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Sample records for aseptic sternal pseudoarthrosis

  1. Congenital Pseudoarthrosis of the Tibia: Case Reports

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    Mehmet Bulut

    2014-03-01

    Full Text Available Congenital pseudoarthrosis of the tibia is rarely seen disease which is very difficult to treat. Congenital pseudoarthrosis of the tibia is frequently seen together with neurofibromatosis. Especially according to Boyd classification, type II and V are in the high risk group. In this study, we presented the treatment result of the three years old male patient with type V congenital pseudoarthrosis of the tibia.

  2. Congenital pseudoarthrosis associated with venous malformation

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    Al-Hadidy, A.; Haroun, A.; Al-Ryalat, N. [Jordan University Hospital, Radiology Department, P.O. Box 340621, Amman (Jordan); Hamamy, H. [Endocrinology and Genetics, National Center for Diabetes, Amman (Jordan); Al-Hadidi, S. [Jordan University Hospital, Departments of Orthopedics, Amman (Jordan)

    2007-06-15

    Congenital pseudoarthrosis is a pathologic entity that may be isolated, or may be associated with neurofibromatosis. We report the case of a 3-year-old female with congenital pseudoarthrosis involving the right tibia and fibula. Magnetic resonance imaging (MRI) and complementary magnetic resonance angiogram (MRA) revealed a lobulated mass with vivid enhancement, which led to the diagnosis of venous malformation. This is the first report of congenital pseudoarthrosis caused by the presence of a vascular malformation. (orig.)

  3. Tuberculous sternal osteomyelitis.

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    Cataño, Juan Carlos; Galeano, Daniela; Botero, Juan Camilo

    2014-10-01

    A 32-year-old female patient with systemic lupus erythematosus presented with 1 month of nocturnal subjective fevers, night sweats, poor appetite, malaise, 8-kg weight loss, and a 6-cm painful sternal mass. She had normal vital signs with a physical examination notable only for the presence of a fluctuating sternal mass. A computed tomographic scan of the thorax showed a 67 × 32 × 27-mm sternal mass associated with severe sternal osteomyelitis (Fig. 1); then a surgical drainage was performed, and abundant caseous material was removed, leaving a penrose drain (Fig. 2). Histologic examination of the bone tissue revealed extensive necrosis and granulomas with multinucleated giant cells. The bone, secretion, and soft tissue were negative for acid-fast bacillae on Ziehl-Neelsen stain; but culture grew Mycobacterioum tuberculosis, and she was started on 4 first-line antituberculosis medications, showing rapid symptomatic improvement, and was discharged 4 weeks after admission (Fig. 3).

  4. Congenital pseudoarthrosis of the clavicle with bifurcation

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    Narender Kumar Magu

    2014-01-01

    Full Text Available Congenital pseudoarthrosis of clavicle is a rare clinical entity. It usually presents as a swelling in the clavicular region at birth or soon after birth. Fitzwilliam′s original description of 60 subtypes of congenital pseudoarthrosis of clavicle have addressed several anatomical variants, e.g. association with cervical rib and abnormally vertical and elevated upper ribs. However, congenital pseudoarthrosis of clavicle associated with bifurcation is an atypical anatomic variant. To the best of our knowledge, this variant has never been mentioned in the literature. In the present report, we have described this subtype of symptomatic congenital pseudoarthrosis of the clavicle with bifurcation and its possible management.

  5. Imaging findings of sternal abnormalities

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    Franquet, T. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Gimenez, A. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Alegret, X. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Sanchis, E. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Rivas, A. [Dept. of Radiology, Hospital Vall d`Hebron, Universidad Autonoma de Barcelona (Spain)

    1997-05-01

    Radiographic findings in the sternal abnormalities are often nonspecific, showing appearances from a localized benign lesion to an aggressive lesion as seen with infections and malignant neoplasms. A specific diagnosis of sternal abnormalities can be suggested on the basis of CT and MR characteristics. Familiarity with the presentation and variable appearance of sternal abnormalities may aid the radiologist is suggesting a specific diagnosis. We present among others characteristic radiographic findings of hemangioma, chondrosarcoma, hydatid disease, and SAPHO syndrome. In those cases in which findings are not specific, cross-sectional imaging modalities may help the clinician in their management. (orig.)

  6. Salmonella typhi sternal wound infection.

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    Sfeir, Maroun; Youssef, Pierre; Mokhbat, Jacques E

    2013-12-01

    Samonella typhi usually causes gastrointestinal infections. Few reports in the literature described skin and soft tissue infections related to Salmonella species, especially in immunocompetent patients. Our case exhibited sternal abscess growing Salmonella typhi.

  7. STERNAL FORAMEN: A CASE REPORT

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    Taqdees

    2015-05-01

    Full Text Available Sternal foramen is a congenital oval defect at the lower third of the sternum that is usually asymptomatic & occurs due to incomplete fusion of multiple ossification centres . During our routine osteology classes, a sternum with a foramen in the lower part of its body measuring about 11mmx10mm was found. Knowledge about such variation is important as it has risk of life threate ning complications like pneumothorax or even pericardial or cardiac puncture during sternal biopsy or acupuncture.

  8. Pathogenicity of aseptic Bursaphelenchus xylophilus.

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    Li-hua Zhu

    Full Text Available Pine wilt is a disease of pine (Pinus spp. caused by the pine wood nematode (PWN, Bursaphelenchus xylophilus. However, the pathogenic mechanism of pine wilt disease (PWD remains unclear. Although the PWN was thought to be the only pathogenic agent associated with this disease, a potential role for bacterial symbionts in the disease process was recently proposed. Studies have indicated that aseptic PWNs do not cause PWD in aseptic pine trees, while PWNs associated with bacteria cause wilting symptoms. To investigate the pathogenicity of the PWN and its associated bacteria, 3-month-old microcuttings derived from certain clones of Pinus densiflora Siebold & Zucc. produced in vitro were inoculated under aseptic conditions with aseptic PWNs, non-aseptic PWNs and bacteria isolated from the nematodes. Six-month-old aseptic P. densiflora microcuttings and 7-month-old P. massoniana seedlings were also inoculated under aseptic conditions with aseptic PWNs and non-aseptic PWNs. The results showed that the aseptic microcuttings and seedlings inoculated with aseptic PWNs or non-aseptic PWNs wilted, while those inoculated with bacterial isolates did not wilt. Nematodes were recovered from wilted microcuttings and seedlings inoculated with aseptic PWNs and non-aseptic PWNs, and the asepsis of nematodes recovered from aseptic PWN-inoculated microcuttings and seedlings was reconfirmed by culturing them in NB liquid medium at 30°C for more than 7 days. Taken together, the results indicate that the asepsis of PWN did not cause the loss of pathogenicity.

  9. Pathogenicity of aseptic Bursaphelenchus xylophilus.

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    Zhu, Li-hua; Ye, Jianren; Negi, Sapna; Xu, Xu-ling; Wang, Zhang-li; Ji, Jin-yi

    2012-01-01

    Pine wilt is a disease of pine (Pinus spp.) caused by the pine wood nematode (PWN), Bursaphelenchus xylophilus. However, the pathogenic mechanism of pine wilt disease (PWD) remains unclear. Although the PWN was thought to be the only pathogenic agent associated with this disease, a potential role for bacterial symbionts in the disease process was recently proposed. Studies have indicated that aseptic PWNs do not cause PWD in aseptic pine trees, while PWNs associated with bacteria cause wilting symptoms. To investigate the pathogenicity of the PWN and its associated bacteria, 3-month-old microcuttings derived from certain clones of Pinus densiflora Siebold & Zucc. produced in vitro were inoculated under aseptic conditions with aseptic PWNs, non-aseptic PWNs and bacteria isolated from the nematodes. Six-month-old aseptic P. densiflora microcuttings and 7-month-old P. massoniana seedlings were also inoculated under aseptic conditions with aseptic PWNs and non-aseptic PWNs. The results showed that the aseptic microcuttings and seedlings inoculated with aseptic PWNs or non-aseptic PWNs wilted, while those inoculated with bacterial isolates did not wilt. Nematodes were recovered from wilted microcuttings and seedlings inoculated with aseptic PWNs and non-aseptic PWNs, and the asepsis of nematodes recovered from aseptic PWN-inoculated microcuttings and seedlings was reconfirmed by culturing them in NB liquid medium at 30°C for more than 7 days. Taken together, the results indicate that the asepsis of PWN did not cause the loss of pathogenicity.

  10. Pseudoarthrosis in atypical femoral fracture: case report.

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    Giannotti, S; Bottai, V; Dell'Osso, G; De Paola, G; Ghilardi, M; Guido, G

    2013-11-01

    Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment; they have a high frequency of delayed healing. The authors describe a femoral pseudoarthrosis of an atypical fracture treated with intramedullary nailing in a female after prolonged alendronate therapy. Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment even if, in the literature, there is no clarity on the exact pathogenetic mechanism. The Task Force of the American Society for Bone and Mineral Research described the major and minor features to define atypical fractures and recommends that all the five major features must be present while minor features are not necessary. Another controversial aspect regarding the atypical femoral fractures is the higher frequency of the delayed healing that can be probably related to a suppressed bone turnover caused by a prolonged period of bisphosphonates treatment. This concept could be corroborated by the Spet Tc exam. In the case of a pseudoarthrosis, there is not a standardization of the treatment. In this report, the authors describe a femoral pseudoarthrosis of an atypical fracture treated with intramedullary nailing in a female after prolonged alendronate therapy; the patient was studied with clinical, bioumoral end SPECT-Tc exam of both femurs. Many studies show the relationship between bisphosphonates and the presence of atypical fractures. These fractures should be monitored more closely due to the risk of nonunion and they require considering an initial treatment with pharmacological augmentation to reduce the complications for the patient and the health care costs.

  11. Durotomy is associated with pseudoarthrosis following lumbar fusion.

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    Bydon, Mohamad; De la Garza-Ramos, Rafael; Abt, Nicholas B; Macki, Mohamed; Sciubba, Daniel M; Wolinsky, Jean-Paul; Bydon, Ali; Gokaslan, Ziya L; Witham, Timothy F

    2015-03-01

    Pseudoarthrosis is a known complication following lumbar fusion, and although several risk factors have been established, the association of durotomy and pseudoarthrosis has not been studied to our knowledge. A retrospective review was performed to identify all adult patients who underwent lumbar posterolateral fusion (without interbody fusion) for degenerative spine disease over a 20 year period at a single institution. Patients were divided into durotomy and no durotomy cohorts. Patients were included if they had at least 1 year of follow-up. The main outcome variable was development of pseudoarthrosis. A total of 327 patients were identified, of whom 17 (5.19%) had a durotomy. Pseudoarthrosis rates were significantly higher in the durotomy group (35.29%) when compared to the no durotomy group (13.87%), with the difference being statistically significant (p=0.016). Univariate analysis revealed that durotomy (p=0.003) and the number of levels fused (p=0.015) were the only two significant risk factors for pseudoarthrosis. After controlling for the number of levels fused, the adjusted relative risk (RR) revealed that patients with a durotomy were 2.23 times more likely to develop pseudoarthrosis (RR 2.23; 95% confidence interval 1.05-4.75) when compared to patients without durotomy. The findings in the present study suggest an association between durotomy and pseudoarthrosis development. Patients with a durotomy were 2.2 times more likely to develop pseudoarthrosis compared to patients without a durotomy. Future and larger studies are required to corroborate our findings.

  12. Reconstruction of sternal defect - a literature review

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    Juhl, Alexander Andersen; Koudahl, Vibeke; Damsgaard, Tine Engberg

    2012-01-01

    OBJECTIVES: The management of sternal defects arisen after deep sternal wound infection is challenging and often requires extensive interdisciplinary teamwork between plastic and thoracic surgeons. In this study, the published literature on methods used to reconstruct sternal defects arisen...... as a result of deep sternal wound infection after open-heart surgery will be reviewed. DESIGN: The Cochrane, Embase, PubMed, and SveMed+ databases were searched in December 2011. Only papers regarding treatment of deep sternal wound infection after open-heart surgery in adults were included. RESULTS......: The literature search identified 224 original papers that met the inclusion criteria. The majority dealt with surgical techniques. None of the studies regarding reconstructive options were designed as randomized controlled trials, and the levels of evidence are generally low. CONCLUSION: The treatment of deep...

  13. Scaphoid pseudo-arthrosis: Frequency, pathogenesis and course

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    Schunk, K.; Teifke, A.; Benning, R.; Dahm, M.; Thelen, R.; Schild, H.

    1989-06-01

    Eighty-three scaphoid pseudo-arthroses were found amongst 1.104 scaphoid examinations. Sixtyseven were present at the first examination and 16 pseudo-arthroses developed amongst 252 scaphoid fractures. Men were affected predominantly, particularly in the 20 to 40-year old group. Fractures in the proximal third of the scaphoid and vertical oblique fractures had a particular tendency to pseudo-arthrosis formation. The operative treatment of choice is a Matti-Russe bone graft. Only one patient in seven with definite scaphoid pseudo-arthrosis showed firm fusion. (orig.).

  14. Repair of Inferior Sternal Cleft Using Bilateral Sternal Bar Turnover Flaps in a Patient with Pentalogy of Cantrell

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    Yeow, Vincent Kok-Leng

    2014-01-01

    We report a case of sternal reconstruction using bilateral sternal bar turnover flaps in a 4-year-old boy with an inferior sternal cleft, as part of Cantrell's pentad. When the patient was 10 months old, he underwent sternal reconstruction using a resorbable poly-L-lactic-polyglycolic acid plate in the first stage when there was insufficient autogenous tissue to provide a reliable reconstruction. Bilateral sternal bar turnover was performed in the second stage at 4 years of age. This operative technique is described in this report. This novel technique provides a robust, dynamic, and reliable reconstruction for inferior sternal defects. PMID:24511499

  15. Bilateral congenital pseudoarthrosis of the clavicles in a newborn

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    Kalagiri, Ram R.; Hemingway, Martha; Beeram, Madhava R.

    2016-01-01

    Bilateral congenital pseudoarthrosis of the clavicles is extremely rare. We report a case of this entity presenting in the neonatal period. We highlight the importance of the differential diagnosis when clavicular fracture shows no evidence of healing or occurs bilaterally. PMID:27695169

  16. Autoimmune Myasthenia Gravis after Sternal Fracture

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    Jens A. Petersen

    2012-01-01

    Full Text Available We report a 54-year-old woman who suffered a commotio cerebri, whiplash injury and a chest trauma with sternal fracture due to a high-velocity car accident. Two months later, she developed unilateral ptosis and blurred vision, which worsened during the day. Multiple diagnoses were suggested, ranging from thoracic outlet syndrome towards depression. Symptoms persisted and five years later, the patient consulted a neurologist. Laboratory analysis revealed significantly elevated levels of antibodies to acetylcholine receptors, and the diagnosis of myasthenia gravis was made. Speculatively, the damage of retrosternal thymic remnants due to a sternal fracture might have precipitated the condition or exacerbated subclinical disease.

  17. Pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture

    OpenAIRE

    2010-01-01

    A pseudo-arthrosis repair of a 4-year-old bony avulsion fracture of the PCL using a minimally invasive technique, screw fixation, and bone grafting is reported. The case presented seems to be rather unique due to the fragment size and the approach for pseudo-arthrosis repair. There was a good functional result following minimally invasive pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture. There are no previous reports of similar pseudo-arthrosis repairs, and other aut...

  18. Pseudoarthrosis following fracture of left lamina of C2 vertebra causing compressive myelopathy

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    B.C.M. Prasad

    2012-04-01

    Full Text Available Pseudoarthrosis involving lamina of C2 vertebra requiring intervention is very rare. We report the unusual case of a 38-year-old man presenting with pseudoarthrosis of an old fracture involving left lamina of C2 vertebra. The patient presented with progressive spastic quadriparesis and history of sustaining injury to his neck 15 years ago. Imaging showed pseudoarthrosis involving the left lamina of C2 vertebra with significant cord compression. Posterior approach was used and decompressive laminectomy was done at C2 and C3 levels with removal of the affected segment with pseudoarthrosis. The postoperative period was uneventful and the neurological recovery was good.

  19. Aseptic meningitis and viral myelitis.

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    Irani, David N

    2008-08-01

    Meningitis and myelitis represent common and very infrequent viral infections of the central nervous system, respectively. The number of cases of viral meningitis that occurs annually exceeds the total number of meningitis cases caused by all other etiologies combined. Focal central nervous system infections, such as occur in the spinal cord with viral myelitis, are much less common and may be confused with noninfectious disorders that cause acute flaccid paralysis. This article reviews some of the important clinical features, epidemiology, diagnostic approaches, and management strategies for patients with aseptic meningitis and viral myelitis. Particular focus is placed on the diseases caused by enteroviruses, which as a group account for most aseptic meningitis cases and many focal infections of the spinal cord.

  20. Traumatic sternal fracture: Incidence, causes and CT features

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    Kim, Hyo Weon; Kim, Young Tong; Jou, Sung Shick; Han, Jong Kyu; Bae, Won Kyung [Dept. of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan (Korea, Republic of)

    2015-05-15

    To evaluate the incidence of sternal fracture due to trauma, the CT features of sternal fractures, and the hospitalization period. The medical records and CT images of 755 patients who suffered trauma from January 2012 to August 2013 were analyzed retrospectively. We compared the incidence of sternal fracture due to various traumatic causes. We evaluated the location and shape of the sternal fracture on CT scans and the relationship between a sternal fracture and the hospitalization period. The incidence of sternal fracture was 9.27% (70/755) in all patients; 11.7% (53/453) due to a traffic accident (TA), and 5.63% (17/302) due to other causes. TA was the most frequent cause (75.71%) of a sternal fracture, fracture incidences after a TA differed by traumatic cause (p < 0.05). Among sternal fractures, the body was the most commonly involved (68.57%), one wall was limited (32.85%), and anteroposterior length increased (7.14%). Body fractures involving two or more segments included 33.33% of the cases. The hospitalization period was not related with sternal fracture (p = 0.30). Fracture was more frequent after a TA than due to other causes. Fracture incidences after a TA depended on the traumatic causes. Involvement of two or more segments and one wall-limitation were common among sternal fractures. Sternal fractures occurred even in slightly injured patients.

  1. Non-union of the triquetrum with pseudoarthrosis: a case report.

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    Sin, Cheuk-Hang; Leung, Yuen-Fai; Ip, Shirley Pui-Sheung; Wai, Yuk-Leung; Ip, Wing-Yuk

    2012-04-01

    We report a case of symptomatic non-union of the triquetrum with pseudoarthrosis in a 34-year-old man. Motion of the pseudoarthrosis was noted from radial to ulnar deviation. The patient was treated with bone grafting and screw fixation. The non-union healed and the symptoms subsided. The Mayo wrist score had improved from 65 (fair) to 90 (excellent).

  2. Neurofibromin deficiency-associated transcriptional dysregulation suggests a novel therapy for tibial pseudoarthrosis in NF1.

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    Paria, Nandina; Cho, Tae-Joon; Choi, In Ho; Kamiya, Nobuhiro; Kayembe, Kay; Mao, Rong; Margraf, Rebecca L; Obermosser, Gerlinde; Oxendine, Ila; Sant, David W; Song, Mi Hyun; Stevenson, David A; Viskochil, David H; Wise, Carol A; Kim, Harry K W; Rios, Jonathan J

    2014-12-01

    Neurofibromatosis type 1 (NF1) is an autosomal dominant disease caused by mutations in NF1. Among the earliest manifestations is tibial pseudoarthrosis and persistent nonunion after fracture. To further understand the pathogenesis of pseudoarthrosis and the underlying bone remodeling defect, pseudoarthrosis tissue and cells cultured from surgically resected pseudoarthrosis tissue from NF1 individuals were analyzed using whole-exome and whole-transcriptome sequencing as well as genomewide microarray analysis. Genomewide analysis identified multiple genetic mechanisms resulting in somatic biallelic NF1 inactivation; no other genes with recurring somatic mutations were identified. Gene expression profiling identified dysregulated pathways associated with neurofibromin deficiency, including phosphoinositide 3-kinase (PI3K) and mitogen-activated protein kinase (MAPK) signaling pathways. Unlike aggressive NF1-associated malignancies, tibial pseudoarthrosis tissue does not harbor a high frequency of somatic mutations in oncogenes or other tumor-suppressor genes, such as p53. However, gene expression profiling indicates that pseudoarthrosis tissue has a tumor-promoting transcriptional pattern, despite lacking tumorigenic somatic mutations. Significant overexpression of specific cancer-associated genes in pseudoarthrosis highlights a potential for receptor tyrosine kinase inhibitors to target neurofibromin-deficient pseudoarthrosis and promote proper bone remodeling and fracture healing.

  3. Pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture.

    NARCIS (Netherlands)

    Hoogervorst, P.; Gardeniers, J.W.M.; Moret-Wever, S.; Kampen, A. van

    2010-01-01

    A pseudo-arthrosis repair of a 4-year-old bony avulsion fracture of the PCL using a minimally invasive technique, screw fixation, and bone grafting is reported. The case presented seems to be rather unique due to the fragment size and the approach for pseudo-arthrosis repair. There was a good functi

  4. Amoxicillin-induced aseptic meningoencephalitis

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    Radi Shahien

    2010-06-01

    Full Text Available Radi Shahien1, Vetaly Vieksler1, Abdalla Bowirrat11Department of Neurology and Neurophysiology, Ziv Medical Center, Safed, IsraelAbstract: Meningitis is usually produced by an infectious agent, but there are multiple noninfectious causes. Drug-induced aseptic meningitis (DIAM is an important entity and has been reported as an uncommon adverse reaction with numerous agents. Thus, DIAM constitutes a diagnostic and patient management challenge. We present a patient with three episodes of aseptic meningitis due to amoxicillin, and then review the literature on this rare idiosyncratic event which may occur after local or systemic drug administration. A 77-year-old man was admitted to our hospital with fever, headache, and neck stiffness. Seven days before admission he had a dental and gingival inflammation. He was treated with two oral doses of 500 mg daily of amoxicillin for one week. The seventh day he awoke with the complaints that prompted hospital admittance. Amoxicillin was stopped 1 day before his admission. From his history we knew of two similar episodes: The first episode was after a dental procedure 3 months before this incident. He had received a 1-week course of postprocedure amoxicillin of 500 mg daily and had similar headache, fever, and chills during the entire course of treatment. He wasn’t admitted to the hospital, because he stopped taking amoxicillin and he felt spontaneous pain relief after taking symptomatic pain treatment. The second episodes was 6 months after his first admission, he had been admitted to our hospital with the same symptoms. Amoxicillin was stopped and changed with intravenous (IV ceftriaxone (CTRX for 10 days due to suspected partial untreated meningitis. The patient improved rapidly within 2 days and was discharged from the hospital. On the basis of these three confirmed episodes of meningitis after recurrent exposure to amoxicillin, with repetitive negative testing for viral, bacterial, and mycobacterial

  5. The safe zone for blinded sternal interventions based on CT evaluation of midline congenital sternal foramina

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    Boruah, Deb K.; Dhingani, Dhaval D.; Achar, Shashidhar; Augustine, Antony; Mahanta, Kangkana [Assam Medical College and Hospital, Department of Radio-diagnosis, Dibrugarh, Assam (India); Prakash, Arjun [NIMHANS, Department of Radio-diagnosis, Bangalore, Karnataka (India); Yadav, Rajnikant R. [Sanjay Gandhi Post Graduate Institute and Medical Sciences, Department of Radio-diagnosis, Lucknow (India)

    2016-12-15

    The aim of this study was to evaluate the safe zone for performing blind sternal procedures based on computed tomography (CT) evaluation of congenital midline sternal foramina using multidetector computed tomography (MDCT). This retrospective study was carried out on 1,180 patients who underwent MDCT of the thorax from March 2015 to February 2016. The MDCT images were evaluated in axial and reformatted planes. Morphometry and prevalence of midline congenital sternal foramina (SF) and manubrio-foraminal distance (MFD) were evaluated. The safe zone was defined for a blinded intervention, based on palpable anatomical landmarks. Data were presented in terms of percentage, mean ± standard deviation and calculations were carried out using Microsoft Excel. The prevalence of SF in our study sample was 11.6 %. The majority of SF were located in a typical position in the lower sternal body at the level of fifth costo-chondral junction (CCJ) in 108 patients (78.8 %). The structure directly beneath the SF was mediastinal fat in 73 patients (53.3 %), followed by anterior pericardium in 44 patients (32.1 %) and lung parenchyma in 20 patients (14.6 %). The mean MFD in our study population was 11.90 ± 1.31 cm. Sternal interventions should be avoided at the level of fourth to sixth CCJ, which is considered the danger zone. An intervention at the fourth to sixth CCJ may lead to disastrous consequences in patients who have SF. (orig.)

  6. Isolated Sternal Fracture. A Case Report

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    Yovanny Ferrer Lozano

    2014-12-01

    Full Text Available Isolated sternal fractures are rare; there are few reports in the medical literature. This article discusses the diagnosis and treatment of a patient who attended the emergency department because of a direct trauma to the anterior chest caused by a car accident. After the diagnosis of isolated sternal fracture, a conservative treatment was adopted. The clinical course was satisfactory until hospital discharge and during the following nine months, the patient remained asymptomatic. The literature on the subject was located and reviewed to support and comment on the case. It is concluded that conservative treatment can lead to consolidation and no sequelae such as pain or different degrees of disability related to the fracture.

  7. Vascularized pedicle graft of ipsilateral fibula for recurrent congenital pseudoarthrosis of the tibia

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    Seyed Esmail Hassanpour

    2007-07-01

    Full Text Available

    We have performed the ipsilateral vascularized fibular transfer for the treatment of congenital pseudoarthrosis of the tibia (CPT. In the case under study, the conventional treatment by intramedullary rod and autogenous iliac bone grafting had failed. The follow up took place during the next 4 years and the patient can now walk without assistance. Combining a pedicle ipsilateral fibular transfer with an internal fixation and iliac bone graft may be a good option for the treatment of congenital pseudoarthrosis of tibia.
    KEY WORDS: Congenital pseudoarthrosis, tibia, vascularized fibular graft, bone graft.

  8. Congenital osteofibrous dysplasia associated with pseudoarthrosis of the tibia and fibula

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    Teo, Harvey E.L.; Peh, Wilfred C.G. [KK Women' s and Children' s Hospital, Department of Diagnostic Imaging, 100 Bukit Timah Road (Singapore); Akhilesh, M. [KK Women' s and Children' s Hospital, Department of Pathology, 100 Bukit Timah Road (Singapore); Tan, S.B. [Singapore General Hospital, Department of Orthopaedic Surgery, Outram Road (Singapore); Ishida, T. [Kanto Medical Center, Department of Pathology, Tokyo (Japan)

    2007-06-15

    The association between congenital pseudoarthrosis and osteofibrous dysplasia of the tibia and fibula is a rare entity that has been recently recognized. We report a male newborn who was found to have swelling and deformity of the left lower leg. Radiographs and magnetic resonance imaging showed an extensive destructive lesion of the tibial shaft, with dysplastic congenital pseudoarthrosis of the lower fibula. Histopathologial examination confirmed the diagnosis of congenital pseudoarthrosis of the tibia and fibula with underlying osteofibrous dysplasia involving both bones. Immunohistochemical stains showed cytokeratin positivity. (orig.)

  9. Computed Tomographic Evaluation of Presumptively Normal Canine Sternal Lymph Nodes.

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    Iwasaki, Ryota; Mori, Takashi; Ito, Yusuke; Kawabe, Mifumi; Murakmi, Mami; Maruo, Kohji

    The sternal lymph nodes receive drainage from a wide variety of structures in the thoraco-abdominal region. Evaluation of these lymph nodes is essential, especially in cancer patients. Computed tomography (CT) can detect sternal lymph nodes more accurately than radiography or ultrasonography, and the criteria of the sternal lymphadenopathy are unknown. The purpose of this retrospective study was to describe the CT characteristics of the sternal lymph nodes in dogs considered unlikely to have lymphadenopathy. The ratio of the short axis dimension of the sternal lymph nodes to the thickness of the second sternebra was also investigated. At least one sternal lymph node was identified in each of the 152 dogs included in the study. The mean long axis and short axis dimensions were 0.700 cm and 0.368 cm, respectively. The mean ratio of the sternal lymph nodes to the second sternebrae was 0.457, and the 95% prediction interval ranged from 0.317 to 0.596 (almost a fixed value independent of body weight). These findings will be useful when evaluating sternal lymphadenopathy using CT.

  10. Embryology, sternal clefts, ectopia cordis, and Cantrell's pentalogy.

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    Engum, Scott A

    2008-08-01

    Sternal clefts, ectopia cordis, and Cantrell's pentalogy continue to be very rare congenital anomalies in pediatric surgery. Unfortunately, these conditions present as neonatal emergencies and demand early surgical intervention. This article reviews the embryological development of the chest wall, specific sternal defect anomalies, along with available methods of treatment.

  11. Congenital medium sternal cleft with partial ectopia cordis repair.

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    Sousa, Paulo Rego; Antunes, Sónia; Couto, Alexandra; Santos, Gonçalo Cassiano; Leal, Luis Gagp; Magalhães, Manuel Pedro

    2009-01-01

    Congenital sternal malformation is a rare anomaly often diagnosed as an asymptomatic condition at birth. The authors report a clinical case of a full-term female neonate with congenital sternal cleft and partial ectopia cordis. Successful surgical repair was accomplished at 6 days of age. When surgery is performed shortly after birth, the procedure is easier and better results are achieved.

  12. Advantages of intramedullar fixation in treatment of congenital tibial pseudoarthrosis--a case report.

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    Kirin, Ivan; Jurisić, Davor; Mokrović, Hrvoje; Salem, Osman; Zamolo, Gordana; Kovacević, Miljenko

    2011-09-01

    This report describes a case of a 29-year old patient with congenital pseudoarthrosis of the distal tibia previously treated unsuccessfully by a conventional surgical method. Tibial congenital pseudoarthrosis is a rare disease characterized by segmental osseous weakness resulting in deformation of the bone and spontaneous fractures which progresses to a tibial nonunion. In our case we used intramedullary stabilization with bone grafting and six month after operation congenital pseudarthrosis of the tibia healed.

  13. Aseptic Plant Culture System (APCS) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aseptic plant culture plays a significant role in biotechnology and plant physiology research, and in vegetative propagation of many plant species. The development...

  14. Aseptic Plant Culture System (APCS) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aseptic plant culture plays a significant role in biotechnology and plant physiology research and in vegetative propagation of many plant species. The development of...

  15. Premature sternal fusion in gonadal dysgenesis with coarctation

    Energy Technology Data Exchange (ETDEWEB)

    Herman, T.E.; Kushner, D.C.; Cleveland, R.H.

    1985-07-01

    In reviewing lateral chest roentgenograms in three infants with Turner's syndrome and aortic coarctation, and in infant with mixed gonadal dysgenesis and aortic coarctation, we have found obvious sternal fusion abnormalities which are reported here.

  16. Modified Transverse Thoracosternotomy and Cost-Effective Reinforced Sternal Closure.

    Science.gov (United States)

    Costa, Joseph; Sonett, Joshua R; D'Ovidio, Frank

    2015-12-01

    The bilateral transverse thoracosternotomy clamshell incision provides excellent exposure to the mediastinal structures in double lung transplantation. The use of a modified transverse sternotomy and a figure of 8 configuration with one monofilament metal wire, along with two longitudinal wires across the sternal division, results in greater stability and equally distributed oblique tension. Our described technique was more cost effective and resulted in no incidence of dehiscence. We present our experience using a modified transverse sternotomy and reinforced sternal closure method.

  17. Scintigraphic imaging with technetium-99M-labelled ceftizoxime is a reliable technique for the diagnosis of deep sternal wound infection in rats

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Paulo Henrique Nogueira; Diniz, Simone Odilia Fernandes; Cardoso, Valbert Nascimento; Tarabal, Bernardo; Takenaka, Isabella; Braga, Otavio; Vidigal, Paula Vieira Teixeira; Gelape, Claudio Leo; Araujo, Ivana Duval, E-mail: phnc@uol.com.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

    2015-07-01

    Purpose: to evaluate whether scintigraphy with technetium-99m-labeled ceftizoxime ({sup 99m}Tc-CFT) can differentiate mediastinitis from aseptic inflammation associated with sternotomy. Methods: twenty female Wistar rats were randomly distributed into four groups: S (control) -partial upper median sternotomy with no treatment; SW (control) - sternotomy and treatment of sternal wounds with bone wax; SB - sternotomy and infection with Staphylococcus aureus; SWB - sternotomy with bone wax treatment and bacterial infection. Scintigraphy with {sup 99m}Tc-CFT was performed eight days after surgery and images were collected 210 and 360 min after infusion of the radiopharmaceutical. Results: no animals exhibited clinical signs of wound infection at the end of the experiment, although histological data verified acute inflammatory response in those experimentally infected with bacteria. Scintigraphic images revealed that tropism of {sup 99m}Tc-CFT to infected sternums was greater than to their non-infected counterparts. Mean counts of radioactivity in bacteria-infected sternal regions (SB and SWB) were significantly higher (p = 0.0007) than those of the respective controls (S and SW).Conclusion: scintigraphy with technetium-99m-labeled ceftizoxime is a method that can potentially detect infection post sternotomy and differentiate from aseptic inflammation in animals experimentally inoculated with S. aureus (author)

  18. Evaluation of Sternal Closure with Absorbable Polydioxanone Sutures in Children

    Directory of Open Access Journals (Sweden)

    Hamid Bigdelian

    2014-03-01

    Full Text Available Introduction: Sternal dehiscence, sternal wound infection and mediastinitis are troublesome complications following median sternotomy which are major causes of morbidity and mortality of patients. Synthetic polydioxanone absorbable suture seems effective in prevention of these complications in children undergoing open heart surgery.Methods: During 2 years period, 620 patients who underwent median sternotomy were studied. The efficacy of absorbable polydioxanone suture was tested on patients using figure-of-eight suture technique. The patients’ age ranged from newborn to 15 years old. All surgical interventions were performed according to a standard protocol.Results: No sternal sutures were broken during the sternal closure and no case of mediastinitis was seen. Two patients experienced sternal dehiscence (0.32%. Follow-up period of patients were established between 1 to 132 months after open heart surgery.Conclusion: Sternal closure with the polydioxanone suture in combination with figure-of-eight technique is a safe and suitable method in children with good clinical results.

  19. CT scan of bacterial and aseptic meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Takemoto, Kazumasa; Saiwai, Shigeo; Tamaoka, Koichi (Kobe Central Municipal Hospital (Japan))

    1983-01-01

    CT scans of the patients with aseptic and bacterial meningitis were reviewed and compared to previous reports. In aseptic meningitis, no abnormal CT findings were observed. In bacterial meningitis, CT findings were ventricular dilatation, subdural fluid collection, parenchymal low density, intracerebral hematoma and meningeal enhancement after contrast injection. Three patients among 48 suffered from status epileptics during the course of the illness. All of the 3 patients developed parenchymal inhomogeneous low density and progressive ventricular dilatation which did not improve after ventricular peritoneal shunt surgery. We believe that these changes are most likely due to hypoxic hypoxemia during epileptic seizure and meningitis itself seems to play a little role.

  20. Extracorporeal shockwaves versus surgery in the treatment of pseudoarthrosis of the carpal scaphoid.

    Science.gov (United States)

    Notarnicola, A; Moretti, L; Tafuri, S; Gigliotti, S; Russo, S; Musci, L; Moretti, B

    2010-08-01

    The peculiar anatomical characteristics and precarious vascularization of the carpal scaphoid are responsible for a difficult healing of fractures and a fairly frequent subsequent evolution to pseudoarthrosis. Recently, extracorporeal shockwaves therapy (ESWT) has yielded encouraging results in the treatment of pseudoarthrosis of various bone segments. We report a retrospective study comparing the results of application of three sessions of shockwaves therapy (SW) with energy flux density (EFD) impulses of 0.09 (SD = 0.02) mJ/mm(2) ESWT emitted by an electromagnetic generator in 58 patients (group I) affected by pseudoarthrosis of the carpal scaphoid, with the results of surgical treatment consisting of stabilization and bone graft according to the Matti-Russe technique, performed in 60 subjects (controls, group II). There were no statistically significant differences in the mean duration of the pseudoarthrosis (p = 0.46), sex distribution (p = 0.41) and mean age at recruitment (p = 0.95) between the two patient groups. Posttreatment clinical-functional assessment, based on the Mayo Wrist Score, showed a significantly improved score, rising from 28-74.6 in group I already after 2 mo (p 0.05). On the basis of our data, we can conclude that the results of ESWT are comparable with those of surgical stabilization and bone graft in the treatment of scaphoid pseudoarthrosis. In view of their minimal invasiveness, shockwaves should therefore be considered the treatment of choice of this disorder.

  1. Spontaneous healing of an atrophic pseudoarthrosis during femoral lengthening : A case report with six-year follow-up

    OpenAIRE

    1999-01-01

     A seven-year old girl developed an atrophic pseudoarthrosis at the midshaft of the femur with 8.5 cm of femoral shortening after an open type II fracture. During a femoral lengthening procedure, the pseudoarthrosis filled with spontaneous callus formation and bone union was obtained.

  2. An alternative treatment method for defective pseudoarthrosis; evaluation of eight patients treated with Artelon+Kryptonite.

    Science.gov (United States)

    Uraş, Ismail; Yavuz, Osman Yüksel; Uygun, Murat; Paslioglu, Ebubekir; Kömürcü, Mahmut

    2016-03-01

    Pseudoarthrosis with bone loss is one of the most challenging orthopaedic problems for surgeons. Bone loss usually leads to technical difficulties during surgery due to instability in the fracture area. Eight patients with pseudoarthrosis of different long bones were operated on by the same surgeon. The median age was 53 years (25-61), and the median time period after the index operation was 21 months (12-72 months). Radiographic union was achieved in all patients in 3.62 months (2-5 months). Efficient healing with new bone formation was observed in all of the patients. The result of the current case series is promising. This treatment method can be used for the treatment of pseudoarthrosis without increasing morbidity. Long-term follow-up and larger case series are needed for evidence of the adequacy and reliability of this method of treatment.

  3. [Early reconstruction of congenital pseudoarthrosis of the tibia with free vascularized fibular grafts].

    Science.gov (United States)

    Fernández Gómez, E; Castro Torre, M; González-Herranz, P; Delgado Sotorrío, C; Rodríguez Lorenzo, A

    2012-04-01

    Congenital pseudoarthrosis of the tibia (CPT) is an uncommon disease presenting a tibial nonunion since birth and frequently associated to neurofibromatosis type 1. Surgical management by wide excision of the pseudoarthrosis and sustitution of the defect with vascularized bone in an early stage has proven to be the most effective technique in terms of bone consolidation. We present a clinical case of a 22-month-old patient with CPT treated successfully by reconstruction with a free vascularized fibula graft with an excellent functional result.

  4. Complete sternal cleft associated with right clavicular, manubrial, and thyroid hypoplasia, pectus deformity, and spinal anomalies.

    Science.gov (United States)

    Golden, Eleza T; Alazraki, Adina; Loewen, Jonathan; Braithwaite, Kiery

    2016-01-01

    Sternal cleft anomalies are rare. Associated anomalies include pentalogy of Cantrell and posterior fossa abnormalities, hemangiomas, arteriopathy, cardiac anomalies, eye abnormalities, and sternal defects syndrome. There is only a single report of complete sternal cleft, pectus excavatum, and right clavicular hypoplasia in an adult. Thyroid hemiagenesis is also very rare. To our knowledge, this is the first case of complete sternal cleft, pectus deformity, and right clavicular hypoplasia in a child and the first case with right thyroid hemiagenesis.

  5. Pulmonary agenesis associated with dextrocardia, sternal defects, and ectopic kidney.

    Science.gov (United States)

    Eroglu, Atilla; Alper, Fatih; Turkyilmaz, Atila; Karaoglanoglu, Nurettin; Okur, Adnan

    2005-12-01

    Pulmonary agenesis is a rare embryological defect, usually unilateral, and is associated with skeletal, cardiovascular, and other anomalies. A 22-month-old girl was admitted to our clinic with recurrent pulmonary infections. A chest X-ray and multidetector computed tomography (MDCT) revealed pulmonary agenesis with dextrocardia, sternal defects, and a right pelvic ectopic kidney. We report on the first known case of right-sided pulmonary agenesis combined with isolated dextrocardia, sternal defects, and an ectopic kidney. The importance of MDCT for the diagnosis of pulmonary agenesis and associated other anomalies is demonstrated.

  6. Congenital sternal foramen in a stillborn Holstein calf

    Institute of Scientific and Technical Information of China (English)

    Shahrzad Azizi; Mohsen Khosravi Bakhtiary; Mehdi Goodarzi

    2012-01-01

    Congenital sternal foramen is an anomaly whose occurrence is rare in human but is especially unusual in animals. This defect was formed when fusion of multiple ossification centers was incomplete. It may be associated with other lesions in body organs especially cardiac anomalies. In the present study, we report a very rare case of congenital sternal foramen in a Holstein calf. The oval defect was like a gunshot wound and located at the lower third of the sternum. Apparently, the rest of skeleton system seems normal. The awareness of the anomaly is important for better diagnosis and treatment of diseases.

  7. Sternal osteomyelitis after bacillus Calmette-Guérin vaccination

    Directory of Open Access Journals (Sweden)

    Rolandas Selvestravičius

    2016-09-01

    Full Text Available Presented here is the case of a nine-month-old boy with the osteomyelitis of the upper area sternum caused by bacillus Calmette-Guerin (BCG, the Danish 1331 strain vaccine against tuberculosis. Upon examination, a swelling of approximately 2×3 cm diameter was observed in the upper sternal area. The mass was hard, fixed and sensitive to palpation with no local skin hyperaemia. Chest X-rays revealed a round mass anterior to the sternum, suggesting a diagnosis of osteomyelitis. A consequent sternal biopsy was performed and Mycobacterium bovis BCG was identified by a positive growth culture.

  8. Sternal Osteomyelitis after Bacillus Calmette-Guérin Vaccination

    Science.gov (United States)

    Selvestravičius, Rolandas; Sučilienė, Elena; Saniukas, Kęstutis; Bobelytė, Odeta; Usonis, Vytautas

    2016-01-01

    Presented here is the case of a nine-month-old boy with the osteomyelitis of the upper area sternum caused by bacillus Calmette-Guerin (BCG), the Danish 1331 strain vaccine against tuberculosis. Upon examination, a swelling of approximately 2×3 cm diameter was observed in the upper sternal area. The mass was hard, fixed and sensitive to palpation with no local skin hyperaemia. Chest X-rays revealed a round mass anterior to the sternum, suggesting a diagnosis of osteomyelitis. A consequent sternal biopsy was performed and Mycobacterium bovis BCG was identified by a positive growth culture. PMID:27777704

  9. Early acute aseptic iritis after cataract extraction.

    Science.gov (United States)

    Allen, H F; Grove, A S

    1976-01-01

    Severe iritis which occurs within the first five days after cataract extraction may be categorized as (1) bacterial endophthalmitis, (2) toxic iritis, or (3) aseptic iritis. These entities can sometimes be distinguished because of their clinical features. If bacterial endophthalmitis is suspected, anterior chamber paracentesis should be considered and appropriate antibiotic treatment should be initiated. Acute iritis may result from the introduction of toxic agents into the eye, and may follow the use of products sterilized with ethylene oxide. Early acute aseptic iritis probably occurs more often than has previously been recognized. Response to intensive anti-inflammatory treatment is usually prompt and dramatic. The judicious use of cryoextraction and the careful manipulation of intraocular tissues may minimize the incidence and the severity of postoperative inflammation.

  10. Role of compressive-destructive osteosynthesis with introduction of cucumazim and marrow in nonunion fractures and pseudoarthrosis of humeral bone

    Directory of Open Access Journals (Sweden)

    Iskandar Khodjanov

    2014-03-01

    Full Text Available Nonunions and pseudoarthrosis of diaphysis of the humeral bone are one of the main problems of modern traumatology and orthopedics. This problem in the literature little lit: lack of information on use of modern diagnostic techniques (CT, X-ray, densitometry of research nonunions and pseudoarthrosis diaphyseal humeral bone. We analyzed treatment of 51 patients with nonunions and pseudoarthrosis of the humeral bone treated in the department of adult trauma in scientific research institute of traumatology and orthopedics of Uzbekistan for 2009 to 2012. The results showed that the method of treating the condition using a proteolytic enzyme cucumazim combined with transosseous osteosynthesis, can improve patient results of treatment.

  11. Treatment of septic pseudoarthrosis of tibia by Ilizarov method: Case report

    Directory of Open Access Journals (Sweden)

    Šešlija Igor

    2010-01-01

    Full Text Available Introduction. Septic pseudoarthroses of the tibia represent a relatively frequent complication of open fractures with a large soft tissue damage. They may be localized: in the proximal metaphysis, between the proximal and middle thirds, between middle and distal thirds, in the distal metaphysis. Case Outline. A case of a 52-year-old man with open fracture of the left tibia is presented. He fell from the height of 30 meters. The external fixation according to Mitkovic was performed in another institution. The patient was referred to our hospital nine months after the accident, with clear clinical and radiological signs of septic pseudoarthrosis of the tibia. The resection of septic pseudoarthrosis was done two weeks after admission. Three weeks later, another operation was performed, bilocal alternating distractive-compressive osteosynthesis according to Ilizarov. After eleven months Ilizarov frame was removed, with clinical, radiological signs of healing of pseudoarthrosis and complete curing of the infection. Five months after removal of the frame, the patient was fully anatomically and functionally recovered. Conclusion. Being satisfied with the achieved results and encouraged with the data from the literature, we recommend this method as the method of choice for the treatment of pseudoarthrosis of the tibia. The advantage consists of curing the infection using the natural bactericide power of the tissue and curing the bone defect, at the same time, and finally, producing the equalization of the legs.

  12. A research related with pseudoarthrosis and correction loss in idiopatic scoliosis cases treated with Harrington rods

    OpenAIRE

    Hamzaoglu, Azmi; Domanic, Unsal; Cakmak, Mehmet; Temucin, Bahattin Oguz; Taser, Omer; Karamehmetoglu, M.

    2004-01-01

    Attempts have been made to investigate the rate of correction loss, rate of pseudoarthrosis and its causes in 25 cases treated by Harrington procedure and whose last controls were made in the Department of Orthopaedics and Traumatology in the Medical School in Istanbul University during 1970-1978.

  13. Management of sternal osteomyelitis and mediastinal infection following median sternotomy

    Institute of Scientific and Technical Information of China (English)

    GAO Ju; WANG Wen-zhang; WANG You-li; LU Shu-qiang; CAI Ai-bing; YANG Zhi-fu; HAN Zhi-yi; LI Jiu-jiang; WEN Yu-ming; GENG Feng-yong

    2010-01-01

    Background Median sternotomy is considered the most usually performed procedure in cardiac operations. This study aimed to assess clinical effectiveness of bilateral pectoralis major muscle flaps (BPMMF) for management of sternal osteomyelitis and mediastinal infection following median sternotomy.Methods Clinical data were collected and retrospectively analyzed from twelve patients who underwent the BPMMF transposition for management of sternal osteomyelitis and mediastinal infection following median sternotomy from January 2006 to June 2009. Procedure consisted of rigorous debridement of necrotic tissues, dead space obliteration using the BPMMF, and placement of drainage tubes connected to a negative pressures generator for adequate drainage.Results No patients died of drainage, and all 12 patients had viable BPMMF when discharged from hospital. At 1 week post discharge, 2 patients presented with sternal infection but recovered following local debridement and medication. No patients showed infection recurrence during the follow-up period over 10 months.Conclusions Sternal osteomyelitis and mediastinal infection following median sternotomy may be effectively managed through rigorous debridement of infected soft tissues, resection of the damaged stermal segment, transposition of the BPMMF to fill the damaged sternum resulting from debridement, and adequate postoperative drainage.

  14. A Case of Lymphoma Simulating Primary Sternal Tumour

    Directory of Open Access Journals (Sweden)

    Atalay Sahin

    2014-02-01

    Full Text Available Any mass on the chest wall may not always be the primary local pathology. A case of lymphoma with an aggressive course may involve the sternum through local invasion and can mimic a chest wall tumour. A 15-year-old boy with mediastinal lymphoma presented with a sternal mass. Partial sternectomy with replacement by methyl methacrylate prosthesis was performed.

  15. Control of the aseptic processing environment.

    Science.gov (United States)

    Frieben, W R

    1983-11-01

    Methods used by industry with applications to hospital pharmacy for maintaining an aseptic environment in production of sterile pharmaceutical products are discussed. A major source of product contamination is airborne microorganisms. The laminar-airflow workbench with a high-efficiency particulate air filter provides an ultraclean environment for preparation of sterile products. However, the workbench does not guarantee sterility of products and is not effective if not properly installed and maintained or if the operator uses poor aseptic technique. The laminar-airflow workbench should be tested for leaks, airflow velocity, and airflow patterns when installed, and the workbench should be checked periodically thereafter. The workbench should be placed in a cleanroom where traffic and air disturbances that might affect the laminar airflow are eliminated. A major source of airborne microbial contamination in cleanrooms is people. Personnel movement through an area and presence of personnel without lint-free, nonshedding protective garments increase the levels of microbial contaminants in an area. The transport of nonsterile products (bottles, boxes, paper products) into a cleanroom should be minimized. The cleanroom itself should be sanitized and should be immaculate. Microbial or particulate monitoring should be conducted in the cleanroom using a quantitative method, and corrective-action limits should be set. Hospital pharmacists should examine industrial sterile-processing techniques and apply them to the preparation of sterile products.

  16. Bone tissue density modification in treatment of shin pseudoarthrosis by transosseous compressive osteosynthesis

    Directory of Open Access Journals (Sweden)

    Tishkov N.V.

    2011-12-01

    Full Text Available Objective is to detect bone mineral density along the shin according to «Esperanto» levels by Hounsfield's scale. Materials and methods. The analysis of density modification in 25 patients with pseudoarthrosis of tibia with predominant localization in a lower one-third of bone has been carried out. Results. By means of computed tomography it has been revealed that the bone tissue density of the tibia in the process of false joint union when using the compressive variant of combined transosseous osteosynthesis has changed according to the regularity reproducing phase character of the accumulation of mineral substances in the bone. Conclution. The growth of mineral density of the bone tissue during treatment spreads in the directions from proximal and distal metaepiphyses to the zone of pseudoarthrosis knitting

  17. [Infected pseudoarthrosis of the tibia, a pediatric case. Case report and literature review].

    Science.gov (United States)

    Mora-Ríos, F G; Antonio-Romero, C E; Mejía-Rohenes, L C; Cortés-Gómez, J; López-Marmolejo, A; Franco-López, E A

    2012-01-01

    Chronic posttraumatic osteomyelitis and infected pseudoarthrosis of the tibia are complex problems associated with considerable morbidity which may compromise the viability of the involved limb. The most frequent age of presentation is 2 to 6 years, with predominance in males at a 2:1 ratio. We present the case of a male 4 year-old patient with diagnosis of infected pseudoarthrosis. During the physical exam a fistula was detected in the anterior aspect of the right leg, with discharge of purulent material, and inability for weight bearing and gait. X-rays, culture of the exudate and biopsy were performed. Treatment consisted of antimicrobial therapy, surgical debridement's, and application of an autologous bone graft. The infection was controlled, the tibia healed, and function was restored.

  18. Posterolateral lumbar fusion: Relationship between computed tomography Hounsfield units and symptomatic pseudoarthrosis

    Directory of Open Access Journals (Sweden)

    Ha Son Nguyen

    2015-01-01

    Conclusion: Currently, CT imaging is typically not obtained prior to lumbar fusion. Results demonstrated that CT HU values were significantly larger for patients who did not exhibit symptomatic pseudoarthrosis at 1-year follow-up compared to those who required revision surgery. As such, CT HU values may serve as a predictor for bony fusion to guide surgical management of patients under consideration for PLF.

  19. Pseudoarthrosis of the hand in neurofibromatosis type 1: a case report.

    Science.gov (United States)

    İncecik, Faruk; Hergüner, M Özlem; Ballı, Tuğsan; Altunbaşak, Şakir

    2013-01-01

    Neurofibromatosis (NF) is a disorder with a wide spectrum of clinical manifestations. Here, we describe a 16-year-old boy with NF1 who had pseudoarthrosis of the 4th and 5th fingers of the left hand. He had specific cutaneous lesions and Lisch nodules in the iris. Because NF1 affects multiple organ systems, patients are likely to benefit most from a multidisciplinary treatment strategy.

  20. MANAGEMENT OF PSEUDOARTHROSIS OF SHAFT HUMERUS BY PLATING (FIVE YEARS FOLLOW UP – A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Shirish Virupanna

    2016-02-01

    Full Text Available Pseudoarthrosis is a condition where union at fracture site is very difficult to obtain. But sticking to the very basic principles of management of non-union – that is freshening at fracture site, removal of sclerotic bone, reaming of medullary canal, rigid fixation and abundant bone grafting-helps in achieving the goal. In the below case, all the steps were carried out and the fracture has healed two months postoperatively.

  1. Chronic aseptic meningitis in a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Lancman, M E; Mesropian, H; Granillo, R J

    1989-08-01

    Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus. It may occur early in the course of the disease and sometimes may be the initial symptom. We report a patient with chronic aseptic meningitis associated with systemic lupus erythematosus. Magnetic resonance imaging showed several ischemic lesions and an appearance which was compatible with chronic inflammation of the ependyma of the lateral ventricles.

  2. Possible Tick-Borne Human Enterovirus Resulting in Aseptic Meningitis

    OpenAIRE

    Freundt, Eric C.; Beatty, Douglas C.; Stegall-Faulk, Teresa; Wright, Stephen M.

    2005-01-01

    Enterovirus-specific genetic sequences were isolated from two Amblyomma americanum tick pools. Identical genetic sequences were later obtained from cerebrospinal fluid of a patient with aseptic meningitis and a recent history of tick attachment. These observations suggest the possibility of an emerging tick-borne human enterovirus associated with aseptic meningitis.

  3. Semester-Long Assessment of Aseptic Technique in Microbiology Labs

    Directory of Open Access Journals (Sweden)

    Daniel Aruscavage

    2013-08-01

    Full Text Available Biology educators emphasize aseptic technique when teaching lab courses. Aseptic technique is very important in microbiology to ensure safety and prevent cross-contamination. Although it can be assessed throughout the semester by examining the students’ technique and observation of contamination, this tool offers a simple semester-long graded assessment of each student’s technique. The procedures allow the students to perform a quick exercise that can determine if cross-contamination occurs, thus determining if aseptic technique was observed. Instructors can quickly check for the presence of cross-contamination. After implementing this procedure, a quantifiable improvement in my students’ aseptic technique throughout the semester was observed. It was noted that between the middle and end of the semester there was a slight increase in the amount of cross-contamination but still well below the contamination observed at the beginning of the semester. This procedure was a valuable way to assess aseptic technique during the course of a semester. A search for “aseptic technique” on the American Society of Microbiology website reveals that several lab experiments and job opportunities mention the importance of aseptic technique. It is a skill that must be used for all laboratory procedures when working with microorganisms. It is important for both the safety of the students and for the proper handling of microorganisms. There are several good explanations of aseptic technique on the Internet, and the Nuffield Foundation provides a very good description of techniques (1. The goal of this project is to provide instructors with a tool to assess the aseptic technique of their students by using simple transfers of bacteria to fresh media to identify cross-contamination. When class experiments do not work students may not understand how poor aseptic technique impacted the project. This tool would work best for undergraduate students in an

  4. Investigation of Sternal Photoplethysmography – Design of a Vital Sign Patch

    DEFF Research Database (Denmark)

    Chreiteh, Shadi

    %). In the second study, sternal PPG recording was conducted from 30 admitted patients with either asthma or Chronic Obstructive Pulmonary Disease (COPD). We compared the SpO2 levels simultaneously obtained from the sternal PPG recording and a conventional finger pulse oximeter. The Pearson correlation between...... to 36 breaths/min the Pearson correlation was 0.93 (p

  5. Sex estimation from sternal measurements using multidetector computed tomography.

    Science.gov (United States)

    Ekizoglu, Oguzhan; Hocaoglu, Elif; Inci, Ercan; Bilgili, Mustafa Gokhan; Solmaz, Dilek; Erdil, Irem; Can, Ismail Ozgur

    2014-12-01

    We aimed to show the utility and reliability of sternal morphometric analysis for sex estimation.Sex estimation is a very important step in forensic identification. Skeletal surveys are main methods for sex estimation studies. Morphometric analysis of sternum may provide high accuracy rated data in sex discrimination. In this study, morphometric analysis of sternum was evaluated in 1 mm chest computed tomography scans for sex estimation. Four hundred forty 3 subjects (202 female, 241 male, mean age: 44 ± 8.1 [distribution: 30-60 year old]) were included the study. Manubrium length (ML), mesosternum length (2L), Sternebra 1 (S1W), and Sternebra 3 (S3W) width were measured and also sternal index (SI) was calculated. Differences between genders were evaluated by student t-test. Predictive factors of sex were determined by discrimination analysis and receiver operating characteristic (ROC) analysis. Male sternal measurement values are significantly higher than females (P < 0.001) while SI is significantly low in males (P < 0.001). In discrimination analysis, MSL has high accuracy rate with 80.2% in females and 80.9% in males. MSL also has the best sensitivity (75.9%) and specificity (87.6%) values. Accuracy rates were above 80% in 3 stepwise discrimination analysis for both sexes. Stepwise 1 (ML, MSL, S1W, S3W) has the highest accuracy rate in stepwise discrimination analysis with 86.1% in females and 83.8% in males. Our study showed that morphometric computed tomography analysis of sternum might provide important information for sex estimation.

  6. Invasive Scedosporium sternal osteomyelitis following lung transplant: Cured

    Directory of Open Access Journals (Sweden)

    E.J. Denton

    2016-06-01

    Full Text Available Scedosporium is an important pathogen in cystic fibrosis (CF and post-transplant but rarely causes invasive infection. Treatment remains challenging, particularly due to inherent resistance to multiple antifungal agents. We present a young man with CF who developed invasive sternal and rib infection 10-months following lung transplant. The infection has been clinically and radiologically cured with extensive surgery and triazole therapy. This case highlights the importance of adjunctive surgery in addition to prolonged triazole treatment to manage invasive Scedosporium infections in immunosuppressed patients.

  7. Chronic sternal osteomyelitis complicating primary manubriosternal septic arthritis.

    Science.gov (United States)

    Sinha, S; Sinha, A; Nagarajah, K; Oei, E L; Critchley, P; McNally, M A

    2006-11-01

    We present a 40-year-old woman complaining of worsening chest pain. She was previously treated with a prolonged course of antibiotics for suspected sternal osteomyelitis. Radiological investigations were suggestive of ongoing inflammation within the manubriosternal joint. Formal surgical debridement yielded evidence corroborating the diagnosis although microbiological samples were negative. Prolonged empirical treatment with intravenous antibiotics leads to a complete resolution of symptoms. Primary culture-negative manubriosternal septic arthritis is rare, and suboptimal treatment, particularly if confused with other conditions such as synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome, compounds its considerable morbidity.

  8. Pseudomass of the sternal manubrium in osteogenesis imperfecta

    Energy Technology Data Exchange (ETDEWEB)

    Yekeler, Ensar; Kumbasar, Basak; Dursun, Memduh; Tunaci, Mehtap [Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, 34390, Capa, Istanbul (Turkey); Cantez, Serdar; Emiroglu, Halil Haldun [Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, 34390, Capa, Istanbul (Turkey)

    2003-06-01

    Skeletal abnormalities such as hypertrophic callus formation and ''popcorn'' calcifications are rare radiological findings of osteogenesis imperfecta, causing tumor-like appearances on imaging. We report on a 7-year-old girl with osteogenesis imperfecta presenting with hepatomegaly and palpable lymphadenopathy in the left inguinal region on physical examination. Computed tomography examination revealed a high-density mass-like lesion of the manubrium sterni. Ultrasonography and a lateral roentgenogram of the chest verified that this was a pseudomass caused by a bowed sternal manubrium. (orig.)

  9. Staphylococcus aureus sternal osteomyelitis: a rare cause of chest pain

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    Kaur M

    2015-10-01

    Full Text Available Chest pain is a common presenting symptom with a broad differential. Life-threatening cardiac and pulmonary etiologies of chest pain should be evaluated first. However, it is critical to perform a thorough assessment for other sources of chest pain in order to limit morbidity and mortality from less common causes. We present a rare case of a previously healthy 45 year old man who presented with focal, substernal, reproducible chest pain and Staphylococcus aureus bacteremia who was later found to have primary Staphylococcus aureus sternal osteomyelitis.

  10. Congenital pseudoarthrosis of the tibia: healing by lengthening over a rod without compression of the nonunion. A preliminary report.

    Science.gov (United States)

    Muhammad Abdul Jamil, Muhammad Kamal; Abdul Rashid, Abdul Halim; Ibrahim, Sharaf

    2013-05-01

    This preliminary report is on two patients with congenital pseudoarthrosis of the tibia who had a persistent nonunion following intramedullary rodding and bone grafting. We do not advocate repeated surgery to achieve union. When limb length discrepancy becomes greater than 5 cm, we proceeded with an Ilizarov procedure with the primary aim of equalizing limb length rather than achieving union. Healing of the pseudoarthrosis occurred in both patients after lengthening over the intramedullary rod without compression of the nonunion site. We believe that union occurs because of hyperaemia during the lengthening. This approach minimizes the repeated surgeries that are usually needed and thus ensures a more normal childhood without frequent hospitalizations.

  11. Giant Leaking Colloid Cyst Presenting with Aseptic Meningitis

    DEFF Research Database (Denmark)

    Bakhtevari, Mehrdad Hosseinzadeh; Sharifi, Guive; Jabbari, Reza

    2015-01-01

    status, and meningismus. Microbiological examination of the cerebrospinal fluid revealed aseptic meningitis. Brain imaging revealed a third ventricular colloid cyst with hydrocephalus. RESULTS: The tumor was resected via endoscopic intervention. There were no persistent operative complications related...

  12. [Benign recurring aseptic meningitis. What requires our attention?].

    Science.gov (United States)

    Kruis, T; Kredel, L; Nassir, M; Godbersen, M; Schneider, T

    2016-02-01

    Benign recurrent aseptic meningitis (BRAM) or Mollaret's meningitis is a rare disease characterized by recurrent episodes of aseptic meningitis followed by spontaneous recovery. Disease courses over several years have been reported. In most cases, BRAM is caused by HSV-2, less frequently by other viruses or autoimmune diseases. In up to 10 %, the aetiology remains unclear. We present a case of idiopathic BRAM and discuss clinical findings, diagnosis and therapeutic options of this rare illness.

  13. THE METHOD OF TREATMENT OF PATIENTS WITH NONUNIONS AND GUNSHOT PSEUDOARTHROSIS OF LONG BONE OF EXTREMITIES

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    B. A. Akhmedov

    2010-01-01

    Full Text Available Developed by the authors the method of treatment for nonunions and pseudoarthrosis of extremities long bones is described. It consist in mini-invasive preparation of interfragmentary space and bone grafting with cancellous graft from the wing of ilium. Successful use this method in 23 patients with gunshot wounds of humeral, forearm, femur and shin bones allows to recommend it for wide application. Suggested method of surgical treatment can be used not only after gunshot wounds, but after long bones fractures of another genesis.

  14. Aseptic Meningitis with Craniopharyngioma Resection: Consideration after Endoscopic Surgery

    Science.gov (United States)

    Chen, Jenny X.; Alkire, Blake C.; Lam, Allen C.; Curry, William T.; Holbrook, Eric H.

    2016-01-01

    Objectives While bacterial meningitis is a concerning complication after endoscopic skull base surgery, the diagnosis can be made without consideration for aseptic meningitis. This article aims to (1) present a patient with recurrent craniopharyngioma and multiple postoperative episodes of aseptic meningitis and (2) discuss the diagnosis and management of aseptic meningitis. Design Case report and literature review. Results A 65-year-old female patient with a symptomatic craniopharyngioma underwent transsphenoidal resection. She returned postoperatively with symptoms concerning for cerebrospinal fluid (CSF) leak and bacterial meningitis. Lumbar puncture demonstrated mildly elevated leukocytes with normal glucose levels. Cultures were sterile and she was discharged on antibiotics. She returned 18 days postoperatively with altered mental status and fever. Again, negative CSF cultures suggested aseptic meningitis. Radiological and intraoperative findings were now concerning for widespread cerebrovascular vasospasm due to leaked craniopharyngioma fluids. In the following months, her craniopharyngioma recurred and required multiple surgical resections. Days after her last operation, she returned with mental status changes and a sterile CSF culture. She was diagnosed with recurrent aseptic meningitis and antibiotics were discontinued. The patient experienced near complete resolution of symptoms. Conclusions Consideration of aseptic meningitis following craniopharyngioma resection is critical to avoid unnecessary surgical re-exploration and prolonged courses of antibiotics. PMID:27722072

  15. Aseptic Meningitis with Craniopharyngioma Resection: Consideration after Endoscopic Surgery.

    Science.gov (United States)

    Chen, Jenny X; Alkire, Blake C; Lam, Allen C; Curry, William T; Holbrook, Eric H

    2016-10-01

    Objectives While bacterial meningitis is a concerning complication after endoscopic skull base surgery, the diagnosis can be made without consideration for aseptic meningitis. This article aims to (1) present a patient with recurrent craniopharyngioma and multiple postoperative episodes of aseptic meningitis and (2) discuss the diagnosis and management of aseptic meningitis. Design Case report and literature review. Results A 65-year-old female patient with a symptomatic craniopharyngioma underwent transsphenoidal resection. She returned postoperatively with symptoms concerning for cerebrospinal fluid (CSF) leak and bacterial meningitis. Lumbar puncture demonstrated mildly elevated leukocytes with normal glucose levels. Cultures were sterile and she was discharged on antibiotics. She returned 18 days postoperatively with altered mental status and fever. Again, negative CSF cultures suggested aseptic meningitis. Radiological and intraoperative findings were now concerning for widespread cerebrovascular vasospasm due to leaked craniopharyngioma fluids. In the following months, her craniopharyngioma recurred and required multiple surgical resections. Days after her last operation, she returned with mental status changes and a sterile CSF culture. She was diagnosed with recurrent aseptic meningitis and antibiotics were discontinued. The patient experienced near complete resolution of symptoms. Conclusions Consideration of aseptic meningitis following craniopharyngioma resection is critical to avoid unnecessary surgical re-exploration and prolonged courses of antibiotics.

  16. Management of isolated sternal fractures using a practical algorithm

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    Dimos Karangelis

    2014-01-01

    Full Text Available Background: The implementation of seat belt legislation has led to an increase in the frequency of isolated sternal fractures (ISFs in motor vehicle crash. Aims: We reviewed retrospectively the medical records of our tertiary center in order to find out the frequency of ISFs, review our experience in their management, and define the mean length of hospitalization. Materials and Methods: From January 2008 to April 2012, 64 patients were admitted to the accident and emergency department of the University Hospital of Larissa, Greece, suffering from sternal fractures (SFs. Of these 64 patients, 45 had sustained ISF, while the remaining 19 had SF and additional injuries (intrathoracic and extrathoracic. The files of these 45 patients were further investigating as concerning the mechanism of injury, hospitalization days, morbidity, and mortality. Results: All the patients had been involved in motor vehicle crashes and most of them were wearing seat belts during the accident (91%. The hospital length of stay (LOS was 1.85 ± 1.67. All the patients had upon admission chest radiograms, serial electrocardiographs (ECGs, echocardiograms, and cardiac enzyme levels. Two patients had abnormal ECG and abnormal cardiac enzymes which contributed in prolonged hospitalization. However, there was no incidence of cardiac complications or deaths. Conclusions: ISFs, with normal electrocardiogram, cardiac enzymes, and chest X-ray in the absence of complications, require no further investigation.

  17. The Association between Blunt Cardiac Injury and Isolated Sternal Fracture

    Science.gov (United States)

    McMaster, Jason; Desai, Pathik J.; Desai, Sapan S.; Kuy, SreyRam; Mata, Maggy; Cooper, Jamie

    2014-01-01

    The treatment of isolated sternal fractures (ISF) throughout the world is heterogeneous. This study aimed to identify the incidence, morbidity, and mortality associated with isolated fractures of the sternum and describe current practice for diagnosis and management of ISF and cardiac injury at a level I trauma center in the UK. A retrospective cohort study of adult patients (>16 years) with ISF presenting from 2006 to 2010 was conducted. Eighty-eight patients with ISF were identified. Most patients (88%, 77) were admitted to hospital with 66% (58) of them discharged within 48 hours. Two (2%) patients had an ER EKG with abnormality but both resolved to normal sinus rhythm within 6 hours of follow-up. Serum CEs were drawn from 55 (63%) patients with only 2 (2%) having a rise in serum troponin >0.04; however, in both of these patients troponin quickly normalized. Six (7%) patients underwent echocardiograms without significant findings. In all 88 patients with ISF, no cases of clinically significant cardiac injury were identified. Patients presenting with an isolated sternal fracture with no changes on EKG or chest X-ray do not warrant an admission to hospital and may be discharged from the ER. PMID:24653859

  18. The Association between Blunt Cardiac Injury and Isolated Sternal Fracture

    Directory of Open Access Journals (Sweden)

    Anahita Dua

    2014-01-01

    Full Text Available The treatment of isolated sternal fractures (ISF throughout the world is heterogeneous. This study aimed to identify the incidence, morbidity, and mortality associated with isolated fractures of the sternum and describe current practice for diagnosis and management of ISF and cardiac injury at a level I trauma center in the UK. A retrospective cohort study of adult patients (>16 years with ISF presenting from 2006 to 2010 was conducted. Eighty-eight patients with ISF were identified. Most patients (88%, 77 were admitted to hospital with 66% (58 of them discharged within 48 hours. Two (2% patients had an ER EKG with abnormality but both resolved to normal sinus rhythm within 6 hours of follow-up. Serum CEs were drawn from 55 (63% patients with only 2 (2% having a rise in serum troponin >0.04; however, in both of these patients troponin quickly normalized. Six (7% patients underwent echocardiograms without significant findings. In all 88 patients with ISF, no cases of clinically significant cardiac injury were identified. Patients presenting with an isolated sternal fracture with no changes on EKG or chest X-ray do not warrant an admission to hospital and may be discharged from the ER.

  19. Complicated sternal dehiscence treated with the strasbourg thoracic osteosyntheses system (STRATOS and the transposition of greater omentum: a case report

    Directory of Open Access Journals (Sweden)

    Casablanca Giuseppe

    2010-06-01

    Full Text Available Abstract Sternal dehiscence is a serious complication after cardiac surgery. Sternal refixation, performed by simple rewiring or techniqual modification of rewiring as described by Robicsek, can fail, overall when the bone quality is poor or the sternum is completely destroyed. The sternal closure systems, consisting of plates, screws or rib clips and titanium bars, have been recently introduced to treat the complicated sternal dehiscence. We describe for the first time the use of the Strasbourg Thoracic Osteosyntheses System (STRATOS and the greater omentum, to treat a complicated sternal dehiscence, causing chest pain and respiratory failure.

  20. Frequency of sternal foramen evaluated by MDCT: a minor variation of great relevance.

    Science.gov (United States)

    Babinski, Marcio A; de Lemos, Leandro; Babinski, Monique S D; Gonçalves, Marianna V T; De Paula, Rafael C; Fernandes, Rodrigo M P

    2015-04-01

    Due to inadvertent cardiac or great vessel injury, sternal foramina may pose as a great hazard during sternal puncture. They can also be misinterpreted as osteolytic lesions in cross-sectional imaging of the sternum. The distribution of these variations differs between populations, but data from Brazilians are scarcely reported. Therefore, this study aimed to verify the frequency of midline sternal foramen and double-ended xiphoid process, as developmental variations, in order to avoid fatal complications following sternal puncture of sternal acupuncture treatment. A total of 114 chest computed tomograms were evaluated. The frequency of midline sternal foramen in a complication risk bearing feature is of approximately 10.5%. The double-ended xiphoid process was present in 17.5%. We conclude that sternal acupuncture should be planned in the region of corpus-previous CT should be done to rule out this variation. Furthermore, we strongly recommend the acupuncture technique which prescribes a safe superficial-oblique approach to the sternum.

  1. Comparative study of the use of electromagnetic fields in patients with pseudoarthrosis of tibia treated by intramedullary nailing.

    Science.gov (United States)

    Cebrián, Juan L; Gallego, Pilar; Francés, Alberto; Sánchez, Piedad; Manrique, Elena; Marco, Fernando; López-Durán, Luis

    2010-03-01

    We made a comparative cohort study in patients suffering from tibial pseudoarthrosis, all of whom were treated by intramedullary nailing. We divided patients into two groups: one treated by intramedullary nailing only (control group) and the other by intramedullary nailing combined with pulsed electromagnetic fields (PEMFs). The study included 57 cases of tibial pseudoarthrosis in 57 patients from February 1987 to February 2002. Pseudoarthrosis was treated surgically in all cases (Grosse-Kempf dynamic intramedullary nailing). This was combined with PEMFs in 22 cases. The average age was 38.3 years (range 14-89 years) and the average duration of follow-up was 27.2 months (range 12-48 months). Forty-nine fractures (86%) healed and eight (14%) did not. Of the group treated with PEMFs, 20 (91%) healed and two (9%) did not; from the group that did not receive PEMF (35), 29 (83%) healed compared to six (17%) that did not. The relationship between union and use of PEMFs, and between time to union and use of PEMFs was clinically relevant. PEMFs are useful when treating tibial pseudoarthrosis. Its noninvasive nature means that there are more complication-free unions.

  2. Congenital pseudoarthrosis of the clavicle: is operative treatment necessary? A report of four cases and literature review.

    Science.gov (United States)

    Kołodziej, Lukasz; Bohatyrewicz, Andrzej; Kotrych, Daniel

    2008-01-01

    Congenital pseudoarthrosis of the clavicle (CPC) is not a common condition. The exact number of cases reported in literature is fewer than two hundred. We present four well-documented cases of true congenital pseudoarthrosis of the clavicle, including two cases of familial occurrence. None of the patients in this study were treated surgically. Evaluation of upper extremity function was done with use of the Constant-Murley method. In spite of clavicle pseudoarthrosis the score results were similar to the unaffected shoulder. Although vertical elevation of the upper ribs or cervical ribs has been suggested as a cause of congenital clavicle lesions, radiological examination failed to reveal such pathology in any of the patients described here. Clavicle pseudoarthrosis is generally regarded as a benign condition. The majority of patients who underwent surgery because of cosmetic or functional heal well and proceed with a normal, unrestricted life. However, for those patients who are not bothered by the cosmetic appearance of their CPC and are asymptomatic in that they are not functionally limited, non-surgical treatment is a viable option.

  3. Pseudoarthrosis and ankylosis of the vertebral spine without sacroiliitis associated with Takayasu's arteritis: review of the association

    Energy Technology Data Exchange (ETDEWEB)

    Schuetz, C.T.; Anderson, S.E. [Department of Diagnostic Radiology, University Hospital of Berne, Inselspital, 3010 Berne (Switzerland); Aeberli, D.; Oertle, S. [Department of Rheumatology, University Hospital of Berne, Inselspital, 3010 Berne (Switzerland)

    2002-09-01

    Pseudoarthrosis and ankylosis of the vertebral spine associated with Takayasu's arteritis is extremely rare. We present a patient with the entity who was HLA-B27 negative and had normal sacroiliac joints. The association between Takayasu's arteritis and ankylosing spondylitis appears real but seemingly rare. (orig.)

  4. MR features in patients with residual paralysis following aseptic meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Dae Chul; Park, Young Seo [College of Medicine, Asan Meidcal Center, University of Ulsan, Seoul (Korea, Republic of)

    1991-01-15

    MR studies were performed in three patients with paralysis in the lower extremities. Poliomyelitis-like paralysis can be caused by neurovirulent strains of nonpolioenteroviruses. Entervirus 71 (EV 71) is documented as one of the potentially neurovirulent strains and a causative agent of some epidemics (1-7). The clinical manifestations associated with the EV 71 infection include aseptic meningitis, hand-food-mouth disease (HFMD), acute respiratory illness and gastrointestinal disease(6). Although rarely fatal, flaccidparalysis can be followed by EV 71 induced aseptic meningitis. Anterior horn cell necrosis was suggested on MR in two patients with residual paralysis (7). MR features, however, have not yet been described in detail. In this report we present three cases of patients with clinical evidence of EV 71 induced aseptic meningitis whose MR studies showed residual changes in spinal cord.

  5. Cat scratch disease complicated with aseptic meningitis and neuroretinitis

    Directory of Open Access Journals (Sweden)

    Vitor Laerte Pinto Jr.

    2008-04-01

    Full Text Available Cat scratch disease (CSD is a self limited condition characterized by fever, lymph node enlargement and less often eye involvement. Central nervous system involvement by Bartonella henselae infection is possibly an important cause of morbidity; its role as an agent of aseptic meningitis is unknown. We report a case of a 40 years-old man with CSD accompanied by aseptic meningitis and neuroretinitis. Serum indirect immmunofluorescence (IFI assays for B. henselae were positive and the cerebrospinal fluid (CSF analysis showed mononuclear pleocytosis and increased level of protein. Serological tests for other etiologies were negative. The patient responded well to antibiotic therapy with oral doxycicline plus rifampin and in the 12th day of hospitalization evolved to total regression of the headache and partial regression of the visual loss. Clinicians should consider CSD as a differential diagnosis when assessing previously healthy patients with aseptic meningitis associated with regional lymphadenopathy and epidemiological history of feline contact.

  6. Aseptic meningitis in children: analysis of 506 cases.

    Directory of Open Access Journals (Sweden)

    Athanasios G Michos

    Full Text Available BACKGROUND: Non-polio human enteroviruses are the leading cause of aseptic meningitis in children. The role of enterovirus PCR for diagnosis and management of aseptic meningitis has not been fully explored. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective study was conducted to determine the epidemiological, clinical, and laboratory characteristics of aseptic meningitis and to evaluate the role of enterovirus PCR for the diagnosis and management of this clinical entity. The medical records of children who had as discharge diagnosis aseptic or viral meningitis were reviewed. A total of 506 children, median age 5 years, were identified. The annual incidence rate was estimated to be 17/100,000 children less than 14 years of age. Most of the cases occurred during summer (38% and autumn (24%. The dominant clinical symptoms were fever (98%, headache (94% and vomiting (67%. Neck stiffness was noted in 60%, and irritation in 46% of the patients. The median number of CSF cell count was 201/mm(3 with polymorphonuclear predominance (>50% in 58.3% of the cases. Enterovirus RNA was detected in CSF in 47 of 96 (48.9% children tested. Children with positive enterovirus PCR had shorter hospitalization stay as compared to children who had negative PCR or to children who were not tested (P = 0.01. There were no serious complications or deaths. CONCLUSIONS: Enteroviruses accounted for approximately one half of cases of aseptic meningitis. PCR may reduce the length of hospitalization and plays important role in the diagnosis and management of children with aseptic meningitis.

  7. Congenital superior sternal cleft repair using our modified Sally technique: A case report

    Directory of Open Access Journals (Sweden)

    Tomoyuki Kuwata

    2014-12-01

    Full Text Available We report the case of an 8-month-old male neonate who underwent reconstructive surgery for a congenital superior sternal cleft to decrease the risk of commotio cordis. With regard to use of the Sally technique for the repair of a relatively wide cleft (4 × 4 cm, we were concerned about respiratory problems caused by compression following closure of the sternal halves. By closing the sternal halves imperfectly, elevation of intrapleural pressure can be avoided to some extent. By bridging the surplus resected cartilage from the lower sternum over the gap of the upper sternum, the heart is protected by more rigid material. We recommend our modified Sally technique because it is both flexible and effective for sternal cleft repair.

  8. Radiographic picture of hypertrophic pseudoarthrosis of the leg and condition of arterial vascularity of the limb; Obraz radiologiczny hipertroficznych stawow rzekomych goleni a stan tetniczego ukrwienia konczyny

    Energy Technology Data Exchange (ETDEWEB)

    Konarski, K.; Trubisz, L.; Piotrowski, W. [Szpital im. J. Jonstona, Lublin (Poland)

    1993-12-31

    Weber and Cech classification of pseudoarthroses allowing for assessment of its viability is presented. An angiography was found to be useful in determination of pseudoarthrosis viability. Femoral arteriography has been performed in 18 cases of hypertrophic pseudoarthroses assessed as viable on the basis of radiographic examination. In 13 cases arterial injuries indicating diminished biological reactivity of pseudoarthrosis of the leg were found. (author). 7 refs, 3 figs, 1 tab.

  9. Sternal fractures and delayed cardiac tamponade due to a severe blunt chest trauma.

    Science.gov (United States)

    Liang, Huai-min; Chen, Qiu-lin; Zhang, Er-yong; Hu, Jia

    2016-04-01

    Sternal fractures caused by blunt chest trauma are associated with an increased incidence of cardiac injury. Reports of the incidence of cardiac injury associated with sternal fracture range from 18% to 62%. Delayed cardiac tamponade is a rare phenomenon that appears days or weeks after injury. Moreover, after nonpenetrating chest trauma, cardiac tamponade is very rare and occurs in less than 1 of 1000. This case describes a patient who had delayed cardiac tamponade 17 days after a severe blunt chest trauma.

  10. Sternal Reconstruction of Deep Sternal Wound Infections Following Median Sternotomy by Single-stage Muscle Flaps Transposition

    Institute of Scientific and Technical Information of China (English)

    Ji-yan Xie

    2014-01-01

    Objective To assess clinical effectiveness of using bilateral pectoralis major or plus rectus abdominis muscle flaps in treating deep sternal wound infection (DSWI) following median sternotomy. Methods Between January 2009 and December 2013, 19 patients with DSWI after median sternotomy for cardiac surgery were admitted to our hospital, including 14 males (73.7%) and 5 females (26.3%), aged 55±13 (18-78) years. According to the Pairolero classification of infected median sternotomies, 3 (15.8%) patients were type II, and the other 16 (84.2%) were type III. Surgical procedure consisted of adequate debridement of infected sternum, costal cartilage, granulation, steel wires, suture residues and other foreign substances. Sternal reconstruction used the bilateral pectoralis major or plus rectus abdominis muscle flaps to obliterate dead space. The drainage tubes were placed and connected to a negative pressure generator for adequate drainage. Results There were no intraoperative deaths. In 15 patients (78.9%), bilateral pectoral muscle flaps were mobilized sufficiently to cover and stabilize the defect created by wound debridement. 4 patients (21.0%) needed bilateral pectoral muscle flaps plus rectus abdominis muscle flaps because their pectoralis major muscle flaps could not reach the lowest portion of the wound. 2 patients (10.5%) presented with subcutaneous infection, and 3 patients (15.8%) had hematoma. They recovered following local debridement and medication. 17 patients (89.5%) were examined at follow-up 12 months later, all healed and having stable sternum. No patients showed infection recurrence during the follow-up period over 12 months. Conclusion DSWI following median sternotomy may be effectively managed with adequate debridement of infected tissues and reconstruction with bilateral pectoralis major muscle or plus rectus abdominis muscle flap transposition.

  11. Pseudoarthrosis and fracture: interaction between severe vitamin D deficiency and primary hyperparathyroidism.

    Science.gov (United States)

    Rastogi, Ashu; Bhadada, Sanjay Kumar; Bhansali, Anil

    2013-11-01

    A young woman with severe vitamin D deficiency presented with proximal muscle weakness, fragility fracture and pseudoarthrosis. On evaluation, she was found to have hypercalcaemia, a single parathyroid adenoma and an undetectable 25-hydroxyvitamin D level. She received parenteral cholecalciferol and subsequently underwent curative parathyroidectomy. Postoperatively, she had hungry bone syndrome, which she gradually recovered from with calcium and calcitriol replacement. Notably, her calcium levels were in the lower limit of normal range and associated with elevated alkaline phosphatase levels at postoperative Day 14. Follow-up for the next four years showed that the patient had remarkable symptomatic and radiological improvements. In this report, we discuss the pathophysiological interactions between vitamin D deficiency and associated primary hyperparathyroidism.

  12. Isolation and Characterization of Multipotential Mesenchymal Stromal Cells from Congenital Pseudoarthrosis of the Tibia: Case Report.

    Science.gov (United States)

    Diaz-Solano, Dylana; Wittig, Olga; Mota, Jose D; Cardier, Jose E

    2015-10-01

    Congenital pseudoarthrosis of the tibia (CPT) is an uncommon disease whose etiology and pathogenesis is unknown. Several evidences suggest that decreased osteogenic capacities, impaired local vascularization, and microenvironment alterations may play a role in the pathogenesis of CPT. Additionally, it is not clear if the pathogenesis of this disease is related to the absence of cells with osteogenic capacity of differentiation. In this work, a two-year-old patient diagnosed with CPT underwent an orthopedic surgery to promote bone union in a pseudoarthrosis lesion. Tissue from CPT lesion was excised, and histological evaluation and tissue culture were performed. Histologic analysis of the soft CPT lesion showed the presence of highly cellular fibrous tissue, vascularization, and abundant extracellular matrix. Fusiform cells of mesenchymal appearance were observed but osteoblasts, osteoclasts, chondrocytes, and adipose cells were not found. There was no evidence of osteogenesis. CPT tissue cultured as explants showed, after one month of culture, evidence of osteogenesis, chondrogenesis, and adipogenesis. Cells isolated from explants of CPT tissue showed a fibroblast-like morphology and expressed the mesenchymal stromal cell (MSC) markers: CD105, CD73, and CD90 (CPT-MSC). Functional analysis showed that CPT-MSC differentiate, in vitro, into osteogenic, chondrogenic, and adipocytic cells. CPT-MSC expressed osteocalcin and agrecan. CPT-MSC produced collagen in the presence of ascorbic acid. MSC from BM of normal individuals were used as control. In summary, our results indicate that CPT tissue contains MSC with osteogenic capacity of differentiation. It is possible that CPT microenvironment may contribute to impair the osteogenic capacity of differentiation of CPT-MSC.

  13. An unconventional indication of the Sauve' - Kapandji procedure in a radial shaft pseudoarthrosis and chronic DRUJ dislocation: a case report.

    Science.gov (United States)

    Theodorakis, E; Fanelli, M; Ottolenghi, P; Pappalardo, S

    2013-01-01

    We present a 42-years-old male who developed a radial shaft pseudoartrosis and a chronic DRUJ dislocation/instability, following a Galeazzi fracture. He presented to our Office with a severe inability of wrist and forearm motion. A Sauve'-Kapandji procedure was adopted, performing a lateral approach to the ulna and grafting the excised ulnar block to retrieve radial length at the pseudoarthrosis level. Cancellous bone grafts from the iliac crest were also applied and mixed with autologous platelet rich plasma to promote callus formation. The goal was to create an intentional pseudoarthrosis of the distal ulna combined with a DRUJ arthrodesis, in order to resolve instability and regain forearm pronation/supination. We obtained bone healing, an excellent clinical recovery, and the patient returned to all his previous activities six months after surgery. To our knowledge, this is the first reported case of a radial shaft psudoarthrosis treated with the Sauve'-Kapandji technique.

  14. Ultrasound assessment of posttraumatic pseudoarthrosis of the carpal scaphoid; Valoracion ecografica de la seudoartrosis postraumatica del escafoides carpiano

    Energy Technology Data Exchange (ETDEWEB)

    Sarria, L.; Garcia, S.; Cozcolluela, R.; Martinez-Berganza, T.; Villacampa, V. [Hospital Reina Sofia. Tudela Navarra (Spain)

    2001-07-01

    to evaluate the utility of ultrasonography in the diagnosis of posttraumatic pseudoarthrosis of the carpal scaphoid, describing the ultrasound findings observed in the patients. Eleven patients diagnosed as having pseudoarthrosis of the carpal scaphoid were studied using a 7.5-MHz probe. The features assessed were irregularity of the cortical surface, presence of a gap in its continuity and swelling of periscaphoid soft tissue, the vascularity of which was studied by means of color Doppler. The findings were compared with those observed in the contralateral hand. Cortical irregularity was observed in all the patients and six presented a gap in the cortex of the palmar surface of the scaphoid. Ten had soft tissue swelling with increased vascularity. One patient with an ununited fracture showed no gap or soft tissue swelling: the bone cortex was found to be intact intraoperatively. Ultrasound is useful in the diagnosis of pseudoarthrosis of the carpal scaphoid. Swelling of the periscaphoid soft tissue with increased vascularity in patients whose fracture occured more than 6 to 8 weeks earlier suggests nonunion of the injured bone. (Author) 13 refs.

  15. An Alternative Technique for Surgical Management of Poststernotomy Osteomyelitis and Reconstruction of the Sternal Defect

    Directory of Open Access Journals (Sweden)

    Petros Konofaos

    2013-01-01

    Full Text Available Introduction. Sternal osteomyelitis with or without mediastinal infection is a severe and rare complication of median sternotomy. In this paper, an alternative technique for the reconstruction of sternal defects with the use of bilateral pectoralis major pedicled muscle flaps is presented. Case presentation. A 70-year-old man with the diagnosis of poststernotomy osteomyelitis underwent reconstruction of his sternal defect with the use of bilateral pectoralis major muscle flaps. The patient had an uneventful recovery, and the physical examination revealed a normal range of motion for both upper limbs and sternal stability. Conclusion. The proposed technique incorporates a simple mobilization of the two pectoralis major muscles to be used as flaps to fill the sternal defect without the need for humeral detachment or a second cutaneous incision. Using this technique, a muscular implant is made that seals the dead space, which has no tension due to the presence of a second layer. Postoperative results are excellent, not only regarding infection and functionality but also from an aesthetic point of view.

  16. A Case of Bilateral Aseptic Necrosis of the Femoral Head

    Science.gov (United States)

    KAMAL, DIANA; TRĂISTARU, RODICA; KAMAL, C.K.; ALEXANDRU, D.O.; MOGOANTĂ, L.; GRECU, D.C.

    2014-01-01

    Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and chronic alcohol consumption, who is diagnosed with aseptic necrosis of the left femoral head, ARCO stage IV, and in just six months after the diagnosis and hip arthroplasty, he suffers an injury which leads to the same diagnosis in the contralateral hip. We want to emphasize that for all patients with a high index of suspicion there should be an MRI examination, because the plane radiographs or CT are most often not relevant in detecting early signs of this condition. Diagnosis of aseptic necrosis of the femoral head in the early stages is a necessity in order to obtain an optimal result of conservative treatment. PMID:26788359

  17. A Case of Bilateral Aseptic Necrosis of the Femoral Head.

    Science.gov (United States)

    Kamal, Diana; Trăistaru, Rodica; Kamal, C K; Alexandru, D O; Mogoantă, L; Grecu, D C

    2014-01-01

    Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and chronic alcohol consumption, who is diagnosed with aseptic necrosis of the left femoral head, ARCO stage IV, and in just six months after the diagnosis and hip arthroplasty, he suffers an injury which leads to the same diagnosis in the contralateral hip. We want to emphasize that for all patients with a high index of suspicion there should be an MRI examination, because the plane radiographs or CT are most often not relevant in detecting early signs of this condition. Diagnosis of aseptic necrosis of the femoral head in the early stages is a necessity in order to obtain an optimal result of conservative treatment.

  18. Viral etiology of aseptic meningitis among children in southern Iran.

    Science.gov (United States)

    Hosseininasab, Ali; Alborzi, Abdolvahab; Ziyaeyan, Mazyar; Jamalidoust, Marzieh; Moeini, Mahsa; Pouladfar, Gholamreza; Abbasian, Amin; Kadivar, Mohamad Rahim

    2011-05-01

    Aseptic meningitis refers to a clinical syndrome of meningeal inflammation in which bacteria cannot be identified in the cerebrospinal fluid (CSF). The viral etiology and the epidemiological, clinical, and laboratory characteristics of aseptic meningitis among children aged 2 months to 15 years in Shiraz, southern Iran were determined. From May 2007 to April 2008, 65 patients were admitted to the hospital with aseptic meningitis. Seven viruses, non-polio human enteroviruses, mumps virus, herpes simplex virus (HSV), varicella-zoster virus (VZV), human cytomegalovirus (HCMV), human herpes virus type 6 (HHV-6), and Epstein-Barr virus (EBV) were investigated by polymerase chain reaction (PCR) method. Viruses were detected in 30 (46.2%) patients in whom non-polio human enterovirus and mumps virus were detected in 13 (43.3%) and 11 (36.7%), respectively. The remaining 6 (20%) of the cases were caused by HSV, VZV, HCMV, and HHV-6. Haemophilus influenzae and non-polio human enterovirus were detected in one patient simultaneously. Viral meningitis was found to be more frequent during spring and summer. The majority (66.6%) of the patients were treated in the hospital for 10 days and had received antibiotics in the case of bacterial meningitis. Rapid diagnosis of viral meningitis using PCR testing of CSF can help shorten hospitalization, and avoid the unnecessary use of antibiotics.

  19. Comparison of gap arthroplasty versus creating a pseudoarthrosis – modified technique for surgical management of temporomandibular joint ankylosis: a new approach

    Directory of Open Access Journals (Sweden)

    Irfan ul Hassan Haji

    2014-01-01

    Full Text Available Objectives: To compare the postoperative results like vertical ramus height, vertical facial height, anterior open bite, unilateral cross bite and reankylosis in patients with TMJ ankylosis after doing gap arthroplasty versus creating a pseudoarthrosis by this modified technique. Background: This surgical study done on 10 patients with TMJ ankylosis were 5 patients had unilateral ankylosis and 5 had bilateral ankylosis. Pseudoarthrosis was created by this modified technique in all 10 patients. Methods: In this technique, a pseudoarthrosis is created by two oblique osteotomies and resection of triangular shaped bony wedge between the articular cavity and subcondylar region involving ankylotic bony mass and sub-ankylotic normal bone and a surgical gap is created without interposing any material with gap of 1cm anteriorly and gap height decreasing posteriorly resulting in pseudoarthrosis at posterior border without any loss of vertical ramus height. Results and conclusion: The postoperative results show that this new approach of creating a pseudoarthrosis is effective and convenient method of treating TMJ ankylosis and has many advantages over conventional gap arthroplasty.

  20. Pectoralis Muscle Flap Repair Reduces Paradoxical Motion of the Chest Wall in Complex Sternal Wound Dehiscence

    Science.gov (United States)

    Zeitani, Jacob; Russo, Marco; Pompeo, Eugenio; Sergiacomi, Gian Luigi; Chiariello, Luigi

    2016-01-01

    Background The aim of the study was to test the hypothesis that in patients with chronic complex sternum dehiscence, the use of muscle flap repair minimizes the occurrence of paradoxical motion of the chest wall (CWPM) when compared to sternal rewiring, eventually leading to better respiratory function and clinical outcomes during follow-up. Methods In a propensity score matching analysis, out of 94 patients who underwent sternal reconstruction, 20 patients were selected: 10 patients underwent sternal reconstruction with bilateral pectoralis muscle flaps (group 1) and 10 underwent sternal rewiring (group 2). Eligibility criteria included the presence of hemisternum diastases associated with multiple (≥3) bone fractures and radiologic evidence of synchronous chest wall motion (CWSM). We compared radiologically assessed (volumetric computed tomography) ventilatory mechanic indices such as single lung and global vital capacity (VC), diaphragm excursion, synchronous and paradoxical chest wall motion. Results Follow-up was 100% complete (mean 85±24 months). CWPM was inversely correlated with single lung VC (Spearman R=−0.72, p=0.0003), global VC (R=−0.51, p=0.02) and diaphragm excursion (R=−0.80, p=0.0003), whereas it proved directly correlated with dyspnea grade (Spearman R=0.51, p=0.02) and pain (R=0.59, p=0.005). Mean CWPM and single lung VC were both better in group 1, whereas there was no difference in CWSM, diaphragm excursion and global VC. Conclusion Our study suggests that in patients with complex chronic sternal dehiscence, pectoralis muscle flap reconstruction guarantees lower CWPM and greater single-lung VC when compared with sternal rewiring and it is associated with better clinical outcomes with less pain and dyspnea. PMID:27733997

  1. Coronary artery bypass surgery in diabetic patients – risk factors for sternal wound infections

    Directory of Open Access Journals (Sweden)

    Lenz, Kristina

    2016-07-01

    Full Text Available The incidence of sternal wound infections (SWI after coronary artery bypass surgery (CABG as reported worldwide is low. However, it is associated with significant increase of postoperative mortality and treatment costs. The major risk factors discussed are diabetes mellitus and bilateral IMA harvesting of the internal mammary artery. This study analyses data of 590 patients receiving CABG concerning the risk factors for SWI. Sternal wound infections occur significantly more often in diabetic patients, one crucial and significant additional risk factor is obesity.

  2. Reconstruction of Chest Wall by Cryopreserved Sternal Allograft after Resection of Aneurysmal Bone Cyst of Sternum

    Directory of Open Access Journals (Sweden)

    Kambiz Sheikhy

    2017-01-01

    Full Text Available A 20-year-old female was referred to our hospital due to deformity and bulging in anterior aspect of chest wall in sternal area. Chest X-ray and CT scan confirmed a large mass with destruction of sternum. Pathologic diagnosis after incisional biopsy was compatible with aneurysmal bone cyst. We resected sternum completely and reconstructed large anterior defect by a cryopreserved sternal allograft. In follow-up of patient there was no unstability of chest wall with good cosmetic result.

  3. Reconstruction of Chest Wall by Cryopreserved Sternal Allograft after Resection of Aneurysmal Bone Cyst of Sternum

    Science.gov (United States)

    Sheikhy, Kambiz; Abbasi Dezfouli, Azizollah

    2017-01-01

    A 20-year-old female was referred to our hospital due to deformity and bulging in anterior aspect of chest wall in sternal area. Chest X-ray and CT scan confirmed a large mass with destruction of sternum. Pathologic diagnosis after incisional biopsy was compatible with aneurysmal bone cyst. We resected sternum completely and reconstructed large anterior defect by a cryopreserved sternal allograft. In follow-up of patient there was no unstability of chest wall with good cosmetic result. PMID:28299230

  4. Congenital Pseudoarthrosis of Medial Malleolus in A Young Soccer Player – Diagnosis in Clinical setting of Ankle Sprain

    Directory of Open Access Journals (Sweden)

    Giuliano Cerulli

    2014-01-01

    Full Text Available Introduction: We report a case of a young female soccer player affected by congenital medial bilateral malleolus pseudoarthrosis and os subfibulare. Congenital pseudoarthrosis is the failure of the bones to fuse prior or at birth. The etiology is still unknown, although frequency is high in subjects affected by neurofibromatosis or correlated syndromes, so it has been suggested that these congenital disorders may be the cause of congenital pseudoarthrosis. Case Report: Our patient, a 16-year-old female, high level soccer player, was referred to us following a right ankle sprain during a match. She reported no medical history of tibia-tarsus joint injuries or disease. Pain, swelling and functional impairment were noted immediately after the accident. Standard radiographs in the emergency department revealed a displaced fracture of the medial malleolus and the presence of os subfibularis. The patient was transferred to our Traumatology and Orthopaedic Department to undergo malleolus ostheosynthesis. Before surgery swelling, functional impairment and intense pain at the medial malleolus level were confirmed. However, there was no radiological opening of ankle, instability or pronation pain; furthermore the flexion-extension was preserved with slight pain. Twenty-four hours later a considerable remission of symptoms was evident with increased range of motion and reduction in the swelling and post-traumatic edema. A radiograph on the left ankle to compare with that of the right ankle was necessary to overcome the discrepancy between the radiological diagnosis and the clinical examination. The radiographic results of both medial malleoli were comparable although on the left the os subfibularis was absent. Since the diagnosis of fracture by the association between the radiographs and the symptomatology was doubtful, a bilateral CT was performed. The scan revealed a medial bilateral malleolus pseudoarthrosis and an accessory right subfibularis nucleus

  5. Case report 400: Unilateral fusion of odontoid to lateral mass of C1 with pseudoarthrosis on left

    Energy Technology Data Exchange (ETDEWEB)

    Nyska, M.; Margulies, J.Y.; Gomori, J.M.; Beauvoir, G.

    1986-11-01

    A case is described of a 19-year-old woman who presented with pain in the neck of several months duration. Torticolis and limitation of rotation of the head and neck to the right were observed. Plain films of the cervical spine were interpreted as normal, but plain film tomography and CT studies demonstrated an unusual anomaly, consisting of fusion of the odontoid process to the right lateral mass of C1 and a pseudoarthrosis in the anterior mass on the left side. (orig./SHA).

  6. Aseptic Meningitis Caused by Lassa Virus: Case Series Report.

    Science.gov (United States)

    Okokhere, Peter O; Bankole, Idowu A; Iruolagbe, Christopher O; Muoebonam, Benard E; Okonofua, Martha O; Dawodu, Simeon O; Akpede, George O

    2016-01-01

    The Lassa virus is known to cause disease in different organ systems of the human body, with varying clinical manifestations. The features of severe clinical disease may include bleeding and/or central nervous system manifestations. Whereas Lassa fever encephalopathy and encephalitis are well described in the literature, there is paucity of data on Lassa virus meningitis. We present the clinical description, laboratory diagnosis, and management of 4 consecutive cases of aseptic meningitis associated with Lassa virus infection without bleeding seen in a region of Nigeria known to be endemic for both the reservoir rodent and Lassa fever. The 4 patients recovered fully following intravenous ribavirin treatment and suffered no neurologic complications.

  7. Associated injuries in traumatic sternal fractures: a review of the National Trauma Data Bank.

    Science.gov (United States)

    Oyetunji, Tolulope A; Jackson, Hope T; Obirieze, Augustine C; Moore, Danier; Branche, Marc J; Greene, Wendy R; Cornwell, Edward E; Siram, Suryanarayana M

    2013-07-01

    Sternal fractures occur infrequently with blunt force trauma. The demographics and epidemiology of associated injuries have not been well characterized from a national trauma database. The National Trauma Data Bank was queried for patients with closed sternal fractures. The demographics were analyzed by age, gender, mechanism and indicators of anatomic and physiologic injuries. Types of commonly associated injuries were also determined. A total of 23,985 records were analyzed. Males accounted for 68.3 per cent and whites 70.9 per cent. Motor vehicle crash was the leading mechanism. More than 56 per cent had severe injuries based on Injury Severity Score (greater than 15) and 17 per cent with Glasgow Coma Score 8 or less. Crude mortality was 7.9 per cent. The majority (57.8%) and approximately one-third (33.7%) of the patients had rib fractures and lung contusions, respectively, 22.0 per cent with closed pneumothorax, 21.6 per cent had a closed thoracic vertebra fracture, 16.9 per cent with lumbar spine fracture, 3.9 per cent with concussion, and blunt cardiac injury in 3.6 per cent. Sternal fractures are usually associated with severe blunt trauma. Lung contusion remains the leading associated injury followed by vertebral spine fractures. Cardiac injuries are less frequent and vascular injuries less so. Mechanism of injury and presence of sternal fractures should alert providers to these potential associated injuries.

  8. Intrapericardial migration of dislodged sternal struts as late complication of open pectus excavatum repairs

    Directory of Open Access Journals (Sweden)

    Haverich Axel

    2011-03-01

    Full Text Available Abstract We present a case of sternal steel strut dislodgement and migration in a patient undergoing Ravitch repair for pectus excavatum (PE 37 years ago. Broken struts perforated the right ventricle and right ventricular outflow tract (RVOT and additionally migrated into the left upper lobar bronchus. Dislodged sternal struts represent rare complications after surgical repair of patients suffering from pectus excavatum. Reviewing the literature, only five cases of intrapericardial migration of dislodged sternal struts or wires have been reported so far. In our case, the first strut was removed from the airways through a left antero-lateral thoracotomy. Using cardiopulmonary bypass, a second strut was removed via ventriculotomy. These life-threatening sequelae underscore the importance of postoperative follow-up and early removal of osteosynthetic materials used in open PE repair. Accurate preoperative localization of migrated materials and availability of CPB support are crucial for successful surgical removal. Introduction The migration of dislodged sternal steel struts or wires into the pericardium and cardiac cavities is a rare but life-threatening complication of open pectus excavatum (PE repair 1. Removal of these materials poses a challenge for cardiothoracic surgeons. Herein, the authors report a case of migration of dislodged steel struts through the right ventricle and right ventricular outflow tract (RVOT into the left upper lobar bronchus in a patient who underwent Ravitch repair 37 years ago.

  9. A clinical study of short-term sternal photoplethysmography: recordings from patients with obstructive airways diseases

    DEFF Research Database (Denmark)

    Chreiteh, Shadi; Saadi, Dorthe Bodholt; Belhage, Bo

    2016-01-01

    and commercially accepted range. We then compared the SpO2 levels simultaneously obtained from the sternal PPGs and a commercially available finger pulse oximeter on 28 admitted patients with either asthma or Chronic Obstructive Pulmonary Disease (COPD). The Pearson correlation between the SpO2 levels estimated...

  10. Mesenchymal Stem/Stromal Cells from Discarded Neonatal Sternal Tissue: In Vitro Characterization and Angiogenic Properties

    Directory of Open Access Journals (Sweden)

    Shuyun Wang

    2016-01-01

    Full Text Available Autologous and nonautologous bone marrow mesenchymal stem/stromal cells (MSCs are being evaluated as proangiogenic agents for ischemic and vascular disease in adults but not in children. A significant number of newborns and infants with critical congenital heart disease who undergo cardiac surgery already have or are at risk of developing conditions related to inadequate tissue perfusion. During neonatal cardiac surgery, a small amount of sternal tissue is usually discarded. Here we demonstrate that MSCs can be isolated from human neonatal sternal tissue using a nonenzymatic explant culture method. Neonatal sternal bone MSCs (sbMSCs were clonogenic, had a surface marker expression profile that was characteristic of bone marrow MSCs, were multipotent, and expressed pluripotency-related genes at low levels. Neonatal sbMSCs also demonstrated in vitro proangiogenic properties. Sternal bone MSCs cooperated with human umbilical vein endothelial cells (HUVECs to form 3D networks and tubes in vitro. Conditioned media from sbMSCs cultured in hypoxia also promoted HUVEC survival and migration. Given the neonatal source, ease of isolation, and proangiogenic properties, sbMSCs may have relevance to therapeutic applications.

  11. Role of Negative-Pressure Wound Therapy in Deep Sternal Wound Infection After Open Heart Surgery

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    Cemalettin Aydın

    2013-08-01

    Full Text Available Introduction: Mediastinitis is a devastating complication in open heart surgery. The most common treatments after debridement are rewiring with antibiotic irrigation. Vacuum assisted closure therapy is a recently introduced technique that promotes the healing of difficult wounds, including post-sternotomy mediastinitis.Patients and Methods: Forty one patients with deep sternal wound infection were divided into two groups based on the treatment method used. Twenty two patients with post-cardio to my deep sternal wound infection were treated primarily by vacuum assisted closure method (group A and 19 patients with deep sternal wound infection who received closed mediastinal irrigation were treated with antibiotics (group B between January 2006 and January 2010.Results: The two groups were compared. Three patients died during treatment in group B. The median healing time was significantly shorter in group A (mean, 13.5 ± 3.2 days compared to 18 days (mean, 21.2 ± 16.4 days in group B (p< 0.001. Deep sternal wound infection showed no recurrences after the vacuum treatment, while 7 (24% patients in group B suffered recurrences. Hospital stay was significantly shorter in group A (median, 30.5 days; mean, 32.2 ± 11.3 days vs. median, 45 days; mean, 49.2 ± 19.3 days (p= 0.001.Conclusion: A significantly shorter healing time was confirmed with vacuum assisted closure. Hospital stay remained significantly shorter in group A (35 vs. 46 days.

  12. Triclosan-coated sutures and sternal wound infections: a prospective randomized clinical trial.

    Science.gov (United States)

    Steingrimsson, S; Thimour-Bergström, L; Roman-Emanuel, C; Scherstén, H; Friberg, Ö; Gudbjartsson, T; Jeppsson, A

    2015-12-01

    Surgical site infection is a common complication following cardiac surgery. Triclosan-coated sutures have been shown to reduce the rate of infections in various surgical wounds, including wounds after vein harvesting in coronary artery bypass grafting patients. Our purpose was to compare the rate of infections in sternotomy wounds closed with triclosan-coated or conventional sutures. A total of 357 patients that underwent coronary artery bypass grafting were included in a prospective randomized double-blind single-center study. The patients were randomized to closure of the sternal wound with either triclosan-coated sutures (Vicryl Plus and Monocryl Plus, Ethicon, Inc., Somerville, NJ, USA) (n = 179) or identical sutures without triclosan (n = 178). Patients were followed up after 30 days (clinical visit) and 60 days (telephone interview). The primary endpoint was the prevalence of sternal wound infection according to the Centers for Disease Control and Prevention (CDC) criteria. The demographics in both groups were comparable, including age, gender, body mass index, and rate of diabetes and smoking. Sternal wound infection was diagnosed in 43 patients; 23 (12.8%) sutured with triclosan-coated sutures compared to 20 (11.2%) sutured without triclosan (p = 0.640). Most infections were superficial (n = 36, 10.1%), while 7 (2.0%) were deep sternal wound infections. There were 16 positive cultures in the triclosan group and 17 in the non-coated suture group (p = 0.842). The most commonly identified main pathogens were Staphylococcus aureus (45.4%) and coagulase-negative staphylococci (36.4%). Skin closure with triclosan-coated sutures did not reduce the rate of sternal wound infection after coronary artery bypass grafting. (clinicaltrials.gov: NCT01212315).

  13. Arteriovenous Loop-Independent Free Flap Reconstruction of Sternal Defects after Cardiac Surgery.

    Science.gov (United States)

    Dornseifer, Ulf; Kleeberger, Charlotte; Ehrl, Denis; Herter, Frank; Ninkovic, Milomir; Iesalnieks, Igors

    2016-09-01

    Background Sternal defects following deep wound infections are predominantly reconstructed using local and regional flaps. The lack of appropriate recipient vessels after cardiac surgery may explain the minor role of free flaps. To date, arteriovenous loops have been the leading solution to enable microsurgical closure of these defects. However, the related surgical effort and the risk of flap failure are increased. We reviewed our experiences with the right gastroepiploic vessels as alternative recipient vessels for free flap reconstructions. Methods Between September 2010 and July 2015, 12 patients suffering deep wound infection after cardiac surgery underwent sternal reconstruction with free flaps anastomosed to the right gastroepiploic vessels. Gracilis flaps (n = 8) and anterolateral thigh perforator flaps (n = 4) were used for sternal reconstruction. Recipient vessels were harvested by laparoscopic dissection in five patients. Half of the free flaps were variably combined with omental flow-through flaps. Results Healing of all flaps was uneventful with no partial or total flap loss. Simultaneous interdisciplinary harvesting of recipient vessels by laparoscopy significantly shortened mean operative time from 313 to 216 minutes (p = 0.018). One incisional hernia was observed in the laparotomy group. Revision of a gracilis donor site was necessary in another patient due to postoperative bleeding. No recurrent sternal infection occurred during a mean follow-up of 20 months (range, 3-59 months). Conclusions The concept of gastroepiploic recipient vessels allows reliable free flap reconstructions of sternal defects in such high-risk patients without the need for arteriovenous loops.

  14. Clinical application of mesenchymal stem cells for aseptic bone necrosis

    Directory of Open Access Journals (Sweden)

    Tomoki Aoyama

    2008-11-01

    Full Text Available Since 2007, we had started clinical trial using mesenchymal stem cell (MSCs for the treatment of aseptic bone necrosis as a first clinical trial permitted by Japanese Health, Labour and Welfare Ministry.Aseptic bone necrosis of the femoral head commonly occurs in patients with two to four decades, causing severe musculoskeletal disability. Although its diagnosis is easy with X-ray and MRI, there has been no gold standard invented for treatment of this disease. MSCs represent a stem cell population in adult tissues that can be isolated and expanded in culture, and differentiate into cells with different nature. Combination with β-tri-calcium phosphate and vascularized bone graft, we succeeded to treat bone necrosis of the femoral head.Regenerative medicine using stem cells is hopeful and shed a light on intractable disease. To become widespread, Basic, Translational, Application, and Developmental study is needed.? From an experience of cell therapy using MSCs, we started to research induced pluripotent stem cell (iPS for clinical application.

  15. Performance analysis of exam gloves used for aseptic rodent surgery.

    Science.gov (United States)

    LeMoine, Dana M; Bergdall, Valerie K; Freed, Carrie

    2015-05-01

    Aseptic technique includes the use of sterile surgical gloves for survival surgeries in rodents to minimize the incidence of infections. Exam gloves are much less expensive than are surgical gloves and may represent a cost-effective, readily available option for use in rodent surgery. This study examined the effectiveness of surface disinfection of exam gloves with 70% isopropyl alcohol or a solution of hydrogen peroxide and peracetic acid (HP-PA) in reducing bacterial contamination. Performance levels for asepsis were met when gloves were negative for bacterial contamination after surface disinfection and sham 'exertion' activity. According to these criteria, 94% of HP-PA-disinfected gloves passed, compared with 47% of alcohol-disinfected gloves. In addition, the effect of autoclaving on the integrity of exam gloves was examined, given that autoclaving is another readily available option for aseptic preparation. Performance criteria for glove integrity after autoclaving consisted of: the ability to don the gloves followed by successful simulation of wound closure and completion of stretch tests without tearing or observable defects. Using this criteria, 98% of autoclaved nitrile exam gloves and 76% of autoclaved latex exam gloves met performance expectations compared with the performance of standard surgical gloves (88% nitrile, 100% latex). The results of this study support the use of HP-PA-disinfected latex and nitrile exam gloves or autoclaved nitrile exam gloves as viable cost-effective alternatives to sterile surgical gloves for rodent surgeries.

  16. Case report of the free vascularized iliac bone graft with groin flap for the pseudoarthrosis of the tibia caused by irradiation osteonecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Moriyama, Masatoshi; Ohkubo, Koichi; Asanuma, Kazuo; Murota, Kagehisa

    1987-04-01

    In a 35-year-old man, bone fracture occurred 6 years after radiotherapy with a total dose of 130 Gy for osteosarcoma of the middle end of the right tibia. The patient developed osteomyelitis and was dignosed as having pseudoarthrosis in the irradiated field. Satisfactory synostosis was attained by performing free vascularized iliac bone graft with groin flap. (Namekawa, K.).

  17. Pseudoarthrosis of the clavicle and copper beaten skull associated with chromosome 10p11.21p12.1 microdeletion.

    NARCIS (Netherlands)

    Shahdadpuri, R.; Vries, B. de; Pfundt, R.P.; Leeuw, N. de; Reardon, W.

    2008-01-01

    Congenital pseudoarthrosis of the clavicle (CPC) has been described in several genetic conditions including Floating-Harbor and Goltz syndromes, but rarely as a prompt to specific cytogenetic abnormalities. We report on a case of a de novo 10p11.21p12.1 microdeletion in a boy with multiple problems

  18. The role of arterial vascularity in pathogenesis of infected pseudoarthrosis of the lower leg; Rola zaburzen ukrwienia tetniczego w patogenezie zakazonych stawow rzekomych goleni

    Energy Technology Data Exchange (ETDEWEB)

    Konarski, K. [Szpital im. J. Jonstona, Lublin (Poland)

    1993-12-31

    A series of 250 femoral arteriographies performed in patients with leg pseudoarthrosis served to asses condition of arteries of the extremity. It was found that vascular injuries contribute significantly to pathogenesis of union disorders in lower leg fractures. (author). 14 refs, 11 figs.

  19. Usefulness of the evaluation of preoperative sternal shape for reconstruction of pectus excavatum using three-dimensional computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Noguchi, Masahiko; Kondoh, Shohji; Kondoh, Yoshiaki; Akabane, Genichiroh [Nagano Children`s Hospital (Japan); Matsuo, Kiyoshi

    1997-04-01

    In the reconstruction of the pectus excavatum deformity, when sternal growth must be considered, it is desirable that osteotomy of the sternum be performed if necessary. From this standpoint, we evaluate the preoperative sternal shape using three-dimensional computed tomography. The sternum is outlined on the mid-sagittal plane, and the curved portions are examined. Preoperatively, the sternums are classified into 3 groups based on the number of curved portions. On the basis of these observations, we determine the position and degree of the sternal osteotomy and, if necessary, combined sternal osteotomy and augmentation using resected cartilage. We think that this method is useful not only for reconstruction of pectus excavatum but also in evaluating the postoperative shape of the thorax. (author)

  20. Recurrent aseptic encephalitis in periodic fever, aphthous stomatitis, pharyngitis and adenopathy (PFAPA) syndrome.

    Science.gov (United States)

    Frye, Richard E

    2006-05-01

    An 11-year-old boy with episodes of periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) is reported. Two PFAPA episodes were associated with aseptic encephalitis and seizures. Recurrent acute aseptic encephalitis or seizures have never been reported during the febrile episodes of PFAPA. This possible association is discussed within the context of the etiology of PFAPA.

  1. RECURRENT ASEPTIC ENCEPHALITIS IN PERIODIC FEVER, APHTHOUS STOMATITIS, PHARYNGITISAND ADENOPATHY (PFAPA) SYNDROME

    OpenAIRE

    Frye, Richard E.

    2006-01-01

    An 11-year-old boy with episodes of periodic fever, aphthous stomatitis, pharyngitis and adenopathy (PFAPA) is reported. Two PFAPA episodes were associated with aseptic encephalitis and seizures. Recurrent acute aseptic encephalitis or seizures have never been reported during the febrile episodes of PFAPA. This possible association is discussed within the context of the etiology of PFAPA.

  2. rhBMP-2 protects against reoperation for pseudoarthrosis and/or instrumentation failure: A matched case-control study of 448 patients.

    Science.gov (United States)

    Macki, Mohamed; Syeda, Sbaa; Kerezoudis, Panagiotis; Bydon, Ali; Witham, Timothy F; Sciubba, Daniel M; Wolinsky, Jean-Paul; Bydon, Mohamad; Gokaslan, Ziya

    2016-10-01

    The objective of this independent study is to determine the impact of recombinant human bone morphogenetic protein 2 (rhBMP-2) on reoperation for pseudarthrosis and/or instrumentation failure. A nested case-control study of first-time posterolateral, instrumented fusion of the lumbar spine for degenerative spinal disease was undertaken. Cases of reoperation for pseudoarthrosis and/or instrumentation failure were assigned to controls, who did not experience the primary outcome measure at the time of reoperation. Cases and controls were matched on number of interspaces fused and inclusion of interbody. Predictors of reoperation for pseudoarthrosis and/or instrumentation failure were assessed with a conditional logistical regression controlling for rhBMP-2, age, obesity, and smoking. Of the 448 patients, 155 cases of reoperation for pseudoarthrosis and/or instrumentation were matched with 293 controls. Twenty-six percent of first-time surgeries included rhBMP-2, which was statistically more commonly used in the control cohort (33.11%) versus the case cohort (12.90%) (Unadjusted odds ratio [ORunadj]=0.28) (95% confidence interval [CI]: 0.16-0.49). Following a multivariate analysis controlling for age, obesity, and smoking, the rhBMP-2 recipients incurred a 73% lower odds of reoperation for pseudoarthrosis and/or instrumentation failure (95% CI, 0.15-0.48). Neither sarcomatous nor osseous neoplasm was detected in the study population. Mean follow up did not differ between the cases (81.57±standard deviation [SD] 4.98months) versus controls (74.75±2.49month) (ORunadj=1.01) (95% CI: 1.00-1.01). rhBMP-2 in lumbar fusion constructs protects against reoperation for pseudoarthrosis and/or instrumentation failure. However, the decision to include fusion supplements should be weighted between surgical determinants and clinical outcomes.

  3. Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC study of aseptic meningitis

    Directory of Open Access Journals (Sweden)

    Robinson Joan L

    2006-04-01

    Full Text Available Abstract Background The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. Methods A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. Results There were 233 cases of proven enteroviral (EV meningitis, 495 cases of clinical aseptic meningitis and 74 cases of possible aseptic meningitis with most cases occurring July to October. Headache, vomiting, meningismus and photophobia were more common in children ≥ 5 years of age, while rash, diarrhea and cough were more common in children Conclusion The clinical presentation of aseptic meningitis varies with the age of the child. Absence of CSF pleocytosis is common in infants

  4. Aseptic multiplication of banana from excised floral apices.

    Science.gov (United States)

    Cronauer, S S; Krikorian, A D

    1985-08-01

    Most economically important bananas and plantains are large triploid seedless herbs that must be propagated vegetatively by removing small side shoots or "suckers" from the parent plant or by planting seed pieces of larger corms. Consequently, multiplication of stock material is time consuming, Recently, the rapid production of young banana plantlets suitable for use as "seed" material has been described. Vegetative shoot apices were isolated and multiplied using aseptic tissue culture techniques. Although these multiplication systems, once established, can produce thousands of plants in a relatively short period of time, their establishment necessitates the initial sacrifice of an individual specimen, which may not always be desirable or prudent should a limited parent stock be available. We describe here the production and multiplication of rooted banana plantlets from the isolation and culture of terminal floral apices.

  5. Cloning higher plants from aseptically cultured tissues and cells

    Science.gov (United States)

    Krikorian, A. D.

    1982-01-01

    A review of aseptic culture methods for higher plants is presented, which focuses on the existing problems that limit or prevent the full realization of cloning plants from free cells. It is shown that substantial progress in clonal multiplication has been made with explanted stem tips or lateral buds which can be stimulated to produce numerous precocious axillary branches. These branches can then be separated or subdivided and induced to root in order to yield populations of genetically and phenotypically uniorm plantlets. Similarly, undifferentiated calluses can sometimes be induced to form shoots and/or roots adventitiously. Although the cell culture techniques required to produce somatic embryos are presently rudimentary, steady advances are being made in learning how to stimulate formation of somatic or adventive embryos from totipotent cells grown in suspension cultures. It is concluded that many problems exist in the producing and growing of totipotent or morphogenetically competent cell suspensions, but the potential benefits are great.

  6. Aseptic Meningitis Caused by Lassa Virus: Case Series Report

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    Peter O. Okokhere

    2016-01-01

    Full Text Available The Lassa virus is known to cause disease in different organ systems of the human body, with varying clinical manifestations. The features of severe clinical disease may include bleeding and/or central nervous system manifestations. Whereas Lassa fever encephalopathy and encephalitis are well described in the literature, there is paucity of data on Lassa virus meningitis. We present the clinical description, laboratory diagnosis, and management of 4 consecutive cases of aseptic meningitis associated with Lassa virus infection without bleeding seen in a region of Nigeria known to be endemic for both the reservoir rodent and Lassa fever. The 4 patients recovered fully following intravenous ribavirin treatment and suffered no neurologic complications.

  7. Early morbidity after aseptic revision hip arthroplasty in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, M.; Hansen, Torben Bæk

    2014-01-01

    aseptic revision THRs from 1st October 2009 to 30th September 2011 using the Danish National Patient Registry, with additional information from the Danish Hip Arthroplasty Registry. There were 1553 procedures (1490 patients) performed in 40 centres and we divided them into total revisions, acetabular...... component revisions, femoral stem revisions and partial revisions. The mean age of the patients was 70.4 years (25 to 98) and the median hospital stay was five days (interquartile range 3 to 7). Within 90 days of surgery, the readmission rate was 18.3%, mortality rate 1.4%, re-operation rate 6.......1%, dislocation rate 7.0% and infection rate 3.0%. There were no differences in these outcomes between high- and low-volume centres. Of all readmissions, 255 (63.9%) were due to 'surgical' complications versus 144 (36.1%) 'medical' complications. Importantly, we found no differences in early morbidity across...

  8. Hand hygiene and aseptic technique in the emergency department.

    Science.gov (United States)

    Al-Damouk, M; Pudney, E; Bleetman, A

    2004-02-01

    Hand hygiene and simple aseptic measures before invasive procedures are effective in reducing rates of healthcare-associated infection. The perceived urgency of a clinical situation in the emergency department, however, may influence medical staff's compliance with good practice in infection control. The aims of this prospective, single-blinded, observational study were twofold. First, to assess doctors' compliance with good practice in hand hygiene between patient episodes and asepsis during invasive procedures in the emergency department. Second, to assess the effect of clinical urgency on compliance with good practice in hand hygiene and asepsis during invasive procedures. Good practice standards for asepsis in invasive procedures and hand hygiene between patient episodes were compiled from a literature search. Doctors' compliance with these standards was observed in two emergency departments (UK and New Zealand). Observed clinical cases were classified as immediate, urgent and non-urgent based on the triage system. There was poor compliance with good practice guidelines for asepsis in invasive procedures in both centres. Staff achieved high compliance with the guidelines in only 27% of cases in the UK and 58% of cases in New Zealand. Clinical urgency did not appear to adversely affect compliance with aseptic good practice. Hand hygiene between patient consultations was very low at 14% in the UK and 12% in New Zealand. Asepsis and hand hygiene was poor in both the UK and New Zealand emergency departments. There may be a need for some compromise in standards of asepsis in very sick patients due to the urgency of the clinical situation. Compliance in all situations especially non-urgent procedures needs to be improved.

  9. Midline raphé, sternal cleft, and other midline abnormalities: a new dominant syndrome?

    Science.gov (United States)

    Forzano, Francesca; Daubeney, Piers E F; White, Susan M

    2005-05-15

    Sternal fusion defects are malformations that often present as an isolated finding. An association with multiple malformations has been reported, in particular with midline raphe and craniofacial hemangiomas and as part of the pentalogy of Cantrell. Most syndromic cases were sporadic with a few families reported with recurrence in sibs. We describe a mother and two daughters with midline raphe and sternal defects. Affected members also had double central incisors, congenital heart defect, neck webbing, bicornuate uterus and minor anomalies including long face with hypotelorism. None of the three affected relatives had hemangiomas. The manifestations of these patients do not fit any previously described condition, and we propose they represent a new syndrome. This family is also important as it points to a possible genetic cause for at least some cases of this disorder of the ventral midline.

  10. Sternal Osteomyelitis and Abscess Caused by Elbowing during a Basketball Game

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    Hideo Ichimura

    2012-01-01

    Full Text Available A 15-year-old boy was referred to our hospital for further investigation and treatment of sternal osteomyelitis due to blunt chest trauma, more specifically elbowing during a basketball game 19 days earlier. On an initial presentation, his chest was markedly swollen and chest computed tomography demonstrated a sternal fracture and massive fluid collection in the chest wall. Since his general condition remained fairly good, we initially selected minimal drainage concomitant with antibiotics; if it was unsuccessful, we planned to switch to a more radical debridement procedure. The patient recovered without further invasive intervention and was discharged on postoperative day 26. There is no sign of recurrence six months after operation. This case report indicates that minimal drainage would be a good option for treatment in a phased strategy.

  11. Degradation of 316L stainless steel sternal wire by steam sterilization.

    Science.gov (United States)

    Shih, Chun-Che; Su, Yea-Yang; Chen, Lung-Ching; Shih, Chun-Ming; Lin, Shing-Jong

    2010-06-01

    Sterilization is an important step prior to the implantation of medical devices inside the human body. In this work we studied the influence of steam sterilization cycles on the oxide film properties of stainless steel sternal wire. Characterization techniques such as open- circuit potential, potentiodynamic measurement, electrochemical impedance spectroscopy, cathodic stripping, transmission electron microscopy, atomic force microscopy and scanning electron microscopy were employed to investigate the cycles of steam sterilization on the corrosion behavior of sternal wire. The results showed that the oxide properties are a function of the number of steam sterilization cycles and deteriorate as the number of cycles increases. Steam sterilization might damage the implant integrity and heavy metals could be released to the surrounding tissues due to deterioration of the oxide film.

  12. Corrosion of stainless steel sternal wire after long-term implantation.

    Science.gov (United States)

    Tomizawa, Yasuko; Hanawa, Takao; Kuroda, Daisuke; Nishida, Hiroshi; Endo, Masahiro

    2006-01-01

    A variety of metallic components have been used in medical devices where lifelong durability and physical strength are demanded. To investigate the in vivo changes of implanted metallic medical devices in humans, stainless steel sternal wires removed from patients were evaluated. Stainless steel (316L) sternal wires removed from four patients after 10, 13, 22, and 30 years of implantation were evaluated using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). Macroscopically, the removed specimens maintained their metallic luster and color. Under SEM, small holes were observed sporadically at 10 years and they tended to connect in the drawing direction. The longer the implanted duration, the more numerous and deeper were the crevices observed. By EDS, sulfur, phosphorus, and calcium were identified in all areas at 10 years, in addition to the component elements of stainless steel, comprising iron, chromium, nickel, and manganese. Corrosion products observed at 30 years were identified as calcium phosphate. In conclusion, stainless steel sternal wires develop corroded pores that grow larger and deeper with time after implantation; however, the pores remain shallow even after decades of implantation and they may not be a cause of mechanical failure. An amount of metal ions equivalent to the corroded volume must have been released into the human body, but the effect of these metal ions on the body is not apparent.

  13. MR analysis of sternal bone marrow using STIR in hematologic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kozawa, Eito [Saitama Medical School, Moroyama (Japan)

    1998-12-01

    The magnetic resonance (MR) signal intensity pattern of sternal bone marrow was examined in 21 normal volunteers and 10 patients with aplastic anemia (n=4), multiple myeloma (2), AML (2), gammaglobulinemia (1) and MDS (1) using a sagittal STIR sequence. Double Echo STIR images (TR/TI/TE/NEX=2000/180/20, 100/1) were obtained with a CP body array coil. Craniocaudal phase-encoding with a handmade positioning device effectively avoided overlapping artifacts due to cardiac pulsation. In the normal volunteers, age showed a significant inverse correlation with the calculated SIR (signal intensity ratio of bone marrow relative to subcutaneous fat) using STIR with short TE. The SIR in the sternal body was significantly higher than that in the manubrium (p<0.05). Knowledge of the sternal bone marrow distribution according to age is useful for evaluating hematologic diseases. The proposed method provided high spatial resolution and an excellent bone marrow signal, and may be useful for determining site for aspiration. (author)

  14. Location of Sternal Fractures as a Possible Marker for Associated Injuries

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    Max J. Scheyerer

    2013-01-01

    Full Text Available Introduction. Sternal fractures often occur together with serious and life-threatening additional injuries. This retrospective study was designed to assess concomitant injuries and develop a correlation between fracture location and the severity of injury. Methods. All patients ( diagnosed with a fracture of the sternum by means of a CT scan were analysed with respect to accident circumstances, fracture morphology and topography, associated injuries, and outcome. Results. Isolated sternal fractures occurred in 9%. In all other admissions, concomitant injuries were diagnosed: mainly rip fractures (64%, injury to the head (48%, the thoracic spine (38%, lumbar spine (27%, and cervical spine (22%. Predominant fracture location was the manubrium sterni. In these locations, the observed mean ISS was the highest. They were strongly associated with thoracic spine and other chest injuries. Furthermore, the incidence of head injuries was significantly higher. ICU admission was significantly higher in patients with manubrium sterni fractures. Conclusion. Sternal fractures are frequently associated with other injuries. It appears that the fracture location can provide important information regarding concomitant injuries. In particular, in fractures of manubrium sterni, the need for further detailed clinical and radiologic workup is necessary to detect the frequently associated injuries and reduce the increased mortality.

  15. Congenital pseudoarthrosis of the tibia – results of treatment by free fibular transfer and associated procedures – preliminary study.

    Science.gov (United States)

    Iamaguchi, Raquel B; Fucs, Patricia M M B; Carlos da Costa, Antonio; Chakkour, Ivan; Gomes, Mogar D

    2011-09-01

    We evaluated 16 children with congenital pseudoarthrosis of the tibia treated with contralateral fibular graft, with the aim to report the difficulties and clinical results in the affected limb after consolidation. Sixty-three percent of the children had characteristics of neurofibromatosis. Consolidation was achieved after the main surgery in 37%of patients, and the remainder, after multiple procedures. Consolidation time was longer for male patients. Refracture was observed in six patients and recurrence of the anterior bowing in six; four of these patients were submitted to correction. Four patients presented femur overgrowth. The average shortening of the affected leg was 3.6 cm. The proposed procedure leads to a long treatment course with many reoperations for correction of possible complications.

  16. One-bone forearm procedure for acquired pseudoarthrosis of the ulna combined with radial head dislocation in a child: a case with 20 years follow-up.

    Science.gov (United States)

    Hahn, Soo Bong; Kang, Ho Jung; Hyung, Ji Ho; Choi, Yun Rak

    2011-01-01

    This report describes a 6 year-old boy who was treated with one-bone forearm procedure for acquired pseudoarthrosis of the ulna combined with radial head dislocation after radical ulna debridement for osteomyelitis. At more than 20 years of follow-up, the patient had a nearly full range of elbow movements with a few additional surgical procedures. Pronation and supination was restricted by 45°, but the patient had near-normal elbow and hand functions without the restriction of any daily living activity. This case shows that one-bone forearm formation is a reasonable option for forearm stability in longstanding pseudoarthrosis of the ulna with radial head dislocation in a child.

  17. Magnetic resonance imaging in the evaluation of patients with aseptic meningoencephalitis and connective tissue disorders

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    Appenzeller, Simone; Kobayashi, Eliane; Costallat, Lilian T.L.; Zanardi, Veronica de Araujo; Ribeiro Neto, Jose Menezes; Damasceno, Benito Pereira; Cendes, Fernando [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas

    2000-03-01

    To describe the role of magnetic resonance imaging (MRI) in the evaluation of patients with chronic and recurrent aseptic meningitis. Method: A retrospective study of five patients with aseptic meningoencefalitis diagnosed by clinical and CSF findings. CT scans showed without no relevant findings. Results: MRI showed small multifocal lesions hyperintense on T2 weight images and FLAIR, with mild or no gadolinium enhancement, mainly in periventricular and subcortical regions. Meningoencephalitis preceded the diagnosis of the underlying disease in four patients (Behcet's disease or systemic lupus erythematosus). After the introduction of adequate treatment for the rheumatic disease, they did not present further symptoms of aseptic meningoencephalitis. Conclusion: Aseptic meningoencephalitis can be an early presentation of an autoimmune disease. It is important to emphasize the role of MRI in the diagnosis and follow-up of these patients. (author)

  18. Magnetic resonance imaging in the evaluation of patients with aseptic meningoencephalitis and connective tissue disorders

    Directory of Open Access Journals (Sweden)

    APPENZELLER SIMONE

    2000-01-01

    Full Text Available OBJECTIVE: To describe the role of magnetic resonance imaging (MRI in the evaluation of patients with chronic and recurrent aseptic meningitis.METHOD: A retrospective study of five patients with aseptic meningoencefalitis diagnosed by clinical and CSF findings. CT scans showed without no relevant findings. RESULTS: MRI showed small multifocal lesions hyperintense on T2 weighted images and FLAIR, with mild or no gadolinium enhancement, mainly in periventricular and subcortical regions. Meningoencephalitis preceded the diagnosis of the underlying disease in four patients (Behçet´s disease or systemic lupus erythematosus. After the introduction of adequate treatment for the rheumatic disease, they did not present further symptoms of aseptic meningoencephalitis. CONCLUSION: Aseptic meningoencephalitis can be an early presentation of an autoimmune disease. It is important to emphasize the role of MRI in the diagnosis and follow-up of these patients.

  19. Application and evaluation of improved surgical aseptic technique curriculum in specialty nurse training in Henan Province

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    Bing Bai

    2016-09-01

    Conclusion: Novel surgical aseptic technique and application in the curriculum design of training for OR nurses should be developed to enhance their mastery of theoretical and practical skills and to modify their behaviors.

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

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    Stefanos D. Koutsostathis

    2014-02-01

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

  1. Aseptic Splenic Abscess as Precursory Extraintestinal Manifestation of Inflammatory Bowel Disease

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    Joel Brooks

    2014-01-01

    Full Text Available Splenic abscesses are most often secondary to aerobic bacterial infections due to Streptococcus, Staphylococcus, and Enterococcus species of organisms. Sterile splenic abscesses rarely occur and diagnosis and treatment of those are challenging. We report a case of a previously healthy young female presenting with aseptic splenic abscesses as the initial manifestation of Crohn’s disease along with a review of the literature on aseptic splenic abscess as an extraintestinal manifestation of Crohn’s disease.

  2. The changing epidemiology of pediatric aseptic meningitis in Daejeon, Korea from 1987 to 2003

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    Lee Mi-Hee

    2005-11-01

    Full Text Available Abstract Background Aseptic meningitis is a relatively frequent childhood disease and virologic data suggest that enteroviruses are the commonest etiologic agents. We evaluated the epidemiologic characteristics of aseptic meningitis in Daejeon, South Korea from 1987 to 2003. Methods 2201 medical records of children with aseptic meningitis admitted to The Catholic University of Korea, Daejeon St Mary's Hospital were retrospectively analyzed. Results Outbreaks of aseptic meningitis were observed in 1990, 1993, 1996, 1997, 2001 and 2002. The age distribution of cases was relatively uniform, with a higher incidence in those aged P = 0.001. Neurologic sequelae were observed in 0.7% of the patients. Conclusion Aseptic meningitis, rare before the 1980s in Korea, has since become a common clinical entity. Since 1990, outbreaks of aseptic meningitis have occurred every 1 to 3 years in Daejeon in keeping with Korea-wide epidemics. The frequency of disease affecting children less than one year of age may reflect herd immunity to the epidemic strain.

  3. Sternal "retraction": a novel application of a mandibular distractor in treating ectopia cordis with complete cleft sternum.

    Science.gov (United States)

    Gart, Michael S; Vicari, Frank A

    2015-05-01

    Complete thoracic ectopia cordis is associated with a uniformly dismal prognosis. The primary challenges of this disorder are (1) returning the heart to the thoracic cavity, (2) stabilizing the chest wall, and (3) repairing the sternal defect. Previously published techniques for achieving these goals have demonstrated very limited success and/or significant morbidity.We present a novel application of a mandibular distraction device as part of staged repair of this historically challenging problem. This method uses immediate stabilization and gradual "retraction" of the sternal remnants, thereby allowing physiologic compensation and avoiding the cardiorespiratory embarrassment associated with returning the heart to the thoracic cavity. Moreover, this technique allows stabilization of the associated sternal cleft and chest wall without the commonly associated morbidity of the currently available techniques.

  4. Transapical Mitral Valve-in-Valve Replacement in Patient With Previous Complex Sternal Reconstruction.

    Science.gov (United States)

    Hynes, Conor F; Fatemi, Omid; Sharma, Aditya C; Nagy, Christian D; Trachiotis, Gregory D

    2016-01-01

    We present a complex case of a transapical redo mitral valve-in-valve replacement. Repeat mitral valve replacement was indicated for severe symptomatic bioprosthetic stenosis. In addition to the patient's numerous comorbidities that included diabetes, hepatic cirrhosis, ischemic cardiomyopathy, and atrial flutter, he had undergone a previous open mitral valve replacement that was complicated by sternal dehiscence requiring extensive chest wall reconstruction. Transapical approach was performed through left minithoracotomy incision with balloon-expandable valve. Transapical valve-in-valve replacement of a stenotic mitral bioprosthesis is a viable solution in a patient with previous complex chest wall reconstruction and multiple comorbidities.

  5. Modelo experimental em ratos para o desenvolvimento de pseudoartrose Experimental model in rats for the development of pseudoarthrosis

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    Manoel Luiz Ferreira

    2009-12-01

    Full Text Available OBJETIVO: Descreve-se a técnica de um novo um modelo de pseudoartrose em Rattus norvegicus albinus livre de espécies patogênicas (SPF. MÉTODOS: Os animais foram aleatoriamente distribuídos em dois Grupos: Grupo 1 - Controle (n =6, Grupo 2 - Experimental (n =6. No grupo Controle realizou-se um acesso ao fêmur, seguido da síntese por planos do músculo e da pele. O grupo Experimental foi submetido à osteotomia do fêmur aduzida da confecção de um retalho pediculado de fáscia lata para interposição entre os segmentos resultantes da fratura induzida cirurgicamente. Prosseguiu-se com o alinhamento e aproximação dos segmentos ósseos, mediante uso de fios de náilon introduzidos em orifícios efetuados na extremidade proximal e distal. RESULTADOS: Estudos radiológico e anatomopatológico evidenciaram a ausência de consolidação óssea com persistência de tecido fibro-osteóide decorridos 120 dias de evolução pós-operatória. CONCLUSÃO: O modelo experimental é adequado para a formação de pseudoartrose em ratos.OBJECTIVE: We sought to describe a new model of pseudoarthrosis in rats free of pathogenic species (Rattus norvegicus albinus - SPF. METHODS: The animals were randomly distributed into two groups were used: Group 1 - Control (n =6; Group 2 - Experimental (n =6. In the Control group an access to the femur followed by the synthesis of the muscular and skin layers was done. The Experimental group was submitted to osteotomy of the femur and a pedicle flap of the fascia lata was interposed between the segments resulting from the surgically induced fracture. The procedure was carried on with both alignment and approximation of the fractured bone through the use of mononylon thread introduced into holes created in the proximal and distal. RESULTS: Radiological and anatomopathological studies showed the absence of bone consolidation with persistence of fibro-osteoid tissue up to 120 days of follow-up. CONCLUSION: The

  6. Cerebrospinal fluid lactate dehydrogenase isoenzymes in children with bacterial and aseptic meningitis.

    Science.gov (United States)

    Nussinovitch, Moshe; Finkelstein, Yaron; Elishkevitz, Keren Politi; Volovitz, Benjamin; Harel, Daniella; Klinger, Gil; Razon, Yaron; Nussinovitch, Udi; Nussinovitch, Naomi

    2009-10-01

    Differentiation of bacterial from aseptic meningitis may be difficult. Our aim was to determine the pattern of distribution of lactate dehydrogenase (LDH) isoenzymes in the cerebrospinal fluid (CSF) of patients with bacterial and aseptic meningitis. One hundred and fifty-seven patients with suspected meningitis were enrolled in the study. They were divided into 3 groups according to the culture- or bacterial antigen assay-proven diagnosis and CSF findings: bacterial meningitis (n = 31), aseptic meningitis (n = 65), and non-meningitis (n = 61). Total LDH level and percentages of LDH isoenzymes in the CSF were measured in each patient. Each group showed a distinct LDH isoenzyme distribution pattern, with a statistically significant difference among the groups in the percentages of the various isoenzymes. Compared with the non-meningitis group, total LDH activity in the CSF was high in the aseptic meningitis group (49.82+/-35.59 U/L, P < 0.001) and exaggerated in the bacterial meningitis group (944.53+/-112.3 U/L, P < 0.001). Low LDH-2 levels were unique to bacterial meningitis (P < 0.01), whereas high LDH-3 levels were characteristic of aseptic meningitis (P < 0.05). Both groups had low levels of LDH-1 and high levels of LDH-4 and LDH-5. In conclusion, the LDH isoenzyme pattern may be of clinical diagnostic value in meningitis, particularly when culture results are pending.

  7. Unusually severe varicella zoster (VZV) virus viral (aseptic) meningitis in an unimmunized, immunocompetent host with chickenpox.

    Science.gov (United States)

    Cunha, Burke A; Warren-Favorito, Heather; Mickail, Nardeen

    2011-01-01

    Chickenpox is caused by the varicella zoster virus (VZV) and may be more severe in adults than in children. Central nervous system (CNS) manifestations of chickenpox and VZV are uncommon, for example, encephalitis and cerebellar ataxis. Viral (aseptic) meningitis is a rare CNS complication of VZV. The cerebrospinal fluid (CSF) profile in VZV viral (aseptic) meningitis is indistinguishable from other causes of viral meningitis. The clue to most of the diagnoses of VZV aseptic meningitis is based on the temporal relationship between antecedent or concomitant chickenpox. Chickenpox is a clinical diagnosis based on the appearance and distribution of the rash. The rash of chickenpox is vesicular/pruritic and typically appears in crops over 3 successive days. VZV vesicles are fragile, superficial, and surrounded by a erythematous halo. Common nonspecific laboratory findings in chickenpox include leukopenia, thrombocytopenia, and elevated serum transaminases (serum glutamate-oxaloacetate transaminase/serum glutamate-pyruvate transaminase). The erythrocyte sedimentation rate (ESR) is not highly elevated in chickenpox. In VZV aseptic meningitis, the CSF shows a lymphocytic pleocytosis with normal protein, glucose, and lactic acid levels. CSF red blood cells are not a feature of VZV meningitis. We present the case of a healthy unimmunized adult who was hospitalized with chickenpox complicated by VZV aseptic meningitis with an unusually severe headache and nuchal rigidity that occurred during hospitalization.

  8. Supportive treatment using a compression garment vest of painful sternal instability following deep surgical wound infection: a case report

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    Klement Andreas

    2010-08-01

    Full Text Available Abstract Introduction Sternal dehiscence and instability poses a significant cause of persistent pain and limited quality of life following hospital discharge for 0.2% to 5% of patients who have undergone median sternotomy for open heart surgery. We report a successful, conservative, supportive long-term therapy of painful sternal non-union using a customized compression garment vest. Case presentation We report a case of painful sternal instability following open heart surgery in a 74-year-old Caucasian man. The complicating factors of obesity (body mass index of 40, renal failure, insulin-dependent diabetes mellitus and absolute arrhythmia with atrial fibrillation were present. Conclusion A number of studies have demonstrated the efficacy of surgical interventions for secondary sternal stabilization, but individual patients may reject this option or may be, for other reasons, no longer operable. The task of primary care physicians and other health care providers is to offer this group of patients an alternative option for pragmatic, inexpensive and effective supportive therapy, of which compression garments are an example.

  9. Recurrent aseptic meningitis in association with Kikuchi-Fujimoto disease: case report and literature review

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    Komagamine Tomoko

    2012-09-01

    Full Text Available Abstract Background Kikuchi Fujimoto disease (KFD, or histiocytic necrotising lymphadenitis, is a benign and self-limiting condition characterised by primarily affecting the cervical lymph nodes. Recurrent aseptic meningitis in association with KFD is extremely rare and remains a diagnostic challenge. Case presentation We report a 28-year-old man who presented 7 episodes of aseptic meningitis associated with KFD over the course of 7 years. Histopathological findings of enlarged lymph nodes led to the diagnosis of KFD. The patient’s headache and lymphadenopathy spontaneously resolved without any sequelae. Conclusions A diagnosis of KFD should be considered when enlarged cervical lymph nodes are observed in patients with recurrent aseptic meningitis. A long-term prognosis remains uncertain, and careful follow-up is preferred.

  10. District nurses' and aseptic technique: where did it all go wrong?

    Science.gov (United States)

    Unsworth, John

    2011-01-01

    Concerns have been raised about whether it is possible to perform aseptic procedures within a community setting. Hallett (2000) has described how community nurses often have a fatalistic view about whether such procedures can really be performed at home. At the same time there has been an increase in the number of patients being cared for at home who need interventions which must adhere to the principles of asepsis. While it has been acknowledged for some time that community nurses must be resourceful and adapt the procedure, the view that community nurses cannot really perform aseptic procedures is a fairly new phenomenon. This article explores the reasons why concerns about the performance of aseptic procedures in the community may have arisen and what steps can be taken to address these concerns to ensure that care at home is both safe and effective.

  11. Etiology of aseptic meningitis and clinical characteristics in immune-competent adults.

    Science.gov (United States)

    Han, Su-Hyun; Choi, Hye-Yeon; Kim, Jeong-Min; Park, Kwang-Ryul; Youn, Young Chul; Shin, Hae-Won

    2016-01-01

    Viral meningitis is the most common cause of aseptic meningitis. Use of the polymerase chain reaction (PCR) has increased the ability to determine the etiology of viral meningitis. This study used PCR analysis to evaluate the etiology of aseptic meningitis in 177 previously healthy adults over a 5-year period, as well as analyzing the clinical characteristics, cerebrospinal fluid (CSF) findings, and prognosis according to each etiology. The most frequent cause of aseptic meningitis was enterovirus (EV), followed by varicella zoster virus (VZV). Patients with EV meningitis were significantly younger than those with VZV meningitis. The percentage of lymphocytes in white blood cell counts and protein concentrations in the CSF differed significantly among patients with EV, VZV and meningitis of undetermined etiology. Younger age and lower percentage of lymphocyte and protein level in CSF analysis may be suggestive of EV meningitis. Further prospective studies are warranted to identify the correlations between the clinical characteristics and the etiologies of meningitis.

  12. An investigation of the aseptic loosening of an AISI 316L stainless steel hip prosthesis.

    Science.gov (United States)

    Godec, Matjaz; Kocijan, Aleksandra; Dolinar, Drago; Mandrino, Djordje; Jenko, Monika; Antolic, Vane

    2010-08-01

    The total replacement of joints by the implantation of permanently indwelling prosthetic components has been one of the major successes of modern surgery in terms of relieving pain and correcting deformity. However, the aseptic loosening of a prosthetic-joint component is the most common reason for joint-revision surgery. Furthermore, it is thought that wear particles are one of the major contributors to the development and perpetuation of aseptic loosening. The aim of the present study was to identify the factors related to the aseptic loosening of an AISI 316L stainless steel total hip prosthesis. The stem was evaluated by x-ray photoelectron spectroscopy, with polished and rough regions being analyzed in order to establish the differences in the chemical compositions of both regions. Specific areas were examined using scanning electron microscopy with energy dispersive x-ray spectroscopy and light microscopy.

  13. MOLECULAR-EPIDEMIOLOGICAL INVESTIGATION OF THE OUTBREAK OF ASEPTIC MENINGITIS IN NOVOSIBIRSK REGION

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    A. V. Demina

    2016-01-01

    Full Text Available The aim of this study was to investigate the outbreak of aseptic meningitis in theNovosibirskregion in 2008–2009. We studied genetic diversity and molecular-epidemiological characteristics of human enteroviruses that caused aseptic meningitis. Materials and metods. In the present study we investigated samples of cerebrospinal fluid from 199 patients with a diagnosis “aseptic meningitis”, based on the clinical characteristics of the disease (headache, stiff neck, fever, nausea, vomiting, and confirmed by laboratory tests of spinal fluid (lymphocyte cell count > 10 cells/ml.All samples were tested by PCR for RNA of Enterovirus and Flavivirus and DNA Myc. tuberculosis, Borrelia spp., Neisseria spp. In the samples there were not found RNA Flavivirus, DNA Myc. tuberculosis, Borrelia spp., Neisseria spp., but in 73 samples (37% was identified RNA enterovirus (EV. Determination of nucleotide sequences of 5’UTR and VP1-region of EV revealed that they belong to the following genotypes: the highest percentage was presented by genotype ECHO 30 (62%; another genotypes were Cox A2 (8%, Cox A4 (5%, Cox A14 (3%, Cox A16 (5%, Cox B5 (8%, ECHO 6 (3%, ECHO 9 (3% and ECHO 25 (3%. In 2008 most of the EV that caused the symptoms of aseptic meningitis belonged to genotype ECHO 30 (76%. In 2009 the clinical specimens containing genotype ECHO 30 were not found, but the largest percentage of EV belonged to genotypes Cox A2 (33% and Cox A4 (22%. Thus, in 2008 we recorded outbreak of aseptic meningitis, the major etiological factor was enterovirus ECHO 30. And the rise of the incidence of aseptic meningitis in 2009 is related to the circulation of new genotypes of EV. The investigated strains were deposited in an international database GenBank under accession numbers KP258231-KP258235, HM559584.

  14. Dual infection with hepatitis A and E virus presenting with aseptic meningitis:A case report

    Institute of Scientific and Technical Information of China (English)

    Kushal Naha; Suman Karanth; Mukhyaprana Prabhu; Manpreet Singh Sidhu

    2012-01-01

    ABSTRACT We report the case of a young male who presented with features of aseptic meningitis and elevated serum liver enzymes, but no symptoms or signs suggestive of an acute hepatitis. Subsequently, he was diagnosed with dual infection with hepatitisA andE viruses, and recovered completely with symptomatic therapy.Isolated aseptic meningitis, unaccompanied by hepatitic features is an unusual presentation of a hepatotrophic viral infection, and is yet to be reported with hepatitisA andE virus co-infection.

  15. Nuss procedure in adult pectus excavatum: a simple artifice to reduce sternal tension.

    Science.gov (United States)

    Ravenni, Giacomo; Actis Dato, Guglielmo Mario; Zingarelli, Edoardo; Flocco, Roberto; Casabona, Riccardo

    2013-07-01

    Nowadays the Nuss operation represents the standard surgical choice for pectus excavatum repair in children and teenagers. Some concerns have been raised regarding its applicability in adults, as compared with younger patients, in view of the higher rate of complications after surgery. We describe an easy trick that has been performed on a 36-year old man with a moderate pectus excavatum after an unsatisfactory Nuss procedure. It consisted of a T-shaped partial anterior sternotomy, performed after positioning of the stainless steel bar, in order to promote a hinge mechanism of the sternum to reduce the tension over the reinforcement. This procedure was successful with well-controlled postoperative pain and great patient satisfaction. No complications were recorded at 1-year follow-up. In our opinion, this simple trick could represent a valid surgical option for pectus excavatum repair in late adolescents and adults to obviate the occurrence of major sternal tension.

  16. The history of the management of sternal osteomyelitis and mediastinitis - from Hippocrates until today.

    Science.gov (United States)

    Ennker, Ina Carolin; Ennker, Jürgen C

    2014-01-01

    Even during the time of Hippocrates, Galen and their colleagues recognized mediastinal affections. However, they were not considered with the surgical treatment. First progress in the treatment options of this severe disease, still denoted as 'terra incognita', over to today's gold standard are pictured. The mediastinitis-registry which was founded by the German Society for Thoracic and Cardiovascular Surgery (DGTHG) in 2011 and the recent establishment of the study group to adopt a guideline 'diagnosis and therapy of postoperative mediastinitis/sternal osteomyelitis following cardiac surgery' are attempts to a standardization of the treatment. Substantial advancement in the treatment of postoperative mediastinitis could be achieved in the past. The mortality dropped as low as less than 10%. With these implementations more benefit for the patients' outcome can be expected.

  17. The history of the management of sternal osteomyelitis and mediastinitis – from Hippocrates until today

    Directory of Open Access Journals (Sweden)

    Ennker, Ina Carolin

    2014-06-01

    Full Text Available Even during the time of Hippocrates, Galen and their colleagues recognized mediastinal affections. However, they were not considered with the surgical treatment. First progress in the treatment options of this severe disease, still denoted as ‘terra incognita’, over to today’s gold standard are pictured.The mediastinitis-registry which was founded by the German Society for Thoracic and Cardiovascular Surgery (DGTHG in 2011 and the recent establishment of the study group to adopt a guideline ‘diagnosis and therapy of postoperative mediastinitis/sternal osteomyelitis following cardiac surgery’ are attempts to a standardization of the treatment. Substantial advancement in the treatment of postoperative mediastinitis could be achieved in the past. The mortality dropped as low as less than 10%. With these implementations more benefit for the patients’ outcome can be expected.

  18. A NEW METHOD OF SINGLE-STAGE ISLAND PLASTY BY TWO BONE AUTOGRAFTS WITH BLOOD SUPPLY IN PATIENTS WITH PSEUDOARTHROSIS OF BOTH FOREARM BONES

    Directory of Open Access Journals (Sweden)

    R. M. Tikhilov

    2010-01-01

    Full Text Available The applied topographic-anatomic studies prepared in 14 fixed and 16 unfixed preparations of upper extremity allowed to precise the details of radius blood supply with reference to possibilities of formation of bone autografts with blood supply. Due to this fact the novel method of single-stage bone plasty for pseudoarthrosis of both forearm bones was developed and successfully approved in clinic. This method proposes the formation of two periosteal-cortical grafts with blood supply and small muscle cuff in distal and middle one-thirds of radius simultaneously.

  19. Re-admissions, re-operations and length of stay in hospital after aseptic revision knee replacement in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, M; Jørgensen, C C; Bæk Hansen, T;

    2014-01-01

    We present detailed information about early morbidity after aseptic revision knee replacement from a nationwide study. All aseptic revision knee replacements undertaken between 1st October 2009 and 30th September 2011 were analysed using the Danish National Patient Registry with additional inform...

  20. Infraareolar pectoralis major myocutaneous island flap as treatment of first choice for deep sternal wound infection.

    Science.gov (United States)

    Simunovic, Filip; Koulaxouzidis, Georgios; Stark, G Bjoern; Torio-Padron, Nestor

    2013-02-01

    Deep sternal wound infection (DSWI) is a grave complication of median sternotomy, associated with high morbidity, mortality and escalating treatment costs. There is general consensus that optimal treatment comprises radical debridement followed by coverage with a vascularised flap. However, there is ongoing debate regarding the ideal operative procedure. We present our experience with the infraareolar pectoralis major island myocutaneous flap (PEC-MI flap) as treatment of first choice in DSWI. Following a retrospective chart review, data pertaining to patient demographics, type of cardiac surgery performed, prevalence of known DSWI risk factors, identified pathogens, duration of surgery, flap-related complications, duration of hospital stay and antibiotic therapy, as well as mortality were noted. Additionally, we describe the operative technique and review the relevant literature. Twenty-five patients underwent coverage with the PEC-MI flap in our department. The average age was 69.2 years. Nineteen patients underwent coronary artery bypass surgery, 10 valve replacement, two aortic replacement surgery and one pericardiectomy. In six cases, no internal mammary artery was used in cardiac surgery, in 11 cases one and in seven cases both internal mammary arteries were used. The average duration of surgery was 154.2 min and the average hospital stay was 28.4 days. Complications which required revision surgery were haematoma in three cases, one wound dehiscence and one recurrent infection. Two cases required coverage with an additional regional flap. The PEC-MI flap has been used as flap of first choice in our clinic for treatment of DSWI. It is sufficient to raise the flap unilaterally, and it does not require skin grafting. The combination of immunocompetent bulky muscle tissue used to obliterate the sternal cavity and the large skin paddle enabling a low-tension skin closure allows reliable and efficient treatment of this severe complication.

  1. [Sternal re-entry using the retractor for harvesting internal thoracic artery].

    Science.gov (United States)

    Niinami, H; Takeuchi, Y

    2002-06-01

    The number of redo cardiac operations, especially coronary artery bypass grafting (CABG), has recently been increasing mainly due to the failure of saphenous vein grafts. Re-opening a median sternotomy is troublesome, because of possible adhesion of the heart to the sternum. Preoperative computed tomography is quite useful and helpful in determining the degree of the adhesion of the heart and ascending aorta to the back of the sternum. We report here a safe and useful technique for sternal re-entry using a retractor for harvesting the internal thoracic artery (ITA). When re-opening a median sternotomy the incision is made to the sternal wires; the wires are then cut and removed. Small rake retractors, which are connected to the ITA retractor, are hooked to both ends of the left side of the sternum. The ITA retractor is gently wound up to lift up the sternum. An oscillating saw is then applied to divide the anterior table of the sternum. When the posterior table of the sternum is carefully divided, the left side of the sternum is automatically elevated slightly. Complete division of the sternum can be confirmed by this slight elevation. If the left side of the sternum is elevated a little bit more by the ITA retractor, the dissection of the adhesion between the sternum and the heart can be performed without assistance. This technique is most beneficial for a case of redo CABG with the use of the left ITA, but it can be applied in any patients who previously underwent median sternotomy.

  2. Improving Quality of Refrigerated Potato Strips by Near-Aseptic Packaging

    Science.gov (United States)

    The effect of hot water blanching and near-aseptic packaging on the shelf-life of refrigerated potato strips was investigated based on quality; microbial, textural and color. Potato strips were first blanched at low temperature (60 °C) for 10- or 20-min, and then second blanched at high temperature ...

  3. Magnetic thermometry in the aseptic processing of foods containing particulates (abstract)

    Science.gov (United States)

    Ghiron, Kenneth; Litchfield, Bruce

    1997-04-01

    Aseptic processing of foods has many advantages over canning, including higher efficiency, lighter packaging, better taste, and higher nutritional value. Aseptic processing is different from canning where the food and container are sterilized together. Instead, a thin stream of food is heated and the packaging is independently sterilized before the food is placed in the package. However, no aseptic processes have been successfully filed with the FDA for foods containing sizable solid particles because of uncertainties in the thermal sterilization of the particles (e.g., soup). We have demonstrated that by inserting small paramagnetic particles in the interior of the simulated and real food particles, the local temperature can be measured. With this information, any questions about the adequate sterilization of the particles can be resolved. The measurements were done by directing the food stream through a magnetic field and sensing the voltages induced in a pickup coil by the motion of the magnetized particles. Details of the equipment design and data analysis will be discussed along with an introduction to the aseptic processing of foods.

  4. Excacerbation of systemic lupus erythematodes, aseptic meningitis and acute mental symptoms, following metrizamide lumbar myelography

    Energy Technology Data Exchange (ETDEWEB)

    Gelmers, H.J.

    1984-01-01

    A clinical constellation of excacerbation of systemic lupus erythematodes (SLE), together with aseptic meningitis, and acutre mental symptoms occurred following lumbar myelography with metrizamide. Excacerbation of SLE has not been previously described following myelography with any contrast agent. Meningeal reactions and acute mental symptoms have been reported earlier, but this clinical constellation is new.

  5. Nuss procedure for surgical stabilization of flail chest with horizontal sternal body fracture and multiple bilateral rib fractures.

    Science.gov (United States)

    Lee, Sung Kwang; Kang, Do Kyun

    2016-06-01

    Flail chest is a life-threatening situation that paradoxical movement of the thoracic cage was caused by multiply fractured ribs in two different planes, or a sternal fracture, or a combination of the two. The methods to achieve stability of the chest wall are controversy between surgical fixation and mechanical ventilation. We report a case of a 33-year-old man who fell from a high place with fail chest due to multiple rib fractures bilaterally and horizontal sternal fracture. The conventional surgical stabilization using metal plates by access to the front of the sternum could not provide stability of the flail segment because the fracture surface was obliquely upward and there were multiple bilateral rib fractures adjacent the sternum. The Nuss procedure was performed for supporting the flail segment from the back. Flail chest was resolved immediately after the surgery. The patient was weaned from the mechanical ventilation on third postoperative day successfully and was ultimately discharged without any complications.

  6. Management plan for deep sternal wound infection targeting to survival free of recurrence: A prospective evaluation study

    Directory of Open Access Journals (Sweden)

    Ibrahim Kasb

    2016-10-01

    Conclusion: Management of DSWI is tedious, has prolonged hospital stay and is associated with high morbidity and mortality rates. Management of DSWI must be personalized according to findings on exploration of the sternal wound and flap coverage must be initiated only when the patient is bacteriologically free. Both PMF and/or VOF provided high acceptable success rate defined as survival free of DSWI recurrence.

  7. Semiochemicals from the predatory stink bug Eocanthecona furcellata (Wolff): components of metathoracic gland, dorsal abdominal gland, and sternal gland secretions.

    Science.gov (United States)

    Ho, Hsaio-Yung; Kou, Rong; Tseng, Hsin-Kuang

    2003-09-01

    Volatile compounds from the metathoracic glands (MTG), dorsal abdominal glands (DAG), and sternal setae of the generalist predatory stink bug Eocanthecona furcellata (Wolff) were studied by gas chromatography-mass spectrometry. MTGs of both male and female bugs contained (E)-2-decenal as the major component, with lesser amounts of (E, E)-2,4-decadienal, (E, Z)-2,4-decadienal, and (E)-2,9-decadienal. The relative amount of (E)-2,9-decadienal in the MTGs of female bugs was higher than in male bugs. There was no dimorphism in the morphology of the DAGs of adults. However, the DAG contents of adult bugs were different between the sexes. Geraniol was found only in the DAGs of males, and limonene and alpha-terpineol were found only in the DAGs of females, whereas linalool oxide isomers, linalool, neral, and geranial were found in DAGs of both sexes. The DAG contents of nymphs were also analyzed, with 4-oxo-(E)-2-hexenal, 4-oxo-(E)-2-octenal, tridecane, and tetradecanal being major components. Male bugs but not females possess sternal setae, and 6,10,13-trimethyltetradecyl isovalerate was detected from extracts of the sternal setae of males. The possible biological significance of dimorphism in the contents of the glands in adults is discussed.

  8. Etiologies and Management of Aseptic Meningitis in Patients Admitted to an Internal Medicine Department.

    Science.gov (United States)

    Jarrin, Irène; Sellier, Pierre; Lopes, Amanda; Morgand, Marjolaine; Makovec, Tamara; Delcey, Veronique; Champion, Karine; Simoneau, Guy; Green, Andrew; Mouly, Stéphane; Bergmann, Jean-François; Lloret-Linares, Célia

    2016-01-01

    Several studies have focused on the clinical and biological characteristics of meningitis in order to distinguish between bacterial and viral meningitis in the emergency setting. However, little is known about the etiologies and outcomes of aseptic meningitis in patients admitted to Internal Medicine.The aim of the study is to describe the etiologies, characteristics, and outcomes of aseptic meningitis with or without encephalitis in adults admitted to an Internal Medicine Department.A retrospective cohort study was conducted in the Internal Medicine Department of the Lariboisière Hospital in Paris, France, from January 2009 to December 2011. Clinical and biological characteristics of aseptic meningitis were recorded. These included cerebrospinal fluid analysis, results of polymerase chain reaction testing, final diagnoses, and therapeutic management.The cohort included 180 patients fulfilling the criteria for aseptic meningitis with (n = 56) or without (n = 124) encephalitis. A definitive etiological diagnosis was established in 83 of the 180 cases. Of the cases with a definitive diagnosis, 73 were due to infectious agents, mainly enteroviruses, Herpes Simplex Virus 2, and Varicella Zoster Virus (43.4%, 16.8%, and 14.5% respectively). Inflammatory diseases were diagnosed in 7 cases. Among the 97 cases without definitive diagnoses, 26 (26.8%) remained free of treatment throughout their management whereas antiviral or antibiotic therapy was initiated in the emergency department for the remaining 71 patients. The treatment was discontinued in only 10 patients deemed to have viral meningitis upon admission to Internal Medicine.The prevalence of inflammatory diseases among patients admitted to internal medicine for aseptic meningitis is not rare (4% of overall aseptic meningitis). The PCR upon admission to the emergency department is obviously of major importance for the prompt optimization of therapy and management. However, meningitis due to viral agents or

  9. Transorbital superior ophthalmic vein sacrifice to preserve vision in ocular hypertension from aseptic cavernous sinus thrombosis.

    Science.gov (United States)

    Ladner, Travis R; Davis, Brandon J; He, Lucy; Mawn, Louise A; Mocco, J

    2015-12-01

    Aseptic cavernous sinus thrombosis (CST) is rare and may clinically masquerade as a carotid cavernous fistula. Conventional management includes oral anticoagulation, but cases of ocular hypertension affecting vision may require more aggressive intervention. We report a case of a woman with spontaneous bilaterally occluded cavernous sinuses with elevated intraocular pressure (IOP), which resolved immediately following unilateral superior ophthalmic vein (SOV) sacrifice. She was subsequently placed on oral anticoagulants. By 4 months postoperatively her IOP was normalized and her vision had improved. Repeat angiography demonstrated stable venous filling, with some mild improvement of flow through the cavernous sinus. Coil-mediated sacrifice of the SOV might be an effective means to relieve ocular hypertension and preserve vision in the setting of aseptic CST.

  10. Radiopharmaceutical uptake as a marker of sternal blood supply following internal mammary artery harvesting.

    Science.gov (United States)

    Rivas, L F; Hawkins, T; Morritt, G N; Behl, R P; Griffin, S C; Brown, A H

    1994-04-01

    To evaluate the impact of internal mammary artery harvesting on sternal blood supply after open heart surgery, a conventional bone scan was performed 7 days after operation in 30 patients. After administration of 370 MBq of technetium 99 m-medronic acid complex, imaging was carried out at the level of the sternum and including the humerus as a reference. A quantitative analysis of uptake (sternum/humerus uptake index) was performed and compared in three different groups of patients: group A, ten patients who had only vein grafts or valve surgery; group B, ten patients with single internal mammary artery harvesting; and group C, ten patients with bilateral internal mammary artery harvesting. These results were compared with 24 non-surgical subjects as a control (group D). Although intervention had a significant influence in raising the uptake index of the surgical groups (A = 3.34; B = 3.09 and C = 3.48) when compared with normal subjects (D = 2.45) (P 0.05). It was concluded that the vascular supply of the sternum is not entirely dependent upon the internal mammary arteries and that mobilization of both vessels does not cause per se additional serious impact to the bone vascularization after midline sternotomy, at least beyond day 7 after operation.

  11. Our experience with pectoralis major flap for management of sternal dehiscence: A review of 25 cases

    Directory of Open Access Journals (Sweden)

    Parag Sahasrabudhe

    2011-01-01

    Full Text Available Objective: To report our experience of the pectoralis major flap as the treatment modality for post coronary artery bypass sternal wound dehiscence. Materials and Methods: A retrospective study of 25 open heart surgery cases, performed between January 2006 and December 2010 at Deenanath Mangeshkar Hospital, Pune, was carried out. Unilateral or bilateral pectoralis major muscle flap by the double breasting technique using rectus extension was used in the management of these patients. The outcome was assessed on the basis of efficacy of flap surgery in achieving wound healing and post-surgery shoulder joint movements to evaluate donor site morbidity. The follow-up ranged from 5 months to 3.5 years. Results: Twenty-three (92% patients were discharged with complete wound closure. One patient (4% had wound dehiscence after flap surgery. One patient (4% died in the hospital in the immediate postoperative period due to mediastinitis. No recurrent sternum infection has occurred till date in 24 patients (96%. For one patient (4% who had wound dehiscence, daily dressing was done and wound healing was achieved with secondary intension. At follow-up, shoulder joint movements were normal in all the patients. Conclusions: The double breasting technique of the pectoralis major muscle flaps with rectus sheath extension is efficient in covering the entire length of the defect and can reduce the morbidity, without affecting the function of the shoulder joint.

  12. Osteomielite esternal por Mycobacterium tuberculosis Sternal osteomyelitis caused by infection with Mycobacterium tuberculosis

    Directory of Open Access Journals (Sweden)

    Diego Michelon De Carli

    2009-07-01

    Full Text Available Descrevemos o caso de um paciente de 74 anos, masculino, com dor torácica na porção superior do esterno com um ano de evolução associada a eritema, edema e fístula com drenagem de material purulento. Paciente HIV negativo e sem história prévia de contato com TB. A TC de tórax evidenciou lesão osteolítica esternal, e o material de biópsia revelou granuloma caseoso negativo para fungos e bacilos álcool-ácido resistentes no exame microbiológico direto. O diagnóstico de osteomielite esternal por Mycobacterium tuberculosis foi realizado por PCR.We report the case of a 74-year-old male patient with a one-year history of chest pain in the suprasternal notch associated with erythema, edema and drainage of purulent material from a fistulous lesion. The patient was HIV-negative with no history of TB. A CT scan of the chest showed an osteolytic lesion in the sternum, and a biopsy revealed caseous granuloma, which, in the microbiological evaluation, was negative for fungi and acid-fast bacilli. The diagnosis of sternal osteomyelitis caused by Mycobacterium tuberculosis was confirmed using PCR.

  13. Sternal Insufficiency Fractures of Post-menopausal Women:Retrospective Analysis of 17 Cases

    Institute of Scientific and Technical Information of China (English)

    Zhe-yuan Huang; Bi-long Yi; Hao-yuan Liu

    2012-01-01

    Objective To retrospectively investigate the clinical characteristics of sternal insufficiency fractures (SIFs) of post-menopausal women.Methods Findings on the clinical presentation,associated diseases,and imaging of SIFs in 17 postmenopausal women admitted to our hospital between February 1999 and January 2009 were reported.Results Twelve patients complained of severe pain in their anterior chest.Other symptoms included cough (5 cases),dyspnoea (3 cases),breathlessness (3 cases),and wheeze (2 cases).Four patients had no discomfort.The sternums of 11 cases were tender to palpation.Seventeen patients had osteoporosis.Other associated diseases were chronic obstructive pulmonary disease (7 cases),rheumatoid arthritis (3 cases),systemic lupus erythematosus (1 case),asthma (1 case),and thoracic vertebral fracture (13 cases).Nine patients had received glucocorticoid treatment.The fractures were located in the body of the sternum in 15 patients,in the manubrium in 1 patient,and in the manubriosternal junction in 1 patient.Displaced fracture was present in 13 cases.Lateral radiography of the sternum showed a fracture line in 14 patients.In the remaining 3 cases,other imaging examinations such as bone scan,computed tomography or magnetic resonance imaging demonstrated the presence of a fracture.Conclusions Osteoporosis,glucocorticoid therapy,chronic obstructive pulmonary disease,and rheumatoid arthritis might be risk factors for SIFs.SIFs should be considered in the differential diagnosis of chest pain.

  14. Molecular epidemiology of human enterovirus associated with aseptic meningitis in Shandong Province, China, 2006-2012.

    Directory of Open Access Journals (Sweden)

    Zexin Tao

    Full Text Available BACKGROUND: Human enteroviruses (HEVs are common causes of acute meningitis. However, there is limited information about HEV associated with aseptic meningitis in mainland China because it has not been classified as a notifiable disease. OBJECTIVES: To characterize the HEVs associated with sporadic aseptic meningitis in China and to analyze their genetic features. STUDY DESIGN: Cerebrospinal fluid, throat swab and feces specimens were collected from patients with aseptic meningitis in 5 sentinel hospitals in Shandong Province, China between 2006 and 2012. Virological investigation (viral isolation and molecular identification and phylogenetic analysis were performed. RESULTS: A total of 437 hospitalized patients were reported, and enteroviruses were detected in the specimens from 84 patients (19.2% and were identified into 17 serotypes. The nine main serotypes were echovirus (E 30 (27.4%, EV71 (13.1%, coxsackievirus (CV B1 (9.5%, CVB3 (7.1%, CVB5 (7.1%, E6 (7.1%, E9 (7.1%, CVA9 (6.0%, and CVA10 (3.6%. Monthly distribution of isolated enteroviruses revealed a major peak in summer-fall season and a small second peak in winter constituted totally by EV71. Sequence analysis on VP1 coding region suggested Shandong strains had great genetic divergence with isolates from other countries. CONCLUSIONS: Multiple serotypes were responsible for enterovirus meningitis in mainland China. Aseptic meningitis caused by EV71 and coxsackie A viruses-the predominant pathogens for the hand, foot, and mouth disease-is currently an important concern in mainland China.

  15. Densitometric evaluation might prevent failure of knee artroplasty for aseptic loosening

    OpenAIRE

    2016-01-01

    Objectives: To study the correlation between quantitative ultrasound (QUS) expressed as stiffness index (SI) and the risk of aseptic loosening of knee arthroplasty. Methods: An observational retrospective controlled study was performed on 85 female patients (mean age: 73.3 years) divided into 2 groups from January 2007 to March 2015 and carried out at the Orthopedic Rehabilitation Unit, Casa di Cura Eremo, Arco, Trento, Italy. Group A included 42 patients who had undergone a revision of knee ...

  16. Storage stability of cashew apple juice preserved by hot fill and aseptic processes

    OpenAIRE

    Costa,Maria Cecília Oliveira; MAIA Geraldo Arraes; Figueiredo,Raimundo Wilane de; Souza Filho,Men de Sá Moreira de; Brasil, Isabella Montenegro

    2003-01-01

    Cashew (Anacardium occidentale L.) apples from Pacajus, Ceará State, Brazil, were processed into high pulp content juice. The juice was packed either by hot fill or an aseptic process and evaluated for physical, physical-chemical, and sensorial changes during a 12-month storage period at room temperature. The results indicated that pH, soluble solids, total acidity, total sugar content and color did not change significantly during storage nor were affected by the type of filling. The sensoria...

  17. Behçet's disease complicated by multiple aseptic abscesses of the liver and spleen.

    Science.gov (United States)

    Maeshima, Keisuke; Ishii, Koji; Inoue, Megumi; Himeno, Katsuro; Seike, Masataka

    2013-05-28

    Aseptic abscesses are an emergent entity and have been described in inflammatory bowel disease, especially in Crohn's disease, and in other diseases. However, aseptic abscesses associated with Behçet's disease are extremely rare. We report a Japanese male diagnosed with an incomplete type of Behçet's disease who developed multiple aseptic abscesses of the spleen and liver. In 2002, the spleen abscesses were accompanied by paroxysmal oral aphthous ulcers and erythema nodosum. As the patient's response to antibiotic treatment was inadequate, a splenectomy was performed. Severe inflammatory cell infiltration, largely of polymorphonuclear neutrophils, was observed without evidence of bacterial or fungal growth. Although the patient had no history of ocular symptoms or genital ulcers, a diagnosis of incomplete Behçet's disease was made according to the Japanese diagnostic criteria because of the presence of paroxysmal arthritis and epididymitis since 2002. In 2005, multiple liver abscesses developed with right hypochondrial pain and seemed to be attributed to Behçet's disease because the abscesses yielded negative results during a microbiologic investigation and failed to go into remission under antibiotic therapy. Oral prednisone (15 mg/d) was started in May 2006, and the abscesses dramatically disappeared 4 wk after treatment. Although the patient had a relapse of the liver abscesses in association with the tapering of prednisone, the augmentation of prednisone dosage yielded a response. The abscesses of the liver and spleen were strongly suggested to be attributed to Behçet's disease. Clinician should be aware of the existence of aseptic abscesses as uncommon manifestations of Behçet's disease.

  18. Mesenteric Lymphadenopathy in Childhood Epidemic Aseptic Meningitis: Sonographic Features and Clinical Significance

    Energy Technology Data Exchange (ETDEWEB)

    Mun, Sung Hee; Park, Young Chan; Lee, Young Hwan [Catholic University of Daegu, College of Medicine, Daegu (Korea, Republic of)

    2006-09-15

    To evaluate the sonographic features of mesenteric lymphadenopathy in childhood epidemic aseptic meningitis and to assess their clinical significance. Thirty-three patients (25 male, 8 female: mean age, 8.6 years) with a diagnosis of aseptic meningitis were prospectively evaluated with abdominal ultrasonography for the presence of enlarged mesenteric nodes. The size and number of enlarged mesenteric lymph nodes were analyzed in relationship with the patient's age, between the patients with abdominal pain or diarrhea (16 cases, 48%) and asymptomatic patients (17 cases, 52%). Mesenteric lymphadenopathy was seen in 31 patients (94%), all 16 symptomatic and 15 of the 17 asymptomatic patients. The number of enlarged nodes was most prevalent between 6-10, seen in 16 patients (52%) and the largest node ranged in size from 4 to 8 mm. Among the 31 patients with mesenteric lymphadenopathy, the mean size of the largest node was statistically different between the symptomatic (6.0 mm) and asymptomatic (5.0 mm) groups (p = 0.021). The number of enlarged nodes and the patient's age were not statistically different between the two groups. Mesenteric lymphadenopathy was seen in almost all cases of childhood epidemic aseptic meningitis, and may be related to the mesenteric lymphadenitis caused by enterovirus

  19. The BCL2 -938C>A Promoter Polymorphism Is Associated with Risk for and Time to Aseptic Loosening of Total Hip Arthroplasty.

    Science.gov (United States)

    Stelmach, Patrick; Wedemeyer, Christian; Fuest, Lena; Kurscheid, Gina; Gehrke, Thorsten; Klenke, Stefanie; Jäger, Marcus; Kauther, Max D; Bachmann, Hagen S

    2016-01-01

    Aseptic loosening is a major cause of revision surgery of total hip arthroplasty (THA). Only few host factors affecting aseptic loosening have been identified until now, although they are urgently needed to identify and possibly treat those patients at higher risk for aseptic loosening. To determine whether the functional single nucleotide polymorphism (SNP) c.-938C>A (rs2279115), located in the promoter region of the BCL2 gene has an impact on aseptic loosening of THA we genotyped and analyzed 234 patients suffering from aseptic loosening and 231 patients after primary THA. The polymorphism is associated with risk for aseptic loosening with the CC genotype at highest risk for aseptic loosening, Odds Ratio CC vs. AA 1.93, 95%CI 1.15-3.25, p = 0.013. In contrast, low risk AA genotype carriers that still developed aseptic loosening showed a significantly shorter time to aseptic loosening than patients carrying the C allele (p = 0.004). These results indicate that the BCL2 -938C>A polymorphism influences the occurrence and course of aseptic loosening and suggests this polymorphism as an interesting candidate for prospective studies and analyses in THA registers.

  20. The BCL2 -938C>A Promoter Polymorphism Is Associated with Risk for and Time to Aseptic Loosening of Total Hip Arthroplasty.

    Directory of Open Access Journals (Sweden)

    Patrick Stelmach

    Full Text Available Aseptic loosening is a major cause of revision surgery of total hip arthroplasty (THA. Only few host factors affecting aseptic loosening have been identified until now, although they are urgently needed to identify and possibly treat those patients at higher risk for aseptic loosening. To determine whether the functional single nucleotide polymorphism (SNP c.-938C>A (rs2279115, located in the promoter region of the BCL2 gene has an impact on aseptic loosening of THA we genotyped and analyzed 234 patients suffering from aseptic loosening and 231 patients after primary THA. The polymorphism is associated with risk for aseptic loosening with the CC genotype at highest risk for aseptic loosening, Odds Ratio CC vs. AA 1.93, 95%CI 1.15-3.25, p = 0.013. In contrast, low risk AA genotype carriers that still developed aseptic loosening showed a significantly shorter time to aseptic loosening than patients carrying the C allele (p = 0.004. These results indicate that the BCL2 -938C>A polymorphism influences the occurrence and course of aseptic loosening and suggests this polymorphism as an interesting candidate for prospective studies and analyses in THA registers.

  1. Computed tomographic assessment of sternal lymph node dimensions and attenuation in healthy dogs.

    Science.gov (United States)

    Milovancev, Milan; Nemanic, Sarah; Bobe, Gerd

    2017-03-01

    OBJECTIVE To assess dimensions and attenuation of sternal lymph nodes (SLNs) observed by means of CT in healthy dogs. ANIMALS 12 healthy adult research dogs. PROCEDURES Precontrast and postcontrast enhanced CT of the thorax was performed on each dog. Objective and subjective contrast-enhanced CT measurements were obtained. RESULTS By use of CT, 2 SLNs were identified in 10 of the 12 dogs and 1 SLN was identified in 2. Median SLN length, height, and width were 8.5 mm (range, 4 to 22 mm), 6.0 mm (range, 3 to 10 mm), and 5.0 mm (range, 3 to 10 mm), respectively. Median SLN length-to-T4 ratio, height-to-T4 ratio, and width-to-T4 ratio were 0.64 (range, 0.24 to 1.22), 0.37 (range, 0.25 to 0.53), and 0.29 (range, 0.19 to 0.67), respectively. Median SLN volume was 123 mm(3) (range, 38 to 484 mm(3)). Median height-to-length ratio, width-to-length ratio, and height-to-width ratio were 0.57 (range, 0.27 to 1.75), 0.51 (range, 0.31 to 1.25), and 1.27 (range, 0.50 to 2.50), respectively. All SLNs had homogenous contrast enhancement with median precontrast and postcontrast attenuation values of 18.3 Hounsfield units (HU; range, 4.4 to 36.9 HU) and 41.3 HU (range, 24.0 to 77.4 HU), respectively. All SLNs had a visible hilus, which was fat attenuating in 8 dogs and hypoattenuating in 4 dogs. CONCLUSIONS AND CLINICAL RELEVANCE CT imaging characteristics described in this study may provide a reference for dimensions and appearance of SLNs of healthy dogs and serve as a basis for comparison with results for diseased dogs.

  2. Sternal pulse rate variability compared with heart rate variability on healthy subjects.

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    Chreiteh, Shadi S; Belhage, Bo; Hoppe, Karsten; Branebjerg, Jens; Thomsen, Erik V

    2014-01-01

    The heart rate variability (HRV) is a commonly used method to quantify the sympathetic and the parasympathetic modulation of the heart rate. HRV is mainly conducted on electrocardiograms (ECG). However, the use of photo-plethysmography (PPG) as a marker of the autonomic tone is emerging. In this study we investigated the feasibility of deriving pulse rate variability (PRV) using PPG signals recorded by a reflectance PPG sensor attached to the chest bone (sternum) and comparing it to HRV. The recordings were conducted on 9 healthy subjects being in a relaxed supine position and under forced respiration, where the subjects were asked to breathe following a visual scale with a rate of 27 breaths/min. HRV parameters such as the mean intervals (meanNN), the standard deviation of intervals (SDNN), the root mean square of difference of successive intervals (RMSSD), and the proportion of intervals differing more than 50 ms (pNN50) were calculated from the R peak-to-R peak (R-R) and pulse-to-pulse (P-P) intervals. In the frequency domain the low and high frequency ratio of the power spectral density (LF/HF) was also computed. The Pearson correlation coefficient showed significant correlation for all the parameters (r > 0.95 with p < 0.001) and the Bland-Altmann analysis showed close agreement between the two methods for all the parameters during resting and forced respiration condition. Thus, PRV analysis using sternal PPG can be an alternative to HRV analysis on healthy subjects at.

  3. Use of a sternal elevator to reverse complete airway obstruction secondary to anterior mediastinal mass in an anesthetized child

    Directory of Open Access Journals (Sweden)

    Maria E. Linnaus

    2016-05-01

    Full Text Available Patients with an anterior mediastinal mass pose significant risk for cardiorespiratory compromise during surgical procedures and general anesthesia. Several techniques have been described to reverse airway obstruction in these patients. In extreme circumstances, patients may require cardiac bypass or extracorporeal membrane oxygenation (ECMO until definitive treatment of the mass and patient stabilization is achieved. We present a case in which the RulTract® system was used for emergency sternal elevation as a bridge to ECMO in acute respiratory collapse in an 11-year-old female with a minimally symptomatic anterior mediastinal mass.

  4. Legal, ethical, and procedural bases for the use of aseptic techniques to implant electronic devices

    Science.gov (United States)

    Mulcahy, Daniel M.

    2013-01-01

    animals often mask the signs of infection to avoid attracting predators (Wobeser 2006). Guidance specific to sterilization of electronic devices for implantation is limited in the wildlife record (Burger et al. 1994; Mulcahy 2003). Few biologists have been formally trained in aseptic technique, but most biologists know that electronic devices should be treated in some way to reduce the chance for infection of the host animal by bacteria, viruses, parasites, and fungi. Most biologists (73%) who implant devices into fishes believe aseptic techniques are important (Wagner and Cooke 2005). However, I maintain that many biologists find it difficult to place the concept of asepsis into practice in their work because of confusion about what constitutes aseptic technique, a lack of surgical knowledge and training, the perception of increased costs, or the belief that aseptic surgeries are impractical or unnecessary for their application. Some have even argued that, while compromising surgical techniques in the field might result in complications or mortalities, the money saved would allow for a compensatory increase in sample size (Anderson and Talcott 2006). In this paper I define aseptic surgical techniques, document the legal and professional guidance for performing aseptic surgeries on wild animals, and present options for sterilizing electronic devices and surgical instruments for field use.

  5. An echovirus 18-associated outbreak of aseptic meningitis in Taiwan: epidemiology and diagnostic and genetic aspects.

    Science.gov (United States)

    Tsai, Huey-Pin; Huang, Sheng-Wen; Wu, Feng-Ling; Kuo, Pin-Hwa; Wang, Shih-Min; Liu, Ching-Chuan; Su, Ih-Jen; Wang, Jen-Ren

    2011-09-01

    In 2006, an outbreak of aseptic meningitis was noted in Taiwan. From January to October 2006, a total of 3283 specimens collected from patients with viral infection, including 173 cerebrospinal fluid (CSF) samples, were examined for virus isolation and identification. Overall, 339 enterovirus (EV)-positive cases were identified by virus culture: echovirus 18 (E18) formed the majority (27.4 %, 93 cases), followed by coxsackievirus B2 (13.8 %, 47 cases) and coxsackievirus A2 (10.8 %, 37 cases). The manifestations of the 93 E18 cases were aseptic meningitis (44.1 %), viral exanthema (23.6 %), acute tonsillitis (15.1 %), acute pharyngitis (14.0 %), acute gastritis (11.8 %), herpangina (7.5 %) and bronchopneumonia (5.3 %). Of 107 E18 isolates identified, 100, 62.5 and 19 % were obtained following culture in RD, MRC-5 and A549 cells, respectively. E18 was identified most frequently from throat swabs (67.2 %) and less frequently from stool samples (15.9 %) and CSF (16.8 %). The detection rate of E18 was 78.2 % from CSF, 50 % from stool samples and 22.9 % from throat swabs. Phylogenetic relationships among the E18 strains were examined. Analysis of the partial VP1 gene showed 3.7-23.8 % variation in sequence compared with sequences from GenBank and, notably, the amino acid change V152S was detected in a protruding loop within the VP1 protein. These results indicate that a genetic variant of E18 was circulating and caused an outbreak of aseptic meningitis in Taiwan in 2006.

  6. A case of aseptic vertebral necrosis in the context of metastatic lumbar disease

    Energy Technology Data Exchange (ETDEWEB)

    Panow, C. [Radiologie Florissant, Geneva (Switzerland); Valavanis, A. [Institut fuer Neuroradiologie, Universitaetsspital Zuerich (Switzerland)

    2002-03-01

    Aseptic bone necrosis has many well recognized etiologies: caisson disease, corticosteroids, alcohol, Gaucher's disease and sickle cell anemia being a few of a long list. Little attention has been paid to metastatic disease as a possible cause and we were unable to find reference in the literature to this association. We present imaging features of metastatic Ewing's sarcoma involving the vertebral spine, which, in certain aspects, mimics other well-known entities of this region, such as Kuemmell's and Scheuermann's diseases. (orig.)

  7. Somatic embryogenesis ofCyclamen persicum Mill. 'Anneke' from aseptic seedlings.

    Science.gov (United States)

    Takamura, T; Miyajima, I; Matsuo, E

    1995-01-01

    InCyclamen persicum 'Anneke', explants from the various vegetative organs of aseptic seedling formed embryoids. The optimal responses were recorded in Murashige and Skoog (MS) medium enriched with 5.0µM 2,4-dichlorophenoxyacetic acid (2,4-D), 0.5µM kinetin and 3-6% sucrose. Embryogenesis was enhanced at higher temperature of 25-30°C. On the other hand, light inhibited embryogenesis. Histological and morphological studies confirmed that the embryoids were indeed somatic embryos.

  8. Combined exposure to big endothelin-1 and mechanical loading in bovine sternal cores promotes osteogenesis.

    Science.gov (United States)

    Meyer, Luisa A; Johnson, Michael G; Cullen, Diane M; Vivanco, Juan F; Blank, Robert D; Ploeg, Heidi-Lynn; Smith, Everett L

    2016-04-01

    Increased bone formation resulting from mechanical loading is well documented; however, the interactions of the mechanotransduction pathways are less well understood. Endothelin-1, a ubiquitous autocrine/paracrine signaling molecule promotes osteogenesis in metastatic disease. In the present study, it was hypothesized that exposure to big endothelin-1 (big ET1) and/or mechanical loading would promote osteogenesis in ex vivo trabecular bone cores. In a 2×2 factorial trial of daily mechanical loading (-2000με, 120cycles daily, "jump" waveform) and big ET1 (25ng/mL), 48 bovine sternal trabecular bone cores were maintained in bioreactor chambers for 23days. The bone cores' response to the treatment stimuli was assessed with percent change in core apparent elastic modulus (ΔEapp), static and dynamic histomorphometry, and prostaglandin E2 (PGE2) secretion. Two-way ANOVA with a post hoc Fisher's LSD test found no significant treatment effects on ΔEapp (p=0.25 and 0.51 for load and big ET1, respectively). The ΔEapp in the "no load + big ET1" (CE, 13±12.2%, p=0.56), "load + no big ET1" (LC, 17±3.9%, p=0.14) and "load + big ET1" (LE, 19±4.2%, p=0.13) treatment groups were not statistically different than the control group (CC, 3.3%±8.6%). Mineralizing surface (MS/BS), mineral apposition (MAR) and bone formation rates (BFR/BS) were significantly greater in LE than CC (p=0.037, 0.0040 and 0.019, respectively). While the histological bone formation markers in LC trended to be greater than CC (p=0.055, 0.11 and 0.074, respectively) there was no difference between CE and CC (p=0.61, 0.50 and 0.72, respectively). Cores in LE and LC had more than 50% greater MS/BS (p=0.037, p=0.055 respectively) and MAR (p=0.0040, p=0.11 respectively) than CC. The BFR/BS was more than two times greater in LE (p=0.019) and LC (p=0.074) than CC. The PGE2 levels were elevated at 8days post-osteotomy in all groups and the treatment groups remained elevated compared to the CC group on days 15

  9. Neuro-Behçet disease: Coexistence of transverse myelitis and aseptic meningitis

    Directory of Open Access Journals (Sweden)

    Volkan Solmaz

    2013-09-01

    Full Text Available Behçet’s disease is a disorder that the etiology and pathogenesisis not well known and this episodic disease ischaracterized with recurrent oral and genital ulcers, panuveitis.The incidence of Behçet’s disease increased inMediterranean region, Middle East region, East Asian region,some part of Japan. The prevalence of this diseasewas 110/100000 in Turkey. If a neurological symptom isadded to Behçet’s disease it is called Neuro-Behçet syndrome.The most seen neurological complication of Neuro-Behçet syndrome is headache. In Behçet’s syndromeif the neurological symptoms are not completely occur,to diagnose neuro-Behçet may be very difficult. However,sometimes neurological complications can be progressvery fast. Especially the formation of transverse myelitisis very rare neurologic condition for this syndrome. Herewe presented a 17-year-old girl with Behçet’s disease;she admitted for her headache and confusion, in lumbarpuncture findings we considered aseptic meningitis. 1day later she complained paraparesis and hypoesthesiaunder thoracal 5 level, MRI scanning showed transversemyelitis in almost all thoracic levels. We presented thiscase because coexistence of transverse myelitis andaseptic meningitis is very rare.Key words: Behçet’s disease, neuro-Behçet, transversemyelitis, aseptic meningitis

  10. Genotyping of human parechoviruses in Iranian young children with aseptic meningitis and sepsis-like illness.

    Science.gov (United States)

    Rahimi, Pooneh; Naser, Hakimeh Mahdian; Siadat, Seyed Davar; Sohrabi, Amir; Mostafavi, Ehsan; Motamedirad, Mahdieh; Bahramali, Golnaz; Sadat, Seyed Mehdi; Ardestani, Mehdi Shafiee

    2013-12-01

    Human parechoviruses (HPeV) are classified into 14 genotypes. HPeV1 and HPeV2 are the most prevalent genotypes in young children, which have been associated with mild to severe diseases. This study was conducted to investigate the involvement of HPeVs in aseptic meningitis and sepsis-like illness in Iran. Viral RNA was extracted from 148 cerebrospinal fluid samples from children meningitis and/or sepsis-like illness. Specific HPeV, HEV real-time PCR and HPeV typing were done to identify the infection rate of these viruses. HPeV and HEV were detected in 64 (43.24 %), 31 (20.94 %) of 148 patients with 10 (6.75 %) coinfection. VP1/VP3 junction region was successfully sequenced from 12 of the HPeV-positive specimens, and all of them were identified as HPeV1. HPeV was more prevalent than HEV in both aseptic meningitis and sepsis-like illness, so further studies are needed to understand the disease burden of HPeV infections, and clinical manifestations especially in specific illnesses of possible viral etiology. Direct detection of these viruses leads to reduce hospitalization and use of antibiotic, which are often followed by other complications in neonates and young children.

  11. Intravenous Immunoglobulin with Enhanced Polyspecificity Improves Survival in Experimental Sepsis and Aseptic Systemic Inflammatory Response Syndromes

    Science.gov (United States)

    Djoumerska-Alexieva, Iglika; Roumenina, Lubka; Pashov, Anastas; Dimitrov, Jordan; Hadzhieva, Maya; Lindig, Sandro; Voynova, Elisaveta; Dimitrova, Petya; Ivanovska, Nina; Bockmeyer, Clemens; Stefanova, Zvetanka; Fitting, Catherine; Bläss, Markus; Claus, Ralf; von Gunten, Stephan; Kaveri, Srini; Cavaillon, Jean-Marc; Bauer, Michael; Vassilev, Tchavdar

    2015-01-01

    Sepsis is a major cause for death worldwide. Numerous interventional trials with agents neutralizing single proinflammatory mediators have failed to improve survival in sepsis and aseptic systemic inflammatory response syndromes. This failure could be explained by the widespread gene expression dysregulation known as “genomic storm” in these patients. A multifunctional polyspecific therapeutic agent might be needed to thwart the effects of this storm. Licensed pooled intravenous immunoglobulin preparations seemed to be a promising candidate, but they have also failed in their present form to prevent sepsis-related death. We report here the protective effect of a single dose of intravenous immunoglobulin preparations with additionally enhanced polyspecificity in three models of sepsis and aseptic systemic inflammation. The modification of the pooled immunoglobulin G molecules by exposure to ferrous ions resulted in their newly acquired ability to bind some proinflammatory molecules, complement components and endogenous “danger” signals. The improved survival in endotoxemia was associated with serum levels of proinflammatory cytokines, diminished complement consumption and normalization of the coagulation time. We suggest that intravenous immunoglobulin preparations with additionally enhanced polyspecificity have a clinical potential in sepsis and related systemic inflammatory syndromes. PMID:26701312

  12. A Fuzzy Expert System for Distinguishing between Bacterial and Aseptic Meningitis

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    Mostafa Langarizadeh

    2015-05-01

    Full Text Available Introduction Bacterial meningitis is a known infectious disease which occurs at early ages and should be promptly diagnosed and treated. Bacterial and aseptic meningitis are hard to be distinguished. Therefore, physicians should be highly informed and experienced in this area. The main aim of this study was to suggest a system for distinguishing between bacterial and aseptic meningitis, using fuzzy logic.    Materials and Methods In the first step, proper attributes were selected using Weka 3.6.7 software. Six attributes were selected using Attribute Evaluator, InfoGainAttributeEval, and Ranker search method items. Then, a fuzzy inference engine was designed using MATLAB software, based on Mamdani’s fuzzy logic method with max-min composition, prod-probor, and centroid defuzzification. The rule base consisted of eight rules, based on the experience of three specialists and information extracted from textbooks. Results Data were extracted from 106 records of patients with meningitis (42 cases with bacterial meningitis in order to evaluate the proposed system. The system accuracy, specificity, and sensitivity were 89%, 92 %, and 97%, respectively. The area under the ROC curve was 0.93, and Kappa test revealed a good level of agreement (k=0.84, P

  13. Immunocytochemical localization of Na+,K(+)-ATPase in the calcium-transporting sternal epithelium of the terrestrial isopod Porcellio scaber L. (Crustacea).

    Science.gov (United States)

    Ziegler, A

    1997-03-01

    Terrestrial isopods store large amounts of calcium carbonate between the epithelium and the old cuticle of the first four anterior sternites before molt. During the formation of these sternal CaCO3 deposits, large amounts of calcium are transported across the anterior sternal epithelium from the base to the apical side of the integument, and in the reverse direction during resorption of the deposit. A monoclonal antibody against the avian alpha-subunit of Na+,K(+)-ATPase was used to localize Na+,K(+)-ATPase in the anterior and the posterior sternal epithelium of Porcellio scaber. Semithin cryosections 0.5 micron thick were used for immunofluorescence microscopy and ultrathin cryosections for immunogold electron microscopy. The Na+,K(+)-ATPase was localized in the basolateral plasma membrane of the posterior and anterior sternal epithelium. The apical plasma membrane, including cytoplasmic extensions into the newly secreted cuticle, was virtually devoid of the enzyme. This pattern of immunolocalization was not affected by the direction of transepithelial calcium transport associated with the deposition and resorption phases of the molt cycle.

  14. Ultrastructural evidence for transepithelial calcium transport in the anterior sternal epithelium of the terrestrial isopod Porcellio scaber (Crustacea) during the formation and resorption of CaCO3 deposits

    Science.gov (United States)

    Ziegler

    1996-05-20

    Before the molt, terrestrial isopods store large amounts of calcium carbonate between the epithelium and the old cuticle of the first four anterior sternites. In order to test whether the anterior sternal epithelium has specific structural differentiations indicative of transepithelial ion transport, the anterior sternal epithelium and, as a control, the posterior sternal epithelium were studied using electron-microscopical techniques. During the formation of calcium carbonate deposits, the basolateral plasma membrane of the anterior sternal epithelium forms an elaborate interconnected network of interstitial dilations and channels. Numerous osmiophilic granules occur within this basolateral intercellular network during resorption of the calcium carbonate deposits. Electron energy-loss spectroscopy of the osmiophilic granules indicates that they contain calcium. During the resorption of the calcium carbonate deposits, the apical plasma membrane of the anterior sternal epithelium has many subcuticular folds. An interstitial network, osmiophilic granules, and apical, subcuticular folds do not occur in the posterior sternal epithelium. Taken together, these structural features are indicative of transepithelial ion transport and are probably necessary for the formation and resorption of the anterior sternal calcium carbonate deposits.

  15. Membrane particle distribution in the sternal epithelia of the terrestrial isopod Porcellio scaber latr. (Crustacea, oniscidea) during CaCO(3) deposit formation and resorption, a freeze-etch analysis.

    Science.gov (United States)

    Ziegler, A; Merz, E

    1999-10-01

    The anterior sternal epithelium of terrestrial isopods transports cuticular Ca(2+) to and from large sternal CaCO(3) deposits. We analyzed the anterior and posterior sternal epithelium by the means of the freeze-etch technique and measured the size distribution and density of intramembrane particles (IMPs) during three different molting stages. At least three IMP size classes around 4.5, 7.7, and 9.4 nm can be distinguished on the P-face of the apical and basolateral plasma membrane. An additional size class of around 12.8 nm is restricted to the apical compartment. In the anterior sternal epithelium, the density of these large particles changes by a factor of 1.9 during the molt cycle, suggesting a role in CaCO(3) formation and/or resorption. The density of the smaller IMPs rises transiently by a factor of 1.3 in the posterior sternal epithelium only. The IMP density of the basolateral plasma membrane increases significantly by a factor of 1.4 and 1.3 in the anterior and posterior sternal epithelia, respectively. The results indicate that increases in the IMP density contribute to the differentiation to an increased transport activity during the cyclic enlargements of the plasma membrane surface area in the anterior sternal epithelium.

  16. A diagnostic dilemma: drug-induced aseptic meningitis in a 45-year-old HIV-positive man.

    LENUS (Irish Health Repository)

    Rowley, D

    2014-03-01

    We describe a case of aseptic meningitis following the administration of moxifloxacin in a 45-year-old man with human immunodeficiency virus (HIV). At presentation he was receiving tuberculosis treatment on a modified regimen following severe hepatotoxicity; this included moxifloxacin, started 8 days previously. Initial cerebrospinal fluid (CSF) analysis was grossly abnormal. Anti-viral and -bacterial treatments were started. All microbiological tests proved negative and his moxifloxacin was withheld resulting in a complete normalisation of CSF. Drug-induced aseptic meningitis is a diagnosis of exclusion and presents a serious diagnostic dilemma. The decision to withhold medication cannot be taken lightly.

  17. Potential application of quantitative microbiological risk assessment techniques to an aseptic-UHT process in the food industry.

    Science.gov (United States)

    Pujol, Laure; Albert, Isabelle; Johnson, Nicholas Brian; Membré, Jeanne-Marie

    2013-04-01

    Aseptic ultra-high-temperature (UHT)-type processed food products (e.g., milk or soup) are ready to eat products which are consumed extensively globally due to a combination of their comparative high quality and long shelf life, with no cold chain or other preservation requirements. Due to the inherent microbial vulnerability of aseptic-UHT product formulations, the safety and stability-related performance objectives (POs) required at the end of the manufacturing process are the most demanding found in the food industry. The key determinants to achieving sterility, and which also differentiates aseptic-UHT from in-pack sterilised products, are the challenges associated with the processes of aseptic filling and sealing. This is a complex process that has traditionally been run using deterministic or empirical process settings. Quantifying the risk of microbial contamination and recontamination along the aseptic-UHT process, using the scientifically based process quantitative microbial risk assessment (QMRA), offers the possibility to improve on the currently tolerable sterility failure rate (i.e., 1 defect per 10,000 units). In addition, benefits of applying QMRA are (i) to implement process settings in a transparent and scientific manner; (ii) to develop a uniform common structure whatever the production line, leading to a harmonisation of these process settings, and; (iii) to bring elements of a cost-benefit analysis of the management measures. The objective of this article is to explore how QMRA techniques and risk management metrics may be applied to aseptic-UHT-type processed food products. In particular, the aseptic-UHT process should benefit from a number of novel mathematical and statistical concepts that have been developed in the field of QMRA. Probabilistic techniques such as Monte Carlo simulation, Bayesian inference and sensitivity analysis, should help in assessing the compliance with safety and stability-related POs set at the end of the manufacturing

  18. Are chest compressions safe for the patient reconstructed with sternal plates? Evaluating the safety of cardiopulmonary resuscitation using a human cadaveric model

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    McKay Douglas R

    2010-08-01

    Full Text Available Abstract Background Plate and screw fixation is a recent addition to the sternal wound treatment armamentarium. Patients undergoing cardiac and major vascular surgery have a higher risk of postoperative arrest than other elective patients. Those who undergo sternotomy for either cardiac or major vascular procedures are at a higher risk of postoperative arrest. Sternal plate design allows quick access to the mediastinum facilitating open cardiac massage, but chest compressions are the mainstay of re-establishing cardiac output in the event of arrest. The response of sternal plates and the chest wall to compressions when plated has not been studied. The safety of performing this maneuver is unknown. This study intends to demonstrate compressions are safe after sternal plating. Methods We investigated the effect of chest compressions on the plated sternum using a human cadaveric model. Cadavers were plated, an arrest was simulated, and an experienced physician performed a simulated resuscitation. Intrathoracic pressure was monitored throughout to ensure the plates encountered an appropriate degree of force. The hardware and viscera were evaluated for failure and trauma respectively. Results No hardware failure or obvious visceral trauma was observed. Rib fractures beyond the boundaries of the plates were noted but the incidence was comparable to control and to the fracture incidence after resuscitation previously cited in the literature. Conclusions From this work we believe chest compressions are safe for the patient with sternal plates when proper plating technique is used. We advocate the use of this life-saving maneuver as part of an ACLS resuscitation in the event of an arrest for rapidly re-establishing circulation.

  19. Clavicles, interclavicles, gastralia, and sternal ribs in sauropod dinosaurs: new reports from diplodocidae and their morphological, functional and evolutionary implications.

    Science.gov (United States)

    Tschopp, Emanuel; Mateus, Octávio

    2013-03-01

    Ossified gastralia, clavicles and sternal ribs are known in a variety of reptilians, including dinosaurs. In sauropods, however, the identity of these bones is controversial. The peculiar shapes of these bones complicate their identification, which led to various differing interpretations in the past. Here we describe different elements from the chest region of diplodocids, found near Shell, Wyoming, USA. Five morphotypes are easily distinguishable: (A) elongated, relatively stout, curved elements with a spatulate and a bifurcate end resemble much the previously reported sauropod clavicles, but might actually represent interclavicles; (B) short, L-shaped elements, mostly preserved as a symmetrical pair, probably are the real clavicles, as indicated by new findings in diplodocids; (C) slender, rod-like bones with rugose ends are highly similar to elements identified as sauropod sternal ribs; (D) curved bones with wide, probably medial ends constitute the fourth morphotype, herein interpreted as gastralia; and (E) irregularly shaped elements, often with extended rugosities, are included into the fifth morphotype, tentatively identified as sternal ribs and/or intercostal elements. To our knowledge, the bones previously interpreted as sauropod clavicles were always found as single bones, which sheds doubt on the validity of their identification. Various lines of evidence presented herein suggest they might actually be interclavicles - which are single elements. This would be the first definitive evidence of interclavicles in dinosauromorphs. Previously supposed interclavicles in the early sauropodomorph Massospondylus or the theropods Oviraptor and Velociraptor were later reinterpreted as clavicles or furculae. Independent from their identification, the existence of the reported bones has both phylogenetic and functional significance. Their presence in non-neosauropod Eusauropoda and Flagellicaudata and probable absence in rebbachisaurs and Titanosauriformes shows a

  20. Prospective study on the chemokine CXCL13 in neuroborreliosis and other aseptic neuroinfections.

    Science.gov (United States)

    Pícha, D; Moravcová, L; Smíšková, D

    2016-09-15

    The study evaluates the clinical significance of CXCL13 (leukocyte chemoattractant synthesized in CSF ) in Lyme neuroborreliosis (LNB) and other aseptic CNS infections. 244 patients with symptoms of neuroinfection and/or LNB were divided into groups: A - patients with LNB-positive antibodies in serum and CSF (96) or CSF only (14); B - patients with aseptic non-borrelial neuroinfections (82); C - negative controls (52). Group A was divided into A1-A4 according to pleocytosis in CSF and AIIgG positivity. The highest CSF CXCL13 concentrations (max. 81,287.60pg/ml; median 1766.90pg/ml) were in A1 (positive AI, pleocytosis) and A3 (negative AIIgG, pleocytosis; max. 7201,60pg/ml, median 56.22pg/ml). A2 (positive AI without pleocytosis) and A4 (negative AI without pleocytosis) had low CXCL13 levels - A2 max. 650.50pg/ml (median<7.80pg/ml); A4 max. 118.56pg/ml (median<7.8pg/ml). In B the median was 28.10pg/ml (max. 595.87pg/ml). In C the CXCL13 concentrations were the lowest (max. 83.83pg/ml; median<7.80pg/ml). The lowest cut-off was 29pg/ml (sensitivity 90.0%, specificity 72.2%), the highest one 400pg/ml (sensitivity 59.6%, specificity 94.0%). The group differences of serum CXCL13 were insignificant. The highest concentrations were at the beginning of the disease. In LNB CXCL13 correlates better with the CSF pleocytosis than AI positivity.

  1. Establishing and monitoring an aseptic workspace for building the MOMA mass spectrometer

    Science.gov (United States)

    Lalime, Erin N.; Berlin, David

    2016-09-01

    Mars Organic Molecule Analyzer (MOMA) is an instrument suite on the European Space Agency (ESA) ExoMars 2020 Rover, and the Mass Spectrometer (MOMA-MS) is being built at Goddard Space Flight Center (GSFC). MOMA-MS is a life-detection instrument and thus falls in the most stringent category of Planetary Protection (PP) biological cleanliness requirements. Less than 0.03 spore/m2 are allowed in the instrument sample path. In order to meet these PP requirements, MOMA-MS must be built and maintained in a low bioburden environment. The MOMA-MS project at GSFC maintains three clean rooms with varying levels of bioburden control. The Aseptic Assembly Clean room has the highest level of control, applying three different bioburden reducing methods: 70% Isopropyl Alcohol (IPA), 7.5% Hydrogen Peroxide, and Ultra-Violet C (UVC) light. The three methods are used in rotation and each kills microorganisms by a different mechanism, reducing the likelihood of microorganisms developing resistance to all three. The Integration and Mars Chamber Clean rooms use less biocidal cleaning, with the option to deploy extra techniques as necessary. To support the monitoring of clean rooms and verification that MOMA-MS hardware meets PP requirements, a new Planetary Protection lab was established that currently has the capabilities of standard growth assays for spore or vegetative bacteria, rapid bioburden analysis that detects Adenosine Triphosphate (ATP), plus autoclave and Dry Heat microbial Reduction (DHMR) verification. The clean rooms are monitored for vegetative microorganisms and by rapid ATP assay, and a clear difference in bioburden is observed between the aseptic and other clean room.

  2. Imaging and histopathological aspects in aseptic osteonecrosis of the femoral head.

    Science.gov (United States)

    Trăistaru, Magdalena Rodica; Kamal, Diana; Kamal, Kamal Constantin; Rogoveanu, Otilia Constantina; Popescu, Mihai; Bondari, Simona; Alexandru, Dragoş Ovidiu; Ionovici, Nina; Grecu, Dan Cristian

    2015-01-01

    Aseptic osteonecrosis causes various clinical manifestations, depending on its location, but has in common a histopathological and radiological substrate. Aseptic osteonecrosis of the femoral head is a condition whose pathogenesis remains unclear despite many theories developed so far, and the discovery of numerous risk factors. The objective of this study is to emphasize the role of imaging techniques and correlating histology and immunohistochemistry methods in order to more accurately stage the disease. This retrospective study was performed on a total of 103 patients with clinical and radiological suspicion of unilateral or bilateral osteonecrosis. For the diagnosis criteria, we used clinical information, pelvic X-ray images, magnetic resonance imaging (MRI) or computed tomography (CT). For the inclusion of patients in a disease stage, we used the Association Research Circulation Osseous (ARCO) classification system. For patients diagnosed at an advanced stage, who underwent hip arthroplasty, we harvested biological material necessary for the histopathological study. There were differences in the appearance and extent of the lesion on the histological samples compared to macroscopic examination and even those obtained through imaging means, particularly for patients in evolutionary stage III. Aspects such as the extension of the area of fibrosis, bone tissue remodeling, the density of the newly formed vascular network and degree of impairment of the cartilage, are determined more accurately using histology and immunohistochemistry techniques. Before classifying patients in a certain stage, after correlating clinical and imaging data, histopathological aspects have to be considered, particularly in patients in stages III and IV, in which total hip arthroplasty could be delayed.

  3. Macrophage response in patients diagnosed with aseptic necrosis of the femoral head presenting different risk factors.

    Science.gov (United States)

    Kamal, Diana; Trăistaru, Rodica; Kamal, Constantin Kamal; Alexandru, Dragoş Ovidiu; Ion, Daniela Adriana; Grecu, Dan Cristian

    2015-01-01

    Aseptic necrosis of the femoral head is a condition caused by partial or total interruption of blood supply to the femoral head. The diminished blood supply causes necrosis of the cellular elements and of the bone marrow, followed by the collapse of the bone structure, events that ultimately lead to the destruction of the bone tissue, the appearance of local pain and loss of function in the affected coxofemoral joint. The importance of this condition is that it mainly affects young adults aged 30-50 years, active from a socio-professional standpoint, and increased life expectancy. The material studied to achieve CD68 immunostaining was represented by bone fragments from the area of necrosis and from the adjacent areas of the femoral heads, harvested from 39 patients when performing hip arthroplasty surgery. The patients were diagnosed with aseptic necrosis of the femoral head and hospitalized in the Clinic of Orthopedics and Traumatology, Emergency County Hospital of Craiova, Romania, from June 2014 to January 2015. The 39 patients included in the study were divided into four categories according to presented risk factors (alcohol, alcohol and smoking, trauma, corticosteroids). All the 39 cases had positive immunostaining for CD68, macrophage being highlighted both in the area of necrosis and in the adjacent areas. We noted significant differences in the number and arrangement of macrophages in patients presenting different risk factors. The highest number of macrophages was present in patients presenting a risk factor corticosteroids, and the lowest number of macrophages was found in patients who had trauma as the main risk factor.

  4. Establishing and Monitoring an Aseptic Workspace for Building the MOMA Mass Spectrometer

    Science.gov (United States)

    Lalime, Erin

    2016-01-01

    Mars Organic Molecule Analyzer (MOMA) is an instrument suite on the ESA ExoMars 2018 Rover, and the Mass Spectrometer (MOMA-MS) is being built at Goddard Space Flight Center (GSFC). As MOMA-MS is a life-detection instrument and it thus falls in the most stringent category of Planetary Protection (PP) biological cleanliness requirements. Less than 0.03 sporem2 is allowed in the instrument sample path. In order to meet these PP requirements, MOMA-MS must be built and maintained in a low bioburden environment. The MOMA-MS project at GSFC maintains three cleanrooms with varying levels of bioburden control. The Aseptic Assembly Cleanroom has the highest level of control, applying three different bioburden reducing methods: 70 IPA, 7.5 Hydrogen Peroxide, and Ultra-Violet C light. The three methods are used in rotation and each kills microbes by a different mechanism, reducing the likelihood of microorganisms developing resistance to all three. The Integration and Mars Chamber Cleanrooms use less biocidal cleaning, with the option to deploy extra techniques as necessary. To support the monitoring of cleanrooms and verification that MOMA-MS hardware meets PP requirements, a new Planetary Protection lab was established that currently has the capabilities of standard growth assays for spore or vegetative bacteria, rapid bioburden analysis that detects Adenosine Triphosphate (ATP), plus autoclave and DHMR verification. The cleanrooms are monitored both for vegetative microorganisms and by rapid ATP assay, and a clear difference in bioburden is observed between the aseptic the other cleanroom.

  5. MRT of scaphoid pseudo-arthrosis using Gd-DTPA. Staging and clinical correlation; MRT der Skaphoidpseudarthrose mit Gd-DTPA. Stadieneinteilung und klinische Korrelation

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Beutel, F. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Wilhelm, K. [LMU Muenchen (Germany). Abt. fuer Handchirurgie; Tempka, A. [Freie Univ. Berlin (Germany). Klinik fuer Unfall- und Wiederherstellungschirurgie; Schedel, H. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Haas, R. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Felix, R. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik

    1994-11-01

    During a period of two years, 134 patients with pseudo-arthrosis of the scaphoid were examined by conventional radiography and by MRI in the course of a prospective study. The aim of the study was to define radiological staging using contrast enhanced MRI in order to improve the prognostic criteria. All MRI examinations were carried out with a 1.5 Tesla scanner (SP63) using a surface coil and T{sub 1} weighted spin echo sequences in sagittal and frontal projection and frontal FLASH T{sub 2}-sequences and axial spin echo T{sub 2} sequences. The T{sub 1} weighted SE sequences in frontal projection were carried out before and after iv contrast (0.1 mmol Gd-DTPA/kg KG). All sequences were compared with conventional radiographs and the operative findings. Eight patients in stage 0 showed high signal intensity of both fragments in T{sub 1} weighted SE sequences and at surgery there was good vascularisation. In 22 cases there was reduced signal intensity in at least one fragment (stage I). 45 patients with scaphoid pseudo-arthrosis showed complete signal loss but marked contrast uptake with still vital nuclei at surgery (stage II). In 22 patients, there was no increase in signal intensity after contrast and complete loss of vitality of the fragments at surgery. Staging was not possible in 37 patients because of previous operative intervention. The use of contrast enhanced MRI provides additional information compared with conventional radiography or plain MRI. (orig.) [Deutsch] Im Rahmen einer prospektiven Studie wurden in einem Zeitraum von 2 Jahren 134 Patienten mit einer Skaphoidpseudarthrose (SPA) vergleichend konventionell roentgenologisch und magnetresonanztomographisch untersucht. Ziel der Studie war die Erstellung einer klinisch radiologischen Stadieneinteilung mit Hilfe der kontrastverstaerkten MRT zur Verbesserung von Prognosekriterien. Alle MRT-Untersuchungen wurden an einem 1,5 Tesla-Geraet (SP63) mittels einer Oberflaechenspule unter Verwendung von T{sub 1

  6. Major bleeding during negative pressure wound/V.A.C.® - therapy for postsurgical deep sternal wound infection - a critical appraisal

    Directory of Open Access Journals (Sweden)

    Segers Patrique

    2011-09-01

    Full Text Available Abstract Negative-pressure wound therapy, commercially known as vacuum-assisted closure (V.A.C.® therapy, has become one of the most popular (and efficacious interim (prior to flap reconstruction or definite methods of managing deep sternal wound infection. Complications such as profuse bleeding, which may occur during negative-pressure therapy but not necessarily due to it, are often attributed to a single factor and reported as such. However, despite the wealth of clinical experience internationally available, information regarding certain simple considerations is still lacking. Garnering information on all the factors that could possibly influence the outcome has become more difficult due to a (fortunate decrease in the incidence of deep sternal wound infection. If more insight is to be gained from fewer clinical cases, then various potentially confounding factors should be fully disclosed before complications can be attributed to the technique itself or improvements to negative-pressure wound therapy for deep sternal wound infection can be accepted as evidence-based and the guidelines for its use adapted. The authors propose the adoption of a simple checklist in such cases.

  7. Ultrastructural changes of the anterior and posterior sternal integument of the terrestrial isopod Porcellio scaber Latr. (Crustacea) during the moult cycle.

    Science.gov (United States)

    Ziegler, A

    1997-02-01

    The ultrastructure of the anterior (ASE) and posterior sternal epithelium (PSE) was investigated during the biphasic moult cycle. During early premoult the sternal epithelial cells increase in size, accumulate huge amounts of glycogen, and increase the abundance of cellular organelles. CaCO(3) deposit formation begins before the secretion of the epicuticle in the anterior sternal integument and continues through the secretion of the first exocuticular layers. The deposition of cuticle is delayed in the ASE until the CaCO(3) deposit is fully resorbed between the anterior and posterior moult. The development of the interstitial network (IN), which enormously increases the basolateral compartment of the plasma membrane, starts at the beginning of the exocuticle deposition. During CaCO(3) deposit formation and resorption the volume fraction of the mitochondria is much larger in the ASE than in the PSE, although the cuticle is secreted faster in the posterior integument. The results suggest that the exocuticular and epicuticular layers are permeable to calcium and probably also carbonate ions; that the IN is required during late premoult, when CaCO(3) deposition is accelerated, but not during early CaCO(3) deposition; and that active mechanisms contribute to transepithelial ion transport during CaCO(3) deposit formation and resorption.

  8. Morphometric analysis of the calcium-transporting sternal epithelial cells of the terrestrial isopods Ligia oceanica, Ligidium hypnorum, and Porcellio scaber during molt.

    Science.gov (United States)

    Glötzner, J; Ziegler, A

    2000-07-01

    Isopods shed first the posterior and then the anterior half of the body. Before molt, most terrestrial species resorb CaCO3 from the posterior mineralized cuticle. The mineral is stored in anterior sternal deposits, which are used to calcify the new posterior cuticle after molt. For Porcellio scaber it is known that the anterior sternal epithelium has specific structural differentiations for epithelial transport. These differentiations include the plasma membrane surface areas, and the volume fraction of the mitochondria. We analyzed the ultrastructure of the sternal epithelium and used a morphometric approach to study the variations of these parameters between species living in different terrestrial environments. In Ligidium hypnorum, which lives in moist environments, the plasma membrane surface area and volume fraction of mitochondria are much larger than in the semiterrestrial Ligia oceanica. This is in accordance with the relatively larger CaCO3 deposits and shorter time intervals for their formation and resorption in L. hypnorum. For P. scaber, which is adapted to mesic habitats, most values are between those of L. oceanica and L. hypnorum. However, P. scaber has even larger CaCO3 deposits which are formed and degraded within similar time intervals as in L. hypnorum. This unexpected result is considered from the standpoint of more effective mechanisms being present for epithelial ion transport.

  9. Molecular characterisation of the smooth endoplasmic reticulum Ca(2+)-ATPase of Porcellio scaber and its expression in sternal epithelia during the moult cycle.

    Science.gov (United States)

    Hagedorn, Monica; Weihrauch, Dirk; Towle, David W; Ziegler, Andreas

    2003-07-01

    The anterior sternal epithelial cells of the terrestrial isopod Porcellio scaber transport large amounts of calcium during the formation and resorption of intermittent calcium carbonate deposits. Recent investigations on epithelia involved in mineralisation processes suggest a role of the smooth endoplasmic reticulum Ca(2+)-ATPase (SERCA) in transcellular calcium transport. We present the first molecular characterisation of a SERCA within a crustacean mineralising epithelium. We cloned the SERCA from a cDNA library of the anterior sternal epithelium and used in situ hybridisation to compare the expression of the SERCA mRNA between three different moulting stages. The full-length SERCA cDNA has an open reading frame of 3006 nucleotides. The deduced 1002 amino-acid polypeptide has a predicted molecular mass of 109.7 kDa and 87% identity to the SERCA of Procambarus clarkii axial muscle isoform. In situ hybridisation confirmed expression within the anterior sternal epithelium and revealed an increase in SERCA mRNA abundance from the non-transporting, early premoult stage to the calcium transporting, late premoult and intramoult stage. The results support previous indications of a contribution by the smooth endoplasmic reticulum to transcellular calcium transport and suggest a transcriptional regulation of SERCA activity.

  10. A case of cerebral salt-wasting syndrome associated with aseptic meningitis in an 8-year-old boy.

    Science.gov (United States)

    Inatomi, Jun; Yokoyama, Yoshiki; Sekine, Takashi; Igarashi, Takashi

    2008-04-01

    Cerebral salt-wasting syndrome is a disorder in which excessive natriuresis and subsequent hyponatremic dehydration occur in patients with intracranial diseases. Cerebral salt-wasting syndrome often develops in patients with severe neurosurgical disorders, such as hydrocephalus, cerebral infarction, and tuberculous meningitis. Here, we report on the case of an 8-year-old boy with cerebral salt-wasting syndrome associated with aseptic meningitis. He showed mild developmental retardation and had a history of convulsion. Four days after his admission, cerebral salt-wasting syndrome abruptly started: natriuresis and hyponatremia gradually improved over 10 days. To the best of our knowledge, this is the first report on cerebral salt-wasting syndrome associated with clinically benign aseptic meningitis.

  11. Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of Literature

    Science.gov (United States)

    Scaffidi, Michael A.; Al-Mazroui, Ahmed; Tessolini, Jenna; Showler, Adrienne; Colak, Errol

    2017-01-01

    Background. Aseptic abscesses (AA) are sterile lesions that represent an extraintestinal manifestation (EIM) of inflammatory bowel disease (IBD). Though Canada has the highest prevalence of IBD in the world, reports of IBD-associated AA are absent in Canada. This may represent a different IBD phenotype or underrecognition and underreporting. Purpose. To explore AA as a possible EIM of IBD and evaluate clinical and investigative findings among patients with IBD-associated AA. Methods. Retrospective chart and literature reviews were performed to find cases of IBD-associated AA at our institution and in the literature. Results. We identified 2 cases of IBD-associated AA in our institution. Both patients had ulcerative colitis and presented with fever, abdominal pain, and weight loss. Radiological workup and aspiration showed sterile splenic abscesses. The AA were unresponsive to antibiotics. One patient improved on corticosteroids and one underwent splenectomy. We retrieved 37 cases of IBD-associated AA from the literature. All patients showed no evidence of infection, failed to resolve with antibiotics, and, if attempted, improved on corticosteroids. Conclusions. Our cases are the first reported in Canada. They support literature which suggests AA as an EIM of IBD and may help increase recognition and reporting of this phenomenon.

  12. MRI evaluation of aseptic osteonecrosis in children over the course of hyperbaric oxygen therapy

    Energy Technology Data Exchange (ETDEWEB)

    Scherer, A.; Engelbrecht, V.; May, P.; Moedder, U. [Duesseldorf Univ. (Germany). Inst. fuer Diagnostische Radiologie; Bernbeck, B.; Goebel, U. [Duesseldorf Univ. (Germany). Dept. of Pediatric Hematology and Oncology; Willers, R. [Duesseldorf Univ. (Germany). Inst. of Statistics

    2000-10-01

    Purpose: The study aimed at MRI evaluation of aseptic osteonecrosis (AON) in children over the course of hyperbaric oxygen (HBO) therapy. Material and methods: Retrospective analysis of 72 MRI studies in 20 children presenting with AON during chemotherapy. Two groups were differentiated: Gr. I (n=8) was treated exclusively with relief of weightbearing structures, Gr. II (n=12) was additionally treated with HBO therapy. The MRI examinations were evaluated by a point-score system (1-6 points) by two radiologists. Results: Gr. II initially showed more severe findings (average score: 3.4) in comparison to Gr. I (average score: 2.65). During the follow-up time period the average scores rose to 3.2 score-points in Gr. I and 4.1 points in Gr. II. No statistically significant difference was evident between the two groups in the course of AON. Conclusion: The majority of chemotherapy associated AON which initially present with advanced findings show a progression in MRI over their further course. HBO therapy in addition to the relief of affected weightbearing structures statistically shows no significant improvement in MRI morphology during the course of the treatment. (orig.)

  13. Herpes simplex virus type 2-associated recurrent aseptic (Mollaret's meningitis in genitourinary medicine clinic: a case report

    Directory of Open Access Journals (Sweden)

    Abou-Foul AK

    2014-03-01

    Full Text Available Ahmad K Abou-Foul, Thajunisha M Buhary, Sedki L Gayed Department of Genitourinary Medicine, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Blackburn, UK Introduction: Cases of idiopathic recurrent benign aseptic meningitis were first described by Mollaret. Today, herpes simplex virus (HSV is considered the cause of most cases of Mollaret's meningitis. Case report: A 40-year-old male was referred to our genitourinary medicine clinic with recurrent genital herpetic lesions. He had HSV-2-positive genital ulcers 8 years earlier. One year after the first infection, he developed severe recurrent attacks of headache associated with meningitis symptoms. The results of all radiological and biochemical tests were normal, but the patient reported a correlation between his attacks and genital herpes flare-ups. We diagnosed the patient with Mollaret's meningitis and started him on continuous suppressive acyclovir therapy, which resulted in marked clinical improvement. Discussion: Mollaret's meningitis is a rare form of idiopathic recurrent aseptic meningitis that has a sudden onset, short duration, and spontaneous remission with unpredictable recurrence. We believe that the presence of concurrent or recurrent mucocutaneous herpetic lesions can aid its diagnosis, prior to which, affected patients usually have many unnecessary investigations and treatments. Therefore, detailed sexual history should be sought in all patients with aseptic meningitis, and clinicians should also ask about history of recurrent headaches in all patients with recurrent herpetic anogenital lesions. Continuous suppressive acyclovir therapy may reduce the frequency and severity of attacks and can dramatically improve lifestyle. Keywords: HSV-2 virus, acyclovir, Mollaret's meningitis, recurrent aseptic meningitis, HSV-2 virus, viral meningitis, acyclovir

  14. Epidemiological and clinical studies on aseptic meningitis in 377 cases, 3. A study on brain CT scan in acute phase

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Masaaki; Kondo, Tomio; Takashima, Akira; Kono, Shinya; Yamashina, Manabu (Ogaki Shimin Hospital, Gifu (Japan))

    1984-02-01

    Brain CT scan performed in the acute phase of aseptic meningitis in 88 cases revealed abnormal findings in 5 consisting of 2 of cerebral edema, 2 of subdural hygroma and one of cerebral atrophy. Clinical findings showed no particular relation to the age, but cerebral edema was observed in the cases of possible cephalomeningitis diagnosed on the basis of accompanying convulsion and disturbance of consciousness. Abnormal findings were associated with 25% of symptoms diagnosed more than 4 days after onset.

  15. Comparative experimental evaluation of the efficacy of Prostamol Uno and Samprost on rat model of chronic aseptic prostate inflammation.

    Science.gov (United States)

    Pahomova, A V; Borovskaja, T G; Fomina, T I; Ermolaeva, L A; Vychuzhanina, A V; Rumpel, O A; Granstrem, O K; Baranova, O V

    2011-11-01

    Comparative experimental evaluation of the efficiency of prostatotropic drugs Prostamol Uno and Samprost on the model of the chronic aseptic prostate inflammation in rats was performed. It was established that peptide drug Samprost decelerates sclerotic processes in the prostate gland to a greater extent than herbal preparation Prostamol Uno. Both products equally stimulate secretory activity of the gland. Prostamol Uno, unlike Samprost, prevents the development of reduced sexual motivation, one of the complications of chronic prostatitis.

  16. Residual non-union in a case of two and half year old child congenital pseudoarthrosis of ipsilateral tibia and fibula treated by intramedullary fixation with K-wire and allogeniccancellous strut graft: A case report

    Directory of Open Access Journals (Sweden)

    Siddaram N Patil, Sankar Rao P, Ranjith K Yalamanchili

    2013-04-01

    Full Text Available The pseudarthrosis usually develops during the first two years of life; however, there are reports of cases in which fractures developed before birth and reports of late-onset pseudarthrosis. There is a strong association between Congenital pseudoarthrosis and Type I neurofibromatosis. CPT develops in about 5.7% of patients with NF-I and 40% of patients with pseudoarthrosis were found to have NF-I. Main pathology is hyperplasia of fibroblasts with the formation of dense fibrous tissue at fracture site causing osteolysis, and persistence of pseudarthrosis. The difficulty in treating this condition occurs because of two factors. 1 Biologic: poor healing ability of the dysplastic segment of bone and 2 Mechanical: technical difficulty to fix small and osteopenic bone fragments in children without damaging the distal physis. A multitude of treatment protocols focusing on stimulating the healing process by using different bone grafting techniques were documented6. The graft materials most commonly used included osteoperiosteal graft, massive onlay graft, autogenous iliac crest bone graft, and vascularised bone graft.

  17. COMPARISON OF THE FREQUENCY AND COMPLICATIONS OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION IN PATIENTS WITH SEPTIC AND ASEPTIC MENINGITIS

    Directory of Open Access Journals (Sweden)

    Ali HONARPISHEH MD

    2010-04-01

    Full Text Available ObjectiveDue to the high prevalence of syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH. This study was carried out to evaluate the prevalence and relevant parameters of SIADH in children with septic and aseptic memingitis hospitalized at Kashan Shahid Beheshti Hospital between 1996 and 2006.Materials & MethodsThis descriptive study was conducted on 230 patients with meningitis hospitalized in the pediatric wards of Kashan Shahid Beheshti Hospital between 1996 and 2006. Relevant information (age, gender, type of meningitis, serum sodium and potassium, urine specific gravity (USG, blood sugar, blood urea nitrogen, serum creatinin, hydration condition was collected from patients' records. Data was analyzed using Mann-Whitney and K2 tests.ResultsOut of 230 patients with meningitis, 33 had incomplete records and only 197 patients were recruited for this study. Sixty eight cases (34.5% suffered from SIADH. It was more frequent among 1-2 year old  children.According to this research, SIADH was diagnosed in 57% of the 121 patients with hyponatremia, 58.7% of the 167 patients with USG > 1.004, 74% of the 93 patients with serum osmolity ConclusionDue to the high prevalence of SIADH in septic and aseptic meningitis and its complication, it is recommended to restrict fluid therapy and monitor serum sodium, urine specific gravity and other diagnostic tests for SIADH.Keywords: Hyponatremia; Meningitis; SIADH, Septic, Aseptic

  18. Establishment of an operating room committee and a training program to improve aseptic techniques for rodent and large animal surgery.

    Science.gov (United States)

    Héon, Hélène; Rousseau, Nathalie; Montgomery, Jane; Beauregard, Gilles; Choiniére, Manon

    2006-11-01

    Investigators of our research facility generally accept the concept of asepsis as an important component of adequate surgical care for animals. However, they experience difficulties putting it into practice, especially in the case of rodents. The reasons for this are inconvenience, cost, and lack of training. To better assist investigators in the implementation of aseptic surgical techniques in their laboratories, we have created an Operating Room (OR) Committee modeled after OR committees found in human hospitals. A reconstructive surgeon, a veterinarian, a research scientist, a nurse involved in the training of OR personnel, interns, graduate students, and an animal health technician were chosen as committee members in light of their OR and animal care expertise. The first task of the OR Committee was to establish institutional guidelines for aseptic surgery, taking into account the costs imposed on research budgets by these procedures. The OR Committee also supports a complete training program in aseptic surgery techniques, which consists of lectures, a training manual, videos, and a practical course. Furthermore, when experimental procedures require specialized equipment, the OR Committee collaborates with researchers to develop strategies to achieve asepsis. This OR Committee and the training program proved to be important tools to promote and improve the quality of animal care during surgery.

  19. Chemistry of the sternal gland secretion of the Mediterranean centipede Himantarium gabrielis (Linnaeus, 1767) (Chilopoda: Geophilomorpha: Himantariidae)

    Science.gov (United States)

    Vujisić, Ljubodrag V.; Vučković, Ivan M.; Makarov, Slobodan E.; Ilić, Bojan S.; Antić, Dragan Ž.; Jadranin, Milka B.; Todorović, Nina M.; Mrkić, Ivan V.; Vajs, Vlatka E.; Lučić, Luka R.; Ćurčić, Božidar P. M.; Mitić, Bojan M.

    2013-09-01

    The geophilomorph centipede, Himantarium gabrielis, when disturbed, discharges a viscous and proteinaceous secretion from the sternal glands. This exudate was found by gas chromatography-mass spectrometry, liquid chromatography-high resolution mass spectrometry, liquid chromatography-mass spectrometry-mass spectrometry and NMR analyses to be composed of hydrogen cyanide, benzaldehyde, benzoyl nitrile, benzyl nitrile, mandelonitrile, mandelonitrile benzoate, 3,7,6 O-trimethylguanine (himantarine), farnesyl 2,3-dihydrofarnesoate and farnesyl farnesoate. This is the first report on the presence of benzyl nitrile and mandelonitrile benzoate in secreted substances from centipedes. Farnesyl 2,3-dihydrofarnesoate is a new compound, while himantarine and farnesyl farnesoate were not known as natural products. A post-secretion release of hydrogen cyanide by reaction of mandelonitrile and benzoyl nitrile was observed by NMR, and hydrogen cyanide signals were completely assigned. In addition, a protein component of the secretion was analysed by electrophoresis which revealed the presence of a major 55 kDa protein. Analyses of the defensive exudates of other geophilomorph families should produce further chemical surprises.

  20. Successful human infection with P. falciparum using three aseptic Anopheles stephensi mosquitoes: a new model for controlled human malaria infection.

    Directory of Open Access Journals (Sweden)

    Matthew B Laurens

    Full Text Available Controlled human malaria infection (CHMI is a powerful method for assessing the efficacy of anti-malaria vaccines and drugs targeting pre-erythrocytic and erythrocytic stages of the parasite. CHMI has heretofore required the bites of 5 Plasmodium falciparum (Pf sporozoite (SPZ-infected mosquitoes to reliably induce Pf malaria. We reported that CHMI using the bites of 3 PfSPZ-infected mosquitoes reared aseptically in compliance with current good manufacturing practices (cGMP was successful in 6 participants. Here, we report results from a subsequent CHMI study using 3 PfSPZ-infected mosquitoes reared aseptically to validate the initial clinical trial. We also compare results of safety, tolerability, and transmission dynamics in participants undergoing CHMI using 3 PfSPZ-infected mosquitoes reared aseptically to published studies of CHMI using 5 mosquitoes. Nineteen adults aged 18-40 years were bitten by 3 Anopheles stephensi mosquitoes infected with the chloroquine-sensitive NF54 strain of Pf. All 19 participants developed malaria (100%; 12 of 19 (63% on Day 11. The mean pre-patent period was 258.3 hours (range 210.5-333.8. The geometric mean parasitemia at first diagnosis by microscopy was 9.5 parasites/µL (range 2-44. Quantitative polymerase chain reaction (qPCR detected parasites an average of 79.8 hours (range 43.8-116.7 before microscopy. The mosquitoes had a geometric mean of 37,894 PfSPZ/mosquito (range 3,500-152,200. Exposure to the bites of 3 aseptically-raised, PfSPZ-infected mosquitoes is a safe, effective procedure for CHMI in malaria-naïve adults. The aseptic model should be considered as a new standard for CHMI trials in non-endemic areas. Microscopy is the gold standard used for the diagnosis of Pf malaria after CHMI, but qPCR identifies parasites earlier. If qPCR continues to be shown to be highly specific, and can be made to be practical, rapid, and standardized, it should be considered as an alternative for diagnosis

  1. Tissue engineering chamber promotes adipose tissue regeneration in adipose tissue engineering models through induced aseptic inflammation.

    Science.gov (United States)

    Peng, Zhangsong; Dong, Ziqing; Chang, Qiang; Zhan, Weiqing; Zeng, Zhaowei; Zhang, Shengchang; Lu, Feng

    2014-11-01

    Tissue engineering chamber (TEC) makes it possible to generate significant amounts of mature, vascularized, stable, and transferable adipose tissue. However, little is known about the role of the chamber in tissue engineering. Therefore, to investigate the role of inflammatory response and the change in mechanotransduction started by TEC after implantation, we placed a unique TEC model on the surface of the groin fat pads in rats to study the expression of cytokines and tissue development in the TEC. The number of infiltrating cells was counted, and vascular endothelial growth factor (VEGF) and monocyte chemotactic protein-1 (MCP-1) expression levels in the chamber at multiple time points postimplantation were analyzed by enzyme-linked immunosorbent assay. Tissue samples were collected at various time points and labeled for specific cell populations. The result showed that new adipose tissue formed in the chamber at day 60. Also, the expression of MCP-1 and VEGF in the chamber decreased slightly from an early stage as well as the number of the infiltrating cells. A large number of CD34+/perilipin- perivascular cells could be detected at day 30. Also, the CD34+/perilipin+ adipose precursor cell numbers increased sharply by day 45 and then decreased by day 60. CD34-/perilipin+ mature adipocytes were hard to detect in the chamber content at day 30, but their number increased and then peaked at day 60. Ki67-positive cells could be found near blood vessels and their number decreased sharply over time. Masson's trichrome showed that collagen was the dominant component of the chamber content at early stage and was replaced by newly formed small adipocytes over time. Our findings suggested that the TEC implantation could promote the proliferation of adipose precursor cells derived from local adipose tissue, increase angiogenesis, and finally lead to spontaneous adipogenesis by inducing aseptic inflammation and changing local mechanotransduction.

  2. Colgajo de omento para tratamiento de dehiscencia de herida esternal Omental flap for management of sternal wound dehiscence

    Directory of Open Access Journals (Sweden)

    A. Pérez García

    2013-03-01

    Full Text Available La mediastinitis es una de las complicaciones más graves de la cirugía cardíaca. Aparece en el 0,5-5 % de las esternotomías y esta incidencia es mucho mayor en pacientes diabéticos, obesos, inmunodeprimidos, con enfermedad pulmonar obstructiva crónica (EPOC, etc. Presentamos el caso de una paciente diabética, obesa mórbida, que sufre mediastinitis tras doble by-pass coronario. Para la cobertura del defecto se empleó un colgajo de epiplon tunelizado transdiafragmático. El colgajo omental permite cubrir grandes defectos además de que posee capacidad antimicrobiana y favorece la revascularización tisular. Las características de este colgajo hacen que actualmente deba considerarse como primera elección en pacientes con grandes defectos esternales y trastornos de la inmunidad y la cicatrización.Mediastinitis is one of the most serious complications from cardiac surgery. It is reported to occur in 0'5-5 % of sternotomy incisions, and this incidence is much higher in diabetic patients, obese, immunocompromised, COPD, etc. We report a case of a diabetic and morbid obese woman suffering mediastinitis after double coronary bypass surgery. For the reconstruction a transdiaphragmatic tunnelled omental flap was used. The omentum is useful to cover large defects. It has antiinfective properties and promotes revascularization of neighbouring tissues. Omental flap can be a highly effective treatment for patients with large sternal wounds and immune disorders and wound healing disorders.

  3. Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG: incidence, risk factors and mortality

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    Abbasi Kyomars

    2007-09-01

    Full Text Available Abstract Background Sternal wound infection (SWI is an uncommon but potentially life-threatening complication of cardiac surgery. Predisposing factors for SWI are multiple with varied frequencies in different studies. The purpose of this study was to assess the incidence, risk factors, and mortality of SWI after coronary artery bypass grafting (CABG at Tehran Heart Center. Methods This study prospectively evaluated multiple risk factors for SWI in 9201 patients who underwent CABG at Tehran Heart Center between January 2002 and February 2006. Cases of SWI were confirmed based on the criteria of the Centers for Disease Control and Prevention. Deep SWI (bone and mediastinitis was categorized according to the Oakley classification. Results In the study period, 9201 CABGs were performed with a total SWI rate of 0.47 percent (44 cases and deep SWI of 0.22 percent (21 cases. Perioperative (in-hospital mortality was 9.1% for total SWI and about 14% for deep SWI versus 1.1% for non-SWI CABG patients. Female gender, preoperative hypertension, high functional class, diabetes mellitus, obesity, prolonged intubation time (more than 48 h, and re-exploration for bleeding were significant risk factors for developing SWI (p = 0.05 in univariate analysis. In multivariate analysis, hypertension (OR = 10.7, re-exploration (OR = 13.4, and female gender (OR = 2.7 were identified as significant predictors of SWI (p Conclusion Rarely reported previously, the two risk factors of hypertension and the female gender were significant risk factors in our study. Conversely, some other risk factors such as cigarette smoking and age mentioned as significant in other reports were not significant in our study. Further studies are needed for better documentation.

  4. Expression and polarity reversal of V-type H+-ATPase during the mineralization-demineralization cycle in Porcellio scaber sternal epithelial cells.

    Science.gov (United States)

    Ziegler, Andreas; Weihrauch, Dirk; Hagedorn, Monica; Towle, David W; Bleher, Reiner

    2004-04-01

    The formation and resorption of CaCO(3) by epithelial cell layers require epithelial transport of protons. We used the anterior sternal epithelium of the terrestrial isopod Porcellio scaber as a model to study the expression pattern and immunolocalization of a V-type H(+)-ATPase during the mineralization and demineralization of intermittent CaCO(3) deposits. Semiquantitative RT-PCR revealed that the expression of the V-type H(+)-ATPase increases from non Ca(2+)-transporting control stages to the stages of CaCO(3) deposit formation and resorption. In the Ca(2+)-transporting stages the expression was larger in the anterior than in the posterior sternal epithelium, which is not involved in deposit formation and transports just moderate amounts of CaCO(3). Immunocytochemistry of the B-subunit of the V-type H(+)-ATPase in the anterior sternal epithelium reveals an increase in the abundance of the protein within the basolateral membrane, from undetectable to strong signals in the control stage to the stages of CaCO(3) deposit formation, respectively. From the stage of CaCO(3) deposit formation to that of CaCO(3) resorption the signal decreased within the basolateral plasma membrane and increased within the apical plasma membrane. For the first time the results indicate a contribution of a V-type H(+)-ATPase to CaCO(3) deposition and a reversal of its polarity from the basolateral to the apical plasma membrane compartment within the same cells.

  5. Aseptic loosening rate of megaprostheses and related factors%肿瘤型人工关节假体无菌性松动率及相关因素

    Institute of Scientific and Technical Information of China (English)

    肖何; 牛晓辉

    2014-01-01

    With the development of chemotherapy, imaging, surgical techniques and material science, limb-salvage has become a widely accepted concept in the treatment of bone and soft tissue tumors. Prosthetic reconstruction after tumor segment resection has become a common operation method. In the history, there appeared many kinds of materials for the reconstruction after the resection of tumors. The megaprosthesis has a history of more than 60 years, and has become the mainstream now, with many advantages over the other reconstruction materials. The aseptic loosening of megaprotheses is a common postoperative complication and also a prominent cause of prosthesis failure. How high is the aseptic loosening rate? Will the rate be affected by such factors as the patient’s age, gender, disease category, implantation site, reconstruction length, chemotherapy and so on? Will the rate be obviously reduced due to the improvement of megaprotheses? These questions are worth researching. The aseptic loosening rate of megaprostheses and related factors are reviewed in this article based on previous studies. According to previous reports, many factors concerning the patient and the prosthesis have an impact on the aseptic loosening rate. The clear and deifnite related factors included the implantation site, porous coating in the collar, type of articulation, age at the time of surgery and reconstruction length, and the gender and disease category are irrelevant factors. As to the size of intramedullary stem, ifxation mode, modular/custom and chemotherapy, their correlation with the aseptic loosening rate is still unclear.

  6. Tratamento da pseudartrose infectada da tíbia pelo método de Ilizarov: técnica do encurtamento agudo com subseqüente alongamento Treatment of infected pseudoarthrosis of the tibia by Ilizarov's method: technique using acute compression and subsequent distraction

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    Jorge Luiz Borges

    2007-09-01

    Full Text Available OBJETIVO:Comprovar a eficácia do tratamento da pseudartrose infectada da tíbia pelo método de Ilizarov, utilizando a técnica do encurtamento agudo do foco da pseudartrose com posterior alongamento ósseo. MÉTODOS: Foram estudados 20 pacientes adultos portadores de pseudartrose unilateral infectada da tíbia, tratados no período entre novembro de 1993 e setembro de 2000. No pós-operatório, os pacientes foram avaliados quanto a dor, necessidade de órtese, avaliação da mobilidade articular, retorno às atividades normais do dia-a-dia e/ou do trabalho, consolidação da pseudartrose, cura da infecção, existência de deformidades ósseas, discrepância no comprimento dos membros e consolidação óssea na área do regenerado ósseo. RESULTADOS: Os resultados funcionais foram: excelentes em 10 pacientes (50%, bons em oito (40%, regulares em um (5% e ruins em um paciente (5%. O tempo de consolidação da pseudartrose, do segmento ósseo alongado e o tempo de uso do fixador foram proporcionais à extensão da perda óssea. CONCLUSÃO: O método de Ilizarov, associado ao encurtamento agudo com subseqüente alongamento ósseo, mostrou-se eficaz para o tratamento da pseudartrose infectada da tíbia.OBJECTIVE: To verify the effectiveness of treating the infected pseudoarthrosis of the tibia by Ilizarov's method using the technique of acute compression of the focus of pseudoarthrosis with later bone distraction. METHODS: 20 adult patients with unilateral infected pseudoarthrosis of the tibia treated from November 1993 to September 2000 were studied. In the postoperative period, the patients were evaluated for pain, orthesis requirement, joint mobility, return to daily life activities and/or to work, union of the pseudoarthrosis, cure of the infection, presence of bone deformities, discrepancy in limb length, and bone union in the bone regenerate area. RESULTS: Functional results were: excellent in 10 patients (50%, good in eight (40%, regular in

  7. 一次性加压延长治疗先天性胫骨假关节%Combined Bone Lengthening and Compressing in the Treatment of Congenital Pseudoarthrosis of Tibia

    Institute of Scientific and Technical Information of China (English)

    李长胜; 张新; 牛丰; 刘一

    1996-01-01

    采用自制长骨外固定器及Ilizarov器械治疗先天性胫骨假关节,使假关节愈合及肢体短缩问题同时得到解决.本组4例先天性胫骨假关节,术前肢体短缩4.0~10.5cm,通过一次性手术对假关节施行切除,加压固定,并应用Ilizarov器械对短缩肢体进行延长.假关节全部愈合,患肢延长4.0~12.0 cm.结论:该手术可使假关节的肢体短缩及愈合两大矛盾同时得到解决,恢复患儿行走功能.%The nonunion and shortness of congenital pseudoarthrosis of the tibia have been solved by self-designed external fixation of Ilizarov technique.In 4 cases of congenital pseudoarthosis-of the tibia.the shortness of the legs ranged 4.0-10.5cm.The pseudoarthrosis was resected and fixed under compression.and the lower extremity lengthened by Ilizalov's technique in one stage.All of them have got leg lengthening (4.0-12.0 cm)and firm healing,This procedure is effective and reliable in the treatment of congenital psudoarthrosis of the tibia.

  8. Vitrified sperm banks: the new aseptic technique for human spermatozoa allows cryopreservation at -86 °C.

    Science.gov (United States)

    Sánchez, R; Risopatrón, J; Schulz, M; Villegas, J V; Isachenko, V; Isachenko, E

    2012-12-01

    The vitrification technique is simple, quick, cost-effective and has showed a significantly stronger cryoprotective effect in contrast to conventional freezing. The method is based on the rapid cooling of the cell by direct immersion in liquid nitrogen (LN (2) ), thereby avoiding the formation of ice crystals, due to the lower risk of water thawing, which impairs cell function. The aim of this study was to evaluate the effect of storage at -86 °C compared to the conventional -196 °C (under LN (2) ) on essential parameters of the functioning of aseptically vitrified human sperm. Sperm motility, integrity of mitochondrial membrane potential and the rate of DNA fragmentation were determined. The comparison of -86 °C and -196 °C demonstrated no statistical difference in sperm progressive motility (73% vs. 77%), integrity of mitochondrial membrane potential (71% vs. 74%) or DNA fragmentation (3.1% vs. 2.9%). In conclusion, aseptically vitrified sperm can be preserved at -86 °C; eliminating the use of LN (2) simplifies and significantly reduces the costs associated with storage in sperm banks by decreasing the time and space needed for storage, the effort in finding stored samples, and by improving safety for the operator. However, for prolonged storage further studies are needed.

  9. Description of a widespread outbreak of aseptic meningitis due to echovirus 30 in Rio de Janeiro state, Brazil

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    Vitor Laerte Pinto Junior

    2009-10-01

    Full Text Available Echovirus 30 belongs to the genus Enterovirus and is widely associated with aseptic meningitis (AM outbreaks. In Brazil epidemics due to this serotype were reported in several states but in Rio de Janeiro, before this study, it was only involved in sporadic episodes. We retrospectively collected data from AM notifications charts and enterovirus isolation database from Rio de Janeiro State Health Department (RJSHD and Enterovirus Reference Laboratory in the year of 2005. An outbreak of AM was detected during March, April and May associated with a high cell culture isolation rate for echovirus 30 (17.4%. Male children with ages varying from 1 to 9 years were more affected. Of the 22 patients with confirmed echovirus 30 disease, clinical information was available in eight; fever, headache and vomiting were the most common manifestations. CSF analysis showed a typical pattern of viral infection with median of cellularity of 100 cells/mm³ and mononuclear cell predominance in 64.7% of the cases. The median of protein and glucose levels of 49 mg/dL and 56.5 mg/dL. The fatality rate was null. Despite its benign course and the lack of treatment options, aseptic meningitis surveillance is crucial for early identification of causative agents of outbreaks, which helps to avoid additional testing and inappropriate use of antimicrobials.

  10. An outbreak of aseptic meningitis caused by coxsackievirus A9 in Gansu, the People's Republic of China

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    Mao Naiying

    2010-04-01

    Full Text Available Abstract Background An outbreak of aseptic meningitis occurred in Tianshui city of Gansu Province, the People's Republic of China, from March to June 2005. A total of 85 patients were clinical confirmed as aseptic meningitis in this outbreak. Results CVA9 was mainly responsible for this outbreak supported by the clinical manifestations of the patients, epidemiological data of the outbreak, the results of RT-PCR and complete VP1 sequence determination, conventional neutralization assays, IgM serological assays, viral isolation and phylogenetics analysis. Through phylogenetic analysis and homogeneity analysis for partial VP1 gene, the nucleotide and amino acid homologies between Gansu isolates and former Chinese CVA9 strains were 88.2%-96.1% and 97.2%-99.2%, respectively. Multiple transmission chains of CVA9 occurred in different provinces or years in China. Moreover, in order to clarify the genotype of CVA9, Gansu CVA9 strains isolated in this outbreak were compared with other CVA9 isolates based on VP1/2A junction regions (genotyping region and they might belong to a new genotype of CVA9, which could be assigned for genotype XIII, Conclusions CVA9 was confirmed as the pathogen responsible for this outbreak. The phylogenetic analysis indicated that the CVA9 strains isolated in this outbreak might belong to a new genotype.

  11. Percutaneous bone cement refixation of aseptically loose hip prostheses: the effect of interface tissue removal on injected cement volumes

    Energy Technology Data Exchange (ETDEWEB)

    Malan, Daniel F. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands); Delft University of Technology, Department of Intelligent Systems, Delft (Netherlands); Valstar, Edward R. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands); Delft University of Technology, Department of Biomechanical Engineering, Delft (Netherlands); Nelissen, Rob G.H.H. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands)

    2014-11-15

    To quantify whether injected cement volumes differed between two groups of patients who underwent experimental minimally invasive percutaneous cement injection procedures to stabilize aseptically loose hip prostheses. One patient group was preoperatively treated using gene-directed enzyme prodrug therapy to remove fibrous interface tissue, while the other group received no preoperative treatment. It was hypothesized that cement penetration may have been inhibited by the presence of fibrous interface tissue in periprosthetic lesions. We analyzed 17 patients (14 female, 3 male, ages 72-91, ASA categories 2-4) who were treated at our institution. Osteolytic lesions and injected cement were manually delineated using 3D CT image segmentation, and the deposition of injected cement was quantified. Patients who underwent preoperative gene-directed enzyme therapy to remove fibrous tissue exhibited larger injected cement volumes than those who did not. The observed median increase in injected cement volume was 6.8 ml. Higher cement leakage volumes were also observed for this group. We conclude that prior removal of periprosthetic fibrous interface tissue may enable better cement flow and penetration. This might lead to better refixation of aseptically loosened prostheses. (orig.)

  12. Analysis of Ca(2+) uptake into the smooth endoplasmic reticulum of permeabilised sternal epithelial cells during the moulting cycle of the terrestrial isopod Porcellio scaber.

    Science.gov (United States)

    Hagedorn, Monica; Ziegler, Andreas

    2002-07-01

    In terrestrial isopods, large amounts of Ca(2+) are transported across anterior sternal epithelial cells during moult-related deposition and resorption of CaCO(3) deposits. Because of its toxicity and function as a second messenger, resting cytosolic Ca(2+) levels must be maintained below critical concentrations during epithelial Ca(2+) transport, raising the possibility that organelles play a role during Ca(2+) transit. We therefore studied the uptake of Ca(2+) into Ca(2+)-sequestering organelles by monitoring the formation of birefringent calcium oxalate crystals in permeabilised anterior and posterior sternal epithelium cells of Porcellio scaber during Ca(2+)-transporting and non-transporting stages of the moulting cycle using polarised-light microscopy. The results indicate ATP-dependent uptake of Ca(2+) into organelles. Half-maximal crystal growth at a Ca(2+) activity, a(Ca), of 0.4 micromol l(-1) and blockade by cyclopiazonic acid suggest Ca(2+) uptake into the smooth endoplasmic reticulum by the smooth endoplasmic reticulum Ca(2+)-ATPase. Analytical electron microscopical techniques support this interpretation by revealing the accumulation of Ca(2+)-containing crystals in smooth membranous intracellular compartments. A comparison of different moulting stages demonstrated a virtual lack of crystal formation in the early premoult stage and a significant fivefold increase between mid premoult and the Ca(2+)-transporting stages of late premoult and intramoult. These results suggest a contribution of the smooth endoplasmic reticulum as a transient Ca(2+) store during intracellular Ca(2+) transit.

  13. The Protective Effect of Bafilomycin A1 Against Cobalt Nanoparticle-Induced Cytotoxicity and Aseptic Inflammation in Macrophages In Vitro.

    Science.gov (United States)

    Wang, Songhua; Liu, Fan; Zeng, Zhaoxun; Yang, Huilin; Jiang, Haitao

    2016-01-01

    Co ions released due to corrosion of Co nanoparticles (CoNPs) in the lysosomes of macrophages may be a factor in the particle-induced cytotoxicity and aseptic inflammation accompanying metal-on-metal (MOM) hip prosthesis failure. Here, we show that CoNPs are easily dissolved under a low pH, simulating the acidic lysosomal environment. We then used bafilomycin A1 to change the pH inside the lysosome to inhibit intracellular corrosion of CoNPs and then investigated its protective effects against CoNP-induced cytotoxicity and aseptic inflammation on murine macrophage RAW264.7 cells. XTT {2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino) carbonyl]-2H-tetrazolium hydroxide} assays revealed that bafilomycin A1 can significantly decrease CoNP-induced cytotoxicity in RAW264.7 cells. Enzyme-linked immunosorbent assays showed that bafilomycin A1 can significantly decrease the subtoxic concentration of CoNP-induced levels of pro-inflammatory cytokines (tumor necrosis factor-α, interleukin-1β, and interleukin-6), but has no effect on anti-inflammatory cytokines (transforming growth factor-β and interleukin-10) in RAW264.7 cells. We studied the protective mechanism of bafilomycin A1 against CoNP-induced effects in RAW264.7 cells by measuring glutathione/oxidized glutathione (GSH/GSSG), superoxide dismutase, catalase, and glutathione peroxidase levels and employed scanning electron microscopy, transmission electron microscopy, and energy dispersive spectrometer assays to observe the ultrastructural cellular changes. The changes associated with apoptosis were assessed by examining the pAKT and cleaved caspase-3 levels using Western blotting. These data strongly suggested that bafilomycin A1 can potentially suppress CoNP-induced cytotoxicity and aseptic inflammation by inhibiting intracellular corrosion of CoNPs and that the reduction in Co ions released from CoNPs may play an important role in downregulating oxidative stress in RAW264.7 cells.

  14. Resection pseudoarthrosis for pelvic malignant tumors around acetabular%髋臼周围恶性肿瘤切除后股骨头旷置术的临床应用

    Institute of Scientific and Technical Information of China (English)

    杨正明; 陶惠民; 叶招明; 李伟栩; 杨迪生

    2011-01-01

    目的 探讨髋臼周围恶性肿瘤切除后股骨头旷置术的临床应用.方法 1997年5月至2005年6月共有25例切除后采用股骨头旷置术的髋臼周围恶性肿瘤患者得到随访,其中男性15例,女性10例;年龄16~75岁,平均42岁;骨肉瘤4例,软骨肉瘤12例,尤文肉瘤1例,原始神经外胚层瘤1例,骨髓瘤1例,恶性纤维组织细胞瘤1例,滑膜肉瘤2例,转移性肿瘤3例.根据Enneking骨盆肿瘤分区:肿瘤累及Ⅰ、Ⅱ区12例;Ⅰ、Ⅱ、Ⅲ区5例;Ⅱ、Ⅲ区4例;Ⅱ区2例;Ⅰ、Ⅱ、Ⅳ区2例.共有7例行新辅助化疗,5例行单纯术后辅助化疗,4例行术后放疗.髋臼周围切除后,采用股骨头旷置术,术后皮牵引6~8周,牵引质量2~3 kg.以后扶拐逐渐步行活动.结果 25例股骨头旷置术中6例出现手术后并发症(24.0%).随访时间3~10年,11例由于肺转移或远处转移并发肺转移死亡;2例带瘤生存;12例无瘤生存.术后5年及10年生存率分别为60%和54%.股骨头旷置术后肢体短缩在2.5~7.5 cm,平均5 cm.本组病例术后功能评价根据Enneking1993MSTS评分系统进行,平均术后功能评分是17分(12~19分).术后3个月后,患者基本能够正常坐,扶单拐跛行,能自主上下楼梯,去拐后也能跛行行走.结论 累及髋臼周围的恶性肿瘤,切除后股骨头旷置术是一种可选择的重建方式,能取得相对满意的临床效果.髋臼周围高度恶性肿瘤、软组织重建条件不佳、具有感染高危倾向者、经济条件不佳的患者,是股骨头旷置术的适应证.%Objective To discuss the resection pseudoarthrosis for pelvic malignant tumors around acetabular. Methods From May 1997 to June 2005, 25 patients with malignant tumors around acetabular were treated surgically with resection pseudoarthrosis. The series comprised 15 males and 10 females with an average age of 42 years old (range from 16 to 75 years old ) . There were 4 osteosareomas, 12chondrosarcomas, 1 Ewing's sarcoma, 1

  15. Data on the cost effective surface sterilization method for C.carandas (L.) seeds and callus induction from aseptic seedling.

    Science.gov (United States)

    Bhadane, Bhushan S; Patil, Ravindra H

    2016-06-01

    Surface sterilization of explant is an important and most sensitive step in plant tissue culture. Inappropriate concentrations of sterilants have lethal effect in cell division and it restricts growth and development of explant. Therefore, suitable concentration, combinations and duration of exposure of sterilant is essential to raise in vitro cultures successfully. This data demonstrates use of various sterilizing agents for aseptic plantlet germination from seed of Carissa carandas (Apocynaceae). The present dataset provides information in support of cost-effective explant sterilization potential of benzalkonium chloride containing commercial bleach (Lizol) and its comparison with traditionally used surface sterilants in plant tissue culture i.e. 0.1% HgCl2 alone and in combination with 70% alcohol. The data on callogenic response using MS medium supplemented with plant growth regulators is also shared.

  16. Data on the cost effective surface sterilization method for C.carandas (L. seeds and callus induction from aseptic seedling

    Directory of Open Access Journals (Sweden)

    Bhushan S. Bhadane

    2016-06-01

    Full Text Available Surface sterilization of explant is an important and most sensitive step in plant tissue culture. Inappropriate concentrations of sterilants have lethal effect in cell division and it restricts growth and development of explant. Therefore, suitable concentration, combinations and duration of exposure of sterilant is essential to raise in vitro cultures successfully. This data demonstrates use of various sterilizing agents for aseptic plantlet germination from seed of Carissa carandas (Apocynaceae. The present dataset provides information in support of cost-effective explant sterilization potential of benzalkonium chloride containing commercial bleach (Lizol and its comparison with traditionally used surface sterilants in plant tissue culture i.e. 0.1% HgCl2 alone and in combination with 70% alcohol. The data on callogenic response using MS medium supplemented with plant growth regulators is also shared.

  17. Metal is not inert: role of metal ions released by biocorrosion in aseptic loosening--current concepts.

    Science.gov (United States)

    Cadosch, Dieter; Chan, Erwin; Gautschi, Oliver P; Filgueira, Luis

    2009-12-15

    Metal implants are essential therapeutic tools for the treatment of bone fractures and joint replacements. The metals and metal alloys used in contemporary orthopedic and trauma surgery are well tolerated by the majority of patients. However, complications resulting from inflammatory and immune reactions to metal implants have been well documented. This review briefly discusses the different mechanisms of metal implant corrosion in the human body, which lead to the release of significant levels of metal ions into the peri-implant tissues and the systemic blood circulation. Additionally, this article reviews the effects of the released ions on bone metabolism and the immune system and discusses their involvement in the pathophysiological mechanisms of aseptic loosening and metal hypersensitivity in patients with metal implants.

  18. Ultrasound of Sternal Fracture

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    Shadi Lahham

    2015-12-01

    Full Text Available A 61-year-old female was brought in by ambulance after being the restrained driver of a head-on motor vehicle collision at 40MPH. There was positive airbag deployment and intrusion from the other vehicle. During workup, the patient complained of midline chest pain, and left chest wall pain. The patient was not in acute respiratory distress, and had the following vital signs: temperature 37°C, heart rate 84, blood pressure of 150/64, respiratory rate 18, and oxygen saturation of 97% on two liters of oxygen. On physical exam, breath sounds were heard bilaterally, with no acute cardiopulmonary issues identified. A bruise was identified on the lower abdomen, which was thought to be a potential seatbelt sign. A focused assessment with sonography for trauma was negative, and an ultrasound of additional chest and mediastinal structures was performed for the chest tenderness.

  19. Aseptic meningitis in a large MMR vaccine campaign (590,609 people in Curitiba, Paraná, Brazil, 1998

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    ARRUDA Walter Oleschko

    2001-01-01

    Full Text Available The aseptic meningitis after Measles-Mumps-Rubella vaccine (MMR is a well recognized complication, and different incidences have been observed in several studies. We retrospectively analyzed forty cases of aseptic meningitis, during a large public immunization campaign (1998 in Curitiba, Southern Brazil (590,609 people, admitted in our Service. The vaccine utilized was Leningrad-3-Zagreb mumps strain, Edmonston-Zagreb measles strain, and RA 27#3 rubella strain. In all county, a total number of 87 cases were reported, resulting in a incidence of 1.7 cases per 10,000 given doses . The mean age was 23.7 ± 12.8 years. The female:male ratio was 1.35:1. Severe headache with meningismus (92.5%, fever (87.5%, nausea/vomiting (82.5% were the most common clinical findings. Three cases (7.5% developed mild mumps. All patients underwent cerebrospinal fluid (CSF tap with the following findings: mononuclear pleocytosis from 100 to 500 cells/mm³ in 17 cases (42.5%; 257.5 ± 260.6 cells/mm³; increased protein 28 cases (67.5%; 92.1 ± 76.9 mg/dL; glucose was normal in all cases (56.8 ± 11.2 mg/dL except in 4 (10% cases, which presented less than 44 mg/dL. All serological tests (latex to bacterial meningitis, Cryptococcus, cysticercosis, VDRL and bacteriological cultures were negative. Virus identification were also negative in 8 samples. None of the patients had neurological deficits or related symptoms after one year of onset. We believe the benefit of vaccination clearly outweights the incidence of benign vaccine-associated meningitis.

  20. Plasmodium falciparum malaria challenge by the bite of aseptic Anopheles stephensi mosquitoes: results of a randomized infectivity trial.

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    Kirsten E Lyke

    Full Text Available BACKGROUND: Experimental infection of malaria-naïve volunteers by the bite of Plasmodium falciparum-infected mosquitoes is a preferred means to test the protective effect of malaria vaccines and drugs. The standard model relies on the bite of five infected mosquitoes to induce malaria. We examined the efficacy of malaria transmission using mosquitoes raised aseptically in compliance with current Good Manufacturing Practices (cGMPs. METHODS AND FINDINGS: Eighteen adults aged 18-40 years were randomized to receive 1, 3 or 5 bites of Anopheles stephensi mosquitoes infected with the chloroquine-sensitive NF54 strain of P. falciparum. Seventeen participants developed malaria; fourteen occurring on Day 11. The mean prepatent period was 10.9 days (9-12 days. The geometric mean parasitemia was 15.7 parasites/µL (range: 4-70 by microscopy. Polymerase chain reaction (PCR detected parasites 3.1 (range: 0-4 days prior to microscopy. The geometric mean sporozoite load was 16,753 sporozoites per infected mosquito (range: 1,000-57,500. A 1-bite participant withdrew from the study on Day 13 post-challenge and was PCR and smear negative. CONCLUSIONS: The use of aseptic, cGMP-compliant P. falciparum-infected mosquitoes is safe, is associated with a precise prepatent period compared to the standard model and appears more efficient than the standard approach, as it led to infection in 100% (6/6 of volunteers exposed to three mosquito bites and 83% (5/6 of volunteers exposed to one mosquito bite. TRIAL REGISTRATION: ClinicalTrials.gov NCT00744133.

  1. Strontium-doped calcium polyphosphate/ultrahigh molecular weight polyethylene composites: A new class of artificial joint components with enhanced biological efficacy to aseptic loosening

    Energy Technology Data Exchange (ETDEWEB)

    Gu, Zhipeng [College of Polymer Science and Engineering, Sichuan University, Chengdu 610065 (China); Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041 (China); Huang, Bingxue; Li, Yiwen [College of Polymer Science and Engineering, Sichuan University, Chengdu 610065 (China); Tian, Meng [Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041 (China); Li, Li [Department of Oncology, the 452 Hospital of Chinese PLA, Chengdu 610021 (China); Yu, Xixun, E-mail: yuxixun@163.com [College of Polymer Science and Engineering, Sichuan University, Chengdu 610065 (China)

    2016-04-01

    To enhance implant stability and prolong the service life of artificial joint component, a new approach was proposed to improve the wear resistance of artificial joint component and endow artificial joint component with the biological efficacy of resistance to aseptic loosening. Strontium calcium polyphosphate (SCPP) were interfused in ultrahigh molecular weight polyethylene (UHMWPE) by a combination of liquid nitrogen ball-milling and flat-panel curing process to prepare the SCPP/UHMWPE composites. The micro-structure, mechanical characterization, tribological characterization and bioactivities of various SCPP/UHMWPE composites were investigated. The results suggested that this method could statistically improve the wear resistance of UHMWPE resulting from a good SCPP particle dispersion. Moreover, it is also observed that the SCPP/UHMWPE composites-wear particles could promote the production of OPG by osteoblasts and decrease the production of RANKL by osteoblasts, and then increase the OPG/RANKL ratio. This indicated that the SCPP/UHMWPE composites had potential efficacy to prevent and treat aseptic loosening. Above all, the SCPP/UHMWPE composites with a suitable SCPP content would be the promising materials for fabricating artificial joint component with ability to resist aseptic loosening. - Highlights: • SCPP/UHMWPE composites could enhance biological efficacy of resistance to aseptic loosening. • SCPP would improve biological efficacy with a few sacrifice of wear resistance. • The results might provide a promising wear-resistant material for fabricating acetabular cup.

  2. Why does it take so long? ‘Lean processing’ in the aseptic compounding unit at the Midland Regional Hospital Tullamore

    LENUS (Irish Health Repository)

    Greene, C

    2011-06-01

    Increasing numbers of oncology\\/haematology patients attending Midland Regional Hospital Tullamore (MRHT) has increased the workload of the Regional Oncology Haematology Pharmacy (ROHP) compounding unit. Staff restrictions require optimisation of current workflow practices. This audit (November 2010 and June 2011) focused on workflow in the aseptic compounding unit.\\r\

  3. Characteristic of endocrine cells of rat small intestine after administration of cryopreserved placenta on the background of acute aseptic peritoneal inflammation

    Directory of Open Access Journals (Sweden)

    Shepitko K.V.

    2015-06-01

    Full Text Available Background. Modern conceptions about mechanisms of inflammation of the small intestine could not be formed without an understanding of intercellular relationships that are realized by biologically active signaling molecules produced by endocrine cells. Methods. The experimental study has been carried out on the small intestine extracted from 140 adult male rats. Electron and light microscopy methods were used. Acute aseptic inflammation was modeled by intraperitoneal carrageenan injection; influence of subcutaneously cryopreserved placenta injection was analyzed. Results. After modeling of the acute aseptic peritoneal inflammation the maximal increase of ECL-cells was noted on the 21st day. The slowest restoration of endocrine cells number occurred on all measured parameters and was observed on day 30th of the observation. In case of administration of cryopreserved placenta at the early stages (days 3rd – 7th the increase of average number of EC- and ECL-cells promoted the enhanced permeability of vessels in the lamina propria. The decrease in number of P-cells prevented the development of hyperacid gastritis. Reduction in the average number of D1- cells prevented the excessive vasodilatation and facilitated the excretion of excess fluid from the foci of inflammation. In simultaneous subcutaneous administration of cryopreserved placenta and modeling of acute aseptic peritoneal inflammation the number of ЕС- and ЕСL-cells increased, accelerating the vascular response to inflammation. Conclusion. Active appearance of low-differentiated cells including those with “shapes of mitosis” on the day 14th indicates restoration of structural components of the small intestine mucosa and processes of absorption and parietal digestion after placenta administration during acute aseptic inflammation. Citation: Shepitko KV. [Characteristic of endocrine cells of rat small intestine after administration of cryopreserved placenta on the background of

  4. [EVALUATION OF THE BACTERIOSTATIC EFFECT OF IMMOBILIZED ON COLLAGEN CARRIER ANTIBIOTICS AND SILVER IONS IN PROVISION OF THE ASEPTIC STATE OF THE TISSUE WOUNDS].

    Science.gov (United States)

    Storublevtsev, S A; Popov, V I; Antipova, L V; Stukalo, O G; Bolgova, S B

    2015-01-01

    In the treatment of tissue wounds practically all the time there is necessary the establishment of aseptic conditions in the area of the damaged tissue. In modern medical practice quite a while the use of materials on the basis of collagen aroused widespread. The aim of the study was an assessment the bacteriostatic properties both of collagenic substance with the antibiotics immobilized on it, and ions of silver also. The presence on a surface of collagen of a large number of active functional groups allow to use it as a matrix for an immobilization of various biologically active and medicinal agents. Authors performed an assessment of possibility of an immobilization of antibiotics on the collagenic carrier. The purpose of an immobilization was in the prolongation of the impact of an active component--Polymyxin-M or Gentamycin. Besides aseptic effect, availability of specific amino acids of collagen will promote the acceleration of the reparative processes in a wound. There were performed investigations on determination of bacteriostatic effect of immobilized on the protein carrier (collagen of hydrobionts) antibiotics, and silver ions also. Bacteriostatic effect was estimated by the disco--a diffusive method with use of E. coli as test culture. Results of the studies showed that the delivered preparation had bacteriostatic effect on the test culture. At that the area of a zone of a growth inhibition in case of the of use--Polymyxin was 1.3 time more than, than in case of the use of a preparation of Gentamycin. The obtained collagenic substances of an origin with the immobilized bacteriostatic components and ions of silver have considerable prospects and real opportunity in the delivery of aseptic preparations of a domestic production. Taking into account the available data in further there is planned the development of aseptic preparations with the occluded biologically active agents and nanoparticles of metals for providing an aseptics and acceleration the

  5. Interleukin-6 in serum and in synovial fluid enhances the differentiation between periprosthetic joint infection and aseptic loosening.

    Directory of Open Access Journals (Sweden)

    Thomas M Randau

    Full Text Available The preoperative differentiation between septic and aseptic loosening after total hip or knee arthroplasty is essential for successful therapy and relies in part on biomarkers. The objective of this study was to assess synovial and serum levels of inflammatory proteins as diagnostic tool for periprosthetic joint infection and compare their accuracy with standard tests. 120 patients presenting with a painful knee or hip endoprosthesis for surgical revision were included in this prospective trial. Blood samples and samples of intraoperatively acquired joint fluid aspirate were collected. White blood cell count, C-reactive protein, procalcitonin and interleukin-6 were determined. The joint aspirate was analyzed for total leukocyte count and IL-6. The definite diagnosis of PJI was determined on the basis of purulent synovial fluid, histopathology and microbiology. IL-6 in serum showed significantly higher values in the PJI group as compared to aseptic loosening and control, with specificity at 58.3% and a sensitivity of 79.5% at a cut-off value of 2.6 pg/ml. With a cut-off >6.6 pg/ml, the specificity increased to 88.3%. IL-6 in joint aspirate had, at a cut-off of >2100 pg/ml, a specificity of 85.7% and sensitivity of 59.4%. At levels >9000 pg/ml, specificity was almost at 100% with sensitivity just below 50%, so PJI could be considered proven with IL-6 levels above this threshold. Our data supports the published results on IL-6 as a biomarker in PJI. In our large prospective cohort of revision arthroplasty patients, the use of IL-6 in synovial fluid appears to be a more accurate marker than either the white blood cell count or the C-reactive protein level in serum for the detection of periprosthetic joint infection. On the basis of the results we recommend the use of the synovial fluid biomarker IL-6 for the diagnosis of periprosthetic joint infection following total hip and knee arthroplasty.

  6. 人工关节假体植入后无菌性松动的发病机制%Pathogenesis of aseptic prosthesis loosening after artificial prosthesis implantation

    Institute of Scientific and Technical Information of China (English)

    马玉超; 田京

    2012-01-01

    BACKGROUND: There are many clinical researches on aseptic loosening of artificial prosthesis, but the exact pathogenesis is still unclear.OBJECTIVE: To review the pathogenesis of prosthesis aseptic loosening after artificial prosthesis implantation.METHODS: A computer-based online search of PubMed and CNKI was performed to search related articles published between 2006 and 2011 with the key words of “artificial prosthesis, aseptic loosening” both in English and Chinese. A total of 77 articles were obtained, and finally 38 articles were included.RESULTS AND CONCLUSION: Aseptic loosening after long-term total hip replacement is one of the main failure reasons. In the recent years, analysis of revision total hip replacement for failed hip arthroplasty showed that aseptic loosening is the chief reason. The mechanism of aseptic loosening mainly includes mechanical mechanisms, biological and other mechanisms. With further research and the improvement of implantation method and prosthetic materials, aseptic loosening will eventually be minimized, so that the service life of prosthesis will be longer.%背景:对于人工关节无菌性松动的基础和临床研究很多,但其确切机制仍不甚明确.目的:综述人工关节假体植入后无菌性松动的发病机制.方法:由第一作者应用计算机检索PubMed和中国期刊全文数据库2006/2011相关文献.在标题、摘要、关键词中以"artificial prosthesis,aseptic loosening"或"人工关节、无菌性松动"为检索词进行检索.共检索到77篇文献,最终纳入符合标准的文献38篇.结果与结论:无菌性松动已成为人工关节置换后远期失败的主要原因之一.近年来对人工全髋关节置换后翻修病例回顾性分析的统计显示,无菌性松动位于翻修原因第1位.关于人工关节无菌性松动的机制主要分为机械机制、生物机制及其他机制,它们的共同结果是造成骨吸收、骨溶解,最终导致假体松动.随着研究

  7. Pyrolysis of aseptic packages (tetrapak) in a laboratory screw type reactor and secondary thermal/catalytic tar decomposition.

    Science.gov (United States)

    Haydary, J; Susa, D; Dudáš, J

    2013-05-01

    Pyrolysis of aseptic packages (tetrapak cartons) in a laboratory apparatus using a flow screw type reactor and a secondary catalytic reactor for tar cracking was studied. The pyrolysis experiments were realized at temperatures ranging from 650 °C to 850 °C aimed at maximizing of the amount of the gas product and reducing its tar content. Distribution of tetrapak into the product yields at different conditions was obtained. The presence of H2, CO, CH4, CO2 and light hydrocarbons, HCx, in the gas product was observed. The Aluminum foil was easily separated from the solid product. The rest part of char was characterized by proximate and elemental analysis and calorimetric measurements. The total organic carbon in the tar product was estimated by elemental analysis of tars. Two types of catalysts (dolomite and red clay marked AFRC) were used for catalytic thermal tar decomposition. Three series of experiments (without catalyst in a secondary cracking reactor, with dolomite and with AFRC) at temperatures of 650, 700, 750, 800 and 850 °C were carried out. Both types of catalysts have significantly affected the content of tars and other components in pyrolytic gases. The effect of catalyst on the tetrapack distribution into the product yield on the composition of gas and on the total organic carbon in the tar product is presented in this work.

  8. [Bacteriological control of blood preservation, production of infusion solutions and dry human plasma under conditions of aseptic work and possible sources of their contamination].

    Science.gov (United States)

    Bosković, S; Lucić, N; Aganović, N; Grbić, E

    1975-01-01

    In premises for blood conservation, production of dry human plasma and infusion solutions "notwithstanding the permanent measures for desinfection, new bacterial contamination occurs from time to time and whose source are the casings and material originating from non-sterile environment. Bacteriological control, which has primarily a preventive character, enables a due forecast for measures to be undertaken by the appropriate desinfection of the working surfaces and air, satisfactory conditions of aseptic work can be maintained. General hygiene should be paid attention to as well as mechanical cleansing of premises, avoidance of groups for lunch-time etc., since the treatment by desinfectors would not be sufficient for maintenance of aseptic working conditions. In order to prevent the transmission of bacterial contamination, premises for blood conservation should be strictly separated from other operations and also prevent the unnecessary movements of personnel through corridors. The results of the bacteriological control of the personnel show that greater attention should be paid to their health care since the workers there work in closed aseptic systems and thus avoid them as a bacteria transmittors in respect to danger of blood and dry human plasma contamination. It is also necessary to efficiently educate the personnel for work in aseptic conditions and also increase their elementary knowledge from bacteriology and hygiene. The bacterial skin-flora on the spot of donor's venepuncture also presents a certain danger for blood contamination. Therefore, it is necessary to establish the most optimal manner of skin desinfecate together with the most appropriate means having a fast bactericidal and fungicidal action. It would also be useful, on the basis of further test, to suggest certain standard for an allowed number of conditionally pathogenic and saprophytic microorganisms which would be used by the instutions performing the blood transfusion and production of

  9. Strontium-doped calcium polyphosphate/ultrahigh molecular weight polyethylene composites: A new class of artificial joint components with enhanced biological efficacy to aseptic loosening.

    Science.gov (United States)

    Gu, Zhipeng; Huang, Bingxue; Li, Yiwen; Tian, Meng; Li, Li; Yu, Xixun

    2016-04-01

    To enhance implant stability and prolong the service life of artificial joint component, a new approach was proposed to improve the wear resistance of artificial joint component and endow artificial joint component with the biological efficacy of resistance to aseptic loosening. Strontium calcium polyphosphate (SCPP) were interfused in ultrahigh molecular weight polyethylene (UHMWPE) by a combination of liquid nitrogen ball-milling and flat-panel curing process to prepare the SCPP/UHMWPE composites. The micro-structure, mechanical characterization, tribological characterization and bioactivities of various SCPP/UHMWPE composites were investigated. The results suggested that this method could statistically improve the wear resistance of UHMWPE resulting from a good SCPP particle dispersion. Moreover, it is also observed that the SCPP/UHMWPE composites-wear particles could promote the production of OPG by osteoblasts and decrease the production of RANKL by osteoblasts, and then increase the OPG/RANKL ratio. This indicated that the SCPP/UHMWPE composites had potential efficacy to prevent and treat aseptic loosening. Above all, the SCPP/UHMWPE composites with a suitable SCPP content would be the promising materials for fabricating artificial joint component with ability to resist aseptic loosening.

  10. Pseudoartrosis maxilar superior post-cirugía ortognática: A propósito de un caso clínico Post surgical orthognathic of upper maxilla pseudoarthrosis: Proposed clinical study

    Directory of Open Access Journals (Sweden)

    I. Zubillaga Rodríguez

    2009-06-01

    number of available treatments but also, when incorrectly applied, the types of complications arising. Material and methods. We present a new case report of upper jaw pseudoarthrosis after a convencional treatment of orthognatic surgery ( osteotomy type LeFort I. Discussion. Pseudarthrosis-nonunion can result after incorrect treatment of facial fractures with titanium miniplatesscrews. When we review the publishing literature, we find that the correct treatment of this potential pitfalls has not changed significantly during last years. The aim is the mechanical immobility of the created fracture. Sometimes we must harvest cancellous bone graft to complete the treatment. We discuss the different terms related to anomalies in the ossification. Conclusions. Inadequate stabilization of fractures by either conservative or operative methods often leads to infection, pseudoarthrosis or both. To promote healing of both infections and pseudarthrosis, absolutely stable fixation of the fragments is necessary. Depending on the defect zones that may develop, the osteosynthesis or reosteosynthesis that is usually necessary must be accompanied by a graft of autogenous cancellous bone.

  11. The role of Card9 overexpression in peripheral blood mononuclear cells from patients with aseptic acute pancreatitis.

    Science.gov (United States)

    Yang, Zhi-wen; Weng, Cheng-zhao; Wang, Jing; Xu, Ping

    2016-03-01

    Activated mononuclear cells are an early event in the course of severe acute pancreatitis (SAP). To date, the molecular mechanism triggering peripheral blood mononuclear cells (PBMCs) is poorly understood. The aim of this paper was to determine the potential role of Card9 in SAP. We collected data from 72 subjects between January 2013 and June 2014. Subsequently, PBMCs were isolated on day 1, 3 and 5 of pancreatitis. Immunofluorescence staining, quantitative real-time PCR, Western blotting, immunoprecipitation and ELISA were used to determine the role of Card9 in SAP. Microbial culture showed that SAP patients at the early period did not develop any bacteria and fungi infection. Card9 expression in SAP patients was higher than that in mild acute pancreatitis and volunteer healthy controls, up to the peak on day 1. The monocyte-derived cytokines interleukin (IL)-17, IL-1β, IL-6 and tumour necrosis factor-α mediated by the induction of Card9 markedly increased in SAP patients compared with the control group. Furthermore, the inducible formation of Card9-Bcl10 complex was found in PBMCs, which may be involved in nuclear factor kappa B (NF-κB) and p38 activation in SAP. Receiver operating characteristic curve indicated that Card9 levels had a high sensitivity of 87.5% and specificity of 67.7%, showing the close correlation with SAP patients. Card9 overexpression was firstly found in aseptic SAP, which may be played an important role in NF-κB and p38 activation in PBMCs. It also provided the new insights into therapeutic interventions by targeting monocytes activation in SAP patients.

  12. Progress of Aseptic Purification Technique of Cyanobacteria%蓝藻无菌化方法研究进展

    Institute of Scientific and Technical Information of China (English)

    李天丽; 郑凌凌; 张琪; 宋立荣

    2015-01-01

    随着微藻产业的蓬勃发展,蓝藻作为具有重要经济价值的资源受到人们越来越多的关注,其多糖和蛋白的开发已被应用于多个领域。为了更深入清晰地挖掘蓝藻的特性和功能,研究者首先需获得无菌的纯种藻株,这是深入开展蓝藻生理生化、遗传和毒性等研究的基础。重点综述了如何根据蓝藻的结构及生理特性选择合适的无菌化方法,介绍了基于蓝藻与污染菌之间差异性的无菌化方法,以期为蓝藻的无菌化工作提供参考。%With the vigorous development of the microalgae industry, people are paying much more attention to cyanobacteria according to its important economic value, as its polysaccharide and protein are applied in many fields.In order to excavate the characteristics and function of cyanobacteria more in-depth and clearly, it is necessary to obtain axenic cultures of cyanobacteria, which is also regarded as the foundation for the further research on physiological, biochemical, genetic and taxonomic characteristics of cyanobacteria.This paper mainly reviewed the chosen of appropriate aseptic purification methods based on their structures and physiological characteristics.Furthermore, the methods based on the differences between cyanobacteria and contaminated bacteria were introduced.The paper was expected to provide useful information for the works on purification of cyanobacteria.

  13. On the absence of sternal elements in Anchiornis (Paraves) and Sapeornis (Aves) and the complex early evolution of the avian sternum.

    Science.gov (United States)

    Zheng, Xiaoting; O'Connor, Jingmai; Wang, Xiaoli; Wang, Min; Zhang, Xiaomei; Zhou, Zhonghe

    2014-09-23

    Anchiornis (Deinonychosauria: Troodontidae), the earliest known feathered dinosaur, and Sapeornis (Aves: Pygostylia), one of the basalmost Cretaceous birds, are both known from hundreds of specimens, although remarkably not one specimen preserves any sternal ossifications. We use histological analysis to confirm the absence of this element in adult specimens. Furthermore, the excellent preservation of soft-tissue structures in some specimens suggests that no chondrified sternum was present. Archaeopteryx, the oldest and most basal known bird, is known from only 10 specimens and the presence of a sternum is controversial; a chondrified sternum is widely considered to have been present. However, data from Anchiornis and Sapeornis suggest that a sternum may also have been completely absent in this important taxon, suggesting that the absence of a sternum could represent the plesiomorphic avian condition. Our discovery reveals an unexpected level of complexity in the early evolution of the avian sternum; the large amount of observable homoplasy is probably a direct result of the high degree of inherent developmental plasticity of the sternum compared with observations in other skeletal elements.

  14. Syphilitic aseptic meningitis

    Science.gov (United States)

    Meningitis - syphilitic; Neurosyphilis - syphilitic meningitis ... Syphilitic meningitis is a form of neurosyphilis . This condition is a life-threatening complication of syphilis infection. Syphilis is ...

  15. Added value of experts' knowledge to improve a quantitative microbial exposure assessment model--Application to aseptic-UHT food products.

    Science.gov (United States)

    Pujol, Laure; Johnson, Nicholas Brian; Magras, Catherine; Albert, Isabelle; Membré, Jeanne-Marie

    2015-10-15

    In a previous study, a quantitative microbial exposure assessment (QMEA) model applied to an aseptic-UHT food process was developed [Pujol, L., Albert, I., Magras, C., Johnson, N. B., Membré, J. M. Probabilistic exposure assessment model to estimate aseptic UHT product failure rate. 2015 International Journal of Food Microbiology. 192, 124-141]. It quantified Sterility Failure Rate (SFR) associated with Bacillus cereus and Geobacillus stearothermophilus per process module (nine modules in total from raw material reception to end-product storage). Previously, the probabilistic model inputs were set by experts (using knowledge and in-house data). However, only the variability dimension was taken into account. The model was then improved using expert elicitation knowledge in two ways. First, the model was refined by adding the uncertainty dimension to the probabilistic inputs, enabling to set a second order Monte Carlo analysis. The eight following inputs, and their impact on SFR, are presented in detail in this present study: D-value for each bacteria of interest (B. cereus and G. stearothermophilus) associated with the inactivation model for the UHT treatment step, i.e., two inputs; log reduction (decimal reduction) number associated with the inactivation model for the packaging sterilization step for each bacterium and each part of the packaging (product container and sealing component), i.e., four inputs; and bacterial spore air load of the aseptic tank and the filler cabinet rooms, i.e., two inputs. Second, the model was improved by leveraging expert knowledge to develop further the existing model. The proportion of bacteria in the product which settled on surface of pipes (between the UHT treatment and the aseptic tank on one hand, and between the aseptic tank and the filler cabinet on the other hand) leading to a possible biofilm formation for each bacterium, was better characterized. It was modeled as a function of the hygienic design level of the aseptic

  16. BIOTECHNOLOGICAL APPROACHES FOR CONSERVATION OF THE ENDANGERED SPECIES Crambe koktebelica (JUNGE N. BUSCH AND EFFECT OF ASEPTIC IN VITRO CULTIVATION ON ITS BIOCHEMICAL PROPERTIES

    Directory of Open Access Journals (Sweden)

    Pushkarova

    2016-08-01

    Full Text Available The aim of the study was to establish efficient protocols of seed surface sterilization with further multiplication in vitro for threatened species Crambe koktebelica (Junge N. Busch and to show the effect of biotechnological approach (in vitro cultivation of biodiversity conservation on plants biochemical properties. Seed surface sterilization was carried out according to the original method with further microclonal multiplication of aseptic sprouts from lateral buds on the Murashige and Skoog (MS medium supplemented with different concentrations of growth regulators. Fatty acid content was determined using Gas chromatography-mass spectrophotometry of fatty acid ethers. Antioxidant activity was determined using 2.2-diphenyl-1-picrylhydrazyl radical scavenging method. Total soluble protein content was measured using Bradford method and polyfructan content determination was based upon ketosugars ability to color in the acidic environment with resorcinol. Plants that were grown under in vitro and in vivo conditions and seeds were used in this research. Efficient protocol of surface sterilization that resulted in 45% of aseptic seed material 50% of which has sprouted was elaborated for C. koktebelica as well as fast microclonal multiplication methods that provided with up to 5.25 ± 0.50 new formed plantlets from 1 lateral bud (on the MS medium that contained 1 mg/L of 6-benzylaminopurine. It was also shown that aseptic cultivation benefits to saturated fatty acid accumulation and increases protein content but on the other hand it reduces unsaturated fatty acid amount and polyfructan content as well as antioxidant activity of plant material. Obtained data confirms the prospect of biotechnology approach to biodiversity conservation and suggest the necessity of father in vitro cultivation effect on biochemical composition of plant study.

  17. An experimental animal model of aseptic loosening of hip prostheses in sheep to study early biochemical changes at the interface membrane

    Directory of Open Access Journals (Sweden)

    Akens Margarete K

    2004-03-01

    Full Text Available Abstract Background Aseptic loosening of hip prosthesis as it occurs in clinical cases in human patients was attributed to wear particles of the implants, the response of the tissue dominated by macrophages and the production of inflammatory mediators and matrix degrading enzymes; however, the cascade of events initiating the process and their interaction regarding the time course is still open and discussed controversially. Therefore, the goal of this study was to establish an experimental animal model in sheep allowing to follow the cascade of early mechanical and biochemical events within the interface membrane and study the sequence of how they contribute to the pathological bone resorption necessary for aseptic loosening of the implant. Methods A cemented modular system (Biomedtrix was used as a hip replacement in 24 adult Swiss Alpine sheep, with one group receiving a complete cement mantle as controls (n = 12, and the other group a cement mantle with a standardized, lateral, primary defect in the cement mantle (n = 12. Animals were followed over time for 2 and 8.5 months (n = 6 each. After sacrifice, samples from the interface membranes were harvested from five different regions of the femur and joint capsule. Explant cell cultures were performed and supernatant of cultures were tested and assayed for nitric oxide, prostaglandin E2, caseinolytic and collagenolytic activity. RNA extraction and quantification were performed for inducible nitric oxide synthase, cyclooxygenase-2, interleukin 1, and interleukin 6. Overall differences between groups and time periods and interactions thereof were calculated using a factorial analysis of variance (ANOVA. Results The development of an interface membrane was noticed in both groups at both time points. However, in the controls the interface membrane regressed in thickness and biological activity, while both variables increased in the experimental group with the primary cement mantle defect over time

  18. Idiopathic Facial Aseptic Granuloma in a 13-Year-Old Boy Dramatically Improved with Oral Doxycycline and Topical Metronidazole: Evidence for a Link with Childhood Rosacea

    Directory of Open Access Journals (Sweden)

    Camille Orion

    2016-07-01

    Full Text Available Idiopathic facial aseptic granuloma (IFAG is a rare, benign pediatric dermatological lesion that occurs in children between 8 months and 13 years of age. The pathogenesis of IFAG is still unclear but it is likely to be associated with granulomatous rosacea in childhood. Here we describe a case of IFAG in a 13-year-old boy who showed a dramatic response to oral doxycycline and topical metronidazole, which supports the hypothesis that IFAG may belong to the spectrum of rosacea.

  19. Molecular detection and genotyping of enteroviruses from CSF samples of patients with suspected sepsis-like illness and/or aseptic meningitis from 2012 to 2015 in West Bank, Palestine

    Science.gov (United States)

    Dumaidi, Kamal; Al-Jawabreh, Amer

    2017-01-01

    Background Human enteroviruses (HEVs) are the most frequently reported cause of aseptic meningitis with or without CSF pleocytosis in childhood. Rapid detection and genotype of HEVs is essential to determine the causative agent and variant causing sepsis-like illness and/or aseptic meningitis. Aim To investigate the molecular epidemiology of enteroviruses (EVs) among patients with sepsis-like illness and/or aseptic meningitis admitted to three major hospitals in West Bank, Palestine from 2012 to 2015. Methods During the study period, 356 CSF samples were collected from patients with sepsis-like illness and/or aseptic meningitis. Two RT-nested PCR assays targeting a partial part of 5'UTR for direct diagnosis and the VP1 region for genotyping by sequence analysis of the viral genome were used. Results HEV RNA was detected in 66 of 356 (18.5%) of CSF samples. Age distribution showed that 64% (42/66) were infants (sepsis-like illness and/or aseptic meningitis. In addition, the molecular method utilized for direct diagnosis and genotyping of HEV from CSF revealed that more than one HEV type circulated in the West Bank, Palestine during the study period. PMID:28225788

  20. Comparison of nuring of thoracoscopic and median sternal incision cononary artery bypass graft operation%胸腔镜与正中开胸冠状动脉搭桥术后的护理比较

    Institute of Scientific and Technical Information of China (English)

    汤红莲; 苏冰莲; 徐建婷

    2010-01-01

    Objective To compare nuring of thoracoscopic and median sternal incision cononary artery bypass graft (CABG) .To investigate the peculiarity of nuring after thoracoscopic CABG.Methods From April 2005 to November 2008 , 57 cases of thoracoscopic CABG and 65 cases of median sternal incision CABG were performed in our hospital.The nuring after both type of operations, including monitoring of hemodynamics, ward of circulatory and respiratory system, using of vasoactive drugs, drainage blood volume and pain were analyzed and campared.Results The patients underwent thoracoscopic CABG had more stable circulatory and respiratory system, less using of vasoactive drugs, earlier time of extubation, eating, movement and recovery, a little more pulmonary complications than the patients underwent median sternal incision CABG.Conclusions The nuring of thoracoscopic CABG is easier, less amount of work and more efficient than those of median sternal incision CABG.The patients of thoracoscopic CABG have less trauma and pain, recover more quickly and cound leave ICU earilier.%目的 比较胸腔镜冠状动脉搭桥与正中开胸冠状动脉搭桥的术后护理方法,探讨术后护理的特点和措施.方法 分析胸腔镜下冠状动脉搭桥患者57例与常规正中开胸冠状动脉搭桥缺损65例患者术后血流动力学监测、循环与呼吸系统的监护、血管活药物的应用、引流血量及术后疼痛护理等方面情况.结果 胸腔镜下冠状动脉搭桥较正中开胸手术患者呼吸系统、循环系统相对稳定,而且术后用药少、拔管早、进食早、活动早、恢复快、但肺部并发症稍多.结论 胸腔镜下冠状动脉搭桥较正中开胸护理相对简单,减少了工作量少,提高了护理工作效率,且患者术后创伤小,疼痛轻,恢复快,住IcU时间明显缩短.

  1. 无菌药品生产车间灭菌系统设计探讨%A Discussion of Sterilization Systems in Production Plants for Aseptic Pharmaceuticals

    Institute of Scientific and Technical Information of China (English)

    李颖

    2012-01-01

    灭菌是无菌药品生产的关键环节,根据《药品生产质量管理规范》(2010年修订)的要求,结合本人的设计实例,对无菌药品生产车间灭菌系统的设计做简单的探讨和归纳。阐述了干热灭菌、湿热灭菌、过滤除菌三种方法的工作原理及影响灭菌效果的主要因素,并对灭菌设备的选用情况作简要说明。%Sterilization was a critical unit operation in production of aseptic pharmaceuticals. Complying with the re- quirements by cGMP (2010 Version) and integrating design examples, a brief discussion and induction on the design of the sterilization systems in production plants for aseptic pharmaceuticals were presented. The operating principle and fac- tors reducing sterilization efficiency of 3 methods including dry -heat sterilization, moist -heat sterilization, and filtration sterilization were summed up, and the sterilization equipment selection was discribed briefly.

  2. The rehabilitation treatment of children after operation of aseptic necrosis of head of femur%小儿股骨头无菌性坏死术后康复治疗

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Background: Aseptic necrosis of head of femur of children is a kind of ischemic necrosis of the center of epiphysis of femoral head. Currently we treat it with synovectomy, transplantation of vessel tract, intertrochanteric osteotomy and every kinds of pelvic truncation to improve head-mortar relation, but the effect is not satisfying. After head of femur conversion and self-ilium transplantation operation, the follow-up effect is satisfying. Objective: Discussing the treatment effect of operation on children aseptic necrosis of head of femur. Unit:Second People's Hospital of Ningxia Municipality.

  3. Cell lineage analysis of the mandibular segment of the amphipod Orchestia cavimana reveals that the crustacean paragnaths are sternal outgrowths and not limbs

    Directory of Open Access Journals (Sweden)

    Scholtz Gerhard

    2006-12-01

    Full Text Available Abstract The question of arthropod head segmentation has become one of the central issues in Evolutionary Developmental Biology. The number of theories pertaining to head segments progressively enlarges, old concepts have been revitalized, and nearly every conceivable composition of the arthropod head has at some point received discussion. One contentious issue involves a characteristic mouthpart in crustaceans – the lower lips or the so-called paragnaths. The paragnaths build the posterior border of the mouth region antagonistic to the upper lip – the labrum. We show here the development of the appendage-like structures in the mandibular region of the amphipod crustacean Orchestia cavimana at a high level of cellular resolution. The embryos are examined during development of the mouthparts using in vivo labeling. An invariant cell division pattern of the mandibular segment was detected by 4D-microscopy and a preliminary model for pattern of the first cleavages in the mandibular region created. With this indispensable precondition single ectodermal cells of the grid-like pattern were labeled with DiI – a lipophilic fluorescent dye – to trace cell lineages and determine the clonal composition of the developing mouthparts, especially the mandibular segment. From our data it is evident that the paragnaths are sternal outgrowths of the mandible segment. The assumption of the limb nature of paragnaths and the presence of an additional head segment between the mandibular and the second antennal segments are clearly refuted by our data. Our results show the power of cell lineage and clonal analyses for inferences on the nature, origin and thus homology of morphological structures. With this kind of investigation morphological and gene expression data can be complemented. We discuss notable similarities of paragnath anlagen to those of the hypopharynx complex in myriapods and hexapods. The fact that both structures grow out as two lateral buds

  4. 心脏外科术后纵膈感染的临床特点%The Clinical Chaar cteristic of Mediastinitis Relve ant to Cardiac Surgery Prco edures via Median Sternal Incisoi n

    Institute of Scientific and Technical Information of China (English)

    卫向阳; 宋志斌; 孙英民

    2014-01-01

    目的:总结经胸骨正中切口行心脏手术后发生纵隔感染的诊治经验。方法:对2005年9月~2012年10月,我科47例胸骨正中切口心脏术后纵隔感染病人的临床表现,诊断方法,鉴别诊断,治疗手段,及预后进行回顾分析,10例行胸骨固定,纵膈冲洗,其中2例行胸大肌肌瓣填充修补,37例局部切开引流换药,47例患者发热6例,无发热41例,患者中毒症状6例,无中毒症状者41例,47例患者均有切口渗出和胸骨不稳定,切口分泌物培养18例阳性,其中MRSA 2例,根据药物敏感试验结果调整抗生素。结果:死亡6例,死亡率12%,见于中毒症状者和MRSA感染者。余患者均存活。随访1~5年,无远期死亡,感染复发3例。结论:胸骨正中切口行心脏手术后,纵膈感染是一种危及生命的严重并发症,早期清创、开放引流冲洗是有效的治疗方法。严重感染者预后极差。%Objective:To summarize the experience of diagnosis and treatment of mediastinitis relevant to cardiac surgery procedures via median sternal incision .Method s:From September 2005 to October 2012, mediastinitis developed in 47 ( 2.8%) of 1645 consecu-tive cardiac surgery procedures via median sternal incision .We reviewed the variation of clinical characteristics、diagnostic approach 、dif-ferential diagnosis、treatment approch and the prognosis in these patients .10 patients underwent extensive sternal and soft tissue debride-ment and dosed mediastinal irrigation with antiseptic solution and drainage through tubes .Two of them were given plastics procedures using rectus abdominus flaps or pectoralis major muscle flaps ,Only local drainage and irrigation with antiseptic solution were given in 37 be-cause of the mild infection .6 patients of 47 patients had a fever , the others had no fever , All of 47 patients had incision exudation and sternum unstability ,Samples of sternal drainage and

  5. Optimization of Culture Conditions for Aseptic Sweet Pepper Seedling%甜椒无菌苗培养条件的优化

    Institute of Scientific and Technical Information of China (English)

    李妹芳; 苗纪忠; 卜祥勇; 刘学芳; 夏江华; 郭尚敬

    2014-01-01

    以茄门甜椒种子为试材,对无菌苗培养前的种子消毒剂种类及不同消毒时间、浓度等的消毒效果进行了比较研究;对影响无菌苗生长的培养基配方、pH值及生长时间等因素进行了探讨。结果表明,甜椒无菌苗的最佳消毒流程和生长条件为:55℃无菌水浸种15 min,室温静置4~5 h,用10%NaClO消毒30 min,无菌水冲洗3次,接种至1/2MS培养基+15 g/L蔗糖+7.5 g/L琼脂,pH值为5.8,(25±1)℃,子叶长出6~10 d左右,即可作为转基因用无菌苗。%Using Qiemen sweet pepper as materials , the disinfection effects of different disinfectant a-gents, disinfection times and contents on seeds before culture were compared , and the effects of medium for-mula, pH value and growth time on growth of aseptic seedling were investigated .The results showed that the optimum disinfection method and culture conditions for aseptic sweet pepper seedling were soaking seeds in a -septic water of 55℃for 15 minutes, then staying at room temperature for 4~5 hours, disinfecting with 10%NaClO for 30 minutes, washing 3 times with aseptic water and then culturing in medium of 1/2MS+15 g/L sugar+7.5 g/L agar with pH value of 5.8 under (25 ±1)℃.When the cotyledon sprouted for 6~10 days, the seedlings could be used for genetic transformation .

  6. Treatment of Congenital Pseudoarthrosis of Tibia——A Report of 8 Cases%先天性胫骨假关节治疗方法的研讨(附带血管腓骨移植八例报告)

    Institute of Scientific and Technical Information of China (English)

    吴晋普; 韩西成; 张正之

    1986-01-01

    Eight children, 5 males and 3 females, aged between 2 to 13, with congenital pseud-oarthrosis of tibia "were treated in our hospital. In 6 cases, pseudoarthrosis occured on the left and in 2 on the right. Vascular pedicle grafting of fibula was performed oa 6 cases, simple resection of a neurofibroma on one pat-ient, and the 8th received a conservative tre-atment. Follow-ups by 4 to 8 yrs., satisfactory results were found in all cases.This disease cannot be treated indiscrimi-nately by any one therapy. Conservative treatment should be chosen for infants who are still too young to be operated oa. Added PEMF therapy is recommended. Pedicle graft of fibula is suitable for older children while other treatments are considered improper. Am-putation should be handled more carefully.When pedicle graft of fibula is performed, postoperative complications and the sequela of the excision of the fibula should be avoided.%@@ 先天性胫骨假关节是一种少见的畸形,治疗较困难.自1709年Hatzoecher描述本病以来,虽然经历了各种各样的治疗方法,但治疗效果至今不能令人满意.我院於1978年开始采用了目前最流行的手术方法一游离腓骨带血管的骨移植术(1).但成功率也是有限的.

  7. Correlation between the findings of magnetic resonance imaging and prognosis of patients with predisposing factors of aseptic necrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Takatori, Yoshio; Nakamura, Shigeru; Nakamura, Toshitaka; Ninomiya, Setsuo; Kokubo, Takashi (Tokyo Univ. (Japan). Faculty of Medicine); Sugimoto, Hisayuki

    1991-08-01

    Eighteen patients with the predisposing factors for aseptic necrosis of the femoral head were followed up for more than two years after the initial magnetic resonance (MR) imaging. At the time of the initial examination, 24 femoral heads showed abnormal low-intensity areas on MR images without abnormal findings on plain radiographs. Among them, six femoral heads collapsed in the follow-up period. The initial mid-coronal T{sub 1}-weighted MR images of these femoral heads had shown characteristic findings, that is, band-shaped low-intensity areas with the lateral end not covered by the acetabulum. Subchondral fracture of the femoral head occurred in the vicinity of the lateral end of the band. The findings of initial MR imaging seem to predict subsequent collapse of the femoral head. (author).

  8. Efficacy and safety of the use of platelet-rich plasma for sternal wound infections: a meta-analysis%富血小板血浆预防胸骨感染效果的Meta分析

    Institute of Scientific and Technical Information of China (English)

    孙斌; 冯子阳; 徐芳芳; 臧艳; 花美仙; 钱宝华

    2015-01-01

    目的 评估富血小板血浆(platelet-rich plasma,PRP)预防胸骨感染(sternal wound infection,SWI)的安全性与有效性.方法 计算机检索PubMed,EMbase,The Cochrane Library以及中国生物医学文献数据库(CBM)中胸心外科手术患者局部应用PRP预防感染的相关研究,并辅以文献追溯法查找相关文献.检索时限均从建库至2014年8月.由2名评价者按纳入与排除标准独立选择文献、提取资料并评价质量后,采用Stata12.0软件进行Meta分析.结果 最终纳入5个研究,共5 613名患者.Meta分析结果显示:与对照组相比,PRP组发生SWI和胸骨浅表切口感染(superficial sternal wound infection,SSWI)的风险分别下降了74%(RR =0.26;95%CI,0.08-0.88;P<0.05)和76%(RR=0.24;95% CI,0.10-0.61;P<0.05),差别有统计学意义;而PRP组胸骨深部切口感染(deep sternal wound infection,DSWI),二次手术以及死亡的风险与对照组的差别无统计学意义.结论 局部应用自体PRP可以降低胸心外科手术患者SWI和SSWI的风险,其确切机制以及其他临床应用有待进一步研究.

  9. APPLICATION OF TITANIUM PLATE AND Teflon PATCH IN CHEST WALL RECONSTRUCTION AFTER STERNAL TUMOR RESECTION%钛板联合Teflon补片重建胸骨肿瘤切除后胸廓

    Institute of Scientific and Technical Information of China (English)

    吴显宁; 陈名久; 喻风雷

    2011-01-01

    Objective To study the reconstruction method and effectiveness of titanium plate and Teflon patch for the chest wall after resection of sternal tumors. Methods Between October 2006 and November 2009, 4 patients with sternal tumors were treated and the thoracic cages were reconstructed. There were 2 males and 2 females, aged 30-55 years. The patients were admitted because of chest lump or pain. The sizes of palpable lump ranged from 4 cm×3 cm to 10 cm×8 cm. CT examination showed bone destruction. After sternal tumor resection, defect size ranged from 10 cm x 8 cm to 18 cm×4 cm, and titanium plate and Teflon patch were used to repair and reconstruct the chest wall defect. Results The operations of the tumor resection and reconstruction of chest wall defect were successfully performed in 4 cases. Incisions healed by first intention with no abnormal breath, subcutaneous emphysema, pneumothorax, and infection. One case failed to be followed up after 6 months; 1 case died of intracranial hemorrhage; and 2 cases were followed up 1 and 4 years respectively without tumor recurrence. The chest wall had good remodeling. No loosening and exposure of titanium plate, difficulty in breathing, chest distress, and chest pain were observed during follow-up. Conclusion Surgical resection of sternal tumors will cause large chest wall defect which can be repaired by titanium plate and Teflon patch because it had the advantages of easy operation, satisfactory remodeling, and less complication.%目的 探讨胸骨肿瘤切除术后采用钛板联合Teflon补片重建胸廓的方法及疗效.方法 2006年10月-2009年11月,收治4例胸骨肿瘤患者.男2例,女2例;年龄30~55岁.以胸部肿块、疼痛1~6个月后入院.检查见胸前区范围为4cm×3em~10cm×8cm的肿块,质硬.CT检查见骨质破坏.采用胸骨肿瘤扩大切除术,切除范围为10cm×8cm~18em×14cm,采用钛板联合Teflon补片重建胸廓.结果 患者手术均顺利完成.术后切口Ⅰ期

  10. The preparation of aseptic rabbit tissue cage infection model%兔组织笼无菌感染模型的制备

    Institute of Scientific and Technical Information of China (English)

    刘树玲; 丁丽; 邢昆

    2015-01-01

    目的:制备兔组织笼无菌感染模型,为药物药动学-药效学结合模型(pharmacokinetic‐pharmaco‐dynamic modeling ,PK‐PD)研究提供在体动物实验载体。方法选取健康家兔28只,耳缘静脉注射盐酸赛拉嗪注射液0.15ml/kg麻醉,每只分别背部备皮、切开皮肤,然后在皮下植入长约5cm的无菌中空胸腔引流管1个,继而在无菌操作下手术缝合。术后应用青霉素肌肉注射3d以预防感染。结果5只家兔先后因不同原因死亡,23只家兔均获得清亮的无菌组织液,成功建立兔组织模型,成功率为82.14%。结论通过严格控制无菌操作,选择合适的麻醉剂,手术刀口选择在兔背部,术后及时预防感染,可以成功制备兔组织笼无菌感染模型,并获得清亮的无菌组织液。%Objective To prepare a rabbit tissue cage model so as to provide drug animal carrier in vivo for drug PK‐PD modeling study .Methods 28 healthy rabbits were selected and injected with the anesthesia xylazine iv respectively .The back hair was cut in each rabbit ,and then the skin was cut open .A 5cm of sterile hollow chest tube drainage was implanted subcutaneously .In the end the wound was sewed up with aseptic technique .After op‐eration penicillin im was injected for 3 days to prevent infection .Results Among the 28 rabbits ,5 rabbits were dead due to different causes .Clear and sterile tissue fluid were gotten from other 23 rabbits .A rabbit tissue model was established successfully ,and the success rate was 82 .14% .Conclusion By stricted controlling aseptic opera‐tion ,selecting the appropriate anesthesia and surgical incision in the back of the rabbit ,timely postoperative anti‐infection ,a rabbit tissue cage model can be successfully established ,so does clear tissue fluid .

  11. Aseptic meningitis by echovirus 30 in São Paulo state, Brazil Meningite asseptica por echovírus 30 no estado de São Paulo, Brasil

    Directory of Open Access Journals (Sweden)

    Bráulio Caetano Machado

    2007-03-01

    Full Text Available The objective of this study was to identify and characterize the immunological and molecular aspects of Human Enterovirus (HEV associated with aseptic meningitis cases in São Paulo State, Brazil. Clinical samples (cerebrospinal fluid CSF, stool and sera were analyzed from 21 viral meningitis suspected cases collected in the period from 1998 to 1999. The isolated virus were identified as belonging to Enterovirus genus and specifically to echovirus serotype 30 (EV-30, using immunological techniques as Indirect Immunofluorescense Assay (IFA and Neutralization (Nt and by molecular technique of Reverse Transcription Polymerase Chain Reaction (RT-PCR directed to the 5' NTR and VP1 regions of viral genome. The results obtained contributed with to the surveillance system of São Paulo State and they are important due to a shortage of epidemiological data about the circulation of EV-30 associated to aseptic meningitis in this region of the world.O objetivo deste estudo foi identificar e caracterizar quanto aos aspectos imunológicos e moleculares os Enterovirus humanos associados a casos de meningite asséptica. Amostras clínicas (líquido cefaloraquidiano, fezes e soro originárias de 21 casos suspeitos de meningite viral, provenientes do estado de São Paulo no período de 1998 a 1999 foram analisadas. Os vírus isolados foram identificados como pertencentes ao gênero Enterovirus e mais especificamente ao sorotipo echovírus 30 (EV-30, utilizando-se técnicas imunológicas como Imunofluorescência Indireta e Neutralização e técnica molecular da transcrição reversa - reação em cadeia da polimerase (RT-PCR direcionada para as regiões 5' não traduzida (5'NTR e Proteína Viral 1(VP1 do genoma viral. Os resultados obtidos contribuíram com o sistema de vigilância epidemiológica do estado de São Paulo na geração de informações sobre a circulação de EV-30 associado à meningite asséptica nessa região do mundo.

  12. The clinical features of 101 cases of children with aseptic encephalitis%101例儿童无菌性脑炎的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    王贤柱; 李玖军

    2015-01-01

    目的:探讨无菌性脑炎的临床特点及转归情况。方法收集2009年12月至2012年12月中国医科大学附属盛京医院PICU收治的诊断为无菌性脑炎的患儿101例,对其临床表现、体征、辅助检查及转归情况进行回顾性分析。结果101例患儿中,男54例,女47例,年龄1~6个月12例,~1岁12例,~3岁36例,~6岁12例,~14岁19例。发热为最常见的临床表现,共有92例(91.1%),其次为抽搐79例(78.2%),脑膜刺激征或病理征阳性63例(62.4%)。辅助检查中敏感性最高的为脑电图,共89例患儿行脑电图检查,异常75例(84.3%),其次为MRI平扫,共97例行头部MRI平扫,异常54例(55.7%),101例患儿均行脑脊液检查,白细胞增高或(和)蛋白增高50例(49.5%),敏感性最低的为CT平扫,63例行头部CT平扫,异常11例(17.5%)。所有患儿入院后均给予止惊、退热、降低颅压及营养脑细胞等综合治疗,治愈70例,留有神经系统后遗症20例,放弃治疗7例,死亡4例。结论儿童无菌性脑炎好发于婴幼儿,男女发病率相当,临床表现呈多样化,以发热及抽搐最为常见,脑电图及头部MRI检查敏感性较高,给予及时对症治疗,大部分患儿转归良好,少数病例留有意识障碍及运动障碍等不同程度的神经系统后遗症,个别病例脑干受累,出现呼吸衰竭、神经源性休克等,最终导致患儿死亡。%Objective To observe and discus the clinical features and outcome of aseptic encephali-tis in children. Methods One hundred and one cases treated in PICU of Shengjing Hospital of China Medi-cal University and diagnosed with aseptic encephalitis from December 2009 to December 2012 were enrolled. Results The clinical manifestations, signs, laboratory examinations and outcome were analyzed retrospec-tively. Among them, 54 cases were male,47 cases were female,12 cases aged from 1 month old to 6 months old,12 cases aged from 7 months old to 1 year old,36 cases aged from 2 years old to

  13. Elucidation of echovirus 30's origin and transmission during the 2012 aseptic meningitis outbreak in Guangdong, China, through continuing environmental surveillance.

    Science.gov (United States)

    Lu, Jing; Zheng, Huanying; Guo, Xue; Zhang, Yong; Li, Hui; Liu, Leng; Zeng, Hanri; Fang, Ling; Mo, Yanling; Yoshida, Hiromu; Yi, Lina; Liu, Tao; Rutherford, Shannon; Xu, Wenbo; Ke, Changwen

    2015-04-01

    An aseptic meningitis outbreak occurred in Luoding City of Guangdong, China, in 2012, and echovirus type 30 (ECHO30) was identified as the major causative pathogen. Environmental surveillance indicated that ECHO30 was detected in the sewage of a neighboring city, Guangzhou, from 2010 to 2012 and also in Luoding City sewage samples (6/43, 14%) collected after the outbreak. In order to track the potential origin of the outbreak viral strains, we sequenced the VP1 genes of 29 viral strains from clinical patients and environmental samples. Sequence alignments and phylogenetic analyses based on VP1 gene sequences revealed that virus strains isolated from the sewage of Guangzhou and Luoding cities matched well the clinical strains from the outbreak, with high nucleotide sequence similarity (98.5% to 100%) and similar cluster distribution. Five ECHO30 clinical strains were clustered with the Guangdong environmental strains but diverged from strains from other regions, suggesting that this subcluster of viruses most likely originated from the circulating virus in Guangdong rather than having been more recently imported from other regions. These findings underscore the importance of long-term, continuous environmental surveillance and genetic analysis to monitor circulating enteroviruses.

  14. Genomic characterization of echovirus 6 causing aseptic meningitis in Hokkaido, Japan: a novel cluster in the nonstructural protein coding region of human enterovirus B.

    Science.gov (United States)

    Miyoshi, Masahiro; Komagome, Rika; Ishida, Setsuko; Nagano, Hideki; Takahashi, Kenichi; Okano, Motohiko

    2013-04-01

    We determined four complete nucleotide sequences of echovirus 6 (E6) isolated from an epidemic of aseptic meningitis (AM) in Hokkaido, Japan, in 2011. Phylogenetic analysis of the genes encoding viral capsid protein 1 revealed that the strains were closely related to E6 strains isolated in China in recent years, but they were distantly related to E6 strains isolated from patients with AM in Osaka Prefecture, Japan, in 2011. The genes encoding the viral protease and RNA-dependent RNA polymerase (3CD) were closely related to those of several non-E6 strains of the species Human enterovirus B isolated in China, South Korea, and Australia from 1999 to 2010, resulting in a novel cluster in the phylogenetic tree. These results suggest that the incidence of AM in Japan in 2011 was caused by at least two lineages of E6 strains, and a lineage of the 3CD gene was interspersed among different serotypic strains isolated in Western Pacific countries.

  15. Storage stability of cashew apple juice preserved by hot fill and aseptic processes Estabilidade do suco de caju preservado pelo método ''hot fill'' e processo asséptico

    OpenAIRE

    Maria Cecília Oliveira Costa; Geraldo Arraes Maia; Raimundo Wilane de Figueiredo; Men de Sá Moreira de Souza Filho; Isabella Montenegro Brasil

    2003-01-01

    Cashew (Anacardium occidentale L.) apples from Pacajus, Ceará State, Brazil, were processed into high pulp content juice. The juice was packed either by hot fill or an aseptic process and evaluated for physical, physical-chemical, and sensorial changes during a 12-month storage period at room temperature. The results indicated that pH, soluble solids, total acidity, total sugar content and color did not change significantly during storage nor were affected by the type of filling. The sensoria...

  16. Advances in diagnosis and treatment of aseptic meningitis after neurosurgical operation%神经外科术后无菌性脑膜炎的诊断及治疗进展

    Institute of Scientific and Technical Information of China (English)

    付东翔; 付强; 刘波

    2014-01-01

    Aseptic meningitis and bacterial meningitis after neurosurgical operation are the postoperative complications which are difficult to identify clinically. They have great differences in treatment and prognosis. The pathogenesis of the postoperative aseptic meningitis is not clear. Its clinical manifestations are similar to bacterial meningitis, but the prognosis is better. The traditional diagnostic methods for postoperative aseptic meningitis has a certain degree of the rate of missed diagnosis and misdiagnosis. In recent years, scholars of the world have conducted many studies on the diagnosis and treatment of postoperative aseptic meningitis, and made some progress, which has improved the diagnostic accuracy of postoperative aseptic meningitis to a certain degree, guided the treatment correctly and reduced patients unnecessary expenses and hospital stays.%神经外科术后无菌性脑膜炎与细菌脑膜炎一直是临床上较难鉴别的术后并发症,二者在治疗过程和预后方面有较大差异。术后无菌性脑膜炎的发病机制尚不明确,临床表现与细菌性脑膜炎相似,易被误诊为细菌性脑膜炎,但预后较好。传统的检查诊断方法对于术后无菌性脑膜炎存在一定程度的漏诊率和误诊率,近年来国内外学者对术后无菌性脑膜炎的诊断及治疗方法进行了多方面的研究,并取得了一些成果,在一定程度上提高了此类术后并发症诊断的准确率,正确指导此类术后并发症的治疗,减少患者不必要的花费及患者的住院时间。

  17. 系统性红斑狼疮并发无菌性股骨头坏死的相关因素研究%Risk factors of systemic lupus erythematosus patients with aseptic necrosis of the femoral head

    Institute of Scientific and Technical Information of China (English)

    石颜军

    2013-01-01

    目的 探讨系统性红斑狼疮并发无菌性股骨头坏死的相关因素.方法 选择本院收治的系统性红斑狼疮患者84例,分为并发无菌性股骨头坏死42例(观察组)和无并发无菌性股骨头坏死42例(对照组),分析系统性红斑狼疮并发无菌性股骨头坏死的相关因素.结果 观察组血管炎、雷诺现象以及Acl阳性的发生率均明显高于对照组,差异有统计学意义(P<0.05);观察组中19例患者使用激素冲击治疗,而对照组仅有8例,差异有统计学意义(P<0.05).结论 以血管炎、雷诺现象为主要临床表现的系统性红斑狼疮患者,其脉管系统对激素敏感性增加,大剂量激素冲击治疗容易并发无菌性股骨头坏死.%Objective To study the risk factors of systemic lupus erythematosus with aseptic necrosis of the femoral head.Methods Eighty-four patients with systemic lupus erythematosus in our hospital were divided into two groups,including 42 patients with aseptic femoral head necrosis (observation group) and 42 cases of without aseptic femoral head necrosis in patients (control group).Related factors concerning systemic lupus erythematosus with aseptic necrosis of the femoral head were analyzed.Results Occurrences of vasculitis,Raynaud's phenomenon,and the ACLpositive of the observation group were higher than those of the control group,the difference being statistically significant (P< 0.05).In the observation group,19 patients were applied with steroid pulse therapy,while in the control group,only eight cases,the difference between the two groups being statistically significant (P < 0.05).Conclusion For patients with systemic lupus erythematosus vasculitis,Raynaud's phenomenon as the main clinical manifestations,its vascular system is more sensitive to the hormone.Large-dose hormone therapy can easily lead to aseptic necrosis of the femoral head.

  18. 新疆阿魏种子无菌苗制备研究%Research on Aseptic Seedling Preparation of Feralu sinkiangensis Seed

    Institute of Scientific and Technical Information of China (English)

    朱军; 李晓瑾; 王月娥; 肖琼

    2011-01-01

    In order to obtain methods of aseptic seedling preparation by tissue culture for Feralu sinkiangensis.Differents plans of sterilization, hormone, temperature of chill and relative humidity were setted to study the effects on germination of Ferula sinkiangensis seed. The results showed that the best sterilization of Ferula sinkiangensis seed was 70% ethanol 30 s + 12% H2O2 15 min. The effect at 4 ℃ chilling temperature and in 50% relvtive humidity was better than others treatment, and seed germination rate declined with temperature hoisted. Seed didn't germinate when chill temperature preponderate over 20 ℃. Although GA3 could break dormancy of Ferula sinkiangensis seed, germination rate was lower.%为获得供新疆阿魏组织培养无菌苗制备的方法.研究了不同的消毒方法、激素、层积温度和相对湿度等条件下,对新疆阿魏无菌苗制作的影响.结果表明:新疆阿魏种子最佳消毒方法为70%酒精30 s+12%H2O2 15 min;层积温度4℃,相对湿度50%,新疆阿魏种子萌发最好;新疆阿魏种子经GA3处理可打破休眠,但发芽率低于低温层积处理.

  19. Incidence and clinical features of herpes simplex viruses (1 and 2) and varicella-zoster virus infections in an adult Korean population with aseptic meningitis or encephalitis.

    Science.gov (United States)

    Choi, Rihwa; Kim, Gyeong-Moon; Jo, Ik Joon; Sim, Min Seob; Song, Keun Jeong; Kim, Byoung Joon; Na, Duk L; Huh, Hee Jae; Kim, Jong-Won; Ki, Chang-Seok; Lee, Nam Yong

    2014-06-01

    Since there are limited data on the incidence and clinical findings of central nervous system (CNS) infection by three α-herpesviruses including human herpes simplex virus 1 (HSV-1), HSV-2 and varicella-zoster virus (VZV) in Korea, a retrospective analysis of clinical data and polymerase chain reaction (PCR) results was performed in patients who presented with suspicion of acute viral meningitis and/or encephalitis at the emergency department of a tertiary referral hospital in Seoul, Korea. During the 3-year study period, a total of 224 cerebrospinal fluid (CSF) samples from 224 patients were examined. Among the 224 patients, 135 (60.3%) patients were identified as having aseptic meningitis (n = 70, 51.9%), encephalitis (n = 41, 30.4%) or meningoencephalitis (n = 24, 17.8%) at discharge. Twenty-four (17.8%) patients were identified as having VZV meningitis (n = 16, 11.9%), VZV meningoencephalitis (n = 2, 1.5%), HSV-2 meningitis (n = 4, 3.0%), or HSV-1 encephalitis (n = 2, 1.5%). Of the 24 patients infected with the three herpesviruses, immunocompromised patients accounted for 33.3% (n = 8). Skin rashes were observed in half (n = 9) of the patients with VZV, and none with HSV-1 or HSV-2. One patient with VZV meningitis and four patients with brain parenchymal involvement had neurologic sequelae. In conclusion, three herpesviruses are important causative agents of CNS infectious disease with significant morbidity in adults, regardless of the immunologic status. Therefore, CSF should be examined for HSV-1, HSV-2, and VZV using sensitive diagnostic methods in all cases of adult patients with clinical manifestations of CNS disease in order to identify the correct etiology and to determine appropriate therapy.

  20. 肿瘤型假体无菌性松动的治疗现状%Current status of the treatment of aseptic loosening in tumor prostheses

    Institute of Scientific and Technical Information of China (English)

    高明; 张清; 牛晓辉

    2014-01-01

    Aseptic loosening ( AL ) is one of the most common complications in tumor prostheses. Loss of bone quantity and decline of bone quality are the main challenges that orthopedists encounter when they deal with AL. Based on the latest reports, prosthesis revision is the primary choice in the treatment of AL, and it can provide relatively satisfactory outcomes when compared with other methods. While it needs enough bone quantity and good bone quality for prosthetic stability. In some reports, it can get a median Musculoskeletal Tumor Society ( MSTS ) functional score of 96% ( range: 50%-100% ) after an average follow-up of 101 months ( range: 47-155 months ) after the surgery. Besides this, allograft-prosthesis composites ( APCs ) are another choice. Allograft segments are used to construct a certain ifxation arm to get a more stable ifxation. However, its outcomes are not as satisfactory as that of prosthesis revision. According to some reports, after an average follow-up of 59 months after the surgery, it can provide an average MSTS functional score of 62% ( range: 57%-67% ). While we must take account that these patients receiving APCs always have less bone quantity and worse bone quality, when compared with those only receiving prosthetic treatment. In recent years, a new type of prosthesis based on extra-cortical plate ifxation has been used in the revision, which is superior to the conventional intramedullary stem prosthesis. The current results illustrate that it has certain application prospects, but high-quality studies are needed to further demonstrate it. When the loss of bone quantity and decline of bone quality are too serious to perform limb salvage treatment, rotationplasty and amputation may be a choice. However, great attention must be paid to their indications.

  1. 3种野生国兰无菌播种研究%Aseptic Seeding of Three Varieties of Native Orchids of China

    Institute of Scientific and Technical Information of China (English)

    卜朝阳; 何荆洲; 严华兵; 卢家仕; 闭志强; 董伟清

    2011-01-01

    选择广西野生春兰、豆瓣兰、独占春3个国兰品种进行种子预处理及培养基成分筛选等无菌播种技术研究.研究结果表明:种子预处理、培养基基本成分、培养基激素、培养基水果附加物对种子萌发都有一定的影响,其中,植物激素和添加椰子汁等对种子萌发有显著促进作用,氢氧化钠或次氯酸钠浸泡种子和低盐培养基可使兰花种子提早萌发并提高萌发数.较优试验处理为:种子在播种前用0.1 mol/L`氧化钠或1%次氯酸钠浸泡20 min,播种培养基采用改良Kyoto+ 6-BA2 mg/L+ NAA1 mg/L+椰子汁10%.%Aseptic seeding of three Guangxi native orchid species, namely, C. Goeringii, C. Serratumr and C. Ebumeum were studied. The results showed that, the seed pre-treatment, the basic media, the hormone combination and the fruit supplements of media had effects on seed germination. The hormone and coconut milk supplemented had significant effects on seed germination; Seeds pre-treatment with NaClO or NaOH and low salt medium made the seed germinate earlier and unproved the germination rate. The preferred pre-treatment method was that the seeds were soaked in the solution of 0.1 mol/L NaOH or 1 % NaClO for 20 min before sowing in the medium. The optimum media for seeding was modified Kyoto supplemented with 2 mg/L 6-BA, 1 mg/L NAA and 10 % coconut milk.

  2. Infecções do esterno pós revascularização do miocárdio: tratamento com retalhos miocutâneos e musculares Sternal infections after myocardial revascularization: treatment by myocutaneous and muscle flaps

    Directory of Open Access Journals (Sweden)

    Rubens T. de Barros

    1989-08-01

    Full Text Available No período de outubro de 1986 a janeiro de 1989, realizamos 445 esternotomias, sendo 158 para revascularização do miocárdio; em 92 pacientes, a artéria mamária interna esquerda (AMIE foi utilizada. Dos 445 casos, sete pacientes tiveram infecção do esterno no período pós-operatório imediato. O tempo médio de aparecimento foi de 8,7 dias (4-15 dias, sendo que seis pacientes eram do sexo masculino e a idade média foi de 48,8 anos (35-60 anos. Em todos os casos, os pacientes estavam sendo submetidos à primeira cirurgia, tendo como possíveis fatores associados diabete (um caso, embolia pulmonar com insuficiência respiratória (um caso, síndrome de baixo débito (três casos, cirurgia prolongada (um caso e dissecção da AMIE (seis casos. Na correção desta complicação, a associação de técnicas de cirurgia plástica, com a utilização de retalhos miocutâneos ou musculares, permitiu mais rápida recuperação dos pacientes, sem que tivéssemos óbitos nesta série. Os resultados estético e funcional foram considerados excelentes, com três pequenas deiscências tratadas ambulatorialmente. A identificação do germe através de cultura e a orientação do tratamento pelo antibiograma também se mostraram de grande importância, ao lado das técnicas cirúrgicas empregadas. Concluindo, julgamos que a intervenção precoce e agressiva nas infecções do esterno contribuiu, efetivamente, na queda da morbi-mortalidade desta complicação.During the period of October 1986 to January 1989 we executed 445 sternotomies; 158 of these were for myocardial revascularization. In 92 cases the left internal mammary artery (LIMA was used. Of 445 cases, 7 patients developed sternal infection in the immediate post operative period. The average time for the infection to appear was 8.7 days (4-15 days. Of these, 6 patients were male with an average age of 48.8 years (35-60 years. All cases were first operations; complicating factors were diabetes

  3. 川崎病并发无菌性脑膜炎31例临床治疗分析%Kawasaki disease complicated with aseptic meningitis clinical treatment of 31 cases were analyzed

    Institute of Scientific and Technical Information of China (English)

    罗云娇; 杜曾庆; 杨小涛

    2014-01-01

    objective the article is to review the 112 cases of Kawasaki disease (Kd) treaded in our department from January to december 2013 with the emphasis of their characteristics,diagnosis,treatment of patients with aseptic meningitis in 31 cases which were retrospectively analyzed. Methods according to Kawasaki disease and aseptic meningitis treatment, the patients were treated with aspirin 50mg/d/ kg,divided into 2 - 3 oral,and given mannitol intracranial pressure lowering treatment. all patients were given intravenous immunoglobulin therapy. Before discharging,cases in the group were given two dimensional echocardiogram Beckoning graph (2de) examination. results the clinical symptoms of all patients were disappeared,their condition improved and discharged. normal cardiac 2de examination of 5 cases of abnormal coronary artery:26 (83.87%) cases had different degrees of coronary artery lesions. conclusion the present (Kd) has replaced the wind damp heat and has become the most important cause of acquired heart disease for children. in recent years Kd with aseptic meningitis cases is increasing,Kd concurrent aseptic meningitis is Kawasaki disease in severe cases,in this group of cases were complicated with multiple organ injury. clinical attention should be paid. Pediatricians should raise awareness of Kd, especially Kd with aseptic meningitis cases. early diagnosis,early treatment is the key to reduce coronary artery disease complicated by Kd.%目的:对我科2013年1月至12月收治的112例川崎病(Kd)中并发无菌性脑膜炎31例病例的临床特征、诊断、治疗进行回顾性分析。方法本组病例入院后按川崎病并无菌性脑膜炎治疗,本组病例均给予阿司匹林50mg/d/㎏,分2~3次口服,并给予甘露醇脱水降颅压等治疗。全部病例均给予静脉丙种球蛋白治疗。出院前本组病例均做了心脏二维超声心动图(2de)检查。结果全部病例出院时临床症状消失

  4. Analysis of {sup 18} F-FDG uptake patterns in PET for diagnosis of septic and aseptic loosening after total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Cremerius, U.; Niethard, F.U. [Rheinisch-Westfaelische Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin; Mumme, T.; Reinartz, P.; Wirtz, D. [Rheinisch-Westfaelische Technische Hochschule Aachen (Germany). Orthopaedische Klinik; Buell, U.

    2003-12-01

    Aim: Identification of typical patterns for fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) to detect aseptic loosening of hip prosthesis (acetabular and/or femoral component) and prosthetic infection. Methods: 18 patients with painful hip prosthesis underwent PET using a dedicated full ring scanner after application of 200-300 MBq FDG. The interface between bone and surrounding soft tissue or bone as displayed on coronal slices was divided into 12 segments in accordance with the classifications of Delee and Gruen. FDG uptake in each of the segments was scored (0-3) by two independent observers. Intraoperative findings were regarded as the gold standard. Results: After surgical revision 14 acetabular components and 9 femoral components were found to be loose and prosthetic infection was present in 7 prostheses. Loosening of the acetabular component was correlated to enhanced uptake in the middle of the acetabular interface, while loosening of the femoral component was correlated to enhanced uptake in the proximal and middle segment of the lateral femoral interface and the proximal segment of the medial femoral interface. A similar pattern was found in prosthetic infection with high uptake along the middle portion of the lateral femoral interface. In 6 of 7 infected prostheses loosening of the acetabular and of the femoral component was present. Taking the typical uptake patterns as criteria for loosening and grade 3 uptake as an additional criterion for septic loosening the accuracy of PET imaging in the detection of loosening of the acetabular or the femoral component and of prosthetic infection was 72, 78 and 89%, respectively. Conclusion: This pilot study presents FDG-PET as a promising diagnostic tool for patients with painful hip prostheses. Its clinical value should be evaluated in a larger patient population. (orig.) [German] Ziel: Identifikation von Befundmustern in der Positronenemissionstomographie (PET) mit {sup 18}F

  5. Urinary tract infection and aseptic meningitis:a case report with literature review%尿路感染合并无菌性脑膜炎1例报告及文献复习

    Institute of Scientific and Technical Information of China (English)

    胡笑月; 徐晓华; 华颖

    2014-01-01

    Objective To analyze and investigate clinical characteristics, pathogenesis and treatment of urinary tract infection and aseptic meningitis. Methods Clinical features and laboratory tests of a two-month-old baby girl with urinary tract infection and aseptic meningitis were reported. Results The patient complained of fever, neck stiffness and a bulging fontanel, accompanied by congestion and abnormal secretion of urethra. The cerebrospinal lfuid (CSF) white blood cell count was 30×106/L. The blood culture and the CSF culture were both negative. And the urine culture was positive for Enterococcus faecium. The patient received a 10-day course of intravenous antibiotic therapy. The prognosis is good with no recurrence of the disease. Conclusions Aseptic meningitis can be concomitant with urinary tract infection, The probable hypothesis may be that sterile CSF pleocytosis is mediated by urinary tract infection. Knowledge of this may prevent unnecessary antibiotics therapy for presumed bacterial meningitis.%目的:探讨尿路感染合并无菌性脑膜炎的临床特点、发病机制及诊治,以提高对此疾病的认识。方法分析1例尿路感染合并无菌性脑膜炎患儿的临床特点和实验室检查结果,并复习相关文献。结果患儿2月龄,临床表现为发热、颈抵抗及前囟隆起,伴有尿道口充血及异常分泌物。脑脊液白细胞计数30×106/L。患儿血培养、脑脊液培养均阴性。尿培养为屎肠球菌生长。经静脉抗感染治疗10 d,病情好转,随访病情无复发。结论尿路感染患儿可合并无菌性脑膜炎,其机制可能与细菌感染引起脑膜炎症反应有关,临床上需与细菌性脑膜炎进行鉴别,如明确为前者可适当缩短抗感染疗程。

  6. Identificação da microbiota fúngica de ambientes considerados assépticos Identification of the fungic microbiota isolated in areas considered aseptic

    Directory of Open Access Journals (Sweden)

    Maria Elisabete Sbrogio de Almeida

    1988-06-01

    Full Text Available Objetivou-se isolar e identificar a microbiota fúngica em ambientes considerados assépticos, através de exposições com meios de cultivo adequados, em três épocas distintas do ano, antes e imediatamente após as manobras técnicas realizadas em três áreas de trabalho: ambiente aberto, ambiente fechado sem filtração de ar e ambiente fechado com filtração de ar, utilizadas em produção de imunobiológicos. Os meios ágar-Sabouraud e ágar-soja, enriquecidos com 0,2% de extrato de levedura e sem cloranfenicol, foram estudados quanto à sua eficácia no isolamento de bolores e leveduras, considerando-se o número de colônias desenvolvidas e a freqüência dos diversos fungos isolados. Isolaram-se 67 espécimens, sendo 64 fungos filamentosos (bolores e três leveduras. Dos bolores, 54 pertenciam a 22 gêneros da divisão Deuteromycota, famílias Moniliaceae e Dematiaceae, cinco amostras filamentosas foram incluídas na ordem Agonomycetales (Mycelia Sterilia, e uma amostra foi classificada na divisão Deuteromycota, ordem Sphaeropsidales, classe Coelomycetes. Da divisão Zygomycota, ordem Mucorales, família Mucoraceae, um único mucoráceo foi identificado até gênero. As três leveduras pertenciam também à divisão Deuteromycota (Fungi Imperfecti, família Cryptococcaceae, e foram identificadas como sendo duas Rhodotorula rubra e uma Torulopsis candida. Comprovou-se que o número de colônias isoladas aumentou após a realização das monobras técnicas e que a filtração de ar através de filtros tipo HEPA, reduzindo o número de colônias isoladas nos ambientes fechados, aumenta a segurança do trabalho; comumente é recomendada para áreas de atividade técnica cujos resultados satisfatórios estão diretamente relacionados com uma baixa incidência de contaminantes.The isolation and identification of the fungic microbiota present in areas considered aseptic (open and/or restricted, with or without air filtration (HEPA filters

  7. 品管圈活动在“降低无菌包不合格件数”中的应用%Application of QCC in"Reduce Aseptic Package Failed in the Number"

    Institute of Scientific and Technical Information of China (English)

    陈翠英; 李黎

    2015-01-01

    Objective To apply the qc circle management methods to reduce the unqualified aseptic package number. Methods Using quality management circle activity 1 ~ 28 July 2013 were retrospectively analyzed Japan hospital disinfection disinfection sterilization supply center 2500 sterile packet loss situation, put forward the cor esponding countermeasures for the cause of loss occur ed, and in 2013 October 1 ~ 28 strictly implemented. Comparing the circle of qc activity aseptic package unqualified number before and after intervention. Results October 2013 to 1 ~ 28 disinfection sterilization, 2500 aseptic package to intervene after the sterile package unqualified number by activity fel to 15.75 /weeks before 5.25 /weeks, compared with the same year 7 phases of the moon has dropped significantly, the dif erence statistical y significant ( < 0.01). Conclusion The quality control circle activities in reducing the aseptic package quantity of unqualified, the satisfactory ef ect, worthy of promotion. Al the members of the ability to solve the problem, the sense of responsibility, cohesion, motivation, communication, cooperation, pleasure, quality management technique, harmonious degree has been improved.%目的运用品管圈管理方法来降低无菌包不合格件数。方法利用品管圈活动回顾性分析2013年7月1日~28日本院消毒供应中心消毒灭菌的2500个无菌物品包缺失情况,针对缺失发生的原因提出相应的对策措施,并于2013年10月1日~28日严格执行。比较品管圈活动干预前后无菌包不合格件数。结果对2013年10月1日~28日消毒灭菌的2500个无菌包进行干预后无菌包不合格件数由活动前15.75件/w降至活动后的5.25件/w,与同年7月相比较有显著下降,差异具有统计学意义(<0.01)。结论品管圈活动在降低无菌包不合格件数中,取得满意效果,值得推广。全体圈成员对解决问题的能力、责任感、凝聚力、积极性、沟通配合、

  8. Accounting and management of aseptic materials at the central sterile supply department of hospital%医院消毒供应中心无菌物品的核算与管理

    Institute of Scientific and Technical Information of China (English)

    周彬; 王亚娟

    2015-01-01

    文章结合原国家卫生部2009年颁布的《消毒供应中心三项标准》和2012年颁布的《医院财务制度》和《医院会计制度》中的相关条款,探讨医院消毒供应中心无菌物品的核算与管理工作。%In the paper, the accounting and management of aseptic materials at the Center Sterile Supply Department of hospital is discussed in accordance with relevant provisions in the Three Standards for Central Sterile Supply Departments promulgated by the former Ministry of Health of China in 2009, as well as the Hospital Financial System and Hospital Accounting System issued in 2012.

  9. 3种植物无菌苗增殖与生根一体化技术研究%Studies on the Technology of Proliferation and Rooting Integration with Aseptic Seedlings in Three Species

    Institute of Scientific and Technical Information of China (English)

    梁称福

    2011-01-01

    Under conventional culture conditions ((25 ±3)℃, relative humidity 60%-70%, 1500-2000 lx for 10-12 h/d), aseptic buds or leaves from the plants of Aloe vera var.chinensis, Pelargonium citrosum vanleenii and triploid Populus tomentosa were respectively used to research the technology of proliferation and rooting integration.The results showed that: after 50 days when aseptic buds of Aloe vera var.chinensis were transferred in MS + 6-BA 2.0 mg/L+ NAA 0.1 mg/L+ AC 0.1%, the average number of differentiated buds reached 3.4 and the rooting rate reached 100% with 6.1 roots which were sturdy, long and yellow-white and 52.0 cm length of all roots per plant.After 45 days transferred in MS + 6-BA 3.0 mg/L + NAA 0.2 mg/L + AC 0.05%, aseptic buds of Pelargonium citrosum vanleenii proliferated most fastest with the average number of differentiated buds reaching 10.2, and the rooting rate amounted to 100% with dark-green leaves.After 55 days when aseptic leaves of triploid Populus tomentosa were transferred in MS + 6-BA 0.5 mg/L + KT 0.4 mg/L + NAA 0.2 mg/L + Ad 25.0 mg/L + AC 0.05%, differentiated buds arrived at an average of 8.6 and the rooting rate achieved 92% with more and longer, light-white roots.%在常规培养环境条件(温度(25士3)℃、湿度60%~70%、光强1500~2000lx,10-12h/天),以中华芦荟、驱蚊香草、三倍体毛杨无菌芽或叶片为材料,研究不同培养基对其无菌苗增殖、生根的影响,探讨其一体化成苗技术.结果表明:中华芦荟无菌芽转接在MS+6-BA2.0 mg/L+NAA 0.1 mg/L+AC 0.1%培养基中50天,分化芽数平均达3.4个;生根率达100%,单株根数达6.1条,单株总根长达52.0 cm,且根系粗长、黄白色.驱蚊香草无菌芽在MS+6-BA 3.0 mg/L+NAA 0.2 mg/L+AC 0.05%培养基中增殖速度最快,转接后45天分化芽数平均为10.2个;生根率为100%,生根苗叶片呈深绿色,生根质量好.三倍体毛白杨无菌叶片接种在MS+6-BA 0.5 mg/L+KT 0.4 mg/L+NAA 0.2 mg/L+Ad 25

  10. The treatment of sternal wound infection by internal fixation of sternum with titanium plate after cardiac surgery%钛板固定在心脏术后胸骨正中切口感染治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    亓发芝; 冯自豪; 张勇; 顾建英

    2013-01-01

    目的 探讨应用钛板内固定,增强胸骨稳定性,提高心脏手术后胸骨正中切口感染的临床治疗效果.方法 采用回顾性调查的方法,对26例应用钛板内固定,治疗胸骨切口感染的病例进行分析.结果 2009年1月至2011年12月应用钛板内固定治疗26例,均为慢性感染患者,感染持续时间均超过3个月.3例深部感染患者采用伤口持续负压吸引(VAC)的方法辅助创面准备.26例患者均行胸大肌肌瓣转移,无一例发生钛板感染需再次手术取出,且无一例因胸骨再次感染而需二次手术.结论 应用钛板内固定可以加强胸骨稳定性,减少局部组织渗出,提高心脏手术后胸骨正中切口感染的临床治疗效果.%Objective To investigate the internal fixation of sternum with titanium plate for the treatment of sternal wound infection after cardiac surgery.Methods A retrospective study of 26 patients from Jan 2009 to Dec 2011 was carried out.All the 26 cases with sternal wounds infection after cardiac surgery,were treated by internal fixation with titanium plates.Results All the patients had choronic infection,lasting for more than 3 months.3 patients received vacuum-assisted closure treatment after complete debridment.All the wounds were covered with pectoral major muscle flap.All the wounds healed completely with no recurrence of infection..Conclusions Internal fixation of sternum with titanium plate can increase the stability.It helps to improve the treatment efficacy of sternal wound infection after cardiac surgery.

  11. Radiation therapy for resistant sternal hydatid disease

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    Ulger, S.; Barut, H.; Tunc, M.; Aydinkarahaliloglu, E. [Ataturk Chest Disease and Thorasic Surgery Training and Research Hospital, Ankara (Turkey). Dept. of Radiation Oncology; Aydin, E.; Karaoglanoglu, N. [Ataturk Chest Disease and Thorasic Surgery Training and Research Hospital, Ankara (Turkey). Dept. of Thorasic Surgery; Gokcek, A. [Ataturk Chest Disease and Thorasic Surgery Training and Research Hospital, Ankara (Turkey). Dept. of Radiology

    2013-06-15

    Hydatid disease is a zoonotic infectious disease for which there are known treatment procedures and effective antibiotics; however, there are resistant cases that do not respond to medication or surgery. We report a case diagnosed as hydatid disease of the chest wall and treated with radiation therapy (RT) after medical and surgical therapy had failed. In conclusion, RT represents an alternative treatment modality in resistant cases. (orig.)

  12. Metal on Metal Surface Replacement of Hip in Young Patients with Rheumatoid Arthritis of Aseptic Necrosis of Femoral Head%金属对金属人工全髋表面置换术的临床应用

    Institute of Scientific and Technical Information of China (English)

    夏庆; 陈统一; 姜晓幸; 姚振钧

    2001-01-01

    Purpose Present study investigated the role of metal on metal surface replacement of the hip in treating the young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head. Methods Between Jan. 1995 and Dec. 1996.16 patients with 17 hips( rheumatoid arthritis 14, aseptic necrosis of femoral head 3) were resurfaced with hybrid metal on metal surface replacement prothesis. Patients were evaluated by self assessment form,hip function examination. Radiographs and Harris hip score. The average follow up time was 58.2 months. Results No patient received revision. Radiographs showed that all implants were in position satisfyingly. No loosening were revealed. The result of self assessment showed that patients were satisfied with 16 hips. The Harris score rose from preoperative 44(31 - 52) to postoperative 91 (79- 96). Conclusions The metal on metal surface replacement of hip is a useful treatment to release pain and keep the hip function of young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head.%目的探讨金属对金属人工全髋表面置换术治疗类风湿性关节炎和股骨头无菌性坏死的临床价值。 方法从1995年1月至1996年12月,对16例患者17个髋关节(其中类风湿性关节炎14个,股骨头无菌性坏 死3个)行混合型金属对金属人工全髋表面置换术,术后行问卷调查、髋关节功能检查、X线和Harris评分分析, 平均随访58.2月。结果所有患者没有一例行翻修手术,X线显示所有表面置换假体植入位置满意,没有假体 松动、移位现象出现。问卷调查显示患者对16个髋关节的术后情况表示非常满意。Harris评分平均指数从术前 的44(31~52)分提高到术后的91(79~96)分。结论金属对金属人工全髋表面置换术不失为患类风湿性关节 炎和股骨头无菌性坏死的年青患者为保存关节功能,改善疼痛的一种有价值的治疗方法。

  13. Survey and analysis on the preventive use of antibiotics during perioperative period in aseptic operation%清洁手术围术期抗菌药物应用调查分析

    Institute of Scientific and Technical Information of China (English)

    孙丽; 王宾; 魏旭

    2013-01-01

    目的 了解广州医学院附属深圳沙井医院(以下简称“我院”)清洁手术围术期抗菌药物预防使用情况,评估其用药的合理性.方法 采用回顾性调查方法,对我院2011年1~12月出院的672例乳腺手术、甲状腺手术、骨折内固定取出术、精索静脉曲张高位结扎术、疝修补术手术患者病历资料进行统计分析,评价其抗菌药物应用的合理性.结果 我院清洁切口手术围术期抗菌药物预防应用率达90.33%,存在无指征用药、疗程过长、用药时机不当、药物选择不当、联合用药不规范等不合理用药情况.结论 我院清洁手术围术期预防性应用抗菌药物存在较严重的不合理现象,需引起重视,加强抗菌药物围术期使用管理,提高抗菌药物应用合理性.%Objective To investigate the preventive use of antibiotics during perioperative period in aseptic operation in Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University ("our hospital" for short),in order to evaluate the rationalization of antibiotics use.Methods Retrospectively study was adopted.The case records of 672 patients underwent breast operation,thyroid operation,internal fixation of fracture removal,ligation of varicocele and hernia repair in our hospital from January to December 2011 were analyzed statistically,then the rationality of antibiotics use was evaluated.Results 90.33% of the patients with aseptic operation received antimicrobial prophylactically.The antibiotics use without indication,prolonged use of antibiotics,improper therapy timing and antibiotics chosen,nonstandard use in drug combination were included in the patterns of irrational preventive use of antibiotics.Conclusion The phenomenon of irrational prophylactic antimicrobials use in aseptic operation in our hospital is severe.Great importance should be attached by strengthening control on the management of antibiotics use,in order to improve rational use of antibiotics.

  14. Comparação funcional entre revisão de artroplastia de joelho séptica e asséptica Functional comparison between septic and aseptic knee arthroplasty review

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    Olavo Biraghi Letaif

    2009-01-01

    Full Text Available INTRODUÇÃO: A artroplastia total de joelho (ATJ não é um procedimento isento de riscos. A infecção na ATJ não é a complicação mais comum, porém é uma das mais graves. A revisão em 2 tempos é a escolha nos casos de infecção profunda da prótese de joelho. Por outro lado, a soltura asséptica chega a quase metade das indicações de revisão de artroplastias primárias. A queda do nível de satisfação do paciente pode cair nas revisões. OBJETIVO: O objetivo do presente estudo foi comparar através dos resultados obtidos nos escores funcionais e de qualidade de vida entre cirurgia de revisão de ATJ por soltura séptica e asséptica. MÉTODO: Realizamos escores HSS e SF-36 para avaliar a qualidade de vida e o resultado funcional entre pacientes submetidos à cirurgia de revisão da ATJ entre dois grupos, um que realizou a substituição da prótese em dois tempos (séptica e outro no qual a substituição ocorreu em tempo único (asséptica. RESULTADOS: A análise dos dados obtidos mostra melhor desempenho do segundo grupo na pontuação do HSS e em 06 dos 08 domínios do SF-36. Conclusão: A revisão de ATJ em tempo único apresenta melhores resultados funcionais.INTRODUCTION: Total knee arthroplasty (TKA imposes many risks. TKA infection is not the most frequent complication, but is probably the most serious one. Two-step review is the procedure of choice in deep knee prosthesis infection. On the other hand, aseptic prosthesis detachment represents almost half of the primary arthroplasty review indications. Patient's satisfaction level might diminish after reviews. OBJECTIVE: The objective of this study was to compare the quality of life and final result of TKA review for septic and aseptic failures. METHODS: The patients were assessed using the HSS and SF-36 scores. The patients were divided in two groups: one group submitted to two-step review (septic and the other to one-step review (aseptic. The analysis of the data

  15. Sternal and vertebral fractures, a well-known association, usually overlooked: review of six clinical cases Fracturas vertebrales y fracturas concomitantes del esternón: revisión de seis casos Fraturas vertebrais e fraturas concomitantes do esterno: revisão de seis casos

    Directory of Open Access Journals (Sweden)

    Alvaro Silva G.

    2010-09-01

    Full Text Available OBJECTIVE: the association of sternal and vertebral fractures has previously been described in the literature. These lesions are frequently overlooked at the initial evaluation. The purpose of this study was to review and discuss the diagnostic methods used to diagnose these lesions and to highlight the importance of early recognition of these fractures. METHODS: we performed a retrospective analysis of six patients who suffered sternal and concomitant vertebral fractures. Clinical charts and imaging studies were reviewed. RESULTS: all patients were diagnosed with sternal fractures at the initial evaluation, but only two were diagnosed with vertebral fractures. CONCLUSION: failure to recognize these fractures at initial evaluation may be associated with the fact that the upper thoracic region is difficult to explore. In the presence of sternal fractures, a vertebral fracture must be ruled out even though major injuries are not present. A computer tomography (CT scan and magnetic resonance imaging (MRI should be obtained despite negative X-rays if clinical suspicion is present.OBJETIVO: la asociación de las fracturas del esternón y vertebrales ha sido descrita previamente en la literatura. Estas lesiones son frecuentemente descuidadas en la evaluación inicial. El objetivo de este estudio fue analizar y discutir los métodos diagnósticos utilizados para estas lesiones y resaltar la importancia del reconocimiento precoz de estas fracturas. MÉTODOS: fue realizado un análisis retrospectivo de seis pacientes que sufrieron concomitantemente fracturas del esternón y vertebrales, por medio del análisis de las historias clínicas y exámenes de imagen. RESULTADOS: todos los pacientes fueron diagnosticados con fracturas del esternón en la evaluación inicial, pero solamente dos fueron diagnosticados con fracturas vertebrales. CONCLUSIONES: el hecho de no reconocer estas fracturas en la evaluación inicial puede estar asociado a la dificultad de

  16. Avaliação da qualidade de caldo de cana envasado a quente e por sistema asséptico Quality of sugarcane (Sacharum ssp. juice packed by hot fill and aseptic processes

    Directory of Open Access Journals (Sweden)

    Karin Samorano da Silva

    2006-12-01

    Full Text Available Dois processos térmicos foram aplicados ao caldo de cana com o objetivo de se obter um produto estável à temperatura ambiente. A variedade de cana de açúcar (Sacharum ssp. utilizada foi a RB72 - 454. A metodologia de planejamento fatorial foi aplicada a fim de se verificar a melhor combinação entre acidez (pH e doçura (°Brix. Houve uma tendência para melhor aceitação sensorial quando o pH foi maior que 4,0 e °Brix maior que 15. Primeiramente, o caldo foi submetido a 141 °C /10 s e envasado assepticamente em garrafas de vidro previamente esterilizadas. No segundo processo, o caldo foi submetido ao tratamento térmico a 110 °C /10 s e envasado a quente (90 ± 5 °C em garrafas de vidro. Análises físico-químicas, microbiológicas e sensoriais foram realizadas durante a estocagem dos lotes à temperatura ambiente. O lote processado assepticamente apresentou vida útil de 30 dias e o envasado a quente, 60 dias, não apresentando diferença estatística (p The objective of this work is to evaluate two thermal processes in order to obtain sugarcane (Sacharum ssp. juice stable at room temperature in glass bottles. An experimental methodology was applied to obtain the best combination between pH and °Brix based on the sensory results. There was a tendency for a better sensory acceptance for pH > 4.0 and °Brix > 15. Two thermal processes were applied to sterilize the juice. Firstly, the juice was submitted to 141 °C /10 s, and then aseptically filled in glass bottles previously sterilized. In the second process, the juice was submitted to 110 °C /10 s and filled into glass bottles at 90 ± 5 °C. Physical-chemical changes, microbiological counts and sensory acceptance were evaluated during the storage at room temperature. The shelf life of aseptically processed juice was 30 days and 60 days for the hot filled juice based on the sensory evaluation. These results indicated that the hot fill process was more efficient for sugarcane

  17. A Study to Assess the Association of Aseptic Practices Being Followed and its Effect on the Overall Outcome of Selected Special Care Newborn Units (SCNUs of Madhya Pradesh at Different Levels.

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    Mahore RK

    2015-04-01

    Full Text Available The neonatal mortality rate in India is high and stagnant. Special Care Newborn Units (SCNUs have been set up at different levels of Health Care Delivery System to provide quality newborn-care services in several hospitals to meet this challenge. Many units are located in the districts where the burden of neonatal deaths is high, and access to special newborn care is poor. The study was conducted to assess the functioning of SCNUs in six centers of India. The evaluation was based on an analysis of secondary data from the six units that had been functioning for at least three year. A cross-sectional survey was also conducted to assess the availability of Quality care and Aseptic practices implemented at different levels of SNCUs. Descriptive statistics were used for analyzing the inputs (Quality care and aseptic practices and outcomes (morbidity and mortality. The rate of mortality among admitted neonates was taken as the key outcome variable to assess the performance of the units. Chi-square test was used for analyzing the trend of case-fatality rate over a period of 3 years considering the first year of operationalization as the base. Correlation coefficients were estimated to understand the possible association of case-fatality rate with factors, such as bed:doctor ratio, bed:nurse ratio, average duration of stay, and bed occupancy rate, and the asepsis score was determined. The rates of admission increased from a median of 16.7 per 100 deliveries in 2012 to 19.5 per 100 deliveries in 2014. The case-fatality rate shows progressive decline in all the units in Last 3 years. Proportional mortality due to sepsis and low birthweight (LBW declined significantly over two years (LBW <2.5 kg. The major reasons for admission and the major causes of deaths were birth asphyxia, sepsis, and LBW/prematurity. The units had a varying nurse:bed ratio (1:1-1:2.14. The bed occupancy rate ranged from 83% to 121% (median 115%, and the average duration of stay

  18. The Progression of Chinese and Western Medicine Treatment of Aseptic Meningitis after Craniotomy Operation%开颅术后无菌性脑膜炎的中西医治疗进展

    Institute of Scientific and Technical Information of China (English)

    徐波; 袁俊

    2015-01-01

    无菌性脑膜炎(AM)为目前开颅术后常见的并发症,同时也是一个比较难解决的疾病。临床表现为发热、头痛、脑膜刺激征等。学者们经过多年的临床探索,在治疗方面已取得宝贵经验,现就对 AM的中医和西医治疗状况及其进展做一简要综述。%AbstractAseptic meningitis (AM)is a common complication after surgical operation,but thedisease is also more difficult to resolve.The clinical manifestations were fever,headache and meningeal irritation sign,etc.Scholars through the years of clinical exploration.In the treatment aspect has made valuable experience. We make a brief review of Chinese medicin -eand Western medicine in treatment of AMand its development status.

  19. Pseudoarthrosis following proximal humeral fractures: A possible mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Rooney, P.J.; Cockshott, W.P.

    1986-01-01

    A small series of four patients with pseudarthrosis of the proximal humeral shaft is reported. These patients all had restricted movement of the shoulder joint prior to the trauma, three as a result of rheumatoid arthritis and one due a surgical fusion of the glenohumeral joint. It is suggested that pseudarthrosis is more likely under these circumstances and that pursuit of union of the fracture in such patients may not always be necessary.

  20. [Treatment of tibial pseudoarthrosis. Complications after intramedullary, allogeneic fibular grafting].

    Science.gov (United States)

    Helfen, T; Prall, W C; Mutschler, W; Thaller, P H

    2015-04-01

    A 24-year-old woman underwent cosmetic bilateral tibial lengthening with severe complications. In all, 15 operations, including allogeneic fibular grafting of both tibia, were required to treat unstable bilateral non-union, malalignment, and osteomyelitis of the right tibia.The present article describes the surgical strategy of revision to achieve good recovery with full consolidation and proper alignment of the lower leg. Furthermore, the indications for allogeneic bone grafting, which was described by Erich Lexer 100 years ago, are discussed. For surgical revision, a T-external fixator was used on the right leg, while a customized tibial nail was used on the left leg. Using these techniques, full consolidation and proper alignment was achieved. Allogeneic bone grafts in upper extremity defects cannot be recommended.

  1. 不同材料人工髋关节关节面磨损对无菌性松动的影响%Effect of articular surface wear of different-material artificial hip joints on aseptic loosening

    Institute of Scientific and Technical Information of China (English)

    肖瑾瑛; 肖小燕; 唐方根; 刘建庭

    2011-01-01

    目的:分析各种人工髋关节假体材料在实际应用中的优势和存在的问题,对不同材料人工髋关节关节面的磨损对无菌性松动的影响进行评价.方法:以"生物材料,人工髋关节,假体,髋关节表面置换"为中文关键词,"biological materials,hip,prosthesis,hip resurfacing"为英文关键词,采用计算机检索1990-01/2009-12相关文章.纳入与不同材料人工髋关节关节面的磨损对无菌性松动的影响相关的文章;排除重复研究或Meta分析类文章.结果:人工髋关节的寿命和关节面的磨损密切相关,人工髋关节置换在临床应用研究过程中,出现无菌性松动等问题,这些问题的产生不但与假体的设计有关,而且与假体所用材料有着密切的关系,比较了不同人工髋关节假体材料的性能,为临床选择一种具耐磨损、生物相容性好的理想人工髋关节假体材料提供依据.结论:髋关节假体材料的表面改性和人体髋关节生物摩擦行为是未来研究的热点,髋关节假体材料性能评价体系的完善是亟待解决的问题.%OBJECTIVE: To analyze the advantage and problems of artificial hip joints made of different materials in clinical applications, andto evaluate the effects of articular surface wear on aseptic loosening.METHODS: A computer search of relevant articles published from January 1990 to December 2009 was performed by using thekeywords of “biological materials, hip, prosthesis, hip resurfacing” in Chinese and English. Repetitive studies or Meta analysis wereexcluded.RESULTS: The life of artificial hip joints is closely related to the articular surface wear. The appearance of aseptic loosening is notonly related to the design of prostheses, but also associated with prosthetic materials. Based on the comparison of different hipprosthesis material properties, we provide the basis for the selection of an ideal hip prosthesis material with good wear resistanceand biocompatibility

  2. Effects of low dosage Co-60 irradiation in the course of aseptic arthritis of the knee joint of rabbits; Effekte einer niedrig dosierten Co-60-Bestrahlung auf den Verlauf einer aseptischen Arthritis am Kniegelenk des Kaninchens

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, U.; Koch, F.; Ludewig, E. [Univ. Leipzig (Germany). Veterinaermedizinische Fakultaet; Kamprad, F.; Melzer, R.; Hildebrandt, G. [Leipzig Univ. (Germany). Klinik fuer Strahlentherapie und Radioonkologie

    1998-12-01

    Purpose: Numerous clinical observations demonstrate the efficacy of low radiation doses in the treatment of painful osteoarthritis. Experimental investigations remain scarce. We investigated the effects of locally daily 5 times 1.0 Gy 60-Co irradiation on an artificially induced aseptic gonarthritis in rabbits. Material and methods: Three separate experiments (EV) were performed (10 rabbits per experiment, 5 treated/5 controls; duration: EV1: 18 days; EV2: 6 days; EV3: 29 days). An aseptic arthritis in the right knee joint of rabbits was induced by intraarticular injection of 0.5 ml papain solution (3%, 30,000 USP/mg) on day 0. The arthritic knee joint of the anesthesized animals was irradiated daily from day 1 to 5 with 5 times 1.0 Gy. The controls were sham-irradiated under the same conditions. The time course of arthritis in treated animals and sham-treated controls was evaluated by clinical, laboratory-chemical and histological criteria. The clinical investigation was performed daily, the puncture of the knee-joints was carried out several times in EV1, and at the end of experiments in EV2 and EV3. At the end of the observation period, animals were killed and the knee joints excised for histological analysis. Results: The intraarticular injection of papain caused a peracute inflammatory response in all animals. After 1 week the chronical stage was reached, and the experimental arthritis resolved slowly within several weeks. Local irradiation accelerated the decrease of inflammatory joint swelling, being significant by day 4. On day 6 the volume of synovial fluid in irradiated knee-joints was significantly smaller. The morphometric data indicated a reduction in thickness of synovial membrane, a decrease in number of synovial cell layers, and a decrease in distance between capillaries and the synovial membrane surface following irradiation of arthritic joints. Due to considerable individual variability, the morphometric data partially did not reach statistically

  3. Colagenopatía y meningitis aséptica recurrente en una paciente de 88 años Colagenopathy and recurrent aseptic meningitis in an 88 year old patient

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    Fernando J. VAzquez

    2004-02-01

    Full Text Available La meningitis aséptica recurrente (MAR en ancianos es rara y generalmente es secundaria a drogas. Su asociación a colagenopatías en ancianos ha sido raramente informada. El Síndrome de Sjögren (SS en ocasiones afecta el sistema nervioso central, pero la MAR asociada a SS es rara en este grupo etario. Se presenta una paciente de 88 años, autoválida, con antecedentes de xerostomía, xeroftalmos, Raynaud, disfagia y agrandamiento parotídeo recurrente autolimitado. En el año 2001 cursó una meningitis linfocítica y evolucionó con recuperación completa. Un año después volvió a presentar una meningitis linfocítica aséptica. Se descartaron causas infecciosas. Se demostró FAN 1/160 con patrón nucleolar moteado, Ac anti Ro y anti RNP positivos y anticoagulante lúpico positivo. Se confirmó sequedad ocular y la biopsia de labio fue compatible con SS. Evolucionó con resolución completa en 10 días sin tratamiento. Se interpretó como una enfermedad mixta del tejido conectivo (EMTC con síntomas predominantemente de SS, que cursó una MAR en su forma pura. La EMTC y el SS deberían ser considerados entre los diagnósticos diferenciales de la MAR, inclusive en ancianos.Recurrent aseptic meningitis (RAM infrequent in elderly patients and generally secondary to drugs. Its association with rheumatologic diseases is also seldom reported in the elderly. Sjögren Syndrome (SS sometimes affects the central nevous system, but the association between recurrent meningitis and SS is rare, specially in this age-group. We present an 88 year-old autovalid patient, with a history of xerostomia, xerophthalmia, Raynaud, dysphagia, and recurrent parotid enlargement. In 2001 she developed a lymphocytic meningitis with a complete remission. A year later, she developed again an aseptic lymphocytic meningitis. We ruled out infeccious causes. We found a FAN titer 1/160 with a nucleolar-mottled pattern, positive anti Ro and anti RNP antibodies and a positive

  4. Study on effect factors for multiplication and growth of aseptic buds of Vietnam Mesona blumes%越南凉粉草无菌芽增殖生长的影响因子

    Institute of Scientific and Technical Information of China (English)

    韦鹏霄; 谭木秀; 岑秀芬; 覃柳兰; 刘洁云; 周芳芳

    2013-01-01

    [Objective]The effect factors on multiplication and growth of the aseptic buds were studied in order to provide technical references for rapid propagation system in vitro of Vietnam Mesona blumes.[Method]The experiments were carried out from two aspects of media directions (different basic media,sucrose concentration and cytokinins) and explant materials (different inoculation positions).[Result]Comparison of the basic media of MS,Miller and modified White displayed that MS medium showed the best effect on bud multiplication and growth of the aseptic buds,in which bud proliferation multiple was 8.53 times.While sucrose concentration was 20.0 g/L,bud proliferation multiple peaked at 8.34 times.When sucrose concentration reached 25.0 g/L,bud proliferation multiple showed 7.05 times and bud growth was the best.The bud multiplication effect of CPPU was better than that of 6-BA and KT,in which bud proliferation multiple reached 9.80 times.Comparing the inoculated materials from stem upper position,the middle part of the stem and the stem base position,the bud multiplication effect of stem upper position was the best,in which the bud proliferation multiple was 9.35 times and the bud growth exhibited the best status.[Conclusion]It was suitable to the bud multiplication and growth of Vietnam Mesona blumes that the basic medium was MS medium,20.0-25.0 g/L sucrose concentration and 0.5 mg/L CPPU.The proper inoculated material was the stem upper position.%[目的]探讨越南凉粉草无菌芽增殖生长的影响因子,为越南凉粉草离体快繁体系的建立提供技术参考.[方法]从培养基配方(不同基本培养基、不同蔗糖浓度及不同细胞分裂素CPPU)和外植体材料(不同接种部位)两方面研究其对越南凉粉草无菌芽增殖的影响.[结果]在MS、Miller与改良White 3种基本培养基中,以MS对凉粉草芽增殖效果最好,芽增殖倍数达8.53倍;当蔗糖浓度为20.0 g/L时芽增殖倍数最高,为8.34

  5. Pesquisa de enterovírus em casos de síndrome de meningite asséptica de Belém, PA Investigation of enterovirus in cases of aseptic meningitis syndrome of Belém, PA

    Directory of Open Access Journals (Sweden)

    Letícia Martins Lamarão

    2005-10-01

    Full Text Available Com o objetivo de isolar e identificar os sorotipos de enterovírus, agentes etiológicos mais freqüentes da síndrome de meningite asséptica, foram estudadas amostras de líquor de pacientes da unidade de saúde de referência da Cidade de Belém-PA, do período de março de 2002 a março de 2003. As amostras foram inoculadas em cultivos celulares RD e HEp-2, e as positivas identificadas por neutralização ou imunofluorescência indireta. De 249 amostras, 33 (13,2% foram positivas sendo 57,6% (n=19 em pacientes menores de 11 anos (pWith the objective of isolating and identifying enteroviral serotypes, which are the most frequent etiologic agents of aseptic meningitis syndrome, cerebrospinal fluid samples were studied from patients referred to the health unit in the City of Belém (State of Pará, Brazil, from March 2002 to March 2003. The samples were inoculated in RD and HEp-2 cells line, and the positive were identified by neutralization test or indirect immunofluorescence. Out of 249 samples, 33 (13.2% were positive 57.6% (n = 19 in patients under 11 years of age (p <0.03 and predominantly (72.7% in males (p <0.008. The serotypes isolated were: Echovirus 30 (n = 31, Coxsackievirus B5 (n = 1 and Echovirus 30 and 4. In conclusion, this type of study also serves to determine the national picture, which is still little defined, regarding the most prevalent viral agents in AMS cases.

  6. Storage stability of cashew apple juice preserved by hot fill and aseptic processes Estabilidade do suco de caju preservado pelo método ''hot fill'' e processo asséptico

    Directory of Open Access Journals (Sweden)

    Maria Cecília Oliveira Costa

    2003-12-01

    Full Text Available Cashew (Anacardium occidentale L. apples from Pacajus, Ceará State, Brazil, were processed into high pulp content juice. The juice was packed either by hot fill or an aseptic process and evaluated for physical, physical-chemical, and sensorial changes during a 12-month storage period at room temperature. The results indicated that pH, soluble solids, total acidity, total sugar content and color did not change significantly during storage nor were affected by the type of filling. The sensorial analysis showed that juice acceptance remained high throughout the storage period regardless of the filling system. Differences in juice viscosity persisted between both processes.Pedúnculos de caju (Anacardium occidentale L. de Pacajus, Estado do Ceará, Brasil, foram processados na forma de suco com alto teor de polpa. O suco foi acondicionado através do processo hot fill ou asséptico e verificada as alterações físicas, físico-químicas e sensoriais durante armazenagem por doze meses à temperatura ambiente. Os resultados indicaram que pH, sólidos solúveis, acidez total, conteúdo de açúcar e cor não mudaram de modo significativo durante a armazenagem nem foram afetadas pelo modo de acondicionamento. Análise sensorial mostrou que a aceitação do suco foi mantida alta durante o período de armazenagem a despeito do sistema de enchimento. Diferenças na viscosidade dos sucos persistiram entre ambos processos.

  7. Effect of different cork puncture methods on aseptic storage period of normal saline%不同方法穿刺瓶塞生理盐水无菌存放时间研究

    Institute of Scientific and Technical Information of China (English)

    程翠年; 张卉; 吴胜林; 王懿睿; 王霞; 谢敏; 李绍婷; 李林; 易旭慧

    2011-01-01

    Objective To study the effect of different materials of cork, puncture methods and frequencies on the aseptic storage period of normal saline injection kept in PIVAS. Methods We grouped normal saline injection bottles according to the materials of the cork (butyl or polyisoprene ), puncture methods(stochastic puncture or repeated puncture of a single site of the cork) and puncture frequencies(three or five times). Sterility test were taken immediately after the puncture, and at 1 h, 2 h,3 h,4 h,5 h,6 h,8 h, 10h and 12 h within storage. Results The normal saline injection with polyisoprene cork stayed aseptic within 10 h after the corks were punctured 3 or 5 times randomly. The injection stayed sterile within 6 h after 3 times of, or within 5 h after 5 times of puncture through a single site of the cork. The normal saline injection with butyl cork stayed aseptic within 8 h after 3 times of, or within 6 h after 5 times of stochastic puncture. The injection with butyl cork stayed sterile within 5 h after 3 times of, or within 4 h after 5 times of puncture through a single site of the cork. Conclusion Normal saline injection with two different materials of the cork is able to stay sterile within 4 h regardless of the puncture methods or frequencies. The storage period of normal saline injection whose corks are repeatedly punctured at a single site is shortened with increasing puncture frequency. Normal saline injection with butyl cork shows shorter storage period compared with those with polyisoprene cork. The results indicate that we should strictly obeythe misalign rules during intravenous drug preparation. Meanwhile, the procedure calls for advisable arrangement of drug preparation time according to the drug properties and usage requirements.%目的 研究静脉药物配置中心环境下瓶塞材质、穿刺方法及穿刺次数对生理盐水无菌存放时间的影响.方法 将静脉输液用生理盐水按胶塞的材质(丁基胶塞和聚异戊二烯胶塞)

  8. [Aseptic meningitis after isotope cisternography. 2 Cases].

    Science.gov (United States)

    Guy, G; Comoy, J; Chevet, D; Thomas, R; le Pogamp, P

    1976-01-01

    In these two patients, as in 13 others described in the literature, a typical meningitic syndrome with excitement, confusion and a fever of 104degrees F (40degrees C) appeared 4-6 hours following the intra-thecal injection. Subsequent lumbar puncture usually reveals a cloudy C.S.F. under increased pressure. The polymorphs and proteins are increased but the glucose remains normal. There are no bacteria either on direct examination or after culture. All the patients receive antibiotics. After a course of three days, the symptoms and the fever have disappeared and the C.S.F. became normal. Bacterial contamination can be ruled out. The relative roles of iodine, radio-acitivity itself, albumine and of the radio-active element which are only used for this radiotracer are discussed. The tracer contains neither stabilizer nor pH buffer. One must presume that the syndrome is due to a direct toxic action rather than to an immunological or allergic reaction. Furthermore, it is of interest that similar reactions, without infection, are seen after spinal anaesthesia and intra-thecal injection of such differing substances such as iodine contrast media, gamma globulins, other isotopes or toxic substances (Lysol) (111In-DTPA).

  9. Estabilidade dos carotenoides,antocianinas e vitamina C presentes no suco tropical de acerola (Malpighia emarginata DC. adoçado envasado pelos processos Hot-Fill e asséptico Stability of carotenoids, anthocyanins and vitamin C presents in acerola sweetened tropical juice preserved by hot fill and aseptic processes

    Directory of Open Access Journals (Sweden)

    Claisa Andréa Silva de Freitas

    2006-10-01

    Full Text Available As frutas tropicais são muito aceitas pelos consumidores, e são importantes fontes de componentes antioxidantes. A acerola, conhecida por conter grandes quantidades de vitamina C, é também rica em antocianinas e carotenóides. O presente trabalho teve por objetivo avaliar a estabilidade dos carotenóides totais, antocianinas totais e vitamina C do suco tropical de acerola adoçado, elaborado pelos processos Hot Fill (garrafas de vidro e asséptico (embalagens cartonadas, durante 350 dias de armazenamento em condições similares às de comercialização (28ºC ± 2ºC. Ao final do experimento observou-se que não houve perdas de antocianinas totais para o processo Hot Fill, no entanto, para o processo asséptico constatou-se uma redução de 86,89% dos teores iniciais. Os valores de carotenóides totais permaneceram inalterados nas amostras do processo asséptico, enquanto nas do Hot Fill houve uma redução de 12,5%. Constatou-se redução nos teores de vitamina C da ordem de 23,61% para o processo Hot Fill e de 35,95% para o processo asséptico.Tropical fruits are widely accepted by consumers, and important sources of antioxidant compounds. Acerola, known to have high vitamin C levels, is also rich in anthocyanins and carotenoids. The purpose of this work was to evaluate the stability of the total carotenoids, total anthocyanins and ascorbic acid of the acerola sweetened tropical juice produced by the Hot Fill (glass bottles and aseptic (packings carton process during 350 days of storage in similar conditions of trade (28ºC ± 2ºC. It was observed that there were not losses of total anthocyanins for the process Hot Fill, however for the aseptic process a reduction of 86.89% of the initial values was observed. The values of total corotenoids stayed unaffected in the samples of the aseptic process, while in the one of the Hot Fill there was a reduction of 12.5%. A reduction in the values of ascorbic acid of 23.61% was observed for the Hot

  10. 基于层次分析法的面制主食杀菌及包装生产线设计与试验%Design and experiment of aseptic packaging line of staple wheat food with analytic hierarchy process method

    Institute of Scientific and Technical Information of China (English)

    徐雪萌; 屈凌波; 徐芸

    2016-01-01

    A design of aseptic packaging system integrated as the end part of the staple wheat food product line is studied, in order to keep the quality of the staple wheat food in the period of the distribution and sale.There are 3 basic parts in the aseptic packaging system, i.e. drying unit, compound sterilization units and packaging unit, considering influence factors for the food quality during storage and circulation as well as fresh-keeping packaging technology. Three basic parts can be freely used for different kinds of staple wheat food. Four technical schemes of aseptic packaging line are established according to different kinds of drying, sterilization and packaging techniques. The 4 schemes are studied with the analytic hierarchy process (AHP) method. In the AHP analysis process, the hierarchy with 3 criteria i.e. working performance, economic efficiency and reliability, and 9 sub-criteria is established. Through evaluation and priority considering, the optimum scheme is chosen. The aseptic packaging line is carefully designed, which is composed of the infrared drying unit, compound sterilization units of ultraviolet (UV), low temperature, Ozone, packaging machine, and reasonable product flow. In order to achieve industrial production of aseptic packaging for different kinds of staple wheat food, the line can be program-controlled with adjustable parameters, such as drying time, drying temperature, sterilization time, UV illumination intensity and Ozone intensity. The aseptic packaging system is set up in accordance with the above optimum scheme by the AHP method. Chinese steamed bread made of flour with primary moisture content of 43% have been processed by the compound sterilization units of aseptic packaging system under the condition of 4℃,relative humidity (RH) of 50%-70%, UV illumination intensity of 90-100µW/m2 and Ozone intensity of 40-60 mg/m3. For processed and the naturally placed Chinese steamed bread, the comparative tests of color, texture and

  11. Variáveis clínicas e laboratoriais para o diagnóstico diferencial entre meningites asséptica e piogênica em crianças Laboratorial and clinical variables to the differential diagnosis between aseptic and pyogenic meningitis in children

    Directory of Open Access Journals (Sweden)

    Rita Lucena

    1997-09-01

    Full Text Available Foram estudadas informações obtidas do prontuário de 573 crianças com idade entre 1 mês e 15 anos e diagnóstico de meningite, internadas no Hospital Couto Maia, na cidade de Salvador-Bahia, no período de janeiro-1990 a dezembro-1992. Crises epilépticas, diminuição do nível de consciência e rigidez de nuca foram mais frequentes no grupo com meningite bacteriana. Glicorraquia menor que 45 mg/dL, proteinorraquia igual ou superior a 140 mg/dL e celularidade liquórica superior a 600 cels/mm³ mostraram-se preditores de meningite piogênica. A análise da curva ROC foi utilizada para estabelecer o melhor ponto de corte nas medidas liquóricas de celularidade, proteínas e glicose capaz de predizer meningite bacteriana. Os resultados encontrados enfatizam que informações clínicas, obtidas com a anamnese e o exame neurológico, e liquóricas simples, definidas pelos níveis de proteína, glicose e análise da celularidade, podem ser utilizadas como medidas de grande acurácia para diferenciar meningite piogênica de asséptica em crianças.We reviewed the charts of 573 children with a final diagnosis of pyogenic or aseptic meningitis, who were hospitalized in a large reference hospital for the treatment of infectious disease, from January 1990 to December 1992. Seizures, decreased consciousness, nuchal rigidity were more frequent in bacterial than in aseptic meningitis. A cerebrospinal fluid (CSF glucose level lower than 45 mg/dL, a protein level equal or greater than 140 mg/dL and cell count greater than 600/mm³ were predictors of pyogenic meningitis. Receiver operating characteristic curve analysis was used to assess the best point in CSF measures of leukocytes, glucose and protein that could predict bacterial meningitis. These results suggest that clinicians should differentiate bacterial from aseptic meningitis in children with greater accuracy utilizing only clinical and simple CSF data.

  12. Meta-analysis of the risk factors of aseptic necrosis of bone in patients with systemic lupus erythematosus%系统性红斑狼疮并发无菌性骨坏死危险因素的Meta分析

    Institute of Scientific and Technical Information of China (English)

    李桂叶; 赵孟君; 马丽; 王国春; 吴东海

    2010-01-01

    目的 探讨系统性红斑狼疮(SLE)并发无菌性骨坏死的危险因素.方法 应用Meta分析方法 对国内外14篇关于SLE并发无菌性骨坏死危险因素的病例对照研究结果进行综合分析;运用Review Manager 4.2进行一致性检验及合并比值比(OR值)和95%可信区间(95%CI)的计算.结果 SLE合并无菌性骨坏死的危险因素的OR值及95%CI分别是:雷诺现象2.43(1.12~5.29),口腔溃疡2.33(1.11~4.88),肾脏受累1.76(1.27~2.44),血管炎4.65(1.62~13.33),高脂血症3.28(1.76~6.12),抗磷脂抗体2.06(0.84~5.06).结论 糖皮质激素是SLE患者发生无菌性骨坏死的重要因素,但不是唯一因素.雷诺现象、口腔溃疡、肾脏受累、血管炎、高脂血症是SLE并发无菌性骨坏死的主要危险因素.%Objective To investigate the major risk factors of aseptic necrosis of bone in patients with systemic lupus erythemattrsus (SLE),and thus provide evidence for decision-making on prevention.Methods Meta-analysis Was used to systemically evaluate the 14 case-control studies about the risk factors of aseptic necrosis of bone in patients with SLE.Review Manager 4.2 Was utilized to carry out homogeneity checking and calculate the pooled odds ratio (OR) with 95% confidence interval.Results The OR values of risk factor of AVN in patients with SLE and 95% CI were as follows:Raynaud's phenomenon 2.43(1.12~5.29):dental ulcer 2.33(1.11~4.88);renal involvement 1.76(1.27~2.44);vasculitis 4.65(1.62~13.33):hyperlipidemia 3.28(1.76~6.12);anti-phospholipid antibody(APL)2.06(0.84~5.06):hypocomplementemia 0.63(0.35~1.14).Conclusion Glucocorticosteroid is an important risk factor in inducing aseptic necrosis of bone in patients with SLE,but it is not the only factor.Raynaud's phenomenon,dental ulcer,renal involve-ment,vasculitis and hyperlipidemia are major risk factors of aseptic necrosis of bone in patients with SLE.

  13. Role of cerebrospinal fluid procalcitonin in identification of intracranial bacterial infection and aseptic meningitis%脑脊液降钙素原在鉴别颅内细菌性感染与无菌性脑膜炎中的作用

    Institute of Scientific and Technical Information of China (English)

    李幽然; 张国军; 高之宪; 季楠; 张力伟; 张扬; 王丽娟; 张洪欣; 康熙雄

    2015-01-01

    目的 探讨脑脊液降钙素原(PCT)在鉴别成人颅内细菌性感染与无菌性脑膜炎中的作用.方法 回顾性分析2013年10月至2014年3月首都医科大学附属北京天坛医院神经外科脑肿瘤术后48 ~ 72 h出现疑似细菌性颅内感染症状的患者178例.行脑脊液常规、生化及PCT的检测.按照颅内感染的诊断标准,将其分为细菌性感染组(50例)和无菌性脑膜炎组(128例).比较两组脑脊液PCT及传统脑脊液检测指标的变化情况,应用受试者工作特征曲线(ROC)分析脑脊液PCT对鉴别感染及无菌性脑膜炎的价值.结果 与无菌性脑膜炎组比较,细菌性感染组脑脊液中白细胞数量、多核细胞比例、蛋白质含量、PCT含量均增高,糖降低,差异均有统计学意义(均P<0.01);氯化物差异无统计学意义.其中感染组脑脊液PCT中位数(范围)为0.15 ng/ml(0 ~3.09 ng/ml),无菌性脑膜炎组为0 ng/ml(0 ~0.46 ng/ml).ROC结果显示,PCT鉴别诊断细菌性颅内感染曲线下面积为0.746,诊断阈值为0.075 ng/ml,敏感性为68.0%,特异性为72.7%,阳性预测值为49.3%,阴性预测值85.3%.脑脊液PCT与白细胞、多核细胞比例、蛋白含量呈正相关(r分别为0.446、0.453、0.482,均P<0.01;与糖呈负相关(r=-0.201,P=0.007).结论 脑脊液PCT检测对诊断神经外科术后细菌性颅内感染具有重要的临床应用价值.%Objective To investigate the role of the cerebrospinal fluid procalcitonin (PCT) in the identification of intracranial bacterial infection and aseptic meningitis in adults.Methods A total of 178 patients with the suspected symptom of intracranial bacterial infection at 48 to 72 h after neurosurgical brain tumor surgery at the Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University from October 2013 to March 2014 were analyzed retrospectively.The cerebrospinal fluid routine,biochemical and procalcitonin tests were performed.According to the diagnostic

  14. Effect observation on locking plate combining with autologous iliac bone graft in the treatment of aseptic nonunion after surgery of long bone fractures of extremities%锁定钢板联合自体髂骨植骨治疗四肢长骨干骨折术后无菌性骨不连的效果观察

    Institute of Scientific and Technical Information of China (English)

    刘志军

    2014-01-01

    Objective To research and evaluate the effect of locking plate combining with autologous iliac bone graft on treating aseptic nonunion after surgery of long bone fractures of extremities. Methods 43 cases of patients with aseptic nonunion on limb long bone caused by bone fixation failure were accepted in our hospital from January 2006 to June 2013.All of patients were treated with locking plate combining with autologous iliac bone graft. Results All patients were followed up.The follow-up time ranged from 7 to 24 months,with an average of 12.6 months.All of nonunion were healed in (5.9±1.0) months.Cut surface infection occurred in 3 cases (6.9%),which were cured after treatment.The slow-ly healed wound were 2 cases (4.7%) and limb about 2 cm shortened in 1 case (2.3%).None of cases suffered from malunion.At the final follow-up,joint activity improved more significantly compared with before surgery,including 35 cases (81.4%) with excellent effect,7 cases (16.3%) moderate,and 1 case (2.3%) poor. Conclusion In the treatment of patients with aseptic nonunion after surgery of long bone fractures of extremities,using locking plate for internal fixation is a curative therapy.Locking plate combining with autologous iliac bone graft can provide reliable fixation stability for fractura,and shows good functions on bone induction and conduction,so it obtains a favorable effect.%目的:研究评价锁定钢板联合自体髂骨植骨治疗四肢长骨干骨折术后无菌性骨不连的临床效果。方法选取2006年1月~2013年6月因内固定失败而造成四肢长骨干无菌性骨不连患者43例,均采用锁定钢板固定联合自体髂骨植骨进行治疗。结果患者均获得随访,随访时间7~24个月,平均12.6个月。骨不连均愈合,愈合时间为(5.9±1.0)个月。3例(6.9%)出现切口表面感染,经治疗后均痊愈;2例(4.7%)切口延迟愈合;1例(2.3%)出现肢体短缩<2 cm,无一例发生骨折畸形愈合。末次随访时关节活

  15. Sternal development in the pediatric population: evaluation using computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Delgado, Jorge; Jaimes, Camilo; Gwal, Kriti [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Jaramillo, Diego; Ho-Fung, Victor [The Children' s Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States)

    2014-04-15

    The normal development of the sternum using CT imaging is not known. To describe the normal development of the sternum in children on chest CT imaging. CT imaging of 300 patients (150 male, 150 female), mean age: 4.97 years (range: 0.01-9.9 years), were evaluated retrospectively. The presence and number of ossification centers in the manubrium, each individual mesosternal segment and the xiphoid were reviewed. Additionally, the vertical and horizontal fusion between ossification centers was evaluated. Differences among age and gender were calculated. Descriptive statistics, analysis of variances (ANOVA), chi-square and Fisher exact tests were performed for statistical analysis. Manubrium: A single ossification center was seen in 88% of cases and two or three ossification centers were seen in 12%. More manubrial ossification centers were correlated to a younger age (P < 0.001, R = -0.2). Mesosternum: Majority of patients had a single ossification center in the first segment (85%). The majority of patients had double ossification centers in the second and third segments (51% and 64%, respectively). No ossification center was seen in the fourth segment in 38% of patients. No significant difference among the age of vertical ossification between mesosternal segments was found. (ANOVA; P > 0.05). Xiphoid: Absence was seen in 67% of the patients. Bifid xiphoid was seen in 1% of the patients. The normal development of the different components of the sternum is a process with wide variation among children. The large variability of mesosternal ossification center types should not be confused with pathology. (orig.)

  16. 陕南3所三级甲等医院清洁手术预防使用抗菌药物的调查分析%Investigation on the preventive use of antibiotics in aseptic operation in three grade A class 3 hospitals in the south Shaanxi province

    Institute of Scientific and Technical Information of China (English)

    程建峰; 杨鹏

    2012-01-01

    目的 调查3所三级甲等医院清洁手术预防使用抗菌药物的情况,评价其应用的合理性.方法 抽取3所医院2011年9月清洁手术(甲状腺、乳腺、腹股沟疝、肾脏、颅脑手术)病例各50份,冠状动脉造影病例各20份,对病例是否使用抗菌药物、抗菌药物的品种、给药时机、给药时限及抗菌药物联合使用情况等进行统计分析.结果 清洁手术及冠状动脉造影诊断预防使用抗菌药物3所医院合计总体使用比例分别为67.3%和57.25%,品种选择合格率为60.8%,用药时机合格率为83.3%,使用疗程合格率为37.5%.结论 3所医院清洁手术预防使用抗菌药物,仅给药时机情况较好,抗菌药物的使用率、品种的选择及使用疗程都存在一定的不合理性.%Objective To investigate on the preventive use of antibiotics of three grade A class 3 hospitals,and to evaluate the rationality of the usage. Methods 50 cases of aseptic operations (thyroid,breast,inguinal hernia,kidney and brain operations) in September of 2011 of the three hospitals and 20 cases of coronary angiography were analyzed in the aspect of utilization,kinds,administration time, time of therapy and the combined use frequency of antibiotics. Results The frequency of preventive using antibiotics was 67. 3 % and 57. 25 % , respectively in the aseptic operation and coronary angiography. The reasonable chosen rate of kinds was 60. 8%, the reasonable chosen rate of administration time was 83. 3% ,and the reasonable chosen rate of time of therapy was 37. 5%. Conclusions The utilization frequency, chosen of kinds and time of therapy of antibiotics are not as reasonable as requested except the administration time of antibiotics in these three grade A class 3 hospitals.

  17. Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery Fatores de risco para infecção de ferida esternal e aplicação do escore da STS em pacientes submetidos à cirurgia de revascularização miocárdica

    Directory of Open Access Journals (Sweden)

    Pedro Silvio Farsky

    2011-12-01

    Full Text Available BACKGROUND: Sternal wound infection (SWI after coronary artery bypass graft (CABG surgery is a major complication. Identifying patients at risk of SWI is essential for the application of preventive measures. OBJECTIVE: To identify the pre- and intra-operative risk factors, apply the STS risk score and determine the correlation between the risk score and microorganisms isolated from surgical wounds in a Brazilian hospital. METHODS: This is a retrospective analysis of a database of all CABG surgeries performed in a single institution from 2006 to 2008. Chi-square analysis was used for categorical variables and Student's t-test was used for quantitative variables. Multivariate logistic regression model was used to identify independent risk factors for SWI. P 40 kg/m² (OR 6.27, 95%CI 2.53-15.48; P40 kg/m², number of affected coronary arteries and use of bilateral internal thoracic artery were associated with a higher risk of infection. The STS risk score can be successfully used and there was no correlation between microorganisms, the score and risk factors at our institution.FUNDAMENTO: A infecção de ferida operatória esternal após cirurgia de revascularização miocárdica (CRM é uma grave complicação. Identificar pacientes com risco elevado é fundamental para introdução de medidas de preventivas. OBJETIVO: Identificar os fatores de risco pré e intra-operatórios, avaliar o escore de risco da STS e correlação entre o escore e os microorganismos isolados em ferida operatória em hospital brasileiro. MÉTODOS: Análise retrospectiva de um banco de dados prospectivamente coletado de todas as CRM realizadas em centro único, no período de 2006 a 2008. Teste do qui-quadrado foi utilizado para variáveis categóricas e teste t-Student, para variáveis quantitativas. Modelo multivariado por regressão logística foi utilizado para identificação de fatores de risco independente para infecção de ferida esternal. P40 kg/m² (OR 5,38; IC

  18. Predictive risk factors for delayed sternal closure in the patients under the age of three months old with congenital cardiac disease%3个月内复杂先天性心脏病患儿术后延迟关胸的因素分析

    Institute of Scientific and Technical Information of China (English)

    张惠锋; 贾兵; 陈张根; 李炘; 叶明; 陶麒麟; 陈刚

    2008-01-01

    Objective To analyze the risk factors related with delayed sternal closure(DSC)in the patients under three months old with complex cardiac disease.Methods One hundred and nineteen patients underwent median sternotomy and cardiopulmonary bypass(CPB)between Jan 2000 to Oct 2006.The age ranged from 1 to 90 days(mean 44±26 days)and the weight ranged from 2.2 kg to 7.1 kg(mean 3.9±0.89 kg).SPSS v 11.5 software was used to analyze the factors including the age,gender,weight,preoperative conditions,diagnose,prematurity,requirement for preoperative mechanic ventilation,preoperative SPO2,cardia-thoracic area ratio,left ventricular faction,CPB duration,clamping time,total circulatory arrest with profound hypothermia.Results Forty-seven patients had DSC.The rate of DSC iS over 75% for IAA or TAPVD(infracardiac)or TGA/VSD.The risk factors including age(P=0.032),pre-operative mechanic ventilation(P=0.001),CPB duration(P=0.000),total circulatory arrest with profound hypothermia(P=0.001).They were statistically significant(multivariate logistic regression).Conclusions DSC is a simple,safe and efficient procedure for the complex cardiac diseases.DSC iS related to IAA or TAPVD(infracardiac)or TGA/VSD.Age,pre-operative mechanic ventilation,CPB duration,total circulatory arrest with profound hypothermia are the risk factors for DSC.Understanding the factors iS helpful in the clinical decision making process.%目的 探讨3个月内的复杂先天性心脏病患儿术后行延迟关胸的危险因素.方法 2000年1月~2006年10月收治119例胸骨正中切口并进行体外循环的患儿,男97例,女22例,年~龄1~90 d,平均(44±26)d,体重2.2~7.1 kg,平均(3.9±0.9)kg,分析年龄、性别、体重、术前胸围、诊断、是否为早产儿、术前是否机械通气、SpO2、胸片测得的心胸比例、心超测得的左心射血分数、体外循环时间、主动脉阻断时间、深低温停循环等因素与延迟关胸的相关性.结果 延迟关胸47

  19. Pseudoarthrosis of medial tibial plateau fracture-role of alignment procedure

    Directory of Open Access Journals (Sweden)

    Devgan Ashish

    2013-04-01

    Full Text Available 【Abstract】 Nonunion in tibial plateau fractures is very rare. Limited literature is available on Pubmed search on intraarticular tibial nonunion. Most of the cases reported have been following failed surgical treatment and none was neglected fractures. Three patients of isolated and neglected medial tibial plateau nonunion with almost similar demo-graphic profile are reported in this paper. All the three pa-tients were managed by minimally invasive compression fixation using lag screws supplemented with limb realign-ment procedure of high tibial osteotomy. We discussed the injury mechanism, management and rehabilitation in such cases and reviewed the available literature regarding such a presentation. Key words: Fracture healing; Tibial fractures; Frac-ture fixation; Osteotomy

  20. Painful pseudoarthrosis following lumbar spinal fusion: Detection by combined SPECT and planar bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Slizofski, W.J.; Hellman, R.S.; Isitman, A.T.; Collier, B.D.; Carrera, G.F.; Flatley, T.J.

    1987-02-01

    Twenty-six adult patients more than 6-months post-lumbar spinal fusion were studied. Flexion and extension radiographs showing motion or bone scintigrams, showing focal areas of increased activity within the fusion mass were considered positive for pseudarthrosis. Patients were classified as either symptomatic or asymptomatic. Among the 15 symptomatic patients, scintigraphy had a sensitivity of 0.78 and a specificity of 0.83 which was superior to the 0.43 sensitivity and 0.50 specificity of radiography. Six of the 11 asymptomatic patients had focal areas of increased activity in the bony fusion mass, possibly reflecting painless pseudarthrosis. Planar imaging was substantially enhanced by SPECT in 14 of the 26 cases. It is concluded that for the patient who remains symptomatic after lumbar spinal fusion, bone scintigraphy with SPECT is of significant value in detecting painful pseudarthrosis.

  1. Pseudoarthrosis of medial tibial plateau fracture——role of alignment procedure

    Institute of Scientific and Technical Information of China (English)

    Ashish Devgan; Pradeep Kamboj; Vinay Gupta; Narender K Magu; Rajesh Rohilla

    2013-01-01

    Nonunion in tibial plateau fractures is very rare.Limited literature is available on Pubmed search on intraarticular tibial nonunion.Most of the cases reported have been following failed surgical treatment and none was neglected fractures.Three patients of isolated and neglected medial tibial plateau nonunion with almost similar demographic profile are reported in this paper.All the three patients were managed by minimally invasive compression fixation using lag screws supplemented with limb realignme nt procedure of high tibial osteotomy.We discussed theinjury mechanism,management and rehabilitation in such cases and reviewed the available literature regarding such a presentation.

  2. Revision of the aseptic and septic total ankle replacement.

    Science.gov (United States)

    Espinosa, Norman; Wirth, Stephan Hermann

    2013-04-01

    Total ankle replacement has become a popular treatment of symptomatic end-stage ankle osteoarthritis. Contemporary total ankle replacement systems provide more anatomic and biomechanically sound function. However, longevity is still limited and long-term results of modern total ankle replacement designs are not available. In the case of failure, conversion into arthrodesis has remained the treatment of choice but at the cost of hindfoot function and potential degeneration of the adjacent joints. Thus, revision total ankle replacement by exchange of the prosthetic components represents an attractive solution. This article focuses on revision total ankle replacement and conversion to ankle arthrodesis.

  3. Degradation of aromatic compounds in plants grown under aseptic conditions

    Energy Technology Data Exchange (ETDEWEB)

    Mithaishvili, T.; Ugrekhelidze, D.; Tsereteli, B.; Sadunishvili, T.; Kvesitadze, G. [Durmishidze Inst. of Biochemistry and Biotechnology, Academy of Sciences of Georgia, Tbilisi (Georgia); Scalla, R. [Lab. des Xenobiotiques, INRA, Toulouse (France)

    2005-02-01

    The aim of the work is to investigate the ability of higher plants to absorb and detoxify environmental pollutants - aromatic compounds via aromatic ring cleavage. Transformation of {sup 14}C specifically labelled benzene derivatives, [1-6-{sup 14}C]-nitrobenzene, [1-6-{sup 14}C]-aniline, [1-{sup 14}C]- and [7-{sup 14}C]-benzoic acid, in axenic seedlings of maize (Zea mays L.), kidney bean (Phaseolus vulgaris L.), pea (Pisum sativum L.) and pumpkin (Cucurbita pepo L.) were studied. After penetration in plants, the above xenobiotics are transformed by oxidative or reductive reactions, conjugation with cell endogenous compounds, and binding to biopolymers. The initial stage of oxidative degradation consists in hydroxylation reactions. The aromatic ring can then be cleaved and degraded into organic acids of the Krebs cycle. Ring cleavage is accompanied by {sup 14}CO{sub 2} evolution. Aromatic ring cleavage in plants has thus been demonstrated for different xenobiotics carrying different substitutions on their benzene ring. Conjugation with low molecular peptides is the main pathway of aromatic xenobiotics detoxification. Peptide conjugates are formed both by the initial xenobiotics (except nitrobenzene) and by intermediate transformation products. The chemical nature of the radioactive fragment and the amino acid composition of peptides participating in conjugation were identified. (orig.)

  4. A Rare Case of Crowned Dens Syndrome Mimicking Aseptic Meningitis

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    Teruyuki Takahashi

    2013-03-01

    Full Text Available Background: Crowned dens syndrome (CDS, related to microcrystalline deposition in the periodontoid process, is the main cause of acute or chronic cervical pain. Microcrystal-line deposition most often consists of calcium pyrophosphate dehydrate crystals and/or hydroxyapatite crystals. Case Presentation: This report describes the case of an 89-year-old woman who presented with sudden onset, high fever, severe occipital headache, and neck stiffness. A laboratory examination revealed a markedly elevated white blood cell count (11,100/µl and C-reactive protein level (23.8 mg/dl. These clinical findings suggested severe infection such as meningitis with sepsis. However, the results of blood culture, serum endotoxin, and procalcitonin were all negative, and cerebrospinal fluid studies revealed only a slight abnormality. The patient was first diagnosed with meningitis and treated with antiviral and antibiotic agents as well as non-steroidal anti-inflammatory drugs, but they only had limited effects. A cervical plain computed tomography (CT scan and its three-dimensional (3D reconstruction detected a remarkable crown-like calcification surrounding the odontoid process. On the basis of the CT findings, the patient was diagnosed as a severe case of CDS and was immediately treated with corticosteroids. The patient's condition drastically improved within a week after one course of corticosteroid therapy. Conclusion: Some atypical symptoms of CDS are misleading and may be misdiagnosed as meningitis, as happened in our case. A CT scan, especially a 3D-CT scan, is necessary and useful for a definitive diagnosis of CDS. CDS should be considered as a differential diagnosis of a possible etiology for fever, headache, and cervical pain of unknown origin.

  5. Echovirus 6 associated to aseptic meningitis outbreak, in São Joaquim da Barra, São Paulo, Brazil Echovirus 6 associado a surto de meningite asséptica em São Joaquim da Barra, São Paulo, Brasil

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    Adriana Luchs

    2008-03-01

    Full Text Available An aseptic meningitis outbreak occurred during a period from February to May 2004 in São Joaquim da Barra, a town in the northern region of São Paulo State. A total of 40 cases were reported to the Epidemiological Surveillance Center of São Paulo State. Cerebrospinal fluid samples obtained from 23 patients were sent to the Adolfo Lutz Institute for isolation of the virus. These samples were inoculated into RD, HEp2 and Vero cell lineages and those presenting a cytopathogenic effect were selected for analysis by indirect immunofluorescence assay (IFA, neutralization testing (Nt and reverse transcriptase-polymerase chain reaction (RT-PCR. Cytopathogenic effects were observed in 52.2% (12/23 of these samples. All isolated viruses were identified as human enterovirus by IFA and RT-PCR and echovirus 6 was typed by IFA and Nt. Our results confirmed the participation and importance of echovirus as the etiological agent responsible for this outbreak and the serotype diversity of human enteroviruses circulating in São Paulo State.Entre fevereiro e maio de 2004, em São Joaquim da Barra, Estado de São Paulo, foi notificado ao Centro de Vigilância Epidemiológica (CVE um surto de meningite asséptica (MA envolvendo 40 indivíduos. Foram enviadas ao Instituto Adolfo Lutz amostras de líquido cefalorraquidiano (LCR de 23 pacientes com MA para tentativa de isolamento viral. Estas amostras foram inoculadas em 3 linhagens celulares: RD, HEp2 e Vero. Culturas celulares que apresentaram efeito citopático (ECP foram submetidas a ensaio de Imunofluorescência Indireta (IFI, reação de Neutralização (Nt e RT-PCR (Transcrição Reversa Reação em Cadeia da Polimerase. Em 52,2% (12/23 das amostras foi observado ECP. Todos os vírus isolados foram identificados como gênero HEV por IFI e RT-PCR e o sorotipo echovirus 6 (E-6 por IFI e Nt. Nossos resultados confirmam a participação e importância dos echovirus como agente etiológico responsável pelo surto

  6. Variação da concentração de vitamina C, ºBrix e acidez em néctar de laranja em embalagens cartonadas = Modification of vitamin C concentration, Brix and acidity in orange nectar in aseptic packaging

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    Telma Lucia de Oliveira

    2007-07-01

    Full Text Available Amostras de néctar de laranja, acondicionadas em embalagens cartonadas, foram armazenadas em local climatizado (25°C e em refrigerador (4°C. Durante oito semanas, análises de vitamina C, Brix e acidez foram realizadas no momento da abertura daembalagem, e seu produto residual foi ainda analisado durante quatro dias de estocagem em refrigerador. Analisando-se os resultados das variáveis por métodos estatísticos, observou-se que a temperatura de armazenagem influencia a quantidade de vitamina C do néctar delaranja. Ocorre decréscimo significativo na concentração de vitamina C, mas não há influência da temperatura de armazenagem no Brix e acidez do produto. O tempo de armazenamento influencia vitamina C, Brix e acidez. Constata-se, ainda, que após oito semanas de estocagem e quatro dias de abertura da embalagem a quantidade de vitamina C,em um copo de 200 mL do néctar de laranja estudado, supre a necessidade média diária de um adulto (60 mg.Samples of orange nectar in aseptic packaging were stored incontrolled room temperature (25°C and in a refrigerator (4°C. For eight weeks, analyses of vitamin C, Brix and acidity were conducted as the packages were opened, and their residual products were further analyzed during a period of four days stored in a refrigerator.By using statistical models from the results found, it was concluded that storage temperature influences the quantity of vitamin C in orange nectar. There was a significant decrease in vitamin C concentration in nectar, but storage temperature does not influenceacidity or Brix. Storage time does influence vitamin C, Brix and acidity. It was concluded that after eight weeks of storage and four days of opening the package, the amount of vitamin C in a 200 mL glass of orange nectar is enough to supply the average needed dailyintake (60 mg of vitamin C for an adult.

  7. Percutaneous Pedicle Screw Fixation with Polymethylmethacrylate Augmentation for the Treatment of Thoracolumbar Intravertebral Pseudoarthrosis Associated with Kummell’s Osteonecrosis

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    Hyeun-Sung Kim

    2016-01-01

    Full Text Available Purpose. The purpose of our study is to evaluate the therapeutic efficacy of short-segment percutaneous pedicle screw fixation with polymethylmethacrylate (PMMA augmentation for the treatment of osteoporotic thoracolumbar compression fracture with osteonecrosis. Methods. Osteoporotic thoracolumbar compression fractures with avascular necrosis were treated by short-segment PPF with PMMA augmentation. Eighteen were followed up for more than 2 years. The kyphotic angle, compression ratio, visual analog scale (VAS score for back pain, and the Oswestry Disability Index (ODI were analyzed. In addition, radiologic and clinical parameters of PPF group were compared with percutaneous vertebroplasty (PVP group. Results. Vertebral height and kyphotic angle of the compressed vertebral bodies were significantly corrected after the operation (P<0.05. Further, restored vertebral height was maintained during the 2 or more years of postoperative follow-up. Compared to the PVP group the postoperative compression ratio and kyphotic angle were significantly lower in the PPF group (P<0.05. The postoperative ODI and VAS of the PVP group were significantly higher than the PPF (P<0.05. Conclusions. According to our results, short-segment PPF with PMMA augmentation may be an effective minimally invasive treatment for osteoporosis in cases of osteoporotic vertebral compression fractures with Kummell’s osteonecrosis.

  8. Sarcomatous transformation of osteochondroma of the coronoid process forming pseudoarthrosis with zygomatic arch mistaken for Jacob disease.

    Science.gov (United States)

    Jha, Abhishek; Gupta, Prakhar; Khalid, Mohd; Naseem, Iqbal; Gupta, Gagan

    2014-01-01

    Osteochondromas are the most common benign osseous neoplasms, with a propensity to involve long bones. The involvement of the coronoid process is extremely rare, and osteochondromas of the coronoid process may form pseudoarticulations with the zygomatic arch when large, an entity that is extremely rare and termed as Jacob disease. Sarcomatous degeneration of osteochondroma of the coronoid process is an extremely rare entity and has not been described to date. Only 1 case of primary mesenchymal chondrosarcoma has been described. We present a case of a 24-year-old man with a chondrosarcoma of the coronoid process, who was wrongly diagnosed with Jacob disease on the basis of radiologic findings.

  9. The use of Papineau technique for the treatment of diabetic and non-diabetic lower extremity pseudoarthrosis and chronic osteomyelitis

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    Vasilios D. Polyzois

    2011-03-01

    Full Text Available The treatment of 31 consecutive adult patients, ages 25–67 years with chronic draining osteomyelitis (12 cases or infected pseudarthrosis (19 cases by the Papineau technique was retrospectively reviewed. The initial injury was an open fracture in 24 patients and a closed fracture in 7 patients. In all cases an Ilizarov circular external fixation device was used for the stabilization of the fracture or for bone lengthening. Mean follow-up for the group was 20 months (range, 10 months to 5 years and there was successful limb salvage in all cases with eradication of infection and bone consolidation was achieved. The Ilizarov circular external fixation was removed at a mean of 18 weeks (range, 14–24 weeks. The mean time to bone union was 5 months (range, 4–10 months. All patients returned to their pre-treatment activity levels or better.

  10. Open segmental fractures of the tibia treated by external fixation

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    Golubović Ivan

    2012-01-01

    Full Text Available Introduction. Open segmental fractures of the tibia are rare but severe injuries. In these fractures the wide zone of injury (damage of all structures of the lower leg creates very unsuitable biological conditions for healing of the fracture. Objective. The aim of our work was to present the results of treatment of patients with segmental open fractures of the tibia treated by external fixation. Methods. We analyzed treatment results of 21 patients with open segmental tibial fractures who were treated using the method of external fixation at the Clinical Center Niš from January 1, 1995 to July 31, 2010. The average age of the patients was 53 years; the youngest patient was 27 years and the oldest one 80 years. According to the Gustilo open fracture classification, there were 3 (14.3% type I, 6 (28.6% type II, 8 (38.1% type IIIA, and 4 (19.0% type IIIB. All the patients were treated by a unilateral type Mitković external fixator by Traffix Company. Results. Union was attained in 16 (76.2% fractures without severe complications (pseudoarthrosis, chronic osteitis and angular deformities of over 10 degrees. Among severe complications associated with open segmental tibial fractures, in two cases we registered septic pseudoarthrosis, in one aseptic pseudoarthrosis and in two large angular deformities of the tibia after union, with a valgus of over 10 degrees and extremity shortening of over 2 cm which required additional surgery. Conclusion. External fixation by the use of Mitković external fixator is one of the methods of choice in the treatment of open segmental tibial fractures, which incorporated with antibiotic therapy provides good biomehanical conditions for segmental fracture healing that enables good stability of the segmental tibial fracture and decreases the risk of deep infections. [Projekat Ministarstva nauke Republike Srbije, br. 41017: Virtuelni koštano­zglobni sistem čoveka i njegova primena u pretkliničkoj i kliničkoj praksi

  11. Nuss procedure in adult pectus excavatum: a simple artifice to reduce sternal tension

    OpenAIRE

    Ravenni, Giacomo; Actis Dato, Guglielmo Mario; Zingarelli, Edoardo; Flocco, Roberto; Casabona, Riccardo

    2013-01-01

    Nowadays the Nuss operation represents the standard surgical choice for pectus excavatum repair in children and teenagers. Some concerns have been raised regarding its applicability in adults, as compared with younger patients, in view of the higher rate of complications after surgery. We describe an easy trick that has been performed on a 36-year old man with a moderate pectus excavatum after an unsatisfactory Nuss procedure. It consisted of a T-shaped partial anterior sternotomy, performed ...

  12. Laparoscopic repair of a Morgagni diaphragmatic hernia in a child, using a trans-sternal technique

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    Shah Amar

    2005-01-01

    Full Text Available Laparoscopic repair of Morgagni hernia has been described in adults and children. In the published reports, the crux of the repair consists of suturing the posterior part of the diaphragmatic defect to the undersurface of the sternum or the posterior rectus sheath. The tissue on the undersurface of the sternum is variable is in its nature and may be inadequate for suturing, hence compromising the strength of the repair. A technique that circumvents this problem and offers a strong anatomical repair is described. A Morgagni hernia was diagnosed in a 2-year-old girl with trisomy 21, who presented with recurrent chest infections. She underwent laparoscopic repair of the hernia using three ports. The tissue on the undersurface of the sternum was inadequate for a conventional repair. The procedure was modified as follows: a small transverse incision was made over the lower end of the sternum. Three nonabsorbable mattress sutures were inserted through the sternum, the anterior edge of the diaphragmatic defect, and back through the sternum and tied with extracorporeal knots. The child was discharged home on the second postoperative day. At 6-month follow up, the child was asymptomatic, and had been infection free. A chest radiograph was normal. This is a simple, novel, noninvasive method, which offers a secure anatomical repair and it is not dependent on the adequacy of the tissue on the undersurface of the sternum.

  13. Sternal Pulse Rate Variability Compared with Heart Rate Variability on Healthy Subjects

    DEFF Research Database (Denmark)

    Chreiteh, Shadi; Belhage, Bo; Hoppe, Karsten

    2014-01-01

    differing more than 50 ms (pNN50) were calculated from the R peak-to-R peak (R-R) and pulse-to-pulse (P-P) intervals. In the frequency domain the low and high frequency ratio of the power spectral density (LF/HF) was also computed. The Pearson correlation coefficient showed significant correlation for all...

  14. Topical negative pressure effects on coronary blood flow in a sternal wound model

    DEFF Research Database (Denmark)

    Lindstedt, Sandra; Malmsjö, Malin; Gesslein, Bodil;

    2008-01-01

    patients with topical negative pressure (TNP)-treated mediastinitis and CABG patients without mediastinitis. The present study was designed to elucidate if TNP, applied over the myocardium, resulted in an increase of the total amount of coronary blood flow. Six pigs underwent median sternotomy....... The coronary blood flow was measured, before and after the application of TNP (-50 mmHg), using coronary electromagnetic flow meter probes. Analyses were performed before left anterior descending artery (LAD) occlusion (normal myocardium) and after 20 minutes of LAD occlusion (ischaemic myocardium). Normal...... coronary blood flow in both normal and ischaemic myocardium....

  15. Inflammatory Metastatic Carcinoma of Sternum Mimicking Sternal Osteomyelitis with Gas Gangrene

    Energy Technology Data Exchange (ETDEWEB)

    Choo, Ji Yung; Je, Bo Kyung; Lee, Ki Yeol; Kim, Baek Hyun [Dept. of Radiology, Korea University College of Medicine, Ansan Hospital, Ansan (Korea, Republic of); Kim, Sung Bum [Dept. of Internal Medicine, Dongshin Hospital, Seoul (Korea, Republic of)

    2013-03-15

    Inflammatory metastasis is a metastatic tumor associated with fever, skin changes, soft tissue inflammation, and laboratory abnormalities, suggesting an inflammation that obscures the underlying malignancy. We report a 69-year-old male with inflammatory metastatic carcinoma of sternum. He presented with clinical findings mimicking osteomyelitis of the sternum. The chest CT scan showed the parasternal soft tissue masses and cortical disruption of sternum which was continuous with air bubbles spreading through the pectoralis muscles. He was diagnosed as poorly-differentiated carcinoma with unknown origin.

  16. Environmental regulation of type X collagen production by cultures of limb mesenchyme, mesectoderm, and sternal chondrocytes.

    Science.gov (United States)

    Solursh, M; Jensen, K L; Reiter, R S; Schmid, T M; Linsenmayer, T F

    1986-09-01

    We have examined whether the production of hypertrophic cartilage matrix reflecting a late stage in the development of chondrocytes which participate in endochondral bone formation, is the result of cell lineage, environmental influence, or both. We have compared the ability of cultured limb mesenchyme and mesectoderm to synthesize type X collagen, a marker highly selective for hypertrophic cartilage. High density cultures of limb mesenchyme from stage 23 and 24 chick embryos contain many cells that react positively for type II collagen by immunohistochemistry, but only a few of these initiate type X collagen synthesis. When limb mesenchyme cells are cultured in or on hydrated collagen gels or in agarose (conditions previously shown to promote chondrogenesis in low density cultures), almost all initiate synthesis of both collagen types. Similarly, collagen gel cultures of limb mesenchyme from stage 17 embryos synthesize type II collagen and with some additional delay type X collagen. However, cytochalasin D treatment of subconfluent cultures on plastic substrates, another treatment known to promote chondrogenesis, induces the production of type II collagen, but not type X collagen. These results demonstrate that the appearance of type X collagen in limb cartilage is environmentally regulated. Mesectodermal cells from the maxillary process of stages 24 and 28 chick embryos were cultured in or on hydrated collagen gels. Such cells initiate synthesis of type II collagen, and eventually type X collagen. Some cells contain only type II collagen and some contain both types II and X collagen. On the other hand, cultures of mandibular processes from stage 29 embryos contain chondrocytes with both collagen types and a larger overall number of chondrogenic foci than the maxillary process cultures. Since the maxillary process does not produce cartilage in situ and the mandibular process forms Meckel's cartilage which does not hypertrophy in situ, environmental influences, probably inhibitory in nature, must regulate chondrogenesis in mesectodermal derivatives. (ABSTRACT TRUNCATED AT 250 WORDS)

  17. Anesthesia for trans-sternal thymectomy: modified non-muscle relaxant technique.

    Science.gov (United States)

    Baftiu, Nehat; Hadri, Burhan; Morina, Muharrem; Mustafa, Aziz

    2011-01-01

    Anesthesia for thymectomy in myasthenia gravis is challenging. Early surgical management is now considered to be an important therapeutic intervention for most of the patients of myasthenia gravis. The anesthetic experience of that technique is quite large. It involves either muscle relaxant or non-muscle relaxant techniques. However, the literature is deficient of standard anesthetic technique for thymectomy. Therefore we present in this report a modified non-muscle relaxant technique for thymectomy. We report one case with thymectomy under general anesthesia using fentanyl and propofol for induction and endotracheal intubation using non-muscle relaxant technique. The intubating, intraoperative and postoperative conditions were excellent.

  18. Resternal closure versus pectoral muscle flap following omental flap in treatment of deep sternal wound infection

    Directory of Open Access Journals (Sweden)

    Fouad Rassekh

    2016-05-01

    Conclusion: Omental flap is safe, easy and effective technique in management of mediastinitis with DSWI following open heart surgery in CABG patients either this procedure was followed by reclosure of the sternum or bilateral pectoral flap. However, reclosure of the sternum is more physiological and less invasive than doing bilateral pectoral flap leaving the sternum unclosed.

  19. Respiratory Function in Voluntary Participating Patagonia Sea Lions (Otaria flavescens) in Sternal Recumbency.

    Science.gov (United States)

    Fahlman, Andreas; Madigan, Johnny

    2016-01-01

    We measured esophageal pressures (n = 4), respiratory flow rates (n = 5), and expired O2 and CO2 (n = 4) in five adult Patagonia sea lions (Otaria flavescens, body mass range 94.3-286.0 kg) during voluntary breaths while laying down out of water. The data were used to estimate the dynamic specific lung compliance (sCL), the O2 consumption rate ([Formula: see text]O2) and CO2 production rates ([Formula: see text]CO2) during rest. Our results indicate that the resting tidal volume in Patagonia sea lions is approximately 47-73% of the estimated total lung capacity. The esophageal pressures indicated that expiration is passive during voluntary breaths. The average sCL of sea lions was 0.41 ± 0.11 cmH2O(-1), which is similar to those measured in anesthetized sea lions and awake cetaceans, and significantly higher as compared to humans (0.08 cmH2O(-1)). The average estimated [Formula: see text]O2 and [Formula: see text]CO2 using breath-by-breath respirometry were 1.023 ± 0.327 L O2 min(-1) (range: 0.695-1.514 L O2 min(-1)) and 0.777 ± 0.318 L CO2 min(-1), (range: 0.510-1.235 L CO2 min(-1)), respectively, which is similar to previously published metabolic measurements from California and Steller sea lions using conventional flow-through respirometry. Our data provide end-tidal gas composition and offer novel data for respiratory physiology in pinnipeds, which may be important for clinical medicine and conservation efforts.

  20. Respiratory function in voluntary participating Patagonia sea lions in sternal recumbency

    Directory of Open Access Journals (Sweden)

    Andreas Fahlman

    2016-11-01

    Full Text Available We measured esophageal pressures (n=4, respiratory flow rates (n=5, and expired O2 and CO2 (n=4 in five adult Patagonia sea lions (Otaria flavescens, body mass range 94.3-286.0 kg during voluntary breaths while laying down. The data were used to estimate the dynamic specific lung compliance (sCL, cmH2O-1, the O2 consumption rate (VO2 and CO2 production rates (VCO2 during rest. Our results indicate that the resting tidal volume in Patagonia sea lions is approximately 47-73% of the estimated total lung capacity. The esophageal pressures indicated that expiration is passive during voluntary breaths. The average sCL of dolphins was 0.41±0.11 cmH2O−1, which is similar to those measured in anesthetized sea lions and awake cetaceans, and significantly higher as compared with humans (0.08 cmH2O−1. The average estimated and using breath-by-breath respirometry were 1.023 ± 0.327 L O2 min-1 (range: 0.695-1.514 L O2 min−1 and 0.777 ± 0.318 L CO2 min-1, (range: 0.510-1.235 L CO2 min-1, respectively, which is similar to previously published metabolic measurements from California and Steller sea lions using conventional flow-through respirometry. Our data provide end-tidal gas composition and provide novel data for respiratory physiology in pinnpeds, which may be important for clinical medicine and conservation efforts.

  1. Effect of P and Ca on the mycorrhiza of P. sylvestris formation in aseptic condition

    Directory of Open Access Journals (Sweden)

    Elżbieta Chruścik

    2014-08-01

    Full Text Available Ihe effect of some phosphorus and calcium compounds on mycorrhiza formation in pure cultures was investigated. In this experiment — Cenococcum groniforme, Suillus bovinus and Tricholoma albobrunneum were used. The ability to synthese acid phosphatase was tested in 11 strains. The presence of P has a stimulating effect on mycorrhiza formation by S. bovinus und T. albobrunneum. On control medium and medium containing CaO mycorrhiza was absent or only single. Ali strains synthetised phosphatase. The lowest enzymatic activity was found in two C. graniforme strains.

  2. Chronic Granulomatous Disease Presenting as Aseptic Ascites in a 2-Year-Old Child

    Directory of Open Access Journals (Sweden)

    J. F. Moreau

    2013-01-01

    Full Text Available Chronic granulomatous disease (CGD is a rare inherited immunodeficiency syndrome that results from abnormal nicotinamide adenine dinucleotide phosphate (NADPH oxidase function. This defect leads to recurrent catalase-positive bacterial and fungal infections as well as associated granuloma formation. We review the case of a 2-year-old boy who presented with ascites and fever of an unknown origin as manifestations of CGD. Cultures were negative for infection throughout his course, and CGD was suspected after identification of granulomas on peritoneal biopsy. Genetic testing revealed a novel mutation in the CYBB gene underlying his condition. This paper highlights the importance of considering CGD in the differential diagnosis of fever of unknown origin and ascites in children.

  3. Loading and unloading of freeze-dryers: airborne contamination risks for aseptically manufactured sterile drug products.

    Science.gov (United States)

    Ljungqvist, Bengt; Reinmüller, Berit

    2007-01-01

    In pharmaceutical manufacturing, freeze-drying processes can be adversely affected by temperature differences relative to the surrounding air. Loading and unloading of freeze-dryers are performed either without or with temperature differences between the cleanroom and the chamber of the freeze-dryer. This operation can cause a flow of room air through the opening, creating a contamination risk, especially when manual handling of material is performed in this area. To minimize this risk, a high-efficiency particulate air (HEPA) filter unit should be installed above the opening to provide clean air and protect the opening. Here the theoretical relationships are discussed and design criteria are presented.

  4. Feasibility Study of Aseptic Homogenization: Affecting Homogenization Steps on Quality of Sterilized Coconut Milk

    Directory of Open Access Journals (Sweden)

    Phungamngoen Chanthima

    2016-01-01

    Full Text Available Coconut milk is one of the most important protein-rich food sources available today. Separation of an emulsion into an aqueous phase and cream phase is commonly occurred and this leads an unacceptably physical defect of either fresh or processed coconut milk. Since homogenization steps are known to affect the stability of coconut milk. This work was aimed to study the effect of homogenization steps on quality of coconut milk. The samples were subject to high speed homogenization in the range of 5000-15000 rpm under sterilize temperatures at 120-140 °C for 15 min. The result showed that emulsion stability increase with increasing speed of homogenization. The lower fat particles were generated and easy to disperse in continuous phase lead to high stability. On the other hand, the stability of coconut milk decreased, fat globule increased, L value decreased and b value increased when the high sterilization temperature was applied. Homogenization after heating led to higher stability than homogenization before heating due to the reduced particle size of coconut milk after aggregation during sterilization process. The results implied that homogenization after sterilization process might play an important role on the quality of the sterilized coconut milk.

  5. Feasibility Study of Aseptic Homogenization: Affecting Homogenization Steps on Quality of Sterilized Coconut Milk

    OpenAIRE

    Phungamngoen Chanthima; Asawajinda Tippunsa; Santad Rujira; Sawedboworn Wanticha

    2016-01-01

    Coconut milk is one of the most important protein-rich food sources available today. Separation of an emulsion into an aqueous phase and cream phase is commonly occurred and this leads an unacceptably physical defect of either fresh or processed coconut milk. Since homogenization steps are known to affect the stability of coconut milk. This work was aimed to study the effect of homogenization steps on quality of coconut milk. The samples were subject to high speed homogenization in the range ...

  6. Importance of Herrings classification in predicting the outcome of aseptic necrosis of the femoral head

    Directory of Open Access Journals (Sweden)

    Žarko Dašić

    2015-02-01

    Full Text Available Aim To highlight the importance of values of the Herring’s classification in the treatment planning of Legg-Calve-Perthes disease (LCPD. Method The charts of 14 patients in a period of 4 years (2004-2008 were retrospectively reviewed. Inclusion criteria was unilateral LCPD and contralateral healthy hip. The patients were divided into three Herring groups according to radiographic images (A, B and C. For all patients the acetabulum/head index (AHI was determined. Results The youngest patient was 4.9 years and the oldest 9.11 years; male patients were dominant (male:female 11:3. The right hip side was more affected comparing to the left one (8:6. The distribution of patients in Herring groups was three in the Group A, six in the Group B and five patients in the Group C. The AHI index was lowest in the group C. Patients in the group C were treated surgically. Conclusion Herrings classification predicts patients with extensive changes and suggests what kind of treatment should be applied.

  7. A Fuzzy Expert System for Distinguishing between Bacterial and Aseptic Meningitis

    Directory of Open Access Journals (Sweden)

    Mostafa Langarizadeh

    2015-05-01

    Data were extracted from 106 records of patients with meningitis (42 cases with bacterial meningitis in order to evaluate the proposed system. The system accuracy, specificity, and sensitivity were 89%, 92 %, and 97%, respectively. The area under the ROC curve was 0.93, and Kappa test revealed a good level of agreement (k=0.84, P

  8. Feasibility of Applying Ohmic Heating and Split-Phase Aseptic Processing for Ration Entree Preservation

    Science.gov (United States)

    1994-08-01

    Sauce Pork* 60.00 48.34 40.00 Tomato paste, 24% solids 22.50 14.24 24.40 Water 13.82 13.96 14.08 Sugar, brown, light 4.40 4.35 4.40 Vinegar ... cider 3.32 3.28 3.32 Starch, waxy maize, modified 2.00 1.20 1.20 Salt 0.08 0.60 0.60 Worcestershire sauce 0.60 0.60 0.60 Onion, dehydrated, chopped

  9. Decision-making support system based on LCA for aseptic packaging recycling.

    Science.gov (United States)

    Varžinskas, Visvaldas; Staniškis, Jurgis K; Knašyte, Milda

    2012-09-01

    In Europe post-consumer beverage carton packages are treated in three ways: dumped in a landfill, incinerated for energy recovery, and recycled. In recent years new technologies for beverage carton recycling have been developed and tested. At the same time in Europe the collection of second-hand raw materials is becoming more efficient. In order to facilitate and justify the decision-making process, different possibilities of poly-aluminium handling were analysed. For this reason, the objective of this study was to compare carbon footprints in the whole life cycle of selected technologies and to provide decision-making with data for beverage carton recycling. The paper is based on some of the results of the project 'Sustainable Production through Innovations in small- and medium-sized enterprises (SPIN)'. The SPIN project is providing small- and medium-sized enterprises with a whole set of instruments that put entrepreneurs in a position to innovate their production processes and products leading to improved business and public benefits.

  10. Echovirus 30 associated with cases of aseptic meningitis in state of Pará, Northern Brazil

    Directory of Open Access Journals (Sweden)

    Ceyla Maria Oeiras de Castro

    2009-05-01

    Full Text Available Investigation of the aetiology of viral meningitis in Brazil is most often restricted to cases that occur in the Southern and Southeastern Regions; therefore, the purpose of this study is to describe the viral meningitis cases that occurred in state of Pará, Northern Brazil, from January 2005-December 2006. The detection of enterovirus (EV in cerebrospinal fluid was performed using cell culture techniques, RT-PCR, nested PCR and nucleotide sequencing. The ages of the 91 patients ranged from 60 years old (median age 15.90 years. Fever (87.1%, headache (77.0%, vomiting (61.5% and stiffness (61.5% were the most frequent symptoms. Of 91 samples analyzed, 18 (19.8% were positive for EV. Twelve were detected only by RT- PCR followed by nested PCR, whereas six were found by both cell culture and RT-PCR. From the last group, five were sequenced and classified as echovirus 30 (Echo 30. Phylogenetic analyses revealed that Echo 30 detected in Northern Brazil clustered within a unique group with a bootstrap value of 100% and could constitute a new subgroup (4c according to the phylogenetic tree described by Oberste et al. (1999. This study described the first molecular characterization of Echo 30 in Brazil and this will certainly contribute to future molecular analyses involving strains detected in other regions of Brazil.

  11. White blood cell scintigraphy for differentiation of infection and aseptic loosening

    DEFF Research Database (Denmark)

    Simonsen, Lene; Buhl, Anna; Oersnes, Thue;

    2007-01-01

    Diagnosis of an infected arthroplasty is often difficult. Fever, abnormal physical findings, radiographic changes, findings at bone scintigraphy, an elevated erythrocyte sedimentation rate, CRP, and leucocytosis are not specific enough. We evaluated the diagnostic value of white blood cell...

  12. Pharmaceutical compositions comprising lubricants for preventing or reducing aseptic loosening in a subject

    DEFF Research Database (Denmark)

    2013-01-01

    The present invention relates to pharmaceutical compositions comprising one or more amphiphilic polymer lubricants for use in association with artificial orthopaedic implants. Additionally, the invention relates to medical use of the lubricants of the invention in connection with conditions...... associated with artificial5 orthopaedic implants. The invention furthermore relates to artificial joint implants comprising the polymer lubricants according to the invention and methods for preparing such implants....

  13. Noninflammatory sclerosis of the sternal end of the clavicle: a follow-up study and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Jurik, A.G. (Dept. of Diagnostic Radiology, Municipal Hospital, Univ. of Aarhus (Denmark))

    1994-07-01

    The cases of 14 adult females with swelling, tenderness, and sclerosis of the inferomedial part of the clavicle are presented. They were seen during a 16-year period, suggesting that the condition is rare. In ten patients strain at the sternoclavicular joint seemed to be an etiological factor. Eleven patients were followed for periods of 1-13 years (mean 5 years). The clavicular sclerosis regressed and they all developed signs of osteoarthrosis. Based upon available biopsy results and review of reported cases, it is hypothesized that the radiographic changes are due to osteonecrosis of the medial end of the clavicle with subsequent development of osteoarthrosis. (orig.)

  14. Long-term quasi-continuous oxygen saturation levels obtained from sternal photoplethysmography on patients with obstructive lung diseases

    DEFF Research Database (Denmark)

    Chreiteh, Shadi; Saadi, Dorthe Bodholt; Belhage, Bo;

    2016-01-01

    the sternum of patients admitted to the hospital with obstructive lung diseases. Due to the lack of a gold standard reference that is suitable for long-term monitoring without interfering with the patient's activity level, we extracted reliable segments based on knowledge from the basic pulse oximeter theory...

  15. Classification of acute stress using linear and non-linear heart rate variability analysis derived from sternal ECG.

    Science.gov (United States)

    Tanev, George; Saadi, Dorthe B; Hoppe, Karsten; Sorensen, Helge B D

    2014-01-01

    Chronic stress detection is an important factor in predicting and reducing the risk of cardiovascular disease. This work is a pilot study with a focus on developing a method for detecting short-term psychophysiological changes through heart rate variability (HRV) features. The purpose of this pilot study is to establish and to gain insight on a set of features that could be used to detect psychophysiological changes that occur during chronic stress. This study elicited four different types of arousal by images, sounds, mental tasks and rest, and classified them using linear and non-linear HRV features from electrocardiograms (ECG) acquired by the wireless wearable ePatch® recorder. The highest recognition rates were acquired for the neutral stage (90%), the acute stress stage (80%) and the baseline stage (80%) by sample entropy, detrended fluctuation analysis and normalized high frequency features. Standardizing non-linear HRV features for each subject was found to be an important factor for the improvement of the classification results.

  16. Architecture of the organic matrix in the sternal CaCO3 deposits of Porcellio scaber (Crustacea, Isopoda).

    Science.gov (United States)

    Fabritius, Helge; Walther, Paul; Ziegler, Andreas

    2005-05-01

    Before the molt terrestrial isopods resorb calcium from the posterior cuticle and store it in large deposits within the first four anterior sternites. In Porcellio scaber the deposits consist of three structurally distinct layers consisting of amorphous CaCO3 (ACC) and an organic matrix that consists of concentric and radial elements. It is thought that the organic matrix plays a role in the structural organization of deposits and in the stabilization of ACC, which is unstable in vitro. In this paper, we present a thorough analysis of the ultrastructure of the organic matrix in the CaCO3 deposits using high-resolution field-emission scanning electron microscopy. The spherules and the homogeneous layer contain an elaborate organic matrix with similar structural organization consisting of concentric reticules and radial strands. The decalcification experiments reveal an inhomogeneous solubility of ACC within the spherules probably caused by variations in the stabilizing properties of matrix components. The transition between the three layers can be explained by changes in the number of spherule nucleation sites.

  17. Sevoflurane and thoracic epidural anesthesia for trans-sternal thymectomy in a child with juvenile myasthenia gravis

    Directory of Open Access Journals (Sweden)

    Valluvan Rangasamy

    2014-01-01

    Full Text Available Literature on anesthetic management of juvenile myasthenia gravis (JMG for thymectomy is limited. Recently, use of inhalational agents and total intravenous anesthesia with propofol and remifentanyl has been reported. All these techniques individually or in combination have been tried to avoid the use of muscle relaxant. We report successful use of sevoflurane as sole anesthetic agent for intubation and in combination with thoracic epidural anesthesia for intraoperative anesthetic management in a 5-year-old child with JMG.

  18. Classification of acute stress using linear and non-linear heart rate variability analysis derived from sternal ECG

    DEFF Research Database (Denmark)

    Tanev, George; Saadi, Dorthe Bodholt; Hoppe, Karsten

    2014-01-01

    features from electrocardiograms (ECG) acquired by the wireless wearable ePatch® recorder. The highest recognition rates were acquired for the neutral stage (90%), the acute stress stage (80%) and the baseline stage (80%) by sample entropy, detrended fluctuation analysis and normalized high frequency...

  19. 先天性胫骨假关节治疗方法的探讨%A Study on the Treatment of Congenital Pseudoarthrosis of Tibia

    Institute of Scientific and Technical Information of China (English)

    贾和庚; 潘少川; 田世林

    1981-01-01

    @@ 先天性胫骨假关节比较少见,系患肢胫骨一段先天性发育不良,早期每为胫骨向前弯曲,或为胫骨内有囊性病变,继而发生病理骨折,逐渐造成严重的肢体畸形和功能障碍.

  20. 胫骨感染性假关节治疗方法的探讨%Treatment of infected pseudoarthrosis of the tibia

    Institute of Scientific and Technical Information of China (English)

    白一冰; 马远征; 常青; 胡明; 关长勇; 席建成; 王国柱

    2002-01-01

    目的探讨胫骨感染性假关节的治疗方法.方法手术分二期完成,一期打通髓腔,外固定架固定,二期交腿皮瓣移植封闭创面.结果 12例感染性假关节采用上述方法治疗,骨折全部愈合,皮瓣生长良好,膝、踝关节活动度明显改善.结论先固定骨折,后封闭创面,可明显改善患肢血运,为骨折愈合,皮瓣成活创造了良好条件.一般无需植骨,且有利于膝踝关节功能康复.

  1. Selective culturing and genus-specific PCR detection for identification of Aeromonas in tissue samples to assist the medico-legal diagnosis of death by drowning.

    Science.gov (United States)

    Huys, Geert; Coopman, Vera; Van Varenbergh, Dirk; Cordonnier, Jan

    2012-09-10

    The detection of autochthonous aquatic bacteria in tissue samples from drowning cases is increasingly considered as an alternative approach to assist the medico-legal diagnosis of death by drowning. Bacteria belonging to the genus Aeromonas may be suitable candidates for this application as they are ubiquitous in natural aquatic environments but are generally not part of the human microbiota. The research aims of this study were (i) to develop a sensitive, specific and rapid screening and confirmation method for Aeromonas species in tissue samples and (ii) to evaluate aseptic sternal puncture as a post-mortem sample technique and bone marrow as an alternative matrix to provide evidence of death by drowning. The presence of Aeromonas in tissue samples was verified by cultivation using the selective media Ampicillin Dextrin Agar (ADA) and Ryan's Aeromonas Medium. The use of ADA medium was found most optimal for the sensitive, inexpensive and quick detection of aeromonads in human tissue samples. Positive culture plates were confirmed by harvesting all colonies for DNA extraction and subsequent PCR amplification using Aeromonas genus-specific primers. Aeromonads were detected in lung swab, blood and bone marrow of drowned bodies (n=3), but were negative in these three matrices for all negative controls (n=90) tested. Bone marrow proved to be a suitable alternative matrix and can be sampled post-mortem by an aseptic sternal puncture. In conclusion, this study confirms previous indications that aeromonads in cultures from blood of water bodies can be considered a potential marker for drowning. Given the fact that the number of immersed bodies (drowned and non-drowned) included in this study is statistically not significant, however, more tissue samples need to be investigated to confirm the validity of these methods to aid the diagnosis of death by wet drowning.

  2. Optimizing Prevention of Healthcare-Acquired Infections After Cardiac Surgery (HAI)_2

    Science.gov (United States)

    2016-10-24

    Cardiovascular Disease; Healthcare Associated Infectious Disease; Sternal Superficial Wound Infection; Deep Sternal Infection; Mediastinitis; Thoracotomy; Conduit Harvest or Cannulation Site; Sepsis; Pneumonia

  3. Aseptic hydroponics to assess rhamnolipid-Cd and rhamnolipid-Zn bioavailability for sunflower (Helianthus annuus): a phytoextraction mechanism study.

    Science.gov (United States)

    Wen, Jia; McLaughlin, Mike J; Stacey, Samuel P; Kirby, Jason K

    2016-11-01

    The availability of cadmium (Cd) and zinc (Zn) to sunflower (Helianthus annuus) was investigated in rhamnolipid- and ethylenediaminetetraacetic acid (EDTA)-buffered solutions in order to evaluate the influence of aqueous speciation of the metals on their uptake by the plant, in relation to predictions of uptake by the free ion activity model (FIAM). Free metal ion activity was estimated using the chemical equilibrium program MINTEQ or measured by Donnan dialysis. The uptake of Cd followed the FIAM for the EDTA-buffered solution at EDTA concentrations below 0.4 μM; for the rhamnolipid-buffered solution, the uptake of both metals in roots was not markedly affected by increasing rhamnolipid concentrations in solution. This suggests rhamnolipid enhanced metal accumulation in plant roots (per unit free metal in solution) possibly through formation and uptake of lipophilic complexes. The addition of normal Ca concentrations (low millimetre range) to the rhamnolipid uptake solutions reduced Cd accumulation in shoots by inhibiting Cd translocation, whereas it significantly increased Zn accumulation in shoots. This study confirms that although rhamnolipid could enhance accumulation of Cd in plants roots at low Ca supply, it is not suitable for Cd phytoextraction in contaminated soil environments where Ca concentrations in soil solution are orders of magnitude greater than those of Cd.

  4. Knowledge of aseptics and antisepsis and following their rules as elements of infection prevention in the work of paramedics

    Directory of Open Access Journals (Sweden)

    Łukasz Szarpak

    2013-04-01

    Full Text Available Background: The health-care professionals, particularly paramedics are exposed to bloodborne infections during medical rescue operations. The aim of this study was to assess knowledge of bloodborne infections, their prevention and interrupted routes of infection transmission among paramedics. Materials and Methods: The study comprised 220 paramedics employed in emergency departments and ambulance services. Material was collected using an anonymus questionnaire, developed for the purpose of this study. Results: As many as 80% of the surveyed people reported frequent contact with patients' blood; 65% of the paramedics before establishing the intravenous access palpates the conduct of the vein; 81% introduce peripheral venous catheter directly after disinfection of the skin; and 98% apply personal protection measures. Conclusions: The analysis of knowledge of asepsis and antisepsis of bloodborne infections among paramedics points to a series of shortcomings in their adequate preparation to reduce the effects of exposure to infectious material. However, it should be emphasized that people with higher education presented a higher level of knowledge than those with postsecondary vocational education. In the opinion of the study group mandatory training in the discussed area would prove to be the most effective method for reducing the number of bloodborne infections. Med Pr 2013;64(2:239–243

  5. Research Progress in Aseptic Germination of Chinese Orchids%国兰无菌萌发的研究进展

    Institute of Scientific and Technical Information of China (English)

    周辉明; 尚伟; 陈燕; 陈芝华; 邓正龙; 周建金

    2010-01-01

    从中国兰花种子的处理、种子的胚龄、无菌播种的培养基、生长调节剂等方面,综述了影响中国兰花无菌萌发的因素及提高萌发率的处理方法,并探讨了该领域研究存在的不足和未来的发展趋势.

  6. Increased levels of cytokines in cerebrospinal fluid of children with aseptic meningitis caused by mumps virus and echovirus 30.

    Science.gov (United States)

    Sulik, A; Kroten, A; Wojtkowska, M; Oldak, E

    2014-01-01

    We measured levels of pro-inflammatory cytokines in the cerebrospinal fluid (CSF) of patients with mumps meningitis, enteroviral echovirus 30 meningitis and children without central nervous system infection to investigate whether these molecules were involved in the pathogenesis of viral meningitis. The CSF was obtained from 62 children suspected with meningitis. These patients were classified to the mumps meningitis (n = 19), echovirus 30 meningitis (n = 22) and non-meningitis (n = 21) groups. The concentrations of interleukin-1 (IL-1), interleukin-1 soluble receptor type 2 (IL-1R2), interleukin-8 (IL-8), human interferon gamma (IFN-γ) and human tumour necrosis factor alpha (TNF-α) were determined by immunoassay. A significant increase was noted in the levels of IL-8, TNF-α and IL-1R2 in the CSF of both meningitis groups as compared to controls. The concentrations of IFN-γ and IL-1 differed significantly only between the mumps group and control. The levels of IL-1, IFN-γ and TNF-α were significantly higher in mumps meningitis when compared to the echovirus 30 group. Of all cytokines examined, only IFN-γ correlated with pleocytosis (r = 0.58) in the mumps meningitis group. The increased CSF cytokine levels are markers of meningeal inflammation, and each virus may cause a specific profile of the cytokine pattern.

  7. Macrophage imaging by USPIO-enhanced MR for the differentiation of infectious osteomyelitis and aseptic vertebral inflammation

    Energy Technology Data Exchange (ETDEWEB)

    Bierry, Guillaume [University Hospital, Department of Radiology, Strasbourg (France); University Louis Pasteur, EA 3432, Strasbourg (France); Jehl, Francois [University Hospital of Strasbourg, Department of Bacteriology, Strasbourg (France); University Louis Pasteur, EA 3432, Strasbourg (France); Boehm, Nelly [University Louis Pasteur, Institute of Histology, Faculty of Medicine, Strasbourg (France); University Louis Pasteur, INSERM U666, Strasbourg (France); Robert, Philippe [Guerbet Research, Roissy (France); Dietemann, Jean-Louis; Kremer, Stephane [University Hospital, Department of Radiology, Strasbourg (France)

    2009-07-15

    The purpose of this study was to prospectively evaluate USPIO-enhanced MR imaging for the differentiation of vertebral infectious osteomyelitis and sterile inflammation. Vertebral osteomyelitis and sterile vertebral inflammation were induced in two groups of six rabbits each. MRI examinations were performed including unenhanced and gadolinium-enhanced fat-saturated SE T1w sequences. Once endplate enhancement was observed on the T1 gadolinium-enhanced MR sequence, a second MRI examination (SE T1w sequence) was performed 24 h after USPIO administration (45 {mu}mol Fe/kg). MR imaging was correlated with histopathological findings (macrophage immunostaining and Perls Prussian blue staining). On gadolinium-enhanced T1 sequences, a significant SNR increase in vertebral endplates was present in both groups without significant difference between the two groups (P = 0.26). On USPIO-enhanced T1 sequences, a significant SNR increase was only observed in the infection group (P = 0.03) with a significant difference in SNR between the infection and the sterile-inflammation groups (P = 0.002). Infected areas presented replacement of bone marrow by an intense macrophage infiltration, some being iron-loaded. Sterile inflammation showed a replacement of bone marrow by inflammatory tissue with only rare macrophages without any Perls blue staining. USPIO-enhanced MR imaging can distinguish infectious osteomyelitis from sterile vertebral inflammation due to different macrophage distributions in the two lesions. (orig.)

  8. Aseptic processing and packaging in food industry%无菌加工和包装的优势

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    自从19世纪中期Louis Pasteur发明了巴氏灭菌消毒法以来,这种技术一直被视为食品科学的重大突破,利用热能消灭导致牛奶及其他液体食品变质和威胁人类健康的有害微生物。大约在1960年,应用于牛奶及其他液体食品的无菌加工和包装工艺面世,更被美国食品科学技术学会(IFT)评为20世纪食品科学至关重要的成果。

  9. [Validation of aseptic technique of parenteral nutrition compounding in a pharmacy service according to USP Chapter 797].

    Science.gov (United States)

    Romero Jiménez, Rosa Ma; Pernía López, Ma Sagrario; Sánchez Fresneda, Ma Norberta; Sanjurjo Sáez, María

    2013-01-01

    Introducción: En el proceso de elaboración de nutrición parenteral se debe garantizar que el personal de enfermería utiliza una técnica aséptica adecuada. En el capítulo 797 de la United States Pharmacopeia se clasifican los niveles de riesgo de las preparaciones estériles y se definen los requerimientos que se deben cumplir en la elaboración. Objetivo: Describir el desarrollo de un procedimiento de validación de la técnica aséptica utilizada por el personal de enfermería que elabora nutriciones parenterales en el área de elaboración del Servicio de Farmacia según las recomendaciones del capítulo 797 de la United States Pharmacopeia. Métodos: Se revisó el capítulo 797 de la United States Pharmacopeia y se clasificaron las nutriciones parenterales como preparaciones de riesgo medio de contaminación microbiológica. Resultados: Se adaptaron las recomendaciones de la United States Pharmacopeia para mezclas de riesgo medio y se estableció un procedimiento de validación de la técnica aséptica para la elaboración de las nutriciones parenterales. Discusión: El procedimiento de validación de la técnica aséptica permite validar la calidad del manejo aséptico del personal de enfermería. El procedimiento se ha incorporado a la práctica habitual, realizándose de forma mensual por el personal de enfermería del área de nutrición.

  10. Results of hip arthroplasty using Paavilainen technique in patients with congenitally dislocated hip

    Directory of Open Access Journals (Sweden)

    R. M. Tikhilov

    2014-01-01

    Full Text Available The purpose of the study was to analyze the medium- and long-term results of hip arthroplasty using Paavilainen technique in patients with the congenitally dislocated hip. Methods: From 2001 to 2012 180 operations were carried out were using the Paavilainen technique in 140 patients with high dislocation of the hip (Crowe IV. All patients were clinically evaluated using the Harris Hip Score (HHS, VAS and radiography. Statistical analysis was performed using the Pearson correlation coefficients, multiple regression analysis and classification trees analysis. Results: The average Harris score improved from preoperative 41.6 (40,3-43,5 to 79.3 (77,9-82,7 at final follow-up, and the difference was significant. Early complications were 9% (the most frequent were fractures of the proximal femur, later - 16.7% (pseudoarthrosis of the greater trochanter, 13.9%; disclocations-1,1%, aseptic loosening of the components - 1.7%, reoperation performed in 8.3% of cases. Such factors as age and limb length has statistically significant effect on functional outcomes. Established predictive model allows to get the best possible functional outcome in such patients with severe dysplasia. Conclusions: Total Hip arthroplasty using the Paavilainen technique is an effective method of surgical treatment in patients with the congenitally dislocated hip, but it is technically difficult operation with a high incidence of complications in comparison with standard primary total hip replacement.

  11. Osteosarcoma of the sternum

    NARCIS (Netherlands)

    Douglas, YL; Meuzelaar, KJ; vanderLei, B; Pras, B; Hoekstra, HJ

    1997-01-01

    Primary malignant sternal tumours are very rare. The most common malignant sternal tumour is a chondrosarcoma. Until now, controversies in the management of malignant sternal tumours were mainly caused by limited clinical experience. However, treatment of malignant sternal tumours should not differ

  12. 胸骨抬举加肋软骨成形治疗小儿漏斗胸%Sternal elevation and costal cartilageplasty in children with pectus excavatum

    Institute of Scientific and Technical Information of China (English)

    陈名久; 喻风雷; 尹邦良; 胡建国; 杨一峰; 袁运长

    2004-01-01

    目的总结胸骨抬举加肋软骨成形治疗小儿漏斗胸的经验.方法 1994年1月至2003年10月,采用胸骨楔形切骨后缝合固定和肋软骨部分切除成形后缝合固定的方法治疗57例漏斗胸小儿,随访6个月~10年,内容包括胸廓外形、临床症状、胸部X线正侧位片.结果无手术死亡,除1例术后6个月胸骨出现轻度下陷外,其余矫形效果满意,临床症状明显好转,术后漏斗指数FI与正常儿童差异无显著性.结论胸骨抬举加肋软骨成形治疗小儿漏斗胸近、远期效果满意.

  13. Modified Sternal Elevation Operation for Pectus Excavatum in Children%改良胸肋抬举术治疗漏斗胸

    Institute of Scientific and Technical Information of China (English)

    周谦让; 韩雪敏

    2008-01-01

    目的 探讨改良胸肋抬举术治疗儿童漏斗胸的临床效果.方法 2000-2007年收治15例漏斗胸患儿,均施行胸骨剑突切除,第3~7过长肋软骨斜形截除,胸骨后充分游离,"8"字或"U"字对应缝合肋软骨.此时,即可观察到凹陷之胸骨被上举成功.结果 15例漏斗胸患儿均实施改良胸肋抬举术,操作简单,出血少,胸前凹陷消失.术后平均随访34个月,效果满意,1例患儿切口皮下积液,经换药伤口愈合.结论 改良胸肋抬举术是治疗漏斗胸的一种简易可行的方法,近期效果好,由于病例数较少,远期效果有待进一步观察.

  14. Modified Sternal Elevation in Children with Pectus Excavatum%改良胸骨抬举术治疗小儿漏斗胸

    Institute of Scientific and Technical Information of China (English)

    尹宏建

    2010-01-01

    目的 探讨采用改良胸骨抬举术治疗小儿漏斗胸的疗效及经验.方法 回顾性分析1999年7月-2008年8月期间采用缝合已切除畸形病变肋软骨的断段、将肋软骨膜包绕肋软骨断段缝线使之呈管状的改良胸骨抬举术治疗42例小儿漏斗胸的临床资料,术后随访14个月~10年,随访内容包括胸廓外形、临床症状、X线胸部正侧位片.结果 均顺利完成手术,无手术死亡,手术后38例患者得到随访,矫形效果满意,活动耐力及反复呼吸道感染症状明显好转,X线胸片心影左移情况消失.结论 改良胸骨抬举术治疗小儿漏斗胸并发症少,操作简单方便,效果满意,值得推广.

  15. O uso da vancomicina em pasta na hemostasia do esterno e profilaxia da mediastinite The use of the vancomycin paste for sternal hemostasis and mediastinitis prophylaxis

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius Ferraz de Arruda

    2008-03-01

    Full Text Available INTRODUÇÃO: A mediastinite é uma das complicações mais temidas pelos cirurgiões cardiovasculares, sendo esta um fator importante na morbidade e mortalidade em cirurgia cardíaca. OBJETIVO: Buscar uma nova opção na prevenção da mediastinite, diminuindo o índice de morbidade e mortalidade. MÉTODOS: Estudo retrospectivo que incluiu 1020 pacientes submetidos a cirurgia cardíaca, no período de fevereiro de 2002 a outubro de 2005. Os pacientes foram submetidos a cirurgia com uso de circulação extracorpórea e implementação da vancomicina em pasta em substituição a cera de osso. RESULTADOS: Os pacientes foram seguidos ao longo de 45 meses, apenas cinco (0,49% desenvolveram mediastinite e não houve óbito. CONCLUSÃO: O uso de vancomicina em pasta em substituição à cera de osso mostrou-se ser uma aliada na prevenção da mediastinite no pós-operatório de cirurgia cardíaca.INTRODUCTION: Mediastinitis is one of the most feared complications for thoracic surgeons, being a significant factor in morbidity and mortality in thoracic surgery. OBJECTIVE: To find a new alternative in order to prevent mediastinitis, reducing the morbidity and mortality. METHODS: A retrospective study including 1020 patients operated between February 2002 and October 2005. Patients underwent bypass surgery and vancomycin paste was used rather than bone wax in all cases. RESULTS: Patients were followed-up for 45 months; there were only five (0.49% cases of mediastinitis; no deaths were observed. CONCLUSION: The use of Vancomycin paste to replace bone wax proved to be a great allied to prevent mediastinitis after thoracic surgery.

  16. Femoral component loosening after hip resurfacing arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Zustin, Jozef; Sauter, Guido [University Medical Centre Hamburg-Eppendorf, Institute of Pathology, Hamburg (Germany); Hahn, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); Morlock, Michael M. [TUHH Hamburg University of Technology, Biomechanics Section, Hamburg (Germany); Ruether, Wolfgang [University Medical Centre Hamburg-Eppendorf, Department of Orthopaedics, Hamburg (Germany); Amling, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); University Medical Centre Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany)

    2010-08-15

    Before the re-introduction of the current generation of total hip resurfacing arthroplasty, component loosening and osteolysis were of great concern to the orthopaedic community. Early, mid- and long-term clinical results are encouraging, but component loosening still exists. Macroscopic, contact radiographic and histopathological analyses after undecalcified preparation of bone tissue specimens were performed. To investigate the frequency and morphological patterns of the loosening of the femoral component, we analysed a series of 190 retrieved femoral remnants that were revised for aseptic failures. Thirty-five (18.4%) hips were revised for clinical and/or radiographic loosening of the femoral component. Pseudoarthrosis (n = 17; median in situ time: 16 weeks, interquartile range [IQR]: 9 to 34), collapsed osteonecrosis (n = 5; median in situ time: 79 weeks, IQR: 63 to 97), cement-socket debonding (n = 3; median in situ time: 89 weeks, IQR: 54 to 97) and at later follow-up bone-cement loosening (n = 10; median in situ time: 175 weeks; IQR 112 to 198; p =0.005) were distinct patterns of the femoral remnant-implant loosening. Fibrocartilaginous metaplasia of interface bone trabeculae (n = 38; median in situ time: 61 weeks, IQR: 32 to 138) was strongly associated with femoral component loosening (p = 0.009). Both the trabecular hyperosteoidosis (n = 32; median in situ time: 71 weeks, IQR 50 to 129) and excessive intraosseous lymphocyte infiltration (n = 12; median in situ time: 75 weeks, IQR 51 to 98) at the bone-cement interface correlated strongly with fibrocartilaginous metaplasia (p = 0.001 and p = 0.016 respectively) and all three lesions were associated with the female gender (p = 0.021, p = 0.009, and p = 0.051). Femoral component loosening at early follow-up was mostly caused by pathological changes of the femoral remnant bone tissue: pseudoarthrosis and collapsed osteonecrosis. Fibrocartilaginous metaplasia was frequently observed in hips with femoral

  17. Pseudoartrosis maxilar superior post-cirugía ortognática: A propósito de un caso clínico Post surgical orthognathic of upper maxilla pseudoarthrosis: Proposed clinical study

    OpenAIRE

    I. Zubillaga Rodríguez; I. Heras Rincón; J.J. Montalvo Moreno

    2009-01-01

    Introducción. La introducción de nuevos métodos de fijación rígida en el tratamiento de fracturas faciales durante los últimos 25 años ha incrementado no sólo el arsenal terapéutico disponible sino también, cuando no es correctamente utilizado, el tipo de complicaciones postquirúrgicas. Material y métodos. Presentamos un nuevo caso clínico con el diagnóstico de pseudoartrosis de maxilar superior tras la realización de una osteotomía convencional tipo LeFort I en el seno de un procedimiento de...

  18. 先天性胫骨假关节雌激素受体的免疫组织化学研究%Estrogen Receptor in Congenital Pseudoarthrosis of Tibia: An Immunohistochemical Study

    Institute of Scientific and Technical Information of China (English)

    雷伟; 黄耀添; 王剑波; 吕荣; 杨光

    1999-01-01

    目的明确先天性胫骨假关节(CPT)不同部位病变组织雌激素受体(ER)的含量,探讨它与发病机制的关系.方法采用免疫组织化学方法(SABC法)对21例CPT的3个不同取材部位所获得的63个标本进行了ER检测.结果 CPT病变软组织的ER阳性表达率比创伤性假关节低,有极显著性差异(P<0.01).结论 CPT的发病机制可能与骨膜上ER含量的显著降低有关.

  19. Treatment of 7 cases of congenital pseudoarthrosis of tibia by extermal fixation%外固定架治疗先天性胫骨假关节7例

    Institute of Scientific and Technical Information of China (English)

    王会领; 赵斌

    2004-01-01

    目的探讨应用外固定架治疗先天性胫骨假关节的临床疗效.方法7例患儿行交叉穿针外固定架固定,在对胫骨假关节加压固定同时做胫骨干骺端骨延长.结果7例假关节均获得骨愈合,愈合时间5~9个月,并达到3~7 cm骨延长,随诊1~5年,未发现再骨折,疗效满意.结论外固定架是治疗先天性假关节的一种有效方法.

  20. Pathogenesis and treatment of pseudoarthrosis with ankylosing spondylitis%强直性脊柱炎并发椎间假关节形成的病理病因和治疗

    Institute of Scientific and Technical Information of China (English)

    李国; 李家顺; 贾连顺; 刘祖德; 谭军; 李玉莉

    2003-01-01

    目的:探讨强直性脊柱炎并发椎间假关节形成的病理病因及治疗方法.方法:对我院1995年~2002年治疗的23例并发假关节的强直性脊柱炎患者的临床资料、病理变化和治疗方法进行回顾性分析.结果:保守治疗13例,手术治疗10例.其中7例行前路椎间融合固定,3例行后路椎间融合固定.经随访观察,假关节全部获得骨性融合,症状缓解.结论:假关节形成是强直性脊柱炎不常见的并发症,与外伤和异常应力有直接关系.对保守治疗无效和出现神经症状的病例行前路或后路椎间植骨融合固定手术治疗效果满意.

  1. 椎体压缩性骨折后假关节形成影像学诊断进展%Progress of radiographic diagnosis of pseudoarthrosis in vertebral compression fractures

    Institute of Scientific and Technical Information of China (English)

    崔伟

    2007-01-01

    椎体假关节形成是脊柱椎体压缩性骨折后较为少见的并发症之一,其诊断标准目前尚未统一.一般认为影像学上椎体骨折后椎体内出现真空征或唇样椎体可明确诊断为椎体假关节形成.过去30年来许多学者对直立正侧位、直立伸展(屈曲)侧位、平卧侧位X线平片观察发现,平卧侧位片诊断椎体假关节形成更为准确.CT、MRI扫描显示骨折椎体内出现气体聚集或液体充盈,椎体假关节形成的诊断即可成立.临床诊断中将X线平片(正侧位、伸展位、平卧侧位)、CT、MRI三者结合起来,可明显提高椎体假关节形成诊断的准确率.该文就椎体压缩性骨折后假关节形成的影像学诊断研究进展作一综述.

  2. 带血管游离腓骨移植术治疗胫骨先天性假关节5例%The Free Fibula Graft with Pedicle Vessels for Congenital Tibial Pseudoarthrosis: Report of 5 Cases

    Institute of Scientific and Technical Information of China (English)

    季海萍; 王继孟; 刘润玑; 郭宗远

    1980-01-01

    @@ 一般植骨术治疗胫骨先天性假关节畸形,效果不佳.我院1964~1977年间共收治11例胫骨先天性假关节病儿,曾采用滑槽植骨、大块同种异体植骨等方法进行治疗,各病例经一次或数次手术,均未成功.

  3. Interest of the SPECT-CT merging to detect pseudo-arthrosis after lumbar arthrodesis: preliminary results; Interet de la fusion TEMP-TDM pour la detection des pseudarthroses apres arthrodese lombaire: resultats preliminaires

    Energy Technology Data Exchange (ETDEWEB)

    Rager, O.; Ratib, O.; Tessitore, E. [Hopitaux universitaire de Geneve (Switzerland)

    2010-07-01

    Pseudo arthrosis is a potential complication after a lumbar arthrodesis. The symptoms are nonspecific and revision surgery is not always an effective treatment. Scintigraphy SPECT / CT with {sup 99m}Tc and CT were studied separately for the diagnosis of pseudo arthrosis before the widespread use of software fusion. It is well established that the diagnosis based on CT led to a number of false positive (10%). The purpose of this study is to evaluate the usefulness of SPECT-CT fusion imaging in the diagnosis of pseudo arthrosis. Conclusions: SPECT / CT fusion imaging may increase the specificity for the diagnosis of pseudo arthrosis at the level of inter body cages and increase sensitivity for the detection of degenerative diseases on the back joints. (N.C.)

  4. Contamination control in HVAC systems for aseptic processing area. Part I: Case study of the airflow velocity in a unidirectional airflow workstation with computational fluid dynamics.

    Science.gov (United States)

    Ogawa, M

    2000-01-01

    A unidirectional airflow workstation for processing a sterile pharmaceutical product is required to be "Grade A," according to EU-GMP and WHO-GMP. These regulations have employed the wording of "laminar airflow" for unidirectional airflow, with an unclear definition given. This seems to have allowed many reports to describe discussion of airflow velocity only. The guidance values as to the velocity are expressed in various words of 90 ft/min, 0.45 m/sec, 0.3 m/sec, +/- 20%, or "homogeneous air speed." It has been also little clarified how variation in airflow velocity gives influences on contamination control of a workstation working with varying key characteristics, such as ceiling height, internal heat load, internal particle generation, etc. The present author has revealed following points from a case study using Computational Fluid Dynamics: the airflow characteristic in Grade A area shows no significant changes with varying the velocity of supplied airflow, and the particles generated from the operator will be exhausted outside Grade A area without contamination.

  5. Contamination of dental unit waterlines and aseptic treatment%口腔综合治疗台水路污染及其无菌处理方法

    Institute of Scientific and Technical Information of China (English)

    章小缓; 凌均棨

    2007-01-01

    口腔综合治疗台水路(Dental Unit Waterlines,DUWLs)污染包括口腔医疗用水水源的污染、手机等使用过程中回吸造成的水污染和水路管道内壁形成生物膜引起的污染。这些污染可能引起患者间及医患间的交叉感染,不仅威胁医护人员的健康,而且引起社会环境的污染。采用清洁水源,在口腔综合治疗台上安装防回吸装置及对DUWLs进行科学的无菌处理,

  6. Experiment of Aseptic Sowing Technique of Lemon[Citrus limon (L.) Burm.f.]%柠檬无菌播种试验

    Institute of Scientific and Technical Information of China (English)

    麦丽瑶; 岑惠锋; 吴道洲; 孙伟冰; 郭丽英; 吉前华

    2014-01-01

    [目的]研究柠檬[Citrus limon(L.) Burm.f.]种子萌发的适宜处理方法.[方法]以不同种皮剥离程度的柠檬种子(不剥种皮、只剥外种皮、剥除内外种皮)为试材,应用不同消毒剂[4%(V/V)蓝月亮、0.1%升汞]消毒不同时间(7、15、23 min),进行柠檬播种试验.[结果]0.1%升汞消毒8 min的效果优于4% (V/V)蓝月亮消毒15 min,但差异性不大;种子在剥除内、外种皮后萌发率、生长势情况都好于只剥外种皮和未剥除种皮的.[结论]考虑到升汞具有致癌变、致突变性等危害,在试验操作中不提倡使用,故以4% (V/V)蓝月亮处理15 min为柠檬种子消毒的最佳方式.该研究可为柠檬组织培养及柑橘无病毒苗木培育提供参考依据.

  7. How and Why Would You Do a Pressure Holding Test on an Aseptic Installation for which You Want to Check the Integrity? Theory and Practical Example.

    Science.gov (United States)

    Chancel, Olivier; Grissely, Raoul; Stering, Magnus; Pisarik, Luc

    2010-01-01

    This paper uses the Boyle-Mariotte Law to restate a few general principles and applies them to rationalise pressure holding tests on sterile installations. The authors offer a methodology to achieve this, as well as a few mathematical models to determine test durations and acceptance limits, as functions of the breach sizes to be considered and the measurement instruments used. Apart from the theoretical approach, readers are offered a few examples to illustrate the models.

  8. Discussion on Waste Recycling Tetra Pak Aseptic Package Status Quo%对我国废弃利乐无菌包回收利用的探讨

    Institute of Scientific and Technical Information of China (English)

    邓蓉

    2014-01-01

    Waste of resources and environmental pollution caused by waste Tetra Pak is the current problem to be solved. Analysis of the domestic and foreign recycling situation about waste Tetra Pak pointed out that the European Union and the United States and other developed countries have developed a relatively complete waste Tetra Pak recycling regulations, the recovery rate of waste Tetra Pak is more than 70% in some EU countries. Although China has been specializing in waste recycling business on Tetra Pak, but recycling system is imperfect, corresponding laws and regulations are not perfect and the recovery less than 20%. Tetra Pak recycling industry needs government’s promotion, concerns of the whole society and help of relevant legislation. We should improve the recovery rate of waste Tetra Pak by measures such as develop relevant policies and regulations reduce the number of productions, establish reasonable logistics recycling system and so on.%废弃利乐包造成的资源浪费以及环境污染问题是当前需要解决的问题。分析了国内外废弃利乐包回收利用状况,指出欧盟及美国等发达国家已制定了相对完善的废弃利乐包回收法规,欧盟一些国家对废弃利乐包的回收率高达70%以上。我国虽然已有专门从事废弃利乐包回收的企业,但回收体系不完善,相应的法规不健全,废弃利乐包的回收率不到20%,利乐包的回收产业需要政府的推动、相关立法的帮助和全社会的关注与配合,应通过制定相关政策法规、减少利乐包的生产数量、建立合理的物流回收处理体系等措施,提高废弃利乐包的回收率。

  9. Late results after intertrochanteric varus angulation in aseptic femoral head necrosis in adults. Spaetergebnisse nach intertrochanterer Varisierungsosteotomie bei der aseptischen Hueftkopfnekrose Erwachsener

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, E.; Ahrendt, J.; Niethard, F.U.; Blaesius, K. (Heidelberg Univ. (Germany, F.R.). Orthopaedische Klinik und Poliklinik)

    1989-04-01

    25 patients suffering from femoral head necrosis in 30 hip joints were radiologically studied for an average of 11.6 years following intertrochanteric varus angulation osteotomy. Preoperatively only stages 2 and 3 according to Meyers were seen. The follow-up results could be distributed into 4 groups. At best the osteonecrosis was reconstructed within 6 to 9 years while the trabeculae started to become rearranged within 2 to 4 years. At worst, rapid destruction in absence of bony reaction was observed. The ability of the bone outside the osteonecrosis to react to changed circumstances following angulation osteotomy correlates with long-term results. This may indicate a general osteopathy even outside the necrotic area. (orig.).

  10. A Vignette-Based Survey to Assess Clinical Decision Making Regarding Antibiotic Use and Hospitalization of Patients with Probable Aseptic Meningitis

    Directory of Open Access Journals (Sweden)

    Glenn Patriquin

    2012-01-01

    Full Text Available BACKGROUND: The many etiologies of meningitis influence disease severity – most viral causes are self-limiting, while bacterial etiologies require antibiotics and hospitalization. Aided by laboratory findings, the physician judges whether to admit and empirically treat the patient (presuming a bacterial cause, or to treat supportively as if it were viral.

  11. A simple technique for the determination of aseptic inoculation room cleanliness%无菌接种室洁净度测定简易技术

    Institute of Scientific and Technical Information of China (English)

    何金柱; 郎凤红; 杨贵荷; 任彦青

    2014-01-01

    This paper reports a method for the determination of super clean sterile chamber and worktable for the wine grape stem tip culture, detoxification and rapid propagation in Ningxia Yuquanying. According to the requirements of determining the number of bacteria count and necessary measures, the cleanliness of asepsis inoculating room can be obtained. The cleanliness standards are discussion too. This study will offer a reference for detoxification and rapid propagation in desert area.%总结在宁夏玉泉营进行酿酒葡萄茎尖培养、脱毒和无菌快繁建立无菌接种室和超净工作台洁净度的测定方法,按要求进行降落菌数测定计数和必要的措施等,能获得符合无菌接种室洁净度,并对洁净度的标准进行讨论,为沙区进行脱毒和快繁提供参考。

  12. Safety, Immunogenicity, and Protective Efficacy of Intradermal Immunization with Aseptic, Purified, Cryopreserved Plasmodium falciparum Sporozoites in Volunteers Under Chloroquine Prophylaxis : A Randomized Controlled Trial

    NARCIS (Netherlands)

    G.J.H. Baestians (Guido); M.P.A. van Meer (Maurits); A. Scholzen (Anja); J.M. Obiero (Joshua); M. Vatanshenassan (Mansoureh); T. van Grinsven (Tim); B.K.L. Sim (B. Kim Lee); P.F. Billingsley (Peter); E.R. James (Eric); A. Gunasekera (Anusha); E.M. Bijker (Else); G-J. van Gemert (Geert-Jan); M. van de Vegte-Bolmer (Magda); W. Graumans (Wouter); C.C. Hermsen (Cornelus); Q. de Mast (Quirijn); A.J.A.M. van der Ven (André); S.L. Hoffman (Stephen); R.W. Sauerwein (Robert)

    2015-01-01

    markdownabstractImmunization of volunteers under chloroquine prophylaxis by bites of *Plasmodium falciparum* sporozoite (PfSPZ)–infected mosquitoes induces > 90% protection against controlled human malaria infection (CHMI). We studied intradermal immunization with cryopreserved, infectious PfSPZ in

  13. HACCP系统在无菌包装苹果汁生产中的应用%Application of HACCP system in production of aseptic packaging apple juice

    Institute of Scientific and Technical Information of China (English)

    孟宏昌; 秦明利; 樊军浩

    2004-01-01

    以无菌包装苹果汁生产为例,探讨了危害分析与关键控制点 HACCP(Hazard Analysi s Critical Control Point) 体系在无菌包装果蔬汁生产中的建立和实施过程,以满足人们对绿色、营养、安全的果蔬汁的消费需求.

  14. 改良胸骨抬举术治疗儿童先天性漏斗胸268例%The surgical treatment of pectus excavatum in children by modified sternal elevation

    Institute of Scientific and Technical Information of China (English)

    潘征夏; 杨杰先; 吴春; 李洪波; 王刚; 李勇刚

    2007-01-01

    目的 总结改良胸骨抬举术治疗儿童先天性漏斗胸268例的经验.方法 2002年1月至2005年12月收治儿童漏斗胸268例中男213例,女55例;年龄2~16岁,平均(4.48±2.74)岁,其中2~3岁69例,3~6岁130例,6岁以上69例.均行改良胸骨抬举术,即胸壁横形小切口、断或不断胸骨、少切肋软骨、肋骨断端用丝线缝合、自行设计的钢板胸骨前悬吊固定.伴肺囊肿、大叶性肺气肿病儿同时行肺叶切除术;伴食管裂孔疝病儿同时行食管裂孔疝修补术;伴先心病病儿同时行先心病根治术.结果 全组无死亡.术后除1例合并肺炎、2例皮下少量积液外,余恢复良好.所有病儿术后随访1~5年,除1例胸骨下段轻度凹陷外,余均有良好外观的胸廓.术后已取出钢板165例,均能维持原有胸廓形态.结论 改良胸骨抬举术具有切口小、损伤轻、并发症少、疗效佳、固定牢靠、材料低廉,适用于任何类型的漏斗胸病儿,不失为目前治疗儿童漏斗胸的一种良好的手段.

  15. Thoracoscopic sternal elevation by a steel bar inserted for the correction of pectus excavatum in children%胸腔镜下钢板植入胸骨抬举术治疗小儿漏斗胸

    Institute of Scientific and Technical Information of China (English)

    徐永根; 徐洪军; 孙庆林; 顾志成

    2006-01-01

    目的 探讨胸腔镜下钢板植入胸骨抬举术(Nuss手术)治疗小儿漏斗胸中的疗效.方法 胸腔镜辅助下,经右侧切口用钝剥离器沿胸骨后穿过纵隔至对侧胸壁切口,牵引已塑形好的合金钢板凸面朝后拖过胸骨后方,调整位置后,翻转钢板使凹陷的胸骨和前胸壁抬高.结果 11例均顺利完成手术,手术时间50~85 min,平均67 min;术中出血量5~20 ml,平均10 ml.优9例,良1例,中1例.8例随访2~15个月,平均6.4月,外观维持良好.结论 胸腔镜下Nuss手术治疗小儿漏斗胸创伤小、出血少、操作简便、恢复快、效果满意,值得推广.

  16. 直接扩增法在血痕、肋软骨和唾液检材中的应用%Direct amplification for detection of DNA in blood stain, sternal cartilage and salivary stain on cigarette butt

    Institute of Scientific and Technical Information of China (English)

    李林; 刘静; 王敏; 王峰; 路俊雷; 于璐; 毕建红

    2013-01-01

    目的 采用Identifiler Direct PCR试剂盒直接扩增法进行棉签擦拭血痕、肋软骨和烟蒂唾液斑DNA分型检验,并评价其应用价值.方法 收集棉签擦拭血痕、烟蒂各20份,肋软骨10份,采用Identifiler Direct PCR试剂盒进行直接扩增及分型检验,以相同检材采用磁珠法/Chelex-100法提取模板DNA后扩增检验结果作为对照,对两组所得结果进行比较分析.结果 棉签擦拭血痕和肋软骨一次检测完整分型率均为100%,分型结果与对照组一致;烟蒂上唾液斑有2份检材第一次未能完整分型,调整方法再次检验后获分型成功.结论 实际检案中的棉签血痕、肋软骨和烟上唾液斑,采用直接扩增法检测,方法简单、快速、稳定、检材用量小,可在实际检案中选择使用.

  17. Osseous scintigraphy and auxiliary graft. Scintigraphie osseuse et greffe d'appoint

    Energy Technology Data Exchange (ETDEWEB)

    Khelifa, F.; Siles, S. (Hopital de la Timone, 13 - Marseille (France)); Puech, B.

    1992-12-01

    The scintigraphy could be a good way to survey the osseous graft: three cases are studied in which were recognized the presence of a graft, surinfection, graft lysis, pseudo-arthrosis, algodystrophy. 8 refs., 5 figs.

  18. Three different approaches to treatment of congenital pseudarthrosis of the tibia

    OpenAIRE

    Ozdemir, Hakan; Akyildiz, Feyyaz; Gur, Semih; Aydin, Ahmet Turan; Altinel, Erdogan

    2004-01-01

    Basic treatment principle for congenital pseudoarthrosis of the tibia is to provide solid union and obtain a functional extremity. Three different surgical approaches are carried out to three patients, aged between 1-6 (av.3) and two of them were females, one male, with congenital pseudoarthrosis of the tibia between 1988-1994 . The operations applied to cases were, excision + isografting + osteosynthesis with plate, excision + isografting + ilizarov external fixation and excision + ilizarov ...

  19. Nonoperative treatment of slipped capital femoral epiphysis: a scientific study

    Directory of Open Access Journals (Sweden)

    Pinheiro Pedro

    2011-02-01

    Full Text Available Abstract Background Treatment of the Slipped Capital Femoral Epiphysis remains a cause of concern due to the fact that the true knowledge of the etiopathogeny is unknown, as well as one of its major complications: chondrolysis. The conservative treatment remains controversial; it has been overlooked in the studies and subjected to intense criticism. The purpose of this study is to investigate the results of treatment on the hip of patients displaying slipped capital femoral epiphysis, using the plaster cast immobilization method and its link to chondrolysis. Methods The research was performed based on the study of the following variables: symptomatology, and the degree of slipping. A hip spica cast and bilateral short/long leg casts in abduction, internal rotation with anti-rotational bars were used for immobilizing the patient's hip for twelve weeks. Statistical analysis was accomplished by Wilcoxon's marked position test and by the Fisher accuracy test at a 5% level. Results A satisfactory result was obtained in the acute group, 70.5%; 94%; in the chronic group (chronic + acute on chronic. Regarding the degree of the slipping, a satisfactory result was obtained in 90.5% of hips tested with a mild slip; in 76% with moderate slip and 73% in the severe slip. The statistical result revealed that a significant improvement was found for flexion (p = 0.0001, abduction (p = 0.0001, internal rotation (p = 0.0001 and external rotation (p = 0.02. Chondrolysis was present in 11.3% of the hips tested. One case of pseudoarthrosis with aseptic capital necrosis was presented. There was no significant variation between age and chondrolysis (p = 1.00.Significant variation between gender/non-white patients versus chondrolysis (p = 0.031 and (p = 0.037, respectively was verified. No causal association between plaster cast and chondrolysis was observed (p = 0.60. In regard to the symptomatology group and the slip degree versus chondrolysis, the p value was not

  20. 单侧双臂外固定架治疗先天性胫骨假关节18例体会%Experience in the Treatment of 18 Cases of Congenital Pseudoarthrosis of Tibia With Lateral Biarms External Skeletal Fixator

    Institute of Scientific and Technical Information of China (English)

    彭丹; 黎志宏; 张湘生; 张庆

    2005-01-01

    目的:探讨先天性胫骨假关节的手术治疗方法,介绍使用单侧双臂外固定架治疗先天性胫骨假关节的临床经验和疗效.方法:在全麻下,采用切除胫骨假关节,以单侧双臂外固定架对正常骨段进行截骨延长、假关节处加压的方法治疗先天性胫骨假关节18例.结果:经4~10月随访,18例患者假关节处与延长段均得以愈合,患肢长度基本恢复,功能良好.结论:单侧双臂外固定架治疗先天性胫骨假关节是一种手术操作简单、治疗效果确切的手术治疗方法.

  1. 模拟一次加压延长治疗先天性胫骨假关节的实验研究%Animal experiment study on treatment of congenital pseudoarthrosis of the tibia using combined bone distraction and compression with auto-iliac grafting

    Institute of Scientific and Technical Information of China (English)

    张新; 孙大辉; 朱东平; 魏军剑

    1999-01-01

    目的:通过动物实验模拟采用自制改进Ilizarov长骨固定延长器,通过一次手术对假关节施行切除、少量髓芯植骨、加压固定延长治疗先天性胫骨假关节,寻求促进假关节愈合的最佳方式.方法:20只绵羊随机分为A、B两组,每组10只.于胫骨结节下约1 cm处横行截骨,自中、下1/3部截除胫骨全长20%的骨段,安装外固定器.A组取髂骨于短缩截骨处行髓芯植骨.B组为空白对照组.术后行组织学、生物力学及放射线影像学分析.结果:A组短缩截骨处骨愈合情况在各项分析中均优于B组.结论:采用自制改进Ilizarov长骨固定延长器,通过一次手术对假关节施行切除、少量髓芯植骨、加压固定,能更好地促进假关节愈合.

  2. 胸腰椎椎体压缩性骨折后椎体假关节的5种体位X射线侧位平片特点%Radiographic evaluation of thoracolumbar and/or lumbar vertebral pseudoarthrosis on five positions

    Institute of Scientific and Technical Information of China (English)

    崔伟; 高桥启介; 齐藤文则

    2008-01-01

    背景:许多临床研究阐述了胸腰椎椎体压缩性骨折后应用常规侧位片来评定是否有假关节形成,作者所查应用仰卧或(和)俯卧侧位X射线片来诊断椎体真空征的文献较少.目的:观察胸腰椎椎体压缩性骨折后椎体假关节的5种体位X射线侧位平片的特点.设计、时间及地点:回顾性病例分析.2002-03/2006-04日本琦玉医科大学医院骨科住院患者.对象:共收治胸、腰椎压缩性骨折患者31例,其中出现椎体假关节患者11例,男2例,女9例;年龄65-83岁,平均74.5岁:累及病变椎体:T11 3例:T127例:L3 1例.方法:所有患者均观察测量其站立位(中立位、过屈位、过伸位)、仰卧位、俯卧位5种位置的侧位X射线平片,均由1名脊柱外科副教授每隔2周连续测量3次.主要观察指标:①病变椎体前岛度.②病变椎体后突角.③椎体真空征的计数.结果:①俯卧位、仰卧位X射线平片上椎体前高度和病变椎体后突角与直立侧位、过屈位、过伸位比较,差异有显著性意义(P0.05).②在直立侧位及过屈侧位X射线平片上,11例患者均末出现椎体真空征,过伸侧位上出现4例(36%),俯卧位及仰卧位均出现椎体真空征(100%).结论:仰卧、俯卧侧位X射线片能更为精确的显示胸腰椎椎体压缩性骨折后椎体假关节的存在.

  3. 模拟一次加压延长治疗先天性胫骨假关节胫骨前肌的变化%Changes of the tibialis anterior muscle after combined bone lengthening and compressing in the treatment of simulant model of congenital pseudoarthrosis of tibia

    Institute of Scientific and Technical Information of China (English)

    张新; 林枫松; 隋福革; 孙大辉; 张伟; 张大光; 李书强; 崔林; 齐心

    1999-01-01

    目的:研究在一次加压延长治疗先天性胫骨假关节过程中由大幅度肢体延长所带来的肌肉组织损害问题.方法:将20只绵羊分成3个实验组,在胫骨下段分别切除胫骨全长的10%、20%和30%,模拟制成切除先天性胫骨假关节后形成的大块骨缺损模型,断端少量髓芯植骨,利用自制改良Ilizarov外固定器械加压固定,在下段形成软组织堆积,干骺端-骨干部截骨延长,取径骨前肌标本,以肌纤维大小变化、肌纤维细胞核的内在化、肌纤维变性、再生、纤维化为基准,建立相应的组织病理学评分标准系统,研究各项参数的变化规律.结果:10%组仅出现肌纤维大小的显著变化,而20%、30%组出现了反映不可逆损害的肌纤维细胞核内在化、肌纤维变性、肌纤维再生,肌纤维内膜纤维化等参数的显著变化.结论:骨延长超过一定限度,以常规1.0 mm/d,4次/d速率,即使下段有软组织堆积的情况下,同样也不能缓解上段因超限延长所带来的肌肉组织不可逆性损害.

  4. Posterior Interbody Osteotomy(PIO) for Late Kyphosis Secondary on Thoracolumbar Fractures and Pseudoarthrosis in Ankylosing Spondylitis%后路椎体间截骨术在胸腰椎骨折迟发性后凸畸形及强直性脊柱炎假关节形成治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    刘振华; 牛国旗; 王祥; 周建生; 王远松; 刘泉

    2010-01-01

    目的:评价后路椎体间截骨术治疗胸腰椎骨折迟发性后凸畸形及强直性脊柱炎假关节形成的初步临床疗效.方法:采用后路椎体间截骨矫形减压植骨融合内固定术治疗胸腰椎骨折迟发性后凸畸形21例及强直性脊柱炎假关节形成患者3例;椎间植骨融合17例,后外侧植骨融合6例,1例截骨矫形后椎管连续性好未植骨.结果:所有患者脊柱畸形均获得良好矫正,Cobb角由术前平均37°(17°~56°)降至术后4°(0°~12°),术后纠正率为89%.经平均31(6~61)个月随访,全部病例均获得融合,无内固定松动及断裂.患者疼痛改善显著,VAS评分由术前的8.7下降到术后2.4,Oswestry评分由术前的69下降到26,最后随访VAS评分和Oswestry评分分别为2.2和23.Frankle分级B级1例无恢复,C级2例恢复至D级,D级4例恢复至E级;2例括约肌功能性功能障碍者部分改善.结论:经椎体间截骨矫形减压脊柱固定融合术,可以有效完成脊柱后凸的矫形、减压与稳定性重建,临床症状缓解满意,能显著提高患者生活质量.

  5. 后路截骨矫形固定融合治疗强直性脊柱炎假关节并脊柱后凸畸形%Posterior correction and fixation fusion for pseudoarthrosis with kyphotic deformity in ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    张国华; 陈鸿昌; 陈盈佑; 林建中; 许香兰; 蔡有虹

    2006-01-01

    目的:探讨后路截骨矫形固定融合术治疗强直性脊柱炎(ankylosing spondylitis,AS)假关节并后凸畸形的可行性.方法:30例AS患者,年龄29~55岁,平均41.7岁,行后路张开式楔形截骨矫正后凸畸形及内固定,平均随访4.7年(2.2~9.1年),根据影像学资料、临床结果与并发症情况评估治疗效果.结果:3例术前有神经压迫症状患者术后均得到改善.脊柱后凸Cobb角从平均45.5°(37°~68°)矫正到7.5°(0°~4°),平均矫正38°.随访时假关节处均已融合,矫正无明显丢失,亦无严重并发症发生.结论:后路张开式楔形截骨矫形内固定融合是治疗AS并假关节和脊柱后凸畸形的有效方法,不需施行前路骨融合手术即可达到假关节处的骨融合.

  6. Percutaneous bone cement fusion for the treatment of spinal pseudoarthrosis formation due to ankylosing spondylitis: report of one case%经皮骨水泥融合术治疗强直性脊柱炎性脊柱假关节一例

    Institute of Scientific and Technical Information of China (English)

    何永福; 吴春根; 顾一峰; 程永德

    2010-01-01

    @@ 临床资料: 患者女,58岁.因腰背部不适伴疼痛10年,加重3个月就诊.患者于10年前无明显诱因下出现腰背部隐痛,弯腰困难.经检查明确诊断为强直性脊柱炎,未作规律治疗,仅在疼痛发作时服用止痛片处理.近3个月来背部疼痛加重,胸腹部有束带感,双下肢酸痛,行走时明显,弯腰时疼痛加剧,翻身困难,大小便功能正常.为进一步诊治于2009年12月31日收住入院.院放射科

  7. 废旧无菌复合包装材料铝塑分离技术研究进展%Research Progress of Separation Technology of Aluminum-plastic in Aseptic Composite Packaging

    Institute of Scientific and Technical Information of China (English)

    张素风; 梅星贤; 张璐璐

    2012-01-01

    The amount of waste aluminum-plastic composite packaging, which contains a large number of high quality fibers and aluminumplastic materials increases year by year. In the present paper, separation technologies of aluminum-plastic composites in the world were reviewed. The principle and processes of various separation approaches, such as separation with solvent, electrical separation and Argon electrolysis were analyzed and compared. Finally the existing problem of efficient separation and recycling as well as future research directions of aluminum-plastic composite were discussed.%文章综述了国内外铝塑分离技术的研究进展,分析和比较了溶剂法、高压静电分离、氩气电解等技术的基本原理和工艺过程等特点;指出铝塑高效分离再利用存在的问题及铝塑分离技术的未来研究方向.

  8. In Vitro Micro-propagation from Hippeastrum's Little Aseptic Bulb and Its Effecting Factors%朱顶红小鳞茎切割繁殖及其影响因素

    Institute of Scientific and Technical Information of China (English)

    邵素娟; 史益敏

    2008-01-01

    利用双鳞片法获得朱顶红组培苗,利用其小鳞茎为材料,经切割诱导出芽产生新植株,以探讨朱顶红种苗工厂化生产技术.结果表明.用1/2MS培养基添加6-BA、NAA可诱导出芽;培养基糖浓度为45 g·L-1、pH为6.6时诱导率最高;小鳞茎四分切的繁殖系数高于二分切;切割代数不影响再切割成苗诱导率;添加磷酸二氢钾和三碘苯甲酸能提高小鳞茎重量.研究可为朱顶红种苗工厂化生产提供技术支持.

  9. Study on technology of aseptic sowing and rapid propagation of Demdrobium officinale%铁皮石斛无菌播种产业化繁育技术研究

    Institute of Scientific and Technical Information of China (English)

    付传明; 赵志国; 黄宁珍; 何金祥; 唐凤鸾; 石云平

    2012-01-01

    Seeds of Demdrobium of ficinale could be used as explants to rapid propagate by the way of seed→protocorm →the whole plant→transplant,and medium in each culture stage and some other factors were studied comparatively. The results showed that all seeds of D.officinale which were 60-180 d,especially 150 -180 d after pollination could germinate, with a germination rate of 87. 2%- 94. 4%. The suitable medium for seed germination was MS+6-BA 1. 0 mg/L+NAA 0. 1 mg/L+potato 200 g/L+active carbon 1. 0 g/L. The best medium for the formation and multiplica tion of protocorm was MS+6-BA 1. 5 mg/L+NAA 0. 1 mg/L+banana mud 100 g/L+active carbon 1. 0 g/L,the prop agation coefficient was about 20 times/50 d. And the protocorm differentiated on MS+6-BA 1. 0 mg/L+NAA 0. 1 mg/ L+potato 200 g/L+active carbon 1. 0 g/L medium,which could have some multiplication in the meantime. After being cultured on MS+6-BA 0. 5 mg/L+NAA 0. 2 mg/L+banana mud 100 g/L+active carbon 1. 0 g/L for a generation,the vigorous plantlets were transferred to rooting medium which was 1/2MS +NAA 0. 8 mg/L+mineral salt A 0. 2 - 0. 5 mg/L +banana mud 100 g/L+active carbon 1. 0 g/L and were cultured for 50 - 70 d,with 100% rooting rate. Mineral salt A could effectively control the formation of callus or protocorm, and obviously improve the quality and quantity of root regeneration plants. The best time for the transplantation of root regeneration plants was March - May and Septem ber - October in Guilin area. The plantlets were transplanted into rotten pine bark handled with high temperature in seedbed of greenhouse resulted in more than 90% survival rates.%以铁皮石斛的蒴果为外植体,采用种子→原球茎→完整植株→移栽的途径快速成苗进行工厂化生产,对各阶段培养基进行筛选,以及其他一些影响因子进行比较研究.结果表明:人工授粉后生长60~180 d的铁皮石斛种子在离体条件下均能萌发,其中授粉150~180 d种子的萌发效果最好,萌发率为87.2%~94.4%,适宜的萌发培养基为MS+6-BA 1.0 mg/L+NAA 0.1 mg/L+马铃薯汁200 g/L+AC 1.0 g/L;原球茎增殖的最佳培养基为MS+6-BA 1.5 mg/L+NAA 0.1 mg/L+香蕉汁100 g/L+AC 1.0 g/L,繁殖系数约为20倍/50 d;原球茎在MS+6-BA 1.0 mg/L+NAA 0.1 mg/L+马铃薯汁200 g/L+AC 1.0 g/L培养基上进行分化培养,分化的同时还能进行一定的增殖;将已分化的芽苗转接到壮苗培养MS+6-BA 0.5 mg/L+NAA 0.2 mg/L+香蕉汁100 g/L+AC 1.0 g/L上培养1代后,转接到生根培养基1/2MS+NAA 0.8 mg/L+无机盐A 0.2~0.5 mg/L +香蕉汁100 g/L+AC 1.0 g/L上,培养50~70 d后,生根率100%,无机盐A可以有效地控制愈伤或原球茎的形成,明显提高生根苗的数量和质量.在桂林地区,生根苗以3~5月和9~10为最佳移栽期,以通过高温处理并堆沤腐熟的松树皮为基质,移栽成活率可达90%.

  10. 无菌液态奶灌装机主电动机控制系统研究%Research of Main Motor Control System on Aseptic Milk Filling Machine

    Institute of Scientific and Technical Information of China (English)

    任树棠; 柏劲松

    2005-01-01

    论述了基于数字集成电路并能够与可编程序逻辑控制器(PLC)通讯的无菌液态奶灌装机主电动机控制系统的研究结果.改进后的控制系统具有结构简单、控制方便的特点,并大大的提高了生产效率,降低了生产成本和劳动强度.

  11. Significance of serum procalcitonin for discrimination between adult septic and aseptic arthritis%血清降钙素原鉴别成人化脓性关节炎与非化脓性关节炎的价值

    Institute of Scientific and Technical Information of China (English)

    王簕; 娄爱菊; 郭元; 李文帧; 张志; 杨波; 尹飚; 唐龙

    2014-01-01

    目的 评价血清降钙素原(PCT)鉴别成人化脓性关节炎与非化脓性关节炎的价值.方法 选择47例急性关节炎患者,根据细菌学培养或染色结果,分为化脓性关节炎(病例组)和非化脓性关节炎(对照组)两组,比较两组间血清PCT、超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)、中性粒细胞计数(NEU)以及红细胞沉降率(ESR)水平的差异.根据受试者工作特征曲线(ROC曲线),比较上述指标鉴别化脓性关节炎与非化脓性关节炎的效能.结果 47例患者中,病例组13例,对照组34例.病例组PCT、hs-CRP、ESR水平明显高于对照组(P<0.01),而两组间WBC、NEU比较差异无统计学意义(P>0.05).PCT的ROC曲线下面积最大,95% CI为0.83 ~0.99,其次分别是hs-CRP和ESR,WBC和NEU的曲线下面积差异则无统计学意义(P>0.05).当PCT取大于截断点值0.93 ng/mL诊断为化脓性关节炎时,其灵敏度可达到100.0%,特异度可达到71.0%.结论 WBC和NEU在鉴别成人化脓性关节炎与非化脓性关节炎中意义有限,hs-CRP和ESR可作为初筛检测指标,PCT对鉴别化脓性关节炎有更好的应用价值.

  12. Colagenopatía y meningitis aséptica recurrente en una paciente de 88 años Colagenopathy and recurrent aseptic meningitis in an 88 year old patient

    OpenAIRE

    Vazquez, Fernando J.; Yuqueri BeguelIn; Natalia Schutz; Luis M. Mayorga

    2004-01-01

    La meningitis aséptica recurrente (MAR) en ancianos es rara y generalmente es secundaria a drogas. Su asociación a colagenopatías en ancianos ha sido raramente informada. El Síndrome de Sjögren (SS) en ocasiones afecta el sistema nervioso central, pero la MAR asociada a SS es rara en este grupo etario. Se presenta una paciente de 88 años, autoválida, con antecedentes de xerostomía, xeroftalmos, Raynaud, disfagia y agrandamiento parotídeo recurrente autolimitado. En el año 2001 cursó una menin...

  13. Bone marrow aspiration

    Science.gov (United States)

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  14. Eliminating Preventable Death on the Battlefield

    Science.gov (United States)

    2011-08-15

    reached the next level of care alive and also ulti- mately survived. Sternal intraosseous access was used in 1 casualty. Consistent with evolving TCCC...from Hospira, Inc, Lake Forest, Illinois. cOne casualty received IVF through a FAST-1 sternal intraosseous device (Pyng Medical Corp, Richmond, British

  15. Radiolucent retractor for operative coronary angiography.

    Science.gov (United States)

    Collins, J J

    1977-05-01

    A new retractor has been designed for sternal separation during cardiac operations. This retractor has the advantage of radiolucent blades that allow visualization of the entire heart by roentgenographic techniques without compromise of surgical exposure during the course of operation. The retractor also has swivel blades that provide excellent conformity to the sternal edges without pressure points, which tend to produce fractures.

  16. Symptomatic fibrous lunato-triquetral coalition

    Energy Technology Data Exchange (ETDEWEB)

    Staebler, A.; Glaser, C.; Reiser, M. [Department of Diagnostic Radiology, Ludwig Maximilians University of Munich (Germany); Resnick, D. [Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)

    1999-10-01

    In general, carpal coalitions are considered to be asymptomatic. Incomplete separated joints and associated changes similar to osteoarthritis and pseudoarthrosis are known as possible causes of wrist pain. We present the clinical history, plain-film, and MR imaging findings of two patients with symptomatic fibrous lunato-triquetral coalition. Conventional films disclosed a narrowed space between the lunate and triquetral bone with cysts and sclerosis similar to pseudoarthrosis. Magnetic resonance imaging showed bone marrow edema adjacent to the incomplete separated lunato-triquetral joint and Gd-DTPA enhancing fibrovascular tissue in the synovium and subarticular cysts, explaining the pain over the ulnar-sided wrist. Patients with congenital lunato-triquetral coalition may poorly tolerate stress loading or trauma, resulting in a symptomatic state similar to degenerative arthritis or pseudoarthrosis, which is demonstrated by enhanced MR imaging. (orig.) With 2 figs., 23 refs.

  17. The Sauvé-Kapandji procedure: indications and tips for surgical success.

    Science.gov (United States)

    Lluch, Alberto

    2010-11-01

    Arthrodesis is the most reliable and durable surgical procedure for the treatment of a joint disorder, with the main disadvantage of loss of motion of the fused joint. The distal radioulnar joint can be arthrodesed, while forearm pronation and supination are maintained or even improved by creating a pseudoarthrosis of the ulna just proximal to the arthrodesis. This is known as the Sauvé-Kapandji procedure. This procedure is not void of possible complications, such as nonunion or delayed union of the arthrodesis, fibrous or osseous union at the pseudoarthrosis, and painful instability at the proximal ulna stump. All of these can be prevented if a careful surgical technique is used.

  18. [Clinical experience with the CHAUX multi-purpose retractor].

    Science.gov (United States)

    Akiyama, K; Horikosi, M; Shimamura, M; Namiki, Y; Koga, M; Nakata, K; Shindo, S; Sezai, Y

    1994-10-01

    We have performed dissection of the ITA using the CHAUX retractor in many patients. This retractor is a two-point sternal/IMA and valve retractor, with four sternal blades with individual and independent dual movement. The sliding sternal blade assemblies permit movement along the horizontal plane of the side arm. This retractor can be used for other types of cardiac surgery, as well. We obtained good results with its use for repair of distal aortic arch aneurysm. We conclude that this retractor is safe and useful for cardiac surgery.

  19. 单头胸锁乳突肌皮瓣功能性修复颌面部复合组织缺损%Functional Repair of the Facial Soft Tissue Defect with Myocutaneous Flap on Sternal-head of Sternocleidomastoid Muscle

    Institute of Scientific and Technical Information of China (English)

    童仁联; 司徒和气

    2000-01-01

    本文报告了应用单头胸锁乳突肌皮瓣功能性修复颌面部组织缺损,15例病例皮瓣基本全部成活.此种肌皮瓣血运丰富且稳定,成活率高;组织量适中,不显臃肿;移植后运动、感觉功能恢复较早,且术后不出现歪颈畸形.

  20. Manglende evidens for skadelig effekt på knogleheling ved behandling med NSAID

    DEFF Research Database (Denmark)

    Janum, Susanne; Kristensen, Billy Bjarne

    2012-01-01

    discard of NSAID for postoperative pain relief in uncomplicated cases. However, NSAID should be considered a potentiel risk factor of impaired bone healing and avoided in patients with a high risk of pseudoarthrosis. Recommended daily doses should be respected and duration of treatment should be limited....

  1. Mutation of the gene promoter synthase nitric oxide eNOS T786С in patients with pseudarthrosis of long bones: relationship with lipid levels and endothelial function

    Directory of Open Access Journals (Sweden)

    Bezsmertnyi Yu.O.

    2013-06-01

    Full Text Available Objective: The prevalence of gene promoter polymorphism eNOS T786С and its relationship with the level of lipids and vascular endothelial function in patients with pseudoarthrosis of long bones was investigated. Materials and methods. In 118 patients with pseudoarthrosis of long bones frequency of mutation of gene promoter eNOS T786C was studied and its relationship to lipid levels and vascular endothelial function was determined. The control group consisted of 48 patients with consolidated diaphyseal fractures, representative by age, gender and location of the damage. Results and discussion. Pathological homozygotes eNOS 786-CC accumulate predominantly in patients with hypoplastic and atrophic type of pseudoarthrosis. The frequency of genotypes distribution in patients with normoplastic type of pseudoarthrosis corresponded to the same in people with consolidated fractures. In patients with genotype eNOS 786-CC more often individuals with aberrant lipid levels and structural and functional changes in the common carotid, brachial and femoral arteries are identified. Conclusions. In patients with pseudarthrosis of long bones tendency to decrease in the proportion of normal homozygotes (786-CT, increase in heterozygotes (786-CT and the proportion of individuals with abnormal genotype 786-CC is observed. The mutation in gene T786C eNOS was associated with the development of hypoplastic and aplastic types of pseudarthrosis, increasing the proportion of persons with aberrant lipid levels, endothelial dysfunction of the central and peripheral vessels.

  2. Two cases of congenital defects within transverse processes of lumbar spine; Dwa przypadki wad wrodzonych wyrostkow poprzecznych ledzwiowego odcinka kregoslupa

    Energy Technology Data Exchange (ETDEWEB)

    Malawski, S.; Sokolski, B. [Klinika Ortopedii, Centrum Medyczne Ksztalcenia Podyplomowego, Otwock (Poland)

    1993-12-31

    Two cases of congenital defects of transverse processes of lumbar spine causing lumbalgia are described. The first one was produced by direct contact of the elongated processes with subsequent pseudoarthrosis. Hypertrophied processes caused stenosis around intervertebral foramen and irritated posterior neural branch in the second case. Surgical resection of the hypertrophied transverse processes has brought the cure. (author). 4 refs, 6 figs.

  3. 1981 walrus harvest, health/welfare study, Gambell, Alaska: Progress report

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Spring walrus harvest data and biological samples (177 pairs of teeth for aging, corresponding sternal skin/blubber thickness and tusk length measurements for health...

  4. Heart Surgery: MedlinePlus Health Topic

    Science.gov (United States)

    ... Is a Pediatric Heart Surgeon? (American Academy of Pediatrics) Also in Spanish Patient Handouts Aortic valve surgery - open (Medical Encyclopedia) ... Spanish Open heart surgery (Medical Encyclopedia) Also in Spanish ... heart surgery Pediatric heart surgery - discharge Sternal exploration or closure Related ...

  5. Non-neoplastic variants of the sternum detected on bone scintigrap

    Directory of Open Access Journals (Sweden)

    Yasser G. Abdelhafez

    2016-06-01

    Conclusion: Increased sternal uptake is significantly associated with CT structural abnormalities and knowledge of these non-neoplastic variants is essential for correct interpretation of SPECT/CT bone scans especially in patients with known cancers.

  6. Thymectomy: Common Questions Patients Ask about Thymectomies

    Science.gov (United States)

    ... A few MG Centers add a formal neck dissection to the sternal technique to also ensure the ... of patient services, public information, medical research, professional education, advocacy and patient care. This publication is intended ...

  7. A self-retaining retractor for mitral valve operations.

    Science.gov (United States)

    Cosgrove, D M

    1986-08-01

    A new self-retaining retractor for mitral valve operations is described. It is universally adjustable, may be affixed to any sternal retractor, and is completely removable when not required for the intracardiac portion of the procedure.

  8. En-Route Care Capability from Point of Injury Impacts Mortality after Severe Wartime Injury

    Science.gov (United States)

    2013-02-01

    thoracotomy, tube or open or needle de- compression; 3. Intraosseous access: sternal, humeral or tibial access sites; 4. Intravenous access: peripheral or...intervention 222 (20.3%) 36 (5.5%) 156 (40.5%) 30 (51.7%) Chest decompression 134 (12.3%) 19 (2.9%) 96 (24.9%) 19 (32.8%) Intraosseous access 255 (23.3%) 39 (6.0...thoracostomy, needle decompression; Intraosseous access = Sternal, humeral, tibial locations; Intravenous access = Peripheral and central access

  9. Straight versus S-shaped sternotomy: a histologic study in the sheep model

    OpenAIRE

    Inan, Bekir; Kucukdurmaz, Fatih; Karakan, Sebnem; Teker, Melike E; Akcan, Caner; Dilek, Gulay B; Daglioglu, Kenan

    2014-01-01

    Introduction Straight sternotomy is the most common access for open heart surgery. Techniques have been proposed for maximizing sternal stability in high-risk patients. This trend implies a growing need for newer surgical techniques. The aim of this experimental study in the sheep model is to evaluate median vs. S shaped sternotomy the feasibility of using a special device to accelerate the sternal instability and bone healing. Materials and methods We enrolled 31 sheep, weighing 18–30 kg. Fo...

  10. Forty-five-degree two-stage venous cannula: advantages over standard two-stage venous cannulation.

    Science.gov (United States)

    Lawrence, D R; Desai, J B

    1997-01-01

    We present a 45-degree two-stage venous cannula that confers advantage to the surgeon using cardiopulmonary bypass. This cannula exits the mediastinum under the transverse bar of the sternal retractor, leaving the rostral end of the sternal incision free of apparatus. It allows for lifting of the heart with minimal effect on venous return and does not interfere with the radially laid out sutures of an aortic valve replacement using an interrupted suture technique.

  11. 基于WIFI和RFID技术的无菌物品供应链质量控制优化设计%The Most Optimized Design and Implementation of Aseptic Supplies Chain and Quality Control Based WiFi and RFID Technology

    Institute of Scientific and Technical Information of China (English)

    夏英兰; 胡顺福; 汪觉民; 杨喜群

    2010-01-01

    为了加强对外来器械的全程质量控制,保证外来器械包的质量安全,有效地减少医院感染,采用先进的WIFI和RFID系统技术建立一个完整、灵活和实时的外来器械处理流程管理,建立全程质量控制体系,即CSSD集中式管理,建立可持续追溯系统,系统操作简化,记录追溯完善质量保证,体现了规范化管理优势,降低了医院感染发生.

  12. 不同种类、浓度的激素配合使用对银斑百里香种子无菌苗生长的影响%Effects on the Growing of Aseptic Seedlings of Thymus Vulgaris ‘Silver Posie' with the Conjunct Use of Hormone of Different Types and Concentration

    Institute of Scientific and Technical Information of China (English)

    张春梅; 闫芳; 陈杰昌

    2013-01-01

    以银斑百里香种子为实验材料,研究了不同浓度的萘乙酸(NAA)和2,4二氯苯氧乙酸(2,4-D)与6-苄基氨基嘌呤(6-BA)配合使用对银斑百里香无菌苗生长的影响.结果表明:NAA在0.15 mg/L和2,4-D在0.45 mg/L时是银斑百里香种子萌发成无菌苗的最适宜浓度;MS培养基+ NAA(0.15 mg/L) +6-BA(0.6 mg/L)和MS +2,4-D(0.45 mg/L) +6-BA(0.6 mg/L)的培养基中银斑百里香无菌苗生长最佳.

  13. Management of a failed metatarso-phalangeal joint fusion utilizing a hemicup prosthesis

    Directory of Open Access Journals (Sweden)

    Nicola Stadler

    2014-10-01

    Full Text Available We report a case of a 65-year-old man with a painful nonunion of the first metatarsophalangeal joint (MTPJ. It is one of the main severe complications of this surgery. Its prevalence is described between 5% and 10% across different operative techniques. The implantation of hemicup-prosthesis has been successfully used for the hallux rigidus treatment with very promising results. In our case report, we introduce a treatment method of converting a pseudoarthrosis of the first MTPJ, made of two crossing screws into a hemicup-prosthesis as a salvage procedure. This is to our best knowledge the first report using this device for treatment of pseudoarthrosis of the first MTPJ.

  14. Trapeziometacarpal narrow pseudarthrosis: a new surgical technique to treat thumb carpometacarpal joint arthritis.

    Science.gov (United States)

    Rubino, M; Civani, A; Pagani, D; Sansone, V

    2013-10-01

    We describe a technique that arose from the observation of the clinical outcome of failed arthrodeses of the thumb carpometacarpal joint. In these cases a pseudoarthrosis developed which, surprisingly, rarely lead to a poor clinical outcome. Thus we developed a simple technique which deliberately caused the formation of a narrow pseudoarthrosis in the carpometacarpal joint. We present a retrospective review of 248 consecutive patients treated for Eaton stages II and III osteoarthritis. We observed a statistically significant improvement in mean appositional and oppositional pinch strength, mean DASH score (63.8 pre-operatively to 10.5 at final follow-up), and the mean pain score (8.3 to 0.2). We conclude that trapeziometacarpal limited excision arthroplasty is a simple and reliable alternative to existing surgical techniques for treating Stage II or III thumb carpometacarpal joint arthritis.

  15. The cationic composition and pH in the moulting fluid of Porcellio scaber (Crustacea, Isopoda) during calcium carbonate deposit formation and resorption.

    Science.gov (United States)

    Ziegler, Andreas

    2008-01-01

    Before moulting, terrestrial isopods resorb calcium carbonate (CaCO(3)) from the posterior cuticle and store it in sternal deposits. These consist mainly of amorphous calcium carbonate (ACC) spherules that develop within the ecdysial space between the anterior sternal epithelium and the old cuticle. Ions that occur in the moulting fluid, including those required for mineral deposition, are transported from the hemolymph into the ecdysial space by the anterior sternal epithelial cells. The cationic composition of the moulting fluid probably affects mineral deposition and may provide information on the ion-transport activity of the sternal epithelial cells. This study presents the concentrations of inorganic cations within the moulting fluid of the anterior sternites during the late premoult and intramoult stages. The most abundant cation is Na(+) followed by Mg(2+), Ca(2+) and K(+). The concentrations of these ions do not change significantly between the stages whereas the mean pH changed from 8.2 to 6.9 units between mineral deposition in late premoult, and resorption in intramoult, respectively. Measurements of the transepithelial potential show that there is little driving force for passive movements of calcium across the anterior sternal epithelium. The results suggest a possible role of magnesium ions in ACC formation, and a contribution of pH changes to CaCO(3) precipitation and dissolution.

  16. Treatment of the femoral neck peudoarthrosis in childhood: Case report

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2013-01-01

    Full Text Available Introduction. Femoral neck fractures in children and adolescents are rare. However, their complications are frequent - avascular necrosis, femoral neck pseudoarthrosis, premature physeal closure with consequent growth disturbance and coxa vara deformity. Case Outline. A 9.5­year­old boy was injured in a car accident, and femoral neck fracture was diagnosed. Prior to admission at our hospital he was surgically treated several times. He was admitted at our hospital eight months following the accident. On the X­ray transcervical pseudoarthrosis of the femoral neck was found, as well as coxa vara deformity and metaphyseal avascular necrosis. He was operated at our hospital; all previously placed ostefixation material was removed, valgus osteotomy of 30 degrees was done as well as additional local osteoplasty using the commercial osteoindactive agent (Osteovit®. Postoperatively, we applied skin traction, bed rest and physical therapy. At the final follow­up, the patient was recovered completely. He is now painless, the legs are of equal length, range of movements in the left hip is full, life activity is normal. The X­ray shows that the femoral neck pseudoarthrosis is fully healed. Conclusion. This case is presented in order to encourage other colleagues to challenge the problematic situation such as this one. Also, we would like to remind them what one should think about and what should be taken into consideration in the primary treatment of femoral neck fractures in children. Valgus femoral osteotomy, as a part of the primary treatment of femoral neck fracture in children (identically as in the adults can prevent the occurrence of femoral neck pseudoarthrosis.

  17. Ankylosing spondylitis complicated by trauma: MR findings correlated with plain radiographs and CT

    Energy Technology Data Exchange (ETDEWEB)

    Goldberg, A.L. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (United States) Medical Coll. of Pennsylvania, Pittsburgh, PA (United States)); Keaton, N.L. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (United States) Medical Coll. of Pennsylvania, Pittsburgh, PA (United States)); Rothfus, W.E. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (United States) Medical Coll. of Pennsylvania, Pittsburgh, PA (United States)); Daffner, R.H. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (United States) Medical Coll. of Pennsylvania, Pittsburgh, PA (United States))

    1993-01-01

    Four patients with ankylosing spondylitis sustained a traumatic spinal injury. In three cases, pseudoarthrosis developed at the discovertebral junction, while involvement of the neural arch occurred in the fourth. Although the diagnosis of ankylosing spondylitis was readily established on plain radiographs, magnetic resonance more effectively indentified the complicating injury and in two cases demonstrated the presence of cord compression. Computed tomography was also contributory in delineating bony and ligamentous abnormalities of the neural arch. (orig.)

  18. Scintiscanning after Harrington spondylodesis

    Energy Technology Data Exchange (ETDEWEB)

    Darsow, F.; Jaster, D.; Krueger, M.

    1986-01-01

    Scintigraphy was performed in 26 patients, 6 months to 6 1/2 years after Harrington's spondylodesis using /sup 99m/Tc methylene diphosphonate. About one year after operation the stabilization process of the fusional area was finished. The value of scintigraphy as to the detection of pseudoarthrosis in the fusional area must be called in question according to the results. (author).

  19. Contributions of human tissue analysis to understanding the mechanisms of loosening and osteolysis in total hip replacement

    DEFF Research Database (Denmark)

    Gallo, Jiri; Vaculova, Jana; Goodman, Stuart B;

    2014-01-01

    Aseptic loosening and osteolysis are the most frequent late complications of total hip arthroplasty (THA) leading to revision of the prosthesis. This review aims to demonstrate how histopathological studies contribute to our understanding of the mechanisms of aseptic loosening/osteolysis developm...

  20. Photobiomodulation of surgical wound dehiscence in a diabetic individual by low-level laser therapy following median sternotomy

    Directory of Open Access Journals (Sweden)

    Snehil Dixit

    2013-01-01

    Full Text Available In this single case study, we attempt to outline the possible effect of low-level laser therapy (LLLT on delayed wound healing and pain in chronic dehiscent sternotomy of a diabetic individual. The methods that were employed to evaluate changes pre and post irradiation were wound photography, wound area measurement, pressure ulcer scale of healing (PUSH, and visual analogue scale (VAS for pain. After irradiation, proliferation of healthy granulation tissue was observed with decrease in scores of PUSH for sternal dehiscence and VAS for bilateral shoulders and sternal dehiscence. We found that LLLT irradiation could be a novel method of treatment for chronic sternal dehiscence following coronary artery bypass grafting, as it augments wound healing with an early closure of the wound deficit. Hence, this might be translated into an early functional rehabilitation and decreased pain perception of an individual following surgical complication.

  1. Estimation of respiratory rates based on photoplethysmographic measurements at the sternum

    DEFF Research Database (Denmark)

    Chreiteh, Shadi; Belhage, Bo; Hoppe, Karsten;

    2015-01-01

    rate is extracted using photoplethysmography (PPG) on the chest bone (sternum). Sternal PPG signals were acquired from 10 healthy subjects resting in a supine position. As reference signals, finger PPG, electrocardiogram (ECG), and capnography were simultaneously recorded during spontaneous and paced...... breathing. The sternal PPG signals were then compared with the reference signals in terms of Bland-Altman analysis, the power spectrum analysis and the magnitude squared coherence. The Bland-Altman analysis showed an average bias of 0.21 breaths/min between RR extracted from sternal PPG and capnography....... The respiratory power content at the sternum was 78.8 (38) % in terms of the median and (the interquartile range). The cardiac content was 19 (18.4) % within the cardiac region. The results from the magnitude squared coherence analysis was 0.97 (0.09) in the respiratory region (6 to 27 breaths/min) and 0.98 (0...

  2. The Shock and Vibration Bulletin. Part 3. Machinery Dynamics, System Identification and Structural Analysis

    Science.gov (United States)

    1985-06-01

    lung system and then to the spine through the costo -vertebral and costo -transverse joints [9, 12 and 14]., The development of the HSM required the...abdominal wall kij = kI + k2 6 (7) system; the costo -vertebral, costo -transverse and costo -sternal joints and the intercondral where k1 and k2 are...pp. 303- "" 309, 1974 21. Schultz, A., Benson, D. and Hirsch, C., "Force-Deformation Properties of Human Costo -Sternal and Costo -Vertebral Arti

  3. Chronic Osteomyelitis in Sternum Mimicking Bone Metastasis of Lung Cancer Patient

    Energy Technology Data Exchange (ETDEWEB)

    Im, Hyung Jun; Kim, Yu Keong; Lee, Sang Mi; Lee, Won Woo; Kim, Sang Eun [Seoul National University Bundang Hospital, Seoul (Korea, Republic of)

    2009-06-15

    Primary sternal osteomyelitis without predisposing factors is a rare condition, and it is hardly differentiated from metastatic bone tumor especially in patient with the history of primary malignancy because osteomyelitis shares frequently common findings with metastatic bone lesion on {sup 18}F-FDG PET and bone scan. Although there have been several publications of primary osteomyelitis mimicking bone metastasis in the spine or extremities, we report a case of primary sternal osteomyelitis in the patient with lung cancer, which has, to our knowledge, not been reported before.

  4. Anterior mediastinal abscess diagnosed in a young sumo wrestler after closed blunt chest trauma

    Institute of Scientific and Technical Information of China (English)

    Tatsuro Sassa; Ken-ichiro Kobayashi; Masayuki Ota; Takuya Washino; Mayu Hikone; Naoya Sakamoto; Sentaro Iwabuchi

    2015-01-01

    Most mediastinal abscesses result from infections after thoracotomy, esophageal perforation or penetrating chest trauma.This disease is rarely caused by closed blunt chest trauma.All previously reported such cases after closed blunt chest trauma presented with hematoma and sternal osteomyelitis resulting from sternal fracture.Here we report a 15-year-old sumo wrestler who presented with an anterior mediastinal abscess without any mediastinal fracture.The mediastinal abscess resulted from the hematogenous spread of Staphylococcus aureus to a hematoma that might have been caused by a closed blunt chest trauma incurred during sumo wrestling exercises.

  5. 非感染性UKA翻修成TKA的临床结果挪威关节成形登记中心的768例TKA和578例UKA翻修为TKA的病例对照研究(1994年至2011年)%Outcomes of Unicompartmental Knee Arthroplasty After Aseptic Revision to Total Knee Arthroplasty A Comparative Study of 768 TKAs and 578 UKAs Revised to TKAs from the Norwegian Arthroplasty Register (1994 to 2011)

    Institute of Scientific and Technical Information of China (English)

    Tesfaye H.Leta; Stein H(a)kon L.Lygre; Arne Skredderstuen; Geir Hallan; Jan-Erik Gjertsen; Befit Rokne; Ove Furnes; 俞银贤; 易诚青

    2016-01-01

    背景:UKA失败后通常建议翻修为TKA.本文目的是对照研究初次UKA失败后翻修为TKA及初次TKA失败翻修为TKA两种情况下的术后效果、术中数据以及失败原因.方法:1994年到2011年间挪威关节成形登记中心记录的768例TKA失败后翻修为TKA (TKA-→TKA)的病例和578例UKA失败后翻修为TKA (UKA→TKA)的病例.研究中使用了患者自述术后效果的方法(以下简称“PROM”),包括:EuroQolEQ-5D、膝关节损伤和骨关节炎评分Knee Injury and Osteoarthritis Outcome Score(KOOS)、视觉模拟评分法(用来评估满意和疼痛程度).我们进行了改良的Kaplan-Meier和Cox回归分析,获取倾向评分,以评估假体生存率、二次翻修风险以及多次线性回归分析,以便用平均PROM值来评估两组的差异.结果:总体上,1994年到2011年之间,UKA→TKA组有12%的患者进行了二次翻修,TKA→TKA组有13%.UKA→TKA组和TKA→TKA组的10年假体生存比例分别为82%和81%(P=0.63).UKA→TKA组和TKA→TKA组的总体二次翻修风险或平均PROM分值无差异[相关风险(RR)=1.2;P=0.19].但对翻修时年龄≥70岁的情况,TKA→TKA患者的二次翻修风险高出2倍(RR=2.1;P=0.05).UKA→TKA组和TKA→TKA组患者二次翻修的主要原因是:胫骨假体松动(28%比17%)、单纯疼痛(22%比12%)、稳定性差(19%比19%)和深部感染(16%比31%),除深部感染以外,观察到的其他因素在两组间的差异并不大.TKA→TKA组深部感染比例更大(RR=2.2;P=0.03).TKA→TKA组手术操作用时更长(平均150分钟,UKA→TKA为114分钟),手术步骤更复杂且需要用到延长柄(58%,UKA→TKA为19%)和稳定性假体(27%,UKA→TKA为9%).结论:尽管初次TKA翻修成TKA手术过程中可能技术难度更高,但初次UKA翻修成TKA时由于深部感染发生而导致再次翻修的比例更高,不过初次UKA→TKA和初次TKA→TKA总体临床疗效相似.

  6. Outbreak of Enterovirus - 71 Meningitis in Calicut

    Directory of Open Access Journals (Sweden)

    CK Sasidharan

    2016-04-01

    Full Text Available Objective: Enterovirus 71(EV 71 causes wide spectrum of infections ranging from asymptomatic conditions to clinical syndromes like diarrhea, rash, hand-foot-and mouth disease (HFMD, herpangina, aseptic meningitis, encephalitis, myocarditis, acute flaccid paralysis, bulbar and brainstem encephalitis Guillain Barre syndrome, pulmonary haemorrhage. This study deals with an outbreak of aseptic meningitis in children caused by EV 71 virus. Methods: The authors report an outbreak of aseptic meningitis in children in and around Calicut in June 2008. Clinical and laboratory study was done in collaboration with National Centre for Disease Control, New Delhi. 149 children with aseptic meningitis were studied and followed up from June 2008 to May 2009. Result: All children had clinical features suggestive of aseptic meningitis and serology showed the rising antibody titre against EV 71 virus infection. CSF analysis also showed four fold rise in antibodies in one and ≥ 1:2 neutralising antibodies titer against EV- 71 in four samples indicating meningitis due to EV-71. Conclusion: EV 71 was identified as the causative agent of the outbreak of aseptic meningitis in the study and the fact that the EV 71 infection has evolved from minor illness like HFMD to major illness like aseptic meningitis from the same locality is truly alarming.

  7. A designated centre for people with disabilities operated by Brothers of Charity Southern Services, Cork

    LENUS (Irish Health Repository)

    Parissis, Haralabos

    2011-09-19

    Abstract Background To report our experience, with Deep mediastinal wound infections (DMWI). Emphasis was given to the management of deep infections with omental flaps Methods From February 2000 to October 2007, out of 3896 cardiac surgery patients (prospective data collection) 120 pts (3.02%) developed sternal wound infections. There were 104 males & 16 females; (73.7%) CABG, (13.5%) Valves & (9.32%) CABG and Valve. Results Superficial sternal wound infection detected in 68 patients (1.75%) and fifty-two patients (1.34%) developed DMWI. The incremental risk factors for development of DMWI were: Diabetes (OR = 3.62, CI = 1.2-10.98), Pre Op Creatinine > 200 μmol\\/l (OR = 3.33, CI = 1.14-9.7) and Prolong ventilation (OR = 4.16, CI = 1.73-9.98). Overall mortality for the DMWI was 9.3% and the specific mortality of the omental flap group was 8.3%. 19% of the "DMWI group", developed complications: hematoma 6%, partial flap loss 3.0%, wound dehiscence 5.3%. Mean Hospital Stay: 59 ± 21.5 days. Conclusion Post cardiac surgery sternal wound complications remain challenging. The role of multidisciplinary approach is fundamental, as is the importance of an aggressive early wound exploration especially for deep sternal infections.

  8. Radiologic considerations in patients undergoing the Nuss procedure for correction of pectus excavatum

    Energy Technology Data Exchange (ETDEWEB)

    Sidden, C.R. [Dept. of Pediatric Radiology, Children' s Hospital of The King' s Daughters and Eastern Virginia Medical School, Norfolk, VA (United States); Katz, M.E. [Dept. of Pediatric Radiology, Children' s Hospital of The King' s Daughters and Eastern Virginia Medical School, Norfolk, VA (United States); Dept. of Radiology, Norfolk, VA (United States); Swoveland, B.C.; Nuss, D. [Dept. of Pediatric Surgery, Children' s Hospital of The King' s Daughters and Eastern Virginia Medical School, Norfolk, VA (United States)

    2001-06-01

    The Nuss procedure has succeeded in minimizing incisions, blood loss, sternal fracturing, operating room time, recovery time, and length of hospital stay. Knowledge of the pre- and postoperative radiologic considerations is essential in providing appropriate imaging support to the surgeons performing this innovative, minimally invasive procedure. (orig.)

  9. Symmetrical progressive erythro-keratoderma

    Directory of Open Access Journals (Sweden)

    Sunil Gupta

    1999-01-01

    Full Text Available A 13-year-old male child had gradually progressive, bilaterall, symmetrical, erythematous hyperkeratotic plaques over knees, elbows, natal cleft, dorsa of hands and feet with palmoplantar keratoderma. High arched palate, fissured tongue and sternal depression (pectus-excavatum were unusual associations.

  10. Postoperative mediastinitis due to Finegoldia magna with negative blood cultures.

    Science.gov (United States)

    Kernéis, Solen; Matta, Matta; Hoï, Annie Buu; Podglajen, Isabelle; Gutmann, Laurent; Novara, Ana; Latremouille, Christian; Mainardi, Jean-Luc

    2009-12-01

    We report a case of Finegoldia magna (formerly known as Peptostreptococcus magnus) mediastinitis following coronary artery bypass in a 50-year-old patient. Even if staphylococci remain the main causative organism of postoperative mediastinitis, the responsibility of anaerobic bacteria must be considered in cases of fever and sternal drainage with negative blood cultures.

  11. [Application of new chest holder in the median sternotomy for open heart surgery in adults].

    Science.gov (United States)

    Xu, C Y; Feng, D G; Wang, J X; Cheng, Z Y; Wang, F; Lin, B; Xie, Z L; Suo, L N; Du, P

    2016-09-13

    Objective: To explore the application of new chest holder in the median sternotomy for open heart surgery in adults. Methods: Two hundred adult patients in Henan Provincial People's Hospital from May 2013 to May 2015 were enrolled in the study and randomly divided into two groups. Experimental group included 100 cases who accepted the new type of chest holder in the open heart surgery. Control group were also composed of 100 cases whose sternums were fixed with the pure steel wire cerclage. Sternal closure time was recorded since the sternum closing. All subjects were followed up to obtain the chest incision healing, the incidence of sternal dehiscence, infection and secondary thoracotomy, and thus to estimated the effect of new chest holder. Results: All patients in the experimental group reached the effect of firm closed chest surgery. Sternal closure time of experimental group was much shorter than that of control group[(10±2) vs (21±4) min, Pholder in the median sternotomy for open heart surgery is more convenient with small surgical trauma. It can also effectively reduce the incidence of sternal instability, dehiscence, infection and secondary thoracotomy.

  12. Anatomical description and clinical significance of unilateral triheaded sternocleidomastoid muscle

    Directory of Open Access Journals (Sweden)

    Preeti Goswami

    2014-06-01

    Full Text Available Objective of this report is to observe and report unusual pattern of origin of sternal and clavicular heads of Sternocleidomastoid (SCM. An embryological insight into the possible causes for present anomaly is elucidated. The neck region of an adult male cadaver during gross anatomy teaching program. An abnormal Sternocleidomastoid (SCM was observed while dissecting the neck region of an adult. Additional clavicular head of SCM muscle were found on the right side. The accessory clavicular head coursed deep to the sternal head whereas the some fibres of main clavicular head joined the accessory belly and together they fused with the main sternal head of SCM. There was another slip arising from sternal head and merge with deep cervical fascia near base of mandible. The topographical anatomy of SCM is extremely important, particularly because it serves as a useful surgical landmark and its relation to crucial neuro-vascular structures of the neck. The usage of SCM in reconstruction operations for covering defects is discussed. A detailed knowledge of the anatomy of SCM proves vital for radiological studies of the neck. [Int J Res Med Sci 2014; 2(3.000: 1161-1164

  13. Preoperative respiratory physical therapy in cardiac surgery

    NARCIS (Netherlands)

    Hulzebos, H.J.

    2006-01-01

    Cardiac surgery is one of the most common surgical procedures and accounts for more resources expended in cardiovascular medicine than any other single procedure. Because cardiac surgery involves sternal incision and cardiopulmonary bypass, patients usually have a restricted respiratory function in

  14. Risk analysis and outcome of mediastinal wound and deep mediastinal wound infections with specific emphasis to omental transposition

    LENUS (Irish Health Repository)

    Parissis, Haralabos

    2011-09-19

    Abstract Background To report our experience, with Deep mediastinal wound infections (DMWI). Emphasis was given to the management of deep infections with omental flaps Methods From February 2000 to October 2007, out of 3896 cardiac surgery patients (prospective data collection) 120 pts (3.02%) developed sternal wound infections. There were 104 males & 16 females; (73.7%) CABG, (13.5%) Valves & (9.32%) CABG and Valve. Results Superficial sternal wound infection detected in 68 patients (1.75%) and fifty-two patients (1.34%) developed DMWI. The incremental risk factors for development of DMWI were: Diabetes (OR = 3.62, CI = 1.2-10.98), Pre Op Creatinine > 200 μmol\\/l (OR = 3.33, CI = 1.14-9.7) and Prolong ventilation (OR = 4.16, CI = 1.73-9.98). Overall mortality for the DMWI was 9.3% and the specific mortality of the omental flap group was 8.3%. 19% of the "DMWI group", developed complications: hematoma 6%, partial flap loss 3.0%, wound dehiscence 5.3%. Mean Hospital Stay: 59 ± 21.5 days. Conclusion Post cardiac surgery sternal wound complications remain challenging. The role of multidisciplinary approach is fundamental, as is the importance of an aggressive early wound exploration especially for deep sternal infections.

  15. Evaluation of feasibility and outcome of isolated aortic valve replacement surgery through J-shaped upper ministernotomy: A comparative study versus full sternotomy

    Directory of Open Access Journals (Sweden)

    Mohamed A. Amr

    2016-08-01

    Conclusion: MSAVR is a feasible procedure despite of the narrow operative field that induced long operative times but it significantly reduced amount of postoperative drainage and improved recovery items. MSAVR is safe with minimal PO morbidities and allowed early rehabilitation and free sleep position without affection of sternal wound healing. Moreover, MSAVR provided cosmetically better wound that was strongly satisfying patients.

  16. Poland syndrome

    OpenAIRE

    Chandra Madhur Sharma; Shrawan Kumar; Meghwani, Manoj K.; Agrawal, Ravi P.

    2014-01-01

    Poland′s syndrome is a rare congenital condition, characterized by the absence of the sternal or breastbone portion of the pectoralis major muscle, which may be associated with the absence of nearby musculoskeletal structures. We hereby report an 8-year-old boy with typical features of Poland syndrome, the first documented case from Uttar Pradesh, India.

  17. Poland syndrome

    Directory of Open Access Journals (Sweden)

    Chandra Madhur Sharma

    2014-01-01

    Full Text Available Poland′s syndrome is a rare congenital condition, characterized by the absence of the sternal or breastbone portion of the pectoralis major muscle, which may be associated with the absence of nearby musculoskeletal structures. We hereby report an 8-year-old boy with typical features of Poland syndrome, the first documented case from Uttar Pradesh, India.

  18. Descending mediastinitis managed by sternotomy, taurolidine and delayed closure.

    Science.gov (United States)

    Iyer, Anand P; Kugathasan, Gana; Prabha, Ramesh; Malik, Paras; Kuteyi, Opeyemi; Larbalestier, Robert

    2013-10-01

    Descending necrotizing mediastinitis is a rare complication of upper respiratory infections. A quick diagnosis and prompt and complete surgical drainage is important for a successful outcome. A 74-year-old man with descending necrotizing mediastinitis needed a sternotomy, multiple washouts, and delayed sternal closure.

  19. Staged repair of pentalogy of Cantrell with ectopia cordis and ventricular septal defect.

    Science.gov (United States)

    Sakasai, Yoshie; Thang, Bui Quoc; Kanemoto, Shinya; Takahashi-Igari, Miho; Togashi, Shinji; Kato, Hideyuki; Hiramatsu, Yuji

    2012-05-01

    Pentalogy of Cantrell is a rare congenital anomaly characterized by a combination of severe defects in the middle of the chest and abdomen including intracardiac defects. Survival rate after cardiac surgery is extremely low. We present a successful staged complete repair of an omphalocele, a ventricular septal defect and a sternal defect in a case of pentalogy of Cantrell.

  20. Refinement and Validation of a Three-Dimensional Head-Spine Model

    Science.gov (United States)

    1978-08-01

    and beam elements respectively. Rib pairs 1 - 7 are connected to the sternum through the costo -sternal joints which are wodeled .as beam elements. Rib...1976), "Vata for Noahumzan Priwtea", Personal cocztuincat ion. Kulak. R. F., (1974), "A Study ol intervortebral DisclMechanics by the Finite Element

  1. Technique for Measuring Body Circumferences and Skinfold Thicknesses.

    Science.gov (United States)

    1984-08-01

    of the tape measure. Technique For ease and accuracy of measurement, male subjects ( persons being measured) should wear swim suits or shorts and female...are now touching the second costo -sternal joint (Figure 3a). There is usually a slight bulge or prominence on the sternum at this level. This

  2. Single stage repair of a complex pathology: end stage ischaemic cardiomyopathy, ascending aortic aneurysm and thoracic coarctation

    Directory of Open Access Journals (Sweden)

    Parissis Haralabos

    2011-11-01

    Full Text Available Abstract The not uncommon combination of ascending aortic pathology with late presenting coarctation is a difficult surgical challenge. The two stage approach is usually adopted. The necessity for cardiac transplantation adds to the complexity: a trans-sternal approach and single stage repair become mandatory.

  3. Four colorful new species of dragon millipedes, genus Desmoxytes Chamberlin, 1923, from northern Thailand (Diplopoda: Polydesmida: Paradoxosomatidae)

    DEFF Research Database (Denmark)

    Srisonchai, R.; Enghoff, Henrik; Likhitrakarn, N.;

    2016-01-01

    were compared with type specimens of closely related species and were all found to exhibit explicit morphological differences from these. They can be distinguished from other members of Desmoxytes by the shape of the gonopods, the sternal process between male coxae 4, the pattern of spines or tubercles...

  4. Chronological study for solitary bone metastasis in the sternum from breast cancer with bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Miyoshi, Hidenao; Otsuka, Nobuaki; Sone, Teruki; Nagai, Kiyohisa; Tamada, Tsutomu; Mimura, Hiroaki; Yanagimoto, Shinichi; Tomomitsu, Tatsushi; Fukunaga, Masao [Kawasaki Medical School, Kurashiki, Okayama (Japan)

    1999-07-01

    Since breast cancer is frequently associated with bone metastasis, bone scintigraphies have been performed to determine pre-operative staging and to survey postoperative bone metastasis. The sternum, in particular, is a site at which is difficult to differentiate between benign bone disease and bone metastasis, because of varied uptake and wide individual variations. In this study, chronological bone images were scintigraphied in six cases with solitary sternal metastasis and three cases with benign bone disease including two fracture cases and one arthritis case. On bone scintigrams in which solitary sternal metastasis appeared, increased uptake was found in five cases, and photon deficiency was observed in one case. During follow-up scintigraphies, abnormal accumulations, such as hot spots and cold lesions, increased in the bone metastasis while abnormal uptake disappeared or was unchanged in the benign bone disease cases. On CT, four cases showed osteolytic change, and one exhibited osteosclerotic change. These findings indicate that sternal metastasis usually shows osteolytic change, even if a hot lesion is recognized on bone scintigraphy. In solitary sternal metastasis, for which early diagnosis is difficult, both an integrated diagnosis using other imaging techniques and chronological bone scintigraphy are important. (author)

  5. Cutaneous metastasis from gastrointestinal adenocarcinoma of unknown primary origin.

    Science.gov (United States)

    Junqueira, Ana Lucia Ariano; Corbett, Ana Maria França; Oliveira Filho, Jayme de; Nasser, Kassila da Rosa; Haddad, Natalie Nejem; Tebet, Ana Carolina Franco

    2015-01-01

    Cutaneous metastasis is a rare manifestation of visceral malignancies that indicates primarily advanced disease. Due to its low incidence and similarity to other cutaneous lesions, it is not uncommon to have a delayed diagnosis and a shortened prognosis. We describe the case of a patient who presented with a cutaneous nodule in the sternal region as a first sign of malignancy.

  6. Manubrial stress fractures diagnosed on MRI: report of two cases and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Baker, Jonathan C.; Demertzis, Jennifer L. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, Musculoskeletal Section, St Louis, MO (United States)

    2016-06-15

    In contrast to widely-reported sternal insufficiency fractures, stress fractures of the sternum from overuse are extremely rare. Of the 5 cases of sternal stress fracture published in the English-language medical literature, 3 were in the sternal body and only 2 were in the manubrium. We describe two cases of manubrial stress fracture related to golf and weightlifting, and present the first report of the MR findings of this injury. In each of these cases, the onset of pain was atraumatic, insidious, and associated with increased frequency of athletic activity. Imaging was obtained because of clinical diagnostic uncertainty. On MRI, each patient had a sagittally oriented stress fracture of the lateral manubrium adjacent to the first rib synchondrosis. Both patients had resolution of pain after a period of rest, with subsequent successful return to their respective activities. One patient had a follow-up MRI, which showed resolution of the manubrial marrow edema and fracture line. Based on the sternal anatomy and MR findings, we hypothesize that this rare injury might be caused by repetitive torque of the muscle forces on the first costal cartilage and manubrium, and propose that MRI might be an effective means of diagnosing manubrial stress fracture. (orig.)

  7. Nipple Sparing Mastectomy: Does Breast Morphological Factor Related to Necrotic Complications?

    Directory of Open Access Journals (Sweden)

    Prakasit Chirappapha, MD

    2014-01-01

    Conclusions: Large glandular specimen increases the risk of NAC necrosis. The degree of ptosis and the distance between the sternal notch and the NAC have no significant impact on necrotic complications in NSM. To reduce the necrotic complications in large breast after NSM, reconstruction should better be performed with autologous flap or slow skin expansion using the expander technique.

  8. Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery: Copenhagen Arterial Revascularization Randomized Patency and Outcome trial

    DEFF Research Database (Denmark)

    Damgaard, S.; Lund, J.T.; Lilleor, N.B.;

    2008-01-01

    .9 in the conventional group (P = .004). Three months' follow-up for the arterial versus conventional groups showed the following: deaths: 1 (0.6%) versus 0; stroke: 3 (1.9%) versus 3 (1.8%); myocardial infarction: 6 (3.7%) versus 4 (2.4%); sternal wound reoperation: 4 (2.5%) versus 0 (P = .054); arm and leg wound...

  9. Laminectomy retractor: a useful tool for redo sternotomy.

    Science.gov (United States)

    Saxena, Pankaj; Zimmet, Adam D

    2014-11-01

    Sternal re-entry represents a critical step during redo cardiac surgery. We describe a simple method that relies on opening of the posterior table of the sternum with a laminectomy retractor after dividing the anterior table with an oscillating saw.

  10. [Mitral valve replacement after previous coronary artery bypass grafting with functioning left internal thoracic artery graft: effectiveness of the method using a direct vision retrosternal approach; report of a case].

    Science.gov (United States)

    Sakata, Junichi; Saito, Tatsuya; Fujii, Akira; Tsukamoto, Masaru; Date, Osamu; Yokoyama, Hideo; Abe, Tomio; Nakase, Atsunobu; Ohori, Katsumi

    2014-08-01

    Performing a redo-sternotomy when a mammary artery graft is patent can be rather difficult. We previously reported a redo-sternotomy technique involving direct visualization with a retrosternal dissection (DR) method using a Kent's retractor. The DR method in detail is as follows: 1) A midline skin incision is extended to the abdomen about 5 cm. 2) The bilateral costal arches are divided from the rectal muscle. 3). A pair of retractors is placed under the costal arch. 4) A stainless steel wire is applied to the previous sternal wire at the center of the sternum. 5) The retractor and sternal wire are lifted up using the Kent's retractor to widen the retrosternal space. 6) The sternum and sub-sternal tissue are carefully divided using an electronic scalpel or metal retractor with an entirely sternal length. 7) Routine sternotomy is performed using a Stryker. Herein, we report a patient who had undergone cardiac surgery, coronary artery bypass grafting (CABG), using a left internal mammary artery and mitral annuloplasty 2 years previously, and then developed mitral regurgitation caused by infectious endocarditis. He successfully underwent redo-sternotomy and mitral valve replacement using the DR method. In a patient with a patent internal mammary artery, the DR method greatly reduces the risk of graft injury.

  11. A fiber-optic retractor for harvesting the internal mammary artery.

    Science.gov (United States)

    Angelini, G D; Azzu, A A

    1990-08-01

    A retractor for exposure and dissection of the internal mammary artery incorporating a fiber-optic transillumination system is presented. The device, which can be converted to a standard sternal retractor, has also proved valuable in improving illumination during procedures on the mitral valve and in facilitating dissection of fibrous adhesions from the anterior surface of the heart at reoperation.

  12. 76 FR 20513 - Revision of the Requirements for Constituent Materials

    Science.gov (United States)

    2011-04-13

    ... example, state-of-the art technologies, such as the development of devices to ensure aseptic withdrawing.... 262), may request review of a scientific controversy by an appropriate scientific advisory panel...

  13. Volatiles produced by Staphylococcus xylosus and Staphylococcus carnosus during growth in sausage minces

    DEFF Research Database (Denmark)

    Stahnke, Marie Louise Heller

    1999-01-01

    Aseptic model minces were inoculated with commercial samples of either Staphylococcus xylosus or Staphylococcus carnosus. Volatiles produced by the cultures were collected during growth by diffusive sampling onto adsorbent traps, identified by thermal desorption-gas chromatography-mass spectromet...

  14. Is there evidence for accelerated polyethylene wear in uncemented compared to cemented acetabular components? A systematic review of the literature

    NARCIS (Netherlands)

    van der Veen, Hugo; van Jonbergen, H.P.W.; Poolman, R.W.; Bulstra, S.K.; van Raay, J.J.A.M.

    2013-01-01

    Joint arthroplasty registries show an increased rate of aseptic loosening in uncemented acetabular components as compared to cemented acetabular components. Since loosening is associated with particulate wear debris, we postulated that uncemented acetabular components demonstrate a higher polyethyle

  15. Physiotherapy of postoperation of lumbar disc protrusion%腰椎间盘突出症术后的理疗康复

    Institute of Scientific and Technical Information of China (English)

    孙艳霞

    2002-01-01

    Background:The common treatment of lumbar disc protrusion is operation.After the extirpation of intervertebral disc,patients always need processes of plerosis and healing and always have edema of nerve root and aseptic inflammation.

  16. List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings 2012

    Science.gov (United States)

    ... tests as required by local and/or national jurisdictions to verify aseptic conditions.  Make sure that workers ... Perspectives in disease prevention and health promotion update: universal precautions for prevention of transmission of human im- ...

  17. 局部阻滞疗法并激光治疗肱骨外上髁炎%Local blocking combined with laser onexternal humeral epicondylitis

    Institute of Scientific and Technical Information of China (English)

    刘崇丽; 李昭杨

    2003-01-01

    @@ BACKGROUND: External epicondylitis of distal humerus is often caused by overwork of wrist which pathological change are hyperemia, edema, exudation and adhesion of local tissue, laceration, calcification, aseptic necrosis of extensor tendon, or local synovitis, burstis.

  18. Practical Tips for the Safe Handling of Micro-organisms in Schools

    Science.gov (United States)

    Holt, G.

    1974-01-01

    Outlines safe laboratory procedures for the handling of micro-organisms including aseptic technique, manipulation of cultures, and treatment of contaminated equipment. Identifies the principal hazard as the microbial aerosol, explains its possible effects, and describes the appropriate precautions. (GS)

  19. CLINICAL TRIALS FOR VAS DEFERENS OCCLUSION BY PERCUTANEOUS INJECTION OF POLYURETHANE ELASTOMER TO FORM PLUGS

    Institute of Scientific and Technical Information of China (English)

    ZHAOSheng-Cai; etal.

    1989-01-01

    A non-incision method of vss occlusion based on the percutaneous injection of polyurethane elastomer solution to form a plug is described. The procedure was conducted under aseptic procedure and local fidocaine anaesthesia. Two different kinds of

  20. Segmentation of the sternum from low-dose chest CT images

    Science.gov (United States)

    Liu, Shuang; Xie, Yiting; Reeves, Anthony P.

    2015-03-01

    Segmentation of the sternum in medical images is of clinical significance as it frequently serves as a stable reference to image registration and segmentation of other organs in the chest region. In this paper we present a fully automated algorithm to segment the sternum in low-dose chest CT images (LDCT). The proposed algorithm first locates an axial seed slice and then segments the sternum cross section on the seed slice by matching a rectangle model. Furthermore, it tracks and segments the complete sternum in the cranial and caudal direction respectively through sequential axial slices starting from the seed slice. The cross section on each axial slice is segmented using score functions that are designed to have local maxima at the boundaries of the sternum. Finally, the sternal angle is localized. The algorithm is designed to be specifically robust with respect to cartilage calcifications and to accommodate the high noise levels encountered with LDCT images. Segmentation of 351 cases from public datasets was evaluated visually with only 1 failing to produce a usable segmentation. 87.2% of the 351 images have good segmentation and 12.5% have acceptable segmentation. The sternal body segmentation and the localization of the sternal angle and the vertical extents of the sternum were also evaluated quantitatively for 25 good cases and 25 acceptable cases. The overall weighted mean DC of 0.897 and weighted mean distance error of 2.88 mm demonstrate that the algorithm achieves encouraging performance in both segmenting the sternal body and localizing the sternal angle.

  1. Ambulant neuropsykologisk opfølgning af patienter indlagt med aseptisk meningitis

    DEFF Research Database (Denmark)

    Damsgaard Gunst, Jesper; Klostergaard, Kirsten Rose; Leutscher, Peter Derek Christian

    2014-01-01

    Aseptic meningitis is considered to be a benign illness with mild symptoms, and the prognosis is usually good. However, retrospective studies have demonstrated that these patients may experience cognitive sequelae. A neuropsychologist was affiliated to the Department of Infectious Diseases......, and neuropsychological findings in patients with aseptic meningitis were assessed. In conclusion, at twelve months of follow-up cognitive dysfunction persist among the majority of patients; 75% had mental fatigue and 45% had changed their work status....

  2. Combined bilateral idiopathic necrosis of the humerus and femur heads: Bone scan, X-ray, CT, and MRI findings. Kombinierte beidseitige idiopathische Nekrose der Humerus- und Femurkoepfe: Skelettszintigraphie, Roentgen-, CT- und MRT-Befunde

    Energy Technology Data Exchange (ETDEWEB)

    Piepenburg, R.; Hahn, K. (Mainz Univ. (Germany). Klinik fuer Nuklearmedizin); Doll, G. (Mainz Univ. (Germany). Klinik fuer Roentgendiagnostik); Grimm, J. (Mainz Univ. (Germany). Orthopaedische Klinik)

    1992-12-01

    Untreated aseptic bone necroses close to a joint commonly leads to severe secondary arthrosis and destruction of the joint within a short time. Therefore, only a diagnosis in an early stage of the disease offers the chance of a successful joint- preserving therapy. In cases of clinically suspected aseptic bone necrosis but still negative or doubtful X-ray findings, bone scans or MRI are reliable methods of verifying the diagnosis. (orig./MG).

  3. An unusual cause of pain post ankle arthrodesis in patients with rheumatoid arthritis.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2012-02-01

    Rheumatoid arthritis is an autoimmune disease which frequently affects the ankle and foot. End stage ankle arthritis from rheumatic disease is commonly managed by the established practice of ankle arthrodesis. Among the adverse sequelae causing pain following this surgery is infection, pseudo-arthrosis and non-union. Stress fracture of the distal third is a recognised but unusual cause of pain of tibia following ankle arthrodesis. The authors\\' present three patients with rheumatoid arthritis who sustained a stress fracture of the distal tibia following arthrodesis, and discuss the contributing factors and highlight the need for orthopaedic surgeons to be suspicious of this complication post surgery.

  4. Scintigraphy of spinal disorders in adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Mandell, G.A. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States)); Harcke, H.T. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States))

    1993-08-01

    Bone scintigraphy in adolescents is useful in helping to differentiate between developmental (atypical lumbar Scheuermann disease), infectious (discitis, osteomyelitis), neoplastic (osteoid osteoma, osteoblastoma), and traumatic (occult fractures, spondylolysis, pseudoarthrosis) disease of the spine. Double-phase (blood pool, delayed images) scintigraphy can characterize the pattern (i.e., linear in fracture, ovoid in nidus of osteoid osteoma). Single-photon emission computed tomography (SPECT) can be helpful in detecting the subtle presence of stress reaction (spondylolyses) not noted on routine planar scintigraphy and radiography. Bone scintigraphy is most beneficial when correlated with other imaging modalities in refining the diagnosis of spinal diseases. (orig.)

  5. A new case of MOMO syndrome.

    Science.gov (United States)

    Wallerstein, Robert; Sugalski, Rachel D

    2010-01-01

    MOMO syndrome, a condition described in three earlier patients, is a constellation of macrosomia, obesity, macrocephaly, and ocular abnormalities as the main findings. We report a 6-year-old child with these findings as well as significant developmental issues, delayed bone age, clavicular pseudoarthrosis, and straight femurs. We believe that this child should be considered as having MOMO syndrome. Careful consideration of his facial features shows some overlap with Kabuki syndrome. Description of this case may help to better elucidate the clinical features of MOMO syndrome.

  6. MR findings of spondylolysis

    Energy Technology Data Exchange (ETDEWEB)

    Ojiri, Hiroya; Fukuda, Kunihiko; Hashimoto, Toru; Doi, Michiko; Irie, Takeo; Tatsuno, Satoshi; Tada, Shinpei (Jikei Univ., Tokyo (Japan). School of Medicine); Toyoda, Keiko

    1994-08-01

    We reviewed MR images of 50 patients with spondylolisthesis to disclose MR findings of spondylolysis. In almost half of our series, spondylolysis was detected as a low signal intensity band traversing in the pairs interarticularis on both T1 and T2 weighted images. Sagittal images was superior to axial image in detection of the low signal intensity band. In some patients, a focal high signal intensity accompanying the low signal intensity band was considered to be fluid collection within pseudoarthrosis due to spondylolysis on T2-weighted image. (author).

  7. Trauma induced eagle syndrome.

    Science.gov (United States)

    Koivumäki, A; Marinescu-Gava, M; Järnstedt, J; Sándor, G K; Wolff, J

    2012-03-01

    Eagle syndrome is characterized by secondary calcification and elongation of the styloid process. Eagle syndrome is often associated with sharp, intermittent pain along the path of the glossopharyngeal nerve located in the hypopharynx and at the base of the tongue. In some cases, the stylohyoid apparatus can compress the internal and/or the external carotid arteries and their perivascular sympathetic fibres, resulting in a persistent pain radiating throughout the carotid territory. The pathogenesis of the syndrome is not understood. The authors report the case of a 52-year-old woman with post traumatic Eagle syndrome-like pain and pseudoarthrosis of the stylohyoid ligament.

  8. The use of a retractor system (SynFrame) for open, minimal invasive reconstruction of the anterior column of the thoracic and lumbar spine

    OpenAIRE

    Kossmann, Thomas; Jacobi, Dagmar; Trentz, Otmar

    2001-01-01

    In 65 consecutive cases of trauma (n=55), pseudo-arthrosis (n=4) and metastasis (n=6), anterior reconstruction of the thoracic and lumbar spine was performed using a new minimal invasive but open access procedure. No operation had to be changed into an open procedure. The thoracolumbar junction was approached by a left-sided mini-thoracotomy (n=50), the thoracic spine by a right-sided mini-thoracotomy (n=8) and the lumbar spine by a left sided mini-retroperitoneal approach (n=7), using a new ...

  9. Update Review and Clinical Presentation in Congenital Insensitivity to Pain and Anhidrosis

    Directory of Open Access Journals (Sweden)

    L. M. Pérez-López

    2015-01-01

    Full Text Available Introduction. Congenital insensitivity to pain and anhidrosis (CIPA or hereditary sensory and autonomic neuropathy type IV is an extremely rare syndrome. Three clinical findings define the syndrome: insensitivity to pain, impossibility to sweat, and mental retardation. This pathology is caused by a genetic mutation in the NTRK1 gene, which encodes a tyrosine receptor (TrkA for nerve growth factor (NGF. Methods. The consultation of a child female in our center with CIPA and a tibia fracture in pseudoarthrosis encouraged us to carefully review literature and examine the therapeutic possibilities. A thorough review of literature published in Pubmed was done about CIPA and other connected medical issues mentioned in the paper. Conclusions. The therapeutic approach of CIPA remains unclear. The preventive approach remains the only possible treatment of CIPA. We propose two new important concepts in the therapeutic approach for these patients: (1 early surgical treatment for long bone fractures to prevent pseudoarthrosis and to allow early weight bearing, decreasing the risk of further osteopenia, and (2 bisphosphonates to avoid the progression of osteopenia and to reduce the number of consecutive fractures.

  10. Evaluation surgical treatment results of scoliosis in patients with neurofibromatosis

    Directory of Open Access Journals (Sweden)

    Hojjat Hossein-Pourfeizi

    2014-08-01

    Full Text Available Introduction: Surgical treatment of spinal deformity resulting from neurofibromatosis (NF is a major challenge for orthopedic spine surgeons. There are several problems and complications including pseudoarthrosis and cure progress despite treatment. Progressive kyphoscoliosis is the most important spinal deformity. The present study aims to evaluate surgical treatment results in severe spinal involvement cases. Methods: This analytical a-descriptive study evaluated 20 patients with NF, severe scoliosis and kyphosis (up to 50° hospitalized and treated at our center during the past 10 years. The treatment failure rate and complications were studied. Results: In this study, 20 cases with NF and kyphoscoliosis with the mean age of 13.00 ± 7.18 years were studied. These case series were consisted of 13 (65% males and 7 (35% females. Overall treatment failure was 45%. However, it was 55% of failure happened in posterior fusion alone. Failure rate was reported 36% in the combined anterior and posterior fusion and mainly seen in younger than 8-years children. Surgical complications were found in 20% with pseudoarthrosis as the most common one. There were no infections and neurological complications. Statistically, there was a significant negative relation between age and curve progression in scoliosis and kyphosis during the 2 years follow-up period. There was not any significant difference between genders considering curvature progress. Conclusion: The combined anterior and posterior fusion is probably more effective treatment, especially at early ages when more aggressive treatment is required since it reduces the treatment failure possibility.

  11. Radiation-Associated Fracture Nonunion of the Clavicle Treated with Locking Plate Fixation and Autologous Bone Grafting

    Directory of Open Access Journals (Sweden)

    Takahiro Niikura

    2012-01-01

    Full Text Available We describe a case of radiation-associated fracture nonunion of the clavicle, which was treated by locking plate fixation and autologous bone grafting. The patient was a 67-year old man who received 70 Gy radiation therapy to treat nasopharyngeal carcinoma. Eight years later, he suffered a pathological fracture of the right clavicle. One year after the fracture, surgical treatment was performed due to persistent pain and weakness. Radiographs demonstrated atrophic nonunion. Bone scan demonstrated hot uptake at both ends of the fractured bone. MRI demonstrated a formation of pseudoarthrosis with fluid collection and suggested bone marrow edema at both ends of the fracture fragments. In surgery, fibrous pseudoarthrosis tissue was excised and both ends of the fracture fragments were refreshed to identify bleeding. Open reduction and internal fixation using a 7-hole locking plate and autologous bone grafting were performed. Successful bony union was obtained 1 year postoperatively, and no adverse events were observed up to 52 months after the operation. Our case suggests that a locking plate provides sufficient fixation and autologous bone grafting is effective in enhancing bone healing in a radiation-associated fracture nonunion of the clavicle in which it is difficult to achieve bony union.

  12. Management of impaired fracture healing: Historical aspects

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe

    2005-01-01

    Full Text Available Introduction Establishing continuity of long bones in cases of impaired bone healing and pseudo-arthrosis is one of the most complex problems in orthopedics. Impaired bone healing The problem of impaired fracture healing is not new. As in other areas of human life, the roots of modern treatment of impaired bone healing lie in ancient medicine. A relatively high percentage of impaired bone healing, as well as unsatisfactory results of standard therapies of impaired bone healing and pseudoarthrosis demonstrate the actuality of this problem. This paper represents an attempt to pay respect to some of those who have dedicated their work to this problem in orthopedic surgery, and it is a historical review on impaired bone fracture healing. At the same time it should be an additional stimulus and challenge for orthopedic surgeons to further study impaired bone fracture healing, improve the existing and find new methods for their adequate treatment. Conclusion The authors are certain that the number of researchers throughout the world who have contributed to treatment modalities of impaired bone healing, is much higher, but not all are mentioned in this paper. However, it does not lessen their contributions to orthopedics.

  13. The sauvé-kapandji procedure.

    Science.gov (United States)

    Lluch, Alberto

    2013-02-01

    Arthrodesis is the most reliable and durable surgical procedure for the treatment of a joint disorder, and its only disadvantage is the loss of motion of the fused joint. The distal radioulnar joint can be arthrodesed, while forearm pronation and supination are maintained or even improved by creating a pseudoarthrosis of the ulna just proximal to the arthrodesis. This is known as the Sauvé-Kapandji (S-K) procedure. The Sauvé-Kapandji differs from the Darrach procedure in that it preserves ulnar support of the wrist, as the distal radioulnar ligaments and ulnocarpal ligaments are maintained. Aesthetic appearance is also superior after the S-K procedure, as the normal prominence of the ulnar head, most noticeable when the forearm is in pronation, is maintained. However, the S-K is not free of possible complications, such as nonunion or delayed union of the arthrodesis, fibrous or osseous union at the pseudoarthrosis, and painful instability at the proximal ulna stump. All of these complications can be prevented if a careful surgical technique is used.

  14. "Hardware breakage in spine surgery (A retrospective clinical study "

    Directory of Open Access Journals (Sweden)

    "Sadat MM

    2001-11-01

    Full Text Available This was a retrospective review of a consecutive series of patients with spinal disease in year 2000, who underwent posterior fusion and instrumentation with Harrington distraction and Cotrel-Dobousset system to evaluate causes of hardware failure. Many cases of clinical failure has been observed in spinal instrumentation used in spinal disorder like spondylolisthesis, fractures, deformities, … . Thirty six cases that were operated because of spinal disorders like spondylolisthesis, fractures, deformities, …, were included in this study. Seventeen of this cases had breakage of device. Factors like age at surgery, type of instrumentation, angles before and after surgery and …, were compared in two groups of patients. The most common instrument breakage was pedicle screw breakage. Pseudoarthrosis was the main factor that was presented in failure group (P value<0.001. Other important causes were, age of patient at surgery (P value=0.04, pedicle screw placement off center in the sagittal or coronal plane of the pedicle (P value=0.04. Instrumentation loads increased significantly as a direct result of variations in surgical technique that produce pseudoarthrosis, pedicle screw placement off center in the sagittal plane of the pedicle, or using less than 6 mm diameter screw. This factor can be prevented with meticulous surgical technique and using proper devices.

  15. Update Review and Clinical Presentation in Congenital Insensitivity to Pain and Anhidrosis

    Science.gov (United States)

    Pérez-López, L. M.; Cabrera-González, M.; Gutiérrez-de la Iglesia, D.; Ricart, S.; Knörr-Giménez, G.

    2015-01-01

    Introduction. Congenital insensitivity to pain and anhidrosis (CIPA) or hereditary sensory and autonomic neuropathy type IV is an extremely rare syndrome. Three clinical findings define the syndrome: insensitivity to pain, impossibility to sweat, and mental retardation. This pathology is caused by a genetic mutation in the NTRK1 gene, which encodes a tyrosine receptor (TrkA) for nerve growth factor (NGF). Methods. The consultation of a child female in our center with CIPA and a tibia fracture in pseudoarthrosis encouraged us to carefully review literature and examine the therapeutic possibilities. A thorough review of literature published in Pubmed was done about CIPA and other connected medical issues mentioned in the paper. Conclusions. The therapeutic approach of CIPA remains unclear. The preventive approach remains the only possible treatment of CIPA. We propose two new important concepts in the therapeutic approach for these patients: (1) early surgical treatment for long bone fractures to prevent pseudoarthrosis and to allow early weight bearing, decreasing the risk of further osteopenia, and (2) bisphosphonates to avoid the progression of osteopenia and to reduce the number of consecutive fractures. PMID:26579324

  16. Transternal repair of a giant Morgagni hernia causing cardiac tamponade in a patient with coexisting severe aortic valve stenosis

    Directory of Open Access Journals (Sweden)

    Koletsis Efstratios N

    2011-03-01

    Full Text Available Abstract Background Foramen of Morgagni hernias have traditionally been repaired by laparotomy, lapascopy or even thoracoscopy. However, the trans-sternal approach should be used when these rare hernias coexist with other cardiac surgical diseases. Case presentation We present the case of a 74 year-old symptomatic male with severe aortic valve stenosis and global respiratory failure due to a giant Morgagni hernia causing additionally cardiac tamponade. The patient underwent simultaneous repair of the hernia defect and aortic valve replacement under cardiopulmonary bypass. The hernia was repaired through the sternotomy approach, without opening of its content and during cardiopulmonary reperfusion. Conclusions Morgagni hernia can rarely accompany cardiac surgical pathologies. The trans-sternal approach for its management is as effective as other popular reconstructive procedures, unless viscera strangulation and necrosis are suspected. If severe compressive effects to the heart dominate the patient's clinical presentation correction during the cardiopulmonary reperfusion period is mandatory.

  17. Tuberculous osteomyelitis/arthritis of the first costo-clavicular joint and sternum.

    Science.gov (United States)

    Patel, Prasan; Gray, Robin R

    2014-12-28

    A young Somali immigrant presents with a two-year history of a large, firm, painful right anterolateral chest wall sternal mass. The patient denied any history of trauma or infection at the site and did not have a fever, erythematous lesion at the site, clubbing, or lymphadenopathy. A lateral chest radiograph demonstrated a low density mass isolated to the subcutaneous soft tissue overlying the sternum, ribs and clavicle. Computed tomography (CT) with contrast demonstrated a cystic lesion in the right anterolateral chest wall deep to the pectoralis muscle. Enhanced CT of the chest demonstrated sclerosis and destruction of the rib and costochondral joint and manubrio-sternal joint narrowing. Ultrasound-guided biopsy and aspiration returned 500 cc of purulent, cloudy yellow, foul-smelling fluid. Acid-fact bacilli stain and the nucleic acid amplification test identified and confirmed Mycobacterium tuberculosis. A diagnosis of tuberculous osteomyelitis/septic arthritis was made and antibiotic coverage for tuberculosis was initiated.

  18. Minimally Invasive Surgery for Pectus Excavatum: Park Technique

    Directory of Open Access Journals (Sweden)

    Hyung Park

    2011-09-01

    Full Text Available Pectus excavatum (PE is the most commonly encountered chest wall deformity which comprises one out of 1,000 live births. Depression of the anterior chest wall due to posterior angulation of the sternum and costal cartilages results in compression of internal thoracic organs as well as aesthetically unpleasant appearance. Multiple surgical techniques have been developed to correct this condition. Ravitch procedure, the technique including the excision of all deformed costal cartilages, division of intercostals bundles from the sternum, and transverse sternal osteotomy, was proposed in 1949 and most widely applied until recently. The Wada technique, principally sternal turnover, has been an alternative procedure. Those invasive techniques involve tedious and bloody operations resulted in a permanent defect of costal cartilages or contracture of the chest wall. Most importantly, a large, unsightly operative scar at the anterior chest is aesthetically dissatisfying. In this study “Minimally Invasive Surgery for Pectus Excavatum: Park Technique” was explained.

  19. [Pain caused by brachial plexus injury during coronary revascularization. Report of 3 cases].

    Science.gov (United States)

    Martín, M A; Marí, C; Miranda, A F; Burón, J A; Fernández, F E; Suárez, R

    1992-01-01

    We report three cases of injury of the brachial plexus after coronary revascularization surgery. During the postoperative phase all patients presented plexopathy involving the left C8 and D1 roots. The symptoms were pain, paresthesia, and motor deficits. The proposed mechanisms for injury of the brachial plexus during cardiac surgery are: hyperabduction of the arm, direct traumatism produced by the needle during catheterization of the internal jugular vein, and traction and compression associated with sternal retraction. In the three patients we ruled out alterations during cannulation of the internal jugular vein and malposition of the arms. We think that in our cases the fundamental mechanism was an excessive and assymetrical opening of sternal and Favoloro's separators that were used in all cases during dissection of the left internal mammary artery. We conclude that injury of the brachial plexus can be minimized by reducing the opening of both separators and by placing Favaloro's separator in a lower position.

  20. Ibuprofen - a Safe Analgesic During Cardiac Surgery Recovery?

    DEFF Research Database (Denmark)

    Qazi, Saddiq Mohammad; Sindby, Eske Jesper; Nørgaard, Martin Agge

    2015-01-01

    , in a short term post-cardiac surgery setting. Particular attention was given to the rate of myocardial infarction, sternal healing, gastro-intestinal complications, renal failure and all-cause mortality. METHODS: This was a single-centre, open label parallel design randomised controlled study. Patients, who...... of sternal healing, postoperative myocardial infarction or gastrointestinal bleeding. The preoperative levels of creatinine were found to increase by 100% in nine patients (9.6%) in the ibuprofen group, resulting in an acute renal injury (in accordance with the RIFLE-criteria). Eight of these patients...... returned to normal renal function within 14 days. The levels of creatinine in patients in the oxycodone group were not found to increase to the same magnitude. CONCLUSION: The results of this study suggest that patients treated postoperatively, following cardiac surgery, are at no greater risk of harm...