to the specialized epithelia surrounding the keratinized nail plate. Moreover, Lgr5-expressing cells contribute to this dermis, but not the blastema, during digit tip regeneration. In contrast, we find that Lgr6 is expressed within cells of the nail matrix portion of the nail epithelium, as well as in a subset of cells in the bone and eccrine sweat glands. Genetic lineage analysis reveals that Lgr6-expressing cells give rise to the nail during homeostatic growth, demonstrating that Lgr6 is a marker of nail stem cells. Moreover, Lgr6-expressing cells contribute to the blastema, suggesting a potential direct role for Lgr6-expressing cells during digit tip regeneration. This role is confirmed by analysis of Lgr6-deficient mice, which have both a nail and bone regeneration defect. PMID:26460010

  11. Lgr6 marks nail stem cells and is required for digit tip regeneration.

    PubMed

    Lehoczky, Jessica A; Tabin, Clifford J

    2015-10-27

    The tips of the digits of some mammals, including human infants and mice, are capable of complete regeneration after injury. This process is reliant on the presence of the overlaying nail organ and is mediated by a proliferative blastema. Epithelial Wnt/β-catenin signaling has been shown to be necessary for mouse digit tip regeneration. Here, we report on Lgr5 and Lgr6 (leucine-rich repeat-containing G protein-coupled receptor 5 and 6), two important agonists of the Wnt pathway that are known to be markers of several epithelial stem cell populations. We find that Lgr5 is expressed in a dermal population of cells adjacent to the specialized epithelia surrounding the keratinized nail plate. Moreover, Lgr5-expressing cells contribute to this dermis, but not the blastema, during digit tip regeneration. In contrast, we find that Lgr6 is expressed within cells of the nail matrix portion of the nail epithelium, as well as in a subset of cells in the bone and eccrine sweat glands. Genetic lineage analysis reveals that Lgr6-expressing cells give rise to the nail during homeostatic growth, demonstrating that Lgr6 is a marker of nail stem cells. Moreover, Lgr6-expressing cells contribute to the blastema, suggesting a potential direct role for Lgr6-expressing cells during digit tip regeneration. This role is confirmed by analysis of Lgr6-deficient mice, which have both a nail and bone regeneration defect.

  12. Oral carriage of enterobacteriaceae among school children with chronic nail-biting habit

    PubMed Central

    Reddy, Sushma; Sanjai, Karpagaselvi; Kumaraswamy, Jayalakshmi; Papaiah, Lokesh; Jeevan, MB

    2013-01-01

    Context: Onychophagia or habitual nail-biting is widespread among children and adolescents, between 10 and 18 years. Prevalence estimates range from 30% during childhood to 45% in adolescence. Nail-biting habit can result in autoinoculation of pathogens and transmission of infection between body parts. Aims: The purpose of the study was to evaluate the differences in prevalence of Enterobacteriaceae (E. coli and Enterobacter spp) in saliva samples from subjects with and without chronic nail-biting habit. Subjects and Methods: One hundred and twenty-two subjects with chronic nail-biting habit and 122 subjects with no oral habit were enrolled in the study. All subjects were aged 11-15 years. The saliva samples were collected by oral rinse technique, samples were studied microbiologically. Statistical Analysis Used: Two-tailed Student's t-test and Chi-square/Fisher's exact test were used to find the significance of study parameters between the groups. Results: Enterobacteriaceae were detected in the saliva samples of 80 of the 122 nail-biting subjects, whereas Enterobacteriaceae were detected in the saliva samples of only 10 of the 122 subjects who were not nail-biters. This difference in prevalence was statistically significant (P < 0.001). Conclusions: Our results suggest a higher carriage of Enterobacteriaceae in the individuals having nail-biting habits when compared to individuals with no habits. Further studies need to be done to know the prevalence of Enterobacteriaceae species in different age groups. PMID:24250072

  13. A Novel Vehicle for Enhanced Drug Delivery Across the Human Nail for the Treatment of Onychomycosis.

    PubMed

    Turner, Rob; Weaver, Sean; Caserta, Francesco; Brown, Marc B

    2016-01-01

    The aim of this study was to use in vitro nail models to investigate the potential of a novel base formulation (Recura) containing either fluconazole or miconazole for the treatment of onychomycosis in comparison to two commercial comparators (Jublia and a Penlac generic). Initially, a modified Franz cell was used, where sections of human nail served as the barrier through which drug penetrated into an agar-filled chamber infected with dermatophytes. A second study was performed using a novel infected nail model where dermatophytes grew into human nail and adenosine triphosphate levels were used as biological marker for antimicrobial activity. The novel enhancing system Recura increased the permeation of both existing drugs through human nail sections mounted in a modified Franz cell. Furthermore, the infected nail model also confirmed that the system also enhanced the permeation through infected nail resulting in a decrease in adenosine triphosphate levels superior (P ≤ 0.05) to Penlac generic and equivalent (P > 0.05) to the commercial comparator Jublia. This study demonstrated that with the use of a novel permeation-enhancing formulation base, Recura enhances delivery of miconazole and fluconazole when applied ungually such that the efficacy was equivalent or superior to commercial comparators. Such a topically applied system has the possibility of overcoming the systemic side effects of antifungals when taken orally.

  14. Hydration of nail plate: a novel screening model for transungual drug permeation enhancers.

    PubMed

    Chouhan, P; Saini, T R

    2012-10-15

    Drug delivery by topical route for the treatment of onychomycosis, a nail fungal infection, is challenging due to the unique barrier properties of the nail plate which imparts high resistance to the passage of antifungal drugs. Permeation enhancers are used in transungual formulations to improve the drug flux across the nail plate. Selection of the effective permeation enhancer among the available large pool of permeation enhancers is a difficult task. Screening the large number of permeation enhancers using conventional Franz diffusion cells is laborious and expensive. The objective of present study was to evolve a simple, accurate and rapid method for screening of transungual drug permeation enhancers based on the principle of hydration of nail plate. The permeation enhancer which affects the structural or physicochemical properties of nail plate would also affect their hydration capacity. Two screening procedures namely primary and secondary screenings were evolved wherein hydration and uptake of ciclopirox olamine by nail plates were measured. Hydration enhancement factor, HEF(24) and drug uptake enhancement factor, UEF(24) were determined for screening of 23 typical permeation enhancers. The Pearson's correlation coefficient between HEF(24) and UEF(24) was determined. A good agreement between the HEF(24) and UEF(24) data proved the validity of the proposed nail plate hydration model as a screening technique for permeation enhancers.

  15. In Vitro Nail Penetration and Antifungal Activity of Tavaborole, a Boron-Based Pharmaceutical.

    PubMed

    Coronado, Dina; Merchant, Tejal; Chanda, Sanjay; Zane, Lee T

    2015-06-01

    An effective topical antifungal medication must penetrate through the nail plate at sufficient concentrations to eradicate the fungal infection. Tavaborole topical solution, 5% is a novel boron-based pharmaceutical approved for the treatment of toenail onychomycosis due to Trichophyton rubrum or T mentagrophytes. Four in vitro studies assessed the antifungal activity and nail penetration of tavaborole. In Study 1, tavaborole demonstrated minimum inhibitory concentration (MIC) values ranging from 0.25-2 μg/mL against all fungi tested; addition of 5% keratin powder did not affect the MIC against T rubrum. The minimum fungicidal concentration (MFC) values for tavaborole against T rubrum and T mentagrophytes were 8 and 16 μg/mL, respectively. In Study 2, tavaborole effectively penetrated through the nail plate; mean concentrations in the ventral/intermediate nail layer were significantly higher than ciclopirox at day 15. In Study 3, mean cumulative tavaborole penetration through ex vivo human nails was significantly higher than ciclopirox at day 15. In Study 4, tavaborole demonstrated superior nail penetration and fungicidal activity, as measured by zones of inhibition. These studies demonstrated the superior penetration of tavaborole through the nail plate vs ciclopirox. Tavaborole demonstrated robust antifungal activity, with low MIC and MFC values, even in the presence of keratin.

  16. Comparing the Intramedullary Nailing Method Versus Dynamic Hip Screw in Treatment of Unstable Intertrochanteric Fractures

    PubMed Central

    Yeganeh, Ali; Taghavi, Roozbeh; Moghtadaei, Mehdi

    2016-01-01

    Introduction: Dynamic Hip Screw fixation is currently considered as a standard treatment for pre-trochanteric fractures; however, due to the long-term hospitalization and some other complications, some researchers have proposed intramedullary nailing as the alternative surgical treatment. The aim of this study was to compare and examine the consequences of the using intramedullary nailing method versus Dynamic Hip Screw. Methods: In this study 114 patients with unstable Intertrochanteric fracture refer to Rasoul Akram hospital during 2011 to 2013 has been selected. After reduction, fixation surgery with PFN nail (60 patients) and Dynamic Hip Screw (54 patients) has been performed. All patients were screen during surgery and six months after surgery and some parameters like, bleeding, union, as well as complications such as collapse, varus and medialization of the distal fragment were record and patients. Results: About some parameters like cutting length, surgery duration, bleeding there were significant differences between two groups. In six months follow up period 2 patinas from nail and 8 patients from DHS group had non-union. Also from the point of radiologic and clinical parameters, like anterior thigh pain, cut out, medialization of the distal fragment, collapse of the neck, walking recovery and daily activities were significant between two groups. Conclusion: Due to the reduced hospital stay in intramedullary nailing method and the necessity of doing repeated surgery and applying intramedullary nailing when the patients are not treated with external fixation, the researchers recommend intramedullary nailing as the first option in treating such patients. PMID:26980933

  17. Onychopharmacokinetics of terbinafine hydrochloride penetration from a novel topical formulation into the human nail in vitro.

    PubMed

    Hui, Xiaoying; Lindahl, Åke; Lamel, Sonia; Maibach, Howard I

    2013-09-01

    This study determined the onychopharmacokinetics, nail absorption, distribution, and penetration of [¹⁴C]-terbinafine HCl in a new topical formulation into/through the human finger nail using the in vitro finite dose model. This study determined the penetration rate of terbinafine HCl from multiple doses of topical formulation applied daily for 14 days. Results showed that the total dose recovery (mass balance) was almost 100%. The concentration of terbinafine HCl in the deeper nail plate (ventral/intermediate layers) and the cotton-pad nail bed samples after the 14-day treatment were 613 ± 145 and (±S.D.) and 27 ± 1.2 µg/cm³ (or 1.9 ± 0.6 µg/cm³ daily) on average, respectively. In comparison with nail concentration data from the literature for other topical terbinatine formulations, our results show that higher amounts of terbinafine HCl reached the deep nail plate and/or the nail bed after a 14-day topical treatment with this topical formulation in vitro.

  18. Breakage of a Third Generation Gamma Nail: A Case Report and Review of the Literature

    PubMed Central

    Iwakura, Takashi; Lee, Sang Yang; Nishida, Kotaro; Kuroda, Ryosuke; Kurosaka, Masahiro

    2013-01-01

    The use of intramedullary nails to treat trochanteric fractures of the femur has increased with the increasing size of the elderly population. The third generation Gamma nail is currently one of the most popular devices for the treatment of trochanteric fractures. Nail breakage is a rare complication, possibly resulting from fatigue fracture of the implant. We present the first reported case of breakage of a third generation Gamma nail that was not used to treat a pathological fracture. An 83-year-old woman with an unstable trochanteric fracture of the femur was treated using a third generation Gamma nail. She was referred to our hospital 14 months postoperatively with nail breakage at the opening for the lag screw. The breakage was secondary to nonunion, which was thought to be mainly due to insufficient reduction of the fracture. The broken nail was removed, and the patient underwent cemented bipolar hemiarthroplasty. At followup 18 months later, she was mobile with a walker and asymptomatic with no complications. This case shows that inadequate operation such as insufficient reduction of the trochanteric fracture may result in nonunion and implant breakage, even when using a high-strength, well-designed implant. PMID:23762698

  19. Treatment of Femoral Shaft Fracture with an Interlocking Humeral Nail in Older Children and Adolescents

    PubMed Central

    Park, Hoon

    2012-01-01

    Purpose Rigid interlocking nailing for femoral shaft fracture is ideal for use in adolescents in terms of stability of the fracture and convenience for the patient. However, numerous authors have reported that rigid interlocking nailing has some limitations in this age group due to the risk of complications. We evaluated the results of intramedullary nailing for femoral shaft fractures with an interlocking humeral nail in older children and adolescents. Materials and Methods We retrospectively reviewed records of patients treated with an interlocking humeral nail. Radiographs were examined for proximal femoral change and evidence of osteonecrosis. Outcomes were assessed by major or minor complications that occurred after operative treatment. Results Twenty-four femoral shaft fractures in 23 patients were enrolled. The mean age at the time of operation was 12 years and 8 months and the mean follow-up period was 21 months. Bony union was achieved in all patients without any complications related to the procedure such as infection, nonunion, malalignment and limb length discrepancy. All fractures were clinically and radiographically united within an average eight weeks. No patients developed avascular necrosis of the femoral head and coxa valga. Conclusion Intramedullary nailing through the greater trochanter using a rigid interlocking humeral nail is effective and safe for the treatment of femoral shaft fractures in older children and adolescents. PMID:22318831

  20. Effects of human hair and nail proteins and their films on rat mast cells.

    PubMed

    Fujii, Toshihiro; Murai, Shinya; Ohkawa, Kousaku; Hirai, Toshihiro

    2008-06-01

    Human hair and nail are valuable materials for producing individual corresponding biocompatible materials. A rapid and convenient protein extraction method (Shindai method) and novel procedures for preparing their protein films from their extracts have been developed using human hair and nail. The effects of the human hair and nail proteins and their films on histamine release from rat peritoneal mast cells were investigated. Both protein solutions and their films, mainly consisting of keratins and matrix proteins, did not induce histamine release from the mast cells. Scanning electron microscopy (SEM) also showed that the mast cells were only slightly affected by adding the human hair and nail proteins or by incubating on their protein films. The IgE-dependent histamine release was inhibited by the hair and nail proteins and their films. Incubation of the mast cells with the hair and nail proteins prior to the addition of the IgE serum resulted in a high inhibition (50%) of the histamine release, while the inhibition was approximately 10% when the protein solutions were mixed with the mast cells after incubation with the IgE serum. These results suggest that the human hair and nail proteins and their films will be useful materials for antiallergic actions.

  1. Molecular diffusion in the human nail measured by stimulated Raman scattering microscopy.

    PubMed

    Chiu, Wing Sin; Belsey, Natalie A; Garrett, Natalie L; Moger, Julian; Delgado-Charro, M Begoña; Guy, Richard H

    2015-06-23

    The effective treatment of diseases of the nail remains an important unmet medical need, primarily because of poor drug delivery. To address this challenge, the diffusion, in real time, of topically applied chemicals into the human nail has been visualized and characterized using stimulated Raman scattering (SRS) microscopy. Deuterated water (D2O), propylene glycol (PG-d8), and dimethyl sulphoxide (DMSO-d6) were separately applied to the dorsal surface of human nail samples. SRS microscopy was used to image D2O, PG-d8/DMSO-d6, and the nail through the O-D, -CD2, and -CH2 bond stretching Raman signals, respectively. Signal intensities obtained were measured as functions of time and of depth into the nail. It was observed that the diffusion of D2O was more than an order of magnitude faster than that of PG-d8 and DMSO-d6. Normalization of the Raman signals, to correct in part for scattering and absorption, permitted semiquantitative analysis of the permeation profiles and strongly suggested that solvent diffusion diverged from classical behavior and that derived diffusivities may be concentration dependent. It appeared that the uptake of solvent progressively undermined the integrity of the nail. This previously unreported application of SRS has permitted, therefore, direct visualization and semiquantitation of solvent penetration into the human nail. The kinetics of uptake of the three chemicals studied demonstrated that each altered its own diffusion in the nail in an apparently concentration-dependent fashion. The scale of the unexpected behavior observed may prove beneficial in the design and optimization of drug formulations to treat recalcitrant nail disease.

  2. Molecular diffusion in the human nail measured by stimulated Raman scattering microscopy

    PubMed Central

    Chiu, Wing Sin; Belsey, Natalie A.; Garrett, Natalie L.; Moger, Julian; Delgado-Charro, M. Begoña; Guy, Richard H.

    2015-01-01

    The effective treatment of diseases of the nail remains an important unmet medical need, primarily because of poor drug delivery. To address this challenge, the diffusion, in real time, of topically applied chemicals into the human nail has been visualized and characterized using stimulated Raman scattering (SRS) microscopy. Deuterated water (D2O), propylene glycol (PG-d8), and dimethyl sulphoxide (DMSO-d6) were separately applied to the dorsal surface of human nail samples. SRS microscopy was used to image D2O, PG-d8/DMSO-d6, and the nail through the O-D, -CD2, and -CH2 bond stretching Raman signals, respectively. Signal intensities obtained were measured as functions of time and of depth into the nail. It was observed that the diffusion of D2O was more than an order of magnitude faster than that of PG-d8 and DMSO-d6. Normalization of the Raman signals, to correct in part for scattering and absorption, permitted semiquantitative analysis of the permeation profiles and strongly suggested that solvent diffusion diverged from classical behavior and that derived diffusivities may be concentration dependent. It appeared that the uptake of solvent progressively undermined the integrity of the nail. This previously unreported application of SRS has permitted, therefore, direct visualization and semiquantitation of solvent penetration into the human nail. The kinetics of uptake of the three chemicals studied demonstrated that each altered its own diffusion in the nail in an apparently concentration-dependent fashion. The scale of the unexpected behavior observed may prove beneficial in the design and optimization of drug formulations to treat recalcitrant nail disease. PMID:26056283

  3. [Infections of finger and toe nails due to fungi and bacteria].

    PubMed

    Nenoff, P; Paasch, U; Handrick, W

    2014-04-01

    Infections of the finger and the toe nails are most frequently caused by fungi, primarily dermatophytes. Causative agents of tinea unguium are mostly anthropophilic dermatophytes. Both in Germany, and worldwide, Trichophyton rubrum represents the main important causative agent of onychomycoses. Yeasts are isolated from fungal nail infections, both paronychia and onychomycosis far more often than generally expected. This can represent either saprophytic colonization as well as acute or chronic infection of the nail organ. The main yeasts causing nail infections are Candida parapsilosis, and Candida guilliermondii; Candida albicans is only in third place. Onychomycosis due to molds, or so called non-dermatophyte molds (NDM), are being increasingly detected. Molds as cause of an onychomycosis are considered as emerging pathogens. Fusarium species are the most common cause of NDM onychomycosis; however, rare molds like Onychocola canadensis may be found. Bacterial infections of the nails are caused by gram negative bacteria, usually Pseudomonas aeruginosa (recognizable because of green or black coloration of the nails) but also Klebsiella spp. and gram positive bacteria like Staphylococcus aureus. Treatment of onychomycosis includes application of topical antifungal agents (amorolfine, ciclopirox). If more than 50 % of the nail plate is affected or if more than three out of ten nails are affected by the fungal infection, oral treatment using terbinafine (in case of dermatophyte infection), fluconazole (for yeast infections), or alternatively itraconazole are recommended. Bacterial infections are treated topically with antiseptic agents (octenidine), and in some cases with topical antibiotics (nadifloxacin, gentamicin). Pseudomonas infections of the nail organ are treated by ciprofloxacin; other bacteria are treated according to the results of culture and sensitivity testing.

  4. External lead contamination of women's nails by surma in Pakistan: Is the biomarker reliable?

    PubMed

    Ikegami, Akihiko; Takagi, Mai; Fatmi, Zafar; Kobayashi, Yayoi; Ohtsu, Mayumi; Cui, Xiaoyi; Mise, Nathan; Mizuno, Atsuko; Sahito, Ambreen; Khoso, Aneeta; Kayama, Fujio

    2016-11-01

    Adverse health effects of heavy metals are a public health concern, especially lead may cause negative health impacts to human fetal and infantile development. The lead concentrations in Pakistani pregnant women's nails, used as a biomarker, were measured to estimate the lead exposure. Thirteen nail samples out of 84 nails analyzed contained lead higher than the concentration (13.6 μg/g) of the fatal lead poisoning case, raising the possibility of an external contamination. Eye cosmetics such as surma are recognized as one of the important sources of lead exposure in Pakistan. We collected in Pakistan 30 eye cosmetics made in Pakistan, Saudi Arabia and western countries. As the metal composition analysis by energy dispersive X-ray fluorescence spectrometry revealed that some surma samples contained lead more than 96%, the surma might contaminate the nail specimen. Scanning electron microscopy observations showed that lead-containing surma consists of fine particle of galena (ore of lead sulfide) in respirable dust range (less than 10 μm). In addition, relative in vitro bioavailability of lead in the surma was determined as 5.2%. Thus, lead-containing surma consists of inhalable and bioavailable particles, and it contributes an increased risk of lead exposure. Moreover, the relationship between the surma and the lead-contaminated nails by lead isotope ratios analysis indicated the potential of lead contamination in nails by surma. These results suggest that lead in the nails was derived both from body burden of lead and external contamination by lead-containing surma. Therefore, nail is not suited as a biomarker for lead exposure in the countries where surma used, because we may overestimate lead exposure by surface lead contamination in the nail by surma.

  5. Permeation studies of novel terbinafine formulations containing hydrophobins through human nails in vitro.

    PubMed

    Vejnovic, Ivana; Huonder, Cornelia; Betz, Gabriele

    2010-09-15

    Existing treatments of onychomycosis are not satisfactory. Oral therapies have many side effects and topical formulations are not able to penetrate into the human nail plate and deliver therapeutical concentrations of active agent in situ. The purpose of the present study was to determine the amount of terbinafine, which permeates through the human nail plate, from liquid formulations containing enhancers, namely hydrophobins A-C in the concentration of 0.1% (w/v). The used reference solution contained 10% (w/v) of terbinafine in 60% (v/v) ethanol/water without enhancer. Permeability studies have been performed on cadaver nails using Franz diffusion cells modified to mount nail plates and filled with 60% (v/v) ethanol/water in the acceptor chamber. Terbinafine was quantitatively determined by HPLC. The amount of terbinafine remaining in the nail was extracted by 96% ethanol from pulverized nail material after permeation experiment and presented as percentage of the dry nail weight before the milling test. Permeability coefficient (PC) of terbinafine from reference solution was determined to be 1.52E-10 cm/s. Addition of hydrophobins improved PC in the range of 3E-10 to 2E-9 cm/s. Remaining terbinafine reservoir in the nail from reference solution was 0.83% (n=2). An increase of remaining terbinafine reservoir in the nail was observed in two out of three tested formulations containing hydrophobins compared to the reference. In all cases, known minimum inhibitory concentration of terbinafine for dermatophytes (0.003 microg/ml) has been exceeded in the acceptor chamber of the diffusion cells. All tested proteins (hydrophobins) facilitated terbinafine permeation after 10 days of permeation experiment, however one of them achieved an outstanding enhancement factor of 13.05 compared to the reference. Therefore, hydrophobins can be included in the list of potential enhancers for treatment of onychomycosis.

  6. Flexible intramedullary nailing in paediatric femoral fractures. A report of 73 cases

    PubMed Central

    2011-01-01

    Background Flexible intramedullary nailing has emerged as an accepted procedure for paediatric femoral fractures. Present indications include all patients with femoral shaft fractures and open physis. Despite its excellent reported results, orthopaedic surgeons remain divided in opinion regarding its usefulness and the best material used for nails. We thus undertook a retrospective study of paediatric femoral fractures treated with titanium or stainless steel flexible nails at our institute with a minimum of 5 years follow up. Material and methods We included 73 femoral shaft fractures in 69 patients treated with retrograde flexible intramedullary nailing with a minimum follow up of 5 years. Final limb length discrepancy and any angular or rotational deformities were determined. Results Mean age at final follow up was 15.5 years (10-21 years). Mean follow up was 7.16 years (5.0-8.6 years). Titanium and stainless steel nails were used in 43 and 30 cases respectively. There were 51 midshaft, 17 proximal, and 5 distal fractures. All fractures united at an average of 11 weeks but asymptomatic malalignment and LLD were seen in 19% and 58% fractures respectively. LLD ranged from -3 cm to 1.5 cm. Other complications included superficial infection(2), proximal migration of nail(3), irritation at nail insertion site(5) and penetration of femoral neck with nail tip(1). There were 59 excellent, 10 satisfactory and 4 poor results. Conclusion Flexible intramedullary nailing is reliable and safe for treating paediatric femoral shaft fractures. It is relatively free of serious complications despite asymptomatic malalignment and LLD in significant percentage of fractures. PMID:22192682

  7. Comparison of human hair and nail low-sulfur protein compositions on two-dimensional electrophoresis.

    PubMed

    Dekio, S; Jidoi, J

    1989-08-01

    Compositions of human normal hair and nail low-sulfur proteins were compared using two-dimensional electrophoresis of their S-carboxymethylated (SCM) derivatives. Six SCM low-sulfur protein components with molecular weights (MWs) of 76,000, 73,000, 72,000, 64,000, 61,000 and 55,000 were common to the hair and nail. One component with a MW of 61,000 was specific to hair, and two components, both with a MW of 50,000, were specific to nail.

  8. Self-administered behavior modification to reduce nail biting: incorporating simple technology to ensure treatment integrity.

    PubMed

    Craig, Andrew R

    2010-01-01

    Habitual behaviors, such as problematic nail biting, are a common target for self-managed behavior-modification programs. The current self-experiment used self-monitoring in conjunction with a self-managed differential-reinforcement procedure for the treatment of problematic nail biting. A simple picture-comparison procedure allowed an independent observer to assist in monitoring treatment progress and outcomes and to ensure treatment integrity. Results provide support that the overall treatment package was successful in decreasing the occurrence of nail biting. Moreover, the treatment-integrity procedure enabled full-day monitoring to take place with limited requirement of a secondary observer.

  9. Randomized Trial of Reamed and Unreamed Intramedullary Nailing of Tibial Shaft Fractures

    PubMed Central

    2008-01-01

    Background: There remains a compelling biological rationale for both reamed and unreamed intramedullary nailing for the treatment of tibial shaft fractures. Previous small trials have left the evidence for either approach inconclusive. We compared reamed and unreamed intramedullary nailing with regard to the rates of reoperations and complications in patients with tibial shaft fractures. Methods: We conducted a multicenter, blinded randomized trial of 1319 adults in whom a tibial shaft fracture was treated with either reamed or unreamed intramedullary nailing. Perioperative care was standardized, and reoperations for nonunion before six months were disallowed. The primary composite outcome measured at twelve months postoperatively included bone-grafting, implant exchange, and dynamization in patients with a fracture gap of <1 cm. Infection and fasciotomy were considered as part of the composite outcome, irrespective of the postoperative gap. Results: One thousand two hundred and twenty-six participants (93%) completed one year of follow-up. Of these, 622 patients were randomized to reamed nailing and 604 patients were randomized to unreamed nailing. Among all patients, fifty-seven (4.6%) required implant exchange or bone-grafting because of nonunion. Among all patients, 105 in the reamed nailing group and 114 in the unreamed nailing group experienced a primary outcome event (relative risk, 0.90; 95% confidence interval, 0.71 to 1.15). In patients with closed fractures, forty-five (11%) of 416 in the reamed nailing group and sixty-eight (17%) of 410 in the unreamed nailing group experienced a primary event (relative risk, 0.67; 95% confidence interval, 0.47 to 0.96; p = 0.03). This difference was largely due to differences in dynamization. In patients with open fractures, sixty of 206 in the reamed nailing group and forty-six of 194 in the unreamed nailing group experienced a primary event (relative risk, 1.27; 95% confidence interval, 0.91 to 1.78; p = 0

  10. Minimizing the complications of intramedullary nailing for distal third tibial shaft and metaphyseal fractures

    PubMed Central

    Yaligod, Vishwanath; Rudrappa, Girish H.; Nagendra, Srinivas; Shivanna, Umesh M.

    2013-01-01

    Background The complications of intramedullary nailing of distal third tibial shaft and metaphyseal fractures have a direct impact on ankle and hind foot function. Methods We retrospectively evaluated 28 patients. Unreamed nail was negotiated across the well reduced fracture till subchondral bone and fixed with 2 to 3 distal locking screws in different planes. Results Fracture union rate was 85%. Three out of 28 patients had malalignment. Mean ankle, hindfoot functional score was 85. Conclusion Complications can be minimized by impacting the unreamed nail till the subchondral bone while maintaining the fracture well reduced and by using multiple distal locking screws in different planes. PMID:24719527

  11. Biomechanical analysis of the cephalomedullary nail versus the trochanteric stabilizing plate for unstable intertrochanteric femur fractures.

    PubMed

    Walmsley, David; Nicayenzi, Bruce; Kuzyk, Paul Rt; Machin, Alan; Bougherara, Habiba; Schemitsch, Emil H; Zdero, Radovan

    2016-10-26

    Unstable intertrochanteric fractures are commonly treated with a cephalomedullary nail due to high failure rates with a sliding hip screw. The Omega3 Trochanteric Stabilizing Plate is a relatively new device that functions like a modified sliding hip screw with a proximal extension; however, its mechanical properties have not been evaluated. This study biomechanically compared a cephalomedullary nail, that is, Gamma3 Nail against the Omega3 plate. Unstable intertrochanteric fractures were created in 24 artificial femurs. Experimental groups were as follows: Nail (i.e. Gamma3 Nail) (n = 8), Plate A (i.e. Omega3 plate with four distal non-locking screws and no proximal locking screws) (n = 8), Plate B (i.e. Plate A plus five proximal locking screws) (n = 8), Plate C (i.e. Omega3 plate with three distal locking screws and no proximal locking screws) (n = 8), and Plate D (i.e. Plate C plus five proximal locking screws) (n = 8). All specimens were stiffness tested, while the Nail and Plate D groups were also strength tested. For lateral bending, Plate B was less stiff than the Nail (p = 0.001) and Plate A (p = 0.009). For torsion, Plate A was less stiff than Plate D (p = 0.020). For axial compression, the Nail was less stiff than Plate A (p = 0.036) and Plate B (p = 0.008). Axial strength for the Nail (5014 ± 308 N) was 66% higher than the Plate D construct (2940 ± 411 N) (p < 0.001). All Nails failed by partial or complete cutout through the femoral head and neck, but Plate D failed by varus collapse and deformation of the lag screw. When the cephalomedullary nail is clinically contra-indicated, this study supports the use of the Omega3 plate, since it had similar stiffness in three test modes to the Gamma3 Nail, but had lower strength. Stability of Omega3 plate constructs was not improved with locked fixation proximally or distally.

  12. A locked hip screw-intramedullary nail (cephalomedullary nail) for the treatment of fractures of the proximal part of the femur combined with fractures of the femoral shaft.

    PubMed

    Alho, A; Ekeland, A; Grøgaard, B; Dokke, J R

    1996-01-01

    Twenty-seven patients with complex femoral fractures (combined shaft and proximal femoral fractures) were treated with a modified Grosse-Kempf slotted locking nail (cephalomedullary nail), wherein two screws were inserted in the hip. Four types of complex, multifocal femoral fractures were represented in the series. Eleven of the femoral shaft fractures were secondary to a previous, internally fixed, not yet united hip fracture (type I). Ten comminuted peritrochanteric fractures occurred in normal bone (type II). Three similar fractures were pathologic because of metastasis. Two patients had an ipsilateral fracture of the femoral shaft and the trochanteric area (type III), and one of the shaft and the femoral neck (type IV). Locking was made static in 24 cases. Additional cerclage wiring was used in three type II fractures. Five complications were as follows: one cutting out of a screw in the femoral head, two fractures of the nail, one deep venous thrombosis, and one wound hematoma. Reoperations were two salvage operations using a new nail and one evacuation of hematoma. One patient with multiple injuries and four elderly patients died within 2 months. Eighteen patients with fractures in normal bone were followed for a median of 20 (6 to 37) months. All fractures united. Two nails were removed. The end result was excellent in ten patients, good in seven, and fair in one (2-cm shortening and 20-degree external rotation). We conclude that a locked intramedullary construct with locking screws in femoral neck and distal femur controls a complex fracture situation well.

  13. Tibial lengthening over humeral and tibial intramedullary nails in patients with sequelae of poliomyelitis: a comparative study.

    PubMed

    Chen, Daoyun; Chen, Jianmin; Jiang, Yao; Liu, Fanggang

    2011-06-01

    Leg discrepancy is common after poliomyelitis. Tibial lengthening is an effective way to solve this problem. It is believed lengthening over a tibial intramedullary nail can provide a more comfortable lengthening process than by the conventional technique. However, patients with sequelae of poliomyelitis typically have narrow intramedullary canals allowing limited space for inserting a tibial intramedullary nail and Kirschner wires. To overcome this problem, we tried using humeral nails instead of tibial nails in the lengthening procedure. In this study, we used humeral nails in 20 tibial lengthening procedures and compared the results with another group of patients who were treated with tibial lengthening over tibial intramedullary nails. The mean consolidation index, percentage of increase and external fixation index did not show significant differences between the two groups. However, less blood loss and shorter operating time were noted in the humeral nail group. More patients encountered difficulty with the inserted intramedullary nail in the tibial nail group procedure. The complications did not show a statistically significant difference between the two techniques on follow-up. In conclusion, we found the humeral nail lengthening technique was more suitable in leg discrepancy patients with sequelae of poliomyelitis.

  14. Characteristics of patients with yellow nail syndrome and pleural effusion.

    PubMed

    Valdés, Luis; Huggins, John T; Gude, Francisco; Ferreiro, Lucía; Alvarez-Dobaño, José M; Golpe, Antonio; Toubes, María E; González-Barcala, Francisco J; José, Esther San; Sahn, Steven A

    2014-10-01

    Yellow nail syndrome (YNS) can be associated with a pleural effusion (PE) but the characteristics of these patients are not well defined. We performed a systematic review across four electronic databases for studies reporting clinical findings, PE characteristics, and most effective treatment of YNS. Case descriptions and retrospective studies were included, unrestricted by year of publication. We reviewed 112 studies (150 patients), spanning a period of nearly 50 years. The male/female ratio was 1.2/1. The median age was 60 years (range: 0-88). Seventy-eight percent were between 41-80 years old. All cases had lymphoedema and 85.6% had yellow nails. PEs were bilateral in 68.3%. The appearance of the fluid was serous in 75.3%, milky in 22.3% and purulent in 3.5%. The PE was an exudate in 94.7% with lymphocytic predominance in 96% with a low count of nucleated cells. In 61 of 66 (92.4%) of patients, pleural fluid protein values were >3 g/dL, and typically higher than pleural fluid LDH. Pleurodesis and decortication/pleurectomy were effective in 81.8% and 88.9% of cases, respectively, in the treatment of symptomatic PEs. The development of YNS and PE occurs between the fifth to eighth decade of life and is associated with lymphoedema. The PE is usually bilateral and behaves as a lymphocyte-predominant exudate. The most effective treatments appear to be pleurodesis and decortication/pleurectomy.

  15. Candida Parapsilosis and Candida Guillermondii: Emerging Pathogens in Nail Candidiasis

    PubMed Central

    Fich, Felix; Abarzúa-Araya, Alvaro; Pérez, Mario; Nauhm, Yalile; León, Eugenia

    2014-01-01

    Background: Onychomycosis of the fingernails and toenails is generally caused by dermatophytes and yeasts. Toenail mycoses involve mainly dermatophytes but when Candida is also involved, the strain most commonly isolated worldwide is C. albicans. Aims: To determine Candida strains prevailing in onychomycosis. Materials and Methods: A retrospective, observational and descriptive study of fungal cultures retrieved from the registry of the microbiology laboratory of the Pontificia Universidad Católica was performed. Specimens obtained from patients attending the healthcare network between December 2007 and December 2010 was analyzed. Statistical Analysis: A descriptive statistical analysis was performed. Results: Candida was retrieved from 467 of 8443 specimens (52% fingernails and 48% toenails). Cultures were negative in 5320 specimens (63.6%). Among Candida-positive cultures, parapsilosis was the most commonly isolated strain with 202 cases (43.3%). While isolates of Candida guillermondii were 113 (24.2%), those of Candida albicans were 110 (23.6%), those of spp. were 20 (4.3%) and there were 22 cases of other isolates (4.71%). Among the 467 patients with positive cultures for Candida, 136 (29,1%) were men and 331 (70,9%) were women. All patients were older than 18 years old. Clinical files were available for only 169 of the 467 patients with positive cultures for Candida. For those, age, gender, underlying illnesses and use of immunossupresive agents during the trial was reviewed. Conclusions: The present study shows that both C. parapsilosis as well as C. guillermondii appear as emerging pathogens that would be in fact taking the place of C. albicans as the most commonly isolated pathogen in patients with Candida onychomycosis. The relative percentage of C parapsilosis increases every year. Identification of Candida strains as etiological agents of nail candidiasis becomes relevant to the management both nail as well as systemic candidiasis, in view of the

  16. Hidrotic ectodermal dysplasia of hair, teeth, and nails: case reports and review.

    PubMed Central

    Chitty, L S; Dennis, N; Baraitser, M

    1996-01-01

    We report two families with the Witkop "tooth and nail syndrome". This term is a misnomer, as the hair was mildly involved in the original case reports and in the families reported here. Images PMID:8863167

  17. Different physicochemical properties of antimycotic agents are relevant for penetration into and through human nails.

    PubMed

    Neubert, R H H; Gensbügel, C; Jäckel, A; Wartewig, S

    2006-07-01

    This article reports the characterization of the physicochemical properties of two important antifungal topical drugs, amorolfine and ciclopirox. Furthermore, the release of the drugs from commercial lacquer formulations for treatment of onychomycosis was studied using the online FTIR-ATR technique. Based on the physicochemical background of these two drugs and their release from commercial lacquer formulations for treatment of onychomycosis, the suitability of these drugs for optimized local antifungal therapy to human nails is discussed. Amorolfine appears to be more suitable for drug delivery to human nails because it penetrates into the nails via the hydrophilic pathway. Furthermore amorolfine penetrates very well into fungal cells, due to the pH value of the nail, as well as the pKa value of this antimycotic agent and the lipophilic properties of its base form.

  18. Medically important fungi found in hallux nails of university students from Cali, Colombia.

    PubMed

    Alvarez, María Inés; Caicedo, Luz Dary

    2007-06-01

    The presence of medically important fungi was studied in hallux nails scrapings obtained from 504 students (204 males, 300 females) of three universities in Cali. Specimens were examined by direct microscopic examination and fungal culture. Medically important fungi were found in 49 (9.7%) students, 24 (4.8%) had onychomycosis while the rest did not have nail lesions. Trichophyton rubrum was the most commonly isolated fungi in students with lesions, where as T. mentagrophytes predominated in healthy nails. Most of the students with fungi were males. The prevalence of fungi was higher in individuals between 26 and 35 years. No association was observed between fungi and practicing sports or undergoing pedicures. These results suggest that dermatophytes can be found in healthy hallux nails, which can be reservoirs of pathogenic fungi.

  19. Comparison between lengthening over nail and conventional Ilizarov lengthening: a prospective randomized clinical study.

    PubMed

    El-Husseini, Timour F; Ghaly, Nabil A M; Mahran, Mahmoud A; Al Kersh, Mohamed Ahmed; Emara, Khaled M

    2013-08-01

    The aim of this study is to compare lengthening over an intramedullary nail to the conventional Ilizarov method with regard to percentage length increase, external fixation index, consolidation index and incidence of complications. This is a prospective randomized controlled study. Thirty-one limbs in 28 patients were included in the study; 15 were lengthened over an intramedullary nail, and 16 limbs were lengthened conventionally. The mean duration of external fixation in the lengthening over nail group was 52.2 days compared to 180.4 days in the conventional group. There was higher incidence of complications in the conventional method group. In comparison with conventional Ilizarov lengthening, lengthening over an intramedullary nail offers a shorter period of external fixation and fewer complications overall, but there is a high incidence of deep intramedullary infection which is serious.

  20. Refractures of the paediatric forearm with the intramedullary nail in situ

    PubMed Central

    van Egmond, Pim W; van der Sluijs, Hans A; van Royen, Barend J; Saouti, Rachid

    2013-01-01

    Forearm fractures in children are common. When conservative treatment fails, internal fixation with Elastic Stable Intramedullary Nailing (ESIN) become the first choice in the operative treatment of diaphyseal forearm shaft fractures. Refractures with the intramedullary nail in situ are known to occur but formal guidelines to guide management in such fractures are lacking. We present a well-documented case of a radius midshaft refracture in a 12-year-old boy with the intramedullary nail in situ, managed by closed reduction. Literature is reviewed for this type of complication, the treatment of 30 similar cases is discussed and a treatment strategy is defined. The refracture of the paediatric forearm fracture with the intramedullary nail in situ is a rare, but probably under recognised complication which is observed in approximately 2.3% of the study population. Closed reduction may be considered in these cases. PMID:24068378

  1. John Dee and the alchemists: Practising and promoting English alchemy in the Holy Roman Empire

    PubMed Central

    Rampling, Jennifer M.

    2012-01-01

    This paper investigates John Dee’s relationship with two kinds of alchemist: the authorities whose works he read, and the contemporary practitioners with whom he exchanged texts and ideas. Both strands coincide in the reception of works attributed to the famous English alchemist, George Ripley (d. c. 1490). Dee’s keen interest in Ripley appears from the number of transcriptions he made of ‘Ripleian’ writings, including the Bosome book, a manuscript discovered in 1574 and believed to have been written in Ripley’s own hand. In 1583, Dee and his associate Edward Kelley left England for East Central Europe, taking with them a proportion of Dee’s vast library, including alchemical books—the contents of which would soon pique the interest of continental practitioners. Kelley used Ripley’s works, including the Bosome book, not only as sources of practical information, but as a means of furthering his own relationships with colleagues and patrons: transactions that in turn influenced Ripley’s posthumous continental reception. The resulting circulation of texts allows us to trace, with unusual precision, the spread of English alchemical ideas in the Holy Roman Empire from the late sixteenth century.

  2. Frasnian/famennian event in the Holy Cross Mts, Central Poland: Stratigraphic and ecologic aspects

    NASA Astrophysics Data System (ADS)

    Racki, Grzegorz

    Current studies in the Holy Cross Mts, Central Poland did not confirm an idea of the persistence of stromatoporoid-coral build-ups into the Famennian, i.e. distinctly after Frasnian/Famennian reef extinction event. Stepwise termination of the Frasnian-type biotas was joined with successive sea-level fluctuations interfering with local tectonic activity, but diversified and locally abundant coral-dominated coelenterate communities, as well as peculiar reef-related associations (e.g. calcareous microbiota), lasted till the end of Frasnian (gigas Zone). Final turning point was the rapid sedimentation change corresponding to the main Kellwasser Event in the Uppermost gigas Zone. Collapse of carbonate depositional system was recorded directly afterwards by significant sedimentary and biotic crises. Local flourishing of the crinoid, articulate brachiopod and nautiloid associations, as well as blue-green algae biota, on the remaining shoals characterised the earliest Famennian time. More successful colonization by diversified, Famennian-type benthic and pelagic faunas started in the crepida Zone, which reflects progressive habitat recovery within the seriously disturbed shelf ecosystem.

  3. Revisiting the Holy Grail: using plant functional traits to understand ecological processes.

    PubMed

    Funk, Jennifer L; Larson, Julie E; Ames, Gregory M; Butterfield, Bradley J; Cavender-Bares, Jeannine; Firn, Jennifer; Laughlin, Daniel C; Sutton-Grier, Ariana E; Williams, Laura; Wright, Justin

    2016-04-22

    One of ecology's grand challenges is developing general rules to explain and predict highly complex systems. Understanding and predicting ecological processes from species' traits has been considered a 'Holy Grail' in ecology. Plant functional traits are increasingly being used to develop mechanistic models that can predict how ecological communities will respond to abiotic and biotic perturbations and how species will affect ecosystem function and services in a rapidly changing world; however, significant challenges remain. In this review, we highlight recent work and outstanding questions in three areas: (i) selecting relevant traits; (ii) describing intraspecific trait variation and incorporating this variation into models; and (iii) scaling trait data to community- and ecosystem-level processes. Over the past decade, there have been significant advances in the characterization of plant strategies based on traits and trait relationships, and the integration of traits into multivariate indices and models of community and ecosystem function. However, the utility of trait-based approaches in ecology will benefit from efforts that demonstrate how these traits and indices influence organismal, community, and ecosystem processes across vegetation types, which may be achieved through meta-analysis and enhancement of trait databases. Additionally, intraspecific trait variation and species interactions need to be incorporated into predictive models using tools such as Bayesian hierarchical modelling. Finally, existing models linking traits to community and ecosystem processes need to be empirically tested for their applicability to be realized.

  4. Chloroplast DNA Phylogeography of Holy Basil (Ocimum tenuiflorum) in Indian Subcontinent

    PubMed Central

    Rani, Pooja

    2014-01-01

    Ocimum tenuiflorum L., holy basil “Tulsi”, is an important medicinal plant that is being grown and traditionally revered throughout Indian Subcontinent for thousands of years; however, DNA sequence-based genetic diversity of this aromatic herb is not yet known. In this report, we present our studies on the phylogeography of this species using trnL-trnF intergenic spacer of plastid genome as the DNA barcode for isolates from Indian subcontinent. Our pairwise distance analyses indicated that genetic heterogeneity of isolates remained quite low, with overall mean nucleotide p-distance of 5 × 10−4. However, our sensitive phylogenetic analysis using maximum likelihood framework was able to reveal subtle intraspecific molecular evolution of this species within the subcontinent. All isolates except that from North-Central India formed a distinct phylogenetic clade, notwithstanding low bootstrap support and collapse of the clade in Bayesian Inference. North-Central isolates occupied more basal position compared to other isolates, which is suggestive of its evolutionarily primitive status. Indian isolates formed a monophyletic and well-supported clade within O. tenuiflorum clade, which indicates a distinct haplotype. Given the vast geographical area of more than 3 million km2 encompassing many exclusive biogeographical and ecological zones, relatively low rate of evolution of this herb at this locus in India is particularly interesting. PMID:24523650

  5. Chloroplast DNA phylogeography of holy basil (Ocimum tenuiflorum) in Indian subcontinent.

    PubMed

    Bast, Felix; Rani, Pooja; Meena, Devendra

    2014-01-01

    Ocimum tenuiflorum L., holy basil "Tulsi", is an important medicinal plant that is being grown and traditionally revered throughout Indian Subcontinent for thousands of years; however, DNA sequence-based genetic diversity of this aromatic herb is not yet known. In this report, we present our studies on the phylogeography of this species using trnL-trnF intergenic spacer of plastid genome as the DNA barcode for isolates from Indian subcontinent. Our pairwise distance analyses indicated that genetic heterogeneity of isolates remained quite low, with overall mean nucleotide p-distance of 5 × 10(-4). However, our sensitive phylogenetic analysis using maximum likelihood framework was able to reveal subtle intraspecific molecular evolution of this species within the subcontinent. All isolates except that from North-Central India formed a distinct phylogenetic clade, notwithstanding low bootstrap support and collapse of the clade in Bayesian Inference. North-Central isolates occupied more basal position compared to other isolates, which is suggestive of its evolutionarily primitive status. Indian isolates formed a monophyletic and well-supported clade within O. tenuiflorum clade, which indicates a distinct haplotype. Given the vast geographical area of more than 3 million km(2) encompassing many exclusive biogeographical and ecological zones, relatively low rate of evolution of this herb at this locus in India is particularly interesting.

  6. A Biomechanical Assessment of Hand/Arm Force with Pneumatic Nail Gun Actuation Systems.

    PubMed

    Lowe, Brian D; Albers, James; Hudock, Stephen D

    2014-09-01

    A biomechanical model is presented, and combined with measurements of tip press force, to estimate total user hand force associated with two pneumatic nail gun trigger systems. The contact actuation trigger (CAT) can fire a nail when the user holds the trigger depressed first and then "bumps" the nail gun tip against the workpiece. With a full sequential actuation trigger (SAT) the user must press the tip against the workpiece prior to activating the trigger. The SAT is demonstrably safer in reducing traumatic injury risk, but increases the duration (and magnitude) of tip force exertion. Time integrated (cumulative) hand force was calculated for a single user from measurements of the tip contact force with the workpiece and transfer time between nails as inputs to a static model of the nail gun and workpiece in two nailing task orientations. The model shows the hand force dependence upon the orientation of the workpiece in addition to the trigger system. Based on standard time allowances from work measurement systems (i.e. Methods-Time Measurement - 1) it is proposed that efficient application of hand force with the SAT in maintaining tip contact can reduce force exertion attributable to the sequential actuation trigger to 2-8% (horizontal nailing) and 9-20% (vertical nailing) of the total hand/arm force. The present model is useful for considering differences in cumulative hand/arm force exposure between the SAT and CAT systems and may explain the appeal of the CAT trigger in reducing the user's perception of muscular effort.

  7. Permanent antibiotic impregnated intramedullary nail in diabetic limb salvage: a case report and literature review.

    PubMed

    Woods, Jason B; Lowery, Nicholas J; Burns, Patrick R

    2012-01-01

    Managing complications after attempted hind foot and ankle arthrodesis with intramedullary nail fixation is a challenge. This situation becomes more problematic in the patient with diabetes mellitus and multiple comorbidities. Infection and subsequent osteomyelitis can be a devastating, limb threatening complication associated with these procedures. The surgeon must manage both the infectious process and the skeletal instability concurrently. This article provides a literature review and detailed management strategies for a modified technique of employing antibiotic impregnated polymethylmethacrylate-coated intramedullary nailing.

  8. A Biomechanical Assessment of Hand/Arm Force with Pneumatic Nail Gun Actuation Systems

    PubMed Central

    Lowe, Brian D.; Albers, James; Hudock, Stephen D.

    2015-01-01

    A biomechanical model is presented, and combined with measurements of tip press force, to estimate total user hand force associated with two pneumatic nail gun trigger systems. The contact actuation trigger (CAT) can fire a nail when the user holds the trigger depressed first and then “bumps” the nail gun tip against the workpiece. With a full sequential actuation trigger (SAT) the user must press the tip against the workpiece prior to activating the trigger. The SAT is demonstrably safer in reducing traumatic injury risk, but increases the duration (and magnitude) of tip force exertion. Time integrated (cumulative) hand force was calculated for a single user from measurements of the tip contact force with the workpiece and transfer time between nails as inputs to a static model of the nail gun and workpiece in two nailing task orientations. The model shows the hand force dependence upon the orientation of the workpiece in addition to the trigger system. Based on standard time allowances from work measurement systems (i.e. Methods-Time Measurement - 1) it is proposed that efficient application of hand force with the SAT in maintaining tip contact can reduce force exertion attributable to the sequential actuation trigger to 2–8% (horizontal nailing) and 9–20% (vertical nailing) of the total hand/arm force. The present model is useful for considering differences in cumulative hand/arm force exposure between the SAT and CAT systems and may explain the appeal of the CAT trigger in reducing the user’s perception of muscular effort. PMID:26321780

  9. Pregnancy-associated acquired arteriovenous malformation of the nail unit: a novel cause of localized erythronychia.

    PubMed

    Rutnin, Suthinee; Nguyen, Jennifer V; Miller, Christopher J; DeHoratius, Danielle; Rubin, Adam I

    2012-11-01

    Localized longitudinal erythronychia describes a solitary red streak limited to a single nail unit. Localized longitudinal erythronychia can be caused by both benign and malignant entities. Most commonly, the cause is a benign process, such as an onychopapilloma. We report a case of an acquired subungual arteriovenous malformation that presented as localized longitudinal erythronychia during pregnancy. To our knowledge, this is the first report of localized longitudinal erythronychia arising from a pregnancy-associated arteriovenous malformation of the nail unit.

  10. In-vitro permeability of the human nail and of a keratin membrane from bovine hooves: penetration of chloramphenicol from lipophilic vehicles and a nail lacquer.

    PubMed

    Mertin, D; Lippold, B C

    1997-03-01

    Lipophilic vehicles and especially nail lacquers are more appropriate for topical application on the nail than aqueous systems because of their better adhesion. This work has, therefore, studied the penetration through the human nail plate of the model compound chloramphenicol from the lipophilic vehicles medium chain triglycerides and n-octanol and from a lacquer based on quaternary poly(methyl methacrylates) (Eudragit RL). The results were compared with data obtained with a keratin membrane from bovine hooves. If the swelling of the nail plate or the hoof membrane is not altered by use of lipophilic vehicles, the maximum flux of the drug is independent of its solubility in the vehicle and is the same as that from a saturated aqueous solution. These vehicles are not able to enter the hydrophilic keratin membrane because of their non-polar character and so cannot change the solubility of the penetrating substance in the barrier. If the concentration of the drug in the nail lacquer is sufficiently high, the maximum flux through both barriers equals that from aqueous vehicles or even exceeds it because of the formation of a supersaturated system. Penetration through the nail plate follows first order kinetics after a lag-time of 400 h. The course of penetration through the hoof membrane is initially membrane-controlled and later becomes a matrix-controlled process because of the membrane's greater permeability. Chloramphenicol is dissolved in the lacquer up to a concentration of 31%. The relative release rates from these solution matrices are independent of the drug concentration but they decrease on changing to a suspension matrix. These results show that drug flux is independent of the character of the vehicle and that penetration of the drug is initially membrane-controlled and changes to being matrix-controlled as the drug content of the lacquer decreases.

  11. Evaluation of Laser-Assisted Trans-Nail Drug Delivery with Optical Coherence Tomography

    PubMed Central

    Tsai, Meng-Tsan; Tsai, Ting-Yen; Shen, Su-Chin; Ng, Chau Yee; Lee, Ya-Ju; Lee, Jiann-Der; Yang, Chih-Hsun

    2016-01-01

    The nail provides a functional protection to the fingertips and surrounding tissue from external injuries. The nail plate consists of three layers including dorsal, intermediate, and ventral layers. The dorsal layer consists of compact, hard keratins, limiting topical drug delivery through the nail. In this study, we investigate the application of fractional CO2 laser that produces arrays of microthermal ablation zones (MAZs) to facilitate drug delivery in the nails. We utilized optical coherence tomography (OCT) for real-time monitoring of the laser–skin tissue interaction, sparing the patient from an invasive surgical sampling procedure. The time-dependent OCT intensity variance was used to observe drug diffusion through an induced MAZ array. Subsequently, nails were treated with cream and liquid topical drugs to investigate the feasibility and diffusion efficacy of laser-assisted drug delivery. Our results show that fractional CO2 laser improves the effectiveness of topical drug delivery in the nail plate and that OCT could potentially be used for in vivo monitoring of the depth of laser penetration as well as real-time observations of drug delivery. PMID:27973451

  12. Backout of the helical blade of proximal femoral nail antirotation and accompanying fracture nonunion.

    PubMed

    Niikura, Takahiro; Lee, Sang Yang; Matsumoto, Tomoyuki; Fukui, Tomoaki; Kawakami, Yohei; Akisue, Toshihiro; Kuroda, Ryosuke; Kurosaka, Masahiro

    2012-08-01

    This article describes a case of backout of the helical blade, a rare complication of proximal femoral nail antirotation. A 31-year-old man had sustained a trochanteric fracture of his right femur. Fracture fixation using proximal femoral nail antirotation and autologous bone grafting 7 months later were performed at another hospital. However, bony union was not obtained, and the patient's pain and limp persisted. Therefore, he presented to the current authors. A radiograph taken at presentation revealed backout of the helical blade and fracture nonunion. A radiograph taken 1 month later showed a more advanced backout of the helical blade. The authors performed exchange nailing supplemented with transplantation of peripheral blood CD34-positive cells and autologous bone grafting. The proximal femoral nail antirotation was revised to a long gamma 3 nail, and a U-lag screw was used to obtain better stability. The postoperative course was uneventful. The patient regained ambulation without pain or support at 12 weeks postoperatively. Radiographic bony union was completed 9 months postoperatively. At 1-year follow-up, he could run and stand on the previously injured leg and had returned to work. Backout of the helical blade should be considered as a possible complication of proximal femoral nail antirotation. Incomplete fixation of the helical blade is the possible reason for backout. The use of a helical blade in young patients may cause difficulty in insertion and result in incomplete fixation.

  13. An innovative polysaccharide nanobased nail formulation for improvement of onychomycosis treatment.

    PubMed

    Flores, Fernanda C; Rosso, Roberta S; Cruz, Letícia; Beck, Ruy C R; Silva, Cristiane B

    2017-03-30

    Tioconazole-loaded nanocapsule suspensions and its coating with a cationic polymer were developed for nail drug delivery. The colloidal systems presented a nanometric size around 155nm for uncoated nanoparticles and 162nm for those with the cationic coating, with negative and positive zeta potential values, respectively. Both nanosuspensions showed drug content close to theoretical values (1mgmL(-1)), association efficiency close to 100% (HPLC) and were able to control tioconazol release. The developed formulations showed in vitro antifungal activity (agar diffusion method) against C. albicans. The cationic nanocapsules were considered bioadhesive, showed higher viscosity and were chosen to be incorporated into an ungueal formulation. Pullulan nanobased nail formulation showed adequate viscosity for nail application and drug content close to the theoretical values. It was equivalent to the commercial formulation Trosid(®) in preventing nail infection by T. rubrum in an in vitro onychomycosis model. The nanocapsule suspensions and Pullulan nanobased nail formulation showed lower irritant potential than the commercial formulation and than free drug in an in vitro evaluation. Pullulan nanobased nail formulation is promising for the treatment of onychomycosis.

  14. Investigation of different formulations for drug delivery through the nail plate.

    PubMed

    Vejnovic, Ivana; Simmler, Linda; Betz, Gabriele

    2010-02-15

    Topical therapies for nail diseases are limited by keratinized cells in the human nail plate. An optimal permeation enhancer would not only improve drug delivery through the nail plate, but would also open new possibilities for treating neighboring target sites if systemic circulation is reached. The aim of the present work was to identify permeation enhancers and to improve the understanding of physicochemical parameters that influence drug permeation. Caffeine served as the model drug, and formulations were prepared in water and 20% (v/v) ethanol/water solutions. Tested enhancers were urea, dimethyl sulfoxide (DMSO), methanol, N-acetyl-L-cysteine (NAC), docusate sodium salt (DSS), boric acid, and fungal proteins, such as hydrophobins. Permeability studies employed cadaver nails in modified Franz-type diffusion cells. The permeability coefficient of caffeine in ethanol/water was determined to be 1.56 E-08 cm/s and was improved to 2.27 E-08 cm/s by the addition of NAC. Formulations containing either methanol or DMSO showed the highest permeability coefficients in the range of 5-7.5 E-08 cm/s. Enhancers could be classified according to their permeation enhancement: methanol>class II hydrophobins>DMSO>followed by class I hydrophobins and urea. Ethanol at a concentration of 20% (v/v) in water did not influence swelling of nail samples. Hydrophobins are suggested to be efficient in drug delivery through the nail plate.

  15. Retrograde intramedullary nails with distal screws locked to the nail have higher fatigue strength than locking plates in the treatment of supracondylar femoral fractures: A cadaver-based laboratory investigation.

    PubMed

    Pekmezci, M; McDonald, E; Buckley, J; Kandemir, U

    2014-01-01

    We investigated a new intramedullary locking nail that allows the distal interlocking screws to be locked to the nail. We compared fixation using this new implant with fixation using either a conventional nail or a locking plate in a laboratory simulation of an osteoporotic fracture of the distal femur. A total of 15 human cadaver femora were used to simulate an AO 33-A3 fracture pattern. Paired specimens compared fixation using either a locking or non-locking retrograde nail, and using either a locking retrograde nail or a locking plate. The constructs underwent cyclical loading to simulate single-leg stance up to 125,000 cycles. Axial and torsional stiffness and displacement, cycles to failure and modes of failure were recorded for each specimen. When compared with locking plate constructs, locking nail constructs had significantly longer mean fatigue life (75,800 cycles (SD 33,900) vs 12,800 cycles (SD 6100); p = 0.007) and mean axial stiffness (220 N/mm (SD 80) vs 70 N/mm (SD 18); p = 0.005), but lower mean torsional stiffness (2.5 Nm/° (SD 0.9) vs 5.1 Nm/° (SD 1.5); p = 0.008). In addition, in the nail group the mode of failure was either cut-out of the distal screws or breakage of nails, and in the locking plate group breakage of the plate was always the mode of failure. Locking nail constructs had significantly longer mean fatigue life than non-locking nail constructs (78,900 cycles (SD 25,600) vs 52,400 cycles (SD 22,500); p = 0.04). The new locking retrograde femoral nail showed better stiffness and fatigue life than locking plates, and superior fatigue life to non-locking nails, which may be advantageous in elderly patients.

  16. Low-Velocity Nail-Gun Injuries to the Interventricular Septum: Report of Two Cases, One in a Child

    PubMed Central

    Michalsen, Kara L.; Iguidbashian, John P.; Kyser, James P.

    2015-01-01

    Nail-gun injury to the heart is rare. Nail-gun injury to the interventricular septum is rarer: we could find only 5 reported cases, and none involving a child. We report 2 additional cases, in which nails penetrated the interventricular septum without causing acute pericardial tamponade, heart block, or shunt across the septum. Transesophageal echocardiography provides a dynamic way to evaluate the patient preoperatively, intraoperatively, and postoperatively. In the cases reported here, both the adult with multiple interventricular nails and the child with a single nail underwent foreign-object removal via median sternotomy. The child needed cardiopulmonary bypass for removal of the nail. There were no short-term or long-term sequelae from these interventricular septal injuries. PMID:26413027

  17. Removal of a femoral nail with osseous overgrowth at the end-cap: A navigated and cannulated minimally invasive technique.

    PubMed

    Marintschev, Ivan; Rausch, Sascha; Fujak, Albert; Klos, Kajetan; Hofmann, Gunther O; Gras, Florian

    2013-01-01

    Intramedullary nail removal can be demanding, especially in cases of implant breakage or bony overgrowth at the end-cap, if the exact insertion depth of the nail is neglected in the index surgery. In the presented case, two challenging nail removals were necessary. The first was performed in a re-nailing procedure due to a pseudarthrosis with implant breakage, and the second was performed during hardware removal after fracture healing in a situation where there was deep intramedullary placement of the exchange nail. For the second implant removal a minimally invasive approach based on instrument placements over a navigated guide-wire was used to reduce the iatrogenic morbidity associated with an extensive open approach to the nail and to decrease the radiation exposure for the patient and the operating team.

  18. Pigmented Onychomatricoma: A Rare Pigmented Nail Unit Tumor Presenting as Longitudinal Melanonychia That Has Potential for Misdiagnosis as Melanoma.

    PubMed

    Wynes, Jacob; Wanat, Karolyn A; Huen, Auris; Mlodzienski, Alan J; Rubin, Adam I

    2015-01-01

    Pigmented onychomatricoma is a rare nail unit tumor that can clinically mimic nail unit melanoma. We report the case of a 63-year-old male with new-onset longitudinal melanonychia involving his right second toe. An excisional biopsy was performed and demonstrated pigmented onychomatricoma. We present this case to alert clinicians of this rare nail unit tumor and the importance of clinicopathologic correlation to avoid misdiagnosis.

  19. Reamed versus unreamed intramedullary nailing for the treatment of femoral fractures

    PubMed Central

    Li, A-Bing; Zhang, Wei-Jiang; Guo, Wei-Jun; Wang, Xin-Hua; Jin, Hai-Ming; Zhao, You-Ming

    2016-01-01

    Abstract Background and objective: Intramedullary nailing is commonly used for treating femoral shaft fractures, one of the most common long bone fractures in adults. The reamed intramedullary nail is considered the standard implant for femoral fractures. This meta-analysis was performed to verify the superiority of reamed intramedullary nailing over unreamed intramedullary nailing in fractures of the femoral shaft in adults. Subgroup analysis of implant failure and secondary procedure was also performed. Methods: Electronic literature databases were used to identify relevant publications and included MEDLINE (Ovid interface), EMBASE (Ovid interface), and the Cochrane Central Register of Controlled Trials (CENTRAL; Wiley Online Library). The versions available on January 30, 2016, were utilized. Only human studies, which were designed as randomized controlled clinical trials, were included. Two authors independently evaluated the quality of original research publications and extracted data from the studies that met the criteria. Results: Around 8 randomized controlled trials involving 1078 patients were included. Reamed intramedullary nailing was associated with shorter time to consolidation of the fracture (SMD = –0.62, 95% CI = –0.89 to –0.35, P < 0.00001), lower secondary procedure rate (OR = 0.25, 95% CI 0.10–0.62, P = 0.003), lower nonunion rate (OR = 0.14, 95% CI = 0.05–0.40, P < 0.01), and lower delayed-union rate (OR = 0.19, 95% CI = 0.07–0.49, P < 0.01) compared to unreamed intramedullary nailing. The 2 groups showed no significant differences in risk of implant failure (OR = 0.50, 95% CI 0.14–1.74, P = 0.27), mortality risk (OR = 0.94, 95% CI 0.19–4.68, P = 0.94), risk of acute respiratory distress syndrome (ARDS; OR = 1.55, 95% CI 0.36–6.57, P = 0.55), or blood loss (SMD = 0.57, 95% CI = –0.22 to 1.36, P = 0.15). Conclusion: Reamed intramedullary nailing

  20. Geologic map and sections of the Holy Cross Quadrangle, Eagle, Lake, Pitkin, and Summit counties, Colorado

    USGS Publications Warehouse

    Tweto, Ogden; Digital edition and database by Brandt, Theodore R.

    1974-01-01

    This map was first published as a printed edition in 1974. The geologic data have now been captured digitally and are presented here along with images of the printed map sheets. The map encompasses the area of four 7.5-minute quadrangles between 39º15' and 39º 30'N and 106º15' and 106º30'W in the Sawatch and Gore mountain ranges, and upper part of the Arkansas River drainage in central Colorado. The Holy Cross geologic map depicts in detail the complex geology at the north end of the Sawatch Range on the west at its junction with south end of the Gore Range on the east. The ranges are separated in the southern part of the map area by the upper reaches of the Arkansas River, and in the northeast part by the narrow valley of the upper Eagle River. Sixty map units and numerous individual beds and thin units within the principal map units are shown. Paleoproterozoic and Mesoproterozoic metamorphic rocks are the principal rocks of the Sawatch Range. In the Gore Range, lower and upper Paleozoic sedimentary rocks rest unconformably on the Precambrian metamorphic rocks. Paleozoic rocks that range in age from Upper Cambrian though Middle Pennsylvanian support the Gore Range along the eastern quarter of the map. The sequence includes a basal quartzite overlain by interbedded, shale, dolomite, quartzite, and sandstone. The Leadville Dolomite, below the dark shale, is the host rock for the ore deposits at Leadville and the neighboring lead-zinc-silver districts. A wide range of Miocene to Cretaceous intrusive rocks dip east off the Sawatch Range. The Dry Union Formation of Pliocene and Miocene age fills the valley of the Arkansas River and is covered by Quaternary alluvium and glacial sediment. Glacial deposits of Bull Lake, Pinedale, and neoglacial age are present in many of the mountain valleys. The geologic structure of the quadrangle is complex in geometry and time with a distinct structural and geographic break along the west front of the Gore Range in the eastern

  1. Air Quality in Mecca and Surrounding Holy Places in Saudi Arabia during Hajj: Initial Survey

    NASA Astrophysics Data System (ADS)

    Simpson, I. J.; Aburizaiza, O. S.; Siddique, A.; Barletta, B.; Blake, N. J.; Gartner, A.; Khwaja, H. A.; Meinardi, S.; Zeb, J.; Blake, D. R.

    2014-12-01

    The Arabian Peninsula experiences severe air pollution yet is highly understudied in terms of surface measurements of ozone and its precursors. Every year the air pollution in Saudi Arabia is intensified by additional traffic and activities during Hajj, the world's largest religious pilgrimage that draws 3‒4 million pilgrims to Mecca (population of 2 million). Using whole air sampling and high-precision measurements of carbon monoxide (CO) and 97 volatile organic compounds (VOCs), we performed an initial survey of air quality in Mecca, its tunnels, and surrounding holy sites during the 2012 Hajj (October 24-27; n = 77). This is the first time such a campaign has been undertaken. Levels of the combustion tracer CO and numerous VOCs were strongly elevated along the pilgrimage route, especially in the tunnels of Mecca, and are a concern for human health. For example CO reached 57 ppmv in the tunnels, exceeding the 30-min exposure guideline of 50 ppmv. Benzene, a known carcinogen, reached 185 ppbv in the tunnels, exceeding the 1-hr exposure limit of 9 ppbv. The gasoline evaporation tracer i-pentane was the most abundant VOC during Hajj, reaching 1200 ppbv in the tunnels. Even though VOC concentrations were generally lower during a follow-up non-Hajj sampling period (April, 2013), many were still comparable to other large cities suffering from poor air quality. Major VOC sources during Hajj included vehicular exhaust, gasoline evaporation, liquefied petroleum gas, and air conditioners. Of the measured compounds, reactive alkenes (associated with gasoline evaporation) and CO showed the strongest potential to form ground-level ozone. Therefore efforts to curb ozone formation likely require dual targeting of both combustive and evaporative fossil fuel sources. However, modeling and other measurements (e.g., nitrogen oxides) are also needed to fully understand Mecca's oxidative environment. We also present specific recommendations to reduce VOC emissions and exposure in

  2. Dust in the wind: Soiling of solar devices : Is there a Holy Grail solution? (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Kazmerski, Lawrence; Costa, Suellen C.; Machado, Marcelo; Diniz, Antonia Sonia A. C.

    2016-09-01

    Soiling, the sedimentation of particulate matter (on the size scale of 1/10 the diameter of a human hair) on the exposed surfaces of solar collectors, is a growing area of concern for solar-system performance, reliability, maintenance, and cost. In the case of photovoltaics (PV), the condition of this first-surface of interaction of the incident photons is critical for ensuring that the maximum-possible light reaches the conversion devices. This paper begins with a more than seven-decade historical look at the research invested into this problem, highlighting the motivation and milestones; the researchers and the progress. The current growing terrestrial markets for solar have brought a new focus on soiling and dust issues. That is because many of these new markets in the solar-rich geographic regions of our world are ironically also in the most dust-rich and soiling-prone ones as well. This paper continues to provide an overview of the status of current research efforts toward understanding the basic soiling mechanisms, the relationships to the PV technology approaches, the geographical differences (highlighting Brasil, India, and the MENA region) in the severity of the problem, the dust physics and chemistry—all relating to the current and future mitigation approaches. Included are some fundamental microscale through nanoscale examinations at how individual dust particles adhere to module glass surfaces—as well as how the particles might stick to each other under certain environmental conditions. These observations are used to show how fundamental science may lead to the macroscale engineering solutions of these soiling problems. This presentation is designed to both overview the soiling area and highlight some of the current and future research directions, speculate on short-term approaches preventing solar showstoppers, and speculate on some "holy-grail" schemes that might lead to the final solutions.

  3. Use of Protective Gloves in Nail Salons in Manhattan, New York City

    PubMed Central

    2016-01-01

    Objectives: Nail salon owners in New York City (NYC) are required to provide their workers with gloves and it is their responsibility to maintain healthy, safe working spaces for their employees. The purpose of this study was to determine the frequency with which nail salon workers wear protective gloves. Methods: A Freedom of Information Law request was submitted to New York Department of State’s Division of Licensing Services for a full list of nail salons in Manhattan, NYC. A sample population of 800 nail salons was identified and a simple random sample (without replacement) of 30% (n=240) was selected using a random number generator. Researchers visited each nail salon from October to December of 2015, posing as a potential customer to determine if nail salon workers were wearing gloves. Results: Among the 169 salons in which one or more workers was observed providing services, a total of 562 workers were observed. For 149 salons, in which one or more worker was observed providing services, none of the workers were wearing gloves. In contrast, in six of the salons observed, in which one or more workers was providing services, all of the workers (1 in 2 sites, 2 in 1 site, 3 in 2 sites, and 4 in 1 site) were wearing gloves. Almost three-quarters of the total number of workers observed (n=415, 73.8%) were not wearing gloves. Conclusions: The findings of this study indicate that, despite recent media attention and legislation, the majority of nail salon workers we observed were not wearing protective gloves when providing services. PMID:27499167

  4. An Effective Approach for Optimization of a Composite Intramedullary Nail for Treating Femoral Shaft Fractures.

    PubMed

    Samiezadeh, Saeid; Tavakkoli Avval, Pouria; Fawaz, Zouheir; Bougherara, Habiba

    2015-12-01

    The high stiffness of conventional intramedullary (IM) nails may result in stress shielding and subsequent bone loss following healing in long bone fractures. It can also delay union by reducing compressive loads at the fracture site, thereby inhibiting secondary bone healing. This paper introduces a new approach for the optimization of a fiber-reinforced composite nail made of carbon fiber (CF)/epoxy based on a combination of the classical laminate theory, beam theory, finite-element (FE) method, and bone remodeling model using irreversible thermodynamics. The optimization began by altering the composite stacking sequence and thickness to minimize axial stiffness, while maximizing torsional stiffness for a given range of bending stiffnesses. The selected candidates for the seven intervals of bending stiffness were then examined in an experimentally validated FE model to evaluate their mechanical performance in transverse and oblique femoral shaft fractures. It was found that the composite nail having an axial stiffness of 3.70 MN and bending and torsional stiffnesses of 70.3 and 70.9 N⋅m², respectively, showed an overall superiority compared to the other configurations. It increased compression at the fracture site by 344.9 N (31%) on average, while maintaining fracture stability through an average increase of only 0.6 mm (49%) in fracture shear movement in transverse and oblique fractures when compared to a conventional titanium-alloy nail. The long-term results obtained from the bone remodeling model suggest that the proposed composite IM nail reduces bone loss in the femoral shaft from 7.9% to 3.5% when compared to a conventional titanium-alloy nail. This study proposes a number of practical guidelines for the design of composite IM nails.

  5. Nail involvement in adult patients with plaque-type psoriasis: prevalence and clinical features*

    PubMed Central

    Schons, Karen Regina Rosso; Beber, André Avelino Costa; Beck, Maristela de Oliveira; Monticielo, Odirlei André

    2015-01-01

    BACKGROUND: Psoriasis is a disease of worldwide distribution with a prevalence of 1 to 3%. Nail psoriasis is estimated in 50% of patients with psoriasis, and in the presence of joint involvement, it can reach 80%. OBJECTIVE: To study the nail changes - and their clinical implications - presented by patients with psoriasis vulgaris under surveillance in a university hospital from the south of Brazil. METHODS: his cross-sectional study evaluated 65 adult patients from January 2012 to March 2013. Cutaneous severity was assessed according to the Psoriasis Area and Severity Index (PASI). The Nail Psoriasis Severity Index (NAPSI) was used to evaluate patient's nails. The diagnosis of psoriatic arthritis was established according to the Classification Criteria for Psoriatic Arthritis (CASPAR). RESULTS: The prevalence of NP was 46.1%. These patients had a median [interquartilic range (IQR)] NAPSI of 1 (0-15). A total of 63.3% of patients reported aesthetic discomfort or functional impairment related to their nails. Onycholysis was the most common feature (80%). When compared with patients without nail involvement, patients with NP had lower mean age at psoriasis onset [21 (18-41) vs. 43 (30-56) years, p=0,001]; longer disease duration [15.5 (10-24) vs. 6 (2-12) years, p=0.001]; higher PASI [9.2 (5-17) vs. 3.7 (2-10), p=0.044], higher frequency of psoriatic arthritis (43.3 vs. 3.7, p = 0.002) and more often reported family history of psoriasis (40% vs. 7.4%, p = 0.011). CONCLUSION: Onycholysis was the most frequent finding and most patients feel uncomfortable with the psoriatic nail changes that they experience. PMID:26131859

  6. Drug delivery to the nail: therapeutic options and challenges for onychomycosis.

    PubMed

    Barot, Bhavesh S; Parejiya, Punit B; Patel, Hetal K; Mehta, Dharmik M; Shelat, Pragna K

    2014-01-01

    Onychomycosis is one of the most common nail disorders. It affects 10-30% of the world population and is caused by dermatophytes, non-dermatophytes, molds, and yeasts. Present treatment methods of onychomycosis include oral therapy, topical therapy, and a combination of both; they have mild-to-moderate efficacy, with a relapse and reinfection rate of 20-25%. For oral therapy, newer antifungal compounds (azole class and allylamine class) are being investigated to increase efficacy and minimize side effects. Oral therapy with antifungal agents have severe side effects, with lesser bioavailability and longer duration of treatment. By contrast, topical therapy of onychomycosis is associated with greater patient compliance and fewer systemic side effects and drug interactions. Current topical treatment options of onychomycosis are nail lacquers, ointments, lotions, solutions, and gels, but these formulations have been unsuccessful due to poor penetration and distribution of drugs at the infected site. Therefore, novel therapeutic options are constantly being researched to improve the efficacy of onychomycosis treatment by enhancing the permeation of the drug across the nail to reach the infected site. Various physical and chemical enhancement methods have been studied to increase the permeation of drugs across the nail plate to the nail bed. Device-based therapeutic options have also been investigated to increase the antifungal drug concentration and its effects in the onychomycotic nail. Randomized clinical trials of these novel therapies have demonstrated better efficacy. The present review discusses the anatomy of the human nail, onychomycosis and its types, onycholysis, and conventional and novel therapies. We also review patents granted as well as design challenges facing optimal drug formulation for onychomycosis treatment.

  7. The oldest rocks of the Holy Cross Mountains, Poland - biostratigraphy of the Cambrian Czarna Shale Formation in the vicinity of Kotuszów

    NASA Astrophysics Data System (ADS)

    Szczepanik, Zbigniew; Żylińska, Anna

    2016-09-01

    Three lower Cambrian acritarch assemblages recognized in four outcrops in the vicinity of Kotuszów in the southernmost part of the Palaeozoic inlier of the Holy Cross Mountains span a stratigraphic interval from the uppermost part of the Asteridium tornatum-Comasphaeridium velvetum Assemblage Zone to the Skiagia ornata- Fimbriaglomerella membranacea Assemblage Zone (most probably its lower part). According to current views (Moczydłowska and Yin 2012), this interval corresponds to the upper part of the Fortunian and to Stage 2 of the Terreneuvian Series. The strata yielding the oldest assemblage are thus the oldest precisely documented rocks in the Palaeozoic succession of the Holy Cross Mountains, and the oldest Cambrian rocks exposed on the surface in Poland. The current biostratigraphic scheme for the pre-trilobitic part of the Cambrian System in the Holy Cross Mountains should be modified so that it is based on local acritarch interval subzones.

  8. Trichophyton onychocola sp. nov. isolated from human nail.

    PubMed

    Hubka, Vit; Cmokova, Adela; Skorepova, Magdalena; Mikula, Peter; Kolarik, Miroslav

    2014-04-01

    A previously undescribed Trichophyton species was isolated from the nail of a 33-year-old man with a history of probable distal lateral subungual onychomycosis (without confirmation by mycological examination). The infection occurred for the first time five years earlier (in 2006) and affected the right great toenail, with complete clinical remission after treatment with ciclopirox olamine. This undescribed species was isolated during probable relapse in 2011, but its etiological significance was not confirmed, that is, direct microscopy was negative and additional clinical samples were not collected. The species is probably geophilic based on phylogenetic analysis (internal transcribed spacer [ITS] rDNA) and is most closely related to the anamorphic T. thuringiense, homothallic Arthroderma ciferrii (anamorph T. georgiae), and heterothallic A. melis. The new species is characterized by yellowish colonies, red reverse on several media, positive urease test, negative hair-perforation test, absence of growth at 34°C, absence of macroconidia, formation of one-celled clavate microconidia, and spiral hyphae. The species grows well on sterilized human hairs placed on agar medium without any additional nutrients and forms gymnothecium-like structures covered by peridial hyphae. The combination of unique micro- and macromorphological features and physiological and sequence data from four unlinked loci (ITS, benA, RPB2, and act1 gene) justified the proposal of a new species T. onychocola sp. nov.

  9. Radiation-free drill guidance in interlocking of intramedullary nails.

    PubMed

    Diotte, Benoit; Fallavollita, Pascal; Wang, Lejing; Weidert, Simon; Thaller, Peter-Helmut; Euler, Ekkehard; Navab, Nassir

    2012-01-01

    Intramedullary nailing is a technically demanding procedure which involves an excessive amount of x-ray acquisitions; one study lists as many as 48 to successfully complete the procedure. In this work, a novel low cost radiation-free drilling guide is designed to assist surgeons in completing the distal locking procedure without any x-ray acquisitions. Using an augmented reality fluoroscope that coregisters optical and x-ray images, we exploit solely the optical images to detect the drilling guide in order to estimate the tip position in real-time in x-ray. We tested over 200 random drill guide poses showing a mean tip-estimation error of 1.72 +/- 0.7mm which is significantly robust and accurate for the interlocking. In a preclinical study on dry bone phantom, three expert surgeons successfully completed the interlocking 56 out of 60 trials with no x-ray acquisition for guidance and an average time of 2 min.

  10. A meta-analysis of reamed versus unreamed intramedullary nailing for the treatment of closed tibial fractures.

    PubMed

    Xia, Liheng; Zhou, Jian; Zhang, Yongtao; Mei, Gang; Jin, Dan

    2014-04-01

    Controversy exists regarding the clinical outcomes of reamed vs unreamed intramedullary nailing in the treatment of closed tibial fractures. This study assessed the effects of reamed vs unreamed intramedullary nailing for closed tibial fractures. The authors searched PubMed, EMBASE, BIOSIS, and the Cochrane Controlled Trials Register for randomized and quasi-randomized controlled clinical trials from January 1980 to June 2012 comparing reamed with unreamed intramedullary nailing for closed tibial fracture in adults. Primary outcomes were nonunion, delayed union, malunion, secondary procedure, failure of implants, compartment syndrome, infection, and knee pain. Eight randomized and 1 quasi-randomized clinical trials (1229 fractures) were included. No statistically significant differences were found between reamed and unreamed nailing groups in delayed union (P=.20), malunion (P=.28), infection (P=.36), compartment syndrome (P=.36), and knee pain (P=.93). The unreamed group had a higher rate of fracture nonunion than the reamed group (P=.02). The subgroup analysis of implant failures (broken screws vs broken nails) indicated that reamed nailing significantly reduced the risk of screw breakage (P<.001); however, there was no significant difference between reamed and unreamed intramedullary nailing in nail breakage (P=.94). The subgroup analysis of a secondary procedure showed that the reamed intramedullary nailing resulted in significantly lower risks of implant exchange (P=.01) and dynamization (P=.04); however, there was no significant difference in bone grafting rate (P=.73). Evidence comparing reamed with unreamed intramedullary nailing for closed tibial fractures indicates that reamed intramedullary nailing may lead to significantly lower risks of nonunion, screw failure, implant exchange, and dynamization without increasing operative complications.

  11. A Clinical Trial to Investigate the Effect of Cynatine HNS on Hair and Nail Parameters

    PubMed Central

    Veghte, Robert H.

    2014-01-01

    Objective. A new, novel product, Cynatine HNS, was evaluated for its effects as a supplement for improving various aspects of hair and nails in a randomized, double-blind, placebo-controlled clinical trial. Methods. A total of 50 females were included and randomized into two groups. The active group (n = 25) received 2 capsules containing Cynatine HNS, comprised of Cynatine brand keratin (500 mg) plus vitamins and minerals, per day, and the placebo group (n = 25) received 2 identical capsules of maltodextrin per day for 90 days. End points for hair loss, hair growth, hair strength, amino acid composition, and hair luster were measured. End points were also measured for nail strength and the appearance of nails. Results. The results show that subjects taking Cynatine HNS showed statistically significant improvements in their hair and nails when compared to placebo. Conclusion. Cynatine HNS is an effective supplement for improving hair and nails in 90 days or less. EudraCT number is 2014-002645-22. PMID:25386609

  12. The potential application of functionally graded material for proximal femoral nail antirotation device.

    PubMed

    Gong, He; Wang, Lizhen; Zheng, Dong; Fan, Yubo

    2012-09-01

    Proximal femoral nail antirotation (PFNA) device is an intramedullary nail system designing for the treatment of trochanteric fractures. It is composed of a helical neck blade, a nail and a distal locking bolt. There were some reports of femoral shaft fractures even after the fractures were healed. The stress shielding effects of the PFNA device made of stiff titanium alloy on the bone-remodeling behavior of the host femur and the uneven distribution of interface shear stress may contribute to this complication. Recently, a new class of composite called functionally graded material (FGM) was developed, that consisted a gradual pattern of material composition and/or microstructures, and was introduced in dental implant and cementless hip stem. Accordingly, in this paper, we hypothesized that FGM might be used as the material of the nail in PFNA device with the material composition of the nail gradually shifting from more stiff at the proximal side of the femur to more flexible 'iso-elastic' towards the distal side. This hypothesis can be evaluated from the long-term remodeling behavior of host femur and the stress distributions in the PFNA device and bone.

  13. Ingenious method of external fixator use to maintain alignment for nailing a proximal tibial shaft fracture.

    PubMed

    Behera, Prateek; Aggarwal, Sameer; Kumar, Vishal; Kumar Meena, Umesh; Saibaba, Balaji

    2015-09-01

    Fractures of the tibia are one of the most commonly seen orthopedic injuries. Most of them result from a high velocity trauma. While intramedullary nailing of tibial diaphyseal fractures is considered as the golden standard form of treatment for such cases, many metaphyseal and metaphyseal-diaphyseal junction fractures can also be managed by nailing. Maintenance of alignment of such fractures during surgical procedure is often challenging as the pull of patellar tendon tends to extend the proximal fragment as soon as one flexes the knee for the surgical procedure. Numerous technical modifications have been described in the literature for successfully nailing such fractures including semi extended nailing, use of medial plates and external fixators among others. In this study, it was aimed to report two cases in which we used our ingenious method of applying external fixator for maintaining alignment of the fracture and aiding in the entire process of closed intramedullary nailing of metaphyseal tibial fractures by the conventional method. We were able to get good alignment during and after the closed surgery as observed on post-operative radiographs and believe that further evaluation of this technique may be of help to surgeons who want to avoid other techniques.

  14. [Flexible metallic intramedullary nail, an ideal osteosynthesis material for femoral fractions].

    PubMed

    Firică, A; Mucichescu, D; Troianescu, O; Răzuş, M

    1977-01-01

    The authors have used modified Ender nails for the treatment of femural fractures. Nails of different sizes are used in different arrangements, depending on the site of the lesion. Thus, for fractures of the femural neck 3 metallic nails, with a diameter of 4 mm are used, introduced through the internal supra-condylian aspect in paralel arcs; two nails, 5 mm in diameter, are introduced in the same way for the correction of the fractures involving the trochanterian massif; for fractures sited under the trochanterian massif (diaphysis, supracondylian, and supra- and inter-condylian), 5 mm diameter nails are used, placed on the internal and external aspects of the condyl in metalic arcs. This type of intervention was demonstrated to be stable, rapid, non-haemorrhagic and with low risk of shock. Supported walking is started in the first week after surgery--in cases with fractures of the trochanterian massif and of the diaphysis--provided these are stable fractures, in the first month when unstable fractures occur at the same level, and after 3--4 months in cases of fractures of the cervical neck. The authors' experience in the treatment of 250 cases is presented.

  15. Antegrade Unreamed Locked Intramedullary Nailing in Open Fractures of Shaft of Humerus

    PubMed Central

    Singh, Jasbir; Lal, Mukand; Chandel, Desh Raj

    2016-01-01

    Introduction Open fractures of shaft of humerus have been treated conservatively as well as operatively. Plate osteosynthesis has been considered as the gold standard treatment. Intramedullary nailing also has same success rate in closed fractures. The results of 30 open fractures of shaft humerus fixed with locked unreamed antegrade intramedullary nailing were evaluated. Aim The purpose of the study was to evaluate the role of locked intramedullary nailing in open fractures of shaft humerus in terms of bone union, secondary procedure required, complication, shoulder dysfunction and infection. Materials and Methods Of consecutive 365 humeral shaft fractures, 63 fractures were open. Thirty-two patients were operated with plate osteosynthesis, while 31 patients who were treated with locked unreamed intramedullary nails fulfilling the inclusion criteria entered the study. Results Twenty eight of thirty patients united in mean duration of 10.5 weeks. There were two non-unions both of them united with bone grafting and plate osteosynthesis. Seven patients had superficial infection which healed with antibiotic course, while two patients had deep infection, which healed with repeat debridement. Eleven patients had preoperative radial nerve palsy, nine of which healed completely in average of six months. Twenty eight patients had excellent functional outcome at final follow-up while two patients had good outcome. Conclusion Antegrade nailing is associated with good union rates and low infection rates and is a good option in open fractures and in polytrauma patients. PMID:27790533

  16. Correlation of Trochanter-Shaft Angle in Selection of Entry Site in Antegrade Intramedullary Femoral Nail

    PubMed Central

    Lakhwani, O. P.

    2012-01-01

    Background. Selection of entry point for nail insertion is controversial and lack firm anatomical basis. The study is done to analyze the proximal anthropometry of femur and measure the Trochanter-Shaft Angle to find its relation and significance in selection of entry point for antegrade uniplanar femoral nail. Materials and Methods. Study involves the measurement of trochanter-shaft angle and other anthropometric measurements on 50 dry femora and on digital radiogram. Results. Trochanter-Shaft angle ranges between 5–17 degrees in anthropometric study and 4–14 degrees in radiological study. Over all in 27 cases (54%), exit points of reamur fall in the middle quadrant in sagittal and coronal plane, which corresponds to the T-S angle of 6–12 degrees. Discussion and Conclusion. Proximal femoral Anthropometry and Trochanter-shaft angle is variable; hence it is difficult to fix any anatomical point as a universal entry point for antegrade femoral nail insertion. Trochanter shaft angle (TSA) can be well accessed radiologically and serve as a guide for selection of proper entry point.for safe nail insertion. Clinical Relevance. Individual variations in the proximal femur anatomy for safe nail insertion can be correlated with Trochanter shaft angle to serve safe entry site. PMID:24977077

  17. Overcoming the nail barrier: A systematic investigation of ungual chemical penetration enhancement.

    PubMed

    Brown, M B; Khengar, R H; Turner, R B; Forbes, B; Traynor, M J; Evans, C R G; Jones, S A

    2009-03-31

    This study investigated the in vitro nail permeability of penetrants of varying lipophilicity-caffeine (CF, logP -0.07), methylparaben (MP, logP 1.96) and terbinafine (TBF, logP 3.3) and the effect of 2 novel penetration enhancers (PEs), thioglycolic acid (TA) and urea hydrogen peroxide (urea H(2)O(2)) on their permeation. Studies were conducted using full thickness human nail clippings and ChubTur((R)) diffusion cells and penetrants were applied as saturated solutions. The rank order of steady-state penetrant flux through nails without PE application (MP>CF>TBF) suggested a greater sensitivity to penetrant molecular weight rather than logP. TA increased the flux of CF and MP approximately 4- and approximately 2-fold, respectively, whilst urea H(2)O(2) proved ineffective at enhancing permeability. The sequential application of TA followed by urea H(2)O(2) increased TBF and CF flux ( approximately 19- and approximately 4-fold, respectively) but reversing the application order of the PEs was only mildly effective at increasing just MP flux ( approximately 2-fold). Both nail PEs are likely to function via disruption of keratin disulphide bonds and the associated formation of pores that provide more 'open' drug transport channels. Effects of the PEs were penetrant specific, but the use of a reducing agent (TA) followed by an oxidising agent (urea H(2)O(2)) dramatically improved human nail penetration.

  18. Investigation of nail permeation enhancement by chemical modification using water as a probe.

    PubMed

    Malhotra, Gouri G; Zatz, Joel L

    2002-02-01

    Our objective was to screen molecules that could interact with keratin in the human nail and thereby improve the topical penetration of actives into and through the nail plate. We used specialized Franz-type diffusion cells for our permeation experiments and water as a marker molecule. Aqueous/hydroalcoholic gels containing the enhancers were spiked with tritiated water and compared with a control (without enhancer). We computed the normalized water flux (defined as a product of flux and nail thickness) for each gel. We defined an enhancement factor for water as the ratio of the normalized water flux from a gel containing enhancer to that of the control. Our results indicate that the chemical structure of the modifier is most important in determining its ability to enhance penetration. The best enhancement effect was obtained using N-(2-mercaptopropionyl) glycine, a mercaptan derivative of an amino acid, in combination with urea. The concentration of each chemical modifier was linearly related to normalized water flux and mercaptan levels were more important that urea levels in penetration enhancement. Barrier integrity of nails was compromised after treatment with effective chemical modifiers. Thus, we have developed a suitable technique to screen nail penetration enhancers using water as a probe.

  19. UNSTABLE FEMORAL FRACTURES TREATED WITH TITANIUM ELASTIC INTRAMEDULLARY NAILS, IN CHILDREN

    PubMed Central

    Soni, Jamil Faissal; Schelle, Gisele; Valenza, Weverley; Pavelec, Anna Carolina; Souza, Camila Deneka Arantes

    2015-01-01

    Objective: To evaluate the indications, epidemiology, associated lesions, complications and prognosis among children with unstable femoral diaphysis fractures who were treated with titanium elastic intramedullary nails. Method: This was a retrospective analysis on 24 patients aged 5-12 years with unstable femoral diaphysis fractures who underwent surgical treatment with elastic titanium intramedullary nails at the Cajuru University Hospital, Curitiba-PR, between April 2002 and March 2008, with a minimum follow-up of 36 months. The epidemiological data, angular deviations, leg shortening and bone consolidation were evaluated. Results: The medical files of 113 cases operated between April 2002 and March 2008 were reassessed. From these, 24 cases of unstable femoral diaphysis fractures treated with elastic titanium intramedullary nails with retrograde insertion were included in the study. There were two bilateral fractures and two exposed fractures. Seven patients were female and 17 were male, and the mean age was 8.3 years. The following were presented at the end of the study: shortening, varus or valgus displacement, final retrocurvatum or antecurvatum of zero, and absence of delayed consolidation or pseudarthrosis. Conclusions: The elastic titanium intramedullary nails were easily placed and removed. We believe that using elastic titanium intramedullary nails is a good option for fixation of unstable femoral fractures in children. PMID:27047868

  20. Effects of Ionic Strength on Passive and Iontophoretic Transport of Cationic Permeant Across Human Nail

    PubMed Central

    Smith, Kelly A.; Hao, Jinsong; Li, S. Kevin

    2010-01-01

    Purpose Transport across the human nail under hydration can be modeled as hindered transport across aqueous pore pathways. As such, nail permselectivity to charged species can be manipulated by changing the ionic strength of the system in transungual delivery to treat nail diseases. The present study investigated the effects of ionic strength upon transungual passive and iontophoretic transport. Methods Transungual passive and anodal iontophoretic transport experiments of tetraethylammonium ion (TEA) were conducted under symmetric conditions in which the donor and receiver had the same ionic strength in vitro. Experiments under asymmetric conditions were performed to mimic the in vivo conditions. Prior to the transport studies, TEA uptake studies were performed to assess the partitioning of TEA into the nail. Results Permselectivity towards TEA was inversely related to ionic strength in both passive and iontophoretic transport. The permeability and transference number of TEA were higher at lower ionic strengths under the symmetric conditions due to increased partitioning of TEA into the nail. Transference numbers were smaller under the asymmetric conditions compared with their symmetric counterparts. Conclusions The results demonstrate significant ionic strength effects upon the partitioning and transport of a cationic permeant in transungual transport, which may be instrumental in the development of transungual delivery systems. PMID:19267187

  1. Allergic contact dermatitis from sculptured acrylic nails: special presentation with an airborne pattern.

    PubMed

    Maio, Paula; Carvalho, Rodrigo; Amaro, Cristina; Santos, Raquel; Cardoso, Jorge

    2012-01-02

    Methylmethacrylate was first reported in 1941 as a cause of contact dermatitis. Since then, occupational contact allergies to acrylates in dentistry, orthopedic surgery, printing industry and industry have been reported, but few reports are found in the literature as a consequence of the contact with sculptured artificial acrylic nails which are increasingly popular. We describe here 3 patients with contact allergy to acrylates in artificial sculptured nails. Patch tests were performed with the Portuguese baseline series of contact allergens and an extended series of acrylates were applied. In particular, we tested three female patients with allergic contact dermatitis from sculptured acrylic nails. Two of these patients were both customers and also technical nail beauticians. Two patients developed periungual eczema; one presented only with face and eyelid dermatitis had no other lesions. The tests showed positive reaction to 2-hydroxyethylmethacrylate (2-HEMA) and 2-hydroxypropylmethacrylate (2-HPMA) in all the three patients. Our cases demonstrate the variety of clinical presentations of allergic contact dermatitis from acrylic sculptured nails. They show the need to warn patients of persistent and sometimes permanent side effects of these products. They also emphasize the importance of cosmetic ingredient labeling.

  2. New Technique for Tibiotalar Arthrodesis Using a New Intramedullary Nail Device: A Cadaveric Study

    PubMed Central

    Eisenstein, Emmanuel D.; Rodriguez, Mario

    2016-01-01

    Introduction. Ankle arthrodesis is performed in a variety of methods. We propose a new technique for tibiotalar arthrodesis using a newly designed intramedullary nail. Methods. We proposed development of an intramedullary device for ankle arthrodesis which spared the subtalar joint using a sinus tarsi approach. Standard saw bones models and computer assisted modeling and stress analysis were used to develop different nail design geometries and determine the feasibility of insertion. After the final design was constructed, the device was tested on three cadaveric specimens. Results. Four basic nail geometries were developed. The optimal design was composed of two relatively straight segments, each with a different radius of curvature for their respective tibial and talar component. We successfully implemented this design into three cadaveric specimens. Conclusion. Our newly designed tibiotalar nail provides a new technique for isolated tibiotalar fusion. It utilizes the advantages of a tibiotalar calcaneal nail and spares the subtalar joint. This design serves as the foundation for future research to include compression options across the tibiotalar joint and eventual transition to clinical practice. PMID:27818800

  3. Role of HLA-DR Alleles to Increase Genetic Susceptibility to Onychomycosis in Nail Psoriasis

    PubMed Central

    Carrillo-Meléndrez, Hilda; Ortega-Hernández, Esteban; Granados, Julio; Arroyo, Sara; Barquera, Rodrigo; Arenas, Roberto

    2016-01-01

    Background Patients with nail psoriasis have an increased risk of onychomycosis. Previous studies suggest it may be due to structural changes of the nails. However, a genetic predisposition seems to be also at play. Objective To determine a genetic susceptibility for onychomycosis in nails with changes of psoriasis. Methods This is a prospective case-control study of patients with suggestive changes of nail psoriasis with onychomycosis (cases) and without onychomycosis (controls) confirmed by mycological tests. HLA typing was performed in all of them by sequence-specific primers. Results Twenty-five patients and 20 controls with a mean age of 50 years (range 37-72 years) were studied. HLA-DRB1*08 was found in 12 cases (48%) and only 3 controls (15%) [p < 0.033, odds ratio (OR) = 3.8, 95% confidence interval (CI): 0.9-19]. HLA-DR1 was found in 9 cases (36%) and only 1 control (5%) (p < 0.023, OR = 8.5, 95% CI: 1-188). Conclusion HLA-DR*08 and HLA-DR*01 probably increase the susceptibility to fungal infection in psoriasis-affected nails, but larger studies are required to confirm this observation. PMID:27843918

  4. An Assessment of Air Quality in the Surrounding Holy Places of Mecca, Saudi Arabia during Hajj

    NASA Astrophysics Data System (ADS)

    Khwaja, H. A.; Aburizaiza, O. S.; Siddique, A.; Hussain, M. M.; Khatib, F.; Zeb, J.; Blake, D. R.

    2014-12-01

    The associations of exposure to air pollution and adverse human health effects have been demonstrated in many epidemiologic studies. Hajj, an annual pilgrimage of Islam, draws millions of pilgrims from more than 200 countries for religious rituals in Mecca, Saudi Arabia. The city is surrounded by mountains with a population of 1.7 million, which gets doubles or even more during Hajj. The city centers on the Grand Mosque (Masjid Al-haram), connected with the network of tunnels. Main Hajj pilgrimage route for five days extends 20 km to the east and includes "Mina", "Arafat", and "Muzdalifah". A detailed study was conducted in Mecca, its tunnels, and surrounding holy places during Hajj (October 13-17, 2013). Spatial and temporal variations in total suspended particulate (TSP), PM10 , PM7 , PM2.5 , PM1 , ozone (O3), and black carbon (BC) levels along the route were recorded using portable monitors and GPS to assess the status of air quality. This is the first study to elucidate the exposure to air pollutants among pilgrims. Extremely high levels of all pollutants were observed during the intensive measuring periods. For example, the PM7 , PM2.5 , O3, and BC concentrations of up to 9,433 µg/m3, 484 µg/m3, 444 ppb, and 468 µg/m3, respectively, were observed. Results of this investigation revealed that most routes had on average exceeded the World Health Organization (WHO) standards for PM10 and PM2.5 . The reasons for the high air pollutants concentrations are most probably high volume of traffic, construction work, re-suspension of particles, and geographical conditions (arid regions). The pilgrim's longer trip duration lead to their highest whole trip exposure to air pollutants, which indicate that they are possibly subject to higher health risk. Better understanding of air pollution exposure and their determinants in the environments will contribute to the development of more appropriate exposure reductive strategies and have significant public health meanings.

  5. Different pollinator assemblages ensure reproductive success of Cleisostoma linearilobatum (Orchidaceae) in fragmented holy hill forest and traditional tea garden.

    PubMed

    Zhou, Xiang; Liu, Qiang; Han, Jessie Yc; Gao, JiangYun

    2016-02-24

    Orchids are generally recognized to have specialist pollination systems and low fruit set is often thought to be characteristic of the family. In this study, we investigated the reproductive ecology of Cleisostoma linearilobatum, an epiphytic tropical orchid, in a holy hill forest fragment and a traditional tea garden in SW China using comparable methods. C. linearilobatum is self-compatible and dependent on insects for pollination. Fruit production in natural conditions was both pollinator- and resource-limited. However, the natural fruit set remained stable over multiple years at both sites. Pollination observations showed that C. linearilobatum has a generalized pollination system and seven insect species were observed as legitimate pollinators. Although the visit frequencies of different pollinators were different in the two sites, the pollinator assemblages ensured reproductive success of C. linearilobatum in both study sites over multiple years. The results partly explain why C. linearilobatum is so successful in the area, and also suggest that holy hill forest fragments and traditional tea gardens in Xishuangbanna are important in preserving orchids, especially those with generalist pollination.

  6. Queering the cosmology of the vikings: a queer analysis of the cult of Odin and "holy white stones".

    PubMed

    Solli, Brit

    2008-01-01

    Ideas concerning Eros, honor and death were central to the Norse perception of the world. Odin is the greatest war god, and associated with manliness. However, Odin is also the most powerful master of seid (sorcery), an activity associated with women. Seid may be interpreted as a form of shamanism. If a man performed seid he could be accused of ergi, that is, unmanliness. Therefore it could be said that Odin exercised an activity considered unmanly. How could Odin perform seid without losing his position as the god of war and warriors? This paradox is discussed from a queer theoretical perspective. On this basis a new interpretation of the so-called "holy white" phallic stones in western Norway is suggested. Most of these stones are associated with burials from the later part of the Scandinavian Early Iron Age. The temporal distribution of the white phallic stones correlates well with the increasing importance of the cult of Odin. There may be a cultic association between the cult of Odin and the burial practices involving white holy phallic stones.

  7. Tabulate Corals after the Frasnian/Famennian Crisis: A Unique Fauna from the Holy Cross Mountains, Poland

    PubMed Central

    Zapalski, Mikołaj K.; Berkowski, Błażej; Wrzołek, Tomasz

    2016-01-01

    Famennian tabulate corals were very rare worldwide, and their biodiversity was relatively low. Here we report a unique tabulate fauna from the mid- and late Famennian of the western part of the Holy Cross Mountains (Kowala and Ostrówka), Poland. We describe eight species (four of them new, namely ?Michelinia vinni sp. nov., Thamnoptychia mistiaeni sp. nov., Syringopora kowalensis sp. nov. and Syringopora hilarowiczi sp. nov.); the whole fauna consists of ten species (two others described in previous papers). These corals form two assemblages—the lower, mid-Famennian with Thamnoptychia and the upper, late Famennian with representatives of genera ?Michelinia, Favosites, Syringopora and ?Yavorskia. The Famennian tabulates from Kowala represent the richest Famennian assemblage appearing after the F/F crisis (these faunas appear some 10 Ma after the extinction event). Corals described here most probably inhabited deeper water settings, near the limit between euphotic and disphotic zones or slightly above. At generic level, these faunas show similarities to other Devonian and Carboniferous faunas, which might suggest their ancestry to at least several Carboniferous lineages. Tabulate faunas described here represent new recruits (the basin of the Holy Cross mountains was not a refuge during the F/F crisis) and have no direct evolutionary linkage to Frasnian faunas from Kowala. The colonization of the seafloor took place in two separate steps: first was monospecific assemblage of Thamnoptychia, and later came the diversified Favosites-Syringopora-Michelinia fauna. PMID:27007689

  8. Yield, Composition and Antioxidant Capacity of the Essential Oil of Sweet Basil and Holy Basil as Influenced by Distillation Methods.

    PubMed

    Shiwakoti, Santosh; Saleh, Osama; Poudyal, Shital; Barka, Abdulssamad; Qian, Yanping; Zheljazkov, Valtcho D

    2017-04-01

    The profile and bioactivity of essential oil (EO) depends on genetic, environmental, and other factors. We hypothesized that the basil EO may be influenced by the distillation methods. Hence, a study was conducted to evaluate the effect of steam distillation (SD) and hydrodistillation (HD) extraction method on the yield, composition, and bioactivity of EO of sweet basil (Ocimum basilicum) and holy basil (Ocimum tenuiflorum). In both basil species, the EO yield (content) was significantly higher from SD than from HD. There were significant differences in the compounds' concentrations of EO obtained from SD and HD as well, however, the same compounds were identified in the EO from HD and SD. In the EO of O. basilicum, the concentration of 74% of the identified compounds were higher in SD than HD, whereas in the EO of O. tenuiflorum, the concentration of 84% of identified compounds were higher in SD than in HD. However, the concentrations of two of the major compounds of O. basilicum EO (estragole and methyl cinnamate) and a major compound of O. tenuiflorum EO (methyl eugenol) were significantly higher in HD than in SD. The type of distillation did not affect the antioxidant capacity of basil EO within the species. This study demonstrated that the type of distillation may significantly affect oil yield and composition but not the antioxidant capacity of the EO from sweet and holy basil.

  9. Different pollinator assemblages ensure reproductive success of Cleisostoma linearilobatum (Orchidaceae) in fragmented holy hill forest and traditional tea garden

    PubMed Central

    Zhou, Xiang; Liu, Qiang; Han, Jessie Yc; Gao, JiangYun

    2016-01-01

    Orchids are generally recognized to have specialist pollination systems and low fruit set is often thought to be characteristic of the family. In this study, we investigated the reproductive ecology of Cleisostoma linearilobatum, an epiphytic tropical orchid, in a holy hill forest fragment and a traditional tea garden in SW China using comparable methods. C. linearilobatum is self-compatible and dependent on insects for pollination. Fruit production in natural conditions was both pollinator- and resource-limited. However, the natural fruit set remained stable over multiple years at both sites. Pollination observations showed that C. linearilobatum has a generalized pollination system and seven insect species were observed as legitimate pollinators. Although the visit frequencies of different pollinators were different in the two sites, the pollinator assemblages ensured reproductive success of C. linearilobatum in both study sites over multiple years. The results partly explain why C. linearilobatum is so successful in the area, and also suggest that holy hill forest fragments and traditional tea gardens in Xishuangbanna are important in preserving orchids, especially those with generalist pollination. PMID:26907369

  10. Tabulate Corals after the Frasnian/Famennian Crisis: A Unique Fauna from the Holy Cross Mountains, Poland.

    PubMed

    Zapalski, Mikołaj K; Berkowski, Błażej; Wrzołek, Tomasz

    2016-01-01

    Famennian tabulate corals were very rare worldwide, and their biodiversity was relatively low. Here we report a unique tabulate fauna from the mid- and late Famennian of the western part of the Holy Cross Mountains (Kowala and Ostrówka), Poland. We describe eight species (four of them new, namely ?Michelinia vinni sp. nov., Thamnoptychia mistiaeni sp. nov., Syringopora kowalensis sp. nov. and Syringopora hilarowiczi sp. nov.); the whole fauna consists of ten species (two others described in previous papers). These corals form two assemblages-the lower, mid-Famennian with Thamnoptychia and the upper, late Famennian with representatives of genera ?Michelinia, Favosites, Syringopora and ?Yavorskia. The Famennian tabulates from Kowala represent the richest Famennian assemblage appearing after the F/F crisis (these faunas appear some 10 Ma after the extinction event). Corals described here most probably inhabited deeper water settings, near the limit between euphotic and disphotic zones or slightly above. At generic level, these faunas show similarities to other Devonian and Carboniferous faunas, which might suggest their ancestry to at least several Carboniferous lineages. Tabulate faunas described here represent new recruits (the basin of the Holy Cross mountains was not a refuge during the F/F crisis) and have no direct evolutionary linkage to Frasnian faunas from Kowala. The colonization of the seafloor took place in two separate steps: first was monospecific assemblage of Thamnoptychia, and later came the diversified Favosites-Syringopora-Michelinia fauna.

  11. 77 FR 46686 - Steel Nails From the People's Republic of China: Notice of Court Decision Not in Harmony With...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-06

    ... \\1\\ as including steel nails found within Target Corporation's toolkits from the People's Republic of... contained within toolkits. See Final Scope Ruling: Certain Steel Nails from the People's Republic of China... Department issued a final scope ruling on toolkits from the PRC ] imported by Target Corporation. See...

  12. Identifying and understanding the role of key stakeholders in promoting worker health and safety in nail salons.

    PubMed

    Quach, Thu; Tsoh, Janice Y; Le, Gem; Le, Minhthu; Pham, Alene; Fu, Lisa; Luu, Vinh; Ngo, Kim; Reynolds, Peggy

    2015-05-01

    The nail salon sector is booming, predominantly with Vietnamese immigrant workers who regularly handle nail care products containing harmful chemicals. Based on lessons learned from an ongoing randomized controlled trial, occupational interventions need to incorporate inputs from different stakeholders, including salon owners, workers, and customers as well as governmental regulatory agencies.

  13. 75 FR 38080 - Certain Steel Nails From the People's Republic of China: Rescission of New Shipper Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-01

    ... International Trade Administration Certain Steel Nails From the People's Republic of China: Rescission of New.... DATES: Effective Date: July 1, 2010. SUMMARY: In response to a request from Maanshan Leader Metal... antidumping duty order on certain steel nails from the People's Republic of China (``PRC'') covering...

  14. 75 FR 43149 - Certain Steel Nails from the Peoples' Republic of China: Notice of Partial Rescission of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-23

    ... International Trade Administration Certain Steel Nails from the Peoples' Republic of China: Notice of Partial... review on the antidumping order on certain steel nails from the People's Republic of China (``PRC'') for..., the Department ] initiated the first antidumping duty administrative review on certain steel...

  15. Speckled variance optical coherence tomography for the assessment of nail involvement in acrodermatitis continua of Hallopeau: A case study.

    PubMed

    Conti, Andrea; Ciardo, Silvana; Mandel, Victor Desmond; Bigi, Laura; Pellacani, Giovanni

    2016-09-01

    Noninvasive techniques for nail imaging would be useful for confirming diagnosis and monitoring treatment response at the microscopic level in patients with nail psoriasis. However, the use of ultrasound and high-resolution magnetic resonance imaging in nail evaluation is limited. Optical coherence tomography (OCT) produces high-resolution images of transversal tissue sections and represents an optimal approach to the study of the nail. This study used a multibeam OCT instrument to produce speckled variance OCT (SV-OCT) blood-flow images, which were used to measure the degree of change over successive scans. Nail changes, inflammation and response to therapy were evaluated in a 75-year-old female patient with psoriasis who had severe acrodermatitis continua of Hallopeau of the hands, treated for 4 weeks with 40 mg adalimumab (administered subcutaneously every other week) and 25 mg prednisone (administered orally, daily). SV-OCT provided a detailed assessment of the nail structures in relation to inflammation of psoriatic tissues. Restoration of the normal anatomy of the nail apparatus was apparent following adalimumab treatment; SV-OCT evaluation correlated with clinical appearance. SV-OCT may have a diagnostic role and provide an objective tool to assess clinical and subclinical inflammation in nail psoriasis.

  16. Identification of Noise Sources and Design of Noise Reduction Measures for a Pneumatic Nail Gun.

    PubMed

    Jayakumar, Vignesh; Kim, Jay; Zechmann, Edward

    An experimental-analytical procedure was implemented to reduce the operating noise level of a nail gun, a commonly found power tool in a construction site. The procedure is comprised of preliminary measurements, identification and ranking of major noise sources and application of noise controls. Preliminary measurements show that the impact noise transmitted through the structure and the exhaust related noise were found to be the first and second major contributors. Applying a noise absorbing foam on the outside of the nail gun body was found to be an effective noise reduction technique. One and two-volume small mufflers were designed and applied to the exhaust side of the nail gun which reduced not only the exhaust noise but also the impact noise. It was shown that the overall noise level could be reduced by as much as 3.5 dB, suggesting that significant noise reduction is possible in construction power tools without any significant increase of the cost.

  17. Surgical treatment of complex proximal humeral fractures with a technique of nail and osteosuture: "NOS".

    PubMed

    Garret, J; Houdré, H; Cievet-Bonfils, M; Godenèche, Arnaud; Duparc, Fabrice; Roussignol, Xavier

    2017-03-14

    Open reduction and internal fixation of complex proximal humeral fracture represents a surgical challenge. The main objective of this procedure is to anatomically reduce the tuberosities. We propose a standardized and reproducible technique that we apply to all complex displaced 3- and 4-part fractures of patients under 50 years. We use an antero-lateral trans-deltoid approach; the humeral head and the tuberosities are reduced under fluoroscopic control. The tuberosities are stabilized with an inter-tuberosity osteosuture, and we then introduce a thin and straight intra-medullary nail (Telegraph IV FH Orthopedics) at the hinge point of the humeral head. The osteosynthesis of the tuberosities is completed by 3- or 4-self-stable divergent screws in the nail. A dynamic distal locking stabilizes the humeral shaft in rotation and facilitates consolidation thanks to micro movements. The removal of the nail with an arthroscopic shoulder arthrolysis in case of stiffness is possible secondarily.

  18. Tibial lengthening using a reamed type intramedullary nail and an Ilizarov external fixator.

    PubMed

    Kim, Hayoung; Lee, Sang Ki; Kim, Kap Jung; Ahn, Jae Hoon; Choy, Won Sik; Kim, Yong In; Koo, Jea Yun

    2009-06-01

    The aim of this study was to evaluate the efficacy of tibial lengthening using a reamed type intramedullary nail and an Ilizarov external fixator for the treatment of leg length discrepancy or short stature. This retrospective study was performed on 18 tibiae (13 patients) in which attempts were made to reduce complications. We used an Ilizarov external fixator and a nail (10 mm diameter in 17 tibiae and 11 mm in one tibia) in combination. Average limb lengthening was 4.19 cm (range, 2.5-5.5). The mean duration of external fixation was 12.58 days per centimetre gain in length, and the mean consolidation index was 40.53 (range, 35.45-51.85). All distracted segments healed spontaneously without refracture or malalignment. Gradual limb lengthening using a reamed type intramedullary nail and circular external fixation in combination was found to be reliable and effective and reduced external fixation time with fewer complications.

  19. Statistical definition of nail fold capillary pattern in patients with systemic sclerosis.

    PubMed

    Ohtsuka, T; Ishikawa, H

    1994-01-01

    Image analysis of videographs of nail fold capillaries was performed in patients with systemic sclerosis (SS), and the capillary patterns were defined by canonical discriminant analysis. Forty-eight of 55 SS patients were significantly differentiated from patients with systemic lupus erythematosus and normal controls. Normal controls and patients with systemic lupus erythematosus showed identical nail fold capillary patterns; in patients with dermatomyositis the pattern was similar to that of SS. The canonical discriminant analysis revealed that only 5 of 55 (9%) SS patients showed a normal capillary pattern. The abnormal capillary pattern in SS patients correlated with microvascular disturbances such as Raynaud's phenomenon, digital pitting scars and low finger temperature. Our results indicate that quantitative analysis of the nail fold capillaries is useful in evaluating the microvascular disturbances in SS patients.

  20. Retrospective Evaluation of Nail Trimming as a Conservative Treatment for Ulcerative Dermatitis in Laboratory Mice

    PubMed Central

    Alvarado, Cynthia G; Franklin, Craig L; Dixon, Lonny W

    2016-01-01

    Ulcerative dermatitis (UD) is an idiopathic disease that affects C57BL/6 mice and those having a B6 background. The hallmark of UD is pruritus, which leads to self-mutilation and epidermal ulceration typically in the intrascapular region. Although several treatments for UD have been published, some involve the use of pharmacologic agents that might confound research results. In this retrospective study, we evaluated nail trimming to determine whether this conservative treatment approach improved the resolution rate of UD at our institution compared with that of untreated mice or those that received oral or topical antibiotics. Our findings show that the incidence of resolution of UD was significantly greater and that the time to resolution was shorter in mice treated with nail trimming compared with other groups. These findings support the use of nail trimming as an effective conservative treatment option for UD in B6 mice. PMID:27423154

  1. Current Evidence: Plate Versus Intramedullary Nail for Fixation of Distal Tibia Fractures in 2016.

    PubMed

    Vallier, Heather A

    2016-11-01

    Displaced distal tibia shaft fractures are effectively treated with standard plates and intramedullary nails. Plate fixation performed with meticulous soft tissue handling results in minimal risks of infection and poor wound healing. Standard plates have high rates of primary union, whereas locking plates may delay union because of increased stiffness. Tibial healing may also be delayed after plating of the fibula, although fibula reduction and fixation may aid accuracy of reduction of the tibia. Malalignment occurs more often with infrapatellar intramedullary nailing versus plates, and early results of suprapatellar nailing appear promising in minimizing intraoperative malalignment. Long-term function after fixation of the distal tibia is good for most, with poor outcomes often associated with baseline social and mental health issues.

  2. Characterization of natural and irradiated nails by means of the depolarization metrics

    NASA Astrophysics Data System (ADS)

    Savenkov, Sergey; Priezzhev, Alexander; Oberemok, Yevgen; Sholom, Sergey; Kolomiets, Ivan; Chunikhina, Kateryna

    2016-07-01

    Mueller polarimetry is applied to study the samples of nails: natural (or reference) and irradiated to 2 Gy ionizing radiation dose. We measure the whole Mueller matrices of the samples as a function of the scattering angle at a wavelength of 632.8 nm. We apply depolarization analysis to measured Mueller matrices by calculating the depolarization metrics [depolarization index, Q(M)-metric, first and second Lorenz indices, Cloude and Lorenz entropy] to quantify separability of the different samples of nails under study based on differences in their Mueller matrix. The results show that nail samples strongly depolarize the output light in backscattering, and irradiation in all cases results in increasing of depolarization. Most sensitive among depolarization metrics are the Lorenz entropy and Q(M)-metric.

  3. [Interlocking medullary nailing. Indications, technic with a new guiding instrument. Analysis of the 1st 50 operations].

    PubMed

    Berentley, G

    1976-01-01

    After a review of Küntsher's intramedullary nailing, the author resumed the informations about the interlocking medullary nail and its technique. A new device, as a guide instrument for easier application of the transverse bolts was constructed on the basis of authors concept. Using the new technique and guide instrument X-ray television controll is not necessary for placing the bolts in their right places through a small incision. The time of operation and the risk of infection was also diminished by the new technique. The indications for the interlocking medullary nailing have been completed by the author with the pathologic fractures. The first 50 cases, treated by the new technique of the interlocking medullary nailing are analysed and a few cases are reported in detail. Good results have been obtained as regards both the bone union and the functional results. Based on the good results the new technique of the interlocking medullary nailing is recommended by the author.

  4. Augmentation of proximal femoral nail in unstable trochanteric fractures

    PubMed Central

    Gadegone, Wasudeo M.; Shivashankar, Bhaskaran; Lokhande, Vijayanad; Salphale, Yogesh

    2017-01-01

    Introduction: Biomechanically proximal femoral nail (PFN) is a better choice of implant, still it is associated with screw breakage, cut out of screw through femoral head, Z effect, reverse Z effect, and lateral migration of screws. The purpose of this study is to evaluate the results of augmented PFN in terms of prevention of postoperative complications and failure rates in unstable trochanteric fractures. Material and methods: We carried out a prospective study of 82 cases with unstable trochanteric femoral fractures from April 2010 to December 2015. Forty-two females and 40 males in the age group between 58 and 81 years were included in this study. There were 45 cases of AO 31 A2 (2.2, 2.3) and 37 cases of AO 31 A3 (3.1, 3.2, 3.3). Fractures were fixed by PFN with augmentation by an additional screw from trochanter to inferior quadrant of femoral head or cerclage wire to strengthen the lateral trochanteric wall. Results: The bone healing is observed in all the cases in the mean period of 14.2 weeks. Nine patients developed complications, including lateral migration of neck screws (n = 5), Z effect (n = 1), infection (n = 2), and breakage of distal interlocking bolt in one case. Removal of screws was required in five cases. Patients were followed up for a mean of 8.4 months. At the end of follow-up the Salvati and Wilson hip function was 32 (out of 40) in 88% of patients. Conclusion: The stabilization of lateral trochanteric wall with additional screw or cerclage wire increases the stability of construct. PMID:28186871

  5. Elastic stable intramedullary nailing of midclavicular fractures in athletes

    PubMed Central

    Jubel, A; Andemahr, J; Bergmann, H; Prokop, A; Rehm, K; Fay, M

    2003-01-01

    Background: Intramedullary fixation of midclavicular fractures may be a better option than non-operative treatment for high performance/professional athletes because of the potential reduction in recovery time. Objectives: To evaluate the effectiveness of intramedullary fixation in high performance athletes and the time required to return to sporting activity. Methods: Data were taken from a prospective study on intramedullary fixation techniques using the elastic stable Ti nail (TEN, Synthes) for the treatment of displaced midclavicular fractures, initiated in 1996. The patients in 12 cases were classified as high performance/professional athletes. These cases were used to evaluate the technique specifically in this population. Fractures were classified according to the Orthopaedic Trauma Association (OTA) system. Patients were evaluated before and after surgery for shoulder function and subjective pain. After the operation, radiological assessments documented fracture healing, and clinical outcomes scores were obtained. Time required to return to training and competition was documented. Results: All fractures were transverse or oblique. Mean (SD) shoulder abduction increased from 36.3 (8)° before surgery to 154.2 (17)° afterwards (p<0.001). Mean subjective pain score using a visual analogue scale (0–100) decreased from 71.7 (18) points before surgery to 19.2 (6) points (p<0.001) three days after. There were no complications. Hospital stay averaged 2.9 (1) days. Mean delay to resumption of training was 5.9 (1) days, and to resumption of competition it was 16.8 (5) days. The mean Constant clinical outcomes score one year after hardware removal was 98.3 (2) points. Conclusions: Intramedullary fixation of displaced midclavicular fracture was successful in terms of clinical outcome and rapid resumption of sporting activities. This treatment should be offered to athletes as an alternative to non-operative treatment. PMID:14665582

  6. Titanium elastic nailing radius and ulna fractures in adolescents.

    PubMed

    Wall, Lindley; O'Donnell, June C; Schoenecker, Perry L; Keeler, Kathryn A; Dobbs, Matthew B; Luhmann, Scott J; Gordon, J Eric

    2012-09-01

    Over the last 40 years, anatomic reduction with plate stabilization has become the standard in adult patients with diaphyseal fractures of the radius and ulna. When operative fixation has been indicated in skeletally immature patients with these fractures, a variety of techniques have been reported, with intramedullary fixation becoming increasingly accepted. There is currently significant variability in the treatment of adolescents with forearm fractures. The purpose of this study was to investigate the clinical and radiographic outcomes in the adolescent population after intramedullary fixation of both bone forearm fractures. A retrospective review identified 32 patients 12-18 years of age who had undergone intramedullary fixation of both forearm bones in the past 20 years at our institution. Galeazzi, Monteggia, radial head, and distal metaphyseal fractures were excluded. Radiographic evaluation was performed to determine union and postoperative radial bow. Clinical follow-up was carried out for postoperative complications and range of motion of the wrist, forearm, and elbow. The mean age of the patients was 14.1 years. A total of 19 fractures were closed injuries, nine were grade 1, three were grade 2, and one fracture was a grade 3b. Of the patients, 15.6% had limited postoperative range of motion. All patients in the older age group, 15-18 years of age, had a normal range of motion. A decrease in radial bow was not associated with limitation in motion. There was a 98% union rate, and all unions occurred by 7.5 months. Only three major complications occurred, two refractures and one ulnar hardware migration, and subsequent radius nonunion occurred in the one grade 3b injury. Flexible intramedullary nailing of both bone forearm fractures provides reliable bony union and excellent postoperative clinical results in adolescents. Level of evidence, IV.

  7. Clinical application of a pedicle nail system with polymethylmethacrylate for osteoporotic vertebral fracture

    PubMed Central

    Tanaka, Masato; Sugimoto, Yoshihisa; Takigawa, Tomoyuki; Ozaki, Toshifumi; Konishi, Hitoshi

    2010-01-01

    The instrumentation of the osteoporotic spine may sometimes result in failure due to the loosening or pullout of the conventional pedicle screw. Moreover, augmentation of screws with polymethylmethacrylate (PMMA) has risks of complications. We developed a new and original pedicle nail system with PMMA for osteoporotic vertebral fractures. A clinical evaluation of this novel pedicle nail system utilized in patients with an osteoporotic vertebral collapse was performed to determine the effectiveness and safety of this technique. Thirty-four elderly patients who suffered from osteoporotic compression fractures were treated by posterolateral fusion using the pedicle nail system. The mean follow-up period was 37 months. Of the 25 patients with neurological symptoms, two patients improved two stages at the Frankel level. Fifteen patients improved one stage at the Frankel level, and eight other patients improved, however, their improvement did not exceed a Frankel level. Nine cases with neuralgia symptoms improved from 4.4 to 2.2 points on average on the Denis pain scale (p < 0.01). The fusion rate was 94% as determined by X-rays of flexion and extension, and the correction of the compression fracture site was maintained well. A pedicle nail system stabilizes the spinal column with osteoporosis and reduces the instrumentation failure. The technique for the insertion of the pedicle nail reduces complication from cement augmentation. The authors speculate that the strategy using the pedicle nail system for osteoporotic spine may be effective and safe when the surgery is performed through a posterior approach. PMID:20414689

  8. Method development for assessing the human exposure to organophosphate flame retardants in hair and nails.

    PubMed

    Alves, Andreia; Covaci, Adrian; Voorspoels, Stefan

    2017-02-01

    In the present study, a new extraction method based on acid digestion and SPE clean-up (Oasis Wax) was developed for measuring four PFR metabolites (i.e. dibutyl phosphate (DBP), diphenyl phosphate (DPhP), bis(1,3-dichloro-2-propyl)phosphate (BDCPP) and bis(2-butoxy ethyl) phosphate (BBEP)) in hair and nails. The method optimization was done according to a combinatorial design (Taguchi) where several parameters were efficiently optimized. Precision was lower for hair than for nails (RSD % 18 and 28%). Recoveries were >74%. High DBP levels in procedural blanks were traced back to the use of SPE cartridges. Therefore a new SPE pre-treatment was tested, reducing significantly DBP levels (<1 ng). Levels of the PFR metabolites were measured in scalp hair, finger, and toe nails collected over two months in two volunteers (female and male). DPhP levels were extremely high (in μg/g range) in both finger and toe nails in the female. BDCPP and BBEP were the minor metabolites detected in nails (average levels of 28-64 ng/g and <2.2-4.1 ng/g, respectively). DPhP was the only metabolite detected in hair (0.23-0.25 ng/g). Results showed that there is a possible contribution from both an external (via deposition) and an internal exposure, however it was not possible to fully understand their extent. Since there were no records of lifestyle and due to the small sample size, the major exposure source could not be addressed here. Nevertheless, there is evidence that hair and nails (finger and toe) might be good indicators of human exposure to PFRs, especially to TPhP.

  9. [Residue of organic fluorine pollutants in hair and nails collected from Tianjin].

    PubMed

    Yao, Dan; Zhang, Hong; Chai, Zhi-Fang; Shen, Jin-Can; Yang, Bo; Wang, Yan-Ping; Liu, Guo-Qing

    2013-02-01

    In order to explore the residue and distributions of organic fluorine pollutants in hair and nails, the residue levels of total fluorine (TF), extractable organic fluorine (EOF) and perfluorinated chemicals (PFCs) in hair and nails collected from Tianjin adults were measured by the cyclic neutron activation analysis (CNAA) combined with the high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The results showed that inorganic fluorine (mean: 2.0 mg.kg-1, 4.5 mg.kg-1) was the primary fluorine in TF while EOF(mean: 0.7 mg.kg-1, 1.8 mg.kg-1) was minor. The average amount of identified fluorine (IF) was 0.038 mg.kg-1 in hair and 0.047 mg.kg-1 in nails, accounting or 7.1% (2.6%-16%) and 3.5% (1.1%-11%) of EOF, respectively, which indicated that more than 84% of EOF was unknown. The major residue in hair and nails were medium-and short-chain PFCs,in which perfluorooctane sulfonate, perfluorooctanoic acid and perfluorononanoic acid were the main species. TF, EOF and IF levels in dyed and permed hair were significantly higher than untreated hair (P <0.05), and the concentrations of Sigma PFCs in hair and nails showed no difference between genders. With significantly higher levels of sigma PFCs and PFOS residues than hair (P <0.01), nails could potentially become a more sensitive bioindicator for the exposure level of PFCs in human.

  10. [Blind nailing of trochanteric fractures using the Ender method (author's transl)].

    PubMed

    Carret, J P; Van Cuyck, A; Bejui, J; Dejour, H; de Mourgues, G; Fischer, L P

    1980-01-01

    After trochanteric fractures, the rate of survival of old patients was best when treated by the Ender method: 15% died during 3 months following the fracture. The procedure is uneasy and an excellent radiologic technique is necessary. The position of the proximal end of the first nail in the femoral head is most important. Excessive external rotation was frequent, but little desabling. Secondary displacement of the nails toward the distal end occurred in 25% of the cases and was difficult to avoid but remained moderate. The procedure is indicated in old people with porotic bones. It should not be done in subtrochanteric fractures.

  11. Speckle-correlation analysis of the microcapillary blood circulation in nail bed

    SciTech Connect

    Vilenskii, M A; Agafonov, D N; Zimnyakov, D A; Tuchin, Valerii V; Zdrazhevskii, R A

    2011-04-30

    We present the results of the experimental studies of the possibility of monitoring the blood microcirculation in human finger nail bed with application of speckle-correlation analysis, based on estimating the contrast of time-averaged dynamic speckles. The hemodynamics at normal blood circulation and under conditions of partially suppressed blood circulation is analysed. A microscopic analysis is performed to visualise the structural changes in capillaries that are caused by suppressing blood circulation. The problems and prospects of speckle-correlation monitoring of the nail bed microhemodynamics under laboratory and clinical conditions are discussed. (optical technologies in biophysics and medicine)

  12. Steroid-responsive nephrotic syndrome in a patient with nail-patella syndrome.

    PubMed

    Hari, Pankaj; Mantan, Mukta; Dinda, Amit; Hari, Smriti; Bagga, Arvind

    2006-08-01

    Nail-patella syndrome (NPS) is a rare disorder with autosomal dominant mode of inheritance. We report a child with NPS and steroid-responsive, frequently relapsing nephrotic syndrome. The child had dystrophic nails, flexion contractures of both elbows and normal renal functions. X-rays of the knees and pelvis showed hypoplastic patellae and iliac horns. Renal histology was unremarkable with mild focal increase in mesangial cellularity compatible with minimal change disease. Ultrastructural features of NPS including thickening of the glomerular basement membrane with electron-lucent areas were not found.

  13. Penetrating eye globe injury from trauma with a metallic nail: a case report.

    PubMed

    Almodóvar-Mercado, Juan C; López-Beauchamp, Vanessa

    2013-01-01

    We report a case of penetrating eye globe injury due to a metallic nail. This is the first case evaluated by our service that presented with an intact 2.5-centimeter nail penetrating the right eye with a significant intraocular component that the patient did not remove. We describe the initial presentation and the multi-step surgery that this complicated injury required. The early postoperative visual acuity remained unchanged when compared to the presenting. In addition, the patient had no retinal pathology or optic nerve damage after the procedure.

  14. Searching for the Holy Grail of Learning Outcomes. SERU Project and Consortium Research Paper. Research & Occasional Paper Series: CSHE.3.12

    ERIC Educational Resources Information Center

    Douglass, John Aubrey; Thomson, Gregg; Zhao, Chun-Mei

    2012-01-01

    The search for the Holy Grail to measure learning gains started in the US, but the Organisation for Economic Co-operation and Development (OECD) wants to take it global. Here we tell a bit of this story and raise serious questions regarding the validity of the Collegiate Learning Assessment test and suggest there are alternatives. The merit of the…

  15. Determining the magnitude, frequency and source of prehistoric events - Is there a Holy Grail?

    NASA Astrophysics Data System (ADS)

    Goff, James; Dominey-Howes, Dale; Chague-Goff, Catherine; Strotz, Luke; Anning, David; Bird, Deanne; Calgaro, Emma; Courtney, Claire

    2010-05-01

    palaeotsunami sources, we need to be able to compare and contrast between national databases. This can only happen if databases exist and are compatible - for example, are the criteria used for palaeotsunami interpretations consistent? Similarly, to be able to start commenting on the magnitude and frequency of palaeotsunamis from local, regional and distant sources there need to be regional and national databases to refer to. Surprisingly, this is rarely the case. We highlight this issue with reference to palaeotsunami data from the Pacific Ocean. Palaeotsunami magnitude, frequency and source (PMFS) modelling can be and has been achieved albeit with some caution. While it is acknowledged that any single palaeotsunami database will never be entirely complete and we may therefore never be fully able to determine the PMFS for any one region, this does not mean that is has no value. Far from it, after all every single historical database is also incomplete and they are regularly used for probabilistic tsunami hazard modelling. Is there a Holy Grail? In many ways it largely depends upon whether you think the cup is half full or half empty.

  16. Comparison of the reconstruction trochanteric antigrade nail (TAN) with the proximal femoral nail antirotation (PFNA) in the management of reverse oblique intertrochanteric hip fractures.

    PubMed

    Makki, Daoud; Matar, Hosam E; Jacob, Nebu; Lipscombe, Stephen; Gudena, Ravindra

    2015-12-01

    Reverse oblique intertrochanteric fractures have unique mechanical characteristics and are often treated with intramedullary implants. We compared the outcomes of the reconstruction trochanteric antegrade nail (TAN) with the proximal femoral nail antirotation (PFNA). Between July 2008 and February 2014, we reviewed all patients with reverse oblique intertrochanteric fractures treated at our hospital. Patients with pathological fractures and those who were treated with other than TAN and PFNA nailing systems were excluded. Preoperative assessment included the Abbreviated mental test score (AMT), the ASA grade, pre-injury mobility and place of residence. Postoperative outcome measures included the type of implant used, time to fracture union, failures of fixation and revision surgeries. Fifty-eight patients were included and divided into two groups based on the treatment: 22 patients treated with TAN and 36 patients treated with PFNA systems. The two groups were well matched with regards to demographics and fracture type. The overall union rate was similar in both groups but the time to union was shorter in the TAN group. There were 8 implant failures in the PFNA (22.2%) group compare to none in the TAN group. Implant failure was associated with the severity of fracture (AO 31.A3.3) but was not related to fracture malreduction or screw position (Tip-apex-distance). Our study suggests that the use of reconstruction system with two screws such as TAN may be more suitable implant for reverse oblique intertrochanteric hip fractures.

  17. Elastic robust intramedullary nailing for forearm fracture in children

    PubMed Central

    Aidelsburger, Pamela; Grabein, Kristin; Huber, Alois; Hertlein, Hans; Wasem, Jürgen

    2006-01-01

    Background Forearm fractures are the most common fractures in children (23% of all fractures). Basically there are two treatment options available for diaphyseal forearm fractures in children: closed reduction with cast immobilisation (conservative therapy) and the elastic stable intramedullary nailing (ESIN). Treatment decision is influenced by the doctor's estimation of fracture instability. Stable fractures can be treated conservatively whereas instable forearm shaft fractures can be treated according the following three treatment strategies: conservative therapy in an outpatient setting conservative therapy in the operating room in attendance to change to ESIN in case that no stabilisation can be achieved with cast immobilisation immediate treatment with ESIN in the operating room. Objectives Aim of this Health Technology Assessment (HTA) report is to assess and report the published evidence concerning effectiveness and cost-effectiveness of ESIN as a treatment option for diaphyseal forearm fractures in children and to identify future research need. Important parameters for the assessment of effectiveness are objective parameters (axis deviation, losses of motion, and numbers of reductions in case of redislocations) and subjective parameters (pain or impairment in quality of life). Furthermore, a health economic evaluation shall be done which refers to the costs of the different therapy strategies. Methods An extensive, systematic literature search in medical, economic, and HTA literature databases was performed. Relevant data were extracted and synthesised. Results Three cohort studies and seven case series have been identified. Controlled clinical studies, systematic reviews and/or HTA reports that gave evidence to answer the own study question have not been found. The identified studies partly differed in respect of defined indication for ESIN, study population and treatment strategies. For that reason comparability of results was limited. In the majority of

  18. Lengthening Over an Existing Intramedullary Nail In Cases of Post-traumatic Femoral Shortening. Technical Note. Case Series Study

    PubMed Central

    Boutsiadis, Achilleas; Iosifidou, Eirini; Nikolaos, Xilouris; Hatzokos, Ippokratis

    2016-01-01

    Background: Intramedullary (IM) nailing is the method of choice for the treatment of most femoral shaft fractures. However, despite successful solid union, great initial fracture comminution can lead to significant leg length discrepancy affecting normal gait mechanics. Femoral osteotomy and distraction osteogenesis over the pre-existing IM nail could restore this limb inequality. Methods: Five patients with an average post-traumatic femoral shortening of 3.83 cm were presented in our department with the nail in situ. Limb lengthening was achieved with the application of a distal hybrid external rail frame over the pre-existing nail. We assumed that the choice of a distal external fixator ring with wires could facilitate the procedure and minimize the possibility of friction–contact problems with the large diameter nail. Results: The amount of length discrepancy, calculated preoperatively, was restored in all patients. The mean time in frame was 57.6 days and the external fixator index 16.978 d/cm. The mean time of total healing was 152.6 days and the average bone-healing index 44.9d/cm. No deep infection or hardware loosening was observed. One superficial pin track infection was treated successfully with oral antibiotics. Conclusion: This technique utilizes the principles and advantages of lengthening over an IM nail, avoids the necessity of nail removal and minimizes the complication rates and the overall time for complete recovery. PMID:27053972

  19. The stability of a hip fracture determines the fatigue of an intramedullary nail.

    PubMed

    Eberle, S; Bauer, C; Gerber, C; von Oldenburg, G; Augat, P

    2010-01-01

    The purpose of this study was to address the question of how the stability of a proximal hip fracture determines the fatigue and failure mechanism of an intramedullary implant. To answer this question, mechanical experiments and finite element simulations with two different loading scenarios were conducted. The two load scenarios differed in the mechanical support of the fracture by an artificial bone sleeve, representing the femoral head and neck. The experiments confirmed that an intramedullary nail fails at a lower load in an unstable fracture situation in the proximal femur than in a stable fracture. The nails with an unstable support failed at a load 28 per cent lower than the nails with a stable support by the femoral neck. Hence, the mechanical support of a fracture is crucial to the fatigue failure of an implant. The simulation showed why the fatigue fracture of the nail starts at the aperture of the lag screw. It is the location of the highest von Mises stress, which is the failure criterion for ductile materials.

  20. Anesthetic management in a patient with osteogenesis imperfecta for rush nail removal in femur

    PubMed Central

    Gupta, Divanshu; Purohit, Alaka

    2016-01-01

    Osteogenesis imperfecta (OI) is a rare genetically inherited syndrome involving connective tissues, resulting in anatomic and physiologic abnormalities, which results in any form of anesthesia, a challenging task. We hereby report a case of OI type I presented with distinctively blue sclera, hearing loss, kyphoscoliosis, and mild pulmonary restrictive disease who underwent rush nail removal in the femur. PMID:27746572

  1. Influence of nail biting and finger sucking habits on the oral carriage of Enterobacteriaceae

    PubMed Central

    Kamal, Firoz G.; Bernard, Reginald Ajay

    2015-01-01

    Background: Oral habits like thumb sucking and nail biting are pernicious habits that act as an adaptive function in obtaining pleasure and subduing anxiety. These habits may also act as carriers of numerous microorganisms into the oral cavity, of which, Enterobacteriaceae members are transient pathogens, which might result in debilitating systemic conditions. Aim: To study the oral carriage of Enterobacteriaceae in children having habit of nail biting and thumb sucking. And to study the association of the organism with the individual's respective plaque indices. Subjects and Methods: Totally, 40 chronic nail biters, 40 chronic thumb suckers, and 20 controls (no habit) (8-15 years old) were enrolled in the study. Appropriate history and their plaque indices recorded. Sterile containers were used to collect the salivary samples and later cultured on Agar plates. Biochemical tests categorized the organisms into subspecies. Statistical Analysis Used: ANNOVA, Student's t-test. Results: Presence of a nail biting habit indicated a higher plaque index, which in turn showed a higher carriage of Enterobacteria spps, predominantly Escherichia coli. Conclusions: Oral surgical intervention in individuals with pernicious oral habits need to be counseled and educated on the possible complications, which might otherwise provide an environment that disseminates these microorganisms resulting in a broad range of local and systemic infections. PMID:26097357

  2. Electrothermic damage to the nail due to arcing in high-voltage discharge.

    PubMed

    Bielefeld, Lena; Mierdel, Katrin; Pollak, Stefan; Perdekamp, Markus Große

    2013-12-10

    The burn effects in high-voltage electrocutions are manifold ranging from inconspicuous marks to deep charring. Apart from lesions caused by direct contact with a live conductor, the victim's body may suffer flash burns from arcing resulting in extensive scattered or confluent heat damage of the skin. In such cases, the nail plates of fingers and toes may undergo thermal changes which up to now have not been mentioned in the pertinent literature. Macroscopically, the nail shows a yellowish discoloration with tiny and closely arranged verruciform elevations. Histologically, the uppermost layer of the nail plate is interspersed with small vacuoles resembling micro-blisters as seen in the corneal layer of common electric marks. The surface of the nail is coated with a thin film of carbonaceous material. Based on an accidental high-voltage electrocution recently observed by the authors, attention is also drawn to the possible occurrence of contact burns from metal objects heated by the current as this finding is usually described only in victims of lightning strikes and not in the context of high-voltage discharges of technical electricity.

  3. [Distal tibia peri-implant fracture with an intramedullary nail: a case report].

    PubMed

    Reyes-Cabrera, J M; González-Alconada, R; García-Mota, M D

    2013-01-01

    Peri-implant fractures of the distal tibia after intramedullary nailing are rare. We present a case of a fracture of the distal tibia at the site of the distal interlocking screw. We found two cases reported in the world literature. There are no cases reported in the Spanish literature.

  4. On the Value of Nonremovable Reminders for Behavior Modification: An Application to Nail-Biting (Onychophagia)

    ERIC Educational Resources Information Center

    Koritzky, Gilly; Yechiam, Eldad

    2011-01-01

    The authors examined the effectiveness of a novel behavior modification method for dysfunctional and impulsive habits, based on nonremovable reminders (NrRs). NrRs were implemented by having participants wear nonremovable wristbands designated to constantly remind them of their resolution to quit the targeted habit (nail-biting). Participants were…

  5. Quantitative Analysis of Nail Polish Remover Using Nuclear Magnetic Resonance Spectroscopy Revisited

    ERIC Educational Resources Information Center

    Hoffmann, Markus M.; Caccamis, Joshua T.; Heitz, Mark P.; Schlecht, Kenneth D.

    2008-01-01

    Substantial modifications are presented for a previously described experiment using nuclear magnetic resonance (NMR) spectroscopy to quantitatively determine analytes in commercial nail polish remover. The revised experiment is intended for a second- or third-year laboratory course in analytical chemistry and can be conducted for larger laboratory…

  6. Effect of hydration on the permeation of ketoconazole through human nail plate in vitro.

    PubMed

    Gunt, Hemali B; Kasting, Gerald B

    2007-12-01

    The impact of hydration on the permeation of the antifungal drug, ketoconazole, through excised human nails in vitro was evaluated in diffusion cell studies. Nails treated with [(3)H]ketoconazole solvent-deposited onto the dorsal surface were maintained in incubators at 32 degrees C and exposed sequentially to relative humidities (dorsal side) of 15, 40, 80 and 100% over a period of 40 days. The ventral side was bathed in a pH 7.4 phosphate buffer. Ascending and descending humidity regimens were tested. Increasing the ambient RH from 15 to 100% enhanced permeation of radiolabel associated with [(3)H]ketoconazole by a factor of three. Diffusivities estimated from these data and the associated nail water contents (estimated in a separate study) can be described by a free volume theory. Therefore, formulations or treatments, which increase nail hydration, have potential to improve topical therapy for onychomycosis, if a favorable balance between drug delivery and growth conditions for the dermatophytes can be achieved.

  7. Planar fuel cell utilizing nail current collectors for increased active surface area

    DOEpatents

    George, Thomas J.; Meacham, G. B. Kirby

    2002-03-26

    A plurality of nail current collector members are useful in the gas flow passages of an electrochemical device to optimize the active surfaces of the device and to provide structural support. In addition, the thicknesses of cathode and anode layers within the electrochemical device are varied according to current flow through the device to reduce resistance and increase operating efficiency.

  8. Measurement of Nitinol Recovery Distance Using Pseudoelastic Intramedullary Nails for Tibiotalocalcaneal Arthrodesis.

    PubMed

    Kildow, Beau J; Gross, Christopher E; Adams, Samuel D; Parekh, Selene G

    2016-07-07

    Background Tibiotalocalcaneal arthrodesis is a salvage procedure for patients with complex disease of the ankle and subtalar joints. Despite the clinical efficacy and mechanical advantage of intramedullary nails, complications, such as nonunion, are common. It may be possible to sustain compression in the face of bone resorption and implant loosening over the course of healing using a novel pseudoelastic intramedullary nail with an internal nitinol element. Methods We identified 15 patients with average age of 54.7 years (range, 28-75 years) who had undergone a tibiotalocalcaneal arthrodesis using a pseudoelastic intramedullary nail. Serial radiographs were used to determine the amount and rate of nitinol element migration over the first 3 postoperative months. Results Postoperatively, there was at least 2.38 mm of nitinol element migration proximally with mean of 5.58 mm (± 1.38), (range, 2.38-8.11 mm). Average follow-up time was 195 days (± 106.3), (range, 89-490 days). On average, 86% of the total recovered distance took place within the first 39.7 days (±10.03). Conclusions The nitinol element recovers distance when stretched intraoperatively and maintains moderate compression in response to bone resorption. Further studies are needed to assess if this increased compression lends itself to higher fusion rates than traditional intramedullary nails.

  9. Limb Lengthening and Then Insertion of an Intramedullary Nail: A Case-matched Comparison

    PubMed Central

    Kleinman, Dawn; Fragomen, Austin T.; Ilizarov, Svetlana

    2008-01-01

    Distraction osteogenesis is an effective method for lengthening, deformity correction, and treatment of nonunions and bone defects. The classic method uses an external fixator for both distraction and consolidation leading to lengthy times in frames and there is a risk of refracture after frame removal. We suggest a new technique: lengthening and then nailing (LATN) technique in which the frame is used for gradual distraction and then a reamed intramedullary nail inserted to support the bone during the consolidation phase, allowing early removal of the external fixator. We performed a retrospective case-matched comparison of patients lengthened with LATN (39 limbs in 27 patients) technique versus the classic (34 limbs in 27 patients). The LATN group wore the external fixator for less time than the classic group (12 versus 29 weeks). The LATN group had a lower external fixation index (0.5 versus 1.9) and a lower bone healing index (0.8 versus 1.9) than the classic group. LATN confers advantages over the classic method including shorter times needed in external fixation, quicker bone healing, and protection against refracture. There are also advantages over the lengthening over a nail and internal lengthening nail techniques. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18800209

  10. Planar fuel cell utilizing nail current collectors for increased active surface area

    SciTech Connect

    George, Thomas J.; Meacham, G.B. Kirby

    1999-11-26

    A plurality of nail current collector members are useful in the gas flow passages of an electrochemical device to optimize the active surfaces of the device and to provide structural support. In addition, the thicknesses of cathode and anode layers within the electrochemical device are varied according to current flow through the device to reduce resistance and increase operating efficiency.

  11. The Lower Devonian marginal-marine ecosystems of the Holy Cross Mountains, Poland - new discoveries and observations

    NASA Astrophysics Data System (ADS)

    Szrek, P.; Niedźwiedzki, G.; Dec, M.

    2012-04-01

    Despite of more than 100 years of study, the Lower Devonian deposits of the Holy Cross Mountains (central Poland) are still not well understood from the biostratigraphical, environmental and also paleontological point of views. During field works and excavations conducted in 2011 numerous fossils (body and trace fossils) were discovered in a few Lower Devonian outcrops of the region. The siliciclastic sequence of the Lower Devonian of the southern part of the Holy Cross Mountains, is renowned for abundant vertebrate fossils, including mainly the jawless fish and placoderm remains. During the first detailed taphonomic study of the vertebrate assemblage from the so-called "Placoderm Sandstones" cropping out at the Podłazie near Daleszyce, abundant vertebrate remains have been collected (more than 600 specimens). Their analysis (that is in progress) will be the first description of so rich and numerous vertebrates association from the Central Europe that contains placoderms, sharks, acathodians and sarcopterygians. The degree of fragmentation of the bones and disarticulation of the skeletons suggest that the carcasses were reworked and transported before burial. Sedimentological data suggest deposition in a shallow marine environment. Numerous invertebrate ichnofossils (Phycodes isp. Skolithos isp., Diplichnites isp., Monomorphichnus isp., Lockeia cf. siliquaria, Corophioides isp. and Teichinus isp.) particularly well preserved were ascertained in another Lower Devonian site near Iwaniska. Moreover a very interesting assemblage of trace fossils corresponding to traces of feeding fishes were discovered. They are very similar to those found in much younger deposits (e.g. from the Eocene of Turkey). Its interpretation found them as made by placoderms is taken into consideration recently, because of its fiting to whole morphology of small coccosteids. They are also important that they could be the first imprints of soft body of the placoderm as a life animal according to

  12. The religious and social principles of patients' rights in holy books (Avesta, Torah, Bible, and Quran) and in traditional medicine.

    PubMed

    Hatami, Hossein; Hatami, Maryam; Hatami, Neda

    2013-03-01

    Health protection and promotion in healthy people and restoring patients' health have been the most important themes in medicine and health throughout our history. Therefore, discussion of different aspects of patients' rights includes implementation of these objectives by the medical community, including physicians, nurses, pharmacists, etc., and the people in charge of health affairs. The principal objective of our research is the study of medical ideology and the approaches of our ancestors in relation to different aspects of patients' rights. To study the different ideologies of traditional medicine in relation to patients' rights, appropriate data were extracted from the original resources of traditional medicine and from religious books. By means of library research we studied these resources in addition to electronic versions of the Alhavi book (by Rhazes), the Kamel-al-Sanaah (by Ahvazi), the Canon of Medicine (by Avicenna), the Zakhireye Khawrazmshahi (by Jorjani), the Avesta, the Torah, the Bible, the Quran, and many other resources, and, finally, after searching, gathering, and encoding the findings, analyzed them qualitatively for thematic content. The holy Avesta book clearly insists on the competence of physicians and setting the appointment fee in accordance with peoples' income. The Old Testament (holy Torah) warned government officials who did not observe patients' rights. In the four gospels (holy Bible) the importance of treatment and taking care of the patient is stressed. After the emergence of Islam, medical students, before beginning the principal courses, had to study Islamic jurisprudence, ethics, logic sciences, natural sciences, geometry, astrology, calculus, and similar courses so that after purifying their soul they could enter the saintly profession of physicians. The holy Quran refers to saving the life of a human irrespective of social class, race, and religion, and insists on exemption of patients from physical activity, including

  13. An integrated lithospheric study targeting the Holy Cross Mountains of the Eastern European Trans-European Suture Zone in Poland

    NASA Astrophysics Data System (ADS)

    Averill, M.; Bond, T.; Sroda, P.; Keller, G.; Miller, K.

    2003-04-01

    The Trans-European Suture Zone (TESZ) in Eastern Europe, of which the TTZ is a portion, marks the boundary between Phanerozoic Western European terrains with the Precambrian Eastern European Craton (EEC). The nature of this suture is known primarily from geophysical studies. Seismic velocity and gravity models indicate changes of crustal thickness from 28-35 km to 42-47 km across the TTZ (Teisseyre-Tornquist Zone) from the Paleozoic Platform of Western Europe to the Eastern European Craton. Tectonic models suggest the presence of a Precambrian/Early Paleozoic passive margin beneath the TTZ. The Holy Cross Mountains in southeastern Poland represent an anomalous crustal block whose origin and interaction with the EEC is largely unknown. The subject of this study is the origin and tectonic evolution of this and adjacent crustal blocks in relation to the eastern TESZ and EEC. We have employed a technique to integrate industry acquired well and reflection data, as well as refraction data from the CELEBRATION 2000, POLONAISE '97 and TTZ seismic experiments. We used well check shot surveys from wells and CDP (common depth point) stacking velocities from reflection surveys in addition to refraction data as data input to a 3-D tomographic inversion. Gravity, magnetics, drilling and geologic data support an integrated interpretation of the output velocity model for this region. Gravity modeling based on geologic and velocity model constraints indicate an incomplete docking of Variscan terranes along the EEC margin with deformation of the Paleozoic margin strata associated with uplift in the Holy Cross Mountains region.

  14. Trace elements in the human scalp hair and finger nails as affected by infection with Schistosoma mansoni

    NASA Astrophysics Data System (ADS)

    El-Khatib, Ahmed M.; Bahnassy, Ahmed A.; Denton, M.

    1995-01-01

    The concentration of 13 elements has been determined in finger nail and scalp hair of 4 groups representing normal and infected Schistosoma mansoni subjects. Samples were irradiated by thermal neutrons from a Triga Mark III Reactor, for 10 min. Measurements were made using a HPGe detector coupled with ADC and PDP {11}/{34} data processing equipment. The results showed significant increases of Al, Cl, I and Br in both finger nails and scalp hair of bilharzial patients above those of normal subjects while Mg, Ca, V, Mn, Cu, Sr, K, S and Na showed significant decreases. Most of the elements showed a higher concentration in finger nails than in hair.

  15. Comparative study on keratin structural changes in onychomycosis and normal human finger nail specimens by Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Wen, Wei; Meng, Yaoyong; Xiao, Jun; Zhang, Pingli; Zhang, Hao

    2013-04-01

    For the purpose of investigating the secondary structural changes of keratins in onychomycosis patient nail, Raman spectra of nail clippings from onychomycosis patients were obtained and used to describe the molecular structure differences from normal nail specimens. Raman spectroscopy revealed that nail from onychomycosis patients had a significant decrease in the content of the sulfur-containing amino acids in comparison to normal nail. And the spectral analysis also demonstrated that the disulfide bonds had the trend to the energetically less favored gauche-gauche-trans (g-g-t) forms in onychomycosis patient nail samples. These results showed that the increased amounts of less stable disulfide conformers were contributed to or associated with the nail brittleness observed in onychomycosis patients. We also found that the positions of the S-S band (500-550 cm-1) in onychomycosis patients were different, which gave us an indication that the disulfide groups might be related to the histopathological level and morphological characteristics. In the region of amide I, the α-helical (1652 cm-1) and β-sheet (1671 cm-1) content changed, these ratios (peak area of 1652 cm-1 divided by peak area of the 1671 cm-1) were between 0.67 and 0.75, while drastically altered ratios for the two conformers were changed to 0.25-0.63 in onychomycosis patient nail, the α-helix form seriously decreased in comparison to the normal nail. This result suggested unfolding of proteins and a more amorphous structure in the onychomycosis nail. On the other hand, the amide III (unordered) band intensity, assigned to the random coil form in normal nail clippings, at 1250 cm-1 is much higher than that for the amide III (α) content (1272 cm-1), and the peak area ratios of random coil band and α-helix band were about 10.00, while in the onychomycosis nail, these ratios were close to 2.00, the random coil form remarkably decreased. All the results of the present work implied that fungal erosion

  16. Miltefosine is effective against Candida albicans and Fusarium oxysporum nail biofilms in vitro.

    PubMed

    Machado Vila, Taissa Vieira; Sousa Quintanilha, Natália; Rozental, Sonia

    2015-11-01

    Onychomycosis is a fungal nail infection that represents ∼50 % of all nail disease cases worldwide. Clinical treatment with standard antifungals frequently requires long-term systemic therapy to avoid chronic disease. Onychomycosis caused by non-dermatophyte moulds, such as Fusarium spp., and yeasts, such as Candida spp., is particularly difficult to treat, possibly due to the formation of drug-resistant fungal biofilms on affected areas. Here, we show that the alkylphospholipid miltefosine, used clinically against leishmaniasis and cutaneous breast metastases, has potent activity against biofilms of Fusarium oxysporum and Candida albicans formed on human nail fragments in vitro. Miltefosine activity was compared with that of commercially available antifungals in the treatment of biofilms at two distinct developmental phases: formation and maturation (pre-formed biofilms). Drug activity towards biofilms formed on nail fragments and on microplate surfaces (microdilution assays) was evaluated using XTT [2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide] assays, and drug effects on fingernail biofilms were analysed by scanning electron microscopy (SEM). For F. oxysporum, miltefosine at 8 μg ml- 1 inhibited biofilm formation by 93%, whilst 256 μg ml- 1 reduced the metabolic activity of pre-formed nail biofilms by 93%. Treatment with miltefosine at 1000 μg ml- 1 inhibited biofilm formation by 89% and reduced the metabolic activity of pre-formed C. albicans biofilms by 99%. SEM analyses of biofilms formed on fingernail fragments showed a clear reduction in biofilm biomass after miltefosine treatment, in agreement with XTT results. Our results show that miltefosine has potential as a therapeutic agent against onychomycosis and should be considered for in vivo efficacy studies, especially in topical formulations for refractory disease treatment.

  17. Cost of external fixation vs external fixation then nailing in bone infection

    PubMed Central

    Emara, Khaled Mohamed; Diab, Ramy Ahmed; Ghafar, Khaled Abd EL

    2015-01-01

    AIM: To study the cost benefit of external fixation vs external fixation then nailing in treatment of bone infection by segment transfer. METHODS: Out of 71 patients with infected nonunion tibia treated between 2003 and 2006, 50 patients fitted the inclusion criteria (26 patients were treated by external fixation only, and 24 patients were treated by external fixation early removal after segment transfer and replacement by internal fixation). Cost of inpatient treatment, total cost of inpatient and outpatient treatment till full healing, and the weeks of absence from school or work were calculated and compared between both groups. RESULTS: The cost of hospital stay and surgery in the group of external fixation only was 22.6 ± 3.3 while the cost of hospital stay and surgery in the group of early external fixation removal and replacement by intramedullary nail was 26.0 ± 3.2. The difference was statistically significant regarding the cost of hospital stay and surgery in favor of the group of external fixation only. The total cost of medical care (surgery, hospital stay, treatment outside the hospital including medications, dressing, physical therapy, outpatient laboratory work, etc.) in group of external fixation only was 63.3 ± 15.1, and total absence from work was 38.6 ± 6.6 wk. While the group of early removal of external fixation and replacement by IM nail, total cost of medical care was 38.3 ± 6.4 and total absence from work or school was 22.7 ± 4.1. The difference was statistically significant regarding the total cost and absence from work in favor of the group of early removal and replacement by IM nail. CONCLUSION: Early removal of external fixation and replacement by intramedullary nail in treatment of infected nonunion showed more cost effectiveness. Orthopaedic society needs to show the cost effectiveness of different procedures to the community, insurance, and health authorities. PMID:25621219

  18. Assessment of Occupational Symptoms and Chemical Exposures for Nail Salon Technicians in Daegu City, Korea

    PubMed Central

    Park, Sung-Ae; Gwak, Sugyeong

    2014-01-01

    Objectives This study aimed to evaluate occupational symptoms and chemical exposures of nail salon technicians. Methods Work-related symptoms of nail salon technicians in Daegu City were surveyed using a researcher-administered questionnaire, and responses were compared to those of non-exposed office workers as controls. Personal exposure level of airborne volatile organic compounds was also monitored using passive samplers. Results A total of 159 subjects in 120 salons were interviewed. Average work-shift concentrations of 13 chemicals were measured for 50 workers from 30 salons using personal passive samplers. The most frequently reported respiratory or neurologic symptoms by nail shop technicians compared to controls were nose irritation (odds ratio [OR], 54.0; confidence interval [CI], 21.6 to 134.8), followed by headache (OR, 9.3; CI, 4.7 to 18), and throat irritation (OR, 4.3; CI, 2.2 to 8.5). For eyes and skin, 92% of respondents complained eye irritation (OR, 13.1; CI, 5.7 to 30.1). In musculoskeletal symptoms, workers reported pain or discomfort in shoulders (OR, 20.3; CI, 7.7 to 54) and neck (OR, 19.7; CI, 8.9 to 43.6). From personal measurements, the proportion of exceeding the Korean Occupational Exposure Limit was the highest for acetone with 64%, followed by toluene (50%), butyl acetate (46%), and methyl methacrylate (12%). However, the service was being provided without a proper ventilation system in most surveyed shops. Conclusions Based on these findings, it is warranted to have appropriate local exhaust ventilation place to ensure adequate health protection of nail shop technicians as well as customers. At the same time, greater policy interests are warranted in nail care business to protect health of both workers and customers. PMID:24921020

  19. Outcome of Titanium Elastic Intramedullary Nail in the Treatment of Shaft of Femur Fracture in Children.

    PubMed

    Khan, J A; Singh, G P; Pandey, A

    2015-01-01

    Background Femoral-shaft fractures are among the most common fractures of the lower extremity in children. There are several different options for treating femoral-shaft fractures in children. Elastic stable intramedullary nailing (ESIN) has become the standard treatment for fractures of shaft of femur in children for reasons including mini-invasive surgery, no need for casting, early mobilization and discharge as well as growing concerns toward cost-effectiveness. Objective To demonstrate the effectiveness of intramedullary fixation of fracture shaft of femur in skeletally immature children using the titanium elastic intramedullary nails. Method Forty children who underwent fixation with titanium intramedullary nails because of fracture of shaft of femur (Winquist and Hansen type 1 and 2) were reviewed. There were 60% male and 40% female patients and mean follow-up was six months. Time of union, deformity at fracture site, limb length discrepancy, knee range of motion and complications were assessed. Result Average age of the patients was 5.17 years (range 3 to 10). All patients achieved complete healing at a mean 12.8 weeks (range 10 to 20 weeks). Average limb length discrepancy was -0.16 cm (range -1.0 to 1.1 cm) average knee range of motion was 137.55 degrees (range 118 to 152 degrees). Complications were recorded in 13 (31.7%) patients and included: Five malunion which did not show any deformity or functional impairment and eight superficial wound infections which were healed after removal of nail. All patients were active as their pre injury levels at six months follow up. Conclusion Elastic stable intramedullary nailing is the method of choice for the simple pediatrics fracture shaft of femur, as it is minimally invasive and shows good functional and cosmetic results. It allows short hospital stay and quick recovery from pain and is cast-free.

  20. Manganese accumulation in nail clippings as a biomarker of welding fume exposure and neurotoxicity.

    PubMed

    Sriram, Krishnan; Lin, Gary X; Jefferson, Amy M; Roberts, Jenny R; Andrews, Ronnee N; Kashon, Michael L; Antonini, James M

    2012-01-27

    Occupational exposure to welding fumes (WF) is thought to cause Parkinson's disease (PD)-like neurological dysfunction. An apprehension that WF may accelerate the onset of PD also exists. Identifying reliable biomarkers of exposure and neurotoxicity are therefore critical for biomonitoring and neurological risk characterization of WF exposure. Manganese (Mn) in welding consumables is considered the causative factor for the neurological deficits seen in welders. Hence, we sought to determine if Mn accumulation in blood or nail clippings can be a marker for adverse exposure and neurotoxicity. To model this, rats were exposed by intratracheal instillation to dissolved or suspended fume components collected from gas metal arc-mild steel (GMA-MS) or manual metal arc-hard surfacing (MMA-HS) welding. Trace element analysis revealed selective Mn accumulation in dopaminergic brain areas, striatum (STR) and midbrain (MB), following exposure to the two fumes. This caused dopaminergic abnormality as evidenced by loss of striatal tyrosine hydroxylase (Th; 25-32% decrease) and Parkinson disease (autosomal recessive, early onset) 7 (Park7; 25-46% decrease) proteins. While blood Mn was not detectable, Mn levels in nails strongly correlated with the pattern of Mn accumulation in the striatum (R(2)=0.9386) and midbrain (R(2)=0.9332). Exposure to manganese chloride (MnCl(2)) caused similar Mn accumulation in STR, MB and nail. Our findings suggest that nail Mn has the potential to be a sensitive and reliable biomarker for long-term Mn exposure and associated neurotoxicity. The non-invasive means by which nail clippings can be collected, stored, and transported with relative ease, make it an attractive surrogate for biomonitoring WF exposures in occupational settings.

  1. In-vitro permeability of the human nail and of a keratin membrane from bovine hooves: prediction of the penetration rate of antimycotics through the nail plate and their efficacy.

    PubMed

    Mertin, D; Lippold, B C

    1997-09-01

    In contrast to the partition coefficient octanol/water the molecular size of penetrating drugs has a noticeable influence on the permeability of the human nail plate and a keratin membrane from bovine hooves. The relationship between permeability and molecular weight is founded on well-established theories. The correlation between the permeability of the nail plate and that of the hoof membrane allows a prediction of the nail permeability after determination of the drug penetration through the hoof membrane. The maximum flux of ten antimycotics (amorolfine, bifonazole, ciclopirox, clotrimazole, econazole, griseofulvin, ketoconazole, naftifine, nystatin and tolnaftate) through the nail plate was predicted on the basis of their penetration rates through the hoof membrane and their water solubilities. An efficacy coefficient against onychomycoses was calculated from the maximum flux and the minimum inhibitory concentration. Accordingly, amorolfine, ciclopirox, econazole and naftifine are expected to be especially effective against dermatophytes, whereas in the case of an infection with yeasts only, amorolfine and ciclopirox are promising.

  2. 76 FR 23788 - Certain Steel Nails From the Peoples' Republic of China: Notice of Extension of Time Limits and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-28

    ... Product Co., Ltd.; 124) Tianjin Shishun Metallic Products Co., Ltd.; 125) Tianjin Xiantong Fucheng Gun... Xiantong Fucheng Gun Nail Manufacture Co., Ltd.; 111) Tianjin Xiantong Juxiang Metal MFG Co., Ltd.;...

  3. [Bilateral clavicular fractures occurring at different times. Conservative vs operative therapy using intramedullary nailing--a case report].

    PubMed

    Braunstein, V; Kirchhoff, C; Buhmann, S; Mutschler, W; Biberthaler, P

    2007-08-01

    In this case report we present treatment strategies and the functional and cosmetic outcome in a case of midclavicular fractures. A 20-year-old patient suffered from nearly identical fractures of the left and right clavicle with a time interval of 2 years following snowboard falls. The first fracture was treated conservatively leading to an unsatisfactory course and result. This was the reason why 2 years later the contralateral fracture was treated by intramedullary nailing using an elastic titanium nail. The functional and cosmetic outcome of this treatment was excellent. In cases of clavicular fractures elastic stable intramedullary nailing (ESIN) is a minimally invasive technique leading to fast analgesia resulting in a high level of mobility and ultimately a pleased patient. If the indication is right, intramedullary nailing can be a helpful operation technique which complements the already established procedures (conservative and plate osteosynthesis) in cases of dislocated clavicular fractures.

  4. Remarkable Improvement of Nail Changes in Alopecia Areata Universalis with 10 Months of Treatment with Tofacitinib: A Case Report

    PubMed Central

    Ferreira, Sineida Berbert; Scheinberg, Morton; Steiner, Denise; Steiner, Tatiana; Bedin, Gustavo Longhi; Ferreira, Rachel Berbert

    2016-01-01

    Alopecia areata (AA) is a chronic, autoimmune disease. The main symptom is massive hair loss, localized or diffuse, in the scalp and the whole body. However, nails may also be involved, and brittleness, fragility and pitting can be signs of nail dystrophy in AA patients. Here, we report the case of a male patient with AA refractory to various treatments, including oral, topical and intralesional corticosteroids, immunosuppressants, cyclosporin and PUVA (oxoralen plus ultraviolet light), all interrupted due to side effects. The patient's nails had erythematous blotches (striated lunulae) with regular and superficial pitting as well as fragility (trachyonychia), and he could no longer play the guitar because of these symptoms. With patient consent, we introduced tofacitinib (5 mg twice daily), which resulted in remarkable improvements not only regarding hair regrowth but also nail changes, with function recovery within 10 months. PMID:28101018

  5. Influence of Lateral Muscle Loading in the Proximal Femur after Fracture Stabilization with a Trochanteric Gamma Nail (TGN)

    NASA Astrophysics Data System (ADS)

    Sitthiseripratip, Kriskrai; Mahaisavariya, Banchong; Suwanprateeb, Jintamai; Bohez, Erik; Vander Sloten, Jos

    The purpose of this study was to investigate the influence of lateral muscle loading on the stress/strain distributions of the trochanteric Gamma nail (TGN) fixation within the healed, trochanteric and subtrochanteric femoral fractures by means of a finite element method. The effect of three muscle groups, the abductors (ABD), the vastus lateralis (VL) and the iliotibial band (ITB), were investigated. The analytical results showed that addition of lateral muscle forces, iliotibial band and vastus lateralis, produced compensation of forces and reduction of bending moments in the bone and in the trochanteric Gamma nail especially in the lateral aspect. The iliotibial band produced a higher impact as compared to the vastus lateralis. Therefore in the finite element analysis of the proximal femur with the trochanteric Gamma nail fracture fixation should include the lateral muscle forces to simulate load condition with maximal physiological relevance to the closed nailing technique.

  6. Prognostic Factors for Predicting Outcomes After Intramedullary Nailing of the Tibia

    PubMed Central

    Schemitsch, Emil H.; Bhandari, Mohit; Guyatt, Gordon; Sanders, David W.; Swiontkowski, Marc; Tornetta, Paul; Walter, Stephen D.; Zdero, Rad; Goslings, J.C.; Teague, David; Jeray, Kyle; McKee, Michael D.; Schemitsch, Emil H.; Bhandari, Mohit; Guyatt, Gordon; Sanders, David W.; Swiontkowski, Marc; Tornetta, Paul; Walter, Stephen D.; Zdero, Rad; Goslings, J.C.; Teague, David; Jeray, Kyle; McKee, Michael D.

    2012-01-01

    Background: Prediction of negative postoperative outcomes after long-bone fracture treatment may help to optimize patient care. We recently completed the Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT), a large, multicenter trial of reamed and unreamed intramedullary nailing of tibial shaft fractures in 1226 patients. Using the SPRINT data, we conducted an investigation of baseline and surgical factors to determine any associations with an increased risk of adverse events within one year of intramedullary nailing. Methods: Using multivariable logistic regression analysis, we investigated fifteen baseline and surgical factors for any associations with an increased risk of negative outcomes. Results: There was an increased risk of negative events in patients with a high-energy mechanism of injury (odds ratio [OR] = 1.57; 95% confidence interval [CI], 1.05 to 2.35), a stainless steel compared with a titanium nail (OR = 1.52; 95% CI, 1.10 to 2.13), a fracture gap (OR = 2.40; 95% CI, 1.47 to 3.94), and full weight-bearing status after surgery (OR = 1.63; 95% CI, 1.00 to 2.64). There was no increased risk with the use of nonsteroidal anti-inflammatory agents, late or early time to surgery, or smoking status. Open fractures had a higher risk of events among patients treated with reamed nailing (OR = 3.26; 95% CI, 2.01 to 5.28) but not in patients treated with unreamed nailing (OR = 1.50; 95% CI, 0.92 to 2.47). Patients with open fractures who had wound management either without any additional procedures or with delayed primary closure had a decreased risk of events compared with patients who required subsequent, more complex reconstruction (OR = 0.18 [95% CI, 0.09 to 0.35] and 0.29 [95% CI, 0.14 to 0.62], respectively). Conclusions: We identified several baseline fracture and surgical characteristics that may increase the risk of adverse events in patients with tibial shaft fractures. Surgeons should consider the

  7. Evaluation of drug incorporation into hair segments and nails by enantiomeric analysis following controlled single MDMA intakes.

    PubMed

    Madry, Milena M; Steuer, Andrea E; Hysek, Cédric M; Liechti, Matthias E; Baumgartner, Markus R; Kraemer, Thomas

    2016-01-01

    Incorporation rates of the enantiomers of 3,4-methylenedioxymethamphetamine (MDMA) and its metabolite 3,4-methylenedioxyamphetamine (MDA) into hair and nails were investigated after controlled administration. Fifteen subjects without MDMA use received two doses of 125 mg of MDMA. Hair, nail scrapings, and nail clippings were collected 9-77 days after the last administration (median 20 days). Hair samples were analyzed in segments of 1- to 2-cm length. After chiral derivatization with N-(2,4-dinitro-5-fluorophenyl)-L-valinamide, MDMA and MDA diastereomers were analyzed by liquid chromatography-tandem mass spectrometry. Highest concentrations in hair segments corresponded to the time of MDMA intake. They ranged from 101 to 3200 pg/mg and 71 to 860 pg/mg for R- and S-MDMA, and from 3.2 to 116 pg/mg and 4.4 to 108 pg/mg for R- and S-MDA, respectively. MDMA and MDA concentrations in nail scrapings and clippings were significantly lower than in hair samples. There was no significant difference between enantiomeric ratios of R/S-MDMA and R/S-MDA in hair and nail samples (medians 2.2-2.4 for MDMA and 0.85-0.95 for MDA). Metabolite ratios of MDA to MDMA were in the same range in hair and nail samples (medians 0.044-0.055). Our study demonstrates that administration of two representative doses of MDMA was detected in the hair segments corresponding to the time of intake based on average hair growth rates. MDMA was detected in all nail samples regardless of time passed after intake. Comparable R/S ratios in hair and nail samples may indicate that incorporation mechanisms into both matrices are comparable.

  8. The low keratin affinity of efinaconazole contributes to its nail penetration and fungicidal activity in topical onychomycosis treatment.

    PubMed

    Sugiura, Keita; Sugimoto, Noriaki; Hosaka, Shinya; Katafuchi-Nagashima, Maria; Arakawa, Yoshio; Tatsumi, Yoshiyuki; Jo Siu, William; Pillai, Radhakrishnan

    2014-07-01

    Onychomycosis is a common fungal nail disease that is difficult to treat topically due to the deep location of the infection under the densely keratinized nail plate. Keratin affinity of topical drugs is an important physicochemical property impacting therapeutic efficacy. To be effective, topical drugs must penetrate the nail bed and retain their antifungal activity within the nail matrix, both of which are adversely affected by keratin binding. We investigated these properties for efinaconazole, a new topical antifungal for onychomycosis, compared with those of the existing topical drugs ciclopirox and amorolfine. The efinaconazole free-drug concentration in keratin suspensions was 14.3%, significantly higher than the concentrations of ciclopirox and amorolfine, which were 0.7% and 1.9%, respectively (P < 0.001). Efinaconazole was released from keratin at a higher proportion than in the reference drugs, with about half of the remaining keratin-bound efinaconazole removed after washing. In single-dose in vitro studies, efinaconazole penetrated full-thickness human nails into the receptor phase and also inhibited the growth of Trichophyton rubrum under the nail. In the presence of keratin, efinaconazole exhibited fungicidal activity against Trichophyton mentagrophytes comparable to that of amorolfine and superior to that of ciclopirox. In a guinea pig onychomycosis model with T. mentagrophytes infection, an efinaconazole solution significantly decreased nail fungal burden compared to that of ciclopirox and amorolfine lacquers (P < 0.01). These results suggest that the high nail permeability of efinaconazole and its potent fungicidal activity in the presence of keratin are related to its low keratin affinity, which may contribute to its efficacy in onychomycosis.

  9. A modified intramedullary nail interlocking design yields improved stability for fatigue cycling in a canine femur fracture model.

    PubMed

    Garlock, Adam N; Donovan, Jim; LeCronier, David J; Houghtaling, John; Burton, Stephen; Atkinson, Patrick J

    2012-06-01

    Intramedullary nailing has evolved to become the standard of care for most diaphyseal femoral and tibial fractures, as well as an expanding number of metaphyseal fractures. Owing to the unstable nature of some fractures, the intramedullary device may be subjected to significant stresses owing to a lack of solid cortical contact after nailing. In such cases, excessive interfragmentary motion (due to construct toggle) has been shown to occur. Such motion increases the likelihood of a non- or delayed-union. In the current study, two versions of a modified, angle stable interlocking design were subjected to fatigue testing in a segmental defect fracture model representing a canine femur. As a control, a third group of constructs were stabilized with a traditional nail that allowed a small amount of toggle. All constructs were subjected to 50,000 fatigue cycles representing 12 weeks of cage activity at physiologic levels of combined axial-torsional loading. Torsional testing pre- and post-fatigue revealed 4.6 +/- 1.3 degrees of toggle in the traditional nail and no toggle with the angle stable nail designs. The stable nails were also significantly stiffer in axial compression and torsion before and after cycling. These data indicate that the enhanced stability of the modified interlocking designs can be maintained throughout fatigue cycling in a challenging fracture model.

  10. Histopathological periodic acid-schiff stains of nail clippings as a second-line diagnostic tool in onychomycosis.

    PubMed

    Mayer, Eliza; Izhak, Ofer Ben; Bergman, Reuven

    2012-05-01

    The diagnosis of onychomycosis, using direct microscopy and fungal cultures, is often negative despite the presence of disease. Periodic acid-Schiff (PAS) staining of nail clippings, using histopathological processing, may be positive in these cases. It is not always clear, however, whether the fungal elements detected by PAS staining are pathogenic fungi or some are saprophytes. We aimed to study the efficacy of histopathological PAS staining of nail clippings as a second-line diagnostic tool in onychomycosis. The study included 100 consecutive cases in which direct microscopy and fungal cultures from suspected onychomycosis were negative on one occasion or more. The obtained nail clippings were processed for routine histology, stained with hematoxylin and eosin and PAS, and examined microscopically. Of the 100 cases, 38 (38%) showed positive fungal elements. As a result, 9 patients had sought and received oral antifungal therapy and all achieved complete clinical cure. The histological examination also revealed parakeratosis and globules of plasma, which were statistically significantly more common in the fungal infected nail samples. This may indicate an ongoing inflammatory process associated with onychomycosis. Neutrophils and bacteria were not statistically and significantly more common in the fungal infected nails. We conclude that as a second-line diagnostic tool, PAS stain of nail clippings increases markedly the diagnostic yield of onychomycosis and, consequently, the outcome of therapy.

  11. A novel 3D-layered electrochemical-thermal coupled model strategy for the nail-penetration process simulation

    NASA Astrophysics Data System (ADS)

    Liang, Guozhou; Zhang, Yiming; Han, Qi; Liu, Zhaoping; Jiang, Zhen; Tian, Shuang

    2017-02-01

    The safety is one of the persisting concerns related with Lithium-ion (Li-ion) batteries, among which the internal short-circuit is the most dangerous abusive situation and has always been the root cause for several catastrophic accidents in recent years. In this work, a 3D-layered electrochemical-thermal coupled model is employed to investigate the nail-penetration process in a Li-ion cell. The model is based on multilayer construction of a cell, and an effective strategy to evaluate the short-circuit area equivalent resistance (i.e. the equivalent resistance of short-circuit area that is caused by nail-penetration) during the penetration process is proposed. The developed model is proved to have capability of estimating the thermal runaway time, as well as the temperature distribution during nail-penetration process. It is also found that the active material loss during the nail-penetration process can be reconstructed by utilizing the developed model, which could provide understandings about the side reactions inside the cell during the nail-penetration process. The present study provides some insights about the nail-penetration process, and can be treated as a useful tool that helps the design of Li-ion cells for improving safety.

  12. Comparative Book Review of Unholy War: Terror in the Name of Islam and The Crisis of Islam: Holy War and Unholy Terror

    DTIC Science & Technology

    2003-01-01

    L. Esposito, Oxford University Press , New York, 2002; and The Crisis of Islam: Holy War and Unholy Terror. By Bernard Lewis, The Modern Library...John L. Esposito, Unholy War: Terror in the Name of Islam (New York: Oxford University Press , 2002), 21. 4 John L. Esposito, Unholy War: Terror in...the Name of Islam (New York: Oxford University Press , 2002), 24, 153. 5 John L. Esposito, Unholy War: Terror in the Name of Islam (New York: Oxford

  13. The Effects of Educational Multimedia for Scientific Signs in the Holy Quran in Improving the Creative Thinking Skills for Deaf Children

    NASA Astrophysics Data System (ADS)

    Abusaleh, Sumaya; Abdelfattah, Eman; Alabadi, Zain; Sharieh, Ahmad

    This paper investigates the role of the scientific signs in the holy Quran in improving the creative thinking skills for the deaf children using multimedia. The paper investigates if the performance made by the experimental group's individuals is statistically significant compared with the performance made by the control group's individuals on Torrance Test for creative thinking (fluency, flexibility, originality and the total degree) in two cases:

  14. Brachiopods and stratigraphy of the Upper Devonian (Frasnian) succession of the Radlin Syncline (Holy Cross Mountains, Poland)

    NASA Astrophysics Data System (ADS)

    Baliński, Andrzej; Racki, Grzegorz; Halamski, Adam T.

    2016-06-01

    The lower part of the Frasnian succession in the Radlin Syncline (Kielce-Łagów Synclinorium, southern region of the Holy Cross Mountains), in the two studied successions: Józefka at Górno and (for the first time) Radlin, consists of the rhythmic marly Szydłówek Beds, the fossil-rich limestones of the Wietrznia Beds (locally) and the atypically developed, calcareous Kostomłoty Beds. The carbon isotope chemostratigraphic pattern overall corresponds well to the global Early-Middle Frasnian biogeochemical perturbation, even if the major punctata positive excursion is only fragmentarily recorded in the Kostomłoty intrashelf basin. Two brachiopod assemblages are abundantly represented in both sections: the Phlogoiderhynchus polonicus Assemblage, typical of the Szydłówek Beds, and the Biernatella lentiformis Assemblage, limited to the middle part of the Wietrznia Beds. Both are highly dominated by the index species. Twenty nine lower Frasnian brachiopod species (Craniida - 1 species, Strophomenida - 1, Productida - 2, Protorthida - 1, Orthida - 5, Pentamerida - 1, Rhynchonellida - 4, Atrypida - 4, Athyridida - 3, Spiriferida - 4, Spiriferinida - 3) are described from the Szydłówek and Wietrznia Beds. Seven new species are introduced: Skenidioides cretus Halamski sp. nov., Biernatium minus Baliński sp. nov., Monelasmina montisjosephi Baliński sp. nov., Atryparia (Costatrypa) agricolae Halamski and Baliński sp. nov., Davidsonia enmerkaris Halamski sp. nov., Leptathyris gornensis Baliński sp. nov., and Echinocoelia parva Baliński sp. nov. Davidsonia enmerkaris Halamski sp. nov. is intermediate between Davidsonia Bouchard-Chantereaux, 1849 and Rugodavidsonia Copper, 1996 and is the youngest known representative of the suborder Davidsonioidea Copper, 1996. Skenidioides cretus Halamski sp. nov. is the last representative of the genus. Statistical investigation of a large sample of Spinatrypina (Exatrypa) explanata did not confirm the existence of two dimorphic

  15. On the value of nonremovable reminders for behavior modification: an application to nail-biting (onychophagia).

    PubMed

    Koritzky, Gilly; Yechiam, Eldad

    2011-11-01

    The authors examined the effectiveness of a novel behavior modification method for dysfunctional and impulsive habits, based on nonremovable reminders (NrRs). NrRs were implemented by having participants wear nonremovable wristbands designated to constantly remind them of their resolution to quit the targeted habit (nail-biting). Participants were 80 nail-biters who resolved to quit. The NrR approach was contrasted with an aversion-based behavioral modification technique. Recovery was assessed after 3 and 6 weeks of treatment and in a 5-month follow-up. The NrR method was associated with lower drop-out rate and was as successful as the aversion-based method altogether. When considering only non-dropouts, the aversion-based method was more effective. This suggests that the use of constantly present reminders broadens the target population that can benefit from reminders in the course of behavior modification.

  16. Humeral Shaft Fracture Treatment in the Elite Throwing Athlete: A Unique Application of Flexible Intramedullary Nailing

    PubMed Central

    Lee, Christopher S.; Davis, Shane M.; Fronek, Jan

    2013-01-01

    Humeral shaft stress fractures are being increasingly recognized as injuries that can significantly impact throwing mechanics if residual malalignment exists. While minimally displaced and angulated injuries are treated nonoperatively in a fracture brace, the management of significantly displaced humeral shaft fractures in the throwing athlete is less clear. Currently described techniques such as open reduction and internal fixation with plate osteosynthesis and rigid antegrade/retrograde locked intramedullary nailing have significant morbidity due to soft tissue dissection and damage. We present a case report of a high-level baseball pitcher whose significantly displaced humeral shaft stress fracture failed to be nonoperatively managed and was subsequently treated successfully with unlocked, retrograde flexible intramedullary nailing. The athlete was able to return to pitching baseball in one year and is currently pitching in Major League Baseball. We were able to recently collect 10-year follow-up data. PMID:24369515

  17. Humeral shaft fracture treatment in the elite throwing athlete: a unique application of flexible intramedullary nailing.

    PubMed

    Lee, Christopher S; Davis, Shane M; Ho, Hoang-Anh; Fronek, Jan

    2013-01-01

    Humeral shaft stress fractures are being increasingly recognized as injuries that can significantly impact throwing mechanics if residual malalignment exists. While minimally displaced and angulated injuries are treated nonoperatively in a fracture brace, the management of significantly displaced humeral shaft fractures in the throwing athlete is less clear. Currently described techniques such as open reduction and internal fixation with plate osteosynthesis and rigid antegrade/retrograde locked intramedullary nailing have significant morbidity due to soft tissue dissection and damage. We present a case report of a high-level baseball pitcher whose significantly displaced humeral shaft stress fracture failed to be nonoperatively managed and was subsequently treated successfully with unlocked, retrograde flexible intramedullary nailing. The athlete was able to return to pitching baseball in one year and is currently pitching in Major League Baseball. We were able to recently collect 10-year follow-up data.

  18. RESIDENTIAL BUILDING STAKEHOLDERS’ ATTITUDES AND BELIEFS REGARDING NAIL GUN INJURY RISKS AND PREVENTION

    PubMed Central

    ALBERS, JAMES T.; HUDOCK, STEPHEN D.; LOWE, BRIAN D.

    2015-01-01

    Pneumatic nail guns are ubiquitous at residential construction sites across the United States. These tools are noted for the traumatic injuries that can occur from their operation. Different trigger mechanisms on these tools are associated with different levels of risk. Residential building subcontractors and workers, both native-born and immigrant, were brought together in focus groups to discuss their attitudes and beliefs regarding risk factors for nail gun injury as well as barriers to the adoption of safer technology. Participants’ comments are organized first by influences on traumatic injury occurrence or prevention and later by sociotechnical system category. Participants attributed influences on injury risk to personal and external causation factors in all sociotechnical system categories; however, participants more frequently described influences on injury prevention as related to workers’ behaviors, rather than to external factors. A discussion of these influences with respect to attribution theory and sociotechnical models of injury causation is presented. PMID:24704813

  19. Opto-Thermal Transient Emission Radiometry (OTTER) to image diffusion in nails in vivo.

    PubMed

    Xiao, P; Zheng, X; Imhof, R E; Hirata, K; McAuley, W J; Mateus, R; Hadgraft, J; Lane, M E

    2011-03-15

    This work describes the first application of Opto-Thermal Transient Emission Radiometry (OTTER), an infrared remote sensing technique, to probe the extent to which solvents permeate the human nail in vivo. Decanol, glycerol and butyl acetate were selected as model solvents. After application of the solvents, individually, to human volunteers, OTTER was used to depth profile the solvents. The permeation rate of the solvents was ranked as glycerol>decanol>butyl acetate. It is possible that some of the butyl acetate may have evaporated during the experiment. The ability of decanol to extract lipids from biological tissue is also considered. These preliminary results demonstrate the potential of OTTER as a tool to identify optimal excipients with which to target drugs to the nail.

  20. Diversity of keratinophilic fungi on human hairs and nails at four governorates in upper egypt.

    PubMed

    Gherbawy, Youssuf A M H; Maghraby, Thanaa A; El-Sharony, Hassan M; Hussein, Mohmaed A

    2006-12-01

    The mycobiota of 160 hair and nail samples collected from 4 different governorates in upper Egypt were estimated using soil plate method for isolating keratinophilic and dermatophytic fungi. Twenty-three fungi were recorded on both hair and nail samples collected from the four governorates. Highest fungal diversity (20) was collected from Red Sea samples followed by Qena (18) and Aswan (17) while lowest fungal diversity was recorded from Sohage samples. The common genera were Aphanoascus, Aspergillus, Penicillium, Paecilomyces and Chrysosporium. The most prevalent species belonging to these genera were: A. fulvescens, Aphanoascus sp. A. flavus link, A. flavus var. columnaris, P. chrysogenium. P. lilacinus and C. sulfureum. True dermatophytes such as Nannizzia fulva appeared in 20~30% of the male samples.

  1. Management of large segmental tibial defects using locking IM nail and absorbable mesh

    PubMed Central

    Whately, Chris; Abdallah, Mohamed Attia; Alwatari, Yahya Ahmed

    2013-01-01

    Tibia accounts for the majority of open fractures with long segmental defects. The management of such defects imposes several challenges due to their associations with extensive soft tissue damage and high infection risk. In this report, we describe a new technique for the reconstruction of tibia in a young patient with 10 cm defect. The patient had a history of Gustilo Anderson type IIIB open fracture following a motorcycle accident. He was initially managed with multiple debridements and application of an external fixator. The defect was treated with the insertion of an antibiotic-coated intramedullary nail along with posterolateral bone grafting using an absorbable mesh. Six months postoperative, radiological assessment showed excellent callus formation diffusely around the intramedullary nail along with optimal alignment. The preliminary follow-up data are quite encouraging and the technique described in our case can be considered as a reasonable option in managing long segmental bone defects. PMID:23887993

  2. Effects of lag screw design and lubrication on sliding in trochanteric nails.

    PubMed

    Kummer, Frederick J

    2010-01-01

    This study compared the sliding characteristics of three lag screw designs used with trochanteric nails and determined the effects of lubrication on sliding. They were tested by an established method to measure initiation and ease of lag screw sliding. These tests were then repeated with calf serum lubrication. There were significant differences (p < 0.05) between the loads required to initiate lag screw sliding that appeared to be related to design. Screw sliding was similar for all three designs; however, the presence of lag screw locking slots affected sliding in that region. Lubrication did not affect either parameter. Lag screw design aspects, such as diameter and, particularly, surface finish, affect sliding. Due to the small contact area between the lag screw and nail creating high interface stresses, lubrication had no effect on lag screw sliding.

  3. Genetic counselling in hereditary osteo-onychodysplasia (HOOD, nail-patella syndrome) with nephropathy.

    PubMed Central

    Looij, B J; te Slaa, R L; Hogewind, B L; van de Kamp, J J

    1988-01-01

    Hereditary osteo-onychodysplasia (HOOD, nail-patella syndrome) is an autosomal dominant condition characterised by nail dysplasia, patellar hypoplasia or aplasia, and nephropathy. The risk for HOOD patients to have a child with HOOD who will develop renal failure cannot easily be deduced from published pedigrees. We have studied a large family with 30 patients with HOOD and have analysed 34 kindreds with HOOD nephropathy from published reports, comprising 213 patients. For a patient with HOOD from a family in which HOOD nephropathy occurs, the risk of having a child with HOOD nephropathy is about 1:4; the risk of having a child in whom renal failure will develop is about 1:10. PMID:3225824

  4. Residential building stakeholders' attitudes and beliefs regarding nail gun injury risks and prevention.

    PubMed

    Albers, James T; Hudock, Stephen D; Lowe, Brian D

    2013-01-01

    Pneumatic nail guns are ubiquitous at residential construction sites across the United States. These tools are noted for the traumatic injuries that can occur from their operation. Different trigger mechanisms on these tools are associated with different levels of risk. Residential building subcontractors and workers, both native-born and immigrant, were brought together in focus groups to discuss their attitudes and beliefs regarding risk factors for nail gun injury as well as barriers to the adoption of safer technology. Participants' comments are organized first by influences on traumatic injury occurrence or prevention and later by sociotechnical system category. Participants attributed influences on injury risk to personal and external causation factors in all sociotechnical system categories; however, participants more frequently described influences on injury prevention as related to workers' behaviors, rather than to external factors. A discussion of these influences with respect to attribution theory and sociotechnical models of injury causation is presented.

  5. A Tumor Hidden Beneath the Nail Plate: Report of A Rare Case of Onychomatricoma with Three-Dimensional Histopathological Analysis and Immunohistochemical Study

    PubMed Central

    Poojary, Shital Amin; Halwai, Vikas

    2015-01-01

    Onychomatricoma is a tumor of the nail matrix which often presents with alterations in the nail plate while the tumor itself is concealed beneath the nail plate. It is a benign, biphasic fibroepithelial tumor which has to be differentiated from other subungual and periungual tumors. We report a rare case of onychomatricoma and describe a three-dimensional histopathological analysis and immunohistochemical patterns of onychomatricoma. PMID:25814731

  6. Sclerosing osteomyelitis of Garré: management of femoral pain by intramedullary nailing

    PubMed Central

    Vannet, Nicola Bader; Williams, Huw L M; Healy, Brendan; Morgan-Jones, Rhidian

    2014-01-01

    We describe a case of chronic sclerosing osteomyelitis of Garré in a 50-year-old woman occurring in her right femur and presenting with uncontrolled pain. The patient was initially treated with intramedullary reaming of the femur, but 3 years later re-presented with similar symptoms. This required further reaming and intramedullary nailing, achieving good clinical outcomes and lasting pain relief at 8-year follow-up. PMID:25538212

  7. Pelvic migration of the helical blade after treatment of transtrochanteric fracture using a proximal femoral nail.

    PubMed

    Gomes, Pedro Luciano Teixeira; Castelo, Luís Sá; Lopes, António Lemos; Maio, Marta; Miranda, Adélia; Dias, António Marques

    2016-01-01

    Proximal femoral nails with a helical blade are a new generation of implants used for treating transtrochanteric fractures. The blade design provides rotational and angular stability for the fracture. Despite greater biomechanical resistance, they sometimes present complications. In the literature, there are some reports of cases of perforation of the femoral head caused by helical blades. Here, a clinical case of medial migration of the helical blade through the femoral head and acetabulum into the pelvic cavity is presented.

  8. [Pyoderma gangrenosum after intramedullary nailing of tibial shaft fracture: A differential diagnosis to necrotizing fasciitis].

    PubMed

    Hackl, S; Merkel, P; Hungerer, S; Friederichs, J; Müller, N; Militz, M; Bühren, V

    2015-12-01

    Pyoderma gangrenosum is a rare non-infectious neutrophilic dermatitis, whereas necrotizing fasciitis is a life-threatening bacterial soft tissue infection of the fascia and adjacent skin. As in the case described here after intramedullary nailing, the clinical appearance of both diseases can be similar. Because of the completely different therapeutic approach and a worse outcome in the case of false diagnosis, pyoderma gangrenosum should always be taken into consideration before treating necrotizing fasciitis.

  9. Clinical guidelines for the recognition of melanoma of the foot and nail unit.

    PubMed

    Bristow, Ivan R; de Berker, David Ar; Acland, Katharine M; Turner, Richard J; Bowling, Jonathan

    2010-11-01

    Malignant melanoma is a life threatening skin tumour which may arise on the foot. The prognosis for the condition is good when lesions are diagnosed and treated early. However, lesions arising on the soles and within the nail unit can be difficult to recognise leading to delays in diagnosis. These guidelines have been drafted to alert health care practitioners to the early signs of the disease so an early diagnosis can be sought.

  10. Clinical guidelines for the recognition of melanoma of the foot and nail unit

    PubMed Central

    2010-01-01

    Malignant melanoma is a life threatening skin tumour which may arise on the foot. The prognosis for the condition is good when lesions are diagnosed and treated early. However, lesions arising on the soles and within the nail unit can be difficult to recognise leading to delays in diagnosis. These guidelines have been drafted to alert health care practitioners to the early signs of the disease so an early diagnosis can be sought. PMID:21040565

  11. UV-curable gel formulations: Potential drug carriers for the topical treatment of nail diseases.

    PubMed

    Kerai, Laxmi Valji; Hilton, Stephen; Murdan, Sudaxshina

    2015-08-15

    Nail diseases are common, cause significant distress and treatments are far from successful. Our aim was to investigate the potential of UV-curable gels - currently used as cosmetics - as topical drug carriers for their treatment. These formulations have a long residence on the nail, which is expected to increase patient compliance and the success of topical therapy. The gels are composed of the diurethane dimethacrylate, ethyl methacrylate, 2-hydroxy-2-methylpropiophenone, an antifungal drug (amorolfine HCl or terbinafine HCl) and an organic liquid (ethanol or NMP) as drug solvent. Following its application to a substrate and exposure to a UVA lamp for 2 min, the gel polymerises and forms a smooth, glossy and amorphous film, with negligible levels of residual monomers. No drug-polymer interactions were found and drug loading did not affect the film's properties, such as thickness, crystallinity and transition temperatures. In contrast, the organic solvent did influence the film's properties; NMP-containing films had lower glass transition temperatures, adhesion and water resistance than ethanol-based ones. Water-resistance being a desired property, ethanol-based formulations were investigated further for stability, drug release and ungual permeation. The films were stable under accelerated stability testing conditions. Compared to terbinafine, amorolfine was released to a greater extent, had a higher ungual flux, but a lower concentration in the nailplate. However, both drugs were present at considerably high levels in the nail when their MICs are taken into account. We thus conclude that UV-curable gels are promising candidates as topical nail medicines.

  12. Intermittent therapy with terbinafine and nail abrasion for dermatophyte toe onychomycosis: a pilot study.

    PubMed

    Succi, Isabella B; Bernardes-Engemann, Andréa R; Orofino-Costa, Rosane

    2013-05-01

    Onychomycosis constitutes up to 50% of all nail disorders. Toenails are generally affected, mostly due to dermatophytes. Terbinafine is the most potent antifungal agent in vitro against dermatophytes. There are few randomised controlled trials using a non-continuous dose of terbinafine. The aim of this open-label pilot study was to reduce the total drug amount, the collateral effects and, specially, the costs; albeit maintaining the same efficacy of the standard regimens. Compare the outcomes of two different intermittent regimens with the same total amount of the medication (42 tablets in 6 months). Forty-one patients were divided into the following groups: terbinafine 250 mg day(-1) , for 7 days, monthly or terbinafine 500 mg day(-1) , once daily, for 7 days, every 2 months, both plus nail abrasion during 6 months. The efficacy was evaluated at months 6, 12 and 18 using the disease free nail criteria. Total cure = group I: eight patients (44.4%) and group II: eight patients (44.4%). Partial cure = group I: five patients (27.8%) and group II: four patients (22.2%). Treatment failure = group I: five patients (27.8%) and group II: three patients (16.7%). Recurrence = group I: zero patients (0.0%) and group II: three patients (16.7%). Two intermittent dosing regimens of terbinafine plus nail abrasion proved to be an alternative statistically effective, safe and with reduced drug costs for dermatophytes toenail onychomycosis.

  13. Robust identification and localization of intramedullary nail holes for distal locking using CBCT: a simulation study.

    PubMed

    Kamarianakis, Z; Buliev, I; Pallikarakis, N

    2011-05-01

    Closed intramedullary nailing is a common technique for treatment of femur and tibia fractures. The most challenging step in this procedure is the precise placement of the lateral screws that stabilize the fragmented bone. The present work concerns the development and the evaluation of a method to accurately identify in the 3D space the axes of the nail hole canals. A limited number of projection images are acquired around the leg with the help of a C-arm. On two of them, the locking hole entries are interactively selected and a rough localization of the hole axes is performed. Perpendicularly to one of them, cone-beam computed tomography (CBCT) reconstructions are produced. The accurate identification and localization of the hole axes are done by an identification of the centers of the nail holes on the tomograms and a further 3D linear regression through principal component analysis (PCA). Various feature-based approaches (RANSAC, least-square fitting, Hough transform) have been compared for best matching the contours and the centers of the holes on the tomograms. The robustness of the suggested method was investigated using simulations. Programming is done in Matlab and C++. Results obtained on synthetic data confirm very good localization accuracy - mean translational error of 0.14 mm (std=0.08 mm) and mean angular error of 0.84° (std=0.35°) at no radiation excess. Successful localization can be further used to guide a surgeon or a robot for correct drilling the bone along the nail openings.

  14. Skeletal metastatic disease of the femur: results by management with intramedullary nailing.

    PubMed

    Märdian, S; Schaser, K-D; Ruppert, M; Melcher, I; Haas, N P; Schwabe, P

    2015-01-01

    PURPOSE OF THE STUDY This study aimed to analyse the outcome following intramedullary nailing for metastases of the femur in a large cohort with special regard to mechanical, implant associated complications and patient survival. Furthermore, we aimed to identify factors influencing the overall survival. MATERIAL AND METHODS All patients (n = 74) that underwent intramedullary nailing for metastatic disease of the femur between 2004 and 2008 and were retrospectively reviewed. Data were recorded from the patients' medical record and the outpatients' clinics files. Details about the tumour biology, the surgery performed as well as the postoperative care were documented. Survival data were extracted from patient records or obtained via communication with outpatient oncologists or the community registration office. RESULTS 74 (28 (37.8%) male, 46 (62.2%) female; p = 0.048) patients with a mean age of 64.4 ± 11.7 years were included. Breast (25, 33.8%), lung (18, 24.3%), bone marrow (7, 9.5%) and kidney (6, 8.1%) were the primary tumours in more than 75% of all patients. The mean overall survival was 17.5 (95% CI: 9.6 - 25.5) months. Patients with osseous metastases had a significant longer survival than patients with visceral and/or cerebral metastases (p = 0.025 and p = 0.032). CONCLUSION Intramedullary nailing represents a valuable fixation method for pathologic fractures or impending fractures of the femur in patients with an advanced stage of metastatic disease. It provides adequate stability to outlast the patient s remaining life-span. However, the balance must be found between therapeutic resignation and surgical overtreatment since operative treatment may be accompanied with serious complications. Key words: bone metastases, intramedullary nailing, metastatic disease, cement augmentation, osteolytic defect.

  15. A Modified Levering Technique for Removing a Broken Solid Intramedullary Tibial Nail: A Technical Tip.

    PubMed

    Pullen, W Michael; Erdle, Nicholas J; Crickard, Colin; Smith, Christopher S

    Intramedullary tibial fixation is a commonly used and highly successfully treatment in acute fractures, nonunion settings, and correctional procedures. In the setting of a nonunion, removal of a failed implant can add to operative time and surgeon frustration while further compromising bone in an area already at risk for failure. Here we present a technique, using readily accessible equipment, for removing a distal solid tibial nail fragment in a manner that preserves bone.

  16. The Retrograde Tibial Nail: presentation and biomechanical evaluation of a new concept in the treatment of distal tibia fractures.

    PubMed

    Kuhn, Sebastian; Appelmann, Philipp; Pairon, Philip; Mehler, Dorothea; Rommens, Pol M

    2014-01-01

    Displaced distal tibia fractures require stable fixation while minimizing secondary damage to the soft tissues by the surgical approach and implants. Antegrade intramedullary nailing has become an alternative to plate osteosynthesis for the treatment of distal metaphyseal fractures over the past two decades. While retrograde intramedullary nailing is a standard procedure in other long bone fractures, only few attempts have been made on retrograde nailing of tibial fractures. The main reasons are difficulties of finding an ideal entry portal and the lack of an ideal implant for retrograde insertion. The Retrograde Tibial Nail (RTN) is a prototype intramedullary implant developed by our group. The implant offers double proximal and triple distal interlocking with an end cap leading to an angle-stable screw-nail construct of the most distal interlocking screw. Its design meets the requirements of a minimally invasive surgical approach, with a stable fracture fixation by multiple locking options. The 8mm diameter curved nail, with a length of 120 mm, is introduced through an entry portal at the medial malleolus. We see possible indications for the RTN in far distal tibial shaft fractures, distal extraarticular metaphyseal tibial fractures and in distal tibia fractures with simple extension into the ankle joint when the nail is combined lag screw fixation. A biomechanical comparison of the current RTN prototype against antegrade nailing (Expert Tibial Nail, Synthes(®), ETN) was performed. Both implants were fixed with double proximal and triple distal interlocking. Seven biomechanical composite tibiae were treated with either osteosynthesis techniques. A 10mm defect osteotomy 40 mm proximal to the joint line served as an AO 43-A3 type distal tibial fracture model. The stiffness of the implant-bone constructs was measured under low and high extra-axial compression (350 and 600 N) and under torsional load (8 Nm). Results show a comparable stability during axial loading

  17. Nail psoriasis as a predictor of the development of psoriatic arthritis.

    PubMed

    Raposo, I; Torres, T

    2015-01-01

    Psoriatic arthritis is a psoriasis-related spondyloarthropathy that occurs in 20-30% of patients with psoriasis. Various imaging studies have demonstrated that there is a considerable proportion of undiagnosed psoriatic arthritis among patients with psoriasis. Since early detection and treatment of psoriatic arthritis could, ultimately, allow the prevention of clinical and radiologic progression of the disease, there is the need to establish clinical indicators to detect this risk. Nail psoriasis has been proposed as a predictor for the development of psoriatic arthritis. The inflammation involving the entheses, called enthesitis, is an early inflammatory change seen in psoriatic arthritis, and nail changes appear to result from the close relationship between the nail and the enthesis of the distal interphalangeal extensor tendon, one of the main entheseal compartments affected in psoriatic arthritis. As skin lesions precede articular symptoms in more than 75-80% of patients with psoriatic arthritis, dermatologists may play a key role in the early detection and management of psoriatic arthritis.

  18. Analysis of nerve agent metabolites from nail clippings by liquid chromatography tandem mass spectrometry.

    PubMed

    Appel, Amanda S; Logue, Brian A

    2016-09-15

    While several methods for the bioanalysis of nerve agents or their metabolites have been developed for the verification of nerve agent exposure, these methods are generally limited in the amount of time after an exposure that markers of exposure can be detected (due to rapid metabolism from biological matrices). In this study, a method for the analysis of nerve agent hydrolysis products from nail clippings was developed to allow evaluation of nails as a long-term repository of these markers. Pinacolyl methylphosphonic acid (PMPA) and isopropyl methylphosphonic acid (IMPA) were extracted from nail samples with N,N-dimethylformamide and subsequently analyzed by liquid chromatography-tandem mass spectrometry. Limits of detection for PMPA and IMPA were 0.3μg/kg and 7.5μg/kg and linear ranges were 0.75-300μg/kg and 30-1500μg/kg, respectively. Precision was within 10% and 8% for PMPA and IMPA, respectively, and accuracy was 100±12% for both analytes. The approach presented here is complementary to current methods for nerve agent exposure verification, and should allow for long-term determination of nerve agent poisoning.

  19. Temporary cavity created by free-flying projectiles propelled from a powder-actuated nail gun.

    PubMed

    Frank, Matthias; Schönekeß, Holger C; Jäger, Frank; Hertel, Heinz; Ekkernkamp, Axel; Bockholdt, Britta

    2012-09-01

    Nails and driving pins discharged from powder-actuated fastening tools bear some special ballistic characteristics. Compared to the usual pistol or revolver projectiles, the sectional density (S) of fastening pins is extremely high. The general prevailing opinion is that the kinetic energy delivered by fastening tools is not high enough to cause a temporary cavity. Therefore, it was the aim of this study to investigate the wound morphology due to fastening bolts discharged from a powder-actuated direct-acting nail gun (where, in contrast to modern piston-type tools, the expanding gases act directly on the fastener) using ballistic soap blocks as simulants. For test shots, a direct-acting powder-actuated nail gun which features three interchangeable barrels (caliber (cal.) 6, 8, and 10 mm) was used. The average kinetic energy was 537, 532, and 694 J for the 6-, 8-, and 10-mm cal. bolts, respectively. Test shots on the ballistic soap blocks demonstrated that free-flying projectiles discharged from direct-acting fastening tools are able to create a temporary cavity.

  20. Efficient DNA extraction from nail clippings using the protease solution from Cucumis melo.

    PubMed

    Yoshida-Yamamoto, Shumi; Nishimura, Sayaka; Okuno, Teruko; Rakuman, Miki; Takii, Yukio

    2010-09-01

    Owing to the increasing importance of genomic information, obtaining genomic DNA easily from biological specimens has become more and more important. This article proposes an efficient method for obtaining genomic DNA from nail clippings. Nail clippings can be easily obtained, are thermostable and easy to transport, and have low infectivity. The drawback of their use, however, has been the difficulty of extracting genomic material from them. We have overcome this obstacle using the protease solution obtained from Cucumis melo. The keratinolytic activity of the protease solution was 1.78-fold higher than that of proteinase K, which is commonly used to degrade keratin. With the protease solution, three times more DNA was extracted than when proteinase K was used. In order to verify the integrity of the extracted DNA, genotype analysis on 170 subjects was performed by both PCR-RFLP and Real Time PCR. The results of the genotyping showed that the extracted DNA was suitable for genotyping analysis. In conclusion, we have developed an efficient extraction method for using nail clippings as a genome source and a research tool in molecular epidemiology, medical diagnostics, and forensic science.