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Sample records for limited internal fixation

  1. Limits of internal fixation in long-bone fracture.

    PubMed

    Nieto, H; Baroan, C

    2017-02-01

    Alternatives to internal fixation of long-bone fracture comprise, depending on location, external fixation or joint replacement. Limitations comprise risk of infection and functional outcome quality, which vary according to technique. The present study examines these limitations, based on comparative or large-scale studies from which certain significant results emerge. Four main questions are dealt with: (1) the present role of locking plates; (2) conditions for intramedullary nailing in Gustilo grade IIIb open fracture; (3) the limitations of conversion from external fixation to intramedullary nailing in open lower leg fracture; (4) and the limitations of definitive anterograde femoral nailing in multiple trauma. Locking plate fixation has yet to prove clinical superiority in any of the anatomic sites for which good-quality comparative analyses are available. Infection risk in Gustilo grade IIIb open lower leg fracture is equivalent when treated by intramedullary nailing or external fixation, if wound care and debridement are effective, antibiotherapy is initiated rapidly and skin cover is restored within 7days. Conversion from primary external fixation to intramedullary nailing is possible if the external fixator was fitted less than 28days previously and skin cover was restored within 7days. The pulmonary and systemic impact of peripheral lesions or definitive anterograde intramedullary nailing of femoral fracture in multiple trauma calls for caution and what is known as "damage-control orthopedics" (DCO), a term covering the general consequences of both the initial trauma and its treatment. Femoral intramedullary nailing is thus contraindicated in case of hemorrhagic shock (blood pressure<90mmHg), hypothermia (<33°C), coagulation disorder (platelet count<90,000) or peripheral lesions such as multiple long-bone fractures, crushed limb or primary pulmonary contusion. In such cases, external fixation or retrograde nailing with a small-diameter nail and without

  2. External Fixation combined with Limited Internal Fixation versus Open Reduction Internal Fixation for Treating Ruedi-Allgower Type III Pilon Fractures

    PubMed Central

    Guo, Yongzhi; Tong, Liangyong; Li, Shaoguang; Liu, Zhi

    2015-01-01

    Background The optimal treatment of type III pilon fractures remains controversial. Hence, we performed this study to investigate whether open reduction and internal fixation (ORIF) is superior to external fixations combined with limited internal fixations (EFLIF). Material/Methods From January 2012 to October 2013, a total of 78 patients were included. Twenty-six patients underwent EFLIF and 52 patients underwent ORIF. All subjects were followed up at 1, 3, 6, and 12 months postoperatively. All outcomes and complications were recorded. Results No statistical differences were observed in Mazur score or ROM between the 2 groups. There were significant differences between the 2 groups in hospital stay (P<0.001), reduction results (P=0.019), screw loosening (P=0.025), and traumatic arthritis (P=0.037). Conclusions Similar functional outcomes were achieved in EFLIF and ORIF groups. Due to several limitations of this study, a well-designed randomized controlled trial involving more patients and long-term follow-up is needed to find an optimal treatment protocol. PMID:26050786

  3. Eighth international congress on nitrogen fixation

    SciTech Connect

    Not Available

    1990-01-01

    This volume contains the proceedings of the Eighth International Congress on Nitrogen Fixation held May 20--26, 1990 in Knoxville, Tennessee. The volume contains abstracts of individual presentations. Sessions were entitled Recent Advances in the Chemistry of Nitrogen Fixation, Plant-microbe Interactions, Limiting Factors of Nitrogen Fixation, Nitrogen Fixation and the Environment, Bacterial Systems, Nitrogen Fixation in Agriculture and Industry, Plant Function, and Nitrogen Fixation and Evolution.

  4. Eighth international congress on nitrogen fixation. Final program

    SciTech Connect

    Not Available

    1990-12-31

    This volume contains the proceedings of the Eighth International Congress on Nitrogen Fixation held May 20--26, 1990 in Knoxville, Tennessee. The volume contains abstracts of individual presentations. Sessions were entitled Recent Advances in the Chemistry of Nitrogen Fixation, Plant-microbe Interactions, Limiting Factors of Nitrogen Fixation, Nitrogen Fixation and the Environment, Bacterial Systems, Nitrogen Fixation in Agriculture and Industry, Plant Function, and Nitrogen Fixation and Evolution.

  5. Internal fixation: a historical review.

    PubMed

    Greenhagen, Robert M; Johnson, Adam R; Joseph, Alison

    2011-08-01

    Internal fixation has become a pillar of surgical specialties, yet the evolution of these devices has been relatively short. The first known description of medical management of a fracture was found in the Edwin Smith Papyrus of Ancient Egypt (circa 2600 bc). The first description of internal fixation in the medical literature was in the 18th century. The advancement of techniques and technology over the last 150 years has helped to preserve both life and function. The pace of advancement continues to accelerate as surgeons continue to seek new technology for osseous fixation. The authors present a thorough review of the history of internal fixation and the transformation into a multibillion dollar industry.

  6. Design and Optimization of Resorbable Silk Internal Fixation Devices

    NASA Astrophysics Data System (ADS)

    Haas, Dylan S.

    Limitations of current material options for internal fracture fixation devices have resulted in a large gap between user needs and hardware function. Metal systems offer robust mechanical strength and ease of implantation but require secondary surgery for removal and/or result in long-term complications (infection, palpability, sensitivity, etc.). Current resorbable devices eliminate the need for second surgery and long-term complications but are still associated with negative host response as well as limited functionality and more difficult implantation. There is a definitive need for orthopedic hardware that is mechanically capable of immediate fracture stabilization and fracture fixation during healing, can safely biodegrade while allowing complete bone remodeling, can be resterilized for reuse, and is easily implantable (self-tapping). Previous work investigated the use of silk protein to produce resorbable orthopedic hardware for non- load bearing fracture fixation. In this study, silk orthopedic hardware was further investigated and optimized in order to better understand the ability of silk as a fracture fixation system and more closely meet the unfulfilled market needs. Solvent-based and aqueous-based silk processing formulations were cross-linked with methanol to induce beta sheet structure, dried, autoclaved and then machined to the desired device/geometry. Silk hardware was evaluated for dry, hydrated and fatigued (cyclic) mechanical properties, in vitro degradation, resterilization, functionalization with osteoinductive molecules and implantation technique for fracture fixation. Mechanical strength showed minor improvements from previous results, but remains comparable to current resorbable fixation systems with the advantages of self-tapping ability for ease of implantation, full degradation in 10 months, ability to be resterilized and reused, and ability to release molecules for osteoinudction. In vivo assessment confirmed biocompatibility, showed

  7. Local versus basin-scale limitation of marine nitrogen fixation.

    PubMed

    Weber, Thomas; Deutsch, Curtis

    2014-06-17

    Nitrogen (N) fixation by diazotrophic plankton is the primary source of this crucial nutrient to the ocean, but the factors limiting its rate and distribution are controversial. According to one view, the ecological niche of diazotrophs is primarily controlled by the ocean through internally generated N deficits that suppress the growth of their competitors. A second view posits an overriding limit from the atmosphere, which restricts diazotrophs to regions where dust deposition satisfies their high iron (Fe) requirement, thus separating N sources from sinks at a global scale. Here we use multiple geochemical signatures of N2 fixation to show that the Fe limitation of diazotrophs is strong enough to modulate the regional distribution of N2 fixation within ocean basins--particularly the Fe-poor Pacific--but not strong enough to influence its partition between basins, which is instead governed by rates of N loss. This scale-dependent limitation of N2 fixation reconciles local observations of Fe stress in diazotroph communities with an inferred spatial coupling of N sources and sinks. Within this regime of intermediate Fe control, the oceanic N reservoir would respond only weakly to enhanced dust fluxes during glacial climates, but strongly to the reduced fluxes hypothesized under anthropogenic climate warming.

  8. Mechanical testing of a device for subcutaneous internal anterior pelvic ring fixation versus external pelvic ring fixation

    PubMed Central

    2014-01-01

    Background Although useful in the emergency treatment of pelvic ring injuries, external fixation is associated with pin tract infections, the patient’s limited mobility and a restricted surgical accessibility to the lower abdomen. In this study, the mechanical stability of a subcutaneous internal anterior fixation (SIAF) system is investigated. Methods A standard external fixation and a SIAF system were tested on pairs of Polyoxymethylene testing cylinders using a universal testing machine. Each specimen was subjected to a total of 2000 consecutive cyclic loadings at 1 Hz with sinusoidal lateral compression/distraction (+/−50 N) and torque (+/− 0.5 Nm) loading alternating every 200 cycles. Translational and rotational stiffness were determined at 100, 300, 500, 700 and 900 cycles. Results There was no significant difference in translational stiffness between the SIAF and the standard external fixation when compared at 500 (p = .089), 700 (p = .081), and 900 (p = .266) cycles. Rotational stiffness observed for the SIAF was about 50 percent higher than the standard external fixation at 300 (p = .005), 500 (p = .020), and 900 (p = .005) cycles. No loosening or failure of the rod-pin/rod-screw interfaces was seen. Conclusions In comparison with the standard external fixation system, the tested device for subcutaneous internal anterior fixation (SIAF) in vitro has similar translational and superior rotational stiffness. PMID:24684828

  9. Characteristics of Fixational Eye Movements in Amblyopia: Limitations on Fixation Stability and Acuity?

    PubMed Central

    Kumar, Girish; Li, Roger W.; Levi, Dennis M.

    2015-01-01

    Persons with amblyopia, especially those with strabismus, are known to exhibit abnormal fixational eye movements. In this paper, we compared six characteristics of fixational eye movements among normal control eyes (n=16), the non-amblyopic fellow eyes and the amblyopic eyes of anisometropic (n=14) and strabismic amblyopes (n=14). These characteristics include the frequency, magnitude of landing errors, amplitude and speed of microsaccades, and the amplitude and speed of slow drifts. Fixational eye movements were recorded using retinal imaging while observers monocularly fixated a 1° cross. Eye position data were recovered using a cross-correlation procedure. We found that in general, the characteristics of fixational eye movements are not significantly different between the fellow eyes of amblyopes and controls, and that the strabismic amblyopic eyes are always different from the other groups. Next, we determined the primary factors that limit fixation stability and visual acuity in amblyopic eyes by examining the relative importance of the different oculomotor characteristics, adding acuity (for fixation stability) or fixation stability (for acuity), and the type of amblyopia, as predictive factors in a multiple linear regression model. We show for the first time that the error magnitude of microsaccades, acuity, amplitude and frequency of microsaccades are primary factors limiting fixation stability; while the error magnitude, fixation stability, amplitude of drifts and amplitude of microsaccades are the primary factors limiting acuity. A mediation analysis showed that the effects of error magnitude and amplitude of microsaccades on acuity could be explained, at least in part, by their effects on fixation stability. PMID:25668775

  10. Diagnosis and rehabilitation of deep wound infection and internal fixation rejection in elbow

    PubMed Central

    Lu, Huiping; Song, Lin; Lin, Ying

    2016-01-01

    Abstract This study aims at diagnosis and rehabilitation of a rare case of deep wound infection and internal fixation rejection in elbow. The patient sustained a distal fracture in the humerus 1 year ago, which was internal fixed. The wound always effused and the elbow had pain and swelling; joint motion was limited. Blood sedimentation rate and C reactive protein level increased, bacterial culture suggested deep wound infection, and ultrasound indicated inflammation. The main diagnoses were deep wound infection and internal fixation rejection. Therapeutics interventions were antibiotic agents, physical therapy, operative debridement, incision, drainage, and exercise and physical therapy. One year later, the internal fixation was taken out. His elbow was fully mobilized and the fracture healed. He got back to his former job. When encountered deep wound infection again and again after internal fixation, rejection should be considered. Except for anti-infection treatment, rehabilitation cannot be neglected, or the healing process may be delayed. PMID:27281079

  11. Complications of open reduction and internal fixation of ankle fractures.

    PubMed

    Leyes, Manuel; Torres, Raúl; Guillén, Pedro

    2003-03-01

    This article discusses the complications after open reduction and internal fixation of ankle fractures. Complications are classified as perioperative (malreduction, inadequate fixation, and intra-articular penetration of hardware), early postoperative (wound edge dehiscence, necrosis, infection and compartment syndrome), and late (stiffness, distal tibiofibular synostosis, degenerative osteoarthritis, and hardware related complications). Emphasis is placed on preventive measures to avoid such complications.

  12. Molybdenum limitation of asymbiotic nitrogen fixation in tropical forest soils

    NASA Astrophysics Data System (ADS)

    Barron, Alexander R.; Wurzburger, Nina; Bellenger, Jean Phillipe; Wright, S. Joseph; Kraepiel, Anne M. L.; Hedin, Lars O.

    2009-01-01

    Nitrogen fixation, the biological conversion of di-nitrogen to plant-available ammonium, is the primary natural input of nitrogen to ecosystems, and influences plant growth and carbon exchange at local to global scales. The role of this process in tropical forests is of particular concern, as these ecosystems harbour abundant nitrogen-fixing organisms and represent one third of terrestrial primary production. Here we show that the micronutrient molybdenum, a cofactor in the nitrogen-fixing enzyme nitrogenase, limits nitrogen fixation by free-living heterotrophic bacteria in soils of lowland Panamanian forests. We measured the fixation response to long-term nutrient manipulations in intact forests, and to short-term manipulations in soil microcosms. Nitrogen fixation increased sharply in treatments of molybdenum alone, in micronutrient treatments that included molybdenum by design and in treatments with commercial phosphorus fertilizer, in which molybdenum was a `hidden' contaminant. Fixation did not respond to additions of phosphorus that were not contaminated by molybdenum. Our findings show that molybdenum alone can limit asymbiotic nitrogen fixation in tropical forests and raise new questions about the role of molybdenum and phosphorus in the tropical nitrogen cycle. We suggest that molybdenum limitation may be common in highly weathered acidic soils, and may constrain the ability of some forests to acquire new nitrogen in response to CO2 fertilization.

  13. MRI analysis of the ISOBAR TTL internal fixation system for the dynamic fixation of intervertebral discs: a comparison with rigid internal fixation

    PubMed Central

    2014-01-01

    Objectives Using magnetic resonance imaging (MRI), we analyzed the efficacy of the posterior approach lumbar ISOBAR TTL internal fixation system for the dynamic fixation of intervertebral discs, with particular emphasis on its effects on degenerative intervertebral disc disease. Methods We retrospectively compared the MRIs of 54 patients who had previously undergone either rigid internal fixation of the lumbar spine or ISOBAR TTL dynamic fixation for the treatment of lumbar spondylolisthesis. All patients had received preoperative and 6-, 12-, and 24-month postoperative MRI scans of the lumbar spine with acquisition of both routine and diffusion-weighted images (DWI). The upper-segment discs of the fusion were subjected to Pfirrmann grading, and the lumbar intervertebral discs in the DWI sagittal plane were manually drawn; the apparent diffusion coefficient (ADC) value was measured. Results ADC values in the ISOBAR TTL dynamic fixation group measured at the 6-, 12-, and 24-month postoperative MRI studies were increased compared to the preoperative ADC values. The ADC values in the ISOBAR TTL dynamic fixation group at 24 months postoperatively were significantly different from the preoperative values (P < 0.05). At 24 months, the postoperative ADC values were significantly different between the rigid fixation group and the ISOBAR TTL dynamic fixation group (P < 0.05). Conclusion MRI imaging findings indicated that the posterior approach lumbar ISOBAR TTL internal fixation system can prevent or delay the degeneration of intervertebral discs. PMID:24898377

  14. Anterior subcutaneous internal fixation for treatment of unstable pelvic fractures

    PubMed Central

    2014-01-01

    Background Fractures of the pelvic ring including disruption of the posterior elements in high-energy trauma have both high morbidity and mortality rates. For some injury pattern part of the initial resuscitation includes either external fixation or plate fixation to close the pelvic ring and decrease blood loss. In certain situations – especially when associated with abdominal trauma and the need to perform laparotomies – both techniques may put the patient at risk of either pintract or deep plate infections. We describe an operative approach to percutaneously close and stabilize the pelvic ring using spinal implants as an internal fixator and report the results in a small series of patients treated with this technique during the resuscitation phase. Findings Four patients were treated by subcutaneous placement of an internal fixator. Screw fixation was carried out by minimally invasive placement of two supra-acetabular iliac screws. Afterwards, a subcutaneous transfixation rod was inserted and attached to the screws after reduction of the pelvic ring. All patients were allowed to fully weight-bear. No losses of reduction or deep infections occurred. Fracture healing was uneventful in all cases. Conclusion Minimally invasive fixation is an alternative technique to stabilize the pelvic ring. The clinical results illustrate that this technique is able to achieve good results in terms of maintenance of reduction the pelvic ring. Also, abdominal surgeries no longer put the patient at risk of infected pins or plates. PMID:24606833

  15. [Complications of open reduction and internal fixation versus external fixation for unstable distal radius fractures: a meta-analysis].

    PubMed

    Yang, Z; Yuan, Z Z; Ma, J X; Ma, X L

    2016-12-20

    Objective: To make a systematic assessment of the complications of open reduction and internal fixation versus external fixation for unstable distal radius fractures. Method: A computer-based online search of PubMed, ScienceDirect, EMBASE, BIOSIS, Springer and Cochrane Library were performed.The randomized and controlled trials of open reduction and internal fixation versus external fixation for unstable distal radius fractures were collected.The included trials were screened out strictly based on the criterion of inclusion and exclusion.The quality of included trials was evaluated.RevMan 5.0 was used for data analysis. Result: A total of 17 studies involving 1 402 patients were included.There were 687 patients with open reduction and internal fixation and 715 with external fixation.The results of Meta-analysis indicated that there were statistically significant differences with regard to the postoperatively total complications, infection, malunion, tendon rupture (I(2)=8%, RR=0.77(95%CI 0.65-0.91, Z=3.10, P<0.05). There were no statistically significant differences observed between two approaches with respect to nounion, re-operation, complex regional pain syndrome, carpal tunnel syndrome, neurapraxia, tendonitis, painful hardware, scar(P>0.05). Conclusion: Postoperative complications are present in both open reduction and internal fixation and external fixation.Compared with external fixation, open reduction and internal fixation is lower in total complications postoperatively, infection and malunion, but external fixation has lower tendon rupture incidence.

  16. Intra-articular scapular fractures: Outcomes after internal fixation

    PubMed Central

    Lewis, Sarah; Argintar, Evan; Jahn, Ryan; Zusmanovich, Mike; Itamura, John; Rick Hatch, George F.

    2013-01-01

    Background Although operative treatment may offer an appropriate management option for displaced glenoid fractures, there is sparse research assessing post-operative functional outcomes. This study assessed functional outcomes of patients after undergoing open reduction and internal fixation of displaced glenoid fractures. Methods Fifteen patients were treated with open reduction and internal fixation for displaced intra-articular fractures between 2005 and 2010. The indication for operative fixation was intra-articular displacement >4 mm. Post-operative functional outcomes were assessed via retrospective chart review. Evaluation included review of pre-operative imaging for fracture type, review of post-operative plain radiographs for fracture healing, Disabilities of the Arm Shoulder and Hand (DASH) and American Shoulder and Elbow Surgeon Assessment (ASES) scores at last follow-up. Results At a mean follow-up of 49 months (24–87 months) all patients had radiographic healing. The mean DASH score was 10 (range 0.83–29.17). Mean ASES score was 90 (range 41.7–100). No patients had evidence of hardware failure or infection. Conclusions Open reduction and internal fixation of displaced intra-articular glenoid fractures results in stable fixation and is associated with good functional outcome. Level of evidence Level IV. Case series. PMID:24396240

  17. Retrospective Comparison of Percutaneous Fixation and Volar Internal Fixation of Distal Radius Fractures

    PubMed Central

    Lozano-Calderón, Santiago A.; Doornberg, Job N.

    2007-01-01

    A change in the practice of a single surgeon provided an opportunity for retrospective comparison of comparable cohorts treated with percutaneous fixation (17 patients) or a volar plate and screws (23 patients) an average of 30 months after surgery. The final evaluation was performed according to the Gartland and Werley and Mayo rating systems and the DASH questionnaire. There were no significant differences on the average scores for the percutaneous and volar plating groups, respectively: Gartland and Werley, 4 vs 5; Mayo, 82 vs 83; and DASH score 13 for both cohorts. Motion, grip, and radiographical parameters were likewise comparable. Volar internal plate and screw fixation can achieve results comparable to percutaneous fixation techniques in the treatment of fractures of the distal radius. PMID:18780085

  18. Fixation of Radiological Contamination; International Collaborative Development

    SciTech Connect

    Rick Demmer

    2013-03-01

    A cooperative international project was conducted by the Idaho National Laboratory (INL) and the United Kingdom’s National Nuclear Laboratory (NNL) to integrate a capture coating with a high performance atomizing process. The initial results were promising, and lead to further trials. The somewhat longer testing and optimization process has resulted in a product that could be demonstrated in the field to reduce airborne radiological dust and contamination.

  19. Outcomes of Internal Fixation in a Combat Environment

    DTIC Science & Technology

    2010-01-01

    A variety of internal fixation procedures were performed to include 44 plate and/or screw (88%), four intramedullary nail (8%), and two tension band...that underwent intramedullary nailing at an Air Force Theater Hospital in Balad, Iraq. Two-thirds of the patients had high-energy ballistic injuries...JOURNAL OF SURGICAL ORTHOPAEDIC ADVANCES 5. Keeney, J. A., Ingari, J. V., Mentzer, K. D., et al. Closed intramedullary nailing of femoral shaft fractures

  20. Internal fixators: a safe option for managing distal femur fractures?

    PubMed Central

    Batista, Bruno Bellaguarda; Salim, Rodrigo; Paccola, Cleber Antonio Jansen; Kfuri, Mauricio

    2014-01-01

    OBJECTIVE: Evaluate safety and reliability of internal fixator for the treatment of intra-articular and periarticular distal femur fractures. METHODS: Retrospective data evaluation of 28 patients with 29 fractures fixed with internal fixator was performed. There was a predominance of male patients (53.5%), with 52% of open wound fractures, 76% of AO33C type fractures, and a mean follow up of 21.3 months. Time of fracture healing, mechanical axis deviation, rate of infection and postoperative complications were registered. RESULTS: Healing rate was 93% in this sample, with an average time of 5.5 months. Twenty-seven percent of patients ended up with mechanical axis deviation, mostly resulting from poor primary intra-operative reduction. There were two cases of implant loosening; two implant breakage, and three patients presented stiff knee. No case of infection was observed. Healing rate in this study was comparable with current literature; there was a high degree of angular deviation, especially in the coronal plane. CONCLUSION: Internal fixators are a breakthrough in the treatment of knee fractures, but its use does not preclude application of principles of anatomical articular reduction and mechanical axis restoration. Level of Evidence II, Retrospective Study. PMID:25061424

  1. Bladder incarceration following anterior external fixation of a traumatic pubic symphysis diastasis treated with immediate open reduction and internal fixation

    PubMed Central

    Finnan, Ryan P; Herbenick, Michael A; Prayson, Michael J; McCarthy, Mary C

    2008-01-01

    Anterior pelvic ring disruptions are often associated with injuries to the genitourinary structures with the potential for considerable resultant morbidity. Herniation of the bladder into the symphyseal region after injury with subsequent entrapment upon reduction of the symphyseal diastasis has seldom been reported in the literature. We report such a case involving bladder herniation and subsequent entrapment after attempted closed reduction with anterior pelvic external fixation immediately treated with open reduction and internal fixation along with a review of the literature. PMID:18928569

  2. A new adhesive technique for internal fixation in midfacial surgery

    PubMed Central

    Endres, Kira; Marx, Rudolf; Tinschert, Joachim; Wirtz, Dieter Christian; Stoll, Christian; Riediger, Dieter; Smeets, Ralf

    2008-01-01

    Background The current surgical therapy of midfacial fractures involves internal fixation in which bone fragments are fixed in their anatomical positions with osteosynthesis plates and corresponding screws until bone healing is complete. This often causes new fractures to fragile bones while drilling pilot holes or trying to insert screws. The adhesive fixation of osteosynthesis plates using PMMA bone cement could offer a viable alternative for fixing the plates without screws. In order to achieve the adhesive bonding of bone cement to cortical bone in the viscerocranium, an amphiphilic bone bonding agent was created, analogous to the dentin bonding agents currently on the market. Methods The adhesive bonding strengths were measured using tension tests. For this, metal plates with 2.0 mm diameter screw holes were cemented with PMMA bone cement to cortical bovine bone samples from the femur diaphysis. The bone was conditioned with an amphiphilic bone bonding agent prior to cementing. The samples were stored for 1 to 42 days at 37 degrees C, either moist or completely submerged in an isotonic NaCl-solution, and then subjected to the tension tests. Results Without the bone bonding agent, the bonding strength was close to zero (0.2 MPa). Primary stability with bone bonding agent is considered to be at ca. 8 MPa. Moist storage over 42 days resulted in decreased adhesion forces of ca. 6 MPa. Wet storage resulted in relatively constant bonding strengths of ca. 8 MPa. Conclusion A new amphiphilic bone bonding agent was developed, which builds an optimizied interlayer between the hydrophilic bone surface and the hydrophobic PMMA bone cement and thus leads to adhesive bonding between them. Our in vitro investigations demonstrated the adhesive bonding of PMMA bone cement to cortical bone, which was also stable against hydrolysis. The newly developed adhesive fixing technique could be applied clinically when the fixation of osteosynthesis plates with screws is impossible. With

  3. Wire internal fixation: an obsolete, yet valuable method for surgical management of facial fractures

    PubMed Central

    Bouletreau, Pierre; Konsem, Tarcissus; Traoré, Ibraïma; Coulibaly, Antoine Toua; Ouédraogo, Dieudonné

    2014-01-01

    In some developing countries wire is still widely used in facial fractures internal fixation. This study presents the effectiveness and complications of wire osteosynthesis in a university teaching hospital in Burkina Faso and discusses some of its other benefits and disadvantages. Notes of 227 patients with facial fractures treated by wire internal fixation at department of stomatology and maxillofacial surgery of CHU Souro Sanou, Burkina Faso between 2006 and 2010 are reviewed retrospectively. A satisfactory treatment outcome was recorded in 91.2% of the 227 patients. Complications occurred in 8.8% of the patients who had operative site infection (3.1%), malocclusion (1.8%), sensory disturbance (1.8), facial asymmetry (1.3%), delayed bone union (0.9%) or enophtalmos (0.4%). The overall complications rate was 7.4% after mandibular osteosynthesis, 6.9% after Le Fort osteosynthesis and 6.5% after zygoma osteosynthesis. Post operative infections occurred irrespective to the surgical site. The other complications were more specific to the surgical site. Wire internal fixation may be a reasonable alternative for the surgical treatment of non-comminuted facial fractures and those without bone substance loss, in the setting of limited resources. PMID:25237416

  4. Evolutionary tradeoffs can select against nitrogen fixation and thereby maintain nitrogen limitation.

    PubMed

    Menge, Duncan N L; Levin, Simon A; Hedin, Lars O

    2008-02-05

    Symbiotic nitrogen (N) fixing trees are absent from old-growth temperate and boreal ecosystems, even though many of these are N-limited. To explore mechanisms that could select against N fixation in N-limited, old-growth ecosystems, we developed a simple resource-based evolutionary model of N fixation. When there are no costs of N fixation, increasing amounts of N fixation will be selected for until N no longer limits production. However, tradeoffs between N fixation and plant mortality or turnover, plant uptake of available soil N, or N use efficiency (NUE) can select against N fixation in N-limited ecosystems and can thereby maintain N limitation indefinitely (provided that there are losses of plant-unavailable N). Three key traits influence the threshold that determines how large these tradeoffs must be to select against N fixation. A low NUE, high mortality (or turnover) rate and low losses of plant-unavailable N all increase the likelihood that N fixation will be selected against, and a preliminary examination of published data on these parameters shows that these mechanisms, particularly the tradeoff with NUE, are quite feasible in some systems. Although these results are promising, a better characterization of these parameters in multiple ecosystems is necessary to determine whether these mechanisms explain the lack of symbiotic N fixers-and thus the maintenance of N limitation-in old-growth forests.

  5. Evolutionary tradeoffs can select against nitrogen fixation and thereby maintain nitrogen limitation

    PubMed Central

    Menge, Duncan N. L.; Levin, Simon A.; Hedin, Lars O.

    2008-01-01

    Symbiotic nitrogen (N) fixing trees are absent from old-growth temperate and boreal ecosystems, even though many of these are N-limited. To explore mechanisms that could select against N fixation in N-limited, old-growth ecosystems, we developed a simple resource-based evolutionary model of N fixation. When there are no costs of N fixation, increasing amounts of N fixation will be selected for until N no longer limits production. However, tradeoffs between N fixation and plant mortality or turnover, plant uptake of available soil N, or N use efficiency (NUE) can select against N fixation in N-limited ecosystems and can thereby maintain N limitation indefinitely (provided that there are losses of plant-unavailable N). Three key traits influence the threshold that determines how large these tradeoffs must be to select against N fixation. A low NUE, high mortality (or turnover) rate and low losses of plant-unavailable N all increase the likelihood that N fixation will be selected against, and a preliminary examination of published data on these parameters shows that these mechanisms, particularly the tradeoff with NUE, are quite feasible in some systems. Although these results are promising, a better characterization of these parameters in multiple ecosystems is necessary to determine whether these mechanisms explain the lack of symbiotic N fixers—and thus the maintenance of N limitation—in old-growth forests. PMID:18223153

  6. Open reduction and temporary internal fixation of a subacute elbow dislocation.

    PubMed

    Neuhaus, Valentin; Alqueza, Arnold; Mudgal, Chaitanya S

    2012-05-01

    We present the case of a 61-year-old woman with a subacute elbow dislocation, who was referred to our institution 4 weeks after a fall. She was treated with open reduction and temporary bridging internal fixation through a posterior approach with a limited contact dynamic compression plate. After 4 weeks, the hardware was removed. One year postoperatively, the patient had nearly pain-free motion of 20° short of full extension and full flexion. Her radiographs showed residual incongruity and degenerative arthritis of the elbow.

  7. Treatment of Spinal Tuberculosis by Debridement, Interbody Fusion and Internal Fixation via Posterior Approach Only.

    PubMed

    Tang, Ming-xing; Zhang, Hong-qi; Wang, Yu-xiang; Guo, Chao-feng; Liu, Jin-yang

    2016-02-01

    Surgical treatment for spinal tuberculosis includes focal tuberculosis debridement, segmental stability reconstruction, neural decompression and kyphotic deformity correction. For the lesions mainly involved anterior and middle column of the spine, anterior operation of debridement and fusion with internal fixation has been becoming the most frequently used surgical technique for the spinal tuberculosis. However, high risk of structural damage might relate with anterior surgery, such as damage in lungs, heart, kidney, ureter and bowel, and the deformity correction is also limited. Due to the organs are in the front of spine, there are less complications in posterior approach. Spinal pedicle screw passes through the spinal three-column structure, which provides more powerful orthopedic forces compared with the vertebral body screw, and the kyphotic deformity correction effect is better in posterior approach. In this paper, we report a 68-year-old male patient with thoracic tuberculosis who underwent surgical treatment by debridement, interbody fusion and internal fixation via posterior approach only. The patient was placed in prone position under general anesthesia. Posterior midline incision was performed, and the posterior spinal construction was exposed. Then place pedicle screw, and fix one side rod temporarily. Make the side of more bone destruction and larger abscess as lesion debridement side. Resect the unilateral facet joint, and retain contralateral structure integrity. Protect the spinal cord, nerve root. Clear sequestrum, necrotic tissue, abscess of paravertebral and intervertebral space. Specially designed titanium mesh cages or bone blocks were implanted into interbody. Fix both side rods and compress both sides to make the mesh cages and bone blocks tight. Reconstruct posterior column structure with allogeneic bone and autologous bone. Using this technique, the procedures of debridement, spinal cord decompression, deformity correction, bone grafting

  8. A novel internal fixator device for peripheral nerve regeneration.

    PubMed

    Chuang, Ting-Hsien; Wilson, Robin E; Love, James M; Fisher, John P; Shah, Sameer B

    2013-06-01

    Recovery from peripheral nerve damage, especially for a transected nerve, is rarely complete, resulting in impaired motor function, sensory loss, and chronic pain with inappropriate autonomic responses that seriously impair quality of life. In consequence, strategies for enhancing peripheral nerve repair are of high clinical importance. Tension is a key determinant of neuronal growth and function. In vitro and in vivo experiments have shown that moderate levels of imposed tension (strain) can encourage axonal outgrowth; however, few strategies of peripheral nerve repair emphasize the mechanical environment of the injured nerve. Toward the development of more effective nerve regeneration strategies, we demonstrate the design, fabrication, and implementation of a novel, modular nerve-lengthening device, which allows the imposition of moderate tensile loads in parallel with existing scaffold-based tissue engineering strategies for nerve repair. This concept would enable nerve regeneration in two superposed regimes of nerve extension--traditional extension through axonal outgrowth into a scaffold and extension in intact regions of the proximal nerve, such as that occurring during growth or limb-lengthening. Self-sizing silicone nerve cuffs were fabricated to grip nerve stumps without slippage, and nerves were deformed by actuating a telescoping internal fixator. Poly(lactic co-glycolic) acid (PLGA) constructs mounted on the telescoping rods were apposed to the nerve stumps to guide axonal outgrowth. Neuronal cells were exposed to PLGA using direct contact and extract methods, and they exhibited no signs of cytotoxic effects in terms of cell morphology and viability. We confirmed the feasibility of implanting and actuating our device within a sciatic nerve gap and observed axonal outgrowth following device implantation. The successful fabrication and implementation of our device provides a novel method for examining mechanical influences on nerve regeneration.

  9. Ensuring precision in lower limb deformity correction through a combination of temporary external fixation followed by internal fixation: Results of a retrospective study

    PubMed Central

    Ganjwala, Dhiren; Shah, Shrenik; Shah, Snehal

    2014-01-01

    Background: It is important to plan preoperatively when contemplating internal fixation following deformity correction. Surgeons often find it difficult to retain the achieved correction till the end of internal fixation. To maintain precise correction we used hybrid technique which uses both external and internal fixation. The objective of the study was to evaluate the effectiveness of this hybrid technique in achieving and retaining desired correction. Materials and Methods: In this retrospective study, we evaluated the magnitude of deformity with radiological parameters. We compared correction which was planned and correction which was achieved. The technique was used during surgery for corrective osteotomies. Before carrying out the osteotomy, rail fixator with two swivel clamps was applied. After osteotomy swivel clamps were loosened. Desired correction was achieved. While fixator held the fragments in corrected position, definitive internal fixation was carried out. External fixator was removed after completion of internal fixation. Position of mechanical axis ratio, mechanical lateral distal femoral angle and mechanical medial proximal tibial angle were measured before and 12 weeks after surgery. Student t-test was used to analyze the difference between correction which was planned and correction which was achieved. Results: There was no statistical difference between the desired correction and the correction achieved. Conclusions: Temporary use of external fixator while correcting angular deformities of lower limb allows to achieve accurate correction. PMID:25298557

  10. Open reduction internal fixation for proximal humerus fractures indications, techniques, and pitfalls.

    PubMed

    Shulman, Brandon S; Egol, Kenneth A

    2013-01-01

    Proximal humerus fractures account for approximately 5% of all fractures. It is estimated that due to our aging population, orthopaedic surgeons will see a three-fold increase in proximal humerus fractures over the next 30 years. Internal fixation with locked plating is the current mainstay of treatment for functionally active patients who desire minimal loss of function. A thorough understanding of the indications, techniques, and drawbacks of treatment with internal fixation is essential to achieve the highest quality of patient care.

  11. Treatment of Early Post-op Wound Infection after Internal Fixation

    DTIC Science & Technology

    2015-10-01

    Approximately 10%-40% of severe fractures fixed with internal fixation develop a deep wound infection during the healing process. Thus, the overall...stable while the bone heals. Approximately 10%-40% of severe fractures fixed with internal fixation develop a deep wound infection during the...a web based system we be able to track medication adherence in a similar fashion as we did with the GlowCaps. The amendment including this adherence

  12. Effect of cortical thickness and cancellous bone density on the holding strength of internal fixator screws.

    PubMed

    Seebeck, J; Goldhahn, J; Städele, H; Messmer, P; Morlock, M M; Schneider, E

    2004-11-01

    Internal fixators are a new class of implants designed to preserve the periosteal blood supply of the bone. In contrast to conventional plate fixation in which the screws have spherical heads and are loaded mainly by axial pullout forces, screws in internal fixators are "locked" within the plate and therefore subjected to axial as well as bending loads. In this study the ultimate loads of screws of a commercially available internal fixator system were tested in a pullout (n = 72) and cantilever bending mode (n = 72) in metaphyseal and diaphyseal regions of four pairs of human tibiae with different bone qualities. Cortical thickness and cancellous bone density were determined at the screw insertion sites. Stepwise multiple linear regression revealed that cortical thickness and cancellous density can explain 93% and 98% of the variance of the ultimate load of the screws in an axial pullout and cantilever bending mode. Screws in internal fixators are better suited to transmit shear forces and thereby make better use of the strength potential of bone than screws used in conventional plate fixation: this is especially advantageous when bone strength is reduced, e.g. due to osteoporosis.

  13. Clamping stiffness and its influence on load distribution between paired internal spinal fixation devices.

    PubMed

    Rohlmann, A; Calisse, J; Bergmann, G; Radvan, J; Mayer, H M

    1996-06-01

    The load distribution between two internal spinal fixation devices depends, besides other factors, on their stiffness. The stiffness ranges were determined experimentally for the clamps of the AO internal fixator with lateral nut and with posterior nut as well as for the clamps of the SOCON fixator. The stiffness of eight devices each differed by a factor of 3.1 for the clamp with lateral nut, by a factor of 1.5 for the clamp with posterior nut, and by a factor of 1.4 for the clamp of the SOCON fixator. For the AO clamp with lateral nut, the influence of the nut-tightening torque on the stiffness was determined. Using instrumented internal spinal fixation devices mounted to plastic vertebrae and simulating a corpectomy, the load distribution between the implants was measured for different tightening torques. It could be shown that, for the AO internal fixator whose clamps have a lateral nut, a nut-tightening torque > 5 Nm has only a negligible influence on load-sharing between the implants. Tooth damage occurs when the teeth of the clamp body and clamping jaw of the clamp with lateral nut do not gear together exactly, which leads to changes in the clamping stiffness and load-sharing between the two implants.

  14. The use of pedicle-screw internal fixation for the operative treatment of spinal disorders.

    PubMed

    Gaines, R W

    2000-10-01

    Pedicle screws have dramatically improved the outcomes of spinal reconstruction requiring spinal fusion. Short-segment surgical treatments based on the use of pedicle screws for the treatment of neoplastic, developmental, congenital, traumatic, and degenerative conditions have been proved to be practical, safe, and effective. The Funnel Technique provides a straightforward, direct, and inexpensive way to very safely apply pedicle screws in the cervical, thoracic, or lumbar spine. Carefully applied pedicle-screw fixation does not produce severe or frequent complications. Pedicle-screw fixation can be effectively and safely used wherever a vertebral pedicle can accommodate a pedicle screw--that is, in the cervical, thoracic, or lumbar spine. Training in pedicle-screw application should be standard in orthopaedic training programs since pedicle-screw fixation represents the so-called gold standard of spinal internal fixation.

  15. Functional outcome after successful internal fixation versus salvage arthroplasty of patients with a femoral neck fracture

    PubMed Central

    Zielinski, Stephanie M.; Keijsers, Noël L.; Praet, Stephan F.E.; Heetveld, Martin J.; Bhandari, Mohit; Wilssens, Jean Pierre; Patka, Peter; Van Lieshout, Esther M.M.

    2014-01-01

    Objectives To determine patient independency, health-related and disease-specific quality of life (QOL), gait pattern, and muscle strength in patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture. Design Secondary cohort study to a randomized controlled trial. Setting Multicenter trial in the Netherlands, including 14 academic and non-academic hospitals Patients Patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture were studied. A comparison was made with patients who healed uneventfully after internal fixation. Intervention None (observatory study) Main outcome measurements Patient characteristics, SF-12, and WOMAC scores were collected. Gait parameters were measured using plantar pressure measurement. Maximum isometric forces of the hip muscles were measured using a handheld dynamometer. Differences between the fractured and contralateral leg were calculated. Groups were compared using univariate analysis. Results Of 248 internal fixation patients (median age 72 years), salvage arthroplasty was performed in 68 patients (27%). Salvage arthroplasty patients had a significantly lower WOMAC score (median 73 versus 90, P=0.016) than patients who healed uneventfully after internal fixation. Health-related QOL (SF-12) and patient independency did not differ significantly between the groups. Gait analysis showed a significantly impaired progression of the center of pressure in the salvage surgery patients (median ratio −8.9 versus 0.4, P=0.013) and a significant greater loss of abduction strength (median −25.4 versus −20.4 N, P=0.025). Conclusion Despite a similar level of dependency and QOL, salvage arthroplasty patients have inferior functional outcome than patients who heal after internal fixation of a femoral neck fracture. PMID:24835623

  16. Internal fixation versus arthroplasty for displaced femoral neck fractures: what is the evidence?

    PubMed

    Heetveld, Martin J; Rogmark, Cecilia; Frihagen, Frede; Keating, John

    2009-07-01

    A review of the current evidence for internal fixation versus hemiarthroplasty versus primary total hip arthroplasty for displaced femoral neck fractures was undertaken. At the meta-analysis level no difference in postoperative pain, function, or quality of life can yet be demonstrated. A significant difference in mortality has also not been found, but a trend towards higher mortality after primary arthroplasty is possible. Internal fixation (IF) has less morbidity, but a higher risk of revision and less cost-effectiveness. Independent adjudication for IF technique is rare in studies and bias towards higher revision rates due to technical failure is an issue. Randomized trials comparing IF with arthroplasty remain underpowered in specific subgroups of patients, in which IF revision rates could be acceptable. In hemiarthroplasty the data suggest minimal differences in outcome between the prosthesis types. The cementless Austin-Moore prosthesis is out-dated. Currently a cemented unipolar or bipolar, depending on costs, hemi-arthroplasty is the treatment of choice for an elderly patient with functional limitations before the fracture. The role of modern, uncemented hemiarthroplasty designs are uncertain until more data are published. Total hip arthroplasty (THA) should be considered in any active older patient with a displaced femoral neck fracture. Patients with concomitant osteoarthritis, rheumatoid arthritis, or renal failure do poorly with other treatment options and should be treated with THA. Randomized trials have shown THA to be a cost-effective treatment with lower revision rates than IF. THA may also appear to be superior to hemiarthroplasty in specific subgroups, but larger trials are needed to confirm this observation.

  17. Flavone Limitations to Root Nodulation and Symbiotic Nitrogen Fixation in Alfalfa 1

    PubMed Central

    Kapulnik, Yoram; Joseph, Cecillia M.; Phillips, Donald A.

    1987-01-01

    Transcription of the nodABC genes in Rhizobium meliloti is required for root nodule formation in alfalfa (Medicago sativa L.) and occurs when specific compounds, such as the flavone luteolin, are supplied by the host plant. Results reported here indicate how luteolin in the root and rhizosphere can affect subsequent N2 fixation and plant growth. Previous experiments with `Hairy Peruvian 32' (HP32), an alfalfa population produced from `Hairy Peruvian' (HP) by two generations of selection for increased N2 fixation and growth, found that HP32 had more root nodules and fixed more N2 than the parental HP population. In the present study, flavonoid extracts of HP32 seedling roots are shown to contain a 60% higher concentration of compounds that induce transcription of a nodABC-lacZ fusion in R. meliloti than comparable extracts of HP roots. Chromatographic data indicated that HP32 roots had a 77% higher concentration of luteolin than HP roots. Adding 10 micromolar luteolin to the rhizosphere of HP seedlings increased nodulation, N2 fixation, total N, and total dry weight but had no effect on nitrate assimilation. These data show that normal levels of flavone nodulation signals in the rhizosphere of HP alfalfa can limit root nodulation, symbiotic N2 fixation, and seedling growth and suggest that one mechanism for increasing N2 fixation can be the genetic enhancement of specific biochemical signals which induce nodulation genes in Rhizobium. PMID:16665583

  18. An Overview of Internal Fixation Implant Metallurgy and Galvanic Corrosion Effects.

    PubMed

    Koh, Justin; Berger, Aaron; Benhaim, Prosper

    2015-08-01

    Orthopedic and hand surgery implants for internal fixation of fractures have evolved substantially over the past 50 years. Newer metal compositions have been used, and new standards have been applied to older alloys, resulting in modern implants with unique physical properties and better clinical performances. Conventional wisdom has long dictated that implanting different metals should be avoided, but few guidelines exist regarding the safety of using in proximity implant systems of dissimilar metals. To better characterize the landscape of internal fixation implant metallurgy, we have compiled the recommendations and conclusions of the currently available and pertinent literature.

  19. Subluxation of the hip joint after internal fixation of a trochanteric fracture.

    PubMed

    Kaneko, Kazuo; Murotani, Rentaroh; Mogami, Atsuhiko; Okahara, Hitoshi; Ohbayashi, Osamu; Iwase, Hideaki; Fujita, Hidemine; Kurosawa, Hisashi

    2004-02-01

    The authors report an unusual case of hip subluxation after internal fixation without associated sepsis. We report one recently treated case in which a 75-year-old female experienced subluxation of her hip joint after open reduction and internal fixation for a trochanteric fracture. In this paper, we describe a case of progressive, spontaneous subluxation of the hip joint over several weeks. Most previously reported cases are associated with cerebral palsy. This entity has not been reported previously. Our patient was treated by hemi-arthroplasty and repair of the disrupted capsule, and achieved a good long-term functional result. The cause of this particular condition is discussed.

  20. Internal polarization limits coronagraph contrast

    NASA Astrophysics Data System (ADS)

    Breckinridge, James Bernard; Lam, Wai Sze T.; Chipman, Russell A.

    2015-08-01

    The performance of exoplanet imaging coronagraphs is limited by internal polarization. The point spread function (PSF) of these systems is determined by the details of the opto-mechanical layout selected to package the system and by the highly reflective metal thin films needed to maintain high optical system transmittance. To obtain the high contrast levels needed for terrestrial exoplanet science requires a comprehensive understanding of the vector electromagnetic wave from the source through the system. The literature contains many studies of polarization transmissivity of telescopes and instruments for the purpose of photo-polarimetry. Here we report for the first time the effects of polarization on high-performance image quality.We modeled a typical 2.4-meter Cassegrain telescope system with one 90-degree fold mirror and analyzed the system for polarization aberrations.We find: 1. The image plane irradiance distribution is the linear superposition of four PSF images: One for each of the two orthogonal polarizations and one for each of two cross-product polarization terms. 2. The PSF image is brighter by 9% for one polarization component compared to its orthogonal state. 3. The image of the PSF for orthogonal components are shifted across the focal plane with respect to each other, causing the PSF image for astronomical sources (polarized or unpolarized) to become slightly elongated (elliptical) with a centroid separation of about 0.6 masec. 4. The orthogonally polarized components of unpolarized sources contain different wavefront aberrations, which are separated by approximately 32 milliwaves. This implies that a wavefront correction system cannot optimally correct the aberrations for all polarizations simultaneously. 5. The polarization aberrations couple small parts (~1E-5) of each polarization component of the light into the orthogonal polarization to create highly distorted secondary, or “ghost” PSF image.. The radius of the spatial extent of the 90

  1. COMPARISON OF VOLUMES OCCUPIED BY DIFFERENT INTERNAL FIXATION DEVICES FOR FEMORAL NECK FRACTURES

    PubMed Central

    Lauxen, Daniel; Schwartsmann, Carlos Roberto; Silva, Marcelo Faria; Spinelli, Leandro de Freitas; Strohaecker, Telmo Roberto; Souza, Ralf Wellis de; Zimmer, Cinthia Gabriely; Boschin, Leonardo Carbonera; Gonçalves, Ramiro Zilles; Yépez, Anthony Kerbes

    2015-01-01

    Objective: The objective of this paper is to measure the volume occupied by the most widely used internal fixation devices for treating femoral neck fractures, using the first 30, 40 and 50 mm of insertion of each screw as an approximation. The study aimed to observe which of these implants caused least bone aggression. Methods: Five types of cannulated screws and four types of dynamic hip screws (DHS) available on the Brazilian market were evaluated in terms of volume differences through water displacement. Results: Fixation with two cannulated screws presented significantly less volume than shown by DHS, for insertions of 30, 40 and 50 mm (p=0.01, 0.012 and 0.013, respectively), fixation with three screws did not show any statistically significant difference (p= 0.123, 0.08 and 0.381, respectively) and fixation with four cannulated screws presented larger volumes than shown by DHS (p=0.072, 0.161 and 0.033). Conclusions: Fixation of the femoral neck with two cannulated screws occupied less volume than DHS, with a statistically significant difference. The majority of screw combinations did not reach statistical significance, although fixation with four cannulated screws presented larger volumes on average than those occupied by DHS. PMID:27047886

  2. Clinical results of using the proximal humeral internal locking system plate for internal fixation of displaced proximal humeral fractures.

    PubMed

    Norouzi, Masoud; Naderi, Mohammad Nasir; Komasi, Mehdi Hemmati; Sharifzadeh, Seyyed Reza; Shahrezaei, Mostafa; Eajazi, Alireza

    2012-05-01

    Proximal humerus fractures are accounting for 4-5% of all fractures with increasing incidence. Proximal Humeral Internal Locking System (PHILOS) plate is a new plate which permits early mobility and lowers the risk of complications. The aim of this study was to evaluate the functional outcome and the complication rate after using this plate. Between 2006-2008, 37 patients with displaced 2-, 3-, and 4-part fractures of the proximal humerus underwent surgery using PHILOS plate. The mean range of follow-up was 12 months. Twenty patients were aged 60 years and younger, and 17 were aged older than 60 years. The average American Shoulder and Elbow Surgeons (ASES) score at the final follow-up was 77.62. According to Michener and colleagues classification, 5.4% of patients had an excellent outcome, 72.9% were minimally functionally limited, 16.2% were moderately functionally limited, and 5.4% were maximally functionally limited. The average ASES score between patients 60 years and older and those 60 years and younger was not different significantly. One patient developed avascular necrosis of the humeral head, 2 patients developed an infection, and no patients developed a nonunion. Fixation with PHILOS plate can be considered a good method with high union rates for this kind of fracture, especially in the older population with osteoporotic bone.

  3. Molybdenum and phosphorus limitation of moss-associated nitrogen fixation in boreal ecosystems.

    PubMed

    Rousk, Kathrin; Degboe, Jefferson; Michelsen, Anders; Bradley, Robert; Bellenger, Jean-Philippe

    2017-04-01

    Biological nitrogen fixation (BNF) performed by moss-associated cyanobacteria is one of the main sources of new nitrogen (N) input in pristine, high-latitude ecosystems. Yet, the nutrients that limit BNF remain elusive. Here, we tested whether this important ecosystem function is limited by the availability of molybdenum (Mo), phosphorus (P), or both. BNF in dominant mosses was measured with the acetylene reduction assay (ARA) at different time intervals following Mo and P additions, in both laboratory microcosms with mosses from a boreal spruce forest and field plots in subarctic tundra. We further used a (15) N2 tracer technique to assess the ARA to N2 fixation conversion ratios at our subarctic site. BNF was up to four-fold higher shortly after the addition of Mo, in both the laboratory and field experiments. A similar positive response to Mo was found in moss colonizing cyanobacterial biomass. As the growing season progressed, nitrogenase activity became progressively more P limited. The ARA : (15) N2 ratios increased with increasing Mo additions. These findings show that N2 fixation activity as well as cyanobacterial biomass in dominant feather mosses from boreal forests and subarctic tundra are limited by Mo availability.

  4. Finite element analysis of the stability of combined plate internal fixation in posterior wall fractures of acetabulum

    PubMed Central

    Liu, Xi-Ming; Pan, Chang-Wu; Wang, Guo-Dong; Cai, Xian-Hua; Chen, Lei; Meng, Cheng-Fei; Huang, Jin-Cheng

    2015-01-01

    Objective: This study aims to explore the mechanical stability of combined plate internal fixation in posterior wall fractures of the acetabulum. Methods: The fracture and internal fixation models were established in this study and they were divided into four kinds of internal fixation models, finite element analysis was performed. The four groups were 2 mini-plates and 1 reconstruction plate fixation (A), Reconstruction plate internal fixation group (B), 2 screws internal fixation group (C) and mini-plates internal fixation group (D). The displacement of each node was measured and evaluated. Results: There was no distortion in the geometric shape of the finite element model. The results of stress showed that it was less in the anterior pelvic ring and distributed uniform in labrum acetabulare; the stress was bigger in the upper and middle of sacroiliac joint and sciatic notch in sitting position. Conclusions: Combined plate internal fixation for posterior wall fractures of acetabular were stable and reliable, it is better than the other three methods. PMID:26550272

  5. Conversion of failed proximal femoral internal fixation to total hip arthroplasty in osteopetrotic bone.

    PubMed

    Ramiah, Reagon D; Baker, Richard P; Bannister, Gordon C

    2006-12-01

    Osteopetrosis is a rare disease. When fractures are encountered, fixation is extremely difficult. A 38-year-old man with osteopetrosis who sustained a displaced Pauwels type IV fracture with 3 failed internal fixations required total hip arthroplasty. Two main problems were perceived during preoperative planning: the removal of failed and broken metalwork and reaming of the tight intramedullary canal to allow seating of the femoral stem. We present technical solutions to aid the surgeon in the management of this difficult type of case using custom-made tungsten carbide instrumentation.

  6. 1-stage primary arthroplasty of mechanically failed internally fixated of hip fractures with deep wound infection

    PubMed Central

    Klatte, Till O; O’Loughlin, Padraigh F; Citak, Mustafa; Rueger, Johannes M; Gehrke, Thorsten; Kendoff, Daniel

    2013-01-01

    Background and purpose Mechanically failed internal fixation following hip fracture is often treated by salvage arthroplasty. If deep wound infection is present, a 2-stage procedure is often used. We have used a 1-stage procedure in infected cases, and we now report the outcome. Patients and methods We reviewed 16 cases of deep wound infection after mechanically failed hip fracture fixation, treated between 1994 and 2010. In all patients, a joint prosthesis was implanted in a 1-stage procedure. Results After an average follow-up period of 12 (2–18) years, no reinfection was detected. In 4 cases, a hip dislocation occurred and 3 of these needed further surgery. Interpretation A 1-stage procedure for arthroplasty of an infected, mechanically failed hip fracture fixation is feasible and carries a low risk of infection. PMID:23799345

  7. Surgical site infection complicating internal fixation of fractures: incidence and risk factors.

    PubMed Central

    Thanni, Lateef O. A.; Aigoro, Nofiu O.

    2004-01-01

    BACKGROUND: There is a dearth of data on surgical site infections (SSIs) complicating internal fixation of fractures from Nigeria. AIMS: To determine the incidence and risk factors for SSIs following internal fixation of fracture. METHODS: A cohort of 90 patients with long bone fractures that were stabilized internally with metallic devices was studied prospectively and retrospectively. RESULTS: The incidence of SSI was 12%. The isolated organisms were Staphylococcus aureus in four patients, Pseudomonas spp. in three, and Escherichia coli in one patient. Diabetes mellitus and perioperative transfusion with allogeneic blood were not predictive of SSI. Duration of operation longer than 120 minutes was a strong predictor (OR 2.25, 95% CL 0.48-10.16). Other risk factors were male sex (OR 2.01, 95% CL 0.44-10.45), injury-operation interval less than six months (OR 2.00, 95% CL 0.22-46.08), fracture fixation with plates and screws (OR 1.51, 95% CL 0.36-6.40), white blood cell count (WBC) less than 5,000 per cumm (OR 1.50, 95% CL 0.15-16.37), preoperative urinary catheterization (OR 1.48, 95% CL 0.00-16.19), and postoperative urinary catheterization (OR 1.24, 95% CL 0.29-5.00). CONCLUSION: The incidence of SSI after internal fixation of long bone fractures in our centers is 12%, and this is within the previously reported range. Use of plates and screws, WBC less than 5,000 per cumm, and perioperative urinary catheterization are important risk factors. PMID:15303412

  8. An electronically instrumented internal fixator for the assessment of bone healing

    PubMed Central

    Kowald, B.; Seide, K.; Aljudaibi, M.; Faschingbauer, M.; Juergens, C.; Gille, J.

    2016-01-01

    Objectives The monitoring of fracture healing is a complex process. Typically, successive radiographs are performed and an emerging calcification of the fracture area is evaluated. The aim of this study was to investigate whether different bone healing patterns can be distinguished using a telemetric instrumented femoral internal plate fixator. Materials and Methods An electronic telemetric system was developed to assess bone healing mechanically. The system consists of a telemetry module which is applied to an internal locking plate fixator, an external reader device, a sensor for measuring externally applied load and a laptop computer with processing software. By correlation between externally applied load and load measured in the implant, the elasticity of the osteosynthesis is calculated. The elasticity decreases with ongoing consolidation of a fracture or nonunion and is an appropriate parameter for the course of bone healing. At our centre, clinical application has been performed in 56 patients suffering nonunion or fracture of the femur. Results A total of 39 cases of clinical application were reviewed for this study. In total, four different types of healing curves were observed: fast healing; slow healing; plateau followed by healing; and non-healing. Conclusion The electronically instrumented internal fixator proved to be valuable for the assessment of bone healing in difficult healing situations. Cost-effective manufacturing is possible because the used electronic components are derived from large-scale production. The incorporation of microelectronics into orthopaedic implants will be an important innovation in future clinical care. Cite this article: B. Kienast, B. Kowald, K. Seide, M. Aljudaibi, M. Faschingbauer, C. Juergens, J. Gille. An electronically instrumented internal fixator for the assessment of bone healing. Bone Joint Res 2016;5:191–197. DOI: 10.1302/2046-3758.55.2000611. PMID:27226357

  9. Enhancement of Apoptosis by Titanium Alloy Internal Fixations during Microwave Treatments for Fractures: An Animal Study

    PubMed Central

    Zhang, Lina; Ye, Dongmei; Feng, Xianxuan; Fu, Tengfei; Bai, Yuehong

    2015-01-01

    Objective Microwaves are used in one method of physical therapy and can increase muscle tissue temperature which is useful for improving muscle, tendon and bone injuries. In the study, we sought to determine whether titanium alloy internal fixations influence apoptosis in tissues subjected to microwave treatments at 2,450 MHz and 40 W during the healing of fractures because this issue is not yet fully understood. Methods In this study, titanium alloy internal fixations were used to treat 3.0-mm transverse osteotomies in the middle of New Zealand rabbits’ femurs. After the operation, 30-day microwave treatments were applied to the 3.0 mm transverse osteotomies 3 days after the operation. The changes in the temperatures of the muscle tissues in front of the implants or the 3.0 mm transverse osteotomies were measured during the microwave treatments. To characterize the effects of titanium alloy internal fixations on apoptosis in the muscles after microwave treatment, we performed TUNEL assays, fluorescent real-time (quantitative) PCR, western blotting analyses, reactive oxygen species (ROS) detection and transmission electron microscopy examinations. Results The temperatures were markedly increased in the animals with the titanium alloy implants. Apoptosis in the muscle cells of the implanted group was significantly more extensive than that in the non-implanted control group at different time points. Transmission electron microscopy examinations of the skeletal muscles of the implanted groups revealed muscular mitochondrial swelling, vacuolization. ROS, Bax and Hsp70 were up-regulated, and Bcl-2 was down-regulated in the implanted group. Conclusion Our results suggest that titanium alloy internal fixations caused greater muscular tissue cell apoptosis following 2,450 MHz, 40 W microwave treatments in this rabbit femur fracture models. PMID:26132082

  10. Displaced Intra-Articular Fractures of the Distal Radius: Open Reduction With Internal Fixation Versus Bridging External Fixation

    PubMed Central

    Fakoor, Mohammad; Fakoor, Morteza; Mohammadhoseini, Payam

    2015-01-01

    Background: Distal radius fracture is common in all ages. Mobility and wrist function is important. The choice of treatment should aim for optimal function with minimal complications. Objectives: In this study we compared two surgical approaches, open reduction and internal fixation (ORIF) and closed reduction with external fixation (CR + EF), for treatment of intra-articular distal radius fractures. Patients and Methods: Ninety-four patients with distal radius fracture (type 3, 4 and 5 Fernandez classification) were treated with two surgical methods (ORIF and CR + EF); 55 were treated with CR + EF and 39 were treated with ORIF by different surgeons. All patients were assessed at the end of the first, third and sixth week; and then after the third, sixth and 12th month. At the end of the follow-up, all patients completed the Michigan hand outcome questionnaire (MHOQ). We compared radiological parameters of distal radius, range of motion (ROM) of the wrist, duration of rehabilitation, complication and patient satisfaction of the methods. Results: In our study, radiological findings for the ORIF group were radial inclination (RI): 19.35, radial length (RL): 10.35, radial tilt (RT): 8.92, and ulnar variance (UV): 1.64, while for the CR + EF group these were RI: 15.13, RL: 8, RT: 4.78, and UV: 0.27. The ROM for ORIF were flexion/extension (F/E): 137, Radial/Ulnar deviation (R/U): 52, and Supination/Pronation (S/P): 141, while for the CR + EF group these were F/E: 117, R/U: 40 and S/P: 116. Michigan hand outcome score for ORIF was 75% and for Ext. fix was 60%. The rate of complication with the ORIF method was 58% and in Ext. fix this was 69%. The patients in CR + EF had more than the ORIF course of physiotherapy and rehabilitation. Conclusions: In comparison of ORIF and CR + EF, all results including functional score, clinical and radiologic criteria were in favor of the ORIF method while there were less complications with this method. We believe that ORIF is a better

  11. Dorsal fracture-dislocation of the proximal interphalangeal joint: a comparative study of percutaneous Kirschner wire fixation versus open reduction and internal fixation.

    PubMed

    Aladin, A; Davis, T R C

    2005-05-01

    Nineteen patients with a dorsal fracture-dislocation of the proximal interphalangeal joint of a finger were treated with either closed reduction and transarticular Kirschner wire fixation (eight cases) or open reduction and internal fixation, using either one or two lag screws (six cases) or a cerclage wire (five cases). At a mean follow-up of 7 (range 6-9) years, most patients reported satisfactory finger function, even though some of the injuries healed with proximal interphalangeal joint incongruency (seven cases) or subluxation (four cases). Those treated by open reduction complained of more "loss of feeling" in the affected finger and those specifically treated by cerclage wire fixation reported more cold intolerance and had a significantly larger fixed flexion deformity (median, 30 degrees : range 18-38 degrees ) and a smaller arc of motion (median, 48 degrees : range 45-60 degrees ) at the proximal interphalangeal joint, despite having the best radiological outcomes. Closed reduction and transarticular Kirschner wire fixation produced satisfactory results, with none of the eight patients experiencing significant persistent symptoms despite a reduced arc of proximal interphalangeal joint flexion (median=75 degrees ; range 60-108 degrees ). The results of this relatively simple treatment appear at least as satisfactory as those obtained by the two techniques of open reduction and internal fixation, both of which were technically demanding.

  12. [Bone cement dry prosthetic with internal fixation treat senile osteoporotic femoral fractures].

    PubMed

    Jiang, Y; Rong, X X; Chen, P; Xu, Y J; Zhu, G X

    2017-03-01

    Objective: To explore the treatment of senile osteoporotic femoral fractures after using internal fixation of bone cement dry prosthetic. Methods: Twelve patients aged from 74 to 94 years with mean age of (84.0±2.5) years with internal fixation of bone cement dry prosthetic surgery who were treated at Department of Orthopaedics in Nanjing Medical University Affiliated Wuxi Second Hospital between May 2013 and May 2015 were retrospectively analyzed. There were 8 male and 4 female, 10 cases of tumble and 2 cases of traffic injury. The fracture types with AO type included 1 case of A1 type, 5 cases of A2 type, 3 cases of A3 type, 1 case of B1 type, 2 cases of B2 type. The steel plate internal fixation with bone cement dry prosthetic method was chosen to treat senile severe femoral fracture. Postoperative observation of postoperative pain assessment, hip joint activity and walking ability were evaluated. Paired simple t test and Wilcoxon rank sum test were used to compare the differences of pain score and the ability to walk. Results: Twelve cases received an average of (16.0±3.6) months follow-up. The average hospitalization days are (9.0±1.4) days and average of intraoperative time was (68.0±10.6) minutes. Intraoperative blood loss compared to normal was (106.0±24.2) ml. Patients began walking load and activities in two weeks. The gait and joint activities gradually restored and there were no obvious deformity and no loose internal fixation. All of the patients didn't have fracture shift with breaking plates or screws deformation and have no bone cement reaction. The walking ability was (4.1±0.9) points, the hip joint activities were 98.5°±7.7° and pain scores were 1.22±0.58 by Holden grading standards. The differences of walking ability (Z=-3.126, P<0.05) and pain scores (t=23.047, P<0.001) between pre- and post-operative were statistically significant. One patient had contralateral hip pain, 2 patients had lateral thigh pain, 10 patients returned to

  13. Seasonally dependent iron limitation of nitrogen fixation in tropical forests of karst landscapes

    NASA Astrophysics Data System (ADS)

    Winbourne, J. B.; Brewer, S.; Houlton, B. Z.

    2015-12-01

    Limestone tropical forests in karst topography are one of the most poorly studied ecosystems on Earth, and has been substantially cleared by human activities throughout much of Central America. This ecosystem is noted for its high level of plant productivity, biomass, endemism and biological diversity compared to nearby neighboring tropical forests on volcanic rock substrates (Brewer et al. 2002). A question remains as to how limestone tropical forests are able to maintain the high nutrient demands of plant photosynthesis and tree biomass growth. Here, we demonstrate that rates of nitrogen (N) fixation are higher in limestone versus volcanic soil substrates, with direct evidence for the emergence of seasonally dependent iron limitation of N fixation in limestone tropical forest. N fixation rates showed a three-fold increase in response to iron additions, especially during the wet season when N demands of the forest trees are highest. In contrast, adjacent forests growing on the more classical acidic volcanic soils showed no response to iron or other nutrient additions. Biologically available pools of iron were exceedingly low in the limestone forest site, consistent with the complexation of iron under high pH conditions. Biological acquisition of iron, as measured by the concentration of iron chelating compounds (i.e. siderophores), provided additional evidence for iron limitation of microbial processes in limestone tropical forests, where concentrations were six times higher than those at the volcanic site. Our results suggest that the functioning of limestone tropical forest is strongly regulated by interactions between iron, soil pH, and N cycling.

  14. Nitrogen limitation and nitrogen fixation during alkane biodegradation in a sandy soil.

    PubMed Central

    Toccalino, P L; Johnson, R L; Boone, D R

    1993-01-01

    We investigated nutrient limitations during hydrocarbon degradation in a sandy soil and found that fixed nitrogen was initially a limiting nutrient but that N limitation could sometimes be overcome by N2 fixation. Hydrocarbon biodegradation was examined in an unsaturated sandy soil incubated aerobically at 20 degrees C with propane or butane and various added nutrients. Propane and butane degradation proceeded similarly during the first 3 months of incubation. That is, bacteria in soil amended with N oxidized these hydrocarbons more rapidly than in controls without nutrient additions or in soil with added phosphate or trace minerals. Both propane- and butane-amended soil apparently became N limited after the initial available inorganic N was utilized, as indicated by a decrease in the rates of hydrocarbon degradation. After 3 months, propane and butane degradation proceeded differently. Bacteria in propane-degrading soil apparently remained N limited because propane degradation rates stayed low unless more N was added. In contrast, bacteria in butane-degrading soil appeared to overcome their N limitation because butane degradation rates later increased regardless of whether more N was added. Analyses of total N and acetylene reduction assays supported this apparent surplus of N in butane-amended soil. Total N was significantly (P < 0.01) higher in soil incubated with butane and no N amendments than in soil incubated with propane, even when the latter was amended with N. Acetylene reduction occurred only in butane-amended soil. These results indicate that N2 fixation occurred in butane-amended soil but not in propane-amended soil. PMID:8215369

  15. Ilizarov hybrid external fixation for fractures of the distal radius: Part II. Internal fixation versus Ilizarov hybrid external fixation: Stability as assessed by cadaveric simulated motion testing.

    PubMed

    Dunning, C E; Lindsay, C S; Bicknell, R T; Johnson, J A; King, G J; Patterson, S D

    2001-03-01

    The in vitro stability of an Ilizarov hybrid external fixator was compared with that of a dorsal 3.5-mm AO T-plate in 8 unpaired, fresh-frozen upper extremities. A specially designed testing device that used computer-controlled pneumatic actuators was used to simulate active finger, wrist, and forearm motions by applying loads to relevant tendons. A comminuted extra-articular distal radius fracture was modelled using a dorsally based wedge osteotomy. Fracture stability was assessed using an electromagnetic tracking device to measure motion across the fracture site after randomized application of the plate and the hybrid fixator. During simulated finger and wrist motions with the forearm pronated or supinated, motion of the distal fragment with the hybrid fixator applied was comparable to or statistically less than with the AO plate applied. During simulated forearm rotation, the stability provided by the 2 fixation types was similar, although the plate allowed statistically less radial-ulnar deviation of the fragment. In this model of a 2-part extra-articular distal radius fracture, the clinically meaningful stability of the Ilizarov hybrid external fixator was comparable to that of the dorsal AO plate.

  16. Assessment of nutrient limitation on the primary production and N2 fixation across the tropical Atlantic

    NASA Astrophysics Data System (ADS)

    Ridame, C.; Mills, M. M.; Davey, M.; Laroche, J.; Geider, R.

    2003-04-01

    In the surface layer of the Tropical North Atlantic, Saharan dust inputs, as a source of iron and phosphate, might preferentially stimulate the growth of diazotrophs. The availability of iron, essential for the synthesis of the nitrogenase enzyme, and/or phosphorus through dust inputs is suspected to impose additional control on N_2 fixation in these waters chronically low in dissolved inorganic nitrogen. Here, we present results from the cruise M-55 (October--November 2002, SOLAS Program) in the tropical Atlantic (11^oN) between Curacao and Cameroon that address this hypothesis. The studied area was particularly interesting because it is characterized by a nutrient gradient from oligotrophic waters (Caribbean Sea) to upwelling dominated regions (NW Africa) and is also subject to a strong lateral gradient of inputs from Saharan mineral aerosol. Using trace metal clean methods, nutrient addition bioassays were used to asses which nutrient (N, P, and Fe) most likely limits of phytoplankton biomass, primary productivity and dinitrogen fixation in incubation experiments along the transect. An additional Saharan dust treatment, considered as a proxy for Saharan aerosol, was used to simulate an atmospheric Saharan dust input into the surface layer.

  17. Open Reduction and Internal Fixation of Displaced Calcaneum, Intra-Articular Fractures by Locking Calcaneal Plate

    PubMed Central

    Santosha; Singh, Arambam Mahendra; Waikhom, Sanjib; Pakhrin, Vishal; Mukherjee, Sagnik; Debbarma, Rajkumar; Prashant, Prabhu Shrinivas

    2016-01-01

    Introduction Calcaneal fractures constitute the most common fractures in hindfoot. Lots of controversies exist in the management of calcaneal fractures but now-a-days, it is preferable to perform open reduction and internal fixation and early mobilizatation. Aim To evaluate the functional outcome after open reduction and internal fixation of displaced intra-articular fractures of the calcaneum by locking calcaneal plate. Materials and Methods The study was conducted in the Department of Orthopaedic Surgery from September 2013 to April 2016. Thirty intra-articular fractures of the calcaneum were treated by locking calcaneal plate. Patients were followed up for a period of 24 months. Bohler’s angle was measured in preoperative, immediate Post-operative period and after 2 years, follow-up was compared. Results were evaluated according to American Orthopaedic Foot and Ankle Society (AOFAS) Score. Results After 24 months of follow-up, all 24 patients were available for evaluation. Radiological union was achieved in a mean time of 12.5 weeks. Mean duration of hospital stay was 21 days. Bohler’s angle was significantly higher after 2 years of follow-up when compared with preoperative x-ray. According to the AOFAS, Ankle–Hind foot Scale outcome score results were excellent in 43.3% of the patients, good in 33.3%, fair in 10%, and poor in 13.3% of patients. The mean AOFAS score was 79.9 (Range 49-96). Conclusion Open reduction and internal fixation of intra-articular fractures of the calcaneum with locking calcaneal plate gives good results. Maintenance of calcaneal height and Bohler’s angle helps to decrease the incidence of subtalar arthritis. PMID:28208957

  18. Rigid internal fixation and the effects on the temporomandibular joint and masticatory system: a prospective study.

    PubMed

    Smith, V; Williams, B; Stapleford, R

    1992-12-01

    A prospective study of 22 patients who underwent a bilateral sagittal osteotomy to advance the mandible and subsequent rigid internal fixation, were examined for signs and symptoms of temporomandibular joint (TMJ) pain and masticatory dysfunction. A modified Helkimo index was used to analyze the anamnestic, clinical, and occlusal data. In addition, 12 of the cases chosen at random were mounted on a semiadjustable (SAM2) articulator and analyzed with the mandibular position indicator (MPI) to determine the amount and the direction of condylar displacement postoperatively. Anamnestic dysfunction decreased because of a reported decrease in muscular pain, joint noise, headache frequency, and parafunctional habits postoperatively. Clinical dysfunction remained unchanged, with a decrease in muscular soreness but with an increased incidence of joint clicking of 7%. The increased incidence of temporomandibular joint pain postoperatively was 4%. Increase in clinical dysfunction was most often seen in women and older patients. Occlusal dysfunction decreased, with the majority of interferences remaining after surgery as a result of insufficient lingual crown torque of the maxillary buccal segments. Occlusion is thought to have played only a minor role in temporomandibular joint and masticatory dysfunction. Reduction in range of motion was 10%, indicating the added benefit of early mobilization with rigid internal fixation procedures. The MPI study found the condyles inferiorly or inferoposteriorly displaced less than 1 mm from their preoperative position. These findings suggest that rigid internal fixation had no adverse effects on the temporomandibular and masticatory system. The variable responses and results can be attributed, at least in part, to the heterogenous population of patients studied and the variations in surgical techniques employed.

  19. End-stage hindfoot arthrosis: outcomes of tibiocalcaneal fusion using internal and Ilizarov fixation.

    PubMed

    Crawford, Brooke; Watson, J Tracy; Jackman, James; Fissel, Brian; Karges, David E

    2014-01-01

    End-stage post-traumatic pantalar arthrosis from ankle, pilon, and talus fractures has often been complicated by infection, bone loss, and a soft tissue deficit. Patients can present with neuropathy, diabetes, tobacco use, and previously failed arthrodesis. Fusion in this population has been challenging, with nonunion rates up to 30%, often leading to amputation. We reviewed the results of a standardized protocol that combined simultaneous internal fixation with the Ilizarov technique to achieve fusion in high-risk patients. With institutional review board approval, a retrospective review of the patients treated with simultaneous internal fixation and an Ilizarov frame was undertaken. The records and radiographs allowed identification of the comorbidities and the presence or absence of successful fusion. Complications were acknowledged and treated. Fifteen patients had undergone the procedure. The mean follow-up period was 27.9 (range 9 to 67) months. Thirteen patients (86.67%) had had previous fusion failure. Twelve patients (80%) had developed post-traumatic arthrosis, 5 (33.33%) of whom had open injuries. All patients had 1 comorbidity, and 10 (66.67%) had multiple, including rheumatoid arthritis, diabetes (types 1 and 2), and smoking. Four patients (26.67%) presented with deep infection and bone loss. Union was achieved in 11 (73.33%), with 12 (80%) patients experiencing profound pain relief. Seven patients (46.67%) required symptomatic hardware removal. Three patients (20%) eventually underwent below-the-knee amputation for recalcitrant nonunion. Statistically significant correlations were found between smoking and wound infection and revision and between nonunion and amputation. Our results have indicated that combined internal fixation with Ilizarov application can provide a strong surgical option for the management of end-stage, pantalar arthritis. More studies are needed to compare the cohort outcomes and gait analysis in these patients with those who have

  20. Effectiveness of Hindfoot Arthrodesis by Stable Internal Fixation in Various Eichenholtz Stages of Neuropathic Ankle Arthropathy.

    PubMed

    Sundararajan, Silvampatty R; Srikanth, Kanchana P; Nagaraja, Handenahally S; Rajasekaran, Shanmuganathan

    The optimal time to treat neuropathic (Charcot) arthropathy of the ankle and peritalar joint is controversial because of the various treatment options available and the variable results reported in published studies. We sought to determine the outcome of hind foot arthrodesis with stable internal fixation in patients with different Eichenholtz stages of arthropathy. We prospectively studied patients with substantial disabilities caused by neuropathic arthropathy in deformed, unstable ankle and peritalar joints, with or without ulcerations, who had undergone treatment from July 2007 to December 2012. All patients underwent ankle arthrodesis, autologous iliac crest bone grafting, and subtalar joint arthrodesis, with or without talonavicular joint arthrodesis, fixed internally with an intramedullary hindfoot nail, with or without an additional plate or cancellous screws. Of the 33 enrolled patients, 9 (27.3%) had stage I, 13 (39.4%) had stage II, and 11 (33.3%) had stage III Charcot arthropathy. The cause of arthropathy was diabetes mellitus in 25 (75.8%) patients. The duration of symptoms ranged from 1 to 120 (median 7) months. The mean follow-up period was 40 (range 12 to 76) months and did not differ markedly among the groups. The hindfoot scores, rate of salvage or amputation, or complication rates did not differ significantly across Eichenholtz stage. For the patients with stage I, II, and III, the preoperative hindfoot score was 50, 49, and 48, respectively (p = .9). The corresponding postoperative scores were 68, 68, and 70 (p = .5). We found no evidence that the effectiveness of hindfoot arthrodesis by stable fixation varied across the Eichenholtz stage of Charcot arthropathy involving ankle and peritalar joint. Furthermore, we found that stable internal fixation and bone grafting using a hindfoot nail results in an 84.84% union rate and salvages the unstable and disabled foot in 90.9% of patients with ankle and peritalar Charcot arthropathy.

  1. Improved Intermittent-clamped Drainage in Lower Lumbar Internal Fixation: A Randomized Prospective Study

    PubMed Central

    Hao, Qing-Ying; Liu, Chu-Yin; Fu, Chan-Juan; Zhang, Xiao-Hua; Tan, Ming-Sheng

    2016-01-01

    Background: Continuous negative pressure drainage (CNPD) is widely used after lower lumbar internal fixation; however, it may cause tremendous blood loss and lead to postoperative hemorrhagic anemia. The present study explored the efficacy and safety of improved intermittent-clamped drainage (ICD) for lower lumbar internal fixation. Methods: This was a prospective study that included 156 patients with decompression of the spinal canal and internal fixation for the first time from January 2012 to December 2014. The patients were randomly divided into ICD group and CNPD group, and each group had 78 cases. A drainage tube was placed under the deep fascia in all patients within 10 min after the commencement of wound closure. The postoperative drainage amount at different time points, the hemoglobin level, and postoperative complications were recorded and compared between the two groups. Shapiro-Wilk test, independent samples t-test, and Mann-Whitney U-test were used in this study. Results: The drainage amount was significantly reduced in the ICD group, as compared with the CNPD group (Z = 10.74, P < 0.01). The mean total drainage amount (in ml) of the single-segment and two-segment procedures was significantly greater in the CNPD group than the ICD group (Z = 10.63 and 10.75, respectively; P < 0.01). For the adverse events, there was no significant difference in postoperative temperature, wound problem, and complications between the two groups. Conclusions: The present study showed a statistically significant reduction in postoperative drainage amount between ICD and CNPD groups, and ICD is an effective, convenient, and safe method for routine use in lower lumbar surgery. It is essential to focus on the effect of clamping drainage with long-segment surgical procedure and complex lumbar disease in the further investigation, as well as the effect of clamping on long-term functional outcomes. PMID:27900992

  2. Displaced avulsion of the ischial apophysis: a hamstring injury requiring internal fixation

    PubMed Central

    Servant, C. T.; Jones, C. B.

    1998-01-01

    A case is reported of an adolescent sprinter who was chronically disabled by pain after non-operative management for an acute hamstring injury. He had sustained an avulsion fracture of the ischial apophysis with displacement of 2.5 cm. Avulsion fractures of the ischial apophysis with displacement of 2 cm or more are unusual, but they frequently result in a symptomatic non-union, and early diagnosis, open reduction, and internal fixation is to be encouraged. 


 PMID:9773178

  3. Management of complications of open reduction and internal fixation of ankle fractures.

    PubMed

    Ng, Alan; Barnes, Esther S

    2009-01-01

    The management of complications resulting from the open reduction and internal fixation of ankle fractures is discussed in detail. The initial radiographic findings of the most common postsurgical complications of ankle fracture reduction are briefly discussed, namely lateral, medial, and posterior malleolar malunion or nonunion, syndesmotic widening, degenerative changes, and septic arthritis with or without concomitant osteomyelitis. Emphasis is placed on the management of these complications, with a review of the treatment options proposed in the literature, a detailed discussion of the authors' recommendations, and an inclusion of different case presentations.

  4. Sphagnum N and P Stoichiometry Indicates P-limitation on N2 Fixation in Ombrotrophic Bogs

    NASA Astrophysics Data System (ADS)

    Zivkovic, T.; Moore, T. R.; Disney, K.

    2015-12-01

    Biological N2 fixation is an important N input in ombrotrophic, nutrient poor and Sphagnum dominated bogs. As an energetically costly process, by which each N2 molecule is fixed to a cost of 16ATP molecules, N2 fixation might be P limited process. In this study we tested whether moss P and N concentrations, and N:P ratios could explain N2 fixation in the top 6cm photosynthetically active Sphagnum moss across eight ombrotrophic bogs along south-north geographical gradient in Ontario and Quebec. Under constant environmental conditions, we incubated subsamples of the surface Sphagnum mosses by using both, acetylene reduction assays (ARA) and 15N2 enriched method to measure N2 fixation rates. Same subsamples were later analyzed for N and P concentrations. Our preliminary data show that the increase of P concentration within moss capitula is related to a significant linear increase of ARA rates (R2=0.18, p<0.0001, N=150). N:P ratios showed a significant negative linear relationship with ARA (R2=0.34, p<0.0001, N=150) indicating that P limitation in the photosynthetically active part of mosses in bogs may also indicate P limitation on microbial N2 fixation

  5. Costs of internal fixation and arthroplasty for displaced femoral neck fractures: a randomized study of 68 patients.

    PubMed

    Rogmark, Cecilia; Carlsson, Ake; Johnell, Olof; Sembo, Ingemar

    2003-06-01

    We included in a prospective, randomized study 68 patients aged 70 years or older, with displaced cervical hip fractures. The patients were randomized to internal fixation with hook-pins (36) or primary arthroplasty (32) (total or hemiarthroplasty due to their prefracture status) and followed for 2 years. Patients with rheumatoid arthritis, mental confusion and/or residence in an institution were excluded. The postoperative stay in hospital, rehabilitation wards or nursing homes were recorded as well as complications and the costs of surgery. The aim of this study was to compare the accumulated costs of each method, during the first 2 years after the fracture. In the internal fixation group, 15/36 were considered failures, as compared to 1/32 in the arthroplasty group. As regards primary treatment of the fracture, the durations of surgery and hospital stay were shorter after internal fixation, but the total need for hospitalization/institutionalization was somewhat longer in these patients. The mean 2-year cost for a patient with internal fixation was USD 21,000 and of one with primary arthroplasty USD 15,000. We conclude that primary arthroplasty is a cost-efficient treatment. Considering the very much higher failure rate after internal fixation--leading to increased suffering for these patients--primary arthroplasty stands out as the best method for displaced fractures of the femoral neck.

  6. Finite element analysis of three patterns of internal fixation of fractures of the mandibular condyle.

    PubMed

    Aquilina, Peter; Chamoli, Uphar; Parr, William C H; Clausen, Philip D; Wroe, Stephen

    2013-06-01

    The most stable pattern of internal fixation for fractures of the mandibular condyle is a matter for ongoing discussion. In this study we investigated the stability of three commonly used patterns of plate fixation, and constructed finite element models of a simulated mandibular condylar fracture. The completed models were heterogeneous in the distribution of bony material properties, contained about 1.2 million elements, and incorporated simulated jaw-adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. This model was considerably larger and more complex than previous finite element models that have been used to analyse the biomechanical behaviour of differing plating techniques. The use of two parallel 2.0 titanium miniplates gave a more stable configuration with lower mean element stresses and displacements over the use of a single miniplate. In addition, a parallel orientation of two miniplates resulted in lower stresses and displacements than did the use of two miniplates in an offset pattern. The use of two parallel titanium plates resulted in a superior biomechanical result as defined by mean element stresses and relative movement between the fractured fragments in these finite element models.

  7. Nuclear Weapon Testing Limitations and International Security

    NASA Astrophysics Data System (ADS)

    Corden, Pierce S.

    2017-01-01

    For over 50 years stopping nuclear weapon tests has been sought to support achieving international security without nuclear weapons. Testing is the critical path beyond primitive fission devices, e.g. to develop thermonuclear weapons, reduce weight and volume and increase yield. The 1958 Geneva Conference of Experts considered ways to verify a test ban. With then-limitations on seismology, and lack of in-country monitoring and on-site inspections, the 1963 Limited Test Ban Treaty prohibits testing only in the atmosphere, outer space and under water, and is verified by National Technical Means. The US and USSR agreed to a limit of 150 kilotons on underground explosions in the 1970s-80s. The 1996 Comprehensive Nuclear-Test-Ban Treaty bans all nuclear explosions. Its International Monitoring System - seismic, hydroacoustic, infrasound and radionuclide sensors - is being used, and has easily detected testing by the DPRK. On-site inspections will be available under an in-force Treaty. A 2012 National Academy report concludes that cheating attempts would not undermine U.S. security, and the program for monitoring and extending the life of US weapons has succeeded since US testing ceased in 1992.

  8. 76 FR 18618 - Operating Limitations at Newark Liberty International Airport

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-04

    ... Federal Aviation Administration Operating Limitations at Newark Liberty International Airport AGENCY... amends the Order Limiting Operations at Newark Liberty International Airport (EWR) that published on May... Management Rule for LaGuardia Airport, John F. Kennedy International Airport, and Newark...

  9. Light-limited growth rate modulates nitrate inhibition of dinitrogen fixation in the marine unicellular cyanobacterium Crocosphaera watsonii.

    PubMed

    Garcia, Nathan S; Hutchins, David A

    2014-01-01

    Biological N2 fixation is the dominant supply of new nitrogen (N) to the oceans, but is often inhibited in the presence of fixed N sources such as nitrate (NO3-). Anthropogenic fixed N inputs to the ocean are increasing, but their effect on marine N2 fixation is uncertain. Thus, global estimates of new oceanic N depend on a fundamental understanding of factors that modulate N source preferences by N2-fixing cyanobacteria. We examined the unicellular diazotroph Crocosphaera watsonii (strain WH0003) to determine how the light-limited growth rate influences the inhibitory effects of fixed N on N2 fixation. When growth (µ) was limited by low light (µ = 0.23 d-1), short-term experiments indicated that 0.4 µM NH4+ reduced N2-fixation by ∼90% relative to controls without added NH4+. In fast-growing, high-light-acclimated cultures (µ = 0.68 d-1), 2.0 µM NH4+ was needed to achieve the same effect. In long-term exposures to NO3-, inhibition of N2 fixation also varied with growth rate. In high-light-acclimated, fast-growing cultures, NO3- did not inhibit N2-fixation rates in comparison with cultures growing on N2 alone. Instead NO3- supported even faster growth, indicating that the cellular assimilation rate of N2 alone (i.e. dinitrogen reduction) could not support the light-specific maximum growth rate of Crocosphaera. When growth was severely light-limited, NO3- did not support faster growth rates but instead inhibited N2-fixation rates by 55% relative to controls. These data rest on the basic tenet that light energy is the driver of photoautotrophic growth while various nutrient substrates serve as supports. Our findings provide a novel conceptual framework to examine interactions between N source preferences and predict degrees of inhibition of N2 fixation by fixed N sources based on the growth rate as controlled by light.

  10. Ureteral penetration caused by drilling during internal pelvic bone fixation: delayed recognition.

    PubMed

    Shin, Yu Seob; Park, Jong Hyuk; Raheem, Omer A; Jeong, Young Beom; Kim, Hyung Jin; Kim, Young Gon

    2013-06-01

    A 49-year-old man was referred to our department with profuse serous fluid discharge from a Penrose drain after undergoing internal fixation with metal screws for multiple pelvic bone fractures. A definite ureteral penetration was identified that was orientated from the lateral to the medial aspect of the right distal ureter. The patient was surgically treated with excision of the 2-cm injured ureteral segment, end-to-end ureteroureterostomy, and double J ureteral stent placement. To our knowledge, a penetrating ureteral injury caused by bone drilling has not been reported previously in the published literature. This case shows that surgeons who do pelvic surgery, including orthopedic surgeons, should be familiar with the anatomical relationship of the ureter and its potential injuries.

  11. Minimally-invasive internal fixation of extra-articular distal femur fractures using a locking plate: tricks of the trade.

    PubMed

    Ehlinger, M; Adam, P; Abane, L; Arlettaz, Y; Bonnomet, F

    2011-04-01

    Fractures of the distal femur are rare and occur in two distinct population categories: young patients after high energy traumas and elderly patients who fall from their full height, and often carry severe co-morbidities making especially difficult to manage theses complex injuries. In elderly patients the potential complications are numerous including infection, non-union and frequent function deterioration. We present a technique of minimally invasive internal fixation of the distal extra-articular femur using a locking plate and present the tricks of the trade to obtain successful reduction and achieve union. The hardware used includes plate fixation with a large fragment locking screw. This minimally invasive surgery combines stability of the internal fixation device with the principles of closed surgery, allowing early mobilization and immediate weight bearing to warrant good functional recovery.

  12. Internal Versus External Fixation for the Treatment of Distal Radial Fractures

    PubMed Central

    Zhang, Qingyu; Liu, Fanxiao; Xiao, Zhenyun; Li, Zhenfeng; Wang, Bomin; Dong, Jinlei; Han, Yong; Zhou, Dongsheng; Li, Jianmin

    2016-01-01

    Abstract Although a serious of meta-analyses have been published to compare the effects of internal versus external fixation (IF vs EF) for treating distal radial fractures (DRF), no consensus was obtained. By performing a systematic review of overlapping meta-analyses comparing IF versus EF for the treatment of distal radial fractures, we attempted to evaluate the methodology and reporting quality of these meta-analyses, interpret the source of discordant results, and therefore determine the dominant strategy for the treatment of distal radial fractures based on the best evidence currently. An electronic databases search was conducted in MEDLINE, Embase, and Cochrane library to retrieve meta-analyses comparing IF versus EF for treating DRF. Reference lists of relevant literatures were also screened manually to retrieve additional ones. Two investigators independently assessed the eligibility of retrieved articles using predefined inclusion and exclusion criteria. All characteristics as well as outcome variables including functional outcomes, range of motion, radiological results, and complication rates with relevant heterogeneity information presented in each included study were extracted. Heterogeneity was thought to be significant when I2 > 50%. We adopted the Oxford Levels of Evidence and the Assessment of Multiple Systematic Reviews (AMSTAR) Instrument to assess the methodological quality of every included study, and applied the Jadad decision algorithm to select studies with more likely reliable conclusions. A total of 8 studies met the inclusion criteria. The AMSTAR scores ranged from 5 to 9 with a median of 7.75. Following the Jadad algorithm, the meta-analyses with most reliable results can be selected based on the search strategies and application of selection. Finally, 2 meta-analyses with most RCTs and highest AMSTAR scores were selected in this systematic review of overlapping meta-analysis. The best available evidence suggested that compared with

  13. Limitations of Using Micro Computed Tomography to Predict Bone-Implant Contact and Mechanical Fixation

    PubMed Central

    Liu, Shuo; Broucek, Joseph; Virdi, Amarjit S.; Sumner, D. Rick

    2013-01-01

    SEM images. However, OV/TV was significantly, but weakly, correlated with implant pull-out strength (r=0.401, p=0.049) and energy to failure (r=0.435, p=0.035). Thus, the need for the 48 μm thick exclusion zone in the OV/TV program to avoid metal-induced artifacts with the scanner used in this study means that it is not possible to make bone measurements sufficiently close to the implant surface to obtain an accurate assessment of BIC. Current generation laboratory-based μCT scanners typically have voxel sizes of 6–8 μm or larger which will still not overcome this limitation. Thus, peri-implant bone measurements at these resolutions should only be used as a guide to predict implant fixation and should not be over-interpreted as a measurement of BIC. Newer generation laboratory-based μCT scanners have several improvements including better spatial resolution and x-ray sources and appear to have less severe metal-induced artifacts, but will need appropriate validation as they become available to researchers. Regardless of the μCT scanner being used, we recommend that detailed validation studies be performed for any study using metal implants since variation in the composition and geometry of the particular implants used may lead to different artifact patterns. PMID:21919905

  14. Single-incision open reduction and internal fixation of comminuted trapezium fractures with distal radius cancellous autograft.

    PubMed

    Matzon, Jonas L; Reb, Christopher W; Danowski, Ryan M; Lutsky, Kevin

    2015-03-01

    Trapezium fractures comprise approximately 3% to 5% of all hand fractures. Although operative management of intra-articular trapezium fractures can result in good functional outcomes, there is very little literature addressing specific operative techniques. We describe a technique for open reduction and internal fixation of severely comminuted, intra-articular trapezium fractures, utilizing autogenous cancellous bone graft from the distal radius.

  15. Effects of rigidity of an internal fixation device. A comprehensive biomechanical investigation.

    PubMed

    Goel, V K; Lim, T H; Gwon, J; Chen, J Y; Winterbottom, J M; Park, J B; Weinstein, J N; Ahn, J Y

    1991-03-01

    Internal fixation with instrumentation often accompanies surgical fusion to augment spinal stability, provide temporary fixation while the surgical fusion mass unites, and enhance postoperative mobilization of a patient. Some surgeons, however, feel that the existing plate-screw designs are too rigid and are the primary cause of "iatrogenic" adverse effects clinically observed. A three-part study, involving in vitro experimental protocol, analytical finite-element-based models, and an in vivo canine investigation, was undertaken to study the role of decreasing rigidity of a device on the biomechanical response of the stabilized segments. Two alternatives--the use of one variable screw placement (Steffee plate [unilateral, 1VSP model]) as opposed to two VSP plates (bilateral, 2VSP model) and two VSP plates with polymer washers placed in between the integral nut and plate (2MVSP model)--were considered for achieving a reduction in the rigidity of the conventional VSP system. The load-displacement data obtained from the in vitro experiments and the stress distributions within the stabilized and intact models predicted by the finite-element models revealed that the unilateral VSP system is less rigid and is likely to reduce stress shielding of the vertebral bodies compared with the 2VSP model. The undesirable effects associated with the use of the 1VSP plate system are the presence of coupled motions due to the inherent asymmetry and the likely inability to provide enough rigidity for decompression procedures requiring a complete excision of the disc. The use of two MVSP plates overcomes these deficiencies.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. An old mismanaged Lisfranc injury treated by gradual deformity correction followed by the second-stage internal fixation.

    PubMed

    Tantray, Mehraj D; Kangoo, Khurshid; Nazir, Asif; Baba, Muzamil; Rameez, Raja; Tabish, Syed; Shahnawaz, Syed

    2017-04-01

    The Lisfranc fracture-dislocation of the foot is uncommon and diagnosis is often missed. The Lisfranc joint involves the articulation between medial cuneiform and base of the second metatarsal and is considered a keystone to structural integrity to the midfoot. The articulation has a stabilization effect on longitudinal and transverse arches of the foot. A neglected or untreated injury to the Lisfranc joint can lead to secondary arthritis and significant morbidity and disability. We present a case of a neglected Lisfranc fracture-dislocation in a 28-year-old female patient who presented 3 months after injury. A staged treatment of distraction with an Ilizarov ring fixator followed in the second stage by the removal of ring fixator and internal fixation with K wires was performed. There was complete relief of pain and a good functional outcome at 3 months after treatment.

  17. Proximal tibial fractures with impending compartment syndrome managed by fasciotomy and internal fixation: A retrospective analysis of 15 cases

    PubMed Central

    Sharma, Naveen; Singh, Varun; Agrawal, Ashish; Bhargava, Rakesh

    2015-01-01

    Background: Proximal tibia fractures with compartment syndrome present a challenge for orthopedic surgeons. More often than not these patients are subjected to multiple surgeries and are complicated by infection osteomyelitis and poor rehabilitation. There is no consensus in the management of these fractures. Most common mode is to do early fasciotomy with external fixation, followed by second stage definitive fixation. We performed a retrospective study of proximal tibia fractures with impending compartment syndrome treated by single stage fasciotomy and internal fixation. Results in terms of early fracture union, minimum complications and early patient mobilization were very good. Materials and Methods: Fifteen patients who were operated between July 2011 and June 2012 were selected for the study. All documents from their admission until the last followup in December 2013 were reviewed, data regarding complications collected and results were evaluated using Oxford Knee scoring system. Results: At the final outcome, there was anatomical or near anatomical alignment with no postoperative problems with range of motion of near complete flexion (>120) in all patients within 3 months. 13 patients started full weight bearing walking at 3 months. Delayed union in two patients and skin necrosis in one patient was observed. Conclusions: Since the results are encouraging and the rehabilitation time is much less when compared to conventional approaches, it is recommended using this protocol to perform early fasciotomy with the definitive internal fixation as single stage surgery to obtain excellent followup results and to reduce rehabilitation time, secondary trauma, expense of treatment and infection rate. PMID:26538755

  18. Internal Fixation Versus Nonoperative Treatment for Displaced 3-Part or 4-Part Proximal Humeral Fractures in Elderly Patients: A Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Li, Jing; Chen, Aimin

    2013-01-01

    Background A few studies focused on open reduction and internal fixation (ORIF) or nonoperative treatment of displaced 3-part or 4-part proximal humeral fractures in elderly patients have been published, all of whom had a low number of patients. In this meta-analysis of randomized controlled trials (RCTs), we aimed to assess the effect of ORIF or nonoperative treatment of displaced 3-part or 4-part proximal humeral fractures in elderly patients on the clinical outcomes and re-evaluate of the potential benefits of conservative treatment. Methods We searched PubMed and the Cochrane Central Register of Controlled Trials databases for randomized controlled trials comparing ORIF and nonoperative treatment of displaced 3-part or 4-part proximal humeral fractures in elderly patients. Our outcome measures were the Constant scores. Results: Three randomized controlled trials with a total of 130 patients were identified and analyzed. The overall results based on fixed-effect model did not support the treatment of open reduction and internal fixation to improve the functional outcome when compared with nonoperative treatment for treating elderly patients with displaced 3-part or 4-part proximal humeral fractures (WMD −0.51, 95% CI: −7.25 to 6.22, P = 0.88, I2 = 0%). Conclusions Although our meta-analysis did not support the treatment of open reduction and internal fixation to improve the functional outcome when compared with nonoperative treatment for treating elderly patients with displaced 3-part or 4-part proximal humeral fractures, this result must be considered in the context of variable patient demographics. Only a limited recommendation can be made based on current data. Considering the limitations of included studies, a large, well designed trial that incorporates the evaluation of clinically relevant outcomes in participants with different underlying risks of shoulder function is required to more adequately assess the role for ORIF or nonoperative

  19. Percutaneous Reduction and Fixation with Kirschner Wires versus Open Reduction Internal Fixation for the Management of Calcaneal Fractures: A Meta-Analysis

    PubMed Central

    Wu, Jianbin; Zhou, Feiya; Yang, Lei; Tan, Jun

    2016-01-01

    The aim of our meta-analysis was to compare outcomes for two surgical treatments of calcaneal fractures, percutaneous reduction and fixation with Kirschner wires (PRFK) and open reduction internal fixation (ORIF), with the intent of evaluating the quality of evidence to inform practice. Search of MEDLINE, Cochrane and CNKI databases to identify randomized controlled trials (RCTs) comparing PRKF and ORIF on the following outcomes: post-operative function, complications and quality of the reduction. Odd ratios (OR) and weighted mean differences were pooled using either a fixed-effects or random-effects model, depending on the heterogeneity of the trials included in the analysis. Eighteen RCTs provided the data from 1407 patients. PRFK was associated with a lower risk of surgical wound complications, and ORIF with better post-operative function, angle of Gissane, calcaneal height, and calcaneal width. There were no statistically significant differences between the techniques with regards to post-operative Böhler’s angle. PRFK does not provide a substantive advantage over ORIF for the treatment of calcaneal fractures in adults. PRFK may, however, yield comparable functional outcomes to ORIF for closed Sanders type II calcaneal fractures but with less complication related to surgical wound healing. PMID:27457262

  20. Using biomechanics to improve the surgical technique for internal fixation of intracapsular femoral neck fractures.

    PubMed

    Wu, Chi-Chuan

    2010-01-01

    Despite advances in science and technology, the success rate for the treatment of displaced intracapsular femoral neck fractures in high-energy injuries remains disappointing. The blood supply system in the femoral head of humans does not favor recovery from these fractures. Once these fractures occur, osteonecrosis and nonunion rates may be as high as 30%, even if the newest technique is used. There are some surgical techniques used to supplement internal fixation to reestablish the blood supply in the femoral head, but none have been evidently successful. After analysis of related studies, the author concludes that immediate surgical treatment using improved techniques incorporating the principles of biomechanics can improve the success rate of treatment of these fractures. Using these principles, the fracture site can achieve sufficient stability. Consequently, the blood supply in the femoral head and neck can be reestablished earlier and loss of reduction of fragments during treatment can be minimized. Thus, the chance of full recovery from these complicated fractures can be maximized. In this study, the biomechanical characteristics of these fractures and the principles associated with the surgical techniques used for treating them are reviewed and clarified. Finally, a surgical technique which is ideal from the author's viewpoint is presented. The author believes that the recommended surgical technique may become the best method for treating these complicated fractures.

  1. Bio-Environment-Induced Degradation and Failure of Internal Fixation Implants

    PubMed Central

    Zhou, Yan; Perkins, Luke A.; Wang, Guodong; Zhou, Dongsheng; Liang, Hong

    2015-01-01

    Internal fixations provide fast healing but their failure remains problematic to patients. Here, we report an experimental study in failure of three typical cases of metals: a bent intramedullary stainless steel nail, a broken exterior pure Ti plate, and a broken intramedullary stainless steel nail. Characterization of the bent nail indicates that those metals are vulnerable to corrosion with the evidence of increased surface roughness and embrittlement. Depredated surface of the Ti plate resulted debris particles in the surrounding tissue of 15.2 ± 6.5 μm in size. Nanoparticles were observed in transmission electron microscope. The electron diffraction pattern of the debris indicates a combination of nanocrystalline and amorphous phases. The failure mode of the broken nail made of stainless steel was found to be fatigue initiated from the surface. This study clearly shows the biological-attack induced surface degradation resulting in debris and fatigue. Future design and selection of implant materials should consider such factors for improvement. PMID:26501330

  2. Rate of Improvement following Volar Plate Open Reduction and Internal Fixation of Distal Radius Fractures

    PubMed Central

    Dillingham, Chris; Horodyski, MaryBeth; Struk, Aimee M.; Wright, Thomas

    2011-01-01

    Purpose. To determine recovery timeline of unstable distal radius fractures treated by open reduction and internal fixation with a locking volar plate. Methods. Data was collected prospectively on a consecutive series of twenty-seven patients during routine post-operative visits at 2 and 6 weeks, and 3, 6, 12 and 24 months. Range of motion measures and grip strength for both wrists were recorded. Results. Greatest gains were made within the first 3 months after surgery. Supination and pronation returned more quickly than flexion or extension, with supination and pronation both at 92% of the uninjured wrist at 3 months. Only flexion improved significantly between 3 and 6 months. All wrist motions showed some improvement until 1 year. Grip strength returned to 94% of the uninjured wrist by 12 months. Conclusions. Range of motion improvement will be greatest between 2 weeks and 3 months, with improvement continuing until 12 months. Grip strength should return to near normal by one year. Function and pain will improve, but not return to normal by the end of 12 months. Clinical Relevance. These results provide the surgeon with information that can be shared with patients on the anticipated timeline for normal recovery of function and strength. PMID:21991417

  3. The Relationship of the Facial Nerve to the Condylar Process: A Cadaveric Study with Implications for Open Reduction Internal Fixation.

    PubMed

    Barham, H P; Collister, P; Eusterman, V D; Terella, A M

    2015-01-01

    Introduction. The mandibular condyle is the most common site of mandibular fracture. Surgical treatment of condylar fractures by open reduction and internal fixation (ORIF) demands direct visualization of the fracture. This project aimed to investigate the anatomic relationship of the tragus to the facial nerve and condylar process. Materials and Methods. Twelve fresh hemicadavers heads were used. An extended retromandibular/preauricular approach was utilized, with the incision being based parallel to the posterior edge of the ramus. Measurements were obtained from the tragus to the facial nerve and condylar process. Results. The temporozygomatic division of the facial nerve was encountered during each approach, crossing the mandible at the condylar neck. The mean tissue depth separating the facial nerve from the condylar neck was 5.5 mm (range: 3.5 mm-7 mm, SD 1.2 mm). The upper division of the facial nerve crossed the posterior border of the condylar process on average 2.31 cm (SD 0.10 cm) anterior to the tragus. Conclusions. This study suggests that the temporozygomatic division of the facial nerve will be encountered in most approaches to the condylar process. As visualization of the relationship of the facial nerve to condyle is often limited, recognition that, on average, 5.5 mm of tissue separates condylar process from nerve should help reduce the incidence of facial nerve injury during this procedure.

  4. Summary of ISX-B limiters and internal components

    SciTech Connect

    Langley, R.A.

    1983-09-01

    This report describes the limiters and internal components of the Impurity Study Experiment (ISX-B) as of May 1983. The positions of the fixed limiters and internal components are noted; for movable limiters the limits of position are given. In addition, the function, shape, size, and material of each component are given, along with the name of the scientist responsible for that component.

  5. Failed operative treatment in two cases of pseudarthrosis of the clavicle using internal fixation and bovine cancellous xenograft (Tutobone).

    PubMed

    Elliot, Robin R; Richards, Robert H

    2011-09-01

    The most commonly reported technique of reconstructive surgery for congenital pseudarthrosis of the clavicle involves resection of the pseudarthrosis, insertion of autologous iliac crest bone graft and internal fixation. In an attempt to avoid the potential complications of iliac crest bone graft harvest we used bovine cancellous xenograft (Tutobone). Two cases of pseudarthrosis of the clavicle treated with resection of the pseudarthrosis, Tutobone graft and internal fixation are presented. Both cases resulted in treatment failures, which were associated with significant osteolysis and failure of incorporation of the graft material. This required removal of the loose metal work and debridement of the failed graft material. We would caution surgeons against the use of Tutobone as a graft material in the surgical management of pseudarthrosis of the clavicle. The level of evidence was level IV case series.

  6. Corrective osteotomy through fracture site and internal fixation with headless screws for type I (Hahn-Steinthal) capitellar malunion.

    PubMed

    Jeevannavar, Santosh Somayya; Shenoy, Keshav Someshwar; Daddimani, Ravi M

    2013-05-24

    A 20-year-old woman presented 6 months after an initial injury to her left elbow with pain and restricted movements. She was diagnosed with a type I malunited (Hahn-Steinthal) type of capitellum fracture through radiographic studies. Classically, the treatment has been excision of the fragment, which carries a risk of valgus instability of the elbow and late osteoarthrosis. We report a case of malunited type I capitellum fracture, for which corrective osteotomy through fracture site, open reduction and internal fixation was done 6 months following missed trauma. At 24 months follow-up the capitellum fracture had united and the patient has a stable elbow and excellent range of motion. Our case demonstrates that for type I malunited capitellum fractures corrective osteotomy through fracture site and internal fixation rather than excision of the fragment in young can result in successful union and stable elbow.

  7. Corrective osteotomy through fracture site and internal fixation with headless screws for type I (Hahn-Steinthal) capitellar malunion

    PubMed Central

    Jeevannavar, Santosh Somayya; Shenoy, Keshav Someshwar; Daddimani, Ravi M

    2013-01-01

    A 20-year-old woman presented 6 months after an initial injury to her left elbow with pain and restricted movements. She was diagnosed with a type I malunited (Hahn-Steinthal) type of capitellum fracture through radiographic studies. Classically, the treatment has been excision of the fragment, which carries a risk of valgus instability of the elbow and late osteoarthrosis. We report a case of malunited type I capitellum fracture, for which corrective osteotomy through fracture site, open reduction and internal fixation was done 6 months following missed trauma. At 24 months follow-up the capitellum fracture had united and the patient has a stable elbow and excellent range of motion. Our case demonstrates that for type I malunited capitellum fractures corrective osteotomy through fracture site and internal fixation rather than excision of the fragment in young can result in successful union and stable elbow. PMID:23709538

  8. Mechanical analysis of a rodent segmental bone defect model: the effects of internal fixation and implant stiffness on load transfer.

    PubMed

    Yavari, S Amin; van der Stok, J; Ahmadi, S M; Wauthle, R; Schrooten, J; Weinans, H; Zadpoor, A A

    2014-08-22

    Segmental bone defect animal models are often used for evaluating the bone regeneration performance of bone substituting biomaterials. Since bone regeneration is dependent on mechanical loading, it is important to determine mechanical load transfer after stabilization of the defect and to study the effects of biomaterial stiffness on the transmitted load. In this study, we assess the mechanical load transmitted over a 6mm femur defect that is stabilized with an internal PEEK fixation plate. Subsequently, three types of selective laser melted porous titanium implants with different stiffness values were used to graft the defect (five specimens per group). In one additional group, the defect was left empty. Micro strain gauges were used to measure strain values at four different locations of the fixation plate during external loading on the femoral head. The load sharing between the fixation plate and titanium implant was highly variable with standard deviations of measured strain values between 31 and 93% of the mean values. As a consequence, no significant differences were measured between the forces transmitted through the titanium implants with different elastic moduli. Only some non-significant trends were observed in the mean strain values that, consistent with the results of a previous finite element study, implied the force transmitted through the implant increases with the implant stiffness. The applied internal fixation method does not standardize mechanical loading over the defect to enable detecting small differences in bone regeneration performances of bone substituting biomaterials. In conclusion, the fixation method requires further optimization to reduce the effects of the operative procedure and make the mechanical loading more consistent and improve the overall sensitivity of this rat femur defect model.

  9. Review of techniques for monitoring the healing fracture of bones for implementation in an internally fixated pelvis.

    PubMed

    Wong, Lydia Chwang Yuh; Chiu, Wing Kong; Russ, Matthias; Liew, Susan

    2012-03-01

    Sacral fractures from high-impact trauma often cause instability in the pelvic ring structure. Treatment is by internal fixation which clamps the fractured edges together to promote healing. Healing could take up to 12 weeks whereby patients are bedridden to avoid hindrances to the fracture from movement or weight bearing activities. Immobility can lead to muscle degradation and longer periods of rehabilitation. The ability to determine the time at which the fracture is stable enough to allow partial weight-bearing is important to reduce hospitalisation time. This review looks into different techniques used for monitoring the fracture healing of bones which could lead to possible methods for in situ and non-invasive assessment of healing fracture in a fixated pelvis. Traditional techniques being used include radiology and CT scans but were found to be unreliable at times and very subjective in addition to being non in situ. Strain gauges have proven to be very effective for accurate assessment of fracture healing as well as stability for long bones with external fixators but may not be suitable for an internally fixated pelvis. Ultrasound provides in situ monitoring of stiffness recovery but only assesses local fracture sites close to the skin surface and has only been tested on long bones. Vibration analysis can detect non-uniform healing due to its assessment of the overall structure but may suffer from low signal-to-noise ratio due to damping. Impedance techniques have been used to assess properties of non-long bones but recent studies have only been conducted on non-biological materials and more research needs to be done before it can be applicable for monitoring healing in the fixated pelvis.

  10. Iron limitation in the marine cyanobacterium Trichodesmium reveals new insights into regulation of photosynthesis and nitrogen fixation.

    PubMed

    Küpper, Hendrik; Setlík, Ivan; Seibert, Sven; Prásil, Ondrej; Setlikova, Eva; Strittmatter, Martina; Levitan, Orly; Lohscheider, Jens; Adamska, Iwona; Berman-Frank, Ilana

    2008-01-01

    * As iron (Fe) deficiency is a main limiting factor of ocean productivity, its effects were investigated on interactions between photosynthesis and nitrogen fixation in the marine nonheterocystous diazotrophic cyanobacterium Trichodesmium IMS101. * Biophysical methods such as fluorescence kinetic microscopy, fast repetition rate (FRR) fluorimetry, and in vivo and in vitro spectroscopy of pigment composition were used, and nitrogenase activity and the abundance of key proteins were measured. * Fe limitation caused a fast down-regulation of nitrogenase activity and protein levels. By contrast, the abundance of Fe-requiring photosystem I (PSI) components remained constant. Total levels of phycobiliproteins remained unchanged according to single-cell in vivo spectra. However, the regular 16-kDa phycoerythrin band decreased and finally disappeared 16-20 d after initiation of Fe limitation, concomitant with the accumulation of a 20-kDa protein cross-reacting with the phycoerythrin antibody. Concurrently, nitrogenase expression and activity increased. Fe limitation dampened the daily cycle of photosystem II (PSII) activity characteristic of diazotrophic Trichodesmium cells. Further, it increased the number and prolonged the time period of occurrence of cells with elevated basic fluorescence (F(0)). Additionally, it increased the effective cross-section of PSII, probably as a result of enhanced coupling of phycobilisomes to PSII, and led to up-regulation of the Fe stress protein IsiA. * Trichodesmium survives short-term Fe limitation by selectively down-regulating nitrogen fixation while maintaining but re-arranging the photosynthetic apparatus.

  11. The effect of HIV on early wound healing in open fractures treated with internal and external fixation.

    PubMed

    Aird, J; Noor, S; Lavy, C; Rollinson, P

    2011-05-01

    There are 33 million people worldwide currently infected with human immunodeficiency virus (HIV). This complex disease affects many of the processes involved in wound and fracture healing, and there is little evidence available to guide the management of open fractures in these patients. Fears of acute and delayed infection often inhibit the use of fixation, which may be the most effective way of achieving union. This study compared fixation of open fractures in HIV-positive and -negative patients in South Africa, a country with very high rates of both HIV and high-energy trauma. A total of 133 patients (33 HIV-positive) with 135 open fractures fulfilled the inclusion criteria. This cohort is three times larger than in any similar previously published study. The results suggest that HIV is not a contraindication to internal or external fixation of open fractures in this population, as HIV is not a significant risk factor for acute wound/implant infection. However, subgroup analysis of grade I open fractures in patients with advanced HIV and a low CD4 count (< 350) showed an increased risk of infection; we suggest that grade I open fractures in patients with advanced HIV should be treated by early debridement followed by fixation at an appropriate time.

  12. Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures

    PubMed Central

    Saltzman, Bryan M.; Erickson, Brandon J.; Harris, Joshua D.; Gupta, Anil K.; Mighell, Mark; Romeo, Anthony A.

    2016-01-01

    Background: Proximal humerus fractures are common problems plaguing the elderly population. Purpose: The purposes of this study were to determine the outcomes of fibular strut allografts in treatment of proximal humerus fractures with open reduction internal fixation (ORIF) and to present the authors’ preferred surgical technique. The hypothesis was that the use of fibular strut allografts in treating proximal humerus fractures with ORIF will provide low reoperation rates with acceptable outcomes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was registered with PROSPERO and performed with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines using 3 publicly available free databases. Therapeutic clinical outcome investigations reporting arthroscopic elbow outcomes with levels of evidence 1 through 4 were eligible for inclusion. All study, subject, and surgical technique demographics were analyzed and compared between continents and countries. Statistics were calculated using Student t tests, 1-way analysis of variance, chi-square tests, and 2-proportion Z tests. Results: Four studies met the inclusion criteria. While there is great heterogeneity existing in the literature surrounding use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures, current evidence shows a humeral head screw penetration rate of 3.7% with acceptable functional outcome scores, with a reoperation rate of 4.4% at a weighted mean 80.78 weeks (1.55 years) of postoperative follow-up. Conclusion: There is great heterogeneity that exists in the literature surrounding the use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures. Current evidence shows a screw penetration rate of 3.7% with acceptable functional outcome scores, demonstrating fibular strut allograft is a viable option for treating proximal humerus fractures. PMID:27504463

  13. Early active motion protocol following open reduction internal fixation of the scaphoid: A pilot study.

    PubMed

    Dunn, J-C; Kusnezov, N; Fares, A; Buccino, Z; Esquivel, D; Mitchell, J

    2017-02-01

    Scaphoid fractures are common injuries which traditionally have been treated with long periods of immobilization even after open reduction and internal fixation (ORIF). The purpose of this pilot investigation was two-fold: 1) describe a precise postoperative Early Active Motion (EAM) rehabilitation protocol following ORIF of scaphoid fractures and 2) record the outcomes of the EAM protocol. Eight consecutive patients having undergone ORIF of the scaphoid were enrolled in the EAM and followed for a minimum of 1 year. At 12 weeks, Disabilities of the Arm Shoulder and Hand (DASH) score, Mayo Wrist score, and range of motion values were obtained. At 1 year, a telephone survey was conducted and several data points were obtained including DASH and Mayo Wrist score, number of push-ups, satisfaction with surgery and ability to remain on active duty. All 8 patients were male, on active duty, with an average age of 26 years. Two patients used tobacco products and none had major health problems. All patients completed the EAM protocol and obtained CT; all CT exams demonstrated healing at 8 weeks. At 12 weeks postoperatively, the average DASH score was 8.8±16 (range: 0-47.5), Mayo wrist score was 88±10 (range: 75-100) and range of motion nearly symmetrical. At a mean final follow-up of 15.4 months postoperatively, the average DASH score was 1.1±1.7 (Range: 0-4.5), Mayo wrist score was 97.5±4 (range 90-100), average number of push-ups was 57 (40-70) at the prior Army Physical Fitness Test. All patients were satisfied with surgery and all remained on active duty at 1 year. There were no reported complications. The EAM protocol following scaphoid fracture ORIF is safe and effective. The EAM can reliably return patients back to high demand activity earlier than a traditional protocol.

  14. Application of IMF screws to assist internal rigid fixation of jaw fractures: our experiences of 168 cases.

    PubMed

    Bai, Zhenxi; Gao, Zhibiao; Xiao, Xia; Zhang, Wenjuan; Fan, Xing; Wang, Zhaoling

    2015-01-01

    Intermaxillary fixation (IMF) screws were first introduced to achieve IMF as a kind of bone borne appliance for jaw fractures in 1989. Because this method can overcome many disadvantages associated with tooth borne appliance, IMF screws have been popularly used for jaw fractures since then. From March 2011 to February 2014, we treated 168 cases with single or multiple jaw fractures by open reduction and a total of 705 IMF screws were intraoperatively applied in all the cases to achieve IMF and maintain dental occlusion as an adjuvant to open reduction. The numbers, implantation sites and complications of IMF screws were retrospectively analyzed. In our experience, we found that IMF screws were important to assist open reduction of jaw fractures but their roles should be objectively assessed and the reliability of open reduction and internal rigid fixation must be emphasized. Much attention should be paid when implanting.

  15. Internal emitter limits for iodine, radium and radon daughters

    SciTech Connect

    Schlenker, R.A.

    1984-08-15

    This paper identifies some of the issues which arise in the consideration of the derivation of new limits on exposure to internal emitters. Basic and secondary radiation protection limits are discussed. Terms are defined and applied to the limitation of risk from stochastic effects. Non-stochastic data for specific internal emitters (/sup 131/I and the radium isotopes) are presented. Emphasis is placed on the quantitative aspects of the limit setting problem. 65 references, 2 figures, 12 tables.

  16. Hardware Removal Due to Infection after Open Reduction and Internal Fixation: Trends and Predictors

    PubMed Central

    Rasouli, Mohammad R.; Viola, Jessica; Maltenfort, Mitchell G.; Shahi, Alisina; Parvizi, Javad; Krieg, James C.

    2015-01-01

    Background: Little is known about trends and predictors of hardware related infection following open reduction and internal fixation (ORIF) of extremity fractures, one of the major causes of failure following ORIF. The present study was designed and conducted to determine trends and predictors of infection-related hardware removal following ORIF of extremities using a nationally representative database. Methods: We used Nationwide Inpatient Sample data from 2002 to 2011 to identify cases of ORIF following upper and lower extremity fractures, as well as cases that underwent infection-related hardware removal following ORIF. Multivariate analysis was performed to identify independent predictors of infection-related hardware removal, controlling for patient demographics and comorbidities, hospital characteristics, site of fracture, and year. Results: For all ORIF procedures, the highest rate of hardware removal related to infection was observed in tarsal fractures (5.56%), followed by tibial (3.65%) and carpal (3.37%) fractures. Hardware removal rates due to infection increased in all fractures except radial/ulnar fractures. Tarsal fractures(odds ratio (OR)=1.06, 95% confidence interval (CI): 1.04-1.09, P<0.001), tibial fractures (OR=1.04, 95% CI: 1.03-1.06, P<0.001) and those patients with diabetes mellitus (OR=2.64, 95% CI: 2.46-2.84, P<0.001), liver disease (OR=2.04, 95% CI: 1.84- 2.26, P<0.001), and rheumatoid arthritis (OR=2.06, 95% CI: 1.88-2.25 P<0.001) were the main predictors of infection-related removals; females were less likely to undergo removal due to infection (OR= 0.61, 95% CI: 0.59-0.63 P<0.001). Conclusions: Hardware removal rates due to infection increased in all fractures except radial/ulnar fractures. Diabetes, liver disease, and rheumatoid arthritis were important predictors of infection-related hardware removal. The study identified some risk factors for hardwarerelated infection following ORIF, such as diabetes, liver disease, and rheumatoid

  17. Approaches for enhancement of N₂ fixation efficiency of chickpea (Cicer arietinum L.) under limiting nitrogen conditions.

    PubMed

    Esfahani, Maryam Nasr; Sulieman, Saad; Schulze, Joachim; Yamaguchi-Shinozaki, Kazuko; Shinozaki, Kazuo; Tran, Lam-Son

    2014-04-01

    Chickpea (Cicer arietinum) is an important pulse crop in many countries in the world. The symbioses between chickpea and Mesorhizobia, which fix N₂ inside the root nodules, are of particular importance for chickpea's productivity. With the aim of enhancing symbiotic efficiency in chickpea, we compared the symbiotic efficiency of C-15, Ch-191 and CP-36 strains of Mesorhizobium ciceri in association with the local elite chickpea cultivar 'Bivanij' as well as studied the mechanism underlying the improvement of N₂ fixation efficiency. Our data revealed that C-15 strain manifested the most efficient N₂ fixation in comparison with Ch-191 or CP-36. This finding was supported by higher plant productivity and expression levels of the nifHDK genes in C-15 nodules. Nodule specific activity was significantly higher in C-15 combination, partially as a result of higher electron allocation to N₂ versus H⁺. Interestingly, a striking difference in nodule carbon and nitrogen composition was observed. Sucrose cleavage enzymes displayed comparatively lower activity in nodules established by either Ch-191 or CP-36. Organic acid formation, particularly that of malate, was remarkably higher in nodules induced by C-15 strain. As a result, the best symbiotic efficiency observed with C-15-induced nodules was reflected in a higher concentration of the total and several major amino metabolites, namely asparagine, glutamine, glutamate and aspartate. Collectively, our findings demonstrated that the improved efficiency in chickpea symbiotic system, established with C-15, was associated with the enhanced capacity of organic acid formation and the activities of the key enzymes connected to the nodule carbon and nitrogen metabolism.

  18. Stability Following Combined Maxillary and Mandibular Osteotomies Treated with Rigid Internal Fixation.

    DTIC Science & Technology

    1987-06-01

    mandible upon closure for approximately 2 to 4 weeks. Cephalometrlc Analysis * . Each patient had standardized lateral cephalometric radiographs taken (Quint...thickness on changes in vertical dimension as it affected the total anterior facial height at B point. The vertical closure from splint removal ranged...conjunction with increases in vertical dimension . Rigid stabilization with good bony apposition of the mandibular segments during fixation

  19. The retromandibular transparotid approach for reduction and rigid internal fixation using two locking miniplates in mandibular condylar neck fractures.

    PubMed

    Kanno, T; Sukegawa, S; Tatsumi, H; Nariai, Y; Ishibashi, H; Furuki, Y; Sekine, J

    2014-02-01

    We evaluated the safety, efficacy, and morbidity associated with the treatment of displaced mandibular condylar neck fractures using a retromandibular transparotid approach to reduce and rigidly fix using two 2.0-mm locking miniplates. Our surgical inclusion criteria were: patient selection of open reduction and fixation, displaced unilateral condylar fractures with derangement of occlusion, and bilateral condylar fractures with an anterior open bite. The study group consisted of 19 patients who underwent surgery for 19 mandibular condylar neck fractures; patients were analyzed prospectively, with more than 6 months of follow-up, and were evaluated in terms of functional results, scar formation, postoperative complications, and stability of fixation. The results showed that functional occlusion identical to the preoperative condition and correct anatomical reduction of the condylar segments in centric occlusion, followed by immediate functional recovery, was achieved in all patients. No patient suffered from any major or permanent complication postoperatively, although there were two cases (11%) of temporary facial nerve palsy, which resolved completely within 3 months. Surgical scars were barely visible. The retromandibular transparotid approach with open reduction and rigid internal fixation for displaced condylar neck fractures of the mandible is a feasible and safe, minimally invasive surgical technique that provides reliable clinical results.

  20. Treatment of Early Post-Op Wound Infection after Internal Fixation

    DTIC Science & Technology

    2014-10-01

    having difficulty maintaining equipoise when prescribing antibiotics . Informational slides have been developed for the sites to use to present the study...to their Infectious Disease teams to assist with this problem. 15. SUBJECT TERMS PO, IV, Antibiotics , plate, fixation, infection 16. SECURITY...and either: (Group 1) operative debridement and PO antibiotic treatment for 6 weeks; or (Group 2) operative debridement and IV antibiotics for 6

  1. Mid-term functional outcome after the internal fixation of distal radius fractures

    PubMed Central

    2012-01-01

    Background Distal radius fracture is a common injury with a variety of operative and non-operative management options. There remains debate as to the optimal treatment for a given patient and fracture. Despite the popularity of volar locking plate fixation, there are few large cohort or long term follow up studies to justify this modality. Our aim was to report the functional outcome of a large number of patients at a significant follow up time after fixation of their distal radius with a volar locking plate. Methods 180 patients with 183 fractures and a mean age of 62.4 years were followed up retrospectively at a mean of 30 months (Standard deviation = 10.4). Functional assessment was performed using the Disabilities of the Arm, Shoulder and Hand (DASH) and modified MAYO wrist scores. Statistical analysis was performed to identify possible variables affecting outcome and radiographs were assessed to determine time to fracture union. Results The median DASH score was 2.3 and median MAYO score was 90 for the whole group. Overall, 133 patients (74%) had a good or excellent DASH and MAYO score. Statistical analysis showed that no specific variable including gender, age, fracture type, post-operative immobilisation or surgeon grade significantly affected outcome. Complications occurred in 27 patients (15%) and in 11 patients were major (6%). Conclusion This single centre large population series demonstrates good to excellent results in the majority of patients after volar locking plate fixation of the distal radius, with complication rates comparable to other non-operative and operative treatment modalities. On this basis we recommend this mode of fixation for distal radius fractures requiting operative intervention. PMID:22280557

  2. Clavicle fractures in 2010: sling/swathe or open reduction and internal fixation?

    PubMed

    McKee, Michael D

    2010-04-01

    Clavicle fractures are common, and they comprise close to 3% of all fractures seen in fracture clinics. Midshaft fractures account for approximately 80% of all clavicle fractures and are the focus of this article. In carefully selected cases primary plate fixation of displaced midshaft clavicle fractures improves outcome, results in earlier return to function, and reduces the nonunion and symptomatic malunion rate significantly compared with nonoperative treatment.

  3. Bone radiofrequency ablation combined with prophylactic internal fixation for metastatic bone tumor of the femur from hepatocellular carcinoma.

    PubMed

    Ogura, Koichi; Miyake, Ryoko; Shiina, Shuichiro; Shinoda, Yusuke; Okuma, Tomotake; Kobayashi, Hiroshi; Goto, Takahiro; Nakamura, Kozo; Kawano, Hirotaka

    2012-08-01

    A 64-year-old man with 6-year history of hepatocellular carcinoma (HCC) was referred to us regarding bone metastasis to the right proximal femur. Although he underwent radiotherapy for pain palliation and local tumor control, the pain persisted and the tumor relapsed 3 months after the radiotherapy and he was thought to be at high risk of pathologic fracture. Given hypervascularity and large tumor size, a prophylactic internal fixation combined with adjuvant radiofrequency ablation (RFA) was proposed to reduce blood loss and prevent viable tumor cells being disseminated. His postoperative course was uneventful without requiring blood transfusion and preoperative symptoms immediately disappeared after surgery. He became capable of weight-bearing walk with a single cane and was almost asymptomatic without local progression on the plain radiographs when he died 14 months after surgery. Combination therapy of RFA and internal fixation using intramedullary nailing for metastases of the long bones from HCC seems to be a very promising technique both for sufficient pain relief and for local control of the tumor. Adjuvant RFA may become a potential option for patients with metastases of the long bones for the purpose of prevention of tumor dissemination and reduction of intraoperative blood loss.

  4. Internal limiting membrane peeling in vitreo-retinal surgery.

    PubMed

    Abdelkader, Ehab; Lois, Noemi

    2008-01-01

    Peeling the internal limiting membrane of the retina has become a very common procedure performed by vitreo-retinal surgeons. The combination of new microsurgical instrumentation with the availability of different dyes to stain this thin and transparent membrane has facilitated the performance of internal limiting membrane peeling, reducing the time and trauma associated with this maneuver. Internal limiting membrane peeling has been used to treat a variety of retinal pathologies, including full-thickness macular hole, epiretinal membrane, macular edema, vitreomacular traction syndrome, and Terson syndrome, among others. Although it appears that peeling the internal limiting membrane in these retinal conditions may be associated with better anatomical and visual outcomes following surgery, further evidence through randomized controlled clinical trials is still needed to guide the vitreo-retinal surgeon on the appropriate use of this surgical maneuver.

  5. Potential Trace Metal Co-Limitation Controls on N2 Fixation and [Formula: see text] Uptake in Lakes with Varying Trophic Status.

    PubMed

    Romero, I C; Klein, N J; Sañudo-Wilhelmy, S A; Capone, D G

    2013-01-01

    The response of N2 fixation and [Formula: see text] uptake to environmental conditions and nutrient enrichment experiments in three western U.S. lake systems was studied (eutrophic Clear Lake; mesotrophic Walker Lake; oligotrophic Lake Tahoe). We tested the effect of additions of bioactive trace metals molybdenum as Mo(V) and iron (Fe) as well as phosphate (P), N2 fixation, [Formula: see text], carbon (C) fixation, chlorophyll a (Chla), and bacterial cell counts under both natural conditions and in mesocosm experiments. We found distinct background N2 fixation and [Formula: see text] uptake rates: highest at Clear Lake (N2 fixation: 44.7 ± 1.8 nmol N L(-1) h(-1)), intermediate at Walker Lake (N2 fixation: 1.7 ± 1.1 nmol N L(-1) h(-1); [Formula: see text] uptake: 113 ± 37 nmol N L(-1) h(-1)), and lowest at Lake Tahoe (N2 fixation: 0.1 ± 0.07 nmol N L(-1) h(-1); [Formula: see text] uptake: 37.2 ± 10.0 nmol N L(-1) h(-1)). N2 fixation was stimulated above control values with the addition of Fe and Pin Clear Lake (up to 50 and 63%, respectively); with Mo(V), Fe, and P in Walker Lake (up to 121, 990, and 85%, respectively); and with Mo(V) and P in Lake Tahoe (up to 475 and 21%, respectively). [Formula: see text] uptake showed the highest stimulation in Lake Tahoe during September 2010, with the addition of P and Mo(V) (∼84% for both). High responses to Mo(V) additions were also observed at some sites for C fixation (Lake Tahoe: 141%), Chla (Walker Lake: 54% and Clear Lake: 102%), and bacterial cell counts (Lake Tahoe: 61%). Overall our results suggest that co-limitation of nutrients is probably a common feature in lakes, and that some trace metals may play a crucial role in limiting N2 fixation and [Formula: see text] uptake activity, though primarily in non-eutrophic lakes.

  6. Diurnal variation in the coupling of photosynthetic electron transport and carbon fixation in iron-limited phytoplankton in the NE subarctic Pacific

    NASA Astrophysics Data System (ADS)

    Schuback, Nina; Flecken, Mirkko; Maldonado, Maria T.; Tortell, Philippe D.

    2016-02-01

    Active chlorophyll a fluorescence approaches, including fast repetition rate fluorometry (FRRF), have the potential to provide estimates of phytoplankton primary productivity at an unprecedented spatial and temporal resolution. FRRF-derived productivity rates are based on estimates of charge separation in reaction center II (ETRRCII), which must be converted into ecologically relevant units of carbon fixation. Understanding sources of variability in the coupling of ETRRCII and carbon fixation provides physiological insight into phytoplankton photosynthesis and is critical for the application of FRRF as a primary productivity measurement tool. In the present study, we simultaneously measured phytoplankton carbon fixation and ETRRCII in the iron-limited NE subarctic Pacific over the course of a diurnal cycle. We show that rates of ETRRCII are closely tied to the diurnal cycle in light availability, whereas rates of carbon fixation appear to be influenced by endogenous changes in metabolic energy allocation under iron-limited conditions. Unsynchronized diurnal oscillations of the two rates led to 3.5-fold changes in the conversion factor between ETRRCII and carbon fixation (Kc / nPSII). Consequently, diurnal variability in phytoplankton carbon fixation cannot be adequately captured with FRRF approaches if a constant conversion factor is applied. Utilizing several auxiliary photophysiological measurements, we observed that a high conversion factor is associated with conditions of excess light and correlates with the increased expression of non-photochemical quenching (NPQ) in the pigment antenna, as derived from FRRF measurements. The observed correlation between NPQ and Kc / nPSII requires further validation but has the potential to improve estimates of phytoplankton carbon fixation rates from FRRF measurements alone.

  7. Diurnal variation in the coupling of photosynthetic electron transport and carbon fixation in iron-limited phytoplankton in the NE subarctic Pacific

    NASA Astrophysics Data System (ADS)

    Schuback, N.; Flecken, M.; Maldonado, M. T.; Tortell, P. D.

    2015-10-01

    Active chlorophyll a fluorescence approaches, including fast repetition rate fluorometry (FRRF), have the potential to provide estimates of phytoplankton primary productivity at unprecedented spatial and temporal resolution. FRRF-derived productivity rates are based on estimates of charge separation at PSII (ETRRCII), which must be converted into ecologically relevant units of carbon fixation. Understanding sources of variability in the coupling of ETRRCII and carbon fixation provides physiological insight into phytoplankton photosynthesis, and is critical for the application of FRRF as a primary productivity measurement tool. In the present study, we simultaneously measured phytoplankton carbon fixation and ETRRCII in the iron-limited NE subarctic Pacific, over the course of a diurnal cycle. We show that rates of ETRRCII are closely tied to the diurnal cycle in light availability, whereas rates of carbon fixation appear to be influenced by endogenous changes in metabolic energy allocation under iron-limited conditions. Unsynchronized diurnal oscillations of the two rates led to 3.5 fold changes in the conversion factor coupling ETRRCII and carbon fixation (Φe:C / nPSII). Consequently, diurnal variability in phytoplankton carbon fixation cannot be adequately captured with FRRF approaches if a constant conversion factor is applied. Utilizing several auxiliary photophysiological measurements, we observed that a high conversion factor is associated with conditions of excess light, and correlates with the expression of non-photochemical quenching (NPQ) in the pigment antenna, as derived from FRRF measurements. The observed correlation between NPQ and the conversion factor Φe:C / nPSII has the potential to improve estimates of phytoplankton carbon fixation rates from FRRF measurements alone.

  8. Closed reduction using the percutaneous leverage technique and internal fixation with K-wires to treat angulated radial neck fractures in children-case report.

    PubMed

    Jiang, Hai; Wu, Yongtao; Dang, Youting; Qiu, Yusheng

    2017-01-01

    Pediatric radial neck fractures are uncommon. Severely displaced and angulated fractures usually require treatment. Our goals for treatment are to avoid incision, reduce the fracture adequately with no reduction loss, and achieve good postoperative function. We aimed to observe the clinical outcomes of closed reduction with the percutaneous leverage technique and internal fixation with Kirschner-wires (K-wires) to treat angulated radial neck fractures in children.From January 2011 to April 2013, we treated 16 cases of angulated radial neck fracture in 12 boys and 4 girls. Five fractures were type II and 11 fractures were type III using the O'Brien classification. One K-wire was percutaneously introduced into the fracture site using the leverage technique to attain good reduction. Two K-wires were introduced from the proximal to the distal areas of the fracture site. The elbow was immobilized by cast in 90° of flexion and the forearm in supination for 3 to 4 weeks. The K-wires were removed at 3 to 4 weeks postoperatively. All cases were followed up for a mean duration of 3 years 6 months.According to the Metaizeau reduction classification, 12 cases were excellent, and 4 cases were good. According to the Metaizeau clinical classification, 14 cases were excellent, and 2 cases were good. There was no necrosis of the radial head. There was no infection, radioulnar synostosis, and damage of the radial nerve deep branch. There was no limitation in the pronation and supination functions of the forearm.Closed reduction using the percutaneous leverage technique and internal fixation using K-wires is easy to perform. It is encouraged to use this approach as the clinical outcome is good.

  9. Closed reduction using the percutaneous leverage technique and internal fixation with K-wires to treat angulated radial neck fractures in children-case report

    PubMed Central

    Jiang, Hai; Wu, Yongtao; Dang, Youting; Qiu, Yusheng

    2017-01-01

    Abstract Pediatric radial neck fractures are uncommon. Severely displaced and angulated fractures usually require treatment. Our goals for treatment are to avoid incision, reduce the fracture adequately with no reduction loss, and achieve good postoperative function. We aimed to observe the clinical outcomes of closed reduction with the percutaneous leverage technique and internal fixation with Kirschner-wires (K-wires) to treat angulated radial neck fractures in children. From January 2011 to April 2013, we treated 16 cases of angulated radial neck fracture in 12 boys and 4 girls. Five fractures were type II and 11 fractures were type III using the O’Brien classification. One K-wire was percutaneously introduced into the fracture site using the leverage technique to attain good reduction. Two K-wires were introduced from the proximal to the distal areas of the fracture site. The elbow was immobilized by cast in 90° of flexion and the forearm in supination for 3 to 4 weeks. The K-wires were removed at 3 to 4 weeks postoperatively. All cases were followed up for a mean duration of 3 years 6 months. According to the Metaizeau reduction classification, 12 cases were excellent, and 4 cases were good. According to the Metaizeau clinical classification, 14 cases were excellent, and 2 cases were good. There was no necrosis of the radial head. There was no infection, radioulnar synostosis, and damage of the radial nerve deep branch. There was no limitation in the pronation and supination functions of the forearm. Closed reduction using the percutaneous leverage technique and internal fixation using K-wires is easy to perform. It is encouraged to use this approach as the clinical outcome is good. Level of evidence: level IV-retrospective case, treatment study. PMID:28072734

  10. Influence of internal fixator flexibility on murine fracture healing as characterized by mechanical testing and microCT imaging.

    PubMed

    Steck, Roland; Ueno, Masaki; Gregory, Laura; Rijken, Noortje; Wullschleger, Martin E; Itoman, Moritoshi; Schuetz, Michael A

    2011-08-01

    Mechanically well-defined stabilization systems have only recently become available, providing standardized conditions for studying the role of the mechanical environment on mouse bone fracture healing. The aim of this study was to characterize the time course of strength recovery and callus development of mouse femoral osteotomies stabilized with either low or high flexibility (in bending and torsion) internal fixation plates. Animals were euthanized and femora excised at 14, 21, and 28 days post-osteotomy for microCT analysis and torsional strength testing. While a larger mineralized callus was observed in osteotomies under more flexible conditions at all time points, the earlier bridging of the mineralized callus under less flexible conditions by 1 week resulted in an earlier recovery of torsional strength in mice stabilized with low flexibility fixation. Ultimate torque values for these bones were significantly higher at 14 and 21 days post-osteotomy compared to bones with the more flexible stabilization. Our study confirms the high reproducibility of the results that are achieved with this new implant system, therefore making it ideal for studying the influence of the mechanical environment on murine fracture healing under highly standardized conditions.

  11. An in vivo evaluation of PLLA/PLLA-gHA nano-composite for internal fixation of mandibular bone fractures.

    PubMed

    Peng, Weihai; Zheng, Wei; Shi, Kai; Wang, Wangshu; Shao, Ying; Zhang, Duo

    2015-11-09

    Internal fixation of bone fractures using biodegradable poly(L-lactic-acid) (PLLA)-based materials has attracted the attention of many researchers. In the present study, 36 male beagle dogs were randomly assigned to two groups: PLLA/PLLA-gHA (PLLA-grafted hydroxyapatite) group and PLLA group. PLLA/PLLA-gHA and PLLA plates were embedded in the muscular bags of the erector spinae and also implanted to fix mandibular bone fractures in respective groups. At 1, 2, 3, 6, 9, and 12 months postoperatively, the PLLA/PLLA-gHA and PLLA plates were evaluated by adsorption and degradation tests, and the mandibles were examined through radiographic analysis, biomechanical testing, and histological analysis. The PLLA/PLLA-gHA plates were non-transparent and showed a creamy white color, and the PLLA plates were transparent and faint yellow in color. At all time points following surgery, adsorption and degradation of the PLLA/PLLA-gHA plates were significantly less than those of the PLLA plates, and the lateral and longitudinal bending strengths of the surgically treated mandibles of the beagle dogs in the PLLA/PLLA-gHA group were significantly greater than those of the PLLA group and reached almost the value of intact mandibles at 12 months postoperatively. Additionally, relatively rapid bone healing was observed in the PLLA/PLLA-gHA group with the formation of new lamellar bone tissues at 12 months after the surgery. The PLLA/PLLA-gHA nano-composite can be employed as a biodegradable material for internal fixation of mandibular bone fractures.

  12. Cementless modular hip arthroplasty as a salvage operation for failed internal fixation of trochanteric fractures in elderly patients.

    PubMed

    Laffosse, Jean-Michel; Molinier, François; Tricoire, Jean-Louis; Bonnevialle, Nicolas; Chiron, Philippe; Puget, Jean

    2007-12-01

    Failure of internal fixation of trochanteric fractures requires repeat surgery in order to avoid the risks of complications affecting bedridden patients. This study was conducted to assess the results of hemi- or total hip arthroplasty with a cementless modular femoral stem, as a salvage operation following early mechanical failure of internal fixation. Twenty nine patients with a mean age of 81.1 years (70-91) were included in the study. Fractures extending into the diaphysis and pathological fractures were excluded, as well as patients who presented late complications. A cementless modular stem designed for metaphyso-diaphyseal anchorage was used in all cases. Twenty-two patients underwent hemiarthroplasty and seven total hip arthroplasty. Four patients died within one year and two were lost to follow-up. The remaining 23 patients were followed for a mean of 20 months (range: 6-89). At the time of last follow-up, 20 were ambulatory with (11 cases) or without support (9 cases) and three were bedridden. There were no intra- or postoperative femoral fractures. Two patients presented an early dislocation after bipolar hemiarthroplasty. One was successfully treated by closed reduction; the other underwent revision with a dual mobility acetabular component because of recurrent dislocation. All the patients reported significant pain relief and functional improvement. Subsidence of the stem greater than 5 mm was noted in three cases, without clinical consequences. The cementless modular femoral stem used in this study appeared as a reliable implant. Primary arthroplasty with such an implant could be considered in selected cases such as markedly unstable fractures and in osteoporotic elderly patients.

  13. Pitfalls associated with open reduction and internal fixation of fractured ribs.

    PubMed

    Sarani, Babak; Schulte, Leah; Diaz, Jose J

    2015-12-01

    Rib fracture is exceedingly common and remains a leading cause of death in patients with chest injury. Probability of death increases by 19% with each broken rib, and the probability of death increases further with age. Treatment is centered on pain control and early mobilization to provide adequate pulmonary hygiene. Multimodality interventions, such as incentive spirometry, postural changes, and coughing, are pivotal in minimizing the risk of pneumonia and death. Recently, many studies have found mortality benefit to operation fixation (ORIF) of ribs in select patients. However, this procedure remains underutilized partly due to lack of familiarity with its technique and pitfalls by trauma surgeons, in particular. Whereas there are publications on operative technique, there are no studies describing pitfalls associated with this procedure. The purpose of this paper is to describe pitfalls on the technical aspects of ORIF of the ribs based on the medical literature where possible and based on our experience in instances where peer reviewed evidence is lacking. The paper is not meant to serve as a protocol for managing rib fractures.

  14. Evaluation of three-dimensional printing for internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach: a preliminary report

    PubMed Central

    Zeng, Canjun; Xiao, Jidong; Wu, Zhanglin; Huang, Wenhua

    2015-01-01

    Objective: The aim of this study is to evaluate the efficacy and feasibility of three-dimensional printing (3D printing) assisted internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach. Methods: A total of 38 patients with unstable pelvic fractures were analyzed retrospectively from August 2012 to February 2014. All cases were treated operatively with internal fixation assisted by three-dimensional printing from minimal invasive para-rectus abdominis approach. Both preoperative CT and three-dimensional reconstruction were performed. Pelvic model was created by 3D printing. Data including the best entry points, plate position and direction and length of screw were obtained from simulated operation based on 3D printing pelvic model. The diaplasis and internal fixation were performed by minimal invasive para-rectus abdominis approach according to the optimized dada in real surgical procedure. Matta and Majeed score were used to evaluate currative effects after operation. Results: According to the Matta standard, the outcome of the diaplasis achieved 97.37% with excellent and good. Majeed assessment showed 94.4% with excellent and good. The imageological examination showed consistency of internal fixation and simulated operation. The mean operation time was 110 minutes, mean intraoperative blood loss 320 ml, and mean incision length 6.5 cm. All patients have achieved clinical healing, with mean healing time of 8 weeks. Conclusion: Three-dimensional printing assisted internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach is feasible and effective. This method has the advantages of trauma minimally, bleeding less, healing rapidly and satisfactory reduction, and worthwhile for spreading in clinical practice. PMID:26550226

  15. Biomechanical Evaluation of Four Methods for Internal Fixation of Comminuted Subtrochanteric Fractures

    PubMed Central

    Wang, Jie; Ma, Jian-xiong; Jia, Hao-bo; Chen, Yang; Yang, Yang; Ma, Xin-long

    2016-01-01

    Abstract Subtrochanteric fractures are common and result in significant morbidity and mortality. Various kinds of implants have been used to fix it. The aim of this study was to compare the biomechanical performance of PFN, DHS, DCS, and the PFLP in the treatment of subtrochanteric comminuted fractures. A total of 32 antiseptic human femurs from 16 donors were randomly allocated to 4 groups for fixation with PFN, DHS, DCS, and PFLP. A 2-cm cylindrical bone fragment was removed 1 cm below the lesser trochanter to simulate OTA/AO 32-C3.2 post instrumentation fracture. All specimens in single-leg stance situation were preloaded 5 times at 100 N in the axial direction to eliminate the time effect of relaxation and settling, followed by cyclic testing at a rate of 1 Hz with stepwise increasing load. Keeping the valley load at a constant level of 100 N during the entire cyclic test, the peak load, starting at 200 N, was increased by 100 N at 300-cycle steps until a maximum of 1500 cycles or until failure of the bone-implant construct occurred. Each specimen was kept unloaded under 100 N compression for 30 minutes between the 300-cycle steps. Femoral head displacement after 1500 cycles was 1.09 mm ± 0.13 for PFN, 1.78 mm ± 0.25 for DHS, 2.63 mm ± 0.46 for DCS, and 2.26 mm ± 0.16 for PFLP, with significant difference between any 2 implants (P < 0.01). The required load to reach 1-mm femoral head displacement was 563.04 N ± 158.34 for PFN, 485.73 N ± 147.27 for DHS, 258.44 N ± 97.23 for DCS, and 332.68 N ± 100.34 for PFLP. Significant differences were detected between any 2 implants (P < 0.001), except between DCS and PFLP and between DHS and PFN. The number of cycles until 1-mm femoral head displacement was 1458 ± 277 for PFN, 908 ± 184 for DHS, 369 ± 116 for DCS, and 603 ± 162 for PFLP. Significant differences were detected between any 2 implants (P < 0.01), except

  16. Inverted Internal Limiting Membrane Flap For Large Traumatic Macular Holes

    PubMed Central

    Abou Shousha, Mohsen Ahmed

    2016-01-01

    Abstract The aim of the study was to assess the role of inverted internal limiting membrane flap as a treatment option for large traumatic macular holes. This is a prospective noncomparative study in which 12 eyes with large traumatic macular holes (basal diameter of 1300–2800 μm) since 3 to 6 months were subjected to standard 23-gauge vitrectomy with removal of the posterior hyaloid, brilliant blue G (BBG)-assisted internal limiting membrane peeling in a circular fashion keeping it attached to the edge of the hole to create a flap. At the end of the surgery, air fluid exchange was done with inversion of the internal limiting membrane flap inside the macular hole using the soft tipped cannula and sulfur hexafluoride 20% as tamponade. The main follow-up measures are the best corrected visual acuity and the optical coherence tomography for 6 to 9 months. All the included eyes had a closed hole from the first week postoperative and along the follow-up period (6–9 months). The best corrected visual acuity improved from 20/2000 to 20/200 with a median of 20/400 preoperatively to 20/400 to 20/50 with a median of 20/100 at the end of follow-up period. Inverted internal limiting membrane flap is a good adjuvant to standard vitrectomy in the management of large traumatic macular holes that led to the 100% closure rate and improvement of best corrected visual acuity. PMID:26817894

  17. Inverted Internal Limiting Membrane Flap For Large Traumatic Macular Holes.

    PubMed

    Abou Shousha, Mohsen Ahmed

    2016-01-01

    The aim of the study was to assess the role of inverted internal limiting membrane flap as a treatment option for large traumatic macular holes.This is a prospective noncomparative study in which 12 eyes with large traumatic macular holes (basal diameter of 1300-2800 μm) since 3 to 6 months were subjected to standard 23-gauge vitrectomy with removal of the posterior hyaloid, brilliant blue G (BBG)-assisted internal limiting membrane peeling in a circular fashion keeping it attached to the edge of the hole to create a flap. At the end of the surgery, air fluid exchange was done with inversion of the internal limiting membrane flap inside the macular hole using the soft tipped cannula and sulfur hexafluoride 20% as tamponade. The main follow-up measures are the best corrected visual acuity and the optical coherence tomography for 6 to 9 months.All the included eyes had a closed hole from the first week postoperative and along the follow-up period (6-9 months). The best corrected visual acuity improved from 20/2000 to 20/200 with a median of 20/400 preoperatively to 20/400 to 20/50 with a median of 20/100 at the end of follow-up period.Inverted internal limiting membrane flap is a good adjuvant to standard vitrectomy in the management of large traumatic macular holes that led to the 100% closure rate and improvement of best corrected visual acuity.

  18. Plasmon-enhanced internal photoemission for photovoltaics: Theoretical efficiency limits

    NASA Astrophysics Data System (ADS)

    White, Thomas P.; Catchpole, Kylie R.

    2012-08-01

    Plasmon-enhanced internal photoemission in metal-semiconductor Schottky junctions has recently been proposed as an alternative photocurrent mechanism for solar cells. Here, we identify and discuss the requirements for efficient operation of such cells and analyze their performance limits under standard solar illumination. We show that the maximum efficiency limit is <8% even if perfect optical absorption can be achieved using plasmonic nanostructures. This limit results from the fundamental electronic properties of metallic absorbers. Modifying the electron density of states of the absorber could increase the efficiency to >20%.

  19. Does Extraction or Retention of the Wisdom Tooth at the Time of Surgery for Open Reduction and Internal Fixation of the Mandible Alter the Patient Outcome?

    PubMed

    Hammond, Douglas; Parmar, Sat; Whitty, Justin; Pigadas, Nick

    2015-12-01

    Whether to extract or retain wisdom teeth present in a fracture line is a controversial topic. This study reviewed the records of all patients who had mandibular wisdom teeth at the time of the injury, and had an open reduction and internal fixation procedure between January 2009 and January 2012. The cohort of patients who concomitantly had their wisdom tooth extracted at the time of fixation had a greater complication rate (24.3%) compared with patients who did not (14.9%). This suggests that if third molars in the line of a fracture have caries, are fractured, show signs of pericoronitis, are periodontally involved, or are interfering with the occlusion are extracted at the time of fixation, this will increase the incidence of complications.

  20. Internal Fixation Versus Hemiarthroplasty for Displaced Intra-Capsular Femoral Neck Fractures in ASA 3-5 Geriatric Patients

    PubMed Central

    Rezaie, W.; Wei, W.; Cleffken, B.I.; van der Vlies, C.H.; Cleffken, B.I.; Roukema, G.R.

    2016-01-01

    Background: The treatment of choice for elderly with a displaced intra-capsular femoral neck fractures is prosthetic replacement. This is however a major surgical procedure for geriatric patients with multiple co-morbidities which can threaten hemodynamic stability and lead to death. In this study we compared the outcome of internal fixation (IF) versus hemiarthroplasty (HA) for the management of intra-capsular femoral neck fractures in the elderly with severe co-morbidities. Methods: We conducted a retrospective cohort study of all the patients who were admitted to our Level-II trauma centre with a femoral neck fracture between January 2009 and June 2011. Inclusion criteria were: 70 years or older, ASA 3 or higher, a displaced femoral neck fracture and treatment with either internal fixation or a cemented hemiprosthesis. The primary outcome was 6-month mortality rate. Secondary outcomes were 30-day mortality, post-operative complications, re-operation rate and length of hospital stay. Results: 80 patients met our inclusion criteria. The mean age of the IF group was 81.6 years and in the HA group it was 84.5 years (P=0.07). The medical records were retrieved 34-64 months after surgery. Two intra-operative deaths due to cement implantation syndrome were found in the HA group and none in the IF group. Twelve patients (21.8%) in the HA group died within 30 days after surgery and 2 (8.0%) in the IF group (P=0.21). The mean operating time was 83 min. for the HA group and 51 min. for the IF group (P=0.000). There were more implant-related complications in the IF than in the HA group (36% vs 9.1% respectively, P=0.008). The 6-month mortality rates didn’t differ between the IF and the HA groups (respectively 28.0% vs 34.5%, P=0.62). Conclusion: The post-operative mortality rates did not differ between the IF and the HA groups in elderly patients with a displaced femoral neck fracture and ASA 3 to 5. However, the HA associated with less implant-related complications than

  1. Comparison of Percutaneous Cementoplasty with and Without Interventional Internal Fixation for Impending Malignant Pathological Fracture of the Proximal Femur

    SciTech Connect

    Tian, Qing-Hua He, Cheng-Jian Wu, Chun-Gen Li, Yong-Dong Gu, Yi-Feng Wang, Tao Xiao, Quan-Ping Li, Ming-Hua

    2016-01-15

    PurposeTo compare the efficacy of percutaneous cementoplasty (PCP) with and without interventional internal fixation (IIF) on malignant impending pathological fracture of proximal femur.MethodsA total of 40 patients with malignant impending pathological fracture of proximal femur were selected for PCP and IIF (n = 19, group A) or PCP alone (n = 21, group B) in this non-randomized prospective study. Bone puncture needles were inserted into the proximal femur, followed by sequential installation of the modified trocar inner needles through the puncture needle sheath. Then, 15–45 ml cement was injected into the femur lesion.ResultsThe overall excellent and good pain relief rate during follow-ups were significantly higher in group A than that in group B (89 vs. 57 %, P = 0.034). The average change of VAS, ODI, KPS, and EFES in group A were significantly higher than those in group B at 1-, 3-, 6-month, 1-year (P < 0.05). Meanwhile, The stability of the treated femur was significantly higher in group A than that in group B (P < 0.05).ConclusionPCP and IIF were not only a safe and effective procedure, but resulted in greater pain relief, bone consolidation, and also reduced the risk of fracture than the currently recommended approach of PCP done on malignant proximal femoral tumor.

  2. Immuno-inflammatory tissue reaction to stainless-steel and titanium plates used for internal fixation of long bones.

    PubMed

    Voggenreiter, Gregor; Leiting, Stefan; Brauer, Holger; Leiting, Peter; Majetschak, Matthias; Bardenheuer, Mark; Obertacke, Udo

    2003-01-01

    The immuno-inflammatory responses to stainless-steel (21 implants in 20 patients) and titanium plates (22 implants in 20 patients) used in the treatment of long bone fractures were studied immunohistochemically. All fractures healed without complications. In the soft tissue adjacent to the surface of the implants a dark discolouration of the tissue was visible in 18/21 stainless-steel and 20/22 titanium plates. Tissue specimens of all patients contained positive staining for macrophages (CD68-positive cells). Serial sections showed that the majority of cells were found to express the HLA-DR molecule indicating their activation. Many of the macrophages were surrounded by clusters of T-lymphocytes (CD3-positive cells). 17 out of 21 steel specimens and 15 out of 22 titanium specimens showed the infiltration of moderate amounts of cytotoxic T-lymphocytes (CD8-positive cells). Moderate amounts of B-lymphocytes (CD79alpha positive cells) were evident in four patients with steel and six patients with titanium implants. The results of the present study clearly demonstrate the presence of a marked inflammation and tissue reaction in the soft tissue covering stainless-steel and titanium plates used for internal fixation of fractures of long bones independently from the material used.

  3. Arthroplasty versus Internal Fixation for Displaced Intracapsular Femoral Neck Fracture in the Elderly: Systematic Review and Meta-analysis of Short- and Long-term Effectiveness

    PubMed Central

    Ye, Chen-Yi; Liu, An; Xu, Ming-Yuan; Nonso, Nwofor Samuel; He, Rong-Xin

    2016-01-01

    Background: There is conflicting evidence as to whether the femoral head should be preserved or replaced in elderly patients with displaced intracapsular femoral neck fractures. In this article, we performed a systematic review and meta-analysis to compare the short- and long-term effectiveness of arthroplasty (AR) and internal fixation (IF). Methods: PubMed, Embase, and the Cochrane Library were searched systematically up to January 2016. All randomized controlled trials directly comparing the effectiveness of AR and IF for displaced intracapsular fracture were retrieved with no limitation on language or publication year. Results: In total, eight prospective randomized studies involving 2206 patients were included. The results of our study showed that patients in the AR group reported significantly lower complication (risk ratio: 0.56, 95% confidence interval [CI] = 0.38–0.80), re-operation (risk ratio: 0.17, 95% CI = 0.13–0.22), revision rates (risk ratio: 0.11, 95% CI: 0.08–0.16), and better function compared with their IF counterparts, and they were less likely to suffer postoperative pain. No statistically significant differences for the rates of mortality, infection, and/or deep vein thrombosis between AR and IF were found. Conclusions: Based on our analysis, we recommend that AR should be used as the primary treatment for displaced intracapsular femoral neck fractures in the elderly. However, IF may be appropriate for those who are very frail. PMID:27779172

  4. Biomechanical in vitro evaluation of three stable internal fixation techniques used in sagittal osteotomy of the mandibular ramus: a study in sheep mandibles

    PubMed Central

    de OLIVERA, Leandro Benetti; SANT'ANA, Eduardo; MANZATO, Antonio José; GUERRA, Fábio Luis Bunemer; ARNETT, G. William

    2012-01-01

    Among the osteotomies performed in orthognathic surgery, the sagittal osteotomy of the mandibular ramus (SOMR) is the most common, allowing a great range of movements and stable internal fixation (SIF), therefore eliminating the need of maxillomandibular block in the postoperative period. Objectives: The purpose of this study was to evaluate the biomechanical resistance of three national systems used for SIF in SOMR in sheep mandibles. Material and methods: The study was performed in 30 sheep hemi-mandibles randomly divided into 3 experimental groups, each containing 10 hemi-mandibles. The samples were measured to avoid discrepancies and then subjected to SOMR with 5-mm advancement. In group I, 2.0x12 mm screws were used for fixation, inserted in an inverted "L" pattern (inverted "L" group). In group II, fixation was performed with two 2.0x12 mm screws, positioned in a linear pattern and a 4-hole straight miniplate and four 2.0x6.0 mm monocortical screws (hybrid group). In group III, fixation was performed with two 4-hole straight miniplates and eight 2.0x6.0 mm monocortical screws (mini plate group). All materials used for SIF were supplied by Osteosin - SIN. The hemimandibles were subjected to vertical linear load test by Kratos K2000MP mechanical testing unit for loading registration and displacement. Results: All groups showed similar resistance during mechanical test for loading and displacement, with no statistically significant differences between groups according to analysis of variance. Conclusion: These results indicate that the three techniques of fixation are equally effective for clinical fixation of SOMR. PMID:23032203

  5. In vitro biomechanical evaluation of internal fixation techniques on the canine lumbosacral junction

    PubMed Central

    Dillard, Stacy; Roe, Simon

    2015-01-01

    Few biomechanical studies have evaluated the effect of internal stabilization techniques after decompressive surgery on the stability of the canine lumbosacral junction. The purpose of this canine cadaver study is to evaluate the stability of the canine lumbosacral (LS) spine in flexion and extension following laminectomy and discectomy and then stabilization with each of the three techniques: pins and polymethylmethacrylate (P/PMMA), two dorsal locking plates (SOP) or bilateral transarticular facet screws (FACET).Using a cantilever biomechanical system, bending moments were applied to the LS and range of motion (ROM) was recorded via a rotational potentiometer. With 3 Nm, the ROM (n = 4 in each group) for P/PMMA, SOP and FACET were 1.92 ± 0.96°, 2.56 ± 0.55°and 3.18 ± 1.14°, respectively. With moments up to 35 Nm, the P/PMMA specimens appeared stable. Sacroiliac motion in the SOP and FACET groups invalidated further comparisons. Each of the stabilization techniques (P/PMMA, SOP, and FACET) significantly decreased the range of motion in flexion and extension for low bending moments. PMID:26312169

  6. In vitro biomechanical evaluation of internal fixation techniques on the canine lumbosacral junction.

    PubMed

    Early, Peter; Mente, Peter; Dillard, Stacy; Roe, Simon

    2015-01-01

    Few biomechanical studies have evaluated the effect of internal stabilization techniques after decompressive surgery on the stability of the canine lumbosacral junction. The purpose of this canine cadaver study is to evaluate the stability of the canine lumbosacral (LS) spine in flexion and extension following laminectomy and discectomy and then stabilization with each of the three techniques: pins and polymethylmethacrylate (P/PMMA), two dorsal locking plates (SOP) or bilateral transarticular facet screws (FACET).Using a cantilever biomechanical system, bending moments were applied to the LS and range of motion (ROM) was recorded via a rotational potentiometer. With 3 Nm, the ROM (n = 4 in each group) for P/PMMA, SOP and FACET were 1.92 ± 0.96°, 2.56 ± 0.55°and 3.18 ± 1.14°, respectively. With moments up to 35 Nm, the P/PMMA specimens appeared stable. Sacroiliac motion in the SOP and FACET groups invalidated further comparisons. Each of the stabilization techniques (P/PMMA, SOP, and FACET) significantly decreased the range of motion in flexion and extension for low bending moments.

  7. Heterotopic Ossification around the Knee after Internal Fixation of a Complex Tibial Plateau Fracture Combined with the Use of Demineralized Bone Matrix (DBM): A Case Report

    PubMed Central

    Nota, Sjoerd P.F.T.; Kloen, Peter

    2014-01-01

    Demineralized bone matrix has been successfully commercialized as an alternative bone graft material that not only can function as filler but also as an osteoinductive graft. Numerous studies have confirmed its beneficial use in clinical practice. Heterotopic ossification after internal fixation combined with the use of demineralized bone matrix has not been widely reported. In this paper we describe a 39 year old male who sustained a complex articular fracture that developed clinically significant heterotopic ossification after internal fixation with added demineralized bone matrix. Although we cannot be sure that there is a cause-and-effect relation between demineralized bone matrix and the excessive heterotopic ossification seen in our patient, it seems that some caution in using demineralised bone matrix in similar cases is warranted. Also, given the known inter- and intraproduct variability, the risks and benefits of these products should be carefully weighed. PMID:25692153

  8. Prophylactic radiotherapy against heterotopic ossification following internal fixation of acetabular fractures: a comparative estimate of risk

    PubMed Central

    Nasr, P; Yip, G; Scaife, J E; House, T; Thomas, S J; Harris, F; Owen, P J; Hull, P

    2014-01-01

    Objective: Radiotherapy (RT) is effective in preventing heterotopic ossification (HO) around acetabular fractures requiring surgical reconstruction. We audited outcomes and estimated risks from RT prophylaxis, and alternatives of indometacin or no prophylaxis. Methods: 34 patients underwent reconstruction of acetabular fractures through a posterior approach, followed by a 8-Gy single fraction. The mean age was 44 years. The mean time from surgery to RT was 1.1 days. The major RT risk is radiation-induced fatal cancer. The International Commission on Radiological Protection (ICRP) method was used to estimate risk, and compared with a method (Trott and Kemprad) specifically for estimating RT risk for benign disease. These were compared with risks associated with indometacin and no prophylaxis. Results: 28 patients (82%) developed no HO; 6 developed Brooker Class I; and none developed Class II–IV HO. The ICRP method suggests a risk of fatal cancer in the range of 1 in 1000 to 1 in 10,000; the Trott and Kemprad method suggests 1 in 3000. For younger patients, this may rise to 1 in 2000; and for elderly patients, it may fall to 1 in 6000. The risk of death from gastric bleeding or perforation from indometacin is 1 in 180 to 1 in 900 in older patients. Without prophylaxis risk of death from reoperation to remove HO is 1 in 4000 to 1 in 30,000. Conclusion: These results are encouraging, consistent with much larger series and endorse our multidisciplinary management. Risk estimates can be used in discussion with patients. Advances in knowledge: The risk from RT prophylaxis is small, it is safer than indometacin and substantially overlaps with the range for no prophylaxis. PMID:25089852

  9. Use of the TRPV1 Agonist Capsaicin to Provide Long-Term Analgesia in a Rat Limb Fracture/Open Repair, Internal Fixation Model

    DTIC Science & Technology

    2012-10-01

    W81XWH-10-2-0093 TITLE: Use of the TRPV1 Agonist Capsaicin to Provide Long-Term Analgesia in a Rat Limb Fracture/Open Repair, Internal Fixation Model...2. REPORT TYPE Final 3. DATES COVERED (From - To) 30September2010-29September2012 4. TITLE AND SUBTITLE Use of the TRPV1 Agonist Capsaicin to...capsaicin around the fracture site. 15. SUBJECT TERMS Femur fracture, Rat Model, Pain, Capsaicin, Trauma, TRPV1 16. SECURITY CLASSIFICATION OF

  10. A comparative study of internal fixation and prosthesis replacement for radial head fractures of Mason type III

    PubMed Central

    Ruan, Hong-Jiang; Liu, Jun-Jian; Zeng, Bing-fang

    2007-01-01

    Although several treatment options for radial head fractures are available, no clear solutions exist. In this study we therefore compare open reduction and internal fixation (ORIF) with bipolar radial head prosthesis replacement in treatment of radial head fractures of Mason type III. Cement stem and bipolar radial prosthesis were used to treat 12 fresh cases and two old cases of Mason type III radial head fracture. As a control group, another eight cases of radial head type III fracture were treated with ORIF with cannulated screws and Kirschner (K) wires. The 14 patients who received radial head prosthesis replacement were followed-up for 15.9 months (range 10–27 months). According to elbow functional evaluation criteria by Broberg and Morrey, we found excellent results in nine cases, good in four, and fair in one. Mean follow-up of the eight cases in the ORIF group was 14 months (range 10–21 months), with good results in one case, fair in four, and poor in three. The result was good or excellent in 92.9% of prosthesis replacement patients and in 12.5% of ORIF patients. This difference is statistically significant (P = 0.0004; Fisher’s exact test). We concluded that bipolar radial head prosthesis replacement is better than ORIF in treatment of Mason type III radial head fracture. Electronic Supplementary Material The online version of this article (doi:10.1007/s00264-007-0453-3) contains supplementary material, which is available to authorized users. PMID:17938924

  11. Outcomes of anterolateral thigh-free flaps and conversion from external to internal fixation with bone grafting in gustilo type IIIB open tibial fractures.

    PubMed

    Lee, Jae Hoon; Chung, Duke Whan; Han, Chung Soo

    2012-09-01

    The purpose of this study was to analyze the utility and the clinical outcomes of anterolateral thigh (ALT)-free flaps and conversion from external to internal fixation with plating and bone grafting in Gustilo type IIIB open tibial fractures. A total of 21 patients were analyzed retrospectively. The mean follow-up period was 18 months and the mean age was 46.7 years. There were 18 men and three women. The mean time from injury to flap coverage was 11.6 days. The mean size of flaps used was 15.3 × 8.2 cm. The mean size of bone defects was 2.26 cm. Segmental bone defects were observed in 5 five cases, for which bone transport or vascularized fibular graft were performed. When flaps were successful and the fracture sites did not have any evidence of infection, internal fixation with plates and bone grafting were performed. Flaps survived in 20 cases. In the 20 cases with successful flaps, two cases developed osteomyelitis, but the 20 cases achieved solid bone union at a mean of 8.6 months after the injury, salvaging the lower extremity in 100% of the cases. At the last follow-up, 9 nine cases were measured excellent or good; 6, fair; and 6, poor in the functional assessment based on the method developed by Puno et al. ALT- free flaps to cover soft tissue defects in Gustilo type IIIB open tibial fractures are considered as useful option for the treatment of composite defects. In addition, conversion to internal fixation and bone grafting can be an alternative method in order to reduce the risk of complications and inconvenience of external fixators.

  12. A systematic review of open reduction and internal fixation of periprosthetic femur fractures with or without allograft strut, cerclage, and locked plates.

    PubMed

    Moore, Ryan E; Baldwin, Keith; Austin, Matthew S; Mehta, Samir

    2014-05-01

    Few comparative studies exist for open reduction and internal fixation of Vancouver B1 and C fractures. We therefore performed a systematic review of fractures treated with or without an allograft strut, and using various fixation techniques. Thirty-seven manuscripts including 682 fractures were identified between 1992 and 2012. Percent union was similar for Vancouver B1 fractures treated with or without an allograft strut (90.7% vs. 91.5%). Time to union (4.4 vs. 6.6 months) and deep infection (3.8% vs. 8.3%) were increased with use of allograft struts. Percent union and time to union were unaffected by plate type or use of cerclage. We conclude that due to increased infection and time to union, allograft struts should be used cautiously during operative treatment of Vancouver B1 factures.

  13. Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients

    PubMed Central

    2014-01-01

    Background During the last 2 decades, many studies on the treatment of mandibular condyle fracture have been published. The incidence of mandibular condyle fractures is variable, ranging from 17.5% to 52% of all mandibular fractures. This retrospective study evaluated the long-term clinical and radiological outcomes after surgical treatment of 25 patients with a total of 26 extracapsular condyle fractures. Methods We used 2 types of surgical approaches, the retromandibular retroparotid or preauricular approach. Three kinds of rigid internal fixation plates were used—single plate, double plate, and trapezoidal plate. The following post-operative clinical parameters were evaluated: dental occlusion, facial nerve functionality, skin scarring, and temporomandibular joint functionality. All patients underwent post-operative orthopanoramic radiography and computed tomography. The patients were also monitored for complications such as Frey’s syndrome, infection, salivary fistula, plate fracture, and permanent paralysis of the facial nerve; the patient’s satisfaction was also recorded. Results Of the 25 patients, 80% showed occlusion recovery, 88% had no facial nerve injury, and 88% presented good surgical skin scarring. The patients showed early complete recovery of temporomandibular joint functionality and 72% of them were found to be asymptomatic. The postoperative radiographs of all patients indicated good recovery of the anatomical condylar region, and 80% of them had no postoperative complications. The average degree of patient satisfaction was 8.32 out of 10. Our results confirm that the technique of open reduction and internal fixation in association with postoperative functional rehabilitation therapy should be considered for treating patients with extracapsular condylar fractures. Conclusion The topic of condylar injury has generated more discussion and controversy than any other topic in the field of maxillofacial trauma. We confirm that open reduction and

  14. Retinal Damage Induced by Internal Limiting Membrane Removal

    PubMed Central

    Gelman, Rachel; Stevenson, William; Prospero Ponce, Claudia; Agarwal, Daniel; Christoforidis, John Byron

    2015-01-01

    The internal limiting membrane (ILM), the basement membrane of the Müller cells, serves as the interface between the vitreous body and the retinal nerve fiber layer. It has a fundamental role in the development, structure, and function of the retina, although it also is a pathologic component in the various vitreoretinal disorders, most notably in macular holes. It was not until understanding of the evolution of idiopathic macular holes and the advent of idiopathic macular hole surgery that the idea of adjuvant ILM peeling in the treatment of tractional maculopathies was explored. Today intentional ILM peeling is a commonly applied surgical technique among vitreoretinal surgeons as it has been found to increase the rate of successful macular hole closure and improve surgical outcomes in other vitreoretinal diseases. Though ILM peeling has refined surgery for tractional maculopathies, like all surgical procedures it is not immune to perioperative risk. The essential role of the ILM to the integrity of the retina and risk of trauma to retinal tissue spurs suspicion with regard to its routine removal. Several authors have investigated the retinal damage induced by ILM peeling and these complications have been manifested across many different diagnostic studies. PMID:26425355

  15. History of internal fixation with plates (part 2): new developments after World War II; compressing plates and locked plates.

    PubMed

    Hernigou, Philippe; Pariat, Jacques

    2016-12-30

    The first techniques of operative fracture with plates were developed in the 19th century. In fact, at the beginning these methods consisted of an open reduction of the fracture usually followed by a very unstable fixation. As a consequence, the fracture had to be opened with a real risk of (sometimes lethal) infection, and due to unstable fixation, protection with a cast was often necessary. During the period between World Wars I and II, plates for fracture fixation developed with great variety. It became increasingly recognised that, because a fracture of a long bone normally heals with minimal resorption at the bone ends, this may result in slight shortening and collapse, so a very rigid plate might prevent such collapse. However, as a consequence, delayed healing was observed unless the patient was lucky enough to have the plate break. One way of dealing with this was to use a slotted plate in which the screws could move axially, but the really important advance was recognition of the role of compression. After the first description of compression by Danis with a "coapteur", Bagby and Müller with the AO improved the technique of compression. The classic dynamic compression plates from the 1970s were the key to a very rigid fixation, leading to primary bone healing. Nevertheless, the use of strong plates resulted in delayed union and the osteoporosis, cancellous bone, comminution, and/or pathological bone resulted in some failures due to insufficient stability. Finally, new devices represented by locking plates increased the stability, contributing to the principles of a more biological osteosynthesis while giving enough stability to allow immediate full weight bearing in some patients.

  16. 76 FR 18620 - Operating Limitations at John F. Kennedy International Airport

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-04

    ... Federal Aviation Administration Operating Limitations at John F. Kennedy International Airport AGENCY... amends the Order Limiting Operations at John F. Kennedy International Airport (JFK) that published on... until the final Congestion Management Rule for LaGuardia Airport, John F. Kennedy International...

  17. Expansive Open-Door Cervical Laminoplasty: In Situ Reconstruction of Extensor Muscle Insertion on the C2 Spinous Process Combined With Titanium Miniplates Internal Fixation.

    PubMed

    Cheng, Zhaohui; Chen, Weishan; Yan, Shigui; Li, Wanli; Qian, Shengjun

    2015-07-01

    Retrospective cohort study. To evaluate efficacy and relevant problems of in situ reconstruction of extensor muscle insertion on the C2 spinous process combined with titanium miniplates internal fixation in expansive open-door cervical laminoplasty in order to improve surgical treatment effect. Expansive open-door cervical laminoplasty has been widely applied in clinical practice, but there are a series of postoperative problems. Therefore, decreasing postoperative complications in order to more effectively relieve symptoms remains a subject for additional research. From October 2011 to September 2013, a total of 60 patients who suffered cervical canal stenosis were treated by expansive open-door laminoplasty with in situ reconstruction of extensor muscle insertion on the C2 spinous process combined with titanium miniplates internal fixation. Changes of cervical curvature index (CI) and range of motion (ROM) were calculated using data from preoperative and postoperative cervical spine X-ray examinations. Clinical function was scored using the Japanese Orthopedics Association Scoring System (JOA) and the neck disability index (NDI). The mean CI before the operation and at 1-year postoperation were 10.49% ± 3.93% and 14.14 ± 2.85 (P < 0.05). The mean ROM values were 43.35 ± 7.55 before the operation, 34.83 ± 7.41 at 1-year postoperation (P < 0.05). The NDI scores decreased from 19.42 ± 4.12 to 7.37 ± 2.58, and the JOA scores increased from 8.87 ± 1.99 to 13.55 ± 1.72, representing significant improvement (P < 0.05). One patient had postoperative C5 nerve root palsy and completely recovered 1 month later. Neither collapse nor door closure in the open-door side occurred in any of the patients. Expansive open-door cervical laminoplasty with in situ reconstruction of extensor muscle insertion on the C2 spinous process combined with titanium miniplates internal fixation is a safe and effective surgical method, and can

  18. The International Baccalaureate and "Growth Scepticism": A "Social Limits" Framework

    ERIC Educational Resources Information Center

    Bunnell, Tristan

    2011-01-01

    The number of schools offering the programmes of the International Baccalaureate (IB) hit 3000 in July 2010. Since 2004 the IB has aimed for further growth within a "wider access" and "greater impact" paradigm. A "further" 7000 schools are expected to be involved by 2020. However, there is now considerable concern about growth, especially within…

  19. Iliopsoas bursitis-associated femoral neuropathy exacerbated after internal fixation of an intertrochanteric hip fracture in rheumatoid arthritis: a case report.

    PubMed

    Tokita, Asami; Ikari, Katsunori; Tsukahara, So; Toki, Hiroe; Miyawaki, Motoko; Mochizuki, Takeshi; Kawamura, Koichiro; Tomatsu, Taisuke; Momohara, Shigeki

    2008-01-01

    We present the case of a 63-year-old woman with a six-year history of rheumatoid arthritis (RA) and a left iliopsoas bursitis. Radiography had detected destructive changes in her hip joint associated with her bursitis, and she had reported some paresthesia along the left anterior distal thigh. Her pain and numbness remained tolerable, and her disease activity was well controlled until she accidentally fell on the floor, which resulted in an unstable intertrochanteric fracture of left femur with displacement of the proximal portion. The fracture was successfully treated with open reduction and internal fixation, but after the surgery, her femoral nerve palsy worsened. She subsequently underwent bursa excision after the failure of conservative treatment. Accordingly, after bursa excision, the postoperative course was uneventful, and her neurological symptoms gradually disappeared. We would recommend that bursa excision be considered even in cases of iliopsoas bursitis associated with mild femoral neuropathy when destructive changes in the hip joint are also present.

  20. Mechanical Comparison of Headless Screw Fixation and Locking Plate Fixation for Talar Neck Fractures.

    PubMed

    Karakasli, Ahmet; Hapa, Onur; Erduran, Mehmet; Dincer, Cemal; Cecen, Berivan; Havitcioglu, Hasan

    2015-01-01

    For talar neck fractures, open reduction and internal fixation have been thought to facilitate revascularization and prevent osteonecrosis. Newer screw systems allow for placement of cannulated headless screws, which provide compression by virtue of a variable pitch thread. The present study compared the biomechanical fixation strength of cannulated headless variable-pitch screw fixation and locking plate fixation. A reproducible talar neck fracture was created in 14 fresh cadaver talar necks. Talar head fixation was then performed using 2 cannulated headless variable-pitch 4-mm/5-mm diameter (4/5) screws (Acutrak; Acumed, Hillsboro, OR) and locking plate fixation. Headless variable-pitch screw fixation had lower failure displacement than did locking plate fixation. No statistically significant differences were found in failure stiffness, yield stiffness (p = .655), yield load (p = .142), or ultimate load between the 2 fixation techniques. Cannulated headless variable-pitch screw fixation resulted in better failure displacement than locking plate fixation in a cadaveric talus model and could be considered a viable option for talus fracture fixation. Headless, fully threaded, variable-pitch screw fixation has inherent advantages compared with locking plate fixation, because it might cause less damage to the articular surface and can compress the fracture for improved reduction. Additionally, plate fixation can increase the risk of avascular necrosis owing to the wider incision and dissection of soft tissues.

  1. International pact limits airline's liability for needle injury.

    PubMed

    1998-09-18

    [Name removed] sued Mexicana de Aviacion S.A. de C.V. for liability after he was pricked in the leg by a hypodermic needle that was found in the plane's seat cushion. A Federal judge ruled that since liability claims resulting from injuries on international flights are covered by the Warsaw Convention, [name removed] could not recover more than $75,000 for his fear-of-AIDS liability lawsuit. The judge also stated that the Signature Support Corporation, a second defendant named in the case because they are subcontracted to clean Mexicana's planes, may also be covered by the Warsaw Convention.

  2. EVALUATION OF SURGICAL TREATMENT OF FRACTURES OF THORACOLUMBAR SPINE WITH THIRD-GENERATION MATERIAL FOR INTERNAL FIXATION

    PubMed Central

    Bortoletto, Adalberto; Rodrigues, Luiz Cláudio Lacerda; Matsumoto, Marcelo Hide

    2015-01-01

    Objective: To evaluate the functional results from patients with surgical fractures in the thoracolumbar spine. Method: A prospective study including 100 patients with spinal fractures in the thoracic and lumbar segments was conducted. The lesions were classified in accordance with the AO system, and the patients were treated surgically. The presence of early kyphosis and its evolution after the surgical intervention, and the presence of postoperative pain and its evolution up to the 24th week after the surgery, were evaluated. We compared our data with the literature. Results: One hundred surgical patients were analyzed, of which 37 were type A, 46 were type B and 17 were Type C. Patients who presented Frankel A kept their clinical status, but patients with Frankel B or higher evolved with some improvement. The average improvement in pain based on a visual analog scale was more than four points. All the patients were able to return to their daily routine activities, although we did not take the return to work to be an assessment criterion. Conclusion: Despite controversy regarding the indications for surgery in cases of fractured spine, we believe that the method that we used was satisfactory because of the good results and low complication rate. However, more randomized prospective studies with longer follow-up are needed in order to evaluate this type of fixation. PMID:27047822

  3. Functional outcomes and cost estimation for extra-articular and simple intra-articular distal radius fractures treated with open reduction and internal fixation versus closed reduction and percutaneous Kirschner wire fixation

    PubMed Central

    Dzaja, Ivan; MacDermid, Joy C.; Roth, James; Grewal, Ruby

    2013-01-01

    Background We sought to compare direct costs and clinical and radiographic outcomes for distal radius fractures (DRF) treated with open reduction internal fixation with volar locking plates (VLP) versus closed reduction and percutaneous pinning (CRPP). Methods We identified patients with AO-type A and C1 DRFs from a prospective database. Outcomes were assessed at 6 weeks and at 3, 6 and 12 months, and surgical care costs were estimated. Results Twenty patients were treated with CRPP and 24 with VLP. There were no significant differences in patient-rated wrist evaluation (PRWE) scores between the 2 groups at any time point (mean 16.2 ± 23.1 in the CRPP group v. 21.5 ± 23.6 in the VLP group, p = 0.91). Overall alignment was maintained in both groups; however, there was a greater loss of radial height over time with CRPP than VLP (0.97 mm v. 0.25 mm, p = 0.018). The mean duration of surgery was longer for VLP than CRPP (113.9 ± 39.5 min v. 86.5 ± 7.8 min, p = 0.029), but there were fewer clinic visits (5.2 ± 1.4 v. 7.8 ± 1.3, p < 0.001) and fewer radiographs (7.4 ± 2.7 v. 9 ± 2.4, p = 0.031). The total cost per case was greater for VLP than CRPP ($1637.27 v. $733.91). Conclusion Based on PRWE scores, VLPs did not offer any significant advantage over CRPP in patients with simple fracture types between 3 and 12 months, but they were much more costly. Whether VLP offers any functional advantage earlier in recovery, thereby justifying their expense, requires further investigation in the form of a prospective randomized trial with a detailed cost analysis. PMID:24284144

  4. Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

    PubMed Central

    Schulz-Drost, Stefan; Oppel, Pascal; Grupp, Sina; Schmitt, Sonja; Carbon, Roman Th.; Mauerer, Andreas; Hennig, Friedrich F.; Buder, Thomas

    2015-01-01

    Different ways to stabilize a sternal fracture are described in literature. Respecting different mechanisms of trauma such as the direct impact to the anterior chest wall or the flexion-compression injury of the trunk, there is a need to retain each sternal fragment in the correct position while neutralizing shearing forces to the sternum. Anterior sternal plating provides the best stability and is therefore increasingly used in most cases. However, many surgeons are reluctant to perform sternal osteosynthesis due to possible complications such as difficulties in preoperative planning, severe injuries to mediastinal organs, or failure of the performed method. This manuscript describes one possible safe way to stabilize different types of sternal fractures in a step by step guidance for anterior sternal plating using low profile locking titanium plates. Before surgical treatment, a detailed survey of the patient and a three dimensional reconstructed computed tomography is taken out to get detailed information of the fracture’s morphology. The surgical approach is usually a midline incision. Its position can be described by measuring the distance from upper sternal edge to the fracture and its length can be approximated by the summation of 60 mm for the basis incision, the thickness of presternal soft tissue and the greatest distance between the fragments in case of multiple fractures. Performing subperiosteal dissection along the sternum while reducing the fracture, using depth limited drilling, and fixing the plates prevents injuries to mediastinal organs and vessels. Transverse fractures and oblique fractures at the corpus sterni are plated longitudinally, whereas oblique fractures of manubrium, sternocostal separation and any longitudinally fracture needs to be stabilized by a transverse plate from rib to sternum to rib. Usually the high convenience of a patient is seen during follow up as well as a precise reconstruction of the sternal morphology. PMID

  5. Surgical fixation of sternal fractures: preoperative planning and a safe surgical technique using locked titanium plates and depth limited drilling.

    PubMed

    Schulz-Drost, Stefan; Oppel, Pascal; Grupp, Sina; Schmitt, Sonja; Carbon, Roman Th; Mauerer, Andreas; Hennig, Friedrich F; Buder, Thomas

    2015-01-05

    Different ways to stabilize a sternal fracture are described in literature. Respecting different mechanisms of trauma such as the direct impact to the anterior chest wall or the flexion-compression injury of the trunk, there is a need to retain each sternal fragment in the correct position while neutralizing shearing forces to the sternum. Anterior sternal plating provides the best stability and is therefore increasingly used in most cases. However, many surgeons are reluctant to perform sternal osteosynthesis due to possible complications such as difficulties in preoperative planning, severe injuries to mediastinal organs, or failure of the performed method. This manuscript describes one possible safe way to stabilize different types of sternal fractures in a step by step guidance for anterior sternal plating using low profile locking titanium plates. Before surgical treatment, a detailed survey of the patient and a three dimensional reconstructed computed tomography is taken out to get detailed information of the fracture's morphology. The surgical approach is usually a midline incision. Its position can be described by measuring the distance from upper sternal edge to the fracture and its length can be approximated by the summation of 60 mm for the basis incision, the thickness of presternal soft tissue and the greatest distance between the fragments in case of multiple fractures. Performing subperiosteal dissection along the sternum while reducing the fracture, using depth limited drilling, and fixing the plates prevents injuries to mediastinal organs and vessels. Transverse fractures and oblique fractures at the corpus sterni are plated longitudinally, whereas oblique fractures of manubrium, sternocostal separation and any longitudinally fracture needs to be stabilized by a transverse plate from rib to sternum to rib. Usually the high convenience of a patient is seen during follow up as well as a precise reconstruction of the sternal morphology.

  6. Open reduction and internal fixation of OTA type C2-C4 fractures of the calcaneus with a triple-plate technique.

    PubMed

    Brunner, Alexander; Müller, Jochen; Regazzoni, Pietro; Babst, Reto

    2012-01-01

    The purpose of this study was to present a surgical technique of open reduction and internal fixation of displaced intra-articular calcaneal fractures with 3 AO mini-fragment plates and to evaluate the clinical and radiological outcome of a consecutive group of patients after a mean follow-up of 41.7 months. A series of 54 patients (16 women and 38 men) with 62 calcaneal fractures were treated over a period of 6.5 years. Forty-five patients with 50 calcaneal fractures were completely clinically and radiologically followed up. Clinical follow-up included assessment of range of motion, pain according to a visual analogue scale, the American Orthopaedic Foot and Ankle Society hindfoot score, and the short-form 36 health survey. Radiological follow-up included plain axial and lateral radiographs and measurement of the Böhler's angle and Gissane's angle. Independent Student's t test and paired Student's t test were used alongside the chi-square test to compare clinical and radiological data and score values between different groups of patients. Eleven patients showed breakage of the osteosynthesis material during the healing process and 2 patients sustained deep wound infection requiring revision surgery. At the final follow-up all fractures had healed. The average range of motion was supination 26.4° (range 0° to 50°; SD 11.6°), pronation 15.4° (range 0° to 30°; SD 6.4°), dorsal extension 14.3° (range -10° to 30°; SD 8.0°), and plantarflexion 39.6° (range 20° to 65°; SD 11.7°). Patients with OTA type C4 fractures achieved significantly lower supination (p < .01) and plantarflexion (p < .01) compared with other fracture types. The mean visual analog scale pain score was 3.6 (range 0 to 8; SD 2.3) points, average American Orthopaedic Foot and Ankle Society hindfoot score was 70.8 (range 33 to 100; SD 17.1) points, and the mean short-form 36 score was 60.98 (range 22.9 to 93.0; SD 18.4) points. The mean postoperative Böhler's angle was 28.9° (range 8

  7. Long-term Results, Functional Outcomes and Complications after Open Reduction and Internal Fixation of Neglected and Displaced Greater Tuberosity of Humerus Fractures

    PubMed Central

    Amroodi, Morteza Nakhaei; Behshad, Vahid; Motaghi, Paniz

    2016-01-01

    Background: Humerus fractures include 5% to 8% of total fractures. Non-union and delayed union of GT (GT) fractures is uncommon; however they present a challenge to the orthopedic surgeons. Significant controversy surrounds optimal treatment of neglected fractures. The purpose of this article was to perform a comparative study to evaluate the outcomes of open reduction and internal fixation (ORIF) of neglected GT fractures. Methods: We retrospectively evaluated the results of surgical intervention in 12 patients with displaced nonunion of GT fractures who were referred to our center. Before and minimally 25 months after surgery ROM, muscle forces, Constant Shoulder Score (Constant-Murley score) (CSS), Visual Analogue Scale (VAS), Activities of Daily Living (ADL) Score and American Shoulder and Elbow Surgeons (ASES) Score were all recorded. Additionally, the results were compared with undamaged shoulder. Results: Between March 2006 and January 2013, 12 patients underwent surgical intervention and followed for 36.2 months in average. All fractures healed. Anatomic reduction achieved only in 6 cases with no report of avascular necrosis or infection. All ROMs and muscle forces increased significantly (Mean Forward Flexion: 49.16 to 153.3, Mean Internal Rotation: 3 to 9, Mean External Rotation: -5 to 27.5) (P value<0.0001). All functional scores including CSS, VAS, ADL and ASES score improved significantly (Mean VAS: 6.5 to 1.3, Mean CSS: 29.83 to 86, Mean ADL: 6.6 to 27.1,: Mean ASES: 28.6 to 88.9) (P value<0.0001). Conclusion: ORIF for neglected and displaced GT fractures has satisfactory functional outcomes, despite of non-anatomical reduction of the fracture. PMID:27847845

  8. Exercise in the Heat is Limited by a Critical Internal Temperature

    DTIC Science & Technology

    2016-06-14

    Exercise in the heat is limited by a critical internal temperature T. J. WALTERS,1,2 K. L. RYAN,1,3 L. M. TATE,1 AND P. A. MASON1 1Air Force Research...April 2000 Walters, T. J., K. L. Ryan, L. M. Tate, and P. A. Mason. Exercise in the heat is limited by a critical internal temper- ature. J Appl Physiol...89: 799–806, 2000.—We examined whether fatigue during exertional heat stress occurred at a critical internal temperature independent of the initial tem

  9. 14 CFR 121.513 - Flight time limitations: Overseas and international operations: airplanes.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Flight time limitations: Overseas and international operations: airplanes. 121.513 Section 121.513 Aeronautics and Space FEDERAL AVIATION...: airplanes. In place of the flight time limitations in §§ 121.503 through 121.511, a certificate...

  10. 14 CFR 121.513 - Flight time limitations: Overseas and international operations: airplanes.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Flight time limitations: Overseas and international operations: airplanes. 121.513 Section 121.513 Aeronautics and Space FEDERAL AVIATION...: airplanes. In place of the flight time limitations in §§ 121.503 through 121.511, a certificate...

  11. The Application of Closed Reduction Internal Fixation and Iliac Bone Block Grafting in the Treatment of Acute Displaced Femoral Neck Fractures

    PubMed Central

    Su, Yanling; Zhang, Qi; Hou, Zhiyong; Pan, Jinshe; Zhang, Yingze

    2013-01-01

    Objective This study aimed to evaluate the preliminary clinical and radiographic outcomes of acute displaced femoral neck fracture treated by closed reduction and internal fixation (CRIF) with free iliac bone block grafting with comparison to a routine protocol of CRIF without bone grafting. Methods From December 2008 to February 2010, 220 adult patients with acute displaced femoral neck fractures were enrolled in this study. In study group, there were 124 patients (57 males, 67 females) with a mean age of 44.8 years (range, 20-64 years). There were 70 transcervical fractures and 54 subcapital fractures. The patients were treated by CRIF and free iliac bone block grafting. The control group consisted of 96 adult patients (46 males, 50 females) with a mean age of 46.3 years (range, 23-64 years). There were 61 transcervical fractures and 35 subcapital fractures. The patients in control group were treated by CRIF without bone grafting. Results In study group, 112 patients were followed up for an average of 27.4 months (range, 24-34 months). All fractures healed within 5 months. However, 10 patients presented AVN of the femoral heads. The mean Harris score was 88.6 (range, 41-100). In control group, 68 patients were followed up for an average of 31.2 months (range, 24-42 months). The rates of AVN of the femoral head and fracture nonunion in control group were 26.5% (18/68) and 16.2% (11/68), respectively, significantly higher than those in study group (both P<0.05). The mean Harris score in control group was 83.8 (41–100), significantly lower than that in study group (P<0.05). Conclusion Acute displaced femoral neck fractures can be treated by CRIF and free iliac bone block grafting in a minimally invasive manner. This technique can guarantee uneventful fracture healing and significantly reduce the rate of femoral head osteonecrosis. PMID:24040414

  12. The pathologist's guide to fixatives.

    PubMed

    Qidwai, Kiran; Afkhami, Michelle; Day, Christina E

    2014-01-01

    Proper tissue fixation is essential to ensure the highest level of specimen evaluation. Pathologists and laboratory staff are frequently consulted by clinical counterparts regarding what fixative should be used for different tissues or to enable a diagnosis of a specific condition. It is vital for the patient that the pathologist provides accurate information to ensure proper fixation. Frequently, once a tissue has been fixed inadequately or inappropriately, remedial changes may no longer be possible. Most often formalin is an adequate choice, if not the optimal one; however, there are certain situations when placing the tissue in formalin may limit the ability to reach a definitive diagnosis. It is imperative for pathologists to have the knowledge to communicate which fixative is optimal. Furthermore, as we move into a world of personalized medicine, where ancillary testing has both diagnostic and specific therapeutic implications, knowledge about how different fixatives affect immunohistochemistry, cytogenetics, and molecular studies becomes even more significant. This chapter provides practical information regarding common fixatives, their mechanism of action and optimal uses.

  13. Core-halo limit and internal dynamics of high intensity beams

    SciTech Connect

    Nghiem, P. A. P.; Valette, M.; Chauvin, N.; Pichoff, N.; Uriot, D.

    2015-08-15

    The dynamics of high-intensity beams largely depends on their internal space charge forces. These forces are responsible of non-linear coupling, emittance growth, and halo generation. They contribute to shape the beam density profile. As a consequence, an analysis of this profile can be a precious indicator capable of revealing the internal dynamics of the beam. This paper recalls the precise core-halo limit determination proposed earlier, then studies its behavior through a wide range of beam profiles, and finally shows its relevance as an indicator of the limit separating the two space charge field regimes of the core and the halo.

  14. A Biomechanical Comparison of Three 1.5-mm Plate and Screw Configurations and a Single 2.0-mm Plate for Internal Fixation of a Mandibular Condylar Fracture

    PubMed Central

    Aquilina, Peter; Parr, William C.H.; Chamoli, Uphar; Wroe, Stephen; Clausen, Philip

    2014-01-01

    The most stable pattern of internal fixation for mandibular condyle fractures is an area of ongoing discussion. This study investigates the stability of three patterns of plate fixation using readily available, commercially pure titanium implants. Finite element models of a simulated mandibular condyle fracture were constructed. The completed models were heterogeneous in bone material properties, contained approximately 1.2 million elements and incorporated simulated jaw adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. No human subjects were involved in this investigation. The stability of the simulated condylar fracture reduced with the different implant configurations, and the von Mises stresses of a 1.5-mm X-shaped plate, a 1.5-mm rectangular plate, and a 1.5-mm square plate (all Synthes (Synthes GmbH, Zuchwil, Switzerland) were compared. The 1.5-mm X plate was the most stable of the three 1.5-mm profile plate configurations examined and had comparable mechanical performance to a single 2.0-mm straight four-hole plate. This study does not support the use of rectangular or square plate patterns in the open reduction and internal fixation of mandibular condyle fractures. It does provide some support for the use of a 1.5-mm X plate to reduce condylar fractures in selected clinical cases. PMID:25136411

  15. Latarjet Fixation

    PubMed Central

    Alvi, Hasham M.; Monroe, Emily J.; Muriuki, Muturi; Verma, Rajat N.; Marra, Guido; Saltzman, Matthew D.

    2016-01-01

    Background: Attritional bone loss in patients with recurrent anterior instability has successfully been treated with a bone block procedure such as the Latarjet. It has not been previously demonstrated whether cortical or cancellous screws are superior when used for this procedure. Purpose: To assess the strength of stainless steel cortical screws versus stainless steel cannulated cancellous screws in the Latarjet procedure. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen matched-pair shoulder specimens were randomized into 2 separate fixation groups: (1) 3.5-mm stainless steel cortical screws and (2) 4.0-mm stainless steel partially threaded cannulated cancellous screws. Shoulder specimens were dissected free of all soft tissue and a 25% glenoid defect was created. The coracoid process was osteomized, placed at the site of the glenoid defect, and fixed in place with 2 parallel screws. Results: All 10 specimens failed by screw cutout. Nine of 10 specimens failed by progressive displacement with an increased number of cycles. One specimen in the 4.0-mm screw group failed by catastrophic failure on initiation of the testing protocol. The 3.5-mm screws had a mean of 274 cycles (SD, ±171 cycles; range, 10-443 cycles) to failure. The 4.0-mm screws had a mean of 135 cycles (SD, ±141 cycles; range, 0-284 cycles) to failure. There was no statistically significant difference between the 2 types of screws for cycles required to cause failure (P = .144). Conclusion: There was no statistically significant difference in energy or cycles to failure when comparing the stainless steel cortical screws versus partially threaded cannulated cancellous screws. Clinical Relevance: Latarjet may be performed using cortical or cancellous screws without a clear advantage of either option. PMID:27158630

  16. Operational Limitations of the High Rate Frame Multiplexer (HRFM) Onboard the International Space Station(ISS)-and How These Limitations Affect Payload Developers (PDs) and International Partners (IPs)

    NASA Technical Reports Server (NTRS)

    Mixson, Charles D.; McElyea, Richard M. (Technical Monitor)

    2002-01-01

    The data system onboard the United States Operating Segment (USOS) of the ISS is currently used to capture, route, record and downlink high-rate science data from experiments inside the US Lab. Once NASDA's Japanese Experiment Module (JEM) and ESA's Attached Pressurized Module (APM) are launched - in the 2004 to 2005 timeframe - data from these facilities will also be routed to the ground using the USOS data system. A critical component of the USOS data system is the High Rate Frame Multiplexer (HRFM). The HRFM combines multiple data/video inputs and combines them into one data stream. This Ku-band data stream is then routed through the Tracking and Data Relay Satellite (TDRS) system to the ground. The Data Management Coordinator (DMC) - located at the Marshall Space Flight Center's Payload Operations Center (POC) - is responsible for commanding and controlling the HRFM. The HRFM can multiplex a maximum of eight digital data sources and four digital video sources. Thus far, this limitation has not been constraining to operations. However, once the JEM and APM are integrated, the HRFM limitations will become a major constraint to science operations onboard. The purpose of this paper is to characterize the limitations of the HRFM and to explain how these limitations can be successfully managed. With this information, Payload Developers and International Partners will be able to more effectively utilize the data systems onboard the ISS. Ultimately, more science data can be captured and downlinked to Flight Controllers and Scientists on the ground.

  17. 14 CFR 399.41 - Zones of limited suspension for international cargo rates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Zones of limited suspension for international cargo rates. 399.41 Section 399.41 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) POLICY STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to...

  18. 14 CFR 399.41 - Zones of limited suspension for international cargo rates.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Zones of limited suspension for international cargo rates. 399.41 Section 399.41 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) POLICY STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to...

  19. 14 CFR 399.41 - Zones of limited suspension for international cargo rates.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Zones of limited suspension for international cargo rates. 399.41 Section 399.41 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) POLICY STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to...

  20. 14 CFR 399.41 - Zones of limited suspension for international cargo rates.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Zones of limited suspension for international cargo rates. 399.41 Section 399.41 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) POLICY STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to...

  1. When femoral fracture fixation fails: salvage options.

    PubMed

    Petrie, J; Sassoon, A; Haidukewych, G J

    2013-11-01

    Most hip fractures treated with modern internal fixation techniques will heal. However, failures occasionally occur and require revision procedures. Salvage strategies employed during revision are based on whether the fixation failure occurs in the femoral neck, or in the intertrochanteric region. Patient age and remaining bone stock also influence decision making. For fractures in young patients, efforts are generally focused on preserving the native femoral head via osteotomies and repeat internal fixation. For failures in older patients, some kind of hip replacement is usually selected. Disuse osteopenia, deformity, bone loss, and stress-risers from previous internal fixation devices all pose technical challenges to successful reconstruction. Attention to detail is important in order to minimise complications. In the majority of cases, good outcomes have been reported for the various salvage strategies.

  2. Dose limits to the lens of the eye: International Basic Safety Standards and related guidance.

    PubMed

    Boal, T J; Pinak, M

    2015-06-01

    The International Atomic Energy Agency (IAEA) safety requirements: 'General Safety Requirements Part 3--Radiation protection and safety of radiation sources: International Basic Safety Standards' (BSS) was approved by the IAEA Board of Governors at its meeting in September 2011, and was issued as General Safety Requirements Part 3 in July 2014. The equivalent dose limit for the lens of the eye for occupational exposure in planned exposure situations was reduced from 150 mSv year(-1) to 20 mSv year(-1), averaged over defined periods of 5 years, with no annual dose in a single year exceeding 50 mSv. This reduction in the dose limit for the lens of the eye followed the recommendation of the International Commission on Radiological Protection in its statement on tissue reactions of 21 April 2011. IAEA has developed guidance on the implications of the new dose limit for the lens of the eye. This paper summarises the process that led to the inclusion of the new dose limit for the lens of the eye in the BSS, and the implications of the new dose limit.

  3. A Limited International Intercomparison of Responsivity Scales at Fiber Optic Wavelengths

    PubMed Central

    Gallawa, R. L.; Gardner, J. L.; Nettleton, D. H.; Stock, K. D.; Ward, T. H.; Li, Xiaoyu

    1991-01-01

    We report here on a recent limited international intercomparison of responsivity scales at wavelengths of interest to the optical communications community. Participants in the comparison were the national laboratories in the United States, the United Kingdom, Germany, and Australia. The wavelengths tested were 1300 and 1550 nm. Data taken at 850 nm are only briefly discussed. The disagreement between the national laboratories’ responsivity scale is comfortably within the uncertainty claimed by each laboratory. PMID:28184112

  4. Inverted internal limiting membrane flap technique for very large macular hole

    PubMed Central

    Khodani, Mitali; Bansal, Pooja; Narayanan, Raja; Chhablani, Jay

    2016-01-01

    AIM To assess the anatomical and visual outcome of idiopathic macular holes greater than 1000 µm using the inverted internal limiting membrane flap technique. METHODS This retrospective case series included 5 eyes of 5 patients with idiopathic macular hole with base diameter greater than 1000 µm who underwent inverted internal limiting membrane flap technique along with standard 23G pars plans vitrectomy with posterior hyaloid detachment and fluid gas exchange with 12%-14% perfluoropropane (C3F8). Preoperative and postoperative visual acuity and spectral domain optical coherence tomography images were evaluated. The main outcome measures were visual outcome and macular hole closure. RESULTS Mean age was 63.2±8.4y with all 5 subjects being females. Mean duration of symptoms was 11±14mo with a mean postoperative follow up of 13.2±13mo. The mean base diameter of the macular holes was 1420±84.8 µm (1280-1480 µm). Type 1 closure was achieved in four out of five patients, while one patient had type 2 closure using the inverted internal limiting membrane (ILM) flap technique. Median baseline BCVA was 0.79 logMAR (Snellen's equivalent 20/120) and median final BCVA 0.6 logMAR (Snellen's equivalent 20/80) with mean visual improvement of approximately three lines improvement. No complications related to surgical procedure were noted. CONCLUSION The inverted internal limiting membrane flap technique may be promising for very large macular holes with high rate of macular closure and good visual outcome. PMID:27588280

  5. Comparison of the Inverted Internal Limiting Membrane Flap Technique and the Internal Limiting Membrane Peeling for Macular Hole with Retinal Detachment

    PubMed Central

    Matsumura, Takehiro; Takamura, Yoshihiro; Tomomatsu, Takeshi; Arimura, Shogo; Gozawa, Makoto; Kobori, Akira; Inatani, Masaru

    2016-01-01

    Purpose To evaluate the efficacy of the inverted internal limiting membrane (ILM) flap technique in vitrectomy for macular hole (MH) with retinal detachment (RD) compared with vitrectomy using ILM peeling. Methods A retrospective case series study was performed. Twenty-two eyes of 22 patients who underwent vitrectomy for MH with RD and followed-up more than 12 months after the surgery were included in this study. We retrospectively reviewed the medical records of patients who underwent vitrectomy with inverted ILM flap technique or vitrectomy with ILM peeling. Ten patients who had been treated vitrectomy with inverted ILM flap technique, and 12 patients who had been treated vitrectomy with ILM peeling were analyzed. We evaluated changes in best-corrected visual acuity (BCVA) before and after surgery, closing rates of MH, and retinal reattachment rates and compared between both groups. Results MH was closed and RD was reattached postoperatively in 9 eyes (90%) in the inverted ILM flap group. In the ILM peeling group, the MH was closed in 4 eyes (33.3%) and the retinas were reattached in 6 eyes (50%) after surgery. Significant improvement in BCVA after surgery (P = 0.0017) was only found in the inverted ILM flap group. Conclusions Higher rates of closed MH and retinal reattachment, and small but significant improvement in BCVA were found in the inverted ILM flap group. Based on our data, the inverted ILM flap technique may be useful in vitrectomy for MH with RD. PMID:27764184

  6. Kennedy Space Center Fixation Tube (KFT)

    NASA Technical Reports Server (NTRS)

    Richards, Stephanie E.; Levine, Howard G.; Romero, Vergel

    2016-01-01

    Experiments performed on the International Space Station (ISS) frequently require the experimental organisms to be preserved until they can be returned to earth for analysis in the appropriate laboratory facility. The Kennedy Fixation Tube (KFT) was developed to allow astronauts to apply fixative, chemical compounds that are often toxic, to biological samples without the use of a glovebox while maintaining three levels of containment (Fig. 1). KFTs have been used over 200 times on-orbit with no leaks of chemical fixative. The KFT is composed of the following elements: a polycarbonate main tube where the fixative is loaded preflight, the sample tube where the plant or other biological specimens is placed during operations, the expansion plug, actuator, and base plug that provides fixative containment (Fig. 2). The main tube is pre-filled with 25 mL of fixative solution prior to flight. When actuated, the specimen contained within the sample tube is immersed with approximately 22 mL (+/- 2 mL) of the fixative solution. The KFT has been demonstrated to maintain its containment at ambient temperatures, 4degC refrigeration and -100 C freezing conditions.

  7. Mouse tissue fixation.

    PubMed

    Cardiff, Robert D; Miller, Claramae H; Munn, Robert J

    2014-05-01

    One of the primary goals of fixation is to stop postmortem changes that degrade the tissue and allow optimal preservation of morphologic and cytological detail as well as nucleic acid integrity. Following death, tissues soon undergo autolysis, and if organisms from the gastrointestinal, urinary, or respiratory tracts are present, their colonization can soon cause putrefaction. Time is of the essence because warmer temperatures accelerate both types of degradation. Placing the tissue into a fixative stops the postmortem changes. Fixatives have their effect on tissue by cross-linking, coagulation, or a combination of both. This article outlines the basic tissue fixation procedure and offers guidance on choosing an appropriate fixative, the timing and duration of fixation, sample storage, and quality issues.

  8. Use of Internal Limiting Membrane Autograft in Primary Vitrectomy for Rhegmatogenous Retinal Detachment

    PubMed Central

    Hernández-Da Mota, Sergio Eustolio; Béjar-Cornejo, Jorge Francisco

    2016-01-01

    During a pars plana vitrectomy, an unplanned retinotomy in the raphe was performed in a 55-year-old female patient with rhegmatogenous retinal detachment and proliferative vitreoretinopathy. Since diathermy and laser therapy were not available at that moment, it was decided to peel off a small graft of the internal limiting membrane adjacent to the retinotomy site which had been previously stained with Brilliant Blue G. The graft was displaced under perfluorocarbon fluids and placed inside the retinotomy. Three weeks after surgery, the apparent closure of the retinotomy was observed clinically. PMID:28101042

  9. Dinitrogen fixation in aphotic oxygenated marine environments

    PubMed Central

    Rahav, Eyal; Bar-Zeev, Edo; Ohayon, Sarah; Elifantz, Hila; Belkin, Natalia; Herut, Barak; Mulholland, Margaret R.; Berman-Frank, Ilana

    2013-01-01

    We measured N2 fixation rates from oceanic zones that have traditionally been ignored as sources of biological N2 fixation; the aphotic, fully oxygenated, nitrate (NO−3)-rich, waters of the oligotrophic Levantine Basin (LB) and the Gulf of Aqaba (GA). N2 fixation rates measured from pelagic aphotic waters to depths up to 720 m, during the mixed and stratified periods, ranged from 0.01 nmol N L−1 d−1 to 0.38 nmol N L−1 d−1. N2 fixation rates correlated significantly with bacterial productivity and heterotrophic diazotrophs were identified from aphotic as well as photic depths. Dissolved free amino acid amendments to whole water from the GA enhanced bacterial productivity by 2–3.5 fold and N2 fixation rates by ~2-fold in samples collected from aphotic depths while in amendments to water from photic depths bacterial productivity increased 2–6 fold while N2 fixation rates increased by a factor of 2 to 4 illustrating that both BP and heterotrophic N2 fixation were carbon limited. Experimental manipulations of aphotic waters from the LB demonstrated a significant positive correlation between transparent exopolymeric particle (TEP) concentrations and N2 fixation rates. This suggests that sinking organic material and high carbon (C): nitrogen (N) micro-environments (such as TEP-based aggregates or marine snow) could support high heterotrophic N2 fixation rates in oxygenated surface waters and in the aphotic zones. Indeed, our calculations show that aphotic N2 fixation accounted for 37 to 75% of the total daily integrated N2 fixation rates at both locations in the Mediterranean and Red Seas with rates equal or greater to those measured from the photic layers. Moreover, our results indicate that that while N2 fixation may be limited in the surface waters, aphotic, pelagic N2 fixation may contribute significantly to new N inputs in other oligotrophic basins, yet it is currently not included in regional or global N budgets. PMID:23986748

  10. Benthic N2 fixation in coral reefs and the potential effects of human-induced environmental change

    PubMed Central

    Cardini, Ulisse; Bednarz, Vanessa N; Foster, Rachel A; Wild, Christian

    2014-01-01

    Tropical coral reefs are among the most productive and diverse ecosystems, despite being surrounded by ocean waters where nutrients are in short supply. Benthic dinitrogen (N2) fixation is a significant internal source of “new” nitrogen (N) in reef ecosystems, but related information appears to be sparse. Here, we review the current state (and gaps) of knowledge on N2 fixation associated with coral reef organisms and their ecosystems. By summarizing the existing literature, we show that benthic N2 fixation is an omnipresent process in tropical reef environments. Highest N2 fixation rates are detected in reef-associated cyanobacterial mats and sea grass meadows, clearly showing the significance of these functional groups, if present, to the input of new N in reef ecosystems. Nonetheless, key benthic organisms such as hard corals also importantly contribute to benthic N2 fixation in the reef. Given the usually high coral coverage of healthy reef systems, these results indicate that benthic symbiotic associations may be more important than previously thought. In fact, mutualisms between carbon (C) and N2 fixers have likely evolved that may enable reef communities to mitigate N limitation. We then explore the potential effects of the increasing human interferences on the process of benthic reef N2 fixation via changes in diazotrophic populations, enzymatic activities, or availability of benthic substrates favorable to these microorganisms. Current knowledge indicates positive effects of ocean acidification, warming, and deoxygenation and negative effects of increased ultraviolet radiation on the amount of N fixed in coral reefs. Eutrophication may either boost or suppress N2 fixation, depending on the nutrient becoming limiting. As N2 fixation appears to play a fundamental role in nutrient-limited reef ecosystems, these assumptions need to be expanded and confirmed by future research efforts addressing the knowledge gaps identified in this review. PMID:24967086

  11. Benthic N2 fixation in coral reefs and the potential effects of human-induced environmental change.

    PubMed

    Cardini, Ulisse; Bednarz, Vanessa N; Foster, Rachel A; Wild, Christian

    2014-05-01

    Tropical coral reefs are among the most productive and diverse ecosystems, despite being surrounded by ocean waters where nutrients are in short supply. Benthic dinitrogen (N2) fixation is a significant internal source of "new" nitrogen (N) in reef ecosystems, but related information appears to be sparse. Here, we review the current state (and gaps) of knowledge on N2 fixation associated with coral reef organisms and their ecosystems. By summarizing the existing literature, we show that benthic N2 fixation is an omnipresent process in tropical reef environments. Highest N2 fixation rates are detected in reef-associated cyanobacterial mats and sea grass meadows, clearly showing the significance of these functional groups, if present, to the input of new N in reef ecosystems. Nonetheless, key benthic organisms such as hard corals also importantly contribute to benthic N2 fixation in the reef. Given the usually high coral coverage of healthy reef systems, these results indicate that benthic symbiotic associations may be more important than previously thought. In fact, mutualisms between carbon (C) and N2 fixers have likely evolved that may enable reef communities to mitigate N limitation. We then explore the potential effects of the increasing human interferences on the process of benthic reef N2 fixation via changes in diazotrophic populations, enzymatic activities, or availability of benthic substrates favorable to these microorganisms. Current knowledge indicates positive effects of ocean acidification, warming, and deoxygenation and negative effects of increased ultraviolet radiation on the amount of N fixed in coral reefs. Eutrophication may either boost or suppress N2 fixation, depending on the nutrient becoming limiting. As N2 fixation appears to play a fundamental role in nutrient-limited reef ecosystems, these assumptions need to be expanded and confirmed by future research efforts addressing the knowledge gaps identified in this review.

  12. Minimally invasive (sinus tarsi) approach for open reduction and internal fixation of intra-articular calcaneus fractures in children: surgical technique and case report of two patients.

    PubMed

    Abdelgawad, Amr A; Kanlic, Enes

    2015-01-01

    Calcaneus fractures in children differ from those in adults. Most calcaneus fractures in children can be managed nonoperatively, with good long-term results expected. The width and height of the calcaneus can remodel with time in children. Recently, there has been a trend toward operative treatment of displaced intra-articular fractures of the calcaneus in children to correct the articular deformity. Studies of calcaneal fracture fixation in children used an extended lateral approach, with its possible complications. In the present report, we describe the operative treatment of 2 children (12 and 13 years old), who had a displaced intra-articular fracture of the calcaneus, using a minimally invasive sinus tarsi approach. Adequate reduction was obtained in both cases with no soft tissue complications or implant discomfort. Fixation was obtained using 3.5-mm cortical screws. Anatomic joint alignment was restored. The children were followed up until they had both resumed their full activities with no complications. We recommend this approach for operative treatment of displaced intra-articular fractures of the calcaneus, because it addresses the intra-articular displacement, which is the most important element of the deformity in children.

  13. Malleolar fractures and their ligamentous injury equivalents have similar outcomes in supination-external rotation type IV fractures of the ankle treated by anatomical internal fixation.

    PubMed

    Berkes, M B; Little, M T M; Lazaro, L E; Sculco, P K; Cymerman, R M; Daigl, M; Helfet, D L; Lorich, D G

    2012-11-01

    It has previously been suggested that among unstable ankle fractures, the presence of a malleolar fracture is associated with a worse outcome than a corresponding ligamentous injury. However, previous studies have included heterogeneous groups of injury. The purpose of this study was to determine whether any specific pattern of bony and/or ligamentous injury among a series of supination-external rotation type IV (SER IV) ankle fractures treated with anatomical fixation was associated with a worse outcome. We analysed a prospective cohort of 108 SER IV ankle fractures with a follow-up of one year. Pre-operative radiographs and MRIs were undertaken to characterise precisely the pattern of injury. Operative treatment included fixation of all malleolar fractures. Post-operative CT was used to assess reduction. The primary and secondary outcome measures were the Foot and Ankle Outcome Score (FAOS) and the range of movement of the ankle. There were no clinically relevant differences between the four possible SER IV fracture pattern groups with regard to the FAOS or range of movement. In this population of strictly defined SER IV ankle injuries, the presence of a malleolar fracture was not associated with a significantly worse clinical outcome than its ligamentous injury counterpart. Other factors inherent to the injury and treatment may play a more important role in predicting outcome.

  14. Limiter

    DOEpatents

    Cohen, S.A.; Hosea, J.C.; Timberlake, J.R.

    1984-10-19

    A limiter with a specially contoured front face is provided. The front face of the limiter (the plasma-side face) is flat with a central indentation. In addition, the limiter shape is cylindrically symmetric so that the limiter can be rotated for greater heat distribution. This limiter shape accommodates the various power scrape-off distances lambda p, which depend on the parallel velocity, V/sub parallel/, of the impacting particles.

  15. 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

  16. The doubtful environmental benefit of reduced maximum sulfur limit in international shipping fuel.

    PubMed

    Mestl, Thomas; Løvoll, Grunde; Stensrud, Erik; Le Breton, Arnaud

    2013-06-18

    On January 1st, 2012, the maximum limit for sulfur concentration in marine fuels on the high seas was lowered from 4.50% to 3.50% by the International Maritime Organization (IMO). It was one of a series of planned steps toward reducing the negative environmental and health impacts of international shipping. This study investigates the effectiveness of the IMO regulation in reducing global sulfur emissions. We found a reduction in global average sulfur concentration of only 0.07% points from 2011 to 2012. On the positive side, we also found that only 2.3% of the bunkerings were noncompliant in 2012, that is, exceeded the new 3.50% sulfur concentration cap. The analysis furthermore suggests that compliance with the new regulation is achieved by blending high sulfur fuel with lower sulfur fuel, rather than by removing high sulfur fuel from the market or removing the excess sulfur. The main conclusion is that the regulation has been effective in reducing the maximum sulfur concentration but has not been very effective in reducing the average sulfur concentration. Thus, the regulation may have resulted in local environmental benefits but has not resulted in global benefits with respect to global sulfur emissions from international shipping.

  17. Histologic and Histometric Analysis of Bone Repair at the Site of Mandibular Body Osteotomy and at the Bone-Screw Interface After Using a Biodegradable 2.0-mm Internal Fixation System.

    PubMed

    Sverzut, Cassio Edvard; de Matos, Fernando Pando; Trivellato, Alexandre Elias; Kato, Rogerio Bentes; Sverzut, Alexander Tadeu; Taba Junior, Mario; de Rezende Duek, Eliana Aparecida; de Oliveira, Paulo Tambasco

    2015-06-01

    The aim of the study was to evaluate histologically and histometrically the bone repair at the mandibular body osteotomy and at the bone-screw interface after using a biodegradable 2.0-mm internal fixation system. Six dogs were subjected to an osteotomy in the mandibular body, which was stabilized by applying a fixation device manufactured with poly-L-DL-lactic acid (70:30). The dogs were euthanized at 2 and 18 weeks. Each screw was sectioned along its long axis, and the osteotomy sites were divided into 3 parts: the upper part was labeled the tension third (TT); the lower part, compression third (CT); and the part between the TT and CT, intermediary third (IT). Histologic analysis showed areas of direct contact between the screw surface and the parent lamellar bone at 2 weeks. At 18 weeks, 3 microscopically distinct layers at the bone-screw interface were noted. At the osteotomy sites, union between the bone fragments was observed at 18 weeks. Statistically significant differences in the newly formed bone among TT, IT, and CT (P = 0.019) were observed. In conclusion, the biomechanical environment created by the biodegradable IF system used in this study facilitated bone repair at the osteotomy site.

  18. Limiter

    DOEpatents

    Cohen, Samuel A.; Hosea, Joel C.; Timberlake, John R.

    1986-01-01

    A limiter with a specially contoured front face accommodates the various power scrape-off distances .lambda..sub.p, which depend on the parallel velocity, V.sub..parallel., of the impacting particles. The front face of the limiter (the plasma-side face) is flat with a central indentation. In addition, the limiter shape is cylindrically symmetric so that the limiter can be rotated for greater heat distribution.

  19. History of POIC Capabilities and Limitations to Conduct International Space Station Payload Operations

    NASA Technical Reports Server (NTRS)

    Grimaldi, Rebecca; Horvath, Tim; Morris, Denise; Willis, Emily; Stacy, Lamar; Shell, Mike; Faust, Mark; Norwood, Jason

    2011-01-01

    Payload science operations on the International Space Station (ISS) have been conducted continuously twenty-four hours per day, 365 days a year beginning February, 2001 and continuing through present day. The Payload Operations Integration Center (POIC), located at the Marshall Space Flight Center in Huntsville, Alabama, has been a leader in integrating and managing NASA distributed payload operations. The ability to conduct science operations is a delicate balance of crew time, onboard vehicle resources, hardware up-mass to the vehicle, and ground based flight control team manpower. Over the span of the last ten years, the POIC flight control team size, function, and structure has been modified several times commensurate with the capabilities and limitations of the ISS program. As the ISS vehicle has been expanded and its systems changed throughout the assembly process, the resources available to conduct science and research have also changed. Likewise, as ISS program financial resources have demanded more efficiency from organizations across the program, utilization organizations have also had to adjust their functionality and structure to adapt accordingly. The POIC has responded to these often difficult challenges by adapting our team concept to maximize science research return within the utilization allocations and vehicle limitations that existed at the time. In some cases, the ISS and systems limitations became the limiting factor in conducting science. In other cases, the POIC structure and flight control team size were the limiting factors, so other constraints had to be put into place to assure successful science operations within the capabilities of the POIC. This paper will present the POIC flight control team organizational changes responding to significant events of the ISS and Shuttle programs.

  20. Guide to radiation fixatives

    SciTech Connect

    Tawil, J.J.; Bold, F.C.

    1983-11-01

    This report identifies and then characterizes a variety of substances available in the market place for potential effectiveness as a fixative on radiologically contaminated surfaces. The substances include both generic chemicals and proprietary products. In selecting a fixative for a particular application, several attributes of the fixative may be relevant to the choice. These attributes include: toxicity, durability, and cleanliness and removability. In addition to the attributes of the fixative, one should also take into account certain characteristics of the site to be treated. These characteristics relate to climate, nature of the surface, use to which the treated surface will be put, subsequent cleanup operations, and type of neighboring surfaces. Finally, costs and potential environmental effects may influence the decision. A variety of fixatives are evaluated with respect to these various attributes and summarized in a reference table.

  1. Cell fixatives for immunostaining.

    PubMed

    Jamur, Maria Célia; Oliver, Constance

    2010-01-01

    Fixation is one of the most critical steps in immunostaining. The object of fixation is to achieve good morphological preservation, while at the same time preserving antigenicity. Tissue blocks, sections, cell cultures or smears are usually immersed in a fixative solution, while in other situations, whole body perfusion of experimental animals is preferable. Fixation can be accomplished by either chemical or physical methods. The chemical methods include cross-linking agents such as formaldehyde, glutaraldehyde and succinimide esters as well as solvents such as acetone and methanol, which precipitate proteins. Of the physical methods, freezing tissue and air drying are most widely used. This chapter deals with the chemical fixation methods most commonly used for light microscopy.

  2. 76 FR 19517 - Orders Limiting Scheduled Operations at John F. Kennedy International Airport, LaGuardia Airport...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-07

    ... Airport, LaGuardia Airport, and Newark Liberty International Airport; High Density Rule at Reagan National.... FAA Analysis Under the FAA's High Density Rule and Orders limiting scheduled operations at LGA,...

  3. Coherent total internal reflection dark-field microscopy: label-free imaging beyond the diffraction limit.

    PubMed

    von Olshausen, Philipp; Rohrbach, Alexander

    2013-10-15

    Coherent imaging is barely applicable in life-science microscopy due to multiple interference artifacts. Here, we show how these interferences can be used to improve image resolution and contrast. We present a dark-field microscopy technique with evanescent illumination via total internal reflection that delivers high-contrast images of coherently scattering samples. By incoherent averaging of multiple coherent images illuminated from different directions we can resolve image structures that remain unresolved by conventional (incoherent) fluorescence microscopy. We provide images of 190 nm beads revealing resolution beyond the diffraction limit and slightly increased object distances. An analytical model is introduced that accounts for the observed effects and which is confirmed by numerical simulations. Our approach may be a route to fast, label-free, super-resolution imaging in live-cell microscopy.

  4. Assessing the Performance Limits of Internal Coronagraphs Through End-to-End Modeling

    NASA Technical Reports Server (NTRS)

    Krist, John E.; Belikov, Ruslan; Pueyo, Laurent; Mawet, Dimitri P.; Moody, Dwight; Trauger, John T.; Shaklan, Stuart B.

    2013-01-01

    As part of the NASA ROSES Technology Demonstrations for Exoplanet Missions (TDEM) program, we conducted a numerical modeling study of three internal coronagraphs (PIAA, vector vortex, hybrid bandlimited) to understand their behaviors in realistically-aberrated systems with wavefront control (deformable mirrors). This investigation consisted of two milestones: (1) develop wavefront propagation codes appropriate for each coronagraph that are accurate to 1% or better (compared to a reference algorithm) but are also time and memory efficient, and (2) use these codes to determine the wavefront control limits of each architecture. We discuss here how the milestones were met and identify some of the behaviors particular to each coronagraph. The codes developed in this study are being made available for community use. We discuss here results for the HBLC and VVC systems, with PIAA having been discussed in a previous proceeding.

  5. Brilliant blue G-assisted peeling of the internal limiting membrane in macular hole surgery.

    PubMed

    Naithani, Prashant; Vashisht, Naginder; Khanduja, Sumeet; Sinha, Subijay; Garg, Satpal

    2011-01-01

    Dye-assisted internal limiting membrane (ILM) peeling and gas tamponade is the surgery of choice for idiopathic macular holes. Indocyanine green and trypan blue have been extensively used to stain the ILM. However, the retinal toxicity of indocyanine green and non-uniform staining with trypan blue has necessitated development of newer vital dyes. Brilliant blue G has recently been introduced as one such dye with adequate ILM staining and no reported retinal toxicity. We performed a 23-gauge pars plana vitrectomy with brilliant blue G-assisted ILM peeling in six patients with idiopathic macular holes, to assess the staining characteristics and short-term adverse effects of this dye. Adequate staining assisted in the complete removal of ILM and closure of macular holes in all cases. There was no evidence of intraoperative or postoperative dye-related toxicity. Brilliant blue G appears to be safe dye for ILM staining in macular hole surgery.

  6. Application of a shape-memory alloy internal fixator for treatment of acetabular fractures with a follow-up of two to nine years in China

    PubMed Central

    Liu, Xinwei; Xu, Shuogui; Su, Jiacan; Yu, Baoqing

    2009-01-01

    Displaced acetabular fractures should be treated surgically. Over the past decade, surgical approaches to the acetabulum and the surgical technique for repair of common fracture patterns have advanced. Excellent outcomes after repair of these injuries can be achieved. The aim of this study was to assess the medium-term results of reconstruction of acetabular fractures by using shape-memory alloy designed by the authors. This is a retrospective review conducted at a level 1 trauma centre. From October 1999 to July 2009, 19 patients with acetabular fractures were treated with our patented Ni-Ti shape-memory alloy acetabular tridimensional memory alloy-fixation system (ATMFS). The ATMFS device was cooled with ice before implantation and then warmed to 40–50°C after implantation to produce balanced axial and compression forces that would stabilise the fracture three dimensionally. Our results are as follows; according to the D’Aubigne−Postel scoring system: Fifteen cases out of 19 (79%) achieved excellent or good clinical results. In two patients, late complications included avascular necrosis of the femoral head (ANFH) associated with posterior dislocation of the hip joint two years after the operation. We also observed two cases of grade II or III ectopic ossification, with good hip function, and one case of traumatic arthritis. In conclusion, these results demonstrate the effectiveness of the ATMFS device for the management of acetabular fracture. The device provides continuous compression of the fracture with minimal disruption to the local blood supply. PMID:20012433

  7. The halo fixator.

    PubMed

    Bono, Christopher M

    2007-12-01

    The halo fixator may be used for the definitive treatment of cervical spine trauma, preoperative reduction in the patient with spinal deformity, and adjunctive postoperative stabilization following cervical spine surgery. Halo fixation decreases cervical motion by 30% to 96%. Absolute contraindications include cranial fracture, infection, and severe soft-tissue injury at the proposed pin sites. Relative contraindications include severe chest trauma, obesity, advanced age, and a barrel-shaped chest. In children, a computed tomography scan of the head should be obtained before pin placement to determine cranial bone thickness. Complications of halo fixation include pin loosening, pin site infection, and skin breakdown. A concerning rate of life-threatening complications, such as respiratory distress, has been reported in elderly patients. Despite a paucity of contemporary data, recent retrospective studies have demonstrated acceptable results for halo fixation in managing some upper and lower cervical spine injuries.

  8. Photographic fixative poisoning

    MedlinePlus

    Photographic fixatives are chemicals used to develop photographs. This article discusses poisoning from swallowing such chemicals. This article is for information only. DO NOT use it to treat or manage an ...

  9. Assessment of the influence of Laser phototherapy on the bone repair process of complete fractures in tibiae of rabbits stabilized with semi-rigid internal fixation treated with or without MTA graft: a histological study

    NASA Astrophysics Data System (ADS)

    Soares, Luiz G. P.; Silva, Aline C. P.; Silva, Anna Paula L. T.; Neves, Bruno Luiz R. C.; Santos, Nicole R. S.; dos Santos, Jean N.; Pinheiro, Antonio L. B.

    2016-03-01

    Beside biomaterials, Laser phototherapy has shown positive effects as auxiliary therapy in bone repair process, especially when involving large bone losses. The aim of this histological study was to evaluate, by light microscopy, the influence of laser phototherapy on the repair of complete tibial fractures in rabbits treated or not with semi-rigid internal fixation and Mineral Trioxide Aggregate - MTA graft. Twelve Rabbits were randomly divided into four groups with three animals each. After general anesthesia, complete fractures were created in one tibia with a carborundum disk. All animals (groups I-IV) had the fracture stabilized with semi-rigid fixation (wire osteosynthesis - WO). Group I was routinely fixed with WO; groups II and IV fracture was filled by blood clot and MTA implant. In Groups III and IV fracture was filled by blood clot and further irradiated with laser (λ780 nm, 70 mW, CW, Φ = 0.04 cm2, 20.4 J/cm2, per session, t = 300s, 142.8 J/cm2 per treatment). The phototherapy protocol was applied immediately after the surgery and repeated each 48 hours during 15 days. Animal death occurred on the 30th postoperative day. After removal of the specimens, the samples were routinely processed, stained with HE and evaluated by light microscopy. Histologically, the group treated with MTA graft and irradiated with laser showed the fracture filled by a more organized and mature trabecular bone, when compared with all other groups. From the results of the present study, it may be concluded that the association of Laser phototherapy + MTA graft in fractures treated with WO improved bone repair when compared with fractures treated only with WO.

  10. Methanotrophy Induces Nitrogen Fixation in Boreal Mosses

    NASA Astrophysics Data System (ADS)

    Tiirola, M. A.

    2014-12-01

    Many methanotrophic bacterial groups fix nitrogen in laboratory conditions. Furthermore, nitrogen (N) is a limiting nutrient in many environments where methane concentrations are highest. Despite these facts, methane-induced N fixation has previously been overlooked, possibly due to methodological problems. To study the possible link between methanotrophy and diazotrophy in terrestrial and aquatic habitats, we measured the co-occurrence of these two processes in boreal forest, peatland and stream mosses using a stable isotope labeling approach (15 N2 and 13 CH4 double labeling) and sequencing of the nifH gene marker. N fixation associated with forest mosses was dependent on the annual N deposition, whereas methane stimulate N fixation neither in high (>3 kg N ha -1 yr -1) nor low deposition areas, which was in accordance with the nifH gene sequencing showing that forest mosses (Pleurozium schreberi and Hylocomium splendens ) carried mainly cyanobacterial N fixers. On the other extreme, in stream mosses (Fontinalis sp.) methane was actively oxidized throughout the year, whereas N fixation showed seasonal fluctuation. The co-occurrence of the two processes in single cell level was proven by co-localizing both N and methane-carbon fixation with the secondary ion mass spectrometry (SIMS) approach. Methanotrophy and diazotrophy was also studied in peatlands of different primary successional stages in the land-uplift coast of Bothnian Bay, in the Siikajoki chronosequence, where N accumulation rates in peat profiles indicate significant N fixation. Based on experimental evidence it was counted that methane-induced N fixation explained over one-third of the new N input in the younger peatland successional stages, where the highest N fixation rates and highest methane oxidation activities co-occurred in the water-submerged Sphagnum moss vegetation. The linkage between methanotrophic carbon cycling and N fixation may therefore constitute an important mechanism in the rapid

  11. Decrease of the foveal avascular zone area after internal limiting membrane peeling: single case study

    PubMed Central

    Kumagai, Kazuyuki; Uemura, Akinori; Furukawa, Mariko; Suetsugu, Tetsuyuki; Ogino, Nobuchika

    2017-01-01

    Purpose To report a patient whose foveal avascular zone (FAZ) decreased after vitrectomy with internal limiting membrane (ILM) peeling. Methods A 58-year-old woman underwent successful phacovitrectomy with ILM peeling for a thin epiretinal membrane in an eye with a normal foveal contour. Optical coherence tomography angiographic en face images of the 3 mm×3 mm superficial and deep inner retinal vascular plexuses were examined preoperatively, and on days 1, 2, 9, and 37 postoperatively. The changes in the FAZ areas and the thicknesses of the parafoveal retinal layers at 500 μm from the foveal center were assessed in the vertical and horizontal B-scan images. Results The areas of the superficial and deep FAZ decreased after the surgery. The course of the postoperative decrease of the FAZ area in the superficial plexus can be fit by a hyperbolic curve (R2=0.993). An increase in the thicknesses of the retinal nerve fiber layer, ganglion cell–inner plexiform layer, and inner nuclear layer was observed at all times postoperatively. Conclusions We observed one case that the FAZ area decreased and the parafoveal inner retinal thickness increased after the vitrectomy with ILM peeling. The decrease in the FAZ area suggests that a centripetal movement of the inner retinal layer is probably due to the ILM peeling. PMID:28331373

  12. Limitations of poster presentations reporting educational innovations at a major international medical education conference

    PubMed Central

    Gordon, Morris; Darbyshire, Daniel; Saifuddin, Aamir; Vimalesvaran, Kavitha

    2013-01-01

    Background In most areas of medical research, the label of ‘quality’ is associated with well-accepted standards. Whilst its interpretation in the field of medical education is contentious, there is agreement on the key elements required when reporting novel teaching strategies. We set out to assess if these features had been fulfilled by poster presentations at a major international medical education conference. Methods Such posters were analysed in four key areas: reporting of theoretical underpinning, explanation of instructional design methods, descriptions of the resources needed for introduction, and the offering of materials to support dissemination. Results Three hundred and twelve posters were reviewed with 170 suitable for analysis. Forty-one percent described their methods of instruction or innovation design. Thirty-three percent gave details of equipment, and 29% of studies described resources that may be required for delivering such an intervention. Further resources to support dissemination of their innovation were offered by 36%. Twenty-three percent described the theoretical underpinning or conceptual frameworks upon which their work was based. Conclusions These findings suggest that posters presenting educational innovation are currently limited in what they offer to educators. Presenters should seek to enhance their reporting of these crucial aspects by employing existing published guidance, and organising committees may wish to consider explicitly requesting such information at the time of initial submission. PMID:24199272

  13. Viscoat Assisted Inverted Internal Limiting Membrane Flap Technique for Large Macular Holes Associated with High Myopia

    PubMed Central

    Song, Zongming; Li, Mei; Liu, Junjie; Hu, Xuting; Hu, Zhixiang

    2016-01-01

    Purpose. To investigate the surgical outcomes of Viscoat® assisted inverted internal limiting membrane (ILM) flap technique for large macular holes (MHs) associated with high myopia. Design. Prospective, interventional case series. Methods. Fifteen eyes of 15 patients with high myopia underwent vitrectomy and Viscoat assisted inverted ILM flap technique to treat MH without RD. Patients were followed up over 6 months. The main outcome measures were MH closure evaluated by optical coherence tomography (OCT) and best-corrected visual acuities (BCVAs). Result. MH closure was observed in all eyes (100%) following the initial surgery. Type 1 closure was observed in 13 eyes (86.7%); type 2 closure was observed in the remaining 2 eyes (13.3%). Compared to the preoperative baseline, the mean BCVA (logarithm of the minimum angle of resolution) improved significantly at 3 months and 6 months after surgery (P = 0.025, 0.019, resp.). The final BCVA improved in 10 eyes (66.7%), remained unchanged in 3 eyes (20.0%), and worsened in 2 eyes (13.3%). Conclusion. Vitrectomy combined with Viscoat assisted inverted ILM flap technique is an effective treatment for large MHs in highly myopic eyes. It may increase the success rate of the initial surgery and enhance the anatomical and functional outcomes. PMID:27047686

  14. Threshold raw retrieved contrast in coronagraphs is limited by internal polarization

    NASA Astrophysics Data System (ADS)

    Breckinridge, James

    The objective of this work is to provide the exoplanet program with an accurate model of the coronagraph complex point spread function, methods to correct chromatic aberration in the presence of polarization aberrations, device requirements to minimize and compensate for these aberrations at levels needed for exoplanet coronagraphy, and exoplanet retrieval algorithms in the presence of polarizaiton aberrations. Currently, space based coronagraphs are designed and performance analyzed using scalar wave aberration theory. Breckinridge, Lam & Chipman (2015) PASP 127: 445-468 and Breckinridge & Oppenheimer (2004) ApJ 600: 1091-1098 showed that astronomical telescopes designed for exoplanet and precision astrometric science require polarization or vector-wave analysis. Internal instrument polarization limits both threshold raw contrast and measurements of the vector wave properties of the electromagnetic radiation from stars, exoplanets, gas and dust. The threshold raw contrast obtained using only scalar wave theory is much more optimistic than that obtained using the more hardware-realistic vector wave theory. Internal polarization reduces system contrast, increases scattered light, alters radiometric measurements, distorts diffraction-limited star images and reduces signal-to-noise ratio. For example, a vector-wave analysis shows that the WFIRST-CGI instrument will have a threshold raw contrast of 10-7 not the 10-8 forecasted using the scalar wave analysis given in the WFIRST-CGI 2015 report. The physical nature of the complex point spread function determines the exoplanet scientific yield of coronagraphs. We propose to use the Polaris-M polarization aberration ray-tracing software developed at the College of Optical Science of the University of Arizona to ray trace both a "typical" exoplanet coronagraph system as well as the WFIRST-CGI system. Threshold raw contrast and the field across the complex PSF will be calculated as a function of optical device vector E

  15. Overcoming Organizational Fixation: Creating and Sustaining an Innovation Culture

    ERIC Educational Resources Information Center

    Stempfle, Joachim

    2011-01-01

    Fixation on established paradigms and practices can severely limit the capability of organizations to change, thereby jeopardizing the ability of organizations to keep up with changes in their environment and new technological developments. Overcoming organizational fixation is therefore a requirement for any organization that strives to achieve…

  16. Soil fixative study progress report aerial application test:

    SciTech Connect

    Teter, A.C.

    1988-03-01

    A soil fixative has been developed (a simple wheat flour paste mixture) and tested in the laboratory that appears suitable for the temporary fixation of radioactive dusts in case of an accidental spill. A limited field test was made and the feasibility of aircraft delivery examined. A videotape was made of the operations. 3 figs.

  17. Fixation of tendo Achilles avulsion fracture.

    PubMed

    Lui, T H

    2009-01-01

    Achilles tendon ruptures occur commonly in the midsubstance of the tendon, usually 2-6 cm proximal to the insertion to the calcaneus. Ruptures near its insertion into the calcaneus are less common and mostly found in hyperpronators with a heel spur (Haglund's deformity). Avulsion of the bony insertion of the Achilles tendon at the calcaneus is infrequent and is diagnosed by radiography. Open reduction and internal fixation is indicated to achieve bone to bone healing and restoration of the function and continuity of the triceps surae mechanism. Screw fixation is not effective to resist the pull out tension of the triceps surae. Moreover, the prominent screw head may cause skin impingement. More secure fixation method is necessary in order to allow early functional rehabilitation. We describe a technique to fix the avulsed fragment of Achilles tendon insertion with 2 suture anchors. This can neutralize the pull of the triceps surae and early post-operative rehabilitation programme is allowed.

  18. Postoperative eccentric macular holes after vitrectomy and internal limiting membrane peeling.

    PubMed

    Brouzas, Dimitrios; Dettoraki, Maria; Lavaris, Anastasios; Kourvetaris, Dimitrios; Nomikarios, Nikolaos; Moschos, Marilita M

    2016-08-16

    The purpose of this study was to describe the incidence, clinical characteristics, and outcome of eccentric macular holes presenting after vitrectomy and internal limiting membrane (ILM) peeling for the treatment of macular pathology and discuss the pathogenesis of holes formation. A retrospective, noncomparative, interventional case-series study of five patients who developed eccentric macular holes postoperatively following vitrectomy in 198 consecutive patients who underwent ILM peeling for idiopathic macular hole and epiretinal membrane formation between 2008 and 2015. Five patients (2.5 %) developed full-thickness eccentric macular holes postoperatively. Three patients presented with a single eccentric macular hole, one patient had an eccentric hole after a failed idiopathic macular hole surgery and one patient developed four eccentric macular holes. The mean diameter of the holes was 584 μm (range 206-1317 μm) and the average time of holes formation after vitrectomy was 27.7 weeks (range 1-140 weeks). Postoperative best-corrected visual acuity ranged from "counting fingers" to 20/25. The eyes with the holes distant from the fovea had the best final visual acuity. No further intervention was attempted and no complications occurred. The mean follow-up time was 26.8 months. The postoperative macular holes after vitrectomy and ILM peeling were variable in number, size, and time of appearance but remained stable and were not associated with any complications. The pathogenesis of macular holes is most consistent with contraction of the residual ILM or secondary epimacular proliferation probably stimulated by ILM peeling.

  19. Improving Carbon Fixation Pathways

    PubMed Central

    Ducat, Daniel C.

    2012-01-01

    A recent resurgence in basic and applied research on photosynthesis has been driven in part by recognition that fulfilling future food and energy requirements will necessitate improvements in crop carbon-fixation efficiencies. Photosynthesis in traditional terrestrial crops is being reexamined in light of molecular strategies employed by photosynthetic microbes to enhance the activity of the Calvin cycle. Synthetic biology is well-situated to provide original approaches for compartmentalizing and enhancing photosynthetic reactions in a species independent manner. Furthermore, the elucidation of alternative carbon-fixation routes distinct from the Calvin cycle raises possibilities that alternative pathways and organisms can be utilized to fix atmospheric carbon dioxide into useful materials. PMID:22647231

  20. Locking versus Non-locking Neutralization Plates with Limited Excision and Internal Fixation for Treatment of Extra-articular Type a Distal Tibial Fractures

    PubMed Central

    Zhou, Kai-hua; Chen, Nong

    2017-01-01

    Purpose: This study aimed to compare the clinical, radiologic, and cost-effectiveness results between locking and non-locking plates for the treatment of extra-articular type A distal tibial fractures. Methods: We performed a retrospective review of AO/OTA 42-A1, A2 distal tibial fractures treated by plates from January 2011 to June 2013. Patients were divided to the locking plate group or the non-locking plate group. Clinical outcomes, radiographic outcomes, and hospitalization fee were compared between the two plates groups. Results: 28 patients were treated with a locking plate and 23 patients were treated with a non-locking plate. The mean follow-up was 18.8 months (12-23 months). There were no significant differences between the groups in surgical time, bleeding, bone union time, or AOFAS scores. The cost of the locking plate was ¥24,648.41 ± 6,812.95 and the cost of the non-locking plate was ¥11,642 ± 3,162.57, p < 0.001. Each group had one patient that experienced superficial infection these wounds were readily healed by oral antibiotics and dressing changes. To date, five patients in the locking group and ten patients in the non-locking group had sensations of metal stimulation or other discomfort (X2 = 3.99, p < 0.05) Until the last follow-up, 14 patients in the locking plate group and 18 patients in the non-locking plate group had their plates removed or wanted to remove their plates (X2 = 4.31, p < 0.05). Conclusion: The use of locking or non-locking plates provides a similar outcome in the treatment of distal fractures. However the locking plate is much more expensive than the non-locking plate.

  1. Risk of Anterior Cruciate Ligament Fatigue Failure Is Increased by Limited Internal Femoral Rotation During In Vitro Repeated Pivot Landings

    PubMed Central

    Beaulieu, Mélanie L.; Wojtys, Edward M.; Ashton-Miller, James A.

    2015-01-01

    Background A reduced range of hip internal rotation is associated with increased peak anterior cruciate ligament (ACL) strain and risk for injury. It is unknown, however, whether limiting the available range of internal femoral rotation increases the susceptibility of the ACL to fatigue failure. Hypothesis Risk of ACL failure is significantly greater in female knee specimens with a limited range of internal femoral rotation, smaller femoral-ACL attachment angle, and smaller tibial eminence volume during repeated in vitro simulated single-leg pivot landings. Study Design Controlled laboratory study. Methods A custom-built testing apparatus was used to simulate repeated single-leg pivot landings with a 4×-body weight impulsive load that induces knee compression, knee flexion, and internal tibial torque in 32 paired human knee specimens from 8 male and 8 female donors. These test loads were applied to each pair of specimens, in one knee with limited internal femoral rotation and in the contralateral knee with femoral rotation resisted by 2 springs to simulate the active hip rotator muscles’ resistance to stretch. The landings were repeated until ACL failure occurred or until a minimum of 100 trials were executed. The angle at which the ACL originates from the femur and the tibial eminence volume were measured on magnetic resonance images. Results The final Cox regression model (P = .024) revealed that range of internal femoral rotation and sex of donor were significant factors in determining risk of ACL fatigue failure. The specimens with limited range of internal femoral rotation had a failure risk 17.1 times higher than did the specimens with free rotation (P = .016). The female knee specimens had a risk of ACL failure 26.9 times higher than the male specimens (P = .055). Conclusion Limiting the range of internal femoral rotation during repetitive pivot landings increases the risk of an ACL fatigue failure in comparison with free rotation in a cadaveric model

  2. Use of the TRPV1 Agonist Capsaicin to Provide Long-Term Analgesia in a Rat Limb Fracture/Open Repair, Internal Fixation Model

    DTIC Science & Technology

    2011-10-01

    AD_________________ Award Number: W81XWH-10-2-0093 TITLE: Use of the TRPV1 Agonist Capsaicin to...TITLE AND SUBTITLE 5a. CONTRACT NUMBER Use of the TRPV1 Agonist Capsaicin to Provide Long-Term Analgesia in a Rat Limb Fracture/Open Repair...Trauma, TRPV1 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON USAMRMC a

  3. Fixation orientation in ankle fractures with syndesmosis injury.

    PubMed

    Nimick, Craig J; Collman, David R; Lagaay, Pieter

    2013-01-01

    Accurate reduction of the syndesmosis has been shown to be an important prognostic factor for functional outcome in ankle injuries that disrupt the syndesmosis. The purpose of the present case series was to assess the fixation orientation and the position of the fibula within the tibial incisura after open reduction and internal fixation of ankle fractures with syndesmosis injury. Computed tomography was used to assess the accuracy of the reduction. Twelve patients were included in the present case series. A ratio representing the relationship between the tibia and fibula and the orientation of the syndesmotic fixation was measured preoperatively and postoperatively and compared with the uninjured contralateral ankle, representing the patient's normal anatomy. The measurements were accomplished electronically to one tenth of 1 mm using Stentor Intelligent Informatics, I-site, version 3.3.1 (Phillips Electronics; Andover, MA). Posteriorly oriented syndesmotic fixation caused posterior translation of the fibula with respect to the tibia and anteriorly oriented syndesmotic fixation caused anterior translation.

  4. 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.

  5. Linking international research to global health equity: the limited contribution of bioethics.

    PubMed

    Pratt, Bridget; Loff, Bebe

    2013-05-01

    Health research has been identified as a vehicle for advancing global justice in health. However, in bioethics, issues of global justice are mainly discussed within an ongoing debate on the conditions under which international clinical research is permissible. As a result, current ethical guidance predominantly links one type of international research (biomedical) to advancing one aspect of health equity (access to new treatments). International guidelines largely fail to connect international research to promoting broader aspects of health equity - namely, healthier social environments and stronger health systems. Bioethical frameworks such as the human development approach do consider how international clinical research is connected to the social determinants of health but, again, do so to address the question of when international clinical research is permissible. It is suggested that the narrow focus of this debate is shaped by high-income countries' economic strategies. The article further argues that the debate's focus obscures a stronger imperative to consider how other types of international research might advance justice in global health. Bioethics should consider the need for non-clinical health research and its contribution to advancing global justice.

  6. Vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes

    PubMed Central

    Nadal, Jeroni; Carreras, Elisa; Canut, Maria Isabel; Barraquer, Rafael I

    2015-01-01

    Background Hypotony maculopathy (HM) changes may persist, and visual acuity remains poor, despite normalization of intraocular pressure (IOP). The aim of this study was to evaluate the visual and anatomical results of pars plana vitrectomy (PPV), internal limiting membrane (ILM) peeling, and 20% SF6 gas tamponade in five myopic patients with HM. Methods This retrospective interventional study was conducted at the Barraquer Center of Ophthalmology, a tertiary care center in Barcelona, Spain, and included five eyes from five consecutive patients (aged 55.4±13.1 years) with HM caused by different conditions. All the patients were treated with 23-gauge PPV, ILM peeling, and 20% SF6 gas tamponade. Preoperative and postoperative evaluation was performed using anterior and posterior biomicroscopy and best corrected visual acuity (BCVA) by logMAR charts. Results Before surgery, median spherical equivalent was −13.1 (range −7, −19) diopters of myopia. Preoperatively, four cases presented IOP <6.5 mmHg for 3 (range 2–8) weeks. In three of these four cases, IOP >6.5 mmHg was achieved over 16 (range 16–28) weeks, without resolution of HM; increased IOP was not achieved in the remaining case treated 2 weeks after diagnosis of HM. One case presented IOP >6.5 mmHg with HM for 28 weeks before surgery. Preoperative BCVA was 0.7 (range 0.26–2.3) logMAR, and 0.6 (range 0.3–0.7) logMAR and 0.5 (range 0.2–1) logMAR, respectively, at 4 and 12 months after surgery. There was no statistically significant difference between preoperative and postoperative BCVA. Hyper-pigmentation lines in the macular area were observed in three cases with hypotony. These lines progressed after surgery despite resolution of the retinal folds in the three cases, and BCVA decreased in parallel in two of these cases. Conclusion PPV with ILM peeling followed by gas tamponade is a good alternative for the treatment of HM in myopic patients. However, persistent choroidal folds may compromise BCVA

  7. Internal cycling, not external loading, decides the nutrient limitation in eutrophic lake: A dynamic model with temporal Bayesian hierarchical inference.

    PubMed

    Wu, Zhen; Liu, Yong; Liang, Zhongyao; Wu, Sifeng; Guo, Huaicheng

    2017-03-19

    Lake eutrophication is associated with excessive anthropogenic nutrients (mainly nitrogen (N) and phosphorus (P)) and unobserved internal nutrient cycling. Despite the advances in understanding the role of external loadings, the contribution of internal nutrient cycling is still an open question. A dynamic mass-balance model was developed to simulate and measure the contributions of internal cycling and external loading. It was based on the temporal Bayesian Hierarchical Framework (BHM), where we explored the seasonal patterns in the dynamics of nutrient cycling processes and the limitation of N and P on phytoplankton growth in hyper-eutrophic Lake Dianchi, China. The dynamic patterns of the five state variables (Chla, TP, ammonia, nitrate and organic N) were simulated based on the model. Five parameters (algae growth rate, sediment exchange rate of N and P, nitrification rate and denitrification rate) were estimated based on BHM. The model provided a good fit to observations. Our model results highlighted the role of internal cycling of N and P in Lake Dianchi. The internal cycling processes contributed more than external loading to the N and P changes in the water column. Further insights into the nutrient limitation analysis indicated that the sediment exchange of P determined the P limitation. Allowing for the contribution of denitrification to N removal, N was the more limiting nutrient in most of the time, however, P was the more important nutrient for eutrophication management. For Lake Dianchi, it would not be possible to recover solely by reducing the external watershed nutrient load; the mechanisms of internal cycling should also be considered as an approach to inhibit the release of sediments and to enhance denitrification.

  8. Detection and quantification limits: basic concepts, international harmonization, and outstanding ("low-level") issues.

    PubMed

    Currie, L A

    2004-01-01

    A brief review is given of concepts, basic definitions, and terminology for metrological detection and quantification capabilities, representing harmonized recommendations and norms of the International Union of Pure and Applied Chemistry (IUPAC) and the International Organization for Standardization (ISO), respectively. Treatment of the (low-level) blank and variance function are discussed in some detail, together with special problems arising with detection decisions and the reporting of low-level data. Key references to the international documents follow, as well as specialized references addressing very low-level counting data, skewed environmental blank distributions, and multiple and multivariate detection decisions.

  9. The Ankle Injury Management (AIM) trial: a pragmatic, multicentre, equivalence randomised controlled trial and economic evaluation comparing close contact casting with open surgical reduction and internal fixation in the treatment of unstable ankle fractures in patients aged over 60 years.

    PubMed Central

    Keene, David J; Mistry, Dipesh; Nam, Julian; Tutton, Elizabeth; Handley, Robert; Morgan, Lesley; Roberts, Emma; Gray, Bridget; Briggs, Andrew; Lall, Ranjit; Chesser, Tim Js; Pallister, Ian; Lamb, Sarah E; Willett, Keith

    2016-01-01

    BACKGROUND Close contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults. OBJECTIVES We aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences. DESIGN A pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study. SETTING Trauma and orthopaedic departments of 24 NHS hospitals. PARTICIPANTS Adults aged over 60 years with unstable ankle fracture. Those with serious limb or concomitant disease or substantial cognitive impairment were excluded. INTERVENTIONS CCC was conducted under anaesthetic in theatre by surgeons who attended training. ORIF was as per local practice. Participants were randomised in 1 : 1 allocation via remote telephone randomisation. Sequence generation was by random block size, with stratification by centre and fracture pattern. MAIN OUTCOME MEASURES Follow-up was conducted at 6 weeks and, by blinded outcome assessors, at 6 months after randomisation. The primary outcome was the Olerud-Molander Ankle Score (OMAS), a patient-reported assessment of ankle function, at 6 months. Secondary outcomes were quality of life (as measured by the European Quality of Life 5-Dimensions, Short Form questionnaire-12 items), pain, ankle range of motion and mobility (as measured by the timed up and go test), patient satisfaction and radiological measures. In accordance with equivalence trial US Food and Drug Administration guidance, primary analysis was per protocol. RESULTS We recruited 620 participants, 95 from the pilot and 525 from the multicentre phase, between June 2010 and November 2013. The majority of participants, 579 out of 620 (93%), received the allocated treatment; 52 out of 275 (19%) who received CCC later

  10. The Fixation of Nitrogen.

    ERIC Educational Resources Information Center

    Andrew, S. P. S.

    1978-01-01

    Discusses the fixation of atmospheric nitrogen in the form of ammonia as one of the foundations of modern chemical industry. The article describes ammonia production and synthesis, purifying the hydrogen-nitrogen mix, nitric acid production, and its commericial plant. (HM)

  11. Molybdenum and phosphorus interact to constrain asymbiotic nitrogen fixation in tropical forests.

    PubMed

    Wurzburger, Nina; Bellenger, Jean Philippe; Kraepiel, Anne M L; Hedin, Lars O

    2012-01-01

    Biological di-nitrogen fixation (N(2)) is the dominant natural source of new nitrogen to land ecosystems. Phosphorus (P) is thought to limit N(2) fixation in many tropical soils, yet both molybdenum (Mo) and P are crucial for the nitrogenase reaction (which catalyzes N(2) conversion to ammonia) and cell growth. We have limited understanding of how and when fixation is constrained by these nutrients in nature. Here we show in tropical forests of lowland Panama that the limiting element on asymbiotic N(2) fixation shifts along a broad landscape gradient in soil P, where Mo limits fixation in P-rich soils while Mo and P co-limit in P-poor soils. In no circumstance did P alone limit fixation. We provide and experimentally test a mechanism that explains how Mo and P can interact to constrain asymbiotic N(2) fixation. Fixation is uniformly favored in surface organic soil horizons--a niche characterized by exceedingly low levels of available Mo relative to P. We show that soil organic matter acts to reduce molybdate over phosphate bioavailability, which, in turn, promotes Mo limitation in sites where P is sufficient. Our findings show that asymbiotic N(2) fixation is constrained by the relative availability and dynamics of Mo and P in soils. This conceptual framework can explain shifts in limitation status across broad landscape gradients in soil fertility and implies that fixation depends on Mo and P in ways that are more complex than previously thought.

  12. Visual recovery in cortical blindness is limited by high internal noise

    PubMed Central

    Cavanaugh, Matthew R.; Zhang, Ruyuan; Melnick, Michael D.; Das, Anasuya; Roberts, Mariel; Tadin, Duje; Carrasco, Marisa; Huxlin, Krystel R.

    2015-01-01

    Damage to the primary visual cortex typically causes cortical blindness (CB) in the hemifield contralateral to the damaged hemisphere. Recent evidence indicates that visual training can partially reverse CB at trained locations. Whereas training induces near-complete recovery of coarse direction and orientation discriminations, deficits in fine motion processing remain. Here, we systematically disentangle components of the perceptual inefficiencies present in CB fields before and after coarse direction discrimination training. In seven human CB subjects, we measured threshold versus noise functions before and after coarse direction discrimination training in the blind field and at corresponding intact field locations. Threshold versus noise functions were analyzed within the framework of the linear amplifier model and the perceptual template model. Linear amplifier model analysis identified internal noise as a key factor differentiating motion processing across the tested areas, with visual training reducing internal noise in the blind field. Differences in internal noise also explained residual perceptual deficits at retrained locations. These findings were confirmed with perceptual template model analysis, which further revealed that the major residual deficits between retrained and intact field locations could be explained by differences in internal additive noise. There were no significant differences in multiplicative noise or the ability to process external noise. Together, these results highlight the critical role of altered internal noise processing in mediating training-induced visual recovery in CB fields, and may explain residual perceptual deficits relative to intact regions of the visual field. PMID:26389544

  13. Visual recovery in cortical blindness is limited by high internal noise.

    PubMed

    Cavanaugh, Matthew R; Zhang, Ruyuan; Melnick, Michael D; Das, Anasuya; Roberts, Mariel; Tadin, Duje; Carrasco, Marisa; Huxlin, Krystel R

    2015-01-01

    Damage to the primary visual cortex typically causes cortical blindness (CB) in the hemifield contralateral to the damaged hemisphere. Recent evidence indicates that visual training can partially reverse CB at trained locations. Whereas training induces near-complete recovery of coarse direction and orientation discriminations, deficits in fine motion processing remain. Here, we systematically disentangle components of the perceptual inefficiencies present in CB fields before and after coarse direction discrimination training. In seven human CB subjects, we measured threshold versus noise functions before and after coarse direction discrimination training in the blind field and at corresponding intact field locations. Threshold versus noise functions were analyzed within the framework of the linear amplifier model and the perceptual template model. Linear amplifier model analysis identified internal noise as a key factor differentiating motion processing across the tested areas, with visual training reducing internal noise in the blind field. Differences in internal noise also explained residual perceptual deficits at retrained locations. These findings were confirmed with perceptual template model analysis, which further revealed that the major residual deficits between retrained and intact field locations could be explained by differences in internal additive noise. There were no significant differences in multiplicative noise or the ability to process external noise. Together, these results highlight the critical role of altered internal noise processing in mediating training-induced visual recovery in CB fields, and may explain residual perceptual deficits relative to intact regions of the visual field.

  14. International Collaboration in Organizations Promoting Geography Education: Exploring Success and Acknowledging Limitations

    ERIC Educational Resources Information Center

    Donert, Karl; Hay, Iain; Theobald, Rebecca; Valiunaite, Vita; Wakefield, Kelly

    2011-01-01

    Effective teaching about many of the geographical issues now confronting Earth and humanity requires collective approaches and shared solutions. It follows, therefore, that there is a need to better understand the basis of and process for sustaining successful international collaboration among geography educators. This paper first examines some of…

  15. Femoral Aperture Fixation Improves Anterior Cruciate Ligament Graft Function When Added to Cortical Suspensory Fixation

    PubMed Central

    Porter, Mark D.; Shadbolt, Bruce

    2016-01-01

    Background: Recommendations for bone tunnel placement during anterior cruciate ligament (ACL) reconstruction have become more precise. However, these recommendations differ neither with the choice of graft nor with the method of fixation used. The influence of the method of femoral fixation used on the biomechanical function of a soft tissue ACL graft remains unknown. Hypothesis: Our null hypothesis was that adding femoral aperture fixation to femoral cortical fixation, using the same bone tunnels, will not alter the control of anterior translation (AT) and internal rotation (IR) during ACL reconstruction using a hamstring graft. Study Design: Controlled laboratory study. Methods: A total of 22 patients with an acute isolated ACL rupture underwent reconstruction using a single-bundle autologous hamstring graft. Computer navigation was used intraoperatively to plot the AT and IR during the pivot-shift test before reconstruction, after ACL reconstruction using cortical suspensory fixation, and after the addition of femoral aperture fixation. Statistical analysis (analysis of variance) was used to compare the AT and IR during the pivot shift at each stage in the procedure. Results: Before ACL reconstruction, the mean (±SD) AT was 14.2 ± 7.3 mm and mean IR was 17.2° ± 5.5°. After reconstruction using femoral cortical suspension, these figures were significantly reduced to 6.2 ± 3.5 mm and 12.5° ± 3.20°, respectively (P < .001). The addition of the aperture fixation was associated with a further significant reduction to 4.6 ± 3.2 mm and 10.4° ± 2.7°, respectively (P < .001). Conclusion: The addition of femoral aperture fixation to suspensory fixation results in a significant reduction in both the AT and IR that occurs during the pivot-shift assessment immediately after ACL reconstruction using autologous hamstring graft. Clinical Relevance: The most precise positioning of bone tunnels during soft tissue ACL reconstruction needs to take into consideration

  16. Scapular thickness--implications for fracture fixation.

    PubMed

    Burke, Charity S; Roberts, Craig S; Nyland, John A; Radmacher, Paula G; Acland, Robert D; Voor, Michael J

    2006-01-01

    The purpose of this study was to measure and map scapula osseous thickness to identify the optimal areas for internal fixation. Eighteen (9 pairs) scapulae from 2 female and 7 male cadavers were used. After harvest and removal of all soft tissues, standardized measurement lines were made based on anatomic landmarks. For consistency among scapulae, measurements were taken at standard percentage intervals along each line approximating the distance between two consecutive reconstruction plate screw holes. Two-mm-diameter drill holes were made at each point, and a standard depth gauge was used to measure thickness. The glenoid fossa (25 mm) displayed the greatest mean osseous thickness, followed by the lateral scapular border (9.7 mm), the scapula spine (8.3 mm), and the central portion of the body of the scapula (3.0 mm). To optimize screw purchase and internal fixation strength, the lateral border, the lateral aspect of the base of the scapula spine, and the scapula spine itself should be used for anatomic sites of internal fixation of scapula fractures.

  17. 76 FR 53847 - New International Commission on Radiological Protection; Recommendations on the Annual Dose Limit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-30

    ... REIRS database (NUREG-0713, ``Occupational Radiation Exposure at Commercial Nuclear Power Reactors and... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY... Annual Dose Limit to the Lens of the Eye AGENCY: Nuclear Regulatory Commission. ACTION: Request...

  18. Novel posterior fixation keratoprosthesis

    NASA Astrophysics Data System (ADS)

    Lacombe, Emmanuel

    1992-08-01

    The keratoprosthesis is the last solution for corneally blind patients that cannot benefit from corneal transplants. Keratoprostheses that have been designed to be affixed anteriorly usually necessitate multi-step surgical procedures and are continuously subjected to the extrusion forces generated by the positive intraocular pressure; therefore, clinical results in patients prove inconsistent. We proposed a novel keratoprosthesis concept that utilizes posterior corneal fixation which `a priori' minimizes the risk of aqueous leakage and expulsion. This prosthesis is implanted in a single procedure thereby reducing the number of surgical complications normally associated with anterior fixation devices. In addition, its novel design makes this keratoprosthesis implantable in phakic eyes. With an average follow-up of 13 months (range 3 to 25 months), our results on 21 cases are encouraging. Half of the keratoprostheses were implanted in severe burn cases, with the remainder in cases of pseudo- pemphigus. Good visual results and cosmetic appearance were obtained in 14 of 21 eyes.

  19. Low Carbon Costs of Nitrogen Fixation in Tropical Dry Forests

    NASA Astrophysics Data System (ADS)

    Gei, M. G.; Powers, J. S.

    2015-12-01

    Legume tree species with the ability to fix nitrogen (N) are highly diverse and widespread across tropical forests but in particular in the dry tropics. Their ecological success in lower latitudes has been called a "paradox": soil N in the tropics is thought to be high, while acquiring N through fixation incurs high energetic costs. However, the long held assumptions that N fixation is limited by photosynthate and that N fixation penalizes plant productivity have rarely been tested, particularly in legume tree species. We show results from three different experiments where we grew eleven species of tropical dry forest legumes. We quantified plant biomass and N fixation using nodulation and the 15N natural isotope abundance (Ndfa or nitrogen derived from fixation). These data show little evidence for costs of N fixation in seedlings grown under different soil fertility, light regimes, and with different microbial communities. Seedling productivity did not incur major costs because of N fixation: indeed, the average slope between Ndfa and biomass was positive (range in slopes: -0.03 to 0.3). Moreover, foliar N, which varied among species, was tightly constrained and not correlated with Ndfa. This finding implies that legume species have a target N that does not change depending on N acquisition strategies. The process of N fixation in tropical legumes may be more carbon efficient than previously thought. This view is more consistent with the hyperabundance of members of this family in tropical ecosystems.

  20. Modeling evolution using the probability of fixation: history and implications.

    PubMed

    McCandlish, David M; Stoltzfus, Arlin

    2014-09-01

    Many models of evolution calculate the rate of evolution by multiplying the rate at which new mutations originate within a population by a probability of fixation. Here we review the historical origins, contemporary applications, and evolutionary implications of these "origin-fixation" models, which are widely used in evolutionary genetics, molecular evolution, and phylogenetics. Origin-fixation models were first introduced in 1969, in association with an emerging view of "molecular" evolution. Early origin-fixation models were used to calculate an instantaneous rate of evolution across a large number of independently evolving loci; in the 1980s and 1990s, a second wave of origin-fixation models emerged to address a sequence of fixation events at a single locus. Although origin fixation models have been applied to a broad array of problems in contemporary evolutionary research, their rise in popularity has not been accompanied by an increased appreciation of their restrictive assumptions or their distinctive implications. We argue that origin-fixation models constitute a coherent theory of mutation-limited evolution that contrasts sharply with theories of evolution that rely on the presence of standing genetic variation. A major unsolved question in evolutionary biology is the degree to which these models provide an accurate approximation of evolution in natural populations.

  1. CARBON DIOXIDE FIXATION.

    SciTech Connect

    FUJITA,E.

    2000-01-12

    Solar carbon dioxide fixation offers the possibility of a renewable source of chemicals and fuels in the future. Its realization rests on future advances in the efficiency of solar energy collection and development of suitable catalysts for CO{sub 2} conversion. Recent achievements in the efficiency of solar energy conversion and in catalysis suggest that this approach holds a great deal of promise for contributing to future needs for fuels and chemicals.

  2. Fixation based event-related fmri analysis: using eye fixations as events in functional magnetic resonance imaging to reveal cortical processing during the free exploration of visual images.

    PubMed

    Marsman, Jan Bernard C; Renken, Remco; Velichkovsky, Boris M; Hooymans, Johanna M M; Cornelissen, Frans W

    2012-02-01

    Eye movements, comprising predominantly fixations and saccades, are known to reveal information about perception and cognition, and they provide an explicit measure of attention. Nevertheless, fixations have not been considered as events in the analyses of data obtained during functional magnetic resonance imaging (fMRI) experiments. Most likely, this is due to their brevity and statistical properties. Despite these limitations, we used fixations as events to model brain activation in a free viewing experiment with standard fMRI scanning parameters. First, we found that fixations on different objects in different task contexts resulted in distinct cortical patterns of activation. Second, using multivariate pattern analysis, we showed that the BOLD signal revealed meaningful information about the task context of individual fixations and about the object being inspected during these fixations. We conclude that fixation-based event-related (FIBER) fMRI analysis creates new pathways for studying human brain function by enabling researchers to explore natural viewing behavior.

  3. Treatment of acute and chronic elbow instability with a hinged external fixator after fracture dislocation.

    PubMed

    Zilkens, Christoph; Graf, Markus; Anastasiadis, Alexandros; Smajic, Samir; Muhr, Gert; Kälicke, Thomas

    2009-04-01

    This is a retrospective analysis of the clinical and radiological outcome in 24 patients with acute or chronic posttraumatic elbow instability, who were treated with open reduction, internal fixation and a hinged external fixator. The instability was acute after elbow fracture dislocation in 11 cases; the other 13 had chronic posttraumatic instability of the elbow. Concentric stability and a sufficient range of motion of the elbow joint were achieved in all cases. The addition of a hinged external fixator in noncompliant patients, who underwent open reduction and internal fixation of an acute or chronic posttraumatic unstable elbow, allows early intensive mobilisation and can improve the clinical outcome after these complex elbow injuries.

  4. Innovative strategies for transforming internal medicine residency training in resource-limited settings: the Mozambique experience.

    PubMed

    Mocumbi, Ana Olga; Carrilho, Carla; Aronoff-Spencer, Eliah; Funzamo, Carlos; Patel, Sam; Preziosi, Michael; Lederer, Philip; Tilghman, Winston; Benson, Constance A; Badaró, Roberto; Nguenha, A; Schooley, Robert T; Noormahomed, Emília V

    2014-08-01

    With approximately 4 physicians per 100,000 inhabitants, Mozambique faces one of the most severe health care provider shortages in Sub-Saharan Africa. The lack of sufficient well-trained medical school faculty is one of Mozambique's major barrier to producing new physicians annually. A partnership between the Universidade Eduardo Mondlane and the University of California, San Diego, has addressed this challenge with support from the Medical Education Partnership Initiative. After an initial needs assessment involving questionnaires and focus groups of residents, and working with key members from the Ministry of Health, the Medical Council, and Maputo Central Hospital, a set of interventions was designed. The hospital's internal medicine residency program was chosen as the focus for the plan. Interventions included curriculum design, new teaching methodologies, investment in an informatics infrastructure for access to digital references, building capacity to support clinical research, and providing financial incentives to retain junior faculty. The number of candidates entering the internal medicine residency program has increased, and detailed monitoring and evaluation is measuring the impact of these changes on the quality of training. These changes are expected to improve the long-term quality of postgraduate training in general through dissemination to other departments. They also have the potential to facilitate equitable distribution of specialists nationwide by expanding postgraduate training to other hospitals and universities.

  5. N2-fixation and seedling growth promotion of lodgepole pine by endophytic Paenibacillus polymyxa.

    PubMed

    Anand, Richa; Grayston, Susan; Chanway, Christopher

    2013-08-01

    We inoculated lodgepole pine (Pinus contorta var. latifolia (Dougl.) Engelm.) with Paenibacillus polymyxa P2b-2R, a diazotrophic bacterium previously isolated from internal stem tissue of a naturally regenerating pine seedling to evaluate biological nitrogen fixation and seedling growth promotion by this microorganism. Seedlings generated from pine seed inoculated with strain P2b-2R were grown for up to 13 months in a N-limited soil mix containing 0.7 mM available N labeled as Ca((15)NO3)2 to facilitate detection of N2-fixation. Strain P2b-2R developed a persistent endophytic population comprising 10(2)-10(6) cfu g(-1) plant tissue inside pine roots, stems, and needles during the experiment. At the end of the growth period, P2b-2R had reduced seedling mortality by 14 % and (15)N foliar N abundance 79 % and doubled foliar N concentration and seedling biomass compared to controls. Our results suggest that N2-fixation by P. polymyxa enhanced growth of pine seedlings and support the hypothesis that plant-associated diazotrophs capable of endophytic colonization can satisfy a significant proportion of the N required by tree seedlings growing under N-limited conditions.

  6. A unifying framework for dinitrogen fixation in the terrestrial biosphere.

    PubMed

    Houlton, Benjamin Z; Wang, Ying-Ping; Vitousek, Peter M; Field, Christopher B

    2008-07-17

    Dinitrogen (N(2)) fixation is widely recognized as an important process in controlling ecosystem responses to global environmental change, both today and in the past; however, significant discrepancies exist between theory and observations of patterns of N(2) fixation across major sectors of the land biosphere. A question remains as to why symbiotic N(2)-fixing plants are more abundant in vast areas of the tropics than in many of the mature forests that seem to be nitrogen-limited in the temperate and boreal zones. Here we present a unifying framework for terrestrial N(2) fixation that can explain the geographic occurrence of N(2) fixers across diverse biomes and at the global scale. By examining trade-offs inherent in plant carbon, nitrogen and phosphorus capture, we find a clear advantage to symbiotic N(2) fixers in phosphorus-limited tropical savannas and lowland tropical forests. The ability of N(2) fixers to invest nitrogen into phosphorus acquisition seems vital to sustained N(2) fixation in phosphorus-limited tropical ecosystems. In contrast, modern-day temperatures seem to constrain N(2) fixation rates and N(2)-fixing species from mature forests in the high latitudes. We propose that an analysis that couples biogeochemical cycling and biophysical mechanisms is sufficient to explain the principal geographical patterns of symbiotic N(2) fixation on land, thus providing a basis for predicting the response of nutrient-limited ecosystems to climate change and increasing atmospheric CO(2).

  7. [Interest and limits of inductively coupled plasma mass spectrometry (ICP-MS) for urinary diagnosis of radionuclide internal contamination].

    PubMed

    Lecompte, Yannick; Bohand, Sandra; Laroche, Pierre; Cazoulat, Alain

    2013-01-01

    After a review of radiometric reference methods used in radiotoxicology, analytical performance of inductively coupled plasma mass spectrometry (ICP-MS) for the workplace urinary diagnosis of internal contamination by radionuclides are evaluated. A literature review (covering the period from 2000 to 2012) is performed to identify the different applications of ICP-MS in radiotoxicology for urine analysis. The limits of detection are compared to the recommendations of the International commission on radiological protection (ICRP 78: "Individual monitoring for internal exposure of workers"). Except one publication describing the determination of strontium-90 (β emitter), all methods using ICP-MS reported in the literature concern actinides (α emitters). For radionuclides with a radioactive period higher than 10(4) years, limits of detection are most often in compliance with ICRP publication 78 and frequently lower than radiometric methods. ICP-MS allows the specific determination of plutonium-239 + 240 isotopes which cannot be discriminated by α spectrometry. High resolution ICP-MS can also measure uranium isotopic ratios in urine for total uranium concentrations lower than 20 ng/L. The interest of ICP-MS in radiotoxicology concerns essentially the urinary measurement of long radioactive period actinides, particularly for uranium isotope ratio determination and 239 and 240 plutonium isotopes discrimination. Radiometric methods remain the most efficient for the majority of other radionuclides.

  8. [International harmonization of regular requirements for the registration of drugs: necessity, frena limitations].

    PubMed

    Santini, C

    1994-01-01

    Considering the necessity of internationalisation, the Pharmaceutical Industry fears the regulatory variations that may result from national evolutions, parallel or divergent, which sometimes impose on it some repeated works, hence causing an undesirable extension of development duration and also higher costs. Therefore it is quite evident to that Industry that a worldwide harmonization is necessary. For the whole collectivity, such an harmonization allows a better utilization of manpower, of animal experimentation, and also of the material means available for the new pharmaceutical products development. The strong interest showed by the Pharmaceutical industry in France for the International regulatory harmonization, confirms that this Profession has effectively taken into account the worldwide dimension for the medicinal products of the year 2000.

  9. Nitrogen fixation apparatus

    DOEpatents

    Chen, Hao-Lin

    1984-01-01

    A method and apparatus for achieving nitrogen fixation includes a volumetric electric discharge chamber. The volumetric discharge chamber provides an even distribution of an electron beam, and enables the chamber to be maintained at a controlled energy to pressure (E/p) ratio. An E/p ratio of from 5 to 15 kV/atm of O.sub.2 /cm promotes the formation of vibrationally excited N.sub.2. Atomic oxygen interacts with vibrationally excited N.sub.2 at a much quicker rate than unexcited N.sub.2, greatly improving the rate at which NO is formed.

  10. Anticipatory eye fixations reveal tool knowledge for tool interaction.

    PubMed

    Belardinelli, Anna; Barabas, Marissa; Himmelbach, Marc; Butz, Martin V

    2016-08-01

    Action-oriented eye-tracking studies have shown that eye fixations reveal much about current behavioral intentions. The eyes typically fixate those positions of a tool or an object where the fingers will be placed next, or those positions in a scene, where obstacles need to be avoided to successfully reach or transport a tool or object. Here, we asked to what extent eye fixations can also reveal active cognitive inference processes, which are expected to integrate bottom-up visual information with internal knowledge for planning suitable object interactions task-dependently. In accordance to the available literature, we expected that task-relevant knowledge will include sensorimotor, semantic, and mechanical aspects. To investigate if and in which way this internal knowledge influences eye fixation behavior while planning an object interaction, we presented pictures of familiar and unfamiliar tools and instructed participants to either pantomime 'lifting' or 'using' the respective tool. When confronted with unfamiliar tools, participants fixated the tool's effector part closer and longer in comparison with familiar tools. This difference was particularly prominent during 'using' trials when compared with 'lifting' trials. We suggest that this difference indicates that the brain actively extracts mechanical information about the unknown tool in order to infer its appropriate usage. Moreover, the successive fixations over a trial indicate that a dynamic, task-oriented, active cognitive process unfolds, which integrates available tool knowledge with visually gathered information to plan and determine the currently intended tool interaction.

  11. Molecular biology and genetic engineering in nitrogen fixation.

    PubMed

    Dos Santos, Patricia C

    2011-01-01

    Biological nitrogen fixation is a complex and tightly regulated process limited to a group of prokaryotic species known as diazotrophs. Among well-studied diazotrophs, Azotobacter vinelandii is the best studied for its convenience of aerobic growth, its high levels of nitrogenase expression, and its genetic tractability. This chapter includes protocols and strategies in the molecular biology and genetic engineering of A. vinelandii that have been used as valuable tools for advancing studies on the biosynthesis, mechanism, and regulation of nitrogen fixation.

  12. The International Society of Nephrology (ISN). Roles & challenges in Africa and other resource-limited communities.

    PubMed

    Feehally, John

    ISN (the International Society of Nephrology) is a global organization with more than 9,000 members in 130 countries. The ISN's mission is to "advance the diagnosis, treatment, and prevention of kidney diseases in the developing and developed world". ISN delivers this mission in low-resource settings through its five education and training programs available exclusively to low- and middle-income countries. These programs are designed to enable sustainable growth in capacity in nephrology and related disciplines to provide the basis for the improvement of care for kidney patients worldwide. ISN also directs its efforts towards advocacy for kidney health and kidney care, seeking to increase understanding of kidney disease among the general population, health professionals, and health policy makers. Such advocacy is challenging because of the complexity of kidney health messages; there is a need to emphasize affordable healthcare solutions for prevention and treatment of acute kidney injury (AKI), as well as the prevention and management of chronic kidney disease (CKD), and the provision of renal replacement therapy (both chronic dialysis and kidney transplantation) that is both affordable and ethically acceptable.

  13. Conversion from temporary external fixation to definitive fixation: shaft fractures.

    PubMed

    Dougherty, Paul J; Silverton, Craig; Yeni, Yener; Tashman, Scott; Weir, Robb

    2006-01-01

    Temporary external fixation is the most common method of initial stabilization of diaphyseal fractures in forward surgical hospitals. Once the patient arrives at a stable environment, usually the United States, the fracture is managed with intramedullary nailing, small-pin external fixation, or a modified external fixator. Future research should be directed toward improving methods of care. It is not precisely known when is the best time to convert to definitive fixation without increasing the risk of infection. The risk factors leading to infection and nonunion are not well-established, making that determination even more difficult. Clinical studies of a suitable size should provide insight into these problems. Although temporary external fixation is commonly used, an optimal construct has not been determined. Data from studies of in vivo fracture-site motion after application of the temporary external fixator should be compared with biomechanical testing of similar constructs. These data could be used to recommend optimal temporary external fixation constructs of tibia, femur, and humerus fractures using currently available devices as well as to provide groundwork for the next generation of fixators.

  14. Biomechanical Analysis of the Fixation System for T-Shaped Acetabular Fracture

    PubMed Central

    Fan, Yanping; Lei, Jianyin; Zhu, Feng; Li, Zhiqiang; Chen, Weiyi; Liu, Ximing

    2015-01-01

    This study aims to evaluate the biomechanical mechanism of fixation systems in the most frequent T-shaped acetabular fracture using finite element method. The treatment of acetabular fractures was based on extensive clinical experience. Three commonly accepted rigid fixation methods (double column reconstruction plates (P × 2), anterior column plate combined with posterior column screws (P + PS), and anterior column plate combined with quadrilateral area screws (P + QS)) were chosen for evaluation. On the basis of the finite element model, the biomechanics of these fixation systems were assessed through effective stiffness levels, stress distributions, force transfers, and displacements along the fracture lines. All three fixation systems can be used to obtain effective functional outcomes. The third fixation system (P + QS) was the optimal method for T-shaped acetabular fracture. This fixation system may reduce many of the risks and limitations associated with other fixation systems. PMID:26495030

  15. Extra Corporeal Fixation of Fractured Mandibular Condyle

    PubMed Central

    Shenoy K, Vandana; Kengagsubbiah, Srivatsa; V, Sathyabhama; Priya, Vishnu

    2014-01-01

    Condylar fracture is the second most common site in the mandibular fractures. Motor vehicle accident and fall are the major causes of such fractures. Because of the anatomical weakness of the condyle and the shape of the condylar head the antero-medial dislocation of the condyle is common. Open reduction and closed reduction is always debatable. The open reduction will bring back the normal function much earlier than closed reduction. Medially dislocated condylar fracture fragments are always managed with open method. In superior or high condylar fractures,exact reduction with conventional open reduction can be difficult due to the limited surgical and visual fields. In such cases extracorporeal fixation of condyle using vertical ramus osteotomy may be better choice to achieve perfect alignment and absolute maintaince of vertical height of the ramus and facial symmetry. We here present a case of extracorporeal fixation of unilateral left high condylar fracture. PMID:25386546

  16. The International Limits and Population at Risk of Plasmodium vivax Transmission in 2009

    PubMed Central

    Guerra, Carlos A.; Howes, Rosalind E.; Patil, Anand P.; Gething, Peter W.; Van Boeckel, Thomas P.; Temperley, William H.; Kabaria, Caroline W.; Tatem, Andrew J.; Manh, Bui H.; Elyazar, Iqbal R. F.; Baird, J. Kevin; Snow, Robert W.; Hay, Simon I.

    2010-01-01

    development and control, P. vivax remains more widely distributed than P. falciparum and is a potential cause of morbidity and mortality amongst the 2.85 billion people living at risk of infection, the majority of whom are in the tropical belt of CSE Asia. The probability of infection is reduced massively across Africa by the frequency of the Duffy negative trait, but transmission does occur on the continent and is a concern for Duffy positive locals and travellers. The final map provides the spatial limits on which the endemicity of P. vivax transmission can be mapped to support future cartographic-based burden estimations. PMID:20689816

  17. Endoscopically assisted reduction and fixation of condylar neck/base fractures--The learning curve.

    PubMed

    Loukota, R A

    2006-12-01

    Following the introduction of a new technique for fixation of fractures of the condylar neck and base in our department, the operative times were compared with those for the traditional and frequently used method of open reduction and internal fixation. A distinct learning curve was seen.

  18. Femoral locking plate failure salvaged with hexapod circular external fixation: a report of two cases.

    PubMed

    Ferreira, N; Marais, L C

    2016-08-01

    Femoral non-unions are difficult to treat even for the experienced orthopaedic trauma surgeon. If the non-union follows failure of modern stable internal fixation, the complexity of the management is further increased. We report two cases of stiff hypertrophic femoral non-unions after failed locking plate fixation that were successfully treated with a new hexapod circular external fixator. In addition to providing the necessary stability for functional rehabilitation and union, the hexapod circular fixator software allows gradual correction of deformities in order to restore the normal mechanical alignment of the limb.

  19. Limited internal radiation exposure associated with resettlements to a radiation-contaminated homeland after the Fukushima Daiichi nuclear disaster.

    PubMed

    Tsubokura, Masaharu; Kato, Shigeaki; Nihei, Masahiko; Sakuma, Yu; Furutani, Tomoyuki; Uehara, Keisuke; Sugimoto, Amina; Nomura, Shuhei; Hayano, Ryugo; Kami, Masahiro; Watanobe, Hajime; Endo, Yukou

    2013-01-01

    Resettlement to their radiation-contaminated hometown could be an option for people displaced at the time of a nuclear disaster; however, little information is available on the safety implications of these resettlement programs. Kawauchi village, located 12-30 km southwest of the Fukushima Daiichi nuclear power plant, was one of the 11 municipalities where mandatory evacuation was ordered by the central government. This village was also the first municipality to organize the return of the villagers. To assess the validity of the Kawauchi villagers' resettlement program, the levels of internal Cesium (Cs) exposures were comparatively measured in returnees, commuters, and non-returnees among the Kawauchi villagers using a whole body counter. Of 149 individuals, 5 villagers had traceable levels of Cs exposure; the median detected level was 333 Bq/body (range, 309-1050 Bq/kg), and 5.3 Bq/kg (range, 5.1-18.2 Bq/kg). Median annual effective doses of villagers with traceable Cs were 1.1 x 10(-2) mSv/y (range, 1.0 x 10(-2)-4.1 x 10(-2) mSv/y). Although returnees had higher chances of consuming locally produced vegetables, Cochran-Mantel-Haenszel test showed that their level of internal radiation exposure was not significantly higher than that in the other 2 groups (p=0.643). The present findings in Kawauchi village imply that it is possible to maintain internal radiation exposure at very low levels even in a highly radiation-contaminated region at the time of a nuclear disaster. Moreover, the risks for internal radiation exposure could be limited with a strict food control intervention after resettlement to the radiation-contaminated village. It is crucial to establish an adequate number of radio-contaminated testing sites within the village, to provide immediate test result feedback to the villagers, and to provide education regarding the importance of re-testing in reducing the risk of high internal radiation exposure.

  20. Role of Tractional Forces and Internal Limiting Membrane in Macular Hole Formation: Insights from Intraoperative Optical Coherence Tomography

    PubMed Central

    Moisseiev, Elad; Yiu, Glenn

    2016-01-01

    We report the case of a 69-year-old patient who underwent vitrectomy for vitreomacular traction (VMT) and developed a postoperative macular hole that was observed 1 week after surgery. The hole did not close by in-office fluid-gas exchange alone, but was achieved after repeat surgery with internal limiting membrane (ILM) peeling. Intraoperative OCT (iOCT) images from the first surgery revealed an occult macular hole that formed after VMT release. We discuss how iOCT findings provide insight into the role of the ILM in macular hole formation and emphasize the importance of carefully inspecting iOCT images in real time to avoid missing small but important findings. PMID:27721786

  1. Limitations of Condensed Teaching Strategies to Develop Hand-Held Cardiac Ultrasonography Skills in Internal Medicine Residents.

    PubMed

    Wilkinson, Jeffrey S; Barake, Walid; Smith, Chris; Thakrar, Amar; Johri, Amer M

    2016-08-01

    Advances in ultrasonographic technology have allowed for hand-held cardiac ultrasonography (HHCU) units that fit into a physician's laboratory coat. Recently, studies to educate internal medicine residents have shown promise. The optimal duration and methodology for teaching HHCU skills has not been established. Over a 1-year period, internal medicine residents were recruited during their cardiology ward rotation into a single-centre nonblinded randomized trial. The 2 condensed teaching strategies were (1) a conventional ward-based program and (2) a technology-driven simulation-based strategy. Outcomes were evaluated by (1) an objective structured clinical examination (OSCE) to evaluate interpretation ability (assessing both type I and type II error rates) and (2) demonstration of HHCU skills graded by 2 level III echocardiographers. Twenty-four internal medicine residents were randomized. After teaching, the conventional teaching group had a significant absolute increase in the ability to make a singular correct diagnosis (20%; P < 0.001). In the technology arm, making a singular correct diagnosis increased 24% from baseline (P = 0.001). Interpretation skill was not significantly different between groups. The false-positive rate increased by an absolute 14% and 17% in the conventional and technology groups, respectively (P = 0.079 and P = 0.008). Our findings suggest that HHCU interpretation skills improve after either a conventional ward-based or a technology-driven approach. However, our study emphasizes the important limitations of both teaching programs, because we detected a trend toward an increase in the false-positive rate after both approaches. This suggests that a short duration of training may not be sufficient for HHCU to be performed in a safe manner.

  2. Neuronal control of fixation and fixational eye movements

    PubMed Central

    2017-01-01

    Ocular fixation is a dynamic process that is actively controlled by many of the same brain structures involved in the control of eye movements, including the superior colliculus, cerebellum and reticular formation. In this article, we review several aspects of this active control. First, the decision to move the eyes not only depends on target-related signals from the peripheral visual field, but also on signals from the currently fixated target at the fovea, and involves mechanisms that are shared between saccades and smooth pursuit. Second, eye position during fixation is actively controlled and depends on bilateral activity in the superior colliculi and medio-posterior cerebellum; disruption of activity in these circuits causes systematic deviations in eye position during both fixation and smooth pursuit eye movements. Third, the eyes are not completely still during fixation but make continuous miniature movements, including ocular drift and microsaccades, which are controlled by the same neuronal mechanisms that generate larger saccades. Finally, fixational eye movements have large effects on visual perception. Ocular drift transforms the visual input in ways that increase spatial acuity; microsaccades not only improve vision by relocating the fovea but also cause momentary changes in vision analogous to those caused by larger saccades. This article is part of the themed issue ‘Movement suppression: brain mechanisms for stopping and stillness’. PMID:28242738

  3. Minimally invasive percutaneous screw fixation of traumatic spondylolisthesis of the axis.

    PubMed

    Buchholz, Avery Lee; Morgan, Steven L; Robinson, Leslie C; Frankel, Bruce M

    2015-05-01

    OBJECT Most cases of traumatic spondylolisthesis of the axis (hangman's fracture) can be treated nonoperatively with reduction and subsequent immobilization in a rigid cervical collar or halo. However, in some instances, operative management is necessary and can be accomplished by using either anterior or posterior fusion techniques. Because open posterior procedures can result in significant blood loss, pain, and limited cervical range of motion, other less invasive options for posterior fixation are needed. The authors describe a minimally invasive, navigation-guided technique for surgical treatment of Levine-Edwards (L-E) Type II hangman's fractures. METHODS For 5 patients with L-E Type II hangman's fracture requiring operative reduction and internal fixation, percutaneous screw fixation directed through the fracture site was performed. This technique was facilitated by use of intraoperative 3D fluoroscopy and neuronavigation. RESULTS Of the 5 patients, 2 were women, 3 were men, and age range was 46-67 years. No intraoperative or postoperative complications occurred. All patients wore a rigid cervical collar, and flexion-extension radiographs were obtained at 6 months. For all patients, dynamic imaging demonstrated a stable construct. CONCLUSIONS L-E type II hangman's fractures can be safely repaired by using percutaneous minimally invasive surgical techniques. This technique may be appropriate, depending on circumstances, for all L-E Type I and II hangman's fractures; however, the degree of associated ligament injury and disc disruption must be accounted for. Percutaneous fixation is not appropriate for L-E Type III fractures because of significant displacement and ligament and disc disruption. This report is meant to serve as a feasibility study and is not meant to show superiority of this procedure over other surgical options.

  4. Molecular Biology of Nitrogen Fixation

    ERIC Educational Resources Information Center

    Shanmugam, K. T.; Valentine, Raymond C.

    1975-01-01

    Reports that as a result of our increasing knowledge of the molecular biology of nitrogen fixation it might eventually be possible to increase the biological production of nitrogenous fertilizer from atmospheric nitrogen. (GS)

  5. Conversion efficiency limits and bandgap designs for multi-junction solar cells with internal radiative efficiencies below unity.

    PubMed

    Zhu, Lin; Mochizuki, Toshimitsu; Yoshita, Masahiro; Chen, Shaoqiang; Kim, Changsu; Akiyama, Hidefumi; Kanemitsu, Yoshihiko

    2016-05-16

    We calculated the conversion-efficiency limit ηsc and the optimized subcell bandgap energies of 1 to 5 junction solar cells without and with intermediate reflectors under 1-sun AM1.5G and 1000-sun AM1.5D irradiations, particularly including the impact of internal radiative efficiency (ηint) below unity for realistic subcell materials on the basis of an extended detailed-balance theory. We found that the conversion-efficiency limit ηsc significantly drops when the geometric mean ηint* of all subcell ηint in the stack reduces from 1 to 0.1, and that ηsc degrades linearly to logηint* for ηint* below 0.1. For ηint*<0.1 differences in ηsc due to additional intermediate reflectors became very small if all subcells are optically thick for sun light. We obtained characteristic optimized bandgap energies, which reflect both ηint* decrease and AM1.5 spectral gaps. These results provide realistic efficiency targets and design principles.

  6. Improved Intravitreal AAV-Mediated Inner Retinal Gene Transduction after Surgical Internal Limiting Membrane Peeling in Cynomolgus Monkeys.

    PubMed

    Takahashi, Kazuhisa; Igarashi, Tsutomu; Miyake, Koichi; Kobayashi, Maika; Yaguchi, Chiemi; Iijima, Osamu; Yamazaki, Yoshiyuki; Katakai, Yuko; Miyake, Noriko; Kameya, Shuhei; Shimada, Takashi; Takahashi, Hiroshi; Okada, Takashi

    2017-01-04

    The retina is an ideal target for gene therapy because of its easy accessibility and limited immunological response. We previously reported that intravitreally injected adeno-associated virus (AAV) vector transduced the inner retina with high efficiency in a rodent model. In large animals, however, the efficiency of retinal transduction was low, because the vitreous and internal limiting membrane (ILM) acted as barriers to transduction. To overcome these barriers in cynomolgus monkeys, we performed vitrectomy (VIT) and ILM peeling before AAV vector injection. Following intravitreal injection of 50 μL triple-mutated self-complementary AAV serotype 2 vector encoding EGFP, transduction efficiency was analyzed. Little expression of GFP was detected in the control and VIT groups, but in the VIT+ILM group, strong GFP expression was detected within the peeled ILM area. To detect potential adverse effects, we monitored the retinas using color fundus photography, optical coherence tomography, and electroretinography. No serious side effects associated with the pretreatment were observed. These results indicate that surgical ILM peeling before AAV vector administration would be safe and useful for efficient transduction of the nonhuman primate retina and provide therapeutic benefits for the treatment of retinal diseases.

  7. Biomechanics of external fixation and limb lengthening.

    PubMed

    Younger, Alastair S E; Morrison, James; MacKenzie, William G

    2004-09-01

    Surgeons who use external fixators for foot and ankle conditions need to understand the biomechanical principles to ensure good outcomes. Fixators can be used for fracture fixation, correction of contractures, distraction osteogenesis, and distraction arthroplasty. A two-ring fixator with wire fixation remains the gold standard with which all other frames are compared. Small changes in mechanical characteristics can have major implications on new bone or cartilage formation.

  8. Emergency department external fixation for provisional treatment of pilon and unstable ankle fractures

    PubMed Central

    Lareau, Craig R.; Daniels, Alan H.; Vopat, Bryan G.; Kane, Patrick M.

    2015-01-01

    Unstable ankle fractures and impacted tibial pilon fractures often benefit from provisional external fixation as a temporizing measure prior to definitive fixation. Benefits of external fixation include improved articular alignment, decreased articular impaction, and soft tissue rest. Uniplanar external fixator placement in the Emergency Department (ED ex-fix) is a reliable and safe technique for achieving ankle reduction and stability while awaiting definitive fixation. This procedure involves placing transverse proximal tibial and calcaneal traction pins and connecting the pins with two external fixator rods. This technique is particularly useful in austere environments or when the operating room is not immediately available. Additionally, this bedside intervention prevents the patient from requiring general anesthesia and may be a cost-effective strategy for decreasing valuable operating time. The ED ex-fix is an especially valuable procedure in busy trauma centers and during mass casualty events, in which resources may be limited. PMID:25709258

  9. Fixation duration surpasses pupil size as a measure of memory load in free viewing.

    PubMed

    Meghanathan, Radha Nila; van Leeuwen, Cees; Nikolaev, Andrey R

    2014-01-01

    Oculomotor behavior reveals, not only the acquisition of visual information at fixation, but also the accumulation of information in memory across subsequent fixations. Two candidate measures were considered as indicators of such dynamic visual memory load: fixation duration and pupil size. While recording these measures, we displayed an arrangement of 3, 4 or 5 targets among distractors. Both occurred in various orientations. Participants searched for targets and reported whether in a subsequent display one of them had changed orientation. We determined to what extent fixation duration and pupil size indicate dynamic memory load, as a function of the number of targets fixated during the search. We found that fixation duration reflects the number of targets, both when this number is within and above the limit of working memory capacity. Pupil size reflects the number of targets only when it exceeds the capacity limit. Moreover, the duration of fixations on successive targets but not on distractors increases whereas pupil size does not. The increase in fixation duration with number of targets both within and above working memory capacity suggests that in free viewing fixation duration is sensitive to actual memory load as well as to processing load, whereas pupil size is indicative of processing load only. Two alternative models relating visual attention and working memory are considered relevant to these results. We discuss the results as supportive of a model which involves a temporary buffer in the interaction of attention and working memory.

  10. Fixation duration surpasses pupil size as a measure of memory load in free viewing

    PubMed Central

    Meghanathan, Radha Nila; van Leeuwen, Cees; Nikolaev, Andrey R.

    2015-01-01

    Oculomotor behavior reveals, not only the acquisition of visual information at fixation, but also the accumulation of information in memory across subsequent fixations. Two candidate measures were considered as indicators of such dynamic visual memory load: fixation duration and pupil size. While recording these measures, we displayed an arrangement of 3, 4 or 5 targets among distractors. Both occurred in various orientations. Participants searched for targets and reported whether in a subsequent display one of them had changed orientation. We determined to what extent fixation duration and pupil size indicate dynamic memory load, as a function of the number of targets fixated during the search. We found that fixation duration reflects the number of targets, both when this number is within and above the limit of working memory capacity. Pupil size reflects the number of targets only when it exceeds the capacity limit. Moreover, the duration of fixations on successive targets but not on distractors increases whereas pupil size does not. The increase in fixation duration with number of targets both within and above working memory capacity suggests that in free viewing fixation duration is sensitive to actual memory load as well as to processing load, whereas pupil size is indicative of processing load only. Two alternative models relating visual attention and working memory are considered relevant to these results. We discuss the results as supportive of a model which involves a temporary buffer in the interaction of attention and working memory. PMID:25653606

  11. Analysis of operational, institutional and international limitations for alternative fuel vehicles and technologies: Means/methods for implementing changes

    SciTech Connect

    Not Available

    1992-07-01

    This project focused upon the development of an approach to assist public fleet managers in evaluating the characteristics and availability of alternative fuels (AF`s) and alternative fuel vehicles (AFV`s) that will serve as possible replacements for vehicles currently serving the needs of various public entities. Also of concern were the institutional/international limitations for alternative fuels and alternative fuel vehicles. The City of Detroit and other public agencies in the Detroit area were the particular focus for the activities. As the development and initial stages of use of alternative fuels and alternative fuel vehicles proceeds, there will be an increasing need to provide information and guidance to decision-makers regarding differences in requirements and features of these fuels and vehicles. There wig be true differences in requirements for servicing, managing, and regulating. There will also be misunderstanding and misperception. There have been volumes of data collected on AFV`S, and as technology is improved, new data is constantly added. There are not, however, condensed and effective sources of information for public vehicle fleet managers on vehicle and equipment sources, characteristics, performance, costs, and environmental benefits. While theoretical modeling of public fleet requirements has been done, there do not seem to be readily available ``practical``. There is a need to provide the best possible information and means to minimize the problems for introducing the effective use of alternative fuels and alternative fuel vehicles.

  12. Full-Thickness Macular Hole Formation after Internal Limiting Membrane Peeling: Beware the “Omega Sign”

    PubMed Central

    2016-01-01

    Purpose. To introduce a clinical sign on spectral domain optical coherence tomography (SDOCT), which may indicate high risk for full-thickness macular hole formation after internal limiting membrane (ILM) peeling. Methods. The preoperative SDOCT images of two patients—one with multilaminar hemorrhage from ruptured retinal artery macroaneurysm and one with serous retinal detachment and severe macular schisis from optic pit maculopathy—who developed full-thickness macular hole (FTMH) after ILM peeling were evaluated retrospectively. Results. On the preoperative SDOCT images of both patients there was a thin bridge of tissue on either side of the foveal center with an outer retinal defect. The photoreceptors were displaced laterally away from the foveal center to create an “omega-” shaped configuration of the remaining tissue. Conclusion. “Omega-” shaped configuration on SDOCT may represent a higher risk of FTMH following ILM peeling. Vitreoretinal surgeons may wish to consider this sign in the process of their surgical decision making. PMID:27747120

  13. Relationship between Peeled Internal Limiting Membrane Area and Anatomic Outcomes following Macular Hole Surgery: A Quantitative Analysis

    PubMed Central

    Goker, Yasin Sakir; Koc, Mustafa; Yuksel, Kemal; Yazici, Ahmet Taylan; Gunes, Hasan; Ozpinar, Yavuz

    2016-01-01

    Purpose. To quantitatively evaluate the effects of peeled internal limiting membrane (ILM) area and anatomic outcomes following macular hole surgery using spectral domain optical coherence tomography (SD-OCT). Methods. Forty-one eyes in 37 consecutive patients with idiopathic, Gass stage 3-4 macular hole (MH) were enrolled in this retrospective comparative study. All patients were divided into 2 groups according to anatomic success or failure. Basal MH diameter, peeled ILM area, and MH height were calculated using SD-OCT. Other prognostic parameters, including age, stage, preoperative BCVA, and symptom duration were also assessed. Results. Thirty-two cases were classified as anatomic success, and 9 cases were classified as anatomic failure. Peeled ILM area was significantly wider and MH basal diameter was significantly less in the anatomic success group (p = 0.024 and 0.032, resp.). Other parameters did not demonstrate statistical significance. Conclusion. The findings of the present study show that the peeled ILM area can affect the anatomic outcomes of MH surgery. PMID:27413544

  14. TEMPORAL INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR A MACULAR HOLE PATIENT UNABLE TO MAINTAIN POSTOPERATIVE PRONE POSITIONING

    PubMed Central

    Tanito, Masaki; Sugihara, Kazunobu; Kodama, Tatsuo; Ohira, Akihiro

    2016-01-01

    Purpose: To report the surgical technique and efficacy of the temporal inverted internal limiting membrane (ILM) flap technique for a patient with an idiopathic macular hole (MH) who is unable to maintain postoperative prone positioning. Methods: Case report. Results: A 73-year-old man with a Stage III MH in his left eye was scheduled to undergo surgery. Owing to his inability to maintain postoperative prone positioning for continuous placement of a transdermal bladder catheter after radical cystoprostatectomy to treat urinary bladder cancer, he underwent pars plana vitrectomy combined with the temporal inverted ILM flap technique and intraocular sulfur hexafluoride gas tamponade. The technique included ILM peeling at a temporal area of the macula to create one 2-disk-diameter semicircular ILM flap and inversion of the ILM flap nasally to cover the MH. Optical coherence tomography showed that MH closure started from the top of the MH just beneath the covered ILM flap; the closure process gradually extended toward the bottom of the MH. The well-aligned fovea recovered in 5 weeks postoperatively. The visual acuity was 20/200 preoperatively and improved to 20/50 postoperatively. Conclusion: The temporal inverted ILM flap technique, a simple surgery to treat MHs, provides scaffolding for retinal gliosis and may facilitate bridge formation between the walls of the MH beneath the flap. The procedure may be a good option to achieve MH closure without postoperative prone positioning. PMID:26674274

  15. The use of titanium and stainless steel in fracture fixation.

    PubMed

    Hayes, J S; Richards, R G

    2010-11-01

    The use of metal in fracture fixation has demonstrated unrivalled success for many years owing to its high stiffness, strength, biological toleration and overall reliable function. The most prominent materials used are electropolished stainless steel and commercially pure titanium, along with the more recent emergence of titanium alloys. Despite the many differences between electropolished stainless steel and titanium, both materials provide a relatively predictable clinical outcome, and offer similar success for fulfilling the main biomechanical and biological requirements of fracture fixation despite distinctive differences in implant properties and biological responses. This article explores these differences by highlighting the limitations and advantages of both materials, and addresses how this translates to clinical success.

  16. Trochanteric osteotomy and fixation during total hip arthroplasty.

    PubMed

    Archibeck, Michael J; Rosenberg, Aaron G; Berger, Richard A; Silverton, Craig D

    2003-01-01

    Once used routinely, trochanteric osteotomy in total hip arthroplasty now is usually limited to difficult primary and revision cases. There are three types: the standard trochanteric osteotomy and its variations, the trochanteric slide, and the extended trochanteric osteotomy. Each has unique indications, fixation techniques, and complications. Primary total hip arthroplasty procedures requiring the enhanced exposure provided by trochanteric osteotomy may be needed in patients with hip ankylosis or fusion, protrusio acetabuli, proximal femoral deformities, developmental dysplasia, or abductor muscle laxity. Trochanteric osteotomies in revision arthroplasties, primarily the extended trochanteric osteotomy, facilitate the removal of well-fixed femoral components, provide direct access to the diaphysis for distal fixation, and enhance acetabular exposure.

  17. Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique

    PubMed Central

    Kase, Satoru; Saito, Wataru; Mori, Shohei; Saito, Michiyuki; Ando, Ryo; Dong, Zhenyu; Suzuki, Tomohiro; Noda, Kousuke; Ishida, Susumu

    2017-01-01

    Purpose The aims of this study were to analyze optical coherence tomography (OCT) imaging of large macular holes (MHs) treated with inverted internal limiting membrane (ILM) flap technique and to perform a histological examination of an ILM-like membrane tissue obtained during vitrectomy. Patients and methods This is a retrospective observational case study. Nine patients, comprising of five males and four females, showing large and myopic MHs, underwent pars plana vitrectomy (PPV) with inverted ILM flap technique assisted by brilliant blue G (BBG) staining. Ophthalmological findings including visual acuity and OCT were investigated based on medical records. Formalin-fixed paraffin-embedded tissue section of an ILM-like membrane was submitted for immunohistochemistry with glial fibrillary acidic protein (GFAP). Results ILM was clearly stained with BBG in eight patients, whereas the ILM in one case revealed no staining with BBG during PPV. Visual acuities improved to >0.2 LogMAR in six patients. The complete closure of MH following PPV with inverted ILM technique was eventually achieved in all patients determined by OCT imaging (100%). Only one patient showed recovery of ellipsoid zone and interdigitation zone following the surgery. Elongation of outer nuclear layer was noted in three eyes. The ILM-like membrane not stained with BBG histologically revealed an amorphous structure admixed with GFAP-positive mononuclear cell infiltration. Conclusion PPV with inverted ILM flap technique achieved 100% closure rates with favorable configuration at an initial surgery in large MHs. Our histopathological data also suggest that even BBG staining-negative membrane may be a useful material for autologous transplantation to the hole. PMID:28031697

  18. Assessing N2 fixation in estuarine mangrove soils

    NASA Astrophysics Data System (ADS)

    Shiau, Yo-Jin; Lin, Ming-Fen; Tan, Chen-Chung; Tian, Guanglong; Chiu, Chih-Yu

    2017-04-01

    Nitrogen (N) limited mangrove forest may have a high potential for microbial N2 fixation. Previous research has focused on soil nitrogenase activity in pristine mangrove forests with little anthropogenic impact. This research was designed to evaluate the magnitude of nitrogenase activity of mangrove soils in a high anthropogenic N-loading environment and the way in which soil N2 fixation in mangrove forest may be related to organic carbon and salinity. The test involved an acetylene reduction method under controlled laboratory conditions. The mangrove forests with high anthropogenic N loading may have high nitrogenase activity in the soils. The diazotrophs in these mangrove soils were mostly heterotrophs and the sulfate-reducing bacteria were the major N2-fixing bacteria. The nitrogenase activity was little affected by the soil salinity, which suggests that these groups of N2 fixation bacteria adapted well to saline conditions in the estuary.

  19. The use of silk-based devices for fracture fixation

    NASA Astrophysics Data System (ADS)

    Perrone, Gabriel S.; Leisk, Gary G.; Lo, Tim J.; Moreau, Jodie E.; Haas, Dylan S.; Papenburg, Bernke J.; Golden, Ethan B.; Partlow, Benjamin P.; Fox, Sharon E.; Ibrahim, Ahmed M. S.; Lin, Samuel J.; Kaplan, David L.

    2014-03-01

    Metallic fixation systems are currently the gold standard for fracture fixation but have problems including stress shielding, palpability and temperature sensitivity. Recently, resorbable systems have gained interest because they avoid removal and may improve bone remodelling due to the lack of stress shielding. However, their use is limited to paediatric craniofacial procedures mainly due to the laborious implantation requirements. Here we prepare and characterize a new family of resorbable screws prepared from silk fibroin for craniofacial fracture repair. In vivo assessment in rat femurs shows the screws to be self-tapping, remain fixed in the bone for 4 and 8 weeks, exhibit biocompatibility and promote bone remodelling. The silk-based devices compare favourably with current poly-lactic-co-glycolic acid fixation systems, however, silk-based devices offer numerous advantages including ease of implantation, conformal fit to the repair site, sterilization by autoclaving and minimal inflammatory response.

  20. Plate selection for fixation of extra-articular distal humerus fractures: a biomechanical comparison of three different implants.

    PubMed

    Scolaro, John A; Hsu, Jason E; Svach, David J; Mehta, Samir

    2014-12-01

    Operative fixation of extra-articular distal humerus using a single posterolateral column plate has been described but the biomechanical properties or limits of this technique is undefined. The purpose of this study was to evaluate the mechanical properties of distal humerus fracture fixation using three standard fixation constructs. Two equal groups were created from forty sawbones humeri. Osteotomies were created at 80mm or 50mm from the tip of the trochlea. In the proximal osteotomy group, sawbones were fixed with an 8-hole 3.5mm LCP or with a 6-hole posterolateral plate. In the distal group, sawbones were fixed with 9-hole medial and lateral 3.5mm distal humerus plates and ten sawbones were fixed with a 6-hole posterolateral plate. Biomechanical testing was performed using a servohydraulic testing machine. Testing in extension as well as internal and external rotation was performed. Destructive testing was also performed with failure being defined as hardware pullout, sawbone failure or cortical contact at the osteotomy. In the proximal osteotomy group, the average bending stiffness and torsional stiffness was significantly greater with the posterolateral plate than with the 3.5mm LCP. In the distal osteotomy group, the average bending stiffness and torsional stiffness was significantly greater with the posterolateral plate than the 3.5mm LCP. In extension testing, the yield strength was significantly greater with the posterolateral plate in the proximal osteotomy specimens, and the dual plating construct in the distal osteotomy specimens. The yield strength of specimens in axial torsion was significantly greater with the posterolateral plate in the proximal osteotomy specimens, and the dual plating construct in the distal osteotomy specimens. Limited biomechanical data to support the use of a pre-contoured posterolateral distal humerus LCP for fixation of extra-articular distal humerus exists. We have found that this implant provided significantly greater

  1. Mini external fixation in the hand.

    PubMed

    Ugwonali, Obinwanne Fidelis C; Jupiter, Jesse B

    2006-09-01

    External fixation is an effective means of addressing several pathologies of the hand. The advantages of its use include the ability to achieve stable fixation, minimize soft tissue trauma at the site of injury, and allow wound care and mobilization of adjacent joints. External fixators can be constructed from material readily available in the operating room or obtained from a commercial source. Sufficient rigidity can be achieved by any of these means. Improper placement, although achieving rigid fixation, may compromise motion and overall function if basic principles of external fixation are not followed or if the anatomy of the hand is not taken into consideration. The objective of this article is to describe the technique of application of mini external fixation, emphasizing the basic principles of external fixation as they relate to the specific anatomy of the hand. In addition to fracture fixation, various other uses are described including distraction lengthening, arthrodesis, treatment of nonunion, and infection.

  2. Missing nitrogen fixation in the Benguela region

    NASA Astrophysics Data System (ADS)

    Wasmund, Norbert; Struck, Ulrich; Hansen, Anja; Flohr, Anita; Nausch, Günther; Grüttmüller, Annett; Voss, Maren

    2015-12-01

    Opposing opinions on the importance of nitrogen fixation in the northern Benguela upwelling region provoked us to investigate the magnitude of nitrogen fixation in front of northern Namibia and southern Angola. Measurements of nitrogen fixation rates using the 15N method at 66 stations during seven cruises from 2008 to 2014 showed that, in general, the 15N content in the biomass did not increase after tracer incubation with 15N2, indicating that no nitrogen fixation occurred. Correspondingly, the filamentous nitrogen-fixing cyanobacterium Trichodesmium was almost not present. The abundant picocyanobacteria did obviously not perform nitrogen fixation to a significant degree. The artificial improvement of conditions for nitrogen fixation in mesocosm experiments, including phosphate and iron additions and a warmer temperature, failed to induce nitrogen fixation. A plausible explanation of these findings is a lack of conditioned cells for nitrogen fixation in the Benguela region.

  3. Complement fixation test to C. burnetii

    MedlinePlus

    ... ency/article/003520.htm Complement fixation test to C burnetii To use the sharing features on this ... JavaScript. The complement fixation test to Coxiella burnetii ( C burnetti ) is a blood test that checks for ...

  4. Transit Fixatives: An Innovative Study

    PubMed Central

    A, Ravi Prakash; G, Sreenath; JK, Sonia Bai; NDVN, Shyam

    2015-01-01

    Background: Universally accepted fixative is 10% formalin which has been used for preserving the tissues and their architecture. In certain conditions, formalin might not be readily available for immediate fixation. We here by explore more economical, eco-friendly and easily available solutions that can be used as transit media/ transporting media for tissue specimens. Materials and Methods: The study included commonly available solutions like Spirit, Saline, Betadine solution, Hydrogen peroxide (H2O2), Local anesthesia (L.A), Rose water, Coconut oil, Coconut water, Ice cold water, Honey and Milk while keeping formalin as control. The fresh tissue sample was cut into multiple bits and placed in different containers for a period of 8 hours before transferring to formalin solution. Conclusion: Transit fixatives are very important in certain situations where formalin is not readily available. These fixatives can be used to fix the tissues for a period of at least 8 hours without causing any damage or distortion before they are fixed in formalin solution. PMID:25954725

  5. A system for quantitative evaluation of fixatives for light microscopy using paraffin sections of kidney and brain.

    PubMed

    Kiernan, J A

    2009-02-01

    A numerical scoring system is presented for evaluating structural fixation of certain mammalian tissues for light microscopy. Small pieces of rat's kidney and brain, tissues for which artifacts of fixation are well documented, were fixed in various fluids. Random code numbers hid their identities, and paraffin sections were stained to show nuclear chromatin, cytoplasm and extracellular materials. Two sections of each specimen were examined and awarded scores according to described schemes, for microanatomical and cytological fixation. The assessment was confined to preservation of structure; chemical changes were not taken into account. When the code was broken, the scores for both sections of each specimen from each fixative were added. The scores obtained (24 best to eight worst) are generally comparable to the grades (I-V) given for traditional fixatives by JR Baker. The criteria for quality of fixation were defined more explicitly than those for Baker's grading method, which used mouse testis as the test object. Assessments are presented for several traditional fixatives and for four zinc-formaldehyde mixtures. The scoring system should be useful for evaluating newly developed fixatives for animal tissues for light microscopic examination of paraffin sections. In an evaluation of four traditional fixatives and four zinc-formaldehyde mixtures, variation among three different observers was only +/-1 point on either side of the median score for microanatomical or cytological preservation by any of the eight fixatives. This approach has certain limitations, notably that the criteria for cytological fixation do not include the preservation of chromosomes or specific cytoplasmic organelles.

  6. Understanding Nitrogen Fixation

    SciTech Connect

    Paul J. Chirik

    2012-05-25

    synthesis of ammonia, NH{sub 3}, from its elements, H{sub 2} and N{sub 2}, via the venerable Haber-Bosch process is one of the most significant technological achievements of the past century. Our research program seeks to discover new transition metal reagents and catalysts to disrupt the strong N {triple_bond} N bond in N{sub 2} and create new, fundamental chemical linkages for the construction of molecules with application as fuels, fertilizers and fine chemicals. With DOE support, our group has discovered a mild method for ammonia synthesis in solution as well as new methods for the construction of nitrogen-carbon bonds directly from N{sub 2}. Ideally these achievements will evolve into more efficient nitrogen fixation schemes that circumvent the high energy demands of industrial ammonia synthesis. Industrially, atmospheric nitrogen enters the synthetic cycle by the well-established Haber-Bosch process whereby N{sub 2} is hydrogenated to ammonia at high temperature and pressure. The commercialization of this reaction represents one of the greatest technological achievements of the 20th century as Haber-Bosch ammonia is responsible for supporting approximately 50% of the world's population and serves as the source of half of the nitrogen in the human body. The extreme reaction conditions required for an economical process have significant energy consequences, consuming 1% of the world's energy supply mostly in the form of pollution-intensive coal. Moreover, industrial H{sub 2} synthesis via the water gas shift reaction and the steam reforming of methane is fossil fuel intensive and produces CO{sub 2} as a byproduct. New synthetic methods that promote this thermodynamically favored transformation ({Delta}G{sup o} = -4.1 kcal/mol) under milder conditions or completely obviate it are therefore desirable. Most nitrogen-containing organic molecules are derived from ammonia (and hence rely on the Haber-Bosch and H{sub 2} synthesis processes) and direct synthesis from

  7. 21 CFR 886.1290 - Fixation device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1290 Fixation device. (a) Identification. A fixation device is an AC-powered device intended for use as a fixation target for the patient during ophthalmological examination. The patient directs his or her gaze so that the visual image of the object falls...

  8. 21 CFR 886.1290 - Fixation device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1290 Fixation device. (a) Identification. A fixation device is an AC-powered device intended for use as a fixation target for the patient during ophthalmological examination. The patient directs his or her gaze so that the visual image of the object falls...

  9. 21 CFR 886.1290 - Fixation device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1290 Fixation device. (a) Identification. A fixation device is an AC-powered device intended for use as a fixation target for the patient during ophthalmological examination. The patient directs his or her gaze so that the visual image of the object falls...

  10. 21 CFR 886.1290 - Fixation device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1290 Fixation device. (a) Identification. A fixation device is an AC-powered device intended for use as a fixation target for the patient during ophthalmological examination. The patient directs his or her gaze so that the visual image of the object falls...

  11. 21 CFR 886.1290 - Fixation device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1290 Fixation device. (a) Identification. A fixation device is an AC-powered device intended for use as a fixation target for the patient during ophthalmological examination. The patient directs his or her gaze so that the visual image of the object falls...

  12. Binocular Fixation Disparity in Single Word Displays

    ERIC Educational Resources Information Center

    Paterson, Kevin B.; Jordan, Timothy R.; Kurtev, Stoyan

    2009-01-01

    It has been claimed that the recognition of words displayed in isolation is affected by the precise location at which they are fixated. However, this putative role for fixation location has yet to be reconciled with the finding from reading research that binocular fixations are often misaligned and, therefore, more than 1 location in a word is…

  13. Tissue fixation and the effect of molecular fixatives on downstream staining procedures.

    PubMed

    Howat, William J; Wilson, Beverley A

    2014-11-01

    It is impossible to underplay the importance of fixation in histopathology. Whether the scientist is interested in the extraction of information on lipids, proteins, RNA or DNA, fixation is critical to this extraction. This review aims to give a brief overview of the current "state of play" in fixation and focus on the effect fixation, and particularly the effect of the newer brand of "molecular fixatives" have on morphology, histochemistry, immunohistochemistry and RNA/DNA analysis. A methodology incorporating the creation of a fixation tissue microarray for the study of the effect of fixation on histochemistry is detailed.

  14. Estimation of Japanese international financial assistance for HIV/AIDS control for 2003-2007: difficulties and limitations of data collection.

    PubMed

    Mori, Koichiro; Yonemoto, Kiyoshi; Takei, Teiji; Izazola-Licea, Jose; Gobet, Benjamin

    2010-01-01

    The purpose of this paper is to: (1) collect relevant data and estimate Japanese international financial assistance for HIV/AIDS control; (2) discuss the difficulties in collecting relevant data and the limitations of the collected data; and (3) conduct a comparative analysis on the estimated data with OECD and Kaiser Family Foundation aggregate data. The point is that we have comprehensively collected and estimated the data on Japanese international expenditures for HIV/AIDS control while there is no reliable data that is totally managed and published. In addition, we discuss the difficulties and limitations of data collection: unpublished data; insufficient data; inseparable data; problems of exchange rates; gaps between disbursement and commitment; and difference in year period among calendar, fiscal and organization-specific years. Furthermore, we show the risk of underestimating the Japanese international contribution to HIV/AIDS control on the basis of OECD and Kaiser data. In this respect, it is significant to comprehensively collect and estimate the data on Japanese international assistance for HIV/AIDS control. Finally, we derive the implication that it is crucial for a relevant international organization and/or individual countries to comprehensively collect and administer data for international cooperation in the development of health policies for HIV/AIDS.

  15. Making Knowledge Accessible across Borders: The Case for Mandatory Minimum International Copyright Exceptions and Limitations for Education, Capacity Building and Development

    ERIC Educational Resources Information Center

    Hinze, Gwen

    2008-01-01

    On March 10-12, 2008, the World Intellectual Property Organization's Standing Committee on Copyright and Related Rights met in Geneva to begin talking about exceptions to, and limitations on, rights granted to copyright holders by international instruments, a topic which is of vital importance to developing countries. World Intellectual Property…

  16. Percutaneous Screw Fixation of Crescent Fracture-Dislocation of the Sacroiliac Joint.

    PubMed

    Shui, Xiaolong; Ying, Xiaozhou; Mao, Chuanwan; Feng, Yongzeng; Chen, Linwei; Kong, Jianzhong; Guo, Xiaoshan; Wang, Gang

    2015-11-01

    Crescent fracture-dislocation of the sacroiliac joint (CFDSIJ) is a type of lateral compression pelvic injury associated with instability. Open reduction and internal fixation is a traditional treatment of CFDSIJ. However, a minimally invasive method has never been reported. The purpose of this study was to assess the outcome of closed reduction and percutaneous fixation for different types of CFDSIJ and present their clinical outcome. The authors reviewed 117 patients diagnosed with CFDSIJ between July 2003 and July 2013. Closed reduction and percutaneous fixation was performed in 73 patients. Treatment selection was based on Day's fracture classification. For type I fractures, fixation perpendicular to the fracture line were performed. For type II fractures, crossed fixation was performed. For type III fractures, fixation was performed with iliosacral screws. Forty-four patients were treated by open reduction and plate fixation. Demographics, fracture pattern distribution, blood loss, incision lengths, revision surgeries, radiological results, and functional scores were compared. All 117 patients were followed for more than 6 months (mean, 14 months [range, 6-24 months]). Blood loss, extensive exposure, duration of posterior ring surgery, duration of hospital stay, and infection rates were lower in the closed group (P<.01). Patients in the closed group achieved better functional performance (P<.01). There were no significant differences in reduction quality (P=.32), revision surgery rates (P=.27), and iatrogenic neurologic injuries (P=.2) between the 2 groups. The authors' results indicate that closed reduction and percutaneous fixation is a safe and effective surgical method for CFDSIJ.

  17. Symbiotic nitrogen fixation in a tropical rainforest: 15N natural abundance measurements supported by experimental isotopic enrichment.

    PubMed

    Pons, Thijs L; Perreijn, Kristel; van Kessel, Chris; Werger, Marinus J A

    2007-01-01

    * Leguminous trees are very common in the tropical rainforests of Guyana. Here, species-specific differences in N(2) fixation capability among nodulating legumes growing on different soils and a possible limitation of N(2) fixation by a relatively high nitrogen (N) and low phosphorus (P) availability in the forest were investigated. * Leaves of 17 nodulating species and 17 non-nodulating reference trees were sampled and their delta(15)N values measured. Estimates of N(2) fixation rates were calculated using the (15)N natural abundance method. Pot experiments were conducted on the effect of N and P availability on N(2) fixation using the (15)N-enriched isotope dilution method. * Nine species showed estimates of > 33% leaf N derived from N(2) fixation, while the others had low or undetectable N(2) fixation rates. High N and low P availability reduced N(2) fixation substantially. * The results suggest that a high N and low P availability in the forest limit N(2) fixation. At the forest ecosystem level, N(2) fixation was estimated at c. 6% of total N uptake by the tree community. We conclude that symbiotic N(2) fixation plays an important role in maintaining high amounts of soil available N in undisturbed forest.

  18. Standards of external fixation in prolonged applications to allow safe conversion to definitive extremity surgery: the Aachen algorithm for acute ex fix conversion.

    PubMed

    Horst, Klemens; Andruszkow, Hagen; Weber, Christian; Dienstknecht, Thomas; Hildebrand, Frank; Tarkin, Ivan; Pape, Hans-Christoph

    2015-09-01

    External fixation has become an important tool in orthopedic surgery. Technology has improved the design and material as well as the construct of the fixator. As most patients are converted from external fixation to definite stabilization during later clinical course, prevention of complications such as infection is of high importance. Based on the current literature, principles of temporary external fixation were summarized. We focused on minimizing the risk of infection and introduce a standardized algorithm how to proceed when converting from external to internal fixation, which also was examined for effectiveness.

  19. 77 FR 68196 - Orders Limiting Operations at John F. Kennedy International Airport, LaGuardia Airport, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-15

    ...Guardia Airport, and Newark Liberty International Airport; High Density Rule at Reagan Washington National... operations took several days after the storm. FAA Analysis Under the FAA's High Density Rule at DCA...

  20. Effect of induced aniseikonia on fixation performance.

    PubMed

    Remole, A

    1988-01-01

    The purpose of the study was to determine to what extent induced aniseikonia affects fixation performance. Aniseikonia was induced in the vertical meridian only, whereas fixation alignment was monitored in the horizontal meridian. A previously developed technique based on the dependency of border enhancement bandwidth on fixation eccentricity was used to monitor deviations from central fixation during fusion. Stress on the fusion mechanism was supplied by controlled increments of forced horizontal vergence. It was found that deviation from central fixation in the horizontal meridian generally increases with increasing amounts of vertical aniseikonia. The effect is particularly pronounced for small amounts of aniseikonia.

  1. Low rates of nitrogen fixation in eastern tropical South Pacific surface waters

    PubMed Central

    Knapp, Angela N.; Casciotti, Karen L.; Berelson, William M.; Prokopenko, Maria G.; Capone, Douglas G.

    2016-01-01

    An extensive region of the Eastern Tropical South Pacific (ETSP) Ocean has surface waters that are nitrate-poor yet phosphate-rich. It has been proposed that this distribution of surface nutrients provides a geochemical niche favorable for N2 fixation, the primary source of nitrogen to the ocean. Here, we present results from two cruises to the ETSP where rates of N2 fixation and its contribution to export production were determined with a suite of geochemical and biological measurements. N2 fixation was only detectable using nitrogen isotopic mass balances at two of six stations, and rates ranged from 0 to 23 µmol N m−2 d−1 based on sediment trap fluxes. Whereas the fractional importance of N2 fixation did not change, the N2-fixation rates at these two stations were several-fold higher when scaled to other productivity metrics. Regardless of the choice of productivity metric these N2-fixation rates are low compared with other oligotrophic locations, and the nitrogen isotope budgets indicate that N2 fixation supports no more than 20% of export production regionally. Although euphotic zone-integrated short-term N2-fixation rates were higher, up to 100 µmol N m−2 d−1, and detected N2 fixation at all six stations, studies of nitrogenase gene abundance and expression from the same cruises align with the geochemical data and together indicate that N2 fixation is a minor source of new nitrogen to surface waters of the ETSP. This finding is consistent with the hypothesis that, despite a relative abundance of phosphate, iron may limit N2 fixation in the ETSP. PMID:26976587

  2. Outcome Analysis of Locking Plate Fixation in Proximal Humerus Fracture

    PubMed Central

    Pathak, Abhishek; Gaur, Sanjiv

    2016-01-01

    Introduction Proximal humerus fractures account for approximately 5% of all fractures. Stable minimally displaced fractures can be treated nonoperatively but the management of displaced fractures remain controversial with various modalities of treatment available. Locking plates provide stable fixation and enable early postoperative mobilization specially in osteoporotic proximal humerus fracture. Aim To evaluate the functional outcome of locking plate fixation and to compare the results of two approaches used for fixation. Materials and Methods This prospective study was conducted at a tertiary level hospital between September 2011 to December 2013. PHILOS plates were used for internal fixation of displaced proximal humerus fractures Neer’s type 2 part, 3 part and 4 part fractures on 26 patients (M/F ratio 1.36:1; mean age 46 years). According to Neer classification, 5,12 and 9 patients had displaced 2, 3 and 4 part fractures respectively. Deltopectoral and deltoid splitting approaches were used for fixation on 13 patients each. Functional outcome was assessed using Constant-Murley shoulder score. Graphpad software version 6.0 was used with Chi-square test and Fisher-exact test are used to compare data. The p-value< 0.05 is considered significant. Results Of the 26 patients, all fractures united radiologically and clinically and average constant score at final follow-up was 72.5. At the final follow-up 8 patients had good score, 10 patients had moderate score, 6 patients had excellent outcome and 2 patients had poor outcome according to Constant score. Mean time to union was 12.3 weeks (9 –15 weeks). Four complications (15.4%) were encountered, 2 cases of varus malunion, 1 case of wound infection which required wound debridement and 1 case of screw cut-out in which screw removal was done. Mean constant score in delto splitting approach was 70.9 and 74 in deltopectoral group (p-value= 0.54). No significant difference existed in constant score in 2 approaches

  3. Tailor's bunion. Is fixation necessary?

    PubMed

    Pontious, J; Brook, J W; Hillstrom, H J

    1996-02-01

    Tailor's bunion or bunionette are terms that describe a pathologic enlargement occurring laterally on the fifth metatarsophalangeal joint. Regardless of the etiology that precipitates the deformity, the resulting abnormal protrusion of soft tissue or bone can result in pain for the patient. Symptoms can range from mild discomfort to severe, debilitating pain. The patient may present with pain dorsolaterally, laterally, or plantarly. The symptoms are mechanically induced, and are often associated with hyperkeratotic lesions and adventitious bursae. Patients complain most often that they cannot find comfortable shoes. The authors compare the effectiveness of fixated versus nonfixated distal osteotomies of the fifth metatarsal for the correction of tailor's bunion. This study shows that fixation can help control postoperative dorsal displacement of the fifth metatarsal capital fragment (p < 0.0001) and produce less shortening of the metatarsal resulting in fewer complications.

  4. Nitrogen fixation by marine cyanobacteria.

    PubMed

    Zehr, Jonathan P

    2011-04-01

    Discrepancies between estimates of oceanic N(2) fixation and nitrogen (N) losses through denitrification have focused research on identifying N(2)-fixing cyanobacteria and quantifying cyanobacterial N(2) fixation. Previously unrecognized cultivated and uncultivated unicellular cyanobacteria have been discovered that are widely distributed, and some have very unusual properties. Uncultivated unicellular N(2)-fixing cyanobacteria (UCYN-A) lack major metabolic pathways including the tricarboxylic acid cycle and oxygen-evolving photosystem II. Genomes of the oceanic N(2)-fixing cyanobacteria are highly conserved at the DNA level, and genetic diversity is maintained by genome rearrangements. The major cyanobacterial groups have different physiological and ecological constraints that result in highly variable geographic distributions, with implications for the marine N-cycle budget.

  5. MECHANICAL STUDY ON DORSAL STABILITY OF INTRAMEDULLARY OSTEOSYNTHESIS ASSOCIATED WITH EXTERNAL FIXATION (ULSON'S METHOD)

    PubMed Central

    Sardenberg, Trajano; Muller, Sérgio Swain; Medeiros, Daniel Ricardo; Baptistão, Pablo Luiz

    2015-01-01

    Objective: To evaluate the Ulson intramedullary fixation method, with external fixation in which the level of the external locking of the Kirschner wires is varied, and without external fixation. Methods: Eighteen porcine tibias were used. Transverse osteotomy was performed in the region of the tuberosity, and two intramedullary Kirschner wires were inserted into each specimen, using three different assembly patterns: Group I: locking with external minifixator at a height of 3.0 cm; Group II: locking at a height of 4.5 cm; Group III: without external locking. Mechanical shear tests were then conducted, to determine the maximum load, proportionality limit and coefficient of rigidity. Results: There were no significant differences in maximum load or proportionality limit between the groups. The coefficient of rigidity was higher in Group II. Conclusion: The locking height for the Kirschner wires in Ulson's method, within the limits evaluated, did not harm the stability of the fracture fixation system. PMID:27027069

  6. Fixation versus primary replacement of displaced femoral neck fractures in the elderly.

    PubMed

    Khan, Moin; Aleem, Ilyas S; Poolman, Rudolf W

    2011-01-01

    Hip fractures are among the most common debilitating injuries in the elderly and are a significant cause of morbidity and mortality worldwide. Despite the ever-increasing literature on the topic of hip fractures, optimal treatment remains uncertain. Trials with small sizes, methodological limitations, strict inclusion criteria and wide confidence intervals leave the optimal approach to treating hip fractures unknown and controversial. In 2005, the International Hip Fracture Research Collaborative was officially established with the mandate of resolving controversies in hip fracture management. Presently, two multicenter randomized trials, FAITH and HEALTH, are underway. The FAITH trial (Fixation Using Alternative Implants for the Treatment of Hip Fractures) will compare Sliding Hip Screws and Cancellous Screws; the HEALTH trial (Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemi-Arthroplasty) will compare total hip arthroplasty and hemi-arthroplasty. The present paper reviews current controversies in hip fracture care. Ultimately, only large randomized trials, such as FAITH and HEALTH, will resolve the longstanding controversy of whether primary replacement or fixation is the preferred treatment modality in this common fracture. Subsequent trials need to focus on surgical strategies in the cognitively impaired patient.

  7. Smaller Fixation Target Size Is Associated with More Stable Fixation and Less Variance in Threshold Sensitivity

    PubMed Central

    Okano, Kana; Koshiji, Risako; Funaki, Wakana; Shoji, Nobuyuki

    2016-01-01

    The aims of this randomized observational case control study were to quantify fixation behavior during standard automated perimetry (SAP) with different fixation targets and to evaluate the relationship between fixation behavior and threshold variability at each test point in healthy young participants experienced with perimetry. SAP was performed on the right eyes of 29 participants using the Octopus 900 perimeter, program 32, dynamic strategy. The fixation targets of Point, Cross, and Ring were used for SAP. Fixation behavior was recorded using a wearable eye-tracking glass. All participants underwent SAP twice with each fixation target in a random fashion. Fixation behavior was quantified by calculating the bivariate contour ellipse area (BCEA) and the frequency of deviation from the fixation target. The BCEAs (deg2) of Point, Cross, and Ring targets were 1.11, 1.46, and 2.02, respectively. In all cases, BCEA increased significantly with increasing fixation target size (p < 0.05). The logarithmic value of BCEA demonstrated the same tendency (p < 0.05). A positive correlation was identified between fixation behavior and threshold variability for the Point and Cross targets (ρ = 0.413–0.534, p < 0.05). Fixation behavior increased with increasing fixation target size. Moreover, a larger fixation behavior tended to be associated with a higher threshold variability. A small fixation target is recommended during the visual field test. PMID:27829030

  8. Fixation strategies for retinal immunohistochemistry.

    PubMed

    Stradleigh, Tyler W; Ishida, Andrew T

    2015-09-01

    Immunohistochemical and ex vivo anatomical studies have provided many glimpses of the variety, distribution, and signaling components of vertebrate retinal neurons. The beauty of numerous images published to date, and the qualitative and quantitative information they provide, indicate that these approaches are fundamentally useful. However, obtaining these images entailed tissue handling and exposure to chemical solutions that differ from normal extracellular fluid in composition, temperature, and osmolarity. Because the differences are large enough to alter intercellular and intracellular signaling in neurons, and because retinae are susceptible to crush, shear, and fray, it is natural to wonder if immunohistochemical and anatomical methods disturb or damage the cells they are designed to examine. Tissue fixation is typically incorporated to guard against this damage and is therefore critically important to the quality and significance of the harvested data. Here, we describe mechanisms of fixation; advantages and disadvantages of using formaldehyde and glutaraldehyde as fixatives during immunohistochemistry; and modifications of widely used protocols that have recently been found to improve cell shape preservation and immunostaining patterns, especially in proximal retinal neurons.

  9. Fixation Strategies For Retinal Immunohistochemistry

    PubMed Central

    Stradleigh, Tyler W.; Ishida, Andrew T.

    2015-01-01

    Immunohistochemical and ex vivo anatomical studies have provided many glimpses of the variety, distribution, and signaling components of vertebrate retinal neurons. The beauty of numerous images published to date, and the qualitative and quantitative information they provide, indicate that these approaches are fundamentally useful. However, obtaining these images entailed tissue handling and exposure to chemical solutions that differ from normal extracellular fluid in composition, temperature, and osmolarity. Because the differences are large enough to alter intercellular and intracellular signaling in neurons, and because retinae are susceptible to crush, shear, and fray, it is natural to wonder if immunohistochemical and anatomical methods disturb or damage the cells they are designed to examine. Tissue fixation is typically incorporated to guard against this damage and is therefore critically important to the quality and significance of the harvested data. Here, we describe mechanisms of fixation; advantages and disadvantages of using formaldehyde and glutaraldehyde as fixatives during immunohistochemistry; and modifications of widely used protocols that have recently been found to improve cell shape preservation and immunostaining patterns, especially in proximal retinal neurons. PMID:25892361

  10. 14 CFR Special Federal Aviation... - Operating Limitations for Unscheduled Operations at Chicago's O'Hare International Airport

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Operations at Chicago's O'Hare International Airport Federal Special Federal Aviation Regulation No. 105 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES SPECIAL AIR TRAFFIC RULES Pt. 93, SFAR No. 105 Special Federal...

  11. Fixation Versus Replacement in Geriatric Hip Fractures

    PubMed Central

    Doshi, H. K.; Selvaraj, Dahshaini; Chan, William; Naidu, G.; Ramason, R.

    2015-01-01

    Introduction: Although there is evidence of improved functional outcomes with our “integrated care pathway” for geriatric hip fractures, we do not know if there is a significant difference in functional recovery of activities of daily living and attainment of independence in self-care between patients who underwent fixation and those treated with arthroplasty. Objective: To determine whether such a difference exists in surgically fixed hip fractures. Materials and Methods: Patients with hip fracture treated surgically were divided into group A (internal fixation, n = 213) and group B (arthroplasty, n = 199). Demographic data, Charlson comorbidity index (CCI) score, time to surgery, and length of stay were recorded. Inpatient complications and mortality rates were also documented. Modified Barthel Index (MBI) scores were recorded for the following intervals: prefall, discharge, 6-month, and at 1-year follow-up. Results: The mean age (A: 80 years and B: 81years), CCI (A: 5.41 and B: 5.43), and length of stay (A: 13.6 days and B: 15.2 days) were not significantly different. However, there was a significant difference (P < .05) in time to surgery (A: 102.2 hours and B: 86.6 hours). Complication rates were about 6% in both groups (A = 6.57%: urinary infections = 13, wound infections = 1 and B = 6.03%: urinary infections = 10, wound infections = 1, pressure ulcer = 1). The preinjury MBI scores were significantly different (P < .05; A: 91.65 and B: 88.19), however, there was no significant difference in scores measured at discharge (A: 60.79 and B: 59.39), 6 months (A: 77.65 and B: 77.47) and 1 year (A: 80.71 and B: 83.03). Patients who underwent surgery for hip fracture had overall recovered 90.9% of their preinjury function (overall MBI at 1 year: 81.83). Conclusion: The MBI scores reflect the extent of attainment of independence in self-care, and actual functional recovery is gauged from the percentage of recovery of preinjury function at 1 year postsurgery. We

  12. Design and analysis of synthetic carbon fixation pathways

    PubMed Central

    Bar-Even, Arren; Noor, Elad; Lewis, Nathan E.; Milo, Ron

    2010-01-01

    Carbon fixation is the process by which CO2 is incorporated into organic compounds. In modern agriculture in which water, light, and nutrients can be abundant, carbon fixation could become a significant growth-limiting factor. Hence, increasing the fixation rate is of major importance in the road toward sustainability in food and energy production. There have been recent attempts to improve the rate and specificity of Rubisco, the carboxylating enzyme operating in the Calvin–Benson cycle; however, they have achieved only limited success. Nature employs several alternative carbon fixation pathways, which prompted us to ask whether more efficient novel synthetic cycles could be devised. Using the entire repertoire of approximately 5,000 metabolic enzymes known to occur in nature, we computationally identified alternative carbon fixation pathways that combine existing metabolic building blocks from various organisms. We compared the natural and synthetic pathways based on physicochemical criteria that include kinetics, energetics, and topology. Our study suggests that some of the proposed synthetic pathways could have significant quantitative advantages over their natural counterparts, such as the overall kinetic rate. One such cycle, which is predicted to be two to three times faster than the Calvin–Benson cycle, employs the most effective carboxylating enzyme, phosphoenolpyruvate carboxylase, using the core of the naturally evolved C4 cycle. Although implementing such alternative cycles presents daunting challenges related to expression levels, activity, stability, localization, and regulation, we believe our findings suggest exciting avenues of exploration in the grand challenge of enhancing food and renewable fuel production via metabolic engineering and synthetic biology. PMID:20410460

  13. One-stage posterior C2 and C3 pedicle screw fixation or combined anterior C2-C3 fusion for the treatment of unstable hangman's fracture.

    PubMed

    Liu, Jingchen; Li, Ye; Wu, Yuntao

    2013-03-01

    The present study aimed to evaluate the effect of using one-stage posterior C2 and C3 pedicle screw fixation or combined anterior C2-C3 fusion in the treatment of unstable hangman's fracture. A total of 13 patients with unstable hangman's fractures underwent C2 and C3 pedicle screw fixation, lamina interbody fusion or combined anterior C2-C3 fusion and imaging examinations to evaluate the fracture fixation and healing condition at three days and three months following surgery. Postoperative X-ray and computed tomography (CT) results showed high fracture reduction, good internal fixation position and reliable fracture fixation. The three-month postoperative CT showed good vertebral fracture healing. C2 and C3 pedicle screw fixation has a good curative effect in the treatment of unstable hangman's fracture. The direct fixation of the fracture enables early ambulation by the patients.

  14. Proposed Use of the Computer as a Tool to Aid Analysis of Properties of Materials in Fixators of Spine

    PubMed Central

    Santos, Antonio; Moreira, Fernando

    2014-01-01

    With objective of analyzing the mechanical behavior of the internal fixators of spine and of the bony structure, the pieces and the group were made (it structures bony x internal fixator) with the aid a software of solid modeling. The materials used in the rehearsals had been the titanium, now in the market and a castor oil polyurethane destined to the development of you implant bony. PMID:24825938

  15. Evaluation of Macular Retinal Ganglion Cell-Inner Plexiform Layer Thickness after Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Macular Holes

    PubMed Central

    Velázquez-Villoria, Álvaro; Zapata, Miguel A.; Figueroa, Marta S.; Suárez-Leoz, Marta; Arrevola, Luis; Teijeiro, María-Ángeles; García-Layana, Alfredo

    2014-01-01

    Purpose. To evaluate macular retinal ganglion cell-inner plexiform layer (GCIPL) thickness changes after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole repair using a high-resolution spectral-domain optical coherence tomography (SD-OCT). Methods. 32 eyes from 32 patients with idiopathic macular holes who underwent vitrectomy with internal limiting membrane peeling between January 2011 and July 2012 were retrospectively analyzed. GCIPL thickness was measured before surgery, and at one month and at six months after surgery. Values obtained from automated and semimanual SD-OCT segmentation analysis were compared (Cirrus HD-OCT, Carl Zeiss Meditec, Dublin, CA). Results. No significant differences were found between average GCIPL thickness values between preoperative and postoperative analysis. However, statistical significant differences were found in GCIPL thickness at the temporal macular quadrants at six months after surgery. Quality measurement analysis performed by automated segmentation revealed a significant number of segmentation errors. Semimanual segmentation slightly improved the quality of the results. Conclusion. SD-OCT analysis of GCIPL thickness found a significant reduction at the temporal macular quadrants at 6 months after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole. PMID:25110679

  16. Growth, N2 fixation and photosynthesis in a cyanobacterium, Trichodesmium sp., under Fe stress.

    PubMed

    Fu, Fei-xue; Bell, P R

    2003-04-01

    Trichodesmium sp., isolated from the Great Barrier Reef lagoon, was cultured in artificial seawater media containing a range of Fe concentration. Fe additions stimulated growth, N2 fixation, cellular chlorophyll a content, light-saturated chlorophyll a-specific gross photosynthetic capacity (Pmchl a) and the dark respiration rate (Rdchl a). Cell yields only doubled for 9 nM Fe relative to zero added Fe, whereas N2 fixation increased 11-fold considerably for 450 nM Fe. The results suggest that N2 fixation of Trichodesmium is more sensitive to Fe limitation than are the cell yields.

  17. Monoaxial external fixation of the calcaneus: An anatomical study assessing the safety of monoaxial pin insertion.

    PubMed

    Thomson, Callum M; Esparon, Tom; Rea, Paul M; Jamal, Bilal

    2016-10-01

    The use of external fixation for intra-articular calcaneal fractures is increasing in popularity. Studies have shown fine wire and monoaxial external fixation to be a viable surgical alternative to more invasive methods of open reduction and internal fixation of the calcaneus. However, there is an absence of literature that quantifies the risk of pin insertion for monoaxial fixation. This study aimed to determine the safety of inserting monoaxial pins within the calcaneus to house the Orthofix Calcaneal Mini-Fixator. Five formalin embalmed cadaveric ankle and lower leg specimens were inserted with six monoaxial pins. Careful dissection then revealed the presence of the tendons of peroneus longus and brevis, the sural nerve and the small saphenous vein in relation to these pins. Measurements from each pin to each of these structures were made as the structures transected lines drawn from each pin to two palpable bony landmarks: the inferior tip of the lateral malleolus and the posterosuperior calcaneus. In doing this, the risk posed by each pin could be evaluated. We found that two particular pins, those used to hold the articular surface of the subtalar joint in a reduced position, posed a larger risk of injury to surrounding structures than the remaining pins. These findings therefore suggest that monoaxial fixation of the calcaneus using a six pin approach is a relatively safe method of rectifying calcaneal fractures and thus may serve as a welcome alternative to other methods of calcaneal fixation.

  18. Two-Pin Fixation of Proximal Interphalangeal Joint Fusion for Hammertoe Correction.

    PubMed

    Boffeli, Troy J; Thompson, Jonathan C; Tabatt, Jessica A

    2016-01-01

    Single-pin external Kirschner wire (K-wire) fixation has traditionally been a mainstay in proximal interphalangeal joint fusion for central hammertoe repair. Concerns over cosmesis, inconvenience, pin tract infection, hardware failure, nonunion, and early hardware removal have led to the development of implantable internal fixation devices. Although numerous implantable devices are now available and represent viable options for hammertoe repair, they are costly and often pose a challenge in the event removal becomes necessary. An alternative fixation option not typically used is a 2-pin K-wire fixation technique. The perceived advantage of obtaining 2 points of fixation compared with 1 across the fusion site is improved stability against the rotational and bending forces, thus decreasing the potential for pin-related complications. A retrospective assessment of 91 consecutive hammertoe repairs consisting of proximal interphalangeal joint fusion with 2-pin fixation in 60 patients was performed. The K-wires were removed at 6 weeks postoperatively, and the overall postoperative follow-up duration was 28.56 (range 1.40 to 86.83) months. Of the 91 digits, 89 (98%) did not encounter a complication postoperatively and 2 (2.20%) had sustained loosened or broken hardware. No postoperative infection was encountered. The low incidence of complications observed supports the 2-pin K-wire fixation technique as a low-cost and viable construct for proximal interphalangeal joint fusion hammertoe repair.

  19. Overcoming fixation with repeated memory suppression.

    PubMed

    Angello, Genna; Storm, Benjamin C; Smith, Steven M

    2015-01-01

    Fixation (blocks to memories or ideas) can be alleviated not only by encouraging productive work towards a solution, but, as the present experiments show, by reducing counterproductive work. Two experiments examined relief from fixation in a word-fragment completion task. Blockers, orthographically similar negative primes (e.g., ANALOGY), blocked solutions to word fragments (e.g., A_L_ _GY) in both experiments. After priming, but before the fragment completion test, participants repeatedly suppressed half of the blockers using the Think/No-Think paradigm, which results in memory inhibition. Inhibiting blockers did not alleviate fixation in Experiment 1 when conscious recollection of negative primes was not encouraged on the fragment completion test. In Experiment 2, however, when participants were encouraged to remember negative primes at fragment completion, relief from fixation was observed. Repeated suppression may nullify fixation effects, and promote creative thinking, particularly when fixation is caused by conscious recollection of counterproductive information.

  20. Methanotrophy induces nitrogen fixation during peatland development.

    PubMed

    Larmola, Tuula; Leppänen, Sanna M; Tuittila, Eeva-Stiina; Aarva, Maija; Merilä, Päivi; Fritze, Hannu; Tiirola, Marja

    2014-01-14

    Nitrogen (N) accumulation rates in peatland ecosystems indicate significant biological atmospheric N2 fixation associated with Sphagnum mosses. Here, we show that the linkage between methanotrophic carbon cycling and N2 fixation may constitute an important mechanism in the rapid accumulation of N during the primary succession of peatlands. In our experimental stable isotope enrichment study, previously overlooked methane-induced N2 fixation explained more than one-third of the new N input in the younger peatland stages, where the highest N2 fixation rates and highest methane oxidation activities co-occurred in the water-submerged moss vegetation.

  1. Methanotrophy induces nitrogen fixation during peatland development

    PubMed Central

    Larmola, Tuula; Leppänen, Sanna M.; Tuittila, Eeva-Stiina; Aarva, Maija; Merilä, Päivi; Fritze, Hannu; Tiirola, Marja

    2014-01-01

    Nitrogen (N) accumulation rates in peatland ecosystems indicate significant biological atmospheric N2 fixation associated with Sphagnum mosses. Here, we show that the linkage between methanotrophic carbon cycling and N2 fixation may constitute an important mechanism in the rapid accumulation of N during the primary succession of peatlands. In our experimental stable isotope enrichment study, previously overlooked methane-induced N2 fixation explained more than one-third of the new N input in the younger peatland stages, where the highest N2 fixation rates and highest methane oxidation activities co-occurred in the water-submerged moss vegetation. PMID:24379382

  2. Nitrogen fixation method and apparatus

    DOEpatents

    Chen, Hao-Lin

    1983-01-01

    A method and apparatus for achieving nitrogen fixation includes a volumetric electric discharge chamber. The volumetric discharge chamber provides an even distribution of an electron beam, and enables the chamber to be maintained at a controlled energy to pressure (E/p) ratio. An E/p ratio of from 5 to 15 kV/atm of O.sub.2 /cm promotes the formation of vibrationally excited N.sub.2. Atomic oxygen interacts with vibrationally excited N.sub.2 at a much quicker rate than unexcited N.sub.2, greatly improving the rate at which NO is formed.

  3. Nitrogen fixation method and apparatus

    DOEpatents

    Chen, H.L.

    1983-08-16

    A method and apparatus for achieving nitrogen fixation includes a volumetric electric discharge chamber. The volumetric discharge chamber provides an even distribution of an electron beam, and enables the chamber to be maintained at a controlled energy to pressure (E/p) ratio. An E/p ratio of from 5 to 15 kV/atm of O[sub 2]/cm promotes the formation of vibrationally excited N[sub 2]. Atomic oxygen interacts with vibrationally excited N[sub 2] at a much quicker rate than unexcited N[sub 2], greatly improving the rate at which NO is formed. 1 fig.

  4. Image recorder with microwave fixation

    SciTech Connect

    Hosono, N.; Isaka, K.

    1984-11-13

    The present invention is directed to improvement in an image recorder for recording developed images or toner images by microwave fixation. According to the invention there is used a novel thermoplastic developer comprising of two components. The first component contains a dielectric material which is able to absorb microwave and generate heat by dielectric loss. The second component contains magnetic loss exothermic material. The microwave absorbing power of the first component is improved by heating the first component with heat generated from the second component.

  5. Nutrient control of N2 fixation in the oligotrophic Mediterranean Sea and the impact of Saharan dust events

    NASA Astrophysics Data System (ADS)

    Ridame, C.; Le Moal, M.; Guieu, C.; Ternon, E.; Biegala, I. C.; L'Helguen, S.; Pujo-Pay, M.

    2011-03-01

    A better understanding of the factors controlling N2 fixation is a pre-requisite for improving our knowledge on the contribution of N2 fixation in the nitrogen cycling in the Mediterranean Sea. Trace-metal clean nutrient/dust additions bioassays (+P, +PFe, +dust) were performed at three stations located in the western, central and eastern Mediterranean Sea, in summer 2008 as part of the BOUM cruise. The main goals were to investigate the nutrient factor(s) limiting N2 fixation (uptake of 15N2) and to evaluate the potential impact of a Saharan dust event on this biological process during the stratification period. Initially, surface waters at the three stations were DIP-depleted (<10 nM) while the DFe concentrations were relatively high (from 1.2 to 2.3 nM) most likely due to atmospheric iron accumulation in the surface mixed layer. At all stations, Saharan dust input relieved the ambient nutrient limitation of diazotrophic activity as demonstrated by the strong stimulation of N2 fixation (from x2.3 to x5.3). The highest dust stimulation of N2 fixation was recorded at the station located in the eastern basin (x5.3). The responses of diazotrophic activity to nutrients addition were contrasted at the sampled stations suggesting a spatial variability of the factor controlling N2 fixation over the whole basin. At all stations, N2 fixation was not limited by Fe nor co-limited by P and Fe. At the western station, N2 fixation was DIP limited while at the eastern one, N2 fixation was first DIP limited then was limited by one or several chemical element(s) released by dust. Our results demonstrated that a Saharan dust input was able to relieve the successive on-going N2 fixation limitations. Very interestingly, at the station located in the central basin, N2 fixation was not limited by the availability of P yet it was strongly stimulated by dust additions (up to x3.1). A chemical element or a combination of several, released by the added dust may have been responsible for

  6. Correlation Between Residual Displacement and Osteonecrosis of the Femoral Head Following Cannulated Screw Fixation of Femoral Neck Fractures.

    PubMed

    Wang, Chen; Xu, Gui-Jun; Han, Zhe; Jiang, Xuan; Zhang, Cheng-Bao; Dong, Qiang; Ma, Jian-Xiong; Ma, Xin-Long

    2015-11-01

    The aim of the study was to introduce a new method for measuring the residual displacement of the femoral head after internal fixation and explore the relationship between residual displacement and osteonecrosis with femoral head, and to evaluate the risk factors associated with osteonecrosis of the femoral head in patients with femoral neck fractures treated by closed reduction and percutaneous cannulated screw fixation.One hundred and fifty patients who sustained intracapsular femoral neck fractures between January 2011 and April 2013 were enrolled in the study. All were treated with closed reduction and percutaneous cannulated screw internal fixation. The residual displacement of the femoral head after surgery was measured by 3-dimensional reconstruction that evaluated the quality of the reduction. Other data that might affect prognosis were also obtained from outpatient follow-up, telephone calls, or case reviews. Multivariate logistic regression analysis was applied to assess the intrinsic relationship between the risk factors and the osteonecrosis of the femoral head.Osteonecrosis of the femoral head occurred in 27 patients (18%). Significant differences were observed regarding the residual displacement of the femoral head and the preoperative Garden classification. Moreover, we found more or less residual displacement of femoral head in all patients with high quality of reduction based on x-ray by the new technique. There was a close relationship between residual displacement and ONFH.There exists limitation to evaluate the quality of reduction by x-ray. Three-dimensional reconstruction and digital measurement, as a new method, is a more accurate method to assess the quality of reduction. Residual displacement of the femoral head and the preoperative Garden classification were risk factors for osteonecrosis of the femoral head. High-quality reduction was necessary to avoid complications.

  7. The role of AO external fixation in proximal femoral osteotomies in the pediatric neuromuscular population.

    PubMed

    Handelsman, John E; Weinberg, Jacob; Razi, Afshin; Mulley, Debra A

    2004-09-01

    Internal fixation in proximal femoral osteotomies using traditional devices may be sub-optimal in children with neuromuscular disorders who have small or osteopenic bone. In this population, between 1988 and 2000, we performed 36 proximal femoral varus osteotomies in 28 patients. These were controlled by the AO external fixator. The average age at surgery was 7 years (range, 2-13 years). A mean varus correction of 34 degrees (range, 15-90 degrees) was obtained. Complications consisted of one superficial pin tract infection, one skin breakdown, and one non-union. Other than the non-union, all osteotomies were stable at the time of the fixator removal. The AO external fixator is an effective alternative in maintaining corrective proximal femoral osteotomies in children with fragile bones.

  8. Treatment of Palatal Fractures by Osteosynthesis with 2.0-mm Locking Plates as External Fixator

    PubMed Central

    Cienfuegos, Ricardo; Sierra, Eduardo; Ortiz, Benjamin; Fernández, Gerardo

    2010-01-01

    Treatment options for palatal fractures range from orthodontic braces, acrylic bars, and arch bars for maxillomandibular fixation to internal fixation, with plates and screws placed under the palate mucosa and periosteum, together with pyriform aperture or alveolar plating plus buttress reconstruction. Forty-five patients, ages 4 to 56, were treated using medium- or high-profile locking plates placed over the palatal mucosa as an external fixator for palatal fractures, together with treatment for other associated facial fractures. In open fractures, plates were placed after approximating the edges of the mucosal wounds. Plates and screws for palate fixation were removed at 12 weeks, when computed tomography scans provided evidence of fracture healing. All palatal fractures healed by 12 weeks, with no cases of mucosal necrosis, bone exposure, fistulae, or infections. This approach achieves adequate stability, reduces the risk of bone and mucosal necrosis, and promotes healing of mucosal wounds in case of open fractures. PMID:22132261

  9. Do Fixation Cues Ensure Fixation Accuracy in Split-Fovea Studies of Word Recognition?

    ERIC Educational Resources Information Center

    Jordan, Timothy R.; Paterson, Kevin B.; Kurtev, Stoyan; Xu, Mengyun

    2009-01-01

    Many studies have claimed that hemispheric processing is split precisely at the foveal midline and so place great emphasis on the precise location at which words are fixated. These claims are based on experiments in which a variety of fixation procedures were used to ensure fixation accuracy but the effectiveness of these procedures is unclear. We…

  10. Heterotrophic organisms dominate nitrogen fixation in the South Pacific Gyre.

    PubMed

    Halm, Hannah; Lam, Phyllis; Ferdelman, Timothy G; Lavik, Gaute; Dittmar, Thorsten; LaRoche, Julie; D'Hondt, Steven; Kuypers, Marcel M M

    2012-06-01

    Oceanic subtropical gyres are considered biological deserts because of the extremely low availability of nutrients and thus minimum productivities. The major source of nutrient nitrogen in these ecosystems is N(2)-fixation. The South Pacific Gyre (SPG) is the largest ocean gyre in the world, but measurements of N(2)-fixation therein, or identification of microorganisms involved, are scarce. In the 2006/2007 austral summer, we investigated nitrogen and carbon assimilation at 11 stations throughout the SPG. In the ultra-oligotrophic waters of the SPG, the chlorophyll maxima reached as deep as 200 m. Surface primary production seemed limited by nitrogen, as dissolved inorganic carbon uptake was stimulated upon additions of (15)N-labeled ammonium and leucine in our incubation experiments. N(2)-fixation was detectable throughout the upper 200 m at most stations, with rates ranging from 0.001 to 0.19 nM N h(-1). N(2)-fixation in the SPG may account for the production of 8-20% of global oceanic new nitrogen. Interestingly, comparable (15)N(2)-fixation rates were measured under light and dark conditions. Meanwhile, phylogenetic analyses for the functional gene biomarker nifH and its transcripts could not detect any common photoautotrophic diazotrophs, such as, Trichodesmium, but a prevalence of γ-proteobacteria and the unicellular photoheterotrophic Group A cyanobacteria. The dominance of these likely heterotrophic diazotrophs was further verified by quantitative PCR. Hence, our combined results show that the ultra-oligotrophic SPG harbors a hitherto unknown heterotrophic diazotrophic community, clearly distinct from other oceanic gyres previously visited.

  11. Carbon fixation by basalt-hosted microbial communities.

    PubMed

    Orcutt, Beth N; Sylvan, Jason B; Rogers, Daniel R; Delaney, Jennifer; Lee, Raymond W; Girguis, Peter R

    2015-01-01

    Oceanic crust is a massive potential habitat for microbial life on Earth, yet our understanding of this ecosystem is limited due to difficulty in access. In particular, measurements of rates of microbial activity are sparse. We used stable carbon isotope incubations of crustal samples, coupled with functional gene analyses, to examine the potential for carbon fixation on oceanic crust. Both seafloor-exposed and subseafloor basalts were recovered from different mid-ocean ridge and hot spot environments (i.e., the Juan de Fuca Ridge, the Mid-Atlantic Ridge, and the Loihi Seamount) and incubated with (13)C-labeled bicarbonate. Seafloor-exposed basalts revealed incorporation of (13)C-label into organic matter over time, though the degree of incorporation was heterogeneous. The incorporation of (13)C into biomass was inconclusive in subseafloor basalts. Translating these measurements into potential rates of carbon fixation indicated that 0.1-10 nmol C g(-1) rock d(-1) could be fixed by seafloor-exposed rocks. When scaled to the global production of oceanic crust, this suggests carbon fixation rates of 10(9)-10(12) g C year(-1), which matches earlier predictions based on thermodynamic calculations. Functional gene analyses indicate that the Calvin cycle is likely the dominant biochemical mechanism for carbon fixation in basalt-hosted biofilms, although the reductive acetyl-CoA pathway and reverse TCA cycle likely play some role in net carbon fixation. These results provide empirical evidence for autotrophy in oceanic crust, suggesting that basalt-hosted autotrophy could be a significant contributor of organic matter in this remote and vast environment.

  12. Carbon fixation by basalt-hosted microbial communities

    PubMed Central

    Orcutt, Beth N.; Sylvan, Jason B.; Rogers, Daniel R.; Delaney, Jennifer; Lee, Raymond W.; Girguis, Peter R.

    2015-01-01

    Oceanic crust is a massive potential habitat for microbial life on Earth, yet our understanding of this ecosystem is limited due to difficulty in access. In particular, measurements of rates of microbial activity are sparse. We used stable carbon isotope incubations of crustal samples, coupled with functional gene analyses, to examine the potential for carbon fixation on oceanic crust. Both seafloor-exposed and subseafloor basalts were recovered from different mid-ocean ridge and hot spot environments (i.e., the Juan de Fuca Ridge, the Mid-Atlantic Ridge, and the Loihi Seamount) and incubated with 13C-labeled bicarbonate. Seafloor-exposed basalts revealed incorporation of 13C-label into organic matter over time, though the degree of incorporation was heterogeneous. The incorporation of 13C into biomass was inconclusive in subseafloor basalts. Translating these measurements into potential rates of carbon fixation indicated that 0.1–10 nmol C g-1rock d-1 could be fixed by seafloor-exposed rocks. When scaled to the global production of oceanic crust, this suggests carbon fixation rates of 109–1012 g C year-1, which matches earlier predictions based on thermodynamic calculations. Functional gene analyses indicate that the Calvin cycle is likely the dominant biochemical mechanism for carbon fixation in basalt-hosted biofilms, although the reductive acetyl-CoA pathway and reverse TCA cycle likely play some role in net carbon fixation. These results provide empirical evidence for autotrophy in oceanic crust, suggesting that basalt-hosted autotrophy could be a significant contributor of organic matter in this remote and vast environment. PMID:26441854

  13. The cyanobacterial nitrogen fixation paradox in natural waters

    PubMed Central

    Paerl, Hans

    2017-01-01

    Nitrogen fixation, the enzymatic conversion of atmospheric N (N 2) to ammonia (NH 3), is a microbially mediated process by which “new” N is supplied to N-deficient water bodies. Certain bloom-forming cyanobacterial species are capable of conducting N 2 fixation; hence, they are able to circumvent N limitation in these waters. However, this anaerobic process is highly sensitive to oxygen, and since cyanobacteria produce oxygen in photosynthesis, they are faced with a paradoxical situation, where one critically important (for supporting growth) biochemical process is inhibited by another. N 2-fixing cyanobacterial taxa have developed an array of biochemical, morphological, and ecological adaptations to minimize the “oxygen problem”; however, none of these allows N 2 fixation to function at a high enough efficiency so that it can supply N needs at the ecosystem scale, where N losses via denitrification, burial, and advection often exceed the inputs of “new” N by N 2 fixation. As a result, most marine and freshwater ecosystems exhibit chronic N limitation of primary production. Under conditions of perpetual N limitation, external inputs of N from human sources (agricultural, urban, and industrial) play a central role in determining ecosystem fertility and, in the case of N overenrichment, excessive primary production or eutrophication. This points to the importance of controlling external N inputs (in addition to traditional phosphorus controls) as a means of ensuring acceptable water quality and safe water supplies. Nitrogen fixation, the enzymatic conversion of atmospheric N 2 to ammonia (NH 3) is a  microbially-mediated process by which “new” nitrogen is supplied to N-deficient water bodies.  Certain bloom-forming cyanobacterial species are capable of conducting N 2 fixation; hence they are able to circumvent nitrogen limitation in these waters. However, this anaerobic process is highly sensitive to oxygen, and since cyanobacteria produce oxygen in

  14. Combined use of Ilizarov external fixation and Papineau technique for septic pseudoarthrosis of the distal tibia in a patient with diabetes mellitus

    PubMed Central

    Koutsostathis, Stefanos D.; Lepetsos, Panagiotis; Polyzois, Vasilios D.; Pneumaticos, Spyros G.; Macheras, George A.

    2014-01-01

    The surgical treatment of open pilon fractures has a high complication rate especially in diabetic patients. In this article, we present a case of an infected tibial non-union after an open reduction and internal fixation in a diabetic patient, treated with Ilizarov external fixation combined with Papineau technique. Combined use of external fixation and Papineau technique can provide an alternative option for the treatment of septic pseudoarthrosis of the distal tibia. PMID:24563728

  15. The interactive effects of temperature and light on biological nitrogen fixation in boreal forests.

    PubMed

    Gundale, Michael J; Nilsson, Madeleine; Bansal, Sheel; Jäderlund, Anders

    2012-04-01

    Plant productivity is predicted to increase in northern latitudes as a result of climate warming; however, this may depend on whether biological nitrogen (N)-fixation also increases. We evaluated how the variation in temperature and light affects N-fixation by two boreal feather mosses, Pleurozium schreberi and Hylocomium splendens, which are the primary source of N-fixation in most boreal environments. We measured N-fixation rates 2 and 4 wk after exposure to a factorial combination of environments of normal, intermediate and high temperature (16.3, 22.0 and 30.3°C) and light (148.0, 295.7 and 517.3 μmol m(-2) s(-1)). Our results showed that P. schreberi achieved higher N-fixation rates relative to H. splendens in response to warming treatments, but that the highest warming treatment eventually caused N-fixation to decline for both species. Light strongly interacted with warming treatments, having positive effects at low or intermediate temperatures and damaging effects at high temperatures. These results suggest that climate warming may increase N-fixation in boreal forests, but that increased shading by the forest canopy or the occurrence of extreme temperature events could limit increases. They also suggest that P. schreberi may become a larger source of N in boreal forests relative to H. splendens as climate warming progresses.

  16. The influence of fixatives and other variations in tissue processing on nuclear morphometric features.

    PubMed

    Baak, J P; Noteboom, E; Koevoets, J J

    1989-08-01

    The influence on the area and numerical density of nuclei was investigated in 5-mm-thick slices of guinea pig liver for different fixatives and variations in tissue processing: delay in fixation, air drying, degree of acidity of 10% formalin (= 4% formaldehyde), Bouin and mercury-formalin fixatives, acetone and ethanol dehydration and understretching and overstretching of the paraffin-embedded sections. Air drying (either forced or as a result of delayed fixation), the type of fixative and the degree of acidity affected the nuclear area. Regarding the latter, nuclear area was approximately 25% lower for pH less than or equal to 3 as compared with pH greater than 5. In comparison with the standard tissue processing used, the nuclear density was higher after all of the variations studied (air drying, acetone dehydration and fixation). These findings indicate that nuclear area, in contrast to other tissue components, is relatively insensitive to variations in tissue processing. However, it is essential to regularly measure the pH of the fixative: deviations from pH = 7 should be carefully avoided in order to keep nuclear area variations as a result of tissue processing within acceptable limits.

  17. Molecular evidence for sediment nitrogen fixation in a temperate New England estuary

    PubMed Central

    Newell, Silvia E.; Pritchard, Kaitlyn R.; Foster, Sarah Q.

    2016-01-01

    Primary production in coastal waters is generally nitrogen (N) limited with denitrification outpacing nitrogen fixation (N2-fixation). However, recent work suggests that we have potentially underestimated the importance of heterotrophic sediment N2-fixation in marine ecosystems. We used clone libraries to examine transcript diversity of nifH (a gene associated with N2-fixation) in sediments at three sites in a temperate New England estuary (Waquoit Bay, Massachusetts, USA) and compared our results to net sediment N2 fluxes previously measured at these sites. We observed nifH expression at all sites, including a site heavily impacted by anthropogenic N. At this N impacted site, we also observed mean net sediment N2-fixation, linking the geochemical rate measurement with nifH expression. This same site also had the lowest diversity (non-parametric Shannon = 2.75). At the two other sites, we also detected nifH transcripts, however, the mean N2 flux indicated net denitrification. These results suggest that N2-fixation and denitrification co-occur in these sediments. Of the unique sequences in this study, 67% were most closely related to uncultured bacteria from various marine environments, 17% to Cluster III, 15% to Cluster I, and only 1% to Cluster II. These data add to the growing body of literature that sediment heterotrophic N2-fixation, even under high inorganic nitrogen concentrations, may be an important yet overlooked source of N in coastal systems. PMID:26977375

  18. Nitrogen Inputs via Nitrogen Fixation in Northern Plants and Soils

    NASA Astrophysics Data System (ADS)

    Thorp, N. R.; Wieder, R. K.; Vile, M. A.

    2015-12-01

    Dominated by cold and often acidic water logged environments, mineralization of organic matter is slow in the majority of northern ecosystems. Measures of extractable ammonium and nitrate are generally low and can be undetectable in peat pore waters. Despite this apparent nitrogen limitation, many of these environments produce deep deposits of soil organic matter. Biological nitrogen fixation carried out by autotrophic and heterotrophic diazotrophs associated with cryptograms provides the majority of known nitrogen inputs in these northern ecosystems. Nitrogen fixation was assessed in a variety of northern soils within rhizospheres of dominant plant communities. We investigated the availability of this newly fixed nitrogen to the vascular plant community in nitrogen limited northern plant communities. We tracked nitrogen flow from 15N2 gas fixed in Sphagnum mosses into tissues of two native vascular plant species, boreal cranberry (Vaccinium oxycoccus) and black spruce (Picea mariana). 15N-labeled Sphagnum microcosms were grown within variable mesh size exclusion/inclusion fabrics in a nitrogen addition experiment in situ in order to investigate the role of mycorrhizal fungi in the uptake of newly fixed nitrogen. Up to 24% of daily fixed 15N label was transferred to vascular plant tissues during 2 months. Nitrogen addition resulted in decreased N2 fixation rates; however, with higher nitrogen availability there was a higher rate of 15N label uptake into the vascular plants, likely the result of increased production of dissolved organic nitrogen. Reliance on mycorrhizal networks for nitrogen acquisition was indicated by nitrogen isotope fractionation patterns. Moreover, N2 fixation activities in mosses were stimulated when vascular plants were grown in moss microcosms versus "moss only" treatments. Results indicate that bog vascular plants may derive considerable nitrogen from atmospheric N2 biologically fixed within Sphagnum mosses. This work demonstrates that

  19. Statewide Implementation of Parenting with Love and Limits Among Youth with Co-Existing Internalizing and Externalizing Functional Impairments Reduces Return to Service Rates and Treatment Costs.

    PubMed

    Sterrett-Hong, Emma M; Karam, Eli; Kiaer, Lynn

    2017-01-24

    Many community mental health (CMH) systems contain inefficiencies, contributing to unmet need for services among youth. Using a quasi-experimental research design, we examined the implementation of an adapted structural-strategic family intervention, Parenting with Love and Limits, in a state CMH system to increase efficiency of services to youth with co-existing internalizing and externalizing functional impairments (PLL n = 296; Treatment-As-Usual n = 296; 54% male; 81% Caucasian). Youth receiving PLL experienced shorter treatment durations and returned to CMH services at significantly lower rates than youth receiving treatment-as-usual. They also demonstrated significant decreases in internalizing and externalizing symptoms over time. Findings lay the foundation for further examination of the role of an adapted structural-strategic family treatment in increasing the efficiency of CMH systems.

  20. Biochemical Approaches to Improved Nitrogen Fixation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Improving symbiotic nitrogen fixation by legumes has emerged again as an important topic on the world scene due to the energy crisis and lack of access to nitrogen fertilizer in developing countries. We have taken a biochemical genomics approach to improving symbiotic nitrogen fixation in legumes. L...

  1. Soil nutrients, land use history and species composition interact to influence tropical N2 fixation

    NASA Astrophysics Data System (ADS)

    Batterman, S. A.; Hall, J.; Van Breugel, M.; Hedin, L. O.

    2011-12-01

    Symbiotic di-nitrogen fixation plays an important role in terrestrial biogeochemical cycles as it can bring in large quantities of nitrogen into ecosystems and provide the nitrogen required for individual plant growth in nitrogen limited environments. Of particular interest is how fixation interacts with nitrogen and phosphorus cycles in heterogeneous tropical forests. Recent advances on this topic using plants grown in a shadehouse show that the interaction of nitrogen and phosphorus control fixation at the level of individual plants and that plants adjust nutrient acquisition strategies with some successes at overcoming nutrient limitation on biomass growth depending on nutrient availability and the strategy employed (Batterman et al. unpublished). Exactly how these results translate to biodiverse tropical forests with heterogeneous resource availabilities and a history of land use disturbances, however, remains largely unresolved. We surveyed fixation across a chronosequence of forest stands in Panama that were at various stages of recovery from the abandonment of cattle pasture. Stands ranged in age from new secondary regrowth to mature forest. We examined nine common species of putative N2 fixing trees and lianas for nodulation, tree size, and abundance for four stands each of four forest ages to determine if species differ in strategies and function. In addition, we measured light availability to each tree and total and bioavailable phosphorus and nitrogen for each stand to examine the interactions of fixation with these biogeochemical cycles. Results were scaled to estimate stand level fixation. We found unique patterns in fixation that contrasted with predictions based on evidence of how fixation interacts with land use and biogeochemical cycles in extra-tropical forests. Soil nutrients showed unexpected patterns in availability across the chronosequence and interacted with fixation. Finally, species displayed distinct differences in temporal patterns in

  2. Do fixation cues ensure fixation accuracy in split-fovea studies of word recognition?

    PubMed

    Jordan, Timothy R; Paterson, Kevin B; Kurtev, Stoyan; Xu, Mengyun

    2009-07-01

    Many studies have claimed that hemispheric processing is split precisely at the foveal midline and so place great emphasis on the precise location at which words are fixated. These claims are based on experiments in which a variety of fixation procedures were used to ensure fixation accuracy but the effectiveness of these procedures is unclear. We investigated this issue using procedures matched to the original studies and an eye-tracker to monitor the locations actually fixated. Four common types of fixation cues were used: cross, two vertical gapped lines, two vertical gapped lines plus a secondary task in which a digit was presented at the designated fixation point, and a dot. Accurate fixations occurred on <35% of trials for all fixation conditions. Moreover, despite the usefulness often attributed to a secondary task, no increase in fixation accuracy was produced in this condition. The indications are that split-fovea theory should not assume that fixation of specified locations occurs in experiments without appropriate eye-tracking control or, indeed, that consistent fixation of specified locations is plausible under normal conditions of word recognition.

  3. DNA identification of formalin-fixed organs is affected by fixation time and type of fixatives: using the AmpF l STR(R) Identifiler(R) PCR Amplification Kit.

    PubMed

    Taguchi, Mami; Inoue, Hiroyuki; Motani-Saitoh, Hisako; Yajima, Daisuke; Hayakawa, Mutsumi; Otsuka, Katsura; Kobayashi, Kazuhiro; Iwase, Hirotaro

    2012-01-01

    Personal identification using DNA typing of formalin-fixed tissue is very important in the forensic sciences. However, few studies have been conducted to determine the detection limit of DNA typing of formalin fixation time in samples using the AmpFℓSTR(®) Identifiler(®) PCR Amplification Kit (Identifiler Kit). We collected samples from five cadavers submitted for forensic autopsies, and fixed them either in a 10% formalin solution, or in a 10% neutral-buffered formalin solution. The amount of template DNA for polymerase chain reaction (PCR) amplification and the detection limit of DNA typing for the Identifiler Kit were determined. When tissues were fixed in 10% formalin, 10 ng of DNA template was required for successful genotyping even after three-hour fixation and 100 ng was required after one-week fixation for PCR amplification. However, when tissues were fixed in 10% neutral-buffered formalin, the required amount of DNA template was 1 ng for a fixation time of three hours to three days and 125 ng for three months. Fixation time in neutral-buffered formalin was longer for successful PCR than that in formalin solution. Dropout was more common with increasing formalin fixation time. These results suggest that neutral-buffered formalin is preferred to formalin for fixation of tissues if they are to be subjected to DNA typing and that tissues fixed with neutral-buffered formalin can be used for DNA typing using the Identifiler Kit unless the fixation time exceeds one month.

  4. Limited and time-delayed internal resource allocation generates oscillations and chaos in the dynamics of citrus crops

    NASA Astrophysics Data System (ADS)

    Ye, Xujun; Sakai, Kenshi

    2013-12-01

    Alternate bearing or masting is a yield variability phenomenon in perennial crops. The complex dynamics in this phenomenon have stimulated much ecological research. Motivated by data from an eight-year experiment with forty-eight individual trees, we explored the mechanism inherent to these dynamics in Satsuma mandarin (Citrus unshiu Marc.). By integrating high-resolution imaging technology, we found that the canopy structure and reproduction output of individual citrus crops are mutually dependent on each other. Furthermore, it was revealed that the mature leaves in early season contribute their energy to the fruiting of the current growing season, whereas the younger leaves show a delayed contribution to the next growing season. We thus hypothesized that the annual yield variability might be caused by the limited and time-delayed resource allocation in individual plants. A novel lattice model based on this hypothesis demonstrates that this pattern of resource allocation will generate oscillations and chaos in citrus yield.

  5. Limited and time-delayed internal resource allocation generates oscillations and chaos in the dynamics of citrus crops

    SciTech Connect

    Ye, Xujun; Sakai, Kenshi

    2013-12-15

    Alternate bearing or masting is a yield variability phenomenon in perennial crops. The complex dynamics in this phenomenon have stimulated much ecological research. Motivated by data from an eight-year experiment with forty-eight individual trees, we explored the mechanism inherent to these dynamics in Satsuma mandarin (Citrus unshiu Marc.). By integrating high-resolution imaging technology, we found that the canopy structure and reproduction output of individual citrus crops are mutually dependent on each other. Furthermore, it was revealed that the mature leaves in early season contribute their energy to the fruiting of the current growing season, whereas the younger leaves show a delayed contribution to the next growing season. We thus hypothesized that the annual yield variability might be caused by the limited and time-delayed resource allocation in individual plants. A novel lattice model based on this hypothesis demonstrates that this pattern of resource allocation will generate oscillations and chaos in citrus yield.

  6. International neurocognitive normative study: neurocognitive comparison data in diverse resource-limited settings: AIDS Clinical Trials Group A5271.

    PubMed

    Robertson, K; Jiang, H; Evans, S R; Marra, C M; Berzins, B; Hakim, J; Sacktor, N; Silva, M Tulius; Campbell, T B; Nair, A; Schouten, J; Kumwenda, J; Supparatpinyo, K; Tripathy, S; Kumarasamy, N; la Rosa, A; Montano, S; Mwafongo, A; Firnhaber, C; Sanne, I; Naini, L; Amod, F; Walawander, A

    2016-08-01

    Infrastructure for conducting neurological research in resource-limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment and normative data needed for clinical interpretation impedes research and clinical care. Here, we report on ACTG 5271, which provided neurological training of clinical site personnel and collected neurocognitive normative comparison data in diverse settings. At ten sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n = 240), India (n = 480), Malawi (n = 481), Peru (n = 239), South Africa (480), Thailand (n = 240), and Zimbabwe (n = 240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline and 770 at 6 months. Participants were enrolled in eight strata, gender (female and male), education (<10 and ≥10 years), and age (<35 and ≥35 years). Of 2400 enrolled, 770 completed the 6-month follow-up. As expected, significant between-country differences were evident in all the neurocognitive test scores (p < 0.0001). There was variation between the age, gender, and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance, and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the necessary neurocognitive normative data needed to build infrastructure for future neurological and neurocognitive studies in diverse RLS. These normative data are a much-needed resource for both clinicians and researchers.

  7. Abnormal Fixational Eye Movements in Amblyopia

    PubMed Central

    Shaikh, Aasef G.; Otero-Millan, Jorge; Kumar, Priyanka; Ghasia, Fatema F.

    2016-01-01

    Purpose Fixational saccades shift the foveal image to counteract visual fading related to neural adaptation. Drifts are slow eye movements between two adjacent fixational saccades. We quantified fixational saccades and asked whether their changes could be attributed to pathologic drifts seen in amblyopia, one of the most common causes of blindness in childhood. Methods Thirty-six pediatric subjects with varying severity of amblyopia and eleven healthy age-matched controls held their gaze on a visual target. Eye movements were measured with high-resolution video-oculography during fellow eye-viewing and amblyopic eye-viewing conditions. Fixational saccades and drifts were analyzed in the amblyopic and fellow eye and compared with controls. Results We found an increase in the amplitude with decreased frequency of fixational saccades in children with amblyopia. These alterations in fixational eye movements correlated with the severity of their amblyopia. There was also an increase in eye position variance during drifts in amblyopes. There was no correlation between the eye position variance or the eye velocity during ocular drifts and the amplitude of subsequent fixational saccade. Our findings suggest that abnormalities in fixational saccades in amblyopia are independent of the ocular drift. Discussion This investigation of amblyopia in pediatric age group quantitatively characterizes the fixation instability. Impaired properties of fixational saccades could be the consequence of abnormal processing and reorganization of the visual system in amblyopia. Paucity in the visual feedback during amblyopic eye-viewing condition can attribute to the increased eye position variance and drift velocity. PMID:26930079

  8. Nutrient control of N2 fixation in the oligotrophic Mediterranean Sea and the impact of Saharan dust events

    NASA Astrophysics Data System (ADS)

    Ridame, C.; Le Moal, M.; Guieu, C.; Ternon, E.; Biegala, I. C.; L'Helguen, S.; Pujo-Pay, M.

    2011-09-01

    A better understanding of the factors controlling N2 fixation is a pre-requisite for improving our knowledge on the contribution of N2 fixation process in the nitrogen cycling. Trace-metal clean nutrient/dust addition bioassays (+P, +PFe, +dust) were performed at three stations located in the western, central and eastern Mediterranean Sea, in summer 2008 as part of the BOUM cruise. The main goals were (1) to investigate the nutrient factor(s) limiting N2 fixation (uptake of 15N2) and (2) to evaluate the potential impact of a Saharan dust event on this biological process during the stratification period. Initially, surface waters at the three stations were DIP-depleted (<10 nM) while the DFe concentrations were relatively high (from 1.2 to 2.3 nM) most likely due to atmospheric iron accumulation in the surface mixed layer. At all stations, Saharan dust input relieved the ambient nutrient limitation of the diazotrophic activity as demonstrated by the strong stimulation of N2 fixation (from 130 % to 430 %). The highest dust stimulation of N2 fixation was recorded at the station located in the eastern basin. The response of diazotrophic activity to nutrient additions was variable between the sampled stations suggesting a spatial variability of the factor controlling N2 fixation over the whole basin. At all stations, N2 fixation was not limited by Fe nor co-limited by P and Fe. At the western station, N2 fixation was DIP limited while at the eastern one, N2 fixation was first DIP limited, then was limited by one or several chemical element(s) released by dust. Our results demonstrated that a Saharan dust input was able to relieve these successive on going limitations. Very interestingly, at the station located in the central basin, N2 fixation was not limited by the availability of P yet it was strongly stimulated by dust addition (x3.1). A chemical element or a combination of several, released by the added dust may have been responsible for the observed stimulations of

  9. What are the minimum requirements for ketogenic diet services in resource-limited regions? Recommendations from the International League Against Epilepsy Task Force for Dietary Therapy.

    PubMed

    Kossoff, Eric H; Al-Macki, Nabil; Cervenka, Mackenzie C; Kim, Heung D; Liao, Jianxiang; Megaw, Katherine; Nathan, Janak K; Raimann, Ximena; Rivera, Rocio; Wiemer-Kruel, Adelheid; Williams, Emma; Zupec-Kania, Beth A

    2015-09-01

    Despite the increasing use of dietary therapies for children and adults with refractory epilepsy, the availability of these treatments in developing countries with limited resources remains suboptimal. One possible contributory factor may be the costs. There is often reported a significant perceived need for a large ketogenic diet team, supplements, laboratory studies, and follow-up visits to provide this treatment. The 2009 Epilepsia Consensus Statement described ideal requirements for a ketogenic diet center, but in some situations this is not feasible. As a result, the International League Against Epilepsy (ILAE) Task Force on Dietary Therapy was asked to convene and provide practical, cost-effective recommendations for new ketogenic diet centers in resource-limited regions of the world.

  10. Functional ecology of free-living nitrogen fixation: A contemporary perspective

    USGS Publications Warehouse

    Reed, Sasha C.; Cleveland, Cory C.; Townsend, Alan R.

    2011-01-01

    Nitrogen (N) availability is thought to frequently limit terrestrial ecosystem processes, and explicit consideration of N biogeochemistry, including biological N2 fixation, is central to understanding ecosystem responses to environmental change. Yet, the importance of free-living N2 fixation—a process that occurs on a wide variety of substrates, is nearly ubiquitous in terrestrial ecosystems, and may often represent the dominant pathway for acquiring newly available N—is often underappreciated. Here, we draw from studies that investigate free-living N2 fixation from functional, physiological, genetic, and ecological perspectives. We show that recent research and analytical advances have generated a wealth of new information that provides novel insight into the ecology of N2 fixation as well as raises new questions and priorities for future work. These priorities include a need to better integrate free-living N2 fixation into conceptual and analytical evaluations of the N cycle's role in a variety of global change scenarios.

  11. Internal methane transport through Juncus effusus: experimental manipulation of morphological barriers to test above- and below-ground diffusion limitation.

    PubMed

    Henneberg, Anders; Sorrell, Brian K; Brix, Hans

    2012-11-01

    Aerenchymatous plants can transport methane (CH(4) ) from the root zone to the atmosphere, bypassing the surface-oxidizing layers of the soil, yet morphological and anatomical factors that govern the transport of methane have rarely been critically tested in manipulative experiments. Here, we investigated the methane transport capacity of hydroponically grown Juncus effusus, in experiments with roots submerged in nutrient solutions sparged with methane (1.16 mmol CH(4) l(-1)). Through a range of manipulations of the above- and below-ground plant parts, we tested the contradictory claims in the literature regarding which sites provide the greatest resistance to gas transport. Root manipulations had the greatest effect on methane transport. Removing root material reduced methane transport significantly, and especially the lateral roots and the root tips were important. Cutting of the shoots, with or without subsequent sealing, did not alter methane transport significantly. We confirm modelling predictions that the limiting factor for methane transport in the tussock forming wetland graminoid, J. effusus, is the amount of permeable root surface, estimated using the proxy measurement of root length. The aerial tissues do not provide any significant resistance to methane transport, and the methane is emitted from the lower 50 mm of the shoots.

  12. Investigations of Internal Flow Fields of Constant-Area Mixing-Tubes under Starting-Limit Conditions

    NASA Astrophysics Data System (ADS)

    Kitamura, Eijiro; Tomioka, Sadatake; Sakuranaka, Noboru; Watanabe, Syuichi; Masuya, Goro

    Flow fields in the constant-area mixing tubes of ejector jets were investigated under the starting-limit conditions of an aerodynamic choking mode by performing numerical simulations and cold flow experiments. Pressure recovery was almost completed in the shock-train region. The length of the shock-train region (Lst) was measured under various conditions. Lst was proportional to the mass flow rate ratio of the secondary flow to the primary flow when this ratio was less than 0.15. On the other hand, Lst became almost constant when the mass flow rate ratio exceeded 0.15. Numerical studies showed that this change was caused by the difference in the mechanism of the flow fields. In the cases with low air mass flow rates, the primary and secondary flows almost mixed in a region between the inlets of the mixing tubes and the choking points. The pressure was recovered by a pseudo-shock-wave generated downstream of the choking point. On the other hand, when the mass flow rate ratio was higher than 0.15, the primary and secondary flows were clearly separated at the choking point. The pressure recovery was achieved by the mixing between the primary and secondary flows downstream of the choking point.

  13. The limits of crop productivity

    NASA Technical Reports Server (NTRS)

    Bugbee, Bruce; Monje, Oscar

    1992-01-01

    The component processes that govern yield limits in food crops are reviewed and how each process can be individually measured is described. The processes considered include absorption of photosynthetic radiation by green tissue, carbon-fixation efficiency in photosynthesis, carbon use efficiency in respiration, biomass allocation to edible products, and efficiency of photosynthesis and respiration. The factors limiting yields in optimal environments are considered.

  14. Impairments, activity limitations, and participation restrictions of the international classification of functioning, disability, and health model in children with ambulatory cerebral palsy

    PubMed Central

    Mutlu, Akmer; Büğüsan, Sema; Kara, Özgün K.

    2017-01-01

    Objectives: To examine the impairments, activity limitations, and participation restrictions in children with spastic unilateral and bilateral cerebral palsy (CP). We investigated the relationship between these factors according to the international classification of functioning, disability, and health (ICF) model. Methods: This prospective cross sectional study included 60 children aged between 4-18 years with spastic CP (30 unilateral, 30 bilateral involvement) classified as Levels I and II on the gross motor function classification system. Children had been referred to the Pediatric Rehabilitation Unit in the Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey between March 2014 and March 2015. The Physician Rating scale was used to assess body functions and structures. The Gillette Functional Assessment Questionnaire 22-item skill set, Pediatric Functional Independence Measure, and Pediatric Outcomes Data Collection Instrument were used to assess activity and participation levels. Results: There was a significant positive correlation between impairments and activity limitations (r=0.558; p=0.000), as well as between activity limitations and participation restrictions (r=0.354, p=0.005). Conclusion: These results show that activity limitations in children with unilateral and bilateral ambulatory CP may be related to their impairments and participation restrictions, although the sample size of our study is not large enough for generalizations. Overall, our study highlights the need for up-to-date, practical evaluation methods according to the ICF model. PMID:28133691

  15. Cr3+-doped fluorides and oxides: role of internal fields and limitations of the Tanabe-Sugano approach.

    PubMed

    Trueba, A; García-Lastra, J M; Garcia-Fernandez, P; Aramburu, J A; Barriuso, M T; Moreno, M

    2011-11-24

    This work is aimed at clarifying the changes on optical spectra of Cr(3+) impurities due to either a host lattice variation or a hydrostatic pressure, which can hardly be understood by means of the usual Tanabe-Sugano (TS) approach assuming that the Racah parameter, B, grows when covalency decreases. For achieving this goal, the optical properties of Cr(3+)-doped LiBaF(3) and KMgF(3) model systems have been explored by means of high level ab initio calculations on CrF(6)(3-) units subject to the electric field, E(R)(r), created by the rest of the lattice ions. These calculations, which reproduce available experimental data, indicate that the energy, E((2)E), of the (2)E(t(2g)(3)) → (4)A(2)(t(2g)(3)) emission transition is nearly independent of the host lattice. By contrast, the energy difference corresponding to (4)A(2)(t(2g)(3)) → (4)T(1)(t(2g)(2)e(g)(1)) and (4)A(2)(t(2g)(3)) → (4)T(2)(t(2g)(2)e(g)(1)) excitations, Δ((4)T(1); (4)T(2)), is shown to increase on passing from the normal to the inverted perovskite host lattice despite the increase in covalency, a fact which cannot be accounted for through the usual TS model. Similarly, when the Cr(3+)-F(-) distance, R, is reduced both Δ((4)T(1); (4)T(2)) and the covalency are found to increase. By analyzing the limitations of the usual model, we found surprising results that are shown to arise from the deformation of both 3d(Cr) and ligand orbitals in the antibonding e(g) orbital, which has a σ character and is more extended than the π t(2g) orbital. By contrast, because of the higher stiffness of the t(2g) orbital, the dependence of E((2)E) with R basically follows the corresponding variation of covalency in that level. Bearing in mind the similarities of the optical properties displayed by Cr(3+) impurities in oxides and fluorides, the present results can be useful for understanding experimental data on Cr(3+)-based gemstones where the local symmetry is lower than cubic.

  16. Nitrogen Fixation Tolerance to Soil Water Deficit Among Commercial Cultivars and breeding Lines of Peanut

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Peanut is often grown in the U.S. on sandy soil with limited water holding capacity. Since nitrogen fixation activity of other grain legume species, and some peanut cultivars, has been found to be especially sensitive to soil drying, this study was undertaken to examine a possible limitation in U.S...

  17. [The Taylor spatial frame fixator. Soft-tissue distraction for post-traumatic varus deformities of the hindfoot].

    PubMed

    Gessmann, J; Seybold, D; Baecker, H; Muhr, G; Graf, M

    2009-02-01

    Despite adequate primary treatment many ankle fractures result in post-traumatic deformities and arthrosis. Revision mostly requires a multidirectional correction whereas internal fixation procedures are often not applicable due to soft tissue damage and the extent of deformity. The Taylor spatial frame enables simultaneous correction of multidirectional deformities through a virtual hinge using the same ideas of distraction osteogenesis as the Ilizarov fixator. The presented case demonstrates minimally invasive correction of a complex deformity of the ankle with the Taylor spatial frame fixator. Orthogonal alignment was achieved and a stabilizing tibiotalar arthrodesis was performed achieving a good functional and pain-free result.

  18. Presentation to International Space University Students on g-LIMIT and STABLE-ATD Projects and Related Microgravity Vibration Isolation Topics

    NASA Technical Reports Server (NTRS)

    Alhorn, Dean

    1998-01-01

    Vibration isolation is a necessity in the development of science in space and especially those experiments destined for operation on the International Space Station (ISS). The premise of microgravity scientific research is that in space, disturbances are minimized and experiments can be conducted in the absence of gravity. Although microgravity conditions exist in space, disturbances are still present in various forms and can be detrimental to the success of a microgravity experiment. Due to the plethora of disturbances and the various types that will occur on the space station, the microgravity community has elected to incorporate various means of isolating scientific payloads from these unwanted vibrations. Designing these vibration isolators is a crucial task to achieve true microgravity science. Since conventional methods of isolating payloads can achieve only limited isolation, new technologies are being developed to achieve the goal of designing a generic vibration isolation system. One such system being developed for the Microgravity Science Glovebox (MSG) is called g-LIMIT which stands for Glovebox Integrated Microgravity Isolation Technology. The g-LIMIT system is a miniaturized active vibration isolator for glovebox experiments. Although the system is initially developed for glovebox experiments, the g-LIMIT technology is designed to be upwardly scaleable to provide isolation for a broad range of users. The g-LIMIT system is scheduled to be flown on the UF-2 mission in August of the year 2000 and will be tested shortly thereafter. Once the system has been fully qualified, the hardware will become available for other researchers and will provide a platform upon which the goal of microgravity science can be achieved.

  19. Neural correlates of fixation duration in natural reading: Evidence from fixation-related fMRI.

    PubMed

    Henderson, John M; Choi, Wonil; Luke, Steven G; Desai, Rutvik H

    2015-10-01

    A key assumption of current theories of natural reading is that fixation duration reflects underlying attentional, language, and cognitive processes associated with text comprehension. The neurocognitive correlates of this relationship are currently unknown. To investigate this relationship, we compared neural activation associated with fixation duration in passage reading and a pseudo-reading control condition. The results showed that fixation duration was associated with activation in oculomotor and language areas during text reading. Fixation duration during pseudo-reading, on the other hand, showed greater involvement of frontal control regions, suggesting flexibility and task dependency of the eye movement network. Consistent with current models, these results provide support for the hypothesis that fixation duration in reading reflects attentional engagement and language processing. The results also demonstrate that fixation-related fMRI provides a method for investigating the neurocognitive bases of natural reading.

  20. Treatment results of bicondylar tibial fractures using hybrid external fixator.

    PubMed

    Sales, Jafar Ganjpour; Soleymaopour, Jafar; Ansari, Maroof; Afaghi, Farhad; Goldust, Mohamad

    2013-05-15

    Tibial condyle fractures affect knee stability and motion. Treatment of bicondylar type of tibial plateau fracture is a challenging problem. This study aimed at evaluating the application of hybrid external fixators with minimum deformation in these patients and the resulted outcomes. In this descriptive analytical study, 28 patients with bicondylar tibial plateau fractures treated by HEF device were evaluated. The surgeon used a semicircular and one circular wire instead of the one or two loop of conventional HEF device for a better range of motion of the knee joint. Treatment outcomes including quality of walking, union condition, knee range of motion, complications and the final outcome according to the knee score (rusmussen) were checked. Twenty-eight male patients, with the mean age of 40.54 +/- 13.83 years were enrolled in the study. Complications occurred in 8 (28.6%) patients; 7 cases with superficial infection and 1 patient with deep vein thrombosis. All complications were managed medically with no significant consequences left. All the patients were able to walk with no aid except in one case. In 96.4% and 89.3% of the cases, the clinical and radiological outcomes were good to excellent, respectively according to the knee score. In 85.7% of the patients, the knee range of motion was in normal limits. Application of hybrid external fixator using one and half ring instead of one or two fixator rings in treating bicondylar tibial fractures was associated with desired clinical and radiological results.

  1. Fixation probabilities of evolutionary coordination games on two coupled populations

    NASA Astrophysics Data System (ADS)

    Zhang, Liye; Ying, Limin; Zhou, Jie; Guan, Shuguang; Zou, Yong

    2016-09-01

    Evolutionary forces resulted from competitions between different populations are common, which change the evolutionary behavior of a single population. In an isolated population of coordination games of two strategies (e.g., s1 and s2), the previous studies focused on determining the fixation probability that the system is occupied by only one strategy (s1) and their expectation times, given an initial mixture of two strategies. In this work, we propose a model of two interdependent populations, disclosing the effects of the interaction strength on fixation probabilities. In the well-mixing limit, a detailed linear stability analysis is performed, which allows us to find and to classify the different equilibria, yielding a clear picture of the bifurcation patterns in phase space. We demonstrate that the interactions between populations crucially alter the dynamic behavior. More specifically, if the coupling strength is larger than some threshold value, the critical initial density of one strategy (s1) that corresponds to fixation is significantly delayed. Instead, the two populations evolve to the opposite state of all (s2) strategy, which are in favor of the red queen hypothesis. We delineate the extinction time of strategy (s1) explicitly, which is an exponential form. These results are validated by systematic numerical simulations.

  2. Biomechanical evaluation of tibial eminence fractures using suture fixation.

    PubMed

    Aoki, Stephen K; Curtis, Stuart H

    2011-12-06

    This study evaluates the initial fixation strength of tibial eminence fracture repair using 1, 2, 3, and 4 sutures to determine the optimal number of sutures required to adequately secure the avulsed fragment to the tibia. Sixteen skeletally immature porcine knees were stripped of all soft tissues, isolating the femur-anterior cruciate ligament (ACL)-tibia complex. Type III tibial eminence fractures were simulated in the specimens, and each specimen was randomly assigned to a repair group using 1, 2, 3, or 4 #2 FiberWire sutures (Arthrex, Inc, Naples, Florida). Initial fixation strength of the repair was measured by single cycle pull to failure testing using a materials testing machine (Instron, Norwood, Massachusetts). The mean ultimate failure force during anterior tibial translation was 389±128, 627±66, 703±77, and 802±29 N for 1, 2, 3, and 4 sutures, respectively. The lower limit of the 95% confidence interval was >500 N (estimated force of native ACL during activities of daily living) for each group with ≥2 sutures. In this study, at least 2 high-strength sutures were needed for tibial eminence fracture repairs to withstand potential forces seen across the ACL in the postoperative period. Suture fixation of tibial eminence fractures is a reproducible method requiring a minimum of 2 high-strength polyester sutures to resist forces seen during early rehabilitation.

  3. Ocular Fixation Abnormality in Patients with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Shirama, Aya; Kanai, Chieko; Kato, Nobumasa; Kashino, Makio

    2016-01-01

    We examined the factors that influence ocular fixation control in adults with autism spectrum disorder (ASD) including sensory information, individuals' motor characteristics, and inhibitory control. The ASD group showed difficulty in maintaining fixation especially when there was no fixation target. The fixational eye movement characteristics of…

  4. Slipped capital femoral epiphysis: is it worth the risk and cost not to offer prophylactic fixation of the contralateral hip?

    PubMed

    Clement, N D; Vats, A; Duckworth, A D; Gaston, M S; Murray, A W

    2015-10-01

    Controversy remains whether the contralateral hip should be fixed in patients presenting with unilateral slipped capital femoral epiphysis (SCFE). This retrospective study compares the outcomes and cost of those patients who had prophylactic fixation with those who did not. Between January 2000 and December 2010 a total of 50 patients underwent unilateral fixation and 36 had prophylactic fixation of the contralateral hip. There were 54 males and 32 females with a mean age of 12.3 years (9 to 16). The rate of a subsequent slip without prophylactic fixation was 46%. The risk of complications was greater, the generic health measures (Short Form-12 physical (p < 0.001) and mental (p = 0.004) summary scores) were worse. Radiographic cam lesions in patients presenting with unilateral SCFE were only seen in patients who did not have prophylactic fixation. Furthermore, prophylactic fixation of the contralateral hip was found to be a cost-effective procedure, with a cost per quality adjusted life year gained of £1431 at the time of last follow-up. Prophylactic fixation of the contralateral hip is a cost-effective operation that limits the morbidity from the complications of a further slip, and the diminished functional outcome associated with unilateral fixation.

  5. Biotic nitrogen fixation in the bryosphere is inhibited more by drought than warming.

    PubMed

    Whiteley, Jonathan A; Gonzalez, Andrew

    2016-08-01

    The boreal forest is of particular interest to climate change research due to its large circumpolar distribution and accumulated soil carbon pool. Carbon uptake in this ecosystem is nitrogen (N)-limited, therefore factors affecting carbon or nitrogen dynamics in the boreal forest can have consequences for global climate. We used a 2-year field experiment to investigate the response of biotic nitrogen fixation by cyanobacteria associated with boreal forest bryophytes, in a factorial experiment combining simulated climate change with habitat fragmentation treatments. We simulated climate change conditions using open-top greenhouse chambers in the field, which increased mean and maximum temperatures, and created a precipitation gradient from ambient levels in the center to extreme drought conditions at the periphery of the chamber. The dry patches near the chamber walls exhibited almost no N-fixation, despite having similar densities of cyanobacteria (predominantly Stigonema sp.) as other patches. Rates of N-fixation were best explained by a model containing moisture, fragmentation, cyanobacteria density and time; warming was not a significant variable affecting N-fixation. There was no significant interaction between warming and fragmentation. These results suggest that cyanobacteria responded physiologically to drought by reducing N-fixation activity long before any changes in density. Ecosystem processes, such as N-fixation, can respond in the short term to environmental change much more rapidly than changes in the underlying community structure. Such rapid physiological responses may occur faster than demographic insurance effects of biodiversity.

  6. Symbiotic Nitrogen Fixation and the Challenges to Its Extension to Nonlegumes

    PubMed Central

    Mus, Florence; Crook, Matthew B.; Garcia, Kevin; Garcia Costas, Amaya; Geddes, Barney A.; Kouri, Evangelia D.; Paramasivan, Ponraj; Ryu, Min-Hyung; Oldroyd, Giles E. D.; Poole, Philip S.; Udvardi, Michael K.; Voigt, Christopher A.

    2016-01-01

    Access to fixed or available forms of nitrogen limits the productivity of crop plants and thus food production. Nitrogenous fertilizer production currently represents a significant expense for the efficient growth of various crops in the developed world. There are significant potential gains to be had from reducing dependence on nitrogenous fertilizers in agriculture in the developed world and in developing countries, and there is significant interest in research on biological nitrogen fixation and prospects for increasing its importance in an agricultural setting. Biological nitrogen fixation is the conversion of atmospheric N2 to NH3, a form that can be used by plants. However, the process is restricted to bacteria and archaea and does not occur in eukaryotes. Symbiotic nitrogen fixation is part of a mutualistic relationship in which plants provide a niche and fixed carbon to bacteria in exchange for fixed nitrogen. This process is restricted mainly to legumes in agricultural systems, and there is considerable interest in exploring whether similar symbioses can be developed in nonlegumes, which produce the bulk of human food. We are at a juncture at which the fundamental understanding of biological nitrogen fixation has matured to a level that we can think about engineering symbiotic relationships using synthetic biology approaches. This minireview highlights the fundamental advances in our understanding of biological nitrogen fixation in the context of a blueprint for expanding symbiotic nitrogen fixation to a greater diversity of crop plants through synthetic biology. PMID:27084023

  7. Shape modifications of porous hydroxyapatite prostheses to improve rigid implant fixation: Experience in 12 cases

    PubMed Central

    Rienzo, Alessandro Di; Iacoangeli, Maurizio; di Somma, Lucia G. M.; Alvaro, Lorenzo; Nocchi, Niccolò; Scerrati, Massimo

    2012-01-01

    Background: Various methods of fixation have been described for custom made hydroxyapatite cranial implants. Their poor malleability limits most of the common used fixation techniques because of the high risk of cranioplasty's fracturing or higher exposure to infections. We present our experience with a new fixation technique, based on an appositely premodified hydroxyapatite implants. Methods: In a 2-year time period, 12 patients underwent cranioplasty by a modified custom made porous hydroxyapatite implant. Once the three-dimensional computer model of the prostheses was performed, three semicircular extensions placed at strategic positions were drawn and the final prosthesis was realized. At surgery, holes fitting the extensions were drilled into the skull borders and the implant was easily embedded inside the defect. Small titanium meshes overlying the extensions were fixed by screws to the surrounding bone. Results: A minimal increase of operative times was recorded, with drilling and fixation requiring additional 30 and 15 minutes, respectively. Optimal contact between cranioplasty and skull borders was always observed at control computed tomography (CT) scans. Permanent rigid fixation was obtained in all cases, with good functional and aesthetic results at follow-up. Conclusions: Modifications of hydroxyapatite implants are obtained without additional costs. The minimal increase of operative times is largely counterbalanced by optimal fixation results. Finally, the bone drilling and the immediate proximity of bone to prosthesis might enhance the potential for osteogenesis and osteointegration. PMID:23372977

  8. Iris fixation of posterior chamber intraocular lenses.

    PubMed

    Yazdani-Abyaneh, Alireza; Djalilian, Ali R; Fard, Masoud Aghsaei

    2016-12-01

    We introduce a technique for iris fixation of a posterior chamber intraocular lens (IOL) in which most of the procedure is done outside the eye. This minimizes intraocular manipulation, maximizes corneal endothelial preservation, and avoids the risk for IOL drop into the vitreous cavity intraoperatively. The IOL is fixated to the most peripheral part of the iris, resulting in a rounder pupil. Sutures are placed at exact positions on the haptics, resulting in a well-centered IOL.

  9. WRIST ARTHRODESIS WITH MINIMAL FIXATION PRESERVING THE CARPOMETACARPAL JOINTS

    PubMed Central

    Pardini, Arlindo Gomes; Pádua Gonçalves, Rodolfo Fonseca; Freitas, Afrânio Donato; Chaves, Antonio Barbosa

    2015-01-01

    Objective: Wrist arthrodesis is a surgical procedure that should always be considered in cases of pathological conditions in which anatomical and functional structures are altered. In general, the results are very satisfactory, particularly for pain relief, and in the majority of cases, there is considerable functional improvement. Various techniques have been described, with different methods of internal fixation, most of which include the carpometacarpal joints in the fusion. The objective of this study was to evaluate the results from wrist arthrodesis using a technique that is simpler, more biological, less expensive, and does not involve the carpometacarpal joints. Methods: Fifteen patients with wrist arthrodesis were evaluated (six with sequelae from trauma, four with rheumatoid arthritis, three with Kienbock grade IV, one with Preiser and one with panarthrosis). The technique consisted of using an iliac bone plate and internal fixation with Kirschner wires, avoiding the carpometacarpal joints. Results: The evaluation was based on consolidation time (93% in seven weeks); movements of the fingers and pronosupination; pinch and grasp strength; functional evaluation through the DASH, pain and patient satisfaction questionnaires. In general, the results were similar to those of other, more aggressive techniques, and the non-inclusion of the carpometacarpal joints did not affect the final result. Conclusion: Wrist arthrodesis with fixation using Kirschner wires and an iliac bone plate, preserving the carpometacarpal joints, gives good or excellent results that are not inferior to those of other techniques that have been described. However, it presents major advantages over other methods: it is less aggressive and cheaper, and does not have the inconvenience and complications associated with the use of plates and screws. PMID:27022522

  10. Arthroscopic-Assisted Fixation of Tibial Plateau Fractures: Patient-Reported Postoperative Activity Levels.

    PubMed

    Kampa, John; Dunlay, Ryan; Sikka, Robby; Swiontkowski, Marc

    2016-05-01

    Tibial plateau fractures may result in significant limitations postoperatively. Studies have described outcomes of arthroscopic-assisted percutaneous fixation (AAPF) of these injuries but have rarely reported postoperative activity levels. Between 2009 and 2013, patients who sustained a lateral split, split depression, or pure depression type tibial plateau fracture (Schatzker types I-III fractures) and underwent outpatient AAPF were eligible for the study. Outcomes were assessed using Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm score, and Marx activity score. Twenty-five consecutive patients were eligible for the study, and 22 (88%) were included in the final analysis, with average follow-up of 2.5 years (range, 1-5.2 years). Thirteen women and 9 men with an average age of 48.3 years (range, 23-65 years) comprised the study population. Average number of screws used for fixation was 2 (range, 1-4). The average depression was 8 mm preoperatively and 0.9 mm (range, 0-3 mm) postoperatively. Four patients (18%) had complications: 2 with hardware removal and 2 with postoperative deep venous thrombosis. Average postoperative Marx activity score was 5.7. Average postoperative KOOS Symptoms, Sports, and Quality of Life scores were 88 (range, 68-100), 85 (range, 45-100), and 77 (range, 50-100), respectively. Average IKDC and Lysholm scores were 81 (range, 55-97) and 87 (range, 54-100), respectively. The AAPF surgical technique, which was performed in an outpatient setting, facilitated excellent postoperative range of motion, outcomes, and activity scores with minimal complications. [Orthopedics. 2016; 39(3):e486-e491.].

  11. Variable Nitrogen Fixation in Wild Populus

    PubMed Central

    Doty, Sharon L.; Sher, Andrew W.; Fleck, Neil D.; Khorasani, Mahsa; Bumgarner, Roger E.; Khan, Zareen; Ko, Andrew W. K.; Kim, Soo-Hyung; DeLuca, Thomas H.

    2016-01-01

    The microbiome of plants is diverse, and like that of animals, is important for overall health and nutrient acquisition. In legumes and actinorhizal plants, a portion of essential nitrogen (N) is obtained through symbiosis with nodule-inhabiting, N2-fixing microorganisms. However, a variety of non-nodulating plant species can also thrive in natural, low-N settings. Some of these species may rely on endophytes, microorganisms that live within plants, to fix N2 gas into usable forms. Here we report the first direct evidence of N2 fixation in the early successional wild tree, Populus trichocarpa, a non-leguminous tree, from its native riparian habitat. In order to measure N2 fixation, surface-sterilized cuttings of wild poplar were assayed using both 15N2 incorporation and the commonly used acetylene reduction assay. The 15N label was incorporated at high levels in a subset of cuttings, suggesting a high level of N-fixation. Similarly, acetylene was reduced to ethylene in some samples. The microbiota of the cuttings was highly variable, both in numbers of cultured bacteria and in genetic diversity. Our results indicated that associative N2-fixation occurred within wild poplar and that a non-uniformity in the distribution of endophytic bacteria may explain the variability in N-fixation activity. These results point to the need for molecular studies to decipher the required microbial consortia and conditions for effective endophytic N2-fixation in trees. PMID:27196608

  12. Nitrogen fixation may enrich phosphorus availability under elevated CO2

    NASA Astrophysics Data System (ADS)

    Houlton, B. Z.; Vitousek, P. M.; Field, C. B.; Michael, A.

    2006-12-01

    The ability of N2 fixers to effectively colonize new terrestrial landscapes has major implications for CO2 uptake, storage, and climate change. As part of the Jasper Ridge Global Change Experiment, we have initiated a manipulation to explore how nutrients, particularly nitrogen N and P, interact with elevated CO2 in controlling rates of N2 fixation and the persistence of symbiotic N2 fixers. Here we report that N2-fixing plants employ an N-rich strategy of P acquisition that enables them to successfully compete for soil P at ambient and elevated CO2 concentrations. Across all treatments (N, P, CO2), the N2 fixer releases large quantities of N-rich phosphatases (organic-P "weathering" enzymes) into the soil, whereas N appears to substantially limit phosphatase production by non-fixers. This investment in phosphatases increases significantly and linearly with biomass N:P ratios, is only slightly affected by elevated CO2, and can explain the very high P contents of N fixing organisms observed. Using a simulation model of C, N, and P cycles to explore this mechanism further, we find that the ability of N fixers to invest N into P liberation can accelerate the P cycle and enrich P availability at the ecosystem level. Consequently, such interactions between N2 fixation and the P cycle may provide a path by which even P-limited terrestrial environments can take up and store additional CO2 in the future. Our findings suggest that P may not represent a constraint on the ability of fixers to colonize new terrestrial environments, though N2 fixation rates are limited by P.

  13. Cervical fixation in the pediatric patient: our experience.

    PubMed

    Crostelli, Marco; Mariani, Massimo; Mazza, Osvaldo; Ascani, Elio

    2009-06-01

    The surgical management of cervical instability in children is a challenging issue. Although the indications for internal fixation are similar to those for adults, accurate pre-surgery study and sharp surgical techniques are necessary because of the size of such patients' anatomy, their peculiar tissue biology and the wide spectrum of diseases requiring cervical fusion. Our case study is made up of 31 patients, 15 male and 16 female, with an average age of 7 years and 6 months (2 years and 6 months to 18 years) who underwent cervical fusion for instability. Their physical condition presented various different pathologies ranging from congenital deformity, systemic skeletal disease, tumors, trauma, post-surgery instability. We performed occipito-cervical fusion in 11 cases, 5 of which involved stabilization at the cranium-vertebral junction. We used instrumentation in 13 cases (3 sublaminar wiring, 10 rigid adult instrumentation). We used rigid adult instrumentation in three patients under 10 years of age, treated by rod, occipital screws and sublaminar hook instrumentation in steel C0-C2 (9-year-old male, affected by os odontoideum in Down's syndrome; male of 7 years and 10 months, affected by os odontoideum in Down's syndrome; female of 4 years and 6 months with occipito-cervical stenosis and C0-C2 instability in Hurler's syndrome). We operated on two patients under 3 years of age, using sublaminar wiring with bone precursors and allograft at level C0-C2 (one of these was a 30-month-old male with post-traumatic instability C0-C2, while the other was a 17-month-old male with C0-C2 instability in Larsen's syndrome). The average follow-up age was 7 years and 1 month (between 1 and 18 years). Cervical fusion was assessed by X-ray examinations at 4th and 12th weeks and at 6th and 12th months after surgery. Where implants could allow, RMN examination was performed at 1st month after surgery. In the other cases, in which implants do not allow RMN to be performed, CT scan

  14. Hinged external fixation for complex fracture-dislocation of the elbow in elderly people.

    PubMed

    Maniscalco, P; Pizzoli, A L; Renzi Brivio, L; Caforio, M

    2014-12-01

    The authors report their experience of treating complex elbow fracture-dislocations in elderly people, using a minimally-invasive approach with a new articulated external fixator that is associated with minimal internal fixation. The clinical results for 19 patients are presented according to outcome factors, such as range of motion, pain and function, rate and type of complications, and reoperation rate. The results indicate that this treatment strategy should be considered as a good alternative to other treatment options reported in the literature, including conservative treatment, ORIF with angular stable plates and total elbow arthroplasty.

  15. Absorbable fixation in forefoot surgery: a viable alternative to metallic hardware.

    PubMed

    Nielson, David L; Young, Nathan J; Zelen, Charles M

    2013-07-01

    After 4 to 8 weeks of normal primary bone healing, rigid internal fixation is no longer required. Newer generation absorbable implants have become reliable and cost-effective alternatives to metallic hardware. Modern implants are formulated to have increased strength and smoother resorption over the course of 18 to 24 months, which decreases the possibility of local inflammation. Historically, bioresorbable screws can be time consuming to insert, but newer devices are being developed that help ease their insertion. A case of a bunionectomy is presented with double osteotomy on a 40-year-old nurse fixated with polyglycolic acid and poly-l-lactic acid copolymer screws.

  16. Minimum exposure limits and measured relationships between the vitamin D, erythema and international commission on non-ionizing radiation protection solar ultraviolet.

    PubMed

    Downs, Nathan; Parisi, Alfio; Butler, Harry; Turner, Joanna; Wainwright, Lisa

    2015-01-01

    The International Commission on Non-Ionizing Radiation Protection (ICNIRP) has established guidelines for exposure to ultraviolet radiation in outdoor occupational settings. Spectrally weighted ICNIRP ultraviolet exposures received by the skin or eye in an 8 h period are limited to 30 J m(-2). In this study, the time required to reach the ICNIRP exposure limit was measured daily in 10 min intervals upon a horizontal plane at a subtropical Australian latitude over a full year and compared with the effective Vitamin D dose received to one-quarter of the available skin surface area for all six Fitzpatrick skin types. The comparison of measured solar ultraviolet exposures for the full range of sky conditions in the 2009 measurement period, including a major September continental dust event, show a clear relationship between the weighted ICNIRP and the effective vitamin D dose. Our results show that the horizontal plane ICNIRP ultraviolet exposure may be used under these conditions to provide minimum guidelines for the healthy moderation of vitamin D, scalable to each of the six Fitzpatrick skin types.

  17. Managing the technological edge: the UNESCO International Computation Centre and the limits to the transfer of computer technology, 1946-61.

    PubMed

    Nofre, David

    2014-07-01

    The spread of the modern computer is assumed to have been a smooth process of technology transfer. This view relies on an assessment of the open circulation of knowledge ensured by the US and British governments in the early post-war years. This article presents new historical evidence that question this view. At the centre of the article lies the ill-fated establishment of the UNESCO International Computation Centre. The project was initially conceived in 1946 to provide advanced computation capabilities to scientists of all nations. It soon became a prize sought by Western European countries like The Netherlands and Italy seeking to speed up their own national research programs. Nonetheless, as the article explains, the US government's limitations on the research function of the future centre resulted in the withdrawal of European support for the project. These limitations illustrate the extent to which US foreign science policy could operate as (stealth) industrial policy to secure a competitive technological advantage and the prospects of US manufacturers in a future European market.

  18. Inverted Internal Limiting Membrane Flap Technique for Repair of Large Macular Holes: A Short-term Follow-up of Anatomical and Functional Outcomes

    PubMed Central

    Chen, Zhe; Zhao, Chan; Ye, Jun-Jie; Wang, Xu-Qian; Sui, Rui-Fang

    2016-01-01

    Background: Inverted internal limiting membrane (ILM) flap technique has recently been reported in a limited number of studies as an effective surgical technique for the management of large macular holes (MHs) with fair MH closure rates as well as gains in visual acuity. In the current study, longitudinal changes in multi-focal electroretinogram (mfERG) responses, best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) were evaluated in eyes with large MHs managed by this technique. Methods: A prospective noncontrolled interventional study of eight patients (eight eyes) with large MHs (minimum diameter >400 μm) was conducted. All MHs were treated with pars plana vitrectomy and indocyanine green-assisted inverted ILM flap technique. SD-OCT images were used to assess the anatomical outcomes of surgery while BCVA and mfERG were used to evaluate the functional outcomes during a 3-month follow-up. Results: All patients underwent successful intended manipulation and translocation of the ILM flap without flap dislocation and achieved complete anatomical closure. Partial microstructural reconstruction, demonstrated on SD-OCT as restoration of the external limiting membrane and the ellipsoid zone, was observed in all cases as early as 1 month after surgery. Functionally, as compared to baseline, all patients showed improvements in BCVA and all but one in mfERG response during follow-up. However, Pearson's test revealed no significant correlations between BCVA and mfERG responses of the fovea and of the macular area at each evaluation time point. Conclusions: Inverted ILM flap technique appeares to be a safe and effective approach for the management of large idiopathic MHs with favorable short-term anatomical and functional results. Postoperative reconstruction of the microstructure generally shows good consistency with improvements in both BCVA and mfERG response, of which the latter might be a supplement for the former in

  19. Biomechanical evaluation of the Pinless external fixator.

    PubMed

    Stene, G M; Frigg, R; Schlegel, U; Swiontkowski, M

    1992-01-01

    In open fractures especially in those with severe soft tissue damage, fracture stabilisation is best achieved by using external fixators. There are some intrinsic complications which occur during classical external pin fixation. To overcome the problem of pin track infection and vascular damage from drilling, the Pinless external fixator was developed. It is based on the idea of a forceps with trocar points, which only penetrate the bone cortex superficially. The function of the device was tested in two mechanical trials and two in vitro tests in which one pinless clamp was put under a controlled load of 50 N, 150 cycles/day and studied over a 5 week period in sheep. The loads and time range of the experiment were chosen to simulate a temporary fracture stabilisation in a patient not bearing weight. The main question to be answered was whether the Pinless external fixator would be able to maintain stable fixation. Furthermore, it was to determine the changes at the trocar-to-bone interface. The clamp was found to maintain 72% of the initially applied clamping force after 5 weeks of in vivo application and it was found to be tight at removal. Some decrease of clamping force was found during the first 20 days and then the force tended to level off. There was no slippage nor did the clamp penetrate the cortex. There were no obvious signs of infection around the trocar-holes and in the bacterial tests no pathological cultures were grown. Histology revealed very localised bone reactions, the indentation caused by the trocar tips being only 1.2 mm deep. The study concludes, as far as could be ascertained from these tests, that it is safe to use pinless external fixation for temporary fracture fixation.

  20. What is the potential for dark CO2 fixation in the facultative crassulacean acid metabolism species Talinum triangulare?

    PubMed

    Herrera, Ana; Ballestrini, Caín; Montes, Enrique

    2015-02-01

    In obligate Crassulacean acid metabolism (CAM) plants, dark CO2 fixation is almost the sole route of CO2 fixation and, under drought, continues for long periods. In contrast, in plants of the facultative CAM species Talinum triangulare under experimental drought, dark CO2 fixation provides a small proportion of the daily assimilation observed in watered plants and occurs only for a few days, after which almost nil CO2 fixation is observed. Under field conditions, with a practically unlimited substrate volume, drought-induced CAM might operate for a longer period and make a higher contribution to daily CO2 fixation. Greenhouse-grown plants of T. triangulare were subjected to low and nearly constant soil water content; the operation of CAM was assessed through the measurement of nocturnal proton accumulation and dark CO2 fixation. Dark CO2 fixation appeared 19d after the onset of drought; its contribution during three months of experiment to daily CO2 assimilation ranged from 0.5 to 30.7% with a mean of 13.5%. Twenty days after the beginning of treatment, nocturnal proton accumulation increased six times and remained high for over three months. In spite of low soil water content, leaves did not engage in dark CO2 fixation all the time but dark CO2 fixation was large enough to produce an increase in relative (13)C composition of mature leaves compared to watered plants but not to the value in short-term drought experiments. Leaf anatomical characteristics may guarantee the achievement of higher rates of dark CO2 fixation but results evidence the occurrence of a limit to the expression of CAM that remains to be determined.

  1. Quantifying nitrogen-fixation in feather moss carpets of boreal forests.

    PubMed

    DeLuca, Thomas H; Zackrisson, Olle; Nilsson, Marie-Charlotte; Sellstedt, Anita

    2002-10-31

    Biological nitrogen (N) fixation is the primary source of N within natural ecosystems, yet the origin of boreal forest N has remained elusive. The boreal forests of Eurasia and North America lack any significant, widespread symbiotic N-fixing plants. With the exception of scattered stands of alder in early primary successional forests, N-fixation in boreal forests is considered to be extremely limited. Nitrogen-fixation in northern European boreal forests has been estimated at only 0.5 kg N ha(-1) yr(-1); however, organic N is accumulated in these ecosystems at a rate of 3 kg N ha(-1) yr(-1) (ref. 8). Our limited understanding of the origin of boreal N is unacceptable given the extent of the boreal forest region, but predictable given our imperfect knowledge of N-fixation. Herein we report on a N-fixing symbiosis between a cyanobacterium (Nostoc sp.) and the ubiquitous feather moss, Pleurozium schreberi (Bird) Mitt. that alone fixes between 1.5 and 2.0 kg N ha(-1) yr(-1) in mid- to late-successional forests of northern Scandinavia and Finland. Previous efforts have probably underestimated N-fixation potential in boreal forests.

  2. Global N2 fixation and its response to global climate change and increasing CO2 level

    NASA Astrophysics Data System (ADS)

    Wang, Y.; Houlton, B. Z.; Field, C. B.; Vitousek, P. M.

    2007-12-01

    Biological nitrogen fixation is the largest nitrogen input to many natural terrestrial ecosystems, particularly tropical ecosystems, thereby influencing primary production, CO2 uptake, and responses to climate change. However, our understanding of biological nitrogen fixation is still very limited, and the dominant plant family capable of fixing N2 symbiotically, the Leguminasae, exhibits considerable geographic variation in the terrestrial biosphere. Based on the principles of resource optimization, we developed a new model to constrain our understanding of the geographic distribution of N fixation globally. Our model treats N fixation according to the C cost of fixing N, coupled with the N cost associated with acquiring P from the soil for plant growth. The model was used to estimate the rate of global symbiotic N2 fixation and the response of symbiotic N2 fixers to changes in climate and rising atmospheric CO2. We shall discuss global N limitation of terrestrial carbon uptake and its implications for climate-carbon cycle feedbacks from present to year 2100.

  3. Revision surgery for nonunion after early failure of fixation of fractures of the distal humerus.

    PubMed

    Ali, A; Douglas, H; Stanley, D

    2005-08-01

    Sixteen patients who underwent a revision operation for nonunion of fractures of the distal humerus following previous internal fixation were reviewed at a mean follow-up of 39 months (8 to 69). The Mayo elbow performance score was excellent in 11, good in two, fair in two and poor in one. In 15 patients union was achieved and in one with an infected nonunion a subsequent bone graft was necessary in order to obtain union.Age, gender, a history of smoking, mechanism of the injury and the AO classification of the initial fracture did not correlate with the development of nonunion. In 12 patients (75%), the initial fixation was assessed as being suboptimal. The primary surgery was regarded as adequate in only three patients. Our findings suggest that the most important determinant of nonunion of a distal humeral fracture after surgery is the adequacy of fixation.

  4. External Fixation Versus Open Reduction With Locked Volar Plating for Geriatric Distal Radius Fractures

    PubMed Central

    Lee, Daniel J.

    2014-01-01

    The optimal management of displaced dorsal radius fractures (DRFs) in older patients remains an issue of debate. Bridging external fixation is a well-accepted treatment modality for severely comminuted DRFs, while open reduction and internal fixation with locked volar plating has emerged as a promising alternative in recent years. The current body of randomized trials supports the trend toward locked volar plating, as it allows for quicker improvement in subjective and functional outcomes. There is no clear evidence to suggest that one technique carries significantly less complications than the other. Locked volar plating should be considered in patients for whom an accelerated functional recovery would be advantageous. Otherwise, both external fixation and locked volar plating provide good long-term clinical outcomes. PMID:25360346

  5. Solar Water Splitting and Nitrogen Fixation with Layered Bismuth Oxyhalides.

    PubMed

    Li, Jie; Li, Hao; Zhan, Guangming; Zhang, Lizhi

    2017-01-17

    Hydrogen and ammonia are the chemical molecules that are vital to Earth's energy, environmental, and biological processes. Hydrogen with renewable, carbon-free, and high combustion-enthalpy hallmarks lays the foundation of next-generation energy source, while ammonia furnishes the building blocks of fertilizers and proteins to sustain the lives of plants and organisms. Such merits fascinate worldwide scientists in developing viable strategies to produce hydrogen and ammonia. Currently, at the forefronts of hydrogen and ammonia syntheses are solar water splitting and nitrogen fixation, because they go beyond the high temperature and pressure requirements of methane stream reforming and Haber-Bosch reaction, respectively, as the commercialized hydrogen and ammonia production routes, and inherit the natural photosynthesis virtues that are green and sustainable and operate at room temperature and atmospheric pressure. The key to propelling such photochemical reactions lies in searching photocatalysts that enable water splitting into hydrogen and nitrogen fixation to make ammonia efficiently. Although the past 40 years have witnessed significant breakthroughs using the most widely studied TiO2, SrTiO3, (Ga1-xZnx)(N1-xOx), CdS, and g-C3N4 for solar chemical synthesis, two crucial yet still unsolved issues challenge their further progress toward robust solar water splitting and nitrogen fixation, including the inefficient steering of electron transportation from the bulk to the surface and the difficulty of activating the N≡N triple bond of N2. This Account details our endeavors that leverage layered bismuth oxyhalides as photocatalysts for efficient solar water splitting and nitrogen fixation, with a focus on addressing the above two problems. We first demonstrate that the layered structures of bismuth oxyhalides can stimulate an internal electric field (IEF) that is capable of efficiently separating electrons and holes after their formation and of precisely channeling

  6. Posterior Fixation Techniques in the Subaxial Cervical Spine

    PubMed Central

    Ghori, Ahmer; Makanji, Heeren; Cha, Thomas

    2015-01-01

    This article reviews the historical context, indications, techniques, and complications of four posterior fixation techniques to stabilize the subaxial cervical spine. Specifically, posterior wiring, laminar screw fixation, lateral mass fixation, and pedicle screw fixation are among the common methods of operative fixation of the subaxial cervical spine. While wiring and laminar screw fixation are now rarely used, both lateral mass and pedicle screw fixation are technically challenging and present the risk of significant complications if performed incorrectly. With a sound understanding of anatomy and rigorous preoperative evaluation of bony structures, both lateral mass and pedicle screw fixation provide a safe and reliable method for subaxial cervical spine fixation. PMID:26594602

  7. Application of alternative fixatives to formalin in diagnostic pathology.

    PubMed

    Benerini Gatta, L; Cadei, M; Balzarini, P; Castriciano, S; Paroni, R; Verzeletti, A; Cortellini, V; De Ferrari, F; Grigolato, P

    2012-05-04

    Fixation is a critical step in the preparation of tissues for histopathology. The objective of this study was to investigate the effects of different fixatives vs formalin on proteins and DNA, and to evaluate alternative fixation for morphological diagnosis and nucleic acid preservation for molecular methods. Forty tissues were fixed for 24 h with six different fixatives: the gold standard fixative formalin, the historical fixatives Bouin and Hollande, and the alternative fixatives Greenfix, UPM and CyMol. Tissues were stained (Haematoxylin-Eosin, Periodic Acid Schiff, Trichromic, Alcian-blue, High Iron Diamine), and their antigenicity was determined by immunohistochemistry (performed with PAN-CK, CD31, Ki-67, S100, CD68, AML antibodies). DNA extraction, KRAS sequencing, FISH for CEP-17, and flow cytometry analysis of nuclear DNA content were applied. For cell morphology the alternative fixatives (Greenfix, UPM, CyMol) were equivalent to formalin. As expected, Hollande proved the best fixative for morphology. The morphology obtained with Bouin was comparable to that with formalin. Hollande was the best fixative for histochemistry. Bouin proved equivalent to formalin. The alternative fixatives were equivalent to formalin, although with greater variability in haematoxylin-eosin staining. It proved possible to obtain immunohistochemical staining largely equivalent to that following formalin-fixation with the following fixatives: Greenfix, Hollande, UPM and CyMol. The tissues fixed in Bouin did not provide results comparable to those obtained with formalin. The DNA extracted from samples fixed with alternative fixatives was found to be suitable for molecular analysis.

  8. The fixation and saccade P3.

    PubMed

    Dandekar, Sangita; Ding, Jian; Privitera, Claudio; Carney, Thom; Klein, Stanley A

    2012-01-01

    Although most instances of object recognition during natural viewing occur in the presence of saccades, the neural correlates of objection recognition have almost exclusively been examined during fixation. Recent studies have indicated that there are post-saccadic modulations of neural activity immediately following eye movement landing; however, whether post-saccadic modulations affect relatively late occurring cognitive components such as the P3 has not been explored. The P3 as conventionally measured at fixation is commonly used in brain computer interfaces, hence characterizing the post-saccadic P3 could aid in the development of improved brain computer interfaces that allow for eye movements. In this study, the P3 observed after saccadic landing was compared to the P3 measured at fixation. No significant differences in P3 start time, temporal persistence, or amplitude were found between fixation and saccade trials. Importantly, sensory neural responses canceled in the target minus distracter comparisons used to identify the P3. Our results indicate that relatively late occurring cognitive neural components such as the P3 are likely less sensitive to post saccadic modulations than sensory neural components and other neural activity occurring shortly after eye movement landing. Furthermore, due to the similarity of the fixation and saccade P3, we conclude that the P3 following saccadic landing could possibly be used as a viable signal in brain computer interfaces allowing for eye movements.

  9. Control and Functions of Fixational Eye Movements

    PubMed Central

    Rucci, Michele; Poletti, Martina

    2016-01-01

    Humans and other species explore a visual scene by rapidly shifting their gaze 2-3 times every second. Although the eyes may appear immobile in the brief intervals in between saccades, microscopic (fixational) eye movements are always present, even when attending to a single point. These movements occur during the very periods in which visual information is acquired and processed and their functions have long been debated. Recent technical advances in controlling retinal stimulation during normal oculomotor activity have shed new light on the visual contributions of fixational eye movements and their degree of control. The emerging body of evidence, reviewed in this article, indicates that fixational eye movements are important components of the strategy by which the visual system processes fine spatial details, enabling both precise positioning of the stimulus on the retina and encoding of spatial information into the joint space-time domain. PMID:27795997

  10. Biometric recognition via fixation density maps

    NASA Astrophysics Data System (ADS)

    Rigas, Ioannis; Komogortsev, Oleg V.

    2014-05-01

    This work introduces and evaluates a novel eye movement-driven biometric approach that employs eye fixation density maps for person identification. The proposed feature offers a dynamic representation of the biometric identity, storing rich information regarding the behavioral and physical eye movement characteristics of the individuals. The innate ability of fixation density maps to capture the spatial layout of the eye movements in conjunction with their probabilistic nature makes them a particularly suitable option as an eye movement biometrical trait in cases when free-viewing stimuli is presented. In order to demonstrate the effectiveness of the proposed approach, the method is evaluated on three different datasets containing a wide gamut of stimuli types, such as static images, video and text segments. The obtained results indicate a minimum EER (Equal Error Rate) of 18.3 %, revealing the perspectives on the utilization of fixation density maps as an enhancing biometrical cue during identification scenarios in dynamic visual environments.

  11. Setting maximum limits for trace elements in baby food in European legislation: the outcome of International Measurement Evaluation Programme®-33.

    PubMed

    Cordeiro, F; Baer, I; Robouch, P; Emteborg, H; Can, S Z; Krata, A; Zampella, M; Quétel, C R; Hearn, R; De la Calle, B

    2013-01-01

    The Institute for Reference Materials and Measurements (IRMM) of the Joint Research Centre (JRC), a Directorate-General of the European Commission, operates the International Measurement Evaluation Programme® (IMEP). It organises various types of inter-laboratory comparisons in support of European Union policies. This paper presents the results of a proficiency testing exercise (PT) focusing on the determination of total cadmium (Cd) and total lead (Pb) mass fractions in baby food in support to Commission Regulation (EC) 1881/2006 of 19 December 2006 setting maximum levels for certain contaminants in foodstuffs. The test material used in this exercise was soya-based baby food formula purchased in a local pharmacy and prepared by the Reference Materials Unit of the IRMM for this exercise. Sixty-six laboratories from 23 countries registered to the exercise and 61 of them reported results. Each participant received one bottle containing approximately 15 g of test material. Participants were asked to quantify the measurands in the powder and in the reconstituted formula. Reference values independent from the participants' results were established using isotope dilution inductively coupled plasma mass spectrometry. The total Cd mass fraction was determined by IRMM and LGC Ltd (UK), while the total Pb was determined by IRMM. The standard deviation for proficiency assessment σ^ was set at 22% of the assigned value for all measurands. Laboratories were rated with z- and ζ- (zeta) scores in accordance with ISO 13528. The outcome of this exercise is clearly influenced by the very low level of Cd and Pb content in the test material which triggered: a high number of 'less than' values; overestimated values especially for Pb very likely due to contamination; and a visible method influence in the case of Pb (methods based on atomic absorption were not sensitive enough to attain such low limits of detection). The results were also evaluated with regard to the reported limit of

  12. Internal Limiting Membrane Flap Techniques for the Repair of Large Macular Holes: a Short-Term Follow-up of Anatomical and Functional Outcomes.

    PubMed

    Guber, J; Lang, C; Valmaggia, C

    2017-02-01

    Background To evaluate the technique of inverted internal limiting membrane (ILM) flaps for the management of large macular holes and autologous ILM free flaps for non-closing macular holes. Patients and methods All macular holes were treated with pars plana vitrectomy and dual blue assisted ILM flap technique. The inverted ILM flap was created as a primary procedure for large macular holes (diameter > 400 µm). On the other hand, the free ILM flap technique was used as a secondary procedure for non-closing macular holes after failed initial standard procedure. SD-OCT images were taken to assess the anatomical outcome of surgery, while best corrected visual acuity (BCVA) was used to evaluate the functional outcome during a 2-month follow-up. Results All patients underwent successful planned manipulation of the ILM flap. In seven patients/eyes, an inverted ILM flap was created, in three patients/eyes a free ILM flap translocation was performed. All patients achieved complete anatomical closure. Partial microstructural reconstruction, demonstrated on SD-OCT as restoration of the external limiting membrane and the ellipsoid zone, was observed in some cases as early as one month after surgery. Functionally, in comparison to baseline, most of the patients showed improvements in BCVA of 1 to 2 lines at the first postoperative follow-up visit. Conclusions Inverted ILM flaps for large macular holes and free flaps for non-closing macular holes appear to be a safe and effective approach, with favourable short-term anatomical and functional results.

  13. The Impact of Type of Examples on Originality: Explaining Fixation and Stimulation Effects

    ERIC Educational Resources Information Center

    Agogué, Marine; Kazakçi, Akin; Hatchuel, Armand; Le Masson, Pascal; Weil, Benoit; Poirel, Nicolas; Cassotti, Mathieu

    2014-01-01

    There are obstacles to creativity: one of them is called fixation effect, the fact that some knowledge about existing or obvious solutions is spontaneously activated and constrains the generation of new solutions. Converging evidence in cognitive psychology has indicated that the ability to generate original ideas can be limited by recently…

  14. Evaluation of kidney bean yield and nitrogen fixation under low soil nitrogen

    Technology Transfer Automated Retrieval System (TEKTRAN)

    U.S. Kidney bean cultivars as a group have limited genetic diversity. They also require more intensive crop management than most other bean market classes. The objective of this study was to evaluate biological nitrogen fixation and seed yield in a diverse group of kidney lines. A 250 line Andean be...

  15. Association of nitrogen fixation to water use efficiency and yield traits of peanut

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Improvement of N2 fixation might be an effective strategy in peanut breeding for high yield under drought stress conditions. However, under water limited conditions peanut varieties having high water-use efficiency (WUE) are favorable. A pot experiment was conducted under greenhouse conditions at ...

  16. Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures

    PubMed Central

    Gali, Rajasekhar; Devireddy, Sathya Kumar; Venkata, Kishore Kumar Rayadurgam; Kanubaddy, Sridhar Reddy; Nemaly, Chaithanyaa; Dasari, Mallikarjuna

    2016-01-01

    Introduction: Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications. Purpose: This retrospective clinical case record study was done to evaluate the preauricular transmasseteric anteroparotid (P-TMAP) approach for open reduction and extracorporeal fixation of displaced and dislocated high condylar fractures of the mandible. Patients and Methods: This retrospective study involved search of clinical case records of seven patients with displaced and dislocated high condylar fractures treated by open reduction and extracorporeal fixation over a 3-year period. The parameters assessed were as follows: a) the ease of access for retrieval, reimplantation and fixation of the proximal segment; b) the postoperative approach related complications; c) the adequacy of anatomical reduction and stability of fixation; d) the occlusal changes; and the e) TMJ function and radiological changes. Results: Accessibility and visibility were good. Accurate anatomical reduction and fixation were achieved in all the patients. The recorded complications were minimal and transient. Facial nerve (buccal branch) palsy was noted in one patient with spontaneous resolution within 3 months. No cases of sialocele or Frey's syndrome were seen. Conclusion: The P-TMAP approach provides good access for open reduction and extracorporeal fixation of severely displaced condylar fractures. It facilitates retrieval, transplantation, repositioning, fixing the condyle and also reduces the chances of requirement of a vertical ramus osteotomy. It gives straight-line access to condylar head and ramus thereby permitting

  17. Symbiosis revisited: phosphorus and acid buffering stimulate N2 fixation but not Sphagnum growth

    NASA Astrophysics Data System (ADS)

    van den Elzen, Eva; Kox, Martine A. R.; Harpenslager, Sarah F.; Hensgens, Geert; Fritz, Christian; Jetten, Mike S. M.; Ettwig, Katharina F.; Lamers, Leon P. M.

    2017-03-01

    In pristine Sphagnum-dominated peatlands, (di)nitrogen (N2) fixing (diazotrophic) microbial communities associated with Sphagnum mosses contribute substantially to the total nitrogen input, increasing carbon sequestration. The rates of symbiotic nitrogen fixation reported for Sphagnum peatlands, are, however, highly variable, and experimental work on regulating factors that can mechanistically explain this variation is largely lacking. For two common fen species (Sphagnum palustre and S. squarrosum) from a high nitrogen deposition area (25 kg N ha-1 yr-1), we found that diazotrophic activity (as measured by 15 - 15N2 labeling) was still present at a rate of 40 nmol N gDW-1 h-1. This was surprising, given that nitrogen fixation is a costly process. We tested the effects of phosphorus availability and buffering capacity by bicarbonate-rich water, mimicking a field situation in fens with stronger groundwater or surface water influence, as potential regulators of nitrogen fixation rates and Sphagnum performance. We expected that the addition of phosphorus, being a limiting nutrient, would stimulate both diazotrophic activity and Sphagnum growth. We indeed found that nitrogen fixation rates were doubled. Plant performance, in contrast, did not increase. Raised bicarbonate levels also enhanced nitrogen fixation, but had a strong negative impact on Sphagnum performance. These results explain the higher nitrogen fixation rates reported for minerotrophic and more nutrient-rich peatlands. In addition, nitrogen fixation was found to strongly depend on light, with rates 10 times higher in light conditions suggesting high reliance on phototrophic organisms for carbon. The contrasting effects of phosphorus and bicarbonate on Sphagnum spp. and their diazotrophic communities reveal strong differences in the optimal niche for both partners with respect to conditions and resources. This suggests a trade-off for the symbiosis of nitrogen fixing microorganisms with their Sphagnum

  18. Dinitrogen fixation associated with shoots of aquatic carnivorous plants: is it ecologically important?

    PubMed Central

    Sirová, Dagmara; Šantrůček, Jiří; Adamec, Lubomír; Bárta, Jiří; Borovec, Jakub; Pech, Jiří; Owens, Sarah M.; Šantrůčková, Hana; Schäufele, Rudi; Štorchová, Helena; Vrba, Jaroslav

    2014-01-01

    Background and Aims Rootless carnivorous plants of the genus Utricularia are important components of many standing waters worldwide, as well as suitable model organisms for studying plant–microbe interactions. In this study, an investigation was made of the importance of microbial dinitrogen (N2) fixation in the N acquisition of four aquatic Utricularia species and another aquatic carnivorous plant, Aldrovanda vesiculosa. Methods 16S rRNA amplicon sequencing was used to assess the presence of micro-organisms with known ability to fix N2. Next-generation sequencing provided information on the expression of N2 fixation-associated genes. N2 fixation rates were measured following 15N2-labelling and were used to calculate the plant assimilation rate of microbially fixed N2. Key Results Utricularia traps were confirmed as primary sites of N2 fixation, with up to 16 % of the plant-associated microbial community consisting of bacteria capable of fixing N2. Of these, rhizobia were the most abundant group. Nitrogen fixation rates increased with increasing shoot age, but never exceeded 1·3 μmol N g–1 d. mass d–1. Plant assimilation rates of fixed N2 were detectable and significant, but this fraction formed less than 1 % of daily plant N gain. Although trap fluid provides conditions favourable for microbial N2 fixation, levels of nif gene transcription comprised <0·01 % of the total prokaryotic transcripts. Conclusions It is hypothesized that the reason for limited N2 fixation in aquatic Utricularia, despite the large potential capacity, is the high concentration of NH4-N (2·0–4·3 mg L–1) in the trap fluid. Resulting from fast turnover of organic detritus, it probably inhibits N2 fixation in most of the microorganisms present. Nitrogen fixation is not expected to contribute significantly to N nutrition of aquatic carnivorous plants under their typical growth conditions; however, on an annual basis the plant–microbe system can supply nitrogen in the order of

  19. The importance of regulation of nitrogen fixation

    NASA Astrophysics Data System (ADS)

    Menge, D. N.

    2012-12-01

    from systematic forest inventory data can be explained by a concomitant switch from predominantly facultative N-fixing trees to predominantly obligate N-fixing trees. This transition in the dominant N-fixing strategy would have important consequences for the rate at which CO2 fertilization can occur and the extent of N surplus in different biomes. These theoretical and forest inventory results suggest that greater knowledge of BNF strategies would greatly increase our understanding of the distribution of N fixers and ecosystem responses to global change. I will finish the talk with a brief literature synthesis that attempts to draw generalizations about BNF strategies. With the limited data available, actinorhizal symbioses in temperate environments appear to be obligate but rhizobial symbioses appear to employ different strategies in different environments. From these results it is unclear whether the strategy is more strongly influenced by the microbes, the plants, or the environments in which the symbiosis has evolved; answering this question would point toward the best ways to incorporate N fixation into global ecosystem models.

  20. Arthroscopically assisted percutaneous fixation of Bennett fractures.

    PubMed

    Culp, Randall W; Johnson, Jeff W

    2010-01-01

    Arthroscopic-assisted reduction and fixation of Bennett-type fractures of the thumb metacarpal allow for the confirmation of reduction as well as the assessment of the degree of chondral damage. With use of a 1.9-mm arthroscope and a traction tower, direct visualization and reduction is possible. Traditional methods of fixation are used to secure the fracture fragment. Postoperative rehabilitation follows the usual protocol used in both open and percutaneous techniques. However, the potential to obtain and confirm a more accurate articular reduction may reduce the incidence of late arthritis of the thumb carpometacarpal articulation.

  1. Analysis of operational, institutional and international limitations for alternative fuel vehicles and technologies: Means/methods for implementing changes. [Public fleet groups--information needs

    SciTech Connect

    Not Available

    1992-07-01

    This project focused upon the development of an approach to assist public fleet managers in evaluating the characteristics and availability of alternative fuels (AF's) and alternative fuel vehicles (AFV's) that will serve as possible replacements for vehicles currently serving the needs of various public entities. Also of concern were the institutional/international limitations for alternative fuels and alternative fuel vehicles. The City of Detroit and other public agencies in the Detroit area were the particular focus for the activities. As the development and initial stages of use of alternative fuels and alternative fuel vehicles proceeds, there will be an increasing need to provide information and guidance to decision-makers regarding differences in requirements and features of these fuels and vehicles. There wig be true differences in requirements for servicing, managing, and regulating. There will also be misunderstanding and misperception. There have been volumes of data collected on AFV'S, and as technology is improved, new data is constantly added. There are not, however, condensed and effective sources of information for public vehicle fleet managers on vehicle and equipment sources, characteristics, performance, costs, and environmental benefits. While theoretical modeling of public fleet requirements has been done, there do not seem to be readily available practical''. There is a need to provide the best possible information and means to minimize the problems for introducing the effective use of alternative fuels and alternative fuel vehicles.

  2. Macular Hole Surgery with Internal Limiting Membrane Peeling Facilitated by Membrane-Blue® versus Membrane-Blue-Dual®: A Retrospective Comparative Study

    PubMed Central

    Shai, Daniel; Loewenstein, Anat

    2016-01-01

    Background. This study aims to compare the outcome of macular hole (MH) surgery with internal limiting membrane (ILM) peeling facilitated by two different vital dyes. Methods. This was a retrospective chart review. The group designated “group-MB” underwent pars plana vitrectomy with ILM peeling facilitated by Membrane-Blue (MB), whereas in “group-MBD,” the vital dye used was Membrane-Blue-Dual (MBD). Results. Seventy-four eyes comprised the study population: 53 in group-MB and 21 in group-MBD. There was no difference in the rate of macular hole closure in group-MB or group-MBD: 71.2% closed MHs compared to 66.7%, respectively (p = 0.7). Postoperative visual improvement was of a higher magnitude in the MBD group compared to the MB group: −0.34 ± 0.81 logMAR versus 0.01 ± 0.06 logMAR, respectively (p = 0.003). Conclusions. In this study, MBD led to better visual results that may be related to better staining characteristics or lesser toxicity compared to MB. PMID:28050275

  3. Successful closure of treatment-naïve, flat edge (Type II), full-thickness macular hole using inverted internal limiting membrane flap technique

    PubMed Central

    Hussain, Nazimul; Hussain, Anjli

    2016-01-01

    Objective The objective of this study was to present the outcome of the internal limiting membrane (ILM) peeling flap technique for a treatment-naïve, flat edge (Type II), full-thickness macular hole (MH). Methods A 52-year-old man presented with complaints of decreased vision and seeing black spot. He was diagnosed to have a flat edge, full-thickness MH, which was confirmed by optical coherence tomography (OCT). He underwent 23G vitrectomy with brilliant blue G-assisted inverted ILM peeling with an inverted flap over the hole followed by fluid gas exchange. Results Postoperative follow-up until 3 months showed successful closure of the MH, which was confirmed by OCT. The best-corrected visual acuity improved from baseline 6/60 to 6/12 at the final follow-up. Conclusion Using the inverted ILM flap technique, a treatment-naïve, flat edge (Type II), full thickness MH achieved successful anatomical and functional outcomes. PMID:27785110

  4. The "medio-latero-superior trajectory technique": an alternative cortical trajectory for pedicle fixation.

    PubMed

    Mobbs, Ralph J

    2013-02-01

    An alternative pedicle trajectory for use at the superior end of a construct to limit dissection of the mobile superior facet joint and reduce incision length and muscle dissection, thus minimizing approach-related trauma during pedicle fixation, is reported. The medio-latero-superior trajectory technique involves a starting point on the medial aspect of the pars and angulation of the pedicle screw in a mediolateral and caudocranial direction. This approach takes advantage of a predominantly cortical trajectory to assist with bone fixation. Drawbacks of this new screw trajectory are discussed along with its potential benefits.

  5. The role of ring external fixation in Charcot foot arthropathy.

    PubMed

    Pinzur, Michael S

    2006-12-01

    domain of practicing orthopedic surgeon. Once that correction has been achieved, this application simply maintains that correction. It helps avoid extensive surgical dissection in a poor host and eliminates the need for bone that is mechanically capable of holding internal fixation devices during the bony and soft tissue healing period.

  6. Arthrodesis with external fixation in the unstable or misaligned Charcot ankle in patients with diabetes mellitus.

    PubMed

    Fabrin, Jesper; Larsen, Kirsten; Holstein, Per E

    2007-06-01

    The unstable or misaligned Charcot ankle with or without chronic foot ulceration is a major clinical challenge. When it cannot be accommodated with an ankle foot orthosis, surgical treatment is indicated in order to avoid leg amputation. This requires extensive soft tissue release and bony resection to realign the foot and arthrodesis with internal or external fixation. The guidance in the literature favors internal fixation. This article reports results with external fixation in 11 patients (12 feet) over a period of 12 years. External fixation was chosen as the surgical option because of the presence of foot ulcers with the attendent risk of infection. There were 7 tibio-talar and 5 tibio-calcaneal fusions. Compression was applied for 6 weeks with an external frame according to Charnley, followed by 6 weeks with total-contact cast. Weight bearing with a rigid leather brace was allowed after 12 weeks. In one case, transtibial amputation was required due to loosening of the distal pins from osteopenic disintegrating bone. In 11 cases (92%), the foot was successfully realigned and independent walking with a brace retained during the follow-up of median 48 months (10-102 months). Bony union took place in 5 out of 7 cases with tibio-talar fusion and in 1 out of 5 with tibio-calcaneal fusion. The functional result in cases with fibrous union was, however, satisfactory. Although meaningful comparisons of series are difficult to conduct and interpret from, the limb salvage rate was similar to results with internal fixation. The authors consider the results to be encouraging and to be used to develop a higher level of evidence.

  7. Posterior fixation suture and convergence excess esotropia.

    PubMed

    Steffen; Auffarth; Kolling

    1998-09-01

    The present study investigates the results of Cuppers' 'Fadenoperation' in patients with non-accommodative convergence excess esotropia. Particular attention is given to postoperative eye alignment at distance fixation. Group 1 (n=96) included patients with a 'normal' convergence excess. The manifest near angles (mean ET 16.73 degrees +/- 6.33 degrees, range 4 degrees -33 degrees ) were roughly twice the size of the distance angles (mean ET 6.50 degrees +/- 3.62 degrees, range 0 degrees -14 degrees ). These patients were treated with a bilateral fadenoperation of the medial recti without additional eye muscle surgery. Three months after surgery, the mean postoperative angles were XT 0.5 degrees +/- 3.3 degrees (range XT 11 degrees -ET 5 degrees ) for distance fixation, and ET 2.7 degrees +/- 3.6 degrees (range XT 5 degrees -ET 14 degrees ) for near fixation, respectively. Postoperative convergent angles at near fixation >ET 10 degrees were present in two patients (1.9%). Group 2 (n=21) included patients with a mean preoperative distance angle of ET 9.2 degrees +/- 3.7 degrees (range 6 degrees -16 degrees ) and a mean preoperative near angle of ET 23.4 degrees +/- 3.1 degrees (range 16 degrees -31 degrees ). These patients were operated on with a bilateral fadenoperation of the medial recti and a simultaneous recession of one or both medial rectus muscles. Mean postoperative angles were XT 0.5 degrees +/- 4.6 degrees (range XT 12 degrees -ET 7 degrees ) for distance fixation and ET 1.4 degrees +/- 4.5 degrees (range XT 8 degrees -ET 13 degrees ) for near fixation, respectively. In this group, 2 patients (10.6%) had a postoperative exotropia >XT 5 degrees at distance fixation, and two patients had residual esotropia>ET 10 degrees at near fixation. Group 3 (n=17) included patients with a pronounced non-accommodative convergence excess. Near angle values (mean of 17.8 degrees +/- 5.3 degrees, range ET 7 degrees -26 degrees ) were several times higher than the distance

  8. The influence of phosphorus deficiency on growth and nitrogen fixation of white clover plants.

    PubMed

    Høgh-Jensen, Henning; Schjoerring, JanK; Soussana, Jean-Francois

    2002-12-01

    The effects of P deficiency on growth, N(2)-fixation and photosynthesis in white clover (Trifolium repens L.) plants were investigated using three contrasting relative addition rates of P, or following abrupt withdrawal of the P supply. Responses to a constant below-optimum P supply rate consisted of a decline in N(2)-fixation per unit root weight and a small reduction in the efficiency with which electrons were allocated to the reduction of N(2) in nodules. Abrupt removal of P arrested nodule growth and caused a substantial decline in nitrogenase activity per unit root weight, but not per unit nodule mass. Similarly, the rate of photosynthesis per unit leaf area was unaffected by abrupt P removal, whereas CO(2) acquisition for the plant as a whole decreased due to a decline in total leaf area, leaf area per unit leaf weight and utilization of incoming radiation. These changes followed the decline in tissue P concentrations. The ratio between CO(2)-fixation and N(2)-fixation was maintained under short-term P deprivation but increased under long-term low P supply, indicating a regulatory inhibition of nodule activity following morphological and growth adjustments. It is concluded that N(2)-fixation did not limit the growth of clover plants experiencing P deficiency. A low P status induced changes in the relative growth of roots, nodules and shoots rather than changes in N and/or C uptake rates per unit mass or area of these organs.

  9. Understanding mechanisms and factors related to implant fixation; a model study of removal torque.

    PubMed

    Stenlund, Patrik; Murase, Kohei; Stålhandske, Christina; Lausmaa, Jukka; Palmquist, Anders

    2014-06-01

    Osseointegration is a prerequisite for achieving a stable long-term fixation and load-bearing capacity of bone anchored implants. Removal torque measurements are often used experimentally to evaluate the fixation of osseointegrated screw-shaped implants. However, a detailed understanding of the way different factors influence the result of removal torque measurements is lacking. The present study aims to identify the main factors contributing to anchorage. Individual factors important for implant fixation were identified using a model system with an experimental design in which cylindrical or screw-shaped samples were embedded in thermosetting polymers, in order to eliminate biological variation. Within the limits of the present study, it is concluded that surface topography and the mechanical properties of the medium surrounding the implant affect the maximum removal torque. In addition to displaying effects individually, these factors demonstrate interplay between them. The rotational speed was found not to influence the removal torque measurements within the investigated range.

  10. From prevention of pin-tract infection to treatment of osteomyelitis during paediatric external fixation.

    PubMed

    Ceroni, Dimitri; Grumetz, Catherine; Desvachez, Odile; Pusateri, Sophie; Dunand, Pierre; Samara, Eleftheria

    2016-12-01

    Pin-tract infection (PTI) is the most commonly expected problem, or even an almost inevitable complication, when using external fixation. Left unteated, PTI will progress unavoidably, lead to mechanical pin loosening, and ultimately cause instability of the external fixator pin-bone construct. Thus, PTI remains a clinical challenge, specifically in cases of limb lengthening or deformity correction. Standardised pin site protocols which encompass an understanding of external fixator biomechanics and meticulous surgical technique during pin and wire insertion, postoperative pin site care and pin removal could limit the incidence of major infections and treatment failures. Here we discuss concepts regarding the epidemiology, physiopathology and microbiology of PTI in paediatric populations, as well as the clinical presentations, diagnosis, classification and treatment of these infections.

  11. Chemosynthetic symbionts of marine invertebrate animals are capable of nitrogen fixation.

    PubMed

    Petersen, Jillian M; Kemper, Anna; Gruber-Vodicka, Harald; Cardini, Ulisse; van der Geest, Matthijs; Kleiner, Manuel; Bulgheresi, Silvia; Mußmann, Marc; Herbold, Craig; Seah, Brandon K B; Antony, Chakkiath Paul; Liu, Dan; Belitz, Alexandra; Weber, Miriam

    2016-10-24

    Chemosynthetic symbioses are partnerships between invertebrate animals and chemosynthetic bacteria. The latter are the primary producers, providing most of the organic carbon needed for the animal host's nutrition. We sequenced genomes of the chemosynthetic symbionts from the lucinid bivalve Loripes lucinalis and the stilbonematid nematode Laxus oneistus. The symbionts of both host species encoded nitrogen fixation genes. This is remarkable as no marine chemosynthetic symbiont was previously known to be capable of nitrogen fixation. We detected nitrogenase expression by the symbionts of lucinid clams at the transcriptomic and proteomic level. Mean stable nitrogen isotope values of Loripes lucinalis were within the range expected for fixed atmospheric nitrogen, further suggesting active nitrogen fixation by the symbionts. The ability to fix nitrogen may be widespread among chemosynthetic symbioses in oligotrophic habitats, where nitrogen availability often limits primary productivity.

  12. Individualized 3D printing navigation template for pedicle screw fixation in upper cervical spine

    PubMed Central

    Guo, Fei; Dai, Jianhao; Zhang, Junxiang; Ma, Yichuan; Zhu, Guanghui; Shen, Junjie; Niu, Guoqi

    2017-01-01

    Purpose Pedicle screw fixation in the upper cervical spine is a difficult and high-risk procedure. The screw is difficult to place rapidly and accurately, and can lead to serious injury of spinal cord or vertebral artery. The aim of this study was to design an individualized 3D printing navigation template for pedicle screw fixation in the upper cervical spine. Methods Using CT thin slices data, we employed computer software to design the navigation template for pedicle screw fixation in the upper cervical spine (atlas and axis). The upper cervical spine models and navigation templates were produced by 3D printer with equal proportion, two sets for each case. In one set (Test group), pedicle screws fixation were guided by the navigation template; in the second set (Control group), the screws were fixed under fluoroscopy. According to the degree of pedicle cortex perforation and whether the screw needed to be refitted, the fixation effects were divided into 3 types: Type I, screw is fully located within the vertebral pedicle; Type II, degree of pedicle cortex perforation is <1 mm, but with good internal fixation stability and no need to renovate; Type III, degree of pedicle cortex perforation is >1 mm or with the poor internal fixation stability and in need of renovation. Type I and Type II were acceptable placements; Type III placements were unacceptable. Results A total of 19 upper cervical spine and 19 navigation templates were printed, and 37 pedicle screws were fixed in each group. Type I screw-placements in the test group totaled 32; Type II totaled 3; and Type III totaled 2; with an acceptable rate of 94.60%. Type I screw placements in the control group totaled 23; Type II totaled 3; and Type III totaled 11, with an acceptable rate of 70.27%. The acceptability rate in test group was higher than the rate in control group. The operation time and fluoroscopic frequency for each screw were decreased, compared with control group. Conclusion The individualized 3D

  13. High potential of nitrogen fixation in pristine, ombrotrophic bogs in Southern Patagonia

    NASA Astrophysics Data System (ADS)

    Knorr, Klaus-Holger; Horn, Marcus A.; Bahamonde Aguilar, Nelson A.; Borken, Werner

    2015-04-01

    Nitrogen (N) input in pristine peatlands occurs via natural input of inorganic N through atmospheric deposition or biological dinitrogen (N2) fixation. However, N2 fixation is to date mostly attributed to bacteria and algae associated to Sphagnum and its contribution to plant productivity and peat buildup has been often underestimated in previous studies. Based on net N storage, exceptionally low N deposition, and high abundance of vascular plants at pristine peatlands in Southern Patagonia, we hypothesized that there must be a high potential of non-symbiotic N2 fixation not limited to the occurrence of Sphagnum. To this end, we chose two ombrotrophic bogs with spots that are dominated either by Sphagnum or by vascular, cushion-forming plants and sampled peat from different depths for incubation with 15N2 to determine N2 fixation potentials. Moreover, we analyzed 15N2 fixation by a nodule-forming, endemic conifer inhabiting the peatlands. Results from 15N2 uptake were compared to the conventional approach to study N2 fixation by the acetylene reduction assay (ARA). Using 15N2 as a tracer, high non-symbiotic N2 fixation rates of 0.3-1.4 μmol N g-1 d-1 were found down to 50 cm under micro-oxic conditions (2 vol.%) in samples from both plots either covered by Sphagnum magellanicum or by vascular cushion plants. Peat N concentrations suggested a higher potential of non-symbiotic N2 fixation under cushion plants, likely because of the availability of easily decomposable organic compounds as substrates and oxic conditions in the rhizosphere. In the Sphagnum plots, high N2 fixation below 10 cm depth would rather reflect a potential fixation that may switch on during periods of low water levels when oxygen penetrates deeper into the peat. 15N natural abundance of live Sphagnum from 0-10 cm pointed to N uptake solely from atmospheric deposition and non-symbiotic N2 fixation. 15N signatures of peat from the cushion plant plots indicated additional N supply from N

  14. Mechanical design optimization of bioabsorbable fixation devices for bone fractures.

    PubMed

    Lovald, Scott T; Khraishi, Tariq; Wagner, Jon; Baack, Bret

    2009-03-01

    Bioabsorbable bone plates can eliminate the necessity for a permanent implant when used to fixate fractures of the human mandible. They are currently not in widespread use because of the low strength of the materials and the requisite large volume of the resulting bone plate. The aim of the current study was to discover a minimally invasive bioabsorbable bone plate design that can provide the same mechanical stability as a standard titanium bone plate. A finite element model of a mandible with a fracture in the body region is subjected to bite loads that are common to patients postsurgery. The model is used first to determine benchmark stress and strain values for a titanium plate. These values are then set as the limits within which the bioabsorbable bone plate must comply. The model is then modified to consider a bone plate made of the polymer poly-L/DL-lactide 70/30. An optimization routine is run to determine the smallest volume of bioabsorbable bone plate that can perform and a titanium bone plate when fixating fractures of this considered type. Two design parameters are varied for the bone plate design during the optimization analysis. The analysis determined that a strut style poly-L-lactide-co-DL-lactide plate of 690 mm2 can provide as much mechanical stability as a similar titanium design structure of 172 mm2. The model has determined a bioabsorbable bone plate design that is as strong as a titanium plate when fixating fractures of the load-bearing mandible. This is an intriguing outcome, considering that the polymer material has only 6% of the stiffness of titanium.

  15. Bacterial N2-fixation in mangrove ecosystems: insights from a diazotroph–mangrove interaction

    PubMed Central

    Alfaro-Espinoza, Gabriela; Ullrich, Matthias S.

    2015-01-01

    Mangrove forests are highly productive ecosystems but represent low nutrient environments. Nitrogen availability is one of the main factors limiting mangrove growth. Diazotrophs have been identified as key organisms that provide nitrogen to these environments. N2-fixation by such organisms was found to be higher in the mangrove roots than in surrounding rhizosphere. Moreover, previous studies showed that mangroves grew better in the presence of N2-fixers indicating a potentially mutualistic relationship. However, the molecular signals and mechanisms that govern these interactions are still poorly understood. Here we present novel insights in the interaction of a diazotroph with a mangrove species to improve our understanding of the molecular and ecophysiological relationship between these two organisms under controlled conditions. Our results showed that Marinobacterium mangrovicola is a versatile organism capable of competing with other organisms to survive for long periods in mangrove soils. N2-fixation by this bacterium was up-regulated in the presence of mangrove roots, indicating a possible beneficial interaction. The increase in N2-fixation was limited to cells of the exponential growth phase suggesting that N2-fixation differs over the bacterial growth cycle. Bacterial transformants harboring a transcriptional nifH::gusA fusion showed that M. mangrovicola successfully colonized mangrove roots and simultaneously conducted N2-fixation. The colonization process was stimulated by the lack of an external carbon source suggesting a possible mutualistic relationship. M. mangrovicola represents an interesting genetically accessible diazotroph, which colonize mangrove roots and exhibit higher N2-fixation in the presence of mangrove roots. Consequently, we propose this microorganism as a tool to study molecular interactions between N2-fixers and mangrove plants and to better understand how changes in the environment could impact these important and relatively unknown

  16. Bacterial N2-fixation in mangrove ecosystems: insights from a diazotroph-mangrove interaction.

    PubMed

    Alfaro-Espinoza, Gabriela; Ullrich, Matthias S

    2015-01-01

    Mangrove forests are highly productive ecosystems but represent low nutrient environments. Nitrogen availability is one of the main factors limiting mangrove growth. Diazotrophs have been identified as key organisms that provide nitrogen to these environments. N2-fixation by such organisms was found to be higher in the mangrove roots than in surrounding rhizosphere. Moreover, previous studies showed that mangroves grew better in the presence of N2-fixers indicating a potentially mutualistic relationship. However, the molecular signals and mechanisms that govern these interactions are still poorly understood. Here we present novel insights in the interaction of a diazotroph with a mangrove species to improve our understanding of the molecular and ecophysiological relationship between these two organisms under controlled conditions. Our results showed that Marinobacterium mangrovicola is a versatile organism capable of competing with other organisms to survive for long periods in mangrove soils. N2-fixation by this bacterium was up-regulated in the presence of mangrove roots, indicating a possible beneficial interaction. The increase in N2-fixation was limited to cells of the exponential growth phase suggesting that N2-fixation differs over the bacterial growth cycle. Bacterial transformants harboring a transcriptional nifH::gusA fusion showed that M. mangrovicola successfully colonized mangrove roots and simultaneously conducted N2-fixation. The colonization process was stimulated by the lack of an external carbon source suggesting a possible mutualistic relationship. M. mangrovicola represents an interesting genetically accessible diazotroph, which colonize mangrove roots and exhibit higher N2-fixation in the presence of mangrove roots. Consequently, we propose this microorganism as a tool to study molecular interactions between N2-fixers and mangrove plants and to better understand how changes in the environment could impact these important and relatively unknown

  17. Trichodesmium and nitrogen fixation in the Kuroshio

    NASA Astrophysics Data System (ADS)

    Shiozaki, T.; Takeda, S.; Itoh, S.; Kodama, T.; Liu, X.; Hashihama, F.; Furuya, K.

    2015-07-01

    Nitrogen fixation in the Kuroshio influences nitrogen balance in the North Pacific Ocean. The genus Trichodesmium is recognized as a major diazotroph in the Kuroshio. Although its abundance is higher in the Kuroshio than in adjacent waters, the reason for this difference remains unclear. The present study investigated the abundance of Trichodesmium spp. and nitrogen fixation together with concentrations of dissolved iron and phosphate, whose availabilities potentially control diazotrophy, in the Kuroshio and its marginal seas. We performed the observations near the Miyako Islands, which form part of the Ryukyu Islands, situated along the Kuroshio, since satellite analysis suggested that material transport could occur from the islands to the Kuroshio. Trichodesmium spp. bloomed (> 20 000 filaments L-1) near the Miyako Islands, and the abundance was high in the Kuroshio and the Kuroshio bifurcation region of the East China Sea, but was low in the Philippine Sea. The abundance of Trichodesmium spp. was significantly correlated with the total nitrogen fixation activity. The surface concentrations of dissolved iron (0.19-0.89 nM) and phosphate (< 3-36 nM) were similar for all of the study areas, indicating that the nutrient distribution could not explain the spatial differences in Trichodesmium spp. abundance and nitrogen fixation. We used a numerical model to simulate the transportation of water around the Ryukyu Islands to the Kuroshio. Our results indicate that Trichodesmium growing around the islands situated along the Kuroshio is potentially important for determining diazotrophy in this region.

  18. Treating Somatic Fixation: A Biopsychosocial Approach

    PubMed Central

    McDaniel, Susan H.; Campbell, Thomas; Seaburn, David

    1991-01-01

    Somatic fixation occurs when the patient or physician focuses exclusively on the biomedical aspects of a complex illness. Individual, family, and cultural factors promote the expression of emotional experience through physical symptoms. The physician or treatment team establishes a collaborative relationship with the patient and family, integrating biomedical and psychosocial evaluations and respecting the patient's defenses. PMID:21228995

  19. Synthetic biology for CO2 fixation.

    PubMed

    Gong, Fuyu; Cai, Zhen; Li, Yin

    2016-11-01

    Recycling of carbon dioxide (CO2) into fuels and chemicals is a potential approach to reduce CO2 emission and fossil-fuel consumption. Autotrophic microbes can utilize energy from light, hydrogen, or sulfur to assimilate atmospheric CO2 into organic compounds at ambient temperature and pressure. This provides a feasible way for biological production of fuels and chemicals from CO2 under normal conditions. Recently great progress has been made in this research area, and dozens of CO2-derived fuels and chemicals have been reported to be synthesized by autotrophic microbes. This is accompanied by investigations into natural CO2-fixation pathways and the rapid development of new technologies in synthetic biology. This review first summarizes the six natural CO2-fixation pathways reported to date, followed by an overview of recent progress in the design and engineering of CO2-fixation pathways as well as energy supply patterns using the concept and tools of synthetic biology. Finally, we will discuss future prospects in biological fixation of CO2.

  20. Introduction to Lumbosacral and Sacropelvic Fixation Strategies.

    PubMed

    Hsieh, Patrick C; Mummaneni, Praveen V

    2016-07-01

    We are pleased to present this Neurosurgical Focus video supplement on lumbosacral and sacropelvic fixation strategies. Despite advancement in surgical techniques and technologies in spine, achieving consistent solid fusion across the lumbosacral junction remains a major challenge. The anatomy of the lumbosacral junction allows for a higher range of motion compared to other areas of the thoracolumbar spine. The L5-S1 interspace is exposed to significant shear forces. As a result, complications such as pseudoarthrosis, screw pull-out, implant fracture, or sacral fractures can occur. Complications are particularly seen in long fusion constructs ending across the lumbosacral junction. To reduce these complications, various lumbosacral and sacropelvic fixation techniques have been developed and utilized. The current supplement is intended to provide instructional videos that illustrate several current techniques for lumbosacral and sacropelvic fixation. The collection includes techniques for anterior L5-S1 interbody fusion, minimally invasive L5-S1 interbody fusions, lumbosacral pedicle screw placement, sacroiliac fusion, and sacro-alar-iliac screw placement. The authors of the videos in the supplement have provided detailed narration and video illustration to describe the nuances of the various open and minimally invasive techniques for lumbosacral and sacral-pelvic fixation. We are pleased to have such a collection of quality video illustration from experts in the field. It's been our privilege to serve as guest editors for this supplement and we believe that you will enjoy the contents of this supplement.

  1. Binocular Fixation in the Newborn Baby

    ERIC Educational Resources Information Center

    Slater, Alan M.; Findlay, John M.

    1975-01-01

    Three experiments are reported in which 15 babies were presented with visual stimuli which varied in shape and distance from the eye. Results indicated that the majority of subjects binocularly fixated all three stimuli and it was concluded that the newborn baby has the basic requirements for binocular vision. (Author/GO)

  2. Fixation of a Proximal Humeral Fracture Using a Novel Intramedullary Cage Construct following a Failed Conservative Treatment

    PubMed Central

    2017-01-01

    A majority of proximal humeral fractures are preferably treated conservatively. However, surgical management may be beneficial in proximal humeral fractures with significant displacement or angulation. Unfortunately, the complication rates associated with current surgical procedures for fracture fixation, ORIF and IM devices, can be unacceptably high. A new technology, termed the PH Cage, addresses the technical limitations associated with current technologies available for fixation of proximal humeral fractures. It allows for intramedullary fixation of a PH fracture and provides direct load bearing support to the articular surface and buttresses the medial column during healing. We are presenting our first experience with the PH Cage for the fixation of a PH fracture, which had previously failed conservative management. PMID:28255485

  3. 21 CFR 872.4880 - Intraosseous fixation screw or wire.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Intraosseous fixation screw or wire. 872.4880... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4880 Intraosseous fixation screw or wire. (a) Identification. An intraosseous fixation screw or wire is a metal device intended to be...

  4. 21 CFR 872.4880 - Intraosseous fixation screw or wire.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Intraosseous fixation screw or wire. 872.4880... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4880 Intraosseous fixation screw or wire. (a) Identification. An intraosseous fixation screw or wire is a metal device intended to be...

  5. 21 CFR 872.4880 - Intraosseous fixation screw or wire.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Intraosseous fixation screw or wire. 872.4880... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4880 Intraosseous fixation screw or wire. (a) Identification. An intraosseous fixation screw or wire is a metal device intended to be...

  6. 21 CFR 872.4880 - Intraosseous fixation screw or wire.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraosseous fixation screw or wire. 872.4880... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4880 Intraosseous fixation screw or wire. (a) Identification. An intraosseous fixation screw or wire is a metal device intended to be...

  7. 21 CFR 872.4880 - Intraosseous fixation screw or wire.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Intraosseous fixation screw or wire. 872.4880... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4880 Intraosseous fixation screw or wire. (a) Identification. An intraosseous fixation screw or wire is a metal device intended to be...

  8. 21 CFR 888.3010 - Bone fixation cerclage.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Bone fixation cerclage. 888.3010 Section 888.3010...) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3010 Bone fixation cerclage. (a) Identification. A bone fixation cerclage is a device intended to be implanted that is made of alloys, such...

  9. 21 CFR 888.3010 - Bone fixation cerclage.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Bone fixation cerclage. 888.3010 Section 888.3010...) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3010 Bone fixation cerclage. (a) Identification. A bone fixation cerclage is a device intended to be implanted that is made of alloys, such...

  10. 21 CFR 888.3010 - Bone fixation cerclage.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bone fixation cerclage. 888.3010 Section 888.3010...) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3010 Bone fixation cerclage. (a) Identification. A bone fixation cerclage is a device intended to be implanted that is made of alloys, such...

  11. 21 CFR 888.3010 - Bone fixation cerclage.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Bone fixation cerclage. 888.3010 Section 888.3010...) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3010 Bone fixation cerclage. (a) Identification. A bone fixation cerclage is a device intended to be implanted that is made of alloys, such...

  12. 21 CFR 888.3010 - Bone fixation cerclage.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Bone fixation cerclage. 888.3010 Section 888.3010...) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3010 Bone fixation cerclage. (a) Identification. A bone fixation cerclage is a device intended to be implanted that is made of alloys, such...

  13. 21 CFR 868.5770 - Tracheal tube fixation device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Tracheal tube fixation device. 868.5770 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5770 Tracheal tube fixation device. (a) Identification. A tracheal tube fixation device is a device used to hold a tracheal tube...

  14. 21 CFR 868.5770 - Tracheal tube fixation device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tracheal tube fixation device. 868.5770 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5770 Tracheal tube fixation device. (a) Identification. A tracheal tube fixation device is a device used to hold a tracheal tube...

  15. 21 CFR 868.5770 - Tracheal tube fixation device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Tracheal tube fixation device. 868.5770 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5770 Tracheal tube fixation device. (a) Identification. A tracheal tube fixation device is a device used to hold a tracheal tube...

  16. 21 CFR 868.5770 - Tracheal tube fixation device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Tracheal tube fixation device. 868.5770 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5770 Tracheal tube fixation device. (a) Identification. A tracheal tube fixation device is a device used to hold a tracheal tube...

  17. 21 CFR 868.5770 - Tracheal tube fixation device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Tracheal tube fixation device. 868.5770 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5770 Tracheal tube fixation device. (a) Identification. A tracheal tube fixation device is a device used to hold a tracheal tube...

  18. Comparison of three cell fixation methods for high content analysis assays utilizing quantum dots.

    PubMed

    Williams, Y; Byrne, S; Bashir, M; Davies, A; Whelan, A; Gun'ko, Y; Kelleher, D; Volkov, Y

    2008-10-01

    Semiconductor nanoparticles or quantum dots are being increasingly utilized as fluorescent probes in cell biology both in live and fixed cell assays. Quantum dots possess an immense potential for use in multiplexing assays that can be run on high content screening analysers. Depending on the nature of the biological target under investigation, experiments are frequently required on cells retaining an intact cell membrane or also on those that have been fixed and permeabilized to expose intracellular antigens. Fixation of cell lines before or after the addition of quantum dots may affect their localization, emission properties and stability. Using a high content analysis platform we perform a quantitative comparative analysis of three common fixation techniques in two different cell lines exposed to carboxylic acid stabilized CdTe quantum dots. Our study demonstrates that in prefixed and permeabilized cells, quantum dots are readily internalized regardless of cell type, and their intracellular location is primarily determined by the properties of the quantum dots themselves. However, if the fixation procedures are preformed on live cells previously incubated with quantum dots, other important factors have to be considered. The choice of the fixative significantly influences the fluorescent characteristics of the quantum dots. Fixatives, regardless of their chemical nature, negatively affected quantum dots fluorescence intensity. Comparative analysis of gluteraldehyde, methanol and paraformaldehyde demonstrated that 2% paraformaldehyde was the fixative of choice. The presence of protein in the media did not significantly alter the quantum dot fluorescence. This study indicates that multiplexing assays utilizing quantum dots, despite being a cutting edge tool for high content cell imaging, still require careful consideration of the basic steps in biological sample processing.

  19. Systematic comparison of tissue fixation with alternative fixatives to conventional tissue fixation with buffered formalin in a xenograft-based model.

    PubMed

    Nietner, Thorben; Jarutat, Tiantom; Mertens, Alfred

    2012-09-01

    In our study we systematically compared the alternative fixatives acidified formal alcohol (AFA), PAXgene®, HOPE®, and combinations of AFA or formalin with ultrasound treatment to standard (buffered) formalin fixation. We examined general morphology and detectability of protein structures by immunohistochemistry of the membrane receptors epidermal growth factor receptor (EGFR), insulin-like growth factor 1 receptor (IGF-1R), and phosphorylated human epidermal growth factor receptor 2 (phospho-HER2). In order to allow for stringent comparability of different fixation techniques, we used matched mouse xenograft tumor samples from three different human cancer cell lines (colon, ovarian, and non-small cell lung cancer), either fixed conventionally with formalin or an alternative fixative. Tissue morphology after fixation with AFA and PAXgene® was comparable to formalin-fixed paraffin-embedded tissue (FFPET) morphology. Ultrasound fixations resulted in slightly inferior morphology and HOPE® fixation preserved morphology only poorly compared to FFPET in this system. None of the tested alternative fixatives enabled immunohistochemical detectability of all three targets in the same manner as FFPET. Pronounced staining was possible for EGFR and IGF-1R with all alternative fixatives but HOPE®, and phospho-HER2 staining was only noteworthy with formalin-ultrasound-fixed tissue. Therefore, the use of alternative fixatives comes with the need for careful validation of obtained IHC results individually for each target.

  20. Femoral neck fracture fixation: rigidity of five techniques compared.

    PubMed Central

    Mackechnie-Jarvis, A C

    1983-01-01

    Artificial cadaveric femoral neck fractures were internally fixed with five different devices and subjected to cyclical loading of 0-1.0 kilonewtons (approximately one body weight) whilst in an anatomical position. Displacement of the proximal fragment was detected by a transducer and charted. Bone strength was assessed by a preliminary control loading phase on the intact bone. Efficiency of each fracture fixator could then be directly compared by the relative movement in each case. Five specimens each were tested with Moore's Pins, Trifin Nail, Garden Screws and a sliding screw-plate (OEC Ltd). By the criteria of the experiment, which put a severe shearing load on the implant, none of these devices reliably bore the representative body weight. An extended barrel-plate, which supported the sliding screw almost up to the fracture line, was then made. This device, employing some of Charnley's concepts, tolerated body weight in four cases out of five. PMID:6887186

  1. Assessment of fixatives, fixation, and tissue processing on morphology and RNA integrity.

    PubMed

    Cox, Melissa L; Schray, Carrie L; Luster, Chandra N; Stewart, Zachary S; Korytko, Peter J; M Khan, Kanwar Nasir; Paulauskis, Joseph D; Dunstan, Robert W

    2006-04-01

    Molecular characterization of morphologic change requires exquisite tissue morphology and RNA preservation; however, traditional fixatives usually result in fragmented RNA. To optimize molecular analyses on fixed tissues, we assessed morphologic and RNA integrity in rat liver when sections were fixed in 70% neutral-buffered formalin, modified Davidson's II, 70% ethanol, UMFIX, modified Carnoy's, modified methacarn, Bouin's, phosphate-buffered saline, or 30% sucrose. Each sample was subjected to standard or microwave fixation and standard or microwave processing, and sections were evaluated microscopically. RNA was extracted and assessed for preservation of quality and quantity. Modified methacarn, 70% ethanol, and modified Carnoy's solution each resulted in tissue morphology representing a reasonable alternative to formalin. Modified methacarn and UMFIX best preserved RNA quality. Neither microwave fixation nor processing affected RNA integrity relative to standard methods, although morphology was modestly improved. We conclude that modified methacarn, 70% ethanol, and modified Carnoy's solution provided acceptable preservation of tissue morphology and RNA quality using both standard and microwave fixation and processing methods. Of these three fixatives, modified methacarn provided the best results and can be considered a fixative of choice where tissue morphology and RNA integrity are being assessed in the same specimens.

  2. Oxygen-Poor Microzones as Potential Sites of Microbial N2 Fixation in Nitrogen-Depleted Aerobic Marine Waters

    PubMed Central

    Paerl, Hans W.; Prufert, Leslie E.

    1987-01-01

    The nitrogen-deficient coastal waters of North Carolina contain suspended bacteria potentially able to fix N2. Bioassays aimed at identifying environmental factors controlling the development and proliferation of N2 fixation showed that dissolved organic carbon (as simple sugars and sugar alcohols) and particulate organic carbon (derived from Spartina alterniflora) additions elicited and enhanced N2 fixation (nitrogenase activity) in these waters. Nitrogenase activity occurred in samples containing flocculent, mucilage-covered bacterial aggregates. Cyanobacterium-bacterium aggregates also revealed N2 fixation. In all cases bacterial N2 fixation occurred in association with surficial microenvironments or microzones. Since nitrogenase is oxygen labile, we hypothesized that the aggregates themselves protected their constituent microbes from O2. Microelectrode O2 profiles revealed that aggregates had lower internal O2 tensions than surrounding waters. Tetrazolium salt (2,3,5-triphenyl-3-tetrazolium chloride) reduction revealed that patchy zones existed both within microbes and extracellularly in the mucilage surrounding microbes where free O2 was excluded. Triphenyltetrazolium chloride reduction also strongly inhibited nitrogenase activity. These findings suggest that N2 fixation is mediated by the availability of the appropriate types of reduced microzones. Organic carbon enrichment appears to serve as an energy and structural source for aggregate formation, both of which were required for eliciting N2 fixation responses of these waters. Images PMID:16347337

  3. In situ stabilization/fixation of chromium-contaminated soil

    SciTech Connect

    Greetis, T.A.; Werntges, W.; Hockenberry, D.

    1996-12-31

    An electroplating operation at a US Army installation was closed in accordance with Resource Conservation and Recovery Act (RCRA) regulations using in situ stabilization/fixation. Since the plating line was located inside of a building immediately adjacent to other ongoing plating lines, the selected and approved technology involved the use of an electric-powered drill rig retrofitted with a mixing blade auger system, and operated within a negative-pressure enclosure. The stabilization process included the introduction of a reagent mixture developed and defined during in situ pilot tests and stabilization studies. Upon completion of each stabilized/fixed column, representative sampling was conducted to verify the success of the process. Concentrations of chromium using the Toxicity Characteristic Leaching Procedure (TCLP) were reduced from 220 mg/L detected in soils prior to the stabilization/fixation process, to below laboratory detection limits in treated columns. Ultimately, the electroplating collection sump was closed in accordance with the approved closure plan, and the owner constructed a new concrete sump pit fitted with a welded steel sheet containment liner.

  4. Nitrogen limitation on land: how can it occur in Earth system models?

    PubMed

    Thomas, R Quinn; Brookshire, E N Jack; Gerber, Stefan

    2015-05-01

    The representation of the nitrogen (N) cycle in Earth system models (ESMs) is strongly motivated by the constraint N poses on the sequestration of anthropogenic carbon (C). Models typically implement a stoichiometric relationship between C and N in which external supply and assimilation by organisms are adjusted to maintain their internal stoichiometry. N limitation of primary productivity thus occurs if the N supply from uptake and fixation cannot keep up with the construction of tissues allowed by C assimilation. This basic approach, however, presents considerable challenges in how to faithfully represent N limitation. Here, we review how N limitation is currently implemented and evaluated in ESMs and highlight challenges and opportunities in their future development. At or near steady state, N limitation is governed by the magnitude of losses from the plant-unavailable pool vs. N fixation and there are considerable differences in how models treat both processes. In nonsteady-state systems, the accumulation of N in pools with slow turnover rates reduces N available for plant uptake and can be challenging to represent when initializing ESM simulations. Transactional N limitation occurs when N is incorporated into various vegetation and soil pools and becomes available to plants only after it is mineralized, the dynamics of which depends on how ESMs represent decomposition processes in soils. Other challenges for ESMs emerge when considering seasonal to interannual climatic oscillations as they create asynchronies between C and N demand, leading to transient alternations between N surplus and deficit. Proper evaluation of N dynamics in ESMs requires conceptual understanding of the main levers that trigger N limitation, and we highlight key measurements and observations that can help constrain these levers. Two of the biggest challenges are the mechanistic representation of plant controls on N availability and turnover, including N fixation and organic matter

  5. Dark Carbon Fixation: An Important Process in Lake Sediments

    PubMed Central

    Santoro, Ana Lúcia; Bastviken, David; Gudasz, Cristian; Tranvik, Lars; Enrich-Prast, Alex

    2013-01-01

    Close to redox boundaries, dark carbon fixation by chemoautotrophic bacteria may be a large contributor to overall carbon fixation. Still, little is known about the relative importance of this process in lake systems, in spite the potentially high chemoautotrophic potential of lake sediments. We compared rates of dark carbon fixation, bacterial production and oxygen consumption in sediments from four Swedish boreal and seven tropical Brazilian lakes. Rates were highly variable and dark carbon fixation amounted up to 80% of the total heterotrophic bacterial production. The results indicate that non-photosynthetic carbon fixation can represent a substantial contribution to bacterial biomass production, especially in sediments with low organic matter content. PMID:23776549

  6. Analysis of Sternal Fixation Results According to Plate Type in Sternal Fracture

    PubMed Central

    Byun, Chun Sung; Park, Il Hwan; Hwang, Wan Jin; Lee, Yeiwon; Cho, Hyun Min

    2016-01-01

    Background Sternal fractures are relatively rare, and caused mainly by blunt anterior chest wall trauma. In most cases, sternal fractures are treated conservatively. However, if the patient exhibits problematic symptoms such as intractable chest wall pain or bony crepitus due to sternal instability, surgical correction is indicated. But no consensus exists regarding the most appropriate surgical method. We analyzed the results of surgical fixation in cases of sternal fracture in order to identify which surgical method led to the best outcomes. Methods We retrospectively reviewed the medical records of patients with sternal fractures from December 2008 to December 2011, and found 19 patients who underwent open reduction and internal fixation of the sternum with a longitudinal plate (L-group) or a T-shaped plate (T-group). We investigated patients’ characteristics, clinical details regarding each case of chest trauma, the presence of other associated injuries, the type of open reduction and fixation, whether a combined operation was performed, and postoperative complications. Results Of the 19 patients, 10 patients (52.6%) were male, and their average age was 56.8 years (range, 32 to 82 years). Seven patients (36.8%) had isolated sternal fractures, while 12 (63.2%) had other associated injuries. Seven patients (36.8%) were in the L-group and 12 patients (63.2%) were in the T-group. Three patients in the L-group (42.9%) showed a loosening of the fixation. In all patients in the T-group, the fracture exhibited stable alignment. Conclusion Open reduction and internal fixation with a T-shaped plate in sternal fractures is a safer and more efficient treatment method than treatment with a longitudinal plate, especially in patients with a severely displaced sternum or anterior flail chest, than a longitudinal plate. PMID:27733996

  7. Southwick Osteotomy Stabilised with External Fixator

    PubMed Central

    Grubor, Predrag; Mitkovic, Milorad; Grubor, Milan

    2014-01-01

    ABSTRACT Introduction: Epiphysiolysis of the femoral head is the most common accident occurring towards the end of pre-puberty and puberty growth. Case report: The author describes the experience in the treatment of chronic epiphysiolysis in two patients treated by Southwick osteotomy. The site is accessed by way of a 15-cm long lateral skin incision and the trochanteric region is reached through the layers. The osteotomy angles prepared beforehand on a thin aluminium model are used to mark the Southwick osteotomy site on the anterior and lateral sides at the level of the lesser trochanter. Before performing the trochanteric osteotomy, two Mitković convergent pins type M20 are applied distally and proximally, above the planned osteotomy site. A tenotomy of the iliopsas muscle is performed, and then the previously marked bone triangle is redissected up to three quarters of the width of the femur. The distal part of the femur is rotated inwards, so that the patella is turned towards the ceiling. The osteotomised fragments of the femur are adapted, repositioned and fixated by installing an external fixator on the previously placed pins. Two more pins are placed, one proximally and one distally, with a view to adequately stabilising the femur. The patient was mobile from day two after the surgery. If, after the surgery, the lead surgeon realises that there is a requirement to make a correction of 5, 10 and 15 degrees of the valgus, varus, anteversion or retroversion deformity, the correction shall be performed without surgically opening the patient, using the fixator pins. Conclusion: After performing a Southwick osteotomy it is easier to adapt, reposition and fixate the osteotomised fragments of the femur using a fixator type M20. Adequate stability allows regaining mobility quickly, which in turn is the best prevention of chondrolysis of the hip. It is possible to make post-operative valgus, varus, anteversion and retroversion corrections of 5, 10 and 15 degrees

  8. Bicondylar tibial plateau fractures treated with fine-wire circular external fixation.

    PubMed

    Ferreira, N; Marais, L C

    2014-04-01

    Bicondylar tibial plateau fractures are serious injuries to a major weight-bearing joint. These injuries are often associated with severe soft tissue injuries that complicate surgical management. We reviewed 54 consecutive patients who sustained bicondylar tibial plateau fractures that were treated with limited open reduction and cannulated screw fixation combined with fine-wire circular external fixation. Forty-six patients met the inclusion criteria of this retrospective review. Eight patients were excluded because they did not complete a minimum of 1-year follow-up. Thirty-six patients had Schatzker type-VI, and ten patients had Schatzker type-V fractures. All fractures were united without loss of reduction; there were no incidences of wound complications, osteomyelitis or septic arthritis. The average Knee Society Clinical Rating Score was 81.6, translating to good clinical results. Minor pin track infection was the most common complication encountered. This review concludes that fine-wire circular external fixation, combined with limited open reduction and cannulated screw fixation, consistently produces good functional results without serious complications.

  9. Contribution of mono and polysaccharides to heterotrophic N2 fixation at the eastern Mediterranean coastline.

    PubMed

    Rahav, E; Giannetto, M J; Bar-Zeev, E

    2016-06-16

    N2 fixation should be a critical process in the nitrogen-poor surface water of the eastern Mediterranean Sea. Despite favorable conditions, diazotroph abundance and N2 fixation rates remains low for reasons yet explained. The main goal of this study was to investigate the limiting nutrients for diazotrophy in this oligotrophic environment. Hence, we conducted dedicated bottle-microcosms with eastern Mediterranean Sea water that were supplemented with mono and polysaccharides as well as inorganic nitrogen and phosphorous. Our results indicate that the diazotrophic community expressing nifH was primarily represented by heterotrophic Proteobacteria. N2 fixation and heterotrophic bacterial activity increased up-to tenfold following two days of dark incubations, once seawater was supplemented with organic carbon substrate in the form of glucose (monosaccharides) or gum-xanthan (polysaccharide surrogate). Furthermore, our results point that carbon-rich polysaccharides, such as transparent exopolymer particles, enhance heterotrophic N2 fixation, by forming microenvironments of intense metabolic activity, high carbon: nitrogen ratio, and possibly low O2 levels. The conclusions of this study indicate that diazotrophs in the eastern Mediterranean coast are primarily limited by organic carbon substrates, as possibly in many other marine regions.

  10. Contribution of mono and polysaccharides to heterotrophic N2 fixation at the eastern Mediterranean coastline

    PubMed Central

    Rahav, E.; Giannetto, M. J.; Bar-Zeev, E.

    2016-01-01

    N2 fixation should be a critical process in the nitrogen-poor surface water of the eastern Mediterranean Sea. Despite favorable conditions, diazotroph abundance and N2 fixation rates remains low for reasons yet explained. The main goal of this study was to investigate the limiting nutrients for diazotrophy in this oligotrophic environment. Hence, we conducted dedicated bottle-microcosms with eastern Mediterranean Sea water that were supplemented with mono and polysaccharides as well as inorganic nitrogen and phosphorous. Our results indicate that the diazotrophic community expressing nifH was primarily represented by heterotrophic Proteobacteria. N2 fixation and heterotrophic bacterial activity increased up-to tenfold following two days of dark incubations, once seawater was supplemented with organic carbon substrate in the form of glucose (monosaccharides) or gum-xanthan (polysaccharide surrogate). Furthermore, our results point that carbon-rich polysaccharides, such as transparent exopolymer particles, enhance heterotrophic N2 fixation, by forming microenvironments of intense metabolic activity, high carbon: nitrogen ratio, and possibly low O2 levels. The conclusions of this study indicate that diazotrophs in the eastern Mediterranean coast are primarily limited by organic carbon substrates, as possibly in many other marine regions. PMID:27306501

  11. Effects of elevated carbon dioxide concentration on growth and N2 fixation of young Robinia pseudoacacia.

    PubMed

    Feng, Z; Dyckmans, J; Flessa, H

    2004-03-01

    Effects of elevated CO2 concentration ([CO2]) on carbon (C) and nitrogen (N) uptake and N source partitioning (N2 fixation versus mineral soil N uptake) of 1-year-old Robinia pseudoacacia were determined in a dual 13C and 15N continuous labeling experiment. Seedlings were grown for 16 weeks in ambient (350 ppm) or elevated [CO2] (700 ppm) with 15NH4 15NO3 as the only mineral nitrogen source. Elevated [CO2] increased the fraction of new C in total C, but it did not alter C partitioning among plant compartments. Elevated [CO2] also increased the fraction of new N in total N and this was coupled with a shift in N source partitioning toward N2 fixation. Soil N uptake was unaffected by elevated [CO2], whereas N2 fixation was markedly increased by the elevated [CO2] treatment, mainly because of increased specific fixation (mg N mg(-1) nodule). As a result of increased N2 fixation, the C/N ratio of tree biomass tended to decrease in the elevated [CO2] treatment. Partitioning of N uptake among plant compartments was unaffected by elevated [CO2]. Total dry mass of root nodules doubled in response to elevated [CO2], but this effect was not significant because of the great variability of root nodule formation. Our results show that, in the N2-fixing R. pseudoacacia, increased C uptake in response to increased [CO2] is matched by increased N2 fixation, indicating that enhanced growth in elevated [CO2] might not be restricted by N limitations.

  12. Application of alternative fixatives to formalin in diagnostic pathology

    PubMed Central

    Gatta, L. Benerini; Cadei, M.; Balzarini, P.; Castriciano, S.; Paroni, R.; Verzeletti, A.; Cortellini, V.; De Ferrari, F.; Grigolato, P.

    2012-01-01

    Fixation is a critical step in the preparation of tissues for histopathology. The aim of this study was to investigate the effects of different fixatives vs formalin on proteins and DNA, and to evaluate alternative fixation for morphological diagnosis and nucleic acid preservation for molecular methods. Forty tissues were fixed for 24 h with six different fixatives: the gold standard fixative formalin, the historical fixatives Bouin and Hollande, and the alternative fixatives Greenfix, UPM and CyMol. Tissues were stained (Haematoxylin-Eosin, Periodic Acid Schiff, Trichromic, Alcian-blue, High Iron Diamine stainings), and their antigenicity was determined by immunohistochemistry (performed with PAN-CK, CD31, Ki-67, S100, CD68, AML antibodies). DNA extraction, KRAS sequencing, FISH for CEP-17, and flow cytometry analysis of nuclear DNA content were applied. For cell morphology the alternative fixatives (Greenfix, UPM, CyMol) were equivalent to formalin. As expected, Hollande proved to be the best fixative for morphology. The morphology obtained with Bouin was comparable to the one with formalin. Hollande was the best fixative for histochemistry. Bouin proved to be equivalent to formalin. The alternative fixatives were equivalent to formalin, although with greater variability in haematoxylin-eosin staining. It proved the possibility to obtain immunohistochemical staining largely equivalent to that following formalin-fixation with the following fixatives: Greenfix, Hollande, UPM and CyMol. The tissues fixed in Bouin did not provide results comparable to those obtained with formalin. The DNA extracted from samples fixed with alternative fixatives was found to be suitable for molecular analysis. PMID:22688293

  13. Early breakage of a titanium volar locking plate for fixation of a distal radius fracture: case report.

    PubMed

    Yukata, Kiminori; Doi, Kazuteru; Hattori, Yasunori; Sakamoto, Soutetsu

    2009-01-01

    This report presents a case demonstrating the early breakage of a titanium volar locking plate implanted for internal fixation of a dorsally displaced distal radius fracture in which the dorsal cortex was severely comminuted. Careful selection of the proper plate and appropriate surgical technique and postoperative management are necessary to avoid this complication.

  14. Finite Element-Derived Surrogate Models of Locked Plate Fracture Fixation Biomechanics.

    PubMed

    Wee, Hwabok; Reid, J Spence; Chinchilli, Vernon M; Lewis, Gregory S

    2017-03-01

    Internal fixation of bone fractures using plates and screws involves many choices-implant type, material, sizes, and geometric configuration-made by the surgeon. These decisions can be important for providing adequate stability to promote healing and prevent implant mechanical failure. The purpose of this study was to develop mathematical models of the relationships between fracture fixation construct parameters and resulting 3D biomechanics, based on parametric computer simulations. Finite element models of hundreds of different locked plate fixation constructs for midshaft diaphyseal fractures were systematically assembled using custom algorithms, and axial, torsional, and bending loadings were simulated. Multivariate regression was used to fit response surface polynomial equations relating fixation design parameters to outputs including maximum implant stresses, axial and shear strain at the fracture site, and construct stiffness. Surrogate models with as little as three regressors showed good fitting (R (2) = 0.62-0.97). Inner working length was the strongest predictor of maximum plate and screw stresses, and a variety of quadratic and interaction terms influenced resulting biomechanics. The framework presented in this study can be applied to additional types of bone fractures to provide clinicians and implant designers with clinical insight, surgical optimization, and a comprehensive mathematical description of biomechanics.

  15. Nitrogen fixation in a non-heterocystous cyanobacterial mat from a mountain river

    PubMed Central

    Berrendero, Esther; Valiente, Eduardo Fernández; Perona, Elvira; Gómez, Claudia L.; Loza, Virginia; Muñoz-Martín, M. Ángeles; Mateo, Pilar

    2016-01-01

    In situ nitrogen fixation was investigated in a cyanobacterial mat growing on the bed of rocks of the Muga River, Spain. The filamentous non-heterocystous cyanobacterium Schizothrix dominated the mat, showing nitrogenase activity in the light at similar rates to those found in nearby heterocystous Rivularia colonies. N2 fixation in the light was significantly increased by an inhibitor of PSII and oxygen evolution, DCMU (3-[3,4-dichlorophenyl]-1,1-dimethylurea), and anaerobic conditions. However, no nitrogenase activity was found in the dark. Addition of fructose as a respiratory substrate induced nitrogenase activity in samples incubated under aerobic conditions in the dark but not in anaerobic conditions. Microelectrode oxygen profiles showed internal microaerobic microzones where nitrogen fixation might concentrate. Analyses of the 16S rRNA gene revealed only the presence of sequences belonging to filamentous non-heterocystous cyanobacteria. nifH gene diversity showed that the major phylotypes also belonged to this group. One of the three strains isolated from the Schizothrix mat was capable of fixing N2 and growing in the absence of combined N. This was consistent with the nifH gene analysis. These results suggest a relevant contribution of non-heterocystous cyanobacteria to nitrogen fixation in these mats. PMID:27476439

  16. External Fixation Vs Orif in the Treatment of Bilateral Calcaneum Fracture

    PubMed Central

    Carluzzo, Fulvio; Longo, G.F.

    2015-01-01

    Introduction: The following is an original case report in the literature of a patient with post-traumatic bilateral calcaneum fracture, both type III of Sanders’ classification, that was treated, by the same surgeon, in the left foot with open reduction and internal fixation and in the right foot with closed reduction and application of an external fixator. Case Report: Patient 43 y.o., male, high fall accident, with bilateral calcaneum fracture, both type III of Sanders’ classification. we have chosen to treat the left foot with ORIF (Fig. 3) and the right one with closed reduction and application of an external fixator. Patient was followed up radiologically with radiographs at 2, 12 and 24 months, and clinically at 15 days, 1, 3, 6, 12, 18 and 24 months with the Maryland Foot Score, as suggested by Sanders et al. Conclusion: In our patient, the one year clinical outcomes post-surgery was better in the foot treated with external fixation, regardless complex fracture and the not good status of soft tissue, due to open surgical treatment and hardwere inside. Long-term clinical follow-up given best outcomes in patients treated with ORIF, due to better reduction of subtalar joint facet and Böhler’s angle. PMID:27299071

  17. Nitrogen fixation in a non-heterocystous cyanobacterial mat from a mountain river

    NASA Astrophysics Data System (ADS)

    Berrendero, Esther; Valiente, Eduardo Fernández; Perona, Elvira; Gómez, Claudia L.; Loza, Virginia; Muñoz-Martín, M. Ángeles; Mateo, Pilar

    2016-08-01

    In situ nitrogen fixation was investigated in a cyanobacterial mat growing on the bed of rocks of the Muga River, Spain. The filamentous non-heterocystous cyanobacterium Schizothrix dominated the mat, showing nitrogenase activity in the light at similar rates to those found in nearby heterocystous Rivularia colonies. N2 fixation in the light was significantly increased by an inhibitor of PSII and oxygen evolution, DCMU (3-[3,4-dichlorophenyl]-1,1-dimethylurea), and anaerobic conditions. However, no nitrogenase activity was found in the dark. Addition of fructose as a respiratory substrate induced nitrogenase activity in samples incubated under aerobic conditions in the dark but not in anaerobic conditions. Microelectrode oxygen profiles showed internal microaerobic microzones where nitrogen fixation might concentrate. Analyses of the 16S rRNA gene revealed only the presence of sequences belonging to filamentous non-heterocystous cyanobacteria. nifH gene diversity showed that the major phylotypes also belonged to this group. One of the three strains isolated from the Schizothrix mat was capable of fixing N2 and growing in the absence of combined N. This was consistent with the nifH gene analysis. These results suggest a relevant contribution of non-heterocystous cyanobacteria to nitrogen fixation in these mats.

  18. The penny drops: change blindness at fixation.

    PubMed

    Smith, Tim J; Lamont, Peter; Henderson, John M

    2012-01-01

    Our perception of the visual world is fallible. Unattended objects may change without us noticing as long as the change does not capture attention (change blindness). However, it is often assumed that changes to a fixated object will be noticed if it is attended. In this experiment we demonstrate that participants fail to detect a change in identity of a coin during a magic trick even though eyetracking indicates that the coin is tracked by the eyes throughout the trick. The change is subsequently detected when participants are instructed to look for it. These results suggest that during naturalistic viewing, attention can be focused on an object at fixation without including all of its features.

  19. The Sequoia circular fixator for limb lengthening.

    PubMed

    Hardy, J M; Tadlaoui, A; Wirotius, J M; Saleh, M

    1991-10-01

    With the Sequoia fixator, lengthenings can be achieved based on the clinical facts of the case. The device is a modular apparatus that can perform corrections in several planes, and, if necessary, in a septic environment. In our opinion, a "lengthener surgeon" is one who can foresee problems and take appropriate steps to prevent them. Likewise, the surgeon must act as the coordinator of an entire team. A successful lengthening is 5% surgery and 95% postoperative nursing and physiotherapy care. In the future, a number of changes will simplify postoperative management: 1. Composite carbon rings will make the frames radiolucent and one third lighter than those made of stainless steel. Automatic tensioners will help maintain steady tension on the wires. 2. Digital analysis of the callus will provide norms of consolidation, allowing faster fixator removal and conversion to an orthosis. 3. Incorporating the foot in the frame to overcome equinus will eliminate the need for tenotomy. We believe that monolateral and ring fixators can work together in certain locations. That is why we proposed, at the 18th Societé Internationale de Chirurgie Orthopédique et Traumatologique meeting, a combined monolateral-ring construct that can be used for lengthening throughout the proximal femoral metaphysis.

  20. "False" migration of rigid fixation appliances in pediatric craniofacial surgery.

    PubMed

    Papay, F A; Hardy, S; Morales, L; Walker, M; Enlow, D

    1995-07-01

    Osseous fixation techniques have been widely used to provide rigid stabilization in the craniofacial skeleton. Reported sequelae of its usage has been limited to palpation of the screw-plate system and radiological imaging artifacts. Over the past 3 years we have identified miniplates, microplates, and wire sutures on the inner cranial table of the growing child. The observation of "false" migration of these appliances has provided the impetus to review these patients in more detail. Twenty patients underwent secondary cranial remodeling within a two-year period; 7 of these patients were seen to have "false" migration. There were no untoward sequelae in removal of these appliances, and no adverse neurological symptoms were seen.

  1. Rib Fracture Fixation Restores Inspiratory Volume and Peak Flow in a Full Thorax Human Cadaveric Breathing Model

    PubMed Central

    Slobogean, Gerard P.; Kim, Hyunchul; Russell, Joseph P.; Stockton, David J.; Hsieh, Adam H.; O’Toole, Robert V.

    2015-01-01

    Background: Multiple rib fractures cause significant pain and potential for chest wall instability. Despite an emerging trend of surgical management of flail chest injuries, there are no studies examining the effect of rib fracture fixation on respiratory function. Objectives: Using a novel full thorax human cadaveric breathing model, we sought to explore the effect of flail chest injury and subsequent rib fracture fixation on respiratory outcomes. Patients and Methods: We used five fresh human cadavers to generate negative breathing models in the left thorax to mimic physiologic respiration. Inspiratory volumes and peak flows were measured using a flow meter for all three chest wall states: intact chest, left-sided flail chest (segmental fractures of ribs 3 - 7), and post-fracture open reduction and internal fixation (ORIF) of the chest wall with a pre-contoured rib specific plate fixation system. Results: A wide variation in the mean inspiratory volumes and peak flows were measured between specimens; however, the effect of a flail chest wall and the subsequent internal fixation of the unstable rib fractures was consistent across all samples. Compared to the intact chest wall, the inspiratory volume decreased by 40 ± 19% in the flail chest model (P = 0.04). Open reduction and internal fixation of the flail chest returned the inspiratory volume to 130 ± 71% of the intact chest volumes (P = 0.68). A similar 35 ± 19% decrease in peak flows was seen in the flail chest (P = 0.007) and this returned to 125 ± 71% of the intact chest following ORIF (P = 0.62). Conclusions: Negative pressure inspiration is significantly impaired by an unstable chest wall. Restoring mechanical stability of the fractured ribs improves respiratory outcomes similar to baseline values. PMID:26848471

  2. New insights into the evolutionary history of biological nitrogen fixation

    PubMed Central

    Boyd, Eric S.; Peters, John W.

    2013-01-01

    Nitrogenase, which catalyzes the ATP-dependent reduction of dinitrogen (N2) to ammonia (NH3), accounts for roughly half of the bioavailable nitrogen supporting extant life. The fundamental requirement for fixed forms of nitrogen for life on Earth, both at present and in the past, has led to broad and significant interest in the origin and evolution of biological N2 fixation. One key question is whether the limited availability of fixed nitrogen was a factor in life's origin or whether there were ample sources of fixed nitrogen produced by abiotic processes or delivered through the weathering of bolide impact materials to support this early life. If the latter, the key questions become what were the characteristics of the environment that precipitated the evolution of this oxygen sensitive process, when did this occur, and how was its subsequent evolutionary history impacted by the advent of oxygenic photosynthesis and the rise of oxygen in the Earth's biosphere. Since the availability of fixed sources of nitrogen capable of supporting early life is difficult to glean from the geologic record, there are limited means to get direct insights into these questions. Indirect insights, however, can be gained through phylogenetic studies of nitrogenase structural gene products and additional gene products involved in the biosynthesis of the complex metal-containing prosthetic groups associated with this enzyme complex. Insights gained from such studies, as reviewed herein, challenge traditional models for the evolution of biological nitrogen fixation and provide the basis for the development of new conceptual models that explain the stepwise evolution of this highly complex life sustaining process. PMID:23935594

  3. C1-c2 pedicle screw fixation for treatment of old odontoid fractures.

    PubMed

    Qi, Lei; Li, Mu; Zhang, Shuai; Si, Haipeng; Xue, Jingsong

    2015-02-01

    Nonunion and C1-C2 instability of odontoid fractures usually result from delayed diagnosis and inappropriate treatment. However, the available treatment options for odontoid fractures remain controversial. The authors evaluated the effectiveness of internal screw fixation via the C1 and C2 pedicle in cases of old odontoid fractures. This retrospective study included 21 patients with old odontoid fractures (13 men and 8 women; mean age, 46.5 years; range, 24-69 years). Internal screw fixation via the C1 and C2 pedicle was performed in all patients. Fracture reduction and C1-C2 fusion were assessed with imaging. The neck pain visual analog scale score and cervical spinal cord functional Japanese Orthopaedic Association score (for those who had cervical spinal cord injury) were used to evaluate the effectiveness of treatment. Postoperative complications were recorded. Postoperative imaging showed that the C1-C2 dislocation was satisfactorily repositioned in all patients. Bone fusion was observed 1 year after surgery in all patients. No loosening or breaking of internal fixation occurred. The preoperative neck pain visual analog scale score was 5.9±1.5 and improved significantly to 1.8±0.8 after surgery (P<.001). The Japanese Orthopaedic Association score in patients with cervical spinal injury (n=14) was 9.2±1.9 and also significantly improved to 13.8±1.9 at the last follow-up examination (P<.001), with an average improvement rate of 61.0%. No iatrogenic vertebral artery injury or severe spinal cord injury occurred. Screw fixation via the C1 and C2 pedicle was found to be an effective and safe surgical approach for the treatment of old odontoid fractures with C1-C2 dislocation or instability.

  4. Will rising CO2 influence how nutrients interact to control tropical N2-fixation?

    NASA Astrophysics Data System (ADS)

    Trierweiler, A.; Winter, K.; Wright, S. J.; Wurzburger, N.; Hedin, L.

    2013-12-01

    The response of terrestrial tropical carbon sinks to increasing CO2 is a pressing question in biogeochemistry. Limitation of nutrients such as N may constrain these sinks. Biological N2-fixation, an important biogeochemical process that provides new nitrogen to ecosystems, potentially plays an important role in supporting tropical carbon sinks. Despite the importance of N2-fixation to the linked nitrogen and carbon cycles, we know little about how nutrient limitation of the process of biological N2-fixation, itself, will affect tropical fixation and N2-fixing plants. While rising CO2 levels may increase tree growth and N2-fixation when nutrients are abundant, at the same time, the increased growth may force N2-fixing plants into phosphorus (P) and molybdenum (Mo) limitation, both elements that are scarce in tropical forests and critical to N2-fixers. This study improves our understanding on what controls fixation through a series of greenhouse and in situ field experiments. First, we used a greenhouse experiment where we manipulated CO2 levels combined with a field study in forest gaps. In the greenhouse study we grew a N2-fixing seedling and a non-fixing seedling at pre-industrial (280 ppm), current (400 ppm), and double (800 ppm) CO2 concentrations with and without P, Mo, or both. In the year-long field study, we applied the same nutrient treatments to seedlings planting in natural light gaps and ambient CO2. To supplement our year-long seedling experiment, we also examined 11 years of growth data from a long-term N x P x K factorial fertilization experiment also on the Gigante Peninsula. In the greenhouse study, we found nutrient limitation was minimal at pre-industrial CO2 levels, but that limitation appeared with increasing CO2. Phosphorus limitation of tree growth and N2-fixation significantly increased with higher CO2. The additions of Mo and P together allowed for even greater growth and fixation, suggesting Mo-P co-limitation at elevated CO2. Compared to

  5. Effect of Interactions Among Algae on Nitrogen Fixation by Blue-Green Algae (Cyanobacteria) in Flooded Soils

    PubMed Central

    Wilson, John T.; Greene, Sarah; Alexander, Martin

    1979-01-01

    Nitrogen fixation (C2H2 reduction) by algae in flooded soil was limited by interactions within the algal community. Nitrogen fixation by either indigenous algae or Tolypothrix tenuis was reduced severalfold by a dense suspension of the green alga Nephrocytium sp. Similarly, interactions between the nitrogen-fixing alga (cyanobacterium) Aulosira 68 and natural densities of indigenous algae limited nitrogen-fixing activity in one of two soils examined. This was demonstrated by developing a variant of Aulosira 68 that was resistant to the herbicide simetryne at concentrations that prevented development of indigenous algae. More nitrogen was fixed by the resistant variant in flooded soil containing herbicide than was fixed in herbicide-free soil by either the indigenous algae or indigenous algae plus the parent strain of Aulosira. Interference from indigenous algae may hamper the development of nitrogen-fixing algae introduced into rice fields in attempts to increase biological nitrogen fixation. PMID:16345463

  6. Reaction products with internal energy beyond the kinematic limit result from trajectories far from the minimum energy path: an example from H + HBr --> H2 + Br.

    PubMed

    Pomerantz, Andrew E; Camden, Jon P; Chiou, Albert S; Ausfelder, Florian; Chawla, Navdeep; Hase, William L; Zare, Richard N

    2005-11-30

    The importance of reactive trajectories straying far from the minimum energy path is demonstrated for the bimolecular reaction H + HBr --> H2(v', j') + Br at 53 kcal/mol collision energy. Product quantum state distributions are measured and calculated using the quasi-classical trajectory technique, and the calculations indicate that highly internally excited H2 products result from indirect reactive trajectories with bent transition states. A general argument is made suggesting that reaction products with internal energy exceeding a kinematic constraint can, in general, be attributed to reactive collisions straying far from the minimum energy path.

  7. Evaluation of sprayable fixatives on a sandy soil for potential use in a dirty bomb response.

    PubMed

    Fritz, Brad G; Whitaker, John D

    2008-06-01

    After the events of 11 September 2001, the possibility of a dirty bomb being detonated within the United States seems more realistic. Development of tools for use in response to a dirty bomb detonation has become a topic of both discussion and research. While it has been reported that the health risk to the public from such an event would likely be small, it is thought that the psychological impact could be considerable. One response option that has been considered is adapting sprayable solutions for the purpose of fixing contamination in place, thereby limiting the spread of contamination by wind and rain and facilitating subsequent cleanup. This work evaluated two commercially available particle fixatives (IsoFIX-HT and IsoFIX-RC) for their effectiveness in preventing dispersal of simulated contamination. Nonradioactive cesium chloride and cobalt oxide particles were selected as the simulated contamination and applied to the surface of three outdoor test plots. Two test plots were treated with fixatives; the third plot provided a control. Samples were collected over 95 days to observe changes in tracer concentration on the surface of the test plots. One fixative (IsoFIX-RC) effectively held the tracer in place with no net loss of tracer, while the other fixative (IsoFIX-HT) had no impact on the loss of tracer relative to the control. Under the conditions tested, IsoFIX-RC appears capable of fixing surface contamination in place for at least several months.

  8. Key role of symbiotic dinitrogen fixation in tropical forest secondary succession.

    PubMed

    Batterman, Sarah A; Hedin, Lars O; van Breugel, Michiel; Ransijn, Johannes; Craven, Dylan J; Hall, Jefferson S

    2013-10-10

    Forests contribute a significant portion of the land carbon sink, but their ability to sequester CO2 may be constrained by nitrogen, a major plant-limiting nutrient. Many tropical forests possess tree species capable of fixing atmospheric dinitrogen (N2), but it is unclear whether this functional group can supply the nitrogen needed as forests recover from disturbance or previous land use, or expand in response to rising CO2 (refs 6, 8). Here we identify a powerful feedback mechanism in which N2 fixation can overcome ecosystem-scale deficiencies in nitrogen that emerge during periods of rapid biomass accumulation in tropical forests. Over a 300-year chronosequence in Panama, N2-fixing tree species accumulated carbon up to nine times faster per individual than their non-fixing neighbours (greatest difference in youngest forests), and showed species-specific differences in the amount and timing of fixation. As a result of fast growth and high fixation, fixers provided a large fraction of the nitrogen needed to support net forest growth (50,000 kg carbon per hectare) in the first 12 years. A key element of ecosystem functional diversity was ensured by the presence of different N2-fixing tree species across the entire forest age sequence. These findings show that symbiotic N2 fixation can have a central role in nitrogen cycling during tropical forest stand development, with potentially important implications for the ability of tropical forests to sequester CO2.

  9. Quantifying the effect of fire disturbance on free-living nitrogen fixation in tropical ecosystems

    NASA Astrophysics Data System (ADS)

    De Oliveira Bomfim, B.; Silva, L. C. R.; Marimon-Junior, B. H.; Marimon, B.; Horwath, W. R.; Neves, L.

    2015-12-01

    Tropical forests and savannas are among the most important biomes on Earth, supporting more than half of all plant and animal species on the planet. Despite growing interest in biogeochemical processes that affect tropical forest dynamics, many, including biological nitrogen fixation (BNF), are still poorly understood. Free-living N-fixers are thought to play a key role in tropical ecosystems, alleviating N and P limitation, supporting above and below ground biomass production, as well as carbon storage in plants and soil, but this influence has yet to be quantified. Of particular interest, the spatial distribution and identity of free-living BNF under disturbance regimes that commonly lead to the conversion of forests to savannas is currently unknown. To address this critical gap in knowledge, we measured free-living BNF quantifying rates of N fixation under contrasting fire regimes in the Amazon-Cerrado transition of central Brazil. Samples were collected in 4 ha of floodable forests affected by fire and 1 ha of unburned (seasonally flooded) forest located at the Araguaia State Park, Mato Grosso State, Brazil. Free-living N-fixation rates were measured by both 15N2 (98 atom% 15N) and acethylene reduction assay (ARA). Samples were incubated in the field and left in the dark at room temperature for 12 hours. In the next few weeks we will quantify N fixation rates that will be presented in the upcoming AGU meeting.

  10. A possible nitrogen crisis for Archaean life due to reduced nitrogen fixation by lightning.

    PubMed

    Navarro-González, R; McKay, C P; Mvondo, D N

    2001-07-05

    Nitrogen is an essential element for life and is often the limiting nutrient for terrestrial ecosystems. As most nitrogen is locked in the kinetically stable form, N2, in the Earth's atmosphere, processes that can fix N2 into biologically available forms-such as nitrate and ammonia-control the supply of nitrogen for organisms. On the early Earth, nitrogen is thought to have been fixed abiotically, as nitric oxide formed during lightning discharge. The advent of biological nitrogen fixation suggests that at some point the demand for fixed nitrogen exceeded the supply from abiotic sources, but the timing and causes of the onset of biological nitrogen fixation remain unclear. Here we report an experimental simulation of nitrogen fixation by lightning over a range of Hadean (4.5-3.8 Gyr ago) and Archaean (3.8-2.5 Gyr ago) atmospheric compositions, from predominantly carbon dioxide to predominantly dinitrogen (but always without oxygen). We infer that, as atmospheric CO2 decreased over the Archaean period, the production of nitric oxide from lightning discharge decreased by two orders of magnitude until about 2.2 Gyr. After this time, the rise in oxygen (or methane) concentrations probably initiated other abiotic sources of nitrogen. Although the temporary reduction in nitric oxide production may have lasted for only 100 Myr or less, this was potentially long enough to cause an ecological crisis that triggered the development of biological nitrogen fixation.

  11. Percutaneous Transpedicular Fixation: Technical tips and Pitfalls of Sextant and Pathfinder Systems

    PubMed Central

    Hassan, Ahmed Salah Aldin

    2016-01-01

    Study Design The efficacy of the operative techniques, possible benefits as well as pitfalls and limitations of the techniques are discussed. Potential drawbacks are also detected. Purpose This study aims to report indications, techniques, and our experience with the use of the Sextant and PathFinder percutaneous transpedicular screw fixation systems. Overview of Literature Percutaneous pedicle screw insertion is a novel technique. Successful percutaneous placement of pedicle screws requires surgical skill and experience because of lack of anatomic surface landmarks. Fluoroscopy-guided percutaneous placement of pedicle screws is effective. Many systems are now available. Methods We conducted a prospective operative and postoperative analysis of 40 patients with absolute indication for thoracic or lumbar instability between January 2009 and June 2013. All procedures were performed with the Sextant (group A) and PathFinder (group B) systems under fluoroscopic guidance. Operative techniques are discussed and the results compared. Results Percutaneous transpedicular screw fixation minimizes the morbidity associated with open techniques without compromising the quality of fixation. A total of 190 screws were inserted. There was no additional morbidity. Postoperative computed tomography images and plain X-rays were analyzed. Reduction of visual analog scale scores of back pain was evident. Conclusions Fluoroscopy-guided percutaneous pedicular screws are feasible and can be safely done. Current systems allow multi-segmental fixation with significantly less difficulties. The described techniques have acceptable intra- and postoperative complication rates, and overall sufficient pain control with early mobilization of patients. PMID:26949466

  12. Key role of symbiotic dinitrogen fixation in tropical forest secondary succession

    NASA Astrophysics Data System (ADS)

    Batterman, Sarah A.; Hedin, Lars O.; van Breugel, Michiel; Ransijn, Johannes; Craven, Dylan J.; Hall, Jefferson S.

    2013-10-01

    Forests contribute a significant portion of the land carbon sink, but their ability to sequester CO2 may be constrained by nitrogen, a major plant-limiting nutrient. Many tropical forests possess tree species capable of fixing atmospheric dinitrogen (N2), but it is unclear whether this functional group can supply the nitrogen needed as forests recover from disturbance or previous land use, or expand in response to rising CO2 (refs 6, 8). Here we identify a powerful feedback mechanism in which N2 fixation can overcome ecosystem-scale deficiencies in nitrogen that emerge during periods of rapid biomass accumulation in tropical forests. Over a 300-year chronosequence in Panama, N2-fixing tree species accumulated carbon up to nine times faster per individual than their non-fixing neighbours (greatest difference in youngest forests), and showed species-specific differences in the amount and timing of fixation. As a result of fast growth and high fixation, fixers provided a large fraction of the nitrogen needed to support net forest growth (50,000kg carbon per hectare) in the first 12years. A key element of ecosystem functional diversity was ensured by the presence of different N2-fixing tree species across the entire forest age sequence. These findings show that symbiotic N2 fixation can have a central role in nitrogen cycling during tropical forest stand development, with potentially important implications for the ability of tropical forests to sequester CO2.

  13. An antibacterial and absorbable silk-based fixation material with impressive mechanical properties and biocompatibility

    PubMed Central

    Shi, Chenglong; Pu, Xiaobing; Zheng, Guan; Feng, Xinglong; Yang, Xuan; Zhang, Baoliang; Zhang, Yu; Yin, Qingshui; Xia, Hong

    2016-01-01

    Implant-associated infections and non-absorbing materials are two important reasons for a second surgical procedure to remove internal fixation devices after an orthopedic internal fixation surgery. The objective of this study was to produce an antibacterial and absorbable fixation screw by adding gentamicin to silk-based materials. The antibacterial activity was assessed against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) in vitro by plate cultivation and scanning electron microscopy (SEM). We also investigated the properties, such as the mechanical features, swelling properties, biocompatibility and degradation, of gentamicin-loaded silk-based screws (GSS) in vitro. The GSS showed significant bactericidal effects against S. aureus and E. coli. The antibacterial activity remained high even after 4 weeks of immersion in protease solution. In addition, the GSS maintained the remarkable mechanical properties and excellent biocompatibility of pure silk-based screws (PSS). Interestingly, after gentamicin incorporation, the degradation rate and water-absorbing capacity increased and decreased, respectively. These GSS provide both impressive material properties and antibacterial activity and have great potential for use in orthopedic implants to reduce the incidence of second surgeries. PMID:27869175

  14. An antibacterial and absorbable silk-based fixation material with impressive mechanical properties and biocompatibility

    NASA Astrophysics Data System (ADS)

    Shi, Chenglong; Pu, Xiaobing; Zheng, Guan; Feng, Xinglong; Yang, Xuan; Zhang, Baoliang; Zhang, Yu; Yin, Qingshui; Xia, Hong

    2016-11-01

    Implant-associated infections and non-absorbing materials are two important reasons for a second surgical procedure to remove internal fixation devices after an orthopedic internal fixation surgery. The objective of this study was to produce an antibacterial and absorbable fixation screw by adding gentamicin to silk-based materials. The antibacterial activity was assessed against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) in vitro by plate cultivation and scanning electron microscopy (SEM). We also investigated the properties, such as the mechanical features, swelling properties, biocompatibility and degradation, of gentamicin-loaded silk-based screws (GSS) in vitro. The GSS showed significant bactericidal effects against S. aureus and E. coli. The antibacterial activity remained high even after 4 weeks of immersion in protease solution. In addition, the GSS maintained the remarkable mechanical properties and excellent biocompatibility of pure silk-based screws (PSS). Interestingly, after gentamicin incorporation, the degradation rate and water-absorbing capacity increased and decreased, respectively. These GSS provide both impressive material properties and antibacterial activity and have great potential for use in orthopedic implants to reduce the incidence of second surgeries.

  15. Assessment of carbon fibre composite fracture fixation plate using finite element analysis.

    PubMed

    Saidpour, Seyed H

    2006-07-01

    In the internal fixation of fractured bone by means of bone-plates fastened to the bone on its tensile surface, an on-going concern has been the excessive stress shielding of the bone by the excessively-stiff stainless-steel plate. The compressive stress shielding at the fracture-interface immediately after fracture-fixation delays callus formation and bone healing. Likewise, the tensile stress shielding in the layer of bone underneath the plate can cause osteoporosis and decrease in tensile strength of this layer. In this study a novel forearm internal fracture fixation plate made from short carbon fibre reinforced plastic (CFRP) was used in an attempt to address the problem. Accordingly, it has been possible to analyse the stress distribution in the composite plates using finite-element modelling. A three-dimensional, quarter-symmetric finite element model was generated for the plate system. The stress state in the underlying bone was examined for several loading conditions. Based on the analytical results the composite plate system is likely to reduce stress-shielding effects at the fracture site when subjected to bending and torsional loads. The design of the plate was further optimised by reducing the width around the innermost holes.

  16. Individual Objective and Subjective Fixation Disparity in Near Vision

    PubMed Central

    Jaschinski, Wolfgang

    2017-01-01

    Binocular vision refers to the integration of images in the two eyes for improved visual performance and depth perception. One aspect of binocular vision is the fixation disparity, which is a suboptimal condition in individuals with respect to binocular eye movement control and subsequent neural processing. The objective fixation disparity refers to the vergence angle between the visual axes, which is measured with eye trackers. Subjective fixation disparity is tested with two monocular nonius lines which indicate the physical nonius separation required for perceived alignment. Subjective and objective fixation disparity represent the different physiological mechanisms of motor and sensory fusion, but the precise relation between these two is still unclear. This study measures both types of fixation disparity at viewing distances of 40, 30, and 24 cm while observers fixated a central stationary fusion target. 20 young adult subjects with normal binocular vision were tested repeatedly to investigate individual differences. For heterophoria and subjective fixation disparity, this study replicated that the binocular system does not properly adjust to near targets: outward (exo) deviations typically increase as the viewing distance is shortened. This exo proximity effect—however—was not found for objective fixation disparity, which–on the average–was zero. But individuals can have reliable outward (exo) or inward (eso) vergence errors. Cases with eso objective fixation disparity tend to have less exo states of subjective fixation disparity and heterophoria. In summary, the two types of fixation disparity seem to respond in a different way when the viewing distance is shortened. Motor and sensory fusion–as reflected by objective and subjective fixation disparity–exhibit complex interactions that may differ between individuals (eso versus exo) and vary with viewing distance (far versus near vision). PMID:28135308

  17. Determination of protein loss during aqueous and phase partition fixation using formalin and glutaraldehyde

    SciTech Connect

    Mays, E.T.; Feldhoff, R.C.; Nettleton, G.S.

    1984-10-01

    In phase partition fixation tissue is immersed in an organic solvent at equilibrium with an aqueous phase containing a fixing agent. By using radioisotope labeling techniques the effects of phase partition fixation on protein retention during fixation of tissue with formalin and glutaraldehyde have been determined and compared with those of standard aqueous fixation using these fixatives. It has been shown that retention of protein in tissue during phase partition fixation was as good or better than during aqueous fixation. Improved retention provides further evidence that phase partition fixation may be a useful alternative to aqueous fixation.

  18. Complications in operative fixation of calcaneal fractures

    PubMed Central

    Li, Ying; Bao, Rong-Hua; Jiang, Zhi-Qiang; Wu, Huo-Yan

    2016-01-01

    Objective: The purpose of this study focused on a number of factors that have been implicated in calcaneal complications and find the incidence of wound complications. Methods: This was a retrospective study. A total of 162 patients (176 feet) who underwent calcaneal fractures between 2007 and 2012 were included. The patient’s personal details, age, time from injury to surgery, cause of injury, type of fracture, operative details, operating and tourniquet times were collected from hospital computers and paper records. Evidence of complications including wound infection, wound necrosis, pain, malunion, nonunion, impingement, loss of fixation, ect were studied. Results: Forty-seven of one hundred and seventy-six fractures (26.704%) had complications, wound infection was noted in seven fractures (3.977%), twelve fractures developed necrosis (6.818%), 14 fractures (7.955%) developed pain. Malunion was found in five fractures (2.841%), nonunion in two fractures (1.136%) and loss of fixation in four fractures (2.272%). Three neurologic injury was also seen in our study (1.705%). Operating time, time from injury to surgery and type of fracture had some association with complications in operative fixation of calcaneal fractures, which showed a statistically significant improvement (P=0.000, 0.031, 0.020, respectively), but there were no evidence that age and tourniquet time affect the incidence of complication after calcaneal fracture surgery (P=0.119, 0.682, respectively). Conclusions: Despite developments in the surgical treatment of calcaneal fracture, wound complications still remain inevitable. Advanced imaging techniques, less invasive surgical procedures, wealth of anatomical knowledge, surgical experience and better postoperative care should be ensured. PMID:27648028

  19. Carbon dioxide fixation in green sulphur bacteria

    PubMed Central

    Sirevåg, Reidun; Ormerod, J. G.

    1970-01-01

    1. About one-third of the CO2 fixed during photosynthesis by washed suspensions of Chlorobium thiosulfatophilum strain 8346 gave rise to α-oxoglutarate and branched-chain oxo acids, mainly β-methyl-α-oxovalerate. Another one-third to one-half gave rise to a polyglucose. 2. The fixation of CO2 was inhibited by fluoroacetate, increasing concentrations up to 1mm stimulating the accumulation of α-oxoglutarate and causing a decrease in the formation of the branched-chain oxo acids and polyglucose. 3. Acetate was converted into the same products as was CO2. 4. Fluoroacetate (1mm) had a negligible effect on the formation of polyglucose from acetate and caused a slight inhibition of the formation of the branched-chain oxo acids and increased accumulation of α-oxoglutarate. 5. Iodoacetate (1mm) strongly inhibited polyglucose formation from acetate and caused accumulation of pyruvate. The formation of the branched-chain oxo acids from acetate was only slightly affected by this inhibitor. 6. Pyruvate can be metabolized by this organism in the presence of a suitable electron donor whether CO2 is present or not. In the absence of CO2 pyruvate is converted into polyglucose. 7. The accumulation of oxo acids during CO2 fixation is completely inhibited by NH4+ ions. The formation of the branched-chain oxo acids is considerably decreased by the presence of isoleucine, leucine or valine, or a mixture of these. 8. CO2 fixation in two other strains of Chlorobium appears to exhibit a similar pattern to that in C. thiosulfatophilum strain 8346. 9. It is concluded that in washed suspensions, CO2 is fixed mainly by a mechanism involving the reductive carboxylic acid cycle. Acetate, the product of the cycle, is converted into polyglucose via pyruvate synthase and a reversal of glycolysis or into branched-chain oxo acids by an unknown mechanism. PMID:5493862

  20. Genetic regulation of nitrogen fixation in rhizobia.

    PubMed Central

    Fischer, H M

    1994-01-01

    This review presents a comparison between the complex genetic regulatory networks that control nitrogen fixation in three representative rhizobial species, Rhizobium meliloti, Bradyrhizobium japonicum, and Azorhizobium caulinodans. Transcription of nitrogen fixation genes (nif and fix genes) in these bacteria is induced primarily by low-oxygen conditions. Low-oxygen sensing and transmission of this signal to the level of nif and fix gene expression involve at least five regulatory proteins, FixL, FixJ, FixK, NifA, and RpoN (sigma 54). The characteristic features of these proteins and their functions within species-specific regulatory pathways are described. Oxygen interferes with the activities of two transcriptional activators, FixJ and NifA. FixJ activity is modulated via phosphorylation-dephosphorylation by the cognate sensor hemoprotein FixL. In addition to the oxygen responsiveness of the NifA protein, synthesis of NifA is oxygen regulated at the level of transcription. This type of control includes FixLJ in R. meliloti and FixLJ-FixK in A. caulinodans or is brought about by autoregulation in B. japonicum. NifA, in concert with sigma 54 RNA polymerase, activates transcription from -24/-12-type promoters associated with nif and fix genes and additional genes that are not directly involved in nitrogen fixation. The FixK proteins constitute a subgroup of the Crp-Fnr family of bacterial regulators. Although the involvement of FixLJ and FixK in nifA regulation is remarkably different in the three rhizobial species discussed here, they constitute a regulatory cascade that uniformly controls the expression of genes (fixNOQP) encoding a distinct cytochrome oxidase complex probably required for bacterial respiration under low-oxygen conditions. In B. japonicum, the FixLJ-FixK cascade also controls genes for nitrate respiration and for one of two sigma 54 proteins. Images PMID:7968919

  1. Alcohol-based solutions for bovine testicular tissue fixation.

    PubMed

    Cabrera, Nelson C; Espinoza, Jorge R; Vargas-Jentzsch, Paul; Sandoval, Patricio; Ramos, Luis A; Aponte, Pedro M

    2017-01-01

    Tissue fixation, a central element in histotechnology, is currently performed with chemical compounds potentially harmful for human health and the environment. Therefore, alternative fixatives are being developed, including alcohol-based solutions. We evaluated several ethanol-based mixtures with additives to study fixative penetration rate, tissue volume changes, and morphologic effects in the bovine testis. Fixatives used were Bouin solution, 4% formaldehyde (F4), 70% ethanol (E70), E70 with 1.5% glycerol (E70G), E70 with 5% acetic acid (E70A), E70 with 1.5% glycerol and 5% acetic acid (E70AG), and E70 with 1.5% glycerol, 5% acetic acid, and 1% dimethyl sulfoxide (DMSO; E70AGD). Five-millimeter bovine testicular tissue cubes could be completely penetrated by ethanol-based fixatives and Bouin solution in 2-3 h, whereas F4 required 21 h. Bouin solution produced general tissue shrinkage, whereas the other fixatives (alcohol-based and F4) caused tissue volume expansion. Although Bouin solution is an excellent fixative for testicular tissue, ethanol-based fixatives showed good penetration rates, low tissue shrinkage, and preserved sufficient morphology to allow identification of the stages of the seminiferous epithelium cycle, therefore representing a valid alternative for histotechnology laboratories. Common additives such as acetic acid, glycerol, and DMSO offered marginal benefits for the process of fixation; E70AG showed the best preservation of morphology with excellent nuclear detail, close to that of Bouin solution.

  2. Bone Plug Versus Suture-Only Fixation of Meniscal Grafts

    PubMed Central

    Wang, Hongsheng; Gee, Albert O.; Hutchinson, Ian D.; Stoner, Kirsten; Warren, Russell F.; Chen, Tony O.; Maher, Suzanne A.

    2014-01-01

    Background Meniscus allograft transplantation (MAT) is primarily undertaken to relieve the symptoms associated with meniscal deficiencies. However, its ability to restore normal knee joint contact mechanics under physiological loads is still unclear. Purpose To quantify the dynamic contact mechanics associated with 2 commonly used fixation techniques in MAT of the medial compartment: transosseous suture fixation via bone plugs and suture-only fixation at the horns. Study Design Controlled laboratory study. Methods Physiological loads to mimic gait were applied across 7 human cadaveric knees on a simulator. A sensor placed on the medial tibial plateau recorded dynamic contact stresses under the following conditions: (1) intact meniscus, (2) MAT using transosseous suture fixation via bone plugs at the anterior and posterior horns, (3) MAT using suture-only fixation, and (4) total medial meniscectomy. A “remove-replace” procedure was performed to place the same autograft for both MAT conditions to minimize the variability in graft size, geometry, and material property and to isolate the effects of the fixation technique. Contact stress, contact area, and weighted center of contact stress (WCoCS) were quantified on the medial plateau throughout the stance phase. Results Knee joint contact mechanics were sensitive to the meniscal condition primarily during the first half of the gait cycle. After meniscectomy, the mean peak contact stress increased from 4.2 ± 1.2 MPa to 6.2 ± 1.0 MPa (P = .04), and the mean contact area decreased from 546 ± 132 mm2 to 192 ± 122 mm2 (P = .01) compared with the intact meniscus during early stance (14% of the gait cycle). After MAT, the mean contact stress significantly decreased with bone plug fixation (5.0 ± 0.7 MPa) but not with suture-only fixation (5.9 ± 0.7 MPa). Both fixation techniques partially restored the contact area, but bone plug fixation restored it closer to the intact condition. The location of WCoCS in the

  3. TREATMENT OF POST-TRAUMATIC HUMERAL FRACTURES AND COMPLICATIONS USING THE OSTEOLINE® EXTERNAL FIXATOR: A TREATMENT OPTION

    PubMed Central

    de Azevedo, Marcos Coelho; de Azevedo, Gualter Maldonado; Hayashi, Alexandre Yoshio; Dourado Nascimento, Paulo Emilio

    2015-01-01

    To evaluate the results obtained from treatment of humeral shaft fractures and their complications using the Osteoline® uniplanar external fixator. Methods: The radiographic and functional results from 78 patients with humeral shaft fractures treated using the uniplanar external fixation technique were retrospectively assessed. The patients' ages ranged from 23 to 71 years, with a mean of 47 years. Male patients predominated (79%). Out of the 78 patients, 45 presented open fractures, 14 presented pseudarthrosis and six presented synthesis failure. There were no losses during the follow-up and all the patients were discharged after fracture consolidation and functional recovery. The results were evaluated based on the studies by Catagni, as good, fair or poor. Results: Fracture consolidation was observed in 98% of the cases treated with uniplanar external fixation. Only one pseudarthrosis case required conversion to rigid internal fixation and autologous bone grafting. At the end of the treatment, all the patients were discharged with consolidated fractures, without pain, and good limb function. Conclusion: The external fixation described in this paper was shown to be an efficient and safe method for treating humeral shaft fractures and their complications. It preserved the local biological status and enabled passive and active movement immediately after surgery. PMID:27027026

  4. Successful treatment of nonunion with an Ilizarov ring fixator after ankle fracture for Charcot arthropathy: a case report

    PubMed Central

    2014-01-01

    Background Ankle fractures in patients with diabetes mellitus have long been recognized as a challenge to orthopedic surgeons. Nonunion and lengthy wound healing in high-risk patients with diabetes, particularly patients with peripheral arterial disease and renal failure, occur secondary to several clinical conditions and are often fraught with complications. Whether diabetic ankle fractures are best treated noninvasively or surgically is controversial. Case presentation A 53-year-old Japanese man fractured his right ankle. The fractured ankle was treated nonsurgically with a plaster cast. Although he remained non-weight-bearing for 3 months, radiography at 3 months showed nonunion. The nonunion was treated by Ilizarov external fixation of the ankle. The external fixator was removed 99 days postoperatively, at which time the patient exhibited anatomical and functional recovery and was able to walk without severe complications. Conclusion In patients with diabetes mellitus, severe nonunion of ankle fractures with Charcot arthropathy in which the fracture fragment diameter is very small and the use of internal fixation is difficult is a clinical challenge. Ilizarov external fixation allows suitable fixation to be achieved using multiple Ilizarov wires. PMID:25103697

  5. Principles of intramedullary pin and wire fixation.

    PubMed

    Howard, P E

    1991-02-01

    Knowledge and experience in the proper use of IM pins, K-wires, and orthopedic wire is a valuable asset to the veterinarian's ability to successfully repair a variety of long bone fractures. Most long bone fractures are amenable to repair with this form of fixation. When the principles of application are violated or the implants are used when contraindicated, complications often occur. Proper use of these implants results in the successful management of complex fractures to the satisfaction of both the animal owner and the veterinarian (Fig 10).

  6. Endotracheal tube fixation methods for optimal stability: a comparison of adhesive tape, suture, and tape-suture fixation.

    PubMed

    Farbod, Frank; Tuli, Puneet; Robertson, Bernard F; Jackson, Ian T

    2010-07-01

    Accidental extubation of an intubated patient is a serious consideration in the surgical patient. Adequate fixation in the intubated patient is essential to prevent potentially life-threatening complications. Several methods of endotracheal tube fixation have been described in the literature. In this study, we examine 3 common methods of fixation: adhesive tape alone, suture, and tape-suture. Testing occurred in a laboratory setting with 2 fresh cadavers. Endotracheal tubes were inserted, using the methods of fixation in question. We subjected each fixation technique to progressively increasing weight to determine which technique is most resistant to accidental removal. We found that fixation of the tube by combining tape around the tube with a suture through the tape is the best noninvasive technique of the 3 methods evaluated in cases where movement of the head is anticipated.

  7. Finite element evaluation of three methods of stable fixation of condyle base fractures.

    PubMed

    de Jesus, G P; Vaz, L G; Gabrielli, M F R; Passeri, L A; V Oliveira, T; Noritomi, P Y; Jürgens, P

    2014-10-01

    The surgical treatment of mandibular condyle fractures currently offers several possibilities for stable internal fixation. In this study, a finite element model evaluation was performed of three different methods for osteosynthesis of low subcondylar fractures: (1) two four-hole straight plates, (2) one seven-hole lambda plate, and (3) one four-hole trapezoidal plate. The finite element model evaluation considered a load applied to the first molar on the contralateral side to the fracture. Results showed that, although the three methods are capable of withstanding functional loading, the lambda plate displayed a more homogeneous stress distribution for both osteosynthesis material and bone and may be a better method when single-plate fixation is the option.

  8. Design of Fracture Fixation Plate for Necessary and Sufficient Bone Stress Shielding

    NASA Astrophysics Data System (ADS)

    Ramakrishna, Kotlanka; Sridhar, Idapalapati; Sivashanker, Sathiamoorthy; Khong, Kok Sun; Ghista, Dhanjoo N.

    The objective of treating the fractured bone is to achieve painless functioning of the bone and undisturbed healing at the fracture. Internal fixation by stiff bone-plate is one of the standard methods to achieve these objectives. Recently, there is considerable interest in the usage of compliant plates to enhance bone healing with reduced stress shielding. Herein, first an analytical solution is developed to determine screw forces in the bone-plate assembly that conforms the plate and the bone under bending load. Based on the analytical calculations, an optimal fixator plate selection criterion for necessary and sufficient stress shielding is proposed. Second, effectiveness of employing a non-homogeneous stiffness graded (SG) plate rather than a homogeneous stainless steel (SS) plate for stress shielding is investigated using a finite element method. It is found that stress shielding on bone by SG plate is less compared to SS plate.

  9. [The experimental investigations upon the influence of ocular fixation on habituation of postural reflexes in pigeon].

    PubMed

    Kaźmierczak, H

    1994-01-01

    The subject of investigation was the influence of ocular fixation on acquisition of habituation in experimental rotatory test in pigeons. The habituation training was performed in the three difference conditions: with full ocular fixation, fixation partly reduced and fixation excluded. Author confirmed that habituation with fixation excluded gave the best results of habituation of postural reflexes and head nystagmus in pigeons in rotatory training.

  10. Anaerobic CO2 fixation by the acetogenic bacterium Moorella thermoacetica

    SciTech Connect

    Hu, P; Rismani-Yazdi, H; Stephanopoulos, G

    2013-05-16

    Anaerobic bacteria such as Moorella thermoacetica have the capacity of fixing carbon dioxide with carbon monoxide and hydrogen for the production of ethanol, acetic acid, and other useful chemicals. In this study, we evaluated the fixation of CO2 for the production of acetic acid, as a product in its own right but also as precursor for lipid synthesis by oleaginous organisms. We achieved maximum cell optical density of 11.3, acetic acid titer of 31 g/L, and productivity of 0.55 g/L-h at CO mass-transfer rate of 83 mM/h. We also showed electron availability by CO mass transfer limited the process at CO mass transfer rates lower than 30 mM/h. Further enhancement of mass-transfer rate removed such limitations in favor of biological kinetics as main limitation. This work underlines the potential of microbial processes for converting syngas to fuel and chemical products in processes suitable for distributed feedstock utilization. (c) 2013 American Institute of Chemical Engineers AIChE J, 59: 3176-3183, 2013

  11. Randomized Prospective Study of Totally Extraperitoneal Inguinal Hernia Repair: Fixation Versus No Fixation of Mesh

    PubMed Central

    Koch, Cody A.; Greenlee, Susan M.; Larson, Dirk R.; Harrington, Jeffrey R.

    2006-01-01

    Background: Fixation of the mesh during laparoscopic totally extraperitoneal (TEP) inguinal hernia repair is thought to be necessary to prevent recurrence. However, mesh fixation may increase postoperative pain and lead to an increased risk of complications. We questioned whether elimination of fixation of the mesh during TEP inguinal hernia repair leads to decreased postoperative pain or complications, or both, without an increased rate of recurrence. Methods: A randomized prospective single-blinded study was carried out in 40 patients who underwent laparoscopic TEP inguinal hernia repair with (Group A=20) or without (Group B=20) fixation of the mesh. Results: Patients in whom the mesh was not fixed had shorter hospital length of stay (8.3 vs 16.0 hours, P=0.01), were less likely to be admitted to the hospital (P=0.001), used less postoperative narcotic analgesia in the PACU (P=0.01), and were less likely to develop urinary retention (P=0.04). No significant differences occurred in the level of pain, time to return to normal activity, or the difficulty of the operation between the 2 groups. No hernia recurrences were observed in either group (follow-up range, 6 to 30 months, median=19). Conclusions: Elimination of tack fixation of mesh during laparoscopic TEP inguinal hernia repair significantly reduces the use of postoperative narcotic analgesia, hospital length of stay, and the development of postoperative urinary retention but does not lead to a significant reduction in postoperative pain. Eliminating tacks does not lead to an increased rate of recurrence. PMID:17575757

  12. Comparison of screw fixation with elastic fixation methods in the treatment of syndesmosis injuries in ankle fractures.

    PubMed

    Seyhan, Mustafa; Donmez, Ferdi; Mahirogullari, Mahir; Cakmak, Selami; Mutlu, Serhat; Guler, Olcay

    2015-07-01

    17 patients with ankle syndesmosic injury were treated with a 4.5mm single cortical screw fixation (passage of screw 4 cortices) and 15 patients were treated with single-level elastic fixation material. All patients were evaluated according to the AOFAS ankle and posterior foot scale at the third, sixth and twelfth months after the fixation. The ankle range of movement was recorded together with the healthy side. The Student's t test was used for statistical comparisons. No statistical significant difference was observed between the AOFAS scores (p>0.05). The range of dorsiflexion and plantar flexion motion of the elastic fixation group at the 6th and 12th months were significantly better compared to the screw fixation group (p<0.01). Elastic fixation is as functional as screw fixation in the treatment of ankle syndesmosis injuries. The unnecessary need of a second surgical intervention for removal of the fixation material is another advantageous aspect of this method of fixation.

  13. Molecular Ecological and Stable Isotopic Studies of Nitrogen Fixation in Modern Microbial Mats

    NASA Technical Reports Server (NTRS)

    Bebout, B. M.; Crumbliss, L. L.; DesMarais, D. J.; Hogan, M. E.; Omoregie, E.; Turk, K. A.; Zehr, J. P.

    2003-01-01

    Nitrogen is usually the element limiting biological productivity in the marine environment. Microbial mats, laminated microbial communities analogous to some of the oldest forms of life on Earth, are often the sites of high rates of N fixation (the energetically expensive conversion of atmospheric dinitrogen into a biologically useful form). The N fixing enzyme nitrogenase is generally considered to be of ancient origin, and is widely distributed throughout the Bacterial and Archaeal domains of life, indicating an important role for this process over evolutionary time. The stable isotopic signature of N fixation is purportedly recognizable in organic matter (ancient kerogens as well as present-day microbial mats) as a delta (15)N(sub organic) near zero. We studied two microbial mats exhibiting different rates of N fixation in order to better understand the impact of N fixation on the delta (15)N (sub organic) of the mats, as well as what organisms are important in this process. Mats dominated by the cyanobacterium Microcoleus chthonoplastes grow in permanently submerged hypersaline salterns, and exhibit low rates of N fixation, whereas mats dominated by the cyanobacterium Lyngbya spp grow in an intertidal area, and exhibit rates of N fixation an order of magnitude higher. To examine successional stages in mat growth, both developing and established mats at each location were sampled. PCR and RT-PCR based approaches were used to identify, respectively, the organisms containing nifH (one of the genes that encode nitrogenase) as well as those expressing nifH in these mats. Both mats exhibited a distinct diel cycle of N fixation, with highest rates occurring at night. The delta (15)N(sub organic) of the subtidal Microcoleus mats is near zero whereas the delta (15)N(sub organic) is slightly more positive (+ 2-3%), in the intertidal Lyngbya mats, an interesting difference in view of the fact that overall rates of activity in the intertidal mats are much higher that those

  14. Global changes in the transcript and metabolic profiles during symbiotic nitrogen fixation in phosphorus-stressed common bean plants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Phosphorus (P) deficiency is widespread in regions where the common bean (Phaseolus vulgaris L.), the most important legume for human consumption, is produced and is perhaps the factor that most limits nitrogen (N) fixation. Global gene expression and metabolome approaches were used to investigate t...

  15. Analysis of Bone Fixation Methods in Digital Replantation

    PubMed Central

    Lee, Seung Woo; Kim, Jin Soo; Roh, Si Young; Lee, Kyung Jin

    2017-01-01

    Background Adequate fixation of replanted digits is essential not only for short-term healing but for long-term function. Various bony fixation methods using Kirschner (K-) and intraosseous wire are available in replantation. We examined clinical and radiographic outcomes of fixation methods on bone union after digital replantation. Methods A single institutional retrospective review identified 992 patients who had undergone 1,247 successful replantations between July 2009 and September 2015. Exclusion criteria included amputations of the distal phalanx, comminuted fractures, and intra-articular fractures. Patients were classified according to 5 categories of fixation methods: single K-wire, double longitudinal K-wires, cross K-wires, wire with, and wire without K-wire support. Bone union was evaluated by 5-month postoperative X-ray and fixation outcomes were compared across the 5 groups. Results The exclusion criteria were applied, and 88 patients with 103 replanted digits remained for analysis. Single K-wire fixation was used in 40 digits, double longitudinal K-wires in 30, and cross fixation in 14. Wire with and without K-wire support was required in 15 and 4 digits. Nonunion was observed in 32 digits (31.1%), of which 13 required additional operations such as bone graft or corrective osteotomy. The highest percent of nonunion was observed after cross fixation (35.7%) and the lowest after wire alone (25.0%). Conclusions In this study, contrary to general knowledge, we found that single K-wire fixation was not associated with poorer outcomes. Successful bone union outcomes may be achieved by careful selection of bone fixation methods. This study provides useful information for planning bone fixation in digital replantation. PMID:28194348

  16. Surgical anatomy for pelvic external fixation.

    PubMed

    Solomon, L B; Pohl, A P; Chehade, M J; Malcolm, A M; Howie, D W; Henneberg, M

    2008-10-01

    Pelvic external fixators have a high rate of reported complications, most of which relate to pin placement. In this descriptive study, we analyzed the morphology of the ilium in cadaveric specimens and compared these with the measures obtained from normal human pelvic computer tomograph scans, and how these related to each of the three basic configurations of pin positioning for the external fixation of a pelvis: anterosuperior (Slätis type), anteroinferior (supra-acetabular), and subcristal. The irregular shape and size of the iliac wing and the abdominal wall overlying the pin's insertion site could hinder accurate placement of anterosuperior pins. Potential disadvantages of the use of anteroinferior pins was found related to the deep location of the anterior inferior iliac spine, interference with the hip flexion area, risk of hip joint penetration, and the variable obliquity of the ilium. As subcristal pins are positioned between two superficial bony landmarks of the iliac crest, our findings suggest that they are more likely to have a correct placement and avoid complications.

  17. Mini-plate fixation versus suture suspensory fixation in cervical laminoplasty

    PubMed Central

    Liu, Feng-Yu; Ma, Lei; Huo, Li-Shuang; Cao, Yan-Xiang; Yang, Da-Long; Wang, Hui; Yang, Si-Dong; Ding, Wen-Yuan

    2017-01-01

    Abstract Background: Both the mini-plate fixation and suture suspensory fixation techniques are extensively applied in cervical laminoplasty, but which technique is superior has not been ascertained. The purpose of this meta-analysis is to compare the results between mini-plate fixation and suture suspensory fixation in cervical laminoplasty for the patients with multilevel cervical compressive myelopathy. Methods: PubMed, Embase, the Cochrane library, CNKI, and WANFANG were searched for studies that compared mini-plate fixation and suture suspensory fixation in cervical laminoplasty up to November 1, 2016. We calculated odds ratio (OR) with 95% confidence interval (CI) for dichotomous outcomes and mean difference (MD) with 95% CI for continuous outcomes. Review Manager 5.3 was used for the statistical analyses. Results: A total of 25 studies, involving 1603 participants, were included in this review. The results of this meta-analysis indicated that there were statistically significant differences in postoperative Japanese Orthopedic Association (JOA) scores (MD = 0.67, 95% CI: 0.34–0.99, P < 0.001), JOA scores improvement rate (MD = 4.00, 95% CI: 2.51–5.50, P < 0.001), postoperative Visual Analogue Score (VAS) (MD = −0.81, 95% CI: −1.36 to −0.26, P = 0.004), postoperative range of motion (ROM) (MD = 4.15, 95% CI: 2.06–6.23, P < 0.001), postoperative cervical lordosis (MD = 3.1, 95% CI: 2.02–4.18, P < 0.001), postoperative anteroposterior diameter of the spinal canal (MD = 1.53, 95% CI: 0.11–2.95, P = 0.03), postoperative open angle (MD = 1.93, 95% CI: 0.14–3.71, P = 0.03), postoperative cross-sectional area of the spinal canal (MD = 37.10, 95% CI: 26.92–47.29, P < 0.001), axial symptoms (OR = 0.28, 95% CI: 0.20–0.37, P < 0.001), operation time (MD = 4.46, 95% CI: 0.74–8.19, P = 0.02), and blood loss (MD = 9.24, 95% CI: 6.86–11.62, P < 0.001). However

  18. Nitrogen fixation in boreal peatlands: the effects of increased N deposition on N2-fixation

    NASA Astrophysics Data System (ADS)

    Popma, J. M.; Wieder, R.; Lamers, L.; Vile, M. A.

    2013-12-01

    Boreal peatlands are of great importance to global carbon and nitrogen cycling. While covering only 3-4 % of the terrestrial surface, they account for 25-30 % of the world's soil C and 9-15 % of the world's soil N. In Western Canada atmospheric dry deposition rates are extremely low: approximately 1 kg N ha-1 yr-1. Though these systems have been functioning as net sinks over the past 11,000 years, natural and anthropogenic disturbances might compromise the historical balance of C and N. Biological N2-fixation has recently been shown to represent a very significant input of N into these systems, contributing to 62% of total N in Western Canada. Interactions between N deposition and biological N2-fixation are as yet, unknown, but the impact of elevated deposition of N-compounds from increased industrial expansion of oil sands mining to peatlands, is concerning. Given that nitrogenase, the enzyme responsible for catalyzing N2-fixation, is energetically costly when active, enhanced inputs of atmospheric N deposition could be a major determinant for enzyme activity and rates of biological N input to these bogs. Understanding interactions between N deposition and N2 fixation in boreal peatlands can aid in predicting the consequences of increased N deposition and setting critical loads. We conducted a field-fertilization experiment in a poor fen in Alberta, Canada, to determine the effects of enhanced N deposition on a dominant fen species Sphagnum angustifolium. The experiment consisted of seven N treatments: Control, 0, 5, 10, 15, 20 and 25 kg N ha-1 y1, n=3. N2-fixation was measured during summer 2012 and 2013 using the acetylene reduction assay (ARA). ARA rates were converted to rates of N2-fixation by calibrating ARA with paired 15N2-incubations. In both 2012 and 2013, with increasing N deposition from 0 kg N ha-1 yr-1 to 25 kg N ha-1 yr-1, rates of N2 fixation decreased, with highest rates in the 0 kg N ha-1 yr-1 treatment mosses (54.2 × 1.40; 48.58 × 7.12 kg N ha

  19. Effects of the end fixation of airplane struts

    NASA Technical Reports Server (NTRS)

    Teichmann, Alfred

    1930-01-01

    The main purpose of this report is to give references to literature on the subject of end fixation of airplane struts and also to furnish the constructor with a general survey of the simplest methods for estimating the end-fixation effect.

  20. Microbial community shifts influence patterns in tropical forest nitrogen fixation.

    PubMed

    Reed, Sasha C; Townsend, Alan R; Cleveland, Cory C; Nemergut, Diana R

    2010-10-01

    The role of biodiversity in ecosystem function receives substantial attention, yet despite the diversity and functional relevance of microorganisms, relationships between microbial community structure and ecosystem processes remain largely unknown. We used tropical rain forest fertilization plots to directly compare the relative abundance, composition and diversity of free-living nitrogen (N)-fixer communities to in situ leaf litter N fixation rates. N fixation rates varied greatly within the landscape, and 'hotspots' of high N fixation activity were observed in both control and phosphorus (P)-fertilized plots. Compared with zones of average activity, the N fixation 'hotspots' in unfertilized plots were characterized by marked differences in N-fixer community composition and had substantially higher overall diversity. P additions increased the efficiency of N-fixer communities, resulting in elevated rates of fixation per nifH gene. Furthermore, P fertilization increased N fixation rates and N-fixer abundance, eliminated a highly novel group of N-fixers, and increased N-fixer diversity. Yet the relationships between diversity and function were not simple, and coupling rate measurements to indicators of community structure revealed a biological dynamism not apparent from process measurements alone. Taken together, these data suggest that the rain forest litter layer maintains high N fixation rates and unique N-fixing organisms and that, as observed in plant community ecology, structural shifts in N-fixing communities may partially explain significant differences in system-scale N fixation rates.

  1. FIXATION OF FISH TISSUES. IN: THE LABORATORY FISH.

    EPA Science Inventory

    This chapter deals with the fixation of fish tissues and whole fish. Traditionally, fixation has been applied to animal tissues mainly for histological or pathological studies. Development of new molecular and immunologic tools now allows tissue and cellular localization of nucle...

  2. CRISP: A Computational Model of Fixation Durations in Scene Viewing

    ERIC Educational Resources Information Center

    Nuthmann, Antje; Smith, Tim J.; Engbert, Ralf; Henderson, John M.

    2010-01-01

    Eye-movement control during scene viewing can be represented as a series of individual decisions about where and when to move the eyes. While substantial behavioral and computational research has been devoted to investigating the placement of fixations in scenes, relatively little is known about the mechanisms that control fixation durations.…

  3. Cultivar effects on nitrogen fixation in peas and lentils

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Increasing nitrogen fixation in legume crops could increase cropping productivity and reduce nitrogen fertilizer use. Studies have found that crop genotype, rhizobial strain, and occasionally genotype-specific interactions affect N fixation, but this knowledge has not yet been used to evaluate or br...

  4. 21 CFR 878.3250 - External facial fracture fixation appliance.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false External facial fracture fixation appliance. 878.3250 Section 878.3250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... External facial fracture fixation appliance. (a) Identification. An external facial fracture...

  5. 21 CFR 878.3250 - External facial fracture fixation appliance.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false External facial fracture fixation appliance. 878.3250 Section 878.3250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... External facial fracture fixation appliance. (a) Identification. An external facial fracture...

  6. 21 CFR 878.3250 - External facial fracture fixation appliance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External facial fracture fixation appliance. 878.3250 Section 878.3250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... External facial fracture fixation appliance. (a) Identification. An external facial fracture...

  7. Acrylic Resin Molding Based Head Fixation Technique in Rodents.

    PubMed

    Roh, Mootaek; Lee, Kyungmin; Jang, Il-Sung; Suk, Kyoungho; Lee, Maan-Gee

    2016-01-12

    Head fixation is a technique of immobilizing animal's head by attaching a head-post on the skull for rigid clamping. Traditional head fixation requires surgical attachment of metallic frames on the skull. The attached frames are then clamped to a stationary platform resulting in immobilization of the head. However, metallic frames for head fixation have been technically difficult to design and implement in general laboratory environment. In this study, we provide a novel head fixation method. Using a custom-made head fixation bar, head mounter is constructed during implantation surgery. After the application of acrylic resin for affixing implants such as electrodes and cannula on the skull, additional resins applied on top of that to build a mold matching to the port of the fixation bar. The molded head mounter serves as a guide rails, investigators conveniently fixate the animal's head by inserting the head mounter into the port of the fixation bar. This method could be easily applicable if implantation surgery using dental acrylics is necessary and might be useful for laboratories that cannot easily fabricate CNC machined metal head-posts.

  8. Excision Versus Fixation of the Radial Head: A Comparative Study of the Functional Outcomes of the Two Techniques

    PubMed Central

    Shetty, Sanath Kumar; Shetty, Ashwin; Balan, Bijith; Rai, H.Ravindranath; Hegde, Anoop

    2017-01-01

    Introduction The management of displaced and comminuted radial head fractures has been a matter of debate amongst surgeons for many years. Radial head excision formed the mainstay of surgical management of these injuries. Over the years, there have been improvements in the surgical techniques and availability of better implants and instrumentation techniques, hence, open reduction and internal fixation of these fractures is gaining popularity. Aim To compare the outcome of elbow function between radial head excision and open reduction and internal fixation of the radial head with mini screws of Mason Type II and Type III radial head fractures and to assess the complications that occur in both techniques. Materials and Methods A prospective study was conducted in the Department of Orthopaedic Surgery of Justice K.S.Hegde Charitable hospital. A total of 40 patients between the age group of 30-50 years with Mason Type II and Type III fresh closed radial head fractures were included in the study. Group I consisted of 20 patients who underwent radial head excision and Group II consisted of 20 patients who underwent open reduction and internal fixation with mini screws. Patients were reviewed at postoperative week 3, 6 and 24. Radiographs were taken and functional outcome assessment of the elbow was done during all the follow ups. Elbow physiotherapy was started on postoperative week three. Scoring of elbow function was done as per the Disabilities of the Arm, Shoulder and Hand (DASH) scoring system. Results were tabulated, compared and analysed statistically using the ‘chi-square test’. Results At the end of six months, the patients of the open reduction and internal fixation group had lower DASH scores (4.82±2.73 points) than the radial head excision group (14.23±5.60 points). This inferred that patients who underwent open reduction and internal fixation had better functional outcomes than the excision group. Complications of proximal radial migration was noted

  9. Precision Medicine Starts With Preanalytics: Real-Time Assessment of Tissue Fixation Quality by Ultrasound Time-of-Flight Analysis.

    PubMed

    Lerch, Melissa L; Bauer, Daniel R; Chafin, David; Theiss, Abbey; Otter, Michael; Baird, Geoffrey S

    2017-03-01

    Personalized medicine promises diagnosis and treatment of disease at the individual level and relies heavily on clinical specimen integrity and diagnostic assay quality. Preanalytics, the collection and handling steps of a clinical specimen before immunohistochemistry or other clinical assay, are critically important to enable the correct diagnosis of disease. However, the effects of preanalytics are often overlooked due to a lack of standardization and limited assessment tools to quantify their variation. Here, we report a novel real-time ultrasound time-of-flight instrument that is capable of monitoring and imaging the critical step in formalin fixation, diffusion of the fixative into tissue, which provides a quantifiable quality metric for tissue fixation in the clinical laboratory ensuring consistent downstream molecular assay results. We analyzed hundreds of tissue specimens from 34 distinct human tissue types and 12 clinically relevant diseased tissues for diffusion and fixation metrics. Our measurements can be converted into tissue diffusivity constants that correlate with the apparent diffusion constant calculated using magnetic resonance imaging (R=0.83), despite the differences in the approaches, indicating that our approach is biophysically plausible. Using data collected from time-of-flight analysis of many tissues, we have therefore developed a novel rapid fixa