Opportunistic toenail onychomycosis. The fungal colonization of an available nail unit space by non-dermatophytes is produced by the trauma of the closed shoe by an asymmetric gait or other trauma. A plausible theory.

PubMed

Zaias, N; Escovar, S X; Rebell, G

2014-08-01

Opportunistic onychomycosis is defined, when a non-dermatophyte mould is cultured from an abnormal nail unit in the absence of a dermatophyte. The presumption is that the mould has caused the abnormal clinical appearance of the nail unit, yet there are no data available to substantiate this claim. Reports have only identified the mould being recovered from the nail unit niche. A review of the published dermatologic literature describing toenail opportunistic onychomycosis by non-dermatophyte fungi has shown toenails with onycholysis, nail bed (NB) keratosis and nail plate surface abnormalities. The appearance of these clinical changes is indistinguishable from the diagnosis of the Asymmetric Gait Nail Unit Signs (AGNUS). AGNUS is produced by the friction of the closed shoe in patients with an asymmetric gait, resulting primarily from the ubiquitous uneven flat feet. Most commonly, species of Acremonium (Cephalosporium), Aspergillus, Fusarium, Scopulariopsis and rarely species of many different fungi genera are capable of surviving and reproducing in a keratinous environment and change the clinical appearance of the involved nail unit. AGNUS toenails predispose to the colonization by the non-dermatophyte opportunistic fungi but not by dermatophyte fungi. © 2014 European Academy of Dermatology and Venereology.

Extraction of the Wichita Fusion Nail after Knee Arthrodesis

PubMed Central

Neuts, Ann-Sophie; Lammens, Johan; Stuyck, Jose

2016-01-01

To avoid a new exposition and partial damage of a knee arthrodesis site due to the removal of the Wichita fusion nail (WFN), a new extraction technique was developed, using a femoral osteotomy at the proximal end of the nail. Fixing the osteotomy with an Ilizarov frame offered the possibility to perform an additional correction of length and/or alignment if necessary. PMID:28529847

Nails in Forensic Toxicology: An Update.

PubMed

Solimini, Renata; Minutillo, Adele; Kyriakou, Chrystalla; Pichini, Simona; Pacifici, Roberta; Busardo, Francesco Paolo

2017-01-01

The analysis of nails as a keratinized matrix to detect drugs or illicit substances has been increasingly used in forensic and clinical toxicology as a complementary test, especially for the specific characteristics of stably accumulating substances for long periods of time. This allows a retrospective investigation of chronic drug abuse, monitoring continuous drug or pharmaceutical use, reveal in utero drug exposure or environmental exposures. We herein review the recent literature investigating drug incorporation mechanisms and drug detection in nails for forensic toxicological purposes. Mechanisms of drug incorporation have not yet been fully elucidated. However, some research has lately contributed to a better understanding of how substances are incorporated into nails, suggesting three potential mechanisms of drug incorporation: contamination from sweat, incorporation from nail bed and incorporation from germinal matrix. In addition, numerous methods dealing with the determination of drugs of abuse, medications and alcohol biomarkers in nails have been reported in studies over the years. The latter methods could find application in clinical and forensic toxicology. The studies herein reviewed point out how important it is to standardize and harmonize the methodologies (either pre-analytical or analytical) for nails analysis and the optimization of sampling as well as the development of proficiency testing programs and the determination of cut-off values. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

High-resolution ultrasonography in assessment of nail-related disorders.

PubMed

Singh, R; Bryson, D; Singh, H P; Jeyapalan, K; Dias, J J

2012-09-01

Disorders of the nail can pose a diagnostic challenge, and non-invasive imaging is frequently required to clarify diagnosis and delineate anatomy pre-operatively. We explored the use of high-resolution ultrasonography in the assessment of patients with nail disorders attending orthopaedic hand clinics. A search of a university teaching hospital musculoskeletal radiology database identified 36 patients (mean age 54.2 years) where ultrasonography was used to assess nail-related disorders between April 2003 and January 2007. Clinical, surgical and histological findings were correlated in these cases with ultrasound reports. Ultrasound findings correlated with the provisional diagnosis in 20 (61%) of 33 patients and provided a diagnosis in 3 patients where a provisional diagnosis was unavailable. In 7 of the 13 cases where the clinical diagnosis differed from ultrasound findings, a lump originally diagnosed as cystic in origin was shown to be solid on ultrasound. Different nail pathologies showed different characteristics on ultrasonography, including differences in vascularity, echogenicity, changes in nail structure/shape and extension into the nail bed, matrix, fold or evidence of bony erosion. The ultrasound findings correlated with histological analysis and intra-operative assessment in 10 of 15 patients who underwent operative treatment. Ultrasound provides important information on the anatomy of the nail apparatus and can differentiate solid and cystic lesions. It can be used as a diagnostic tool and can therefore help in pre-operative planning of nail-related disorders. In our series ultrasound supported or improved upon the clinical diagnosis in 31 (86%) out of the 36 patients presenting with nail-related disorders.

Road Nail: Experimental Solar Powered Intelligent Road Marking System

NASA Astrophysics Data System (ADS)

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

2012-03-01

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

75 FR 43149 - Certain Steel Nails from the Peoples' Republic of China: Notice of Partial Rescission of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... Metals & Minerals Import and Export Co., Ltd.; 29) Xuzhou CIP International Group Co., Ltd.; 30) Zhaoqing... and Export Co., Ltd.; 24) Xuzhou CIP International Group Co., Ltd.; 25) Zhaoqing Harvest Nails Co...

Benzocaine and Babies: Not a Good Mix

MedlinePlus

... Signs Symptoms of methemoglobinemia include: pale, gray, or blue-colored skin, lips and nail beds shortness of breath fatigue confusion headache light-headedness rapid heart rate “Symptoms can occur within ...

Verrucous Onychomycosis Caused by Curvularia in a Patient with Congenital Pterygium.

PubMed

Vineetha, Mary; Palakkal, Seena; Sobhanakumari, K; Celine, M I; Letha, V

2016-01-01

A 57 year healthy farmer with congenital nail pterygium presented with a verrucous growth on nail bed since 8 months. He was not diabetic and HIV rapid card test negative. Our clinical diagnosis was chromoblastomycosis but culture showed growth of curvularia species on two occasions and histopathology showed hyphal and yeast forms of the pigmented fungus. After excision biopsy patient was started on oral itraconazole. This case is reported due to rarity of verrucous cutaneous lesions caused by curvularia in immunocompetent individuals.

Diclofenac-Induced Photo-Onycholysis

PubMed Central

Al-Kathiri, Lutfi; Al-Asmaili, Abla

2016-01-01

Onycholysis is the detachment of the nail plate from the nail bed. If drug-induced, it can be an isolated phenomenon, but it may also accompany or follow a cutaneous phototoxicity reaction due to drug intake and exposure to ultraviolet irradiation. Photo-onycholysis is a rare photosensitivity reaction due to exposure to either a natural or artificial source of light. Many drugs are responsible for this phototoxic reaction, especially tetracyclines, psoralens, chloramphenicol, non-steroidal anti-inflammatory drugs, fluoroquinolones, and, rarely, doxycycline. Any patient given enough of a therapeutic dose of an inducing drug and sufficient light irradiation can develop phototoxic reactions. While there is no need to avoid these drugs completely, precautions should be taken. Here we have reported the case of a patient who developed onycholysis of his fingernails with sparing of the toenails following administration of diclofenac therapy for lower back pain. The onycholysis was associated with a phototoxic reaction. The swellings resolved totally within two days, and the patient started to notice the separation of all fingernail plates from their nail beds. The patient was treated symptomatically. On follow-up, onycholysis had regressed slowly, and the condition recovered totally within three months without any sequelae. PMID:26816569

Assessment, management and treatment of acute fingertip injuries.

PubMed

Kearney, Anthony; Canty, Louise

2016-06-01

Fingertip injuries with nail bed trauma can require specialist hand surgery, depending on severity. However, most of these injuries can be managed in well-equipped emergency departments by emergency nurses with an in-depth knowledge and understanding of the anatomy and physiology of the fingernail and surrounding structures, assessment and examination, pain management and treatment. This article describes the surface and underlying anatomy and physiology of the nail, the most common mechanisms of injury, relevant diagnostic investigations, and initial assessment and management. It also discusses treatment options, referral pathways, and patient discharge advice.

Evaluation of dermal symptoms in hypothyroidism and hyperthyroidism.

PubMed

Razi, Ahad; Golforoushan, Farideh; Nejad, Amir Bahrami Shahla Babaee; Goldust, Mohamad

2013-06-01

Many symptoms arise in thyroid diseases. The aim of this study was to evaluate the dermal symptoms in hypothyroidism and hyperthyroidism. In this cross sectional study, 120 patients with hyperthyroidism and 50 patients suffering from hypothyroidism were studied. Cutaneous, hair and nail clinical symptoms were studied and registered in a special questionnaire. Mean age of patients suffering from hypothyroidism and hyperthyroidism were 38.24 +/- 14.45 and 25.86 +/- 14.69 years old. Dry and Coarse/rough skin were the most prevalent manifestations in the skin involvement in hypothyroidism since softness was the most prevalent ones in hyperthyroidism. Fragileness was the most prevalent symptom in patients with nail involvement in hypothyroidism since soft skin was the most prevalent ones in hyperthyroidism. Coarse/rough skin was observed more in patients with hair involvement in hypothyroidism since the most prevalent ones was separation of nail from its bed in hyperthyroidism. High prevalence of skin, hair and nail symptoms in thyroid patients, early diagnosis of the signs may be helpful in premature diagnosis and treatment of thyroid diseases.

78 FR 16651 - Certain Steel Nails From the People's Republic of China; Final Results of Third Antidumping Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-18

... People's Republic of China; Final Results of Third Antidumping Duty Administrative Review; 2010-2011... on certain steel nails from the People's Republic of China (``PRC'') on September 4, 2012.\\1\\ The... from the People's Republic of China: Preliminary Results and Partial Rescission of the Third...

77 FR 53845 - Certain Steel Nails From the People's Republic of China: Preliminary Results and Partial...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-04

...., a Chinese producer of subject merchandise and its Korean parent company, ECO System Corporation d/b...., Ltd.; (10) Nanjing Yuechang Hardware Co., Ltd.; (11) S-Mart (Tianjin) Technology Development Co. Ltd...) Zhaoqing Harvest Nails Co., Ltd.; (6) S-Mart Tianjing Technology Development Co., Ltd.; and (7) SDC...

The fracture properties and mechanical design of human fingernails.

PubMed

Farren, L; Shayler, S; Ennos, A R

2004-02-01

Fingernails are a characteristic feature of primates, and are composed of three layers of the fibrous composite keratin. This study examined the structure and fracture properties of human fingernails to determine how they resist bending forces while preventing fractures running longitudinally into the nail bed. Nail clippings were first torn manually to examine the preferred crack direction. Next, scissor cutting tests were carried out to compare the fracture toughness of central and outer areas in both the transverse and longitudinal direction. The fracture toughness of each of the three isolated layers was also measured in this way to determine their relative contributions to the toughness. Finally, the structure was examined by carrying out scanning electron microscopy of free fracture surfaces and polarized light microscopy of nail sections. When nails were torn, cracks were always diverted transversely, parallel to the free edge of the nail. Cutting tests showed that this occurred because the energy to cut nails transversely, at approximately 3 kJ m(-2), was about half that needed (approx. 6 kJ m(-2)) to cut them longitudinally. This anisotropy was imparted by the thick intermediate layer, which comprises long, narrow cells that are oriented transversely; the energy needed to cut this layer transversely was only a quarter of that needed to cut it longitudinally. In contrast the tile-like cells in the thinner dorsal and ventral layers showed isotropic behaviour. They probably act to increase the nail's bending strength, and as they wrap around the edge of the nail, they also help prevent cracks from forming. These results cast light on the mechanical behaviour and care of fingernails.

Longitudinal erythronychia: individual or multiple linear red bands of the nail plate: a review of clinical features and associated conditions.

PubMed

Cohen, Philip R

2011-08-01

Longitudinal erythronychia is a linear red band on the nail plate that originates at the proximal nail fold, traverses the lunula, and extends to the free edge of the nail plate. Longitudinal erythronychia is classified based upon the number of nails affected and the number of red streaks present on each nail as follows: type Ia (monodactylous - single band), type Ib (monodactylous - bifid bands), type IIa (polydactylous - single band), and type IIb (polydactylous - multiple bands). Associated morphologic findings that can be present at the distal tip of the nail with longitudinal erythronychia include fragility, onycholysis, splinter hemorrhage, splitting, subungual keratosis, thinning, and V-shaped nick. Some patients with longitudinal erythronychia seek medical evaluation because of pain in the associated distal digit; however, the linear red nail plate dyschromia is often asymptomatic and the individual is concerned about the cosmetic appearance or distal nail fragility. Longitudinal erythronychia can be a clinical manifestation of an underlying local or systemic condition. Benign tumors (glomus tumor, onychopapilloma, and warty dyskeratoma), malignant neoplasms (malignant melanoma and squamous cell carcinoma), and other conditions (hemiplegia and postsurgical scar) can be associated with monodactylous longitudinal erythronychia or it may be idiopathic or the initial stage of polydactylous longitudinal erythronychia-associated systemic conditions. Polydactylous longitudinal erythronychia is most commonly reported in patients with Darier disease (keratosis follicularis); other associated conditions include acantholytic dyskeratotic epidermal nevus, acantholytic epidermolysis bullosa, acrokeratosis verruciformis of Hopf, amyloidosis, graft-versus-host disease, lichen planus, and pseudobulbar syndrome. Polydactylous longitudinal erythronychia has also been observed as an idiopathic finding. Biopsy of the nail matrix and nail bed may be necessary to establish the diagnosis of a longitudinal erythronychia-associated condition. Indeed, a biopsy should be seriously considered in patients aged more than 50 years who present with a monodactylous longitudinal red band to exclude squamous cell carcinoma. Treatment of longitudinal erythronychia depends on the etiology. For patients with longitudinal erythronychia-associated discomfort or severe nail splitting, a surgical excision may provide not only the underlying diagnosis of the nail dyschromia, but also relief of related symptoms.

Partial matricectomy with curettage and electrocautery: a comparison of two surgical methods in the treatment of ingrown toenails.

PubMed

Ozan, Firat; Doğar, Fatih; Altay, Taşkin; Uğur, Sabri Gökhan; Koyuncu, Şemmi

2014-10-01

An ingrown toenail is a common, painful, and debilitating condition. This study aims to compare 2 surgical methods (partial matricectomy with curettage and electrocautery) in the treatment of ingrown toenails. A total of 92 ingrown nails of the big toe in 86 patients underwent partial matricectomy with curettage, whereas 57 ingrown nails of the big toe in 52 patients underwent partial matricectomy with electrocautery. Recurrence was observed in 2 toenails in the partial matricectomy with curettage group, whereas no recurrence was observed in the partial matricectomy with electrocautery group (p > .05). The mean period of postoperative pain was 2.3 and 3.1 days in the curettage group and the electrocautery group, respectively (p < .05). There was a significant difference in the duration of scar tissue inflammation (p < .05). Both surgical methods are safe treatment modalities with a high success rate. Partial matricectomy, which is achieved using curettage, seems to be superior to electrocautery in respect of reduced inflammation and duration of pain.

Complications of sodium hydroxide chemical matrixectomy: nail dystrophy, allodynia, hyperalgesia.

PubMed

Bostancı, Seher; Koçyiğit, Pelin; Güngör, Hilayda Karakök; Parlak, Nehir

2014-11-01

Ingrown toenails are seen most commonly in young adults, and they can seriously affect daily life. Partial nail avulsion with chemical matrixectomy, generally by using either sodium hydroxide or phenol, is one of the most effective treatment methods. Known complications of phenol matrixectomy are unpredictable tissue damage, prolonged postoperative drainage, increased secondary infection rates, periostitis, and poor cosmetic results. To our knowledge, there have been no reports about the complications related to sodium hydroxide matrixectomy. Herein, we describe three patients who developed nail dystrophy, allodynia, and hyperalgesia after sodium hydroxide matrixectomy.

Partial Removal of Nail Matrix in the Treatment of Ingrown Nails: Prospective Randomized Control Study Between Curettage and Electrocauterization.

PubMed

Kim, Maru; Song, In-Guk; Kim, Hyung Jin

2015-06-01

The aim of this study was to compare the result of electrocauterization and curettage, which can be done with basic instruments. Patients with ingrown nail were randomized to 2 groups. In the first group, nail matrix was removed by curettage, and the second group, nail matrix was removed by electrocautery. A total of 61 patients were enrolled; 32 patients were operated by curettage, and 29 patients were operated by electrocautery. Wound infections, as early complication, were found in 15.6% (5/32) of the curettage group, 10.3% (3/29) of the electrocautery group patients each (P = .710). Nonrecurrence was observed in 93.8% (30/32) and 86.2% (25/29) of the curettage and electrocautery groups, respectively, (lower limit of 1-sided 90% confidence interval = -2.3% > -15% [noninferiority margin]). To remove nail matrix, the curettage is effective as well as the electrocauterization. Further study is required to determine the differences between the procedures. © The Author(s) 2014.

42 CFR 484.36 - Condition of participation: Home health aide services.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... (B) Sponge, tub, or shower bath. (C) Shampoo, sink, tub, or bed. (D) Nail and skin care. (E) Oral... extended) survey as a result of having been found to have furnished substandard care (or for other reasons...

42 CFR 484.36 - Condition of participation: Home health aide services.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... (B) Sponge, tub, or shower bath. (C) Shampoo, sink, tub, or bed. (D) Nail and skin care. (E) Oral... extended) survey as a result of having been found to have furnished substandard care (or for other reasons...

42 CFR 484.36 - Condition of participation: Home health aide services.

Code of Federal Regulations, 2013 CFR

2013-10-01

.... (B) Sponge, tub, or shower bath. (C) Shampoo, sink, tub, or bed. (D) Nail and skin care. (E) Oral... extended) survey as a result of having been found to have furnished substandard care (or for other reasons...

42 CFR 484.36 - Condition of participation: Home health aide services.

Code of Federal Regulations, 2012 CFR

2012-10-01

.... (B) Sponge, tub, or shower bath. (C) Shampoo, sink, tub, or bed. (D) Nail and skin care. (E) Oral... extended) survey as a result of having been found to have furnished substandard care (or for other reasons...

42 CFR 484.36 - Condition of participation: Home health aide services.

Code of Federal Regulations, 2014 CFR

2014-10-01

.... (B) Sponge, tub, or shower bath. (C) Shampoo, sink, tub, or bed. (D) Nail and skin care. (E) Oral... extended) survey as a result of having been found to have furnished substandard care (or for other reasons...

Close association between metal allergy and nail lichen planus: detection of causative metals in nail lesions.

PubMed

Nishizawa, A; Satoh, T; Yokozeki, H

2013-02-01

Lichen planus (LP) is a common skin disorder of unknown aetiology that affects the skin, mucous membranes and nails. Although metal allergies have been implicated in the development of oral LP (OLP), the contribution of these allergies to nail LP (NLP) has yet to be studied in detail. To elucidate the link between metal allergy and NLP. We retrospectively analysed 115 LP patients with respect to the contribution of metals to either NLP or OLP. We also attempted to detect the specific metals involved in these nail lesions. Of the 79 patients that received a metal patch test (PT), 24 (30%) were positive for at least one of the metal compounds tested. Notably, the prevalence of positive reactions to metals in the NLP patients was significantly higher as compared with the OLP patients (59% vs. 27%, P < 0.05). Among the 10 PT-positive patients with NLP, improvement of the skin lesions was seen in six of the patients after removal of dental materials containing causative metals or systemic disodium cromoglycate therapy. On the other hand, only 3 of 16 PT-positive patients with OLP exhibited improvement after the removal of dental materials. Causative metals in the dental fillings/braces were detected in the involved nail tissues. This study suggests that metal allergies are more closely associated with NLP vs. OLP, and that deposited metals in the nail apparatus contribute to the development of lichenoid tissue reactions in the nail bed and matrix. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

FRACTURES OF THE FEMUR NECK RESULTING FROM RADIATION DAMAGE (in German)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koschitz-Kosic, H.

Fractures of the neck of the femur following radiation therapy may involve three interrelated factors: age of the patient, archetectonic phylogenesis of the femur neck, and onset of radionecrosis. Up to now approximates 144 cases of femur neck fracture have been reported in the literature. Of the 10 cases reported here there was no clear relation between the time of irradiation and the fracture. One fracture followed 35 months after 17,400 r, and another 15 months after 4000 r of x ray, but both of these patients had also received Ra therapy. The average time span between irradiation and fracturemore » was 21 months. Only x ray had been given to five patients, but five had received combined x-ray and Ra treatment. One of the patients with a medial femur neck fracture became ambulatory after three weeks bed rest. The other nine fractures were nailed without any fatality. Subsequently, two cases were practically free of difficulties 12 and 18 months later, three cases exhibited slight fatigue 2, 5, and 63 months later, and five cases limped and required a cane 1, 3, 14, 17, and 76 months later. So far none of the nails have been removed. In no case was there complete recalcification of the fracture, and the ability of the ambulatory patients to walk depended on a combination of callus formation and the support of the nail. The fractures never gave any contraindication for use of the nails. Their use reduced the time for bed rest needed to an average of approximates 5 weeks. Treatment of this type of patient should also include appropriate geriatric and physical therapy measures. (BBB)« less

Osteosynthesis of fractures of the femur with flexible metallic intramedullary nails.

PubMed

Firica, A; Troianescu, O; Petre, M

1978-04-01

The authors discuss their use of Ender's method in the treatment of fractures of the femur. The diameter and length of the nails depends on the type of fracture. 1) Three nails of 4 mm diameter are introduced in parallel from the medial condyle in fractures of the femoral neck; 2) 5 mm nails are used, in similar fashion, for the fixation of intertrochanteric and subtrochanteric fractures; 3) 5 mm nails are used for diaphyseal, supracondylar and intercondylar fractures, introduced in crossed fashion ("Eiffel Tower" technique) from both medial and lateral condyles. This method of fixation has proved to be extremely stable. The operation itself is quick, with no blood loss or shock. The patient can resume partial weight bearing after a week in stabilised intertrochanteric and shaft fractures, after a month in less stable types, and after three to four months in fractures of the neck of the femur. This report is based on the first 250 cases treated by this method.

Skin bridging secondary to ingrown toenail

PubMed Central

Dadaci, Mehmet; Ince, Bilsev; Altuntas, Zeynep; Kamburoglu, Haldun Onuralp; Bitik, Ozan

2014-01-01

Ingrown toenails are painful conditions that especially affect young people and may become chronic if not treated. We describe a case of chronically inflamed ingrown toenail left untreated for three years. In the physical examination, skin bridging and epithelialization was observed in midline secondary to soft tissue hypertrophy of the lateral nail matrixes. Epithelized fibrous tissue was cut across the lateral nail matrix and left for secondary healing. Partial matrixectomy was applied and the remnants were cauterized in compliance with the Winograd procedure after removal of the nail. Our case is an advanced condition which is the second report in the literature. Skin bridging secondary to excess soft tissue hypertrophy can be observed in untreated bilateral Heinfert or Frost stage 3 ingrown nails. This rare case can be classified as advanced stage 3 disease or stage 4. PMID:25674152

Polydactylous Transverse Erythronychia: Report of a Patient with Multiple Horizontal Red Bands Affecting the Fingernails.

PubMed

Chang, Carina; Beutler, Bryce D; Cohen, Philip R

2017-06-01

Redness of the nail plate-erythronychia-is a common condition involving one or multiple digits. It may affect the entire nail or present as longitudinal red bands that extend from the proximal nail fold to the distal tip of the nail plate. Rarely, red bands may traverse the nail bed horizontally. Although erythronychia is often idiopathic, it has also been associated with amyloidosis, Darier's disease, lichen planus, and various other cutaneous conditions. We describe the clinical features of a 64-year-old Caucasian man who presented with transverse and longitudinal erythronychia affecting his fingernails. In addition, we review the classification of erythronychia and summarize the acute and chronic conditions that have been associated with this clinical finding. The features of a man with polydactylous transverse and longitudinal erythronychia are presented. In addition, PubMed was used to search the following terms: erythronychia, longitudinal erythronychia, red lunulae, and subungual. All papers were reviewed, and relevant articles, along with their references, were evaluated. Informed consent was obtained from the patient for being included in the study. A 64-year-old Caucasian man with a past medical history significant for testicular cancer and pulmonary embolism presented with multiple horizontal pink-red bands affecting his fingernails. The discoloration was most prominent in the region distal to the lunula. In addition, the nails of the fifth digit of his left hand and third digit of his right hand featured longitudinal red bands extending from the distal curvature of the lunula to the free edge of the nail plate. A diagnosis of polydactylous longitudinal and transverse erythronychia, based on the clinical presentation, was established. Our patient's red bands were asymptomatic and he was not concerned about the cosmetic appearance of his nails; therefore, no additional investigation or treatment was required. Polydactylous transverse erythronychia is a rare condition characterized by the development of horizontal red bands affecting the fingernails or toe nails. It has only been previously described in a man with multiple system atrophy. In our patient, both transverse and longitudinal red bands were present simultaneously. Therefore, it is possible that horizontal erythronychia is an early clinical manifestation of longitudinal erythronychia.

Retrograde nailing for distal third femoral shaft fractures: a prospective study.

PubMed

Acharya, K N; Rao, M R

2006-12-01

To evaluate the postoperative knee function and results of unreamed retrograde nailing for distal third femoral shaft fractures. Between January 2002 and 2003 inclusive, a consecutive series of 27 patients (with 28 fractures) who underwent retrograde nailing were prospectively evaluated. Outcome measures were union time, initiation of weight bearing, deformity and shortening, functional length of the nail, knee function assessed using a modified Knee Society Knee Score. Correlations between union time and other variables were also studied. In these patients 26 (93%) of the 28 fractures achieved union, of which 5 underwent dynamisation; the mean union time for the other 21 fractures was 4.4 months. Angular malalignment was present in 4 patients and shortening in 4 others. There was negligible correlation between union time and variables of nail-canal diameter mismatch, functional length of nail, fracture geometry, or initiation of partial weight bearing ambulation. Knee flexion of more than 100 degrees was achieved in 26 patients. 19 patients had anterior knee pain and 10 had instability. By the end of one year, excellent or good scores for pain and function were recorded in 77% and 73% respectively, of the 26 patients. In view of such favourable union rates but significant deterioration in overall knee joint function, at best retrograde nailing is a reliable alternative in the management of selected complicated fractures of the distal femoral shaft.

[Treatment of periprosthetic femoral fractures after total hip arthroplasty with specially constructed retrograde hollow nails].

PubMed

Szalay, G; Meyer, C; Mika, J; Schnettler, R; Thormann, U

2014-12-01

Treatment of periprosthetic fractures by implantation of a specially constructed, retrograde hollow nail which fits over the tip of the prosthesis and becomes locked on it. Periprosthetic femoral fractures with firmly anchored prosthesis shaft after total hip arthroplasty of types B1 and C according to the Vancouver classification. Loosened prosthesis (type B2/B3) and trochanteric fractures (type A). Broken or damaged prosthesis, florid inflammation and soft tissue injuries in the operation field, contracted knee joint, advanced deformation in the knee joint and distal femur, enclosed prosthesis and general contraindications. In a supine position the periprosthetic fracture is exposed via a lateral access. For cemented prostheses the cement is removed around the tip of the prosthesis (at least 2-3 cm) and medullary cavity. Arthrotomy with flexion of the knee joint and marking of the nail entry point. Drill the medullary cavity, retrograde introduction of the nail, visually fit the nail over the tip of the prosthesis and lock the nail with the prosthesis. If necessary use additional spongiosaplasty or also placement of additional cerclages depending on fracture type and size of the defect zone. Lock the nail distally. Use intraoperative radiological imaging to control correct positioning and length of the nail. Close the wound layer by layer with placement of suction drainage devices and dressing. Partial loading for 6 weeks with a subsequent pain-adapted loading gradient until full loading is possible. If selective partial loading is not possible, a decision must be made in individual cases as to whether the intraoperative findings allow immediate full loading. From 2004 to 2011 a total of 25 periprosthetic femoral fractures in 25 patients were treated in 2 locations using specially constructed slotted hollow nails. Within the framework of a retrospective study 20 of these patients (16 female and 4 male; average age 77.2 [72-84] years) were clinically and radiologically re-examined on average 19.3 (7-31) months postoperatively. No postoperative bleeding, wound healing disorders and infections. In all patients there was a loading stable consolidation of the fracture in the correct femoral axis, length and rotation with no evidence for radiological signs of loosening of the prosthesis or dislocation of the nails. In one case there was loosening of the prosthesis which had obviously occurred during the operative procedure. After consolidation of the fracture it was necessary to exchange the prosthesis for a long shafted prosthesis. A comparable situation to the preoperative degree of mobility was found in 12 out of the 20 patients, a moderate deterioration in 5 patients, a substantial residual impairment in 2 patients and an improvement of the situation in 1 patient.

Mating of a PROSTALAC spacer with an intramedullary nail for reconstruction of an infected interprosthetic femoral shaft fracture: a case report.

PubMed

Kamath, Atul F; Austin, Daniel; Lee, Gwo-Chin

2012-08-01

Reconstruction for concurrent infection of an ipsilateral total hip arthroplasty (THA) and total knee arthroplasty (TKA) is a challenge. We report a 2-stage reconstruction of a THA for chronic infection of both the THA and TKA with severe femoral bone loss secondary to interprosthetic fractures. The reconstruction involved using a custom-made, temporary, antibiotic-impregnated PROSTALAC spacer mated with an intramedullary nail. The acetabulum was then exposed and the necrotic cartilage was removed and curetted. The acetabulum was reamed to accept a PROSTALAC acetabular shell. The shell was cemented into the acetabulum with antibiotic cement. The custom-made spacer was then inserted distally first into the tibia. The distal end of the intramedullary nail was interlocked with a bicortical bolt to minimise nail rotation. Antibiotic-impregnated cement was moulded around the nail and spacer. The proximal end of the spacer was then reduced into the acetabular socket, and the joint was irrigated and the wound closed. A customised abduction brace was fitted, and partial weight bearing was allowed. Sufficient leg length, soft-tissue tension, and range of hip motion were restored, and a total femur and constrained liner was re-implanted 4 months later. Mating of an intramedullary nail with a PROSTALAC spacer is a viable reconstructive option.

The microvascular and morphostructural changes of nails in psoriatic patients with nail disease; a link between ultrasound and videocapillaroscopy findings in the nailfold.

PubMed

Bakirci Ureyen, Sibel; Kara, Rabia Oztas; Erturk, Zeynep; Yaldiz, Mahizer

2018-05-02

The objective of this study is to evaluate the link between nail fold vessel resistive index (NVRI) measured by ultrasound (US) and capillary loops diameters measured using nailfold videocapillarascopy (NVC), and to assess the morphological appearance of the nail bed in patients with psoriatic nail disease (PND) as compared with healthy controls (HCs). This study was conducted in patients with PND and HCs. General demographic data were collected and clinical assessments were performed for all subjects. The nail plate thickness (NPT) was measured on gray scale using US. The NVRI was measured using color Doppler (CD) US. The measurements of the apical, arterial, venous limb diameters and morpho-structural changes (tortuous, cross-linked capillaries) were assessed using NVC. Thirty-four patients with PND and 15 HCs were enrolled in this study. The two groups were matched for age and body mass index (BMI). Patients with PND had higher NPT and NVRI in comparison with HCs [(20 (17-23) vs 14 (14-15), p<0.001), (0.55 (0.51-0.61) vs 0.43 (0.38-0.49), p<0.001), respectively]. A higher proportion of patients with PND had tortuous capillaries than HCs (62% and 20% respectively, p=0.005). The mean NVRI was higher in patients with PND who had tortuous capillaries than patients who did not have tortuous capillaries (0.58 (0.7) and 0.52 (0.09), respectively p=0.033). Microvascular changes can be detected easily using non-invasive methods such as US and NVC. These methods can provide an objective data to better assess PND.

Anatomic relationship of the proximal nail matrix to the extensor hallucis longus tendon insertion.

PubMed

Palomo López, P; Becerro de Bengoa Vallejo, R; López López, D; Prados Frutos, J C; Alfonso Murillo González, J; Losa Iglesias, M E

2015-10-01

The purpose of this study was to delineate the relationship of the terminal extensor hallucis longus tendon insertion to the proximal limit of the nail matrix of the great toe. Fifty fresh-frozen human cadaver great toes with no evidence of trauma (average age, 62.5 years; 29 males and 21 females) were used for this study. Under 25X magnification, the proximal limit of the nail matrix and the terminal bony insertion of the extensor hallucis longus tendons were identified. The distance from the terminal tendon insertion to the nail matrix was ascertained using precision calipers, an optical microscope, and autocad(®) software for windows. Twenty-five great toes were placed in a neutral formalin solution and further analysed by histological longitudinal-sections. The specimens were stained with haematoxylin and eosin and examined microscopically to determine the presence of the extensor hallucis longus tendon along the dorsal aspect of the distal phalanx of each great toe. The main result we found in great toes was that the extensor tendon is between the matrix and the phalanx and extends dorsally to the distal aspect of the distal phalanx in all, 100%, specimens. The nail matrix of the great toe is not attached to the periosteum of the dorsal aspect of the base of the distal phalanx as is the case for fingers, because the extensor hallucis tendon is plantar or directly underneath the nail matrix and the tendon is dorsal to the bone. We have found that the extensor tendon is between the matrix and the phalanx and extends dorsally to the distal aspect of the distal phalanx. The nail matrix of the great toe is not attached to the periosteum of the dorsal aspect of the base of distal phalanx as is the case in fingers, because the extensor hallucis tendon is plantar or directly underneath the nail matrix and the tendon is dorsal to the bone. Our anatomic study demonstrates that the proximal limit of the matrix and nail bed of the human great toe are dorsal and overlapping the terminal extensor hallucis longus tendon until its distal bony insertion in all specimens. © 2015 European Academy of Dermatology and Venereology.

How was the Turin Shroud Man crucified?

PubMed

Bevilacqua, M; Fanti, G; D'Arienzo, M; Porzionato, A; Macchi, V; De Caro, R

2014-12-01

As the literature is not exhaustive with reference to the way the Turin Shroud (TS) Man was crucified, and it is not easy to draw significant information from only a "photograph" of a man on a linen sheet, this study tries to add some detail on this issue based on both image processing of high resolution photos of the TS and on experimental tests on arms and legs of human cadavers. With regard to the TS Man hands, a first hypothesis states that the left hand of the TS Man was nailed twice at two different anatomical sites: the midcarpal joint medially to the pisiform between the lunate/pyramidal and capitate/uncinate bones (Destot's space) and the radiocarpal joint between the radio, lunate and scaphoid; also the right hand would have been nailed twice. A second hypothesis, preferred by the authors, states that the hands were nailed only once in the Destot's space with partial lesion of the ulnar nerve and flexion of the metacarpophalangeal joint of the thumbs. With regard to the TS Man feet, the imprint of the sole of the right foot leads to the conclusion that TS Man suffered a dislocation at the ankle just before the nailing. The entrance hole of the nail on the right foot is a few inches from the ankle, and excludes a double nailing. The nail has been driven between the tarsal bones. The TS Man suffered the following tortures during crucifixion: a very serious and widespread causalgia due to total paralysis of the upper right limb (paradoxical causalgia); a nailing of the left wrist with damage to the ulnar nerve; a similar nailing of the right wrist; and a nailing to both feet using one only nail that injured the plantaris medialis nerves. The respiratory limitation was probably not sufficient to cause death by asphyxiation. Also considering the hypovolemia produced by scourging and the many other tortures detectable on the TS, the principal cause of death can be attributed to a myocardial infarction. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluation of the morphological effects of TDT 067 (terbinafine in Transfersome) and conventional terbinafine on dermatophyte hyphae in vitro and in vivo.

PubMed

Ghannoum, M; Isham, N; Henry, W; Kroon, H-A; Yurdakul, S

2012-05-01

TDT 067 is a novel, carrier-based dosage form of terbinafine in Transfersome (1.5%) formulated for topical delivery of terbinafine to the nail, nail bed, and surrounding tissue. We examined the effects of TDT 067 and conventional terbinafine on the morphology of dermatophytes. Trichophyton rubrum hyphae were exposed to TDT 067 or terbinafine (15 mg/ml) and examined under white light, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Subungual debris from patients treated with TDT 067 in a clinical trial was also examined. Exposure of T. rubrum hyphae to TDT 067 led to rapid and extensive ultrastructural changes. Hyphal distortion was evident as early as 4 h after exposure to TDT 067. After 24 h, there was complete disruption of hyphal structure with few intact hyphae remaining. Exposure to terbinafine resulted in morphological alterations similar to those seen with TDT 067; however, the effects of TDT 067 were more extensive, whereas a portion of hyphae remained intact after 24 h of exposure to terbinafine. Lipid droplets were observed under TEM following 30 min of exposure to TDT 067, which after 24 h had filled the intracellular space. These effects were confirmed in vivo in subungual debris from patients with onychomycosis who received topical treatment with TDT 067. The Transfersome in TDT 067 may potentiate the action of terbinafine by delivering terbinafine more effectively to its site of action inside the fungus. Our in vivo data confirm that TDT 067 can enter fungus in the nail bed of patients with onychomycosis and exert its antifungal effects.

Evaluation of the Morphological Effects of TDT 067 (Terbinafine in Transfersome) and Conventional Terbinafine on Dermatophyte Hyphae In Vitro and In Vivo

PubMed Central

Isham, N.; Henry, W.; Kroon, H.-A.; Yurdakul, S.

2012-01-01

TDT 067 is a novel, carrier-based dosage form of terbinafine in Transfersome (1.5%) formulated for topical delivery of terbinafine to the nail, nail bed, and surrounding tissue. We examined the effects of TDT 067 and conventional terbinafine on the morphology of dermatophytes. Trichophyton rubrum hyphae were exposed to TDT 067 or terbinafine (15 mg/ml) and examined under white light, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Subungual debris from patients treated with TDT 067 in a clinical trial was also examined. Exposure of T. rubrum hyphae to TDT 067 led to rapid and extensive ultrastructural changes. Hyphal distortion was evident as early as 4 h after exposure to TDT 067. After 24 h, there was complete disruption of hyphal structure with few intact hyphae remaining. Exposure to terbinafine resulted in morphological alterations similar to those seen with TDT 067; however, the effects of TDT 067 were more extensive, whereas a portion of hyphae remained intact after 24 h of exposure to terbinafine. Lipid droplets were observed under TEM following 30 min of exposure to TDT 067, which after 24 h had filled the intracellular space. These effects were confirmed in vivo in subungual debris from patients with onychomycosis who received topical treatment with TDT 067. The Transfersome in TDT 067 may potentiate the action of terbinafine by delivering terbinafine more effectively to its site of action inside the fungus. Our in vivo data confirm that TDT 067 can enter fungus in the nail bed of patients with onychomycosis and exert its antifungal effects. PMID:22354309

Active Authentication: Beyond Passwords

DTIC Science & Technology

2011-11-18

103m 26-Jul-07 208k 27-Dec-10 4.9m Source: www.privacyrights.org/data-breach Hackers broke into a Gannett Co database containing personal...Pattern • Knuckle Pattern • Lip Pattern • Nail bed Pattern • Nose Pattern • Oto-acoustic Emissions • Palmprint • Retina Pattern • Skin... Palmprint Knuckle Pattern Pulse Electrocardiogram Electroencephalogram Face Geometry Lip Pattern Blue may be suitable for continuous monitoring

[Disruption of the arteria nutricia tibiae by reamed and unreamed intramedullary nailing. Study of the vascular architecture of the human tibial intramedullary cavity].

PubMed

Paar, O; mon O'Dey, D; Magin, M N; Prescher, A

2000-01-01

By reason of the pseudarthrotic healing of fractures due to vascular complications after reamed and unreamed intramedullary nailing, the intraosseous course and branching of the tibial nutrient artery and its impairment by nailing procedures needs an actual analysis. The nutrient vessel of 24 tibiae taken from fresh corpses were prepared by injection of Technovit and lead oxide. After this procedure the medullary cavities of 12 bones were opened by a frontal cut. These specimens were subjected to routine maceration. The other 12 tibiae were naed with the unreamed (6) and the reamed nailing (6) techniques. X-rays were also taken routinely. After penetration of the tibial compact bone the main trunk of the nutrient vessel runs through a perforated osseous tunnel (pars tecta arteriae nutriciae tibiae). At its end the vessel divides into a descending branch (obligate) and two ascending branches (facultative). The descending branch lies near to the centromedial region of the medullary cavity which is termed as the pars liberal arteriae nutriciae tibiae. All branches pass through supporting horizontal osseous lamellas. Due to this topography the reamed nailing technique destroyed the nutrient vessel completely in all specimens. In contrast to this observation the unreamed nailing destroyed the vessel completely only in 1 (16.7%) and partially in 3 (50%) bones; 2 (33.3%) specimens exhibited no destruction of the vessel. The unreamed as well as the reamed nailing technique can destroy the intramedullary course of the tibial nutrient artery. Fractures as well as displacement osteotomies or corticotomies are able to diminish the medullary blood supply seriously, if they are localised within the area of the tactic an of the tibial nutrient artery.

Program Evaluation of Outcomes Based Orthotic and Prosthetic Education

DTIC Science & Technology

2006-12-01

Rheumatoid Arthritis; synovial joints ; tendon sheaths. b. Osteoarthritis; weight bearing joints ; loading areas. c. Osteoporosis; cancellous bone...flexion. 32. The desirable length of a thumb post is: a. to the thumb IP joint . b. proximal to the IP joint . c. to the nail bed. d. just...assist hyperextension of the thoracic spine. b. eliminate motion. c. prevent lumbar flexion. d. reduce axial load on lumbar vertebrae. 44

77 FR 12556 - Certain Steel Nails From the People's Republic of China: Final Results and Final Partial...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

..., respectively. Case History On September 12, 2011, the Department published in the Federal Register the... Comment 6: Stanley's Surrogate Values A. Copper Plated Steel Welding Wire B. Sodium Sulfate C. Glass Balls...

A review of the mechanism of action of lasers and photodynamic therapy for onychomycosis.

PubMed

Bhatta, Anil Kumar; Keyal, Uma; Wang, Xiuli; Gellén, Emese

2017-02-01

Onychomycosis is one of the most common diseases in the field of dermatology. It refers to the fungal infection of the nail plate or nail bed with high incidence in the general population. The available treatment options for onychomycosis have limited use due to side effects, drug interactions, and contraindications, which necessitates the application of an alternative treatment for onychomycosis. In the recent years, lasers and photodynamic therapy (PDT) have been recognized as alternative treatment options. Most of the previous studies have found them to be safe and effective treatment modalities in this indication; however, the results varied greatly and the in vitro and in vivo outcomes are contradictory. In the present review, studies related to the mechanism of action of lasers and PDT for the treatment of onychomycosis will be discussed, with a focus on to find explanation to the contradictory results.

"Nailing" the management of the ingrown great toenail.

PubMed

Block, Stan L

2014-11-01

"Nailing" the management of the severely ingrown great toenail, commonly encountered in the adolescent population, is an important tool in the pediatrician's armamentarium. I have found great toenail removal to be worthwhile, with straightforward indications; and quite rewarding for my patients in terms of time, convenience, and costs. The key to the procedure is to keep it simple. Four basic vital steps are involved: (1) operative permit and explanation; (2) performing a careful complete digital nerve block; (3) removing the entire toenail; and, importantly, (4) performing a partial chemical matricectomy--with readily available silver nitrate sticks--to prevent frequent recurrences. Copyright 2014, SLACK Incorporated.

[Treatment of calcaneal fractures with a locking nail (C-Nail)].

PubMed

Pompach, M; Carda, M; Amlang, M; Zwipp, H

2016-06-01

Anatomic reconstruction of the posterior facet by primary stabilization of the calcaneal fracture with a locking nail. All intraarticular calcaneal fractures and unstable two-part fractures independent of the degree of closed/open soft tissue trauma. High perioperative risk, soft tissue infection, beak fracture (type II fracture) and still open apophysis. Anatomic reduction of the posterior facet using a sinus tarsi approach. Reduction and temporary fixation of the sustentacular, tuberosity, and anterior process fragments with 1.8-2.0 mm Kirschner wires. Thereafter, the C-Nail (calcaneus nail) is introduced with its guiding device stabilizing the sustentacular, tuberostity, and anterior process fragments through its three guiding arms with 6 or 7 locking screws. Passive and active motion starts on postoperative day 2. Lymph drains help reduce swelling. Partial weightbearing with 20 kg for 6-8 weeks in the patient's own shoes is recommended. X‑ray controls are done at 4 and 8 weeks as well as after 6 and 12 months. A total of 107 calcaneal fractures treated with the C-Nail between 2011 and 2014 were evaluated according to the AOFAS score 6 months and 1 year after surgery. The measured values were on average 93.0 (range 65-100) points at 6 months and 94.1 (range 75-100) points 12 months after the surgery. Böhler's angle with initial traumatic values of 6.2° (-30 to +13°) improved postoperatively to 31.8°, after 3 months slightly decreased to 29.6°, and after 12 months to 28.3°. There were 2 cases of superficial wound necrosis (1.9 %) and 1 case a deep infection (0.93 %) with need of early C-Nail removal.

Surgical Management of Complex Lower-Extremity Trauma With a Long Hindfoot Fusion Nail: A Case Report.

PubMed

Jain, Nickul S; Lopez, Gregory D; Bederman, S Samuel; Wirth, Garrett A; Scolaro, John A

2016-08-01

High-energy injuries can result in complete or partial loss of the talus. Ipsilateral fractures to the lower limb increase the complexity of surgical management, and treatment is guided by previous case reports of similar injuries. A case of complex lower-extremity trauma with extruded and missing talar body and ipsilateral type IIIB open tibia fracture is presented. Surgical limb reconstruction and salvage was performed successfully with a single orthopaedic implant in a manner not described previously in the literature. The purpose of this case report is to present the novel use of a single orthopaedic implant for treatment of a complex, open traumatic injury. Previous case reports in the literature have described the management of complete or partial talar loss. We describe the novel use of a long hindfoot fusion nail and staged bone grafting to achieve tibiocalcaneal arthrodesis for the treatment of complex lower-extremity trauma. Therapeutic, Level IV: Case study. © 2015 The Author(s).

Characterization of tabique walls nails of the Alto Douro Wine Region

NASA Astrophysics Data System (ADS)

Cardoso, Rui; Pinto, Jorge; Paiva, Anabela; Lanzinha, João Carlos

2016-11-01

Tabique is one of the main Portuguese traditional building techniques which use raw materials as stone, earth andwood. In general, a tabique building component as a wall consist of a wooden structure made up of vertical boards connected to laths by metal nails and covered on both sides by an earth based material. This traditional building technology as an expressive incidence in the Alto Douro Wine Region located in the interior of Northern Portugal, added to the UNESCO's Word Heritage Sites List in December 2001 as an `evolved continuing cultural landscape'. Furthermore, previous research works have shown that the existing tabique construction, in this region, reveals a certain lack of maintenance partially justified by the knowledge loosed on that technique, consequently this construction technique present an advanced stage of deterioration. This aspect associated to the fact that there is still a lack of scientific studies in this field motivated the writing of this paper, the main objectives are to identify and characterize the nails used in the timber connections. The nails samples were collected from tabique walls included in tabique buildings located in LamegoMunicipality, near Douro River, in the Alto Douro Wine Region. This work also intends to give guidelines to the rehabilitation and preservation of this important legacy.

Hair and Nails as Noninvasive Biomarkers of Human Exposure to Brominated and Organophosphate Flame Retardants.

PubMed

Liu, Liang-Ying; He, Ka; Hites, Ronald A; Salamova, Amina

2016-03-15

After the phase-out of polybrominated diphenyl ethers (PBDEs), the use of alternative flame retardants (AFRs), such as FireMaster 550, and of organophosphate esters (OPEs) has increased. However, little is known about human exposure to these chemicals. This lack of biomonitoring studies is partially due to the absence of reliable noninvasive biomarkers of exposure. Human hair and nails can provide integrated exposure measurements, and as such, these matrices can potentially be used as noninvasive biomarkers of exposure to these flame retardants. Paired human hair, fingernail, toenail, and serum samples obtained from 50 adult participants recruited at Indiana University Bloomington campus were analyzed by gas chromatographic mass spectrometry for 36 PBDEs, 9 AFRs, and 12 OPEs. BDE-47, BDE-99, 2-ethylhexyl-2,3,4,5-tetrabromobenzoate (TBB), di(2-ethylhexyl) tetrabromophthalate (TBPH), tris(1,3-dichloro-2-propyl)phosphate (TDCIPP), and triphenyl phosphate (TPHP) were the most abundant compounds detected in almost all hair, fingernail, and toenail samples. The concentrations followed the order OPEs > TBB+TBPH > Σpenta-BDE. PBDE levels in the hair and nail samples were significantly correlated with their levels in serum (P < 0.05), suggesting that human hair and nails can be used as biomarkers to assess human exposure to PBDEs.

Arterio-Venous Anastomoses and Thermoregulation (Arterio-Veneuze Anastomosen en Thermoregulatie)

DTIC Science & Technology

1991-08-22

in the skin of the nose, ears and lips. Furthermore, they are found in the nail bed, corpus cavernosum of the penis of the man, ovarium of the woman...diameter of the vessels was a criterion for the existence of an AVA. Enlarged capillaries or preferential channels are thus wrongly seen as AVA. 10 3.3...considerably enlarged . It makes an S-shaped curve and then narrows down to become continuous with a short funnel-shaped vein which opens at right angles, into

Intermittent therapy with terbinafine and nail abrasion for dermatophyte toe onychomycosis: a pilot study.

PubMed

Succi, Isabella B; Bernardes-Engemann, Andréa R; Orofino-Costa, Rosane

2013-05-01

Onychomycosis constitutes up to 50% of all nail disorders. Toenails are generally affected, mostly due to dermatophytes. Terbinafine is the most potent antifungal agent in vitro against dermatophytes. There are few randomised controlled trials using a non-continuous dose of terbinafine. The aim of this open-label pilot study was to reduce the total drug amount, the collateral effects and, specially, the costs; albeit maintaining the same efficacy of the standard regimens. Compare the outcomes of two different intermittent regimens with the same total amount of the medication (42 tablets in 6 months). Forty-one patients were divided into the following groups: terbinafine 250 mg day(-1) , for 7 days, monthly or terbinafine 500 mg day(-1) , once daily, for 7 days, every 2 months, both plus nail abrasion during 6 months. The efficacy was evaluated at months 6, 12 and 18 using the disease free nail criteria. Total cure = group I: eight patients (44.4%) and group II: eight patients (44.4%). Partial cure = group I: five patients (27.8%) and group II: four patients (22.2%). Treatment failure = group I: five patients (27.8%) and group II: three patients (16.7%). Recurrence = group I: zero patients (0.0%) and group II: three patients (16.7%). Two intermittent dosing regimens of terbinafine plus nail abrasion proved to be an alternative statistically effective, safe and with reduced drug costs for dermatophytes toenail onychomycosis. © 2012 Blackwell Verlag GmbH.

Processes for washing a spent ion exchange bed and for treating biomass-derived pyrolysis oil, and apparatuses for treating biomass-derived pyrolysis oil

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baird, Lance Awender; Brandvold, Timothy A.

Processes and apparatuses for washing a spent ion exchange bed and for treating biomass-derived pyrolysis oil are provided herein. An exemplary process for washing a spent ion exchange bed employed in purification of biomass-derived pyrolysis oil includes the step of providing a ion-depleted pyrolysis oil stream having an original oxygen content. The ion-depleted pyrolysis oil stream is partially hydrotreated to reduce the oxygen content thereof, thereby producing a partially hydrotreated pyrolysis oil stream having a residual oxygen content that is less than the original oxygen content. At least a portion of the partially hydrotreated pyrolysis oil stream is passed throughmore » the spent ion exchange bed. Water is passed through the spent ion exchange bed after passing at least the portion of the partially hydrotreated pyrolysis oil stream therethrough.« less

Tanning bed and nail lamp use and the risk of cutaneous malignancy: a review of the literature.

PubMed

O'Sullivan, Niamh-Anna; Tait, Clare P

2014-05-01

Malignant melanoma (MM) and non-melanoma skin cancer (NMSC) are increasingly common and both can be fatal. In 2009 the World Health Organization (WHO) classified the whole ultraviolet spectrum and tanning beds as carcinogenic to humans, placing them in the same category as asbestos and tobacco. Despite this, the trend for indoor tanning continues. A growing body of evidence has now associated indoor tanning with an increased risk of MM and NMSC. As a result, there has been an upsurge in regulations in the tanning industry ranging from age restrictions to complete bans on commercial tanning. This article examines the evidence and strengthens the case for a complete ban of a recognised modifiable risk factor for cutaneous malignancy. © 2014 The Australasian College of Dermatologists.

A critical analysis of methods for rapid and nondestructive determination of wood density in standing trees

Treesearch

Shan Gao; Xiping Wang; Michael C. Wiemann; Brian K. Brashaw; Robert J. Ross; Lihai Wang

2017-01-01

Key message Field methods for rapid determination of wood density in trees have evolved from increment borer, torsiometer, Pilodyn, and nail withdrawal into sophisticated electronic tools of resistance drilling measurement. A partial resistance drilling approach coupled with knowledge of internal tree density distribution may...

CTR Fuel recovery system using regeneration of a molecular sieve drying bed

DOEpatents

Folkers, Charles L.

1981-01-01

A primary molecular sieve drying bed is regenerated by circulating a hot inert gas through the heated primary bed to desorb water held on the bed. The inert gas plus water vapor is then cooled and passed through an auxiliary molecular sieve bed which adsorbs the water originally desorbed from the primary bed. The main advantage of the regeneration technique is that the partial pressure of water can be reduced to the 10.sup.-9 atm. range. This is significant in certain CTR applications where tritiated water (T.sub.2 O, HTO) must be collected and kept at very low partial pressure.

Nacelle Aerodynamic and Inertial Loads (NAIL) project. Appendix B

NASA Technical Reports Server (NTRS)

1981-01-01

The testing was conducted on the Boeing-owned 747 RA001 test bed airplane during the concurrent 767/JT9D-7R4 engine development program. Following a functional check flight conducted from Boeing Field International (BFI) on 3 October 1980, the airplane and test personnel were ferried to Valley Industrial Park (GSG) near Glasgow, Montana, on 7 October 1980. The combined NAL and 7670JT9D-7R4 test flights were conducted at the Glasgow remote test site, and the airplane was returned to Seattle on 26 October 1980.

An electronic brachytherapy technique for treating squamous cell carcinoma in situ of the digit: a case report.

PubMed

Arterbery, V Elayne; Watson, Alice C

2013-04-15

Squamous cell carcinoma in situ of the digit presents a complex management problem, which is usually treated with surgery or radiation or topical agents. The outcome of the surgical treatment can be an undesirable cosmetic result and loss of function. We report a unique Electronic Brachytherapy technique to treat the digit, which uses a 50 Kv miniaturized X-ray source with specialized applicators. A 62-year-old African-American male was presented with a 12-month history of gradual darkening of the dorsal-distal middle left finger. Examination revealed a hyper pigmented scaly patch on the proximal to lateral nail fold of the L 3rd finger, nail dystrophy, and vertical split in the lateral section of the nail. The patient underwent evaluation of the lesion by Plastic Surgery with the removal of the lateral nail and a nail bed biopsy. Pathology revealed squamous cell carcinoma in situ with a possible focal positive, deep margin. The patient deliberated over surgical opinions, and eventually decided on radiation. A high dose rate Electronic Brachytherapy system using the XOFT Accent controller delivered dose of 4000 cGy in eight fractions, twice weekly, with at least 48 hours between fractions and treatment prescribed to a depth of 0 to 2 mm. The Xoft unit has specialized skin applicators that permit superficial treatment. Parameters assessed included the efficacy, cosmetic results feasibility, and acute safety of the Electronic Brachytherapy technique. The patient exhibited moderate redness, hyperpigmentation erythema, desquamation, and Grade 1 to 2 edema acutely (following radiation), which resolved within 1 month of the treatment. Electronic brachytherapy treatment delivery took about 6 minutes, and the total procedure time was about 15 minutes. At the median follow-up of one year, the area revealed excellent cosmesis, and there was no infection or fat necrosis, desquamation, no cancer recurrence, and no evidence of fibrosis at the last follow-up. This suggests that Electronic Brachytherapy was a viable treatment option for this particular patient.

Learning Curve and Clinical Outcomes of Performing Surgery with the InterTan Intramedullary Nail in Treating Femoral Intertrochanteric Fractures

PubMed Central

2017-01-01

Purpose. The purpose of this study is to evaluate the learning curve of performing surgery with the InterTan intramedullary nail in treating femoral intertrochanteric fractures, to provide valuable information and experience for surgeons who decide to learn a new procedure. Methods. We retrospectively analyzed data from 53 patients who underwent surgery using an InterTan intramedullary nail at our hospital between July 2012 and September 2015. The negative exponential curve-fit regression analysis was used to evaluate the learning curve. According to 90% learning milestone, patients were divided into two group, and the outcomes were compared. Results. The mean operative time was 69.28 (95% CI 64.57 to 74.00) minutes; with the accumulation of surgical experience, the operation time was gradually decreased. 90% of the potential improvement was expected after 18 cases. In terms of operative time, intraoperative blood loss, hospital stay, and Harris hip score significant differences were found between two groups (p = 0.009, p = 0.000, p = 0.030, and p = 0.002, resp.). Partial weight bearing time, fracture union time, tip apex distance, and the number of blood transfusions and complications were similar between two groups (p > 0.5). Conclusion. This study demonstrated that the learning curve of performing surgery with the InterTan intramedullary nail is acceptable and 90% of the expert's proficiency level is achieved at around 18 cases. PMID:28503572

Retrograde intramedullary nail arthrodesis for avascular necrosis of the talus.

PubMed

Devries, J George; Philbin, Terrence M; Hyer, Christopher F

2010-11-01

Avascular necrosis (AVN) of the talus from any etiology is a devastating pathology. There are few salvage options available and controversy exists as to the surgical management for patients with talar AVN. The authors present their results of tibiotalocalcaneal arthrodesis with a retrograde nail. A comprehensive chart and radiographic review was pulled from our database for patients with AVN of the talus, who were treated by tibiotalocalcaneal fusion with retrograde intramedullary nail. Primary outcome was union, with time to clinical union as a secondary endpoint. Fourteen patients were included. The average age at surgery was 47.4 ± 12.8 years, there were nine female patients, and the average Body Mass Index was 33.5 ± 6.0. Surgical risk factors included two patients who smoked, one was diabetic, and one had a preoperative ulceration. The average time to partial weightbearing was 70.6 ± 25.4 days, and the average time to full weightbearing was 100.6 ± 35.5 days. Four patients had postoperative complications, while no patients required major revision surgery. Twelve patients went on to solid fusion, while two went on to a stable, braceable pseudoarthrosis. Eight patients were able to return to shoes, and eight were able to walk unaided at final followup. Salvage of talar AVN is possible by tibiotalocalcaneal arthrodesis with an intramedullary nail. Physicians may offer this as a salvage option to patients with a high likelihood of successful fusion.

Objective guidelines for removing an external fixator after tibial lengthening using pixel value ratio: a pilot study.

PubMed

Zhao, Li; Fan, Qing; Venkatesh, K P; Park, Man S; Song, Hae Ryong

2009-12-01

During limb lengthening over an intramedullary nail, decisions regarding external fixator removal and weightbearing depend on the amount of callus seen at the lengthening area on radiographs. However, this method is subjective and objective evaluation of the amount of callus likely would minimize nail or interlocking screw breakage and refracture after fixator removal. We asked how many cortices with full corticalization of the newly formed bone at the lengthening area are needed to allow fixator removal and full weightbearing and how to radiographically determine the stage of corticalization. We retrospectively reviewed 17 patients (34 lengthenings) who underwent bilateral tibial lengthenings over an intramedullary nail. The average gain in length was 7.2 +/- 3.4 cm. We determined the pixel value ratio (ratio of pixel value of regenerate versus the mean pixel value of adjacent bone) of the lengthened area on radiographs. There were no nail or screw breakage and refracture. Partial weightbearing with crutches was permitted when the pixel value ratio was 1 in two cortices and full weightbearing without crutches was permitted when the pixel value ratio was 1 in three cortices. The pixel value ratio on radiographs can be an objective parameter for callus measurement and may provide guidelines for the timing of external fixator removal. We cannot determine from our limited data the minimum pixel value in how many cortices would suggest safe removal, but we can say our criteria were not associated with subsequent refracture.

Prediction of a nail polish colour applied on a nail.

PubMed

Monpeurt, C; Cinotti, E; Razafindrakoto, J; Rubegni, P; Fimiani, M; Perrot, J L; Hebert, M

2018-02-01

The colour of a nail polish varies according to the nail on which it is applied. The objective of this study was to predict the colour of the nail polish on a given nail and to study how the colour varies depending on the nail polish thickness. Six nail polishes were applied in one, two and three layers on the nails of one subject, thus forming eighteen samples. The spectral reflectances of the eighteen nail polishes applied on the nails with different thicknesses were obtained by spectrophotometry. The spectral reflectances of the nails without polish were also measured using the same technique. The thicknesses of nail polishes were measured by high-definition optical coherence tomography (HD-OCT). Then, to determine the physical parameters of the nail polish itself, we applied the six nail polishes on an opacity drawdown chart and we measured the spectral reflectance and the thickness of each patch using spectrophotometry and HD-OCT, respectively. The Kubelka-Munk theory was used to get the predicted spectral reflectance of the nail polish applied on the nail according to the polish thickness by knowing the parameter of the polish itself and the spectral reflectance of the nail. The predicted spectral reflectances were finally compared with those measured directly on the nails. The predicted spectral reflectances were rather close to measured ones. Consequently, knowing the colour of the nail without polish and the optical parameters of the nail polish itself, we can estimate the colour of the nail polish applied on the nail depending on its thickness. Our study showed that the Kubelka-Munk theory can be used to predict the nail polish colour. The ability to predict the real colour of a nail polish applied on a nail could help a nail polish manufacturer to improve his polish formulae in order to obtain a precise colour. © 2017 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

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

PubMed

Rauch, Cyril; Cherkaoui-Rbati, Mohammed

2014-10-16

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

Nail cosmetics.

PubMed

Madnani, Nina A; Khan, Kaleem J

2012-01-01

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

Partial entrainment of gravel bars during floods

USGS Publications Warehouse

Konrad, Christopher P.; Booth, Derek B.; Burges, Stephen J.; Montgomery, David R.

2002-01-01

Spatial patterns of bed material entrainment by floods were documented at seven gravel bars using arrays of metal washers (bed tags) placed in the streambed. The observed patterns were used to test a general stochastic model that bed material entrainment is a spatially independent, random process where the probability of entrainment is uniform over a gravel bar and a function of the peak dimensionless shear stress τ0* of the flood. The fraction of tags missing from a gravel bar during a flood, or partial entrainment, had an approximately normal distribution with respect to τ0* with a mean value (50% of the tags entrained) of 0.085 and standard deviation of 0.022 (root‐mean‐square error of 0.09). Variation in partial entrainment for a given τ0* demonstrated the effects of flow conditioning on bed strength, with lower values of partial entrainment after intermediate magnitude floods (0.065 < τ0*< 0.08) than after higher magnitude floods. Although the probability of bed material entrainment was approximately uniform over a gravel bar during individual floods and independent from flood to flood, regions of preferential stability and instability emerged at some bars over the course of a wet season. Deviations from spatially uniform and independent bed material entrainment were most pronounced for reaches with varied flow and in consecutive floods with small to intermediate magnitudes.

Dermoscopy in the Evaluation of Nail Disorders

PubMed Central

Alessandrini, Aurora; Starace, Michela; Piraccini, Bianca Maria

2017-01-01

Nail dermoscopy was initially used only in the assessment of nail pigmentation, but now it is widely utilized for the evaluation of many nail disorders. In daily practice, dermoscopy may confirm clinical diagnoses and guides in the management of nail diseases and treatments, permitting a better visualization of symptoms. Dry dermoscopy is required for evaluation of the nail plate surface, while gel as an interface is necessary for assessment of nail pigmentation and onycholysis, as well as for the evaluation of the distal nail margin. In this review, we describe the dermoscopic features of the most important nail disorders, looking at the different areas of the nail. Dermatoscopic changes that usually accompany specific nail diseases are also reviewed. PMID:28560217

A quantitative method for measuring forces applied by nail braces.

PubMed

Erdogan, Fatma G

2011-01-01

Nail bracing is a conservative method used for ingrown nails; however, lack of objective measurements limits its use for various nails. Double-string nail braces with extra metal springs were applied to 12 patients with 21 chronic, thick, and overcurved ingrown nails. Force was measured with a force gauge meter. Treatment was stopped once patients stood on their tiptoes and walked in shoes pain free without braces. A force gauge meter was also used on a model nail to show the forces applied by various nail braces and to compare their pulling forces. After 6 to 10 months of treatment, all of the patients were pain free; 600 to 1,000 centi Newtons of force were applied to the nails. As the width of the nail increased, so did the force. Braces exert more force on larger nails, which may shorten treatment durations. By measuring forces, it may be possible to standardize force and duration of treatment according to variables such as nail thickness, nail width, angle of ingrown nail, and duration of symptoms.

Phototoxic action of light emitting diode in the in vitro viability of Trichophyton rubrum.

PubMed

Amorim, José Cláudio Faria; Soares, Betania Maria; Alves, Orley Araújo; Ferreira, Marcus Vinícius Lucas; Sousa, Gerdal Roberto; Silveira, Lívio de Barros; Piancastelli, André Costa Cruz; Pinotti, Marcos

2012-01-01

Trichophyton rubrum is the most common agent of superficial mycosis of the skin and nails causing long lasting infections and high recurrence rates. Current treatment drawbacks involve topical medications not being able to reach the nail bed at therapeutic concentrations, systemic antifungal drugs failing to eradicate the fungus before the nails are renewed, severe side effects and selection of resistant fungal isolates. Photodynamic therapy (PDT) has been a promising alternative to conventional treatments. This study evaluated the in vitro effectiveness of toluidine blue O (TBO) irradiated by Light emitting diode (LED) in the reduction of T. rubrum viability. The fungal inoculums' was prepared and exposed to different TBO concentrations and energy densities of Light emitting diode for evaluate the T. rubrum sensibility to PDT and production effect fungicidal after photodynamic treatment. In addition, the profiles of the area and volume of the irradiated fungal suspensions were also investigated. A small reduction, in vitro, of fungal cells was observed after exposition to 100 µM toluidine blue O irradiated by 18 J/cm² Light emitting diode. Fungicidal effect occurred after 25 µM toluidine blue O irradiation by Light emitting diode with energy density of 72 J/cm². The analysis showed that the area and volume irradiated by the Light emitting diode were 52.2 mm² and 413.70 mm³, respectively. The results allowed to conclude that Photodynamic therapy using Light emitting diode under these experimental conditions is a possible alternative approach to inhibit in vitro T. rubrum and may be a promising new treatment for dermatophytosis caused by this fungus.

Update on nail cosmetics.

PubMed

Jefferson, Julie; Rich, Phoebe

2012-01-01

Nail cosmetics are used by millions of people worldwide who desire smooth, lustrous nails. The nail cosmetic industry continues to expand to meet increasing consumer demand. In 2011 alone, consumers spent $6.6 billion on nail salon services. Although nail cosmetics are relatively safe, poor application techniques can promote disease, deformity, and allergic and irritant contact dermatitis. The foundation for managing nail cosmetic problems is prevention through education. Familiarity with the procedures and materials used in the nail cosmetic industry is necessary in order to recommend safe nail care strategies. © 2012 Wiley Periodicals, Inc.

Colour change in cyanosis and the confusions of congenital colour vision deficient observers.

PubMed

McNamara, Renae; Taylor, Clair M; McKenzie, David K; Coroneo, Minas T; Dain, Stephen J

2010-09-01

Visual recognition of cyanosis is an important clinical activity. While pulse oximetry is almost universal in the hospital environment, there are circumstances where it is not available or may be unreliable. Cyanosis recognition is affected by lighting colour. In addition, there is, mainly anecdotal, evidence that people with greater colour vision deficiencies (CVDs) have particular difficulty and there is no effective lighting strategy to assist in the observation. The change of blood colour with oxygenation has been shown to lie close to the direction of colour confusions made by congenital red-green dichromats. The important sites of observation are lips, nail beds and palm creases. 10 subjects who were known to be chronically hypoxaemic were recruited from the chronic respiratory program. Their blood oxygen saturation (SpO(2)) varied from 84% to 96% pre-exercise, and 61-84% post-exercise. Ten normal subjects were recruited whose SpO(2) was 99% or 100%. The spectral radiances of lips, nail beds and palm creases were measured using a telespectroradiometer and compared with the spectral radiances of a white tile of known spectral reflectances measured in the same location. This is a non-contact method of measurement, avoiding the blanching caused by pressure of contact methods. The spectral reflectances were calculated, and the chromaticities calculated for a Planckian radiator T = 4000K. Measurements on lips yielded the most consistent results. The colour changes pre- and post-exercise and compared with normal colour lie generally along a deutan confusion line. These results show the direction of the colour change and confirm the, previously anecdotal, difficulties in detecting cyanosis by observers with CVDs. © 2010 The Authors, Ophthalmic and Physiological Optics © 2010 The College of Optometrists.

Biomechanical investigation of a novel ratcheting arthrodesis nail.

PubMed

McCormick, Jeremy J; Li, Xinning; Weiss, Douglas R; Billiar, Kristen L; Wixted, John J

2010-10-14

Knee or tibiotalocalcaneal arthrodesis is a salvage procedure, often with unacceptable rates of nonunion. Basic science of fracture healing suggests that compression across a fusion site may decrease nonunion. A novel ratcheting arthrodesis nail designed to improve dynamic compression is mechanically tested in comparison to existing nails. A novel ratcheting nail was designed and mechanically tested in comparison to a solid nail and a threaded nail using sawbones models (Pacific Research Laboratories, Inc.). Intramedullary nails (IM) were implanted with a load cell (Futek LTH 500) between fusion surfaces. Constructs were then placed into a servo-hydraulic test frame (Model 858 Mini-bionix, MTS Systems) for application of 3 mm and 6 mm dynamic axial displacement (n = 3/group). Load to failure was also measured. Mean percent of initial load after 3-mm and 6-mm displacement was 190.4% and 186.0% for the solid nail, 80.7% and 63.0% for the threaded nail, and 286.4% and 829.0% for the ratcheting nail, respectively. Stress-shielding (as percentage of maximum load per test) after 3-mm and 6-mm displacement averaged 34.8% and 28.7% (solid nail), 40.3% and 40.9% (threaded nail), and 18.5% and 11.5% (ratcheting nail), respectively. In the 6-mm trials, statistically significant increase in initial load and decrease in stress-shielding for the ratcheting vs. solid nail (p = 0.029, p = 0.001) and vs. threaded nail (p = 0.012, p = 0.002) was observed. Load to failure for the ratcheting nail; 599.0 lbs, threaded nail; 508.8 lbs, and solid nail; 688.1 lbs. With significantly increase of compressive load while decreasing stress-shielding at 6-mm of dynamic displacement, the ratcheting mechanism in IM nails may clinically improve rates of fusion.

Biomechanical investigation of a novel ratcheting arthrodesis nail

PubMed Central

2010-01-01

Background Knee or tibiotalocalcaneal arthrodesis is a salvage procedure, often with unacceptable rates of nonunion. Basic science of fracture healing suggests that compression across a fusion site may decrease nonunion. A novel ratcheting arthrodesis nail designed to improve dynamic compression is mechanically tested in comparison to existing nails. Methods A novel ratcheting nail was designed and mechanically tested in comparison to a solid nail and a threaded nail using sawbones models (Pacific Research Laboratories, Inc.). Intramedullary nails (IM) were implanted with a load cell (Futek LTH 500) between fusion surfaces. Constructs were then placed into a servo-hydraulic test frame (Model 858 Mini-bionix, MTS Systems) for application of 3 mm and 6 mm dynamic axial displacement (n = 3/group). Load to failure was also measured. Results Mean percent of initial load after 3-mm and 6-mm displacement was 190.4% and 186.0% for the solid nail, 80.7% and 63.0% for the threaded nail, and 286.4% and 829.0% for the ratcheting nail, respectively. Stress-shielding (as percentage of maximum load per test) after 3-mm and 6-mm displacement averaged 34.8% and 28.7% (solid nail), 40.3% and 40.9% (threaded nail), and 18.5% and 11.5% (ratcheting nail), respectively. In the 6-mm trials, statistically significant increase in initial load and decrease in stress-shielding for the ratcheting vs. solid nail (p = 0.029, p = 0.001) and vs. threaded nail (p = 0.012, p = 0.002) was observed. Load to failure for the ratcheting nail; 599.0 lbs, threaded nail; 508.8 lbs, and solid nail; 688.1 lbs. Conclusion With significantly increase of compressive load while decreasing stress-shielding at 6-mm of dynamic displacement, the ratcheting mechanism in IM nails may clinically improve rates of fusion. PMID:20942976

Heat and mass transfer within partially wetted packed fractured granular beds

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khalil, E.B.; Karim, G.A.

1996-10-01

Fractured granular beds heated by hot gaseous streams have been the subject of numerous investigations in recent years due to their importance in many applications such as in in-situ and enhanced oil recovery. In a previous paper (Khalil and Karim, 1995) the results of an investigation of some aspects of the transport processes that occur within dry granular beds were reported. The present contribution examines similar beds when partially wetted. The granular beds were cylindrical in shape containing an axial central small diameter circular channel representing a fracture which can have different permeability from that of the main bed. Itmore » is shown that the mass flow rate of the hot gases, the relative permeability of the bed and the central channel as well as the initial liquid content of the bed control the drying rate. The results of an analytical model formulated to simulate the drying process in unobstructed channel beds showed good agreement with experimental results at low temperatures, however deviations occurred as the drying proceeds at higher temperatures.« less

Nail involvement in patients with moderate-to-severe alopecia areata treated with oral tofacitinib.

PubMed

Lee, Ji Su; Huh, Chang-Hun; Kwon, Ohsang; Yoon, Hyun-Sun; Cho, Soyun; Park, Hyun-Sun

2018-05-07

A few anecdotal case reports demonstrated that tofacitinib improved nail changes associated with AA. To investigate nail changes in patients with AA treated with tofacitinib and evaluate the relationship between nail and hair responses to tofacitinib. This is a retrospective study of 33 adult patients with moderate-to-severe AA treated with oral tofacitinib monotherapy for at least 4 months. Fifteen patients had nail involvement and demonstrated more severe hair loss than those without nail involvement (p = .040). However, there was no significant difference in hair regrowth between two groups. Of 15 patients with nail involvement, 11 (73.3%) showed improvement regardless of type of nail change; the first improvement was observed at a median of 5 months (range, 1-11) after administration. Nail improvement was associated with neither initial severity of hair loss nor hair response to tofacitinib. Nail improvement tended to occur later than hair regrowth. Oral tofacitinib monotherapy improves nail involvement associated with AA. Nail involvement is not a poor prognosis factor in hair regrowth with tofacitinib treatment and there is no evident relationship between nail and hair responses.

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

PubMed

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

2013-12-01

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

Understanding the Formidable Nail Barrier: A Review of the Nail Microstructure, Composition and Diseases

PubMed Central

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

2016-01-01

The topical treatment of nail fungal infections has been a focal point of nail research in the past few decades as it offers a much safer and focused alternative to conventional oral therapy. Although the current focus remains on exploring the ways of enhancing permeation through the formidable nail barrier, the understanding of the nail microstructure and composition is far from complete. This article reviews our current understanding of the nail microstructure, composition and diseases. A few of the parameters affecting the nail permeability and potential causes of the recurrence of fungal nail infection are also discussed. PMID:28098391

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

PubMed

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

2017-05-01

The topical treatment of nail fungal infections has been a focal point of nail research in the past few decades as it offers a much safer and focused alternative to conventional oral therapy. Although the current focus remains on exploring the ways of enhancing permeation through the formidable nail barrier, the understanding of the nail microstructure and composition is far from complete. This article reviews our current understanding of the nail microstructure, composition and diseases. A few of the parameters affecting the nail permeability and potential causes of the recurrence of fungal nail infection are also discussed. © 2017 Blackwell Verlag GmbH.

Genetics Home Reference: nonsyndromic congenital nail disorder 10

MedlinePlus

... Nails MalaCards: nail disorder, nonsyndromic congenital, 10 Merck Manual Consumer Version: Deformities, Dystrophies, and Discoloration of the Nails Orphanet: Autosomal recessive nail dysplasia Patient Support ...

Finite Element Analysis of Absorbable Sheath to Prevent Stress Shielding of Tibial Interlocking Intramedullary Nail

NASA Astrophysics Data System (ADS)

Dong, Yansheng; Wang, Yongqing; Dong, Limin; Jia, Peng; Lu, Fengcheng

2017-07-01

The nail with absorbable sheath (AS nail) is designed to reduce the stress shielding effect of internal fixation with interlocking intramedullary nail. In order to verify its feasibility, two types of the finite element models of internal fixation of tibia with the AS nail and the common metal nail (CM nail) are established using the Softwares of Mimics, Geomagic, SolidWorks and ANSYS according to the CT scanning data of tibia. The result of the finite element analysis shows that the AS nail has great advantages compared with the CM nail in reducing the stress shielding effect in different periods of fracture healing. The conclusion is that the AS nail can realize the static fixation to the dynamic fixation from the early to the later automatically to shorten the time of fracture healing, which also provides a new technique to the interlocking intramedullary nail.

A case of generalized argyria after ingestion of colloidal silver solution.

PubMed

Kim, Yangho; Suh, Ho Seok; Cha, Hee Jeong; Kim, Suk Hwan; Jeong, Kyoung Sook; Kim, Dong Hoon

2009-03-01

A 58-year-old woman was referred to our hospital due to progressive skin darkening, which began 5 months previously. The patient had strikingly diffuse blue-gray discoloration of the skin, most prominent in sun-exposed areas, especially her face and hands. The oral mucosa, tongue, gums, eye conjunctiva, ears, nail beds, and trunk were also involved. Bluish-gray discoloration of all nails was aggravated by cold weather. She had ingested 1 L of colloidal silver solution daily for approximately 16 months as a traditional remedy. Her serum silver concentration was 381 ng/ml which was a very high (reference level: <15 ng/ml). Light microscopic examination of a punch biopsy specimen from her nose revealed fine, minute, round, and brown-black granules deposited in the basement membrane of hair follicular epithelium. Scanning electron microscopic examination showed electron-dense granules deposited in the intercellular space of sweat glands. Energy disperse X-ray spectrometry analysis demonstrated peaks for silver and sulfur in the dense black deposits. The ingestion of colloidal silver appears to be an increasing practice among patients using alternative health practices. All silver-containing products including colloidal silver should be labeled with a clear warning to prevent argyria, especially in alternative health practices.

Nail abnormalities

MedlinePlus

... appearance of the thumbnails. Long-term exposure to moisture or nail polish can cause nails to peel ... nail, if your nails are constantly exposed to moisture, or whether you are always picking at your ...

[Should one choose the nail or the plate in treating a leg fracture?].

PubMed

Vives, P; Massy, E; Dubois, P; Decoopmann, P

1975-12-01

The authors have analysed the results of 126 tibial fractures treated by blind nailing with reaming and 112 tibial fractures treated by plating. They noted 5 septic complications after nailing, after plating, one non-union after nailing and 12 after plating, 3 malunions after nailing and 2 after plating. The cases treated by nailing united earlier. The Authors conclude that nailing is a more fiable technique than plating, and that the only fractures which should be plated are those which are not fit for nailing.

Analysis of protein glycation in human fingernail clippings with near-infrared (NIR) spectroscopy as an alternative technique for the diagnosis of diabetes mellitus.

PubMed

Monteyne, Tinne; Coopman, Renaat; Kishabongo, Antoine S; Himpe, Jonas; Lapauw, Bruno; Shadid, Samyah; Van Aken, Elisabeth H; Berenson, Darja; Speeckaert, Marijn M; De Beer, Thomas; Delanghe, Joris R

2018-05-11

Glycated keratin allows the monitoring of average tissue glucose exposure over previous weeks. In the present study, we wanted to explore if near-infrared (NIR) spectroscopy could be used as a non-invasive diagnostic tool for assessing glycation in diabetes mellitus. A total of 52 patients with diabetes mellitus and 107 healthy subjects were enrolled in this study. A limited number (n=21) of nails of healthy subjects were glycated in vitro with 0.278 mol/L, 0.556 mol/L and 0.833 mol/L glucose solution to study the effect of glucose on the nail spectrum. Consequently, the nail clippings of the patients were analyzed using a Thermo Fisher Antaris II Near-IR Analyzer Spectrometer and near infrared (NIR) chemical imaging. Spectral classification (patients with diabetes mellitus vs. healthy subjects) was performed using partial least square discriminant analysis (PLS-DA). In vitro glycation resulted in peak sharpening between 4300 and 4400 cm-1 and spectral variations at 5270 cm-1 and between 6600 and 7500 cm-1. Similar regions encountered spectral deviations during analysis of the patients' nails. Optimization of the spectral collection parameters was necessary in order to distinguish a large dataset. Spectra had to be collected at 16 cm-1, 128 scans, region 4000-7500 cm-1. Using standard normal variate, Savitsky-Golay smoothing (7 points) and first derivative preprocessing allowed for the prediction of the test set with 100% correct assignments utilizing a PLS-DA model. Analysis of protein glycation in human fingernail clippings with NIR spectroscopy could be an alternative affordable technique for the diagnosis of diabetes mellitus.

A comparative study of intramedullary interlocking nailing and minimally invasive plate osteosynthesis in extra articular distal tibial fractures.

PubMed

Daolagupu, Arup K; Mudgal, Ashwani; Agarwala, Vikash; Dutta, Kaushik K

2017-01-01

Extraarticular distal tibial fractures are among the most challenging fractures encountered by an orthopedician for treatment because of its subcutaneous location, poor blood supply and decreased muscular cover anteriorly, complications such as delayed union, nonunion, wound infection, and wound dehiscence are often seen as a great challenge to the surgeon. Minimally invasive plate osteosynthesis (MIPO) and intramedullary interlocking nail (IMLN) are two well-accepted and effective methods, but each has been historically related to complications. This study compares clinical and radiological outcome in extraarticular distal tibia fractures treated by intramedullary interlocking nail (IMLN) and minimally invasive plate osteosynthesis (MIPO). 42 patients included in this study, 21 underwent IMLN and 21 were treated with MIPO who met the inclusion criteria and operated between June 2014 and May 2015. Patients were followed up for clinical and radiological evaluation. In IMLN group, average union time was 18.26 weeks compared to 21.70 weeks in plating group which was significant ( P < 0.0001). Average time required for partial and full weight bearing in the nailing group was 4.95 weeks and 10.09 weeks respectively which was significantly less ( P < 0.0001) as compared to 6.90 weeks and 13.38 weeks in the plating group. Lesser complications in terms of implant irritation, ankle stiffness, and infection, were seen in interlocking group as compared to plating group. Average functional outcome according to American Orthopedic Foot and Ankle Society score was measured which came out to be 96.67. IMLN group was associated with lesser duration of surgery, earlier weight bearing and union rate, lesser incidence of infection and implant irritation which makes it a preferable choice for fixation of extra-articular distal tibial fractures. However, larger randomized controlled trials are required for confirming the results.

Effect of mechanical forces on finger nail curvature: an analysis of the effect of occupation on finger nails.

PubMed

Sano, Hitomi; Shionoya, Kaori; Ogawa, Rei

2014-04-01

We studied the relationship between mechanical force and nail curvature. The effect of different frequencies and strengths of mechanical force on nail curvature was assessed. In Study 1, 63 carpenters and 63 office workers were enrolled, and the configurations of their thumb nails were assessed by measuring the curve index (defined as nail height/width) and pinch strength. In Study 2, nail curvature and pinch strength of jazz bassists, who characteristically do not use the right fourth and fifth fingers but use the left fifth finger a lot, were compared. In Study 3, the thumb nail curvature and pinch strength of the dominant and nondominant sides of the 126 participants from Study 1 were compared. Study 1: Carpenters had a significantly lower mean thumb nail curve index and higher mean pinch strength. Study 2: The nails of the unused right fourth and fifth fingers were much more curved than the nails of the frequently used left fourth and fifth fingers. The pinch strength of the right fifth finger was much weaker than the pinch strength of the left fifth finger. Study 3: The dominant side had a significantly lower nail curve index and higher pinch strength. The frequency and strength of mechanical forces on finger nails significantly affect nail appearance. © 2014 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Clinical features and nail clippings in 52 children with psoriasis.

PubMed

Uber, Marjorie; Carvalho, Vânia O; Abagge, Kerstin T; Robl Imoto, Renata; Werner, Betina

2018-03-01

Nail clipping, the act of cutting the distal portion of a nail for microscopic analysis, can complement the diagnosis of skin diseases with nail involvement, such as psoriasis. This study aimed to describe histopathologic findings on 81 nails from 52 children and adolescents with skin psoriasis and to determine whether these changes correlated with the severity of skin and nail involvement. Children with psoriasis were enrolled in this cross-sectional study to obtain Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) scores. The most altered nails were processed using periodic acid-Schiff with diastase staining. Fifty-two patients with a median age of 10.5 years were included. The median Nail Psoriasis Severity Index score of the 20 nails from these patients was 17 (range 3-80). The most common findings were pitting (94.2%), leukonychia (73.0%), and longitudinal ridges (63.5%). Eighty-one nail fragments were collected by clipping. Neutrophils were found in 6 samples (7.6%) and serous lakes in 15 (19%). Median nail plate thickness was 0.3 mm (range 0.1-0.63 mm). Patients whose nails had neutrophils had a higher median PASI score (6.1 vs 2.0, P = .03). Patients whose nails had serous lakes had higher median PASI (5.3 vs 1.9, P = .008) and NAPSI (median 45.0 vs 18.0, P = .006) scores. There seems to be a correlation between some microscopic nail features in children with psoriasis and their PASI and NAPSI scores, so nail clippings from children with suspected psoriasis may help with diagnosis, especially in the presence of neutrophils, and in excluding onychomycosis. © 2018 Wiley Periodicals, Inc.

Factors influencing interlocking screw failure in unreamed small diameter nails--a biomechanical study using a distal tibia fracture model.

PubMed

Weninger, Patrick; Schueller, Michael; Jamek, Michael; Stanzl-Tschegg, Stefanie; Redl, Heinz; Tschegg, Elmar K

2009-05-01

Unreamed tibia nails with small diameters are increasingly used for fracture fixation. However, little is known about the fatigue strength of proximal and distal interlocking screws in those nails. To date, no data are available reporting on mechanical differences of solid compared to cannulated tibial nails. The aim of this study was to assess the fatigue strength of proximal and distal interlocking screws of solid and cannulated small diameter tibia nails. We created a distal tibia fracture model (AO/OTA 43 A3) using 16 Sawbones. After fracture stabilization with one of four different nail types (Expert Tibial Nail, VersaNail, T2 Tibial Nailing System, Connex), mechanical testing was performed in three loading series (40,000 cycles each) with incremental loads. Timing and type of interlocking screw failure were assessed. Interlocking screw failure was observed significantly earlier (after a mean interval of 57,042 cycles) in cannulated tibial nails (VersaNail, T2) compared to solid nails (after a mean interval of 88,415 cycles; P < 0.001). Proximal interlocking screw failure was recorded if oblique screws were used proximally (VersaNail, T2, Connex). No distal interlocking screw failure was recorded in the Connex nail. Two- and three-part fractures of proximal or distal interlocking screws were observed in all specimen. Proximal and distal interlocking screw failure has to be considered in small diameter nails in case of delayed fracture healing. To support our results, further experimental studies and clinical series are necessary.

Hapsite Gas Chromatography - Mass Spectrometry with Solid Phase Microextraction

DTIC Science & Technology

2005-07-18

Polydimethylsiloxane /Divinylbenzene (PDMS/DVB) 65um/partially crosslinked*** Polar volatiles 60urn/ partially crosslinked General purpose (for HPLC ... Polydimethylsiloxane (PDMS). The HAPSITE with tri-bed concentrator achieved the lowest detection limits. The HAPSITE and the field portable GCUMS... Polydimethylsiloxane (PDMS). The HAPSITE with tri-bed concentrator achieved the lowest detection limits. The HAPSITE and the field portable GC/MS instrument coupled

The surgical manegement of metastases to humerus-clinical evaluation.

PubMed

Chrobok, Adam; Spindel, Jerzy; Miszczyk, Leszek; Koczy, Bogdan; Pilecki, Bogdan; Jarosz, Adam; Mrozek, Tomasz

2003-06-30

Background. The humerus is a common localisation of cancer metastases. The restoration of anatomical order and tumor resection within humerus is important for patients quality of everyday life and for their pain relief. The surgical treatment is one of the most important part of the whole oncological ways of tratment.
The study objective was a clinical assesment of tumor resection and reconstruction within humerus according to matastasis localisation and the choice of surgical technique.
Material and methods. In the years 1999-2002 19 patients underwent surgery due to pathological fracture or/and cancer metastasis within humerus. The shaft localisation of the tumor was found in 8 cases and in 11 patients the metastatic foci were found in proximnal diaphysis. In patients with proximal diaphysis localisation of the tumor the partial resection with subsequent joint exchange procedure was made. The humeral shaft metastatic cancer changes were treated by the segmental resection with subsequent surgical cement filling or auto/allogenical bone grafting combined with intramedullary nail or AO/ASIF plate stabilisation. The average follow-up period was 8,5 months.
Results. In patients after resection with shoulder joint alloplasty according to the Enneking test a very good result was found in 7 and very good in 4 cases.
In patients with femoral shaft metastatic tumor locaslisation, 6 good and 2 fair results were found. In 1 patient after 2 months rehabilitation a reoperation was needed due to the mechanical destabilisation. The best results were found in patients after intramedullary nailing.An acute soft tissue inflamation requiering surgical treatment was found in 1 patient after shoulder joint replacement.
Conclusions. After clinical analysis of the material we highly recomend the partial humeral bone resection with subsequent shoulder alloplasty in patients with proximal humeral diaphysis metastatic localisation. In cases with shaft localisation a better results were found after intramedullary nailing compared to common plate technique.

77 FR 27421 - Certain Steel Nails From the United Arab Emirates: Amended Final Determination of Sales at Less...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-10

... limited to, nails made of round wire and nails that are cut. Certain steel nails may be of one piece construction or constructed of two or more pieces. Certain steel nails may be produced from any type of steel... following products: Non-collated (i.e., hand-drive or bulk), two-piece steel nails having plastic or steel...

Nail toxicity induced by cancer chemotherapy.

PubMed

Gilbar, Peter; Hain, Alice; Peereboom, Veta-Marie

2009-09-01

To provide a comprehensive literature review of chemotherapy-induced nail toxicity, including clinical presentation, implicated drugs and approaches for prevention and management. A search of MEDLINE and EMBASE (1966-2008) databases was conducted using the terms (and variations of the terms) antineoplastic agents, nails, nail toxicity, onycholysis, and paronychia. Bibliographies from selected articles were reviewed for appropriate references. The retrieved literature was reviewed to include all articles relevant to the clinical presentation, diagnosis, incidence, prevention, and treatment of chemotherapy-induced nail toxicity. Nail toxicity is a relatively uncommon adverse effect linked to a number of chemotherapeutic agents. Clinical presentation varies, depending on which nail structure is affected and the severity of the insult. Nail changes may involve all or some nails. Toxicity may be asymptomatic and limited to cosmetic concerns, however, more severe effects, involving pain and discomfort can occur. Taxanes and anthracyclines are the antineoplastic drug groups most commonly implicated. It is suggested that the administration schedule may influence the incidence of nail abnormalities, for example reported cases linked to the weekly administration of paclitaxel.Before instituting chemotherapy, patients should be educated regarding potential nail toxicities and strategies for prevention implemented. Management includes appropriate nail cutting, avoiding potential irritants, topical, or oral antimicrobials, and possibly cessation or dose reduction of the offending agent. Cryotherapy, through the application of frozen gloves or socks, has been beneficial in reducing docetaxel-induced nail toxicity and may be effective for other drugs.

[Tibiocalcaneal arthrodesis using retrograde insertion of a compression nail].

PubMed

Bölderl, A; Dallapozza, C; Wille, M

2011-12-01

OPERATION GOAL: Arthrodesis of the upper and lower ankle joint because of problematic bone positioning or failed arthrodesis. Osteosynthesis procedure using a retrograde compression nail. To achieve stable, fully weight-bearing osteosynthesis for early, pain-free mobilization. Rearthrodesis because of failure of the conventional arthrodesis technique and development of osteoarthritis of the lower ankle joint. Painful osteoarthritis of the upper ankle joint because of inadequate perfusion or a major bone defect because of sclerosis or necrosis. Primary arthrodesis because of facture of the lower leg (pilon tibial) with joint involvement and preexisting osteoarthritis. Acute osteitis/osteomyelitis, sclerosis in the marrow of the distal tibia, malalignment of the distal tibial shaft and local soft tissue inflammation. Preparation of the articular surface of the upper and lower ankle for arthrodesis using a transfibular approach. If necessary, correction of bone defects with iliac crest spongiosa. Stabile osteosynthesis by retrograde insertion of a compression nail. A split lower leg cast on the 2nd postoperative day, mobilization of the patient with underarm crutches with floor contact for 2 weeks, then with application of a lower leg walking cast for 8 weeks with partial weight-bearing for 4 weeks and full weight-bearing for the last 4 weeks of cast fixation. X-ray controls immediately postoperatively, then after 6 and 12 weeks. From 2006 to 2008, 12 patients (7 men, 5 women; mean age 59 years) with various indications were treated with retrograde insertion of a compression nail. All patients were routinely controlled radiologically and clinically after 2, 4, 8 and 12 weeks. Follow-up was carried out at 6, 12 and 24 months. All arthrodeses showed osseous consolidation 16 weeks postoperatively. Ten patients were able to use full weight-bearing without pain after 12 weeks. Two patients reported experiencing pain after walking for 2 h. In total three complications occurred: one hindfoot healed with varus malalignment; one patient fell, fracturing the lower leg above the nail; one distal locking screw loosened.

The management of pediatric subtrochanteric femur fractures with a statically locked intramedullary nail.

PubMed

Herrera-Soto, José A; Meuret, Robert; Phillips, Jonathan H; Vogel, Daniel J

2015-01-01

To evaluate locked intramedullary (IM) fixation as an alternative treatment method for children with subtrochanteric fractures. Retrospective review. Level 1 trauma center in a Children's Hospital. Pediatric patients with subtrochanteric femur fractures with open growth plates. All patients were treated with a lateral entry IM locking nail. Patients were followed until full fracture consolidation or until implant removal. Data on time to full weight bearing, return to full activity, residual pain, any form of gait abnormality, and any other complication from follow-up visits were collected. There were 9 males and 1 female patient with an average age of 12 years and average follow-up of 22 months. Most of the fractures occurred secondary to high-energy trauma. Partial weight bearing was started at 24 days and full at 66 days. Implants were removed on average at 11 months after implantation. There were neither intraoperative complications nor major complications in the postoperative period recorded after removal. Two patients presented with a longer limb on the affected side, both 8 mm, and 2 presented with asymptomatic grade I heterotopic ossification. The use of a statically locked lateral entry IM nail for subtrochanteric femur fractures in children is a safe and efficacious method of treatment with few complications and risks and satisfactory outcomes in children over the age of 8 years. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Arsenic levels in immigrant children from countries at risk of consuming arsenic polluted water compared to children from Barcelona.

PubMed

Piñol, S; Sala, A; Guzman, C; Marcos, S; Joya, X; Puig, C; Velasco, M; Velez, D; Vall, O; Garcia-Algar, O

2015-11-01

Arsenic is a highly toxic element that pollutes groundwater, being a major environmental problem worldwide, especially in the Bengal Basin. About 40% of patients in our outpatient clinics come from those countries, and there is no published data about their arsenic exposure. This study compares arsenic exposure between immigrant and native children. A total of 114 children (57 natives, 57 immigrants), aged 2 months to 16 years, were recruited and sociodemographic and environmental exposure data were recorded. Total arsenic in urine, hair, and nails and arsenic-speciated compounds in urine were determined. We did not find significant differences in total and inorganic arsenic levels in urine and hair, but in organic arsenic monomethylarsenic acid (MMA) and dimethylarsinous acid (DMA) in urine and in total arsenic in nails. However, these values were not in the toxic range. There were significant differences between longer than 5 years exposure and less than 5 years exposure (consumption of water from tube wells), with respect to inorganic and organic MMA arsenic in urine and total arsenic in nails. There was partial correlation between the duration of exposure and inorganic arsenic levels in urine. Immigrant children have higher arsenic levels than native children, but they are not toxic. At present, there is no need for specific arsenic screening or follow-up in immigrant children recently arrived in Spain from exposure high-risk countries.

Post-combustion CO2 capture with activated carbons using fixed bed adsorption

NASA Astrophysics Data System (ADS)

Al Mesfer, Mohammed K.; Danish, Mohd; Fahmy, Yasser M.; Rashid, Md. Mamoon

2018-03-01

In the current work, the capturing of carbon dioxide from flue gases of post combustion emission using fixed bed adsorption has been carried out. Two grades of commercial activated carbon (sorbent-1 and sorbent-2) were used as adsorbent. Feed consisting of CO2 and N2 mixture was used for carrying out the adsorption. The influence of bed temperature, feed rate, equilibrium partial pressure and initial % CO2 in feed were considered for analyzing adsorption-desorption process. It was found that the total adsorption-desorption cycle time decreases with increased column temperature and feed rates. The time required to achieve the condition of bed saturation decreases with increased bed temperature and feed rates. The amount of CO2 adsorbed/Kg of the adsorbent declines with increased bed temperature with in studied range for sorbent-1 and sorbent-2. It was suggested that the adsorption capacity of the both the sorbents increases with increased partial pressure of the gas.

Complications of short versus long cephalomedullary nail for intertrochanteric femur fractures, minimum 1 year follow-up.

PubMed

Vaughn, Josh; Cohen, Eric; Vopat, Bryan G; Kane, Patrick; Abbood, Emily; Born, Christopher

2015-05-01

Hip fractures are becoming increasingly common resulting in significant morbidity, mortality and raising healthcare costs. Both short and long cephalomedullary devices are currently employed to treat intertrochanteric hip fractures. However, which device is optimal continues to be debated as each implant has unique characteristics and theoretical advantages. This study looked to identify rates of complications associated with both long and short cephalomedullary nails for the treatment of intertrochanteric hip fractures. We retrospectively reviewed charts from 2006 to 2011, and we identified 256 patients were identified with AO class 31.1-32.3 fractures. Sixty were treated with short nails and 196 with long nails. Radiographs and charts were then analysed for failures and hardware complications. Catastrophic failure and hardware complication rates were not statistically different between short or long cephalomedullary nails. The overall catastrophic failure rate was 3.1 %; there was a 5 % failure rate in the short-nail group compared with a 2.6 % failure rate in the long-nail group (p = 0.191). There was a 3.33 % secondary femur fracture rate in the short-nail group, compared with none in the long-nail cohort (p = 0.054). The rate of proximal fixation failure was 1.67 % for the short-nail group and 2.0 % in the long-nail group (p = 0.406). Our data suggests equivocal outcomes as measured by similar catastrophic failure rate between both short and long cephalomedullary nails for intertrochanteric femur fractures. However, there was an increased risk of secondary femur fracture with short cephalomedullary nails when compared to long nails that approached statistical significance.

A new case of partial trisomy 19q (q13.2-->qter) owing to an unusual maternal translocation.

PubMed Central

Valerio, D; Lavorgna, F; Scalona, M; Conte, A

1993-01-01

A new case of trisomy 19q13.2-->qter is described in a male child which was caused by a maternal balanced translocation (13;19)(p13;q13.2). The major clinical features detected in the patient included the following: facial dysmorphism, bilateral coloboma, narrow and hypoplastic nails, cardiac malformations (Fallot's tetralogy), genitourinary and gastrointestinal anomalies, and agenesis of the corpus callosum. A comparison with other reported cases of partial trisomy 19q is presented. A hypothesis is proposed to account for the involvement of p13 regions of different acrocentrics in some cases of familial translocations involving a chromosome 19. Images PMID:8411060

[A favourable outcome in yellow nail syndrome: role of respiratory physiotherapy].

PubMed

Fournier, C; Just, N; Leroy, S; Wallaert, B

2003-12-01

The yellow nail syndrome is a rare condition that is easily diagnosed but the nail manifestations are poorly understood. A 51 year old patient presented with a chronic cough. The diagnosis was based on the typical appearance of the nails. The patient had bilateral basal bronchiectasis. Daily physiotherapy with bronchial drainage lead to a progressive improvement in the respiratory symptoms without recourse to antibiotics. Surprisingly the abnormalities of the nails disappeared after 2 years treatment. This observation illustrates the possibility of spontaneous resolution of severe nail abnormalities during the course of the yellow nail syndrome.

Revisiting Pneumatic Nail Gun Trigger Recommendations.

PubMed

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

2015-03-01

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

Hand injury with a nail gun: a case report with literature review.

PubMed

Boya, Hakan; Uzun, Belkan

2015-01-01

The nail gun was introduced in the late 1950s to increase the ease of driving nails, studs, bolts, or staples into various hard surfaces. The nail gun is a potentially dangerous device that is still commonly used in the construction industry. Since its introduction, an increasing number of studies have reported injuries associated with nail guns. Nail gun-related injuries-such as to the head, neck, and chest-can be devastating, and in some cases, even fatal. Extremity injuries, notably in the hand, can cause loss of function, missed work, and long-term health effects. This case report describes a nail-gun injury of the hand along with a discussion of the unique features of and treatment strategies for nail gun injuries.

Nail-Gun Injuries to the Hand

PubMed Central

Pierpont, Yvonne N.; Pappas-Politis, Effie; Naidu, Deepak K.; Salas, R. Emerick; Johnson, Erika L.; Payne, Wyatt G.

2008-01-01

Background: The nail gun is a commonly utilized tool in carpentry and construction. When used properly with appropriate safety precautions, it can facilitate production and boost efficiency; however, this powerful tool also has the potential to cause serious injury. The most common site of nail-gun injuries in both industrial and nonoccupational settings is the hand. Materials and Methods: We report on two patients with nail-gun injuries to the hand. A review of the literature and discussion of clinical evaluation and treatment of nail-gun injuries to the hand are presented. Results: Two patients present with soft tissue injuries to the hand with the nail embedded and intact at the injury site. Operative removal of the nail and wound care resulted in successful treatment in both cases. Nail-gun injuries to the hand vary in severity on the basis of the extent of structural damage. Treatment is based on the severity of injury and the presence and location of barbs on the penetrating nail. Conclusion: Healthcare providers must understand and educate patients on the prevention mechanics of nail-gun injuries. Nail-gun injuries to the hand necessitate appropriate evaluation techniques, understanding of surgical management versus nonsurgical management, and awareness of potential pitfalls in treatment. PMID:19079574

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

PubMed

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

2011-06-01

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

EPR spectroscopic investigation of psoriatic finger nails.

PubMed

Nakagawa, Kouichi; Minakawa, Satoko; Sawamura, Daisuke

2013-11-01

Nail lesions are common features of psoriasis and found in almost half of the patients. However, there is no feasible spectroscopic method evaluating changes and severity of nail psoriasis. EPR (electron paramagnetic resonance) might be feasible for evaluating nail conditions in the patients of psoriasis. Finger nails of five cases with nail psoriasis, (three females and two males) were examined. Nail samples were subjected to the EPR assay. The small piece of the finger nail (1.5 × 5 mm(2)) was incubated in ~50 μM 5-DSA (5-doxylstearic acid) aqueous solutions for about 60 min at 37°C. After rinsing and wiping off the excess 5-DSA solution, the nail samples were measured by EPR. EPR spectra were analyzed using the intensity ratio (Fast/Slow) of the two motions at the peaks of the lower magnetic field. We observed two distinguishable sites on the basis of the EPR results. In addition, the modern EPR calculation was performed to analyze the spectra obtained. The nail psoriasis-related region is 2~3 times higher than that of the control. The present EPR results show that there are two distinguishable sites in the nail. In the case of nail psoriasis, the fragile components are 2~3 times more than those of the control. Thus, the EPR method is thought to be a novel and reliable method of evaluating the nail psoriasis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Secondary telangiectatic osteosarcoma of the left femur. A case presentation of an unusual course of disease].

PubMed

Zajonz, D; Werner, M; Panzert, S; Strübing, A S; Tiepolt, S; Fabsits, E; Brandmaier, P; Heyde, C-E; Prietzel, T

2014-05-01

This article presents the unusual case of a 73-year-old male patient who was treated with primary interlocking nailing after a pathological femoral fracture. Despite comprehensive diagnostics including several biopsies, a tumor could not be detected. In 2008 when progressive cystic femoral destruction leading to loosening of the nail necessitated a partial femoral prosthesis, an osteosarcoma could first be diagnosed in the resected bone. Advanced progression of the tumor required an extended hip exarticulation. During the current restaging of the now 84-year-old patient no tumor could be detected. When a malignancy cannot be excluded even by repeated biopsies of radiologically suspicious structures, an adequate tumor staging followed by close monitoring should be carried out. For a clinically silent, long-term course of cystic destruction of a long bone over several years, an age over 60 years and a lack of distant metastases, an atypical osteosarcoma should be considered in the differential diagnosis.

Eyelid Dermatitis Caused by Allergic Contact to Acrylates in Artificial Nails.

PubMed

Moreira, Jorge; Gonçalves, Rita; Coelho, Pedro; Maio, Tiago

2017-03-13

Over the past few years, there has been an increase in cases of allergic contact dermatitis caused by acrylates, because of the growing popularity of artificial nails. Pathological reactions to artificial nails typically occur on or around the nail area. Eyelid contact dermatitis due to artificial nails is rarely seen, especially in a nonoccupational setting. The authors report the case of a 45-year-old female accountant who developed eyelid dermatitis due to artificial nails.

Onycholysis

MedlinePlus

... reaction to "poison Ivy") to nail hardener or adhesives used to attach the nail tips, or simply ... avoid mechanical cleaning under nails. One should not bandage or cover the cut nails. A drying agent ...

Method and apparatus for enhancing the desulfurization of hot coal gas in a fluid-bed coal gasifier

DOEpatents

Grindley, T.

1988-04-05

A process and apparatus for providing additional desulfurization of the hot gas produced in a fluid-bed coal gasifier, within the gasifier is described. A fluid-bed of iron oxide is located inside the gasifier above the gasification bed in a fluid-bed coal gasifier in which in-bed desulfurization by lime/limestone takes place. The product gases leave the gasification bed typically at 1600 to 1800 F and are partially quenched with water to 1000 to 1200 F before entering the iron oxide bed. The iron oxide bed provides additional desulfurization beyond that provided by the lime /limestone. 1 fig.

Method for enhancing the desulfurization of hot coal gas in a fluid-bed coal gasifier

DOEpatents

Grindley, Thomas

1989-01-01

A process and apparatus for providing additional desulfurization of the hot gas produced in a fluid-bed coal gasifier, within the gasifier. A fluid-bed of iron oxide is located inside the gasifier above the gasification bed in a fluid-bed coal gasifier in which in-bed desulfurization by lime/limestone takes place. The product gases leave the gasification bed typically at 1600.degree. to 1800.degree. F. and are partially quenched with water to 1000.degree. to 1200.degree. F. before entering the iron oxide bed. The iron oxide bed provides additional desulfurization beyond that provided by the lime/limestone.

Revisiting Pneumatic Nail Gun Trigger Recommendations

PubMed Central

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

2015-01-01

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

The use of topical minoxidil to accelerate nail growth: a pilot study.

PubMed

Aiempanakit, Kumpol; Geater, Alan; Limtong, Preeyachat; Nicoletti, Kathleen

2017-07-01

Linear nail growth rate is affected by various conditions, one of which is the level of blood flow. Our supposition was that topical minoxidil, which has vasodilatory properties, can increase the rate of nail growth. The aim of this study was to determine the impact of topical minoxidil on nail growth. A 5% topical minoxidil solution was applied twice daily to the fingernails of 32 participants. Two groups of 16 participants were randomly chosen. In one group, the applications were made to the right index and left ring fingernails, and, in the other, the left index and right ring fingernails. During each visit (weekly during the first month and every 2 weeks during the second month), the nail length of six fingernails (index, middle, and ring of both hands) was measured using a digital caliper. Beginning in the first week, the mean nail length of the treated nails was greater than that of nails in the untreated group with statistical significance. There were no systemic or cutaneous side effects. During the first month, the mean growth of the treated nails was 4.27 mm/month compared with 3.91 mm/month in the untreated nails (P = 0.003). These findings suggest that a 5% concentration of topical minoxidil can stimulate nail growth with increased growth beginning in the first week of application. The results may have important implications for the treatment of nail disorders; however, a comparable study involving participants with nail disorders is highly recommended. © 2017 The International Society of Dermatology.

When all you have is a dermatoscope— start looking at the nails

PubMed Central

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

2014-01-01

Pigmented and non-pigmented nail alterations are a frequent challenge for dermatologists. A profound knowledge of clinical and dermatoscopic features of nail disorders is crucial because a range of differential diagnoses and even potentially life-threatening diseases are possible underlying causes. Nail matrix melanocytes of unaffected individuals are in a dormant state, and, therefore, fingernails and toenails physiologically are non-pigmented. The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma). In general, non-continuous nail alterations, affecting only limited parts of the nail apparatus, are most frequently of non-melanocytic origin. Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis. In addition, foreign bodies, bacterial infections, traumatic injuries, or artificial discolorations of the nail unit may less frequently cause non-continuous nail alterations. Many systemic diseases that may also show involvement of the nails (e.g., psoriasis, atopic dermatitis, lichen planus, alopecia areata) tend to induce alterations in numerous if not all nails of the hands and feet. A similar extensive and generalized alteration of nails has been reported after treatment with a number of systemic drugs, especially antibiotics and cytostatics. Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen’s disease, squamous cell carcinoma, and rare collision tumors. This review aims to assist clinicians in correctly evaluating and diagnosing nail disorders with the help of dermatoscopy. PMID:25396079

Tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail: a biomechanical analysis of the effect of nail length.

PubMed

Noonan, Timothy; Pinzur, Michael; Paxinos, Odysseas; Havey, Robert; Patwardhin, Avinash

2005-04-01

Fatigue fractures of the tibia have been observed at the level of the proximal end of the nail after successful tibiocalcaneal arthrodesis with a retrograde intramedullary device. To study the effect of nail length, five matched pairs of cadaver tibiae were instrumented with strain gauges and potted in methylmethacrylate from a level 3 cm proximal to the distal medial malleolus to simulate a successful tibiocalcaneal arthrodesis. A standard length (15 cm) ankle arthrodesis nail and an identical longer device terminating in the proximal tibial metaphysis were inserted in each paired tibia using appropriate technique. The strain of the posterior cortex of the tibia was recorded under bending moments of up to 50 Nm for each intact specimen after nail insertion and after proximal locking of the nail. The nails were then exchanged between the specimens of the same pairs and the experiment was repeated to insure uniformity. The standard length locked nail increased the principal strain of the posterior cortex of the tibia at the level of the proximal screw holes 5.3 times more than the locked long nail (353 and 67 microstrains), respectively. This stress concentration was not observed when the proximal extent of the nail terminated within the proximal tibial metaphysis. A successful tibiocalcaneal arthrodesis with a standard length locked intramedullary nail creates stress concentration around the proximal screw holes that may be responsible for the fractures observed clinically. This study supports the use of a "long" retrograde locked intramedullary nail for tibiocalcaneal arthrodesis in patients with systemic or localized osteopenia.

Eyelid Dermatitis Caused by Allergic Contact to Acrylates in Artificial Nails

PubMed Central

Moreira, Jorge; Gonçalves, Rita; Coelho, Pedro; Maio, Tiago

2017-01-01

Over the past few years, there has been an increase in cases of allergic contact dermatitis caused by acrylates, because of the growing popularity of artificial nails. Pathological reactions to artificial nails typically occur on or around the nail area. Eyelid contact dermatitis due to artificial nails is rarely seen, especially in a nonoccupational setting. The authors report the case of a 45-year-old female accountant who developed eyelid dermatitis due to artificial nails. PMID:28603598

Clinical Evidence for the Relationship between Nail Configuration and Mechanical Forces

PubMed Central

Ogawa, Rei

2014-01-01

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

Angle-stable and compressed angle-stable locking for tibiotalocalcaneal arthrodesis with retrograde intramedullary nails. Biomechanical evaluation.

PubMed

Mückley, Thomas; Hoffmeier, Konrad; Klos, Kajetan; Petrovitch, Alexander; von Oldenburg, Geert; Hofmann, Gunther O

2008-03-01

Retrograde intramedullary nailing is an established procedure for tibiotalocalcaneal arthrodesis. The goal of this study was to evaluate the effects of angle-stable locking or compressed angle-stable locking on the initial stability of the nails and on the behavior of the constructs under cyclic loading conditions. Tibiotalocalcaneal arthrodesis was performed in fifteen third-generation synthetic bones and twenty-four fresh-frozen cadaver legs with use of retrograde intramedullary nailing with three different locking modes: a Stryker nail with compressed angle-stable locking, a Stryker nail with angle-stable locking, and a statically locked Biomet nail. Analyses were performed of the initial stability of the specimens (range of motion) and the laxity of the constructs (neutral zone) in dorsiflexion/plantar flexion, varus/valgus, and external rotation/internal rotation. Cyclic testing up to 100,000 cycles was also performed. The range of motion and the neutral zone in dorsiflexion/plantar flexion at specific cycle increments were determined. In both bone models, the intramedullary nails with compressed angle-stable locking and those with angle-stable locking were significantly superior, in terms of a smaller range of motion and neutral zone, to the statically locked nails. The compressed angle-stable nails were superior to the angle-stable nails only in the synthetic bone model, in external/internal rotation. Cyclic testing showed the nails with angle-stable locking and those with compressed angle-stable locking to have greater stability in both models. In the synthetic bone model, compressed angle-stable locking was significantly better than angle-stable locking; in the cadaver bone model, there was no significant difference between these two locking modes. During cyclic testing, five statically locked nails in the cadaver bone model failed, whereas one nail with angle-stable locking and one with compressed angle-stable locking failed. Regardless of the bone model, the nails with angle-stable or compressed angle-stable locking had better initial stability and better stability following cycling than did the nails with static locking.

76 FR 75871 - Certain Steel Nails From the People's Republic of China: Final Rescission of Antidumping Duty New...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... published in the Federal Register our preliminary notice to rescind the NSR with respect to Shanghai Colour... should be rescinded. \\1\\ Shanghai Colour Nail Co., Ltd. (aka, Shanghai Colour Nail Import & Export Co., Ltd.), and Wuxi Colour Nail Co., Ltd. (collectively ``Shanghai Colour''). \\2\\ See Certain Steel Nails...

Method for removing particulate matter from a gas stream

DOEpatents

Postma, Arlin K.

1984-01-01

Particulate matter is removed from a stream of pressurized gas by directing the stream of gas upwardly through a bed of porous material, the porous bed being held in an open ended container and at least partially submerged in liquid. The passage of the gas through the porous bed sets up a circulation in the liquid which cleans the particulate matter from the bed.

Treatment of psoriatic nails with indigo naturalis oil extract: a non-controlled pilot study.

PubMed

Lin, Yin-Ku; See, Lai-Chu; Chang, Ya-Ching; Huang, Yu-Huei; Chen, Jiun-Liang; Tsou, Teng-Cheng; Leu, Yann-Lii; Shen, Yu-Ming

2011-01-01

In the treatment of nail psoriasis, standardized therapeutic regimens are currently lacking. To evaluate the therapeutic efficacy of indigo naturalis oil extract in patients with nail psoriasis. Patients with nail psoriasis applied indigo naturalis oil extract on affected nails twice daily for 24 weeks. Efficacy was evaluated using the Nail Psoriasis Severity Index (NAPSI) and modified target NAPSI for the single most severely affected nail. Twenty-eight out of 32 patients completed the study. The mean NAPSI was 36.1 ± 14.7 at baseline and decreased to 14.9 ± 11.1 at week 24 while the mean modified target NAPSI was 11.7 ± 3.9 at baseline and decreased to 3.6 ± 3.2 at week 24. Indigo naturalis oil extract appeared to improve nail psoriasis. Although preliminary, these results indicate that it could provide a novel therapeutic option for nail psoriasis, a disease notoriously difficult to treat. Copyright © 2011 S. Karger AG, Basel.

Nail disorders in infants and children.

PubMed

Piraccini, Bianca Maria; Starace, Michela

2014-08-01

Nail diseases in infants and children are an uncommon cause of consultation and are often difficult to diagnose and to manage. This review will cover nail diseases that are most commonly seen in clinical practice, including congenital and hereditary disorders and inflammatory, infective, and neoplastic nail diseases. The purpose of the review is to help the reader to recognize nail disorders at an early age and to manage them appropriately. Two recent large studies have reported the clinical findings of genetic disorders involving the nails, that is, pachyonychia congenita and epidermolysis bullosa. Only a few articles gave a comprehensive review of a disease, as occurred for onychomycosis, while the majority of the reports published in the recent literature involve single cases. Nail diseases in children and neonates are not easy to diagnose by nonexperts. Basic knowledge of the anatomy and biology of the nail facilitates their diagnosis as the understanding of their pathophysiology. This review gives hints at the most common nail diseases that affect infants and children.

Computational comparison of tibial diaphyseal fractures fixed with various degrees of prebending of titanium elastic nails and with and without end caps.

PubMed

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

2016-10-01

Elastic stable intramedullary nailing (ESIN) is a treatment strategy for the management of diaphyseal long-bone fractures in adolescents and children, but few studies have investigated the mechanical stability of tibial diaphyseal fractures treated with various degrees of prebending of the elastic nails. Therefore, the aim of this study was to compare the mechanical stability, including the gap deformation and nail dropping, of a tibia fracture with various fracture sites and fixed with various degrees of prebending of the elastic nails by the finite element method. Furthermore, the contribution of end caps to stability was taken into consideration in the simulation. A tibia model was developed with a transverse fracture at the proximal, middle and distal parts of the diaphysis, and fixed with three degrees of prebending of elastic nails, including those equal to, two times and three times the diameter of the intramedullary canal. The outer diameter of the nail used in the computation was 3.5mm, and the fractured tibia was fixed with two elastic double C-type nails. Furthermore, the proximal end of each nail was set to free or being tied to the surrounding bone by a constraint equation to simulate with or without using end caps. The results indicated that using end caps can prevent the fracture gap from collapsing by stopping the ends of the nails from dropping back in all prebending conditions and fracture patterns, and increasing the prebending of the nails to a degree three times the diameter of the canal reduced the gap shortening and the dropping distance of the nail end in those without using end caps under axial compression and bending. Insufficient prebending of the nails and not using end caps caused the gap to collapse and the nail to drop back at the entry point under loading. Using end caps or increasing the prebending of the nails to three times the diameter of the canal is suggested to stop the nail from dropping back and thus produce a more stable structure, with less gap deformation, in the management of a simulated tibial diapyhseal fracture by using titanium elastic nails with a double C-shape. Copyright © 2016 Elsevier Ltd. All rights reserved.

Biomechanical evaluation of primary stiffness of tibiotalocalcaneal fusion with intramedullary nails.

PubMed

Mückley, Thomas; Eichorn, Stephan; Hoffmeier, Konrad; von Oldenburg, Geert; Speitling, Andreas; Hoffmann, Gunther O; Bühren, Volker

2007-02-01

Intramedullary implants are being used with increasing frequency for tibiotalocalcaneal fusion (TTCF). Clinically, the question arises whether intramedullary (IM) nails should have a compression mode to enhance biomechanical stiffness and fusion-site compression. This biomechanical study compared the primary stability of TTCF constructs using compressed and uncompressed retrograde IM nails and a screw technique in a bone model. For each technique, three composite bone models were used. The implants were a Biomet nail (static locking mode and compressed mode), a T2 femoral nail (compressed mode); a prototype IM nail 1 (PT1, compressed mode), a prototype IM nail 2 (PT2, dynamic locking mode and compressed mode), and a three-screw construct. The compressed contact surface of each construct was measured with pressure-sensitive film and expressed as percent of the available fusion-site area. Stiffness was tested in dorsiflexion and plantarflexion (D/P), varus and valgus (V/V), and internal rotation and external rotation (I/E) (20 load cycles per loading mode). Mean contact surfaces were 84.0 +/- 6.0% for the Biomet nail, 84.0 +/- 13.0% for the T2 nail, 70.0 +/- 7.2% for the PTI nail, and 83.5 +/- 5.5% for the compressed PT2 nail. The greatest primary stiffness in D/P was obtained with the compressed PT2, followed by the compressed Biomet nail. The dynamically locked PT2 produced the least primary stiffness. In V/V, PT1 had the (significantly) greatest primary stiffness, followed by the compressed PT2. The statically locked Biomet nail and the dynamically locked PT2 had the least primary stiffness in V/V. In I/E, the compressed PT2 had the greatest primary stiffness, followed by the PT1 and the T2 nails, which did not differ significantly from each other. The dynamically locked PT2 produced the least primary stiffness. The screw construct's contact surface and stiffness were intermediate. The IM nails with compression used for TTCF produced good contact surfaces and primary stiffness. They were significantly superior in these respects to the uncompressed nails and the screw construct. The large contact surfaces and great primary stiffness provided by the IM nails in a bone model may translate into improved union rates in patients who have TTCF.

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

PubMed Central

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

2017-01-01

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

Nail tic disorders: Manifestations, pathogenesis and management.

PubMed

Singal, Archana; Daulatabad, Deepashree

2017-01-01

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

Review of end grain nail withdrawal research

Treesearch

Douglas R. Rammer; Samuel L. Zelinka

2004-01-01

This study reviewed the literature on static and impact withdrawal of nails driven into the end grain of wood members. From this, an empirical relationship was created relating the specific gravity of the wood, the diameter of the nail, and the depth of penetration of the nail to the static withdrawal capacity of nails driven into the wood and withdrawn immediately....

Investigation of Human Nail Microstructure with Ultrasound

NASA Astrophysics Data System (ADS)

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

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

Jumbo Cutter for Removal of A Bent Femoral Interlocking Nail: A Cost Effective Method

PubMed Central

Dhanda, Manjeet Singh; Sharma, Sansar C; Ali, Nadeem; Bhat, Abedullah

2015-01-01

Closed diaphyseal femoral shaft fractures can be treated with multiple surgical options. It is more challenging to remove a bent nail than a broken one because it is difficult to retrieve the bent nail through the intramedullary canal. Various authors have published their techniques for removal of bent femoral interlocking nail. This article describes a simple technique using Jumbo cutter for sectioning and removal of bent interlocking nail. This technique will help orthopaedic surgeons to remove bent nail without using any specialised metal cutting instruments. PMID:26266173

The nail and hair in forensic science.

PubMed

Daniel, C Ralph; Piraccini, Bianca Maria; Tosti, Antonella

2004-02-01

Drugs, chemicals, and biological substances accumulate and are stored in hair and nails where they can be detected and measured. Advantages of analyzing hair and nail samples also include their easy and non-invasive collection, the small sample size required for analysis, and their easy storage at room temperature. We report 3 examples of heavy metal poisoning diagnosed because of the hair or nail symptoms. Drugs and toxins that can be detected in hair and nails are reviewed and the application of hair/nail analysis in general and in forensic medicine is discussed.

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

PubMed

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

2017-03-01

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

(Meth)Acrylate Occupational Contact Dermatitis in Nail Salon Workers: A Case Series.

PubMed

DeKoven, Samuel; DeKoven, Joel; Holness, D Linn

Recently, many cases of acrylate-associated allergic contact dermatitis have appeared among nail salon workers. Common acrylate-containing products in nail salons include traditional nail polish, ultraviolet-cured shellac nail polish, ultraviolet-cured gel nails, and press-on acrylic nails. Nail salon technicians seen in the occupational medicine clinic in 2015 and 2016 were identified, and their patch test results and clinical features were summarized. Patch testing was done with the Chemotechnique (Meth)Acrylate nail series, and either the North American Standard series or the North American Contact Dermatitis Group screening series. Six patients were identified, all women, ages 38 to 58. Common presentations included erythematous dermatitis of the dorsa of the hands, palms, and forearms and fissures on the fingertips. Less common sites of eruptions included the periorbital region, cheeks, posterior ears, neck, sacral area, lateral thighs, and dorsa of the feet. All patients reacted to hydroxyethyl methacrylate, and 5 patients reacted to ethyl acrylate. Each patient also reacted to (meth)acrylates that are not found on either standard series, including ethyleneglycol dimethacrylate, 2-hydroxypropyl methacrylate, and 2-hydroxyethyl acrylate. The authors report 6 cases of allergic contact dermatitis to acrylates in nail technicians seen over the past year, representing a new trend in their clinic. These cases are reflective of a growing trend of nail technicians with allergic contact dermatitis associated with occupational (meth)acrylate exposure. Efforts to improve prevention are needed.

Arthrodesis of the knee: experience with intramedullary nailing.

PubMed

Incavo, S J; Lilly, J W; Bartlett, C S; Churchill, D L

2000-10-01

Knee arthrodesis using an intramedullary nail has gained acceptance as treatment in difficult cases such as infection after total knee arthroplasty (TKA), neuropathic joint, and obesity. A retrospective review of 22 cases treated at our institution using an intramedullary nail for knee arthrodesis was performed. Deep infection after primary (11) or revision (6) TKA was the most common indication for this procedure. A long intramedullary nail was used in 3 cases, a long nail with a proximal interlocking screw was used in 6 cases, and a customized nail with a valgus bend and a proximal interlocking screw was used in 11 cases. A modular knee fusion nail was used in 1 case. Successful fusion occurred in all cases, although 4 patients required additional surgery. Average operative blood loss was 748 mL, and average time to union was 7 months. Shortening of the extremity averaged 3.2 cm. Tibiofemoral alignment was improved by using a customized valgus nail (average, 3.1 valgus; range, 1-5) when compared with a straight nail (average, 0.2 valgus; range, 3 varus to 3 valgus). No patient developed infection in the hip or ankle region as a result of the long intramedullary nail. Intramedullary nailing is an excellent technique for knee arthrodesis in difficult cases. A customized proximal interlocking nail with 5 degrees to 7 degrees of valgus and 5 degrees of anterior angulation improves tibiofemoral alignment and is straightforward to insert or extract should it be necessary. Stability and pain relief are rapid, and the fusion rate is maximized.

Knee arthrodesis using a short locked intramedullary nail. A new technique.

PubMed

Cheng, S L; Gross, A E

1995-01-01

This article reports on the use of a new intramedullary nail designed specifically for fixation of knee fusions. The nail is a short locked stainless steel nail that is inserted through a single anterior knee incision and uses an outrigger targeting rod to guide the insertion of the locking screws. The successful use of this technique is illustrated in two cases. The advantages of this nail compared with previously reported techniques of fixation for knee fusions are that the short locked nail avoids the second incision required for the insertion of long knee fusion nails, the bulkiness of the double plating technique in the relatively subcutaneous anterior knee area, and the difficulties inherent with the prolonged use of pins for external fixation.

Low-Velocity Nail-Gun Injuries to the Interventricular Septum: Report of Two Cases, One in a Child.

PubMed

Michalsen, Kara L; Iguidbashian, John P; Kyser, James P; Long, William B

2015-08-01

Nail-gun injury to the heart is rare. Nail-gun injury to the interventricular septum is rarer: we could find only 5 reported cases, and none involving a child. We report 2 additional cases, in which nails penetrated the interventricular septum without causing acute pericardial tamponade, heart block, or shunt across the septum. Transesophageal echocardiography provides a dynamic way to evaluate the patient preoperatively, intraoperatively, and postoperatively. In the cases reported here, both the adult with multiple interventricular nails and the child with a single nail underwent foreign-object removal via median sternotomy. The child needed cardiopulmonary bypass for removal of the nail. There were no short-term or long-term sequelae from these interventricular septal injuries.

76 FR 16379 - Certain Steel Nails From the People's Republic of China: Final Results of the First Antidumping...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

...) Maanshan Longer Nail Product Co., Ltd. (24) Nanjing Dayu Pneumatic Gun Nails Co., Ltd. (25) Qingdao.... (71) Tianjin Shishun Metallic Products Co., Ltd. (72) Tianjin Xiantong Fucheng Gun Nail Manufacture Co...

Soil nailing of a bridge fill embankment : construction report.

DOT National Transportation Integrated Search

1991-08-01

Soil nailing as an alternative lateral earth support method has recently been introduced in Oregon to build the first permanent Soil-Nailed Wall on the State's Highway System. : The soil nailing technique was used for an underpass widening to provide...

Nail Scabies: An Unusual Presentation Often Overlooked and Mistreated.

PubMed

Tempark, Therdpong; Lekwuttikarn, Ramrada; Chatproedprai, Susheera; Wananukul, Siriwan

2017-04-01

Nail scabies is an interesting clinical presentation of scabies. Although it is usually found concomitant with characteristic dermatologic manifestations, it may present as an isolated finding in the immunocompromised host. This condition is commonly mistaken with other diseases such as nail dystrophy, nail psoriasis and onychomycosis. We report two cases of unusual nail presentations that provide clues to diagnosis. Also, literature on unusual nail and dermatologic presentations was reviewed to recognize dermatologist consideration for appropriate treatment options. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Efficacy and safety of Indigo naturalis extract in oil (Lindioil) in treating nail psoriasis: a randomized, observer-blind, vehicle-controlled trial.

PubMed

Lin, Yin-Ku; See, Lai-Chu; Huang, Yu-Huei; Chang, Ya-Ching; Tsou, Teng-Cheng; Lin, Tung-Yi; Lin, Na-Ling

2014-06-15

Treating nail psoriasis is notoriously difficult and lacks standardized therapeutic regimens. Indigo naturalis has been demonstrated to be safe and effective in treating skin psoriasis. This trial was conducted to evaluate the efficacy and safety of refined indigo naturalis extract in oil (Lindioil) in treating nail psoriasis. Thirty-one outpatients with symmetrically comparable psoriatic nails were enrolled. Lindioil (experimental group) or olive oil (control group) was applied topically to the same subjects' two bilaterally symmetrical psoriatic nails twice daily for the first 12 weeks and then subjects applied Lindioil to both hands for 12 additional weeks. Outcomes were measured using Nail Psoriasis Severity Index (NAPSI) for five nails on one hand and for the single most severely affected nail from either hand. The results show a reduction of NAPSI scores for the 12-week treatment for the Lindioil group (49.8% for one hand and 59.3% for single nail) was superior to the reduction in the scores for the control group (22.9%, 16.3%, respectively). There were no adverse events during the 24 weeks of treatment. This trial demonstrates that Lindioil is a novel, safe and effective therapy for treating nail psoriasis. Copyright © 2014 Elsevier GmbH. All rights reserved.

Elastic intramedullary nailing and DBM-Bone marrow injection for the treatment of simple bone cysts

PubMed Central

Kanellopoulos, Anastasios D; Mavrogenis, Andreas F; Papagelopoulos, Panayiotis J; Soucacos, Panayotis N

2007-01-01

Background Simple or unicameral bone cysts are common benign fluid-filled lesions usually located at the long bones of children before skeletal maturity. Methods We performed demineralized bone matrix and iliac crest bone marrow injection combined with elastic intramedullary nailing for the treatment of simple bone cysts in long bones of 9 children with a mean age of 12.6 years (range, 4 to 15 years). Results Two of the 9 patients presented with a pathological fracture. Three patients had been referred after the failure of previous treatments. Four patients had large lesions with impending pathological fractures that interfered with daily living activities. We employed a ratio to ascertain the severity of the lesion. The extent of the lesion on the longitudinal axis was divided with the normal expected diameter of the long bone at the site of the lesion. The mean follow-up was 77 months (range, 5 to 8 years). All patients were pain free and had full range of motion of the adjacent joints at 6 weeks postoperatively. Review radiographs showed that all 7 cysts had consolidated completely (Neer stage I) and 2 cysts had consolidated partially (Neer stage II). Until the latest examination there was no evidence of fracture or re-fracture. Conclusion Elastic intramedullary nailing has the twofold benefits of continuous cyst decompression, and early immediate stability to the involved bone segment, which permits early mobilization and return to the normal activities of the pre-teen patients. PMID:17916249

Research on the reasonable pile spacing of micro pile composite soil nailing

NASA Astrophysics Data System (ADS)

Liu, Jun yan; Liu, Yan; Song, Xiang hua

2017-08-01

Through the numerical simulation software FLAC3D, study on the synergetic effect of micro pile composite soil nailing will be studied. By adjusting the micro pile spacing and analysing the displacement field and stress field of soil, we can find that supporting effect of the soil nail hasn’t work yet when the micro pile spacing is 2D. The soil arching between piles has been formed in the pile spacing 4D ∼ 6D. The composite effect of micro pile and soil nailing will be the best and the soil arch behind piles will be firstly formed in 6D, the horizontal saddle soil arch will be formed between the nails. The nail head coincidence pressure area and micro pile pressure area are overlapping to maintain stability in the soil between piles. When the micro pile spacing is 9D, the arch behind piles will be failure, the soil flows around, but the saddle arch between the nails into circular arch, the supporting effect of the soil nailing is enhanced. When the micro pile spacing is 12D, the arch of the nails becomes smaller, sliding surface appears primitively. Based on the conclusions above, it is suggested that the micro pile spacing between 2D ∼ 6D is suitable for the micro pile and soil nailing composite support. The conclusion can provide theoretical basis for the design and construction of micro pile composite soil nailing.

Closed retrograde retrieval of the distal broken segment of femoral cannulated intramedullary nail using a ball-tipped guide wire.

PubMed

Metikala, Sreenivasulu; Mohammed, Riazuddin

2011-07-01

Extracting broken segments of intramedullay nails from long bones can be an operative challenge, particularly from the distal end. We report a case series where a simple and reproducible technique of extracting broken femoral cannulated nails using a ball-tipped guide wire is described. This closed technique involves no additional equipment or instruments. Eight patients who underwent the described method were included in the study. The technique involves using a standard plain guide wire passed through the cannulated distal broken nail segment after extraction of the proximal nail fragment. The plain guide wire is then advanced distally into the knee joint carefully under fluoroscopy imaging. Over this wire, a 5-millimeter (mm) cannulated large drill bit is used to create a track up to the distal broken nail segment. Through the small knee wound, a ball-tipped guide wire is passed, smooth end first, till the ball engages the end of the nail. The guide wire is then extracted along with the broken nail through the proximal wound. The method was successfully used in all eight patients for removal of broken cannulated intramedullary nail from the femoral canal without any complications. All patients underwent exchange nailing with successful bone union in six months. None of the patients had any problems at the knee joint at the final follow-up. We report a technique for successful extraction of the distal fragment of broken femoral intramedullary nails without additional surgical approaches.

Fusarium onychomycosis: prevalence, clinical presentations, response to itraconazole and terbinafine pulse therapy, and 1-year follow-up in nine cases.

PubMed

Ranawaka, Ranthilaka R; Nagahawatte, Ajith; Gunasekara, Thusitha Aravinda

2015-11-01

Invasive fusariosis is an infection with Fusarium spp. that primarily affects patients with hematologic malignancies and hematopoietic cell transplant recipients. Wounds, digital ulcers, onychomycosis, and paronychia are the typical cutaneous portals of entry. Early management of mycotic nails in immunocompromised and diabetic hosts is crucial to prevent life-threatening disease. We report nine cases of Fusarium onychomycosis (F. dimerum, n = 5; F. oxysporum, n = 3; Fusarium spp., n = 1) in immunocompetent hosts and their response to itraconazole and terbinafine pulse therapy. The patients received either itraconazole 400 mg daily or terbinafine 500 mg daily for 7 d/month; two pulses for fingernails and three pulses for toenails. Of the 68 confirmed cases of onychomycosis, eight (11.7%) were Fusarium spp.; the ninth patient was culture positive but microscopy negative and responded well to itraconazole. Distal subungual onychomycosis was the commonest clinical manifestation (seven of nine), one had proximal subungual onychomycosis, and total onychodystrophy was noted on four patients. Associated paronychia was marked on 66.7% (six of eight) patients. Itraconazole was given to six patients/25 nails and terbinafine to three patients/20 nails. All nine patients completed treatments, but one defaulted at 12 months follow-up. The efficacy parameters were clinical cure (CC) and mycological cure (MC). At month 12 after the start of treatment, the response was itraconazole CC 13 of 25 (52%)/MC four of six (66.6%) and terbinafine CC four of eight (50%)/MC one of two (50%). Recurrence was noted in four of 13 (30.7%) and eight of 13 (61.5%) cured nails in the itraconazole group within 3 and 12 months, respectively. Fusarium onychomycosis was clinically indistinguishable from other onychomycosis. Both itraconazole and terbinafine pulse therapy were only partially effective on Fusarium onychomycosis. Antifungals that are more effective should be sought. © 2015 The International Society of Dermatology.

Retained portion of latex glove during femoral nailing. Case report.

PubMed

Sadat-Ali, M; Marwah, S; al-Habdan, I

1996-11-01

A case of retained glove during Kuntscher intramedullary nailing is described. An abscess around the glove could have lead to osteomyelitis. One need to be cautious feeling the top end of the nail while femoral nailing to avoid such a complication.

Control of the micromovements of a composite-material nail design: A finite element analysis.

PubMed

Ben-Or, Mor; Shavit, Ronen; Ben-Tov, Tomer; Salai, Moshe; Steinberg, Ely L

2016-02-01

Intramedullary nail fixation is the most accepted modality for stabilizing long bone midshaft fractures. The commercially used nails are fabricated from Stainless Steel or Titanium. Composite-materials (CM) mainly carbon-fiber reinforced polymers (CFRP) have been gaining more interest and popularity due to their properties, such as modulus of elasticity close to that of bone, increased fatigue strength, and radio-opacity to irradiation that permits a better visualization of the healing process. The use of CFRP instead of metals allows better control of different directional movements along a fracture site. The purpose of this analysis was to design a CM intramedullary nail to enable micromovements as depicted on a finite element analysis method. We designed a three-dimentional femoral nail model. Three CFRP with different laminates arrangements, were included in the analysis. The finite element analysis involved applying vertical and horizontal loads on each of the designed and tested nails. The nails permitted a transverse micromovement of 0.75mm for the 45° lay-up and 1.5mm for the 90° lay-up for the CM, 1.38mm for the Titanium and 0.74mm for the Stainless Steel nails. The recorded axial movements were 0.53mm for the 45° lay-up, 0.87mm for the 90° lay-up, 0.46mm for the unsymmetrical lay-up CM, 0.046 for the Titanium and 0.02 for the Stainless Steel nails. Overall, the simulations showed that nail transverse micromovements can be reduced by using 45° carbon fiber orientations. Similar results were observed with each metal nails. We found that nail micromovements can be controlled by changing the directional stiffness using different lay-up orientations. These results can be useful for predicting nail micromovements under specified loading conditions which are crucial for stimulating callus formation in the early stages of healing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effects of nail polish on microbial growth of fingernails. Dispelling sacred cows.

PubMed

Baumgardner, C A; Maragos, C S; Walz, J; Larson, E

1993-07-01

Nail polish worn on short, healthy nails does not appear to be associated with increased microbial counts on the fingernails. Additional studies to examine the effect of wearing nail polish on other aspects of hand hygiene may be warranted, however.

Treatment of Nail Psoriasis: Common Concepts and New Trends

PubMed Central

Oram, Yasemin; Akkaya, A. Deniz

2013-01-01

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

Management of comminuted proximal ulna fracture-dislocations using a multiplanar locking intramedullary nail.

PubMed

Edwards, Scott G; Argintar, Evan; Lamb, Joshua

2011-06-01

Intramedullary nails have been used for the fixation of olecranon fractures in an attempt to reduce the soft tissue irritation and resulting need for hardware removal seen with plating and tension banding. Further benefits include preservation of vascular supply, and increase stability and improved compression over some alternative techniques. Most intramedullary nails have been limited to simple olecranon fractures or osteotomies. One novel multiplanar, locking intramedullary nail, however, is indicated to stabilize all fracture patterns of the proximal ulna, including the coronoid. This particular locking nail has screws that radiate in multiple planes and form a fixed-angle lattice throughout the bone. The nail also has fixed-angle screws dedicated to the 3 parts of the coronoid: process tip, medial facet, and medial wall. This allows the nail to secure multiple fragments regardless of the fracture pattern's extent of instability. The objective of this article is to illustrate the recommended steps in reducing and stabilizing a comminuted proximal ulna fracture-dislocation using this multiplanar locking intramedullary nail.

Size and Charge Dependence of Ion Transport in Human Nail Plate

PubMed Central

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

2016-01-01

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

Intramedullary nailing of humeral shaft fractures.

PubMed

Pickering, Robert M; Crenshaw, Andrew H; Zinar, Daniel M

2002-01-01

The development of interlocking humeral nail systems has greatly broadened the indications for nailing of humeral shaft fracture. Rotational control is better than with earlier nail systems, and most nails have an oblong distal hole that allows axial loading of the fracture site with muscle contraction. When nailing is done with closed technique, loss of the fracture hematoma and periosteal stripping are avoided. Even when open reduction is required, periosteal stripping can be kept to a minimum. Surgical wounds are smaller, even when open reduction is necessary, and when closed nailing is done, bone grafting is unnecessary. Intramedullary nails are ideal for segmental fractures, pathologic fractures, and fractures in osteopenic bone. Because the arm usually is not a weight-bearing extremity, hardware failure is rare and union rates are equivalent to those of compression plate and screw fixation. Compression plates and external fixation certainly have their place for some fracture patterns and for severe wounds that are unsuitable for intramedullary nailing. The surgeon should be well versed in all three techniques and should be able to rapidly choose among these, depending upon the fracture pattern, skin wound, associated injuries, and overall condition of the patient.

Creep behavior of soil nail walls in high plasticity index (PI) soils : technical report.

DOT National Transportation Integrated Search

2017-04-01

An aspect of particular concern in the Geotechnical Engineering Circular No. 7: Soil Nail Walls (i.e., the soil : nail wall manual and construction guidelines) is the creep behavior of soil nail systems in high-plasticity : clays. This research proje...

A comparative study of the therapeutic effect between long and short intramedullary nails in the treatment of intertrochanteric femur fractures in the elderly.

PubMed

Guo, Xue-Feng; Zhang, Ke-Ming; Fu, Hong-Bo; Cao, Wen; Dong, Qiang

2015-01-01

To compare the clinical effects of long vs. short intramedullary nails in the treatment of intertrochanteric fractures in old patients more than 65 years old. A retrospective analysis of 178 cases of intertrochanteric fractures of the femur (AO type A1 and A2) in the elderly was conducted from January 2008 to December 2013. There were 85 males (47.8%) and 93 females (52.2%) with the age of 65e89 (70.2±10.8) years. The patients were treated by closed reduction and long or short intramedullary nail (Gamma 3) fixation. The length of short nail was 180 mm and that for long nail was 320e360 mm. The general data of patients, operation time, intraoperative blood loss, length of hospital stay, preoperative hemoglobin level, blood transfusion rate, postoperative periprosthetic fractures, infections, complications, etc were carefully recorded. There were 76 cases (42.7%) in the long intramedullary nail group and 102 cases (57.3%) in the short nail group. All the cases were followed up for 12e48 (21.3±6.8) months, during which there were 21 deaths (11.8%), mean (13.8±6.9) months after operation. The intraoperative blood loss was (90.7±50.6) ml in short nail group, greatly less than that in long nail group (127.8±85.9) ml (p=0.004). The short nail group also had a significantly shorter operation time (43.5 min±12.3 min vs. 58.5 min±20.3 min, p=0.002) and lower rate of postoperative transfusion (42.3% vs. 56.7%, p=0.041). But the length of hospital stay showed no big differences. After operation, in each group there was 1 case of periprosthetic fracture with a total incidence of 1.1%, 1.3% in long nail group and 0.9% in short nail group. At the end of the follow-up, all patients achieved bony union. The average healing time of the long nail group was (6.5±3.1) months, and the short nail group was (6.8±3.7) months, revealing no significant differences (p=0.09). Postoperative complications showed no great differences either. Both the intramedullary long and short nail fixation has a good clinical effect in treating intertrochanteric femur fractures in the elderly. They showed no significant difference in terms of therapeutic effect, hospital stay and postoperative complications. The incidence of periprosthetic fractures treated by either length of nails was low. But short intramedullary nailing can obviously decrease the intraoperative blood loss, operation time and postoperative blood transfusion.

Knee fusion--a new technique using an old Belgian surgical approach and a new intramedullary nail.

PubMed

Alt, V; Seligson, D

2001-02-01

Knee arthrodesis is a useful procedure in difficult cases such as failed total knee arthroplasty, severe articular trauma, bone tumors, and infected knee joints. The most common techniques for knee fusion include external fixation and intramedullary nailing. Küntscher's nail is driven antegrade from the intertrochanteric region into the knee. We describe a new technique for knee arthrodesis using a new intramedullary nail and an old Belgian surgical approach to the knee joint published by Lambotte in 1913. This approach provides excellent exposure for the implantation of the nail by osteotomizing the patella vertically. The nail is implanted using HeyGroves method, whereby the nail is inserted retrograde into the femur and pulled distally anterograde into the tibia. We now use this technique as our standard procedure for knee fusion.

78 FR 78382 - Steel Nails From China; Determination

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-1114 (Review)] Steel Nails From China... U.S.C. 1675(c)), that revocation of the antidumping duty order on steel nails from China would be... 2013), entitled Steel Nails from China: Investigation No. 731-TA-1114 (Review). By order of the...

Guidance on maintaining personal hygiene in nail care.

PubMed

Malkin, Bridget; Berridge, Pat

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-08

... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-1185 (Final)] Certain Steel Nails From... is materially injured by reason of imports from the United Arab Emirates of certain steel nails... of certain steel nails from the United Arab Emirates were being sold at LTFV within the meaning of...

Ability of organic and inorganic bedding materials to promote growth of environmental bacteria.

PubMed

Godden, S; Bey, R; Lorch, K; Farnsworth, R; Rapnicki, P

2008-01-01

The major objective of this study was to contrast the ability of 4 commonly utilized bedding materials to promote growth of environmental bacteria under controlled conditions. A second objective was to describe the relationship between bacterial growth and specific biochemical or nutritional properties of these bedding materials. Unused samples of clean sand (CS; n = 20), recycled sand (RS; n = 21), digested manure solids (DS; n = 15), and shavings (SH; n = 15) were collected from bedding storage areas on 49 commercial Minnesota and Wisconsin dairy farms. Sterilized bedding samples were inoculated with Klebsiella pneumoniae and Enterococcus faecium then incubated, in triplicate, for 72 h at 37 degrees C. Subsamples were collected after 0, 24, 48, and 72 h of incubation for culture and enumeration of bacteria. Subsamples of bedding were also tested for pH, total C content (%), and total N content (%). If bacterial growth occurred, peak levels were typically achieved within 24 h. Digested manure solids promoted the greatest amounts of growth of K. pneumoniae, followed by RS and then SH, whereas CS promoted the least. There would seem to be a tradeoff in selecting SH as a bedding material, because it supported moderate growth of K. pneumoniae but caused a rapid decline in the numbers of E. faecium. However, RS, CS, and DS each only supported relatively small amounts of growth of E. faecium, so the benefit of SH relative to other bedding materials is limited. High bedding pH may partially explain why some bedding materials supported growth of E. faecium (e.g., DS and RS). Both high bedding pH (e.g., as for DS or RS) and high total C (%) content (e.g., as for DS and SH) may partially explain why some bedding materials supported growth of K. pneumoniae.

Removal of a broken trigen intertan intertrochanteric antegrade nail.

PubMed

Zheng, Xuan-Lin; Park, Young-Chang; Kim, Sungmin; An, Haemosu; Yang, Kyu-Hyun

2017-02-01

Implant breakage is a serious complication after cephalomedullary nailing for unstable intertrochanteric fracture. Failure usually occurs at the lag screw hole in the nail body. On the other hand, lag screw failure is extremely rare and occurs around the nail-lag screw junction. We experienced rare mechanical failure of the Intertan nail, which showed breakage at the lag screw hole and failure of the integrated compression screw underneath the main lag screw. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evidence-based practice: use of the ventilator bundle to prevent ventilator-associated pneumonia.

PubMed

Tolentino-DelosReyes, Arlene F; Ruppert, Susan D; Shiao, Shyang-Yun Pamela K

2007-01-01

To examine critical care nurses' knowledge about the use of the ventilator bundle to prevent ventilator-associated pneumonia. Published reports were reviewed for current evidence on the use of the ventilator bundle to prevent ventilator-associated pneumonia, and education sessions were held to present the findings to 61 nurses in coronary care and surgical intensive care units. Changes in the nurses' knowledge were evaluated by using a 10-item test, given both before and after the sessions. Changes in the nurses' practices related to ventilator-associated pneumonia, including elevation of the head of the bed to 30 degrees to 45 degrees , were observed in 99 intubated patients. After the education sessions, the nurses performed better on 8 of the 10 items tested (P from .03 to <.001). The areas of most significant improvement were elevation of the head of the bed (P < .001), charting of the elevation of the head of the bed (P= .009), oral care (P= .009), checking of the nasogastric tube for residual volume (P = .008), washing of hands before contact with patients (P < .001), and limiting the wearing of rings (P < .001) and nail polish (P = .04). Even after the education sessions, the nurses' compliance with hand-washing recommendations before contact with patients was low, though statistically some improvement was apparent. Contraindications to elevation of the head of the bed did not appear to affect the nurses' practices (P= .38). Education sessions designed to inform nurses about the ventilator bundle and its use to prevent ventilator-associated pneumonia have a significant effect on participants' knowledge and subsequent clinical practice.

From immobilized cells to motile cells on a bed-of-nails: effects of vertical nanowire array density on cell behaviour

PubMed Central

Persson, Henrik; Li, Zhen; Tegenfeldt, Jonas O.; Oredsson, Stina; Prinz, Christelle N.

2015-01-01

The field of vertical nanowire array-based applications in cell biology is growing rapidly and an increasing number of applications are being explored. These applications almost invariably rely on the physical properties of the nanowire arrays, creating a need for a better understanding of how their physical properties affect cell behaviour. Here, we investigate the effects of nanowire density on cell migration, division and morphology for murine fibroblasts. Our results show that few nanowires are sufficient to immobilize cells, while a high nanowire spatial density enables a ”bed-of-nails” regime, where cells reside on top of the nanowires and are fully motile. The presence of nanowires decreases the cell proliferation rate, even in the “bed-of-nails” regime. We show that the cell morphology strongly depends on the nanowire density. Cells cultured on low (0.1 μm−2) and medium (1 μm−2) density substrates exhibit an increased number of multi-nucleated cells and micronuclei. These were not observed in cells cultured on high nanowire density substrates (4 μm−2). The results offer important guidelines to minimize cell-function perturbations on nanowire arrays. Moreover, these findings offer the possibility to tune cell proliferation and migration independently by adjusting the nanowire density, which may have applications in drug testing. PMID:26691936

76 FR 22369 - Certain Steel Nails From the People's Republic of China: Initiation and Preliminary Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-21

... Review AGENCY: Import Administration, International Trade Administration, Department of Commerce. DATES... review and a request to revoke, in part, the antidumping duty order on certain steel nails from the... nails. In addition to the four physical descriptions of steel nails, Petitioner requested three of the...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-20

... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-1185 Preliminary] Certain Steel Nails... Emirates of certain steel nails, provided for in subheadings 7317.00.55, 7317.00.65 and 7317.00.75 of the... threatened with material injury by reason of LTFV imports of certain steel nails from the United Arab...

Nail psoriasis in an adult successfully treated with a series of herbal skin care products family – a case report.

PubMed

Tirant, M; Hercogovấ, J; Fioranelli, M; Gianfaldoni, S; Chokoeva, A A; Tchernev, G; Wollina, U; Novotny, F; Roccia, M G; Maximov, G K; França, K; Lotti, T

2016-01-01

Psoriasis is a common chronic inflammatory dermatosis that causes significant distress and morbidity. Approximately 50% of patients with cutaneous psoriasis and 90% of patients with psoriatic arthritis demonstrate nail involvement of their psoriasis. Left untreated, nail psoriasis may progress to debilitating nail disease that leads to not only impairment of function but also on quality of life. We report the case of a 50-year-old male patient with recalcitrant nail dystrophies on the fingers since the age of 40, who responded successfully to Dr. Michaels® product family. The patient had a 35-year history of plaque psoriasis localised on the scalp, ears, groin, limbs, and trunk and with psoriatic arthritis. The nail symptoms consisted of onycholysis, onychomycosis, leukonychia, transverse grooves, nail plate crumbling and paronychia of the periungal skin. This case represents the efficacy and safety of the Dr. Michaels® (Soratinex® and Nailinex®) product family with successful resolution of nail dystrophies and surrounding paronychia with no reported adverse events.

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

PubMed

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

2016-03-01

The electrical properties of human nail plate are poorly characterized yet are a key determinate of the potential to treat nail diseases, such as onychomycosis, using iontophoresis. To address this deficiency, molar conductivities of 17 electrolytes comprising 12 ionic species were determined in hydrated human nail plate in vitro. Cation transport numbers across the nail for 11 of these electrolytes were determined by the electromotive force method. Effective ionic mobilities and diffusivities at infinite dilution for all ionic species were determined by regression analysis. The ratios of diffusivities in nail to those in solution were found to correlate inversely with the hydrodynamic radii of the ions according to a power law relationship having an exponent of -1.75 ± 0.27, a substantially steeper size dependence than observed for similar experiments in skin. Effective diffusivities of cations in nail were 3-fold higher than those of comparably sized anions. These results reflect the strong size and charge selectivity of the nail plate for ionic conduction and diffusion. The analysis implies that efficient transungual iontophoretic delivery of ionized drugs having radii upward of 5 Å (molecular weight, ca. ≥ 340 Da) will require chemical or mechanical alteration of the nail plate. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Influence of pH on Transungual Passive and Iontophoretic Transport

PubMed Central

SMITH, KELLY A.; HAO, JINSONG; LI, S. KEVIN

2010-01-01

The present study investigated the effects of pH on nail permeability and the transport of ions such as sodium (Na) and chloride (Cl) ions endogenous to nail and hydronium and hydroxide ions present at low and high pH, which might compete with drug transport across hydrated nail plate during iontophoresis. Nail hydration and passive transport of water across the nail at pH 1–13 were assessed. Subsequently, passive and iontophoretic transport experiments were conducted using 22Na and 36Cl ions under various pH conditions. Nail hydration was independent of pH under moderate pH conditions and increased significantly under extreme pH conditions (pH>11). Likewise, nail permeability for water was pH independent at pH 1–10 and an order of magnitude higher at pH 13. The results of passive and iontophoretic transport of Na and Cl ions are consistent with the permselective property of nail. Interestingly, extremely acidic conditions (e.g., pH 1) altered nail permselectivity with the effect lasting several days at the higher pH conditions. Hydronium and hydroxide ion competition in iontophoretic transport was generally negligible at pH 3–11 was significant at the extreme pH conditions studied. PMID:19904826

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

PubMed

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

2017-06-01

Onychomycosis is a fungal nail infection. The development of new topical antifungal agents for the treatment of onychomycosis has focused on formulation enhancements that optimize the pharmacological characteristics required for its effective treatment. Polyurethanes (PUs) have never been used in therapeutic nail lacquers. The aim of this work has been the development of new PU-based nail lacquers with antifungal activity containing 1.0% (wt/wt) of terbinafine hydrochloride. The biocompatibility, wettability, and the prediction of the free volume in the polymeric matrix were assessed using a human keratinocytes cell line, contact angle, and Positron Annihilation Lifetime Spectroscopy determinations, respectively. The morphology of the films obtained was confirmed by scanning electron microscopy, while the nail lacquers' bioadhesion to nails was determined by mechanical tests. Viscosity, in vitro release profiles, and antifungal activity were also assessed. This study demonstrated that PU-terbinafine-based nail lacquers have good keratinocyte compatibility, good wettability properties, and adequate free volume. They formed a homogenous film after application, with suitable adhesion to the nail plate. Furthermore, the antifungal test results demonstrated that the terbinafine released from the nail lacquer Formulation A PU 19 showed activity against dermatophytes, namely Trichophyton rubrum. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

Ghanizadeh, Ahmad; Bazrafshan, Amir; Dehbozorgi, Gholamreza

2013-01-01

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

Application of cosmetic nail varnish does not affect the antifungal efficacy of amorolfine 5% nail lacquer in the treatment of distal subungual toenail onychomycosis: results of a randomised active-controlled study and in vitro assays.

PubMed

Sigurgeirsson, B; Ghannoum, M A; Osman-Ponchet, H; Kerrouche, N; Sidou, F

2016-05-01

As onychomycosis is unsightly, this study clinically evaluated whether the antifungal efficacy of amorolfine 5% nail lacquer (NL) was affected by a masking, natural-coloured, cosmetic nail varnish applied 24 h later; in vitro investigations were also performed. Subjects with mild-to-moderate distal subungual toenail onychomycosis were randomised to receive amorolfine 5% NL once weekly with or without cosmetic nail varnish applied 24 h later. After 12-week treatment, antifungal activity of affected toenail clippings was assessed by measurement of zones of inhibition (ZOIs) on Trichophyton mentagrophytes seeded agar plates. Mean diameters were 53.5 mm for the amorolfine 5% NL-alone group (n = 23) and 53.6 mm for amorolfine 5% NL plus cosmetic nail varnish group (n = 25). Also, mycological cultures of subungual debris at week 12 were negative for all subjects in both groups. Most subjects (88%) reported that cosmetic nail varnish masked their infected toenails. Additionally, cadaver human nails coated in vitro with or without cosmetic nail varnish 10 min or 24 h post amorolfine NL application all gave ZOIs on Trichophyton rubrum agar plates representing potent antifungal activity. In conclusion, cosmetic nail varnish applied post amorolfine had no effect on the subungual antifungal activity of amorolfine 5% NL or its penetration through toenails. © 2016 The Authors Mycoses published by Blackwell Verlag GmbH.

Trochanteric fracture-implant motion during healing - A radiostereometry (RSA) study.

PubMed

Bojan, Alicja J; Jönsson, Anders; Granhed, Hans; Ekholm, Carl; Kärrholm, Johan

2018-03-01

Cut-out complication remains a major unsolved problem in the treatment of trochanteric hip fractures. A better understanding of the three-dimensional fracture-implant motions is needed to enable further development of clinical strategies and countermeasures. The aim of this clinical study was to characterise and quantify three-dimensional motions between the implant and the bone and between the lag screw and nail of the Gamma nail. Radiostereometry Analysis (RSA) analysis was applied in 20 patients with trochanteric hip fractures treated with an intramedullary nail. The following three-dimensional motions were measured postoperatively, at 1 week, 3, 6 and 12 months: translations of the tip of the lag screw in the femoral head, motions of the lag screw in the nail, femoral head motions relative to the nail and nail movements in the femoral shaft. Cranial migration of the tip of the lag screw dominated over the other two translation components in the femoral head. In all fractures the lag screw slid laterally in the nail and the femoral head moved both laterally and inferiorly towards the nail. All femoral heads translated posteriorly relative to the nail, and rotations occurred in both directions with median values close to zero. The nail tended to retrovert in the femoral shaft. Adverse fracture-implant motions were detected in stable trochanteric hip fractures treated with intramedullary nails with high resolution. Therefore, RSA method can be used to evaluate new implant designs and clinical strategies, which aim to reduce cut-out complications. Future RSA studies should aim at more unstable fractures as these are more likely to fail with cut-out. Copyright © 2018 Elsevier Ltd. All rights reserved.

Taxane-induced nail changes: Predictors and efficacy of the use of frozen gloves and socks in the prevention of nail toxicity.

PubMed

Can, Gulbeyaz; Aydiner, Adnan; Cavdar, Ikbal

2012-07-01

The primary endpoint of this study was to determine predictors of taxane-related nail toxicity. The secondary endpoint was to evaluate the efficacy of the use of frozen gloves and socks in the prevention of taxane-related nail toxicity. This descriptive, interventional, cross-sectional study was conducted with 200 patients. The patients were assigned to the frozen gloves/socks intervention group or control group. Frozen gloves/socks were applied only in hourly taxane-based treatments. The Patients Record Forms of the clinic were used in data collection. Nail changes were graded using the NCI Common Toxicity Criteria for each patient and treatment. Logistic regression analysis was performed to predict the factors that affect nail changes. The majority of the patients enrolled in the study were women diagnosed with breast cancer. The two groups were statistically similar for the cancer diagnosis, type and number of taxane cycles administered. Grade 1 nail toxicity was found in 34%, grade 2 in 11%, and grade 3 in 5.5% patients. Taxane-related nail toxicity was higher in patients who were female, had a history of diabetes, received capecitabine in conjunction with docetaxel and had breast or gynecological cancer diagnosis. Nail changes increased with an increase in the number of taxane cycles administered, BMI and severity of treatment-related neuropathy. The multivariate analysis demonstrated that BMI, breast or ovarian cancer diagnosis and the number of taxane cycles administered were the independent factors for this toxicity. No statistically significant difference in nail toxicity incidence and time to occurrence of nail changes was found between the intervention and the control groups. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Respiratory manifestations of yellow nail syndrome: report of two cases and literature review].

PubMed

Li, S; Huang, H; Xu, K; Xu, Z J

2018-03-12

Objective: To describe the clinical characteristics of respiratory manifestations of yellow nail syndrome. Methods: We conducted a retrospective analysis of 2 patients with respiratory diseases associated with yellow nail syndrome. Their clinical and chest radiological data were collected. We searched PubMed, Wanfang and CNKI databases with the keywords "yellow nail syndrome, yellow nail and lung" in Chinese and English. And the relevant literatures, including 6 articles in Chinese and 81 articles in English, were reviewed. Results: Our 2 patients were male, one 60 years old and the other 76. Typical yellow nails were present in their fingers, and one of them also showed toe yellow nails. One patient was admitted for refractory respiratory infection and he was diagnosed with diffuse bronchiectasis. The respiratory symptoms could be relieved with antibiotics according to the results of sputum microbiological analysis. The other patient was admitted for cough and exertional dyspnea, and refractory pleural effusions were revealed bilaterally. He received repeated effusion drainage by thoracentesis, and Octreotide was tried recently. A total of 373 cases were reviewed in Chinese and English literatures. Pleural effusions (152 cases) and diffuse bronchiectasis (121 cases) were the most common reported respiratory manifestations. Lymphoedema was present in almost all cases with pleural effusion associated with yellow nail syndrome, and the effusion was usually exudative and lymphocyte predominant. Pleurodesis and decortication were effective for them. But, somatostatin analogues had been tried effectively for these patients recently. On the other hand, literatures showed that diffuse bronchiectasis in yellow nail syndrome was less severe than idiopathic diffuse bronchiectasis, and might benefit from long-term macrolide antibiotics. Conclusions: Yellow nail syndrome is a very rare disorder. Besides yellow nail, respiratory manifestations are the main clinical presentations. Diffuse bronchiectasis and recurrent pleural effusions are the common manifestations.

Nail gun injuries to the head with minimal neurological consequences: a case series.

PubMed

Makoshi, Ziyad; AlKherayf, Fahad; Da Silva, Vasco; Lesiuk, Howard

2016-03-16

An estimated 3700 individuals are seen annually in US emergency departments for nail gun-related injuries. Approximately 45 cases have been reported in the literature concerning nail gun injuries penetrating the cranium. These cases pose a challenge for the neurosurgeon because of the uniqueness of each case, the dynamics of high pressure nail gun injuries, and the surgical planning to remove the foreign body without further vascular injury or uncontrolled intracranial hemorrhage. Here we present four cases of penetrating nail gun injuries with variable presentations. Case 1 is of a 33-year-old white man who sustained 10 nail gunshot injuries to his head. Case 2 is of a 51-year-old white man who sustained bi-temporal nail gun injuries to his head. Cases 3 and 4 are of two white men aged 22 years and 49 years with a single nail gun injury to the head. In the context of these individual cases and a review of similar cases in the literature we present surgical approaches and considerations in the management of nail gun injuries to the cranium. Case 1 presented with cranial nerve deficits, Case 2 required intubation for low Glasgow Coma Scale, while Cases 3 and 4 were neurologically intact on presentation. Three patients underwent angiography for assessment of vascular injury and all patients underwent surgical removal of foreign objects using a vice-grip. No neurological deficits were found in these patients on follow-up. Nail gun injuries can present with variable clinical status; mortality and morbidity is low for surgically managed isolated nail gun-related injuries to the head. The current case series describes the surgical use of a vice-grip for a good grip of the nail head and controlled extraction, and these patients appear to have a good postoperative prognosis with minimal neurological deficits postoperatively and on follow-up.

Pulmonary fat embolism after reamed and unreamed nailing of femoral fractures.

PubMed

Högel, F; Gerlach, U V; Südkamp, N P; Müller, C A

2010-12-01

To determine whether reamed or unreamed intramedullary nailing of femoral fractures results in higher incidence of pulmonary fat embolism, three different methods of intramedullary nailing were compared in sheep. To analyze the presence of bone marrow fat embolism in pulmonary arteries, histological evaluation was undertaken using a quantitative computer-assisted measurement system. In this experimental model of 27 female Swiss alpine sheep, an osteotomy of the proximal femur was conducted in each animal. Then, the animals were divided into three groups according to the method of treatment: two different reamed intramedullary nailing techniques and an unreamed nailing technique were used. In the first group "ER" (experimental reamer; n=9), the nail was inserted after reaming with an experimental reamer; in the second group "CR" (conventional reamer; n=7), the intramedullary nail was inserted after reaming with the conventional AO-reamer. In the third group "UN" (unreamed; n=8) unreamed nailing was performed. During the operation procedure intramedullary pressure was measured in the distal fragment. After sacrificing the animals, quantitative histological analyses of bone marrow fat embolism in pulmonary arteries were done using osmium tetroxide fixation and staining of the fat. The measurement of intramedullary pressure showed significantly lower values for reamed nailing than for the unreamed technique. The quantitative histological evaluation of lung vessels concerning bone marrow fat embolism revealed a statistically significant difference between reamed and unreamed insertion of the nail: 7.77%±6.93 (ER) and 6.66%±5.61 (CR) vs. 16.25%±10.05 (UN) (p<0.05) of the assessed lung vessels were filled with fat emboli. However, no difference was found between the traditional and experimental reamer. Intramedullary nailing after reaming is a safe procedure with low systemic embolisation when compared to the unreamed insertion of the nail. Copyright © 2010 Elsevier Ltd. All rights reserved.

Comparison of two intramedullary nails for tibiotalocalcaneal fusion: anatomic and radiographic considerations.

PubMed

Mückley, Thomas; Ullm, Sebastian; Petrovitch, Alexander; Klos, Kajetan; Beimel, Claudia; Fröber, Rosemarie; Hofmann, Gunther O

2007-05-01

Retrograde intramedullary nailing is an established procedure for tibiotalocalcaneal arthrodesis. This study was conducted to see whether, and if so to what extent, nail design modifications would influence the risk to anatomic structures and the bony coverage of the nail base. Six pairs of thawed fresh-frozen cadaver legs received two different intramedullary nails (N1: straight nail, lateral-medial tip locking; N2: valgus-curved nail, medial-lateral tip locking) under simulated operative conditions. The specimens were dissected; distances between the at-risk structures and the hardware were measured. The hindfoot axis and the volume of the intracalcaneal nail portion were determined with CT. At the plantar entry site, N2 was significantly farther from the flexor hallucis longus tendon (p=0.047), the medial plantar artery (p=0.026), and the lateral plantar nerve (p=0.026) than N1. The lateral-medial calcaneal locking screw of N1 damaged significantly more often the peroneus brevis tendon (p=0.03) than N2. The proximal tip-locking screw, N2, was significantly farther from the anterior tibial artery (p=0.075) and the deep (p=0.047) and superficial peroneal nerves (p=0.009) than N1; N1 was significantly farther from the great saphenous vein (p=0.075) than N2. The distal tip-locking screw, N1. damaged significantly more often the extensor digitorum longus (p=0.007), the anterior tibial artery(p = 0.04), and the deep and superficial peroneal nerves (p=0.03) than N2. CT did not show any significant changes in the hindfoot axis with either device; intracalcaneal nail volumes were similar. A curved nail can increase the distance to at-risk plantar structures. Medial-lateral nail-tip locking appears to have less risk to neurovascular structures. Safer retrograde intramedullary nailing for tibiotalocalcaneal fusion requires knowledge of the structures at risk and appropriate operative technique.

Pediatric Diaphyseal Femur Fractures: Submuscular Plating Compared With Intramedullary Nailing.

PubMed

Sutphen, Sean A; Mendoza, Juan D; Mundy, Andrew C; Yang, Jingzhen G; Beebe, Allan C; Samora, Walter P; Klingele, Kevin E

2016-11-01

This study compared the radiographic and clinical outcomes of pediatric diaphyseal femur fractures treated by submuscular plating, flexible retrograde intramedullary nailing, or rigid antegrade intramedullary nailing with a trochanteric entry point in skeletally immature patients who were 8 years and older. A retrospective review was conducted of skeletally immature patients 8 years and older who were treated for femur fracture with submuscular plating, flexible intramedullary nailing, or rigid intramedullary nailing from 2001 to 2014 with a minimum 12-week follow-up. Treatment outcomes were compared for statistical significance, including time to union, malunion, nonunion, heterotopic ossification, avascular necrosis, time to full weight bearing, limb length discrepancy, residual limp, painful hardware, and infection. The study identified 198 femur fractures in 196 patients (mean age, 11.9 years). Each femur fracture was treated with submuscular plating (35), flexible intramedullary nailing (61), or rigid intramedullary nailing (102). Mean follow-up across the cohort was 48 weeks, ranging from 12 to 225 weeks. Flexible nailing was associated with an increased incidence of malunion (P<.0001) and hardware irritation (P=.0204) and longer time to full weight bearing (P=.0018). Rigid nailing was associated with an increased incidence of limp at 12-week followup (P=.0412). Additionally, 23.5% of patients who were treated with rigid nailing had heterotopic ossification. Of all surgical methods, submuscular plating allowed for the most rapid return to full weight bearing (mean, 7 weeks) and offered the fastest healing rate (mean, 6 weeks). Submuscular plating resulted in faster times to union and full weight bearing, with minimal complication rates. Rigid intramedullary nailing with trochanteric entry resulted in a lower incidence of malunion and hardware-related complications; however, these patients had an increased incidence of heterotopic ossification and residual limp postoperatively. Flexible retrograde intramedullary nailing resulted in the highest rates of malunion and hardware irritation and the longest time to full weight bearing. [Orthopedics. 2016; 39(6):353-358.]. Copyright 2016, SLACK Incorporated.

Withdrawal Strength and Bending Yield Strength of Stainless Steel Nails

Treesearch

Douglas R. Rammer; Samuel L. Zelinka

2015-01-01

It has been well established that stainless steel nails have superior corrosion performance compared to carbon steel or galvanized nails in treated wood; however, their mechanical fastening behavior is unknown. In this paper, the performance of stainless steel nails is examined with respect to two important properties used in wood connection design: withdrawal strength...

77 FR 17029 - Certain Steel Nails From the United Arab Emirates: Final Determination of Sales at Less Than Fair...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-23

... coils using materials such as plastic, paper, or wire. Certain steel nails subject to this investigation... plastic or steel washers (``caps'') already assembled to the nail, having a bright or galvanized finish, a... Initiation Notice,\\2\\ by removing the language referring to the packaging characteristics of certain nails...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-14

... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-1114 (Review)] Steel Nails From China; Scheduling of an Expedited Five-Year Review Concerning the Antidumping Duty Order on Steel Nails From China... steel nails from China would be likely to lead to continuation or recurrence of material injury within a...

[The present study situation and application prospect of nail analysis for abused drugs].

PubMed

Chen, Hang; Xiang, Ping; Shen, Min

2010-10-01

In forensic toxicology analysis, various types of biological samples have their own special characteristics and scope of applications. In this article, the physiological structure of nails, methods for collecting and pre-processing samples, and for analyzing some poisons and drugs in the nails are reviewed with details. This paper introduces the influence factors of drug abuse of the nails. The prospects of its further applications are concluded based on the research results. Nails, as an unconventional bio-sample without general application, show great potential and advantages in forensic toxicology.

Effects of reinforcement without extinction on increasing compliance with nail cutting: A systematic replication.

PubMed

Dowdy, Art; Tincani, Matt; Nipe, Timothy; Weiss, Mary Jane

2018-06-17

Personal hygiene routines, such as nail cutting, are essential for maintaining good health. However, individuals with autism spectrum disorder (ASD) and other developmental disabilities often struggle to comply with essential, personal hygiene routines. We conducted a systematic replication of Schumacher and Rapp (2011), Shabani and Fisher (2006), and Bishop et al. (2013) to evaluate an intervention that did not require escape extinction for increasing compliance with nail cutting. With two adolescents diagnosed with ASD who resisted nail cutting, we evaluated the effects of delivering a preferred edible item contingent on compliance with nail cutting. Results indicated that the treatment reduced participants' escape responses and increased their compliance with nail cutting. © 2018 Society for the Experimental Analysis of Behavior.

Mosaic Trisomy 9p in a Patient with Mild Dysmorphic Features and Normal Intelligence.

PubMed

Brar, Randeep; Basel, Donald G; Bick, David P; Weik, LuAnn; vanTuinen, Peter; Peterson, Jess F

2017-01-01

To the Editor: Partial and whole duplications of the short arm of chromosome 9 have been commonly reported in the literature with characteristic phenotypic features and intellectual disabilities. The clinical features of 9p duplications are broad and can include growth retardation, developmental delay, intellectual disability, microbrachycephaly, deep set eyes, hypertelorism, downslanting palpebral fissures, prominent nasal root, bulbous nasal tip, low-set ears, short fingers and toes with hypoplastic nails, and delayed bone age (Bonaglia et al., 2002; Zou et al., 2009; Guilherme et al., 2014).

3D Optical Investigation of 2 Nail Systems Used in Tibiotalocalcaneal Arthrodesis: A Biomechanical Study.

PubMed

Evers, Julia; Lakemeier, Martin; Wähnert, Dirk; Schulze, Martin; Richter, Martinus; Raschke, Michael J; Ochman, Sabine

2017-05-01

Although retrograde intramedullary nails for tibiotalocalcaneal arthrodesis (TTCA) are an established fixation method, few studies have evaluated the stability of the available nail systems. The purpose of this study was to compare biomechanically the primary stability of 2 nail-systems, A3 (Small Bone Innovations) and HAN (Synthes), in human cadavers and analyze the exact point of instability in TTCA by means of optical measurement. In 6 pairs of lower legs (n = 12) of fresh-frozen human cadavers with osteoporotic bone structure, bone mineral density (BMD) was determined. Pairwise randomized implantation of either an HAN or A3 nail was executed. Performance and stability were measured by quasi-static tests using 3D motion tracking (NDI Optotrak-Certus) followed by cyclic loading tests during dorsi- and plantarflexion. 3D optical analysis in quasi-static tests showed a significantly lower degree of movement for the HAN nail in rotational and dorsi-/plantarflexion, especially in the subtalar joint. Cyclic loading tests were consistent with quasi-static tests. The A3 nail offered lower stability during axial torsion in the ankle and subtalar joints and during plantar- and dorsiflexion in the subtalar joint in osteoporotic bones. This study was the first to examine the primary stability of different arthrodesis nails in TTCA and their bony parts with a 3D motion analysis. The better stability of the locking-only HAN nail in this osteoporotic test setup could lead to more favorable results in comparison to the A3 nail in clinical use.

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

PubMed

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

2015-04-01

Intramedullary nailing is the standard fixation method for displaced diaphyseal fractures of tibia. Selection of the correct nail insertion point is important for axial alignment of bone fragments and to avoid iatrogenic fractures. However, the standard entry point (SEP) may not always optimise the bone-nail fit due to geometric variations of bones. This study aimed to investigate the optimal entry for a given bone-nail pair using the fit quantification software tool previously developed by the authors. The misfit was quantified for 20 bones with two nail designs (ETN and ETN-Proximal Bend) related to the SEP and 5 entry points which were 5 mm and 10 mm away from the SEP. The SEP was the optimal entry point for 50% of the bones used. For the remaining bones, the optimal entry point was located 5 mm away from the SEP, which improved the overall fit by 40% on average. However, entry points 10 mm away from the SEP doubled the misfit. The optimised bone-nail fit can be achieved through the SEP and within the range of a 5 mm radius, except posteriorly. The study results suggest that the optimal entry point should be selected by considering the fit during insertion and not only at the final position. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Arthrodesis in septic knees using a long intramedullary nail: 17 consecutive cases.

PubMed

Leroux, B; Aparicio, G; Fontanin, N; Ohl, X; Madi, K; Dehoux, E; Diallo, S

2013-06-01

Intramedullary nailing using long or modular nails is the most reliable mean of achieving femorotibial fusion. Here, we report the operative, clinical, functional, and radiological outcomes of 17 long intramedullary nail arthodeses in patients with infection. Clinical and functional outcomes after long intramedullary nailing are at least as good as those obtained using other implants. We retrospectively reevaluated 17 patients after unilateral two-stage knee arthrodesis with a long titanium intramedullary nail and autologous bone grafting. We evaluated satisfaction, leg length discrepancy, and function (Lequesne and WOMAC indices). Radiographs were obtained to assess fusion, time to fusion, and femorotibial angles. No cases of material failure were recorded. One or more complications occurred in seven patients. Mean limb shortening was 27.6mm. Of the 17 patients, 15 were satisfied with the procedure. The mean Lequesne index was 10.5/24 and the mean overall WOMAC score was 26/88. Fusion was achieved in 16 patients, with a mean time to fusion of 5 months. Mean femorotibial angles were 178.6° of varus and 1.9° of flexion. This simple and rapid surgical technique provides functional outcomes similar to those obtained using modular nails. The fusion rate is high. Nail extraction is simple and causes minimal damage, in contrast to modular nails. Increased attention to misalignment is needed. Level IV, retrospective study. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Application of soil nails to the stability of mine waste slopes

DOE Office of Scientific and Technical Information (OSTI.GOV)

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

1996-12-31

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

Avoiding Pitfalls of Tibiotalocalcaneal Nail Malposition With Internal Rotation Axial Heel View.

PubMed

Callahan, Ryan; Juliano, Paul; Aydogan, Umur; Clayton, Justin

2018-04-01

Tibiotalocalcaneal (TTC) nails are often used for complex hind foot arthrodesis and deformity correction. The natural valgus alignment of the hindfoot creates a challenge to optimum placement of the guidewire and eventual nail with a straight or valgus-curved nail. Five fresh frozen cadavers were used for placement of a TTC guidewire with standard anterior-posterior (AP), lateral, and Harris axial heel views as a reference for proper placement. The limb was then rotated 15°, 30°, and 45° both internally and externally to evaluate the perceived amount of osseous purchase within the calcaneus. The TTC nail was then inserted and dissection was performed to demonstrate proximity of the nail to the sustentaculum tali and neurovascular structures. A 30° internal rotation Harris axial heel view demonstrated the most accurate representation of osseous purchase within the calcaneus with the guidewire and nail placement. When the guidewire was placed with standard imaging the nail was often ultimately placed in close proximity to the sustentaculum tali and neurovascular structures. Careful placement of the guidewire prior to reaming and nail placement should be undertaken to avoid neurovascular injury and to increase osseous purchase. For optimal guidewire placement, the authors suggest using appropriate anatomic landmarks and using a 30° internally rotated Harris axial heel view to verify correct placement. Level V: Expert opinion.

A patient specific finite element simulation of intramedullary nailing to predict the displacement of the distal locking hole.

PubMed

Mortazavi, Javad; Farahmand, Farzam; Behzadipour, Saeed; Yeganeh, Ali; Aghighi, Mohammad

2018-05-01

Distal locking is a challenging subtask of intramedullary nailing fracture fixation due to the nail deformation that makes the proximally mounted targeting systems ineffective. A patient specific finite element model was developed, based on the QCT data of a cadaveric femur, to predict the position of the distal hole of the nail postoperatively. The mechanical interactions of femur and nail (of two sizes) during nail insertion was simulated using ABAQUS in two steps of dynamic pushing and static equilibrium, for the intact and distally fractured bone. Experiments were also performed on the same specimen to validate the simulation results. A good agreement was found between the model predictions and the experimental observations. There was a three-point contact pattern between the nail and medullary canal, only on the proximal fragment of the fractured bone. The nail deflection was much larger in the sagittal plane and increased for the larger diameter nail, as well as for more distally fractured or intact femur. The altered position of the distal hole was predicted by the model with an acceptable error (mean: 0.95; max: 1.5 mm, in different tests) to be used as the compensatory information for fine tuning of proximally mounted targeting systems. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

Are there any advantages in using a distal aiming device for tibial nailing? Comparing the Centro Nailing System with the Unreamed Tibia Nail.

PubMed

Veen, Egbert J D; Ettema, Harmen B; Zuurmond, Rutger G; Mostert, Adriaan K

2011-10-01

The distal locking of an intramedullary tibial nail can be challenging and time consuming when performed freehand. This study was conducted to evaluate if a distal aiming device would reduce surgical time. A case-controlled study was performed between 2007 and 2009 with 30 patients receiving a reamed tibial nail (Centronail) with the use of a distal aiming device and 30 patients who were treated with an Unreamed Tibia Nail (UTN), with freehand distal locking, in the same period. The primary outcome in this study was operative time. Secondary outcomes were the need for fluoroscopy, time to consolidation and complications. Operation time was longer in the Centronail group compared with the UTN group (126 min vs. 96 min, p=0.000). Use of fluoroscopy for distal locking was needed in half of the cases (n=16) using a distal aiming device. No differences were found regarding time to consolidation, time to removal of the nail and complications. The use of an aiming device for distal locking of a tibia nail lengthens operation time rather than reducing it. Fluoroscopy was still needed in about half of the cases. No difference was seen in clinical outcomes. The use of a distal aiming device to lock a tibial nail appears to have no benefit. Copyright © 2011 Elsevier Ltd. All rights reserved.

Withdrawal strength of ring-shank nails embedded in southern pine lumber

Treesearch

M. J. Skulteti; D. A. Bender; S. G. Winistorfer; D. G. Pollock

1997-01-01

Ring-shank nails are used extensively in post-frame construction due to their superior performance, yet surprisingly little testing has been done on nail sizes above 12d Experience in the post-frame industry suggests that published allowable design values for ring-shank nails may be overly conservative and need revision. The goal of the research reported herein was to...

Tibiotalocalcaneal arthrodesis using a dynamically locked retrograde intramedullary nail.

PubMed

Pelton, Kevin; Hofer, Jason K; Thordarson, David B

2006-10-01

Tibiotalocalcaneal arthrodesis is an important salvage method for patients with complex hindfoot problems, including Charcot arthropathy, osteonecrosis of the talus, combined arthritis of the ankle and subtalar joint, and failed total ankle arthroplasty. This study evaluated the results of a dynamic retrograde intramedullary nail for fixation with posterior to anterior distal interlocking screws placed through the calcaneus for tibiotalocalcaneal fusion. Thirty-three consecutive tibiotalocalcaneal fusions were done by a single surgeon (DBT) and were stabilized with a dynamic retrograde intramedullary nail. Time to fusion, impaction of the nail relative to the intramedullary canal, nail-tibial angle, and complications were noted. Average followup was 14 months. Twenty-nine of 33 feet (88%) fused at an average of 3.7 months after surgery. Average impaction of the nail was 2.3 (0.5 to 5.0) mm. Cortical hypertrophy at the tip of the rod or at the proximal interlocking screw was noted in 13 of 27 patients. A trend toward a higher nonunion rate was noted in patients with an increased nail-tibial angle. Dynamic retrograde intramedullary nailing for fixation of the tibiotalocalcaneal fusions is a good method of stabilizing this complex fusion construct.

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

PubMed

El-Heis, S; Abadie, Al

2016-11-15

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

Penetrating brain injury caused by nail guns: two case reports and a review of the literature.

PubMed

Luo, Wei; Liu, Hai; Hao, Shuyu; Zhang, Ying; Li, Jingsheng; Liu, Baiyun

2012-01-01

To the best of the authors' knowledge, there are few case reports of penetrating brain injuries (PBI) caused by nail guns and these have usually involved incomplete penetration of the skull. Complete penetration of a nail into the intracranial cavity is extremely rare. Here, two such cases are presented. In the first, the nail entered through the right temporal bone, lodged in the right temporal lobe and was removed via craniotomy with intra-operative ultrasound guidance. In the second, the nail destroyed the left parietal bone, damaged the left internal capsule and lodged in the left temporal lobe near the left petrous apex and the brain stem. According to the latest literature retrieval, this is the first reported case of nail-gun injury to the internal capsule. The position of the nail precluded removal without further neurologic damage. Treatment strategies designed to optimize outcome, with or without surgery, and possible complications are discussed in this report.

[RESEARCH PROGRESS IN COMPLICATIONS OF RETROGRADE INTRAMEDULLARY NAIL FIXATION FOR TIBIOTALOCALCANEAL ARTHRODESIS].

PubMed

Feng, Jun; Yu, Guangrong

2015-09-01

To review the cause, treatment, and prevention of complications of retrograde intramedullary nail fixation for tibiotalocalcaneal arthrodesis and enhance the recognition on the complications of tibiotalocalcaneal arthrodesis. The recent literature concerning intramedullary nail fixation for tibiotalocalcaneal arthrodesis was consulted and reviewed. There are intraoperative and postoperative complications of intramedullary nail fixation for tibiotalocalcaneal arthrodesis, and the causes, treatment, and prevention of complications are various. Progress of retrograde intramedullary nail fixation increases the successful rate of tibiotalocalcaneal arthrodesis. However, there is still a high complication rate, so strict preoperative assessment and skilled surgical technique are necessary to prevent complications.

Intramedullary nailing: experience in 427 patients.

PubMed

Lambiris, E; Tyllianakis, M; Megas, P; Panagiotopoulos, E

1996-01-01

In the Orthopaedic Department in Patras University 427 intramedullary nailings in the lower limbs were performed between 1989 and 1994 and retrospectively reviewed to evaluate the range of complications. One hundred and seventy-two were nailings of the femur; 80 gamma nails mainly for subtrochanteric and intertrochanteric with subtrochanteric extension fractures were included, (total 252/59%); 175 (41%) were nailings of the tibia. Union was achieved in all case. Overall the complication rate in this series was 3.3% (14 cases) and included infection (4 cases), neuropraxia (2 cases), implant failure (5 cases), limb length deficiency (2 cases) and malrotation (1 case).

Distal tibial fractures and non-unions treated with shortened intramedullary nail.

PubMed

Megas, P; Zouboulis, P; Papadopoulos, A X; Karageorgos, A; Lambiris, E

2003-01-01

We reviewed 18 patients, 14 with acute fractures and four with non-union of the distal tibia, treated between 1990 and 2001 with a shortened, reamed intramedullary nail. The mean follow-up was 38 (8-144) months. The fractures united at an average of 16 (12-18) weeks and the non-unions at 20 (12-30) weeks. Two patients required nail dynamization. No limb shortening nor material failures were seen. All patients returned to normal daily activities. Although technically demanding, intramedullary nailing for distal tibial fractures and non-unions with a shortened nail represents a safe and reliable method.

Congenital yellow nail syndrome: a case report and its relationship to nonimmune fetal hydrops.

PubMed

Nanda, Arti; Al-Essa, Fahad H; El-Shafei, Wael M; Alsaleh, Qasem A

2010-01-01

Yellow nail syndrome (YNS) is an uncommon disorder characterized by a triad of nail dystrophy, lymphedema, and pleural effusion. It is rare in children and congenital occurrence of YNS has been very rarely described. We report a 2-year-old Arab boy having congenital yellow nail syndrome with mild facial dysmorphism and bilateral conjunctival pigmentation born to consanguineous parents. One of his older siblings had died of nonimmune fetal hydrops (NIFH). The case supports the genetic basis of yellow nail syndrome with a possible relationship to nonimmune fetal hydrops. © 2010 Wiley Periodicals, Inc.

Impact of a Healthy Nails Program on Nail-Biting in Turkish Schoolchildren: A Controlled Pretest-Posttest Study

ERIC Educational Resources Information Center

Ergun, Ayse; Toprak, Rumeysa; Sisman, Fatma Nevin

2013-01-01

This study was conducted to examine the effect of a healthy nails program on nail-biting in Turkish schoolchildren. This quasi-experimental study was of pretest-posttest control group design. A total of 50 students of a primary school formed the intervention group, while 53 students from the same school formed the control group. Data were…

The Effect of Psychological State and Social Support on Nail-Biting in Adolescents: An Exploratory Study

ERIC Educational Resources Information Center

Sisman, Fatma Nevin; Tok, Ozlem; Ergun, Ayse

2017-01-01

Nail-biting is one of the most common behavioral problems in children. This study aimed to examine factors affecting nail-biting among adolescents and the effects of psychological state and social support on nail-biting. This cross-sectional study was conducted between January and May of 2014 in seven schools in Istanbul (N = 724). Data were…

Comparison of knee function in patients with a healed fracture of the femoral shaft fixed with retrograde and antegrade intramedullary nailing.

PubMed

Andrzejewski, Krzysztof; Panasiuk, Michał; Grzegorzewski, Andrzej; Synder, Marek

2013-10-31

BACKGROUND. Despite extensive current knowledge about fractures of the femoral shaft, the choice between antegrade and retrograde intramedullary (IM) nailing with respect to the future function of the joint serving to introduce the nail continues to raise controversy. To compare knee function in patients with a healed fracture of the femoral shaft fixed by antegrade vs. retrograde IM nailing. MATERIAL AND METHODS. The study involved a group of 65 individuals with traumatic fractures of the femoral shaft who underwent stabilisation with IM nails in the years 2001-2010. Thirty-two cases were retrograde nails (Group R) and 33 antegrade nails (Group A). Patient age at trauma ranged from 19 to 91 years (mean: 47). Knee function was assessed in both groups with the KOOS, KSS1 and KSS2 scoring systems. RESULTS. Knee function as assessed with KOOS differed significantly between retrograde and antegrade nailing, with a greater incidence of poor and fair results in the former and more excellent outcomes in the latter group (p=0.0133). As regards KSS1 and KSS2, there were no significant differences between the groups (p=0.1947, p=0.4038). The range of motion was 86-125 degrees in Group R and 121-125 degrees in Group A. Knee pain was reported by 37.5% of the patients treated with retrograde nailing and 39.4% of those who had the IM nail inserted via the antegrade approach (p=0.22). The mean time to bone union was 180 days in Group R and 219 days in Group A (p=0.25). Age and presence of osteoarthritis at trauma significantly lowered the KOOS (p=0.0027, p= 0.005) and KSS (p=0.0002, p=0.002) scores, as well as the knee range of motion (p=0.0014, p=0.004) CONCLUSIONS. 1. Knee function following retrograde and antegrade IM nailing to stabilise femoral shaft fractures was comparable. 2. The choice of IM nailing method should not be based solely on orthopaedic indications, but also on the severity of osteoarthritis present at trauma.

Experimental investigation of internal short circuits in lithium-ion batteries

NASA Astrophysics Data System (ADS)

Poramapojana, Poowanart

With outstanding performance of Lithium-ion batteries, they have been widely used in many applications. For hybrid electric vehicles and electric vehicles, customer concerns of battery safety have been raised as a number of car accidents were reported. To evaluate safety performance of these batteries, a nail penetration test is used to simulate and induce internal short circuits instantaneously. Efforts to explain failure mechanisms of the penetration using electrochemical-thermal coupled models have been proposed. However, there is no experimental validation because researchers lack of a diagnostic tool to acquire important cell characteristics at a shorting location, such as shorting current and temperature. In this present work, diagnostic nails have been developed to acquire nail center temperatures and shorting current flow through the nails during nail penetration tests. Two types of cylindrical wall structures are used to construct the nails: a double-layered stainless steel wall and a composite cylindrical wall. An inner hollow cylinder functions as a sensor holder where two wires and one thermocouple are installed. To study experimental reproducibility and repeatability of experimental results, two nail penetration tests are conducted using two diagnostic nails with the double-layered wall. Experimental data shows that the shorting resistance at the initial stage is a critical parameter to obtain repeatable results. The average shorting current for both tests is approximately 40 C-rate. The fluctuation of the shorting current is due to random sparks and fire caused loose contacts between the nail and the cell components. Moreover, comparative experimental results between the two wall structures reveal that the wall structure does not affect the cell characteristics and Ohmic heat generation of the nail. The wall structure effects to current measurements inside the nail. With the composite wall, the actual current redistribution into the inner wall is found to be a sinusoidal waveform.

A Laboratory Experiment on the Evolution of a Sand Gravel Reach Under a Lack of Sediment Supply

NASA Astrophysics Data System (ADS)

Orru, C.; Chavarrias, V.; Ferrara, V.; Blom, A.

2014-12-01

A flume experiment was conducted to examine the evolution of a sand-gravel reach under a lack of sediment supply. The experimental data are used to validate a numerical sand-gravel model. A bed composed of a bi-modal sediment mixture is installed with a uniform slope and an imposed gradual fining pattern. Initially, the sand fraction gradually increases in streamwise direction until the bed is fully composed of sand. The water discharge and downstream water level were constant, and the sediment feed rate was equal to zero. The experiment was dominated by bed load, partial transport, and a subcritical flow regime was imposed. The flow rate was such that only sand was mobile (partial transport), which led to a coarsening over the upstream reach and a gradual reduction of the sediment transport rate during the experiment. New equipment was used to measure the evolution of the grain size distribution of the bed surface during the experiment over the entire flume using image analysis. In the upstream reach we observed a gradual coarsening over time and the formation of an armour layer, which resulted in a more abrupt transition in grain size of the bed surface. Bed degradation increased in streamwise direction. This is due to the initial streamwise increase in the availability of sand in the bed. The different volume fraction content of sand in the bed allowed for the gravel to sink more in the downstream part of the upstream reach. The sand reach suffered from a larger degradation. Finally, we see one reach dominated by sand, small bedforms, and a small bed slope, and a gravel reach dominated by a larger bed slope.

Allergic contact dermatitis from acrylic nails in a flamenco guitarist.

PubMed

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

2016-12-01

Acrylates are molecules that are well known for their strong sensitizing properties. Historically, many beauticians and individuals using store-bought artificial nail products have developed allergic contact dermatitis from acrylates. More recently, the use of acrylic nails among flamenco guitarists to strengthen their nails has become very popular. A 40-year-old non-atopic male patient working as a flamenco guitarist developed dystrophy, onycholysis and paronychia involving the first four nails of his right hand. The lesions were confined to the fingers where acrylic materials were used in order to strengthen his nails to play the guitar. He noticed improvement whenever he stopped using these materials and intense itching and worsening when he began reusing them. Patch tests were performed and positive results obtained with 2-hydroxyethyl methacrylate (2-HEMA), 2-hydroxyethyl acrylate (2-HEA), ethyleneglycol-dimethacrylate (EGDMA) and 2-hydroxypropyl methacrylate (2-HPMA). The patient was diagnosed with occupational allergic contact dermatitis likely caused by acrylic nails. Artificial nails can contain many kinds of acrylic monomers but most cases of contact dermatitis are induced by 2-HEMA, 2-HPMA and EGDMA. This is the first reported case of occupational allergic contact dermatitis from acrylates in artificial nails in a professional flamenco guitar player. Since the practice of self-applying acrylic nail products is becoming very popular within flamenco musicians, we believe that dermatology and occupational medicine specialists should be made aware of the potentially increasing risk of sensitization from acrylates in this setting. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

PubMed

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

2016-11-01

Adverse health effects of heavy metals are a public health concern, especially lead may cause negative health impacts to human fetal and infantile development. The lead concentrations in Pakistani pregnant women's nails, used as a biomarker, were measured to estimate the lead exposure. Thirteen nail samples out of 84 nails analyzed contained lead higher than the concentration (13.6 μg/g) of the fatal lead poisoning case, raising the possibility of an external contamination. Eye cosmetics such as surma are recognized as one of the important sources of lead exposure in Pakistan. We collected in Pakistan 30 eye cosmetics made in Pakistan, Saudi Arabia and western countries. As the metal composition analysis by energy dispersive X-ray fluorescence spectrometry revealed that some surma samples contained lead more than 96%, the surma might contaminate the nail specimen. Scanning electron microscopy observations showed that lead-containing surma consists of fine particle of galena (ore of lead sulfide) in respirable dust range (less than 10 μm). In addition, relative in vitro bioavailability of lead in the surma was determined as 5.2%. Thus, lead-containing surma consists of inhalable and bioavailable particles, and it contributes an increased risk of lead exposure. Moreover, the relationship between the surma and the lead-contaminated nails by lead isotope ratios analysis indicated the potential of lead contamination in nails by surma. These results suggest that lead in the nails was derived both from body burden of lead and external contamination by lead-containing surma. Therefore, nail is not suited as a biomarker for lead exposure in the countries where surma used, because we may overestimate lead exposure by surface lead contamination in the nail by surma. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nail gun injuries in residential carpentry: lessons from active injury surveillance.

PubMed

Lipscomb, H J; Dement, J M; Nolan, J; Patterson, D; Li, L

2003-03-01

To describe circumstances surrounding injuries involving nail guns among carpenters, calculate injury rates, identify high risk groups and preventive measures. and setting: Active injury surveillance was used to identify causes of injury among a large cohort of union residential and drywall carpenters. Injured carpenters were interviewed by experienced journeymen; enumeration of workers and hourworked were provided by the union. The combined data allowed definition of a cohort of carpenters, their hours worked, detailed information on the circumstances surrounding injuries, and identification of preventive measures from the perspectives of the injured worker and an experienced investigator. Nail guns were involved in 14% of injuries investigated. Ninety percent of these injuries were the result of the carpenter being struck, most commonly by a nail puncturing a hand or fingers. The injury rate among apprentices was 3.7 per 200 000 hours worked (95% confidence interval (CI) 2.7 to 4.9) compared with a rate of 1.2 among journeymen (95% CI 0.80 to 1.7). While not always the sole contributing factor, a sequential trigger would have likely prevented 65% of the injuries from tools with contact trip triggers. Training, engineering, and policy changes in the workplace and manufacturing arena are all appropriate targets for prevention of these injuries. Use of sequential triggers would likely decrease acute injury rates markedly. Over 70% of injuries among residential carpenters were associated with through nailing tasks (such as nailing studs or blocks, trusses or joists) or toe nailing (angled, corner nailing) as opposed to flat nailing used for sheathing activities; this provides some indication that contact trip tools could be used solely for flat nailing.

Nail gun injuries in residential carpentry: lessons from active injury surveillance

PubMed Central

Lipscomb, H; Dement, J; Nolan, J; Patterson, D; Li, L

2003-01-01

Objective: To describe circumstances surrounding injuries involving nail guns among carpenters, calculate injury rates, identify high risk groups and preventive measures. Methods and setting: Active injury surveillance was used to identify causes of injury among a large cohort of union residential and drywall carpenters. Injured carpenters were interviewed by experienced journeymen; enumeration of workers and hourworked were provided by the union. The combined data allowed definition of a cohort of carpenters, their hours worked, detailed information on the circumstances surrounding injuries, and identification of preventive measures from the perspectives of the injured worker and an experienced investigator. Results: Nail guns were involved in 14% of injuries investigated. Ninety percent of these injuries were the result of the carpenter being struck, most commonly by a nail puncturing a hand or fingers. The injury rate among apprentices was 3.7 per 200 000 hours worked (95% confidence interval (CI) 2.7 to 4.9) compared with a rate of 1.2 among journeymen (95% CI 0.80 to 1.7). While not always the sole contributing factor, a sequential trigger would have likely prevented 65% of the injuries from tools with contact trip triggers. Conclusions: Training, engineering, and policy changes in the workplace and manufacturing arena are all appropriate targets for prevention of these injuries. Use of sequential triggers would likely decrease acute injury rates markedly. Over 70% of injuries among residential carpenters were associated with through nailing tasks (such as nailing studs or blocks, trusses or joists) or toe nailing (angled, corner nailing) as opposed to flat nailing used for sheathing activities; this provides some indication that contact trip tools could be used solely for flat nailing. PMID:12642553

The effect of different torque wrenches on rotational stiffness in compressive femoral nails: a biomechanical study.

PubMed

Karaarslan, A A; Acar, N

2018-02-01

Rotation instability and locking screws failure are common problems. We aimed to determine optimal torque wrench offering maximum rotational stiffness without locking screw failure. We used 10 conventional compression nails, 10 novel compression nails and 10 interlocking nails with 30 composite femurs. We examined rotation stiffness and fracture site compression value by load cell with 3, 6 and 8 Nm torque wrenches using torsion apparatus with a maximum torque moment of 5 Nm in both directions. Rotational stiffness of composite femur-nail constructs was calculated. Rotational stiffness of composite femur-compression nail constructs compressed by 6 Nm torque wrench was 3.27 ± 1.81 Nm/angle (fracture site compression: 1588 N) and 60% more than that compressed with 3 Nm torque wrench (advised previously) with 2.04 ± 0.81 Nm/angle (inter fragmentary compression: 818 N) (P = 0.000). Rotational stiffness of composite-femur-compression nail constructs compressed by 3 Nm torque wrench was 2.04 ± 0.81 Nm/angle (fracture site compression: 818 N) and 277% more than that of interlocking nail with 0.54 ± 0.08 Nm/angle (fracture site compression: 0 N) (P = 0.000). Rotational stiffness and fracture site compression value produced by 3 Nm torque wrench was not satisfactory. To obtain maximum rotational stiffness and fracture site compression value without locking screw failure, 6 Nm torque wrench in compression nails and 8 Nm torque wrench in novel compression nails should be used.

Reducing intraoperative duration and ionising radiation exposure during the insertion of distal locking screws of intramedullary nails: a small-scale study comparing the current fluoroscopic method against radiation-free, electromagnetic navigation.

PubMed

Grimwood, Darren; Harvey-Lloyd, Jane

2016-12-01

Intramedullary nailing is the standard surgical treatment for mid-diaphyseal fractures of long bones; however, it is also a high radiation dose procedure. Distal locking is regularly cited as a demanding element of the procedure, and there remains a reliance on X-ray fluoroscopy to locate the distal holes. A recently developed electromagnetic navigation (EMN) system allows radiation-free distal locking, with a virtual on-screen image. To compare operative duration, fluoroscopy time and radiation dose when using EMN over fluoroscopy, for the distal locking of intramedullary nails. Consecutive patients with mid-diaphyseal fractures of the tibia and femur, treatable with intramedullary nails, were prospectively enrolled during a 9-month period. The sample consisted of 29 individuals, 19 under fluoroscopic guidance and 10 utilising EMN. Participants were allocated depending on the type of intramedullary nail used and surgeon's preference. These were further divided into tibial and femoral subcategories, relative to the fracture site. EMN reduced fluoroscopy time by 49 (p = 0.038) and 28 s during tibial and femoral nailings, respectively. Radiation dose was reduced by 18 cGy/cm 2 (p = 0.046) during tibial and 181 cGy/cm 2 during femoral nailings when utilising EMN. Operative duration was 11 min slower during tibial nailings using EMN, but 38 min faster in respect of femoral nailings. This study has evidenced statistically significant reductions in both fluoroscopy time and radiation dose when using EMN for the distal locking of intramedullary nails. It is expected that overall operative duration would also decrease in line with similar studies, with increased usage and a larger sample.

Aging changes in hair and nails

MedlinePlus

... page: //medlineplus.gov/ency/article/004005.htm Aging changes in hair and nails To use the sharing ... you age, your hair and nails begin to change. HAIR CHANGES AND THEIR EFFECTS Hair color change . ...

A fatal nail gun injury--an unusual ricochet?

PubMed

Nadesan, K

2000-01-01

An 18-year-old construction worker suddenly collapsed while handling a power-actuated nail gun and died shortly after. A neat, almost circular puncture wound was found on the front of his left chest. No fire-arm residues were detected on the surrounding skin. The police stated that it was an accidental injury, at a construction site, where a nail fired from a nail gun by the deceased had deflected off the wall and struck him on the front of the chest. Since the entry wound appeared to be a neat hole, and that too on the front of the left chest overlying the heart area, there was reluctance on the part of the pathologist to accept it as an accidental injury due to a ricochet. A visit to the scene, interrogation of witnesses, examination of the alleged tool and post-mortem X-ray of the deceased were undertaken prior to autopsy. A bent nail was found in the heart. The scene visit and the subsequent autopsy revealed that the nail took a roughly circular flightpath after it had struck the wall, all the while travelling with its pointed end directed forward. Within the body too, the nail maintained the same path. Various medicolegal issues are discussed pertaining to nail-gun injuries. The importance of a visit to the scene, examination of the alleged tool, interrogation of witnesses and the X-ray of the body, all prior to autopsy, are emphasized. The conclusion was: accidental death due to the unusual ricochet of a nail.

Common Child and Adolescent Cutaneous Infestations and Fungal Infections.

PubMed

Alter, Sherman J; McDonald, Megan B; Schloemer, Julie; Simon, Ryan; Trevino, Julian

2018-01-01

Cutaneous infections and infestations are common among children and adolescents. Ectoparasitic infestations affect individuals across the globe. Head lice, body lice, scabies, and infestations with bed bugs are seen in individuals who reside in both resource poor areas and in developed countries. Superficial cutaneous and mucosal candida infections occur throughout the life cycle. Dermatophyte infections of keratin-containing skin and skin structures result in tinea capitis (scalp), tinea corporis (body), tinea pedis (foot), and tinea unguium (nails). Less frequent endemic fungal infections such as blastomycosis, coccidiodomycosis, and histoplasmosis may present with skin findings. This article will describe the epidemiology and transmission of these conditions as well as their clinical manifestations. The approach to diagnosis will be addressed as well as primary prevention and current therapies. Copyright © 2018 Mosby, Inc. All rights reserved.

Sub-Trochanteric Hip Fracture Following Core Decompression for Osteonecrosis in a Patient with a Pre-Existing Contralateral Occult Femoral Neck Fracture.

PubMed

Berger, Ryan J; Sultan, Assem A; Cole, Connor; Sodhi, Nipun; Khlopas, Anton; Mont, Michael A

2018-06-01

We present a unique case of a 62-year-old patient with bilateral osteonecrosis of the femoral heads secondary to corticosteroid use. She presented with an occult right femoral neck fracture and was treated with percutaneous pinning of the right femoral neck and a left-sided percutaneous drilling. Despite apparent appropriate technique, the patient sustained a left sub-trochanteric hip fracture while shifting in bed in the postoperative care unit and was taken back for cephalo-medullary nail fixation. Femoral head osteonecrosis may be an under-reported risk factor for development of pathological neck fractures. We present an overview of this topic along with suggestions for joint preservation treatment of similar patients at higher risk for perioperative fracture.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... steel nails: (1) Non-collated (i.e., hand-driven or bulk), two-piece steel nails having plastic or steel...-collated (i.e., hand-driven or bulk), steel nails having a bright or galvanized finish, a smooth, barbed or... actual head diameter of 0.3375'' to 0.500'', inclusive; and (4) Non-collated (i.e., hand-driven or bulk...

Sarcoidosis: nail dystrophy without underlying bone changes.

PubMed

Wakelin, S H; James, M P

1995-06-01

Sarcoidosis is a chronic granulomatous disease of unknown origin that affects multiple organs and may present with a variety of skin lesions. Involvement of the nails is rare and almost invariably associated with underlying bone disease. We describe a patient with sarcoid nail dystrophy in whom this diagnosis was confirmed by a proximal nail fold biopsy. Radiologic investigation did not show evidence of an associated bone dystrophy in this case.

Influence of the intramedullary nail preparation method on nail's mechanical properties and degradation rate.

PubMed

Morawska-Chochół, Anna; Chłopek, Jan; Szaraniec, Barbara; Domalik-Pyzik, Patrycja; Balacha, Ewa; Boguń, Maciej; Kucharski, Rafael

2015-06-01

When it comes to the treatment of long bone fractures, scientists are still investigating new materials for intramedullary nails and different manufacturing methods. Some of the most promising materials used in the field are resorbable polymers and their composites, especially since there is a wide range of potential manufacturing and processing methods. The aim of this work was to select the best manufacturing method and technological parameters to obtain multiphase, and multifunctional, biodegradable intramedullary nails. All composites were based on a poly(l-lactide) matrix. Either magnesium alloy wires or carbon and alginate fibres were introduced in order to reinforce the nails. The polylactide matrix was also modified with tricalcium phosphate and gentamicin sulfate. The composite nails were manufactured using three different methods: forming from solution, injection moulding and hot pressing. The effect of each method of manufacturing on mechanical properties and degradation rate of the nails was evaluated. The study showed that injection moulding provides higher uniformity and homogeneity of the particle-modified polylactide matrix, whereas hot pressing favours applying higher volume fractions of fibres and their better impregnation with the polymer matrix. Thus, it was concluded that the fabrication method should be individually selected dependently on the nail's desired phase composition. Copyright © 2015 Elsevier B.V. All rights reserved.

Application of Soil Nailing Technique for Protection and Preservation Historical Buildings

NASA Astrophysics Data System (ADS)

Kulczykowski, Marek; Przewłócki, Jarosław; Konarzewska, Bogusława

2017-10-01

Soil nailing is one of the recent in situ techniques used for soil improvement and in stabilizing slopes. The process of soil nailing consists of reinforcing the natural ground with relatively small steel bars or metal rods, grouted in the pre-drilled holes. This method has a wide range of applications for stabilizing deep excavations and steep slopes. Soil nailing has recently become a very common method of slope stabilisation especially where situated beneath or adjacent to historical buildings. Stabilisation by nails drilled into existing masonry structures such as failing retaining walls abutments, provide long term stability without demolition and rebuilding costs. Two cases of soil nailing technology aimed at stabilising slopes beneath old buildings in Poland are presented in this paper. The first concerns application of this technology to repair a retaining wall supporting the base of the dam at the historic hydroelectric power plant in Rutki. The second regards a concept of improving the slope of the Castle Hill in Sandomierz. An analysis of the slope stability for the latter case, using stabilisation technique with the piling system and soil nailing was performed. Some advantages of soil nailing especially for protection of historical buildings, are also underlined. And, the main results of an economic comparison analysis are additionally presented.

An evaluation of flexible intramedullary nail fixation in femoral shaft fractures in paediatric age group.

PubMed

Kumar, Sanjay; Roy, Sandip Kumar; Jha, Amrish Kumar; Chatterjee, Debdutta; Banerjee, Debabrata; Garg, Anant Kumar

2011-06-01

Sixty-two femoral shaft fractures in 60 patients treated by elastic intramedullary nailing with mean age of the patients being 9.2 years (range 5 years to 12 years) and average follow-up of 15 months (range 7 months to 60 months) are evaluated. Twenty-eight fractures were fixed with titanium elastic nail while 34 fractures were fixed with Enders nail. There were 40 midshaft fractures, 18 proximal femoral and 4 were fractures of distal third. Fracture patterns were transverse in 35, short oblique in 14 cases and 13 were spiral fractures. Mean age of union in this series was 17 weeks (range 12 weeks to 28 weeks). Ten cases had complications, 5 had nail tip irritation, 3 varus or valgus malalignment and 2 had delayed union. In this series, we did not have any non-union, refracture, limb length discrepancy or any major infection. The result demonstrates 100% union rate irrespective of the age, weight and height of the patient. Regardless of the site of fracture and their pattern, it united every time with elastic nail fixation. We did not find and mismatch in the results of fractures stabilised with titanium elastic nail with that of elastic stainless steel nail.

Treatment of the femoral shaft fracture with a curved heat-treated COP clover-leaf nail.

PubMed

Onoue, Y; Sunami, Y; Fujiwara, H; Sadakane, T; Yasuda, S

1979-01-01

The commonly used straight intramedullary nail has certain limitations and disadvantages. Following radiographic and metallurgical studies we have developed a curved heat-treated clover-leaf nail using a newly developed precipitation hardening stainless steel (COP). The nail is bent with a slot on the convex side and the radius of curvature is 115 cm which corresponds to the anatomical antero-lateral convexity of the human femur. The nail has been satisfactory in clinical use since 1971 and has provided not only more stable internal fixation but also allowed fixation of fractures beyond the middle third of the shaft.

Managing Chemotherapy Side Effects: Skin and Nail Changes

MedlinePlus

... ational C ancer I nstitute Managing Chemotherapy Side Effects Skin and Nail Changes “I was glad to ... services national institutes of health Managing Chemotherapy Side Effects: Skin and Nail Changes Protect your skin from ...

Reconstructive procedures for segmental resection of bone in giant cell tumors around the knee.

PubMed

Aggarwal, Aditya N; Jain, Anil K; Kumar, Sudhir; Dhammi, Ish K; Prashad, Bhagwat

2007-04-01

Segmental resection of bone in Giant Cell Tumor (GCT) around the knee, in indicated cases, leaves a gap which requires a complex reconstructive procedure. The present study analyzes various reconstructive procedures in terms of morbidity and various complications encountered. Thirteen cases (M-six and F-seven; lower end femur-six and upper end tibia -seven) of GCT around the knee, radiologically either Campanacci Grade II, Grade II with pathological fracture or Grade III were included. Mean age was 25.6 years (range 19-30 years). Resection arthrodesis with telescoping (shortening) over intramedullary nail (n=5), resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail (n=3) and resection arthrodesis with intercalary fibular autograft and simultaneous limb lengthening (n=5) were the procedure performed. Shortening was the major problem following resection arthrodesis with telescoping (shortening) over intramedullary nail. Only two patients agreed for subsequent limb lengthening. The rest continued to walk with shortening. Infection was the major problem in all cases of resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail and required multiple drainage procedures. Fusion was achieved after two years in two patients. In the third patient the allograft sequestrated. The patient underwent sequestrectomy, telescoping of fragments and ilizarov fixator application with subsequent limb lengthening. The patient was finally given an ischial weight relieving orthosis, 54 months after the index procedure. After resection arthrodesis with intercalary autograft and simultaneous lengthening the resultant gap (∼15cm) was partially bridged by intercalary nonvascularized dual fibular strut graft (6-7cm) and additional corticocancellous bone graft from ipsilateral patella. Simultaneous limb lengthening with a distal tibial corticotomy was performed on an ilizarov fixator. The complications were superficial infection (n=5), stress fracture of fibula (n=2). The stress fracture fibula required DCP fixation and bone grafting. The usual time taken for union and limb length equalization was approximately one year. Resection arthrodesis with intercalary dual fibular autograft and cortico-cancellous bone grafting with simultaneous limb lengthening achieved limb length equalization with relatively short morbidity.

[Arthrodesis (with/without correction) of the ankle and subtalar joint: A3 nail fixation with triple bending and mechanical navigation].

PubMed

Richter, M

2014-08-01

Restoration of a stable and plantigrade foot in deformities of the ankle and/or hindfoot and concomitant degenerative changes at the ankle and subtalar joints. Deformities at the ankle and/or hindfoot and concomitant degenerative changes at the ankle and subtalar joint. Failed (corrective) arthrodesis of the ankle and subtalar joints. Fused ankle and degeneration of the subtalar joint. Failed total ankle replacement with insufficient substance of talar body and/or degeneration of subtalar joint. Massive hindfoot instability. Active local infection or relevant vascular insufficiency, possible preservation of the ankle or subtalar joint (relative contraindication). Prone position and posterolateral approach to ankle and subtalar joints (alternative supine position/anterior approach; lateral position/lateral approach). Exposition of ankle and subtalar joints and removal of remaining cartilage. Optional corrective osteotomies and/or bone grafting. Correction and optional fixation of the corrected position with 2.0 mm K-wires. Mechanically navigated insertion of a retrograde guide wire in projection of the tibial axis and insertion of a second guide wire through the entry point of the nail lateral and dorsal to the tibial axis. Reaming and insertion of the A3 nail with a distal double bend; one posterior and one lateral, and a proximal bend corresponding to a slight recurvatum. Insertion of locking screws into the calcaneus, talus and tibia (twice with optional static or dynamic locking). Optional compression between calcaneus and talus, and between tibia and talus. Insertion of a drainage and layer-wise closure. For the first 6 weeks 15 kg partial weight bearing in an orthosis, followed by full weight bearing in a stable standard shoe. In October 2010 (n = 2) and from 15 October 2011 to 13 April 2012 (n = 26) 28 arthrodeses (with/without correction) with A3 fixation were performed. In all cases, exact nail placement was achieved. Thirteen cases completed follow-up (3-11 months) and showed timely fusion and full mobilization.

[Comparison of LCP and locked intramedullary nailing fixation in treatment of tibial diaphysis fractures].

PubMed

Huang, Peng; Tang, Peifu; Yao, Qi

2007-11-01

To evaluate the treatment results of LCP and locked intramedullary nailing for tibial diaphysis fractures. From October 2003 to April 2006, 55 patients with tibial diaphysis fractures (58 fractures) were treated. Of them there were 39 males and 16 females with an average of 39 years years ( 14 to 62 years). The fractures were on the left side in 27 patients and on the right side in 31 patients (3 patients had bilateral involvement). Thirty-four fractures were treated by intramedullary nailing (intramedullary nailing group) and 24 fractures by LCP fixation (LCP group). The average disease course was 3 days (intramedullary nailing group) and 3.1 days (LCP group). The operation time, the range of motion of knee and ankle joints, fracture healing time, and complications were evaluated. The patients were followed up 8-26 months (13 months on average). The operation time was 84.0+/-9.2 min (intramedullary nailing group) and 69.0+/-8.4 min (LCP group); the average cost in hospital was yen 19,297.78 in the intramedullary nailing group and yen 14,116.55 in the LCP group respectively, showing significant differences (P < 0.05). The flexion and extension of knee joint was 139.0 +/- 3.7 degrees and 4.0 +/- 0.7 degrees in intramedullary nailing group and 149.0+/-4.2 degrees and 0+/-0.4 degrees in LCP group, showing no significant difference (P>0.05). The doral flexion and plantar flexion of ankle joint were 13.0+/-1.7 degrees and 41.0+/-2.6 degrees in intramedullary nailing group, and 10.0+/-1.4 degrees and 44.0+/-2.3 degrees in LCP group, showing no significant differences (P>0.05). The mean healing time was 3.3 months in intramedullary nailing group, and 3. 1 months in LCP group. Length discrepancy occurred in 1 case (2.5 cm), delayed union in 1 case and nailing end trouble in 3 cases in intramedullary nailing group; moreover rotation deformity occurred 1 case and anterior knee pain occurred in 6 cases (17.1%). One angulation and open fracture developed osteomyelitis in 1 case 1 week postoperatively and angulation deformity occurred in 1 case of distal-third tibial fractures in LCP group. LCP and locked intramedullary nailing can achieve satisfactory results in treating tibial diaphysis fracture LCP has advantages in less complication, operation time and cost in hospital.

The effect of retained intramedullary nails on tibial bone mineral density.

PubMed

Allen, J C; Lindsey, R W; Hipp, J A; Gugala, Z; Rianon, N; LeBlanc, A

2008-07-01

Intramedullary nailing has become a standard treatment for adult tibial shaft fractures. Retained intramedullary nails have been associated with stress shielding, although their long-term effect on decreasing tibial bone mineral density is currently unclear. The purpose of this study was to determine if retained tibial intramedullary nails decrease tibial mineral density in patients with successfully treated fractures. Patients treated with statically locked intramedullary nails for isolated, unilateral tibia shaft fractures were studied. Inclusion required that fracture had healed radiographically and that the patient returned to the pre-injury activity level. Data on patient demographic, fracture type, surgical technique, implant, and post-operative functional status were tabulated. Dual energy X-ray absorptiometry was used to measure bone mineral density in selected regions of the affected tibia and the contralateral intact tibia. Image reconstruction software was employed to ensure symmetry of the studied regions. Twenty patients (mean age 43; range 22-77 years) were studied at a mean of 29 months (range 5-60 months) following intramedullary nailing. There was statistically significant reduction of mean bone mineral density in tibiae with retained intramedullary nails (1.02 g/cm(2) versus 1.06 g/cm(2); P=0.04). A significantly greater decrease in bone mineral density was detected in the reamed versus non-reamed tibiae (-7% versus +6%, respectively; P<0.05). The present study demonstrates a small, but statistically significant overall bone mineral density decrease in healed tibiae with retained nails. Intramedullary reaming appears to be a factor potentiating the reduction of tibia bone mineral density in long-term nail retention.

A Biomechanical Assessment of Hand/Arm Force with Pneumatic Nail Gun Actuation Systems.

PubMed

Lowe, Brian D; Albers, James; Hudock, Stephen D

2014-09-01

A biomechanical model is presented, and combined with measurements of tip press force, to estimate total user hand force associated with two pneumatic nail gun trigger systems. The contact actuation trigger (CAT) can fire a nail when the user holds the trigger depressed first and then "bumps" the nail gun tip against the workpiece. With a full sequential actuation trigger (SAT) the user must press the tip against the workpiece prior to activating the trigger. The SAT is demonstrably safer in reducing traumatic injury risk, but increases the duration (and magnitude) of tip force exertion. Time integrated (cumulative) hand force was calculated for a single user from measurements of the tip contact force with the workpiece and transfer time between nails as inputs to a static model of the nail gun and workpiece in two nailing task orientations. The model shows the hand force dependence upon the orientation of the workpiece in addition to the trigger system. Based on standard time allowances from work measurement systems (i.e. Methods-Time Measurement - 1) it is proposed that efficient application of hand force with the SAT in maintaining tip contact can reduce force exertion attributable to the sequential actuation trigger to 2-8% (horizontal nailing) and 9-20% (vertical nailing) of the total hand/arm force. The present model is useful for considering differences in cumulative hand/arm force exposure between the SAT and CAT systems and may explain the appeal of the CAT trigger in reducing the user's perception of muscular effort.

A Biomechanical Assessment of Hand/Arm Force with Pneumatic Nail Gun Actuation Systems

PubMed Central

Lowe, Brian D.; Albers, James; Hudock, Stephen D.

2015-01-01

A biomechanical model is presented, and combined with measurements of tip press force, to estimate total user hand force associated with two pneumatic nail gun trigger systems. The contact actuation trigger (CAT) can fire a nail when the user holds the trigger depressed first and then “bumps” the nail gun tip against the workpiece. With a full sequential actuation trigger (SAT) the user must press the tip against the workpiece prior to activating the trigger. The SAT is demonstrably safer in reducing traumatic injury risk, but increases the duration (and magnitude) of tip force exertion. Time integrated (cumulative) hand force was calculated for a single user from measurements of the tip contact force with the workpiece and transfer time between nails as inputs to a static model of the nail gun and workpiece in two nailing task orientations. The model shows the hand force dependence upon the orientation of the workpiece in addition to the trigger system. Based on standard time allowances from work measurement systems (i.e. Methods-Time Measurement - 1) it is proposed that efficient application of hand force with the SAT in maintaining tip contact can reduce force exertion attributable to the sequential actuation trigger to 2–8% (horizontal nailing) and 9–20% (vertical nailing) of the total hand/arm force. The present model is useful for considering differences in cumulative hand/arm force exposure between the SAT and CAT systems and may explain the appeal of the CAT trigger in reducing the user’s perception of muscular effort. PMID:26321780

Comparative study between biologic plating and intramedullary nailing for the treatment of subtrochanteric fractures: Is biologic plating using LCP-DF superior to intramedullary nailing?

PubMed

Shin, Won Chul; Moon, Nam Hoon; Jang, Jae Hoon; Lee, Hee Jin; Suh, Kuen Tak

2017-10-01

The objective of this study is to evaluate the outcome measures of subtrochanteric fractures between biologic plating and intramedullary nailing and determine if biologic plating is superior to intramedullary nailing. Between March 2009 and December 2015, 81 patients with subtrochanteric fractures were enrolled (52 males and 29 females; 31 treated with biologic plating and 50 with intramedullary nailing). Biologic plating was conducted consecutively between May 2011 and March 2013 and intramedullary nailing was performed for the rest of period. Perioperative outcomes including operation time and blood loss during the operation; postoperative radiologic outcomes including union, time to union, coronal alignment, and shortening of the femur; and clinical outcomes including walking ability and pain were evaluated. The biologic plating group was compared with the intramedullary nailing group as a historical control. No significant differences were identified for bony union and time to union between the two different fixation methods Coronal alignment was significantly better in the biologic plating group than in the intramedullary nailing group (p<0.016). Postoperative coronal alignment was the only risk factor associated with the nonunion of subtrochanteric fractures (unadjusted OR: 1.915, 95% CI: 0.190 - 19.273; adjusted OR: 0.042, 95% CI: 0.000 - 21.517; p=0.320). Surgical outcomes using LCP-DF are comparable to those using intramedullary nailing. Further clinical studies with a larger sample size are required to show the advantage of biologic plating for the treatment of subtrochanteric fractures. Copyright © 2017 Elsevier Ltd. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Donovan, Ellen M., E-mail: ellen.donovan@icr.ac.u; Ciurlionis, Laura; Fairfoul, Jamie

Purpose: To establish planning solutions for a concomitant three-level radiation dose distribution to the breast using linear accelerator- or tomotherapy-based intensity-modulated radiotherapy (IMRT), for the U.K. Intensity Modulated and Partial Organ (IMPORT) High trial. Methods and Materials: Computed tomography data sets for 9 patients undergoing breast conservation surgery with implanted tumor bed gold markers were used to prepare three-level dose distributions encompassing the whole breast (36 Gy), partial breast (40 Gy), and tumor bed boost (48 or 53 Gy) treated concomitantly in 15 fractions within 3 weeks. Forward and inverse planned IMRT and tomotherapy were investigated as solutions. A standardmore » electron field was compared with a photon field arrangement encompassing the tumor bed boost volume. The out-of-field doses were measured for all methods. Results: Dose-volume constraints of volume >90% receiving 32.4 Gy and volume >95% receiving 50.4 Gy for the whole breast and tumor bed were achieved. The constraint of volume >90% receiving 36 Gy for the partial breast was fulfilled in the inverse IMRT and tomotherapy plans and in 7 of 9 cases of a forward planned IMRT distribution. An electron boost to the tumor bed was inadequate in 8 of 9 cases. The IMRT methods delivered a greater whole body dose than the standard breast tangents. A contralateral lung volume >2.5 Gy was increased in the inverse IMRT and tomotherapy plans, although it did not exceed the constraint. Conclusion: We have demonstrated a set of widely applicable solutions that fulfilled the stringent clinical trial requirements for the delivery of a concomitant three-level dose distribution to the breast.« less

Treatment of pediatric femoral shaft fractures by stainless steel and titanium elastic nail system: A randomized comparative trial.

PubMed

Gyaneshwar, Tank; Nitesh, Rustagi; Sagar, Tomar; Pranav, Kothiyal; Rustagi, Nitesh

2016-08-01

Literature suggests that the lower modulus of elasticity of titanium makes it ideal for use in children compared with stainless steel. Better fracture stability was observed in association with titanium nails on torsional and axial compression testing. However, stainless steel nails are stiffer than titanium counterparts, which may provide a rigid construct when fixing paediatric femoral shaft fractures. Complications have been observed more frequently by various researchers when titanium nails are used for fracture fixation in patients with increasing age or weight. The concept of this study was to compare the functional outcome after internal fixation with titanium elastic nail system and stainless steel elastic nail system in paediatric femoral shaft fractures. The study was conducted on 34 patients admitted in the department of orthopaedics, LLRM Medical College & SVBP Hospital, Meerut, India from January 2013 to August 2014. We included patients aged 5-12 years with fracture of the femoral shaft, excluding compound fractures, pathological fractures and other lower limb fractures. Patients were treated by titanium (n=17) or stainless steel (n=17) elastic nail system and followed up for one year. The clinical parameters like range of motion at hip and knee joints, time to full weight bearing on the operated limb and radiological parameters like time to union were compared between two groups. A special note was made of intra- and post-operative complications. Functional outcomes were analysed according to Flynn criteria. Based on the Flynn criteria, 59% of patients had excellent results, 41% had satisfactory results, and no one showed poor results. There was no clinically significant difference between the two groups with respect to time to union and full weight bearing. But the incidence of puncture of the opposite cortex while inserting the nail and trying to advance it through the diaphysis during operation is greatly different. Only one such case was observed in titanium group but five in stainless steel group. Majority of paediatric femoral shaft fractures are now treated operatively by elastic stable intramedullary nails. Operative intervention results in a shorter hospital stay and has economic and social benefits over conservative treatment. The cost of stainless steel nail is one third the cost of titanium nail. However, the clinico-radiological results are not significantly different between titanium and stainless steel nails at one year follow-up as observed by our study.

Trochanteric entry femoral nails yield better femoral version and lower revision rates-A large cohort multivariate regression analysis.

PubMed

Yoon, Richard S; Gage, Mark J; Galos, David K; Donegan, Derek J; Liporace, Frank A

2017-06-01

Intramedullary nailing (IMN) has become the standard of care for the treatment of most femoral shaft fractures. Different IMN options include trochanteric and piriformis entry as well as retrograde nails, which may result in varying degrees of femoral rotation. The objective of this study was to analyze postoperative femoral version between three types of nails and to delineate any significant differences in femoral version (DFV) and revision rates. Over a 10-year period, 417 patients underwent IMN of a diaphyseal femur fracture (AO/OTA 32A-C). Of these patients, 316 met inclusion criteria and obtained postoperative computed tomography (CT) scanograms to calculate femoral version and were thus included in the study. In this study, our main outcome measure was the difference in femoral version (DFV) between the uninjured limb and the injured limb. The effect of the following variables on DFV and revision rates were determined via univariate, multivariate, and ordinal regression analyses: gender, age, BMI, ethnicity, mechanism of injury, operative side, open fracture, and table type/position. Statistical significance was set at p<0.05. A total of 316 patients were included. Piriformis entry nails made up the majority (n=141), followed by retrograde (n=108), then trochanteric entry nails (n=67). Univariate regression analysis revealed that a lower BMI was significantly associated with a lower DFV (p=0.006). Controlling for possible covariables, multivariate analysis yielded a significantly lower DFV for trochanteric entry nails than piriformis or retrograde nails (7.9±6.10 vs. 9.5±7.4 vs. 9.4±7.8°, p<0.05). Using revision as an endpoint, trochanteric entry nails also had a significantly lower revision rate, even when controlling for all other variables (p<0.05). Comparative, objective comparisons between DFV between different nails based on entry point revealed that trochanteric nails had a significantly lower DFV and a lower revision rate, even after regression analysis. However, this is not to state that the other nail types exhibited abnormal DFV. Translation to the clinical impact of a few degrees of DFV is also unknown. Future studies to more in-depth study the intricacies of femoral version may lead to improved technology in addition to potentially improved clinical outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Coexistence of nail lichen planus and lichen planus pigmentosus.

PubMed

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

2016-01-01

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

Management of Infection After Intramedullary Nailing of Long Bone Fractures: Treatment Protocols and Outcomes

PubMed Central

Makridis, Kostas G; Tosounidis, Theodoros; Giannoudis, Peter V

2013-01-01

Implant related sepsis is a relatively unusual complication of intra-medullary nail fixation of long bone fractures. Depending on the extent of infection, timing of diagnosis and progress of fracture union, different treatment strategies have been developed. The aim of this review article is to collect and analyze the existing evidence about the incidence and management of infection following IM nailing of long bone fractures and to recommend treatment algorithms that could be valuable in everyday clinical practice. After searching the P u b M e d /Medline databases, 1270 articles were found related to the topic during the last 20 years. The final review included 28 articles that fulfilled the inclusion criteria. Only a few prospective studies exist to report on the management of infection following IM nailing of long-bone fractures. In general, stage I (early) infections only require antibiotic administration with/without debridement. Stage II (delayed) infections can be successfully treated with debridement, IM reaming, antibiotic nails, and administration of antibiotics. Infected non-unions are best treated with exchange nailing, antibiotic administration and when infection has been eradicated with graft implantation if it is needed. Debridement, exchange nailing and systemic administration of antibiotics is the best indication for stage III (late) infections, while stage III infected non-unions can successfully be treated with nail removal and Ilizarov frame, especially when large bone defects exist. PMID:23919097

Exchange nailing for nonunion of diaphyseal fractures of the tibia: our results and an analysis of the risk factors for failure.

PubMed

Tsang, S T J; Mills, L A; Frantzias, J; Baren, J P; Keating, J F; Simpson, A H R W

2016-04-01

The aim of this study was to identify risk factors for the failure of exchange nailing in nonunion of tibial diaphyseal fractures. A cohort of 102 tibial diaphyseal nonunions in 101 patients with a mean age of 36.9 years (15 to 74) were treated between January 1992 and December 2012 by exchange nailing. Of which 33 (32%) were initially open injuries. The median time from primary fixation to exchange nailing was 6.5 months (interquartile range (IQR) 4.3 to 9.8 months). The main outcome measures were union, number of secondary fixation procedures required to achieve union and time to union. Univariate analysis and multiple regression were used to identify risk factors for failure to achieve union. Multiple causes for the primary nonunion were found for 28 (27%) tibiae, with infection present in 32 (31%). Six patients were lost to follow-up. Further surgical procedures were required in 35 (36%) nonunions. Other fixation modalities were required in five fractures. A single nail exchange procedure achieved union in 60/96 (63%) of all nonunions. Only 11 out of 31 infected nonunions (35.4%) healed after one exchange nail procedure. Up to five repeated exchange nailings, with or without bone grafting, ultimately achieved union in 89 (93%) fractures. The median time to union after exchange nailing was 8.7 months (IQR 5.7 to 14.0 months). Univariate analysis confirmed that an oligotrophic/atrophic pattern of nonunion (p = 0.002), a bone gap of 5 mm or more (p = 0.04) and infection (p < 0.001), were predictive for failure of exchange nailing Multiple regression analysis found that infection was the strongest predictor of failure (p < 0.001). Exchange nailing is an effective treatment for aseptic tibial diaphyseal nonunion. However, in the presence of severe infection with a highly resistant organism, or extensive sclerosis of the bone, other fixation modalities, such as Ilizarov treatment, should be considered. Exchange nailing is an effective treatment for aseptic tibial diaphyseal nonunion. ©2016 The British Editorial Society of Bone & Joint Surgery.

Nail gun injuries among construction workers.

PubMed

Dement, John M; Lipscomb, Hester; Li, Leiming; Epling, Carol; Desai, Tejas

2003-05-01

Pneumatic nail guns greatly increase worker productivity and are extensively used in wood frame building construction, with especially high use in residential construction. One surveillance report of nail gun injuries in Washington State has been published; however, other literature consists largely of case reports and case series in trauma journals. The major objective of the current study was to investigate the occurrence of nail gun-associated injuries among construction workers and to identify preventable work-related factors associated with these injuries. Nail gun-related injuries occurring among a cohort of 13,347 carpenters in Ohio who worked union hours during the time period January 1, 1994, until September 30, 1997, were identified by matching the cohort with workers' compensation claims made to the Ohio Bureau of Workers' Compensation. We also analyzed workers' compensation claims for North Carolina Home Builders Association members for the period July 1996-November 1999 to identify nail gun-related injuries. Analyses included stratified analyses of claims by nature and body part injured, calculation of nail gun injury rates, and analyses of free text descriptions of injuries. Overall, nail gun injuries were responsible for 3.9 percent of workers' compensation claims with 8.3 percent to 25.5 percent of claims involving paid lost work time. The overall rate of nail gun injuries (cases per 200,000 work hours) was 0.33 in North Carolina and 0.26 in Ohio, reflecting the greater concentration of wood frame construction workers in the North Carolina population studied. Higher rates of injury were observed for carpenters in North Carolina and among residential carpenters in Ohio. The predominant body part injured was the hands/fingers, with 80 to 89 percent of injuries being nail punctures. Analyses of free text information for puncture injuries found approximately 70 percent of injuries to occur during the framing/sheathing stage of construction. Our data suggest that approximately 69 percent of puncture injuries may be due to an inadvertent gun discharge or misfire, preventable in large part by the use of sequential triggers. Worker training and education also are important components of nail gun injury prevention.

76 FR 23788 - Certain Steel Nails From the Peoples' Republic of China: Notice of Extension of Time Limits and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

... Gun Nail Manufacture Co., Ltd.; 126) Tianjin Xiantong Juxiang Metal MFG Co., Ltd.; 127) Tianjin...., Ltd.; 110) Tianjin Xiantong Fucheng Gun Nail Manufacture Co., Ltd.; 111) Tianjin Xiantong Juxiang...

Use of flexible facing for soil nail walls.

DOT National Transportation Integrated Search

2011-11-01

Soil nail walls are a widely used technology for retaining vertical and nearly vertical cuts in soil. A : significant portion of the cost of soil nail wall construction is related to the construction of a reinforced : concrete face. The potential for...

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

PubMed

Vejnovic, Ivana; Huonder, Cornelia; Betz, Gabriele

2010-09-15

Existing treatments of onychomycosis are not satisfactory. Oral therapies have many side effects and topical formulations are not able to penetrate into the human nail plate and deliver therapeutical concentrations of active agent in situ. The purpose of the present study was to determine the amount of terbinafine, which permeates through the human nail plate, from liquid formulations containing enhancers, namely hydrophobins A-C in the concentration of 0.1% (w/v). The used reference solution contained 10% (w/v) of terbinafine in 60% (v/v) ethanol/water without enhancer. Permeability studies have been performed on cadaver nails using Franz diffusion cells modified to mount nail plates and filled with 60% (v/v) ethanol/water in the acceptor chamber. Terbinafine was quantitatively determined by HPLC. The amount of terbinafine remaining in the nail was extracted by 96% ethanol from pulverized nail material after permeation experiment and presented as percentage of the dry nail weight before the milling test. Permeability coefficient (PC) of terbinafine from reference solution was determined to be 1.52E-10 cm/s. Addition of hydrophobins improved PC in the range of 3E-10 to 2E-9 cm/s. Remaining terbinafine reservoir in the nail from reference solution was 0.83% (n=2). An increase of remaining terbinafine reservoir in the nail was observed in two out of three tested formulations containing hydrophobins compared to the reference. In all cases, known minimum inhibitory concentration of terbinafine for dermatophytes (0.003 microg/ml) has been exceeded in the acceptor chamber of the diffusion cells. All tested proteins (hydrophobins) facilitated terbinafine permeation after 10 days of permeation experiment, however one of them achieved an outstanding enhancement factor of 13.05 compared to the reference. Therefore, hydrophobins can be included in the list of potential enhancers for treatment of onychomycosis. Copyright 2010 Elsevier B.V. All rights reserved.

Nail Psoriasis: A Review of Treatment Options.

PubMed

Pasch, Marcel C

2016-04-01

Nail involvement affects 80-90 % of patients with plaque psoriasis, and is even more prevalent in patients with psoriatic arthritis. This review is the result of a systemic approach to the literature and covers topical, intralesional, conventional systemic, and biologic systemic treatments, as well as non-pharmacological treatment options for nail psoriasis. The available evidence suggests that all anti-tumor necrosis factor-α, anti-interleukin (IL)-17, and anti-IL-12/23 antibodies which are available for plaque psoriasis and psoriatic arthritis are highly effective treatments for nail psoriasis. Conventional systemic treatments, including methotrexate, cyclosporine, acitretin, and apremilast, as well as intralesional corticosteroids, can also be effective treatments for nail psoriasis. Topical treatments, including corticosteroids, calcipotriol, tacrolimus, and tazarotene, have also been shown to have a position in the treatment of nail psoriasis, particularly in mild cases. Finally, non-pharmacological treatment options, including phototherapy, photodynamic therapy, laser therapy, and several radiotherapeutic options, are also reviewed but cannot be advised as first-line treatment options. Another conclusion of this review is that the lack of a reliable core set of outcomes measures for trials in nail psoriasis hinders the interpretation of results, and is urgently needed.

Augmentation plating in management of failed femoral nailing.

PubMed

Verma, Rahul; Sharma, Pulak; Gaur, Sanjiv

2017-08-01

Non-union following interlocking nailing is a troubling complication in treatment of shaft femur fractures. There is no clear consensus on the treatment of this problem. This research was undertaken to study the role of augmentation plating combined with exchange nailing in such cases. A prospective clinical study was undertaken from January 2010 to December 2015. Patients with aseptic femoral shaft non-union, with or without implant failure following intramedullary nailing were included in the study. Augmentation plating combined with Exchange Nailing with a 4.5mm LCP was done. Fifteen patients (nine male and six female) with an average age of 43.7 years (range 18-67 years) were treated. Average timing from the first surgery was 7.3 months. Complete clinical and radiological union was achieved in all cases in a mean duration of 5.2 months. Average duration of follow up was 12.6 months. All the patients retained the preoperative hip and knee range of motion till the last follow up. Augmentation plating combined with exchange nailing in non-unions following intramedullary nailing of femur shaft fractures is a reasonably good and effective procedure with a very high success rate. © 2017 Elsevier Ltd. All rights reserved.

Unusual penetration of a construction nail through the orbit to the cranium: a case report.

PubMed

Erkutlu, Ibrahim; Alptekin, Mehmet; Dokur, Mehmet; Geyik, Murat; Gök, Abdulvahap

2011-01-01

Penetrating head and neck trauma with construction nails are uncommon life-threatening injuries and an important problem in developing countries. Assessment of the neurovascular and systemic physical status is a first requirement, and the decision concerning which surgical approach to perform for the removal of the nail is of critical importance. A 10-year-old girl was presented one hour after a fall injury with complaint of a swelling and foreign body lodgment on the left forehead. Neurological and systemic physical examinations were normal except for weak direct pupillary light reflex on the left side and the patient's state of uneasiness. Radiological investigations showed that the head of the nail had entered from the left infra-orbital region and become lodged through the orbital roof, below the frontal bone. Surgical extraction of the nail in the operating room was performed successfully using left pterional craniotomy and lateral orbitotomy technique, and there was no complication after surgery. Here, we report a case with a rare craniocerebral penetrating wound and type, with the head of the nail lodged in the anterior fossa through the orbital roof, which may be defined as 'reverse penetration of the nail'.

[Ankle arthrodesis with interposition graft as a salvage procedure after failed total ankle replacement].

PubMed

Schill, Stephan

2007-12-01

Restoration of painless function to the lower limb by ankle fusion after failure of total ankle arthroplasty. Loose total ankle replacement. Severe ankle destruction and axial deviation in rheumatoid patients. Severe osteoarthritis in the subtalar and ankle joints. Infected total ankle replacement. Severe arterial occlusive disease of the affected extremity. Transfibular approach to the subtalar and ankle joints. Osteotomy and resection of the distal fibula 7-8 cm proximal to the tip of the lateral malleolus. Removal of the prosthetic components, synovectomy, and revitalization of the remaining bone surface. Removal of any residual articular cartilage from the subtalar joint surfaces. Determination of the extent of bone loss and defect filling with horizontally or vertically placed tricortical and cancellous bone graft from the resected fibula and, if necessary, from the ipsilateral anterior iliac crest. Tibiotalocalcaneal arthrodesis by retrograde insertion of a retrograde locking nail. Wound closure in layers. Split below-knee cast. Mobilization with below-knee cast without weight bearing for 6 weeks. Dynamic locking of the intramedullary nail. Partial weight bearing with a walker up to 20 kg for an additional 6 weeks. Gradual increase in weight bearing in accordance with radiologic evidence of consolidation. Fitted orthopedic shoe with rocker-bottom sole, and made to measure insoles. From January 2003 to September 2006, 15 patients with infected ankle prosthesis loosening (six Thompson-Richards prostheses, eight S.T.A.R. prostheses, and one Salto prosthesis) were treated. All patients underwent tibiotalocalcaneal interposition arthrodesis with femoral nailing in retrograde technique. The average AOFAS (American Orthopaedic Foot and Ankle Society) Score was 57.9 points (35-81 points) postoperatively. One patient developed a nonunion and revision surgery will have to be performed. Another patient with delayed wound healing and skin necrosis needed plastic surgery.

A clinical review of phototherapy for psoriasis.

PubMed

Zhang, Ping; Wu, Mei X

2018-01-01

Psoriasis is an autoimmune inflammatory skin disease. In the past several decades, phototherapy has been widely used to treat stable psoriatic lesions, including trunk, scalp, arms and legs, and partial nail psoriasis. A variety of light/lasers with different mechanisms of action have been developed for psoriasis including ultraviolet B (UVB), psoralen ultraviolet A (PUVA), pulsed dye laser (PDL), photodynamic therapy (PDT), intense pulsed light (IPL), light-emitting diodes (LED), and so on. Because light/laser each has specific therapeutic and adverse effects, it is important to adequately choose the sources and parameters in management of psoriasis with different pathogenic sites, severities, and duration of the disorder. This review aims at providing most updated clinic information to physicians about how to select light/laser sources and individual therapeutic regimens. To date, UV light is primarily for stable plaque psoriasis and PDL for topical psoriatic lesions with small area, both of which are safe and effective. On the other hand, PUVA has better curative effects than UVB for managing refractory psoriasis plaques, if its side effects can be better controlled. PDL provides optimal outcomes on nail psoriasis compared with other lasers. Although the trails of low-level light/laser therapy (LLLT) are still small, the near infrared (NIR) and visible red light with low energy show promise for treating psoriasis due to its strong penetration and encouraging photobiomodulation. IPL is rarely reported for psoriasis treatment, but PDT-IPL has been found to offer a moderate effect on nail psoriasis. In brief, various phototherapies have been used either in different combinations or as monotherapy. The modality has become a mainstay in the treatment of mild-to-moderate psoriasis without systemic adverse events in today's clinical practice.

TOXIC TRACE METALS IN MAMMALIAN HAIR AND NAILS

EPA Science Inventory

Data have been compiled from the available world literature on the accumulation and bioconcentration of selected toxic trace metals in human hair and nails and other mammalian hair, fur, nails, claws, and hoofs. The toxic trace metals and metalloids include antimony, arsenic, bor...

CalNail : a design tool for soil nail projects using field case histories.

DOT National Transportation Integrated Search

2006-06-01

Currently, geotechnical staff within Caltrans do not have ready access to detailed information on : previously designed soil nail walls. Much of this information is kept by individual designers, or stored in : paper format, with no organized method o...

Evaluating a county-based Healthy nail Salon Recognition Program

EPA Science Inventory

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

Clinical Issues-October 2016.

PubMed

Wood, Amber

2016-10-01

Wearing nail polish Key words: nail, polish, UV-cured, gel nail, Shellac. Preventing dry skin Key words: dry skin, chapped, dermatitis, hand hygiene. Wearing rings Key words: ring, jewelry, wedding ring, band, hand hygiene. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Application research of 3D additive manufacturing technology in the nail shell

NASA Astrophysics Data System (ADS)

Xiao, Shanhua; Yan, Ruiqiang; Song, Ning

2018-04-01

Based on the analysis of hierarchical slicing algorithm, 3D scanning of enterprise product nailing handle case file is carried out, point cloud data processing is performed on the source file, and the surface modeling and innovative design of nail handling handle case are completed. Using MakerBot Replicator2X-based 3D printer for layered 3D print samples, for the new nail product development to provide reverse modeling and rapid prototyping technical support.

Contribution of Gypsum Wallboard to Racking Resistance of Light-Frame Walls.

DTIC Science & Technology

1983-12-01

contribution to wall ’ ~sheathing to the framing members, and axial loads on racking resistance. Such information may lead to more diagonal braces used...wallboard was centered over the joint and fastened to the narrow face of the wood pieces using 1-1/4-inch drywall nails . Two nails were used to fasten...pulled apart placing a lateral load on the nailed connection, similar to the connector loading incurred at the nailed connection along the bottom plate of

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burge, S.W.

Erosion has been identified as one of the significant design issues in fluid beds. A cooperative R&D venture of industry, research, and government organizations was recently formed to meet the industry need for a better understanding of erosion in fluid beds. Research focussed on bed hydrodynamics, which are considered to be the primary erosion mechanism. As part of this work, ANL developed an analytical model (FLUFIX) for bed hydrodynamics. Partial validation was performed using data from experiments sponsored by the research consortium. Development of a three-dimensional fluid bed hydrodynamic model was part of Asea-Babcock`s in-kind contribution to the R&D venture.more » This model, FORCE2, was developed by Babcock & Wilcox`s Research and Development Division existing B&W program and on the gas-solids modeling and was based on an existing B&W program and on the gas-solids modeling technology developed by ANL and others. FORCE2 contains many of the features needed to model plant size beds and, therefore can be used along with the erosion technology to assess metal wastage in industrial equipment. As part of the development efforts, FORCE2 was partially validated using ANL`s two-dimensional model, FLUFIX, and experimental data. Time constraints as well as the lack of good hydrodynamic data, particularly at the plant scale, prohibited a complete validation of FORCE2. This report describes this initial validation of FORCE2.« less

Evaluation of drug incorporation into hair segments and nails by enantiomeric analysis following controlled single MDMA intakes.

PubMed

Madry, Milena M; Steuer, Andrea E; Hysek, Cédric M; Liechti, Matthias E; Baumgartner, Markus R; Kraemer, Thomas

2016-01-01

Incorporation rates of the enantiomers of 3,4-methylenedioxymethamphetamine (MDMA) and its metabolite 3,4-methylenedioxyamphetamine (MDA) into hair and nails were investigated after controlled administration. Fifteen subjects without MDMA use received two doses of 125 mg of MDMA. Hair, nail scrapings, and nail clippings were collected 9-77 days after the last administration (median 20 days). Hair samples were analyzed in segments of 1- to 2-cm length. After chiral derivatization with N-(2,4-dinitro-5-fluorophenyl)-L-valinamide, MDMA and MDA diastereomers were analyzed by liquid chromatography-tandem mass spectrometry. Highest concentrations in hair segments corresponded to the time of MDMA intake. They ranged from 101 to 3200 pg/mg and 71 to 860 pg/mg for R- and S-MDMA, and from 3.2 to 116 pg/mg and 4.4 to 108 pg/mg for R- and S-MDA, respectively. MDMA and MDA concentrations in nail scrapings and clippings were significantly lower than in hair samples. There was no significant difference between enantiomeric ratios of R/S-MDMA and R/S-MDA in hair and nail samples (medians 2.2-2.4 for MDMA and 0.85-0.95 for MDA). Metabolite ratios of MDA to MDMA were in the same range in hair and nail samples (medians 0.044-0.055). Our study demonstrates that administration of two representative doses of MDMA was detected in the hair segments corresponding to the time of intake based on average hair growth rates. MDMA was detected in all nail samples regardless of time passed after intake. Comparable R/S ratios in hair and nail samples may indicate that incorporation mechanisms into both matrices are comparable.

Nail disorders in older people, and aspects of their pharmaceutical treatment.

PubMed

Murdan, Sudaxshina

2016-10-30

The aim of this paper was to explore how aging influences the nail unit, its disorders and its response to treatment, and to identify some of the age-related gaps in the ungual drug delivery literature. Aging causes obvious changes to the nail, some of which are inherently due to old age, while others are due to diseases/conditions which become more prevalent as we age. Alterations in the nail plate's colour, contour, thickness, fragility, surface features, cell size, chemical composition and growth rate are some of the changes, with toenails and fingernails showing different effects. With respect to disease, the incidence of onychomycosis - the most common nail disorder - is considerably higher in older people. Similarly, brittle nails become more common as we age. In contrast, the literature about aging and the incidence of nail psoriasis is inconclusive, although, it is clear that as one gets older, the negative impact of nail psoriasis on one's quality of life decreases. Pharmaceutical treatment of the diseases comprises local and systemic therapies, sometimes in combination. Systemic therapies have the inherent disadvantages of adverse systemic effects, drug interactions and the need for monitoring, disadvantages which are especially problematic for older people who are more likely to suffer from co-morbidities and be on other medications. Topical therapy avoids such disadvantages. However, the success rates of commercially available preparations are low, and older people may need help with their application. It is also proposed that regular inspection and grooming of nails should become part of routine care of older people, as these would provide opportunities to identify and treat any problems at an earlier stage. Copyright © 2016 Elsevier B.V. All rights reserved.

Biomechanical assessment of composite versus metallic intramedullary nailing system in femoral shaft fractures: A finite element study.

PubMed

Samiezadeh, Saeid; Tavakkoli Avval, Pouria; Fawaz, Zouheir; Bougherara, Habiba

2014-08-01

Intramedullary nails are the primary choice for treating long bone fractures. However, complications following nail surgery including non-union, delayed union, and fracture of the bone or the implant still exist. Reducing nail stiffness while still maintaining sufficient stability seems to be the ideal solution to overcome the abovementioned complications. In this study, a new hybrid concept for nails made of carbon fibers/flax/epoxy was developed in order to reduce stress shielding. The mechanical performance of this new implant in terms of fracture stability and load sharing was assessed using a comprehensive non-linear FE model. This model considers several mechanical factors in nine fracture configurations at immediately post-operative, and in the healed bone stages. Post-operative results showed that the hybrid composite nail increases the average normal force at the fracture site by 319.23N (P<0.05), and the mean stress in the vicinity of fracture by 2.11MPa (P<0.05) at 45% gait cycle, while only 0.33mm and 0.39mm (P<0.05) increases in the fracture opening and the fragments' shear movement were observed. The healed bone results revealed that implantation of the titanium nail caused 20.2% reduction in bone stiffness, while the composite nail lowered the stiffness by 11.8% as compared to an intact femur. Our results suggest that the composite nail can provide a preferred mechanical environment for healing, particularly in transverse shaft fractures. This may help bioengineers better understand the biomechanics of fracture healing, and aid in the design of effective implants. Copyright © 2014. Published by Elsevier Ltd.

Intramedullary fixation of forearm fractures with new locked nail.

PubMed

Bansal, Himanshu

2011-09-01

Lack of availability of interlocked nails made plate osteosynthesis the first choice of treatment of forearm fractures inspite of more surgical exposure, periosteal stripping and big skin incision subsequent scar along with higher risk of refracture on implant removal. We hereby report the first 12 cases with 19 forearm bone fractures internally fixed by indegenous interlocked nail. Existing square nails were modified to have a broad proximal end of 5.5 mm with a hole for locking screw of 2.5 mm. The nail has a distal hole of 1/1.2/1.5 mm in 2.5/3/3.5 mm diameter nail, respectively. A new method of distal locking with a clip made of k wire is designed. The clip after insertion into the bone and hole in nail and opposite cortex snuggly fits the bone providing a secure locking system. Twelve skeletally mature patients, mean age 32 years (range 24-45 years) with 19 diaphyseal fractures of the forearm were treated with this indigenously made new nail. The patient were evaluated for fracture union, functional recovery and complications. The functional outcome was assessed by disabilities of arm, shoulder and hand questionnaire (DASH score). Time to radiographic union ranged between 12 and 28 weeks, with a 100% union rate. Complications were minimal, with mild infection in open fracture (n=1) and delayed union (n=1) in patient with comminuted fracture of the ulna only. The clinical results were excellent. The DASH score ranged between 0 and 36 points. This new interlocking nail may be considered as an alternative to plate osteosynthesis for fractures of the forearm in adults. The advantages are benefit of closed reduction, smaller residual scar, reduced cost and early union with allowance of immediate movements.

Anterior augmentation plating of aseptic humeral shaft nonunions after intramedullary nailing.

PubMed

Gessmann, Jan; Königshausen, Matthias; Coulibaly, Marlon Osman; Schildhauer, Thomas Armin; Seybold, Dominik

2016-05-01

Humeral shaft nonunion after intramedullary nailing is a rare but serious complication. Treatment options include implant removal, open plating, exchange nailing and external fixation. The objective of this retrospective study was to determine whether augmentation plating without nail removal is feasible for treating a humeral shaft nonunion. Between 2002 and 2014, 37 patients (mean age 51, range 20-84 years) with aseptic humeral shaft nonunions prior to intramedullary nailing were treated with augmentation plating. The initial fractures had been fixed with retrograde nails (10 cases) or anterograde nails (27 cases). There were 34 atrophic nonunions and 3 hypertrophic nonunions. Nonunion treatment of all patients consisted of local debridement through an anterior approach to the humerus and anterior placement of the augmentation plates. Supplemental bone grafting was performed in all atrophic nonunion cases. All patients were followed until union was radiologically confirmed. Union was achieved in 36 patients (97 %) after a mean of 6 months (range 3-24 months). There was one case of iatrogenic median nerve palsy that showed complete spontaneous recovery 6 weeks postoperatively. One patient sustained a peri-implant stress fracture that was treated successfully by exchanging the augmentation plate to bridge the nonunion and the fracture. No infections or wound healing complications developed. At a mean follow-up of 14 months, all patients showed free shoulder and elbow motion and no restrictions in daily or working life. The results indicate that augmentation plating using an anterior approach is a safe and reliable option for humeral shaft nonunions after failed nailing, and the treatment has no substantial complications. Because the healing rates are similar to the standard technique of nail removal and fixation by compression or locking plates, we consider this technique to be an alternative choice for treatment.

Percutaneous osteoplasty with a bone marrow nail for fractures of long bones: experimental study.

PubMed

Nakata, Kouhei; Kawai, Nobuyuki; Sato, Morio; Cao, Guang; Sahara, Shinya; Tanihata, Hirohiko; Takasaka, Isao; Minamiguchi, Hiroyuki; Nakai, Tomoki

2010-09-01

To develop percutaneous osteoplasty with the use of a bone marrow nail for fixation of long-bone fractures, and to evaluate its feasibility and safety in vivo and in vitro. Six long bones in three healthy swine were used in the in vivo study. Acrylic cement was injected through an 11-gauge bone biopsy needle and a catheter into a covered metallic stent placed within the long bone, creating a bone marrow nail. In the in vitro study, we determined the bending, tug, and compression strengths of the acrylic cement nails 9 cm long and 8 mm in diameter (N = 10). The bending strength of the artificially fractured bones (N = 6) restored with the bone marrow nail and cement augmentation was then compared with that of normal long bones (N = 6). Percutaneous osteoplasty with a bone marrow nail was successfully achieved within 1 hour for all swine. After osteoplasty, all swine regained the ability to run until they were euthanized. Blood tests and pathologic findings showed no adverse effects. The mean bending, tug, and compression strengths of the nail were 91.4 N/mm(2) (range, 75.0-114.1 N/mm(2)), 20.9 N/mm(2) (range, 6.6-30.4 N/mm(2)), and 103.0 N/mm(2) (range, 96.3-110.0 N/mm(2)), respectively. The bending strength ratio of artificially fractured bones restored with bone marrow nail and cement augmentation to normal long bone was 0.32. Percutaneous osteoplasty with use of a bone marrow nail and cement augmentation appears to have potential in treating fractures of non-weight-bearing long bones. Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.

A Pilot Study: Nailing Indian Elections with the Indelible Ink Mark

PubMed Central

Abraham, Anil; Roga, Gillian; Thomas, Naveen

2015-01-01

Context: The indelible ink that's used in our elections was developed by National Physical Laboratories (NPL), Delhi in 1962, and has been used ever since. Though formulated by NPL, it is manufactured by Mysore Paints and Varnish Ltd. owned by the Karnataka Government. Earlier, the ink mark was applied on the cuticle but with effect from February 01, 2006 the ink is applied on the voter's left index fingernail from the distal end proximally until the cuticle using an applicator. This idea of the ink mark applied during elections was used as a simple tool to measure the rate of nail growth in a busy outpatient department of a Tertiary Hospital in South India. Aims: To assess the feasibility of using the ink mark during elections as a method of obtaining data of nail growth across the spectrum of the entire country. Subjects and Methods: In 74 patients presenting to a hospital, the rate of nail growth was measured. The voter's mark on the left index fingernail of patients during the recent elections was used as a marker for measuring the length of the nail. Results: The average rate of nail growth was 0.113 mm/day. The rate of nail growth was found to be more in females, younger individuals, pregnancy, patients on nutritional supplementation, psoriasis. Conclusion: This study which was conducted on 74 patients using the election ink mark successfully confirmed the possibility of using it as an efficient tool in measuring the rate of nail growth. The findings revealed the slightly higher rate of nail growth as compared to a study done by Rani et al. However, the limited sample size in this study was the major limitation. PMID:26677268

Activity of TDT 067 (Terbinafine in Transfersome) against Agents of Onychomycosis, as Determined by Minimum Inhibitory and Fungicidal Concentrations▿

PubMed Central

Ghannoum, Mahmoud; Isham, Nancy; Herbert, Jacqueline; Henry, William; Yurdakul, Sam

2011-01-01

TDT 067 is a novel carrier-based dosage form (liquid spray) of 15 mg/ml of terbinafine in Transfersome that has been developed to deliver terbinafine to the nail bed to treat onychomycosis. In this study, we report the in vitro activities of TDT 067 against dermatophytes, compared with those of the Transfersome vehicle, naked terbinafine, and commercially available terbinafine (1%) spray. The MICs of TDT 067 and comparators against 25 clinical strains each of Trichophyton rubrum, T. mentagrophytes, and Epidermophyton floccosum were determined according to the CLSI M38–A2 susceptibility method (2008). Minimum fungicidal concentrations (MFCs) were determined by subculturing visibly clear wells from the MIC microtiter plates. TDT 067 demonstrated potent activity against the dermatophyte strains tested, with an MIC range of 0.00003 to 0.015 μg/ml. Overall, TDT 067 MIC50 values (defined as the lowest concentrations to inhibit 50% of the strains tested) were 8-fold and 60-fold lower than those of naked terbinafine and terbinafine spray, respectively. The Transfersome vehicle showed minimal inhibitory activity. TDT 067 demonstrated lower MFC values for T. rubrum and E. floccosum than naked terbinafine and terbinafine spray. TDT 067 has more potent antifungal activity against dermatophytes that cause nail infection than conventional terbinafine preparations. The Transfersome vehicle appears to potentiate the antifungal activity of terbinafine. Clinical investigation of TDT 067 for the topical treatment of onychomycosis is warranted. PMID:21411586

Activity of TDT 067 (terbinafine in Transfersome) against agents of onychomycosis, as determined by minimum inhibitory and fungicidal concentrations.

PubMed

Ghannoum, Mahmoud; Isham, Nancy; Herbert, Jacqueline; Henry, William; Yurdakul, Sam

2011-05-01

TDT 067 is a novel carrier-based dosage form (liquid spray) of 15 mg/ml of terbinafine in Transfersome that has been developed to deliver terbinafine to the nail bed to treat onychomycosis. In this study, we report the in vitro activities of TDT 067 against dermatophytes, compared with those of the Transfersome vehicle, naked terbinafine, and commercially available terbinafine (1%) spray. The MICs of TDT 067 and comparators against 25 clinical strains each of Trichophyton rubrum, T. mentagrophytes, and Epidermophyton floccosum were determined according to the CLSI M38-A2 susceptibility method (2008). Minimum fungicidal concentrations (MFCs) were determined by subculturing visibly clear wells from the MIC microtiter plates. TDT 067 demonstrated potent activity against the dermatophyte strains tested, with an MIC range of 0.00003 to 0.015 μg/ml. Overall, TDT 067 MIC(50) values (defined as the lowest concentrations to inhibit 50% of the strains tested) were 8-fold and 60-fold lower than those of naked terbinafine and terbinafine spray, respectively. The Transfersome vehicle showed minimal inhibitory activity. TDT 067 demonstrated lower MFC values for T. rubrum and E. floccosum than naked terbinafine and terbinafine spray. TDT 067 has more potent antifungal activity against dermatophytes that cause nail infection than conventional terbinafine preparations. The Transfersome vehicle appears to potentiate the antifungal activity of terbinafine. Clinical investigation of TDT 067 for the topical treatment of onychomycosis is warranted.

Nail care feature gets to the heart of core nursing skills.

PubMed

Lindsay, Margot

2009-07-07

Thank you for drawing attention to the importance of personal hygiene in nail care (art&science June 17). Authors Bridget Malkin and Pat Berridge discuss the subject in depth and address the confusion over who should perform nail care for patients.

A clinical trial to investigate the effect of Cynatine HNS on hair and nail parameters.

PubMed

Beer, Christina; Wood, Simon; Veghte, Robert H

2014-01-01

A new, novel product, Cynatine HNS, was evaluated for its effects as a supplement for improving various aspects of hair and nails in a randomized, double-blind, placebo-controlled clinical trial. A total of 50 females were included and randomized into two groups. The active group (n = 25) received 2 capsules containing Cynatine HNS, comprised of Cynatine brand keratin (500 mg) plus vitamins and minerals, per day, and the placebo group (n = 25) received 2 identical capsules of maltodextrin per day for 90 days. End points for hair loss, hair growth, hair strength, amino acid composition, and hair luster were measured. End points were also measured for nail strength and the appearance of nails. The results show that subjects taking Cynatine HNS showed statistically significant improvements in their hair and nails when compared to placebo. Cynatine HNS is an effective supplement for improving hair and nails in 90 days or less. EudraCT number is 2014-002645-22.

A Clinical Trial to Investigate the Effect of Cynatine HNS on Hair and Nail Parameters

PubMed Central

Veghte, Robert H.

2014-01-01

Objective. A new, novel product, Cynatine HNS, was evaluated for its effects as a supplement for improving various aspects of hair and nails in a randomized, double-blind, placebo-controlled clinical trial. Methods. A total of 50 females were included and randomized into two groups. The active group (n = 25) received 2 capsules containing Cynatine HNS, comprised of Cynatine brand keratin (500 mg) plus vitamins and minerals, per day, and the placebo group (n = 25) received 2 identical capsules of maltodextrin per day for 90 days. End points for hair loss, hair growth, hair strength, amino acid composition, and hair luster were measured. End points were also measured for nail strength and the appearance of nails. Results. The results show that subjects taking Cynatine HNS showed statistically significant improvements in their hair and nails when compared to placebo. Conclusion. Cynatine HNS is an effective supplement for improving hair and nails in 90 days or less. EudraCT number is 2014-002645-22. PMID:25386609

Pseudoelastic intramedullary nailing for tibio-talo-calcaneal arthrodesis.

PubMed

Yakacki, Christopher M; Gall, Ken; Dirschl, Douglas R; Pacaccio, Douglas J

2011-03-01

Tibio-talo-calcaneal (TTC) arthrodesis is a procedure to treat severe ankle arthropathy by providing a pain-free and stable fusion. Intramedullary (IM) nails offer a method of internal fixation for TTC arthrodesis by providing compressive stability, as well as shear and torsional rigidity. IM nails have been developed to apply compression to the TTC complex during installation; however, current designs are highly susceptible to a loss of compression when exposed to small amounts of bone resorption and cyclic loading. Nickel titanium (NiTi) is a shape-memory alloy capable of recovering large amounts of deformation via shape-memory or pseudoelasticity. Currently, the next generation of IM nails is being developed to utilize the adaptive, pseudoelastic properties of NiTi and provide a fusion nail that is resistant to loss of compression or loosening. Specifically, the pseudoelastic IM nail contains an internal NiTi compression element that applies sustained compression during the course of fusion, analogous to external fixators. © 2011 Expert Reviews Ltd

Several cases of undesirable effects caused by methacrylate ultraviolet-curing nail polish for non-professional use.

PubMed

Dahlin, Jakob; Berne, Berit; Dunér, Kari; Hosseiny, Sara; Matura, Mihály; Nyman, Gunnar; Tammela, Monica; Isaksson, Marléne

2016-09-01

Ultraviolet (UV)-curing nail polishes based on acrylates or methacrylates are currently also available for non-professional use. The Swedish Medical Products Agency recently prohibited one brand of UV-curing polish, because several consumers reported undesirable effects after using it. To investigate whether consumers with undesirable effects after using the UV-curing nail polish that was later prohibited were contact allergic to the polish and its individual ingredients. Eight patients who had reported severe skin reactions after the use of the UV-curing polish were patch tested with two coatings of the nail polish and its ingredients at five dermatology departments in Sweden. All patients tested except one showed contact allergic reactions to one or several of the acrylate-based or methacrylate-based ingredients in the nail polish. The non-professional use of UV-curing nail polishes poses a risk of sensitization from acrylates and methacrylates. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Fuel utilization during exercise after 7 days of bed rest

NASA Technical Reports Server (NTRS)

Barrows, Linda H.; Harris, Bernard A.; Moore, Alan D.; Siconolfi, Steven F.

1992-01-01

Energy yield from carbohydrate, fat, and protein during physical activity is partially dependent on an individual's fitness level. Prolonged exposure to microgravity causes musculoskeletal and cardiovascular deconditioning; these adaptations may alter fuel utilization during space flight. Carbohydrate and fat metabolism during exercise were analyzed before and after 7 days of horizontal bed rest.

A triple murder.

PubMed

Vidanapathirana, M; Ruwanpura, P R; Ariyaratne, D; Karunanayake, D S K

2015-12-01

Three partially burnt bodies were found in a burnt out bedroom. A candle and matches were found on a partially burnt bed, suggesting accidental deaths. Careful scene analysis and forensic post-mortems demonstrated that this was a multiple murder rather than an accident. © The Author(s) 2015.

Soil nailing of a bridge embankment : report 2 : design and field performance report.

DOT National Transportation Integrated Search

1995-07-01

Soil nailing has recently been introduced in Oregon as an alternative lateral earth support method. The first permanent soil nail wall on the state's highway system was used where an underpass was widened under the existing Oregon Slough Bridge in Po...

Functional Analysis and Treatment of Nail Biting

ERIC Educational Resources Information Center

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

2008-01-01

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

Pediatric Digital Necrosis Secondary to Dressing Application: A Case Series.

PubMed

Bjorklund, Kim A; Rice, Dahlia M; Amalfi, Ashley N

2018-04-01

Pediatric digital necrosis resulting in revision amputation is a devastating outcome following digital dressing application. We report a series of 4 pediatric patients (age: 21 months-11 years) who presented for surgical consultation related to digital ischemia and irreversible necrosis following the application of Coban digital dressings. A review of the literature demonstrated that such injuries had not previously been described. In our case series, Coban dressing was utilized as a deterrent for thumb sucking, fingertip tuft fractures with nail bed lacerations, and a phalanx fracture secondary to crush injury. All 4 children suffered digital necrosis secondary to Coban dressings and ultimately required revision amputation. We discuss risks factors, application practices, and strategies to minimize complications with digital dressings in the pediatric population with the intent of creating awareness among hand surgeons to help promote safe practices and improve patient outcomes.

[First report of alkaptonuria in Peru].

PubMed

Guillén-Mendoza, Daniel; Quiroga de Michelena, María

2014-01-01

Alkaptonuria is an inborn error of metabolism caused by deficiency of homogentisate 1,2-dioxygenase (HGD) which produces an excess of homogentisic acid (HGA). A case is presented of a 57 year old woman whose urine has turned black since birth. For 9 years she presented a greenish pigmentation in her nail beds that did not improve with antifungal treatments, and in the last 9 months she showed worsening large joint osteoarthritis. This situation forced her to use a wheelchair due to the intense pain caused by osteoarthritis in her hips and lumbar spine. From the description of symptoms, her urinary HGA was measured which confirmed the diagnosis of alkaptonuria. Analgesics and a diet without tyrosine-containing products were suggested. The patient was also referred for hip replacement surgery. This is the first reported case of alkaptonuria in Peru.

A numerical investigation into the performance of the soil nail wall and pile foundation at the Swift Delta I-5 Interchange.

DOT National Transportation Integrated Search

1993-12-01

Finite Difference Methods (FDM) and Finite Element Methods (FEM) studies are reported studying the soil nail wall construction at the Swift Delta I-5 Interchange bridge reconstruction in North Portland, Oregon. Five layers of soil nails were installe...

Mycobacteria in nail salon whirlpool footbaths, California.

PubMed

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

2005-04-01

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

Mycobacteria in Nail Salon Whirlpool Footbaths, California

PubMed Central

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

2005-01-01

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

Scabies of the nail unit.

PubMed

Oh, Susan; Vandergriff, Travis

2014-10-15

Scabies limited to the nail unit is quite unusual, but may persist after treatment of crusted scabies. We present a man with a history of crusted scabies that resolved with treatment, but later the patient reported a chronic problem with crumbly, thickened nails, which were found to be harboring scabies mites.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-06

... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-1185 (Preliminary)] Certain Steel Nails From the United Arab Emirates AGENCY: United States International Trade Commission. ACTION: Institution... certain steel nails, provided for in subheadings 7317.00.55, 7317.00.65 and 7317.00.75 of the Harmonized...

Dorsal dimelia in patau syndrome: a case report.

PubMed

Fattah, A; Pickford, M A

2007-10-01

We present a case of a child with Patau syndrome that exhibits features consistent with congenital palmar nail syndrome. The literature is reviewed and evidence presented to demonstrate that this is a defect in the dorso-ventral patterning of the limb and thus a form of dorsal dimelia. In order to differentiate this from other instances of ectopic nail tissue we suggest congenital palmar nail syndrome should be more specifically defined as duplicated nails, absent flexion creases, non-glabrous skin on the palmar surface, reduced movement at the interphalangeal joints and hypoplastic terminal phalanges.

Periarticular locking plate vs intramedullary nail for tibiotalocalcaneal arthrodesis: a biomechanical investigation.

PubMed

Ohlson, Blake L; Shatby, Meena W; Parks, Brent G; White, Kacey L; Schon, Lew C

2011-02-01

Augmented retrograde intramedullary (IM) nail fixation was compared with augmented periarticular locking- plate fixation for tibiotalocalcaneal arthrodesis. Specimens in 10 matched pairs were randomly assigned to a fixation construct and loaded cyclically in dorsiflexion. The groups did not differ in initial or final stiffness, load to failure, or construct deformation. No correlation was found between bone mineral density and construct deformation for either group. A humeral locking plate may be a viable alternative to an IM nail for tibiotalocalcaneal fixation in cases not amenable to IM nailing.

Intramedullary nailing for the treatment of aseptic femoral shaft non-unions after plating failure: effectiveness and timing.

PubMed

Megas, Panagiotis; Syggelos, Spyros A; Kontakis, Georgios; Giannakopoulos, Andreas; Skouteris, Georgios; Lambiris, Elias; Panagiotopoulos, Elias

2009-07-01

This retrospective, multicentre study aimed to evaluate reamed intramedullary nailing (IMN) for the treatment of 30 cases of aseptic femoral shaft non-union after plating failure. Following nailing, 29 non-unions had healed by a mean 7.93 months. In one case a hypertrophic non-union required renailing after 8 months, using a nail of greater diameter, and united within five further months. Healing times were not related to whether the fracture was open or closed, the type non-union or the type of fracture. The delay from the initial plating to intramedullary nailing had a statistically significant effect on healing time and final outcome. This treatment is cost effective and should be implemented as soon as the non-union is diagnosed.

Clinical and dermoscopic clues to differentiate pigmented nail bands: an International Dermoscopy Society study.

PubMed

Benati, E; Ribero, S; Longo, C; Piana, S; Puig, S; Carrera, C; Cicero, F; Kittler, H; Deinlein, T; Zalaudek, I; Stolz, W; Scope, A; Pellacani, G; Moscarella, E; Piraccini, B M; Starace, M; Argenziano, G

2017-04-01

Longitudinal melanonychia might be difficult to differentiate and the use of dermoscopy can be useful for the preoperative evaluation and management decision. The aim of our study was to investigate clinical and dermoscopic criteria of acquired longitudinal melanonychia in adults to identify the best predictors of melanoma using a multivariate analysis and to explore eventual new dermoscopic criteria for nail melanoma diagnosis. In this retrospective observational study, 82 histopathologically diagnosed, acquired nail pigmented bands were collected and examined. All variables were included in the analysis and examined as possible predictors of nail melanoma. Both univariate and multivariable analyses have been performed. Among 82 cases, 25 were diagnosed as nail melanoma and 57 as benign lesions (including 32 melanocytic nevi and 25 benign melanocytic hyperplasia). Melanoma cases were significantly associated with a width of the pigmented band higher than 2/3 of the nail plate, grey and black colours, irregularly pigmented lines, Hutchinson and micro-Hutchinson signs, and nail dystrophy. Granular pigmentation, a newly defined dermoscopic criterion, was found in 40% of melanomas and only in 3.51% of benign lesions. Dermoscopic examination of longitudinal melanonychia provides useful information that could help clinicians to improve melanoma recognition. © 2016 European Academy of Dermatology and Venereology.

Health hazard evaluation report HETA 90-048-2253, Haute Nails, Norman, Oklahoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Almaguer, D.; Blade, L.M.

In response to a request from the owner/operator of the Haute Nails Salon, Norman, Oklahoma, an evaluation was undertaken of possible chemical exposures from the use of nail sculpturing products. Haute Nails was an artificial nail sculpturing and tanning salon employing two full time nail sculpturers and four part time receptionists. The company was located on the first floor of a two story brick building. Long term general area air sampling was conducted for volatile organic chemicals, formaldehyde, and methacrylates; personal breathing zone air sampling was conducted for methacrylates. Ethyl-methacrylate concentrations in long term samples ranged from 10.3 to 14.1more » mg/cu m. Breathing zone concentrations of ethyl-methacrylate were 128 mg/cu m for a 7 minute sample and 78.9 mg/cu m for a 14 minute sample during nail sculpturing. Carbon-dioxide measurements exceeded the recommended level of 1000 parts per million. The authors conclude that there were no overexposures to ethyl-methylacrylate during the evaluation. The heating and air conditioning system did not provide for the mechanical exchange of outside air and no exhaust fans were located in the area served by the system. The authors recommend that an outside air supply duct be added to the present system.« less

Reamed versus unreamed intramedullary nailing for the treatment of femoral fractures

PubMed Central

Li, A-Bing; Zhang, Wei-Jiang; Guo, Wei-Jun; Wang, Xin-Hua; Jin, Hai-Ming; Zhao, You-Ming

2016-01-01

Abstract Background and objective: Intramedullary nailing is commonly used for treating femoral shaft fractures, one of the most common long bone fractures in adults. The reamed intramedullary nail is considered the standard implant for femoral fractures. This meta-analysis was performed to verify the superiority of reamed intramedullary nailing over unreamed intramedullary nailing in fractures of the femoral shaft in adults. Subgroup analysis of implant failure and secondary procedure was also performed. Methods: Electronic literature databases were used to identify relevant publications and included MEDLINE (Ovid interface), EMBASE (Ovid interface), and the Cochrane Central Register of Controlled Trials (CENTRAL; Wiley Online Library). The versions available on January 30, 2016, were utilized. Only human studies, which were designed as randomized controlled clinical trials, were included. Two authors independently evaluated the quality of original research publications and extracted data from the studies that met the criteria. Results: Around 8 randomized controlled trials involving 1078 patients were included. Reamed intramedullary nailing was associated with shorter time to consolidation of the fracture (SMD = –0.62, 95% CI = –0.89 to –0.35, P < 0.00001), lower secondary procedure rate (OR = 0.25, 95% CI 0.10–0.62, P = 0.003), lower nonunion rate (OR = 0.14, 95% CI = 0.05–0.40, P < 0.01), and lower delayed-union rate (OR = 0.19, 95% CI = 0.07–0.49, P < 0.01) compared to unreamed intramedullary nailing. The 2 groups showed no significant differences in risk of implant failure (OR = 0.50, 95% CI 0.14–1.74, P = 0.27), mortality risk (OR = 0.94, 95% CI 0.19–4.68, P = 0.94), risk of acute respiratory distress syndrome (ARDS; OR = 1.55, 95% CI 0.36–6.57, P = 0.55), or blood loss (SMD = 0.57, 95% CI = –0.22 to 1.36, P = 0.15). Conclusion: Reamed intramedullary nailing is correlated with shorter time to union and lower rates of delayed-union, nonunion, and reoperation. Reamed intramedullary nailing did not increase blood loss or the rates of ARDS, implant failure, and mortality compared to unreamed intramedullary nailing. Therefore, the treatment of femoral fractures using reamed intramedullary nailing is recommended. PMID:27442651

[Electromagnetic navigation interlocking intramedullary nail technology for treatment of femoral shaft fractures].

PubMed

Zuo, Kangkang; Qin, Wei; Guo, Qing; Palati-Ababaikeli; Qiao, Peiliu; Shen, Mingquan; Yin, Lele; Pan, Qilin; Xu, Xiaoxiong

2014-10-01

To explore the value of electromagnetic navigation interlocking intramedullary nail in the treatment of femoral shaft fracture. Between July 2012 and October 2013, 53 cases of femoral shaft fracture were treated. There were 40 males and 13 females, aged 16-52 years (mean, 38.3 years). The causes of injury were traffic accident in 28 cases, falling from height in 11 cases, falling in 7 cases, crush injury in 4 cases, and other in 3 cases. Of 53 cases, there were 3 cases of open fracture (Gustilo I degree) and 50 cases of closed fracture. Fracture was located in the proximal femur in 17 cases, middle femur in 29 cases, and distal femur in 7 cases. According to Winquist classification, 7 cases were rated as type I, 8 cases as type II, 22 cases as type III, and 16 cases as type IV; according to AO classification, 18 cases were rated as type 32-A, 28 cases as type 32-B, and 7 cases as type 32-C. The time from injury to operation was 3-11 days (mean, 5 days). Distal interlocking intramedullary nail was implanted using electromagnetic navigation. The distal locking nail operation with interlocking intramedullary nail was successfully completed under electromagnetic navigation; the one-time success rate of distal locking nail operation reached 100%; and the locking nail time was 5.0-9.5 minutes (mean, 7.0 minutes). Healing of incision by first intention was obtained after operation, and no complication of skin necrosis, infection, and sinus tract occurred. Fifty-three cases were all followed up 5-12 months (mean, 9 months). One case had hip pain and weaken middle gluteal muscle strength, and the symptoms disappeared after removing the nail. During the follow-up period, no broken nails, nail exit, infection, or re-fracture occurred. All fractures achieved clinical healing, and the healing time was 8-22 weeks (mean, 14.5 weeks). In 49 patients followed up 8 months, the Lysholm score was excellent in 44 cases, good in 4 cases, and acceptable in 1 case, with an excellent and good rate of 98%. Electromagnetic navigation system is safe and reliable, with the advantages of high positioning accuracy, short operation time, and no radiation, the clinical application of the system for distal locking nail operation can obtain excellent short-term effectiveness.

Limb Lengthening Using the PRECICETM Nail System: Complications and Results

PubMed Central

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

2016-01-01

Background Three types of telescopic nails are mainly used for intramedullary limb lengthening nowadays. Despite some important advantages of this new technology (e.g. controlled distraction rate, not restricted availability, possibility to perform accordion maneuvers), few articles exist on clinical results and complications after lengthening with the PRECICETM nail (Ellipse, USA). Objectives The aim of the current study was to describe and analyze the complications associated with lengthening with the PRECICETM nail. Are the problems preventable when using the PRECICE, related to the distraction rate control, the lengthening goals and technique and handling? Methods We retrospectively reviewed the charts of 9 patients operated between 2012 and 2013 with a PRECICETM nail for a leg length discrepancy (LLD). The mean age of the patients was 32 years (range, 17 - 48 years). There were 5 femoral and 4 tibial procedures. The causes of LLD were posttraumatic (n = 5) and congenital (n = 4). The mean LLD was 36.4 ± 11.4 mm. The minimum follow-ups were 2 months (average, 5 months; range, 2 - 9 months). Results The mean distraction rate was 0.5 ± 0.1 mm/day. We observed in 7 patients differences in achieving the lengthening goals (average, 1.6 mm; range, -20.0 - 5.0 mm). Average lengthening was 34.7 ± 10.7 mm. All patients reached normal alignment and normal joint orientation. An unintentional loss of the achieved length during the consolidation phase was noticed in patients with delayed bone healing in two cases. In the first case (loss of 20mm distraction) the nail could be redistracted and the goal length was achieved. In the second case (loss of 10mm distraction) the nail broke shortly after the diagnosis and the nail was exchanged. Conclusions We report of loss of achieved length after lengthening with a telescopic nail. Weight bearing before complete consolidation of the regenerate might be a risk factor for that. Thorough examination of the limb length and careful evaluation of the radiographs are required in the follow-up period. The PRECICE nail system requires the same vigilance like the other intramedullary systems too. PMID:28144605

Sensory factors affecting female consumers' acceptability of nail polish.

PubMed

Sun, C; Koppel, K; Adhikari, K

2015-12-01

The objectives of this study were to determine what sensory factors impact consumers' acceptability of nail polishes, to explore how these sensory factors impact consumers' acceptability of nail polishes, to investigate whether there are any consumer segments according to their overall acceptability on different nail polishes and to scrutinize how the consumer segments are related to the sensory factors. Ninety-eight females participated in a nail polish consumer study at Kansas State University. Eight commercial products belonging to four categories - regular (REG), gel (GEL), flake (FLK) and water-based (WAT) - were evaluated. Each nail polish sample was evaluated twice by each participant in two different tasks - a task devoted to applying and evaluating the product and a task devoted to observing the appearance and evaluating the product. Pearson's correlation analysis, analysis of variance (ANOVA), external preference mapping, cluster analysis and internal preference mapping were applied for data analysis. Participants' scores of overall liking of the nail polishes were similar in the application task and in the observation task. In general, participants liked the REG and GEL product samples more than the FLK and WAT samples. Among all the sensory attributes, appearance attributes were the major factors that affected participants' overall liking. Aroma seemed to be a minor factor to participants' overall liking. Some sensory attributes, such as runny, shininess, opacity, spreadability, smoothness, coverage and wet appearance, were found to drive participants' overall acceptability positively, whereas others such as pinhole, fatty-edges, blister, brushlines, pearl-like, flake-protrusion, glittery and initial-drag impacted participants' overall acceptability negatively. Four clusters of participants were identified according to their overall liking scores from both the application task and the observation task. Participants' acceptability, based on different sensory attributes, could help a nail polish manufacturer modify or improve their nail polish formulas. Nail polish manufacturers could use the consumer cluster information to improve their marketing strategies for specific categories of their products and to target their advertising on particular consumer groups. © 2015 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

PubMed

Beytemür, Ozan; Albay, Cem; Adanır, Oktay; Yüksel, Serdar; Güleç, Mehmet Akif

2016-12-01

This study aims to evaluate the functional and radiographic results and treatment complications of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) type 43C1 and C2 fractures treated with intramedullary nailing. We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%). Intramedullary nailing was applied in eight patients (23%) without external screws. Fracture union, union time, alignment problems, and complications were evaluated. Clinical evaluation of patients was conducted using the Olerud and Molander score and by measuring the ankle joint range of motion. Union was achieved in all 35 patients. Mean union time was 16.5±2.8 weeks (range 12 to 24 weeks) and mean Olerud and Molander score was 88±8.24. Varus deformity was detected in one patient, valgus deformity was detected in two patients, and rotation deformity was detected in one patient. Superficial infection was detected in three patients (9%). Deep infection was not detected in any patient. Intramedullary nailing is not contraindicated for simple intra-articular distal tibial fractures. In these fractures, intramedullary nailing performed in accordance with its technique, with an additional percutaneous screw if necessary, is a successful treatment option with high fracture union rates, high functional results, and low complication rates.

Methods for determination of fingernail steroids by LC/MS/MS and differences in their contents between right and left hands.

PubMed

Higashi, Tatsuya; Yamagata, Kenichiro; Kato, Yuina; Ogawa, Yu; Takano, Kaori; Nakaaze, Yutaro; Iriyama, Takashi; Min, Jun Zhe; Ogawa, Shoujiro

2016-05-01

Fingernail clipping is expected to be a specimen for steroid testing, because it has several advantages over blood; i.e., noninvasive collection, ease of storage, portability and handling, and possibility for an assessment of the steroid status over a relatively long and retrospective time window. In this study, we examined whether there is a difference in the nail contents between the right and left hands for five steroids [glycochenodeoxycholic acid (GCDCA), taurochenodeoxycholic acid (TCDCA), dehydroepiandrosterone sulfate (DHEAS), testosterone (TST) and cortisol (CRT)] using newly developed liquid chromatography/electrospray ionization-tandem mass spectrometry methods. The nail contents between the hands were significantly different for GCDCA, TCDCA and DHEAS, whereas those of TST and CRT only slightly differed. These results might be due to the difference in the binding affinity of each steroid for the nail keratin. The relatively hydrophilic steroids, GCDCA, TCDCA and DHEAS, may be lost from nails in daily life due to their low affinity for keratin, which would produce differences in the nail contents between the hands. Thus, the fingernail GCDCA, TCDCA and DHEAS contents may be influenced by factors other than the disease; the nail analysis is inefficient in the diagnosis of the disease associated with these steroids. On the other hand, the nail analysis looks promising for evaluation of the status of TST and CRT, which are lipophilic and inferred to be tightly bound to the keratin. In fact, the nail TST content showed a significant sex difference, just like its serum/plasma concentration. Copyright © 2016 Elsevier Inc. All rights reserved.

A Comparative Analysis of Nursing Manpower Requirements: Traditional Staffing Methodology versus Patient Classification System at Madigan Army Medical Center

DTIC Science & Technology

1983-07-01

Bathing an infant 22. Bed bath (complete - adult) 23. Back bath (partial - legs, back, abdomen) 24. Bed shampoo (female) 25. Catheter care ( cleansing ...Stool testing 126. Applying condum catheter 127. Removal chest tubes 128. Assisting with vaginal /pelvic examination INDIRECT 1. Admission of a patient

Chevron nails: a normal variant in the pediatric population.

PubMed

Delano, Sofia; Belazarian, Leah

2014-01-01

A 7-month-old girl was evaluated for V-shaped ridging of the fingernails consistent with chevron nails. Chevron nails are a normal variant in the pediatric population that is frequently outgrown. This case nicely demonstrates this normal finding that has so rarely been reported in the literature. © 2013 Wiley Periodicals, Inc.

Fractures above and below a modular nail for knee arthrodesis. A case report.

PubMed

Hinarejos, Pedro; Ginés, Alberto; Monllau, Juan C; Puig, Lluis; Cáceres, Enric

2005-06-01

Several techniques have been advocated for knee arthrodesis, and there has been an increasing interest in modular intramedullary nails in the recent last years. We report a case of femoral and tibial fractures at each end of a modular nail in a solidly fused knee 8 months after an arthrodesis.

29 CFR 1915.72 - Ladders.

Code of Federal Regulations, 2013 CFR

2013-07-01

... shipbreaking. (a) General requirements. (1) The use of ladders with broken or missing rungs or steps, broken or... 10d common wire nails or fastened with through bolts or other fasteners of equivalent strength. Cleats... nailed to each rail with five 10d common wire nails or fastened with through bolts or other fasteners of...

76 FR 52313 - Certain Steel Nails From the United Arab Emirates: Postponement of Preliminary Determination of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

... United Arab Emirates: Postponement of Preliminary Determination of Antidumping Duty Investigation AGENCY... antidumping duty investigation on nails from the United Arab Emirates. See Certain Steel Nails From the United Arab Emirates: Initiation of Antidumping Duty Investigation, 76 FR 23559 (April 27, 2011). The notice...

The study on length and diameter ratio of nail as preliminary design for slope stabilization

NASA Astrophysics Data System (ADS)

Gunawan, Indra; Silmi Surjandari, Niken; Muslih Purwana, Yusep

2017-11-01

Soil nailing technology has been widely applied in practice for reinforced slope. The number of studies for the effective design of nail-reinforced slopes has also increased. However, most of the previous study was focused on a safety factor of the slope; the ratio of length and diameter itself has likely never been studied before. The aim of this study is to relate the length and diameter ratio of the nail with the safety factor of the 20 m height of sand slope in the various angle of friction and steepness of the slope. Simplified Bishop method was utilized to analyze the safety factor of the slope. This study is using data simulation to calculate the safety factor of the slope with soil nailing reinforcement. The results indicate that safety factor of slope stability increases with the increase of length and diameter ratio of the nail. At any angle of friction and steepness of the slope, certain effective length and diameter ratio was obtain. These results may be considered as a preliminary design for slope stabilization.

Study on laser-assisted drug delivery with optical coherence tomography

NASA Astrophysics Data System (ADS)

Tsai, Wen-Guei; Tsai, Ting-Yen; Yang, Chih-Hsun; Tsai, Meng-Tsan

2017-04-01

The nail provides a functional protection to the fingertips and surrounding tissue from external injuries. Nail plate divided into three layers including dorsal, intermediate, and ventral layers. The dorsal layer consists of compact, hard keratins, limiting topical drug delivery through the nail. In this study, we investigate the application of fractional CO2 laser that produces arrays of microthermal ablation zones (MAZs) to facilitate drug delivery in the nails. Moreover, optical coherence tomography (OCT) is implemented for real-time monitoring of the laser-skin tissue interaction, sparing the patient from invasive surgical sampling procedure. Observations of drug diffusion through the induced MAZ array are achieved by evaluating the time-dependent OCT intensity variance. Subsequently, nails are treated with cream and liquid topical drugs to investigate the feasibility and diffusion efficacy of laser-assisted drug delivery. Our results show that fractional CO2 laser improves the efficacy of topical drug delivery in the nail plate, and that OCT could potentially be used for in vivo monitoring of the depth of laser penetration as well as real-time observations of drug delivery.

New Technique for Tibiotalar Arthrodesis Using a New Intramedullary Nail Device: A Cadaveric Study

PubMed Central

Eisenstein, Emmanuel D.; Rodriguez, Mario

2016-01-01

Introduction. Ankle arthrodesis is performed in a variety of methods. We propose a new technique for tibiotalar arthrodesis using a newly designed intramedullary nail. Methods. We proposed development of an intramedullary device for ankle arthrodesis which spared the subtalar joint using a sinus tarsi approach. Standard saw bones models and computer assisted modeling and stress analysis were used to develop different nail design geometries and determine the feasibility of insertion. After the final design was constructed, the device was tested on three cadaveric specimens. Results. Four basic nail geometries were developed. The optimal design was composed of two relatively straight segments, each with a different radius of curvature for their respective tibial and talar component. We successfully implemented this design into three cadaveric specimens. Conclusion. Our newly designed tibiotalar nail provides a new technique for isolated tibiotalar fusion. It utilizes the advantages of a tibiotalar calcaneal nail and spares the subtalar joint. This design serves as the foundation for future research to include compression options across the tibiotalar joint and eventual transition to clinical practice. PMID:27818800

New Technique for Tibiotalar Arthrodesis Using a New Intramedullary Nail Device: A Cadaveric Study.

PubMed

Eisenstein, Emmanuel D; Rodriguez, Mario; Abdelgawad, Amr A

2016-01-01

Introduction . Ankle arthrodesis is performed in a variety of methods. We propose a new technique for tibiotalar arthrodesis using a newly designed intramedullary nail. Methods . We proposed development of an intramedullary device for ankle arthrodesis which spared the subtalar joint using a sinus tarsi approach. Standard saw bones models and computer assisted modeling and stress analysis were used to develop different nail design geometries and determine the feasibility of insertion. After the final design was constructed, the device was tested on three cadaveric specimens. Results . Four basic nail geometries were developed. The optimal design was composed of two relatively straight segments, each with a different radius of curvature for their respective tibial and talar component. We successfully implemented this design into three cadaveric specimens. Conclusion . Our newly designed tibiotalar nail provides a new technique for isolated tibiotalar fusion. It utilizes the advantages of a tibiotalar calcaneal nail and spares the subtalar joint. This design serves as the foundation for future research to include compression options across the tibiotalar joint and eventual transition to clinical practice.

A novel method for assessing chronic cortisol concentrations in dogs using the nail as a source.

PubMed

Mack, Z; Fokidis, H B

2017-04-01

Cortisol, a glucocorticoid secreted in response to stress, is used to assess adrenal function and mental health in clinical settings. Current methods assess cortisol sources that reflect short-term secretion that can vary with current stress state. Here, we present a novel method for the extraction and quantification of cortisol from the dog nail using solid phase extraction coupled to enzyme-linked immunosorbent assay. Validation experiments demonstrated accuracy (r = 0.836, P < 0.001) precision (15.1% coefficients of variation), and repeatability (14.4% coefficients of variation) with this method. Furthermore, nail cortisol concentrations were positively correlated to an established hair cortisol method (r = 0.736, P < 0.001). Nail cortisol concentrations did not differ with dog sex, breed, age, or weights; however, sample size limitations may preclude statistical significance. Nail cortisol may provide information on cortisol secretion integrated over the time corresponding to nail growth and may be useful as a tool for diagnosing stress and adrenal disorders in dogs. Copyright © 2016 Elsevier Inc. All rights reserved.

Epithelium-derived Wnt ligands are essential for maintenance of underlying digit bone

PubMed Central

Takeo, Makoto; Hale, Christopher S.; Ito, Mayumi

2018-01-01

Clinically, many nail disorders accompany bone deformities, but whether the two defects are causally related is under debate. To investigate the potential interactions between the two tissue types, we analyzed epithelial-specific β-catenin deficient mice, in which nail differentiation is abrogated. These mice showed regression of not only the nail plate but also of the underlying digit bone. Characterization of these bone defects revealed active bone resorption, which is suppressed by Wnt activation in osteoblast and osteoclast precursors. Furthermore, we found that Wntless (Wls) expression, essential for Wnt ligand secretion, was lacking in the β-catenin deficient nail epithelium and that genetic deletion of Wls in the nail epithelium led to the lack of Wnt activation in osteoblast and osteoclast precursors and subsequently led to defective regression of the underlying digit bone. Together, these data show epithelial Wnt ligands can ultimately regulate Wnt signaling in osteoblasts and osteoclast precursors, known to regulate bone homeostasis. These results reveal a critical role for the nail epithelium on the digit bone during homeostatic regeneration and show that Wnt/β-catenin signaling is critical for this interaction. PMID:27021406

Nail haemorrhages in native highlanders of the Peruvian Andes

PubMed Central

Heath, Donald; Harris, Peter; Williams, David; Krüger, Hever

1981-01-01

Nail haemorrhages are of interest to the chest physician and cardiologist. While the common type in the distal part of the nail is produced by the minor trauma of daily life, the rarer form—scattered through the nail substance—appears to be related to hypoxaemia brought about by heart and lung disease. We thought it would be of interest to study a population which was naturally hypoxaemic because of living at high altitude. Accordingly we have studied the frequency and types of nail haemorrhage in Quechua Indians who are permanently exposed to the hypobaric hypoxia of the Andes. We found the haemorrhages to be common both in mestizos living on the coastal plain and in the native highlanders. They appeared to increase in frequency with altitude but were of the distal type and would thus seem to be the result of minor trauma as at sea level. However, just as in cases of cyanotic congenital heart disease at low altitude, those with exaggerated hypoxaemia and pronounced elevation of haematocrit—namely, subjects with Monge's disease (chronic mountain sickness)—had scattered haemorrhages in the nail substance. Images

Tibiotalocalcaneal Arthrodesis Using a Nitinol Intramedullary Hindfoot Nail.

PubMed

Hsu, Andrew R; Ellington, J Kent; Adams, Samuel B

2015-10-01

Tibiotalocalcaneal (TTC) arthrodesis using an intramedullary hindfoot nail is a common procedure for deformity correction and the treatment of combined tibiotalar and subtalar end-stage arthritis. Nonunion at one or both fusion sites is a difficult complication that can result in reoperation, significant morbidity, and below-knee amputation. There is currently a need for sustained compression across fusion sites using a TTC hindfoot nail with good mechanical stability. The DynaNail TTC Fusion System (MedShape, Inc, Atlanta, GA) uses an internal nitinol compression element to apply sustained compression across the tibiotalar and subtalar joints after surgery. In preliminary clinical cases, we have found that the nail is safe, reliable, and has promising clinical and radiographic results in settings of hindfoot arthritis, complex deformity, Charcot arthropathy, and talar avascular necrosis. Expert opinion, Level V. © 2015 The Author(s).

Anatomic structures at risk: curved hindfoot arthrodesis nail--a cadaveric approach.

PubMed

Knight, Timothy; Rosenfeld, Peter; Jones, Ioan Tudur; Clark, Callum; Savva, Nick

2014-01-01

Retrograde intramedullary nailing of the hindfoot and ankle is an established procedure for salvage of severe foot and ankle deformity, arthritis, tumor, and instability. In the present study, retrograde hindfoot (tibiotalocalcaneal) arthrodesis nailing was performed using a standardized technique on 7 cadaver specimens by trained senior surgeons. The specimens were then dissected to determine the distance of the subcalcaneal structures at risk from the insertion point of the nail. The findings showed that the distance of the lateral neurovascular bundle from the edge of the nail was 6.5 (range 3.5 to 8, 95% confidence interval 5.9 to 7.1) mm. No neurovascular bundle was compromised, and all were within a previously described "safe window." Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

[The direct AAS determination of micro elements in hair and nail by base-digestion].

PubMed

Ju, Hong-fang

2002-08-01

The study of micro elements is more and more extensively, and people can gain some informations by the level of micro elements in tissue. This paper tempts to dissolve hair or nail in 2 mol.L-1 NaOH and determinate nine micro elements including calcium, zinc, iron, manganese, nickel, cadmium, copper, lead and bismuth in them by base-digestion with FAAS and GFAAS. It shows that the measured value of these elements is coincident with reference articles reported, except bismuth. The elements' percent recoveries are 90.0%-110.8%. The result also shows that the level of zinc and copper in hair are higher than in nail, and the level of bismuth, cadmium and iron in hair are lower than in nail, but the level of micro elements in hair and in nail are not correlative.

[Treatment of trochanteric fractures of the femoral bone].

PubMed

Wierer, I; Pospísil, M; Holubár, J; Volf, V

1994-01-01

The authors present the evaluation of some most often methods of treatment of trochanteric fractures of femur. They analyze the group of 235 patients in the years 1987 - 1991 treated for fractures by the McLaughlin technique and by Ender nailing. The first method was performed on 121 people and the technique of Ender nailing on 97 people. The results and complications of these methods of osteosynthesis are presented in the paper. The experiences of the authors confirm the advantage of Ender nailing in treating fractures of the oldest injured patients. The Ender nailing method of osteosynthesis is the more advantageous, because the operation takes less time and is easier for patients. After Ender nailing, the possibility of functional rehabilitation and walking on crutches is greater. McLaughlin osteosynthesis of these fractures proved the more advantageous in younger injured patients.

Exercise Within LBNP to Produce Artificial Gravity

NASA Technical Reports Server (NTRS)

Hargens, Alan R.

1996-01-01

Integrated physiologic countermeasures are needed to maintain orthostatic tolerance after spaceflight or bed rest. We hypothesized that supine exercise during LBNP would prevent bed rest-induced loss of orthostatic tolerance by preventing hemoconcentration. In a study conducted jointly with NASA Johnson Space Center and the University of Texas Medical Branch, Galveston, TX, fifteen male subjects underwent 5 days of 6 deg head-down bed rest: 5 control subjects did not exercise, and 10 performed 30 min/day of supine interval treadmill exercise at intensities up to 90% VO(sub 2peak). We will undertake two 14 day bed-rest studies (6 deg head-down tilt bed rest, HDT) to investigate the mechanism of action and efficacy of our partial vacuum exerciser concept. These 14 day bed rest studies were chosen to simulate current microgravity exposures for Space Shuttle crew members.

Comparison between locked intramedullary nailing and anatomical locking plating in the treatment of displaced clavicular midshaft fractures.

PubMed

Zehir, Sinan; Çalbıyık, Murat; Şahin, Ercan; İpek, Deniz

2016-01-01

The aim of this study was to compare the results of expandable flexible locked intramedullary nailing and anatomical locking plating in clavicular midshaft fractures. Thirty-three patients (21 male, 12 female) who had displaced fractures and at least 2-cm shortening fixed with expandable flexible locked intramedullary nailing and 38 patients (24 male, 14 female) who underwent anatomical locking plating were recruited. Duration of surgery, incision size, duration of hospital stay, union time, and early and late complications were compared between the groups. Functional results were compared with Constant scoring system. Mean duration of surgery was 32.4±9.1 minutes (range: 20-42 minutes) in the nailing group and 54.1±11.9 minutes (range: 42-70 minutes) in the plating group. The incision was 4.1±0.9 cm (range: 3-5 cm) in the nailing group and 9.5±1.7 cm (range: 7-12 cm) in the plating group. Mean union time was 14.8 weeks (range: 10-24 weeks) in the nailing group and 21.3 weeks (range: 12-33 weeks) in the plating group. Mean duration of hospital stay was 3.6±1.1 days (range: 2-4 days) in the plating group, whereas it was 2.3±0.8 days (range: 1-3 days) in the nailing group. In the plating group, an average of 2.7-mm (range: 0-7 mm) shortening was determined in the clavicles that underwent surgery as compared to the intact clavicles, whereas shortening was 2.3 mm (range: 0-6 mm) in the nailing group. Expandable flexible locked intramedullary nailing can provide more successful outcomes than plating in displaced clavicular midshaft fractures, due to advantages such as shorter union time, lower complication rate, and better cosmetic outcomes.

The efficacy of single-stage open intramedullary nailing of neglected femur fractures.

PubMed

Boopalan, P R J V C; Sait, Azad; Jepegnanam, Thilak Samuel; Matthai, Thomas; Varghese, Viju Daniel

2014-02-01

Neglected femur fractures are not rare in the developing world. Treatment options include single-stage open reduction and intramedullary nailing, or open release, skeletal traction, and then second-stage open intramedullary nailing, with bone grafting. Single-stage procedures have the potential advantage of avoiding neurovascular complications secondary to acute lengthening, but they require a second operation, with potentially increased resource use and infection risk. We sought to determine the (1) likelihood of union, (2) complications and reoperations, and (3) functional results with single-stage open intramedullary nailing without bone grafting in patients with neglected femur fractures. Between January 2003 and December 2007, 17 consecutive patients presented to our practice with neglected femoral shaft fractures. All were treated with single-stage nailing without bone grafting. There were 15 men and two women with a median age of 27 years. The average time from fracture to treatment was 13 weeks (range, 4-44 weeks). Eleven patients underwent open nailing with interlocked nails and six were treated with cloverleaf Kuntscher nails. Patients were followed for a minimum of 6 months (mean, 33 months; range, 6-72 months). The mean preoperative ROM of the knee was 28° (range, 10°-150°) and femoral length discrepancy was 3.1 cm (range, 1-5 cm). All fractures united and the mean time to union was 16 weeks (range, 7-32 weeks). There were no neurologic complications secondary to acute lengthening. The mean postoperative ROM of the knee was 130° (range, 60°-150°). All patients were able to return to preinjury work. Sixteen patients regained their original femoral length. One-stage open intramedullary nailing of neglected femoral diaphyseal fractures without bone grafting was safe and effective, and obviated the need for a two-stage approach. Although the findings need to be replicated in larger numbers of patients, we believe this technique may be useful in treating patients with this injury, and may offer advantages in resource-constrained environments.

Successful treatment of pediatric nail psoriasis with periodic pustular eruption using topical indigo naturalis oil extract.

PubMed

Liang, Chung-Yu; Lin, Tung-Yi; Lin, Yin-Ku

2013-01-01

Psoriasis of the nail greatly affects quality of life because of the difficulty in achieving long-lasting remission. Pustular psoriasis of the nail apparatus is characterized by the formation of sterile pustules, starting on one or two fingers or less often on the toes, and spontaneous improvement has rarely been observed. This case presents a girl with refractory nail psoriasis accompanied by periodic pustular eruption that responded well to topical treatment with indigo naturalis oil extract drops, achieving a remission of longer than 1 year. © 2012 Wiley Periodicals, Inc.

Heat profiles of laser-irradiated nails

NASA Astrophysics Data System (ADS)

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

2014-01-01

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

Investigating relations among stress, sleep and nail cortisol and DHEA.

PubMed

Doan, Stacey N; DeYoung, Gerrit; Fuller-Rowell, Thomas E; Liu, Cindy; Meyer, Jerrold

2018-03-01

In the current study, we present data investigating the relationships among stress, sleep disturbance, self-control, and levels of cortisol (CORT) and dehydroepiandrosterone (DHEA) in fingernail clippings. Currently, hair CORT is the only routinely used noninvasive, validated, biomarker of chronic exposure to stress-related hormones. Nail clippings represent an important potential alternative sample matrix for assessing chronic hormone exposure, as it offers a different timeline of hormone incorporation than scalp hair, and may be obtainable from populations in which hair either is lacking or is unavailable for cultural reasons. Moreover, there is established precedent for using fingernail clippings to attain biomarker data. However, the value of nail hormone assessment for psychological research is currently unknown due to a paucity of information on the relations between nail hormone concentrations and environmental or psychological variables. In the present study, we collected data from a low income, minority population (N = 47; 97% African American) to demonstrate feasibility and acceptability of nail collection and analysis of the adrenal steroids CORT and DHEA. Participants reported on perceived stress, sleep and self-control abilities. Correlational analyses suggest that exposure to stressful events, disturbances in sleep and waking were associated with higher levels of nail DHEA, while self-control was associated with higher levels of nail CORT. We discuss the potential importance of this methodology for investigating biological, behavioral, and subjective indices of stress and well-being.

Heat profiles of laser-irradiated nails.

PubMed

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

2014-01-01

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

Neurovascular Structures at Risk With Curved Retrograde TTC Fusion Nails.

PubMed

de Cesar Netto, Cesar; Johannesmeyer, David; Cone, Brent; Araoye, Ibukunoluwa; Hudson, Parke William; Sahranavard, Bahman; Johnson, Michael; Shah, Ashish

2017-10-01

The purpose of this study was to assess the risk of iatrogenic injury to plantar neurovascular structures of the foot during insertion of a curved retrograde tibiotalocalcaneal (TTC) fusion nail. Ten below-knee thawed fresh-frozen cadaveric specimens underwent curved retrograde nailing of the ankle. The shortest distance between the nail and the main plantar neurovascular branches and injured structures were recorded during dissection. We also evaluated the relative position of these structures along 2 lines (AB, connecting the calcaneus to the first metatarsal, and BC, connecting the first and fifth metatarsal). The lateral plantar artery was found to be in direct contact with the nail 70% of the time, with a macroscopic laceration 30% of the time. The Baxter nerve was injured 20% of the time, as was the lateral plantar nerve. The medial plantar artery and nerve were never injured. The most proximal structure to cross line AB was the Baxter nerve followed by the lateral plantar artery, the nail, the lateral plantar nerve, and the medial plantar nerve. Our cadaveric anatomic study found that the most common structures at risk for iatrogenic injury by lateral curved retrograde TTC fusion nails were the lateral plantar artery and nerve, and the Baxter nerve. Determination of a true neurovascular safe zone is challenging and therefore warrants careful operative dissection to minimize neurovascular injuries.

[Intramedullary nailing of the distal tibia illustrated with the Expert(TM) tibia nail].

PubMed

El Attal, R; Hansen, M; Rosenberger, R; Smekal, V; Rommens, P M; Blauth, M

2011-12-01

Restoration of axis, length, and rotation of the lower leg. Sufficient primary stability of the osteosynthesis for functional aftercare and to maintain joint mobility. Good bony healing in closed and open fractures. Closed and open fractures of the tibia and complete lower leg fractures distal to the isthmus (AO 42), extraarticular fractures of the distal tibia (AO 43 A1/A2/A3), segmental fractures of the tibia with a fracture in the distal tibia, and certain intraarticular fractures of the distal tibia without impression of the joint line with the use of additional implants (AO 43 C1) Patient in reduced general condition (e.g., bed ridden), flexion of the knee of less than 90°, patients with knee arthroplasty of the affected leg, infection in the area of the nail's insertion, infection of the tibial cavity, complex articular fractures of the proximal or distal tibia with joint depression. Closed reduction of the fracture preferably on a fracture table or using a distractor or an external fixation frame. If necessary, use pointed reduction clamps or sterile drapery. In some cases, additional implants like percutaneous small fragment screws, poller screws or k-wires are helpful. Open reduction is rarely necessary and must be avoided. Opening of the proximal tibia in line with the medullary canal. Canulated insertion of the Expert(TM) tibia nail (ETN; Synthes GmbH, Oberdorf, Switzerland) with reaming of the medullary canal. Control of axis, length, and rotation. Distal interlocking with the radiolucent drill and proximal interlocking with the targeting device. Immediate mobilization of ankle and knee joint. Mobilization with 20 kg weight-bearing with crutches. X-ray control 6 weeks postoperatively and increased weight-bearing depending on the fracture status. In cases with simple fractures, good bony contact, or transverse fracture pattern, full weight-bearing at the end of week 6 is targeted. Between July 2004 and May 2005, 180 patients were included in a multicenter study. The follow-up rate was 81% after 1 year. Of these, 91 fractures (50.6%) were located in the distal third of the tibia. In this segment, the rate of delayed union was 10.6%. Malalignment of > 5° was observed in 5.4%. A secondary malalignment after initial good reduction was detected in only 1.1% of all cases. The implant-specific risk for screw breakage was 3.2%. One patient sustained a deep infection. If additional fibula plating was performed an 8-fold higher risk for delayed bone healing was observed (95%CI: 2.9-21.2, p< 0.001). If the fracture of the fibula was at the same height as on the tibia, the risk for delayed healing was even 14-fold (95% CI: 3.4-62.5, p< 0.001). Biomechanically plating of the fibula does not increase stability in suprasyndesmal distal tibia-fibular fractures treated with an intramedullary nail. Using the ETN with its optimized locking options, fibula plating is not recommended, thus, avoiding soft tissue problems and potentially delayed bone healing.

[Intramedullary nailing of the tibia with the expert tibia nail].

PubMed

Hansen, Matthias; El Attal, René; Blum, Jochen; Blauth, Michael; Rommens, Pol Maria

2009-12-01

Restoration of axis, length, and rotation of the lower leg. Sufficient primary stability of the osteosynthesis for functional aftercare. Early functional aftercare to maintain joint mobility. Good bony healing in closed and open fractures. All closed and open fractures of the tibia and complete lower leg fractures (AO 42). Certain extraarticular fractures of the proximal and distal tibia (AO 41 A2/A3; AO 43 A1/A2/A3). Segmental fractures of the tibia. Certain intraarticular fractures of the tibia with use of additional implants (AO 41 C1/C2; AO 43 C1/C2). Stabilization during and after segmental bone transport or callus distraction of the tibia. Patients in poor general condition (e.g., bedridden). Flexion of the knee of less than 90 degrees . Infection in the nail's insertion area. Infection of the tibial cavity. Complex articular fractures of the proximal or distal tibia with joint depression. Closed reduction of the fracture. If necessary, use of reduction clamps through additional stab incisions or open surgical procedures. In some cases, additional osteosynthesis procedures are necessary (e.g., screws). Positioning of the patient may be performed on a radiolucent table or a traction table. Opening of the proximal tibia in line with the medullary canal. Cannulated or noncannulated insertion of the Expert Tibia Nail((R)) with or without reaming of the medullary canal depending on the fracture type and soft-tissue condition. Control of axis, length, and rotation. Distal interlocking with the radiolucent drill and proximal interlocking with the targeting device. Immediate mobilization of ankle joint and knee joint. Depending on the type of fracture, mobilization with 20 kg partial weight bearing or pain-dependent full weight bearing with crutches. X-ray control 6 weeks postoperatively and increased weight bearing depending on the fracture status. In a prospective, international multicentric study, 181 patients with 186 fractures were included between July 2004 and May 2005. 57 of these fractures (30.7%) initially were graded open, 15 of them grade I, 32 grade II, and ten grade III. Most of the fractures (36%) were shaft fractures. After 1 year, 146 patients (81%) could be evaluated clinically and radiologically. The overall pseudarthrosis rate was 12.2% (18.2% for open and 9.7% for closed fractures). The risk for secondary operations or revisions (including dynamization of the nail) was 18.8%. Without consideration of dynamization procedures, revisions were necessary in only 5.4% of all patients. The risk for varus, valgus or antecurvation malalignment of more than 5 degrees in any plane on radiologic long leg views was 4.3% for shaft fractures, 1.5% for distal fractures, and 13.6% for proximal fractures. The implant-specific risk for bolt breakage was 3.2%.

75 FR 61132 - Certain Steel Nails from the People's Republic of China: Initiation of Antidumping Duty New...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

...), the Department received a NSR request from Shanghai Colour Nail Co., Ltd. (``Shanghai Colour''). Shanghai Colour's request was properly made during August 2010, which is the annual anniversary of the Antidumping Duty Order. Shanghai Colour certified that it is the exporter and Wuxi Colour Nail Co., Ltd...

The Hammer-and-Nail Phenomenon in Mathematics Education

ERIC Educational Resources Information Center

Lim, Kien H.

2012-01-01

This paper uses the hammer-and-nail metaphor to highlight the rigidity and impulsiveness that can be found in student mathematical behaviour. The hammer-and-nail phenomenon can be attributed to two plausible causes: (1) the way the human mind works; and (2) the way mathematics is traditionally taught in school. In this paper, the following aspects…

Ectodermal Dysplasia with Anodontia: A Report of Two Cases

PubMed Central

Bani, Mehmet; Tezkirecioglu, Ali Melih; Akal, Nese; Tuzuner, Tamer

2010-01-01

Ectodermal dysplasia is a hereditary disorder that occurs as a consequence of disturbances in the ectoderm of the developing embryo. The triad of nail dystrophy, alopecia or hypotrichosis and palmoplantar hyperkeratosis is usually accompanied by a lack of sweat glands and a partial or complete absence of primary and/or permanent dentition. Two case reports illustrating the prosthetic rehabilitation of 2 young boys with anhidrotic ectodermal dysplasia associated with severe anodontia are presented. Since the oral rehabilitation of these cases is often difficult; particularly in pediatric patients, treatment should be administered by a multidisciplinary team involving pediatric dentistry, orthodontics, prosthodontics and oral-maxillofacial surgery. PMID:20396456

Focal osteolysis at the junctions of a modular stainless-steel femoral intramedullary nail.

PubMed

Jones, D M; Marsh, J L; Nepola, J V; Jacobs, J J; Skipor, A K; Urban, R M; Gilbert, J L; Buckwalter, J A

2001-04-01

During routine follow-up of patients treated with a three-piece stainless-steel modular femoral nail, osteolysis and periosteal reaction around the modular junctions of some of the nails were noted on radiographs. The purpose of this study was to evaluate the prevalence, etiology, and clinical relevance of these radiographic findings. Forty-four femoral fractures or nonunions in forty-two patients were treated with a modular stainless-steel femoral intramedullary nail. Seventeen nails were excluded, leaving twenty-seven intramedullary nails in twenty-seven patients for this study. All patients had had a femoral diaphyseal fracture; nineteen had had an acute fracture and eight, a nonunion. These twenty-seven patients returned for radiographs, a physical examination, assessment of functional outcomes, assessment of thigh pain with a visual analog scale, determination of serum chromium levels, and nail removal if desired. A control group of sixteen patients treated with a one-piece stainless-steel femoral intramedullary nail was evaluated with use of the same outcome measures and was compared with the group treated with the modular femoral nail with regard to prevalence of thigh pain and serum chromium levels. Twelve modular femoral nails were removed according to the study protocol. The modular nail junctions were analyzed for corrosion products, and histopathologic analysis of tissue specimens from the femoral canal was performed. The twenty-seven patients were seen at a mean of twenty-one months after fracture fixation; twenty-six of the twenty-seven fractures healed. Twenty-three femora had at least one of three types of abnormalities-osteolysis, periosteal reaction, or cortical thickening--localized to one or both modular junctions. Eighteen patients had severe reactions, defined as osteolysis of > or =2 mm, cortical thickening of > or =5 mm, and/or a periosteal reaction (group 1). Nine patients had mild or no reactions (group 2). Serum chromium levels in group 1 (mean, 1.27 ng/ mL; range, 0.34 to 3.12 ng/mL) were twice as high as those in group 2 (mean, 0.53 ng/mL; range, 0.12 to 1.26 ng/mL). However, this difference did not reach significance with the numbers available. The differences in serum chromium levels between group 1 and the control group with a one-piece nail (mean, 0.26 ng/mL; range, 0.015 to 1.25 ng/mL) (p<0.01) and a control group without an implant (mean, 0.05 ng/mL; range, 0.015 to 0.25 ng/ mL) (p<0.01) were significant. The level of thigh pain recorded on the visual analog scale was also significantly different between group 1 and the control group with a one-piece implant (p = 0.03). Retrieved modular nails had signs of fretting corrosion as well as stainless-steel corrosion products adherent to the junction where the osteolysis occurred. Histologic and spectrographic analysis revealed two types of corrosion products that were consistent with stainless-steel within the peri-implant tissue and were associated with a foreign-body granulomatous response. The presence of corrosion products at the taper junctions suggests that particulate debris was a major factor in the etiology of the radiographic findings of osteolysis, periosteal reaction, and cortical thickening. Serum chromium levels were substantially elevated in the patients with a modular femoral nail, and such levels may serve as a marker of fretting corrosion of these devices.

Modification of elastic stable intramedullary nailing with a 3rd nail in a femoral spiral fracture model - results of biomechanical testing and a prospective clinical study.

PubMed

Kaiser, Martin M; Stratmann, Christine; Zachert, Gregor; Schulze-Hessing, Maaike; Gros, Nina; Eggert, Rebecca; Rapp, Marion

2014-01-08

Elastic stable intramedullary nailing (ESIN) is the standard treatment for displaced diaphyseal femoral fractures in children. However, high complication rates (10-50%) are reported in complex fractures. This biomechanical study compares the stiffness with a 3rd nail implanted to that in the classical 2C-shaped configuration and presents the application into clinical practice. For each of the 3 configurations of ESIN-osteosynthesis with titanium nails eight composite femoral grafts (Sawbones®) with an identical spiral fracture were used: 2C configuration (2C-shaped nails, 2 × 3.5 mm), 3CM configuration (3rd nail from medial) and 3CL configuration (3rd nail from lateral). Each group underwent biomechanical testing in 4-point bending, internal/external rotation and axial compression. 2C and 3CM configurations showed no significant differences in this spiroid type fracture model. 3CL had a significantly higher stiffness during anterior-posterior bending, internal rotation and 9° compression than 2C, and was stiffer in the lateral-medial direction than 3CM. The 3CL was less stable during p-a bending and external rotation than both the others. As biomechanical testing showed a higher stability for the 3CL configuration in two (a-p corresponding to recurvation and 9° compression to shortening) of three directions associated with the most important clinical problems, we added a 3rd nail in ESIN-osteosynthesis for femoral fractures. 11 boys and 6 girls (2.5-15 years) were treated with modified ESIN of whom 12 were '3CL'; due to the individual character of the fractures 4 patients were treated with '3CM' (third nail from medial) and as an exception 1 adolescent with 4 nails and one boy with plate osteosynthesis. No additional stabilizations or re-operations were necessary. All patients achieved full points in the Harris-Score at follow-up; no limb length discrepancy occurred. The 3CL configuration provided a significantly higher stiffness than 2C and 3CM configurations in this biomechanical model. These results were successfully transmitted into clinical practice. All children, treated by 3CL or 3CM according to the individual character of each fracture, needed no additional stabilization and had no Re-Do operations. As a consequence, at our hospital all children with femoral diaphyseal fractures with open physis are treated with this modified ESIN-technique.

Complications of the Intramedullary Skeletal Kinetic Distractor (ISKD) in distraction osteogenesis.

PubMed

Lee, Dong Hoon; Ryu, Keun Jung; Song, Hae Ryong; Han, Soo-Hong

2014-12-01

The Intramedullary Skeletal Kinetic Distractor (ISKD) (Orthofix Inc, Lewisville, TX, USA) is an intramedullary device designed for more comfortable limb lengthening than that with external fixators; lengthening is achieved with this nail using rotational oscillation between two telescoping sections. However, the degree to which this device achieves this goal and its complication rate have not been fully documented. We determined (1) the frequency with which distraction was not achieved at the desired rate, (2) whether pain differed between patients with normally and abnormally distracting nails, (3) risk factors for abnormal nails, and (4) other complications. We analyzed 35 lengthening segments (26 femurs, nine tibias) in 19 patients. Mean length achieved was 47 mm. Femoral nails were categorized into four groups according to distraction rate: normal, runaway (unintentionally faster rate [> 1.5 mm/day]), difficult-to-distract (slower rate [< 0.8 mm/day] requiring manual manipulation but not requiring general anesthesia), and nondistracting (slower rate [< 0.8 mm/day] requiring manual manipulation under general anesthesia or reosteotomy). Possible risk factors, including age, BMI, preoperative thigh circumferences, degree of intramedullary overreaming, and length of the thicker portion of the nail within the distal fragment, were compared among groups. VAS pain scores were compared among groups under three conditions: rest, physiotherapy, and distraction motion. Complications were also analyzed. Minimum followup was 15 months (mean, 26 months; range, 15-38 months) after first-stage surgery. Abnormal distraction rate was observed in 21 of 35 segments (60%; 17 femurs, four tibias). VAS pain scores showed no differences among groups during rest or physiotherapy but were higher (p = 0.02) in the problematic nails (7-8 points) versus normal nails (3 points) during distraction. Only mean length of the thicker portion of the nail within the distal fragment differed between normally and abnormally distracting nails (95 mm versus 100 mm; p = 0.03), although this was unlikely to be clinically important. Complications occurred in 10 patients (53%), including five with decreased ankle ROM during distraction, four with delayed bone healing, and one with mechanical device failure during distraction. Rate control was difficult to achieve with the ISKD nail for femoral and tibial lengthenings, complications were relatively common, and among patients in whom rate control was not achieved, pain levels were high. Based on our findings, we believe that surgeons should avoid use of this nail. Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

Knee arthodesis using a modular customized intramedullary nail.

PubMed

Letartre, R; Combes, A; Autissier, G; Bonnevialle, N; Gougeon, F

2009-11-01

Arthrodesis of the knee, particularly in infectious situations, can be achieved using either an external fixator or an intramedullary device. The objective of this study is to report the clinical, functional, and radiographic outcomes of a continuous series of 19 cases of knee arthrodesis using a customized modular intramedullary nailing system. The modular intramedullary nail offers a satisfactory functional result while maintaining limb length, in spite of a nonunion risk, since acting like a true endoprosthesis. In our retrospective series of 19 patients, the main source of patients were infected total knee replacements. The nail was customized from assembling a dual surface-sanded titanium component (femoral and tibial). The Lequesne Algofunctional score and the WOMAC score were recorded, as well as the length discrepancy between the lower extremities. Arthrodesis consolidation and the nail's fit in the shaft were verified on anterior-posterior (AP) and lateral radiographs. Five complications were observed: one anterior cortical break, one excessive tibial rotation, two cases of delayed union, and one nail revision due to residual nail instability. The postoperative Lequesne Algofunctional score was 13/24 and the WOMAC score 57/100. The nonunion rate was 32%. From a functional point of view, the patients who did not achieve complete union and those who did had similar scores. The subjective results were not as good in patients who did not achieve final consolidation. Modular intramedullary nailing simplifies the technique, shortens the procedure, and reduces the amount of blood loss at surgery. Our nonunion rate was high, although the functional result did not seem compromised by such nonunion. The risk of long-term implant failure was not studied and requires longer follow-up studies. Level IV therapeutic study. 2009 Published by Elsevier Masson SAS.

A Fast, Accurate and Easy to Implement Method for Pose Recognition of an Intramedullary Nail using a Tracked C-arm

NASA Astrophysics Data System (ADS)

Esfandiari, H.; Amiri, S.; Lichti, D. D.; Anglin, C.

2014-06-01

A C-arm is a mobile X-ray device that is frequently used during orthopaedic surgeries. It consists of a semi-circular, arc-shaped arm that holds an X-ray transmitter at one end and an X-ray detector at the other. Intramedullary nail (IM nail) fixation is a popular orthopaedic surgery in which a metallic rod is placed into the patient's fractured bone (femur or tibia) and fixed using metal screws. The main challenge of IM-nail fixation surgery is to achieve the X-ray shot in which the distal holes of the IM nail appear as circles (desired view) so that the surgeon can easily insert the screws. Although C-arm X-ray devices are routinely used in IM-nail fixation surgeries, the surgeons or radiation technologists (rad-techs) usually use it in a trial-and-error manner. This method raises both radiation exposure and surgery time. In this study, we have designed and developed an IM-nail distal locking navigation technique that leads to more accurate and faster screw placement with a lower radiation dose and a minimum number of added steps to the operation to make it more accepted within the orthopaedic community. The specific purpose of this study was to develop and validate an automated technique for identifying the current pose of the IM nail relative to the C-arm. An accuracy assessment was performed to test the reliability of the navigation results. Translational accuracy was demonstrated to be better than 1 mm, roll and pitch rotations better than 2° and yaw rotational accuracy better than 2-5° depending on the separate angle. Computation time was less than 3.5 seconds.

[Results of femoral lengthening over an intramedullary nail and external fixator].

PubMed

Jasiewicz, Barbara; Kacki, Wojciech; Tesiorowski, Maciej; Potaczek, Tomasz

2008-01-01

Current techniques of operative limb lengthening usually are based on distraction osteogenesis. One of the techniques is limb lengthening over an intramedullary nail. The goal of this study is to evaluate the results of femoral lengthening over an intramedullary nail. Between 1999 and 200619 femoral "over nail" lengthenings were performed. There were 7 males and 12 females. Mean patients' age at surgery was 15.8 years, and mean initial femoral shortening was 5.1 cm. Operative technique consisted of one-stage implantation of intramedullary nail and external fixator. Ilizarov apparatus was used in 9 patients, monolateral fixator in 10 cases--ORTHOFIX in 9 patients, Wagner fixator--in 1 patient. Intramedullary nail was locked proximally with screws or Schanz pins from external fixator. After distraction phase, external fixator was removed and distal locking screws were applied. Evaluation criteria: obtained lengthening, time of external fixator, treatment time, healing index, external fixation index, range of motion in hip and knee joints and complications according to Paley. The mean lengthening was 4.6 cm, and mean distraction time was 66.6 days. Mean time of external fixation was 115.5 days, and external fixation index was 26.2 days for centimeter. Healing index was 36.9 days for centimeter. In cases with monolateral fixator, healing index did not differ with the whole group. During treatment 18 complications occurred, for a rate of 0.9 complication per segment. Lengthening over an intramedullary nail reduces the time of external fixator. Over nail femoral lengthening can prevent axis deviation following regenerate bending. Complication rate is similar to lengthenings with the classic Ilizarov technique. There are no differences in the treatment time in relation to the type of external fixator.

Surgical Results of the Cephalomedullary Nail for the Femoral Intertrochanteric Fracture: Comparison between Non-experienced Surgeons and Experienced Surgeon

PubMed Central

Seo, Jae-Seong; Min, Hak-Jin; Kim, Dong Min; Oh, Seung-Min

2016-01-01

Purpose Cephalomedullary nail (CM nail) in the treatment of femoral intertrochanteric fractures is in the lime light in recent years. The purpose of this study is to compare surgical outcomes between experienced surgeon and non-experienced surgeons in respect of CM nail for femoral intertrochanteric fractures. Materials and Methods The 129 patients underwent CM nail for femoral intertrochanteric fracture more than six months of follow-up from April 2011 to March 2014 in Seoul Medical Center (Seoul, Korea) were participated in this study. For this study, group A consisted of experienced surgeons who performed more than 500 times of CM nail, and group B consisted of non-experienced surgeons who performed less than 50 times of CM nail. Clinical and radiologic outcomes, complications and the need for reoperation between both groups were compared in the study. Results According to clinical result, both the mean operation time and transfusion volume were significantly longer and greater in group B (P<0.05). In the radiologic outcomes, adequacy of reduction, tip-apex distance and numbers of case placed in the Cleveland zones 5, 6 and 8; there was no statistical difference between both groups. Moreover, rate of complication and reoperation had same results as radiologic outcomes. Conclusion There was no significant difference with statistical data in complications from CM nail for femoral intertrochanteric fractures between experienced surgeon and non-experienced surgeon. Although the operation time and transfusion volume were significantly longer and greater in the case of operation by non-experienced surgeon, satisfactory performance was seen in the complications and the need for reoperation. PMID:28097112

[Intramedullary nailing in diaphyseal clavicle fractures using minimally invasive percutaneous reduction].

PubMed

Müller, M; Freude, T; Stöckle, U; Kraus, T M

2017-02-01

Closed reduction and intramedullary nailing is common in diaphyseal clavicle fractures. The aim of this report is to demonstrate a surgical method with minimally invasive percutaneous reduction in cases where closed reduction fails. The procedure is associated with good cosmetic results. Percutaneous reduction using two reduction forceps enables intramedullary nailing without an open procedure. Open, multifragmented or non-dislocated fractures, oblique fractures due to postoperative dislocation or shortening risk, fracture having potential to become compound fractures, neurovascular complications, pseudoarthroses. The patient is in beach-chair position. After an incision, the nail is entered from medial, two reduction forceps are mounted percutaneously at the lateral and medial fragment. After reduction the nail is pushed forward into the lateral fragment. Thereby, the fracture hematoma is not disturbed for the most part. Early functional rehabilitation with maximal abduction and anteversion of 90° for 6 weeks. Anatomic reduction can be achieved with mild cosmetic impairment.

Invasive onychocytic carcinoma.

PubMed

Wang, Lei; Gao, Tianwen; Wang, Gang

2015-05-01

Neoplasms originating from nail matrix keratinocytes are very rare. Onychomatricoma and onychocytic matricoma are benign tumors arising from nail matrix keratinocytes. Only one case of onychocytic carcinoma, the malignant counterpart of onychocytic matricoma, has been reported in the literature. Herein, we describe a case of invasive onychocytic carcinoma. Two biopsy specimens of the tumor, obtained at early and invasive stages, were examined histopathologically. The first biopsy specimen showed a retiform proliferation of eosinophilic and basophilic cells in the nail matrix. The second biopsy specimen showed a retiform basophilic cell proliferation with focal keratinization. Similar to normal nail matrix keratinocytes, the proliferating basophilic cells failed to express cytokeratin (CK)1, CK6 and CK10. Focal expression of hair-specific keratins, including K31, K85 and K86, was observed. On the basis of these findings, the tumor was identified as an invasive malignant tumor originating from nail matrix keratinocytes. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Refractures of the paediatric forearm with the intramedullary nail in situ.

PubMed

van Egmond, Pim W; van der Sluijs, Hans A; van Royen, Barend J; Saouti, Rachid

2013-09-24

Forearm fractures in children are common. When conservative treatment fails, internal fixation with Elastic Stable Intramedullary Nailing (ESIN) become the first choice in the operative treatment of diaphyseal forearm shaft fractures. Refractures with the intramedullary nail in situ are known to occur but formal guidelines to guide management in such fractures are lacking. We present a well-documented case of a radius midshaft refracture in a 12-year-old boy with the intramedullary nail in situ, managed by closed reduction. Literature is reviewed for this type of complication, the treatment of 30 similar cases is discussed and a treatment strategy is defined. The refracture of the paediatric forearm fracture with the intramedullary nail in situ is a rare, but probably under recognised complication which is observed in approximately 2.3% of the study population. Closed reduction may be considered in these cases.

First Partial Skeleton of a 1.34-Million-Year-Old Paranthropus boisei from Bed II, Olduvai Gorge, Tanzania

PubMed Central

Domínguez-Rodrigo, Manuel; Pickering, Travis Rayne; Baquedano, Enrique; Mabulla, Audax; Mark, Darren F.; Musiba, Charles; Bunn, Henry T.; Uribelarrea, David; Smith, Victoria; Diez-Martin, Fernando; Pérez-González, Alfredo; Sánchez, Policarpo; Santonja, Manuel; Barboni, Doris; Gidna, Agness; Ashley, Gail; Yravedra, José; Heaton, Jason L.; Arriaza, Maria Carmen

2013-01-01

Recent excavations in Level 4 at BK (Bed II, Olduvai Gorge, Tanzania) have yielded nine hominin teeth, a distal humerus fragment, a proximal radius with much of its shaft, a femur shaft, and a tibia shaft fragment (cataloged collectively as OH 80). Those elements identified more specifically than to simply Hominidae gen. et sp. indet are attributed to Paranthropus boisei. Before this study, incontrovertible P. boisei partial skeletons, for which postcranial remains occurred in association with taxonomically diagnostic craniodental remains, were unknown. Thus, OH 80 stands as the first unambiguous, dentally associated Paranthropus partial skeleton from East Africa. The morphology and size of its constituent parts suggest that the fossils derived from an extremely robust individual who, at 1.338±0.024 Ma (1 sigma), represents one of the most recent occurrences of Paranthropus before its extinction in East Africa. PMID:24339873

Power partial-discard strategy to obtain improved performance for simulated moving bed chromatography.

PubMed

Chung, Ji-Woo; Kim, Kyung-Min; Yoon, Tae-Ung; Kim, Seung-Ik; Jung, Tae-Sung; Han, Sang-Sup; Bae, Youn-Sang

2017-12-22

A novel power partial-discard (PPD) strategy was developed as a variant of the partial-discard (PD) operation to further improve the separation performance of the simulated moving bed (SMB) process. The PPD operation varied the flow rates of discard streams by introducing a new variable, the discard amount (DA) as well as varying the reported variable, discard length (DL), while the conventional PD used fixed discard flow rates. The PPD operations showed significantly improved purities in spite of losses in recoveries. Remarkably, the PPD operation could provide more enhanced purity for a given recovery or more enhanced recovery for a given purity than the PD operation. The two variables, DA and DL, in the PPD operation played a key role in achieving the desired purity and recovery. The PPD operations will be useful for attaining high-purity products with reasonable recoveries. Copyright © 2017 Elsevier B.V. All rights reserved.

Infant Sleep Location and Breastfeeding Practices in the United States, 2011-2014.

PubMed

Smith, Lauren A; Geller, Nicole L; Kellams, Ann L; Colson, Eve R; Rybin, Denis V; Heeren, Timothy; Corwin, Michael J

2016-08-01

To describe the prevalence of breastfeeding and sleep location practices among US mothers and the factors associated with these behaviors, including advice received regarding these practices. A nationally representative sample of 3218 mothers who spoke English or Spanish were enrolled at a sample of 32 US birth hospitals between January 2011 and March 2014. Exclusive breastfeeding was reported by 30.5% of mothers, while an additional 29.5% reported partial breastfeeding. The majority of mothers, 65.5%, reported usually room sharing without bed sharing, while 20.7% reported bed sharing. Compared to mothers who room shared without bed sharing, mothers who bed shared were more likely to report exclusive breastfeeding (adjusted odds ratio 2.46, 95% confidence interval 1.76, 3.45) or partial breastfeeding (adjusted odds ratio 1.75, 95% confidence interval 1.33, 2.31). The majority of mothers reported usually room sharing without bed sharing regardless of feeding practices, including 58.2% of exclusively breastfeeding mothers and 70.0% of nonbreastfeeding mothers. Receiving advice regarding sleep location or breastfeeding increased adherence to recommendations in a dose response manner (the adjusted odds of room sharing without bed sharing and exclusive breastfeeding increased as the relevant advice score increased); however, receiving advice regarding sleep location did not affect feeding practices. Many mothers have not adopted the recommended infant sleep location or feeding practices. Receiving advice from multiple sources appears to promote adherence in a dose response manner. Many women are able to both breastfeed and room share without bed sharing, and advice to adhere to both of these recommendations did not decrease breastfeeding rates. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

76 FR 30101 - Certain Steel Nails From the People's Republic of China: Final Results of Antidumping Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... shaft length up to 12 inches. Certain steel nails include, but are not limited to, nails made of round... finishes, heads, shanks, point types, shaft lengths and shaft diameters. Finishes include, but are not... collated with adhesive or polyester film tape backed with a heat seal adhesive. Also excluded from the...

Mechanical Performance of Nail-Laminated Posts Manufactured from Reclaimed Chromated Copper Arsenate-Treated Decking Lumber

Treesearch

John J. Janowiak; Robert H. Falk; Brad A. Gething; John A. Tsirigotis

2014-01-01

This study determined the mechanical properties of nail-laminated (nail-lam) posts manufactured from reclaimed chromated copper arsenate (CCA)–treated decking lumber. Though CCA-treated lumber is no longer accepted for use in residential applications, it is permitted in agricultural and industrial applications where health and environmental impacts are deemed to be...

Case reports: A subtrochanteric femur fracture with long intramedullary femorotibial nail for knee arthrodesis.

PubMed

Torga-Spak, Roger; Gugala, Zbigniew; Lindsey, Ronald W

2006-03-01

We present a case report of a patient who had a transverse subtrochanteric femur fracture develop 2 months after uneventful placement of a long femorotibial intramedullary nail for knee arthrodesis. To date, diaphyseal fracture of a femur already stabilized with an intramedullary nail has not been reported. The possible etiology for this unusual complication is discussed.

Attic Retrofits Using Nail-Base Insulated Panels

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mallay, David; Kochkin, Vladimir

This project developed and demonstrated a roof/attic energy retrofit solution using nail-base insulated panels for existing homes where traditional attic insulation approaches are not effective or feasible. Nail-base insulated panels (retrofit panels) consist of rigid foam insulation laminated to one face of a wood structural panel. The prefabricated panels are installed above the existing roof deck during a reroofing effort.

[Tibio-talo-calcaneal arthrodesis by retrograde intramedullary nail--a case report].

PubMed

Lipiński, Łukasz; Synder, Marek; Sibiński, Marcin

2011-01-01

We described a case of 64 year old overweight women, who was treated with revision tibio-talo-calcaneal artrodesis with the use of retrograde intramedullary nail. The procedure was performed after failed primary arthrodesis with the use of lateral approach and fibula osteotomy. Stabilization with intramedullary nail gave good clinical and functional result with a good bone healing.

A Randomized Controlled Trial of a Novel Self-Help Technique for Impulse Control Disorders: A Study on Nail-Biting

ERIC Educational Resources Information Center

Moritz, Steffen; Treszl, Andras; Rufer, Michael

2011-01-01

Nail-biting is currently classified as an impulse control disorder not otherwise specified. Although seldom targeted as a primary symptom, nail-biting is often associated with somatic complications and decreased quality of life. The present study assessed the effectiveness of an innovative self-help technique, titled decoupling (DC). DC aims at…

Knee arthrodesis with the Wichita fusion nail.

PubMed

Domingo, L J; Caballero, M J; Cuenca, J; Herrera, A; Sola, A; Herrero, L

2004-02-01

We reviewed 32 patients who all had knee arthrodesis performed after failed knee replacement. The minimum clinical follow-up was 1 year. The arthrodesis was performed by means of the Wichita fusion nail in 11, by external fixation in 15 cases, by plating in three and by intramedullary nailing in three. The mean patient age was 68.6 years. When the Wichita nail was used, fusion was achieved in ten out of 11 cases after a mean period of 4.5 (3-7) months. Of the remaining 21 patients, fusion was only achieved in 11 cases after a mean period of 6.5 (4.5-10) months.

[Onychocola canadensis Sigler in onychomycosis : A new dermatophyte-like mould in Germany].

PubMed

Nenoff, P; Schorlemmer, B; Uhrlaß, S; Baunacke, A; Baunacke, A; Friedrichs, C; Iffländer, J; Syhre, E; Schneider, A; Krüger, C; Maier, T

2016-09-01

Moulds or non-dermatophyte moulds (NDM) are being increasingly isolated as causative agent of onychomycoses. Known causes of a NDM-OM are Scopulariopsis brevicaulis, Fusarium, Aspergillus, Acremonium, Neoscytalidium dimidiatum, Arthrographis kalrae, and Chaetomium. In this article, 5 patients with suspected nail infection due to Onychocola canadensis are reported for the first time in Germany. Systemic antifungal agents are not considered to be effective in NDM onychomycosis. In individual cases, however, terbinafine seems to be effective in Onychocola canadensis infection of the nails. Treatment of choice represents, however, nontraumatic nail avulsion using 40 % urea ointment followed by antifungal nail lacquer with ciclopirox olamine or amorolfine.

Allergic contact dermatitis from sculptured acrylic nails: special presentation with an airborne pattern

PubMed Central

Maio, Paula; Carvalho, Rodrigo; Amaro, Cristina; Santos, Raquel; Cardoso, Jorge

2012-01-01

Methylmethacrylate was first reported in 1941 as a cause of contact dermatitis. Since then, occupational contact allergies to acrylates in dentistry, orthopedic surgery, printing industry and industry have been reported, but few reports are found in the literature as a consequence of the contact with sculptured artificial acrylic nails which are increasingly popular. We describe here 3 patients with contact allergy to acrylates in artificial sculptured nails. Patch tests were performed with the Portuguese baseline series of contact allergens and an extended series of acrylates were applied. In particular, we tested three female patients with allergic contact dermatitis from sculptured acrylic nails. Two of these patients were both customers and also technical nail beauticians. Two patients developed periungual eczema; one presented only with face and eyelid dermatitis had no other lesions. The tests showed positive reaction to 2-hydroxyethylmethacrylate (2-HEMA) and 2-hydroxypropylmethacrylate (2-HPMA) in all the three patients. Our cases demonstrate the variety of clinical presentations of allergic contact dermatitis from acrylic sculptured nails. They show the need to warn patients of persistent and sometimes permanent side effects of these products. They also emphasize the importance of cosmetic ingredient labeling. PMID:25386316

Biomechanical Testing of a 3-Hole versus a 4-Hole Sliding Hip Screw in the presence of a Retrograde Intramedullary Nail for Ipsilateral Intertrochanteric and Femur Shaft Fractures.

PubMed

Olsen, Michael; Goshulak, Peter; Crookshank, Meghan C; Moktar, Joel; Brazda, Ignace J; Schemitsch, Emil H; Zdero, Radovan

2018-04-03

The goal of this study was to compare a 3-hole vs. a 4-hole sliding hip screw (SHS) in the presence of a retrograde intramedullary (RIM) nail for fixing intertrochanteric and comminuted midshaft femur fractures. Mechanical tests were performed on 10 matched pairs of human cadaveric femurs that were osteotomized and then fixed using a 3-hole SHS vs. the traditional "gold standard" 4-hole SHS in the presence of a RIM nail. Data showed no differences between the 3-hole SHS with RIM nail vs. 4-hole SHS with RIM nail for stiffness (281 +/- 127 vs. 260 +/- 118 N/mm, p=0.76), clinical failure at 10 mm of hip displacement (2014 +/- 363 vs. 2134 +/- 614 N, p=0.52), or ultimate mechanical failure (3476 +/- 776 vs. 3669 +/- 755 N, p=0.12). For this fracture pattern, a 3-hole SHS with RIM nail may be a suitable surgical alternative to the traditional "gold standard" method, since it provides the same biomechanical properties while potentially reducing surgical time, blood loss, and hardware used. Level III biomechanical study.

Comparative study of nail sampling techniques in onychomycosis.

PubMed

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

2009-07-01

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

[Scabies of the nail unit in an infant].

PubMed

Finon, A; Desoubeaux, G; Nadal, M; Georgescou, G; Baran, R; Maruani, A

2017-05-01

There are no guidelines regarding the management of scabies in infants and recurrence is common at this age. We report the case of an infant with subungual hyperkeratosis and ungual lesions subsequent to classic scabies. A 7-month-girl, treated 6 weeks earlier with esdepallethrin for scabies, consulted for acquired lesions on 3 toe nails. These nails were thickened and displayed subungual hyperkeratosis. Physical examination of the skin, the finger nails and mucous membranes was otherwise normal. Fungal analyses were negative, but direct microscopic examination revealed numerous larvae of Sarcoptes scabiei as well as ovular debris. The child was treated with urea 40% to obtain chemical avulsion of the nails, and with topical esdepallethrin and a quarter tablet of ivermectin orally; there was no follow-up of the child. Ungual scabies has already been reported in crusted scabies and very rarely in classic scabies. Subungual and ungual locations of S. scabiei may constitute a source of reinfestation with scabies in infants. Treatment is not well defined and currently involves chemical avulsion of the nails and the application of topical antiscabies treatment. Copyright © 2016. Published by Elsevier Masson SAS.

Epithelium-Derived Wnt Ligands Are Essential for Maintenance of Underlying Digit Bone.

PubMed

Takeo, Makoto; Hale, Christopher S; Ito, Mayumi

2016-07-01

Clinically, many nail disorders accompany bone deformities, but whether the two defects are causally related is under debate. To investigate the potential interactions between the two tissue types, we analyzed epithelial-specific β-catenin-deficient mice, in which nail differentiation is abrogated. These mice showed regression of not only the nail plate but also of the underlying digit bone. Characterization of these bone defects revealed active bone resorption, which is suppressed by Wnt activation in osteoblast and osteoclast precursors. Furthermore, we found that Wntless expression, essential for Wnt ligand secretion, was lacking in the β-catenin-deficient nail epithelium and that genetic deletion of Wntless (Wls) in the nail epithelium led to the lack of Wnt activation in osteoblast and osteoclast precursors and subsequently led to defective regression of the underlying digit bone. Together, these data show that epithelial Wnt ligands can ultimately regulate Wnt signaling in osteoblast and osteoclast precursors, known to regulate bone homeostasis. These results reveal a critical role for the nail epithelium on the digit bone during homeostatic regeneration and show that Wnt/β-catenin signaling is critical for this interaction. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

The role of endothelium in the vasorelaxant effects of the essential oil of Ocimum gratissimum in aorta and mesenteric vascular bed of rats.

PubMed

Pires, Alana F; Madeira, Socorro V Frota; Soares, Pedro M G; Montenegro, Claudia M; Souza, Emmanuel P; Resende, Angela C; Soares de Moura, Roberto; Assreuy, Ana M S; Criddle, David N

2012-10-01

This study investigated the endothelium-dependent vasorelaxant effects of the essential oil of Ocimum gratissimum (EOOG) in aortas and mesenteric vascular beds isolated from rats. EOOG (3-300 µg/mL) relaxed the tonic contractions induced by phenylephrine (0.1 µmol/L) in isolated aortas in a concentration-dependent manner in both endothelium-containing and endothelium-denuded preparations. This effect was partially reversed by L-NAME (100 µmol/L) but not by indomethacin (10 µmol/L) or TEA (5 mmol/L). In mesenteric vascular beds, bolus injections of EOOG (30, 50, 100, and 300 ng) decreased the perfusion pressure induced by noradrenaline (6 µmol/L) in endothelium-intact preparations but not in those treated with deoxycholate. L-NAME (300 µmol/L) but not TEA (1 mmol/L) or indomethacin (3 µmol/L) significantly reduced the vasodilatory response to EOOG at all of the doses tested. Our data showed that EOOG exerts a dose-dependent vasodilatory response in the resistance blood vessels of rat mesenteric vascular beds and in the capacitance blood vessel, the rat aorta. This action is completely dependent on endothelial nitric oxide (NO) release in the mesenteric vascular beds but only partially dependent on NO in the aorta. These novel effects of EOOG highlight interesting differences between resistance and capacitance blood vessels.

Successful treatment of Raynaud's syndrome with Iloprost, a chemically stable prostacyclin analogue.

PubMed

Yardumian, D A; Isenberg, D A; Rustin, M; Belcher, G; Snaith, M L; Dowd, P M; Machin, S J

1988-06-01

Twelve female patients with severe secondary Raynaud's phenomenon were treated in a randomized order with both placebo and Iloprost infusions. Infusions were for 5 hours on 3 consecutive days and Iloprost was administered at variable dosage from 1.0 to 3.0 ng/kg/min. A 6-week follow-up period was used between the two sets of infusions. A significant number of patients reported Iloprost had improved Raynaud's symptomatology compared with placebo and this effect lasted for up to 6 weeks. The number of attacks of Raynaud's as recorded by patients in diary books was similarly reduced after Iloprost. Digital and nail-bed blood flows measured by laser-Doppler methods were increased for up to 6 weeks after Iloprost, but not after placebo infusions. Iloprost may be a useful therapeutic agent in the treatment of severe secondary Raynaud's syndrome.

Evaluation of blood microcirculation parameters by combined use of laser Doppler flowmetry and videocapillaroscopy methods

NASA Astrophysics Data System (ADS)

Volkov, M. V.; Kostrova, D. A.; Margaryants, N. B.; Gurov, I. P.; Erofeev, N. P.; Dremin, V. V.; Zharkikh, E. V.; Zherebtsov, E. A.; Kozlov, I. O.; Dunaev, A. V.

2017-03-01

Laser Doppler flowmetry (LDF) is widely used for diagnosing blood microcirculation diseases. It is well known that the Doppler shift of laser radiation scattered by moving red blood cells (RBC) can be assessed through analyzing photocurrent produced by a photodetector. LDF signal contains information about regulating blood flow rhythms: myogenic, cardiac, nervous and endothelial. The method of videocapillaroscopy (VCS) allows local capillary blood flow velocity evaluation and, using video data processing algorithms, is able to assess RBC velocity changes into capillary. We present the results of simultaneous investigations of changes in tissue perfusion of the distal phalanx of human finger by the LDF as well as changes in capillary blood flow velocity in the nail bed evaluated by the VCS method during arterial occlusion test. The experimental results confirmed the correspondence between blood perfusion and blood flow velocity.

New Described Dermatological Disorders

PubMed Central

Cevirgen Cemil, Bengu; Keseroglu, Havva Ozge; Kaya Akis, Havva

2014-01-01

Many advances in dermatology have been made in recent years. In the present review article, newly described disorders from the last six years are presented in detail. We divided these reports into different sections, including syndromes, autoinflammatory diseases, tumors, and unclassified disease. Syndromes included are “circumferential skin creases Kunze type” and “unusual type of pachyonychia congenita or a new syndrome”; autoinflammatory diseases include “chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) syndrome,” “pyoderma gangrenosum, acne, and hidradenitis suppurativa (PASH) syndrome,” and “pyogenic arthritis, pyoderma gangrenosum, acne, and hidradenitis suppurativa (PAPASH) syndrome”; tumors include “acquired reactive digital fibroma,” “onychocytic matricoma and onychocytic carcinoma,” “infundibulocystic nail bed squamous cell carcinoma,” and “acral histiocytic nodules”; unclassified disorders include “saurian papulosis,” “symmetrical acrokeratoderma,” “confetti-like macular atrophy,” and “skin spicules,” “erythema papulosa semicircularis recidivans.” PMID:25243162

Crystallization process

DOEpatents

Adler, Robert J.; Brown, William R.; Auyang, Lun; Liu, Yin-Chang; Cook, W. Jeffrey

1986-01-01

An improved crystallization process is disclosed for separating a crystallizable material and an excluded material which is at least partially excluded from the solid phase of the crystallizable material obtained upon freezing a liquid phase of the materials. The solid phase is more dense than the liquid phase, and it is separated therefrom by relative movement with the formation of a packed bed of solid phase. The packed bed is continuously formed adjacent its lower end and passed from the liquid phase into a countercurrent flow of backwash liquid. The packed bed extends through the level of the backwash liquid to provide a drained bed of solid phase adjacent its upper end which is melted by a condensing vapor.

Genetic variants in pachyonychia congenita-associated keratins increase susceptibility to tooth decay

PubMed Central

Carlson, Jenna C.; Karacz, Chelsea M.; Schwartz, Mary E.; Cross, Michael A.; Marazita, Mary L.

2018-01-01

Pachyonychia congenita (PC) is a cutaneous disorder primarily characterized by nail dystrophy and painful palmoplantar keratoderma. PC is caused by mutations in KRT6A, KRT6B, KRT6C, KRT16, and KRT17, a set of keratin genes expressed in the nail bed, palmoplantar epidermis, oral mucosal epithelium, hair follicle and sweat gland. RNA-seq analysis revealed that all PC-associated keratins (except for Krt6c that does exist in the mouse genome) are expressed in the mouse enamel organ. We further demonstrated that these keratins are produced by ameloblasts and are incorporated into mature human enamel. Using genetic and intraoral examination data from 573 adults and 449 children, we identified several missense polymorphisms in KRT6A, KRT6B and KRT6C that lead to a higher risk for dental caries. Structural analysis of teeth from a PC patient carrying a p.Asn171Lys substitution in keratin-6a (K6a) revealed disruption of enamel rod sheaths resulting in altered rod shape and distribution. Finally, this PC-associated substitution as well as more frequent caries-associated SNPs, found in two of the KRT6 genes, that result in p.Ser143Asn substitution (rs28538343 in KRT6B and rs151117600 in KRT6C), alter the assembly of K6 filaments in ameloblast-like cells. These results identify a new set of keratins involved in tooth enamel formation, distinguish novel susceptibility loci for tooth decay and reveal additional clinical features of pachyonychia congenita. PMID:29357356

Genetic variants in pachyonychia congenita-associated keratins increase susceptibility to tooth decay.

PubMed

Duverger, Olivier; Carlson, Jenna C; Karacz, Chelsea M; Schwartz, Mary E; Cross, Michael A; Marazita, Mary L; Shaffer, John R; Morasso, Maria I

2018-01-01

Pachyonychia congenita (PC) is a cutaneous disorder primarily characterized by nail dystrophy and painful palmoplantar keratoderma. PC is caused by mutations in KRT6A, KRT6B, KRT6C, KRT16, and KRT17, a set of keratin genes expressed in the nail bed, palmoplantar epidermis, oral mucosal epithelium, hair follicle and sweat gland. RNA-seq analysis revealed that all PC-associated keratins (except for Krt6c that does exist in the mouse genome) are expressed in the mouse enamel organ. We further demonstrated that these keratins are produced by ameloblasts and are incorporated into mature human enamel. Using genetic and intraoral examination data from 573 adults and 449 children, we identified several missense polymorphisms in KRT6A, KRT6B and KRT6C that lead to a higher risk for dental caries. Structural analysis of teeth from a PC patient carrying a p.Asn171Lys substitution in keratin-6a (K6a) revealed disruption of enamel rod sheaths resulting in altered rod shape and distribution. Finally, this PC-associated substitution as well as more frequent caries-associated SNPs, found in two of the KRT6 genes, that result in p.Ser143Asn substitution (rs28538343 in KRT6B and rs151117600 in KRT6C), alter the assembly of K6 filaments in ameloblast-like cells. These results identify a new set of keratins involved in tooth enamel formation, distinguish novel susceptibility loci for tooth decay and reveal additional clinical features of pachyonychia congenita.

[Residue of organic fluorine pollutants in hair and nails collected from Tianjin].

PubMed

Yao, Dan; Zhang, Hong; Chai, Zhi-Fang; Shen, Jin-Can; Yang, Bo; Wang, Yan-Ping; Liu, Guo-Qing

2013-02-01

In order to explore the residue and distributions of organic fluorine pollutants in hair and nails, the residue levels of total fluorine (TF), extractable organic fluorine (EOF) and perfluorinated chemicals (PFCs) in hair and nails collected from Tianjin adults were measured by the cyclic neutron activation analysis (CNAA) combined with the high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The results showed that inorganic fluorine (mean: 2.0 mg.kg-1, 4.5 mg.kg-1) was the primary fluorine in TF while EOF(mean: 0.7 mg.kg-1, 1.8 mg.kg-1) was minor. The average amount of identified fluorine (IF) was 0.038 mg.kg-1 in hair and 0.047 mg.kg-1 in nails, accounting or 7.1% (2.6%-16%) and 3.5% (1.1%-11%) of EOF, respectively, which indicated that more than 84% of EOF was unknown. The major residue in hair and nails were medium-and short-chain PFCs,in which perfluorooctane sulfonate, perfluorooctanoic acid and perfluorononanoic acid were the main species. TF, EOF and IF levels in dyed and permed hair were significantly higher than untreated hair (P <0.05), and the concentrations of Sigma PFCs in hair and nails showed no difference between genders. With significantly higher levels of sigma PFCs and PFOS residues than hair (P <0.01), nails could potentially become a more sensitive bioindicator for the exposure level of PFCs in human.

Attentional bias for food cues in binge eating disorder.

PubMed

Schmitz, Florian; Naumann, Eva; Trentowska, Monika; Svaldi, Jennifer

2014-09-01

The aim of the present study was to investigate an attentional bias toward food stimuli in binge eating disorder (BED). To this end, a BED and a weight-matched control group (CG) completed a clarification task and a spatial cueing paradigm. The clarification task revealed that food stimuli were faster detected than neutral stimuli, and that this difference was more pronounced in BED than in the CG. The spatial cueing paradigm indicated a stimulus engagement effect in the BED group but not in the CG, suggesting that an early locus in stimulus processing contributes to differences between BED patients and obese controls. Both groups experienced difficulty disengaging attention from food stimuli, and this effect was only descriptively larger in the BED group. The effects obtained in both paradigms were found to be correlated with reported severity of BED symptoms. Of note, this relationship was partially mediated by the arousal associated with food stimuli relative to neutral stimuli, as predicted by an account on incentive sensitization. Copyright © 2014 Elsevier Ltd. All rights reserved.

Exposure test of fasteners in preservative-treated wood

Treesearch

Samuel L. Zelinka; Douglas R. Rammer

2006-01-01

This study examined nails and screws exposed to ACQ-treated wood for up to 12 months in a controlled environment. The environment (27ºC, 100% relative humidity) was chosen so that comparisons could be made with previous exposure tests run using CCA-treated wood in the same environment. Five types of fasteners (common 8d nail, hot-dipped galvanized 8d nail, 4d aluminum...

Interlocking Nailing Versus Interlocking Plating in Intra-articular Calcaneal Fractures: A Biomechanical Study.

PubMed

Reinhardt, Sophia; Martin, Heiner; Ulmar, Benjamin; Döbele, Stefan; Zwipp, Hans; Rammelt, Stefan; Richter, Martinus; Pompach, Martin; Mittlmeier, Thomas

2016-08-01

Open reduction and internal fixation with a plate is deemed to represent the gold standard of surgical treatment for displaced intra-articular calcaneal fractures. Standard plate fixation is usually placed through an extended lateral approach with high risk for wound complications. Minimally invasive techniques might avoid wound complications but provide limited construct stability. Therefore, 2 different types of locking nails were developed to allow for minimally invasive technique with sufficient stability. The aim of this study was to quantify primary stability of minimally invasive calcaneal interlocking nail systems in comparison to a variable-angle interlocking plate. After quantitative CT analysis, a standardized Sanders type IIB fracture model was created in 21 fresh-frozen cadavers. For osteosynthesis, 2 different interlocking nail systems (C-Nail; Medin, Nov. Město n. Moravě, Czech Republic; Calcanail; FH Orthopedics SAS; Heimsbrunn, France) as well as a polyaxial interlocking plate (Rimbus; Intercus GmbH; Rudolstadt, Germany) were used. Biomechanical testing consisted of a dynamic load sequence (preload 20 N, 1000 N up to 2500 N, stepwise increase of 100 N every 100 cycles, 0.5 mm/s) and a load to failure sequence (max. load 5000 N, 0.5 mm/s). Interfragmentary movement was detected via a 3-D optical measurement system. Boehler angle was measured after osteosynthesis and after failure occurred. No significant difference regarding load to failure, stiffness, Boehler angle, or interfragmentary motion was found between the different fixation systems. A significant difference was found with the dynamic failure testing sequence where 87.5% of the Calcanail implants failed in contrast to 14% of the C-Nail group (P < .01) and 66% of the Rimbus plate. The highest load to failure was observed for the C-Nail. Boehler angle showed physiologic range with all implants before and after the biomechanical tests. Both minimally invasive interlocking nail systems displayed a high primary stability that was not inferior to an interlocking plate. Based on our results, both interlocking nails appear to represent a viable option for treating displaced intra-articular calcaneal fractures. © The Author(s) 2016.

Biomechanical comparison of blade plate and intramedullary nail fixation for tibiocalcaneal arthrodesis.

PubMed

Lee, Arthur T; Sundberg, Eric B; Lindsey, Derek P; Harris, Alex H S; Chou, Loretta B

2010-02-01

Tibiocalcaneal arthrodesis is an uncommon salvage procedure used for complex problems of the ankle and hindfoot. A biomechanical evaluation of the fixation constructs of this procedure has not been studied previously. The purpose of this study was to compare intramedullary nail to blade plate fixation in a deformity model in fatigue endurance testing and load to failure. Nine matched pairs of fresh frozen cadaveric legs underwent talectomy followed by fixation with a blade plate and 6.5-mm fully threaded cancellous screw or an ankle arthrodesis intramedullary nail. The specimens were loaded to 270 N at a rate of 3 Hz for a total of 250,000 cycles, followed by loading to failure. Intramedullary nail fixation demonstrated greater mean stiffness throughout the fatigue endurance testing, from cycles 10 through 250,000 (blade plate versus intramedullary nail; cycle 10, 93 +/- 34 N/mm versus 117 +/- 40 N/mm (t = 2.33, p = 0.04); cycle 100, 89 +/- 34 N/mm versus 118 +/- 42 N/mm (t = 3.16, p = 0.01); cycle 1000, 86 +/- 32 N/mm versus 120 +/- 45 N/mm (t = 3.52, p = 0.01); cycle 10,000, 83 +/- 36 N/mm versus 128 +/- 50 N/mm (t = 3.80, p = 0.01); cycle 100,000, 82 +/- 34 N/mm versus 126 +/- 52 N/mm (t = 3.70, p = 0.01); cycle 250,000, 80 +/- 31 N/mm versus 125 +/- 49 N/mm (t = 4.2, p = 0.003). There was no statistically significant difference between the intramedullary nail and blade plate fixation in cycle one or in load to failure; cycle 10, blade plate 70 +/- 38 N/mm and intramedullary nail 67 +/- 20 N/mm (t = 0.60, p = 0.56); load to failure, blade plate 808 +/- 193 N, IMN 1074 +/- 290 N) (p = 0.15). Intramedullary nail fixation was biomechanically superior to blade plate and screw fixation in a tibiocalcaneal arthrodesis construct. The ankle arthrodesis intramedullary nail provides greater stiffness for fixation in tibiocalcaneal arthrodesis, which may improve healing.

Biomechanical properties of a structurally optimized carbon-fibre/epoxy intramedullary nail for femoral shaft fracture fixation.

PubMed

Samiezadeh, Saeid; Fawaz, Zouheir; Bougherara, Habiba

2016-03-01

Intramedullary nails are the golden treatment option for diaphyseal fractures. However, their high stiffness can shield the surrounding bone from the natural physiologic load resulting in subsequent bone loss. Their stiff structure can also delay union by reducing compressive loads at the fracture site, thereby inhibiting secondary bone healing. Composite intramedullary nails have recently been introduced to address these drawbacks. The purpose of this study is to evaluate the mechanical properties of a previously developed composite IM nail made of carbon-fibre/epoxy whose structure was optimized based on fracture healing requirements using the selective stress shielding approach. Following manufacturing, the cross-section of the composite nail was examined under an optical microscope to find the porosity of the structure. Mechanical properties of the proposed composite intramedullary nail were determined using standard tension, compression, bending, and torsion tests. The failed specimens were then examined to obtain the modes of failure. The material showed high strength in tension (403.9±7.8MPa), compression (316.9±10.9MPa), bending (405.3±8.1MPa), and torsion (328.5±7.3MPa). Comparing the flexural modulus (41.1±0.9GPa) with the compressive modulus (10.0±0.2GPa) yielded that the material was significantly more flexible in compression than in bending. This customized flexibility along with the high torsional stiffness of the nail (70.7±2.0Nm(2)) has made it ideal as a fracture fixation device since this unique structure can stabilize the fracture while allowing for compression of fracture ends. Negligible moisture absorption (~0.5%) and low porosity of the laminate structure (< 3%) are other advantages of the proposed structure. The findings suggested that the carbon-fibre/epoxy intramedullary nail is flexible axially while being relatively rigid in bending and torsion and is strong enough in all types of physiologic loading, making it a potential candidate for use as an alternative to the conventional titanium-alloy intramedullary nails. Copyright © 2015 Elsevier Ltd. All rights reserved.

Interlocking Nailing Versus Plating in Tibial Shaft Fractures in Adults: A Comparative Study.

PubMed

Mukherjee, Sagnik; Arambam, Mahendra Singh; Waikhom, Sanjib; Santosha; Masatwar, Pranav Vitthal; Maske, Rohan Gautam

2017-04-01

Tibial diaphyseal fractures are the commonest long bone fractures in adults, most commonly managed by intramedullary interlocking nailing. However, several meta-analysis show that locking plate osteosynthesis is equally effective in managing tibial diaphyseal fractures and are associated with less number of complications. To compare the results of fixation of tibial fractures following plating and nailing in terms of union, patient satisfaction and complications. A hospital based non randomized clinical trial was performed from September 2013 to August 2016 where closed or open diaphyseal or metaphyseo- diaphyseal fractures of the tibia (closed or open Gustilo Anderson type 1 through 3B) were included. Simple sequential allocation was used for allotting the patients to two groups, one for interlocking nailing and other for plating. The patients were followed up for clinical, radiographic and functional results. Forty patients with 41 involved limbs completed follow up for one year. The duration of surgery and average blood loss during surgery was 75.45±3.03 minutes and 165.00±5.31 ml respectively in case of nailing and 85.05±2.54 minutes and184.29±5.33 ml respectively in case of plating and their difference was statistically significant. In our study union was achieved in less than 20 weeks in 29 (70.8%) of the patients and 25-30 weeks in nine (22%) cases. The average time of union in our study was 19.55±0.69 weeks in case of interlocking nailing and 20.38±1.39 weeks in case of plating and there was no statistically significant difference between the two. However, there is statistically significant difference in the functional score in between the two groups in terms of Lower Extremity Functional Score (LEFS). Delayed union in one case of nailing and two cases of plating, valgus malunion in one case of nailing and joint stiffness in two cases each of nailing and plating were the major complications observed. There was no difference between the two modalities in terms of fracture union. Complications were lesser but more serious in case of plating. Patient satisfaction was more with plating.

Bed load tracer mobility in a mixed bedrock/alluvial channel

NASA Astrophysics Data System (ADS)

Ferguson, R. I.; Sharma, B. P.; Hodge, R. A.; Hardy, R. J.; Warburton, J.

2017-04-01

The presence of bare or partially covered rock in an otherwise alluvial river implies a downstream change in transport capacity relative to supply. Field investigations of this change and what causes it are lacking. We used two sets of magnet-tagged tracer clasts to investigate bed load transport during the same sequence of floods in fully alluvial, bare rock, and partial-cover reaches of an upland stream. High-flow shear stresses in different reaches were calculated by using stage loggers. Tracers seeded in the upstream alluvial channel moved more slowly than elsewhere until the frontrunners reached bare rock and sped up. Tracers seeded on bare rock moved rapidly off it and accumulated just upstream from, and later in, a partial-cover zone with many boulders. The backwater effect of the boulder-rich zone is significant in reducing tracer mobility. Tracer movement over full or partial sediment cover was size selective but dispersion over bare rock was not. Along-channel changes in tracer mobility are interpreted in terms of measured differences in shear stress and estimated differences in threshold stress.

Direct measurements of lift and drag on shallowly submerged cobbles in steep streams: Implications for flow resistance and sediment transport

NASA Astrophysics Data System (ADS)

Lamb, Michael P.; Brun, Fanny; Fuller, Brian M.

2017-09-01

Steep mountain streams have higher resistance to flow and lower sediment transport rates than expected by comparison with low gradient rivers, and often these differences are attributed to reduced near-bed flow velocities and stresses associated with form drag on channel forms and immobile boulders. However, few studies have directly measured drag and lift forces acting on bed sediment for shallow flows over coarse sediment, which ultimately control sediment transport rates and grain-scale flow resistance. Here we report on particle lift and drag force measurements in flume experiments using a planar, fixed cobble bed over a wide range of channel slopes (0.004 < S < 0.3) and water discharges. Drag coefficients are similar to previous findings for submerged particles (CD ˜ 0.7) but increase significantly for partially submerged particles. In contrast, lift coefficients decrease from near unity to zero as the flow shallows and are strongly negative for partially submerged particles, indicating a downward force that pulls particles toward the bed. Fluctuating forces in lift and drag decrease with increasing relative roughness, and they scale with the depth-averaged velocity squared rather than the bed shear stress. We find that, even in the absence of complex bed topography, shallow flows over coarse sediment are characterized by high flow resistance because of grain drag within a roughness layer that occupies a significant fraction of the total flow depth, and by heightened critical Shields numbers and reduced sediment fluxes because of reduced lift forces and reduced turbulent fluctuations.

Nail injury to the brain obfuscated by a fall from height - homicide or suicide? a case report.

PubMed

Aggrawal, Anil; Pradhan, Monisha; Sreenivas, M

2015-01-01

Penetrating head injuries caused by unconventional objects such as a nail generate speculation and doubt regarding the manner of infliction. We report a case of a 24-year-old woman alleged to have committed suicide by a fall from height. Autopsy revealed an unprecedented penetrating intracranial injury caused by a nail over the right temporal region, confounding the manner of death. The underlying intersecting pattern of fractures determined the chronological sequence of events. In this paper, we discuss the manner, incidence and pathology of nail injuries to the brain. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

The use of intramedullary nails in tibiotalocalcaneal arthrodesis.

PubMed

Thomas, Ruth L; Sathe, Vinayak; Habib, Syed I

2012-01-01

Tibiotalocalcaneal arthrodesis is a salvage procedure undertaken for hindfoot problems that affect both the ankle and subtalar joints (eg, two-joint arthritis, severe acute trauma, osteonecrosis of the talus, severe malalignment deformities, significant hindfoot bone loss). Methods of achieving fusion include Steinmann pins, screws, plates, external fixators, and retrograde intramedullary nailing. Retrograde intramedullary nailing provides a load-sharing fixation device with superior biomechanical properties and is an excellent choice for use in tibiotalocalcaneal arthrodesis. This technique can be performed through relatively small incisions. In addition, recent design modifications include the availability of dynamization and the choice of curved or straight nails. Contraindications to the technique include the presence of infection, severe vascular disease, and severe malalignment of the tibia.

"Clothesline technique" for proximal tibial shaft fracture fixation using conventional intramedullary nail: a simple, useful, and inexpensive technique to prevent fracture malalignment.

PubMed

Belangero, William Dias; Santos Pires, Robinson Esteves; Livani, Bruno; Rossi, Felipe Lins; de Andrade, Andre Luis Lugnani

2018-05-01

Treatment of proximal tibial shaft fractures is always challenging. Despite the development of modern techniques, the literature still shows high complication rates, especially regarding proximal fragment malalignment. It is well known that knee position in flexion during tibial nailing is responsible for extension and valgus deformities of the proximal fragment. Unlike in tibial shaft fractures, nails do not reduce proximal tibial fractures due to the medullary canal width. This study aims to describe a simple, useful, and inexpensive technique to prevent valgus and extension deformities when treating proximal tibial fractures using conventional nails: the so-called clothesline technique.

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

PubMed Central

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

2013-01-01

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

[Clinico-mycological study of onychomycosis in elderly patients].

PubMed

Rodríguez-Soto, M E; Fernández-Andreu, C M; Moya Duque, S; Rodríguez Díaz, R M; Martínez-Machín, G

1993-01-01

Physical examination of nails was carried out in 210 elderly patients and nail scrapings were obtained from onychomycosis suggested lesions in order to determine their causative agents, incidence and clinical characteristics. Diagnostic was confirmed by the isolation of the agents from 74 patients, mainly from toe-nails (incidence 35.2). Tinea pedis occurred in 25% of the cases and Diabetes mellitus was the most prevalent associated disease and the most frequent clinical characteristics were the thickening, the opacity and the presence of longitudinal strias in the surface of the nails. It was compared the results obtained by microscopic examination and by culture. Trichophyton rubrum was the most common dermatophyte isolated; Candida parapsilosis was dominant among Candida species.

Health resource use after robot-assisted surgery vs open and conventional laparoscopic techniques in oncology: analysis of English secondary care data for radical prostatectomy and partial nephrectomy.

PubMed

Hughes, David; Camp, Charlotte; O'Hara, Jamie; Adshead, Jim

2016-06-01

To evaluate postoperative health resource utilisation and secondary care costs for radical prostatectomy and partial nephrectomy in National Health Service (NHS) hospitals in England, via a comparison of robot-assisted, conventional laparoscopic and open surgical approaches. We retrospectively analysed the secondary care records of 23 735 patients who underwent robot-assisted (RARP, n = 8 016), laparoscopic (LRP, n = 6 776) or open radical prostatectomy (ORP, n = 8 943). We further analysed 2 173 patients who underwent robot-assisted (RAPN, n = 365), laparoscopic (LPN, n = 792) or open partial nephrectomy (OPN, n = 1 016). Postoperative inpatient admissions, hospital bed-days, excess bed-days and outpatient appointments at 360 and 1 080 days after surgery were reviewed. Patients in the RARP group required significantly fewer inpatient admissions, hospital bed-days and excess bed-days at 360 and 1 080 days than patients undergoing ORP. Patients undergoing ORP had a significantly higher number of outpatient appointments at 1 080 days. The corresponding total costs were significantly lower for patients in the RARP group at 360 days (£1679 vs £2031 for ORP; P < 0.001) and at 1 080 days (£3461 vs £4208 for ORP; P < 0.001). In partial nephrectomy, Patients in the RAPN group required significantly fewer inpatient admissions and hospital bed-days at 360 days compared with those in the OPN group; no significant differences were observed in outcomes at 1 080 days. The corresponding total costs were lower for patients in the RAPN group at 360 days (£779 vs £1242 for OPN, P = 0.843) and at 1 080 days (£2122 vs £2889 for ORP; P = 0.570). For both procedure types, resource utilisation and costs for laparoscopic surgeries lay at the approximate midpoint of those for robot-assisted and open surgeries. Our analysis provides compelling evidence to suggest that RARP leads to reduced long-term health resource utilisation and downstream cost savings compared with traditional open and laparoscopic approaches. Furthermore, despite the limitations that arise from the inclusion of a small sample, these results also suggest that robot-assisted surgery may represent a cost-saving alternative to existing surgical options in partial nephrectomy. Further exploration of clinical cost drivers, as well as an extension of the analysis into subsequent years, could lend support to the wider commissioning of robot-assisted surgery within the NHS. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

Negative affect mediates the relationship between interpersonal problems and binge-eating disorder symptoms and psychopathology in a clinical sample: a test of the interpersonal model.

PubMed

Ivanova, Iryna V; Tasca, Giorgio A; Hammond, Nicole; Balfour, Louise; Ritchie, Kerri; Koszycki, Diana; Bissada, Hany

2015-03-01

This study evaluated the validity of the interpersonal model of binge-eating disorder (BED) psychopathology in a clinical sample of women with BED. Data from a cross-sectional sample of 255 women with BED were examined for the direct effects of interpersonal problems on BED symptoms and psychopathology, and indirect effects mediated by negative affect. Structural equation modelling analyses demonstrated that higher levels of interpersonal problems were associated with greater negative affect, and greater negative affect was associated with higher frequency of BED symptoms and psychopathology. There was a significant indirect effect of interpersonal problems on BED symptoms and psychopathology mediated through negative affect. Interpersonal problems may lead to greater BED symptoms and psychopathology, and this relationship may be partially explained by elevated negative affect. The results of the study are the first to provide support for the interpersonal model of BED symptoms and psychopathology in a clinical sample of women. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

A Review of Indigo Naturalis as an Alternative Treatment for Nail Psoriasis.

PubMed

McDermott, Laura; Madan, Raman; Rupani, Reena; Siegel, Daniel

2016-03-01

Nail psoriasis is challenging to treat. The few currently available therapies are limited in efficacy, and often produce unfavorable side effects. A plant extract widely used in Traditional Chinese Medicine, indigo naturalis (Qing Dai), is presented in this review as an alternative topical treatment for skin and nail psoriasis. The purpose of this article is to present information on a viable alternative treatment with a favorable side effect profile for a difficult disease to treat. A PubMed search for the term "indigo naturalis" was performed, and literature from 2006 to the present relevant to indigo naturalis and treatment of psoriasis and nail psoriasis was reviewed. Indigo naturalis shares several therapeutic mechanisms with current psoriasis treatments, such as regulation of keratinocyte proliferation and differentiation, restoration of epidermal barrier function, and reduction of inflammatory processes. Clinically, it is well tolerated. Recent research of indigo naturalis suggests that it is a safe, inexpensive, and effective alternative topical treatment for skin and nail psoriasis.

Complications of tibio-talar-calcaneal fusion using intramedullary nails.

PubMed

Fenton, P; Bali, N; Matheshwari, R; Youssef, B; Meda, K

2014-12-01

Hindfoot nails are being increasingly used, however significant complications can occur. The purpose of this study was to assess the complications following the use of hindfoot nails at our institution. We identified patients from a retrospective database. All underwent hindfoot nailing under the care of the senior author. Details of complications were recorded. We identified 52 patients undergoing 55 procedures. Mean follow up was 44.8 months (18-69). Forty patients achieved ankle fusion and 36 subtalar joint fusion. Complications included prominent metalwork in 13 patients, CRPS in five and one peri-prosthetic fracture. Nine developed deep infection, and of these limb salvage was achieved in six patients by removal of metalwork, debridement and insertion of antibiotic loaded cement beads. The remaining three patients underwent below knee amputation. Significant complications can occur, although limb preservation was possible in most cases of deep infection. Hindfoot nailing should be reserved as salvage procedure. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

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

PubMed

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

2016-02-05

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

Intramedullary knee arthrodesis as a salvage procedure after failed total knee replacement.

PubMed

Panagiotopoulos, E; Kouzelis, A; Matzaroglou, Ch; Saridis, A; Lambiris, E

2006-12-01

Septic and aseptic loosening with or without extensive bone loss after total knee replacement are the most common indications for knee fusion. Both external fixation and intramedullary nailing can be used for the treatment, though the latter appears to be the method of choice for most patients. Nine patients were treated after a total knee replacement failure using intramedullary nailing. A long intramedullary nail with a proximal interlocking screw was used in five cases, and a customised nail was used in four cases. Successful fusion occurred in eight of nine patients (89%). Average time for the joint union was 6.5 months, and average operative blood loss was 860 ml. In two patients, iliac crest and patellar bone graft were also used. In conclusion, intramedullary nailing can give excellent results in achieving knee fusion after a failed knee replacement as it allows early weight bearing and at the same time offers stability, pain relief, and a high rate of union, even though the surgical technique is demanding.

Firearm suicide committed using an unusual combination of tandem missiles: a bullet, a nail, and a screw.

PubMed

Mihailovic, Zoran; Savic, Slobodan; Atanasijevic, Tatjana

2007-09-01

An interesting case of firearm suicide carried out using an unusual type of handmade weapon and a peculiar combination of tandem missiles is presented. A nail and a screw were placed in the rifle barrel ahead of a bullet, and all 3 were simultaneously discharged. The inflicted injury began with 1 common channel, which later split in 2 separate channels, both directed backwards and upwards; one was caused by the screw, ending in the epistropheal body, and the other, caused by the bullet and the nail, penetrated into the cranial cavity, where it bifurcated in 2 branches, one from the bullet, ending in the cerebellar tissue, and the other from the nail, penetrated through the brain stem. The established site of the entrance suicidal wound, the appearance of the weapon, and the unusual missiles are discussed with regard to the available references dealing with different types of nail injuries to the head.

Imaging technique for the diagnosis of onychomatricoma.

PubMed

Cinotti, E; Veronesi, G; Labeille, B; Cambazard, F; Piraccini, B M; Dika, E; Perrot, J L; Rubegni, P

2018-06-05

Onychomatricoma is a rare tumour that derives from the nail matrix and grows within the nail plate. The clinical presentation can mimic many other tumours and conditions, and surgical biopsy and histopathological examination are necessary to confirm the diagnosis. As nail surgery is a painful experience for the patient and sometimes can leave permanent onychodistrophy, more precise preoperative diagnosis is needed to distinguish onychomatricoma from other nail diseases more accurately and to limit surgical interventions. The objective of this study was to evaluate current literature on imaging techniques for the diagnosis of onychomatricoma in order to understand how this technology can help the presurgical diagnosis of this tumour. We searched in the Cochrane Skin Group Specialised library, Medline, Embase and LILACS databases all studies evaluating imaging technique for the diagnosis of onychomatricoma up to February 2018. We found that not only nail dermoscopy, but also reflectance confocal microscopy, optical coherence tomography, ultrasonography and magnetic resonance can be useful in this field. © 2018 European Academy of Dermatology and Venereology.

An electrochemical modeling of lithium-ion battery nail penetration

NASA Astrophysics Data System (ADS)

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

2014-04-01

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

Nail-fold excision for the treatment of ingrown toenail in children.

PubMed

Haricharan, Ramanath N; Masquijo, Javier; Bettolli, Marcos

2013-02-01

To evaluate the effectiveness of the nail-fold excision procedure in children. Prospectively collected data on patients less than 18 years of age who underwent a nail-fold excision for symptomatic ingrown toenail were analyzed. Patients were seen in 2 centers and data collected included demographics, site of ingrown toenail, complications (including recurrence), patient satisfaction, and duration of follow-up. Overall, 67 procedures were performed on 50 patients between June 2009 and July 2011 at the 2 institutions. The mean age was 14 years (range, 9-18 years) and 30 were male patients. No recurrences were seen after a follow-up for a median of 14 months (range 6-28 months). Patients were very satisfied with the cosmetic outcomes. Six minor complications occurred, including 3 patients with bleeding requiring dressing change, 2 with excessive granulation tissue, and 1 with nail growth abnormality. The nail-fold excision technique is highly effective in the pediatric population, with no recurrence, excellent cosmesis, and very high patient satisfaction. Copyright © 2013 Mosby, Inc. All rights reserved.

Subsurface Characterization using Geophysical Seismic Refraction Survey for Slope Stabilization Design with Soil Nailing

NASA Astrophysics Data System (ADS)

Ashraf Mohamad Ismail, Mohd; Ng, Soon Min; Hazreek Zainal Abidin, Mohd; Madun, Aziman

2018-04-01

The application of geophysical seismic refraction for slope stabilization design using soil nailing method was demonstrated in this study. The potential weak layer of the study area is first identify prior to determining the appropriate length and location of the soil nail. A total of 7 seismic refraction survey lines were conducted at the study area with standard procedures. The refraction data were then analyzed by using the Pickwin and Plotrefa computer software package to obtain the seismic velocity profiles distribution. These results were correlated with the complementary borehole data to interpret the subsurface profile of the study area. It has been identified that layer 1 to 3 is the potential weak zone susceptible to slope failure. Hence, soil nails should be installed to transfer the tensile load from the less stable layer 3 to the more stable layer 4. The soil-nail interaction will provide a reinforcing action to the soil mass thereby increasing the stability of the slope.

Scanning electron microscopy of superficial white onychomycosis*

PubMed Central

de Almeida Jr., Hiram Larangeira; Boabaid, Roberta Oliveira; Timm, Vitor; Silva, Ricardo Marques e; de Castro, Luis Antonio Suita

2015-01-01

Superficial white onychomycosis is characterized by opaque, friable, whitish superficial spots on the nail plate. We examined an affected halux nail of a 20-year-old male patient with scanning electron microscopy. The mycological examination isolated Trichophyton mentagrophytes. Abundant hyphae with the formation of arthrospores were found on the nail's surface, forming small fungal colonies. These findings showed the great capacity for dissemination of this form of onychomycosis. PMID:26560225

Effects of ionic strength on passive and iontophoretic transport of cationic permeant across human nail.

PubMed

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

2009-06-01

Transport across the human nail under hydration can be modeled as hindered transport across aqueous pore pathways. As such, nail permselectivity to charged species can be manipulated by changing the ionic strength of the system in transungual delivery to treat nail diseases. The present study investigated the effects of ionic strength upon transungual passive and iontophoretic transport. Transungual passive and anodal iontophoretic transport experiments of tetraethylammonium ion (TEA) were conducted under symmetric conditions in which the donor and receiver had the same ionic strength in vitro. Experiments under asymmetric conditions were performed to mimic the in vivo conditions. Prior to the transport studies, TEA uptake studies were performed to assess the partitioning of TEA into the nail. Permselectivity towards TEA was inversely related to ionic strength in both passive and iontophoretic transport. The permeability and transference number of TEA were higher at lower ionic strengths under the symmetric conditions due to increased partitioning of TEA into the nail. Transference numbers were smaller under the asymmetric conditions compared with their symmetric counterparts. The results demonstrate significant ionic strength effects upon the partitioning and transport of a cationic permeant in transungual transport, which may be instrumental in the development of transungual delivery systems.

Advanced concepts in knee arthrodesis.

PubMed

Wood, Jennifer H; Conway, Janet D

2015-03-18

The aim is to describe advanced strategies that can be used to diagnose and treat complications after knee arthrodesis and to describe temporary knee arthrodesis to treat infected knee arthroplasty. Potential difficult complications include nonunited knee arthrodesis, limb length discrepancy after knee arthrodesis, and united but infected knee arthrodesis. If a nonunited knee arthrodesis shows evidence of implant loosening or failure, then bone grafting the nonunion site as well as exchange intramedullary nailing and/or supplemental plate fixation are recommended. If symptomatic limb length discrepancy cannot be satisfactorily treated with a shoe lift, then the patient should undergo tibial lengthening over nail with a monolateral fixator or exchange nailing with a femoral internal lengthening device. If a united knee arthrodesis is infected, the nail must be removed. Then the surgeon has the option of replacing it with a long, antibiotic cement-coated nail. The authors also describe temporary knee arthrodesis for infected knee arthroplasty in patients who have the potential to undergo insertion of a new implant. The procedure has two goals: eradication of infection and stabilization of the knee. A temporary knee fusion can be accomplished by inserting both an antibiotic cement-coated knee fusion nail and a static antibiotic cement-coated spacer. These advanced techniques can be helpful when treating difficult complications after knee arthrodesis and treating cases of infected knee arthroplasty.

Advanced concepts in knee arthrodesis

PubMed Central

Wood, Jennifer H; Conway, Janet D

2015-01-01

The aim is to describe advanced strategies that can be used to diagnose and treat complications after knee arthrodesis and to describe temporary knee arthrodesis to treat infected knee arthroplasty. Potential difficult complications include nonunited knee arthrodesis, limb length discrepancy after knee arthrodesis, and united but infected knee arthrodesis. If a nonunited knee arthrodesis shows evidence of implant loosening or failure, then bone grafting the nonunion site as well as exchange intramedullary nailing and/or supplemental plate fixation are recommended. If symptomatic limb length discrepancy cannot be satisfactorily treated with a shoe lift, then the patient should undergo tibial lengthening over nail with a monolateral fixator or exchange nailing with a femoral internal lengthening device. If a united knee arthrodesis is infected, the nail must be removed. Then the surgeon has the option of replacing it with a long, antibiotic cement-coated nail. The authors also describe temporary knee arthrodesis for infected knee arthroplasty in patients who have the potential to undergo insertion of a new implant. The procedure has two goals: eradication of infection and stabilization of the knee. A temporary knee fusion can be accomplished by inserting both an antibiotic cement-coated knee fusion nail and a static antibiotic cement-coated spacer. These advanced techniques can be helpful when treating difficult complications after knee arthrodesis and treating cases of infected knee arthroplasty. PMID:25793160

Tibio-talocalcaneal arthrodesis as a primary procedure using a retrograde intramedullary nail: a retrospective study of 26 patients with rheumatoid arthritis.

PubMed

Anderson, Thomas; Linder, Lars; Rydholm, Urban; Montgomery, Fredrik; Besjakov, Jack; Carlsson, Ake

2005-08-01

Arthrodesis of the ankle joint using screws or external fixation is often a demanding procedure, notably in patients with rheumatoid arthritis. We investigated whether tibio-talocalcaneal arthrodesis with the use of an intramedullary nail is a safe and simple procedure. We retrospectively reviewed 25 ankles (25 patients) at median 3 (1-7) years after tibio-talocalcaneal arthrodesis because of rheumatoid arthritis. All had been operated on by retrograde insertion of a retrograde nail. 5 types of nail had been used. Complications, functional outcome scores, and patient satisfaction were determined and the radiographs evaluated for healing. All but 1 ankle had a radiographically healed arthrodesis. We recorded 3 deep infections, all healed--in 2 cases after extraction of the nail--and the arthrodesis healed in all 3 patients. The average functional scores at follow-up were high, considering that the patients suffered from rheumatoid arthritis. 23 patients were satisfied with the outcome. We found a correlation between the functional scores and the general activity of the disease expressed as a Health Assessment Questionnaire score. In patients with rheumatoid arthritis, tibio-talocalcaneal arthrodesis with a retrograde intra-medullary nail results in a high rate of healing, a high rate of patient satisfaction, and relatively few complications.

Outcome of intramedullary interlocking SIGN nail in tibial diaphyseal fracture.

PubMed

Khan, Irfanullah; Javed, Shahzad; Khan, Gauhar Nawaz; Aziz, Amer

2013-03-01

To determine the outcome of intramedullary interlocking surgical implant generation network (SIGN) nail in diaphyseal tibial fractures in terms of union and failure of implant (breakage of nail or interlocking screws). Case series. Orthopaedics and Spinal Surgery, Ghurki Trust Teaching Hospital, Lahore Medical and Dental College, Lahore, from September 2008 to August 2009. Fifty patients aged 14 - 60 years, of either gender were included, who had closed and Gustilo type I and II open fractures reported in 2 weeks, whose closed reduction was not possible or was unsatisfactory and fracture was located 7 cm below knee joint to 7 cm above ankle joint. Fractures previously treated with external fixator, infected fractures and unfit patients were excluded. All fractures were fixed with intramedullary interlocking SIGN nail and were followed clinically and radiographically for union and for any implant failure. Forty one (88%) patients had united fracture within 6 months, 5 (10%) patients had delayed union while 4 (8%) patients had non-union. Mean duration for achieving union was 163 + 30.6 days. Interlocking screws were broken in 2 patients while no nail was broken in any patient. Intramedullary interlocking nailing is an effective measure in treating closed and grade I and II open tibial fractures. It provides a high rate of union less complications and early return to function.

Can nail, hair and urine be used for biomonitoring of human exposure to perfluorooctane sulfonate and perfluorooctanoic acid?

PubMed

Li, Jingguang; Guo, Feifei; Wang, Yuxin; Zhang, Jialing; Zhong, Yuxin; Zhao, Yunfeng; Wu, Yongning

2013-03-01

Because of the disadvantages of invasive sampling, it is desirable to explore non-invasive matrices for human biomonitoring of perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). The aim of this study was to evaluate the application of nail, hair and urine for human biomonitoring of PFOS and PFOA. The concentrations of PFOS and PFOA in matched nail, hair, urine and serum samples collected from 64 donors were measured. The chemicals of interest were detected with high detection frequency in these matrices (90%-100%) except for PFOA in urine samples (56%). Generally, the gender influences on the levels of PFOS and PFOA in these non-invasive matrices were in agreement with that in serum. For PFOS, the coefficients of Spearman correlation between serum samples and nail, hair and urine samples were 0.786 (p<0.001), 0.545 (p<0.001) and 0.302 (p<0.05), respectively. For PFOA, the correlation was only observed between nail samples and serum samples with a correlation coefficient of 0.299 (p<0.05). The results suggested that nail has more potential than hair and urine to be applied in human biomonitoring for PFOS and PFOA in general populations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Patterns of clinical nail appearances in patients with cutaneous psoriasis

PubMed Central

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

2017-01-01

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

Treatment of humeral shaft fractures using antegrade nailing: functional outcome in the shoulder.

PubMed

Patino, Juan Martin

2015-08-01

The purpose of this study was to evaluate shoulder outcomes and function after humeral shaft fractures treated with antegrade nailing. Thirty patients with acute humeral shaft fractures who underwent antegrade locked intramedullary nailing were retrospectively studied. Range of motion (ROM) of the affected shoulder was evaluated, comparing it with the nonaffected shoulder, radiologic position of the nails, complications, and need for a second surgery. The study enrolled 20 men and 10 women (average age, 41.9 years). The average follow-up was 35.8 months. The average shoulder elevation averaged 157°, internal rotation was variable (reaching the sacroiliac joint to T7), and external rotation averaged 75°. Elbow flexion-extension ROM averaged 133° (115°-145°). According to the Rodriguez-Merchan criteria, 12 patients achieved excellent results (40%), 7 good (20%), and 6 fair (23.3%); poor results were found in 5 cases (16.6%). Twelve patients achieved full mobility of the shoulder, whereas 18 had some loss of motion, with significant differences between the affected and nonaffected shoulders (P = .001). Decreased shoulder ROM is common after antegrade nailing of humeral shaft fractures. Avoidance of nail impingement can improve final outcomes. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Minimizing Leg Length Discrepancy After Intramedullary Nailing of Comminuted Femoral Shaft Fractures: A Quality Improvement Initiative Using the Scout Computed Tomography Scanogram.

PubMed

Gheraibeh, Petra; Vaidya, Rahul; Hudson, Ian; Meehan, Robert; Tonnos, Frederick; Sethi, Anil

2018-05-01

To prevent leg length discrepancy (LLD) after locked femoral nailing in patients with comminuted femoral shaft fractures. Prospective consecutive case series aimed at quality improvement. Level 1 Trauma Center PATIENTS:: Ninety-eight consecutive patients with a comminuted femoral shaft fracture underwent statically locked intramedullary nailing, with a focused attempt at minimizing LLD during surgery. A computed tomography scanogram of both legs was performed on postoperative day 1 to assess for residual LLD. Patients were offered the option to have LLD >1.5 cm corrected before discharge. LLD >1.5 cm. Twenty-one patients (21.4%) were found to have an LLD >1.5 cm. An LLD >1.5 cm occurred in 10/55 (18%) antegrade nail patients and 11/43 (26%) retrograde nail patients (P = 0.27). No difference was noted based on the mechanism of injury, surgeon training and OTA/AO type B versus C injury. Ninety of 98 patients left with <1.5 cm LLD, 13/21 had a correction all to ≤0.6 cm, and 8 decided to accept the LLD and declined early correction. No patient left the hospital with an LLD >1.5 cm after locked intramedullary nailing for a comminuted femoral shaft fracture without being informed and the option of early correction. We recommend using a full-length computed tomography scanogram after IM nailing of comminuted femur fractures to prevent iatrogenic LLD. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Comparison of calcaneal fixation of a retrograde intramedullary nail with a fixed-angle spiral blade versus a fixed-angle screw.

PubMed

Klos, Kajetan; Gueorguiev, Boyko; Schwieger, Karsten; Fröber, Rosemarie; Brodt, Steffen; Hofmann, Gunther O; Windolf, Markus; Mückley, Thomas

2009-12-01

Retrograde intramedullary nailing is an established technique for tibiotalocalcaneal arthrodesis (TTCA). In poor bone stock (osteoporosis, neuroarthropathy), device fixation in the hindfoot remains a problem. Fixed-angle spiral-blade fixation of the nail in the calcaneus could be useful. In seven matched pairs of human below-knee specimens, bone mineral density (BMD) was determined, and TTCA was performed with an intramedullary nail (Synthes Hindfoot Arthrodesis Nail HAN Expert Nailing System), using a conventional screw plus a fixed-angle spiral blade versus a conventional screw plus a fixed-angle screw, in the calcaneus. The constructs were subjected to quasi-static loading (dorsiflexion/plantarflexion, varus/valgus, rotation) and to cyclic loading to failure. Parameters studied were construct neutral zone (NZ) and range of motion (ROM), and number of cycles to failure. With dorsiflexion/plantarflexion loading, the screw-plus-spiral-blade constructs had a significantly smaller ROM in the quasi-static test (p = 0.028) and early in the cyclic test (p = 0.02); differences in the other parameters were not significant. There was a significant correlation between BMD and cycles to failure for the two-screw constructs (r = 0.94; p = 0.002) and for the screw-plus-spiral-blade constructs (r = 0.86; p = 0.014). In TTCA with a HAN Expert Nailing System, the use of a calcaneal spiral blade can further reduce motion within the construct. This may be especially useful in poor bone stock. Results obtained in this study could be used to guide the operating surgeon's TTCA strategy.

Time-course measurements of drug concentrations in hair and toenails after single administrations of pharmaceutical products.

PubMed

Kuwayama, Kenji; Miyaguchi, Hajime; Iwata, Yuko T; Kanamori, Tatsuyuki; Tsujikawa, Kenji; Yamamuro, Tadashi; Segawa, Hiroki; Inoue, Hiroyuki

2017-04-01

Hair and nails are often used to prove long-term intake of drugs in forensic drug testing. The aim of this study was to evaluate the effectiveness of drug testing using hair and nails and the feasibility of determining when drugs were ingested by measuring the time-courses of drug concentrations in hair and toenails after single administrations of various drugs. Healthy subjects ingested four pharmaceutical products containing eight active ingredients in single doses. Hair and toenails were collected at predetermined intervals, and drug concentrations in hair and nails were measured for 12 months. The administered drugs and their main metabolites were extracted using micropulverized extraction with a stainless steel bullet and were analyzed using liquid chromatography/tandem mass spectrometry. Acidic compounds such as ibuprofen and its metabolites were not detected in both specimens. Acetaminophen, a weakly acidic compound, was detected in nails more frequently than in hair. The maximum concentration of allyl isopropyl acetylurea, a neutral compound, in nails was significantly higher than in hair. Nails are an effective specimen to detect neutral and weakly acidic compounds. For fexofenadine, a zwitterionic compound, and for most basic compounds, the maximum concentrations in hair segments tended to be higher than those in nails. The hair segments showing the maximum concentrations varied between drugs, samples, and subjects. Drug concentrations in hair segments greatly depended on the selection of the hair. Careful interpretation of analytical results is required to predict the time of drug intake. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

A preliminary survey of Vietnamese nail salon workers in Alameda County, California.

PubMed

Quach, Thu; Nguyen, Kim-Dung; Doan-Billings, Phuong-An; Okahara, Linda; Fan, Cathyn; Reynolds, Peggy

2008-10-01

In recent decades, the nail salon industry has been one of the fastest growing in the U.S. California has over 300,000 workers licensed to perform nail care services. Though little is known about their health, these workers routinely handle cosmetic products containing carcinogens and endocrine disruptors that may increase a woman's breast cancer risk. Additionally, an estimated 59-80% of California nail salons are run by Vietnamese women who face socio-cultural barriers that may compromise their workplace safety and health care access. In a pilot project designed to characterize Vietnamese nail salon workers in Alameda County, California in order to inform future health interventions and reduce occupational exposures, we conducted face-to-face surveys with a convenience sample of 201 Vietnamese nail salon workers at 74 salons. Of the workers surveyed, a majority reported that they are concerned about their health from exposure to workplace chemicals. Additionally, a sizeable proportion reported having experienced some health problem after they began working in the industry, particularly acute health problems that may be associated with solvent exposure (e.g. skin and eye irritation, breathing difficulties and headaches). Our findings highlight a critical need for further investigation into the breast cancer risk of nail salon workers, underscored by the workers' routine use of carcinogenic and endocrine-disrupting chemicals, their prevalent health concerns about such chemicals, and their high level of acute health problems. Moreover, the predominance of Vietnamese immigrant women in this workforce makes it an important target group for further research and health interventions.

Efalizumab in the Treatment of Scalp, Palmoplantar and Nail Psoriasis: Results of a 24-Week Latin American Study

PubMed Central

Takahashi, María Denise; Chouela, Edgardo Néstor; Dorantes, Gladys Leon; Roselino, Ana Maria; Santamaria, Jesùs; Allevato, Miguel Angel; Cestari, Tania; de Aillaud, Maria Eugenia Manzanera; Stengel, Fernando Miguel; Licu, Daiana

2010-01-01

Introduction Plaque-type psoriasis affecting the nails, scalp, hands or feet can often be difficult to treat; for example, topical treatments and phototherapy may not penetrate the nail plate or scalp. The objective of this large, international, multicentre study was to investigate the efficacy of efalizumab in a Latin American population of adult patients with moderate-to-severe chronic plaque psoriasis who were candidates for systemic therapy or phototherapy. Methods Eligible patients were enrolled in a 24-week, open-label, single-arm, Phase IIIb/IV study of continuous treatment with subcutaneous efalizumab, 1.0 mg/kg/wk. Involvement of the nails, scalp, or hands or feet was assessed using the Nail Psoriasis Severity Index (NAPSI), the Psoriasis Scalp Severity Index (PSSI), or the Palmoplantar Pustulosis Psoriasis Area and Severity Index (PPPASI), respectively. Missing data were handled using a last observation carried forward or nonresponder imputation approach. Results Of the 189 patients who received treatment, 112 patients had nail involvement, 172 had scalp involvement, and 19 had palmoplantar disease at baseline. At Week 24, ≥50% improvement on the NAPSI, PSSI and PPPASI was observed in 31%, 71% and 68% of patients, respectively, whereas ≥75% improvement on these scores was observed in 17%, 52% and 63%, respectively. Descriptive statistics showed lower NAPSI-75 and higher PSSI-75 and -50 response rates among patients with higher baseline scores. Conclusions This open-label, uncontrolled study provides supportive evidence of the potential of efalizumab as a treatment for nail, scalp and palmoplantar psoriasis. PMID:20428227

Comparison of diagnostic methods in the evaluation of onychomycosis.

PubMed

Haghani, Iman; Shokohi, Tahereh; Hajheidari, Zohreh; Khalilian, Alireza; Aghili, Seyed Reza

2013-04-01

Onychomycosis is a common nail problem, accounting for up to half of all nail diseases. Several nail disorders may mimic the onychomycosis clinically. Therefore, a sensitive, quick, and inexpensive test is essential for screening nail specimens for the administration of the proper drug. The aim of this study was to compare 4 different diagnostic methods in the evaluation of onychomycosis and to determine their sensitivity, specificity, positive predictive value, and negative predictive value. In a cross-sectional study, nail specimens were collected from 101 patients suspected to have onychomycosis during a 14-month period. The nail specimens were examined using potassium hydroxide (KOH) 20 %, KOH-treated nail clipping stained with periodic acid-Schiff (KONCPA), and calcofluor white (CFW) stain, and grew a fungal culture. The culture was chosen as the gold standard for statistical analysis using the McNemar and chi-square tests. Out of 101 patients, 100 (99 %) patients had at least 1 of the 4 diagnostic methods positive for the presence of organisms. The positive rates for the fungal culture, KOH preparation, CFW, and KONCPA were 74.2, 85.1, 91.09, and 99.01 %, respectively. The sensitivity and negative predictive value of KONCPA was 100 %. KONCPA was the most sensitive among the tests and was also superior to other methods in its negative predictive value. KONCPA was easy to perform, rapid, and gave significantly higher rates of detection of onychomycosis compared to the standard methods of KOH preparation and fungal culture. Therefore, KONCPA should be the single method of choice for the evaluation of onychomycosis.

Risk for hepatitis B and C virus transmission in nail salons and barbershops and state regulatory requirements to prevent such transmission in the United States.

PubMed

Yang, Jun; Hall, Keri; Nuriddin, Azizeh; Woolard, Diane

2014-01-01

The potential for hepatitis B and C virus (HBV/HCV) transmission in nail salons and barbershops has been reported, but a systematic review has not been conducted. These businesses are regulated by state cosmetology or barbering boards, but adequacy of sanitary requirements has not been evaluated. To conduct literature review to assess risk for HBV/HCV transmission in nail salons and barbershops and to evaluate sanitary requirements in HBV/HCV prevention in these businesses in 50 states and District of Columbia. Several search engines were used for literature search. Studies that quantified risks associated with manicuring, pedicuring, or barbering were included. State requirements for disinfection and sterilization were reviewed and evaluated. For literature review, odds ratios, 95% confidence intervals, and confounding adjustment were extracted and evaluated. For regulation review, requirements for disinfection or sterilization for multiuse items in nail salons and barbershops were assessed according to the US federal guidelines. Forty-six studies were identified and 36 were included in this study. Overall, the results were not consistent on risk for HBV/HCV transmission in nail salons and barbershops. For sanitary requirements, disinfection with an Environmental Protection Agency-registered disinfectant is required in 39 states for nail salons and in 26 states for barbershops. Sterilization was described in 15 states for nail salons and in 11 states for barbershops, but the majority of these states listed it as an optional approach. Sanitary requirements are consistent in states where 1 board regulates both businesses but are substantially discrepant in states with separate boards. Current literature cannot confirm or exclude the risk for HBV/HCV transmission in nail salons and barbershops. Existing sanitary requirements are adequate in the majority of states, but compliance is needed to prevent HBV/HCV transmission in these businesses.

The efficacy of fractional carbon dioxide (CO2) laser combined with terbinafine hydrochloride 1% cream for the treatment of onychomycosis.

PubMed

Shi, Jian; Li, Jin; Huang, He; Permatasari, Felicia; Liu, Juan; Xu, Yang; Wu, Di; Zhou, Bing-Rong; Luo, Dan

2017-10-01

Although systemic and topical antifungal agents are widely used to treat onychomycosis, oral medications can cause adverse effects and the efficacy of topical agents is not satisfying. Currently, laser treatment has been studied for its efficacy in the treatment of onychomycosis. Our study was aimed to evaluate the efficacy of fractional carbon dioxide (CO 2 ) laser treatment combined with terbinafine cream for 6 months in the treatment of onychomycosis and to analyze the influencing factors. A total of 30 participants (124 nails) with clinical and mycological diagnosis of onychomycosis received fractional CO 2 laser treatment at 2-week interval combined with terbinafine cream once daily for 6 months. The clinical efficacy rate (CER) was assessed from the percentage of fully normal-appearing nails or nails with ≤5% abnormal appearance, and the mycological clearance rate (MCR) was assessed from the percentage of nails with negative fungal microscopy. The CER was evaluated at 3 time points: at the end of treatment (58.9%), at 1 month after the last treatment (63.5%), and at 3 months after the last treatment (68.5%). The MCRs at 1 month and 3 months after the last treatment were 77.4 and 74.2%, respectively. The evaluation of influencing factors showed significantly higher CER (p < 0.05) in nails of participants with age <50 years, distal lateral subungual onychomycosis (DLSO), superficial white onychomycosis (SWO), nail thickness <2 mm, affected first-to-fourth finger/toenails, Trichophyton rubrum, and Trichophyton mentagrophytes. All participants experienced tolerable mild burning sensation during laser treatment, but there were no other adverse reactions reported. Fractional CO 2 laser treatment combined with terbinafine cream for 6 months was an effective and safe method for the treatment of onychomycosis. There were 5 factors that positively influenced the treatment outcome: age, clinical type of onychomycosis, nail thickness, involved nail, and species of fungus.

A prospective randomised controlled trial of the fibular nail versus standard open reduction and internal fixation for fixation of ankle fractures in elderly patients.

PubMed

White, T O; Bugler, K E; Appleton, P; Will, E; McQueen, M M; Court-Brown, C M

2016-09-01

The fundamental concept of open reduction and internal fixation (ORIF) of ankle fractures has not changed appreciably since the 1960s and, whilst widely used, is associated with complications including wound dehiscence and infection, prominent hardware and failure. Closed reduction and intramedullary fixation (CRIF) using a fibular nail, wires or screws is biomechanically stronger, requires minimal incisions, and has low-profile hardware. We hypothesised that fibular nailing in the elderly would have similar functional outcomes to standard fixation, with a reduced rate of wound and hardware problems. A total of 100 patients (25 men, 75 women) over the age of 65 years with unstable ankle fractures were randomised to undergo standard ORIF or fibular nailing (11 men and 39 women in the ORIF group, 14 men and 36 women in the fibular nail group). The mean age was 74 years (65 to 93) and all patients had at least one medical comorbidity. Complications, patient related outcome measures and cost-effectiveness were assessed over 12 months. Significantly fewer wound infections occurred in the fibular nail group (p = 0.002). At one year, there was no evidence of difference in mean functional scores (Olerud and Molander Scores 63; 30 to 85, versus 61; 10 to 35, p = 0.61) or scar satisfaction. The overall cost of treatment in the fibular nail group was £91 less than in the ORIF group despite the higher initial cost of the implant. We conclude that the fibular nail allows accurate reduction and secure fixation of ankle fractures, with a significantly lower rate of soft-tissue complications, and is more cost-effective than ORIF. Cite this article: Bone Joint J 2016;98-B:1248-52. ©2016 The British Editorial Society of Bone & Joint Surgery.

Comparison of Posterior Approach With Intramedullary Nailing Versus Lateral Transfibular Approach With Fixed-Angle Plating for Tibiotalocalcaneal Arthrodesis.

PubMed

Mulligan, Ryan P; Adams, Samuel B; Easley, Mark E; DeOrio, James K; Nunley, James A

2017-12-01

A variety of operative approaches and fixation techniques have been described for tibiotalocalcaneal (TTC) arthrodesis. The intramedullary (IM) nail and lateral, fixed-angle plating are commonly used because of ease of use and favorable biomechanical properties. A lateral, transfibular (LTF) approach allows for direct access to the tibiotalar and subtalar joints, but the posterior, Achilles tendon-splitting (PATS) approach offers a robust soft tissue envelope. The purpose of this study was to compare the results of TTC arthrodesis with either a PATS approach with IM nailing or LTF approach with fixed-angle plating. A retrospective review was performed on all patients who underwent simultaneous TTC arthrodesis with minimum 1 year clinical and radiographic follow up. Patients were excluded if they underwent TTC arthrodesis through an approach other than PATS or LTF, and received fixation without an IM nail or fixed-angle plate. Primary outcomes examined were union rate, revisions, and complications. Thirty-eight patients underwent TTC arthrodesis with a PATS approach and IM nailing, and 28 with a LTF approach and lateral plating. The overall union rate was 71%; 76% (29 of 38 patients) for the PATS/IM nail group, and 64% (18 of 28) for LTF/plating group ( P = .41). Symptomatic nonunion requiring revision arthrodesis occurred in 16% (6 of 38) of the PATS/IM nail group versus 7% (2 of 28) in the LTF/lateral plating group ( P = .45). There were no significant differences in individual tibiotalar or subtalar union rates, superficial wound problems, infection, symptomatic hardware, stress fractures, or nerve irritations. Union, revision, and complication rates were similar for TTC arthrodesis performed with a PATS approach and IM nail compared with an LTF approach and fixed-angle plate in a complex patient population. Both techniques were adequate, especially when prior incisions, preexisting hardware, or deformity preclude options. Level III, retrospective comparative study.

Fixation of 4-part fractures of the proximal humerus: Can we identify radiological criteria that support locking plates or IM nailing? Comparative, retrospective study of 107 cases.

PubMed

Gadea, F; Favard, L; Boileau, P; Cuny, C; d'Ollone, T; Saragaglia, D; Sirveaux, F

2016-12-01

No objective criteria exist to help surgeons choose between IM nailing and plate fixation for 4-part fractures of the proximal humerus. The goal of this study was to identify radiological criteria that would make one technique a better choice than the other. This was a comparative, multicentre, retrospective study of 54 cases of antegrade nailing and 53 cases of plating performed between 1st January 2009 and 31 December 2011 for 4-part fractures of the proximal humerus. All patients had a minimum radiological and clinical follow-up of 18 months. The functional outcomes were evaluated using the weighted Constant score; a poor result was defined as a weighted Constant score<70%. The following radiological criteria were evaluated during the preoperative assessment and at the last follow-up: initial displacement and reduction of humeral head and tuberosities; morphology of the medial column (i.e. calcar comminution, posteromedial hinge, size of metaphyseal head extension); occurrence of avascular necrosis (AVN). After an average follow-up of 42 months, the weighted Constant scores and rate of poor outcomes were 77% and 48% in the nail group and 81% and 38% in the plate group, respectively (ns). The humeral head was reduced into an anatomical position, valgus or varus in 57%, 30% and 13% of cases in the nail group, and 58%, 29% and 13% in the plate group, respectively. The tuberosities healed in an anatomical position in 72% of nail cases and 70% of plate cases (ns). Only the presence of a medial hinge preoperatively had an effect on the functional outcomes in the nail and plate groups: the weighted Constant scores (P=0.05) and rate of poor outcomes (P=0.02) were 82% and 52% in the nail group and 97% and 9% in the plate group, respectively. The complication rates were comparable: the rates of AVN and articular screw penetration were 17% and 11% in the nail group, and 15% and 11% in the plate group, respectively. The surgical revision rate was 18.5% in the nail group and 30% in the plate group. If the medial hinge is preserved, we recommend locking plate fixation. In other cases, either technique can be used as long as the general rules of internal fixation are applied: reduction of the tuberosities, varus correction and stabilization of the calcar area. IV, retrospective study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Modelling the strength of an aluminium-steel nailed joint

NASA Astrophysics Data System (ADS)

Goldspiegel, Fabien; Mocellin, Katia; Michel, Philippe

2018-05-01

For multi-material applications in automotive industry, a cast aluminium (upper layer) and dual-phase steel (lower layer) superposition joined with High-Speed Nailing process is investigated through an experimental vs numerical framework. Using FORGE® finite-element software, results from joining simulations have been inserted into models in charge of nailed-joint mechanical testings. Numerical Shear and Cross-tensile tests are compared to experimental ones to discuss discrepancy and possible improvements.

Aseptic nonunion of the tibia treated by intramedullary osteosynthesis.

PubMed

Gualdrini, G; Rollo, G; Montanari, A; Zinghi, G F

1996-01-01

The authors report 52 cases of aseptic nonunion of the tibia treated by intramedullary osteosynthesis. The means of synthesis used were the Küntscher nail, the Eiffel Tower Rush nail, and the Grosse-Kempf nail. Which means of synthesis was used depended on the site and the features of the nonunion. Healing occurred in all of the cases after an average of 5 months. Mean follow-up was 4.5 years.

29 CFR Appendix E to Subpart L of... - Test Methods for Protective Clothing

Code of Federal Regulations, 2011 CFR

2011-07-01

... penetration. One block shall have a hole drilled to hold an 8D common nail firmly at an angle of 98°. The second block shall have a maximum 1/2-inch (1.3 cm) diameter hole drilled through it so that the hole... 11 irons thick, and a new 8D nail, shall be placed as follows: the 8D nail in the hole, the sample of...

29 CFR Appendix E to Subpart L of... - Test Methods for Protective Clothing

Code of Federal Regulations, 2013 CFR

2013-07-01

... penetration. One block shall have a hole drilled to hold an 8D common nail firmly at an angle of 98°. The second block shall have a maximum 1/2-inch (1.3 cm) diameter hole drilled through it so that the hole... 11 irons thick, and a new 8D nail, shall be placed as follows: the 8D nail in the hole, the sample of...

Unusual manifestations of ectodermal dysplasia-syndactyly syndrome type I in two Yemeni siblings.

PubMed

Mohammad, Alshami

2015-01-15

Ectodermal dysplasias (EDs) are a group of genodermatoses characterized by malformations of tissues derived from the ectoderm, including the skin, its appendages (hair, nails, sweat glands), teeth, and the breasts. Ectodermal dysplasia syndactyly syndrome (EDSS) is a rare, newly described type of ED involving syndactyly. We report 2 Yemeni siblings with typical EDSS manifestations, including bilateral, partial cutaneous syndactyly of the fingers and toes; sparse, coarse, brittle scalp hair, eyebrows, and eyelashes; and conical, widely spaced teeth with enamel notches. In addition, the siblings presented with other features hitherto not described for this syndrome, such as adermatoglyphia, onychogryphosis, hypoplastic widely spaced nipples, hypoplastic thumbs, and red scalp hair.

Evaluating the Effects of Constriction by Levees on a Dynamic Gravel-Bed River through Morphological Sediment Budgeting and Bed Mobility Studies, Snake River, WY

NASA Astrophysics Data System (ADS)

Leonard, C.; Legleiter, C. J.

2014-12-01

High-energy gravel-bed rivers are subject to a range of management practices used to control the system's dynamic behavior. The Snake River, near Jackson, WY, offers an opportunity to study the morphological effects of management practices through a comparison of a reach confined by levees to an unmanaged reach just upstream within Grand Teton National Park (GTNP). I hypothesize that levees have reduced sediment supply by disconnecting the river from its banks and increased transport capacity by increasing flow velocity. Together, these effects accentuate the sediment deficit in the leveed reach. To test this I am developing a morphological sediment budget from GTNP to Wilson, WY, using LiDAR data from 2007 and 2012. This analysis will yield insight as to how sediment transport varies between the relatively natural reach in GTNP and the leveed reach downstream. A problem inherent to morphological budgets is the inability to decipher when change occurs within the budget timeframe. To combat this, a partial mobility study was executed using 300 PIT tagged gravels within the leveed reach. Gravels were relocated to decipher how bed mobility and sediment transport varied with grain size under a range of hydraulic conditions. These results are then used to estimate a critical discharge representing the inception of bed motion and geomorphic change. The critical discharge will be used to reconstruct the timing of bed mobility based on streamflow records and thus deconvolve when morphological change occurred during the sediment budget period. I further hypothesize that a greater imbalance between transport capacity and sediment supply in the leveed reach causes the bed to armor, resulting in larger critical shear stresses and implying that the bed will be mobilized only during greater discharge events. To test this hypothesis I will measure armor ratios within the leveed reach and examine how bed mobility differs between the two reaches by comparing the results of our partial mobility study to a previous tracer study within GTNP.

Skin or nail culture

MedlinePlus

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

Plate Versus Intramedullary Nail Fixation of Anterior Tibial Stress Fractures: A Biomechanical Study.

PubMed

Markolf, Keith L; Cheung, Edward; Joshi, Nirav B; Boguszewski, Daniel V; Petrigliano, Frank A; McAllister, David R

2016-06-01

Anterior midtibial stress fractures are an important clinical problem for patients engaged in high-intensity military activities or athletic training activities. When nonoperative treatment has failed, intramedullary (IM) nail and plate fixation are 2 surgical options used to arrest the progression of a fatigue fracture and allow bone healing. A plate will be more effective than an IM nail in preventing the opening of a simulated anterior midtibial stress fracture from tibial bending. Controlled laboratory study. Fresh-frozen human tibias were loaded by applying a pure bending moment in the sagittal plane. Thin transverse saw cuts, 50% and 75% of the depth of the anterior tibial cortex, were created at the midtibia to simulate a fatigue fracture. An extensometer spanning the defect was used to measure the fracture opening displacement (FOD) before and after the application of IM nail and plate fixation constructs. IM nails were tested without locking screws, with a proximal screw only, and with proximal and distal screws. Plates were tested with unlocked bicortical screws (standard compression plate) and locked bicortical screws; both plate constructs were tested with the plate edge placed 1 mm from the anterior tibial crest (anterior location) and 5 mm posterior to the crest. For the 75% saw cut depth, the mean FOD values for all IM nail constructs were 13% to 17% less than those for the saw cut alone; the use of locking screws had no significant effect on the FOD. The mean FOD values for all plate constructs were significantly less than those for all IM nail constructs. The mean FOD values for all plates were 28% to 46% less than those for the saw cut alone. Anterior plate placement significantly decreased mean FOD values for both compression and locked plate constructs, but the mean percentage reductions for locked and unlocked plates were not significantly different from each other for either plate placement. The percentage FOD reductions for all plate constructs and the unlocked IM nail were significantly less with a 50% saw cut depth. Plate fixation was superior to IM nail fixation in limiting the opening of a simulated midtibial stress fracture, and anterior-posterior placement of the plate was an important variable for this construct. Results from these tests can help guide the selection of fixation hardware for patients requiring surgical treatment for a midtibial stress fracture. © 2016 The Author(s).

Interlocking Nailing Versus Plating in Tibial Shaft Fractures in Adults: A Comparative Study

PubMed Central

Arambam, Mahendra Singh; Waikhom, Sanjib; Santosha; Masatwar, Pranav Vitthal; Maske, Rohan Gautam

2017-01-01

Introduction Tibial diaphyseal fractures are the commonest long bone fractures in adults, most commonly managed by intramedullary interlocking nailing. However, several meta-analysis show that locking plate osteosynthesis is equally effective in managing tibial diaphyseal fractures and are associated with less number of complications. Aim To compare the results of fixation of tibial fractures following plating and nailing in terms of union, patient satisfaction and complications. Materials and Methods A hospital based non randomized clinical trial was performed from September 2013 to August 2016 where closed or open diaphyseal or metaphyseo- diaphyseal fractures of the tibia (closed or open Gustilo Anderson type 1 through 3B) were included. Simple sequential allocation was used for allotting the patients to two groups, one for interlocking nailing and other for plating. The patients were followed up for clinical, radiographic and functional results. Results Forty patients with 41 involved limbs completed follow up for one year. The duration of surgery and average blood loss during surgery was 75.45±3.03 minutes and 165.00±5.31 ml respectively in case of nailing and 85.05±2.54 minutes and184.29±5.33 ml respectively in case of plating and their difference was statistically significant. In our study union was achieved in less than 20 weeks in 29 (70.8%) of the patients and 25-30 weeks in nine (22%) cases. The average time of union in our study was 19.55±0.69 weeks in case of interlocking nailing and 20.38±1.39 weeks in case of plating and there was no statistically significant difference between the two. However, there is statistically significant difference in the functional score in between the two groups in terms of Lower Extremity Functional Score (LEFS). Delayed union in one case of nailing and two cases of plating, valgus malunion in one case of nailing and joint stiffness in two cases each of nailing and plating were the major complications observed. Conclusion There was no difference between the two modalities in terms of fracture union. Complications were lesser but more serious in case of plating. Patient satisfaction was more with plating. PMID:28571220

Distribution of uranium, thorium and some stable trace and toxic elements in human hair and nails in Niška Banja Town, a high natural background radiation area of Serbia (Balkan Region, South-East Europe).

PubMed

Sahoo, S K; Žunić, Z S; Kritsananuwat, R; Zagrodzki, P; Bossew, P; Veselinovic, N; Mishra, S; Yonehara, H; Tokonami, S

2015-07-01

Human hair and nails can be considered as bio-indicators of the public exposure to certain natural radionuclides and other toxic metals over a long period of months or even years. The level of elements in hair and nails usually reflect their levels in other tissues of body. Niška Banja, a spa town located in southern Serbia, with locally high natural background radiation was selected for the study. To assess public exposure to the trace elements, hair and nail samples were collected and analyzed. The concentrations of uranium, thorium and some trace and toxic elements (Mn, Ni, Cu, Sr, Cd, and Cs) were determined using inductively coupled plasma mass spectrometry (ICP-MS). U and Th concentrations in hair varied from 0.0002 to 0.0771 μg/g and from 0.0002 to 0.0276 μg/g, respectively. The concentrations in nails varied from 0.0025 to 0.0447 μg/g and from 0.0023 to 0.0564 μg/g for U and Th, respectively. We found significant correlations between some elements in hair and nails. Also indications of spatial clustering of high values could be found. However, this phenomenon as well as the large variations in concentrations of heavy metals in hair and nail could not be explained. As hypotheses, we propose possible exposure pathways which may explain the findings, but the current data does not allow testing them. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Arthrodesis After Infected Revision TKA: Retrospective Comparison of Intramedullary Nailing and External Fixation.

PubMed

Iacono, Francesco; Francesco, Iacono; Raspugli, Giovanni Francesco; Francesco, Raspugli Giovanni; Bruni, Danilo; Danilo, Bruni; Lo Presti, Mirco; Mirco, Lo Presti; Sharma, Bharat; Bharat, Sharma; Akkawi, Ibrahim; Ibrahim, Akkawi; Marcacci, Maurilio; Maurilio, Marcacci

2013-10-01

Infection after revision total knee arthroplasty (TKA) for previous septic TKA can be a challenging problem to treat due to loss of bone stock and soft tissue integrity. In these cases, arthrodesis is a well-recognized salvage procedure. The aim of this retrospective study was to compare the results as described by a Visual Analogue Scale (VAS) and the Lequesne Algofunctional Score (LAS) of knee arthrodeses performed by using either an external fixator (EF) or an intramedullary nail (IM). The study included 34 knee arthrodesis divided in two groups: first group included 12 patients treated with EF and the second group of 22 patients dealt with IM nail. Clinical and functional evaluation was performed using the VAS and the LAS. Full-length radiographs were used to verify limb length discrepancy. VAS and LAS results showed a substantial improvement relative to preoperative condition in both groups. However, the LAS was significantly better in the IM nail group. The mean leg length discrepancy was significantly greater (4.5 cm) in the first group than in the second one (0.8 cm). No recurrence of infection was observed in the EF group while there were three recurrent infections in the IM nail group. Our study supported the existing literature and found that reinfection after revision TKA can be effectively treated with arthrodesis. In presence of massive bone loss, we recommend arthrodesis with IM nail used as an endoprosthesis, without bone-on-bone fusion, to produce a stable and painless knee, while preserving the limb length. Use of an IM nail allowed us to get a better functional result than EF.

Adalimumab for nail psoriasis: Efficacy and safety from the first 26 weeks of a phase 3, randomized, placebo-controlled trial.

PubMed

Elewski, Boni E; Okun, Martin M; Papp, Kim; Baker, Christopher S; Crowley, Jeffrey J; Guillet, Gérard; Sundaram, Murali; Poulin, Yves; Gu, Yihua; Geng, Ziqian; Williams, David A; Rich, Phoebe A

2018-01-01

Previous clinical trials have not evaluated improvement in nail psoriasis as a primary end point. This phase 3 trial evaluated the safety and efficacy of adalimumab in patients with moderate-to-severe fingernail psoriasis and moderate-to-severe plaque psoriasis. Patients were randomized 1:1 to 40 mg adalimumab every other week or placebo. The primary efficacy end point was at least 75% improvement in total-fingernail modified Nail Psoriasis Severity Index (NAPSI75) response rate at week 26. Ranked secondary end point scores evaluated at week 26 were total-fingernail NAPSI and modified NAPSI, nail pain, Nail Psoriasis Physical Functioning Severity, Brigham Scalp Nail Inverse Palmo-Plantar Psoriasis Index, and Physician's Global Assessment (fingernail psoriasis). Of the 217 randomized patients (108 received placebo and 109 received adalimumab), 188 (86.6%) completed 26 weeks of treatment (period A) or escaped early to the open-label period. The study met the primary end point (response rate of 3.4% with placebo vs 46.6% with adalimumab [P < .001]) and all ranked secondary end points. The serious adverse event rates (placebo vs adalimumab) in period A were 4.6% versus 7.3%; the serious infections rates were 1.9% versus 3.7%. Patients with less than 5% BSA involvement were not eligible for enrollment. After 26 weeks of adalimumab treatment, significant improvements were seen in the primary and all ranked secondary end points and in signs and symptoms of moderate-to-severe nail psoriasis versus with placebo and no new safety risks were identified. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Tibiotalocalcaneal Arthrodesis Nails: A Comparison of Nails With and Without Internal Compression.

PubMed

Taylor, James; Lucas, Douglas E; Riley, Aimee; Simpson, G Alex; Philbin, Terrence M

2016-03-01

Hindfoot arthrodesis with tibiotalocalcaneal (TTC) intramedullary nails is used commonly when treating ankle and subtalar arthritis and other hindfoot pathology. Adequate compression is paramount to avoid nonunion and fatigue fracture of the hardware. Arthrodesis systems with internal compression have demonstrated superior compression to systems relying on external methods. This study examined the speed of union with TTC fusion nails with internal compression over nails without internal compression. A retrospective review was performed identifying nail type and time to union of the subtalar joint (STJ) and tibiotalar joint (TTJ). A total of 198 patients were included from 2003 to 2011. The median time to STJ fusion without internal compression was 104 days compared to 92 days with internal compression (P = .044). The median time to TTJ fusion without internal compression was 111 days compared to 93 days with internal compression (P = .010). Adjusting for diabetes, there was no significant difference in fusion speed with or without internal compression for the STJ (P = .561) or TTJ (P = .358). Nonunion rates were 24.5% for the STJ and 17.0% for the TTJ with internal compression, and 43.4% for the STJ and 42.1% for the TTJ without internal compression. This difference remained statistically significant after adjusting for diabetes for the TTJ (P = .001) but not for the STJ (P = .194). The intramedullary hindfoot arthrodesis nail was a viable treatment option in degenerative joint disease of the TTC joint. There appeared to be an advantage using systems with internal compression; however, there was no statistically significant difference after controlling for diabetes. Level III, retrospective comparative series. © The Author(s) 2015.

A comparison of two techniques for knee arthrodesis: the custom made intramedullary Mayday nail versus a monoaxial external fixator.

PubMed

Yeoh, David; Goddard, Richard; Macnamara, Paul; Bowman, Nicholas; Miles, Kim; East, Debra; Butler-Manuel, Adrian

2008-08-01

The most common indication for knee arthrodesis is pain and instability in an unreconstructable knee following an infected knee arthroplasty. In this study, we compare the use of the Mayday arthrodesis nail (Orthodynamics, Christchurch, UK) versus external fixation, Orthofix (Berkshire UK) and Stryker Hoffman II (County Cork, Ireland). All patients in this study underwent arthrodesis between 1995 and 2006 at Conquest Hospital, Hastings. In group A, 11 patients underwent arthrodesis with a Mayday nail. In all cases, the indications were infected total knee replacements (TKR). Three of these patients previously had failed attempts at arthrodesis with external fixation devices. In group B, seven patients underwent arthrodesis using external fixation. In six patients, the indication was infected TKRs. Results were reviewed retrospectively, with union assessed both clinically and radiologically. The mean inpatient stay for the Mayday nail group was 23 days (range 8-45 days) compared with 76 days (range 34-122) for the external fixation group (p<0.01, CI 95). Ten patients in group A went on to confirmed primary arthrodesis. One patient underwent revision arthrodesis with a Mayday nail and subsequently united. In group B only two patients achieved union. The rate of union was significantly greater in the Mayday nail group than the external fixation group (91% vs 29%, p<0.01). Of those patients that achieved union, there was no difference in the time to fusion between groups. Our study supported the existing literature and found that the Mayday nail appeared more effective than monoaxial external fixators for arthrodesis in the management of infected total knee replacements.

Dermoscopy of subungual haemorrhage: its usefulness in differential diagnosis from nail-unit melanoma.

PubMed

Mun, J-H; Kim, G-W; Jwa, S-W; Song, M; Kim, H-S; Ko, H-C; Kim, B-S; Kim, M-B

2013-06-01

Subungual haemorrhages are characterized by well-circumscribed dots or blotches with a red to red-black pigmentation, but some cases can be difficult to distinguish from subungual melanoma by the naked eye alone. Dermoscopy has proven to be a useful, noninvasive tool in the diagnosis of pigmented lesions in the nail; however, few dermoscopic studies of subungual haemorrhages have been reported. To investigate characteristic dermoscopic patterns of subungual haemorrhages, and to find distinctive features that can differentiate them from nail-unit melanomas. Patients with a confirmed diagnosis of either subungual haemorrhage or nail-unit melanoma at a tertiary university hospital were included in the study. Clinical features and dermoscopic patterns were evaluated. Sixty-four patients with a total of 90 lesions of subungual haemorrhage were enrolled in the study. The majority of cases (84%) showed combinations of more than one colour, while 16% had only one colour. The most common colour of the subungual haemorrhages was purple-black, in 37% of cases. A homogeneous pattern was observed in 92% of cases, globular patterns in 42% and streaks in 39%. Peripheral fading and periungual haemorrhages were found in 54% and 22% of cases, respectively. Destruction or dystrophy of the nail plate was observed in 16% of cases. In the 16 cases of nail-unit melanomas, Hutchinson sign, longitudinal irregular bands or lines, triangular shape of bands, vascular pattern, and ulcerations were found in 100%, 81%, 25%, 6% and 81% of cases, respectively. In contrast, these features were not found in subungual haemorrhages. Dermoscopy provides valuable information for the diagnosis of subungual haemorrhage and aids in the differential diagnosis from nail-unit melanoma. © 2013 The Authors. BJD © 2013 British Association of Dermatologists.

Comparison of knee function after antegrade and retrograde intramedullary nailing for diaphyseal femoral fractures: results of isokinetic evaluation.

PubMed

Daglar, Bulent; Gungor, Ertugrul; Delialioglu, Onder M; Karakus, Dilek; Ersoz, Murat; Tasbas, Bulent Adil; Bayrakci, Kenan; Gunel, Ugur

2009-10-01

To evaluate knee function in patients having femoral diaphyseal fractures treated with antegrade or retrograde intramedullary nail insertion. Prospective. Level I referral center. Seventy patients having 71 OTA 32 fractures were randomly allocated into 2 groups to be treated with either antegrade or retrograde intramedullary nails inserted with reaming. Antegrade nail in 41 fractures and retrograde femoral intramedullary nails in 30 fractures. Postoperative knee range of motion, Lysholm Knee Score, and isokinetic knee muscle function testing at least 6 months after documented fracture healing, minimum 1 year postoperatively. Groups had similar data with regard to demographics and injury patterns. Mean follow-up time was 44 (range: 25-80) months. Mean knee flexion angle was 132 and 134 degrees, and mean Lysholm Score was 84 and 83.1 in antegrade and retrograde groups, respectively (P = 0.893 and P = 0.701). Isokinetic evaluation revealed similar results for peak torque deficiencies at 30 and 180 degrees per second and total work deficiencies at 180 degrees per second (P > 0.05). Age affected the knee functioning as the higher the age of the patient is, the lower the Lysholm Score and knee flexion angle (r = -0.449, P = 0.0321 and r = -0.568, P = 0.001, respectively). Knee function seems to have similar clinical results after either antegrade or retrograde nail insertion for femoral diaphyseal fractures when knee range of motion, Lysholm Scores, and isokinetic knee evaluation are considered as outcome measures. With increasing patient age, a decrease in knee functioning should be anticipated in patients with femoral fractures treated with intramedullary nails regardless of technique.

Hair and Nail Changes During Long-term Therapy With Ibrutinib for Chronic Lymphocytic Leukemia.

PubMed

Bitar, Carole; Farooqui, Mohammed Z H; Valdez, Janet; Saba, Nakhle S; Soto, Susan; Bray, Amanda; Marti, Gerald; Wiestner, Adrian; Cowen, Edward W

2016-06-01

Ibrutinib, a Bruton tyrosine kinase inhibitor, is a new targeted agent approved by the US Food and Drug Administration for the treatment of chronic lymphocytic leukemia (CLL), mantle cell lymphoma, and Waldenström macroglobulinemia. Ibrutinib is overall well tolerated but long-term treatment is required until disease progression or intolerable toxic effects occur. Little is known regarding its cutaneous adverse effects. To describe the hair and nail manifestations associated with the long-term use of ibrutinib for the treatment of CLL. Prospective study of 66 patients with CLL enrolled in a single-arm phase 2 clinical trial of ibrutinib for CLL between March 2014 and October 2015 at the National Institutes of Health. The primary outcome, nail and hair changes associated with ibrutinib therapy, was assessed by an 11-question survey. In addition, the severity of nail changes was determined from a 0 to 3 rating scale for both onychoschizia and onychorrhexis. Among 66 patients (43 men and 23 women with ages ranging from 55 to 85 years), 44 (67%) reported brittle fingernails at a median of 6.5 (95% CI, 6-12) months after starting ibrutinib therapy. Fifteen patients (23%) developed brittle toenails after a median of 9 (95% CI, 6-15) months of ibrutinib therapy. Textural hair changes were reported in 17 patients (26%), at a median of 9 (95% CI, 6-12) months of ibrutinib treatment. Hair and nail abnormalities are commonly associated with ibrutinib and appear several months after initiating therapy. Ibrutinib inhibits Bruton tyrosine kinase by covalently binding to cysteine 481. Whether ibrutinib affects the hair and nails by binding and altering cysteine-rich proteins of hair and nails or by means of another mechanism remains unknown. clinicaltrials.gov Identifier: NCT01500733.

Nursing Care Hour Standards Study. Part 5 thru Part 8

DTIC Science & Technology

1981-09-01

undressing, into shower, with bath and hair shampoo , assist in redressing, and back into the wheelchair. (Must remain with patient and provide assistance...from area. (Buttocks, hips, shoulders , heels.) BACK RUB: Place equipment at patient’s bedside, remove pajama top, 1 turn patient to expose back, rub back...NAIL CARE: Place equipment at bedside, wash hands/feet and 1 nails, trim and clean finger/toe nails, remove equipment from area. SHAMPOO : Place equipment

Splitting of the Proximal Femur With a New Femoral Nail

DTIC Science & Technology

2010-04-01

should be exercised with the use of new implants that require a change in customary technique. In addition, some concern must be raised by the amount of...the potential for gluteus medius tendon injury,8 whereas other authors have found greater soft-tissue injury by inserting a nail through the...Entry Femoral Nail (Synthes USA, Paoli, PA) moved the entry point further lateral (10 degrees) and distal to completely avoid the gluteus medius tendon

Evidence appraisal of Arrowsmith VA, Taylor R. Removal of nail polish and finger rings to prevent surgical infection (Review). Cochrane Database Syst Rev. 2014;8:CD003325.

PubMed

Girard, Nancy

2015-06-01

This systematic review revealed that there remains no evidence to indicate whether removing nail polish and finger rings affects the rate of SSIs after surgery. Given that there are no new studies on this topic, there is insufficient evidence to determine whether wearing finger rings or nail polish affects the number of bacteria on the skin after surgical hand scrubbing.

[Influence of nail polish on pulse oximeter readings of oxygen saturation: a systematic review].

PubMed

Ballesteros-Peña, Sendoa; Fernández-Aedo, Irrintzi; Picón, Artzai; Lorrio-Palomino, Sergio

2015-10-01

Nail polish has traditionally been assumed to absorb light emitted by pulse oximeters and to interfere with the detection and measurement of oxygenated hemoglobin. In a systematic review of the literature we aimed to assess the influence of nail polish on the measurement of oxygen saturation by pulse oximetry (SpO2). A search protocol for online databases (MEDLINE, Embase, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature, and IBECS [the Spanish health sciences index]) was established to find clinical trials or observational studies published between 1999 and February 2014. Twelve nonrandomized clinical trials were found. Ten were in healthy volunteers. One of the remaining 2 studies was in critical patients undergoing mechanical ventilation, and the other was in patients with stable chronic obstructive pulmonary disease. One study recreated the low oxygen level of high altitudes, while the others were done in normal atmospheric conditions. Differences between pulse oximeters and type of nail polish were found. Nail polish was associated with a statistically significant decrease in SpO2 for at least 1 color in all but 2 studies. However, the differences were within the standard error (±2.0%) of the pulse oximeters used. The authors of the studies all concluded that although nail polish might change SpO2 readings significantly, the variations are not clinically significant.

Stress relaxation of grouted entirely large diameter B-GFRP soil nail

NASA Astrophysics Data System (ADS)

Li, Guo-wei; Ni, Chun; Pei, Hua-fu; Ge, Wan-ming; Ng, Charles Wang Wai

2013-08-01

One of the potential solutions to steel-corrosion-related problems is the usage of fiber reinforced polymer (FRP) as a replacement of steel bars. In the past few decades, researchers have conducted a large number of experimental and theoretical studies on the behavior of small size glass fiber reinforce polymer (GFRP) bars (diameter smaller than 20 mm). However, the behavior of large size GFRP bar is still not well understood. Particularly, few studies were conducted on the stress relaxation of grouted entirely large diameter GFRP soil nail. This paper investigates the effect of stress levels on the relaxation behavior of GFRP soil nail under sustained deformation ranging from 30% to 60% of its ultimate strain. In order to study the behavior of stress relaxation, two B-GFRP soil nail element specimens were developed and instrumented with fiber Bragg grating (FBG) strain sensors which were used to measure strains along the B-GFRP bars. The test results reveal that the behavior of stress relaxation of B-GFRP soil nail element subjected to pre-stress is significantly related to the elapsed time and the initial stress of relaxation procedure. The newly proposed model for evaluating stress relaxation ratio can substantially reflect the influences of the nature of B-GFRP bar and the property of grip body. The strain on the nail body can be redistributed automatically. Modulus reduction is not the single reason for the stress degradation.

Allergic contact dermatitis caused by (meth)acrylates in nail cosmetic products in users and nail technicians - a 5-year study.

PubMed

Raposo, Inês; Lobo, Inês; Amaro, Cristina; Lobo, Maria de Lurdes; Melo, Helena; Parente, Joana; Pereira, Teresa; Rocha, Joana; Cunha, Ana P; Baptista, Armando; Serrano, Pedro; Correia, Teresa; Travassos, Ana R; Dias, Margarida; Pereira, Fátima; Gonçalo, Margarida

2017-12-01

The increasing use of long-lasting nail aesthetic products has led to a growing number of cases of allergic contact dermatitis (ACD) caused by (meth)acrylates in recent years. To provide information on ACD caused by (meth)acrylates related to nail cosmetic products. We retrospectively reviewed files of patients with ACD caused by (meth)acrylates related to nail cosmetic products, who were patch tested between January 2011 and December 2015 in 13 departments of dermatology in Portugal. Two-hundred and thirty cases of ACD caused by (meth)acrylates (55 technicians, 56 consumers, and 119 with mixed exposure) had been documented, mostly as chronic hand eczema (93%). The most common sensitizers were: 2-hydroxyethyl methacrylate (HEMA), which was positive in 90% of the tested patients, 2-hydroxypropyl methacrylate (HPMA), which was positive in 64.1%, and ethyleneglycol dimethacrylate, which was positive in 54.5%. HEMA and HPMA were the most frequent positive allergens. HEMA, which identified 90% of cases, can be considered to be a good screening allergen. The high number of cases of ACD caused by (meth)acrylates in nail cosmetic products certainly warrants better preventive measures at the occupational level, and specific regulation in the field of consumer safety. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Nail findings in patients with psoriatic arthritis: A cross-sectional study with special reference to transverse grooves.

PubMed

Zenke, Yukari; Ohara, Yuri; Kobayashi, Daiki; Arai, Satoru; Kishimoto, Mitsumasa; Okada, Masato; Eto, Hikaru

2017-11-01

Patients with psoriatic arthritis (PsA) commonly present with nail manifestations; however, little is known about these manifestations. This study investigated whether nail findings can be used to discriminate between PsA and psoriasis without arthritis. We performed a retrospective analysis of 118 patients with PsA and 974 patients with psoriasis without arthritis who visited St. Luke's International Hospital (Tokyo, Japan) between July 2003 and February 2015. Patients with PsA were classified according to the Classification of Psoriatic Arthritis criteria. Skin lesion severity was assessed by using the Psoriasis Area and Severity Index, and 9 types of nail findings were investigated. The incidence of nail involvement in patients with PsA was 67.6%. Female sex, presence of transverse grooves, onycholysis, and splinter hemorrhages were significantly related to PsA, with transverse grooves demonstrating the strongest association (odds ratio, 5.01; 95% confidence interval, 2.31-10.8; P < .01). Furthermore, the presence of transverse grooves was strongly related to both distal interphalangeal arthritis and enthesitis. The PsA population was relatively small. Nail findings enabled us to distinguish patients with PsA from those without arthritis. The presence of transverse grooves is significantly associated with PsA and may be associated with distal interphalangeal arthritis and enthesitis. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

The influence of distal locking on the need for fibular plating in intramedullary nailing of distal metaphyseal tibiofibular fractures.

PubMed

Attal, R; Maestri, V; Doshi, H K; Onder, U; Smekal, V; Blauth, M; Schmoelz, W

2014-03-01

Using human cadaver specimens, we investigated the role of supplementary fibular plating in the treatment of distal tibial fractures using an intramedullary nail. Fibular plating is thought to improve stability in these situations, but has been reported to have increased soft-tissue complications and to impair union of the fracture. We proposed that multidirectional locking screws provide adequate stability, making additional fibular plating unnecessary. A distal tibiofibular osteotomy model performed on matched fresh-frozen lower limb specimens was stabilised with reamed nails using conventional biplanar distal locking (CDL) or multidirectional distal locking (MDL) options with and without fibular plating. Rotational stiffness was assessed under a constant axial force of 150 N and a superimposed torque of ± 5 Nm. Total movement, and neutral zone and fracture gap movement were analysed. In the CDL group, fibular plating improved stiffness at the tibial fracture site, albeit to a small degree (p = 0.013). In the MDL group additional fibular plating did not increase the stiffness. The MDL nail without fibular plating was significantly more stable than the CDL nail with an additional fibular plate (p = 0.008). These findings suggest that additional fibular plating does not improve stability if a multidirectional distal locking intramedullary nail is used, and is therefore unnecessary if not needed to aid reduction.

Comparison of sand-based water filters for point-of-use arsenic removal in China.

PubMed

Smith, Kate; Li, Zhenyu; Chen, Bohan; Liang, Honggang; Zhang, Xinyi; Xu, Ruifei; Li, Zhilin; Dai, Huanfang; Wei, Caijie; Liu, Shuming

2017-02-01

Contamination of groundwater wells by arsenic is a major problem in China. This study compared arsenic removal efficiency of five sand-based point-of-use filters with the aim of selecting the most effective filter for use in a village in Shanxi province, where the main groundwater source had arsenic concentration >200 μg/L. A biosand filter, two arsenic biosand filters, a SONO-style filter and a version of the biosand filter with nails embedded in the sand were tested. The biosand filter with embedded nails was the most consistent and effective under the study conditions, likely due to increased contact time between water and nails and sustained corrosion. Effluent arsenic was below China's standard of 50 μg/L for more than six months after construction. The removal rate averaged 92% and was never below 86%. In comparison, arsenic removal for the nail-free biosand filter was never higher than 53% and declined with time. The arsenic biosand filter, in which nails sit in a diffuser basin above the sand, performed better but effluent arsenic almost always exceeded the standard. This highlights the positive impact on arsenic removal of embedding nails within the top layer of biosand filter sand and the promise of this low-cost filtration method for rural areas affected by arsenic contamination. Copyright © 2016 Elsevier Ltd. All rights reserved.

Arsenic speciation in hair and nails of acute promyelocytic leukemia (APL) patients undergoing arsenic trioxide treatment.

PubMed

Chen, Baowei; Cao, Fenglin; Lu, Xiufen; Shen, Shengwen; Zhou, Jin; Le, X Chris

2018-07-01

Arsenic in hair and nails has been used to assess chronic exposure of humans to environmental arsenic. However, it remains to be seen whether it is appropriate to evaluate acute exposure to sub-lethal doses of arsenic typically used in therapeutics. In this study, hair, fingernail and toenail samples were collected from nine acute promyelocytic leukemia (APL) patients who were administered intravenously the daily dose of 10 mg arsenic trioxide (7.5 mg arsenic) for up to 54 days. These hair and nail samples were analyzed for arsenic species using high performance liquid chromatography separation and inductively coupled plasma mass spectrometry detection (HPLC-ICPMS). Inorganic arsenite was the predominant form among water-extractable arsenicals. Dimethylarsinic acid (DMA V ), monomethylarsonic acid (MMA V ), monomethylarsonous acid (MMA III ), monomethylmonothioarsonic acid (MMMTA V ), and dimethylmonothioarsinic acid (DMMTA V ) were also detected in both hair and nail samples. This is the first report of the detection of MMA III and MMMTA V as metabolites of arsenic in hair and nails of APL patients. Copyright © 2018 Elsevier B.V. All rights reserved.

The SIGN nail for knee fusion: technique and clinical results

PubMed Central

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

2016-01-01

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

Knee stabilisation following infected knee arthroplasty with bone loss and extensor mechanism impairment using a modular cemented nail.

PubMed

Rao, M C; Richards, O; Meyer, C; Jones, R Spencer

2009-12-01

Infected Total Knee Replacement with significant bone loss and loss of extensor mechanism poses a difficult management problem. Arthrodesis relying on bony union can be difficult to achieve and can result in significant limb shortening. We retrospectively looked at the outcome of seven patients with significant bone loss and extensor mechanism insufficiency following infected TKR who underwent knee stabilisation using a modular cemented nail. The nail relied on the strong coupling mechanism between the modular femoral and tibial components. Pain score improved from a mean of 7.9 pre-operatively to 1.5 post-operatively at a mean follow up of 39.6 months (range 7-68) months. Two patients underwent technically easy revision nailing for recurrent infection and aseptic loosening. The Endo-Model(R) Knee Fusion Nail (Newsplint, UK/Waldemar Link, GmbH & Co. KG, Hamburg, Germany) has good early results in terms of pain relief and provides a stable knee in cases with significant bone loss and extensor mechanism insufficiency following an infected TKR thus avoiding an above knee amputation.

The stability of a hip fracture determines the fatigue of an intramedullary nail.

PubMed

Eberle, S; Bauer, C; Gerber, C; von Oldenburg, G; Augat, P

2010-01-01

The purpose of this study was to address the question of how the stability of a proximal hip fracture determines the fatigue and failure mechanism of an intramedullary implant. To answer this question, mechanical experiments and finite element simulations with two different loading scenarios were conducted. The two load scenarios differed in the mechanical support of the fracture by an artificial bone sleeve, representing the femoral head and neck. The experiments confirmed that an intramedullary nail fails at a lower load in an unstable fracture situation in the proximal femur than in a stable fracture. The nails with an unstable support failed at a load 28 per cent lower than the nails with a stable support by the femoral neck. Hence, the mechanical support of a fracture is crucial to the fatigue failure of an implant. The simulation showed why the fatigue fracture of the nail starts at the aperture of the lag screw. It is the location of the highest von Mises stress, which is the failure criterion for ductile materials.

Emerging topical onychomycosis therapies - quo vadis?

PubMed

Elkeeb, Rania; Hui, Xiaoying; Murthy, Narasimha; Maibach, Howard I

2014-12-01

Onychomycosis, a common chronic fungal infection affecting fingernails and toenails, globally may affect 10 - 30% of the population. This chronic disease is difficult to eradicate. The goal of developing a highly effective and safe topical treatment has not yet been reached as it depends on the type of onychomycosis and the variety of invaders. Topical drug delivery to the nail is highly desirable in treating nail disorders. However, efficacy of topical therapies is low due to their limited permeability across the nail plate. Advances have especially been made by the development of new therapeutic options including new drug entities, new formulations and reformulations. This overview updates emerging topical treatments for onychomycosis, research progress and future perspectives. Development of novel effective noninvasive topical therapy for treating onychomycosis and other nail diseases such as psoriasis is long overdue. Previously there was a lack of basic knowledge about nail and its barrier properties, but with the recent increased interest in this field both from industry and academia, we hope extensive research will continue in this field to bring about successful and safe treatments for such chronic diseases.

Anatomic aspects of tibiotalocalcaneal nail arthrodesis.

PubMed

Hyer, Christopher F; Cheney, Nick

2013-01-01

During the past 15 years, tibiotalocalcaneal nail arthrodesis has become an established procedure for the treatment of specific disorders of the hindfoot and ankle. However, controversy exists regarding the proper starting point for obtaining and maintaining the correct hindfoot position to allow successful fusion. One of the challenges with this procedure is aligning the tibial canal with the central talus and calcaneus for placement of the intramedullary nail. We performed a cadaver study to evaluate the radiographic and anatomic position of the tibial canal and the central talus as it relates to placement of a retrograde tibiotalocalcaneal nail. In our subjects, guide wires directed in an antegrade fashion down the tibial canal were more likely to enter lateral to the midline of the talus and miss the calcaneal body medially. These data have revealed a mismatch among the central axis of the tibia, talus, and calcaneus. Surgeons must pay careful attention to wire placement across these 3 bone segments during retrograde tibiotalocalcaneal nailing. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

The effect of keratolytic agents on the permeability of three imidazole antimycotic drugs through the human nail.

PubMed

Quintanar-Guerrero, D; Ganem-Quintanar, A; Tapia-Olguín, P; Kalia, Y N; Buri, P

1998-07-01

The permeability of three imidazole antimycotics (miconazole nitrate, ketoconazole, and itraconazole) through the free edge of healthy human nail was evaluated in vitro using side-by-side diffusion cells. The influence of keratolytic substances (papain, urea, and salicylic acid) on the permeability of the antimycotics was also studied. The results suggested that the nail constituted an impermeable barrier for these antimycotics; it could be considered that the nail behaved as a hydrophilic gel membrane, through which drugs of low solubility could not permeate. The use of ethanol did not promote the passage of any of the antimycotic drugs. Although scanning electron microscopy indicated that the keratolytic substances had a significant effect on the nail surface (papain > salicylic acid > urea), the passage of the three antimycotics was not improved by pretreatment with salicylic acid alone (20% for 10 days), or by the application of the drug in a 40% urea solution. It was found that only the combined effects of papain (15% for 1 day) and salicylic acid (20% for 10 days) were capable of enhancing the permeability of the antimycotic.

The use of blocking screws with internal lengthening nail and reverse rule of thumb for blocking screws in limb lengthening and deformity correction surgery.

PubMed

Muthusamy, Saravanaraja; Rozbruch, S Robert; Fragomen, Austin T

2016-11-01

Internal lengthening nail (ILN) is a recent development in limb lengthening and deformity correction specialty. The ILN has the distinct advantage of combining acute deformity correction with gradual lengthening of bone. While using ILN, the short metaphyseal bone fragment may develop a deformity at the time of osteotomy and nail insertion or during bone lengthening because of the wide medullary canal. These deformities are typically predictable, and blocking screws (Poller screws) are helpful in these situations. This manuscript describes the common deformities that occur in femur and tibia with osteotomies at different locations while using ILN in antegrade and retrograde nailing technique. Also, a systematic approach to the appropriate use of blocking screws in these deformities is described. In addition, the "reverse rule of thumb" is introduced as a quick reference to determine the ideal location(s) and number of blocking screws. These principles are applicable to limb lengthening and deformity correction as well as fracture fixation using intramedullary nails.

Using three-dimensional computational modeling to compare the geometrical fitness of two kinds of proximal femoral intramedullary nail for Chinese femur.

PubMed

Zhang, Sheng; Zhang, Kairui; Wang, Yimin; Feng, Wei; Wang, Bowei; Yu, Bin

2013-01-01

The aim of this study was to use three-dimensional (3D) computational modeling to compare the geometric fitness of these two kinds of proximal femoral intramedullary nails in the Chinese femurs. Computed tomography (CT) scans of a total of 120 normal adult Chinese cadaveric femurs were collected for analysis. With the three-dimensional (3D) computational technology, the anatomical fitness between the nail and bone was quantified according to the impingement incidence, maximum thicknesses and lengths by which the nail was protruding into the cortex in the virtual bone model, respectively, at the proximal, middle, and distal portions of the implant in the femur. The results showed that PFNA-II may fit better for the Chinese proximal femurs than InterTan, and the distal portion of InterTan may perform better than that of PFNA-II; the anatomic fitness of both nails for Chinese patients may not be very satisfactory. As a result, both implants need further modifications to meet the needs of the Chinese population.

Anxiety Among Patients Undergoing Nail Surgery and Skin Punch Biopsy: Effects of Age, Gender, Educational Status, and Previous Experience.

PubMed

Göktay, Fatih; Altan, Zeynep Müzeyyen; Talas, Anıl; Akpınar, Esma; Özdemir, Ekin Özge; Aytekin, Sema

2016-01-01

Patient anxiety about nail surgery relates mainly to pain associated with needle puncture, anesthetic flow during the procedure, and postoperative care, as well as possible past traumatic experience. The aims of this study were to compare anxiety levels among patients undergoing nail surgery and skin punch biopsy and to assess the effects of demographic characteristics on anxiety. Forty-eight consecutive patients who were referred to a dermatological surgery unit for nail surgery intervention (group 1) and 50 age- and sex-matched patients referred to the same unit for skin punch biopsy (group 2) were enrolled in the study. Patients' anxiety levels were measured using Spielberger's State-Trait Anxiety Inventory. There was no significant difference in median anxiety level between group 1 (42.00; interquartile range, 6.50) and group 2 (41.00; interquartile range, 8.25) (P = .517). The demographic factors of patient sex, educational status, and prior surgery showed no significant effects on anxiety levels. Nail surgery does not seem to cause significantly greater anxiety than skin punch biopsy. © The Author(s) 2015.

Plasma treatment of onychomycosis

NASA Astrophysics Data System (ADS)

Xiong, Zilan; Roe, Jeff; Grammer, Tim; Him, Yeon-Ho; Graves, David B.

2015-09-01

Onychomycosis or fungal infection of the toenail or fingernail is a common affliction. Approximately 10% of the world's adult population is estimated to suffer from onychomycosis. Current treatment options such as topical creams, oral drugs, or laser treatments are generally limited by a variety of problems. We present results for an alternative onychomycosis treatment scheme using atmospheric pressure cold air plasmas. Using thinned cow hoof as a model nail material, we tested the ability of various plasma sources to act through the model nail to eradicate either bacteria or fungus deposited on the opposite side. Following 20 minute exposure to a surface microdischarge (SMD) device operating in room air, we observed a ~ 2 log reduction of E. coli. A similar result was obtained against T. rubrum after 45 min plasma treatment. NOx species concentration penetrating through the model nail as well as uptake into the nail were measured as a function of nail thickness. We propose that these plasma-generated species, or perhaps their reaction products, are responsible for at least part of the observed anti-microbial effect. We also explore the use of ultraviolet light acting in synergy with plasma-generated chemical species.

Nail Care Products

MedlinePlus

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

Fungal Tests

MedlinePlus

... preparation is needed. See More See Less Accordion Title Common Questions How is it used? Fungal tests ... involving skin, nails, or mucous membranes appear, for example: Itchy, red, scaly areas of skin Nails that ...

Ingrown Toenails

MedlinePlus

... The most common reason for ingrown toenails is cutting toenails too short. When people cut their nails ... ingrown because they don't have defined corners. Cutting nails in a rounded shape instead of straight ...

Nail Hygiene

MedlinePlus

... diligently cleaning and trimming fingernails, which may harbor dirt and germs and can contribute to the spread ... of their length, longer fingernails can harbor more dirt and bacteria than short nails, thus potentially contributing ...

A comparative study of trochanteric and basicervical fractures of the femur treated with the Ender and McLaughlin techniques.

PubMed

Indemini, E; Clerico, P; Fenoglio, E; Mariotti, U

1982-09-01

Endomedullary nailing as proposed by Ender is an important alternative in the treatment of trochanteric and basicervical fractures of the femur (Amici et al., 1980; Carret et al., 1980; Ender, 1970; Kempf et al., 1979; Zinghi et al., 1979). Rush's concept (Eiffel Tower, for the distal epiphysis) is reproposed with some variations and transposed to the femoral neck. The aim of the operation differs from that of the nail and plate technique in that, instead of trying to achieve anatomical reconstruction, an immediate functional by-pass of the fractured part is attempted. After using this technique for three years, we compared the old method, which we had not abandoned, the McLaughlin nail and plate, with the new Ender nail.

The Chinese Nail Murders: forensic medicine in Imperial China.

PubMed Central

Summers, W. C.

1999-01-01

Robert van Gulik was a respected Dutch sinologist and author who first translated a collection of traditional Chinese detective stories into English and then created additional fictional stories based on the same characters and setting in the Tang dynasty. One of these stories, The Chinese Nail Murders, draws on van Gulik's professional interest in law and his knowledge of early Chinese works on forensic medicine. This novel develops a common theme in Chinese detective fiction, murder by a nail wound to the head. The difficulty in detection of this mode of violence posed a particular problem for the examining magistrate because postmortem examination was mostly limited to external observations. This essay compares the development of Chinese and Western forensic medicine in the context of the nail murder motif. PMID:11138936

Nail polish poisoning

MedlinePlus

... poisoning URL of this page: //medlineplus.gov/ency/article/002722.htm Nail polish poisoning To use the sharing features on this page, please enable JavaScript. This poisoning is from swallowing or breathing in ( ...

Novel treatment of onychomycosis using over-the-counter mentholated ointment: a clinical case series.

PubMed

Derby, Richard; Rohal, Patrick; Jackson, Constance; Beutler, Anthony; Olsen, Cara

2011-01-01

current medication treatments for onychomycosis have less than full cure-rate efficacy and have the potential for adverse side effects. Vicks VapoRub (The Proctor & Gamble Company, Cincinnati, OH) has been advocated in the lay literature as an effective treatment for onychomycosis. This pilot study tested Vicks VapoRub as a safe, cost-effective alternative for treating toenail onychomycosis. eighteen participants were recruited to use Vicks VapoRub as treatment for onychomycosis. Participants were followed at intervals of 4, 8, 12, 24, 36, and 48 weeks; digital photographs were obtained during initial and follow-up visits. Primary outcome measures were mycological cure at 48 weeks and clinical cure through subjective assessment of appearance and quantifiable change in the area of affected nail by digital photography analysis. Patient satisfaction was a secondary outcome, measured using a single-item questionnaire scored by a 5-point Likert scale. fifteen of the 18 participants (83%) showed a positive treatment effect; 5 (27.8%) had a mycological and clinical cure at 48 weeks; 10 (55.6%) had partial clearance, and 3 (16.7%) showed no change. All 18 participants rated their satisfaction with the nail appearance at the end of the study as "satisfied" (n = 9) or "very satisfied" (n = 9). Vicks VapoRub seems to have a positive clinical effect in the treatment onychomycosis.

Phylogenetic diversity of human pathogenic Fusarium and emergence of uncommon virulent species.

PubMed

Salah, Husam; Al-Hatmi, Abdullah M S; Theelen, Bart; Abukamar, Mohammed; Hashim, Samar; van Diepeningen, Anne D; Lass-Florl, Cornelia; Boekhout, Teun; Almaslamani, Muna; Taj-Aldeen, Saad J

2015-12-01

Fusarium species cause a broad spectrum of infections. However, little is known about the etiological agents to the species level. We identified Fusarium species isolated from clinical specimens including those of high risk patients to better understand the species involved in the pathogenesis. A set of 44 Fusarium isolates were identified by two-locus sequence typing using partial sequences of the second largest subunit of RNA polymerase (RPB2) and translation elongation factor 1 alpha (TEF-1α). The identified species belonged to four species complexes (SC); the most common SC was Fusarium solani (FSSC) (75%), followed by Fusarium oxysporum (FOSC) (4.5%), Fusarium fujikuroi (FFSC) (13.6%), and Fusarium dimerum (FDSC) (6.8%). Sites of infections were nails (n = 19, 43.2%), skin (n = 7, 15.9%), cornea (n = 6, 13.6%), blood (n = 3, 9%), wound (n = 4, 6.8%), burn (n = 2, 4.5%), tissue (n = 2, 4.5%), and urine (n = 1, 2.27%). Fusarium acutatum was rare and seem restricted to the Middle East. Comorbidities associated with invasive infections were hematological malignancy and autoimmune disorders. Members of the FSSC predominantly caused cornea, nail and bloodstream infections. Less frequently encountered were the FOSC, FFSC and FDSC. More accurate molecular identification of Fusarium species is important to predict therapeutic outcome and the emergence of these species. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Practical Aspects of Posttrauma Reconstruction With an Intramedullary Lengthening Nail

PubMed Central

2017-01-01

Summary: Limb equalization using the Ilizarov method has evolved and adapted the use of internal lengthening devices. One of the newest devices, termed “PRECICE,” is a magnetically controlled telescoping nail. Complications such as pin site infection and skin irritation are eliminated. Despite trauma surgeons’ familiarity with intramedullary nailing, the Ilizarov method requires sound knowledge of deformity analysis and awareness of specific complications associated with distraction osteogenesis. This manuscript discusses some of the practical preoperative and intraoperative components of limb lengthening. PMID:28486286

Optimizing Soft Tissue Management and Spacer Design in Segmental Bone Defects

DTIC Science & Technology

2016-12-01

proximal and distal bone segments. 3. Debride 10 grams of tibialis anterior and gastrocnemius muscles. 4. Place an interlocking intramedullary nail ...using a custom spacer to maintain 5-cm defect length. 5. Place a pre-molded 5 cm long x 2 cm diameter PMMA spacer around the nail in the defect. 6...tibia. 3. Open the IM surrounding the PMMA spacer using a “bomb bay door opening”. 4. Remove the spacer without damaging the membrane or nail . 5

Congenital malalignment of the great toenails: case report and literature review.

PubMed

Cohen, P R

1991-03-01

A 10-year-old black boy had congenital malalignment of the great toenails (CMGTN). It is important to recognize this condition since several nail disorders can occur concurrently with and/or clinically mimic it. Treatment is dependent on the severity of the condition, and includes conservative management and subsequent examination to detect CMGTN-associated complications for patients with mild lateral deviation of the nail plate, or surgical realignment for individuals with either marked nail plate deviation or condition-related disabling sequelae.

Technique tip: use of anterior cruciate ligament jig for hindfoot fusion by calcanio-talo-tibial nail.

PubMed

Haque, Syed; Sarkar, Jay

2012-08-01

The use of intramedullary nail fixation for tibio-talo-calcaneal fusion is gaining popularity. There is chance of failure of procedure following faulty operative technique specially alignment. The article describes a useful application of tibial tunnel jig in inserting the calcanio-talo-tibial guide wire. There is precision of few millimeters in the exit point of guide wire on talus. The authors believe that this helps in better positioning of nail and hence better alignment and better operative outcome.

[Tibio-Calcaneal Arthrodesis with Vertically Placed Tricortical Bone Graft after Traumatic Talar Extrusion - a Case Report].

PubMed

Popelka, V; Zamborský, R

2017-01-01

The aim of this publication is to present a case report of a 38-year-old patient with traumatic astragalectomy and resultant foot reconstruction surgery using a combination of talus compensation by vertically placed tricortical autograft and pantalar arthrodesis with a retrograde calcaneotibial nail (hindfoot nail). The advantage of this treatment is based on a solid, stable osteosynthesis, while maintaining the length of the limb. Key words: traumatic talar extrusion, tibiocalcaneal arthrodesis, hindfoot nail, bone graft, pantalar arthrodesis.

Transportability Testing of the Joint Modular Intermodal Platform (JMIP), TP-94-01, Transportability Testing Procedures

DTIC Science & Technology

2006-11-01

Serial #: T-018447EFJM Weight: 19,340 pounds 4. Semitrailer, flatbed , breakbulk/container transporter, 34 ton Model #: M872A1 Manufactured by Heller...WILL BE USED WHENEVER POS- SIBLE WHEN NAILS ARE DRIVEN INTO JOINTS OF DUNNAGE AS- SEMBLIES OR WHEN LAMINATING DUNNAGE. ADDITIONALLY, THE NAILING...PATTERN FOR AN UPPER PIECE OF LAMINATED DUNNAGE WILL BE ADJUSTED AS REQUIRED SO THAT A NAIL FOR THAT PIECE WILL NOT BE DRIVEN THROUGH, ONTO, OR RIGHT

White Nail Radio Transmitter: Billion Dollar Savings through Energy Efficiency

DTIC Science & Technology

2011-05-10

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

TEM characterization of the fine scale microstructure of a Roman ferrous nail

NASA Astrophysics Data System (ADS)

Douin, J.; Henry, O.; Dabosi, F.; Sciau, P.

2010-07-01

This paper describes the microstructure of a Roman ferrous nail through its observation by transmission electron microscopy. The morphologies of pearlitic colonies and ferritic grains are detailed and the relationship between pearlitic colonies and ferrite in Roman nails is explicitly demonstrated for the first time. Observations also confirm the presence of dislocations in ferritic grains and attest to the existence of very small carbide precipitates that have not been pointed out previously in standard archaeometric studies.

Diabetes and Foot Problems

MedlinePlus

... medicated pads use liquid corn and callus removers Cutting and over-the counter corn removal products can ... nonsharp nail file. Trimming this way helps prevent cutting your skin and keeps the nails from growing ...

Nail Problems (Toenails)

MedlinePlus

... the surface of the nail can be PODIAT PHYSIC filed off, followed by the application of an ... toes ◆ Repeated trauma to the feet from normal activities Problems If you suspect an infection due to ...

Comparison and analysis of reoperations in two different treatment protocols for trochanteric hip fractures - postoperative technical complications with dynamic hip screw, intramedullary nail and Medoff sliding plate.

PubMed

Paulsson, Johnny; Stig, Josefine Corin; Olsson, Ola

2017-08-24

In treatment of unstable trochanteric fractures dynamic hip screw and Medoff sliding plate devices are designed to allow secondary fracture impaction, whereas intramedullary nails aim to maintain fracture alignment. Different treatment protocols are used by two similar Swedish regional emergency care hospitals. Dynamic hip screw is used for fractures considered as stable within the respective treatment protocol, whereas one treatment protocol (Medoff sliding plate/dynamic hip screw) uses biaxial Medoff sliding plate for unstable pertrochanteric fractures and uniaxial Medoff sliding plate for subtrochanteric fractures, the second (intramedullary nail/dynamic hip screw) uses intramedullary nail for subtrochanteric fractures and for pertrochanteric fractures with intertrochanteric comminution or subtrochanteric extension. All orthopedic surgeries are registered in a regional database. All consecutive trochanteric fracture operations during 2011-2012 (n = 856) and subsequent technical reoperations (n = 40) were derived from the database. Reoperations were analysed and classified into the categories adjustment (percutaneous removal of the locking screw of the Medoff sliding plate or the intramedullary nail, followed by fracture healing) or minor, intermediate (reosteosynthesis) or major (hip joint replacement, Girdlestone or persistent nonunion) technical complications. The relative risk of intermediate or major technical complications was 4.2 (1.2-14) times higher in unstable pertrochanteric fractures and 4.6 (1.1-19) times higher in subtrochanteric fractures with treatment protocol: intramedullary nail/dynamic hip screw, compared to treatment protocol: Medoff sliding plate/dynamic hip screw. Overall rates of intermediate and major technical complications in unstable pertrochanteric and subtrochanteric fractures were with biaxial Medoff sliding plate 0.68%, with uniaxial Medoff sliding plate 1.4%, with dynamic hip screw 3.4% and with intramedullary nail 7.2%. The treatment protocol based on use of biaxial Medoff sliding plate for unstable pertrochanteric and uniaxial Medoff sliding plate for subtrochanteric fractures reduced the risk of severe technical complications compared to using the treatment protocol based on dynamic hip screw and intramedullary nail.

A straightforward, validated liquid chromatography coupled to tandem mass spectrometry method for the simultaneous detection of nine drugs of abuse and their metabolites in hair and nails.

PubMed

Cappelle, Delphine; De Doncker, Mireille; Gys, Celine; Krysiak, Kamelia; De Keukeleire, Steven; Maho, Walid; Crunelle, Cleo L; Dom, Geert; Covaci, Adrian; van Nuijs, Alexander L N; Neels, Hugo

2017-04-01

Hair and nails allow for a stable accumulation of compounds over time and retrospective investigation of past exposure and/or consumption. Owing to their long window of detection (weeks to months), analysis of these matrices can provide information complementary to blood and urine analysis or can be used in standalone when e.g. elimination from the body has already occurred. Drugs of abuse are often used together and, therefore, multi-analyte methods capable of detecting several substances and their metabolites in a single run are of importance. This paper presents the development and validation of a method based on liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) for the simultaneous detection of nine drugs of abuse and their metabolites in hair and nails. We focused on a simple and straightforward sample preparation to reduce costs, and allow application in routine laboratory practice. Chromatographic and mass spectrometric parameters, such as column type, mobile phase, and multiple reaction monitoring transitions were optimized. The method was validated according to the European Medicine Agency guidelines with an assessment of specificity, limit of quantification (LOQ), linearity, accuracy, precision, carry-over, matrix effects, recovery, and process efficiency. Linearity ranged from 25 to 20 000 pg mg -1 hair and from 50 to 20 000 pg mg -1 nails, and the lowest calibration point achieved the requirements for the LOQ (25 pg mg -1 for hair and 50 pg mg -1 for nails). Although it was not the main focus of the article, the reliability of the method was proven through successful participation in a proficiency test, and by investigation of authentic hair and nail samples from self-reported drug users. In the future, the method should allow comparison between the two matrices to acquire an in-depth knowledge of nail analysis and to define cutoff levels for nail analysis, as they exist for hair. Copyright © 2017 Elsevier B.V. All rights reserved.

Elastic nailing of tibia shaft fractures in young children up to 10 years of age.

PubMed

Heo, Jeong; Oh, Chang-Wug; Park, Kyeong-Hyeon; Kim, Joon-Woo; Kim, Hee-June; Lee, Jong-Chul; Park, Il-Hyung

2016-04-01

Although tibia shaft fractures in children usually have satisfactory results after closed reduction and casting, there are several surgical indications, including associated fractures and soft tissue injuries such as open fractures. Titanium elastic nails (TENs) are often used for pediatric tibia fractures, and have the advantage of preserving the open physis. However, complications such as delayed union or nonunion are not uncommon in older children or open fractures. In the present study, we evaluated children up to 10 years of age with closed or open tibial shaft fractures treated with elastic nailing technique. A total of 16 tibia shaft fractures treated by elastic nailing from 2001 to 2013 were reviewed. The mean patient age at operation was 7 years (range: 5-10 years). Thirteen of 16 cases were open fractures (grade I: 4, grade II: 6, grade IIIA: 3 cases); the other cases had associated fractures that necessitated operative treatments. Closed, antegrade intramedullary nailing was used to insert two nails through the proximal tibial metaphysis. All patients were followed up for at least one year after the injury. Outcomes were evaluated using modified Flynn's criteria, including union, alignment, leg length discrepancies, and complications. All fractures achieved union a mean of 16.1 weeks after surgery (range: 11-26 weeks). No patient reported knee pain or experienced any loss of knee or ankle motion. There was a case of superficial infection in a patient with grade III open fracture. Three patients reported soft tissue discomfort due to prominent TEN tips at the proximal insertion site, which required cutting the tip before union or removing the nail after union. At the last follow-up, there were no angular or rotational deformities over 10° in either the sagittal or coronal planes. With the exception of one case with an overgrowth of 15 mm, no patient showed shortening or overgrowth exceeding 10mm. Among final outcomes, 15 were excellent and 1 was satisfactory. Even with open fractures or soft tissue injuries, elastic nailing can achieve satisfactory results in young children, with minimal complications of delayed bone healing, or infection. Copyright © 2015 Elsevier Ltd. All rights reserved.

A prospective, randomised trial comparing closed intramedullary nailing with percutaneous plating in the treatment of distal metaphyseal fractures of the tibia.

PubMed

Guo, J J; Tang, N; Yang, H L; Tang, T S

2010-07-01

We compared the outcome of closed intramedullary nailing with minimally invasive plate osteosynthesis using a percutaneous locked compression plate in patients with a distal metaphyseal fracture in a prospective study. A total of 85 patients were randomised to operative stabilisation either by a closed intramedullary nail (44) or by minimally invasive osteosynthesis with a compression plate (41). Pre-operative variables included the patients' age and the side and pattern of the fracture. Peri-operative variables were the operating time and the radiation time. Postoperative variables were wound problems, the time to union of the fracture, the functional American Orthopaedic Foot and Ankle surgery score and removal of hardware. We found no significant difference in the pre-operative variables or in the time to union in the two groups. However, the mean radiation time and operating time were significantly longer in the locked compression plate group (3.0 vs 2.12 minutes, p < 0.001, and 97.9 vs 81.2 minutes, p < 0.001, respectively).After one year, all the fractures had united. Patients who had intramedullary nailing had a higher mean pain score (40 = no pain, 0 = severe pain), [corrected] but better function, alignment and total American Orthopaedic Foot and Ankle surgery scores, although the differences were not statistically significant (p = 0.234, p = 0.157, p = 0.897, p = 0.177 respectively). Three (6.8%) patients in the intramedullary nailing group and six (14.6%) in the locked compression plate group showed delayed wound healing, and 37 (84.1%) in the former group and 38 (92.7%) in the latter group expressed a wish to have the implant removed. We conclude that both closed intramedullary nailing and a percutaneous locked compression plate can be used safely to treat Orthopaedic Trauma Association type-43A distal metaphyseal fractures of the tibia. However, closed intramedullary nailing has the advantage of a shorter operating and radiation time and easier removal of the implant. We therefore prefer closed intramedullary nailing for patients with these fractures.

Analysis of polybrominated diphenyl ethers and emerging halogenated and organophosphate flame retardants in human hair and nails.

PubMed

Liu, Liang-Ying; Salamova, Amina; He, Ka; Hites, Ronald A

2015-08-07

A method for the digestion, extraction, fractionation, and analysis of three classes of flame retardants, including 36 polybrominated diphenyl ethers (PBDEs), 9 halogenated alternative flame retardants (AFRs), and 12 organophosphate esters (OPEs) in human hair and nail samples was developed. The method employed HNO3/H2O2 digestion, liquid-liquid extraction with (4:1 vol) hexane:dichloromethane, fractionation on a 6g column of 2.5% water deactivated Florisil, and analysis by gas chromatographic mass spectrometry. The accuracy and precision of the method was validated using spiked samples of 6 replicates for both hair and nail samples. The method validation results showed good accuracy and precision for all PBDEs except BDE-209, all AFRs except hexabromobenzene (HBB), and all of the 12 OPEs, with average recovery efficiencies>90% and relative standard deviations (RSDs)<10%. The average recovery efficiencies for HBB were between 60% and 86%, with RSDs<10%. BDE-209 had recovery efficiencies of 64% (RSD, 13%) for hair and 71% (RSD, 10%) for nail. This method was applied to analyze 5 human hair and 5 fingernail samples from the general student population at Indiana University Bloomington campus. BDE-47 and BDE-99 were the predominant PBDEs detected in both hair and nail samples, with a concentration range of 11-620 and 4.6-780ng/g (dry weight) in hair and 7.3-43 and 2.1-11ng/g in nails, respectively. Di-(2-ethylhexyl)-tetrabromophthalate (TBPH) and 2-ethylhexyl-2,3,4,5-tetrabromobenzoate (TBB) were detected in all the samples, with concentrations of 20-240 and 11-350ng/g in hair and <17-80 and <9.2-71ng/g in nails, respectively. Among the 12 OPEs analyzed, tris(2-chloroethyl)phosphate (TCEP), tris(1-chloro-2-propyl)phosphate (TCIPP), tris(1,3-dichloro-2-propyl) phosphate (TDCIPP), and triphenyl phosphate (TPHP) were most often detected. The concentrations of these OPEs (summed together) were 1100-3900 and 380-18,000ng/g in hair and nails, respectively. These levels exceed those of both the PBDEs and the AFRs. Copyright © 2015 Elsevier B.V. All rights reserved.

29 CFR 1918.91 - Housekeeping.

Code of Federal Regulations, 2014 CFR

2014-07-01

... safe reach of employees. (e) Coaming clearance. Dunnage, hatch beams, tarpaulins or gear not in use... hatch coaming. (f) Nails. (1) Nails that are protruding from shoring or fencing in the work area shall...

29 CFR 1918.91 - Housekeeping.

Code of Federal Regulations, 2011 CFR

2011-07-01

... safe reach of employees. (e) Coaming clearance. Dunnage, hatch beams, tarpaulins or gear not in use... hatch coaming. (f) Nails. (1) Nails that are protruding from shoring or fencing in the work area shall...

29 CFR 1918.91 - Housekeeping.

Code of Federal Regulations, 2013 CFR

2013-07-01

... safe reach of employees. (e) Coaming clearance. Dunnage, hatch beams, tarpaulins or gear not in use... hatch coaming. (f) Nails. (1) Nails that are protruding from shoring or fencing in the work area shall...

29 CFR 1918.91 - Housekeeping.

Code of Federal Regulations, 2012 CFR

2012-07-01

... safe reach of employees. (e) Coaming clearance. Dunnage, hatch beams, tarpaulins or gear not in use... hatch coaming. (f) Nails. (1) Nails that are protruding from shoring or fencing in the work area shall...

Nail Ridges: Cause for Concern?

MedlinePlus

... of a health problem? Answers from Lawrence E. Gibson, M.D. It depends on the direction of ... indicate an underlying health condition. With Lawrence E. Gibson, M.D. Habif TP. Nail diseases. In: Clinical ...

Noise Source Identification and Dynamic Modeling of a Pneumatic Nailing Device =

NASA Astrophysics Data System (ADS)

Nili Ahmadabadi, Zahra

Exposure to hazardous noise levels emitted by pneumatic nailing devices contributes significantly to risk of hearing damage among the construction workers throughout the world. This health problem comes from the lack of appropriate technology such as low noise devices which in turn results from the lack of scientific knowledge about designing reduced noise devices. This study contributes to the design improvement of pneumatic nailing devices through identifying the noise sources and developing the simulation tool required to redesign the pneumatic nailing device. To identify the noise sources, the study uses a combination of two complementary experimental approaches. The first makes use of time-synchronized data analysis of several variables during the machine operation. This strategy allows identifying the physical processes and provides a detailed separation of the noise generation mechanisms in successive time sequences. However, since multiple noise sources radiate at the same time, this observation approach is not sufficient for noise source identification and ranking. Thus, it is completed by a selective wrapping and muffler procedure. This technique provides overall generated noise associated with each process, as well as ranking of the three major sources: (1) exhaust noise, (2) machine body vibrations, and (3) workpiece vibrations. A special investigation is conducted on this third one with two cases: a workpiece/worktable setup representative of the actual field usage of a nailing device and a workpiece/sandbox setup used in a standardized laboratory test. The study evaluates the efficiency of the workpiece/sandbox setup in reducing the workpiece radiation and obtains a typical workpiece contribution on an actual worksite. To provide a simulation tool, a dynamic model of the pneumatic nailing device needs to be developed. Dynamic modeling of the nailing device requires mathematical modeling of the physical processes involved in its operation. All of these processes can be described through already existing mathematical relations, except for the penetration resistance force (PRF) imposed on the nails when penetrating the wood. The PRF depends on various factors. This study follows two approaches in parallel to develop an empirical prediction law for the PRF: quasi-static and high-speed. The quasi-static approach provides a rapid and precise representation of the law at quasistatic penetration velocities. The law covers the entire displacement range, various nail geometries and sizes, and wood types. The high-speed approach aims to provide a law which covers a much wider range of penetration velocities. The approach is complicated since it requires a sophisticated test machine to conduct the nail driving tests at high penetration velocities. The study designs and fabricates an advanced test machine to later extend the prediction range of the PRF law. The last part of this study develops the dynamic model of a nail gun while integrating the quasi-static PRF law. The model includes dynamics of all the air chambers and the moving parts, and interactions and impacts/contacts between different parts. The study integrates a comprehensive experimental validation of the model. Future improvements in the dynamic model precision will be possible by using the extended version of the PRF law.

Fingernails Yield Clues to Limb Regeneration

MedlinePlus

... in mice. The findings, published in the journal Nature, could eventually lead to the development of novel ... Nail Epithelium Couples Nail Growth to Digit Regeneration. Nature 2013 Jul 11;499(7457):228-32. doi: ...

Are fingernails a key to unlocking the puzzle of mammalian limb regeneration?

PubMed

Lehoczky, Jessica A

2017-06-01

Some mammalian digit tips, including those of mice and human children, can regenerate following amputation, whereas mammalian limb regeneration does not occur. One major difference between the digit tip and the rest of the limb is the presence of the nail, which is necessary for this type of regeneration. This couples well with the finding that canonical Wnt signalling and Lgr6, an agonist of Wnt signalling that marks nail stem cells, are necessary for digit tip regeneration. This viewpoint essay discusses the role of the nail in digit tip regeneration and explores whether nail stem cells and their presumptive niche can be solely accountable for why regeneration is possible in the digit tip, but not the rest of the limb. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Novel Homozygous Missense Mutation in HOXC13 Leads to Autosomal Recessive Pure Hair and Nail Ectodermal Dysplasia.

PubMed

Li, Xiaoxiao; Orseth, Meredith Lee; Smith, J Michael; Brehm, Mary Abigail; Agim, Nnenna Gebechi; Glass, Donald Alexander

2017-03-01

Pure hair and nail ectodermal dysplasia (PHNED) is a rare disorder that presents with hypotrichosis and nail dystrophy while sparing other ectodermal structures such as teeth and sweat glands. We describe a homozygous novel missense mutation in the HOXC13 gene that resulted in autosomal recessive PHNED in a Hispanic child. The mutation c.812A>G (p.Gln271Arg) is located within the DNA-binding domain of the HOXC13 gene, cosegregates within the family, and is predicted to be maximally damaging. This is the first reported case of a missense HOXC13 mutation resulting in PHNED and the first reported case of PHNED identified in a North American family. Our findings illustrate the critical role of HOXC13 in human hair and nail development. © 2017 Wiley Periodicals, Inc.

Does the Angle of the Nail Matter for Pertrochanteric Fracture Reduction? Matching Nail Angle and Native Neck-Shaft Angle.

PubMed

Parry, Joshua A; Barrett, Ian; Schoch, Bradley; Yuan, Brandon; Cass, Joseph; Cross, William

2018-04-01

To determine whether fixation of pertrochanteric hip fractures with cephalomedullary nails (CMNs) with a neck-shaft angle (NSA) less than the native NSA affects reduction and lag screw cutout. Retrospective comparative study. Level I trauma center. Patients treated with a CMN for unstable pertrochanteric femur fractures (OTA/AO 31-A2.2 and 31-A2.3) between 2005 and 2014. CMN fixation. NSA reduction and lag screw cutout. Patients fixed with a nail angle less than their native NSA were less likely to have good reductions [17% vs. 60%, 95% confidence interval (CI), -63% to -18%; P = 0.0005], secondary to more varus reductions (41% vs. 10%, 95% CI, 9%-46%; P = 0.01) and more fractures with ≥4 mm of displacement (63% vs. 35%, 95% CI, 3%-49%; P = 0.03). The cutout was not associated with the use of a nail angle less than the native NSA (60% vs. 76%, 95% CI, -56% to 18%; P = 0.5), varus reductions (60% vs. 32%, 95% CI, -13% to 62%; P = 0.3), or poor reductions (20% vs. 17%, 95% CI, -24% to 44%; P = 1.0). The fixation of unstable pertrochanteric hip fractures with a nail angle less than the native NSA was associated with more varus reductions and fracture displacement but did not affect the lag screw cutout. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Low concentrations of selenium and zinc in nails are associated with childhood asthma.

PubMed

Carneiro, Maria Fernanda Hornos; Rhoden, Claudia Ramos; Amantéa, Sérgio Luis; Barbosa, Fernando

2011-12-01

The purpose of this study was to investigate possible associations between Zn, Se, Cu, Mn, and Co concentrations in nails and asthma in a young population from a Southern Brazil city. Additionally, correlations between these chemical elements among asthmatic and non-asthmatic children were evaluated. Before nail collection (n = 165), children were asked to complete the International Study of Asthma and Allergies in Childhood questionnaire. The concentrations of trace elements were determined by inductively coupled plasma mass spectrometry. The chi-square test was used to evaluate the association between element concentrations in nails and the respiratory outcome. To evaluate correlations between the elements, we used the Spearman correlation test. For all tests, the significance level was set at 95% (P ≤ 0.05). Children included in the highest quartile of nail Se and Zn concentration presented a fivefold decrease in the prevalence ratio of asthma while children in the lowest Se range presented an almost 2.5-fold increase in the asthma prevalence ratio. There were weak to strong correlations between Cu vs. Zn, Cu vs. Co, Cu vs. Se, Zn vs. Se, Zn vs. Mn, and Mn vs. Co in both asthmatic and non-asthmatic children. Interestingly, non-asthmatics also presented correlations between Co vs. Se and Zn. Taken together, our results clearly demonstrated an association between concentrations of selenium and zinc and childhood asthma and the usefulness of nail as a noninvasive matrix to detect minerals imbalance in asthma patients.

Subclinical onychomycosis is associated with tinea pedis.

PubMed

Walling, H W

2009-10-01

Onychomycosis is a common cause of nail dystrophy and may be associated with tinea pedis. The presence of dermatophyte fungi in clinically normal nails is unknown. To assess the presence of dermatophyte fungi in normal-appearing toenails and to compare the risk of subclinical dermatophytosis in patients without and with concurrent tinea pedis. This is a prospective, University-based study of adults without and with microscopically confirmed tinea pedis. Subjects with dystrophy of any toenail were excluded, as were those ever previously diagnosed as having onychomycosis and those who had used topical antifungals in the past year. A great toenail clipping obtained from each subject was submitted for periodic acid-Schiff histology. One hundred and one subjects (63 men and 38 women, mean +/- SD age 45.4 +/- 15.7 years) were included. Overall, septate hyphae (ostensibly dermatophyte) were identified in seven specimens. Of the 66 control subjects, one case (1.5%) of nail dermatophyte was identified. Of the 35 subjects with tinea pedis, six cases (17%) of nail dermatophyte were identified (P = 0.0066; odds ratio 13.4, 95% confidence interval 1.6-117). There were no significant differences in age or gender between the experimental and control groups or between the nail dermatophyte-positive and negative cohorts. Dermatophyte fungi may be isolated from normal-appearing toenails. The presence of dermatophytes in this situation is strongly associated with the presence of tinea pedis. Subclinical dermatophyte in the nail plate may serve as a reservoir for ongoing local infection.

Intramedullary nailing versus plating for distal tibia fractures without articular involvement: a meta-analysis.

PubMed

Mao, Zhi; Wang, Guoqi; Zhang, Lihai; Zhang, Licheng; Chen, Shuo; Du, Hailong; Zhao, Yanpeng; Tang, Peifu

2015-06-16

The choice between intramedullary (IM) nailing or plating of distal tibia fractures without articular involvement remains controversial. A meta-analysis of randomized controlled trials (RCTs) and observational studies was performed to compare IM nailing with plating for distal tibia fractures without articular involvement and to determine the dominant strategy. The PubMed, Embase, Cochrane Library databases, Chinese Wan-Fang Database, and China National Knowledge Infrastructure were searched. Twenty-eight studies, which included 1863 fractures, met the eligible criteria. The meta-analysis did not identify a statistically significant difference between the two treatments in terms of the rate of deep infection, delayed union, removal of instrumentation, or secondary procedures either in the RCT or retrospective subgroups. IM nailing was associated with significantly more malunion events and a higher incidence of knee pain in the retrospective subgroup and across all the studies, but not significantly in the RCT subgroup, and a lower rate of delayed wound healing and superficial infection both in the RCT and retrospective subgroups relative to plating. A meta-analysis of the functional scores or questionnaires was not possible because of the considerable variation among the included studies, and no significant differences were observed. Evidence suggests that both IM nailing and plating are appropriate treatments as IM nailing shows lower rate of delayed wound healing and superficial infection and plating may avoid malunion and knee pain. These findings should be interpreted with caution, however, because of the heterogeneity of the study designs. Large, rigorous RCTs are required.

Evaluation of the Stryker S2 IM Nail Distal Targeting Device for reduction of radiation exposure: a case series study.

PubMed

Anastopoulos, George; Ntagiopoulos, Panagiotis G; Chissas, Dionisios; Loupasis, George; Asimakopoulos, Antonios; Athanaselis, Eustratios; Megas, Panagiotis

2008-10-01

Distal locking is one challenging step during intramedullary nailing of femoral shaft fractures that can lead to an increase of radiation exposure. In the present study, the authors describe a technique for the distal locking of femoral nails, implementing a new targeting device in an attempt to reduce radiation exposure and operational time. Over a 2-year period, 127 consecutive cases of femoral shaft fractures were included in the study. All cases were treated with nailing of femoral shaft fractures with an unslotted reamed antegrade femoral nail and distal locking was performed with the use of a proximally mounted aiming device. Mean duration of the procedure was 63.5 18.1 min while the duration for distal locking was 6.6 +/- 2.6 min. In all successful cases, exposure from intraoperative fluoroscopy was 17.2 +/- 7.4 s for the whole operative procedure, and for distal locking was 2 shots, 1.35 s (range, 0.9-2.2 s) and 1.9 mGy (range, 1.1-2.9 mGy). Five cases (3.9%) were unsuccessful, but overall no intraoperative complications were encountered from the application of this technique. The ability of the device to correspond to the level of nail deformation and to properly identify the distal holes, reduced exposure to radiation compared to other published reports, and should be considered as a valuable tool for distal locking of femoral fractures.

Protection during production: Problems due to prevention? Nail and skin condition after prolonged wearing of occlusive gloves.

PubMed

Weistenhöfer, Wobbeke; Uter, Wolfgang; Drexler, Hans

2017-01-01

Wearing of occlusive gloves during the whole working shift is considered a risk factor for developing hand eczema, similar to wet work. Moreover, the increased hydration due to glove occlusion may lead to brittle nails. Two hundred and seventy clean room workers, wearing occlusive gloves for prolonged periods, and 135 administrative employees not using gloves were investigated. This included a dermatological examination of the nails and the hands, using the Hand Eczema ScoRe for Occupational Screening (HEROS), measurement of transepidermal water loss (TEWL), and a standardized interview. Of the clean room workers, 39%, mainly women, reported nail problems, mostly brittle nails with onychoschisis. Skin score values showed no significant differences between HEROS values of both groups. TEWL values of exposed subjects were similar to TEWL values of controls 40 min after taking off the occlusive gloves. In a multiple linear regression analysis, male gender and duration of employment in the clean room were associated with a significant increase in TEWL values. The effect of occlusion on TEWL seems to be predominantly transient and not be indicative of a damaged skin barrier. This study confirmed the results of a previous investigation showing no serious adverse effect of wearing of occlusive gloves on skin condition without exposure to additional hazardous substances. However, occlusion leads to softened nails prone to mechanical injury. Therefore, specific prevention instructions are required to pay attention to this side effect of occlusion.

Effect of polyethylene glycols on the trans-ungual delivery of terbinafine.

PubMed

Nair, Anroop B; Chakraborty, Bireswar; Murthy, S Narasimha

2010-12-01

Topical nail drug delivery could be improved by identifying potent chemical penetration enhancers. The purpose of this study was to assess the effect of polyethylene glycols (PEGs) on the trans-ungual delivery of terbinafine. In vitro permeation studies were carried out by passive and iontophoresis (0.5 mA/cm2) processes for a period of 1 h using gel formulations containing different molecular weight PEGs (30%w/w). The release of drug from the loaded nail plates and the possible mechanisms for the enhanced delivery was studied. Passive delivery using formulation with low molecular weight PEGs (200 and 400 MW) indicated moderate enhancement in the permeation and drug load in the nail plate, compared to the control formulation. However, the effect of low molecular weight PEGs was predominant during iontophoresis process with greater amount of terbinafine being permeated (≈35 µg/cm2) and loaded into the nail plate (≈2.7 µg/mg). However, little or no effect on drug delivery was observed with high molecular weight PEGs (1000- 3350 MW) in passive and iontophoresis processes. Release of drug from the nail plates loaded by iontophoresis using low molecular weight PEG (400 MW) exhibited sustain effect which continued over a period of 72 days. The enhancement in drug permeation by low molecular weight PEGs is likely due to their ability to lead to greater water uptake and swelling of nail. This study concluded that the low molecular weight PEGs are indeed a promising trans-ungual permeation enhancer.

Titanium elastic nail - Complications in the treatment of paediatric diaphyseal fracture of femur [corrected].

PubMed

Sarkar, Saikat; Bandyopadhyay, Ranadeb; Mukherjee, Arindam

2013-01-01

Femoral shaft fracture is the most common major paediatric orthopaedic. For generations traction and casting was the standard treatment for all femoral shaft fractures in children. Over the past two decades the advantages of fixation and rapid mobilisation have been increasingly recognised. A prospective study was conducted in five private hospitals in the district of Bankura, West Bengal over a period of two years (April 2010 to March 2012) on 70 patients with closed shaft femur fractures between 6- 14 years age of either sex. The aim was to find out the short term complications of titanium elastic nailing in diaphyseal fracture of femur in children and compare the findings of this study with pre- existing studies in this field. In our study the most common complication was pain at nail entry site (60%). 5.71% had local inflammatory reaction due to nails. Superficial infection occurred in 2.85%. At the end of 1 year, 2.85% had limb length discripancies. Proximal migration occurred in 2.85%. 2.85% encountered acute reactive synovitis, 5.71% developed angulation of fracture site and 2.85% developed per operative breakage of nail. The treatment of paediatric shaft femur fracture has been drastically changed over the last two decades to internal fixation by elastically stable intra- medullary nail (ESIN). In our study, we encountered only a few complications most of them being minor. Most of the complications were surgical technique related and were seen at the initial phase of the learning curve.

Fragility fractures of the ankle in the elderly: Open reduction and internal fixation versus tibio-talo-calcaneal nailing: Short-term results of a prospective randomized-controlled study.

PubMed

Georgiannos, D; Lampridis, V; Bisbinas, I

2017-02-01

The management of ankle fractures in the elderly remains unpredictable, secondary to their various co-morbidities. Although tibiotalocalcaneal (TTC) nailing has been an effective option for ankle arthrodesis due to ankle arthritis or Charcot arthropathy there are few reports regarding the use of TTC nail for the treatment of ankle fractures. Aim of this study was to compare the results of ORIF versus TTC nailing for the treatment of unstable ankle fractures in the elderly. We hypothesized that the elderly may benefit from TTC nailing, as it allows the patient to be mobilized immediately after surgery and minimizes the risk of wound or bone problems. This was a prospective, randomized-controlled, comparative study. Between 2009 and 2015, 43 patients were treated with a TTC nail (Group A) and 44 with ORIF (Group B). The Olerud-Molander ankle score was obtained and intraoperative-postoperative complications, length of hospital stay, mobility status and reoperation rate were recorded. The nail fixation was performed with the TrigenR hindfoot nail after closed reduction. ORIF was performed, using a 1/3 tubular plate and 3.5mm screws for the lateral malleolus and two 4.0 mm cannulated screws for the medial. Mortality rate at one year was 13.9% for Group A and 18.1% for Group B. Mean follow-up was 14 months (12-18m). There were no intraoperative complications. Three complications in Group A (8.1%) and twelve (33.3%) in Group B were encountered postoperatively (p<0.05). There was significant shorter hospital stay in Group A (5.2±3.1d) than in Group B (8.4±5.2d). In Group A, 28 patients returned to their pre-injury mobility status (75.6%) while 9 declined one level of the mobility scale (24.3%). In Group B, 26 patients remained at the same mobility level (72.2%) and 10 declined one level (27.7%). There was no significant difference between the postoperative OMAS scores in the two Groups (56.9±9.85 and 56.6±9.3 respectively). We believe that TTC nailing is a safe and effective method of treatment of unstable ankle fractures in the elderly because it has a low risk of complications and restores function and mobility allowing an immediate return to full weight-bearing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Inclined fluidized bed system for drying fine coal

DOEpatents

Cha, Chang Y.; Merriam, Norman W.; Boysen, John E.

1992-02-11

Coal is processed in an inclined fluidized bed dryer operated in a plug-flow manner with zonal temperature and composition control, and an inert fluidizing gas, such as carbon dioxide or combustion gas. Recycled carbon dioxide, which is used for drying, pyrolysis, quenching, and cooling, is produced by partial decarboxylation of the coal. The coal is heated sufficiently to mobilize coal tar by further pyrolysis, which seals micropores upon quenching. Further cooling with carbon dioxide enhances stabilization.

Single and multi-component adsorption of salicylic acid, clofibric acid, carbamazepine and caffeine from water onto transition metal modified and partially calcined inorganic-organic pillared clay fixed beds.

PubMed

Cabrera-Lafaurie, Wilman A; Román, Félix R; Hernández-Maldonado, Arturo J

2015-01-23

Fixed-beds of transition metal (Co(2+), Ni(2+) or Cu(2+)) inorganic-organic pillared clays (IOCs) were prepared to study single- and multi-component non-equilibrium adsorption of a set of pharmaceutical and personal care products (PPCPs: salicylic acid, clofibric acid, carbamazepine and caffeine) from water. Adsorption capacities for single components revealed that the copper(II) IOCs have better affinity toward salicylic and clofibric acid. However, multi-component adsorption tests showed a considerable decrease in adsorption capacity for the acids and an unusual selectivity toward carbamazepine depending on the transition metal. This was attributed to a combination of competition between PPCPs for adsorption sites, adsorbate-adsorbate interactions, and plausible pore blocking caused by carbamazepine. The cobalt(II) IOC bed that was partially calcined to fractionate the surfactant moiety showcased the best selectivity toward caffeine, even during multi-component adsorption. This was due to a combination of a mildly hydrophobic surface and interaction between the PPCP and cobalt(II). In general, the tests suggest that these IOCs may be a potential solution for the removal of PPCPs if employed in a layered-bed configuration, to take care of families of adsorbates in a sequence that would produce sharpened concentration wavefronts. Copyright © 2014 Elsevier B.V. All rights reserved.

Partial nitritation of raw anaerobic sludge digester liquor by swim-bed and swim-bed activated sludge processes and comparison of their sludge characteristics.

PubMed

Qiao, Sen; Kawakubo, Yuki; Koyama, Toichiro; Furukawa, Kenji

2008-11-01

This study evaluated performance of swim-bed (SB) reactors packed with a novel acrylic fiber carrier (BF) and swim-bed activated sludge (SBAS) reactor for partial nitritation of anaerobic sludge digester liquor from a municipal wastewater treatment plant. Comparison of characteristics of sludge obtained from both the reactors was also made. The average conversion rates of ammonium to nitrite were 52.3% and 40.0% under relatively high nitrogen loading rates over 3.0 kg-N/m(3)/d, respectively in two reactors. The average BOD(5) removal efficiencies were 74.3% and 64.4%, respectively in the two reactors. The size of the sludge pellets taken from SB and SBAS reactors was found to be approximately three times (229 mum versus 88 mum) of that of the seed sludge. This sludge also had relatively high extracellular proteins levels indicating better sludge settling capability as compared to the sludge taken from SBAS reactor. Although the effluent nitrite/ammonium ratios had fluctuated in both reactor in some extent, the low dissolved oxygen concentration (average of 2.5 versus 0.35 mg/l), low suspended solids (average of 33.3 versus 33.5 mg/l), and about 50% ammonium conversion to nitrite demonstrated the application potential of anammox process for nitrogen removal.

Magnesium and Space Flight

PubMed Central

Smith, Scott M.; Zwart, Sara R.

2015-01-01

Magnesium is an essential nutrient for muscle, cardiovascular, and bone health on Earth, and during space flight. We sought to evaluate magnesium status in 43 astronauts (34 male, 9 female; 47 ± 5 years old, mean ± SD) before, during, and after 4–6-month space missions. We also studied individuals participating in a ground analog of space flight (head-down-tilt bed rest; n = 27 (17 male, 10 female), 35 ± 7 years old). We evaluated serum concentration and 24-h urinary excretion of magnesium, along with estimates of tissue magnesium status from sublingual cells. Serum magnesium increased late in flight, while urinary magnesium excretion was higher over the course of 180-day space missions. Urinary magnesium increased during flight but decreased significantly at landing. Neither serum nor urinary magnesium changed during bed rest. For flight and bed rest, significant correlations existed between the area under the curve of serum and urinary magnesium and the change in total body bone mineral content. Tissue magnesium concentration was unchanged after flight and bed rest. Increased excretion of magnesium is likely partially from bone and partially from diet, but importantly, it does not come at the expense of muscle tissue stores. While further study is needed to better understand the implications of these findings for longer space exploration missions, magnesium homeostasis and tissue status seem well maintained during 4–6-month space missions. PMID:26670248

Magnesium and Space Flight.

PubMed

Smith, Scott M; Zwart, Sara R

2015-12-08

Magnesium is an essential nutrient for muscle, cardiovascular, and bone health on Earth, and during space flight. We sought to evaluate magnesium status in 43 astronauts (34 male, 9 female; 47 ± 5 years old, mean ± SD) before, during, and after 4-6-month space missions. We also studied individuals participating in a ground analog of space flight (head-down-tilt bed rest; n = 27 (17 male, 10 female), 35 ± 7 years old). We evaluated serum concentration and 24-h urinary excretion of magnesium, along with estimates of tissue magnesium status from sublingual cells. Serum magnesium increased late in flight, while urinary magnesium excretion was higher over the course of 180-day space missions. Urinary magnesium increased during flight but decreased significantly at landing. Neither serum nor urinary magnesium changed during bed rest. For flight and bed rest, significant correlations existed between the area under the curve of serum and urinary magnesium and the change in total body bone mineral content. Tissue magnesium concentration was unchanged after flight and bed rest. Increased excretion of magnesium is likely partially from bone and partially from diet, but importantly, it does not come at the expense of muscle tissue stores. While further study is needed to better understand the implications of these findings for longer space exploration missions, magnesium homeostasis and tissue status seem well maintained during 4-6-month space missions.

Arthrodesis of the knee using a custom-made intramedullary coupled device.

PubMed

White, S P; Porteous, A J; Newman, J H; Mintowt-Czyz, W; Barr, V

2003-01-01

Nine patients underwent arthrodesis of the knee using customised coupled nail (the Mayday arthrodesis nail), five after infected arthroplasty, one following failed arthrodesis, one for intractable anterior knee pain, one for Charcot instability and one after trauma. Comparison was made with 17 arthrodeses, eight undertaken using external fixation, four with dual compression plates, and five with long Kütntscher nails. Union was achieved in all patients (100%) at a mean time of ten months using the customised implant. There were no complications despite early weight-bearing. No further procedures were required. This contrasted with a rate of union of 53% and a complication rate of 76% with alternative techniques. Of this second group, 76% required a further operative procedure. We compared the Mayday arthrodesis nail with other techniques of arthrodesis of the knee. The differences in the need for further surgery and occurrence of complications were statistically significant (p < 0.001), and differences in the rate of nonunion and inpatient stay of less than three weeks were also significant (p < 0.05) using Fisher's exact test. We conclude that a customised coupled intramedullary nail can give excellent stability allowing early weight-bearing, and results in a high rate of union with minimal postoperative complications.

Titanium Nanoparticle Size Influences Trace Concentration Levels in Skin Appendages.

PubMed

Tasat, Deborah R; Domingo, Mariela G; Bruno, Marcos E; Guglielmotti, María B; Olmedo, Daniel G

2017-07-01

As a result of biotribocorrosion, the surface of a titanium (Ti) biomedical device can be a potential source of systemic contamination with Ti nanoparticles (NPs). Although NPs can be chemically similar, differences in particle size may lead to different biological responses. The aim of this experimental study was to determine Ti trace levels in skin appendages and plasma and explore the influence of NP size on trace levels using a murine model. Results showed the presence of Ti traces in the nails, hair, and plasma. The concentration of the smallest NPs (5 Nm) was higher than that of 10 Nm NPs in all the studied samples. Irrespective of NP size, Ti levels were always lower in plasma than in skin appendages. Ti levels were higher in nails than in hair. Ti NPs size influenced trace concentration levels in hair/nails, suggesting that 5 Nm Ti particles are more easily eliminated through these skin appendages. Given that the nails showed the highest levels of Ti, and that these skin appendages are not exposed to agents that can leach out Ti, as occurs with hair, we propose the nails as the most suitable and reliable bioindicator for monitoring systemic contamination with Ti.

Reduction and internal fixation of displaced intra-articular calcaneal fractures with a locking nail: a prospective study of sixty nine cases.

PubMed

Simon, P; Goldzak, M; Eschler, A; Mittlmeier, T

2015-10-01

The best treatment for intra-articular fractures of the calcaneus is still debated. The aims of this study were to determine whether intrafocal reduction of thalamic fractures is effective, to evaluate whether a locking nail is able to maintain reduction of the articular surface and to analyse the functional results of this original method. This prospective study assessed 69 fractures treated with a locking fracture nail in 63 cases and with primary subtalar fusion in six (Calcanail (®), FH). Articular congruity and global reduction of the calcaneus was assessed in all patients by computed tomography (CT) scan three months postoperatively. Functional results were evaluated according to the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS-AHS) and all complications recorded. For the 63 fracture nails, the average AOFAS score was 85.9 at a mean final follow-up of 12 months. Only three secondary fusions were performed. For the six comminuted fractures requiring primary fusion, the average AOFAS score was 75.9 at the last follow-up. The posterior intrafocal approach for both reduction and locked nailing of intra-articular calcaneal fractures has been proven as an effective and reliable procedure.

Green Nail Syndrome

MedlinePlus

... if continued for one to four months. Alternatively, chlorine bleach, diluted 1:4 with water, is effective in suppressing growth of P. aeruginosa when applied topically to affected nails. Vinegar (acetic acid) has been reported to be useful in this ...

Transitioning to an Intramedullary Lengthening and Compression Nail

PubMed Central

2017-01-01

Summary: The magnetic intramedullary lengthening nail is an innovative technology that allows for creative ways to treat difficult problems. The lengthening option has revolutionized femur fracture management with bone loss and malunion therapy. The compression version of this nail has provided a gradual method to compress nonunions and difficult fractures that may obviate the need for many current uses of external fixation. Three cases are presented in this manuscript demonstrating a new paradigm in the management of bone loss/shortening of the tibia and femur, and recalcitrant nonunions. PMID:28486284

Optimization of Soft Tissue Management, Spacer Design, and Grafting Strategies for Large Segmental Bone Defects using the Chronic Caprine Tibial Defect Model

DTIC Science & Technology

2016-12-01

gastrocnemius muscles. 4. Place an interlocking intramedullary nail using a custom spacer to maintain 5-cm defect length. 5. Place a pre-molded 5 cm long x...2 cm diameter PMMA spacer around the nail in the defect. 6. Irrigate the wound with normal (0.9 %) saline and close the wound. The Treatment...PMMA spacer using a “bomb bay door opening”. 4. Remove the spacer without damaging the membrane or nail . 5. Collect appropriate IM samples as

Permanent antibiotic impregnated intramedullary nail in diabetic limb salvage: a case report and literature review

PubMed Central

Woods, Jason B.; Lowery, Nicholas J.; Burns, Patrick R.

2012-01-01

Managing complications after attempted hind foot and ankle arthrodesis with intramedullary nail fixation is a challenge. This situation becomes more problematic in the patient with diabetes mellitus and multiple comorbidities. Infection and subsequent osteomyelitis can be a devastating, limb threatening complication associated with these procedures. The surgeon must manage both the infectious process and the skeletal instability concurrently. This article provides a literature review and detailed management strategies for a modified technique of employing antibiotic impregnated polymethylmethacrylate-coated intramedullary nailing. PMID:22396833

Finite element validation of stress intensity factor calculation models for thru-thickness and thumb-nail cracks in double edge notch specimens

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beres, W.; Koul, A.K.

1994-09-01

Stress intensity factors for thru-thickness and thumb-nail cracks in the double edge notch specimens, containing two different notch radius (R) to specimen width (W) ratios (R/W = 1/8 and 1/16), are calculated through finite element analysis. The finite element results are compared with predictions based on existing empirical models for SIF calculations. The effects of a change in R/W ratio on SIF of thru-thickness and thumb-nail cracks are also discussed. 34 refs.

Thinking dimensional: prevalence of DSM-5 early adolescent full syndrome, partial and subthreshold eating disorders in a cross-sectional survey in German schools.

PubMed

Hammerle, Florian; Huss, Michael; Ernst, Verena; Bürger, Arne

2016-05-05

Investigating for the first time in Germany Diagnostic and Statistical Manual Fifth Edition (DSM-5) prevalences of adolescent full syndrome, Other Specified Feeding or Eating Disorder (OSFED), partial and subthreshold anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). A national school-based cross-sectional survey with nine schools in Germany was undertaken that was aimed at students from grades 7 and 8. Of the 1775 students who were contacted to participate in the study, 1654 participated (participation rate: 93.2%). The sample consisted of 873 female and 781 male adolescents (mean age=13.4 years). Prevalence rates were established using direct symptom criteria with a structured inventory (SIAB-S) and an additional self-report questionnaire (Eating Disorder Inventory 2 (EDI-2)). Prevalences for full syndrome were 0.3% for AN, 0.4% for BN, 0.5% for BED and 3.6% for OSFED-atypical AN, 0% for BN (low frequency/limited duration), 0% for BED (low frequency/limited duration) and 1.9% for purging disorder (PD). Prevalences of partial syndrome were 10.9% for AN (7.1% established with cognitive symptoms only, excluding weight criteria), 0.2% for BN and 2.1% for BED, and of subthreshold syndrome were 0.8% for AN, 0.3% for BN and 0.2% for BED. Cases on EDI-2 scales were much more pronounced with 12.6-21.1% of the participants with significant sex differences. The findings were in accordance with corresponding international studies but were in contrast to other German studies showing much higher prevalence rates. The study provides, for the first time, estimates for DSM-5 prevalences of eating disorders in adolescents for Germany, and evidence in favour of using valid measures for improving prevalence estimates. DRKS00005050; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Intramedullary nail fixation versus locking plate fixation for adults with a fracture of the distal tibia: the UK FixDT RCT.

PubMed

Costa, Matthew L; Achten, Juul; Hennings, Susie; Boota, Nafisa; Griffin, James; Petrou, Stavros; Maredza, Mandy; Dritsaki, Melina; Wood, Thomas; Masters, James; Pallister, Ian; Lamb, Sarah E; Parsons, Nick R

2018-05-01

The best treatment for fractures of the distal tibia remains controversial. Most of these fractures require surgical fixation, but the outcomes are unpredictable and complications are common. To assess disability, quality of life, complications and resource use in patients treated with intramedullary (IM) nail fixation versus locking plate fixation in the 12 months following a fracture of the distal tibia. This was a multicentre randomised trial. The trial was conducted in 28 UK acute trauma centres from April 2013 to final follow-up in February 2017. In total, 321 adult patients were recruited. Participants were excluded if they had open fractures, fractures involving the ankle joint, contraindication to nailing or inability to complete questionnaires. IM nail fixation ( n  = 161), in which a metal rod is inserted into the hollow centre of the tibia, versus locking plate fixation ( n  = 160), in which a plate is attached to the surface of the tibia with fixed-angle screws. The primary outcome measure was the Disability Rating Index (DRI) score, which ranges from 0 points (no disability) to 100 points (complete disability), at 6 months with a minimum clinically important difference of 8 points. The DRI score was also collected at 3 and 12 months. The secondary outcomes were the Olerud-Molander Ankle Score (OMAS), quality of life as measured using EuroQol-5 Dimensions (EQ-5D), complications such as infection, and further surgery. Resource use was collected to inform the health economic evaluation. Participants had a mean age of 45 years (standard deviation 16.2 years), were predominantly male (61%, 197/321) and had experienced traumatic injury after a fall (69%, 223/321). There was no statistically significant difference in DRI score at 6 months [IM nail fixation group, mean 29.8 points, 95% confidence interval (CI) 26.1 to 33.7 points; locking plate group, mean 33.8 points, 95% CI 29.7 to 37.9 points; adjusted difference, 4.0 points, 95% CI -1.0 to 9.0 points; p  = 0.11]. There was a statistically significant difference in DRI score at 3 months in favour of IM nail fixation (IM nail fixation group, mean 44.2 points, 95% CI 40.8 to 47.6 points; locking plate group, mean 52.6 points, 95% CI 49.3 to 55.9 points; adjusted difference 8.8 points, 95% CI 4.3 to 13.2 points; p  < 0.001), but not at 12 months (IM nail fixation group, mean 23.1 points, 95% CI 18.9 to 27.2 points; locking plate group, 24.0 points, 95% CI 19.7 to 28.3 points; adjusted difference 1.9 points, 95% CI -3.2 to 6.9 points; p  = 0.47). Secondary outcomes showed the same pattern, including a statistically significant difference in mean OMAS and EQ-5D scores at 3 and 6 months in favour of IM nail fixation. There were no statistically significant differences in complications, including the number of postoperative infections (13% in the locking plate group and 9% in the IM nail fixation group). Further surgery was more common in the locking plate group (12% in locking plate group and 8% in IM nail fixation group at 12 months). The economic evaluation showed that IM nail fixation provided a slightly higher quality of life in the 12 months after injury and at lower cost and, therefore, it was cost-effective compared with locking plate fixation. The probability of cost-effectiveness for IM nail fixation exceeded 90%, regardless of the value of the cost-effectiveness threshold. As wound dressings after surgery are clearly visible, it was not possible to blind the patients to their treatment allocation. This evidence does not apply to intra-articular (pilon) fractures of the distal tibia. Among adults with an acute fracture of the distal tibia who were randomised to IM nail fixation or locking plate fixation, there were similar disability ratings at 6 months. However, recovery across all outcomes was faster in the IM nail fixation group and costs were lower. The potential benefit of IM nail fixation in several other fractures requires investigation. Research is also required into the role of adjuvant treatment and different rehabilitation strategies to accelerate recovery following a fracture of the tibia and other long-bone fractures in the lower limb. The patients in this trial will remain in longer-term follow-up. Current Controlled Trials ISRCTN99771224 and UKCRN 13761. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 22, No. 25. See the NIHR Journals Library website for further project information.

[Tibio-talo-calcaneal arthrodesis with the retrograde intramedullary nail MEDIN].

PubMed

Popelka, S; Vavřík, P; Landor, I; Bek, J; Popelka ml, S; Hromádka, R

2013-01-01

When the talus and the talocalcaneal joint are both affected, their fusion is the method of treatment. Ankle arthrodesis is carried out using various osteosynthetic materials such as external fixators, screws and plates. One of the options is retrograde nailing. Tibio-talo-calcaneal arthrodesis is frequently indicated in patients with rheumatoid arthritis (RA) in whom both the talus and the subtalar joint are often affected. A retrograde nail for tibio-talo-calcaneal arthrodesis was developed at our department in cooperation with MEDIN Company. This is a titanium double-curved nail, with the distal part bent at 8 degrees ventrally and 10 degrees laterally. It is inserted from the transfibular approach. Sixty-two patients, 35 women and 27 men, were treated at our department from 2005. Since one patient had bilateral surgery, 63 ankles were included. The indications for arthrodesis involved rheumatoid arthritis in 42, post-traumatic arthritis in 10, failed ankle arthrodesis in two and failed total ankle arthroplasty in five ankles; tibial stress fractures close above the ankle in two RA patients, one patient with dermatomyositis and one with lupus erythematodes. The average age at the time of surgery was 64.2 years (range, 30 to 80). The average follow-up was 4.5 years (range, 1 to 9 years), Satisfaction with the treatment outcome and willingness to undergo surgery on the other side were reported by 82% of the patients. The AOFAS score improved from 35 to 74 points. Three (4.8%) patients complained of painful feet due to the fact that exact correction of the calcaneus was not achieved and the heel after arthrodesis remained in a slightly varus position. Of them, two had a failed total ankle arthroplasty. Post-operative complications included early infection managed by antibiotic treatment and early surgical revision with irrigation.in two (3.2%) RA patients, who were undergoing biological therapy. Late infection developed at 2 to 3 years after surgery in three (4.3%) patients (two had RA). The infection was managed by revision surgery with nail removal and irrigation. All patients healed well. Necrosis of the talus and development of a pseudoarthrosis were recorded in four (6.4%) patients, who subsequently underwent nail removal and repeat fusion using an external fixator. Retrograde nailing for tibio-talo-calcaneal arthrodesis is used by many authors. Its complication rate is comparable with the other methods of arthrodesis. The use of tibio-talo-calcaneal arthrodesis aims at a painless and stable joint. Arthrodesis of the talus and the subtalar joint using a retrograde nail is an effective surgical treatment of the joints affected. It is especially recommended for RA patients who have severe deviations. Retrograde nailing provides a stable osteosynthesis which does not require plaster cast immobilisation. The double-curved nail allows for its insertion in the solid part of the calcaneus and helps avoiding injury to the neurovascular bundle.

Therapeutic Efficacy of Topically Applied KP-103 against Experimental Tinea Unguium in Guinea Pigs in Comparison with Amorolfine and Terbinafine

PubMed Central

Tatsumi, Yoshiyuki; Yokoo, Mamoru; Senda, Hisato; Kakehi, Kazuaki

2002-01-01

The therapeutic efficacy of KP-103, a novel topical triazole, in a guinea pig tinea unguium model was investigated. Experimental tinea unguium and tinea pedis were produced by inoculation of Trichophyton mentagrophytes SM-110 between the toes of the hind paw of guinea pigs. One percent solution (0.1 ml) of KP-103, amorolfine, or terbinafine was topically applied to the nails and whole sole of an infected foot once daily for 30 consecutive days, and terbinafine was also orally administered at a daily dose of 40 mg/kg of body weight for 30 consecutive days, starting on day 60 postinfection. The fungal burdens of nails and plantar skin were assessed using a new method, which makes it possible to recover infecting fungi by removing a carryover of the drug remaining in the treated tissues into the culture medium. Topically applied KP-103 inhibited the development of nail collapse, significantly reduced the fungal burden of the nails, and sterilized the infected plantar skin. On the other hand, topical amorolfine and topical or oral terbinafine were ineffective for tinea unguium, although these drugs eradicated or reduced the fungal burden of plantar skin. The in vitro activities of amorolfine and terbinafine against T. mentagrophytes SM-110 were 8- and 32-fold, respectively, decreased by the addition of 5% keratin to Sabouraud dextrose broth medium. In contrast, the activity of KP-103 was not affected by keratin because its keratin affinity is lower than those of the reference drugs, suggesting that KP-103 largely exists in the nails as an active form that was not bound to keratin and diffuses in the nail without being trapped by keratin. The effectiveness of KP-103 against tinea unguium is probably due to its favorable pharmacokinetic properties in the nails together with its potent antifungal activity. PMID:12435679

Flexible intramedullary nailing for the treatment of unicameral bone cysts in long bones.

PubMed

Roposch, A; Saraph, V; Linhart, W E

2000-10-01

Unicameral bone cyst is characterized by its tenacity and risk of recurrence. Pathological fracture is common and is often the presenting symptom. The objective of the present study was to evaluate the results of flexible intramedullary nailing for the treatment of a unicameral bone cyst with or without a pathological fracture. Flexible intramedullary nailing for the treatment of a unicameral bone cyst was performed in thirty-two patients. Thirty of these patients presented with a pathological fracture; twenty-four were managed immediately with intramedullary nailing, and the other six had been managed conservatively at other clinics before they were referred to our department. The remaining two cysts were detected incidentally. The cyst was located in the humerus in twenty-one patients, in the femur in nine, and in the radius in two. The mean age of the patients at the time of surgery was 9.8 years, and the mean duration of follow-up was 53.7 months. Radiographic evaluation was performed according to the criteria of Capanna et al., and the cyst was classified as completely healed, healed with residual radiolucency (osteolysis), recurred, or having no response. The healing period ranged from three to 105 months. Fourteen cysts healed completely, and sixteen healed with residual radiolucent areas visible on radiographs. There was recurrence of two cysts that had healed with residual radiolucency. All of the cysts in the present study responded to treatment. A change of nails was necessary in nine patients, as the nails had become too short after bone growth. No major complications were observed. Flexible intramedullary nailing provides early stability, which allows early mobilization and thus obviates the need for a plaster cast and decreases the prevalence of the most common complication: a pathological fracture. This method of treatment also allows for an early return to normal activity.