Quantification of C2 cervical spine rotatory fixation by X-ray, MRI and CT

International Nuclear Information System (INIS)

Gradl, Georg; Maier-Bosse, Tamara; Staebler, Axel; Penning, Randolph

2005-01-01

Atlanto-axial rotatory displacement is known to be a cause of childhood torticollis and may as well be responsible for chronic neck pain after rear-end automobile collisions. The objective was to determine whether quantification of C2 malrotation is possible by plain radiographs in comparison to CT as the golden standard. MR imaging was evaluated as to whether it was of equal value in the detection of bony landmarks. C2 vertebra of five human cadaveric cervical spine specimens, ligamentously intact, were rotated using a Steinmann pin in steps of 5 up to 15 right and 15 left. Plain radiographs, CT and MRI images were taken in each rotational step. Data were analyzed for quantification of C2 rotation by three independent examiners. A rotation of 5 led to a spinous process deviation (SPD) from the midline of 3 mm as measured on an a.p. plain radiograph. A coefficient of rotation was calculated (1.62 mm -1 ). Data analyzed by three examiners revealed a small coefficient of variation (0.03). MRI and CT measurements showed comparable results for the quantification of rotation; however, in both techniques the 15 rotation was underestimated. Quantification of upper cervical spine malrotation was possible on plain radiographs using the SPD and a rotation coefficient. MRI and CT were equally successful in the assessment of C2 malrotation. (orig.)

Surgical Management for Destructive Atlantoaxial Spondyloarthropathy in Long-Term Hemodialysis Patients.

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Jeong, Je Hoon; Kim, Hee Kyung; Im, Soo Bin

2017-01-01

Atlantoaxial spondyloarthropathy most often results from rheumatoid arthritis, cancer metastasis, or basilar invagination. Dialysis-related spondyloarthropathy is a rare cause of spinal deformity and cervical myelopathy at the atlantoaxial joint. We report 2 patients on long-term hemodialysis who presented with atlantoaxial spondyloarthropathy. Two patients with end-stage renal failure presented with a history of progressively worsening neck pain, motion limitation, and gait disturbance. In both patients, radiologic findings showed a bone-destroying soft tissue mass lateral to C1 and C2, compressing the spinal cord and causing atlantoaxial instability. We performed a C1 laminectomy and C12 transarticular screw fixation and biopsied the osteolytic mass. The neck pain, hand numbness, and gait disturbance improved. Although the surgical management of these patients involves many challenges, appropriate decompression and fusion surgery is an effective treatment option. Copyright © 2016 Elsevier Inc. All rights reserved.

Traumatic Posterior Atlantoaxial Dislocation Without Associated Fracture but With Neurological Deficit

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Xu, Yong; Li, Feng; Guan, Hanfeng; Xiong, Wei

2015-01-01

Abstract Posterior atlantoaxial dislocation without odontoid fracture is extremely rare and often results in fatal spinal cord injury. According to the reported literature, all cases presented mild or no neurologic deficit, with no definite relation to upper spinal cord injury. Little is reported about traumatic posterior atlantoaxial dislocation, with incomplete quadriplegia associated with a spinal cord injury. We present a case of posterior atlantoaxial dislocation without associated fracture, but with quadriplegia, and accompanying epidural hematoma and subarachnoid hemorrhage. The patient underwent gentle traction in the neutral position until repeated cranial computed tomography revealed no progression of the epidural hematoma. Thereafter, the atlantoaxial dislocation was reduced by using partial odontoidectomy via a video-assisted transcervical approach and maintained with posterior polyaxial screw-rod constructs and an autograft. Neurological status improved immediately after surgery, and the patient recovered completely after 1 year. Posterior fusion followed by closed reduction is the superior strategy for posterior atlantoaxial dislocation without odontoid fracture, according to literature. But for cases with severe neurological deficit, open reduction may be the safest choice to avoid the lethal complication of overdistraction of the spinal cord. Also, open reduction and posterior srew-rod fixation are safe and convenient strategies in dealing with traumatic posterior atlantoaxial dislocation patients with neurological deficit. PMID:26512572

C1-C2 transarticular screw fixation for atlantoaxial instability due to rheumatoid arthritis: a seven-year analysis of outcome.

LENUS (Irish Health Repository)

Nagaria, Jabir

2009-12-15

STUDY DESIGN.: Observational study. Retrospective analysis of prospectively collected data. OBJECTIVE.: The purpose of this article was to report long-term (minimum 7 years) clinical and radiologic outcome of our series of patients with Rheumatoid Arthritis who underwent transarticular screw fixation to treat atlantoaxial subluxation. SUMMARY OF BACKGROUND DATA.: The indications for intervention in patients with atlantoaxial instability are pain, myelopathy, and progressive neurologic deficit. The various treatment options available for these patients are isolated C1-C2 fusion, occipitocervical fusion with or without transoral surgery. Review of current literature suggests that C1-C2 transarticular screw fixation has significant functional benefits, although there is discrepancy in this literature regarding improvement in function following surgery. METHODS.: Myelopathy was assessed using Ranawat myelopathy score and Myelopathy Disability Index. Pain scores were assessed using Visual Analogue Scale. The radiologic imaging was assessed and the following data were extracted; atlanto-dens interval, space available for cord, presence of signal change on T2 weighted image, and fusion rates. RESULTS.: Thirty-seven patients, median age 56, were included in the study. Average duration of neck symptoms was 15.8 months. Average duration of rheumatoid arthritis before surgery was 20.6 years. Preoperative symptoms: suboccipital pain in 26 patients; neck pain, 32; myelopathy, 22; and 5 were asymptomatic. After surgery: suboccipital pain, 2; neck pain, 3; and myelopathy, 10. Ninety percent patients with neck and suboccipital pain improved after surgery in their Visual Analogue pain scores, with all of them having >50% improvement in VAS scores (6.94-2.12 [P < 0.05]).Preoperative Ranawat grade was as follows: grade 1 in 15 patients, grade 2 in 7, and grade 3a in 14, grade 3b in 1.After surgery: grade 1 in 27 patients, grade 2 in 7, grade 3a in 1, and grade 3b in 2. The mean

Diagnosis of acute atlanto-axial rotatory fixation in adults

International Nuclear Information System (INIS)

Stenson, Debbie

2011-01-01

This case report presents a case of a Fielding and Hawkins Type I AARF in an adult following trauma. It is presented to draw attention to the medical and technical details associated with the management of this rare spinal injury. The importance of imaging in the diagnosis and management of AARF is discussed. Early recognition and treatment of AARF is paramount in the avoidance of subsequent deformity and instability in these patients and are the key to the prevention of operable treatment.

Traumatic atlantoaxial subluxation, posterior transfacet fixation: a case report

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Mario Cahueque Lemus

2015-03-01

Full Text Available Cervical spine injuries are often described as catastrophic events in neurological terms, with very low survival rate. Lesions to C3-C7 segment are the most common (about 80% followed by segment C1-C2 (20%. The cervical spine injuries are of great importance, both by severity as the neurological implications. It is important to consider that among cervical traumas that do not present neurological damage at the time of the accident, 10% have deficits later, so all cervical trauma should be considered as potential spinal cord traumas, until the evolution of the case shows that definitively there is no spinal cord or nerve root damage. Cases have been reported with both atlantooccipital and atlantoaxial dislocations without neurological deficit, so these lesions went unnoticed in the emergency services. Some of the events to be considered at the time of the accident are suboccipital pain on axial skull pressure and spontaneous stiffness of the patient's neck. Dysphagia, pain on palpation of the anterior neck and a visible increase of prepharyngeal mass can also be observed, which is why it is important to keep the suspicion of craniocervical trauma in all patients who have these symptoms and carry out the relevant tests. This paper presents a case of post-traumatic atlantoaxial dislocation, which showed no neurological deficit at the time of the accident, but was later presented, as well as the surgical procedure carried out.

Atlanto-Occipital Rotatory Dislocation: A Case Report and Systematic Review.

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Robles, Luis A; Mundis, Greg M; Cuevas-Solórzano, Abel

2018-02-01

Atlanto-occipital rotatory dislocation (AORD) has rarely been reported in the literature; for this reason, the clinicoradiologic characteristics of this injury are not well described. We describe the case of a 67-year-old man who sustained a cervical spine trauma. He reported only neck pain and was neurologically intact. A computed tomography scan showed a rotatory displacement of the atlanto-occipital joints associated with a widened condylar-C1 interval; in addition, magnetic resonance imaging showed injuries to the stabilizing ligaments of this area. A systematic literature review was also performed to identify previous cases of patients with AORD. The patient was treated with craniocervical fixation from occipital to C1, achieving a good outcome. The literature review yielded 9 cases of patients with AORD. Compared with patients with atlanto-occipital dislocation, patients with rotatory dislocations have a less severe degree of displacement of the atlanto-occipital joints and better clinical outcome. Compared with previously classified atlanto-occipital dislocations, AORD is an independent and unique variation. AORD presents with different biomechanical, clinicoradiologic, and prognostic characteristics and represents an important addition to the spectrum of atlanto-occipital dislocation injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

Posterolateral Rotatory Apprehension Test in Tennis Elbow.

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Chanlalit, Cholawish; Phorkhar, Termphong

2015-11-01

Tennis elbow is a syndrome that commonly diagnosed in patient who comes with lateral elbow pain. Instability pain in tennis elbow patient was observed and reported in many previous literatures. Posterolateral rotatory apprehension test was proposed for diagnosis of posterolateral rotatory instability of elbow. However, no review literatures that studied about posterolateral rotatory apprehensions test in tennis elbow. To find out the relationship between posterolateral rotatory apprehension test and tennis elbow. There were 44 patients that were recruited in this study. We examined the posterolateral rotatory apprehension test in tennis elbow patients. The examination was done in our outpatient clinic from March 2012 to April 2012. The data was collected to find out the ratio of negative test in tennis elbow patient. The results from the posterolateral rotatory apprehension test were negative in 43 patients. The ratio of the negative test result was 98%. A result from posterolateral rotatory apprehension test should be negative in general tennis elbow patients. If this test is used in a tennis elbow patients who are suspected with hidden instability and the result is positive, further evaluation is strongly suggested.

Anterior transarticular C1-C2 fixation with contralateral screw insertion: a report of two cases and technical note.

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Lvov, Ivan; Grin, Andrey; Kaykov, Aleksandr; Smirnov, Vladimir; Krylov, Vladimir

2017-08-08

Anterior transarticular fixation of the C1-C2 vertebrae is a well-known technique that involves screw insertion through the body of the C2 vertebra into the lateral masses of the atlas through an anterior transcervical approach. Meanwhile, contralateral screw insertion has been previously described only in anatomical studies. We describe two case reports of the clinical application of this new technique. In Case 1, the patient was diagnosed with an unstable C1 fracture. The clinical features of the case did not allow for any type of posterior atlantoaxial fusion, Halo immobilization, or routine anterior fixation using the Reindl and Koller techniques. The possible manner of screw insertion into the anterior third of the right lateral mass was via a contralateral trajectory, which was performed in this case. Case 2 involved a patient with neglected posteriorly dislocated dens fracture who could not lie in the prone position due to concomitant cardiac pathology. Reduction of atlantoaxial dislocation was insufficient, even after scar tissue resection at the fracture, while transdental fusion was not possible. Considering the success of the previous case, atlantoaxial fixation was performed through the small approach, using the Reindl technique and contralateral screw insertion. These two cases demonstrate the potential of anterior transarticular fixation of C1-C2 vertebrae in cases where posterior atlantoaxial fusion is not achievable. This type of fixation can be performed through a single approach if one screw is inserted using the Reindl technique and another is inserted via a contralateral trajectory.

Spinal instrumentation for unstable C1-2 injury.

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Mizuno, J; Nakagawa, H

1999-06-01

Seventeen patients with unstable C1-2 injuries were treated between 1990 and 1997. Various methods of instrumentation surgery were performed in 16 patients, excluding a case of atlantoaxial rotatory fixation. Posterior stabilization was carried out in 14 cases using Halifax interlaminar clamp, Sof'wire or Danek cable, or more recently, transarticular screws. Transodontoid anterior screw fixation was performed in four cases of odontoid process fractures, with posterior instrumentation in two cases because of malunion. Rigid internal fixation by instrumentation surgery for the unstable C1-2 injury avoids long-term application of a Halo brace and facilitates early rehabilitation. However, the procedure is technically demanding with the risk of neural and vascular injuries, particularly with posterior screw fixation. Sagittal reconstruction of thin-sliced computed tomography scans at the C1-2 region, neuronavigator, and intraoperative fluoroscopy are essential to allow preoperative surgical planning and intraoperative guidance.

[Clinical application of atlas translaminar screws fixation in treatment of atlatoaxial instability].

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Wang, Guoyou; Fu, Shijie; Shen, Huarui; Guan, Taiyuan; Xu, Ping

2013-10-01

To explore the effectiveness of fixation of atlas translaminar screws in the treatment of atlatoaxial instability. A retrospective analysis was made on the clinical data of 32 patients with atlatoaxial instability treated with atlantoaxial trans-pedicle screws between March 2007 and August 2009. Of them, 7 patients underwent atlas translaminar screws combined with axis transpedicle screws fixation because of fracture types, anatomic variation, and intraoperative reason, including 5 males and 2 females with an average age of 48.2 years (range, 35-69 years). A total of 9 translaminar screws were inserted. Injury was caused by traffic accident in 4 cases, falling from height in 2 cases, and crushing in 1 case. Two cases had simple odontoid fracture (Anderson type II), and 5 cases had odontoid fracture combined with other injuries (massa lateralis atlantis fracture in 2, atlantoaxial dislocation in 1, and Hangman fracture in 2). The interval between injury and operation was 4-9 days (mean, 6 days). The preoperative Japanese Orthopaedic Association (JOA) score was 8.29 +/- 1.60. The X-ray films showed good position of the screws. Healing of incision by first intention was obtained, and no patient had injuries of the spinal cord injury, nerve root, and vertebral artery. Seven cases were followed up 9-26 months (mean, 14 months). Good bone fusion was observed at 8 months on average (range, 6-11 months). No loosening, displacement, and breakage of internal fixation, re-dislocation and instability of atlantoaxial joint, or penetrating of pedicle screw into the spinal canal and the spinal cord occurred. The JOA score was significantly improved to 15.29 +/- 1.38 at 6 months after operation (t = 32.078, P = 0.000). Atlas translaminar screws fixation has the advantages of firm fixation, simple operating techniques, and relative safety, so it may be a remedial measure of atlatoaxial instability.

Posterior atlantoaxial dislocation without odontoid fracture

International Nuclear Information System (INIS)

Chaudhary, Reema; Raut, Abhijit; Chaudhary, Kshitij; Metkar, Umesh; Rathod, Ashok; Sanghvi, Darshana

2008-01-01

We report a case of posterior atlantoaxial dislocation without a fracture of the odontoid in a 35-year-old woman. There have been nine reported cases of similar injury in the English literature. The integrity of the transverse ligament following posterior atlantoaxial dislocations has not been well documented in these reports. In the present case, MRI revealed an intact transverse ligament, which probably contributed to the stability of the C1-C2 complex following closed reduction. (orig.)

Atlantoaxial subluxation

International Nuclear Information System (INIS)

Yamashita, Y.; Takahashi, M.; Sakamoto, Y.; Kojima, R.

1989-01-01

Twenty-nine patients with atlantoaxial subluxation (18 with rheumatoid arthritis, 2 due to trauma, 4 with os odontoideum, and one each with polyarteritis nodosa, rheumatic fever, Klippel-Feil syndrome, achondroplasia, and cause unknown) were evaluated using a 0.22 tesla resistive MRI unit. Cord compression was classified into four grades according to the degree on magnetic resonance imaging. There were 7 patients with no thecal sac compression (grade 0), 10 with a minimal degree of subarachnoid space compression without cord compression (grade 1), 7 with mild cord compression (grade 2), and 5 with severe cord compression or cord atrophy (grade 3). Although the severity of myelopathy showed poor correlation with the atlantodental interval on conventional radiography, high correlation was observed between MR grading and the degree of myelopathy. The high signal intensity foci were observed in 7 or 12 patients with cord compression (grades 2 and 3) on T2 weighted images. Other frequently observed findings in rheumatoid arthritis included soft tissue masses of low to intermediate signal intensity in the paraodontoid space, erosions of the odontoid processes, and atlanto-axial impaction on T1 and T2 weighted images. (orig.)

Atlanto-axial Subluxation in rheumatoid arthritis: description of a case

International Nuclear Information System (INIS)

Medina, Yimy F; Martinez V, Jose B; Restrepo, Jose Felix; Rondon H, Federico; Iglesias G, Antonio

2004-01-01

The damage of the spine by rheumatoid arthritis is multiple and a variety of affectations have been described at cervical level, being the anterior atlanto-axial subluxation and vertical subluxation the more common. However the posterior atlanto-axial subluxation has been rarely described. In this paper, we describe the case of a patient with posterior atlanto-axial subluxaction in addition to its infrequent manifestation of alteration of the lower cranial nerves as a manifestation of myelopathy

Diagnostic value of multi-slice spiral CT for atlantoaxial spine injuries in children

International Nuclear Information System (INIS)

Xia Chengde; Qin Hongwei; Li Junhong

2009-01-01

Objective: To evaluate the diagnostic value of multi-slice spiral CT (MSCT) for the atlantoaxial spine injuries in children. Methods: The CT findings of 21 cases with the atlantoaxial spine injuries in children were reviewed retrospectively. Results: Fractures of dens occurred in 4 cases, isolated atlantoaxial dislocation in 15 cases, subluxation of the C2/3 right vertebra facet in 1 and atlanto-occipital subluxation in 1. CT diagnosis was correct in all cases. And plain film diagnosis was correct ia 13. Conclusion: MSCT could clearly demonstrate the fractures and dislocations of the atlantoaxial spine injuries in children and correctly determine the type of the atlantoaxial spine injuries in children, MSCT is the modality of choice in diagnosis of the atlantoaxial spine injuries in children and should be performed routinely. (authors)

Progressive atlanto-axial subluxation in Behcet's disease

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Kim, Sang-hyuk [Chonbuk National University Hospital, Department of Neurosurgery, Jeonju City, Jeonbuk (Korea); Eoh, Whan [Sungkyunkwan University School of Medicine, Samsung Medical Center, Department of Neurosurgery, Seoul (Korea)

2010-03-15

Behcet's disease is a chronic inflammatory condition involving several organs, such as the skin, mucous membranes, eyes, joints, intestines, lungs and central nervous system. It rarely affects the spinal column. We describe a case of progressive atlanto-axial subluxation in a 44-year-old woman with Behcet's disease. The patient started complaining of posterior neck pain 10 years after the diagnosis of her Behcet's disease. Initial radiographs showed no abnormal finding, but follow-up radiographs 6 month later demonstrated atlanto-axial subluxation. To the best of our knowledge, this is the second reported case in the worldwide literature of an atlanto-axial instability in a patient with Behcet's disease. (orig.)

Atlantoaxial instability: An exceptional complication of ankylosing spondylitis

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Zeineb Alaya

2018-04-01

Full Text Available Background: Atlantoaxial instability (AAI and more rarely odontoid pannus formation, similar to the one observed in Rheumatoid Arthritis, are seldom reported in ankylosing spondylitis (AS. We report a new case of a patient with AS with a pannus in the atlanto-axial region and cervical C1-C2 instability. Case presentation: The patient, now aged 41, was diagnosed with AS in 2010. She was put on different non steroidal anti inflammatory treatments with persistent spinal pain. She was referred to our department in 2015 with severe cervical pain and stiffness since 3 months. On examination, the patient had severely limited cervical spine movements. Lumbar spine movements were moderately affected. There was no neurological deficit. Her Bath Ankylosing Spondylitis Disease Activity Index (BASDAI was 4.9/10 and Bath Ankylosing Spondylitis Functional Index (BASFI was 5/10. Plain Radiographs of the pelvis showed bilateral grade 4 sacroilitis and bilateral coxitis. Dorsal and lumbar spine plain radiographs showed squaring of vertebral bodies. Cervical spine radiographs showed an increased atlanto-axial distance. Spinal MRI confirmed the atlantoaxial subluxation with an anterior distance of 8 mm, with marked intraspinal pannus formation and synovitis around the odontoid peg. Synovial thickening exerted an anterior mark on the bulbo-medullary junction with no evidence of oedema signs. Posterior zygapophysial ankylosis involving all cervical levels was also observed. The patient had a cervical collar with anti-tumor necrosis factor-α (cerolizumab-pegol prescription with favorable outcome. Conclusion: Odontoid pannus formation is rare in AS. Clinical and radiological follow-up are important to assess the impact on the cervical spine. Keywords: Ankylosing spondylitis, Atlantoaxial instability, MRI, Cerolizumab-pegol

Impact of Starting Point and Bicortical Purchase of C1 Lateral Mass Screws on Atlantoaxial Fusion: Meta-Analysis and Review of the Literature.

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Elliott, Robert E; Tanweer, Omar; Smith, Michael L; Frempong-Boadu, Anthony

2015-08-01

Structured review of literature and application of meta-analysis statistical techniques. Review published series describing clinical and radiographic outcomes of patients treated with C1 lateral mass screws (C1LMS), specifically analyzing the impact of starting point and bicortical purchase on successful atlantoaxial arthrodesis. Biomechanical studies suggest posterior arch screws and C1LMS with bicortical purchase are stronger than screws placed within the center of the lateral mass or those with unicortical purchase. Online databases were searched for English-language articles between 1994 and 2012 describing posterior atlantal instrumentation with C1LMS. Thirty-four studies describing 1247 patients having posterior atlantoaxial fusion with C1LMS met inclusion criteria. All studies provided class III evidence. Arthrodesis was quite successful regardless of technique (99.0% overall). Meta-analysis and multivariate regression analyses showed that neither posterior arch starting point nor bicortical screw purchase translated into a higher rate of successful arthrodesis. There were no complications from bicortical screw purchase. The Goel-Harms technique is a very safe and successful technique for achieving atlantoaxial fusion, regardless of minor variations in C1LMS technique. Although biomechanical studies suggest markedly increased rigidity of bicortical and posterior arch C1LMS, the significance of these findings may be minimal in the clinical setting of atlantoaxial fixation and fusion with modern techniques. The decision to use either technique must be made after careful review of the preoperative multiplanar computed tomography imaging, assessment of the unique anatomy of each patient, and the demands of the clinical scenario such as bone quality.

Posterior atlanto-occipital and atlanto-axial area and its surgical interest

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Newton José Godoy Pimenta

2014-10-01

Full Text Available Classic anatomical studies describe two membranes – atlanto-occipital and atlanto-axial in the posterior aspect of the craniocervical region. During many surgical procedures in this area, however, we have not found such membranes. Objective To clarify the anatomical aspects and structures taking part of the posterior atlanto-occipital and atlanto-axial area. Method Analysis of histological cuts of three human fetuses and anatomical studies of 8 adult human cadavers. Results In both atlanto-occipital and atlanto-axial areas, we have observed attachment between suboccipital deep muscles and the spinal cervical dura. However, anatomical description of such attachments could not be found in textbooks of anatomy. Conclusion Our study shows the absence of the classical atlanto-occipital and atlanto-axial membranes; the occipito-C1 and C1-C2 posterior intervals are an open area, allowing aponeurotic attachment among cervical dura mater and posterior cervical muscles.

Rigid Occipitocervical Instrumented Fusion for Atlantoaxial Instability in an 18-Month-Old Toddler With Brachytelephalangic Chondrodysplasia Punctata: A Case Report.

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Oba, Hiroki; Takahashi, Jun; Takano, Kyoko; Inaba, Yuji; Motobayashi, Mitsuo; Nishimura, Gen; Kuraishi, Shugo; Shimizu, Masayuki; Ikegami, Shota; Futatsugi, Toshimasa; Uehara, Masashi; Kosho, Tomoki; Kato, Hiroyuki; Uno, Koki

2017-12-01

Case report. We report here on an 18-month-old boy with brachytelephalangic chondrodysplasia punctata (BCDP), whose atlantoaxial instability was successfully managed with occipitocervical instrumented fusion (OCF) using screw and rod instrumentations. Recently, there have been a number of reports on BCDP with early onset of cervical myelopathy. Surgical OCF is a vital intervention to salvage affected individuals from the life-threatening morbidity. Despite recent advancement of instrumentation techniques, however, rigid OCF is technically demanding in very young children with small and fragile osseous elements. To our best knowledge, this is the first report on application of the instrumentation technique to a toddler patient with BCDP. A 16-month-old boy with BCDP presented with tetraplegia and swallow obstacle. Hypoplasia of the odontoid process and atlantoaxial instability were present in lateral radiographs. T2-weighted magnetic resonance (MR) images revealed a high signal region in the spinal cord at the C1-2 and C7-T1 levels. Cervical computed tomography (CT) showed that the pedicles and lateral masses in the cervical spine were small and immature, but the laminae were comparatively thick. One week before surgery, the patient was fitted with a Halo-body jacket. We performed plate-rod placement with occipital cortical screws and C2/C3 interlaminar screws, and added an autogenous bone graft using the right 8 and 9 ribs. Rigid fixation of the occipito-cervical spine was completed successfully without major complications. Postoperative halo-body jacket immobilization was continued for 3 months, after which Aspen collar was fitted. CT confirmed occipitocervical bone fusion at 6 months after surgery. Mild clinical improvements in motor power of the affected muscles and swallowing were witnessed at 1 year postoperatively. Rigid fixation using screw, rod, and occipital plate instrumentation was successful in an 18-month-old toddler with BCDP and atlantoaxial

Regression of an atlantoaxial rheumatoid pannus following posterior instrumented fusion.

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Bydon, Mohamad; Macki, Mohamed; Qadi, Mohamud; De la Garza-Ramos, Rafael; Kosztowski, Thomas A; Sciubba, Daniel M; Wolinsky, Jean-Paul; Witham, Timothy F; Gokaslan, Ziya L; Bydon, Ali

2015-10-01

Rheumatoid patients may develop a retrodental lesion (atlantoaxial rheumatoid pannus) that may cause cervical instability and/or neurological compromise. The objective is to characterize clinical and radiographic outcomes after posterior instrumented fusion for atlantoaxial rheumatoid pannus. We retrospectively reviewed all patients who underwent posterior fusions for an atlantoaxial rheumatoid pannus at a single institution. Both preoperative and postoperative imaging was available for all patients. Anterior or circumferential operations, non-atlantoaxial panni, or prior C1-C2 operations were excluded. Primary outcome measures included Nurick score, Ranawat score (neurologic status in patients with rheumatoid arthritis), pannus regression, and reoperation. Pannus volume was determined with axial and sagittal views on both preoperative and postoperative radiological images. Thirty patients surgically managed for an atlantoaxial rheumatoid pannus were followed for a mean of 24.43 months. Nine patients underwent posterior instrumented fusion alone, while 21 patients underwent posterior decompression and instrumented fusion. Following a posterior instrumented fusion in all 30 patients, the pannus statistically significantly regressed by 44.44%, from a mean volume of 1.26cm(3) to 0.70cm(3) (ppannus radiographically regressed by 44.44% over a mean of 8.02 months, and patients clinically improved per the Nurick score. The Ranawat score did not improve, and 20% of patients required reoperation over a mean of 13.18 months. The annualized reoperation rate was approximately 13.62%. Copyright © 2015 Elsevier B.V. All rights reserved.

Quantum optical rotatory dispersion

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Tischler, Nora; Krenn, Mario; Fickler, Robert; Vidal, Xavier; Zeilinger, Anton; Molina-Terriza, Gabriel

2016-01-01

The phenomenon of molecular optical activity manifests itself as the rotation of the plane of linear polarization when light passes through chiral media. Measurements of optical activity and its wavelength dependence, that is, optical rotatory dispersion, can reveal information about intricate properties of molecules, such as the three-dimensional arrangement of atoms comprising a molecule. Given a limited probe power, quantum metrology offers the possibility of outperforming classical measurements. This has particular appeal when samples may be damaged by high power, which is a potential concern for chiroptical studies. We present the first experiment in which multiwavelength polarization-entangled photon pairs are used to measure the optical activity and optical rotatory dispersion exhibited by a solution of chiral molecules. Our work paves the way for quantum-enhanced measurements of chirality, with potential applications in chemistry, biology, materials science, and the pharmaceutical industry. The scheme that we use for probing wavelength dependence not only allows one to surpass the information extracted per photon in a classical measurement but also can be used for more general differential measurements. PMID:27713928

Atlantoaxial subluxation after otoplasty.

LENUS (Irish Health Repository)

Kelly, E J

2012-02-03

A case of iatrogenic atlantoaxial subluxation after bilateral otoplasty is presented. Cineradiography was required for definitive diagnosis. Bed rest and Halter traction successfully resolved the condition. Great care is required while turning the head during skin preparation, draping, planning, and surgery, especially in young children. A high index of suspicion is necessary when a child develops torticollis after otoplasty.

The subatlantic triangle: gateway to early localization of the atlantoaxial vertebral artery.

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Tayebi Meybodi, Ali; Gandhi, Sirin; Preul, Mark C; Lawton, Michael T

2018-04-27

OBJECTIVE Exposure of the vertebral artery (VA) between C-1 and C-2 vertebrae (atlantoaxial VA) may be necessary in a variety of pathologies of the craniovertebral junction. Current methods to expose this segment of the VA entail sharp dissection of muscles close to the internal jugular vein and the spinal accessory nerve. The present study assesses the technique of exposing the atlantoaxial VA through a newly defined muscular triangle at the craniovertebral junction. METHODS Five cadaveric heads were prepared for surgical simulation in prone position, turned 30°-45° toward the side of exposure. The atlantoaxial VA was exposed through the subatlantic triangle after reflecting the sternocleidomastoid and splenius capitis muscles inferiorly. The subatlantic triangle was formed by 3 groups of muscles: 1) the levator scapulae and splenius cervicis muscles inferiorly and laterally, 2) the longissimus capitis muscle inferiorly and medially, and 3) the inferior oblique capitis superiorly. The lengths of the VA exposed through the triangle before and after unroofing the C-2 transverse foramen were measured. RESULTS The subatlantic triangle consistently provided access to the whole length of atlantoaxial VA. The average length of the VA exposed via the subatlantic triangle was 19.5 mm. This average increased to 31.5 mm after the VA was released at the C-2 transverse foramen. CONCLUSIONS The subatlantic triangle provides a simple and straightforward pathway to expose the atlantoaxial VA. The proposed method may be useful during posterior approaches to the craniovertebral junction should early exposure and control of the atlantoaxial VA become necessary.

[Exploratory study of 3D printing technique in the treatment of basilar invagination and atlantoaxial dislocation].

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Yin, Yiheng; Yu, Xinguang; Tong, Huaiyu; Xu, Tao; Wang, Peng; Qiao, Guangyu

2015-10-06

To investigate the clinical application value of the 3D printing technique in the treatment of basilar invagination and atlantoaxial dislocation. From January 2013 to September 2013, 10 patients with basilar invagination and atlantoaxial dislocation needing posterior fixation undertook 3D printing modes at the Department of Neurosurgery in PLA General Hospital. The 1:1 size models were established from skull base to C4 level with different colors between bone structures and vertebral arteries. The simulation of screw insertion was made to investigate the fixation plan and ideal entry point to avoid vertebral artery injury. After obtaining the individual screw insertion data in 3D printing modes, the according surgical operations were performed. The actual clinical results and virtual screw data in 3D printing mode were compared with each other. The 3D printing modes revealed that all the 10 patients had the dysplasia or occipitalized C1 posterior arch indicating C1 posterior arch screw implantation was not suitable. C1 lateral masses were chosen as the screws entry points. C2 screws were designed individually based on the 3D printing modes as follows: 3 patients with aberrant vertebral artery or narrow C2 pedicle less than 3.5 mm were not suitable for pedicle screw implantation. Among the 3 patients, 1 was fixed with C2 laminar screw, and 1 with C2-3 transarticular screw and 1 with C3 pedicle screw (also combined with congenital C2-3 vertebral fusion). Two patients with narrow C2 pedicle between 3.5 and 4mm were designed to choose pedicle screw fixation after 3D printing mode evaluation. One patient with C1 lateral mass vertically dislocated axis was planned with C1-2 transarticular screw fixation. All the other patients were planned with C2 pedicle screws. All the 10 patients had operation designed as the 3D printing modes schemes. The follow-up ranged from 12 to 18 months and all the patients recovered from the clinical symptoms and the bony fusion attained to

Misdiagnosis and management of iatrogenic pseudoaneurysm of vertebral artery after Harms technique of C1-C2 fixation

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MIN Li

2012-12-01

Full Text Available 【Abstract】 Harms technique of C1-C2 fixation for atlantoaxial complex becomes more popular due to good fusion rate and low vertebral artery injury (VAI rate. But considering the unique and variable anatomy of atlanto-axial complex, iatrogenic VAI will result in catastrophic con-sequences and provides particular surgical challenges for surgeons. To our knowledge, comparing with iatrogenic VAI in the screw hole, iatrogenic VAI in the “open space” is much rarer during the Harms technique of C1-C2 fixation. In this article, we present a case of iatrogenic vertebral artery pseudoaneurysm after Harms technique of posterior C1-C2 fixation. This case of iatrogenic VAI effectively treated by endovascular coil occlusion and external local compression was initially misdiagnosed as VAI by pedicle screw perforation. It can be concluded that intraoperative or post-operative computed angiography is very helpful to diag-nose the exact site of VAI and the combination of endovascular coil occlusion as well as external local com-pression can further prevent bleeding and abnormal verte-bral artery flow in the pseudoaneurysm. However, patients treated require further follow-up to confirm that there is no recurrence of the pseudoaneurysm. Key words: Vertebral artery; Aneurysm, false; Endovascular procedures

[The randomized controlled trial of the treatment for clavicular fracture by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation].

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Bi, Hong-zheng; Yang, Mao-qing; Tan, Yuan-chao; Fu, Song

2008-07-01

To study the curative effect and safety of rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation in treating clavicular fracture. All 201 cases of clavicular fractures were randomly divided into treatment group (101 cases) and control group (100 cases). The treatment group was treated by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation. The control group was treated by open reduction and internal fixation with Kirschner pin. All cases were followed up for 4 to 21 months (mean 10.6 months). SPSS was used to analyze clinic healing time of fracture and shoulder-joint function in both two groups. After operation, 101 cases of treatment group achieved union of fracture and the clinical healing time was 28 to 49 days (mean 34.5+/-2.7 days). In control group,there were 4 cases with nonunion of fracture,the other 96 cases were union,the clinical healing time was 36 to 92 days (mean 55.3+/-4.8 days). The excellent and good rate of shoulder-joint function was 100% in treatment group and 83% in control group. By t-test and chi2-test, there was significant difference between the two groups in curative effect (Pmanual reduction with forceps holder and retrograde pinning transfixation can be used in various kinds of clavicular shaft fracture, with many virtues such as easy operation, reliable fixation, short union time of fracture, good functional recovery of shoulder-joint and no incision scar affecting appearance.

Computed Tomographic Analysis of Ventral Atlantoaxial Optimal Safe Implantation Corridors in 27 Dogs.

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Leblond, Guillaume; Gaitero, Luis; Moens, Noel M M; Zur Linden, Alex; James, Fiona M K; Monteith, Gabrielle J; Runciman, John

2017-11-01

Objectives  Ventral atlantoaxial stabilization techniques are challenging surgical procedures in dogs. Available surgical guidelines are based upon subjective anatomical landmarks, and limited radiographic and computed tomographic data. The aims of this study were (1) to provide detailed anatomical descriptions of atlantoaxial optimal safe implantation corridors to generate objective recommendations for optimal implant placements and (2) to compare anatomical data obtained in non-affected Toy breed dogs, affected Toy breed dogs suffering from atlantoaxial instability and non-affected Beagle dogs. Methods  Anatomical data were collected from a prospectively recruited population of 27 dogs using a previously validated method of optimal safe implantation corridor analysis using computed tomographic images. Results  Optimal implant positions and three-dimensional numerical data were generated successfully in all cases. Anatomical landmarks could be used to generate objective definitions of optimal insertion points which were applicable across all three groups. Overall the geometrical distribution of all implant sites was similar in all three groups with a few exceptions. Clinical Significance  This study provides extensive anatomical data available to facilitate surgical planning of implant placement for atlantoaxial stabilization. Our data suggest that non-affected Toy breed dogs and non-affected Beagle dogs constitute reasonable research models to study atlantoaxial stabilization constructs. Schattauer GmbH Stuttgart.

Traumatic posterior atlantoaxial dislocation without fracture of the odontoid process: A case report and literature review

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KIm, Yong Kyun; Park, Jin Gyoon; Jung, Hyun Nyeong [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Kim, Ju Won [Dept. of Radiology, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Lee, Seung Jin [Dept. of Radiology, Chonnam National University Bitgoeul Hospital, Gwangju (Korea, Republic of)

2017-03-15

Traumatic posterior atlantoaxial dislocation without odontoid fracture is very rare. Patient prognosis depends on the neurologic symptoms or the extent of damage to the structures. In this case, a 78-year-old-male suffered a posterior atlantoaxial dislocation without odontoid fracture after a traffic accident. We report this case because an exact diagnosis and proper treatment can reduce the neurologic complications in patients with posterior atlantoaxial dislocation.

Atlantoaxial Ankylosis Detected on Neck CT Scans in a Patient with Ankylosing Spondylitis: A Case Report

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Lee, Jeong Ah; Lee, Seung Hun; Joo, Kyung Bin [Dept. of Radiology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of); Ryu, Jeong Ah [Dept. of Radiology, Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of); Kim, Tae Hwan [Dept. of Rheynmatology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of)

2011-07-15

Ankylosing spondylitis is a chronic inflammatory disorder of unknown cause that principally affects the axial skeleton. The cervical spine is also vulnerable to this disease process and the characteristic feature of cervical involvement is atlantoaxial subluxation. However, only a few cases of atlantoaxial ankylosis have been reported to date. We report a case of atlantoaxial ankylosis in a patient with ankylosing spondylitis with radiologic findings incidentally detected on neck CT scans.

Atlantoaxial Ankylosis Detected on Neck CT Scans in a Patient with Ankylosing Spondylitis: A Case Report

International Nuclear Information System (INIS)

Lee, Jeong Ah; Lee, Seung Hun; Joo, Kyung Bin; Ryu, Jeong Ah; Kim, Tae Hwan

2011-01-01

Ankylosing spondylitis is a chronic inflammatory disorder of unknown cause that principally affects the axial skeleton. The cervical spine is also vulnerable to this disease process and the characteristic feature of cervical involvement is atlantoaxial subluxation. However, only a few cases of atlantoaxial ankylosis have been reported to date. We report a case of atlantoaxial ankylosis in a patient with ankylosing spondylitis with radiologic findings incidentally detected on neck CT scans.

Piezosurgery versus Rotatory Osteotomy in Mandibular Impacted Third Molar Extraction

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Bhati, Bharat; Kukreja, Pankaj; Kumar, Sanjeev; Rathi, Vidhi C.; Singh, Kanika; Bansal, Shipra

2017-01-01

Aim: The aim of this study is to compare piezoelectric surgery versus rotatory osteotomy technique in removal of mandibular impacted third molar. Materials and Methods: Sample size of 30 patients 18 males, 12 females with a mean age of 27.43 ± 5.27. Bilateral extractions were required in all patients. All the patients were randomly allocated to two groups in one group, namely control group, surgical extraction of mandibular third molar was done using conventional rotatory osteotomy and in the other group, namely test group, extraction of lower third molar was done using Piezotome. Results: Parameters assessed in this study were – mouth opening (interincisal opening), pain (visual analog scale VAS score), swelling, incidence of dry socket, paresthesia and duration of surgery in both groups at baseline, 1st, 3rd, and 7th postoperative day. Comparing both groups pain scores with (P piezosurgery group (51.40 ± 17.9) minutes compared to the conventional rotatory group with a mean of (37.33 ± 15.5) minutes showing a statistically significant difference (P = 0.002). Conclusion: The main advantages of piezosurgery include soft tissue protection, optimal visibility in the surgical field, decreased blood loss, less vibration and noise, increased comfort for the patient, and protection of tooth structures. Therefore, the piezoelectric device was efficient in decreasing the short-term outcomes of pain and swelling although taking longer duration than conventional rotatory technique it significantly reduces the associated postoperative sequelae of third molar surgery. PMID:28713729

Conservative management of idiopathic anterior atlantoaxial subluxation without neurological deficits in an 83-year-old female: A case report.

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Marchand, Andrée-Anne; Wong, Jessica J

2014-03-01

Atlantoaxial subluxation that is not related to traumatic, congenital, or rheumatological conditions is rare and can be a diagnostic challenge. This case report details a case of anterior atlantoaxial subluxation in an 83-year-old female without history of trauma, congenital, or rheumatological conditions. She presented to the chiropractor with insidious neck pain and headaches, without neurological deficits. Radiographs revealed a widened atlantodental space (measuring 6 mm) indicating anterior atlantoaxial subluxation and potential sagittal atlantoaxial instability. Prompt detection and appropriate conservative management resulted in favourable long-term outcome at 13-months follow-up. Conservative management included education, mobilizations, soft tissue therapy, monitoring for neurological progression, and co-management with the family physician. The purpose of this case report is to heighten awareness of the clinical presentation of idiopathic anterior atlantoaxial subluxation without neurological deficits. Discussion will focus on the incidence, mechanism, clinical presentation, and conservative management of a complex case of anterior atlantoaxial subluxation.

The effect of rotatory inertia on the dynamic response of cantilever structures

International Nuclear Information System (INIS)

Lin, Y.J.; Hadjian, A.H.

1977-01-01

For the dynamic response of cantilever beams, the error introduced by the bending theory becomes significant as the ratio of the radius of gyration to the beam length (r/l), exceeds 0.1. In this case, the use of Timoshenko's beam equation becomes more appropriate. This equation includes, in addition to the bending effects, both shear deformation and rotatory inertia effects. In the discrete modeling of beam elements, both the shear deformation and rotatory inertia terms play roles in the mass matrix, while only the shear deformation terms appear in the stiffness matrix. The effect of rotatory inertia on the frequencies and dynamic response of cantilever structures subjected to lateral earthquake excitation is thoroughly studied. This is done by using both the consistent and lumped mass matrices and analytical solution. The beam support is treated either as fixed or elastically restrained to consider soil-structure interaction effects. Since containment structures can be treated as hollow beams, the cantilever beam of uniform cross-section is examined first. For those cases where the ratio of the radius of gyration to beam length lies within the range of interest, all the solutions show that rotatory inertia has an important impact on both the frequencies (other than that of the fundamental mode) and the vertical component of the response. However, as the soil-structure interaction effects become significant rotatory inertia effects become secondary. For shear wall structures used in nuclear power plants, the floors may be treated as rigid diaphragms and the shear walls between floors are usually considered to be beam elements of uniform cross-section

Long-term sequel of posterolateral rotatory instability of the elbow: a case report

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Cheng Chun-Ying

2010-01-01

Full Text Available Abstract The natural course of untreated posterior lateral rotatory instability of the elbow is unclear. A case of elbow arthrosis with progressing deformity and flexion contracture after an episode of elbow dislocation about 20 years ago presented the possibility the long term outcome of untreated posterior lateral rotatory instability of the elbow.

Acute neck pain caused by arthritis of atlanto-axial joint

International Nuclear Information System (INIS)

Kobayashi, Takashi; Ishikawa, Yoshinori; Abe, Eiji; Konno, Norikazu; Noguchi, Hideaki

2009-01-01

We reviewed 27 cases in which the patient complained of acute neck pain. We had performed arthrocentesis of the atlanto-axial joint in every case. An aspirate was obtained in 16 of the cases, and calcium pryophosphate dihydrate (CPPD) crystals were demonstrated in 10 of them. The patients' scores on the visual analogue scale decreased 30 minutes after aspiration of the crystals (p<0.001). CT demonstrated calcification of the transverse ligament in 22 cases, calcification anterior to the body of C2 in 2 cases, and no calcification in 3 cases. The results in these patients suggest that acute neck pain in some elderly patients is related to arthritis of the atlanto-axial joint. (author)

The internal vertebral venous plexus prevents compression of the dural sac during atlanto-axial rotation

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Reesink, E.M.; Lataster, L.M.A.; Mameren, H. van [Dept. of Anatomy/Embryology, Maastricht Univ. (Netherlands); Wilmink, J.T. [Dept. of Radiology, University Hospital Maastricht (Netherlands); Kingma, H. [Dept. of ENT, University Hospital Maastricht (Netherlands)

2001-10-01

Deformation of the extradural space and the possibility of impression upon the dural sac during atlanto-axial rotation are investigated. Atlanto-axial rotation leads to a reduction in the cross-sectional area of the bony spinal canal of approximately 40 %. Atlanto-axial rotation was recorded by endocanalar views from a video camera fixed inside the skull of six unembalmed cadavers. Axial thin-section T1-weighted MRI slice sets were acquired from three volunteers (mid-position and maximal left and right rotation of the head and cervical spine). The axial cross-sectional areas of the bony spinal canal, dural sac and spinal cord were measured. In two other persons post-gadolinium contrast-enhanced T1-weighted MRI volume scans with fat-suppression prepulse were acquired (mid-position and rotation) to determine venous contents of the extradural space. The 50:50 ratio between left and right extradural halves in mid-position changed to an ipsilateral:contralateral ratio of 20:80 in maximum rotation at the level just above the lateral C1-C2 joints. Directly below these joints the opposite occurred. The post-contrast studies showed an enhancing internal vertebral venous plexus (IVVP), which almost completely occupied the extradural space at the atlanto-axial level. This could not be shown in the cadaver experiments, because of absence of blood and cerebrospinal fluid (CSF) pressure. During atlanto-axial rotation blood displacement in the IVVP allows major deformations of the extradural space. This prevents dural sac impression. (orig.)

Atlanto-axial malformation and instability in dogs with pituitary dwarfism due to an LHX3 mutation.

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Voorbij, A M W Y; Meij, B P; van Bruggen, L W L; Grinwis, G C M; Stassen, Q E M; Kooistra, H S

2015-01-01

Canine pituitary dwarfism or combined pituitary hormone deficiency (CPHD) in shepherd dogs is associated with an LHX3 mutation and can lead to a wide range of clinical manifestations. Some dogs with CPHD have neurological signs that are localized to the cervical spine. In human CPHD, caused by an LHX3 mutation, anatomical abnormalities in the atlanto-axial (C1-C2) joint have been described. To evaluate the presence of atlanto-axial malformations in dogs with pituitary dwarfism associated with an LHX3 mutation and to investigate the degree of similarity between the atlanto-axial anomalies found in canine and human CPHD patients with an LHX3 mutation. Three client-owned Czechoslovakian wolfdogs and 1 client-owned German shepherd dog, previously diagnosed with pituitary dwarfism caused by an LHX3 mutation, with neurological signs indicating a cervical spinal disorder. Radiography, computed tomography, and magnetic resonance imaging of the cranial neck and skull, necropsy, and histology. Diagnostic imaging identified abnormal positioning of the dens axis and incomplete ossification of the suture lines between the ossification centers of the atlas with concurrent atlanto-axial instability and dynamic compression of the spinal cord by the dens axis. The malformations and aberrant motion at C1-C2 were confirmed at necropsy and histology. The atlanto-axial abnormalities of the dwarf dogs resemble those encountered in human CPHD patients with an LHX3 mutation. These findings suggest an association between the LHX3 mutation in dogs with CPHD and atlanto-axial malformations. Consequently, pituitary dwarfs should be monitored closely for neurological signs. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Internal Medicine.

Randomized clinical study comparing piezosurgery and conventional rotatory surgery in mandibular cyst enucleation.

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Pappalardo, Sabrina; Guarnieri, Renzo

2014-07-01

The aim of the present study is to compare piezoelectric surgery to the conventional rotatory surgery in mandibular cyst enucleation, and to determine the 2 method's suitability and the postoperative outcomes. Eighty patients were included in the study. 35 male and 45 female, which showed cystic mandibular lesions, compared with the inferior alveolar nerve or the mental nerve. The patients were randomly divided into two groups. In the test group, cystectomy was performed using conventional rotatory instrumentation (rotatory-group), and in the other one piezoelectric surgery (piezo-group). The swelling was documented 24/48/72 h and 1 week post-surgery and the patients recorded their subjective postoperative pain daily for 7 days using a Visual Analog Scale (VAS). Patients treated with piezoelectric technique have presented a lower VAS, minor swelling and less recovery time compared to the rotatory-group. No lesions of the mandible nerve were detected with piezosurgery whereas surgery with rotary instruments resulted in 8% hypesthesia at least up to one week. The results of this study suggest that piezosurgery may be considered effective in cyst enucleation compared to traditional procedures with burs, since it grants the patients significantly less post-surgical pain and swelling. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Traumatic spinal cord injury caused by suspected hyperflexion of the atlantoaxial joint in a 10-year-old cat

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Annette Wessmann

2015-06-01

Full Text Available Case summary A 10-year-old cat presented 5 days after a traumatic event with acute recumbency followed by some clinical improvement. The neuroanatomical localisation was the C1–C5 spinal cord segments. Initial survey radiographs, including lateral flexed views, showed no convincing abnormalities. Magnetic resonance imaging (MRI revealed a marked focal intramedullary lesion at the level of the dens and suspected oedema extending over C2–C3 vertebrae, suggesting early syrinx formation. The cat made an initial excellent recovery on restricted exercise without medical treatment. The MRI changes largely resolved on follow-up MRI 4 weeks later yet recurred following a relapse 4 months later. At this stage, a post-traumatic syrinx had developed. Moreover, the suspected atlantoaxial instability was finally diagnosed on radiography with fully flexed lateral views. A hyperflexion injury causing tearing of the atlantoaxial ligaments was considered most likely given the lack of malformations or fractures. The cat made a full recovery on conservative management. Relevance and novel information This is the first report of sequential MRI findings in a cat with atlantoaxial instability. Moreover, post-traumatic syringomyelia formation following atlantoaxial injury has not been reported. Sequential MRI aids in the diagnosis of hyperflexion injury if survey radiographs fail to identify atlantoaxial instability.

Asymptomatic atlantoaxial subluxation in rheumatoid arthritis.

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Mohammadali Nazarinia

2014-06-01

Full Text Available This cross-sectional study is conducted to determine the prevalence of asymptomatic cervical spine subluxation in rheumatoid arthritis patients by plain radiographs and its relation to demographic and clinical characteristics, disease activity measures and medications. 100 rheumatoid arthritis patients (18 male and 82 female were selected randomly, according to the American college of Rheumatology Criteria, who were under follow up in the rheumatology clinic. A complete history was taken, and physical examination has been done with focus on the cervical spine to determine their demographic data, disease duration, age of disease onset, drug history, swollen and tender joint counts, and ESR, Hb, CRP, RF levels. The disease activity of patients with rheumatoid arthritis was measured using the disease activity score 28. Radiographs of the cervical spine included lateral views taken in flexion, extension, neutral position of the neck and anterioposterior and odontoid projection view. Asymptomatic cervical spine subluxation was found in 17 of the 100 patients (17%. The prevalence of, anterior atlantoaxial subluxation, atlantoaxial impaction and subaxial subluxation was 10(10%, 5(5% and 6(6%, respectively. Posterior subluxation was not detected. The only characteristic that showed meaningful relationship with cervical spine subluxation was CRP (P=0.036. Our results showed that patients with RA, who have cervical spine subluxation cannot be distinguished on the basis of symptoms. Cervical spine involvement is common and may be asymptomatic, indicating routine cervical spine imaging is needed in patients with RA.

SYMPTOM COMPLEX OF CHRONICAL ATLANTOAXIAL SUBLUXATION IN PAEDIATRIC PATIENTS

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A. G. Baindurashvili

2012-01-01

Full Text Available The objective of this study is to determine the complex of symptoms, including both orthopedic and neurological changes that occur against the backdrop of long-existing disturbances of the atlanto-axial joint. The authors conducted in-depth analysis of the orthopedic and neurological examination of 58 children aged between 10 and 17 years with first diagnosed disturbances of relationship between C1 and C2 vertebrae. Complexes of symptoms are identified from the combination of clinical data obtained with in-depth orthopedic and neurological examinations that are pathognomonic for lateral and posterior atlanto-axial chronic subluxation. Rotational subluxation of C1-C2 vertebral-motor segment was associated with concomitant neurological disorders and additionally with the no gross structural deformity of the spine and the disturbed foot support function in all cases. Using of the study findings will allow to make an adequate diagnosis and to determine the correct choice of additional diagnostic and therapeutic methods for this category of patients on the stage of conventional examination of the patient in clinical practice.

Assessment of rotatory instability after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft

International Nuclear Information System (INIS)

Tashiro, Yasutaka; Okazaki, Ken; Miura, Hiromasa

2010-01-01

Anatomically oriented anterior cruciate ligament (ACL) reconstruction has been advocated recently, but its effect on rotatory instability remains to be cleared objectively. The purpose of this study was to quantitatively evaluate rotatory instability in ACL reconstructed knees with a bone-patellar tendon-bone (BTB) graft using an open MRI system. Eighteen subjects underwent arthroscopic ACL reconstruction with a BTB graft. The tibial tunnel was placed in the center of the ACL footprint. The femoral tunnel was drilled transtibially at the 10:00 to 10:30-o'clock position for the right knees. Subjects were examined using a Slocum anterolateral rotatory instability test in open MRI. Anterior tibial translation was measured at the medial and lateral compartments by evaluating sagittal images. Anterior knee stability was evaluated using the KT-2000 arthrometer. The clinical knee function was assessed with the Lysholm and Tegner scoring scales before and after the surgery. Side-to-side differences of anterolateral tibial translation was 0.1 mm. Side-to-side difference on KT-2000 arthrometer measurement was 1.8 mm. The Lysholm score improved to 96 and the latest Tegner score reached substantially the preinjury level. ACL reconstruction with a BTB graft was successful in restoring rotatory stability as well as anterior stability and knee function. (author)

C1-C2 instability with severe occipital headache in the setting of vertebral artery facet complex erosion.

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Taher, Fadi; Bokums, Kristaps; Aichmair, Alexander; Hughes, Alexander P

2014-05-01

An exact understanding of patient vertebral artery anatomy is essential to safely place screws at the atlanto-axial level in posterior arthrodesis. We aim to report a case of erosion of the left vertebral artery into the C1-C2 facet complex with resultant rotatory and lateral listhesis presenting with severe occipital headache. This represents a novel etiology for this diagnosis and our report illustrates technical considerations when instrumenting the C1-C2 segment. We report a case of severe occipital headache due to C1-C2 instability with resultant left C2 nerve compression in the setting of erosion of the vertebral artery into the C1-C2 facet complex. A 68-year-old woman presented with a 12-month history of progressively debilitating headache and neck pain with atlanto-axial instability. Computed tomography (CT) angiography demonstrated erosion of the left vertebral artery into the left C1-C2 facet complex. In addition, the tortuous vertebral arteries had eroded into the C2 pedicles, eliminating the possibility for posterior pedicle screw placement. The patient underwent posterior arthrodesis of C1-C2 utilizing bilateral lateral mass fixation into C1 and bilateral trans-laminar fixation into C2 with resolution of all preoperative complaints. This study constitutes the first report of a tortuous vertebral artery causing the partial destruction of a C1-C2 facet complex, as well as instability, with the clinical presentation of severe occipital headache. It hereby presents a novel etiology for both the development of C1-C2 segment instability as well as the development of occipital headache. Careful evaluation of such lesions utilizing CT angiography is important when formulating a surgical plan.

Atlantoaxial Subluxation after Pyogenic Spondylitis around the Odontoid Process

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Atsushi Hasegawa

2015-01-01

Full Text Available Study Design. A case report and review of the literature. Objective. The aim of this study was to describe the conservative management of pyogenic spondylitis around the odontoid process. Summary of Background Data. Atlantoaxial subluxation after pyogenic spondylitis is rare. The therapeutic approach to infection of the upper cervical spine is controversial. Methods. Medical chart and radiological images of a 76-year-old male patient were retrospectively reviewed. Radiography revealed atlantoaxial subluxation, and an abscess was seen around the odontoid process on magnetic resonance images. Intravenous antibiotics and a halo vest were used to treat the patient. We then observed the patient’s conservative treatment course. Results. C-reactive protein levels returned to normal 4 weeks after administration of the intravenous antibiotics. The patient’s muscle weakness also completely recovered 8 weeks after administration of the intravenous antibiotics. Because the patient was able to walk without any support, surgical treatment was not necessary. Conclusions. Pyogenic spondylitis of the upper cervical spine is a rare manifestation. Surgical or conservative treatment must be selected carefully based on the patient’s symptoms. If early diagnosis and treatment can be provided to the patients, conservative treatment can be achieved.

[Finite element analysis of lumbar pelvic and proximal femur model with simulate lumbar rotatory manipulation].

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Hu, Hua; Xiong, Chang-Yuan; Han, Guo-Wu

2012-07-01

To study the changes of displacement and stress in the model of lumbar pelvic and proximal femur during lumbar rotatory manipulation. The date of lumbar pelvic and proximal femur CT scan by Mimics 10.01 software was established a lumbar pelvic and proximal femur geometric model, then the model was modified with Geomagic 9, at last the modified model was imported into hypermesh 10 and meshed with tetrahedron, at the same time,add disc and ligaments. According to the principle of lumbar rotatory manipulation,the lumbar rotatory manipulation were decomposed. The mechanical parameters assigned into the three-dimensional finite element model. The changes of displacement and stress in the model of lunbar pelvic and proximal femur under the four conditions were calculated with Abaqus model of Hypermesh 10. 1) Under the same condition,the displacement order of lumbar was L1>L2>L3>L5 L5, anterior column > middle column > posterior column. 2) Under the different conditions, the displacement order of lumbar,case 3>case 1>case 4>case 2. 3) Under the same conditions, the displacement order of lumbar inter-vertebral disc from L1,2 to L5S1 was L1,2>L2,3>L3,4>L4,5>L5S1, as for the same inter-vertebral disc, the order was: second quadrant>third quadrant>first quadrant>fourth quadrant. 4) Under the different conditions,the displacement order of the inter-vertebral disc was L1,2>L2,3>L3,4>L4,5>L5S1, but to same inter-vertebral disc: case 3>case 4>case 1 >case 2. 5) There were apparent displacement and stress concentration in pelvis and hip during the manipulation. 1) The principles of lumbar rotation manipulation closely related to the relative displacement caused by rotation of various parts of lumbar pelvic and proximal femur model; 2) During the process of lumbar rotatory manipulation, the angle of lateral bending and flexion can not be randomly increased; 3) During the process of lumbar rotatory manipulation, all the conditions of lumbar pelvic and proximal femur must be

Atlantoaxial subluxation. Radiography and magnetic resonance imaging correlated to myelopathy

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Yamashita, Y.; Takahashi, M.; Sakamoto, Y.; Kojima, R.

Twenty-nine patients with atlantoaxial subluxation (18 with rheumatoid arthritis, 2 due to trauma, 4 with os odontoideum, and one each with polyarteritis nodosa, rheumatic fever, Klippel-Feil syndrome, achondroplasia, and cause unknown) were evaluated using a 0.22 tesla resistive MRI unit. Cord compression was classified into four grades according to the degree on magnetic resonance imaging. There were 7 patients with no thecal sac compression (grade 0), 10 with a minimal degree of subarachnoid space compression without cord compression (grade 1), 7 with mild cord compression (grade 2), and 5 with severe cord compression or cord atrophy (grade 3). Although the severity of myelopathy showed poor correlation with the atlantodental interval on conventional radiography, high correlation was observed between MR grading and the degree of myelopathy. The high signal intensity foci were observed in 7 or 12 patients with cord compression (grades 2 and 3) on T2 weighted images. Other frequently observed findings in rheumatoid arthritis included soft tissue masses of low to intermediate signal intensity in the paraodontoid space, erosions of the odontoid processes, and atlanto-axial impaction on T1 and T2 weighted images.

Lateral femoral notch depth is not associated with increased rotatory instability in ACL-injured knees: a quantitative pivot shift analysis.

Science.gov (United States)

Kanakamedala, Ajay C; Burnham, Jeremy M; Pfeiffer, Thomas R; Herbst, Elmar; Kowalczuk, Marcin; Popchak, Adam; Irrgang, James; Fu, Freddie H; Musahl, Volker

2018-05-01

A deep lateral femoral notch (LFN) on lateral radiographs is indicative of ACL injury. Prior studies have suggested that a deep LFN may also be a sign of persistent rotatory instability and a concomitant lateral meniscus tear. Therefore, the purpose of this study was to evaluate the relationship between LFN depth and both quantitative measures of rotatory knee instability and the incidence of lateral meniscus tears. It was hypothesized that greater LFN depth would be correlated with increased rotatory instability, quantified by lateral compartment translation and tibial acceleration during a quantitative pivot shift test, and incidence of lateral meniscus tears. ACL-injured patients enrolled in a prospective ACL registry from 2014 to 2016 were analyzed. To limit confounders, patients were only included if they had primary ACL tears, no concurrent ligamentous or bony injuries requiring operative treatment, and no previous knee injuries or surgeries to either knee. Eighty-four patients were included in the final analysis. A standardized quantitative pivot shift test was performed pre-operatively under anesthesia in both knees, and rotatory instability, specifically lateral compartment translation and tibial acceleration, was quantified using tablet image analysis software and accelerometer sensors. Standard lateral radiographs and sagittal magnetic resonance images (MRI) of the injured knee were evaluated for LFN depth. There were no significant correlations between LFN depth on either imaging modality and ipsilateral lateral compartment translation or tibial acceleration during a quantitative pivot shift test or side-to-side differences in these measurements. Patients with lateral meniscus tears were found to have significantly greater LFN depths than those without on conventional radiograph and MRI (1.0 vs. 0.6 mm, p quantitative measures of rotatory instability. Concomitant lateral meniscus injury was associated with significantly greater LFN depth. Based on

Remoção da cartilagem articular associada ou não a implante homógeno ou enxerto autógeno de osso esponjoso em cães submetidos à artrodese atlantoaxial Joint cartilage removal associated or not to homologous implant or autologous cancellous bone graft in dogs submitted to atlantoaxial arthrodesis

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Rafael Festugatto

2013-03-01

same amount. Group III (GIII: this was the same procedure as GI, however, was used autogenous cancellous bone graft at the given location. Radiographic examinations were performed on all animals at 30, 60 and 90 days postoperatively. At 90 days of PO was carried out euthanasia of animals for testing of manual palpation and CT evaluation and histological. Samples were kept in solution in 10% buffered formaldehyde for fixation for a minimum of 72 hours and after, decalcified in formic acid and sodium citrate for subsequent processing and included in paraffin. Sections were stained with hematoxylin-eosin for light microscopy evaluation. Statistical analysis of the association between the degree of joint fusion assessed by manual palpation, the digitized radiographic images and CT scans and treatment groups, we applied the Chi-square test of independence. The test results were evaluated by the exact significance and considered statistically significant at 5% significance (P<0.05. By manual palpation test and by the CT images can be seen that there was no statistically significant difference between groups at 90 days postoperatively. Radiographic analysis of the atlantoaxial joint showed that the degree of fusion was similar among treatments, no statistical difference at 30, 60 and 90 days postoperatively. Regarding the histopathological study of atlantoaxial joint of dogs after 90 days postoperatively was found that bone formation in group I had 25% of each intensity (absent, mild, moderate, severe in group II, 75% lighter and 25% sharp and in group III, 25% moderate and 75% severe. It can be concluded that the use of graft homogenous preserved in 98% glycerin in dogs undergoing atlantoaxial fusion method is a viable alternative for treatment of atlantoaxial instability. There is no difference in the degree of joint fusion and bone formation when the technique of atlantoaxial arthrodesis in dogs is associated with autogenous cancellous bone graft or implant homogenous. The

Odontoid fractures: A retrospective analysis of 53 cases

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Shetty Arjun

2009-01-01

Full Text Available Background: The management of odontoid fracture has evolved but controversy persists as to the best method for Type II odontoid fractures with or without atlantoaxial (AA instability. The anterior odontoid screw fixation can be associated with significant morbidity while delayed odontoid screw fixation has shown to be associated with reasonable good fusion rates. We conducted a retrospective analysis to evaluate the outcome of a trial of conservative management in type II odontoid fractures without atlantoaxial instability (Group A followed by delayed odontoid screw fixation in cases in which fusion was not achieved by conservative treatment. The outcome of type II odontoid fracture with AA subluxation (Group B was also analysed where closed reduction on traction could be achieved and in those atlantoaxial subluxations that were irreducible an intraoperative reduction was done. Materials and Methods: A retrospective evaluation of 53 cases of odontoid fractures treated over a 9-year period is being reported. All odontoid fractures without AA instability (n=29 were initially managed conservatively. Three patients who did not achieve union with conservative management were treated with delayed anterior screw fixation. Twenty-four cases of odontoid fractures were associated with AA instability; 17 of them could be reduced with skeletal traction and were managed with posterior fusion and fixation. Of the seven cases that were irreducible, the initial three cases were treated by odontoid excision followed by posterior fusion and fixation; however, in the later four cases, intra operative reduction was achieved by a manipulation procedure, and posterior fusion and fixation was performed. Results: Twenty-six of 29 cases of odontoid fracture without AA instability achieved fracture union with conservative management whereas the remaining three patients achieved union following delayed anterior odontoid screw fixation. 17 out of 24 odontoid fracture with

Case report 344: Tuberculous spondyilitis resulting in atlanto-axial dislocation

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Dowd, C.F.; Sartoris, D.J.; Resnick, D.; Haghighi, P.

1986-01-01

In summary, this case exhibits many of the typical features of atlanto-axial tuberculous spondylitis, including its presenting symptomatology and radiological manifestations. No other sites of tuberculous involvement were discovered on subsequent work-up in this patient. He was treated with traction and transoral debridement of soft tissues and bone, followed by anti-tuberculous chemotherapy for eight weeks and a posterior spinal fusion. The patient subsequently recovered full motor and sensory function and is currently undergoing rehabilitation therapy several months following surgery. (orig.)

Extracranial internal carotid artery dissection caused by compression from a giant osteophyte due to atlantoaxial osteoarthritis: case report.

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Ikedo, Taichi; Nakamura, Kazuhito; Sano, Noritaka; Nagata, Manabu; Okada, Yumiko; Kawakami, Taichiro; Murata, Takaho

2017-10-01

Deformed osseous structures have been reported as rare causes of extracranial internal carotid artery (ICA) dissection, including the styloid process and the hyoid bone. Here, the authors describe the first known case of symptomatic ICA dissection caused by a giant osteophyte due to atlantoaxial osteoarthritis. The left ICA was fixed at the skull base and at the ICA portion compressed by the osteophyte, and it was highly stretched and injured between the two portions during neck rotation. The patient was successfully treated with ligation of the affected ICA following balloon test occlusion. Atlantoaxial osteoarthritis should be considered in the differential diagnosis of ICA dissection in patients with a severely deformed cervical spine.

The investigation of the lateral atlanto-dental interval of atlanto-axial joint by multi-slice spiral CT

International Nuclear Information System (INIS)

Cui Wei; Peng Lei; Wang Jincai; Liu Jihua; Feng Weihua

2010-01-01

Objective: To explore imaging features of the lateral atlanto-dental interval (LADI) of atlanto-axial joint and its value in the diagnosis of atlanto-axial joint dislocation/subluxation. Methods: Two hundred and forty healthy volunteers without atlanto-axial joint dysfunction and 32 patients with torticollis and/or functional impairment at atlanto-axial.joint were enrolled into this study. All subjects were examined with multi-slice CT in both neutral and max rotation positions to the left/right. Clinical endpoints including VBLADI, variance range of the VBLADI and asymmetric conditions were evaluate. χ 2 test is used to evaluate the variance of incidence of bilateral LADI asymmetry in different age groups, Pearson-test (2-tailed) is used to evaluate the correlation between VBLADI and rotary function of atlanto-axial joint, precise test of fourfold table is used to compare normal group with patient groups. Results: (1) In the normal control group: asymmetry of bilateral LADI were observed in 204 among 240 (85.00%) healthy volunteers including 60 youngsters ( 95% of ∣ VBLADI ∣ were 0.850 mm, 2.450 mm in the young ( 95% in the young and in the adult respectively. There was no correlation between VBLADI(-2.146 to 2.114 mm, Median 0.000 mm) and LA (22.949° to 44.649°, Median 34.500°), RA (25.284° to 45.334°, Median 35.300°), VLRA (-11.643° to 8.623°, median 0.000°) respectively in normal people (r=-0.030, -0.005, 0.026, P>0.05). (2) In the study with 32 patients including 25 youngsters ( 95% in group AALSD and group AACD than in abnormal group (P<0.01), but there is no difference between group AARD and normal group (P=0.738). Conclusion: The imaging finding of 'asymmetry of bilateral LADI' may be either a physiological variation or a pathological condition, clinical manifestations and other imaging findings should be evaluated to make a diagnosis. (authors)

"Two-step" technique with OsiriXTM to evaluate feasibility of C2 pedicle for surgical fixation

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Luis Miguel Sousa Marques

2016-01-01

Full Text Available Background: Surgical treatment of craniovertebral junction pathology has evolved considerably in recent decades with the implementation of short atlanto-axial fixation techniques, notwhithstanding increasing neurovascular risks. Also, there is strong evidence that fixation of C2 anatomical pedicle has the best biomechanical profile of the entire cervical spine. However, it is often difficult and misleading, to evaluate anatomical bony and vascular anomalies using the three orthogonal planes (axial, coronal, and sagittal of CT. Objectives: The authors describe an innovative and simple technique to evaluate the feasibility of C2 pedicle for surgical screw fixation using preoperative planning with the free DICOM (Digital Imaging and Communications in Medicine software OsiriX TM . Materials and Methods: The authors report the applicatin of this novel technique in 5 cases (3 traumatic, 1 Os Odontoideum, and 1 complex congenital malformation collected from our general case series of the Department in the last 5 years. Results: In this "proof of concept" study, the pre-operative analysis with the "two-step" tecnique was detrimental for choosing the surgical tecnique. Detailed post-operative analysis confirmed correct position of C2 screws without cortical breach. There were no complications or mortality reported. Conclusion: This "two-step" technique is an easy and reliable way to determine the feasibility of C2 pedicle for surgical fixation. The detailed tridimensional radiological preoperative evaluation of craniovertebral junction anatomy is critical to the sucess and safety of this surgeries, and can avoid, to certain degree, expensive intra-operative tridimensional imaging facilities.

Rotatory and collic vestibular evoked myogenic potential testing in normal-hearing and hearing-impaired children.

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Maes, Leen; De Kegel, Alexandra; Van Waelvelde, Hilde; Dhooge, Ingeborg

2014-01-01

Vertigo and imbalance are often underestimated in the pediatric population, due to limited communication abilities, atypical symptoms, and relatively quick adaptation and compensation in children. Moreover, examination and interpretation of vestibular tests are very challenging, because of difficulties with cooperation and maintenance of alertness, and because of the sometimes nauseatic reactions. Therefore, it is of great importance for each vestibular laboratory to implement a child-friendly test protocol with age-appropriate normative data. Because of the often masked appearance of vestibular problems in young children, the vestibular organ should be routinely examined in high-risk pediatric groups, such as children with a hearing impairment. Purposes of the present study were (1) to determine age-appropriate normative data for two child-friendly vestibular laboratory techniques (rotatory and collic vestibular evoked myogenic potential [cVEMP] test) in a group of children without auditory or vestibular complaints, and (2) to examine vestibular function in a group of children presenting with bilateral hearing impairment. Forty-eight typically developing children (mean age 8 years 0 months; range: 4 years 1 month to 12 years 11 months) without any auditory or vestibular complaints as well as 39 children (mean age 7 years 8 months; range: 3 years 8 months to 12 years 10 months) with a bilateral sensorineural hearing loss were included in this study. All children underwent three sinusoidal rotations (0.01, 0.05, and 0.1 Hz at 50 degrees/s) and bilateral cVEMP testing. No significant age differences were found for the rotatory test, whereas a significant increase of N1 latency and a significant threshold decrease was noticeable for the cVEMP, resulting in age-appropriate normative data. Hearing-impaired children demonstrated significantly lower gain values at the 0.01 Hz rotation and a larger percentage of absent cVEMP responses compared with normal-hearing children

Novel Synchronous Linear and Rotatory Micro Motors Based on Polymer Magnets with Organic and Inorganic Insulation Layers

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Andreas WALDSCHIK

2008-12-01

Full Text Available In this work, we report on the development of several synchronous motors with rotatory or linear movements. The synchronous micro motors are brushless DC motors or stepper motors with electrically controlled commutation consisting of a stator and a rotor. The rotor is mounted onto the stator and is adjusted by an integrated guidance. Inside the stator different coil systems are realized, like double layer sector coils or special nested coils. The coil systems can be controlled by three or six phases depending on the operational mode. Furthermore, inorganic insulation layers were used in order to reduce the thickness of the system. By this means four layers of electrical conductors can be realized especially for the 2D devices. The smallest diameter of the rotatory motor is 1 mm and could be successfully driven.

Comparison of occipitocervical and atlantoaxial fusion in treatment of unstable Jefferson fractures

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Yong Hu

2017-01-01

Full Text Available Background: Controversy exists regarding the management of unstable Jefferson fractures, with some surgeons performing reduction and immobilization of the patient in a halo vest and others performing open reduction and internal fixation. This study compares the clinical and radiological outcome parameters between posterior atlantoaxial fusion (AAF and occipitocervical fusion (OCF constructs in the treatment of the unstable atlas fracture. Materials and Methods: 68 consecutive patients with unstable Jefferson fractures treated by AAF or OCF between October 2004 and March 2011 were included in this retrospective evaluation from institutional databases. The authors reviewed medical records and original images. The patients were divided into two surgical groups treated with either AAF ( n = 48, F/M 30:18 and OCF ( n = 20, F/M 13:7 fusion. Blood loss, operative time, Japanese Orthopaedic Association (JOA score, visual analog scale (VAS score, atlanto-dens interval, lateral mass displacement, complications, and the bone fusion rates were recorded. Results: Five patients with incomplete paralysis (7.4% demonstrated postoperative improvement by more than 1 grade on the American Spinal Injury Association impairment scale. The JOA score of the AAF group improved from 12.5 ± 3.6 preoperatively to 15.7 ± 2.3 postoperatively, while the JOA score of the OCF group improved from 11.2 ± 3.3 preoperatively to 14.8 ± 4.2 postoperatively. The VAS score of AAF group decreased from 4.8 ± 1.5 preoperatively to 1.0 ± 0.4 postoperatively, the VAS score of the OCF group decreased from 5.4 ± 2.2 preoperatively to 1.3 ± 0.9 postoperatively. Conclusions: The OCF or AAF combined with short-term external immobilization can establish the upper cervical stability and prevent further spinal cord injury and nerve function damage.

Atlantoaxial subluxation as an early manifestation in an adolescent with undifferentiated spondyloarthritis: a case report and review of the literature

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Jea Andrew

2011-07-01

Full Text Available Abstract Introduction Atlantoaxial instability has been described as a manifestation of ankylosing spondylitis (juvenile and adult onset, reactive arthritis, juvenile idiopathic arthritis, and rheumatoid arthritis; however, it has rarely been reported as an early manifestation of these disorders. We present this case report to increase awareness of the condition in the hope that earlier recognition of this disease may prevent further serious injury. Case presentation We report the case of a 17-year-old Hispanic adolescent woman who was initially diagnosed with undifferentiated spondyloarthritis due to peripheral arthritis, enthesitis, a positive human leukocyte antigen B27 result, and inflammatory spinal pain lasting two months. Our patient experienced persistent and worsening occipitocervical pain and signs of myelopathy three months after diagnosis; consequently, we found atlantoaxial instability along with cervical spine bone erosion and pannus formation. She was treated surgically with a C1-2 posterior instrumented fusion and at six weeks post-operatively was started on tumor necrosis factor α blockade. Her occipitocervical symptoms subsided following surgery and initiation of immunomodulation. Conclusions Our report serves to emphasize to pediatric and adult general practitioners, pediatricians, internists, family physicians, pediatric and adult rheumatologists and spine surgeons that atlantoaxial subluxation may be an early manifestation of spondyloarthritis, and that the condition is treatable by surgical intervention and immunomodulation.

Distraction, Compression, Extension, and Reduction Combined With Joint Remodeling and Extra-articular Distraction: Description of 2 New Modifications for Its Application in Basilar Invagination and Atlantoaxial Dislocation: Prospective Study in 79 Cases.

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Chandra, P Sarat; Prabhu, Manik; Goyal, Nishant; Garg, Ajay; Chauhan, Avnish; Sharma, Bhawani Shankar

2015-07-01

Recent strategies for treatment of basilar invagination (BI) and atlantoaxial dislocation (AAD) are based on simultaneous posterior reduction and fixation. To describe new modifications of the procedure distraction, compression, extension, and reduction (DCER), ie, joint remodeling (JRM) and extra-articular distraction (EAD) in patients with "vertical" joints, and to quantify the improvement in joint indices, ie, sagittal inclination (SI), craniocervical tilt (CCT), and coronal inclination. Prospective study (May 2010 to September 2014). Joint indices measured included (normal values): SI (87.15 ± 5.65°), CCT (60.2 ± 9.2°), and coronal inclination (110.3 ± 4.23°). Surgical procedures included DCER alone (performed in SI joints (SI >160°, group III). Seventy-nine patients were selected (mean, 22.5 years of age). All conventional indices improved significantly (P 100°). Joint indices provide useful information for surgical strategy and planning.

Unilateral atlanto-axial fractures in near side impact collisions: An under recognized entity in cervical trauma

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Andrew M Lozen

2014-01-01

Full Text Available Objective: Nearside impact collisions presenting with lateral mass fractures of atlanto-axial vertebrae contralateral to the impact site represents a rare fracture pattern that does not correlate with previously described injury mechanism. We describe our clinical experience with such fractures and propose a novel description of biomechanical forces involved in this unique injury pattern. The findings serve to alert clinicians to potentially serious consequences of associated unrecognized and untreated vertebral artery injury. Material and Methods : In addition to describing our clinical experience with three of these fractures, a review of Crash Injury Research and Engineering Network (CIREN database was conducted to further characterize such fractures. A descriptive analysis of three recent lateral mass fractures of the atlanto-axial segment is coupled with a review of the CIREN database. A total of 4047 collisions were screened for unilateral fractures of atlas or axis. Information was screened for side of impact and data regarding impact velocity, occupant injuries and use of restraints. Results: Following screening of unilateral fractures of atlas and axis for direct side impacts, 41 fractures were identified. Cross referencing these cases for occurrence contralateral to side of impact identified four such fractures. Including our recent clinical experience, seven injuries were identified: Five C1 and two C2 fractures. Velocity ranged from 14 to 43 km/h. Two associated vertebral artery injuries were identified. Conclusions: Complexity of the atlanto-axial complex is responsible for a sequence of events that define load application in side impacts. This study demonstrates the vulnerability of vertebral artery to injury under unique translational forces and supports the use or routine screening for vascular injury. Diminished sensitivity of plain radiography in identifying these injuries suggests that computerized tomography should be used in

[Analysis of medical cost of atlantoaxial disorders in patients receiving innovated treatment technologies].

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Wu, Yunxia; Liu, Zhongjun

2016-01-19

To explore the effects of innovated technologies and products on improving outcomes and decreasing medical costs by analyzing a total and subtotal medical costs of patients with atlantoaxial disorders. The medical costs of 1 489 patients with atlantoaxial disorders from Peking University Third Hospital from 2005 to 2014, who received innovated technologies and products treatment were retrospectively analyzed and compared.Descriptive analysis and ANOVA were used for statistical analysis, and SPSS 19.0 was used to analyze data. From 2005 to 2014, under the situation of a general increase in medical cost by 327%, the total medical costs were stable for patients who used innovated technologies and products for treatment, fluctuating from 20 851 in 2005 to 20 878 in 2014; however, the cases of operation increased year by year, from 88 in 2005 to 163 in 2014; the average length of stay decreased from 21 in 2005 to 10 in 2014; the total cases of transfusion were 22 from 2005 to 2014; the safety, stability and feasibility of the innovated technologies and products were illustrated through the decrease of average length of stay, the reduction of bleeding and the significance of outcomes. It is illustrated that the innovated technologies and products not only decrease patients' suffering and medical costs but also are safe, stable and feasible.

Odontoid pannus formation in a patient with ankylosing spondylitis causing atlanto-axial instability

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Rajak, Rizwan; Wardle, Phil; Rhys-Dillon, Ceril; Martin, James C

2012-01-01

Ankylosing spondylitis is one of the commonest inflammatory diseases of the axial skeleton and can be complicated by atlanto-axial instability. This serious and likely underestimated complication can be easily overlooked. However, there are clear features which can help alert suspicion to initiate the appropriate investigations with imaging that is very effective at diagnosing and assessing this complication. The authors report an unusual case where odontoid pannus formation, akin to that seen in rheumatoid arthritis, was the underlying cause. PMID:22665557

Study of the interaction of Tb (III) with dextran through fluorescence spectroscopy and optical rotatory dispersion

International Nuclear Information System (INIS)

Vasconcelos, Sandra S.; Rodrigues, J.F.

1984-01-01

A study of the interaction of Tb(III) with dextran in aqueous solution was perform using fluorescence spectroscopy and optical rotatory dispersion. The results indicate the formation of a complex with the displacent of water from the cation coordinated sphere by hydroxyl groups at the second and third carbon atoms of the monomer unit. (Author) [pt

Atlantoaxial Subluxation due to an Os Odontoideum in an Achondroplastic Adult: Report of a Case and Review of the Literature

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Abolfazl Rahimizadeh

2015-01-01

Full Text Available The authors report the first example of an adult achondroplastic dwarf with progressive quadriparesis secondary to atlantoaxial subluxation as a consequence of an os odontoideum. Actually, craniocervical region is a frequent site of compression and myelopathy in achondroplasia particularly in children as a result of small foramen magnum and hypertrophied opisthion. Moreover, very rarely in achondroplastic patients, coexistence of atlantoaxial instability as the sequel of os odontoideum can result in further compression of the already compromised cervicomedullary neural tissues, the scenario that has been reported only in five achondroplastic children. Herein, a 39-year-old achondroplastic male suffering such an extremely rare combination is presented. With C1-C2 screw rod instrumentation, atlas arch laminectomy, limited suboccipital craniectomy, and release of dural fibrous bands, reduction, decompression, and stabilization could be achieved properly resulting in steady but progressive recovery.

MRI of the transverse and alar ligaments in rheumatoid arthritis: feasibility and relations to atlantoaxial subluxation and disease activity

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Vetti, Nils; Kraakenes, Jostein; Roervik, Jarle; Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Surgical Sciences, Bergen (Norway); Alsing, Rikke; Brun, Johan Gorgas [Haukeland University Hospital, Department of Rheumatology, Bergen (Norway); University of Bergen, Section for Rheumatology, Institute of Medicine, Bergen (Norway); Gilhus, Nils Erik [Haukeland University Hospital, Department of Neurology, Bergen (Norway); University of Bergen, Section for Neurology, Department of Clinical Medicine, Bergen (Norway)

2010-03-15

Dysfunctional transverse and alar craniovertebral ligaments can cause instability and osseous destruction in rheumatoid arthritis (RA). This study examined (1) the feasibility of high-resolution magnetic resonance imaging (MRI) of these ligaments in RA and (2) the relation between ligament high-signal changes and atlantoaxial subluxation and RA duration/severity. Consecutive RA patients (n=46) underwent clinical examination, functional radiography, and high-resolution MRI. Two blinded radiologists rated MRI image quality, graded ligament high-signal changes 0-3 on proton-weighted sequences using an existing grading system, and assessed cervical spine rheumatic changes on short tau inversion recovery images. Agreement was analyzed using kappa and relations using multiple logistic regression. MRI images had good quality in 42 (91.3%) of 46 patients and were interpretable in 44 (32 women and 12 men, median age/disease duration 60.4/9.1 years). MRI grades 2-3 changes of the transverse and alar ligaments showed moderate and good interobserver agreement (kappa 0.59 and 0.78), respectively, and prevalence 31.8% and 34.1%. Such ligament changes were more frequent with increasing anterior atlantoaxial subluxation (p=0.012 transverse, p=0.028 alar), higher erythrocyte sedimentation rate (p=0.003 transverse), positive rheumatoid factor (p=0.002 alar), and neck pain (p = 0.004 alar). This first study of high-resolution MRI of these ligaments in RA showed high feasibility and relations with atlantoaxial subluxation, RA disease activity, and neck pain. The clinical usefulness of such MRI needs further evaluation. (orig.)

MRI of the transverse and alar ligaments in rheumatoid arthritis: feasibility and relations to atlantoaxial subluxation and disease activity

International Nuclear Information System (INIS)

Vetti, Nils; Kraakenes, Jostein; Roervik, Jarle; Espeland, Ansgar; Alsing, Rikke; Brun, Johan Gorgas; Gilhus, Nils Erik

2010-01-01

Dysfunctional transverse and alar craniovertebral ligaments can cause instability and osseous destruction in rheumatoid arthritis (RA). This study examined (1) the feasibility of high-resolution magnetic resonance imaging (MRI) of these ligaments in RA and (2) the relation between ligament high-signal changes and atlantoaxial subluxation and RA duration/severity. Consecutive RA patients (n=46) underwent clinical examination, functional radiography, and high-resolution MRI. Two blinded radiologists rated MRI image quality, graded ligament high-signal changes 0-3 on proton-weighted sequences using an existing grading system, and assessed cervical spine rheumatic changes on short tau inversion recovery images. Agreement was analyzed using kappa and relations using multiple logistic regression. MRI images had good quality in 42 (91.3%) of 46 patients and were interpretable in 44 (32 women and 12 men, median age/disease duration 60.4/9.1 years). MRI grades 2-3 changes of the transverse and alar ligaments showed moderate and good interobserver agreement (kappa 0.59 and 0.78), respectively, and prevalence 31.8% and 34.1%. Such ligament changes were more frequent with increasing anterior atlantoaxial subluxation (p=0.012 transverse, p=0.028 alar), higher erythrocyte sedimentation rate (p=0.003 transverse), positive rheumatoid factor (p=0.002 alar), and neck pain (p = 0.004 alar). This first study of high-resolution MRI of these ligaments in RA showed high feasibility and relations with atlantoaxial subluxation, RA disease activity, and neck pain. The clinical usefulness of such MRI needs further evaluation. (orig.)

MEMS-based non-rotatory circumferential scanning optical probe for endoscopic optical coherence tomography

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Xu, Yingshun; Singh, Janak; Siang, Teo Hui; Ramakrishna, Kotlanka; Premchandran, C. S.; Sheng, Chen Wei; Kuan, Chuah Tong; Chen, Nanguang; Olivo, Malini C.; Sheppard, Colin J. R.

2007-07-01

In this paper, we present a non-rotatory circumferential scanning optical probe integrated with a MEMS scanner for in vivo endoscopic optical coherence tomography (OCT). OCT is an emerging optical imaging technique that allows high resolution cross-sectional imaging of tissue microstructure. To extend its usage to endoscopic applications, a miniaturized optical probe based on Microelectromechanical Systems (MEMS) fabrication techniques is currently desired. A 3D electrothermally actuated micromirror realized using micromachining single crystal silicon (SCS) process highlights its very large angular deflection, about 45 degree, with low driving voltage for safety consideration. The micromirror is integrated with a GRIN lens into a waterproof package which is compatible with requirements for minimally invasive endoscopic procedures. To implement circumferential scanning substantially for diagnosis on certain pathological conditions, such as Barret's esophagus, the micromirror is mounted on 90 degree to optical axis of GRIN lens. 4 Bimorph actuators that are connected to the mirror on one end via supporting beams and springs are selected in this micromirror design. When actuators of the micromirror are driven by 4 channels of sinusoidal waveforms with 90 degree phase differences, beam focused by a GRIN is redirected out of the endoscope by 45 degree tilting mirror plate and achieve circumferential scanning pattern. This novel driving method making full use of very large angular deflection capability of our micromirror is totally different from previously developed or developing micromotor-like rotatory MEMS device for circumferential scanning.

Occult posterolateral rotatory dislocation of the elbow with olecranon fracture in a child: a case report

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Fujimori Takahito

2012-09-01

Full Text Available Abstract Introduction Acute posterolateral rotator elbow dislocation in a child is rare and can be easily misdiagnosed due to immaturity of the epiphysis. This is the first case of occult posterolateral rotator elbow dislocation in combination with an olecranon fracture. We report our experience with this case, which was not diagnosed correctly by plain radiographs. Case presentation An 11-year-old Asian boy suffered severe pain and swelling of his right elbow after his outstretched arm hit a car dashboard in a motor vehicle accident. Plain radiographs showed only a minimally displaced olecranon fracture and a tiny lateral epicondylar avulsion fracture. However, stress radiographs under general anesthesia revealed severe posterolateral rotatory instability. During surgery, we found that the cartilaginous lateral epicondylar apophysis was much larger than the epicondylar fragment on the radiographs. After the lateral epicondylar osteochondral fragment and lateral collateral ligament complex were fixed, the instability disappeared. Conclusion Our experience with this case shows that it is important to check for instability with pediatric elbow fractures, because a tiny avulsion fracture was able to cause severe posterolateral rotatory instability in a child.

Pediatric Patient with Incidental Os Odontoideum Safely Treated with Posterior Fixation Using Rod-Hook System and Preoperative Planning Using 3D Printer: A Case Report.

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Sakai, Toshinori; Tezuka, Fumitake; Abe, Mitsunobu; Yamashita, Kazuta; Takata, Yoichiro; Higashino, Kosaku; Nagamachi, Akihiro; Sairyo, Koichi

2017-05-01

Os odontoideum is often found incidentally. Surgical treatment is recommended for patients with atlantoaxial instability or neurologic deficits. Although various techniques have been used for C1-C2 fusion in adults, the use of these procedures in children is not widely accepted. We present a 12-year-old boy with incidental os odontoideum and obvious C1-C2 instability, in which bony union was achieved safely and successfully by posterior fixation using a rod-hook system and perioperative planning using a three-dimensional printer. At the 2-year follow-up, bone formation around the gap of the dens, which has been generally considered as pseudoarthrosis, was obtained after union of the posterior element of C1-C2. Georg Thieme Verlag KG Stuttgart · New York.

ASSESSMENT OF EFFECTIVENESS OF TB POSTING DURING THE COMPULSORY ROTATORY RESIDENTIAL INTERNSHIP (CRRI PROGRAMME

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Pradeep Aggarwal

2011-12-01

Full Text Available Research Question: What is the effectiveness of TB posting during the Compulsory Rotatory Residential Internship (CRRI programme? Objectives: To assess the effectiveness of TB posting during the CRRI programme. To find out the need of making Tuberculosis & Respiratory Diseases Department posting mandatory during CRRI Programme. Study Design: Cross Sectional study. Study Duration: 12 months i.e. 01st April 2009 till 31st March 2010 Participants: 90 students who joined the CRRI programme formed the study group. Out of these 90 interns only 57 (64% of them joined their two months Compulsory Rotatory Internship in the Department of Community Medicine and these were posted in Tuberculosis & Respiratory Diseases Department for 15 days. Methodology: A pre-designed pre-tested self-administered questionnaire was administered to the participants on the first day and last day of their posting in Tuberculosis & Respiratory Diseases Department. The results were analysed by using suitable statistical package. Results: The mean pre-test score was 28 (49.6% and the mean post-test score was 38 (61.5%. It was observed that there was a 27% improvement in the knowledge of the participants when the question about the year of launching of RNTCP programme in India was asked. A remarkable improvement (46% was found in the difference between pre and post-test knowledge of the participants when the questions like “Who are the DOTS providers” and “What is the colour coding of boxes for different categories of patients” were asked. A significant difference in the knowledge was found in the pre and post-test assessment in reference to Tuberculosis and its National Programm

Fixation distance and fixation duration to vertical road signs.

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Costa, Marco; Simone, Andrea; Vignali, Valeria; Lantieri, Claudio; Palena, Nicola

2018-05-01

The distance of first-fixation to vertical road signs was assessed in 22 participants while driving a route of 8.34 km. Fixations to road signs were recorded by a mobile eye-movement-tracking device synchronized to GPS and kinematic data. The route included 75 road signs. First-fixation distance and fixation duration distributions were positively skewed. Median distance of first-fixation was 51 m. Median fixation duration was 137 ms with a modal value of 66 ms. First-fixation distance was linearly related to speed and fixation duration. Road signs were gazed at a much closer distance than their visibility distance. In a second study a staircase procedure was used to test the presentation-time threshold that lead to a 75% accuracy in road sign identification. The threshold was 35 ms, showing that short fixations to a road signs could lead to a correct identification. Copyright © 2018 Elsevier Ltd. All rights reserved.

Surgical treatment of upper cervical spine injuries (c1-c2): experience in 26 patients

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Pasha, I.F.; Qureshi, M.A.; Khalique, A.B.; Afzal, W.; Qureshi, M.A.

2013-01-01

Objective: To describe the spectrum of operations in unstable upper cervical spinal injuries in (atlanto-axial) region at our unit. Study Design: A cross-sectional study. Place And Duration: Spine Unit, Department of Orthopedics, Combined Military Hospital (CMH), Rawalpindi from Jan 2001 to Dec 2008. Patients and Methods: Frequency of different kind of operations in 26 patients operated for upper cervical spinal injuries was reviewed. A performa was made for each patient and records were kept in a custom built Microsoft access database. Results: Average age of patients studied was 27 years with male pre dominance. Total 12(46%) patients had Atlanto-axial instability, 8(31%) had Hangman's fracture and 6(23%) patients had odontoid peg fracture. While 11(42%) patients had no neurological deficit according to American spinal injury association impairment scale (AIS-E) and 15(58%) had partial neurological deficit. The patients were divided into three groups. Group A had odontoid peg fracture, Group B had atlanto-axial instability and Group C had Hangman's fracture. The spine was approached posteriorly in 19(73(Yo) cases and anteriorly in 7(27%). Pedicle screw fixation was done in 6(23%) patients, odontoid peg screw fixation in 6(23%), Gallie's fusion in 5(19%), occipito-cervical fusion in 4(15%), posterior transarticular fixation in 3(12%), anterior transarticular fixation and decompression in others, 9(60%) patients improved neurologically postoperatively and there was no deterioration of neurological status. Nonunion in two (8%) cases and implant failure in one (4%) were complications. Conclusion: Upper cervical injuries (C1-C2) are rare and their management is complex, necessitating lot of experience for their management. Early diagnosis and appropriate treatment is essential for good outcome. Each injury has to be managed at its own merit and a single operation may not be appropriate in all situations. General guidelines can be drawn from our study for the

Usefulness of MRI in the diagnosis of atlanto-axial dislocation

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Nakamura, Ko; Fukui, Keiji; Sadamoto, Kazuhiko; Miki, Hitoshi; Niida, Akira; Sakaki, Saburo.

1988-08-01

We studied 14 cases of atlanto-axial dislocation (AAD) by means of a 0.5 Tesla superconductive magnetic resonance imaging (MRI) system using saturation recovery sequences (Tr: 500 msec, Te: 20 - 30 msec) with a 5 - 10 mm slice thickness, and directly evaluated the degree of the spinal-cord compression in flexion, neutral, and extension of the head on the midsagittal images. The patients ranged from 11 to 76 years of age, and 8 of the 14 were male. In all cases we could demonstrate the cord compression in various degrees by either the odontoid process or the posterior arch of the atlas. The spinal cords were compressed from ventral in flexion in 6 cases, from dorsal in flexion in 2 cases, from dorsal in extension in 2 cases, and from ventral in both flexion and extension in 2 cases each. In addition, syringomyelia could be revealed by MRI in combination with AAD in 2 cases. MRI is useful in revealing the direction and degree of spinal-cord compression in patients with AAD, and in evaluating combined diseases such as syringomyelia and Arnold-Chiari malformations.

Lateral atlanto-axial joint block for cervical headache

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Shantanu P Mallick

2013-01-01

Full Text Available The patient is a 32-year-old car mechanic, having chronic headache for three years affecting the left upper lateral part of the neck, suboccipital region, and scalp (VAS: 8/10, having a history of whiplash injury from a car accident three years ago, with a deep cut injury on the scalp. He was complaining of neck stiffness and pain during all neck movements and a burning pain in the entire left side of the neck and scalp. He was treated, using conservative methods, by Orthopedists, Neurologists, as well as Psychiatrists, and all investigations including computed tomography (CT of the brain, X-ray cervical spine, and all related blood reports were within normal limits. He was sent to the Pain Clinic for further assessment. Suspecting sympathetic mediated pain on the left side and upper cervical facet pain, he was given a diagnostic Stellate Ganglion Block, a Third Occipital Nerve block, and a fourth cervical medial branch block (MBB, which gave him good relief; by this the visual analog scale (VAS score reduced to 3/10. Yet, he was complaining of pain on a focal area on the left upper cervical spine corresponding to the C1-2 joint with lateral rotation on the left side. Subsequently it was decided that a diagnostic Atlanto-axial joint block under fluoroscopy would be carried out. This gave him very good relief from the cervicogenic headache.

Mandibular condylar fractures and acute atlanto-axial subluxation Part 2 A physiopathological factor for the cervical spine sprain.

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Cutilli, T; Corbacelli, A

2009-05-01

The aim of this study was to analyze the physiopathology of the acute cervical injure in the event of mandibular condylar fractures. As in the Part 1, 25 non-consecutive cases of condylar mandibular fractures (16 males and 9 females, mean age: 22.96/range 14-36 years) observed and treated in the Maxillofacial Surgery Department of the University of L'Aquila, have been studied. Types of fractures examined included: unilateral: 19 cases (solitary: 12; associated with other mandibular fractures: 7, homolateral: 2); bilateral: 6 cases (equivalent: 2, not equivalent: 4). A control group was constituted of 10 patients, 5 males and 5 females, aged from 19 to 24 years (mean range: 21.6) suffering from acute isolated cervical distorsion (whiplash). The study has been performed by means of the analysis of X-ray and computed tomography (CT)-CT/3D of the mandibular condylar regions, the occipital-atlanto-axial structures and the cervical region. In all the patients the following constant alterations that link up with these fractures have been observed: the rotation of atlas, the atlanto-axial subluxation and the derangement of the occipital-atlanto-epistropheal joint, homolateral to the side of the mandibular condylar fracture. The cervical spine shows the constant loss of physiological lordosis with hinge between C3 and C4. In the whiplash, as the authors have been able to assess in the control group, there are no alterations of occipital-atlanto-axial joint and the kinetic vector is placed on the longitudinal plane. In the mandibular condylar fractures the kinetic mechanism is completely different regarding the whiplash. The point of entry is the chin and the kinetic vector is oriented down-up, sometimes oblique in the opposite side. Subsequently the kinetic force is transmitted throughout the mandibular structure and causes the condylar or bicondylar fracture. The kinetic vector is placed before on the vertical plane, then on the horizontal plane and later on the vertical

[Effectiveness comparison of suspension fixation plus hinged external fixator and double plate internal fixation in treatment of type C humeral intercondylar fractures].

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Zhang, Jian; Lin, Xu; Zhong, Zeli; Wu, Chao; Tan, Lun

2017-07-01

To compare the effectiveness of suspension fixation plus hinged external fixator with double plate internal fixation in the treatment of type C humeral intercondylar fractures. Between January 2014 and April 2016, 30 patients with type C (Association for the Study of Internal Fixation, AO/ASIF) humeral intercondylar fractures were treated. Kirschner wire suspension fixation plus hinged external fixator was used in 14 cases (group A), and double plate internal fixation in 16 cases (group B). There was no significant difference in gender, age, injury cause, disease duration, injury side, and type of fracture between 2 groups ( P >0.05). There was no significant difference in operation time and hospitalization stay between 2 groups ( P >0.05). But the intraoperative blood loss in group A was significantly less than that in group B ( P internal fixation removal, the intraoperative blood loss, and VAS score at 1 day and 3 days after operation in group A were significant better than those in group B ( P external fixator and double plate internal fixation for the treatment of type C humeral intercondylar fractures have ideal outcome in elbow function. But the suspension fixation plus hinged external fixator is better than double plate internal fixation in intraoperative blood loss, postoperative VAS score, and time of internal fixation removal.

MRI of atlantoaxial subluxation; Correlating with plain X-ray films and CT findings

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Saikawa, Yuko; Nishi, Naoko; Saitoh, Yoko; Akimura, Rumiko; Sasaki, Taisuke; Yodono, Hiraku; Takekawa, Shoichi; Harata, Seikou; Sannohe, Akio (Hirosaki Univ., Aomori (Japan). School of Medicine)

1991-04-01

Twenty-three patients with atlantoaxial subluxation (14 with rheumatoid arthritis, one each with rheumatoid arthritis and Arnold-Chiari malformation, os odontoideum, Klippel-Feil syndrome, trauma, and 5 with unknown causes) were evaluated with MRI. We used 0.5 T MRI unit (RESONA; Yokogawa Medical Systems, Japan) and 1.5 T MRI unit (SMT 150; Shimazu, Japan) with head or flexible coils. We compared the usefulness of MRI with those of plain X-ray films and CT regarding several points. MRI provided better image of the soft tissue mass around the odontoid process, compression of cord or subarachnoid space than plain X-ray films and CT. Atlanto-odontoid distance on MRI is nearer to that on plain X-ray films than CT. MRI is useful in analyzing the anatomic details such as transverse ligament, alar ligament, tectorial membrane and thickened synovium. Both MRI and CT provided detailed bony changes. High correlation was observed between MRI grading of cord compression and the degree of myelopathy. (author).

Intrascleral IOL Fixation.

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Jacob, Soosan

2017-01-01

Intrascleral sutureless intraocular lens (IOL) fixation utilizes direct haptic fixation within the sclera in eyes with deficient capsular support. This has advantages of long-term stability, good control of tilt and decentration, and lesser pseudophakodonesis. This review summarizes various techniques for intrascleral haptic fixation, results, complications, adaptations in special situations, modifications of the technique, combination surgeries, and intrascleral capsular bag fixation techniques (glued capsular hook). Copyright 2017 Asia-Pacific Academy of Ophthalmology.

[Comparison of external fixation with or without limited internal fixation for open knee fractures].

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Li, K N; Lan, H; He, Z Y; Wang, X J; Yuan, J; Zhao, P; Mu, J S

2018-03-01

Objective: To explore the characteristics and methods of different fixation methods and prevention of open knee joint fracture. Methods: The data of 86 cases of open knee joint fracture admitted from January 2002 to December 2015 in Department of Orthopaedics, Affiliated Hospital of Chengdu University were analyzed retrospectively.There were 65 males and 21 females aged of 38.6 years. There were 38 cases treated with trans articular external fixation alone, 48 cases were in the trans articular external fixation plus auxiliary limited internal fixation group. All the patients were treated according to the same three stages except for different fixation methods. Observation of external fixation and fracture fixation, fracture healing, wound healing and treatment, treatment and related factors of infection control and knee function recovery. χ(2) test was used to analyze data. Results: Eleven patients had primary wound healing, accounting for 12.8%. Seventy-five patients had two wounds healed, accounting for 87.2%. Only 38 cases of trans articular external fixator group had 31 cases of articular surface reduction, accounting for 81.6%; Five cases of trans articular external fixator assisted limited internal fixation group had 5 cases of poor reduction, accounting for 10.4%; There was significant difference between the two groups (χ(2)=44.132, P external fixation group, a total of 23 cases of patients with infection, accounted for 60.5% of external fixation group; trans articular external fixation assisted limited internal fixation group there were 30 cases of patients with infection, accounting for the assistance of external fixator and limited internal fixation group 62.5%; There was significant difference between the two groups(χ(2)=0.035, P >0.05). Five cases of fracture nonunion cases of serious infection, patients voluntarily underwent amputation. The Lysholm Knee Scale: In the external fixation group, 23 cases were less than 50 points, accounting for 60

Fractures of the atlantoaxial complex in the elderly: assessment of radiological spectrum of fractures and factors influencing imaging diagnosis; Frakturen des Atlas und Axis bei aelteren Patienten: Untersuchung des Radiologischen Spektrums der Frakturen und bedeutsamer Faktoren fuer die Bildgebende Diagnostik

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Lomoschitz, F.M. [Universitaetsklinik fuer Radiodiagnostik, AKH Wien, Wien (Germany); Dept. of Radiology, Harborview Medical Center, Univ. of Washington, Seattle, WA (United States); Blackmore, C.C.; Linnau, K.F.; Mann, F.A. [Dept. of Radiology, Harborview Medical Center, Univ. of Washington, Seattle, WA (United States); Stadler, A. [Universitaetsklinik fuer Radiodiagnostik, AKH Wien, Wien (Germany)

2004-02-01

Objective: to describe patterns of atlantoaxial fractures in a population of consecutive elderly patients, including assessment of type, distribution and associated clinical and radiological findings, and to analyze any influence of the causative trauma mechanism on the individual fracture pattern. Materials and methods: the distribution and type of 123 atlantoaxial fractures in 95 subjects older than 65 years (range: 65-102; mean age: 79 years) were retrospectively assessed. For each subject, trauma mechanism and clinical and neurological status were recorded at admission. Initial imaging studies of the cervical spine were reviewed. Preexistent degenerative changes were assessed and the atlantoaxial fractures classified. Data were evaluated for the frequency of different types of fractures of C1 and C2 and for accompanying fractures of cervical vertebrae or the occipital condyles, respectively. Results: the majority of patients with injuries of the atlantoaxial complex had fractures of C2 (90 of 95, 95%). A large proportion of these patients (67 of 90, 74%) had odontoid fractures. An isolated fracture of C1 was present in only 5 (5%) patients. Associated fractures of the occipital condyles or other cervical vertebrae were rare (10 of 95, 11%). The main trauma mechanism for atlantoaxial injuries was a fall (56 of 95, 59%). Elderly patients injured in motor vehicle accidents were more likely to have isolated fractures of C2 and Type III fractures of the odontoid (p < 0.02). Conclusion: in elderly patients, fractures of the atlantoaxial complex are mainly caused by falls and almost always involve C2. The trauma mechanism influences the fracture pattern (orig.) [German] Untersuchung von Frakturen des Atlas (C1) und Axis (C2) in einer konsekutiven Population aelterer Patienten ({>=} 65 Jahre) hinsichtlich Fraktur-Typus, -Haeufigkeit, und -Kombinationen, und Analyse von assoziierter Klinik sowie Einfluss von unfall-ursaechlichen Faktoren auf Frakturen des atlanto

REVISION ANKLE SYNDESMOSIS FIXATION - FUNCTIONAL OUTCOME AFTER TIGHTROPE ® FIXATION

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Sendhilvelan Rajagopalan

2016-07-01

Full Text Available BACKGROUND Syndesmotic disruptions are often seen in ankle fractures. Malreduction of these fractures can result in arthritis and instability. A proportion of these patients with malreduction require revision fixation. This study presents the results of revision fixation in such patients, using the Ankle TightRope ® (Arthrex system. METHODS Between January 2000 to December 2009, 124 patients who underwent ankle fracture fixations with syndesmotic stabilisation were analysed. Out of 124 patients, 8 patients were diagnosed with failure of primary stabilisation (based on radiological and clinical criteria and subjected to revision fixation using the Ankle TightRope ® (Arthrex system. Followup was done at periodic time intervals of 3, 6 and 12 months. Both clinical and radiological assessment was performed. Complications and duration of hospital stay was recorded. Functional evaluation was performed using the American Orthopaedic Foot and Ankle Society (AOFAS scoring system. RESULTS Five patients had good results, one satisfactory and two had poor outcomes. CONCLUSIONS Ankle TightRope ® fixation is an alternative method of stabilisation in patients who require revision syndesmosis fixation. Further studies are required to evaluate this method of revision stabilisation as compared to screws.

The long time follow-up of craniovertebral junction fixation in patients with rheumatoid arthritis

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Kadir Kotil

2012-01-01

Full Text Available Background: Rheumatoid arthritis (RA can have very destructive effects, especially in the cervical spine. Bone quality is poor in these patients. The purpose of this study is to evaluate the feasibility of fusion and accuracy of fluoroscopy in cervical transpedicular fixation (CPF in a standardized clinical protocol for RA patients. Materials and Methods: 96 pedicles of 15 patients operated between January 2000 and ay 2010 due to atlanto-axial and subaxial cervical subluxation were investigated for post-operative malposition of the transpedicular screws. Three-dimensional computed tomography was used as a useful tool in preoperative planning and in transarticular or transpedicular screw placement with the free hand technique in the cervical spine of RA patients. Fixation and reduction with fusion was performed in all of the patients, and autogrefts from iliac wing were used for fusion. Ranawat′s and Nurick scales were used to assess the results. All screws were evaluated by Kast′s criteria. Fusion or stability was evaluated on plain radiographs taken 3 weeks and 6, 12 and 60 months after the surgery. Results: Female to male ratio was 6/9. The mean age at the time of surgery was 57.4 years (range 44-72 years. Five of the patients were operated for both C1-2 and subaxial subluxation. Two of the 15 patients had only C1-2 subluxation and the remaining eight patients had only subaxial cervical subluxation. The screws were at their correct places in 84 pedicles (87.5.% while minor breach was detected in 9 (10.9%. According to Ranawat′s criteria, seven patients remained the same, and eight patients showed improvement. Instrumentation failure, loss of reduction or non-union was not observed at the final follow-up (average 31.5 months; range 24-60 months. Conclusion: CPF provides a very strong three column stabilization and solid fusion in the osteoporotic vertebrae, but also carries a risk of vascular injury without nerve damage or in the RA

Hemodynamic Alteration of the Cervical Venous Circulation in a Patient Suffering From Atlantoaxial Degenerative Osteoarthritis with Subluxation: A Case Report

International Nuclear Information System (INIS)

Lee, Hyun; Jang, Yi Sheng; Lee, Sang Jin; Hwang, Byeong Wook; Lee, Sang Ho; Choi, Won Gyu

2010-01-01

A 52-year-old female patient was admitted to our hospital with severe occipitocervical pain. The radiographic examination revealed degenerative osteoarthritis and subluxation of the right atlantoaxial joint. Her pain was completely and immediately relieved after occipitocervical reduction and fusion. The marked dilatation of the extradural venous plexus around the vertebral artery and the enlarged deep cervical veins seen on the preoperative MR images had returned to normal dimensions on the postoperative MR images, and this explained the observed rapid pain relief. We report here on this case together with a review of the relevant literature

[Fusion of reconstructed titanic plate, vertebral pedical screws and autogenous granulated cancellous bone graft in posterior occipitocervical region].

Science.gov (United States)

Zhong, Dejun; Song, Yueming

2006-08-01

To explore the technique of fusing the reconstructed titanic plate, the C2 pedical screws, and the autogenous granulated cancellous bone graft in the occipitocervical region. From April 2002 to January 2005, 19 patients aged 31-67 years with occipitocervical instability underwent the occipitocervical fusion using the reconstructed plate, C2 pedical screws, and autogenous granulated cancellous bone graft. Of the patients, 8 had complex occipitocervical deformity, 8 had old atlantoaxial fracture and dislocation, 2 had rheumatoid arthritis and anterior dislocation of the atlantoaxial joint, and 1 had cancer of the deltoid process of the axis. No complication occurred during and after operation. The follow-up for an average of 16 months in 19 patients showed that all the patients achieved solid bony fusion in the occipitocervical region. There was no broken plate, broken screw, looseness of the internal fixation or neurovascular injury. The fixation of the C2 pedical screws with the reconstructed titanic plate is reliable, the insertion is easy, and the autogenous granulated cancellous bone graft has a high fusion rate, thus resulting in a satisfactory effect in the occipitocervical fusion.

Anesthetic management of a child with Down’s Syndrome having atlanto axial instability

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Basant Bhattarai

2009-01-01

Full Text Available Down's syndrome is the most commonly encountered congenital anomaly in medical practice. These patients are of special concern to medical practice because of their associated problems with regard to respiratory, cardiovascular and other systemic problems. As these patients present for repeated surgeries like dental extraction, facial reconstruction and fixation of cervical spine, these patients pose challenges to the anesthesiologist because of their unique set of problems, namely atlantoaxial instability, small trachea, congenital heart disease and repeated chest infections due to lowered immunity. Their reactivity to inhalational anesthetics and atropine is variable. Here we present an interesting case report of a child with Down's syndrome who presented with atlantoaxial instability for MRI of cervical spine under general anesthesia. KeyWords:atlanto axial instability, down’s syndrome, trisomy 21

Compressible Analysis of Bénard Convection of Magneto Rotatory Couple-Stress Fluid

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Mehta C.B.

2018-02-01

Full Text Available Thermal Instability (Benard’s Convection in the presence of uniform rotation and uniform magnetic field (separately is studied. Using the linearized stability theory and normal mode analyses the dispersion relation is obtained in each case. In the case of rotatory Benard’s stationary convection compressibility and rotation postpone the onset of convection whereas the couple-stress have duel character onset of convection depending on rotation parameter. While in the absence of rotation couple-stress always postpones the onset of convection. On the other hand, magnetic field on thermal instability problem on couple-stress fluid for stationary convection couple-stress parameter and magnetic field postpones the onset of convection. The effect of compressibility also postpones the onset of convection in both cases as rotation and magnetic field. Graphs have been plotted by giving numerical values to the parameters to depict the stationary characteristics. Further, the magnetic field and rotation are found to introduce oscillatory modes which were non-existent in their absence and then the principle of exchange of stability is valid. The sufficient conditions for non-existence of overstability are also obtained.

Comparison of Outcomes of Operatively Treated Bicondylar Tibial Plateau Fractures by External Fixation and Internal Fixation

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CC Chan

2012-03-01

Full Text Available The outcome of bicondylar tibial plateau fractures treated with either external fixation (35 patients or internal fixation (24 patients was reviewed. Outcome measures included the Rasmussen score, clinical complications, development of osteoarthritis and the requirement for total knee replacement (TKR. Twenty-two (92% anatomical reductions were achieved in the internal fixation group compared to 27 (77% in the external fixation group. Infective complications were more common in the external fixation group (9 patients, 26% due to pin tract infection. There were no deep infections in the internal fixation group. The mean Rasmussen score was not significantly different (mean score 32 in external fixation and 29 in internal fixation between the two groups and the incidence of osteoarthritis was the same in both groups. Four patients in the external fixation group underwent a TKR compared to 5 patients in the internal fixation group. Bicondylar tibial plateau fractures have similar outcomes following external or internal fixation.

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

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Kazunori Hirasawa

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

Eighth international congress on nitrogen fixation

Energy Technology Data Exchange (ETDEWEB)

1990-01-01

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

Isotopes in biological dinitrogen fixation

Energy Technology Data Exchange (ETDEWEB)

1978-10-01

Nineteen papers were presented at the conference. Some topics discussed are as follows: biochemistry and genetics of dinitrogen fixation; genetics of the Rhizobium-legume symbiosis and of the nitrogen-fixing bacteria; studies on nonsymbiotic dinitrogen fixation in grass-bacteria associations and blue--green algae; use of /sup 15/N and /sup 13/N for the assay of dinitrogen fixation; effects of management practices on dinitrogen fixation; economy of C and N in nitrogen-fixing legumes; and survey of international and national programs on dinitrogen fixation. (HLW)

Surgical Management in Cervical Spondylotic Myelopathy Due to Alkaptonuria.

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Karadag, Ali; Sandal, Evren; Middlebrooks, Erik H; Senoglu, Mehmet

2018-05-01

Ochronotic arthropathy related to alkaptonuria is a rare condition. Cervical spine involvement with myelopathic features has been even more rarely described, particularly related to atlantoaxial instability. As such, little is known about the optimal surgical management in these patients. We described the first case, to our knowledge, of a patient with alkaptonuria and related cervical spondylotic myelopathy from pannus formation at the atlantoaxial joint. We describe our choices in surgical management of this rare condition in a patient with an excellent outcome. Ochronotic cervical spondylotic myelopathy is a rare condition and may require additional considerations in surgical treatment compared to more common causes of cervical spondylotic myelopathy. In our case, we elected for decompression with posterior occipitocervical screw fixation and were able to achieve neurologic recovery with no complications, currently at 2-year follow-up. Copyright © 2018 Elsevier Inc. All rights reserved.

Comparison of skeletal stability after sagittal split ramus osteotomy among mono-cortical plate fixation, bi-cortical plate fixation, and hybrid fixation using absorbable plates and screws.

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Ueki, Koichiro; Moroi, Akinori; Yoshizawa, Kunio; Hotta, Asami; Tsutsui, Takamitsu; Fukaya, Kenichi; Hiraide, Ryota; Takayama, Akihiro; Tsunoda, Tatsuta; Saito, Yuki

2017-02-01

The purpose of this study was to examine skeletal stability and plate breakage after sagittal split ramus osteotomy (SSRO) with the mono-cortical plate fixation, bi-cortical plate fixation, and hybrid fixation techniques using absorbable plates and screws. A total of 76 Japanese patients diagnosed with mandibular prognathism with and without maxillary deformity were divided into 3 groups randomly. A total of 28 patients underwent SSRO with mono-cortical plate fixation, 23 underwent SSRO with bi-cortical plate fixation, and 25 underwent SSRO with hybrid fixation. Skeletal stability and horizontal condylar angle were analyzed by axial, frontal, and lateral cephalograms from before the operation to 1 year postoperatively. Breakage of the plate and screws was observed by 3-dimensional computed tomography (3DCT) immediately after surgery and after 1 year. Although there was a significant difference between the mono-cortical plate fixation group and hybrid fixation group regarding right MeAg in T1 (P = 0.0488) and occlusal plane in T1 (P = 0.0346), there were no significant differences between the groups for the other measurements in each time interval. In 2 cases, namely, 6 sides in the mono-cortical plate fixation group, breakage of the absorbable plate was found by 3DCT. However, there was no breakage in the bi-cortical plate fixation group and hybrid fixation group. This study results suggested that there were no significant differences in the postoperative skeletal stability among the 3 groups, and bi-cortical fixation as well as hybrid fixation was a reliable and useful method to prevent plate breakage even if an absorbable material was used. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Vibration analysis of carbon nanotubes-based zeptogram masses sensors and taking into account their rotatory inertia

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Azrar A.

2018-01-01

Full Text Available In this research work, the transverse vibration behaviour of single-walled carbon nanotubes (SCNT based mass sensors is studied using the Timoshenko beam and nonlocal elasticity theories. The nonlocal constitutive equations are used in the formulations and the CNT with different lengths, attached mass (viruses and bacteria and the general boundary conditions are considered. The dimensionless frequencies and associated modes are obtained for one and two attached masses and different boundary conditions. The effects of transverse shear deformation and rotatory inertia, nonlocal parameter, length of the carbon nanotubes, and attached mass and its location are investigated in detail for each considered problem. The relationship between the frequencies and mode shapes of the sensor and the attached zeptogramme masses are obtained. The sensing devices for biological objects including viruses and bacteria can be elaborated based on the developed sensitivity and frequency shift methodological approach.

Guide to radiation fixatives

International Nuclear Information System (INIS)

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

1983-11-01

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

Piezosurgery or conventional rotatory instruments for inferior third molar extractions?

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Piersanti, Luigi; Dilorenzo, Matteo; Monaco, Giuseppe; Marchetti, Claudio

2014-09-01

The purpose of this study was to compare the discomfort and surgical outcomes of a piezosurgery device with those of rotatory instruments in lower third molar extraction. A split-mouth, randomized, unblinded clinical study was designed; the 2 molars had to have the same extraction difficulty score. The test side was extracted using a piezosurgery technique and the control side was extracted using a conventional handpiece. The primary endpoint was patient discomfort evaluated with the Postoperative Symptom Severity (PoSSe) scale, which was administered to each patient; secondary endpoints were pain, trismus, swelling, and surgical time evaluation. Paired-samples t test and repeated-measures analysis of variance were used to compare outcomes within patients. Ten consecutive patients (6 female, 4 male; mean age, 22.4 ± 2.3 yr) were recruited. The total score on the PoSSe scale was significantly lower for piezosurgery compared with the conventional rotating handpiece (24.7 ± 10.3 vs 36.0 ± 7.6; t = -4.27; P = .002). Moreover, postoperative swelling 1 week after surgery was significantly lower for piezosurgery than for the conventional rotating handpiece (2.75 ± 0.23 vs 3.1 ± 0.39 cm; t = -2.63; P = .027). Piezosurgery was associated with less postoperative discomfort and yielded better results for swelling. Piezosurgery seems to be a good technique in daily surgical practice, especially if applied in the critical steps in which safety and respect for soft tissue, bone, and nerves are necessary. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Biomechanics of lumbar cortical screw-rod fixation versus pedicle screw-rod fixation with and without interbody support.

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Perez-Orribo, Luis; Kalb, Samuel; Reyes, Phillip M; Chang, Steve W; Crawford, Neil R

2013-04-15

Seven different combinations of posterior screw fixation, with or without interbody support, were compared in vitro using nondestructive flexibility tests. To study the biomechanical behavior of a new cortical screw (CS) fixation construct relative to the traditional pedicle screw (PS) construct. The CS is an alternative to the PS for posterior fixation of the lumbar spine. The CS trajectory is more sagittally and cranially oriented than the PS, being anchored in the pars interarticularis. Like PS fixation, CS fixation uses interconnecting rods fastened with top-locking connectors. Stability after bilateral CS fixation was compared with stability after bilateral PS fixation in the setting of intact disc and with direct lateral interbody fixation (DLIF) or transforaminal lateral interbody fixation (TLIF) support. Standard nondestructive flexibility tests were performed in cadaveric lumbar specimens, allowing non-paired comparisons of specific conditions from 28 specimens (4 groups of 7) within a larger experiment of multiple hardware configurations. Condition tested and group from which results originated were as follows: (1) intact (all groups); (2) with L3-L4 bilateral PS-rods (group 1); (3) with bilateral CS-rods (group 2); (4) with DLIF (group 3); (5) with DLIF + CS-rods (group 4); (6) with DLIF + PS-rods (group 3); (7) with TLIF + CS-rods (group 2), and (8) with TLIF + PS-rods (group 2). To assess spinal stability, the mean range of motion, lax zone, and stiff zone at L3-L4 were compared during flexion-extension, lateral bending, and axial rotation. With intact disc, stability was equivalent after PS-rod and CS-rod fixation, except that PS-rod fixation was stiffer during axial rotation. With DLIF support, there was no significant difference in stability between PS-rod and CS-rod fixation. With TLIF support, PS-rod fixation was stiffer than CS-rod fixation during lateral bending. Bilateral CS-rod fixation provided about the same stability in cadaveric specimens

Results of application of external fixation with different types of fixators

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Grubor Predrag

2012-01-01

Full Text Available Introduction. Extra-focal or external fixation is the method of fracture fixation through the healthy part of the bone using pins or wires. Objective. The aim was to determine which external splints (Ortofix, Mitković, Charnley and Ilizarov had the best biomechanical properties in primary stabilization of spiral, transverse and commutative bone fractures. Methods. To determine the investigation methodology of biomechanical characteristics of the external fixator we used mathematical and computer simulator (software, juvidur physical model and clinical examination. Results. Values of advancing fragments in millimetres obtained by the study of mathematical and computer simulator (software: Charnley - 0.080 mm, Mitković M 20 - 0.785 mm, Ilizarov - 2.245 mm and Ortofix - 1.400 mm. In testing the juvidur model the following values were obtained: the external fixator Mitković M20 - 1.380 mm, Ortofix - 1.470 mm, Ilizarov - 2.410 mm, and Charnley - 2.510 mm. Clinical research of biomechanical characteristics of the effect of vertical force yielded the following results: Mitković M20 - 0.89 mm, Ortofix - 0.14 mm, Charnley - 0.80 mm and Ilizarov - 1.23 mm. Conclusion. When determining the total number of the stability test splints under the effect of vertical force (compression and force effect in antero-posterior, later-lateral plane of cross, spiral and comminuted long bone fractures, the best unified biomechanical stability was shown by the following external fixators: firstly, Mitković M20 (0.93mm, secondly, Charnley fixator (1.14 mm, thirdly, Ortofix (1.22 mm, and fourthly, Ilizarov (1.60 mm.

Biomechanical Evaluation of Standard Versus Extended Proximal Fixation Olecranon Plates for Fixation of Olecranon Fractures.

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Boden, Allison L; Daly, Charles A; Dalwadi, Poonam P; Boden, Stephanie A; Hutton, William C; Muppavarapu, Raghuveer C; Gottschalk, Michael B

2018-01-01

Small olecranon fractures present a significant challenge for fixation, which has resulted in development of plates with proximal extension. Olecranon-specific plates with proximal extensions are widely thought to offer superior fixation of small proximal fragments but have distinct disadvantages: larger dissection, increased hardware prominence, and the increased possibility of impingement. Previous biomechanical studies of olecranon fracture fixation have compared methods of fracture fixation, but to date there have been no studies defining olecranon plate fixation strength for standard versus extended olecranon plates. The purpose of this study is to evaluate the biomechanical utility of the extended plate for treatment of olecranon fractures. Sixteen matched pairs of fresh-frozen human cadaveric elbows were used. Of the 16, 8 matched pairs received a transverse osteotomy including 25% and 8 including 50% of the articular surface on the proximal fragment. One elbow from each pair was randomly assigned to a standard-length plate, and the other elbow in the pair received the extended-length plate, for fixation of the fracture. The ulnae were cyclically loaded and subsequently loaded to failure, with ultimate load, number of cycles, and gap formation recorded. There was no statistically significant difference between the standard and extended fixation plates in simple transverse fractures at either 25% or 50% from the proximal most portion of the articular surface of the olecranon. Standard fixation plates are sufficient for the fixation of small transverse fractures, but caution should be utilized particularly with comminution and nontransverse fracture patterns.

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

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

2016-12-20

Objective: To make a systematic assessment of the complications of open reduction and internal fixation versus external fixation for unstable distal radius fractures. Method: A computer-based online search of PubMed, ScienceDirect, EMBASE, BIOSIS, Springer and Cochrane Library were performed.The randomized and controlled trials of open reduction and internal fixation versus external fixation for unstable distal radius fractures were collected.The included trials were screened out strictly based on the criterion of inclusion and exclusion.The quality of included trials was evaluated.RevMan 5.0 was used for data analysis. Result: A total of 17 studies involving 1 402 patients were included.There were 687 patients with open reduction and internal fixation and 715 with external fixation.The results of Meta-analysis indicated that there were statistically significant differences with regard to the postoperatively total complications, infection, malunion, tendon rupture ( I 2 =8%, RR =0.77(95% CI 0.65-0.91, Z =3.10, P 0.05). Conclusion: Postoperative complications are present in both open reduction and internal fixation and external fixation.Compared with external fixation, open reduction and internal fixation is lower in total complications postoperatively, infection and malunion, but external fixation has lower tendon rupture incidence.

Effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures.

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Han, L R; Jin, C X; Yan, J; Han, S Z; He, X B; Yang, X F

2015-03-31

This study compared the efficacy between external fixator combined with palmar T-plate internal fixation and simple plate internal fixation for the treatment of comminuted distal radius fractures. A total of 61 patients classified as type C according to the AO/ASIF classification underwent surgery for comminuted distal radius fractures. There were 54 and 7 cases of closed and open fractures, respectively. Moreover, 19 patients received an external fixator combined with T-plate internal fixation, and 42 received simple plate internal fixation. All patients were treated successfully during 12-month postoperative follow-up. The follow-up results show that the palmar flexion and dorsiflexion of the wrist, radial height, and palmar angle were significantly better in those treated with the external fixator combined with T-plate compared to those treated with the simple plate only (P 0.05). Hence, the effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures was satisfactory. Patients sufficiently recovered wrist, forearm, and hand function. In conclusion, compared to the simple T-plate, the external fixator combined with T-plate internal fixation can reduce the possibility of the postoperative re-shifting of broken bones and keep the distraction of fractures to maintain radial height and prevent radial shortening.

CSF coccidioides complement fixation

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... this page: //medlineplus.gov/ency/article/003526.htm CSF coccidioides complement fixation test To use the sharing features on this page, please enable JavaScript. CSF coccidioides complement fixation is a test that checks ...

Complement fixation test to C burnetii

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... complement fixation test; Coxiella burnetii - complement fixation test; C burnetii - complement fixation test ... a specific foreign substance ( antigen ), in this case, C burnetii . Antibodies defend the body against bacteria, viruses, ...

Sutureless Intrascleral Fixated Intraocular Lens Implantation.

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Karadag, Remzi; Celik, Haci Ugur; Bayramlar, Huseyin; Rapuano, Christopher J

2016-08-01

To review sutureless intrascleral intraocular lens (IOL) fixation methods. Review of published literature. Sutureless intrascleral IOL fixation methods are newer and have been developed to eliminate the suture-related complications of sutured scleral fixation methods such as suture-induced inflammation or infection and IOL dislocation or subluxation due to suture degradation or suture breakage. Sutureless intrascleral fixation methods aim for intrascleral haptic fixation to achieve stability of the IOL. Various methods of sutureless scleral fixation have been described. Using a needle, a blade, or a trochar, sclerostomies are created in all techniques for intraocular access. Some surgeons prefer to create scleral tunnels, whereas others use scleral flaps for scleral fixation of haptics. The stability of IOLs is attained by the scar tissue formed around the haptics. Short-term results of these new methods are acceptable; studies including more cases with longer follow-up are needed to determine their long-term success. [J Cataract Refract Surg. 2016;32(9):586-597.]. Copyright 2016, SLACK Incorporated.

Transient improvements in fixational stability in strabismic amblyopes following bifoveal fixation and reduced interocular suppression.

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Raveendran, Rajkumar Nallour; Babu, Raiju J; Hess, Robert F; Bobier, William R

2014-03-01

To test the hypothesis that fixational stability of the amblyopic eye in strabismics will improve when viewing provides both bifoveal fixation and reduced inter-ocular suppression by reducing the contrast to the fellow eye. Seven strabismic amblyopes (Age: 29.2 ± 9 years; five esotropes and two exotropes) showing clinical characteristics of central suppression were recruited. Interocular suppression was measured by a global motion task. For each participant, a balance point was determined which defined contrast levels for each eye where binocular combination was optimal (interocular suppression minimal). When the balance point could not be determined, this participant was excluded. Bifoveal fixation was established by ocular alignment using a haploscope. Participants dichoptically viewed similar targets (a cross of 2.3° surrounded by a square of 11.3°) at 40 cm. Target contrasts presented to each eye were either high contrast (100% to both eyes) or balanced contrast (attenuated contrast in the fellow fixing eye). Fixation stability was measured over a 5 min period and quantified using bivariate contour ellipse areas in four different binocular conditions; unaligned/high contrast, unaligned/balance point, aligned/high contrast and aligned/balance point. Fixation stability was also measured in six control subjects (Age: 25.3 ± 4 years). Bifoveal fixation in the strabismics was transient (58.15 ± 15.7 s). Accordingly, fixational stability was analysed over the first 30 s using repeated measures anova. Post hoc analysis revealed that for the amblyopic subjects, the fixational stability of the amblyopic eye was significantly improved in aligned/high contrast (p = 0.01) and aligned/balance point (p suppression. However, once initiated, bifoveal fixation is transient with the strabismic eye drifting away from foveal alignment, thereby increasing the angle of strabismus. © 2014 The Authors Ophthalmic & Physiological Optics © 2014 The College of Optometrists.

[Treatment of pediatric distal femur fractures by external fixator combined with limited internal fixation].

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Wei, Sheng-wang; Shi, Zhan-ying; Hu, Ju-zheng; Wu, Hao

2016-03-01

To discuss the clinical effects of external fixator combined with limited internal fixation in the treatment of pediatric distal femur fractures. From January 2008 to June 2014, 17 children of distal femur fractures were treated by external fixator combined with limited internal fixation. There were 12 males and 5 females, aged from 6 to 13 years old with an average of 10.2 years, ranged in the course of disease from 1 h to 2 d. Preoperative diagnoses were confirmed by X-ray films in all children. There were 11 patients with supracondylar fracture , and 6 patients with intercondylar comminuted fracture. According to AO/ASIF classification, 9 fractures were type A1, 5 cases were type A2,and 3 cases were type C1. The intraoperative and postoperative complications, postoperative radiological examination, lower limbs length and motion of knee joints were observed. Knee joint function was assessed by KSS score. All the patients were followed up from 6 to 38 months with an average of 24.4 months. No nerve or blood vessel injury was found. One case complicated with the external fixation loosening, 2 cases with the infection of pin hole and 3 cases with the leg length discrepancy. Knee joint mobility and length measurement (compared with the contralateral), the average limited inflexion was 10 degrees (0 degrees to 20 degrees), the average limited straight was 4 degrees (0 degrees to 10), the average varus or valgus angle was 3 degrees (0 degrees to 5 degrees). KSS of the injured side was (96.4 +/- 5.0) points at final follow-up, 16 cases got excellent results and 1 good. All fractures obtained healing and no epiphyseal closed early was found. External fixator combined with limited internal fixation has advantages of simple operation, reliable fixation, early functional exercise in treating pediatric distal femurs fractures.

Comparison of screw fixation with elastic fixation methods in the treatment of syndesmosis injuries in ankle fractures.

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Seyhan, Mustafa; Donmez, Ferdi; Mahirogullari, Mahir; Cakmak, Selami; Mutlu, Serhat; Guler, Olcay

2015-07-01

17 patients with ankle syndesmosic injury were treated with a 4.5mm single cortical screw fixation (passage of screw 4 cortices) and 15 patients were treated with single-level elastic fixation material. All patients were evaluated according to the AOFAS ankle and posterior foot scale at the third, sixth and twelfth months after the fixation. The ankle range of movement was recorded together with the healthy side. The Student's t test was used for statistical comparisons. No statistical significant difference was observed between the AOFAS scores (p>0.05). The range of dorsiflexion and plantar flexion motion of the elastic fixation group at the 6th and 12th months were significantly better compared to the screw fixation group (pankle syndesmosis injuries. The unnecessary need of a second surgical intervention for removal of the fixation material is another advantageous aspect of this method of fixation. Copyright © 2015. Published by Elsevier Ltd.

External fixation combined with delayed internal fixation in treatment of tibial plateau fractures with dislocation.

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Tao, Xingguang; Chen, Nong; Pan, Fugen; Cheng, Biao

2017-10-01

The aim of this study was to evaluate the clinical efficacy of external fixation, delayed open reduction, and internal fixation in treating tibial plateau fracture with dislocation.Clinical data of 34 patients diagnosed with tibial plateau fracture complicated with dislocation between January 2009 and May 2015 were retrospectively analyzed. Fifteen patients in group A underwent early calcaneus traction combined with open reduction and internal fixation and 19 in group B received early external fixation combined with delayed open reduction and internal fixation. Operation time, postoperative complication, bone healing time, knee joint range of motion, initial weight-bearing time, Rasmussen tibial plateau score, and knee function score (HSS) were statistically compared between 2 groups.The mean follow-up time was 18.6 months (range: 5-24 months). The mean operation time in group A was 96 minutes, significantly longer than 71 minutes in group B (P  .05). In group A, initial weight-bearing time in group A was (14.0 ± 3.6) weeks, significantly differing from (12.9 ± 2.8) weeks in group B (P  0.05). Rasmussen tibial plateau score in group A was slightly lower than that in group B (P > .05). The excellent rate of knee joint function in group A was 80% and 84.21% in group B (P > .05).External fixation combined with delayed open reduction and internal fixation is a safer and more efficacious therapy of tibial plateau fracture complicated with dislocation compared with early calcaneus traction and open reduction and internal fixation.

Management and follow up of tibial plateau fractures by ′T′ clamp external fixator and limited internal fixation

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Thimmegowda M

2005-01-01

Full Text Available Background: Tibial plateau fractures are difficult to treat especially when soft tissue is compromised by open reduction and internal fixation. Many methods have be1en tried in the past to manage these cases of which external fixation were shown to be effective as they limit the soft tissue and wound complications. Methods: Complex tibial plateau fractures of sixteen patients were treated by closed reduction, fixation of articular fragments by screws and application of unilateral external fixator. The external fixator was kept in place till fracture united clinically and radiologically. The patients were followed up for at least one year to assess the function of the knee joint Results: The average duration of external fixation was 13 weeks. All the fractures healed. Pin track infection (five patients and instability (six patients of the knee were encountered with this procedure. The average duration of follow up was 62 weeks. The mean range of motion was 1250 arc. The IOWA knee score averaged 90.3 points. Conclusions: External fixation with limited internal fixation may be effective in the management of complex tibial plateau fractures which requires further support from studies with large sample size. ′T′ clamp external fixation with limited Internal fixation is the procedure of choice when alignment, stability, early mobilisation is required in a soft tissue compromised tibial plateau fractures.

A Meta-Analysis for Postoperative Complications in Tibial Plafond Fracture: Open Reduction and Internal Fixation Versus Limited Internal Fixation Combined With External Fixator.

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Wang, Dong; Xiang, Jian-Ping; Chen, Xiao-Hu; Zhu, Qing-Tang

2015-01-01

The treatment of tibial plafond fractures is challenging to foot and ankle surgeons. Open reduction and internal fixation and limited internal fixation combined with an external fixator are 2 of the most commonly used methods of tibial plafond fracture repair. However, conclusions regarding the superior choice remain controversial. The present meta-analysis aimed to quantitatively compare the postoperative complications between open reduction and internal fixation and limited internal fixation combined with an external fixator for tibial plafond fractures. Nine studies with 498 fractures in 494 patients were included in the present study. The meta-analysis found no significant differences in bone healing complications (risk ratio [RR] 1.17, 95% confidence interval [CI] 0.68 to 2.01, p = .58], nonunion (RR 1.09, 95% CI 0.51 to 2.36, p = .82), malunion or delayed union (RR 1.24, 95% CI 0.57 to 2.69, p = .59), superficial (RR 1.56, 95% CI 0.43 to 5.61, p = .50) and deep (RR 1.89, 95% CI 0.62 to 5.80) infections, arthritis symptoms (RR 1.20, 95% CI 0.92 to 1.58, p = .18), or chronic osteomyelitis (RR 0.31, 95% CI 0.05 to 1.84, p = .20) between the 2 groups. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Overcoming fixation with repeated memory suppression.

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

2015-01-01

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

Eighth international congress on nitrogen fixation. Final program

Energy Technology Data Exchange (ETDEWEB)

1990-12-31

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

Modeling fixation locations using spatial point processes.

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Barthelmé, Simon; Trukenbrod, Hans; Engbert, Ralf; Wichmann, Felix

2013-10-01

Whenever eye movements are measured, a central part of the analysis has to do with where subjects fixate and why they fixated where they fixated. To a first approximation, a set of fixations can be viewed as a set of points in space; this implies that fixations are spatial data and that the analysis of fixation locations can be beneficially thought of as a spatial statistics problem. We argue that thinking of fixation locations as arising from point processes is a very fruitful framework for eye-movement data, helping turn qualitative questions into quantitative ones. We provide a tutorial introduction to some of the main ideas of the field of spatial statistics, focusing especially on spatial Poisson processes. We show how point processes help relate image properties to fixation locations. In particular we show how point processes naturally express the idea that image features' predictability for fixations may vary from one image to another. We review other methods of analysis used in the literature, show how they relate to point process theory, and argue that thinking in terms of point processes substantially extends the range of analyses that can be performed and clarify their interpretation.

Biomechanical stability of a supra-acetabular pedicle screw internal fixation device (INFIX) vs external fixation and plates for vertically unstable pelvic fractures.

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Vigdorchik, Jonathan M; Esquivel, Amanda O; Jin, Xin; Yang, King H; Onwudiwe, Ndidi A; Vaidya, Rahul

2012-09-27

We have recently developed a subcutaneous anterior pelvic fixation technique (INFIX). This internal fixator permits patients to sit, roll over in bed and lie on their sides without the cumbersome external appliances or their complications. The purpose of this study was to evaluate the biomechanical stability of this novel supraacetabular pedicle screw internal fixation construct (INFIX) and compare it to standard internal fixation and external fixation techniques in a single stance pelvic fracture model. Nine synthetic pelves with a simulated anterior posterior compression type III injury were placed into three groups (External Fixator, INFIX and Internal Fixation). Displacement, total axial stiffness, and the stiffness at the pubic symphysis and SI joint were calculated. Displacement and stiffness were compared by ANOVA with a Bonferroni adjustment for multiple comparisons The mean displacement at the pubic symphysis was 20, 9 and 0.8 mm for external fixation, INFIX and internal fixation, respectively. Plate fixation was significantly stiffer than the INFIX and external Fixator (P = 0.01) at the symphysis pubis. The INFIX device was significantly stiffer than external fixation (P = 0.017) at the symphysis pubis. There was no significant difference in SI joint displacement between any of the groups. Anterior plate fixation is stiffer than both the INFIX and external fixation in single stance pelvic fracture model. The INFIX was stiffer than external fixation for both overall axial stiffness, and stiffness at the pubic symphysis. Combined with the presumed benefit of minimizing the complications associated with external fixation, the INFIX may be a more preferable option for temporary anterior pelvic fixation in situations where external fixation may have otherwise been used.

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

Science.gov (United States)

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

2017-11-07

Objective: To make a systematic assessment of the Long-term efficacy of open reduction and internal fixation versus external fixation for unstable distal radius fractures. Methods: A computer-based online search of PubMed, ScienceDirect, EMBASE, BIOSIS, Springer and Cochrane Library were performed. The randomized and controlled trials of open reduction and internal fixation versus external fixation for unstable distal radius fractures were collected. The included trials were screened out strictly based on the criterion of inclusion and exclusion. The quality of included trials was evaluated. RevMan 5.0 was used for data analysis. Results: Sixteen studies involving 1 268 patients were included. There were 618 patients with open reduction and internal fixation and 650 with external fixation. The results of meta-analysis indicated that there were statistically significant differences with regard to the complications postoperatively (infection( I (2)=0%, RR =0.27, 95% CI 0.16-0.45, Z =4.92, P internal fixation and external fixation are effective treatment for unstable distal radius fractures. Compared with external fixation, open reduction and internal fixation provides reduced complications postoperatively, lower DASH scores and better restoration of volar tilt for treatment of distal radius fractures.

Dinitrogen fixation in aphotic oxygenated marine environments

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Eyal eRahav

2013-08-01

Full Text Available We measured N2 fixation rates from oceanic zones that have traditionally been ignored as sources of biological N2 fixation; the aphotic, fully oxygenated, nitrate (NO3--rich, waters of the oligotrophic Levantine Basin (LB and the Gulf of Aqaba (GA. N2 fixation rates measured from pelagic aphotic waters to depths up to 720 m, during the mixed and stratified periods, ranged from 0.01 nmol N L-1 d-1 to 0.38 nmol N L-1 d-1. N2 fixation rates correlated significantly with bacterial productivity and heterotrophic diazotrophs were identified from aphotic as well as photic depths. Dissolved free amino acid amendments to whole water from the GA enhanced bacterial productivity by 2to 3.5 and N2 fixation rates by ~ 2 fold in samples collected from aphotic depths while in amendments to water from photic depths bacterial productivity increased 2 to 6 fold while N2 fixation rates increased by a factor of 2 to 4 illustrating that both BP an heterotrophic N2 fixation are carbon limited. Experimental manipulations of aphotic waters from the LB demonstrated a significant positive correlation between transparent exopolymeric particles (TEP concentration and N2 fixation rates. This suggests that sinking organic material and high carbon (C: nitrogen (N micro-environments (such as TEP-based aggregates or marine snow could support high heterotrophic N2 fixation rates in oxygenated surface waters and in the aphotic zones. Indeed, our calculations show that aphotic N2 fixation accounted for 37 to 75 % of the total daily integrated N2 fixation rates at both locations in the Mediterranean and Red Seas with rates equal or greater to those measured from the photic layers. Moreover, our results indicate that that while N2 fixation may be limited in the surface waters, aphotic, pelagic N2 fixation may contribute significantly to new N inputs in other oligotrophic basins, yet it is currently not included in regional or global N budgets.

[Effectiveness comparison of flexible fixation and rigid fixation in treatment of ankle pronation-external rotation fractures with distal tibiofibular syndesmosis].

Science.gov (United States)

Li, Yuewei; Zhang, Minghui; Li, Xiaorong; Chen, Xiaoyong; Deng, Jianlong

2017-07-01

To compare the effectiveness of flexible fixation and rigid fixation in the treatment of ankle pronation-external rotation fractures with distal tibiofibular syndesmosis. A retrospective analysis was made on the clinical data of 50 patients with ankle pronation-external rotation fractures and distal tibiofibular syndesmosis treated between January 2013 and December 2015. Suture-button fixation was used in 23 patients (flexible fixation group) and cortical screw fixation in 27 patients (rigid fixation group). There was no significant difference in age, gender, weight, side, fracture type, and time from trauma to surgery between 2 groups ( P >0.05). The operation time, medial clear space (MCS), tibiofibular clear space (TFCS), tibiofibular overlap (TFO), American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Disability Index (FADI) score were compared between 2 groups. The operation time was (83.0±9.1) minutes in the flexible fixation group and was (79.6±13.1) minutes in the rigid fixation group, showing no significant difference ( t =1.052, P =0.265). All patients achieved healing of incision by first intention. The patients were followed up 12-20 months (mean, 14 months). The X-ray films showed good healing of fracture in 2 groups. There was no screw fracture, delayed union or nounion. The fracture healing time was (12.1±2.5) months in the flexible fixation group and was (11.3±3.2) months in the rigid fixation group, showing no significant difference between 2 groups ( t =1.024, P =0.192). Reduction loss occurred after removal of screw in 2 cases of the rigid fixation group. At last follow-up, there was no significant difference in MCS, TFCS, TFO, AOFAS score and FADI score between 2 groups ( P >0.05). Suture-button fixation has similar effectiveness to screw fixation in ankle function and imaging findings, and flexible fixation has lower risk of reduction loss of distal tibiofibular syndesmosis than rigid fixation.

Accessory atlantoaxial ligament avulsion fracture of the axis: Are there any clinical implications?

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Hamid Reza Niknejad

2016-01-01

Full Text Available Injuries to the craniocervical support structures are frequently observed in neurotrauma cases. Stability of this region is of vital importance. Literature has mainly focused on three major ligaments of the craniocervical junction: The tectorial membrane, the transverse ligament, and the alar ligaments. However, the accessory atlantoaxial ligament (ALL also seems to be involved in craniocervical stability as shown in cadaveric specimens. Still, the biomechanical importance of this structure needs to be determined, especially in trauma settings. Here, we describe a case of isolated traumatic injury to this structure and discuss the clinical outcome. A 64 year old polytrauma patient with a remarkable avulsion fracture at the site of the insertion of the ALL was admitted to our center. We evaluated the patient both clinical and radiological at admission, after 3 months and after 1 year. We clinically assessed the upper cervical rotational stability using the cervical flexion rotation test. We observed no rotational instability or any other clinical repercussions at the long term after an isolated ALL injury. This case shows that isolated traumatic damage to the ALL is possible. Unilateral damage to the ALL probably does not cause rotational instability of the craniocervical junction. In case a similar avulsion fracture is observed, we recommend performing a magnetic resonance imaging of the craniovertebral region to assess for any ligamentous lesions.

Permanganate Fixation of Plant Cells

Science.gov (United States)

Mollenhauer, Hilton H.

1959-01-01

In an evaluation of procedures explored to circumvent some of the problems of osmium tetroxide-fixation and methacrylate embedding of plant materials, excised segments of root tips of Zea mays were fixed for electron microscopy in potassium permanganate in the following treatment variations: unbuffered and veronal-acetate buffered solutions of 0.6, 2.0, and 5.0 per cent KMnO4 at pH 5.0, 6.0, 6.7, and 7.5, and temperatures of 2–4°C. and 22°C. After fixation the segments were dehydrated, embedded in epoxy resin, sectioned, and observed or photographed. The cells of the central region of the rootcap are described. The fixation procedures employing unbuffered solutions containing 2.0 to 5.0 per cent KMnO4 at a temperature of 22°C. gave particularly good preservation of cell structure and all membrane systems. Similar results were obtained using a solution containing 2.0 per cent KMnO4, buffered with veronal-acetate to pH 6.0, and a fixation time of 2 hours at 22°C. The fixation procedure utilizing veronal-acetate buffered, 0.6 per cent KMnO4 at 2–4°C. and pH 6.7 also gave relatively good preservation of most cellular constituents. However, preservation of the plasma membrane was not so good, nor was the intensity of staining so great, as that with the group of fixatives containing greater concentrations of KMnO4. The other fixation procedures did not give satisfactory preservation of fine structure. A comparison is made of cell structures as fixed in KMnO4 or OsO4. PMID:14423414

Acute Retropharyngeal Calcific Tendinitis in an Unusual Location: a Case Report in a Patient with Rheumatoid Arthritis and Atlantoaxial Subluxation

Energy Technology Data Exchange (ETDEWEB)

Lee, Seung Hun; Joo, Kyung Bin; Lee, Kyu Hoon; Uhm, Wan Sik [Hanyang University Hospital, Seoul (Korea, Republic of)

2011-08-15

Retropharyngeal calcific tendinitis is defined as inflammation of the longus colli muscle and is caused by the deposition of calcium hydroxyapatite crystals, which usually involves the superior oblique fibers of the longus colli muscle from C1-3. Diagnosis is usually made by detecting amorphous calcification and prevertebral soft tissue swelling on radiograph, CT or MRI. In this report, we introduce a case of this disease which was misdiagnosed as a retropharyngeal tuberculous abscess, or a muscle strain of the ongus colli muscle. No calcifications were visible along the vertical fibers of the longus colli muscle. The lesion was located anterior to the C4-5 disc, in a rheumatoid arthritis patient with atlantoaxial subluxation. Calcific tendinitis of the longus colli muscle at this location in a rheumatoid arthritis patient has not been reported in the English literature.

Strain-stress analysis of lower limb with applied fixator

Directory of Open Access Journals (Sweden)

Mrázek M.

2010-07-01

Full Text Available This paper compares physiological state of tibia before and after application of an external fixator. The fixator systems’ models but also model of tibia are loaded in the direction of body axis. The paper is focused on the examination of differences in stiffness before and after the application of fixation. Two types of axial external fixators are compared. Both fixators differ in their construction. The first fixator is two-frame and fixation rods are used for fixing the bone tissue (variant I. The second one is fixed into tibia with screws (variant II. We have found out that the two-frame external fixator has much bigger stiffness during limb fixation than the fixator with one body. Much higher deformations compared to physiological state of tibia occur in the variant II.

Fixation of displaced subcapital femoral fractures. Compression screw fixation versus double divergent pins.

Science.gov (United States)

Christie, J; Howie, C R; Armour, P C

1988-03-01

One hundred and twenty-seven consecutive patients with displaced subcapital fractures of the femoral neck (Garden Grade III or IV) all under 80 years of age and independently mobile, were randomly allocated to fixation with either double divergent pins or a single sliding screw-plate device. The incidence of non-union and infection in the sliding screw-plate group was significantly higher, and we believe that when internal fixation is considered appropriate multiple pinning should be used. Mobility after treatment was disappointing in about half of the patients, and we feel that internal fixation can only be justified in patients who are physiologically well preserved and who maintain a high level of activity.

Flexible fixation and fracture healing

DEFF Research Database (Denmark)

Schmal, Hagen; Strohm, Peter C; Jaeger, Martin

2011-01-01

, noncomminuted fractures. External fixation uses external bars for stabilization, whereas internal fixation is realized by subcutaneous placement of locking plates. Both of these "biologic" osteosynthesis methods allow a minimally invasive approach and do not compromise fracture hematoma and periosteal blood...

[Extramedullary fixation combined with intramedullary fixation in the surgical reduction of sagittal mandibular condylar fractures].

Science.gov (United States)

Chuanjun, Chen; Xiaoyang, Chen; Jing, Chen

2016-10-01

This study aimed to evaluate the clinical effect of extramedullary fixation combined with intramedullary fixation during the surgical reduction of sagittal mandibular condylar fractures. Twenty-four sagittal fractures of the mandibular condyle in18 patients were fixed by two appliances: intramedullary with one long-screw osteosynthesis or Kirschner wire and extramedullary with one micro-plate. The radiologically-recorded post-operative stability-associated com-plications included the screw/micro-plate loosening, micro-plate twisting, micro-plate fractures, and fragment rotation. The occluding relations, the maximalinter-incisal distances upon mouth opening, and the mandibular deflection upon mouth opening were evaluated based on follow-up clinical examination. Postoperative panoramic X-ray and CT scans showed good repositioning of the fragment, with no redislocation or rotation, no screw/plate loosening, and no plate-twisting or fracture. Clinical examination showed that all patients regained normal mandibular movements, ideal occlusion, and normal maximal inter-incisal distances upon mouth opening. Extramedullary fixation combined with intramedullary fixation is highly recommended for sagittal condylar fractures because of the anti-rotation effect of the fragment and the reasonable place-ment of the fixation appliances.

Customizable rigid head fixation for infants: technical note.

Science.gov (United States)

Udayakumaran, Suhas; Onyia, Chiazor U

2016-01-01

The need and advantages of rigid fixation of the head in cranial surgeries are well documented (Berryhill et al., Otolaryngol Head Neck Surg 121:269-273, 1999). Head fixation for neurosurgical procedures in infants and in early years has been a challenge and is fraught with risk. Despite the fact that pediatric pins are designed, rigid head fixation involving direct application of pins to the head of infants and slightly older children is still generally not safe (Agrawal and Steinbok, Childs Nerv Syst 22:1473-1474, 2006). Yet, there are some surgeries in which some form of rigid fixation is required (Agrawal and Steinbok, Childs Nerv Syst 22:1473-1474, 2006). We describe a simple technique to achieve rigid fixation of the head in infants for neurosurgical procedures. This involves applying a head band made of Plaster of Paris (POP) around the head and then applying the fixation pins of the fixation frame directly on to the POP. We have used this technique of head fixation successfully for infants with no complications.

Fixation probability on clique-based graphs

Science.gov (United States)

Choi, Jeong-Ok; Yu, Unjong

2018-02-01

The fixation probability of a mutant in the evolutionary dynamics of Moran process is calculated by the Monte-Carlo method on a few families of clique-based graphs. It is shown that the complete suppression of fixation can be realized with the generalized clique-wheel graph in the limit of small wheel-clique ratio and infinite size. The family of clique-star is an amplifier, and clique-arms graph changes from amplifier to suppressor as the fitness of the mutant increases. We demonstrate that the overall structure of a graph can be more important to determine the fixation probability than the degree or the heat heterogeneity. The dependence of the fixation probability on the position of the first mutant is discussed.

Immaturity of Visual Fixations in Dyslexic Children.

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TIADI eBi Kuyami Guy Aimé

2016-02-01

Full Text Available To our knowledge, behavioral studies recording visual fixations abilities in dyslexic children are scarce. The object of this paper is to explore further the visual fixation ability in dyslexics compared to chronological age-matched and reading age-matched non-dyslexic children. Fifty-five dyslexic children from 7 to 14 years old, fifty-five chronological age-matched non-dyslexic children and fifty-five reading age-matched non-dyslexic children participated to this study. Eye movements from both eyes were recorded horizontally and vertically by a video-oculography system (EyeBrain® T2. The fixation task consisted in fixating a white-filled circle appearing in the centre of the screen for 30 seconds. Results showed that dyslexic children produced a significantly higher number of unwanted saccades than both groups of non-dyslexic children. Moreover, the number of unwanted saccades significantly decreased with age in both groups of non-dyslexic children, but not in dyslexics. Furthermore, dyslexics made more saccades during the last 15 sec of fixation period with respect to both groups of non-dyslexic children. Such poor visual fixation capability in dyslexic children could be due to impaired attention abilities, as well as to an immaturity of the cortical areas controlling the fixation system.

Graft fixation in cruciate ligament reconstruction.

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Brand, J; Weiler, A; Caborn, D N; Brown, C H; Johnson, D L

2000-01-01

Cruciate ligament reconstruction has progressed dramatically in the last 20 years. Anatomic placement of ligament substitutes has fostered rehabilitation efforts that stress immediate and full range of motion, immediate weightbearing, neuromuscular strength and coordination, and early return to athletic competition (3 months). This has placed extreme importance on secure graft fixation at the time of ligament reconstruction. Current ligament substitutes require a bony or soft tissue component to be fixed within a bone tunnel or on the periosteum at a distance from the normal ligament attachment site. Fixation devices have progressed from metal to biodegradable and from far to near-normal native ligament attachment sites. Ideally, the biomechanical properties of the entire graft construct would approach those of the native ligament and facilitate biologic incorporation of the graft. Fixation should be done at the normal anatomic attachment site of the native ligament (aperture fixation) and, over time, allow the biologic return of the histologic transition zone from ligament to fibrocartilage, to calcified fibrocartilage, to bone. The purpose of this article is to review current fixation devices and techniques in cruciate ligament surgery.

External fixation of "intertrochanteric" fractures.

Science.gov (United States)

Gani, Naseem Ul; Kangoo, Khursheed Ahmed; Bashir, Arshad; Muzaffer, Rahil; Bhat, Mohammad Farooq; Farooq, Munir; Badoo, Abdul Rashid; Dar, Imtiyaz Hussian; Wani, Mudassir Maqbool

2009-10-10

In developing countries, due to limited availability of modern anesthesia and overcrowding of the hospitals with patients who need surgery, high-risk patients with "intertrochanteric" fractures remain unsuita ble for open reduction and internal fixation.The aim of this study was to analyze the results of external fixation of "intertrochanteric" fractures in high-risk geriatric patients in a developing country.The results of 62 ambulatory high-risk geriatric patients with a mean age of 70 years (range 58-90 years) with "intertrochanteric" fractures, in whom external fixation was performed, are reported.Eight patients died during follow-up due to medical causes unrelated to the surgical procedure. So only 54 patients were available for final assessment. Procedure is simple, performed under local anesthesia, requires less time for surgery and is associated with less blood loss. Good fixation and early ambulation was achieved in most of the patients. Average time to union was 14 weeks. Thirty-one patients developed superficial pin tract infection and 28 patients had average shortening of 15 mm due to impaction and varus angulation. Functional outcome was assessed using Judet's point system. Good to excellent results were achieved in 44 patients.This study demonstrated that external fixation of "intertrochantric" fractures performed under local anesthesia offers significant advantage in ambulatory high-risk geriatric patients especially in a developing country.

Phase-Contrast Hounsfield Units of Fixated and Non-Fixated Soft-Tissue Samples

Science.gov (United States)

Willner, Marian; Fior, Gabriel; Marschner, Mathias; Birnbacher, Lorenz; Schock, Jonathan; Braun, Christian; Fingerle, Alexander A.; Noël, Peter B.; Rummeny, Ernst J.; Pfeiffer, Franz; Herzen, Julia

2015-01-01

X-ray phase-contrast imaging is a novel technology that achieves high soft-tissue contrast. Although its clinical impact is still under investigation, the technique may potentially improve clinical diagnostics. In conventional attenuation-based X-ray computed tomography, radiological diagnostics are quantified by Hounsfield units. Corresponding Hounsfield units for phase-contrast imaging have been recently introduced, enabling a setup-independent comparison and standardized interpretation of imaging results. Thus far, the experimental values of few tissue types have been reported; these values have been determined from fixated tissue samples. This study presents phase-contrast Hounsfield units for various types of non-fixated human soft tissues. A large variety of tissue specimens ranging from adipose, muscle and connective tissues to liver, kidney and pancreas tissues were imaged by a grating interferometer with a rotating-anode X-ray tube and a photon-counting detector. Furthermore, we investigated the effects of formalin fixation on the quantitative phase-contrast imaging results. PMID:26322638

Methanotrophy induces nitrogen fixation during peatland development

Science.gov (United States)

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

2014-01-01

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

Polymeric media for tritium fixation. Supplement I

International Nuclear Information System (INIS)

Franz, J.A.; Burger, L.L.

1976-01-01

Procedures for the fixation of tritium as TH or THO in two different polymeric media are described. The complete procedure for THO fixation in a polyureylene-polyurethane polumer, including polymer molding procedures and leach tests is presented. The catalytic tritiation of polystyrene under very mild conditions using a rhodium catalyst is also described. Thermal stabilities and cost estimates for the polymers examined under this program are discussed. Organic polymers were found to have attractive features for the fixation and storage of concentrated tritium wastes due to the convenience of fixation procedures and favorable properties of the resulting media

Fixation of Selenium by Clay Minerals and Iron Oxides

DEFF Research Database (Denmark)

Hamdy, A. A.; Nielsen, Gunnar Gissel

1977-01-01

In studying Se fixation, soil components capable of retaining Se were investigated. The importance of Fe hydrous oxides in the fixation of Se was established. The clay minerals common to soils, such as kaolinite, montmorillonite and vermiculite, all exhibited Se fixation, but greater fixation occ...

Evaluation of functional outcome of pilon fractures managed with limited internal fixation and external fixation: A prospective clinical study.

Science.gov (United States)

Meena, Umesh Kumar; Bansal, Mahesh Chand; Behera, Prateek; Upadhyay, Rahul; Gothwal, Gyan Chand

2017-11-01

The management of pilon fractures is controversial primarily due to the high rate of complications irrespective of the mode of treatment. Limited internal fixation with external fixation is associated with minimal soft tissue handling. This may reduce the chances of wound dehiscence and infection. This study was designed to evaluate the functional and clinical outcomes in patients treated with limited internal fixation combined with external fixation in pilon fractures. This study was conducted as a prospective clinical study on 56 skeletally mature patients with closed fractures with poor skin condition, and with open grade 1 and grade 2 distal tibial intra-articular fractures. All patients were treated with combined limited internal fixation and ankle spanning external fixation. All fractures in this series united with an average time period of union of 18.3weeks (ranging from 13 weeks to 30 weeks). There was no non-union in any case. There was malunion in 4 cases, varus malunion (>5 degree) in 2 cases and recurvatum in another 2 cases). Excellent to good functional results were observed in 88% cases based on the modified Ovadia and Beals score. The mean ankle dorsiflexion and planter flexion movements were 10.2±5.3 degrees and 27.4±7.2 degrees respectively. infections occurred in 6 patients which included 4 pin tract infections and 2 superficial wound infection, all 6 healed after removal of pin tract and with oral antibiotics. The technique of combined external fixation with internal fixation is safe and effective management option for intra-articular distal tibial fractures.

Fixation Time for Evolutionary Graphs

Science.gov (United States)

Nie, Pu-Yan; Zhang, Pei-Ai

Evolutionary graph theory (EGT) is recently proposed by Lieberman et al. in 2005. EGT is successful for explaining biological evolution and some social phenomena. It is extremely important to consider the time of fixation for EGT in many practical problems, including evolutionary theory and the evolution of cooperation. This study characterizes the time to asymptotically reach fixation.

Nitrogen fixation in denitrified marine waters.

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Camila Fernandez

Full Text Available Nitrogen fixation is an essential process that biologically transforms atmospheric dinitrogen gas to ammonia, therefore compensating for nitrogen losses occurring via denitrification and anammox. Currently, inputs and losses of nitrogen to the ocean resulting from these processes are thought to be spatially separated: nitrogen fixation takes place primarily in open ocean environments (mainly through diazotrophic cyanobacteria, whereas nitrogen losses occur in oxygen-depleted intermediate waters and sediments (mostly via denitrifying and anammox bacteria. Here we report on rates of nitrogen fixation obtained during two oceanographic cruises in 2005 and 2007 in the eastern tropical South Pacific (ETSP, a region characterized by the presence of coastal upwelling and a major permanent oxygen minimum zone (OMZ. Our results show significant rates of nitrogen fixation in the water column; however, integrated rates from the surface down to 120 m varied by ∼30 fold between cruises (7.5±4.6 versus 190±82.3 µmol m(-2 d(-1. Moreover, rates were measured down to 400 m depth in 2007, indicating that the contribution to the integrated rates of the subsurface oxygen-deficient layer was ∼5 times higher (574±294 µmol m(-2 d(-1 than the oxic euphotic layer (48±68 µmol m(-2 d(-1. Concurrent molecular measurements detected the dinitrogenase reductase gene nifH in surface and subsurface waters. Phylogenetic analysis of the nifH sequences showed the presence of a diverse diazotrophic community at the time of the highest measured nitrogen fixation rates. Our results thus demonstrate the occurrence of nitrogen fixation in nutrient-rich coastal upwelling systems and, importantly, within the underlying OMZ. They also suggest that nitrogen fixation is a widespread process that can sporadically provide a supplementary source of fixed nitrogen in these regions.

Nitrogen Fixation in Denitrified Marine Waters

Science.gov (United States)

Fernandez, Camila; Farías, Laura; Ulloa, Osvaldo

2011-01-01

Nitrogen fixation is an essential process that biologically transforms atmospheric dinitrogen gas to ammonia, therefore compensating for nitrogen losses occurring via denitrification and anammox. Currently, inputs and losses of nitrogen to the ocean resulting from these processes are thought to be spatially separated: nitrogen fixation takes place primarily in open ocean environments (mainly through diazotrophic cyanobacteria), whereas nitrogen losses occur in oxygen-depleted intermediate waters and sediments (mostly via denitrifying and anammox bacteria). Here we report on rates of nitrogen fixation obtained during two oceanographic cruises in 2005 and 2007 in the eastern tropical South Pacific (ETSP), a region characterized by the presence of coastal upwelling and a major permanent oxygen minimum zone (OMZ). Our results show significant rates of nitrogen fixation in the water column; however, integrated rates from the surface down to 120 m varied by ∼30 fold between cruises (7.5±4.6 versus 190±82.3 µmol m−2 d−1). Moreover, rates were measured down to 400 m depth in 2007, indicating that the contribution to the integrated rates of the subsurface oxygen-deficient layer was ∼5 times higher (574±294 µmol m−2 d−1) than the oxic euphotic layer (48±68 µmol m−2 d−1). Concurrent molecular measurements detected the dinitrogenase reductase gene nifH in surface and subsurface waters. Phylogenetic analysis of the nifH sequences showed the presence of a diverse diazotrophic community at the time of the highest measured nitrogen fixation rates. Our results thus demonstrate the occurrence of nitrogen fixation in nutrient-rich coastal upwelling systems and, importantly, within the underlying OMZ. They also suggest that nitrogen fixation is a widespread process that can sporadically provide a supplementary source of fixed nitrogen in these regions. PMID:21687726

Variable Nitrogen Fixation in Wild Populus.

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Sharon L Doty

Full Text Available The microbiome of plants is diverse, and like that of animals, is important for overall health and nutrient acquisition. In legumes and actinorhizal plants, a portion of essential nitrogen (N is obtained through symbiosis with nodule-inhabiting, N2-fixing microorganisms. However, a variety of non-nodulating plant species can also thrive in natural, low-N settings. Some of these species may rely on endophytes, microorganisms that live within plants, to fix N2 gas into usable forms. Here we report the first direct evidence of N2 fixation in the early successional wild tree, Populus trichocarpa, a non-leguminous tree, from its native riparian habitat. In order to measure N2 fixation, surface-sterilized cuttings of wild poplar were assayed using both 15N2 incorporation and the commonly used acetylene reduction assay. The 15N label was incorporated at high levels in a subset of cuttings, suggesting a high level of N-fixation. Similarly, acetylene was reduced to ethylene in some samples. The microbiota of the cuttings was highly variable, both in numbers of cultured bacteria and in genetic diversity. Our results indicated that associative N2-fixation occurred within wild poplar and that a non-uniformity in the distribution of endophytic bacteria may explain the variability in N-fixation activity. These results point to the need for molecular studies to decipher the required microbial consortia and conditions for effective endophytic N2-fixation in trees.

Clinical and stereoradiographic analysis of adult spinal deformity with and without rotatory subluxation.

Science.gov (United States)

Ferrero, E; Lafage, R; Challier, V; Diebo, B; Guigui, P; Mazda, K; Schwab, F; Skalli, W; Lafage, V

2015-09-01

In degenerative adult spinal deformity (ASD), sagittal malalignment and rotatory subluxation (RS) correlate with clinical symptomatology. RS is defined as axial rotation with lateral listhesis. Stereoradiography, recently developed for medical applications, provides full-body standing radiographs and 3D reconstruction of the spine, with low radiation dose. 3D stereoradiography improves analysis of RS and of its relations with transverse plane and spinopelvic parameters and clinical impact. One hundred and thirty adults with lumbar ASD and full-spine EOS® radiographs (EOS Imaging, Paris, France) were included. Spinopelvic sagittal parameters and lateral listhesis in the coronal plane were measured. The transverse plane study parameters were: apical axial vertebral rotation (apex AVR), axial intervertebral rotation (AIR) and torsion index (TI). Two groups were compared: with RS (lateral listhesis>5mm) and without RS (without lateral listhesis exceeding 5mm: non-RS). Correlations between radiologic and clinical data were assessed. RS patients were significantly older, with larger Cobb angle (37.4° vs. 26.6°, P=0.0001), more severe sagittal deformity, and greater apex AVR and TI (respectively: 22.9° vs. 11.3°, P10° without visible RS on 2D radiographs. RS patients reported significantly more frequent low back pain and radiculalgia. In this EOS® study, ASD patients with RS had greater coronal curvature and sagittal and transverse deformity, as well as greater pain. Further transverse plane analysis could allow earlier diagnosis and prognosis to guide management. 4, retrospective study. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Percutaneous anterior C1/2 transarticular screw fixation: salvage of failed percutaneous odontoid screw fixation for odontoid fracture

OpenAIRE

Wu, Ai-Min; Jin, Hai-Ming; Lin, Zhong-Ke; Chi, Yong-Long; Wang, Xiang-Yang

2017-01-01

Background The objective of this study is to investigate the outcomes and safety of using percutaneous anterior C1/2 transarticular screw fixation as a salvage technique for odontoid fracture if percutaneous odontoid screw fixation fails. Methods Fifteen in 108 odontoid fracture patients (planned to be treated by percutaneous anterior odontoid screw fixation) were failed to introduce satisfactory odontoid screw trajectory. To salvage this problem, we chose the percutaneous anterior C1/2 trans...

Improving Saliency Models by Predicting Human Fixation Patches

KAUST Repository

Dubey, Rachit

2015-04-16

There is growing interest in studying the Human Visual System (HVS) to supplement and improve the performance of computer vision tasks. A major challenge for current visual saliency models is predicting saliency in cluttered scenes (i.e. high false positive rate). In this paper, we propose a fixation patch detector that predicts image patches that contain human fixations with high probability. Our proposed model detects sparse fixation patches with an accuracy of 84 % and eliminates non-fixation patches with an accuracy of 84 % demonstrating that low-level image features can indeed be used to short-list and identify human fixation patches. We then show how these detected fixation patches can be used as saliency priors for popular saliency models, thus, reducing false positives while maintaining true positives. Extensive experimental results show that our proposed approach allows state-of-the-art saliency methods to achieve better prediction performance on benchmark datasets.

Improving Saliency Models by Predicting Human Fixation Patches

KAUST Repository

Dubey, Rachit; Dave, Akshat; Ghanem, Bernard

2015-01-01

There is growing interest in studying the Human Visual System (HVS) to supplement and improve the performance of computer vision tasks. A major challenge for current visual saliency models is predicting saliency in cluttered scenes (i.e. high false positive rate). In this paper, we propose a fixation patch detector that predicts image patches that contain human fixations with high probability. Our proposed model detects sparse fixation patches with an accuracy of 84 % and eliminates non-fixation patches with an accuracy of 84 % demonstrating that low-level image features can indeed be used to short-list and identify human fixation patches. We then show how these detected fixation patches can be used as saliency priors for popular saliency models, thus, reducing false positives while maintaining true positives. Extensive experimental results show that our proposed approach allows state-of-the-art saliency methods to achieve better prediction performance on benchmark datasets.

Performance evaluation of a rotatory dual-head PET system with 90o increments for small animal imaging

Science.gov (United States)

Meng, F.; Zhu, S.; Li, L.; Wang, J.; Cao, X.; Cao, X.; Chen, X.; Liang, J.

2017-09-01

A rotatory dual-head positron emission tomography (PET) system with 90o increments has been built up by our lab. In this study, a geometric calibration phantom was designed and then used to calibrate the geometric offset of the system. With the geometric calibration, the artifacts in the reconstructed images were greatly eliminated. Then, we measured the imaging performance including resolution, sensitivity and image quality. The results showed that the full width at half maximum (FWHMs) of the point source were about 1.1 mm in three directions. The peak absolute sensitivity in the center of the field of view varied from 5.66% to 3.17% when the time window was fixed to 10 ns and the energy window was changed from 200-800 keV to 350-650 keV. The recovery coefficients ranged from 0.13 with a standard deviation of 17.5% to 0.98 with a standard deviation of 15.76%. For the air-filled and water-filled chamber, the spill-over ratio was 14.48% and 15.38%, respectively. The in vivo mouse experiment was carried out and further demonstrated the potential of our system in small animal studies.

Performance evaluation of a rotatory dual-head PET system with 90o increments for small animal imaging

International Nuclear Information System (INIS)

Meng, F.; Zhu, S.; Li, L.; Wang, J.; Cao, X.; Cao, X.; Chen, X.; Liang, J.

2017-01-01

A rotatory dual-head positron emission tomography (PET) system with 90 o increments has been built up by our lab. In this study, a geometric calibration phantom was designed and then used to calibrate the geometric offset of the system. With the geometric calibration, the artifacts in the reconstructed images were greatly eliminated. Then, we measured the imaging performance including resolution, sensitivity and image quality. The results showed that the full width at half maximum (FWHMs) of the point source were about 1.1 mm in three directions. The peak absolute sensitivity in the center of the field of view varied from 5.66% to 3.17% when the time window was fixed to 10 ns and the energy window was changed from 200-800 keV to 350–650 keV. The recovery coefficients ranged from 0.13 with a standard deviation of 17.5% to 0.98 with a standard deviation of 15.76%. For the air-filled and water-filled chamber, the spill-over ratio was 14.48% and 15.38%, respectively. The in vivo mouse experiment was carried out and further demonstrated the potential of our system in small animal studies.

Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis.

Science.gov (United States)

Wang, Yicun; Jiang, Hui; Deng, Zhantao; Jin, Jiewen; Meng, Jia; Wang, Jun; Zhao, Jianning; Sun, Guojing; Qian, Hongbo

2017-01-01

To compare the salvage rate and complication between internal fixation and external fixation in patients with small bone defects caused by chronic infectious osteomyelitis debridement. 125 patients with chronic infectious osteomyelitis of tibia fracture who underwent multiple irrigation, debridement procedure, and local/systemic antibiotics were enrolled. Bone defects, which were less than 4 cm, were treated with bone grafting using either internal fixation or monolateral external fixation. 12-month follow-up was conducted with an interval of 3 months to evaluate union of bone defect. Patients who underwent monolateral external fixation had higher body mass index and fasting blood glucose, longer time since injury, and larger bone defect compared with internal fixation. No significant difference was observed in incidence of complications (23.5% versus 19.3%), surgery time (156 ± 23 minutes versus 162 ± 21 minutes), and time to union (11.1 ± 3.0 months versus 10.9 ± 3.1 months) between external fixation and internal fixation. Internal fixation had no significant influence on the occurrence of postoperation complications after multivariate adjustment when compared with external fixation. Furthermore, patients who underwent internal fixation experienced higher level of daily living scales and lower level of anxiety. It was relatively safe to use internal fixation for stabilization in osteomyelitis patients whose bone defects were less than 4 cm and infection was well controlled.

Maxwellian Eye Fixation during Natural Scene Perception

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Jean Duchesne

2012-01-01

Full Text Available When we explore a visual scene, our eyes make saccades to jump rapidly from one area to another and fixate regions of interest to extract useful information. While the role of fixation eye movements in vision has been widely studied, their random nature has been a hitherto neglected issue. Here we conducted two experiments to examine the Maxwellian nature of eye movements during fixation. In Experiment 1, eight participants were asked to perform free viewing of natural scenes displayed on a computer screen while their eye movements were recorded. For each participant, the probability density function (PDF of eye movement amplitude during fixation obeyed the law established by Maxwell for describing molecule velocity in gas. Only the mean amplitude of eye movements varied with expertise, which was lower in experts than novice participants. In Experiment 2, two participants underwent fixed time, free viewing of natural scenes and of their scrambled version while their eye movements were recorded. Again, the PDF of eye movement amplitude during fixation obeyed Maxwell’s law for each participant and for each scene condition (normal or scrambled. The results suggest that eye fixation during natural scene perception describes a random motion regardless of top-down or of bottom-up processes.

Maxwellian Eye Fixation during Natural Scene Perception

Science.gov (United States)

Duchesne, Jean; Bouvier, Vincent; Guillemé, Julien; Coubard, Olivier A.

2012-01-01

When we explore a visual scene, our eyes make saccades to jump rapidly from one area to another and fixate regions of interest to extract useful information. While the role of fixation eye movements in vision has been widely studied, their random nature has been a hitherto neglected issue. Here we conducted two experiments to examine the Maxwellian nature of eye movements during fixation. In Experiment 1, eight participants were asked to perform free viewing of natural scenes displayed on a computer screen while their eye movements were recorded. For each participant, the probability density function (PDF) of eye movement amplitude during fixation obeyed the law established by Maxwell for describing molecule velocity in gas. Only the mean amplitude of eye movements varied with expertise, which was lower in experts than novice participants. In Experiment 2, two participants underwent fixed time, free viewing of natural scenes and of their scrambled version while their eye movements were recorded. Again, the PDF of eye movement amplitude during fixation obeyed Maxwell's law for each participant and for each scene condition (normal or scrambled). The results suggest that eye fixation during natural scene perception describes a random motion regardless of top-down or of bottom-up processes. PMID:23226987

Articular Contact Area and Pressure in Posteromedial Rotatory Instability of the Elbow.

Science.gov (United States)

Bellato, Enrico; Fitzsimmons, James S; Kim, Youngbok; Bachman, Daniel R; Berglund, Lawrence J; Hooke, Alexander W; O'Driscoll, Shawn W

2018-03-21

Joint incongruity in posteromedial rotatory instability (PMRI) has been theorized to determine early articular degenerative changes. Our hypothesis was that the articular contact area and contact pressure differ significantly between an intact elbow and an elbow affected by PMRI. Seven cadaveric elbows were tested under gravity varus stress using a custom-made machine designed to simulate muscle loads and allow passive elbow flexion (0° to 90°). The mean contact area and contact pressure data were collected and processed using the Tekscan sensor and software. After testing the intact specimen (intact elbow), a PMRI injury was simulated (PMRI elbow) and the specimen was tested again. The PMRI elbows were characterized by initial joint subluxation and significantly elevated articular contact pressure. Both worsened, corresponding with a reduction in contact area, as the elbow was flexed from 0° until the joint subluxation and incongruity spontaneously reduced (at a mean [and standard error] of 60° ± 5° of flexion), at which point the mean contact pressure decreased from 870 ± 50 kPa (pre-reduction) to 440 ± 40 kPa (post-reduction) (p contact area increased from 80 ± 8 mm to 150 ± 58 mm (p contact area from the coronoid fracture edge toward the lower portion of the coronoid. At the flexion angle at which the PMRI elbows reduced, both the contact area and the contact pressure of the intact elbows differed significantly from those of the PMRI elbows, both before and after the elbow reduction (p contact area and increased contact pressures due to joint subluxation and incongruity could explain the progressive arthritis seen in some elbows affected by PMRI. This biomechanical study suggests that the early degenerative changes associated with PMRI reported in the literature could be subsequent to joint incongruity and an increase in contact pressure between the coronoid fracture surface and the trochlea.

Overcoming design fixation through education and creativity methods

DEFF Research Database (Denmark)

Howard, Thomas J.; Maier, Anja; Onarheim, Balder

2013-01-01

. The first intervention consisted of educating each team on the phenomena and effects of design fixation. The results showed that this intervention reduced the number of fixation elements in comparison to the control group (p=0.025). The second intervention involved using Dix et als' (2006) 'Bad Ideas...... of ideas produced per group and the groups' fixation ratios, adding to the quantity breads novelty debate. Finally, the study also provided further evidence of the hypothesis by Agogué et al (2011) that example solutions constructed from restrictive partitions have a greater fixation affect....

STUDY ON SPANNING EXTERNAL FIXATORS FOR PERIARTICULAR OPEN FRACTURES

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Prasanth Maddila

2017-04-01

Full Text Available BACKGROUND Open fractures which occur close to any fracture need immobilisation for the soft tissues to heal. Some open fractures are even fixed with provisional fixations to maintain the alignment of the fractures. The provisional fixation needs to be augmented with external support, which can be given by spanning external fixators across a joint. MATERIALS AND METHODS Our study consists of 38 open fractures of the lower limbs, which are of Gustilo-Anderson’s type IIIB, an MT4 of AO-ASIF soft tissue injury classification essentially requiring open wound management as well as fracture fixation. Wound lavage and debridements are carried out till the soft tissues show granulations. The position in which joint is immobilised is functional and with access to open wound for dressings and inspection without any displacement of the fracture as well as creeping granulation tissue. RESULTS All the cases in our study are maintained with functional position till soft tissue cover is achieved and provisional fixation is done with definitive fixation after soft tissue cover with skin grafting. CONCLUSION Spanning external fixators are useful in maintaining functional positions as well as augmenting the provisional fixation of the compound fractures.

Internal Versus External Fixation of Charcot Midfoot Deformity Realignment.

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Lee, Daniel J; Schaffer, Joseph; Chen, Tien; Oh, Irvin

2016-07-01

Internal and external fixation techniques have been described for realignment and arthrodesis of Charcot midfoot deformity. There currently is no consensus on the optimal method of surgical reconstruction. This systematic review compared the clinical results of surgical realignment with internal and external fixation, specifically in regard to return to functional ambulation, ulcer occurrence, nonunion, extremity amputation, unplanned further surgery, deep infection, wound healing problems, peri- or intraoperative fractures, and total cases with any complication. A search of multiple databases for all relevant articles published from January 1, 1990, to March 22, 2014, was performed. A logistic regression model evaluated each of the outcomes and its association with the type of fixation method. The odds of returning to functional ambulation were 25% higher for internal fixation (odds ratio [OR], 1.259). Internal fixation had a 42% reduced rate of ulcer occurrence (OR, 0.578). External fixation was 8 times more likely to develop radiographic nonunion than internal fixation (OR, 8.2). Internal fixation resulted in a 1.5-fold increase in extremity amputation (OR, 1.488), a 2-fold increase in deep infection (OR, 2.068), a 3.4-fold increase in wound healing complications (OR, 3.405), and a 1.5-fold increase in the total number of cases experiencing any complication (OR, 1.525). This was associated with a 20% increase in the need for unplanned further surgery with internal fixation (OR, 1.221). Although internal fixation may decrease the risk of nonunion and increase return to functional ambulation, it had a higher rate of overall complications than external fixation for realignment and arthrodesis of Charcot midfoot deformity. [Orthopedics. 2016; 39(4):e595-e601.]. Copyright 2016, SLACK Incorporated.

Outcome of rail fixator system in reconstructing bone gap

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Amit Lakhani

2014-01-01

Conclusion: All patients well tolerated rail fixator with good functional results and gap reconstruction. Easy application of rail fixator and comfortable distraction procedure suggest rail fixator a good alternative for gap reconstruction of limbs.

Fixation Characteristics of Severe Amblyopia Subtypes: Which One is Worse?

Science.gov (United States)

Koylu, Mehmet Talay; Ozge, Gokhan; Kucukevcilioglu, Murat; Mutlu, Fatih Mehmet; Ceylan, Osman Melih; Akıncıoglu, Dorukcan; Ayyıldız, Onder

2017-01-01

To determine differences in macular sensitivity and fixation patterns in different subtypes of severe amblyopia. This case-control study enrolled a total of 73 male adults, including 18 with pure strabismic severe amblyopia, 19 with pure anisometropic severe amblyopia, 18 with mixed (strabismic plus anizometropic) severe amblyopia, and 18 healthy controls. MP-1 microperimetry was used to evaluate macular sensitivity, location of fixation, and stability of fixation. Mean macular sensitivity, stability of fixation, and location of fixation were significantly worse in all amblyopia subtypes when compared with healthy controls. Intergroup comparisons between amblyopia subtypes revealed that mean macular sensitivity, stability of fixation, and location of fixation were significantly worse in pure strabismic and mixed amblyopic eyes when compared with pure anisometropic amblyopic eyes. Strabismus seems to be a worse prognostic factor in severe amblyopia than anisometropia in terms of fixation characteristics and retinal sensitivity.

Fixation Probability in a Haploid-Diploid Population.

Science.gov (United States)

Bessho, Kazuhiro; Otto, Sarah P

2017-01-01

Classical population genetic theory generally assumes either a fully haploid or fully diploid life cycle. However, many organisms exhibit more complex life cycles, with both free-living haploid and diploid stages. Here we ask what the probability of fixation is for selected alleles in organisms with haploid-diploid life cycles. We develop a genetic model that considers the population dynamics using both the Moran model and Wright-Fisher model. Applying a branching process approximation, we obtain an accurate fixation probability assuming that the population is large and the net effect of the mutation is beneficial. We also find the diffusion approximation for the fixation probability, which is accurate even in small populations and for deleterious alleles, as long as selection is weak. These fixation probabilities from branching process and diffusion approximations are similar when selection is weak for beneficial mutations that are not fully recessive. In many cases, particularly when one phase predominates, the fixation probability differs substantially for haploid-diploid organisms compared to either fully haploid or diploid species. Copyright © 2017 by the Genetics Society of America.

Fixation and escape times in stochastic game learning

International Nuclear Information System (INIS)

Realpe-Gomez, John; Szczesny, Bartosz; Galla, Tobias; Dall’Asta, Luca

2012-01-01

Evolutionary dynamics in finite populations is known to fixate eventually in the absence of mutation. We here show that a similar phenomenon can be found in stochastic game dynamical batch learning, and investigate fixation in learning processes in a simple 2×2 game, for two-player games with cyclic interaction, and in the context of the best-shot network game. The analogues of finite populations in evolution are here finite batches of observations between strategy updates. We study when and how such fixation can occur, and present results on the average time-to-fixation from numerical simulations. Simple cases are also amenable to analytical approaches and we provide estimates of the behaviour of so-called escape times as a function of the batch size. The differences and similarities with escape and fixation in evolutionary dynamics are discussed. (paper)

External fixation of “intertrochanteric” fractures

Science.gov (United States)

Gani, Naseem ul; Kangoo, Khursheed Ahmed; Bashir, Arshad; Muzaffer, Rahil; Bhat, Mohammad Farooq; Farooq, Munir; Badoo, Abdul Rashid; Dar, Imtiyaz Hussian; Wani, Mudassir Maqbool

2009-01-01

In developing countries, due to limited availability of modern anesthesia and overcrowding of the hospitals with patients who need surgery, high-risk patients with “intertrochanteric” fractures remain unsuita ble for open reduction and internal fixation. The aim of this study was to analyze the results of external fixation of “intertrochanteric” fractures in high-risk geriatric patients in a developing country. The results of 62 ambulatory high-risk geriatric patients with a mean age of 70 years (range 58–90 years) with “intertrochanteric” fractures, in whom external fixation was performed, are reported. Eight patients died during follow-up due to medical causes unrelated to the surgical procedure. So only 54 patients were available for final assessment. Procedure is simple, performed under local anesthesia, requires less time for surgery and is associated with less blood loss. Good fixation and early ambulation was achieved in most of the patients. Average time to union was 14 weeks. Thirty-one patients developed superficial pin tract infection and 28 patients had average shortening of 15 mm due to impaction and varus angulation. Functional outcome was assessed using Judet's point system. Good to excellent results were achieved in 44 patients. This study demonstrated that external fixation of “intertrochantric” fractures performed under local anesthesia offers significant advantage in ambulatory high-risk geriatric patients especially in a developing country. PMID:21808680

External fixation of “intertrochanteric” fractures

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Naseem ul Gani

2009-08-01

Full Text Available In developing countries, due to limited availability of modern anesthesia and overcrowding of the hospitals with patients who need surgery, high-risk patients with “intertro-chanteric” fractures remain unsuitable for open reduction and internal fixation. The aim of this study was to analyze the results of external fixation of “intertro-chanteric” fractures in high-risk geriatric patients in a developing country. The results of 62 ambulatory high-risk geriatric patients with a mean age of 70 years (range 58-90 years with “intertrochanteric” fractures, in whom external fixation was performed, are reported. Eight patients died during follow-up due to medical causes unrelated to the surgical procedure. So only 54 patients were available for final assessment. Procedure is simple, performed under local anesthesia, requires less time for surgery and is associated with less blood loss. Good fixation and early ambulation was achieved in most of the patients. Average time to union was 14 weeks. Thirty-one patients developed superficial pin tract infection and 28 patients had average shortening of 15 mm due to impaction and varus angulation. Functional outcome was assessed using Judet’s point system. Good to excellent results were achieved in 44 patients. This study demonstrated that external fixation of “intertrochantric” fractures performed under local anesthesia offers significant advantage in ambulatory high-risk geriatric patients especially in a developing country.

A modified transcondylar screw to accommodate anatomical skull base variations.

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Ghaly, R F; Lissounov, A

2017-01-01

Occipitocervical instability may be attributed to congenital, bony/ligamentous abnormalities, trauma, neoplasm, degenerative bone disease, and failed atlantoaxial fixation. Indications for occipitocervical fixation include the prevention of disabling pain, cranial nerve dysfunction, paralysis, or even sudden death. The screw trajectory for the modified transcondylar screw (mTCS) is optimally planned utilizing a three-dimensional skull reconstructed image. The modified mTCS technique is helpful where there is a loss of bone, such as after prior suboccipital craniotomy and/or an inadequate occipital condyle. The new proposed technique is similar to the classical transcondylar screw placement but follows a deeper course along the bony lip of foramen magnum toward clivus from a dorsolateral approach. The modified mTCS technique allows for direct visualization and, therefore, helps to avoid damage to the hypoglossal nerve and lateral aspect of brain stem.

The influence on the contact condition and initial fixation stability of the main design parameters of a self-expansion type anterior cruciate ligament fixation device

International Nuclear Information System (INIS)

Kim, Jong Dae; Oh, Chae Youn; Kim, Cheol Sang

2008-01-01

This paper proposes a self-expansion type anterior cruciate ligament fixation device. The proposed fixation device provides graft fixation force by maintaining contact with the bone tunnel. Since the device maintains contact with the bone tunnel by the force that expands by the self-driven elastic force of the device, the main design parameters that determine the performance of this device are the ring thickness and expansion angle. This paper develops the three-dimensional finite element models of the fixation device and bone. By simulation with the developed finite element model, this paper studies the influence of the main design parameters of the device on the maximum stress around the ring when grasping the fixation device. Through the analysis of the stress on the bone tunnel wall when the fixation device comes in contact with the bone tunnel, this paper shows the influence of the main design parameters of the fixation device on the contact condition. In addition, through the analysis of the migration that occur upon application of the pull-out force, this paper studies the influence of the main design parameters on the initial fixation stability of the fixation device

The influence on the contact condition and initial fixation stability of the main design parameters of a self-expansion type anterior cruciate ligament fixation device

Energy Technology Data Exchange (ETDEWEB)

Kim, Jong Dae [Jeonju University, Jeonju (Korea, Republic of); Oh, Chae Youn; Kim, Cheol Sang [Chonbuk National University, Jeonju (Korea, Republic of)

2008-12-15

This paper proposes a self-expansion type anterior cruciate ligament fixation device. The proposed fixation device provides graft fixation force by maintaining contact with the bone tunnel. Since the device maintains contact with the bone tunnel by the force that expands by the self-driven elastic force of the device, the main design parameters that determine the performance of this device are the ring thickness and expansion angle. This paper develops the three-dimensional finite element models of the fixation device and bone. By simulation with the developed finite element model, this paper studies the influence of the main design parameters of the device on the maximum stress around the ring when grasping the fixation device. Through the analysis of the stress on the bone tunnel wall when the fixation device comes in contact with the bone tunnel, this paper shows the influence of the main design parameters of the fixation device on the contact condition. In addition, through the analysis of the migration that occur upon application of the pull-out force, this paper studies the influence of the main design parameters on the initial fixation stability of the fixation device

Analysis and an overview of fixators in medicine and the methods of processing materials for producing fixators

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Dalibor Milojko Đenadić

2013-06-01

Full Text Available The fixator is a medical device that provides support to fractured biological structures. Metal biomaterials are mainly used for replacing broken or damaged hard tissues such as bones because of their high strenght, toughness and corrosion resistance. Materials such as stainless steel, titanium and aluminium alloys (Ti-6Al-4V, cobalt and chromium alloys, composite materials and other biocompatible materials are used in orthopedy for the stabilization of connective tissue injuries or as a substitute for the bone tissues. Fixators are classified according to the place of installation to external and internal fixators. Widely used medical fixators are pins, rods plates, screws, pipes, wires, nails and external fixators. Conventional and non-conventional methods of processing are used in the production process for all types of fixators. Introduction Fixators are medical devices manufactured to support damaged biological structures. In the field of orthopedic surgery that deals with skeletal disorders such as bone, spine, joints, muscles and tendons injuries and diseases, various metals, titanium and cobalt alloys etc. are used to stabilize the supporting tissue injuries or as a substitute for bone tissues. Metallic implants are frequently used in orthopedic surgery as joint prosthesis (hip, knee and elbow fracture fixation devices (plates, screws, external fixators and devices for the fixation of the spine. In principle, fixators are devided into external and internal ones, depending on the place of installation (outside or inside the body. The most common types of medical fixators are pins, rods and plates. This paper presents some of the most common materials used for the production of fixators, their processing and possibilties of use in medicine for various purposes. Types of fixators and materials used for their production Nowadays, biocompatible materials are usually used for the production of fixators and implants. These materials show good

External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review

DEFF Research Database (Denmark)

Ladeby Erichsen, Julie; Jensen, Carsten; Damborg, Frank Lindhøj

Internal Fixation (ORIF) or External Fixation (EF). Method : A search was conducted using PUBMED, Embase, Cochrane Central, Open Grey, Orthopaedic Proceedings and WHO International Clinical Trials Registry Platform. Studies with level of evidence I-IV comparing EF with two-stage ORIF of DIATF in patients...

The importance of nodule CO2 fixation for the efficiency of symbiotic nitrogen fixation in pea at vegetative growth and during pod formation.

Science.gov (United States)

Fischinger, Stephanie Anastasia; Schulze, Joachim

2010-05-01

Nodule CO2 fixation is of pivotal importance for N2 fixation. The process provides malate for bacteroids and oxaloacetate for nitrogen assimilation. The hypothesis of the present paper was that grain legume nodules would adapt to higher plant N demand and more restricted carbon availability at pod formation through increased nodule CO2 fixation and a more efficient N2 fixation. Growth, N2 fixation, and nodule composition during vegetative growth and at pod formation were studied in pea plants (Pisum sativum L.). In parallel experiments, 15N2 and 13CO2 uptake, as well as nodule hydrogen and CO2 release, was measured. Plants at pod formation showed higher growth rates and N2 fixation per plant when compared with vegetative growth. The specific activity of active nodules was about 25% higher at pod formation. The higher nodule activity was accompanied by higher amino acid concentration in nodules and xylem sap with a higher share of asparagine. Nodule 13CO2 fixation was increased at pod formation, both per plant and per 15N2 fixed unit. However, malate concentration in nodules was only 40% of that during vegetative growth and succinate was no longer detectable. The data indicate that increased N2 fixation at pod formation is connected with strongly increased nodule CO2 fixation. While the sugar concentration in nodules at pod formation was not altered, the concentration of organic acids, namely malate and succinate, was significantly lower. It is concluded that strategies to improve the capability of nodules to fix CO2 and form organic acids might prolong intensive N2 fixation into the later stages of pod formation and pod filling in grain legumes.

Carbon dioxide fixation in isolated Kalanchoe chloroplasts

Energy Technology Data Exchange (ETDEWEB)

Levi, C.; Gibbs, M.

1975-07-01

Chloroplasts isolated from Kalanchoe diagremontiana leaves were capable of photosynthesizing at a rate of 5.4 ..mu..moles of CO/sub 2/ per milligram of chlorophyll per hour. The dark rate of fixation was about 1 percent of the light rate. A high photosynthetic rate was associated with low starch content of the leaves. Ribose 5-phosphate, fructose 1, 6-diphosphate, and dithiothreitol stimulated fixation, whereas phosphoenolpyruvate and azide were inhibitors. The products of CO/sub 2/ fixation were primarily those of the photosynthetic carbon reduction cycle. (auth)

The effect of hubs and shortcuts on fixation time in evolutionary graphs

Science.gov (United States)

Askari, Marziyeh; Moradi Miraghaei, Zeinab; Aghababaei Samani, Keivan

2017-07-01

How can a new species (like a gene, an idea, or a strategy) take over the whole of a population? This process, which is called fixation, is considerably affected by the structure of the population. There are two key quantities to quantify the fixation process, namely fixation probability and fixation time. Fixation probability has been vastly studied in recent years, but fixation time has not been completely explored, yet. This is because the discovery of a relationship between fixation time and network structure is quite challenging. In this paper we investigate this relationship for a number of well-known complex networks. We show that the existence of a few high-degree nodes (hubs) in the network results in a longer fixation time, while the existence of a few short-cuts decreases the fixation time. Furthermore we investigate the effect of network parameters, such as connection probability, on fixation time. We show that by increasing the density of edges, fixation time decreases for all types of studied networks. Finally, we survey the effect of rewiring probability in a Watts-Strogatz network on fixation time.

Skin Graft Fixation Using Hydrofiber (Aquacel® Extra).

Science.gov (United States)

Yen, Ya-Hui; Lin, Chih-Ming; Hsu, Honda; Chen, Ying-Chen; Chen, Yi-Wen; Li, Wan-Yu; Hsieh, Chia-Nan; Huang, Chieh-Chi

2018-06-01

The traditional method of skin graft fixation is with tie-over bollus dressing. The use of splints in the extremities for skin graft fixation is a common practice. However, these splints are heavy and uncomfortable and contribute considerably to our overall medical waste. Hydrofiber (Aquacel Extra) has a strong fluid absorption property and fixates well to the underlying wound once applied. In this study, we used hydrofiber for fixation, avoiding the use of splints after skin grafting. A total of 56 patients reconstructed with split-thickness skin graft that was fixated only with hydrofiber between March 2015 and March 2016 were included in this retrospective study. There were 44 men and 12 women with a mean age of 61 ± 18 years. The defect size ranged from 1 × 1 cm for fingertips to 30 × 12 cm for lower limb defects. The average defect size was 61 ± 78 cm. The mean skin graft take was 96% ± 6%. Because splints were not required, we saved around 48 kg of medical waste over the space of 1 year. The use of hydrofiber for skin graft fixation was effective and technically very simple. Splints were not required with this method, decreasing the medical waste created and increasing patient comfort. We suggest that this is an excellent alternative for skin graft fixation while at the same time decreasing our carbon footprint as surgeons.

Do you like what you see? The role of first fixation and total fixation duration in consumer choice

NARCIS (Netherlands)

Laan, van der L.N.; Hooge, I.T.C.; Ridder, de D.T.D.; Viergever, M.A.; Smeets, P.A.M.

2015-01-01

Although there has been recent growing interest in the associations between measures of visual attention and consumer choice, there is still uncertainty about the role of the first fixation in consumer choice and the factors that drive total fixation duration. The study aimed (1) to investigate the

Do you like what you see? : The role of first fixation and total fixation duration in consumer choice

NARCIS (Netherlands)

van der Laan, Laura N.; Hooge, Ignace T C; De Ridder, Denise T D; Viergever, Max A.; Smeets, Paul A M

2015-01-01

Although there has been recent growing interest in the associations between measures of visual attention and consumer choice, there is still uncertainty about the role of the first fixation in consumer choice and the factors that drive total fixation duration. The study aimed (1) to investigate the

[Case-control study on effects of external fixation combined with limited internal fixation for the treatment of Pilon fractures of Rüedi-Allgower type III].

Science.gov (United States)

Duan, Da-Peng; You, Wu-Lin; Ji, Le; Zhang, Yong-Tao; Dang, Xiao-Qian; Wang, Kun-Zheng

2014-01-01

To analyze the effects of three surgical operations in the treatment of Pilon fracture of Rüedi-Allgower type III, and put forward the best therapeutic method. The clinical data of 33 patients with Pilon fracture who received surgical operations (plaster immobilization group, 10 cases; distal tibia anatomical plate group, 11 cases; external fixation with limited internal fixation group, 12 cases) from October 2009 to January 2012 were analyzed. There were 5 males and 5 females, ranging in age from 24 to 61 years in the plaster immobilization group. There were 7 males and 4 females, ranging in age from 21 to 64 years in the distal tibia anatomical plate group. There were 7 males and 5 females, ranging in age from 23 to 67 years in the external fixation with limited internal fixation group. The Ankle X-ray of Pilon fracture after operation, ankle score, early and late complications were collected. Bourne system was used to evaluate ankle joint function. After 8 months to 3 years follow-up, it was found that three kinds of treatment had significant differences in the outcomes and complications (P external fixation with limited internal fixation group got the best results. The number of anatomic reduction cases in the external fixation with limited internal fixation group (7 cases) and the distal tibia anatomical plate group (8 cases) was more than the plaster immobilization group (2 cases). According to the ankle score, 8 patients got an excellent result, 3 good and 1 poor in the limited internal fixation group ,which was better than those of distal tibia anatomical plate group (5 excellent, 4 good and 2 poor) and the plaster immobilization group (3 excellent, 4 good and 3 poor). The number of early and late complications in the external fixation with limited internal fixation group was more than those in the plaster immobilization group and the distal tibia anatomical plate group (Pexternal fixation with limited internal fixation in the treatment of Pilon fracture

Bilateral Laparoscopic Totally Extraperitoneal Repair Without Mesh Fixation

OpenAIRE

Dehal, Ahmed; Woodward, Brandon; Johna, Samir; Yamanishi, Frank

2014-01-01

Background and Objectives: Mesh fixation during laparoscopic totally extraperitoneal repair is thought to be necessary to prevent recurrence. However, mesh fixation may increase postoperative chronic pain. This study aimed to describe the experience of a single surgeon at our institution performing this operation. Methods: We performed a retrospective review of the medical records of all patients who underwent bilateral laparoscopic totally extraperitoneal repair without mesh fixation for ing...

Predicting Eye Fixations on Complex Visual Stimuli Using Local Symmetry.

Science.gov (United States)

Kootstra, Gert; de Boer, Bart; Schomaker, Lambert R B

2011-03-01

Most bottom-up models that predict human eye fixations are based on contrast features. The saliency model of Itti, Koch and Niebur is an example of such contrast-saliency models. Although the model has been successfully compared to human eye fixations, we show that it lacks preciseness in the prediction of fixations on mirror-symmetrical forms. The contrast model gives high response at the borders, whereas human observers consistently look at the symmetrical center of these forms. We propose a saliency model that predicts eye fixations using local mirror symmetry. To test the model, we performed an eye-tracking experiment with participants viewing complex photographic images and compared the data with our symmetry model and the contrast model. The results show that our symmetry model predicts human eye fixations significantly better on a wide variety of images including many that are not selected for their symmetrical content. Moreover, our results show that especially early fixations are on highly symmetrical areas of the images. We conclude that symmetry is a strong predictor of human eye fixations and that it can be used as a predictor of the order of fixation.

Application of monorail fixator for femoral gap nonunion

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Agrawal Hemendra Kumar

2014-07-01

Full Text Available 【Abstract】Difficult femoral nonunion takes account of infective nonunion and aseptic gap nonunion. Limb length discrepancy and nonunion need to be tackled simultaneously. Conventionally Ilizarov ring fixator is in vogue but it has some limitations. To overcome these, monorail fixator is an effective alternative. Persistent good results can be obtained if we can get a perfect anatomical alignment and good regeneration. Key words: Femur; Ilizarov technique; External fixators

Stress and stability of plate-screw fixation and screw fixation in the treatment of Schatzker type IV medial tibial plateau fracture: a comparative finite element study.

Science.gov (United States)

Huang, Xiaowei; Zhi, Zhongzheng; Yu, Baoqing; Chen, Fancheng

2015-11-25

The purpose of this study is to compare the stress and stability of plate-screw fixation and screw fixation in the treatment of Schatzker type IV medial tibial plateau fracture. A three-dimensional (3D) finite element model of the medial tibial plateau fracture (Schatzker type IV fracture) was created. An axial force of 2500 N with a distribution of 60% to the medial compartment was applied to simulate the axial compressive load on an adult knee during single-limb stance. The equivalent von Mises stress, displacement of the model relative to the distal tibia, and displacement of the implants were used as the output measures. The mean stress value of the plate-screw fixation system was 18.78 MPa, which was significantly (P stress value of the triangular fragment in the plate-screw fixation system model was 42.04 MPa, which was higher than that in the screw fixation model (24.18 MPa). But the mean stress of the triangular fractured fragment in the screw fixation model was significantly higher in terms of equivalent von Mises stress (EVMS), x-axis, and z-axis (P < 0.001). This study demonstrated that the load transmission mechanism between plate-screw fixation system and screw fixation system was different and the stability provided by the plate-screw fixation system was superior to the screw fixation system.

14CO2 fixation pattern of cyanobacteria

International Nuclear Information System (INIS)

Erdmann, N.; Schiewer, U.

1985-01-01

The 14 CO 2 fixation pattern of three cyanobacteria in the light and dark were studied. Two different chromatographic methods widely used for separating labelled photosynthetic intermediates were compared. After ethanolic extraction, a rather uniform fixation pattern reflecting mainly the β-carboxylation pathway is obtained for all 3 species. Of the intermediates, glucosylglycerol is specific and high citrulline and low malate contents are fairly specific to cyanobacteria. The composition of the 14 CO 2 fixation pattern is hardly affected by changes in temperature or light intensity, but it is severely affected by changes in the water potential of the medium. (author)

Acromioclavicular joint dislocation: a Dog Bone button fixation alone versus Dog Bone button fixation augmented with acromioclavicular repair-a finite element analysis study.

Science.gov (United States)

Sumanont, Sermsak; Nopamassiri, Supachoke; Boonrod, Artit; Apiwatanakul, Punyawat; Boonrod, Arunnit; Phornphutkul, Chanakarn

2018-03-20

Suspension suture button fixation was frequently used to treat acromioclavicular joint (ACJ) dislocation. However, there were many studies reporting about complications and residual horizontal instability after fixation. Our study compared the stability of ACJ after fixation between coracoclavicular (CC) fixation alone and CC fixation combined with ACJ repair by using finite element analysis (FEA). A finite element model was created by using CT images from the normal shoulder. The model 1 was CC fixation with suture button alone, and the model 2 was CC fixation with suture button combined with ACJ repair. Three different forces (50, 100, 200 N) applied to the model in three planes; inferior, anterior and posterior direction load to the acromion. The von Mises stress of the implants and deformation at ACJs was recorded. The ACJ repair in the model 2 could reduce the peak stress on the implant after applying the loading forces to the acromion which the ACJ repair could reduce the peak stress of the FiberWire at suture button about 90% when compared to model 1. And, the ACJ repair could reduce the deformation of the ACJ after applying the loading forces to the acromion in both vertical and horizontal planes. This FEA supports that the high-grade injuries of the ACJ should be treated with CC fixation combined with ACJ repair because this technique provides excellent stability in both vertical and horizontal planes and reduces stress to the suture button.

"Cold" Fixation: Reconciliation of Nitrogen Fixation Rates and Diazotroph Assemblages in the Arctic Ocean

Science.gov (United States)

Fong, A. A.; Waite, A.; Rost, B.; Richter, K. U.

2016-02-01

Measurements of biological nitrogen fixation are typically conducted in oligotrophic subtropical and tropical marine environments where concentrations of fixed inorganic nitrogen are low. To date, only a handful of nitrogen fixation studies have been conducted in high latitude marine environments, but further investigation is needed to resolve the distribution of cold ocean diazotrophic assemblages. Nitrogen fixation rates and nifH gene distributions were measured at seven stations from 5°E to 20°E, north of 81°N in the Arctic Ocean at the onset of summer 2015. Discrete water samples in ice-covered regions were collected from the sea surface to 200 m for 15N2-tracer additions and targeted nifH gene and transcript analyses. Previous work suggests that heterotrophic bacteria dominate diazotrophic communities in the Arctic Ocean. Therefore, additional nifH gene surveys of sinking particles were conducted to test for enrichment on organic matter-rich microenvironments. Together, these measurements aim to reconcile diazotrophic activity with microbial community composition, further elucidating how nitrogen fixers could impact current concepts in polar carbon and nutrient cycling.

Comparative study of thyroid fixation of different iodine compounds; Etude comparative de la fixation thyroidienne de differents composes iodes

Energy Technology Data Exchange (ETDEWEB)

Rinaldi, R; Coeur, A; Raynfeld, Ch [Commissariat a l' Energie Atomique, Grenoble (France).Centre d' Etudes Nucleaires

1961-07-01

The aim of this work is to study the thyroid fixation of various iodine compounds in mineral or organic form. The animals (rats) are given therapeutic doses of the derivative orally with the object of saturating the thyroid, and then receive a determined dose of radio-iodine 131 by intra-peritoneal injection; any fixation of this latter is then measured under anaesthetic by means of a scintillation counter. Whatever form of iodine derivative was used whether in ionic (potassium iodide type) or organic form (iodo-tannic syrup) or in the form of elementary iodine (iodinated water), thyroid saturation was always obtained, as shown by practically zero fixation of the 4 {mu}curies of iodine 131 administered by intra-peritoneal injection. (author) [French] Notre travail a pour but l'etude de la fixation thyroidienne de differents composes iodes sous forme minerale ou organique. Les animaux (rats), apres absorption orale de doses therapeutiques de derives destines a saturer leur thyroide recoivent par voie intra-peritoneale une dose determinee de radio-iode {sup 131}I, la fixation eventuelle de ce dernier est ensuite mesuree sous anesthesie en utilisant un compteur a scintillation. Quelle que soit la forme utilisee, c'est-a-dire derive iode sous forme ionique (type iodure de potassium) ou sous forme organique (sirop iodotanique) ou encore sous forme d'iode metalloidique (eau iodee), nous avons obtenu chaque fois une saturation thyroidienne mise en evidence par une fixation pratiquement nulle des 4 {mu}curies de l'iode 131 injectes par voie intraperitoneale. (auteur)

A cell shrinkage artefact in growth plate chondrocytes with common fixative solutions: importance of fixative osmolarity for maintaining morphology

Directory of Open Access Journals (Sweden)

MY Loqman

2010-05-01

Full Text Available The remarkable increase in chondrocyte volume is a major determinant in the longitudinal growth of mammalian bones. To permit a detailed morphological study of hypertrophic chondrocytes using standard histological techniques, the preservation of normal chondrocyte morphology is essential. We noticed that during fixation of growth plates with conventional fixative solutions, there was a marked morphological (shrinkage artifact, and we postulated that this arose from the hyper-osmotic nature of these solutions. To test this, we fixed proximal tibia growth plates of 7-day-old rat bones in either (a paraformaldehyde (PFA; 4%, (b glutaraldehyde (GA; 2% with PFA (2% with ruthenium hexamine trichloride (RHT; 0.7%, (c GA (2% with RHT (0.7%, or (d GA (1.3% with RHT (0.5% and osmolarity adjusted to a ‘physiological’ level of ~280mOsm. Using conventional histological methods, confocal microscopy, and image analysis on fluorescently-labelled fixed and living chondrocytes, we then quantified the extent of cell shrinkage and volume change. Our data showed that the high osmolarity of conventional fixatives caused a shrinkage artefact to chondrocytes. This was particularly evident when whole bones were fixed, but could be markedly reduced if bones were sagittally bisected prior to fixation. The shrinkage artefact could be avoided by adjusting the osmolarity of the fixatives to the osmotic pressure of normal extracellular fluids (~280mOsm. These results emphasize the importance of fixative osmolarity, in order to accurately preserve the normal volume/morphology of cells within tissues.

Clinical efficacy and safety of limited internal fixation combined with external fixation for Pilon fracture: A systematic review and meta-analysis

OpenAIRE

Zhang, Shaobo; Zhang, Yibao; Wang, Shenghong; Zhang, Hua; Liu, Peng; Zhang, Wei; Ma, Jing-Lin; Wang, Jing

2017-01-01

Purpose: To compare the clinical efficacy and complications of limited internal fixation combined with external fixation (LIFEF) and open reduction and internal fixation (ORIF) in the treatment of Pilon fracture. Methods: We searched databases including Pubmed, Embase, Web of science, Cochrane Library and China Biology Medicine disc for the studies comparing clinical efficacy and complications of LIFEF and ORIF in the treatment of Pilon fracture. The clinical efficacy was evaluated by the ...

Translaminar screw fixation in the lumbar spine: technique, indications, results

OpenAIRE

Grob, D.; Humke, T.

1998-01-01

Translaminar screw fixation of the lumbar spine represents a simple and effective technique for short segment fusion in the degenerative spine. Clinical experience with 173 patients who underwent translaminar screw fixation revealed a fusion rate of 94%. The indications for translaminar screw fixation as a primary fixation procedure are: segmental dysfunction, lumbar spinal stenosis with painful degenerative changes, segmental revision surgery after discectomies, and painful disc-related synd...

Miniplate fixation of Le Fort I osteotomies.

Science.gov (United States)

Rosen, H M

1986-12-01

The use of rigid, internal, three-dimensional fixation using vitallium bone plates in 28 consecutive Le Fort I osteotomies is presented. A minimum follow-up period of 6 months was required for inclusion in this patient group. Maxillary movements included advancements (17), intrusions (9), lengthenings (5), and retrusions (2). The majority of maxillae were moved in more than one plane of space. Technical details, complications, and relapse potential are discussed. Advantages of rigid plate fixation include marked reductions in the length of intermaxillary fixation with light training elastics only. Immediate postoperative airway problems are thereby eliminated. Six months of follow-up would appear to indicate a low potential for osseous relapse when compared to wire osteosynthesis, regardless of the direction of maxillary movement. The major disadvantage is the decreased ability of postoperative orthodontics to move dento-osseous segments if skeletal occlusal disharmony persists postoperatively. For this reason, close attention to preoperative planning and operative technique is critical for the success of this fixation method.

Fixation orientation in ankle fractures with syndesmosis injury.

Science.gov (United States)

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

2013-01-01

Accurate reduction of the syndesmosis has been shown to be an important prognostic factor for functional outcome in ankle injuries that disrupt the syndesmosis. The purpose of the present case series was to assess the fixation orientation and the position of the fibula within the tibial incisura after open reduction and internal fixation of ankle fractures with syndesmosis injury. Computed tomography was used to assess the accuracy of the reduction. Twelve patients were included in the present case series. A ratio representing the relationship between the tibia and fibula and the orientation of the syndesmotic fixation was measured preoperatively and postoperatively and compared with the uninjured contralateral ankle, representing the patient's normal anatomy. The measurements were accomplished electronically to one tenth of 1 mm using Stentor Intelligent Informatics, I-site, version 3.3.1 (Phillips Electronics; Andover, MA). Posteriorly oriented syndesmotic fixation caused posterior translation of the fibula with respect to the tibia and anteriorly oriented syndesmotic fixation caused anterior translation. Copyright © 2013. Published by Elsevier Inc.

EFFECT OF EMBEDDING METHODS VERSUS FIXATIVE TYPE ON KARYOMETRIC MEASURES

NARCIS (Netherlands)

BOON, ME; VANDERPOEL, HG; TAN, CJA; KOK, LP

The influence of fixation and embedding methods in seven urologic tumor samples was studied karyometrically for 12 preparatory techniques. Routine histologic formalin fixation was compared with Carbowax and Kryofix fixatives. Also, histologic material was studied embedded in paraffin and plastic

Fracture healing using degradable magnesium fixation plates and screws.

Science.gov (United States)

Chaya, Amy; Yoshizawa, Sayuri; Verdelis, Kostas; Noorani, Sabrina; Costello, Bernard J; Sfeir, Charles

2015-02-01

Internal bone fixation devices made with permanent metals are associated with numerous long-term complications and may require removal. We hypothesized that fixation devices made with degradable magnesium alloys could provide an ideal combination of strength and degradation, facilitating fracture fixation and healing while eliminating the need for implant removal surgery. Fixation plates and screws were machined from 99.9% pure magnesium and compared with titanium devices in a rabbit ulnar fracture model. Magnesium device degradation and the effect on fracture healing and bone formation were assessed after 4 weeks. Fracture healing with magnesium device fixation was compared with that of titanium devices using qualitative histologic analysis and quantitative histomorphometry. Micro-computed tomography showed device degradation after 4 weeks in vivo. In addition, 2-dimensional micro-computed tomography slices and histologic staining showed that magnesium degradation did not inhibit fracture healing or bone formation. Histomorphology showed no difference in bone-bridging fractures fixed with magnesium and titanium devices. Interestingly, abundant new bone was formed around magnesium devices, suggesting a connection between magnesium degradation and bone formation. Our results show potential for magnesium fixation devices in a loaded fracture environment. Furthermore, these results suggest that magnesium fixation devices may enhance fracture healing by encouraging localized new bone formation. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

2008-01-01

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

Carbon Dioxide Fixation in Isolated Kalanchoe Chloroplasts 1

Science.gov (United States)

Levi, Carolyn; Gibbs, Martin

1975-01-01

Chloroplasts isolated from Kalanchoe diagremontiana leaves were capable of photosynthesizing at a rate of 5.4 μmoles of CO2 per milligram of chlorophyll per hour. The dark rate of fixation was about 1% of the light rate. A high photosynthetic rate was associated with low starch content of the leaves. Ribose 5-phosphate, fructose 1,6-diphosphate, and dithiothreitol stimulated fixation, whereas phosphoenolpyruvate and azide were inhibitors. The products of CO2 fixation were primarily those of the photosynthetic carbon reduction cycle. PMID:16659249

Changes in biomolecular profile in a single nucleolus during cell fixation.

Science.gov (United States)

Kuzmin, Andrey N; Pliss, Artem; Prasad, Paras N

2014-11-04

Fixation of biological sample is an essential technique applied in order to "freeze" in time the intracellular molecular content. However, fixation induces changes of the cellular molecular structure, which mask physiological distribution of biomolecules and bias interpretation of results. Accurate, sensitive, and comprehensive characterization of changes in biomolecular composition, occurring during fixation, is crucial for proper analysis of experimental data. Here we apply biomolecular component analysis for Raman spectra measured in the same nucleoli of HeLa cells before and after fixation by either formaldehyde solution or by chilled ethanol. It is found that fixation in formaldehyde does not strongly affect the Raman spectra of nucleolar biomolecular components, but may significantly decrease the nucleolar RNA concentration. At the same time, ethanol fixation leads to a proportional increase (up to 40%) in concentrations of nucleolar proteins and RNA, most likely due to cell shrinkage occurring in the presence of coagulant fixative. Ethanol fixation also triggers changes in composition of nucleolar proteome, as indicated by an overall reduction of the α-helical structure of proteins and increase in the concentration of proteins containing the β-sheet conformation. We conclude that cross-linking fixation is a more appropriate protocol for mapping of proteins in situ. At the same time, ethanol fixation is preferential for studies of RNA-containing macromolecules. We supplemented our quantitative Raman spectroscopic measurements with mapping of the protein and lipid macromolecular groups in live and fixed cells using coherent anti-Stokes Raman scattering nonlinear optical imaging.

Mini-Fragment Fixation Is Equivalent to Bicortical Screw Fixation for Horizontal Medial Malleolus Fractures.

Science.gov (United States)

Wegner, Adam M; Wolinsky, Philip R; Robbins, Michael A; Garcia, Tanya C; Amanatullah, Derek F

2018-05-01

Horizontal fractures of the medial malleolus occur through application of valgus or abduction force through the ankle that creates a tension failure of the medial malleolus. The authors hypothesize that mini-fragment T-plates may offer improved fixation, but the optimal fixation construct for these fractures remains unclear. Forty synthetic distal tibiae with identical osteotomies were randomized into 4 fixation constructs: (1) two parallel unicortical cancellous screws; (2) two parallel bicortical cortical screws; (3) a contoured mini-fragment T-plate with 2 unicortical screws in the fragment and 2 bicortical screws in the shaft; and (4) a contoured mini-fragment T-plate with 2 bicortical screws in the fragment and 2 unicortical screws in the shaft. Specimens were subjected to offset axial tension loading on a servohydraulic testing system and tracked using high-resolution video. Failure was defined as 2 mm of articular displacement. Analysis of variance followed by a Tukey-Kramer post hoc test was used to assess for differences between groups, with significance defined as Pfragment T-plate constructs (239±83 N/mm and 190±37 N/mm) and the bicortical screw construct (240±17 N/mm) were not statistically different. The mean stiffness values of both mini-fragment T-plate constructs and the bicortical screw construct were higher than that of a parallel unicortical screw construct (102±20 N/mm). Contoured T-plate constructs provide stiffer initial fixation than a unicortical cancellous screw construct. The T-plate is biomechanically equivalent to a bicortical screw construct, but may be superior in capturing small fragments of bone. [Orthopedics. 2018; 41(3):e395-e399.]. Copyright 2018, SLACK Incorporated.

Design and Optimization of Resorbable Silk Internal Fixation Devices

Science.gov (United States)

Haas, Dylan S.

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

Anterior fixation of the axis.

Science.gov (United States)

Traynelis, Vincent C; Fontes, Ricardo B V

2010-09-01

Although anterior fixation of the axis is not commonly performed, plate fixation of C2 is an important technique for treating select upper cervical traumatic injuries and is also useful in the surgical management of spondylosis. To report the technique and outcomes of C2 anterior plate fixation for a series of patients in which the majority presented with symptomatic degenerative spondylosis. Forty-six consecutive patients underwent single or multilevel fusions over a 7-year period; 30 of these had advanced degenerative disease manifested by myelopathy or deformity. Exposure was achieved with rostral extension of the standard anterior cervical exposure via careful soft tissue dissection, mobilization of the superior thyroid artery, and the use of a table-mounted retractor. It was not necessary to remove the submandibular gland, section the digastric muscle, or make additional skin incisions. Screws were placed an average of 4.6 mm (+/- 2.3 mm) from the inferior C2 endplate with a mean sagittal trajectory of 15.7 degrees (+/- 7.6 degrees). Short- and long-term procedure-related mortality was 4.4%, and perioperative morbidity was 8.9%. Patients remained intubated an average of 2.5 days following surgery. Dysphagia was initially reported by 15.2% of patients but resolved by the 8th postoperative week in all patients. Arthrodesis was achieved in all patients available for long-term follow-up. Multilevel fusions were not associated with longer hospitalization or morbidity. Anterior plate fixation of the axis for degenerative disease can be accomplished with acceptable morbidity employing an extension of the standard anterolateral route.

Sacroiliac Screw Fixation

NARCIS (Netherlands)

E.W. van den Bosch

2003-01-01

textabstractThe aim of this thesis is to evaluate three major aspects of the use of sacroiliac screws in patients with unstable pelvic ring fractures: the optimal technique for sacroiliac screw fixation, the reliability of peroperative fluoroscopy and the late results. We focused on the questions

Subchondral cysts of the atlantoaxial joint: a risk factor for odontoid fractures in the elderly.

Science.gov (United States)

Julien, Terrill P; Schoenfeld, Andrew J; Barlow, Brian; Harris, Mitchel B

2009-10-01

Scholars have postulated that cervical degeneration can predispose the upper cervical spine to injury after minor trauma. Subchondral cysts have previously been recognized as potentiators of fracture in the hip and knee but no cases of cervical degenerative cysts contributing to fracture have been reported. This report documents a case series in which patients sustained significant injury to the upper cervical spine in the setting of subchondral cervical cysts. Case series/academic level I trauma center. Between 2004 and 2008, six patients (ages 73-91 years) with cervical pathology were admitted to the trauma service at our Level I trauma center. The most common mechanism of injury was a low velocity fall, which occurred in 5 out of 6 patients. All patients suffered an odontoid fracture. In all cases, there was radiographic evidence of cyst formation, and computed tomographic imaging demonstrated fracture communication with the subchondral cyst. Of the six cases, four were treated definitively with immobilization in a cervical orthosis and two required surgery. One patient was treated with an occipital-cervical fusion, whereas the other underwent Brooks wiring. All patients ultimately went on to heal their fractures. Degenerative changes in the cervical spine have previously been recognized to potentiate injury. This report raises the question of whether degenerative processes at the C1-C2 articulation predispose elderly patients to injury at this level. The presence of cystic degeneration at the atlantoaxial joint should be recognized as a potential risk factor for cervical injury after relatively minor trauma.

Nitrogen fixation by legumes in retorted shale

Energy Technology Data Exchange (ETDEWEB)

Hersman, L E; Molitoris, E; Klein, D A

1981-01-01

A study was made to determine whether retorted shale additions would significantly affect symbiotic N/sub 2/ fixation. Results indicate that small additions of the shale may stimulate plant growth but with higher concentrations plants are stressed, resulting in a decreased biomass and a compensatory effect of an increased number of nodules and N/sub 2/ fixation potential. (JMT)

Improper tube fixation causing a leaky cuff

Directory of Open Access Journals (Sweden)

Gupta Babita

2010-01-01

Full Text Available Leaking endotracheal tube cuffs are common problems in intensive care units. We report a case wherein the inflation tube was damaged by the adhesive plaster used for tube fixation and resulted in leaking endotracheal tube cuff. We also give some suggestions regarding the tube fixation and some remedial measures for damaged inflation system.

External fixation of tibial pilon fractures and fracture healing.

Science.gov (United States)

Ristiniemi, Jukka

2007-06-01

Distal tibial fractures are rare and difficult to treat because the bones are subcutaneous. External fixation is commonly used, but the method often results in delayed union. The aim of the present study was to find out the factors that affect fracture union in tibial pilon fractures. For this purpose, prospective data collection of tibial pilon fractures was carried out in 1998-2004, resulting in 159 fractures, of which 83 were treated with external fixation. Additionally, 23 open tibial fractures with significant > 3 cm bone defect that were treated with a staged method in 2000-2004 were retrospectively evaluated. The specific questions to be answered were: What are the risk factors for delayed union associated with two-ring hybrid external fixation? Does human recombinant BMP-7 accelerate healing? What is the role of temporary ankle-spanning external fixation? What is the healing potential of distal tibial bone loss treated with a staged method using antibiotic beads and subsequent autogenous cancellous grafting compared to other locations of the tibia? The following risk factors for delayed healing after external fixation were identified: post-reduction fracture gap of >3 mm and fixation of the associated fibula fracture. Fracture displacement could be better controlled with initial temporary external fixation than with early definitive fixation, but it had no significant effect on healing time, functional outcome or complication rate. Osteoinduction with rhBMP-7 was found to accelerate fracture healing and to shorten the sick leave. A staged method using antibiotic beads and subsequent autogenous cancellous grafting proved to be effective in the treatment of tibial bone loss. Healing potential of the bone loss in distal tibia was at least equally good as in other locations of the tibia.

[Case-control study on T-shaped locking internal fixation and external fixation for the treatment of dorsal Barton's fracture].

Science.gov (United States)

Chen, Huan-qing; Wen, Xi-le; Li, Yang-ming; Wen, Cong-you

2015-06-01

To compare clinical effect of T-shaped locking internal fixation and external fixation in treating dorsal Barton's fracture,and investigate selective strategy of internal fixation. From January 2008 to January 2013, 100 patients with dorsal Barton's fracture were randomly divided into two groups. In treatment group, there were 30 males and 20 females with an average age of (33.8±3.6) years old;30 cases were type B, 20 cases were type C;and treated with T-shaped locking internal fixation. In control group, there were 32 male and 18 females with an average age of (32.9±3.4) years old; 29 cases were type B, 21 cases were type C; and treated with external fixation. Volar tilt, ulnar deviation and radial height at 3 months after operation were detected and compared between two groups. Mechara functional evaluation were used to evaluate postoperative clinical effects. Clinical cure time, postoperative complications,joint mobility and function score were recorded and compared between two groups. In treatment group,volar tilt was (11.9±2.7)°, ulnar deviation was (20.8+ 2.9)°,and radial height was (10.9±1.8) mm; while volar tilt was (9.1±1.6)°, ulnar deviation was (17.1±2.9)°, and radial height was (8.1±1.5) mm in control group. Treatment group was better than control group in volar tilt, ulnar deviation and radial height. Clinical cure time in treatment group was(12.0±2.3) weeks, shorter than control group (18.0±4.1) weeks. The incidence of complications in treatment group was lower than control group. According to Mehara functional evaluation,20 cases got excellent results, 25 good, 3 moderate and 2 poor in treatment group; 16 cases got excellent results, 14 good, 10 moderate and 10 poor in control group. Treatment group was better than control group in clinical effects. T-shaped locking internal fixation with postoperative functional exercise for the treatment of dorsal Barton's fracture fits for biomechanics demands,and has advantages of stable fixation

Headspace analysis of foams and fixatives

Energy Technology Data Exchange (ETDEWEB)

Harper, Kyle [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Truong, Thanh-Tam [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Magwood, Leroy [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Peters, Brent [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Nicholson, James [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Washington, II, Aaron L. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2017-07-27

In the process of decontaminating and decommissioning (D&D) older nuclear facilities, special precautions must be taken with removable or airborne contamination. One possible strategy utilizes foams and fixatives to affix these loose contaminants. Many foams and fixatives are already commercially available, either generically or sold specifically for D&D. However, due to a lack of revelant testing in a radioactive environment, additional verification is needed to confirm that these products not only affix contamination to their surfaces, but also will function in a D&D environment. Several significant safety factors, including flammability and worker safety, can be analyzed through the process of headspace analysis, a technique that analyzes the off gas formed before or during the curing process of the foam/fixative, usually using gas chromatography-mass spectrometry (GC-MS). This process focuses on the volatile components of a chemical, which move freely between the solid/liquid form within the sample and the gaseous form in the area above the sample (the headspace). Between possibly hot conditions in a D&D situation and heat created in a foaming reaction, the volatility of many chemicals can change, and thus different gasses can be released at different times throughout the reaction. This project focused on analysis of volatile chemicals involved in the process of using foams and fixatives to identify any potential hazardous or flammable compounds.

Biomechanical Comparison of External Fixation and Compression Screws for Transverse Tarsal Joint Arthrodesis.

Science.gov (United States)

Latt, L Daniel; Glisson, Richard R; Adams, Samuel B; Schuh, Reinhard; Narron, John A; Easley, Mark E

2015-10-01

Transverse tarsal joint arthrodesis is commonly performed in the operative treatment of hindfoot arthritis and acquired flatfoot deformity. While fixation is typically achieved using screws, failure to obtain and maintain joint compression sometimes occurs, potentially leading to nonunion. External fixation is an alternate method of achieving arthrodesis site compression and has the advantage of allowing postoperative compression adjustment when necessary. However, its performance relative to standard screw fixation has not been quantified in this application. We hypothesized that external fixation could provide transverse tarsal joint compression exceeding that possible with screw fixation. Transverse tarsal joint fixation was performed sequentially, first with a circular external fixator and then with compression screws, on 9 fresh-frozen cadaveric legs. The external fixator was attached in abutting rings fixed to the tibia and the hindfoot and a third anterior ring parallel to the hindfoot ring using transverse wires and half-pins in the tibial diaphysis, calcaneus, and metatarsals. Screw fixation comprised two 4.3 mm headless compression screws traversing the talonavicular joint and 1 across the calcaneocuboid joint. Compressive forces generated during incremental fixator foot ring displacement to 20 mm and incremental screw tightening were measured using a custom-fabricated instrumented miniature external fixator spanning the transverse tarsal joint. The maximum compressive force generated by the external fixator averaged 186% of that produced by the screws (range, 104%-391%). Fixator compression surpassed that obtainable with screws at 12 mm of ring displacement and decreased when the tibial ring was detached. No correlation was found between bone density and the compressive force achievable by either fusion method. The compression across the transverse tarsal joint that can be obtained with a circular external fixator including a tibial ring exceeds that

Biometric recognition via fixation density maps

Science.gov (United States)

Rigas, Ioannis; Komogortsev, Oleg V.

2014-05-01

This work introduces and evaluates a novel eye movement-driven biometric approach that employs eye fixation density maps for person identification. The proposed feature offers a dynamic representation of the biometric identity, storing rich information regarding the behavioral and physical eye movement characteristics of the individuals. The innate ability of fixation density maps to capture the spatial layout of the eye movements in conjunction with their probabilistic nature makes them a particularly suitable option as an eye movement biometrical trait in cases when free-viewing stimuli is presented. In order to demonstrate the effectiveness of the proposed approach, the method is evaluated on three different datasets containing a wide gamut of stimuli types, such as static images, video and text segments. The obtained results indicate a minimum EER (Equal Error Rate) of 18.3 %, revealing the perspectives on the utilization of fixation density maps as an enhancing biometrical cue during identification scenarios in dynamic visual environments.

Large fluctuations and fixation in evolutionary games

International Nuclear Information System (INIS)

Assaf, Michael; Mobilia, Mauro

2010-01-01

We study large fluctuations in evolutionary games belonging to the coordination and anti-coordination classes. The dynamics of these games, modeling cooperation dilemmas, is characterized by a coexistence fixed point separating two absorbing states. We are particularly interested in the problem of fixation that refers to the possibility that a few mutants take over the entire population. Here, the fixation phenomenon is induced by large fluctuations and is investigated by a semiclassical WKB (Wentzel–Kramers–Brillouin) theory generalized to treat stochastic systems possessing multiple absorbing states. Importantly, this method allows us to analyze the combined influence of selection and random fluctuations on the evolutionary dynamics beyond the weak selection limit often considered in previous works. We accurately compute, including pre-exponential factors, the probability distribution function in the long-lived coexistence state and the mean fixation time necessary for a few mutants to take over the entire population in anti-coordination games, and also the fixation probability in the coordination class. Our analytical results compare excellently with extensive numerical simulations. Furthermore, we demonstrate that our treatment is superior to the Fokker–Planck approximation when the selection intensity is finite

Locking plate fixation for proximal humerus fractures.

LENUS (Irish Health Repository)

Burke, Neil G

2012-02-01

Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis. The goals of surgery for proximal humeral fractures should involve minimal soft tissue dissection and achieve anatomic reduction of the head complex with sufficient stability to allow for early shoulder mobilization. This article reviews various treatment options, in particular locking plate fixation. Locking plate fixation is associated with a high complication rate, such as avascular necrosis (7.9%), screw cutout (11.6%), and revision surgery (13.7%). These complications are frequently due to the varus deformation of the humeral head. Strategic screw placement in the humeral head would minimize the possibility of loss of fracture reduction and potential hardware complications. Locking plate fixation is a good surgical option for the management of proximal humerus fractures. Complications can be avoided by using better bone stock and by careful screw placement in the humeral head.

The Role of Personality and Team-Based Product Dissection on Fixation Effects

Science.gov (United States)

Toh, Christine; Miller, Scarlett; Kremer, Gül E. Okudan

2013-01-01

Design fixation has been found to be complex in its definition and expression, but it plays an important role in design idea generation. Identifying the factors that influence fixation is crucial in understanding how to enhance the design process and reduce the negative effects of fixation. One way to potentially mitigate fixation is through…

Environmental and biogeochemical controls on N2 fixation in ombrotrophic peatlands

Science.gov (United States)

Zivkovic, T.; Moore, T. R.

2017-12-01

Northern peatlands have low atmospheric nitrogen (N) inputs and acquire N mostly via biological, microbially-driven N2-fixation. Little is known about rates and controls on N2-fixation in ombrotrophic bogs. We conducted two studies to test environmental and biogeochemical controls on N2-fixation. First, we used acetylene reduction assay (ARA) calibrated with 15N2 tracer to measure N2-fixation rates in three species of Sphagnum mosses along a hydrological gradient (beaver pond, hollow and hummock in bog margin and in bog) at Mer Bleue bog from June-October 2013 and May - November 2014. We tested the following controls: moisture availability, temperature, and PAR. The largest ARA rates throughout both seasons occurred in the pond in floating Sphagnum cuspidatum mats (50.3 ± 12.9 μmol m-2 d-1 Mean ± SE), which were up to 2.5 times larger than the rates found in the driest hummock site. There was a significant seasonal peak in both years in July and early August that coincided with the peak of the air temperature. In fact, 45% of the variance of N2 fixation rates over the two field seasons was explained by rain events, water table fluctuations and the surface peat temperature (multiple regression analysis, n = 539). Our results highlight the potential impact of climate change, namely negative effects due to potential droughts and positive effect of warming, on N2 fixation patterns in ombrotrophic peatlands. Secondly, we tested stoichiometric controls (Sphagnum tissue N and phosphorous (P) ratio) of N2-fixation. In a controlled environment, we selected eight study sites along a latitudinal gradient from temperate, boreal to subarctic zone in eastern Canada. We found that decreasing N:P ratio corresponded to increasing N2-fixation. N:P explained 65% of the variance in N2-fixation in hollows but only 20% in hummocks. Changes in neither N or P concentration alone explained the increase in N2-fixation better than N:P ratio. We interpret that the difference between

Elevated CO2 concentration around alfalfa nodules increases N2 fixation

OpenAIRE

Fischinger, Stephanie A.; Hristozkova, Marieta; Mainassara, Zaman-Allah; Schulze, Joachim

2009-01-01

Nodule CO2 fixation via PEPC provides malate for bacteroids and oxaloacetate for N assimilation. The process is therefore of central importance for efficient nitrogen fixation. Nodule CO2 fixation is known to depend on external CO2 concentration. The hypothesis of the present paper was that nitrogen fixation in alfalfa plants is enhanced when the nodules are exposed to elevated CO2 concentrations. Therefore nodulated plants of alfalfa were grown in a hydroponic system that allowed separate ae...

Cosmetic arm lengthening with monorail fixator.

Science.gov (United States)

Agrawal, Hemendra Kumar; Singh, Balvinder; Garg, Mohit; Khatkar, Vipin; Batra, Sumit; Sharma, Vinod Kumar

2015-01-01

Upper limb length discrepancy is a rare occurrence. Humerus shortening may need specialized treatment to restore the functional and cosmetic status of upper limb. We report a case of humerus lengthening of 9 cm with a monorail external fixator and the result was observed during a 2-year follow-up. Humerus lengthening needs specialized focus as it is not only a cosmetic issue but also a functional demand. The monorail unilateral fixator is more functional and cosmetically acceptable, and thus becomes an effective treatment option.

Modified fixation with pinning and external fixation components for feline femur multiple-lined fracture: A case report

International Nuclear Information System (INIS)

Okamoto, Y.; Minami, S.; Matuhashi, A.

1992-01-01

A 3-year-old female Japanese domestic cat, weighing 3kg, was referred to us because of right hind leg lameness occuring for 3 days' duration. Radiography of the affected leg revealed severe femoral diaphysial comminuted fracture. The affected leg was treated using wire with an intramedullary Stainman pin being placed completely through the femur. After suturing the wound, both ends of the intramedullary pin exposed both proximally and distally were fixed with external fixation components (two double clamps, two single clamps, two short rods and one long rod) to prevent the pin from rotation. There was a slight gait problem due to the external apparatus and no post-operative infection. The function of the right hind leg gradually recovered. The intramedullary pin and external fixative apparatus were removed on the 52nd day after surgery. This modified fixation appears to offer versatility in the treatment of various fractures in smaller dogs and cats

Early Experience with Biodegradable Fixation of Pediatric Mandibular Fractures

OpenAIRE

Mazeed, Ahmed Salah; Shoeib, Mohammed Abdel-Raheem; Saied, Samia Mohammed Ahmed; Elsherbiny, Ahmed

2014-01-01

This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-l/dl-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3–12 years old) with 14 mandibular fractures. They were treated by open reduction and internal fixation by SR-PLDLA plates and screws. Maxillomandibular fixation was maintained for 1 week postoperatively. Clinical follow-up was performed at 1 week, 6 weeks, 3 months, and...

Preliminary experience with biodegradable implants for fracture fixation

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Dhillon Mandeep

2008-01-01

Full Text Available Background: Biodegradable implants were designed to overcome the disadvantages of metal-based internal fixation devices. Although they have been in use for four decades internationally, many surgeons in India continue to be skeptical about the mechanical strength of biodegradable implants, hence this study. Materials and Methods: A prospective study was done to assess the feasibility and surgeon confidence level with biodegradable implants over a 12-month period in an Indian hospital. Fifteen fractures (intra-articular, metaphyseal or small bone fractures were fixed with biodegradable implants. The surgeries were randomly scheduled so that different surgeons with different levels of experience could use the implants for fixation. Results: Three fractures (one humeral condyle, two capitulum, were supplemented by additional K-wires fixation. Trans-articular fixator was applied in two distal radius and two pilon fractures where bio-pins alone were used. All fractures united, but in two cases the fracture displaced partially during the healing phase; one fibula due to early walking, and one radius was deemed unstable even after bio-pin and external fixator. Conclusions: Biodegradable -implants are excellent for carefully selected cases of intra-articular fractures and some small bone fractures. However, limitations for use in long bone fractures persist and no great advantage is gained if a "hybrid" composite is employed. The mechanical properties of biopins and screws in isolation are perceived to be inferior to those of conventional metal implants, leading to low confidence levels regarding the stability of reduced fractures; these implants should be used predominantly in fracture patterns in which internal fixation is subjected to minimal stress.

Buckminsterfullerenes: a non-metal system for nitrogen fixation.

Science.gov (United States)

Nishibayashi, Yoshiaki; Saito, Makoto; Uemura, Sakae; Takekuma, Shin-Ichi; Takekuma, Hideko; Yoshida, Zen-Ichi

2004-03-18

In all nitrogen-fixation processes known so far--including the industrial Haber-Bosch process, biological fixation by nitrogenase enzymes and previously described homogeneous synthetic systems--the direct transformation of the stable, inert dinitrogen molecule (N2) into ammonia (NH3) relies on the powerful redox properties of metals. Here we show that nitrogen fixation can also be achieved by using a non-metallic buckminsterfullerene (C60) molecule, in the form of a water-soluble C60:gamma-cyclodextrin (1:2) complex, and light under nitrogen at atmospheric pressure. This metal-free system efficiently fixes nitrogen under mild conditions by making use of the redox properties of the fullerene derivative.

Nitrogen fixation by free-living organisms in rice soils. Studies with 15N

International Nuclear Information System (INIS)

Rao, V.R.; Charyulu, P.B.B.N.; Nayak, D.N.; Ramakrishna, C.

1979-01-01

Heterotrophic nitrogen fixation as influenced by water regime, organic matter, combined nitrogen and pesticides was investigated in several Indian rice soils by means of the 15 N 2 tracer technique. Soil submergence accelerated nitrogen fixation. Addition of cellulose to both non-flooded and flooded soils enhanced nitrogen fixation. Under submerged conditions, addition of sucrose, glucose and malate in that order stimulated nitrogen fixation in alluvial soil, while only sucrose enhanced nitrogen fixation in laterite soil. Nitrogen fixation in flooded alluvial and laterite soils decreased with increasing concentration of combined nitrogen. Nitrogen fixation was appreciable in acid sulphate and saline soils under both flooded and non-flooded conditions, despite high salinity and acidity. Application of certain pesticides at rates equivalent to recommended field level greatly influenced nitrogen fixation in flooded rice soils. Additions of benomyl (carbamate fungicide) and carbofuran (methyl carbamate insecticide) to alluvial and laterite soils resulted in significant stimulation of nitrogen fixation. Gamma-BHC stimulated nitrogen fixation only in alluvial soil, with considerable inhibition in a laterite soil. Nitrogen fixation by Azospirillum lipoferum was investigated by 15 N 2 . Large variations in 15 N 2 incorporation by A. lipoferum isolated from the roots of several rice cultivars was observed. Specific lines of rice harbouring A. lipoferum with high nitrogenase activity might be selected. Nitrogen fixed by heterotrophic organisms in a complex system such as soil could not be evaluated precisely. Indigenous nitrogen fixation in a flooded soil would be in the range of 5-10 kg N/ha, increasable 3 to 4-fold by appropriate fertilizers and cultural practices

Two-stage open reduction and internal fixation versus limited internal fixation combined with external fixation: a meta-analysis of postoperative complications in patients with severe Pilon fractures.

Science.gov (United States)

Cui, Xueliang; Chen, Hui; Rui, Yunfeng; Niu, Yang; Li, He

2018-01-01

Objectives Two-stage open reduction and internal fixation (ORIF) and limited internal fixation combined with external fixation (LIFEF) are two widely used methods to treat Pilon injury. However, which method is superior to the other remains controversial. This meta-analysis was performed to quantitatively compare two-stage ORIF and LIFEF and clarify which method is better with respect to postoperative complications in the treatment of tibial Pilon fractures. Methods We conducted a meta-analysis to quantitatively compare the postoperative complications between two-stage ORIF and LIFEF. Eight studies involving 360 fractures in 359 patients were included in the meta-analysis. Results The two-stage ORIF group had a significantly lower risk of superficial infection, nonunion, and bone healing problems than the LIFEF group. However, no significant differences in deep infection, delayed union, malunion, arthritis symptoms, or chronic osteomyelitis were found between the two groups. Conclusion Two-stage ORIF was associated with a lower risk of postoperative complications with respect to superficial infection, nonunion, and bone healing problems than LIFEF for tibial Pilon fractures. Level of evidence 2.

Free flap reconstructions of tibial fractures complicated after internal fixation.

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Nieminen, H; Kuokkanen, H; Tukiainen, E; Asko-Seljavaara, S

1995-04-01

The cases of 15 patients are presented where microvascular soft-tissue reconstructions became necessary after internal fixation of tibial fractures. Primarily, seven of the fractures were closed. Eleven fractures had originally been treated by open reduction and internal fixation using plates and screws, and four by intramedullary nailing. All of the patients suffered from postoperative complications leading to exposure of the bone or fixation material. The internal fixation material was removed and radical revision of dead and infected tissue was carried out in all cases. Soft tissue reconstruction was performed using a free microvascular muscle flap (11 latissimus dorsi, three rectus abdominis, and one gracilis). In eight cases the nonunion of the fracture indicated external fixation. The microvascular reconstruction was successful in all 15 patients. In one case the recurrence of deep infection finally indicated a below-knee amputation. In another case, chronic infection with fistulation recurred postoperatively. After a mean follow-up of 26 months the soft tissue coverage was good in all the remaining 13 cases. All the fractures united. Microvascular free muscle flap reconstruction of the leg is regarded as a reliable method for salvaging legs with large soft-tissue defects or defects in the distal leg. If after internal fixation of the tibial fracture the osteosynthesis material or fracture is exposed, reconstruction of the soft-tissue can successfully be performed by free flap transfer. By radical revision, external fixation, bone grafting, and a free flap the healing of the fracture can be achieved.

The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review

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Michael Bemelman

2016-02-01

Full Text Available More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950’s, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has becomeavailable suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review

Science.gov (United States)

Bemelman, Michael; van Baal, Mark; Yuan, Jian Zhang; Leenen, Luke

2016-01-01

More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950’s, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has become available suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation. PMID:26889439

Tightrope fixation of ankle syndesmosis injuries: clinical outcome, complications and technique modification.

LENUS (Irish Health Repository)

Naqvi, Gohar A

2012-06-01

Ankle syndesmotic injuries are complex and require anatomic reduction and fixation. Tightrope fixation is a relatively new technique and we present the largest series of syndesmosis fixation using Arthrex Tightrope™ (Naples, FL, USA).

Fractures of the proximal fifth metatarsal: percutaneous bicortical fixation.

Science.gov (United States)

Mahajan, Vivek; Chung, Hyun Wook; Suh, Jin Soo

2011-06-01

Displaced intraarticular zone I and displaced zone II fractures of the proximal fifth metatarsal bone are frequently complicated by delayed nonunion due to a vascular watershed. Many complications have been reported with the commonly used intramedullary screw fixation for these fractures. The optimal surgical procedure for these fractures has not been determined. All these observations led us to evaluate the effectiveness of percutaneous bicortical screw fixation for treating these fractures. Twenty-three fractures were operatively treated by bicortical screw fixation. All the fractures were evaluated both clinically and radiologically for the healing. All the patients were followed at 2 or 3 week intervals till fracture union. The patients were followed for an average of 22.5 months. Twenty-three fractures healed uneventfully following bicortical fixation, with a mean healing time of 6.3 weeks (range, 4 to 10 weeks). The average American Orthopaedic Foot & Ankle Society (AOFAS) score was 94 (range, 90 to 99). All the patients reported no pain at rest or during athletic activity. We removed the implant in all cases at a mean of 23.2 weeks (range, 18 to 32 weeks). There was no refracture in any of our cases. The current study shows the effectiveness of bicortical screw fixation for displaced intraarticular zone I fractures and displaced zone II fractures. We recommend it as one of the useful techniques for fixation of displaced zone I and II fractures.

Characterization for Soil Fixation by Polyelectrolyte Complex

Energy Technology Data Exchange (ETDEWEB)

Choi, Yong Suk; Kwon, Sang Woon; Yang, Heeman; Lee, Kune Woo; Seo, Bumkyoung; Moon, Jei Kwon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2014-05-15

According to report, the radioactivity bulk (approx. 95%) is localized within topsoil. Therefore soil surface on topsoil should be fixed to prevent the spreading of the contaminated soils with Cs-137 by wind and water erosion. Many methods have been developing for soil fixation to remove radioactive contaminants in soil and prevent to diffuse radioactive materials. Various materials have been also used as fixatives such as clays, molecular sieves, polymer, and petroleum based products. One of the methods is a soil fixation or solidification using polyelectrolyte. Polyelectrolytes have many ionic groups and make into the polyelectrolyte complex (PEC) due to electrostatic interaction of polyanion and polycation in an aqueous solution. It can be avoids using the chemical cross-linking agents, and reducing the possible toxicity and other undesirable effects of the reagents. PEC can fix soil particles by flocculation and formation of crust between soil. The method can also prevent a spread of radioactive material by floating on a soil surface. Recently, PEC used for the solidification of soil near the Fukushima nuclear power plant in Japan. The decontamination efficiency of the surface soils reached 90%, and dust release was effectively suppressed during the removal of surface soils. In this study, it was investigated the fixation of the soil by PEC to avoid the spread of the contamination in addition to the separation of soil and PEC. The physicochemical properties of polyelectrolyte complex solution and the stability of fixed soil by PEC were investigated. The mode of the addition is important to prepare the polyelectrolytes complex without PAA agglomerate. The concentration of salt in the polyelectrolyte complex solution is a very important parameter for the soil fixation.

Characterization for Soil Fixation by Polyelectrolyte Complex

International Nuclear Information System (INIS)

Choi, Yong Suk; Kwon, Sang Woon; Yang, Heeman; Lee, Kune Woo; Seo, Bumkyoung; Moon, Jei Kwon

2014-01-01

According to report, the radioactivity bulk (approx. 95%) is localized within topsoil. Therefore soil surface on topsoil should be fixed to prevent the spreading of the contaminated soils with Cs-137 by wind and water erosion. Many methods have been developing for soil fixation to remove radioactive contaminants in soil and prevent to diffuse radioactive materials. Various materials have been also used as fixatives such as clays, molecular sieves, polymer, and petroleum based products. One of the methods is a soil fixation or solidification using polyelectrolyte. Polyelectrolytes have many ionic groups and make into the polyelectrolyte complex (PEC) due to electrostatic interaction of polyanion and polycation in an aqueous solution. It can be avoids using the chemical cross-linking agents, and reducing the possible toxicity and other undesirable effects of the reagents. PEC can fix soil particles by flocculation and formation of crust between soil. The method can also prevent a spread of radioactive material by floating on a soil surface. Recently, PEC used for the solidification of soil near the Fukushima nuclear power plant in Japan. The decontamination efficiency of the surface soils reached 90%, and dust release was effectively suppressed during the removal of surface soils. In this study, it was investigated the fixation of the soil by PEC to avoid the spread of the contamination in addition to the separation of soil and PEC. The physicochemical properties of polyelectrolyte complex solution and the stability of fixed soil by PEC were investigated. The mode of the addition is important to prepare the polyelectrolytes complex without PAA agglomerate. The concentration of salt in the polyelectrolyte complex solution is a very important parameter for the soil fixation

External fixation for closed pediatric femoral shaft fractures: where are we now?

Science.gov (United States)

Kong, Heather; Sabharwal, Sanjeev

2014-12-01

Recent advances in external fixation technique and pin design have sought to minimize complications such as pin site infection and premature removal of the external fixator. Although newer forms of internal fixation have gained popularity, external fixation may still have a role in managing pediatric femoral shaft fractures. We sought to assess the time to healing, limb alignment, and complications observed in a cohort of pediatric patients with closed femoral shaft fractures who were treated with external fixation. Over a 15-year period, one surgeon treated 289 pediatric patients with femur fractures, 31 (11%) of whom received an external fixator. The general indications for use of an external fixator during the period in question included length-unstable fractures, metadiaphyseal location, refracture, and pathologic fracture. Six patients (19%) had inadequate followup data and four patients (13%) were treated with a combination of flexible intramedullary nails and external fixation, leaving 21 patients for analysis. Mean age at injury was 10 years (range, 6-15 years) and followup averaged 22 months (range, 5-45 months) after removal of the fixator. Radiographs were examined for alignment and limb length discrepancy. Complications were recorded from a chart review. Mean time in the fixator was 17 weeks (range, 9-24 weeks). One patient sustained a refracture and one patient with an isolated femur fracture had a leg length discrepancy > 2 cm. There were no pin site infections requiring intravenous antibiotics or additional surgery. One patient with Blount disease and previous tibial osteotomy developed transient peroneal nerve palsy. Despite improvements in pin design and predictable fracture healing, complications such as refracture and leg length discrepancy after external fixation of pediatric femoral shaft fractures can occur. However, external fixation remains a viable alternative for certain fractures such as length-unstable fractures, metadiaphyseal

Symbiotic N fixation of several soybean varieties and mutants

International Nuclear Information System (INIS)

Soertini, G.; Hendratno

1988-01-01

Symbiotic N fixation of several soybean varieties and mutants. Research activities comprising of three experiments were carried out to screen several soybean varieties and mutants for symbiotic N fixation potential. The first two experiments involved screening of seven rhizobium strains/isolate for effective N fixation. Depending on the medium used, plant response to strains was different. In sterile medium, rhizobium strain USDA 136, 142 and TAL 102 showed a high nitrogen fixation potential. In soil only rhizobium strain USDA 110 had better performance and proved to be competitive to the native strains. Nitrogen-15 dilution method was used to screen nitrogen fixing ability of several soybean varieties and mutants. Guntur variety showed a better response to high dose of N fertilizer without disturbance in its fixing ability. This variety then was considered good to be introduced in the cropping system. (author). 8 refs

Loads applied to fixations for chain stretching

Energy Technology Data Exchange (ETDEWEB)

Ahrens, K; Brychta, P

1985-06-01

The chains of scraper chain conveyors must be pre-stretched during standstill in order to compensate the elongations occurring during operation. They require frequent retensiening in order to meet the varying operational requirements. During tensioning, the chains are fixed in a point in the top run by means of fixation elements. The authors present a method for calculating the retaining force needed in the fixations. There are three different initial conditions of the chain before trensioning: Tensionsfree chain, pretensioned chain (stressed chain), slack chain. In all three cases, it is important to find out whether or nor the tensioning drive reaches full speed. The method of calculation is illustrated by the example of a scraper chain conveyor; it enables the establishment of rules for tensioning without damaging the chain and is a good basis for the dimensioning of new types of fixation elements.

Nitrogen fixation dynamics of two diazotrophic communities in Mono Lake, California

Science.gov (United States)

Oremland, R.S.

1990-01-01

Two types of diazotrophic microbial communities were found in the littoral zone of alkaline hypersaline Mono Lake, California. One consisted of anaerobic bacteria inhabiting the flocculent surface layers of sediments. Nitrogen fixation (acetylene reduction) by flocculent surface layers occurred under anaerobic conditions, was not stimulated by light or by additions of organic substrates, and was inhibited by O2, nitrate, and ammonia. The second community consisted of a ball-shaped association of a filamentous chlorophyte (Ctenocladus circinnatus) with diazotrophic, nonheterocystous cyanobacteria, as well as anaerobic bacteria (Ctenocladus balls). Nitrogen fixation by Ctenocladus balls was usually, but not always, stimulated by light. Rates of anaerobic dark fixation equaled those in the light under air. Fixation in the light was stimulated by 3-(3,4-dichlorophenyl)-1,1-dimethylurea and by propanil [N-(3,4-dichlorophenyl)propanamide]. 3-(3,4-Dichlorophenyl)-1,1-dimethyl urea-elicited nitrogenase activity was inhibited by ammonia (96%) and nitrate (65%). Fixation was greatest when Ctenocladus balls were incubated anaerobically in the light with sulfide. Dark anaerobic fixation was not stimulated by organic substrates in short-term (4-h) incubations, but was in long-term (67-h) ones. Areal estimates of benthic N2 fixation were measured seasonally, using chambers. Highest rates (~29.3 ??mol of C2H4 m-2 h-1) occurred under normal diel regimens of light and dark. These estimates indicate that benthic N2 fixation has the potential to be a significant nitrogen source in Mono Lake.

A Novel Handmade External Fixator for Phalangeal and Metacarpal Fractures

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Davod Jafari

2016-12-01

Full Text Available Background The value of external fixation in complex hand injuries is well established. Expenses and technical difficulties of commercial mini external fixator sets have led to the innovation of handmade external fixators. These fixators are used as versatile facilities to treat certain hand fractures. Usually, these structures are made by k-wires crossed filled with cement plastic tube. However, these fixators have multiple deficiencies that should be addressed. Objectives In this study, we described in detail the surgical technique of a handmade concrete like mini external fixator and report its clinical use and results. Methods Our handmade external fixator was applied for 52 patients with 56 fractures. Only 5% of the fractures were closed, non-comminuted extra-articular, and the other 51 fractures were more complex injuries. The mean follow up time was 9.3 months. At the end of the follow up, radiologic and functional assessment (DASH: Disability of arm, shoulder and hand and TAM: Total active motion was evaluated. Results All 56 fractures were united completely. None of the cases experienced pin loosening or reduction loss. Of the fractures, 8.9% malunited due to fracture complexity. The mean dash score was 3.76. TAM was excellent in 45% of the fractures; it was good in 7% and fair in 4%. Conclusions This type of handmade external fixator is simple, lightweight, and cheap. Furthermore, all implements are readily available in most operating fields. The probability of loosening has been greatly diminished because of the concrete like structure. Easy and fast assembly and good clinical and functional results are the other advantages of this technique. Due to the less complication and benefits, this technique could be used for many phalangeal and metacarpal fractures with confidence.

A new 3-dimensional head fixation device for brain imaging

International Nuclear Information System (INIS)

Goto, Ryoi; Kawashima, Ryuta; Yoshioka, Seiro; Ono, Shuichi; Ito, Hiroshi; Sato, Kazunori; Akaizawa, Takashi; Koyama, Masamichi; Fukuda, Hiroshi

1995-01-01

We have developed a new head fixation device for studies of brain function. This device was designed to immobilize subject's heads during image scanning and to precisely reproduce the head position for two different imaging modalities such as MRI and PET. The device consists of a plastic frame, a pillow filled with beads of styrene foam, and a face mask of thermoplastic resin which was originally intended for application in radiotherapy. A bridge for biting was incorporated into the mask for stable fixation. The device enables immobilization of subject's heads with good reproducibility of position at the practical level. Our results indicate that this head fixation system is useful for fixation of head during activation studies using PET. (author)

Distribution of nitrogen fixation and nitrogenase-like sequences amongst microbial genomes

Science.gov (United States)

2012-01-01

Background The metabolic capacity for nitrogen fixation is known to be present in several prokaryotic species scattered across taxonomic groups. Experimental detection of nitrogen fixation in microbes requires species-specific conditions, making it difficult to obtain a comprehensive census of this trait. The recent and rapid increase in the availability of microbial genome sequences affords novel opportunities to re-examine the occurrence and distribution of nitrogen fixation genes. The current practice for computational prediction of nitrogen fixation is to use the presence of the nifH and/or nifD genes. Results Based on a careful comparison of the repertoire of nitrogen fixation genes in known diazotroph species we propose a new criterion for computational prediction of nitrogen fixation: the presence of a minimum set of six genes coding for structural and biosynthetic components, namely NifHDK and NifENB. Using this criterion, we conducted a comprehensive search in fully sequenced genomes and identified 149 diazotrophic species, including 82 known diazotrophs and 67 species not known to fix nitrogen. The taxonomic distribution of nitrogen fixation in Archaea was limited to the Euryarchaeota phylum; within the Bacteria domain we predict that nitrogen fixation occurs in 13 different phyla. Of these, seven phyla had not hitherto been known to contain species capable of nitrogen fixation. Our analyses also identified protein sequences that are similar to nitrogenase in organisms that do not meet the minimum-gene-set criteria. The existence of nitrogenase-like proteins lacking conserved co-factor ligands in both diazotrophs and non-diazotrophs suggests their potential for performing other, as yet unidentified, metabolic functions. Conclusions Our predictions expand the known phylogenetic diversity of nitrogen fixation, and suggest that this trait may be much more common in nature than it is currently thought. The diverse phylogenetic distribution of nitrogenase

Distribution of nitrogen fixation and nitrogenase-like sequences amongst microbial genomes

Directory of Open Access Journals (Sweden)

Dos Santos Patricia C

2012-05-01

Full Text Available Abstract Background The metabolic capacity for nitrogen fixation is known to be present in several prokaryotic species scattered across taxonomic groups. Experimental detection of nitrogen fixation in microbes requires species-specific conditions, making it difficult to obtain a comprehensive census of this trait. The recent and rapid increase in the availability of microbial genome sequences affords novel opportunities to re-examine the occurrence and distribution of nitrogen fixation genes. The current practice for computational prediction of nitrogen fixation is to use the presence of the nifH and/or nifD genes. Results Based on a careful comparison of the repertoire of nitrogen fixation genes in known diazotroph species we propose a new criterion for computational prediction of nitrogen fixation: the presence of a minimum set of six genes coding for structural and biosynthetic components, namely NifHDK and NifENB. Using this criterion, we conducted a comprehensive search in fully sequenced genomes and identified 149 diazotrophic species, including 82 known diazotrophs and 67 species not known to fix nitrogen. The taxonomic distribution of nitrogen fixation in Archaea was limited to the Euryarchaeota phylum; within the Bacteria domain we predict that nitrogen fixation occurs in 13 different phyla. Of these, seven phyla had not hitherto been known to contain species capable of nitrogen fixation. Our analyses also identified protein sequences that are similar to nitrogenase in organisms that do not meet the minimum-gene-set criteria. The existence of nitrogenase-like proteins lacking conserved co-factor ligands in both diazotrophs and non-diazotrophs suggests their potential for performing other, as yet unidentified, metabolic functions. Conclusions Our predictions expand the known phylogenetic diversity of nitrogen fixation, and suggest that this trait may be much more common in nature than it is currently thought. The diverse phylogenetic

Effects of tissue fixation and dehydration on tendon collagen nanostructure.

Science.gov (United States)

Turunen, Mikael J; Khayyeri, Hanifeh; Guizar-Sicairos, Manuel; Isaksson, Hanna

2017-09-01

Collagen is the most prominent protein in biological tissues. Tissue fixation is often required for preservation or sectioning of the tissue. This may affect collagen nanostructure and potentially provide incorrect information when analyzed after fixation. We aimed to unravel the effect of 1) ethanol and formalin fixation and 2) 24h air-dehydration on the organization and structure of collagen fibers at the nano-scale using small and wide angle X-ray scattering. Samples were divided into 4 groups: ethanol fixed, formalin fixed, and two untreated sample groups. Samples were allowed to air-dehydrate in handmade Kapton pockets during the measurements (24h) except for one untreated group. Ethanol fixation affected the collagen organization and nanostructure substantially and during 24h of dehydration dramatic changes were evident. Formalin fixation had minor effects on the collagen organization but after 12h of air-dehydration the spatial variation increased substantially, not evident in the untreated samples. Generally, collagen shrinkage and loss of alignment was evident in all samples during 24h of dehydration but the changes were subtle in all groups except the ethanol fixed samples. This study shows that tissue fixation needs to be chosen carefully in order to preserve the features of interest in the tissue. Copyright © 2017 Elsevier Inc. All rights reserved.

Plant, Microbiome, and Biogeochemistry: Quantifying moss-associated N fixation in Alaska

Science.gov (United States)

Stuart, J.; Mack, M. C.; Holland Moritz, H.; Fierer, N.; McDaniels, S.; Lewis, L.

2017-12-01

The future carbon (C) sequestration potential of the Arctic and boreal zones, currently the largest terrestrial C sink globally, is linked to nitrogen (N) cycling and N availability vis-a-vis C accumulation and plant species composition. Pristine environments in Alaska have low anthropogenic N deposition (<1 kg N ha-1 yr-1), and the main source of new N to these ecosystems is through previously overlooked N-fixation from microbial communities on mosses. Despite the importance of moss associated N-fixation, the relationship between moss species, microbial communities, and fixation rates remains ambiguous. In the summer of 2016, the fixation rates of 20 moss species from sites around both Fairbanks and Toolik Lake were quantified using 15N2 incubations. Subsequently, the microbial community and moss genome of the samples were also analyzed by collaborators. The most striking result is that all sampled moss genera fixed N, including well-studied feather mosses such as Hylocomium splendens and Pleurozium schreberi as well as less common but ecologically relevant mosses such as Aulacomnium spp., Dicranum spp., Ptilium crista-castrensis, and Tomentypnum nitens. Across all samples, preliminary fixation rates ranged from 0.004-19.994 µg N g-1 moss d-1. Depending upon percent cover, moss-associated N fixation is the largest input of new N to the ecosystem. Given this, linking variation in N-fixation rates to microbial and moss community structures can be helpful in predicting future trends of C and N cycling in northern latitudes. Vegetation changes, alterations in downstream biogeochemical N processes, and anthropogenic N deposition could all interact with or alter moss associated N-fixation, thereby changing ecosystem N inputs. Further elucidation of the species level signal in N-fixation rates and microbial community will augment our knowledge of N cycling in northern latitudes, both current and future.

Femoral fractures : indications an[d] biomechanics of external fixation

NARCIS (Netherlands)

A.H. Broekhuizen (Tom); B. van Linge

1988-01-01

textabstractInternal fixation can be carried out in various ways. For femoral shaft fractures, an (interlocking) nail is becoming increasingly popular, instead of open realignment of the fracture. External fixation, which has become a generally accepted method of treating fractures of the lower

Time Savings and Surgery Task Load Reduction in Open Intraperitoneal Onlay Mesh Fixation Procedure

Directory of Open Access Journals (Sweden)

Sanjoy Roy

2015-01-01

Full Text Available Background. This study assessed the reduction in surgeon stress associated with savings in procedure time for mechanical fixation of an intraperitoneal onlay mesh (IPOM compared to a traditional suture fixation in open ventral hernia repair. Study Design. Nine general surgeons performed 36 open IPOM fixation procedures in porcine model. Each surgeon conducted two mechanical (using ETHICON SECURESTRAPTM Open and two suture fixation procedures. Fixation time was measured using a stopwatch, and related surgeon stress was assessed using the validated SURG-TLX questionnaire. T-tests were used to compare between-group differences, and a two-sided 95% confidence interval for the difference in stress levels was established using nonparametric methodology. Results. The mechanical fixation group demonstrated an 89.1% mean reduction in fixation time, as compared to the suture group (p<0.00001. Surgeon stress scores measured using SURG-TLX were 55.5% lower in the mechanical compared to the suture fixation group (p<0.001. Scores in five of the six sources of stress were significantly lower for mechanical fixation. Conclusions. Mechanical fixation with ETHICON SECURESTRAPTM Open demonstrated a significant reduction in fixation time and surgeon stress, which may translate into improved operating efficiency, improved performance, improved surgeon quality of life, and reduced overall costs of the procedure.

Tricortical cervical inter-body screw fixation.

Directory of Open Access Journals (Sweden)

Goel A

1997-01-01

Full Text Available A new tricortical method of screw implantation for anterior cervical interbody plate fixation is described. The screws are placed obliquely such that they engage the anterior cortex of the body and traverse through the cortices adjoining the disc space. By this method the screws not only hold the plate firmly with a tricortical purchase, but by virtue of their course stabilize the two adjoining vertebral bodies by themselves. Sixteen patients were treated by this method. In three of these cases only tricortical screws without the metal plate were used for fixation. The advantages of the technique are discussed.

Internal fixation of mandibular angle fractures: a meta-analysis.

Science.gov (United States)

Regev, Eran; Shiff, Jacob S; Kiss, Alex; Fialkov, Jeffrey A

2010-06-01

The degree of rigidity of internal fixation required for the treatment of mandibular angle fractures has long been at the center of debate in the literature. A statistical comparison between rigid fixation and monocortical fixation has been difficult because of multiple terms, definitions, and technical variations. The purpose of this study was to use the meta-analysis tool to combine information from multiple studies and to compare complication rates for different fixation methods. An English language literature search was conducted for articles on mandibular angle fractures. Information was collected on four variables of interest: compression/noncompression technique, monocortical/bicortical screws, number of plates, and location of plates. Five outcome rates were analyzed: infection, reoperation, hardware removal, malunion, and nonunion. Meta-analyses were run using Comprehensive Meta Analysis, version 2.2.03. Twenty-four studies with relevant data on the variables and outcomes of interest met the inclusion criteria. Significantly higher rates of infection, reoperation, and hardware removal were found for compression compared with noncompression, two plates compared with one plate, and for plates located on both the inferior and superior borders as compared with superior or inferior only. There were also significantly higher infection rates for bicortical screws compared with monocortical screws and higher malunion rates for compression compared with noncompression plating techniques. The results of this meta-analysis found lower complication rates with the use of noncompression, monocortical, and single-plate fixation, supporting the trend toward a single, superiorly placed, monocortical miniplate for fixation of mandibular angle fractures.

Influence of removal of invisible fixation on the saccadic and manual gap effect.

Science.gov (United States)

Ueda, Hiroshi; Takahashi, Kohske; Watanabe, Katsumi

2014-01-01

Saccadic and manual reactions to a peripherally presented target are facilitated by removing a central fixation stimulus shortly before a target onset (the gap effect). The present study examined the effects of removal of a visible and invisible fixation point on the saccadic gap effect and the manual gap effect. Participants were required to fixate a central fixation point and respond to a peripherally presented target as quickly and accurately as possible by making a saccade (Experiment 1) or pressing a corresponding key (Experiment 2). The fixation point was dichoptically presented, and visibility was manipulated by using binocular rivalry and continuous flash suppression technique. In both saccade and key-press tasks, removing the visible fixation strongly quickened the responses. Furthermore, the invisible fixation, which remained on the display but suppressed, significantly delayed the saccadic response. Contrarily, the invisible fixation had no effect on the manual task. These results indicate that partially different processes mediate the saccadic gap effect and the manual gap effect. In particular, unconscious processes might modulate an oculomotor-specific component of the saccadic gap effect, presumably via subcortical mechanisms.

Removal of internal fixation--the effect on patients' complaints: a study of 66 cases of removal of internal fixation after malleolar fractures

DEFF Research Database (Denmark)

Jacobsen, S; Honnens de Lichtenberg, M; Jensen, C M

1994-01-01

To estimate the effect of removal of internal fixation after treatment of malleolar fractures on postoperatively presented complaints, we retrospectively evaluated 66 patients by their records and by personal questionnaires. Of all the patients, 89.4% had one or more complaints. These were...... typically soreness over implant and cicatrix, reduced movement of the ankle joint, and strain-related pain. About 75% of these patients reported improvement after removal. The AO mode of fixation, i.e., typically by lateral semitubular plating and transsyndesmotic screw and a medial screw or pins...... period. We conclude that removal of internal fixation after malleolar fractures is indicated when common types of complaints are presented....

Application of monorail fixator for femoral gap nonunion.

Science.gov (United States)

Agrawal, Hemendra-Kumar; Jaiman, Ashish; Khatkar, Vipin; Sharma, Vinod-Kumar

2014-01-01

Difficult femoral nonunion takes account of infective nonunion and aseptic gap nonunion. Limb length discrepancy and nonunion need to be tackled simultaneously. Conventionally Ilizarov ring fixator is in vogue but it has some limitations. To overcome these, monorail fixator is an effective alternative. Persistent good results can be obtained if we can get a perfect anatomical alignment and good regeneration.

Pediatric mandibular fractures treated by rigid internal fixation.

Science.gov (United States)

Wong, G B

1993-09-01

Mandibular fractures in the pediatric patient population are relatively uncommon. These patients present with their own unique treatment requirements. Most fractures have been treated conservatively by dental splints. Closed reduction techniques with maxillomandibular fixation (MMF) in very young children can pose several concerns, including cooperation, compliance and adequate nutritional intake. Rigid internal fixation of unstable mandibular fractures using miniplates and screws circumvents the need for MMF and allows immediate jaw mobilization. At major pediatric trauma institutions, there has been an increasing trend toward the use of this treatment when open reduction is necessary. This article presents a report of a five-year-old child who presented with bilateral mandibular fractures and was treated by rigid internal fixation and immediate mandibular mobilization.

Effects of Long-term Fertilization on Potassium Fixation Capacity in Brown Soil

Science.gov (United States)

Li, Na; Guo, Chunlei; Wang, Yue; Gao, Tianyi; Yang, Jinfeng; Han, Xiaori

2018-01-01

This study concentrated on the research of features of fixation. The objective of this study was to provide theoretical foundation of rational application of potassium fertilizer along with improving fertilizer availability ratio. A 32 years long-term experiment was conducted to evaluate the effects of fertilizer application on potassium changes and the factors affecting K fixation on brown soil by simulation in laboratory. When the concentration of exogenous potassium was in range of 400∼4000 mg·kg-1, potassium fixation capacity increased along with the rise of concentration of exogenous potassium, whereas K fixation rate reduced; Compared with no-potassium fertilizer, application of potassium fertilizer and organic fertilizer reduced soil potassium fixation capacity. Potassium rate and fixation-release of potassium character in soil should be taken into comprehensive consideration for rational fertilization to maintain or improve soil fertility for increasing potassium fertilizers efficiency in agriculture.

Tropical Dominance of N2 Fixation in the North Atlantic Ocean

Science.gov (United States)

Marconi, Dario; Sigman, Daniel M.; Casciotti, Karen L.; Campbell, Ethan C.; Alexandra Weigand, M.; Fawcett, Sarah E.; Knapp, Angela N.; Rafter, Patrick A.; Ward, Bess B.; Haug, Gerald H.

2017-10-01

To investigate the controls on N2 fixation and the role of the Atlantic in the global ocean's fixed nitrogen (N) budget, Atlantic N2 fixation is calculated by combining meridional nitrate fluxes across World Ocean Circulation Experiment sections with observed nitrate 15N/14N differences between northward and southward transported nitrate. N2 fixation inputs of 27.1 ± 4.3 Tg N/yr and 3.0 ± 0.5 Tg N/yr are estimated north of 11°S and 24°N, respectively. That is, 90% of the N2 fixation in the Atlantic north of 11°S occurs south of 24°N in a region with upwelling that imports phosphorus (P) in excess of N relative to phytoplankton requirements. This suggests that, under the modern iron-rich conditions of the equatorial and North Atlantic, N2 fixation occurs predominantly in response to P-bearing, N-poor conditions. We estimate a N2 fixation rate of 30.5 ± 4.9 Tg N/yr north of 30°S, implying only 3 Tg N/yr between 30° and 11°S, despite evidence of P-bearing, N-poor surface waters in this region as well; this is consistent with iron limitation of N2 fixation in the South Atlantic. Since the ocean flows through the Atlantic surface in Pacific basins.

Stimulation of nitrogen fixation in soddy-podzolic soils with fungi

Science.gov (United States)

Kurakov, A. V.; Prokhorov, I. S.; Kostina, N. V.; Makhova, E. G.; Sadykova, V. S.

2006-09-01

Stimulation of nitrogen fixation in soddy-podzolic soils is related to the hydrolytic activity of fungi decomposing plant polymers. It was found that the rate of nitrogen fixation upon the simultaneous inoculation of the strains of nitrogen-fixing bacteria Bacillus cereus var. mycoides and the cellulolytic fungus Trichoderma asperellum into a sterile soil enriched with cellulose or Jerusalem artichoke residues is two to four times higher than upon the inoculation of the strains of Bacillus cereus var. mycoides L1 only. The increase in the nitrogen fixation depended on the resistance of the substrates added into the soil to fungal hydrolysis. The biomass of the fungi decomposing plant polymers increased by two-four times. The nitrogen-fixing activity of the soil decreased when the growth of the fungi was inhibited with cycloheximide, which attested to a close correlation between the intensity of the nitrogen fixation and the decomposition of the plant polymers by fungi. The introduction of an antifungal antibiotic, together with starch or with plant residues, significantly (by 60-90%) decreased the rate of nitrogen fixation in the soll.

Reliability analysis for manual radiographic measures of rotatory subluxation or lateral listhesis in adult scoliosis.

Science.gov (United States)

Freedman, Brett A; Horton, William C; Rhee, John M; Edwards, Charles C; Kuklo, Timothy R

2009-03-15

Retrospective observational study. To define the inter- and intraobserver reliability of 3 measures of rotatory subluxation (RS) in adult scoliosis (AS). RS is a hallmark of AS. To accurately track this measure, one must know its reliability. Reliability testing has not been performed. PA 36" films of 29 AS patients were collected from one surgeon's practice. Three observers on 2 separate occasions measured all levels with >or=3-mm RS (60 levels, 360 measurements) on the convexity of the involved segment using 3 different techniques-midbody (MB), endplate (EP), and centroid (C). These data were then analyzed to determine the intraclass correlation coefficient (ICC) for inter- and intraobserver reliability. The thoracolumbar/lumbar curve (average 58 degrees ) was the major curve for the majority (62%) of patients. RS at L3/4 was most common (35%). The overall inter- and intraobserver reliability was good-excellent for all methods, but the centroid method consistently had the highest ICC. ICC correlated with observer experience. Moderate-severe arthritic change (present in 55%) and poor image quality (52%) decreased ICC, but it still remained good-excellent for each measure. The reproducibility coefficient for each measure was 4 mm for MB and 2.8 mm for C and EP. MB, EP, and C are reliable techniques to measure RS even in elderly arthritic spines, but the methods inherently produce different values for a given level. The centroid method is most reliable and least influenced by experience. The EP method is easy to perform and very reliable. Spine surgeons should pick their preferred method and apply it consistently. Changes >3 mm suggest RS progression. RS may be a useful measure in addition to Cobb angle in AS. Having defined measurement reliability, the role of RS progression in surgical indications and patient outcomes can be evaluated.

The role of minimally invasive plate osteosynthesis in rib fixation : A review

NARCIS (Netherlands)

Bemelman, Michael; Van Baal, Mark; Yuan, Jian Zhang; Leenen, Luke

2016-01-01

More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950's, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation.

Capsule-Fixated Intraocular Lens Implantation in Small Pupil Cases.

Science.gov (United States)

Schojai, Merita; Schultz, Tim; Burkhard Dick, H

2017-08-01

To describe a new technique for implantation of capsule-fixated intraocular lenses (IOLs) (FEMTIS; Oculentis, Berlin, Germany) in patients with small pupils. In 4 eyes with small pupils, an anterior capsule-fixated IOL was implanted into the capsular bag after femtosecond laser treatment. The two large and two small flaps of the IOL were elevated to the front of the iris and the anterior capsule. Finally, the iris was flipped over the flaps to ensure a fixation of the capsule inside of the capsulotomy. In all cases, the implantation of anterior capsule-fixated IOLs was possible. No complications occurred during surgery or within the first months after surgery. With the described technique, capsulefixated IOLs can be implanted in eyes with small pupil easily and safely. This type of IOL has great potential to improve the refractive outcome by better prediction of the postoperative IOL position and eliminating IOL rotation after cataract surgery. [J Refract Surg. 2017;33(8):568-570.]. Copyright 2017, SLACK Incorporated.

The emergence and early evolution of biological carbon-fixation.

Science.gov (United States)

Braakman, Rogier; Smith, Eric

2012-01-01

The fixation of CO₂ into living matter sustains all life on Earth, and embeds the biosphere within geochemistry. The six known chemical pathways used by extant organisms for this function are recognized to have overlaps, but their evolution is incompletely understood. Here we reconstruct the complete early evolutionary history of biological carbon-fixation, relating all modern pathways to a single ancestral form. We find that innovations in carbon-fixation were the foundation for most major early divergences in the tree of life. These findings are based on a novel method that fully integrates metabolic and phylogenetic constraints. Comparing gene-profiles across the metabolic cores of deep-branching organisms and requiring that they are capable of synthesizing all their biomass components leads to the surprising conclusion that the most common form for deep-branching autotrophic carbon-fixation combines two disconnected sub-networks, each supplying carbon to distinct biomass components. One of these is a linear folate-based pathway of CO₂ reduction previously only recognized as a fixation route in the complete Wood-Ljungdahl pathway, but which more generally may exclude the final step of synthesizing acetyl-CoA. Using metabolic constraints we then reconstruct a "phylometabolic" tree with a high degree of parsimony that traces the evolution of complete carbon-fixation pathways, and has a clear structure down to the root. This tree requires few instances of lateral gene transfer or convergence, and instead suggests a simple evolutionary dynamic in which all divergences have primary environmental causes. Energy optimization and oxygen toxicity are the two strongest forces of selection. The root of this tree combines the reductive citric acid cycle and the Wood-Ljungdahl pathway into a single connected network. This linked network lacks the selective optimization of modern fixation pathways but its redundancy leads to a more robust topology, making it more

The emergence and early evolution of biological carbon-fixation.

Directory of Open Access Journals (Sweden)

Rogier Braakman

Full Text Available The fixation of CO₂ into living matter sustains all life on Earth, and embeds the biosphere within geochemistry. The six known chemical pathways used by extant organisms for this function are recognized to have overlaps, but their evolution is incompletely understood. Here we reconstruct the complete early evolutionary history of biological carbon-fixation, relating all modern pathways to a single ancestral form. We find that innovations in carbon-fixation were the foundation for most major early divergences in the tree of life. These findings are based on a novel method that fully integrates metabolic and phylogenetic constraints. Comparing gene-profiles across the metabolic cores of deep-branching organisms and requiring that they are capable of synthesizing all their biomass components leads to the surprising conclusion that the most common form for deep-branching autotrophic carbon-fixation combines two disconnected sub-networks, each supplying carbon to distinct biomass components. One of these is a linear folate-based pathway of CO₂ reduction previously only recognized as a fixation route in the complete Wood-Ljungdahl pathway, but which more generally may exclude the final step of synthesizing acetyl-CoA. Using metabolic constraints we then reconstruct a "phylometabolic" tree with a high degree of parsimony that traces the evolution of complete carbon-fixation pathways, and has a clear structure down to the root. This tree requires few instances of lateral gene transfer or convergence, and instead suggests a simple evolutionary dynamic in which all divergences have primary environmental causes. Energy optimization and oxygen toxicity are the two strongest forces of selection. The root of this tree combines the reductive citric acid cycle and the Wood-Ljungdahl pathway into a single connected network. This linked network lacks the selective optimization of modern fixation pathways but its redundancy leads to a more robust topology

Biomechanical analysis of titanium fixation plates and screws in ...

African Journals Online (AJOL)

Conclusions: It was concluded that the use of double 4-hole straight plates provided the sufficient stability on the osteotomy site when compared with the other rigid fixation methods used in this study. Key words: Bone plates, bone screws, finite element analysis, jaw fixation techniques, mandible, mandibular osteotomy ...

Surgical treatment of neglected clubfoot using external fixator

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Rodrigo Mota Pacheco Fernandes

Full Text Available ABSTRACT The definition of neglected clubfoot (NC includes a variable range of complex deformities of the foot that are refractory to conventional treatments or are treated inappropriately. Several etiologies may be related to this. The Ilizarov method has become established as a tool for treating these deformities. It minimizes soft-tissue damage through gradual correction of the deformity, with a high success rate in relation to achieving a plantigrade foot, with low incidence of recurrence. The indications for treatment include severe rigid deformities (Dimeglio III and IV, or adverse skin conditions. Careful clinical and radiological examination is fundamental for proper planning and installation of the external fixator. The techniques used include selection of external fixation assemblies, which can be closed when there is a connection between the leg, hindfoot and forefoot. This closed assembly may or may not be constricted, according to whether hinges are provided or whether use of the natural anatomical hinges during correction of the deformity is envisaged. An open assembly makes it possible to add flexibility to the foot through histogenesis, while allowing closed corrections of greater precision later on. Hexapod fixators are an innovation with high potential for accuracy in correcting deformities. Procedures associated with external fixation include soft-tissue release and bone procedures. These procedures enable corrections that are more anatomical, for different degrees of severity and stiffness of deformity. It can be concluded from analyzing this case series that treatment of neglected clubfoot using an external fixator has a high rate of good and excellent results, with low frequency of complications.

Operative Fixation Options for Elective and Diabetic Ankle Arthrodesis.

Science.gov (United States)

Ramanujam, Crystal L; Stapleton, John J; Zgonis, Thomas

2017-07-01

Ankle arthrodesis remains one of the most definitive treatment options for end-stage arthritis, paralysis, posttraumatic and postinfectious conditions, failed total ankle arthroplasty, and severe deformities. The general aims of ankle arthrodesis are to decrease pain and instability, correct the accompanying deformity, and create a stable plantigrade foot. Several surgical approaches have been reported for ankle arthrodesis with internal fixation options. External fixation has also evolved for ankle arthrodesis in certain clinical scenarios. This article provides a comprehensive analysis of midterm to long-term outcomes for ankle arthrodesis using internal and/or external fixation each for elective and diabetic conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

Time Savings and Surgery Task Load Reduction in Open Intraperitoneal Onlay Mesh Fixation Procedure

Science.gov (United States)

Roy, Sanjoy; Hammond, Jeffrey; Panish, Jessica; Shnoda, Pullen; Savidge, Sandy; Wilson, Mark

2015-01-01

Background. This study assessed the reduction in surgeon stress associated with savings in procedure time for mechanical fixation of an intraperitoneal onlay mesh (IPOM) compared to a traditional suture fixation in open ventral hernia repair. Study Design. Nine general surgeons performed 36 open IPOM fixation procedures in porcine model. Each surgeon conducted two mechanical (using ETHICON SECURESTRAPTM Open) and two suture fixation procedures. Fixation time was measured using a stopwatch, and related surgeon stress was assessed using the validated SURG-TLX questionnaire. T-tests were used to compare between-group differences, and a two-sided 95% confidence interval for the difference in stress levels was established using nonparametric methodology. Results. The mechanical fixation group demonstrated an 89.1% mean reduction in fixation time, as compared to the suture group (p Open demonstrated a significant reduction in fixation time and surgeon stress, which may translate into improved operating efficiency, improved performance, improved surgeon quality of life, and reduced overall costs of the procedure. PMID:26240834

Comparison of two-staged ORIF and limited internal fixation with external fixator for closed tibial plafond fractures.

Science.gov (United States)

Wang, Cheng; Li, Ying; Huang, Lei; Wang, Manyi

2010-10-01

To compare the results of two-staged open reduction and internal fixation (ORIF) and limited internal fixation with external fixator (LIFEF) for closed tibial plafond fractures. From January 2005 to June 2007, 56 patients with closed type B3 or C Pilon fractures were randomly allocated into groups I and II. Two-staged ORIF was performed in group I and LIFEF in group II. The outcome measures included bone union, nonunion, malunion, pin-tract infection, wound infection, osteomyelitis, ankle joint function, etc. These postoperative data were analyzed with Statistical Package for Social Sciences (SPSS) 13.0. Incidence of superficial soft tissue infection (involved in wound infection or pin-tract infection) in group I was lower than that in group II (P delayed union, and arthritis symptoms, with no statistical significance. Both groups resulted similar ankle joint function. Logistic regression analysis indicated that smoking and fracture pattern were the two factors significantly influencing the final outcomes. In the treatment of closed tibial plafond fractures, both two-staged ORIF and LIFEF offer similar results. Patients undergo LIFEF carry significantly greater radiation exposure and higher superficial soft tissue infection rate (usually occurs on pin tract and does not affect the final outcomes).

Nonunited humerus shaft fractures treated by external fixator augmented by intramedullary rod

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Mahmoud A El-Rosasy

2012-01-01

Full Text Available Background: Nonunion of humeral shaft fractures after previously failed surgical treatment presents a challenging therapeutic problem especially in the presence of osteoporosis, bone defect, and joint stiffness. It would be beneficial to combine the use of external fixation technique and intramedullary rod in the treatment of such cases. The present study evaluates the results of using external fixator augmented by intramedullary rod and autogenous iliac crest bone grafting (ICBG for the treatment of humerus shaft nonunion following previously failed surgical treatment. Materials and Methods: Eighteen patients with atrophic nonunion of the humeral shaft following previous implant surgery with no active infection were included in the present study. The procedure included exploration of the nonunion, insertion of intramedullary rod (IM rod, autogenous ICBG and application of external fixator for compression. Ilizarov fixator was used in eight cases and monolateral fixator in ten cases. The monolateral fixator was preferred for females and obese patients to avoid abutment against the breast or chest wall following the use of Ilizarov fixator. The fixator was removed after clinical and radiological healing of the nonunion, but the IM rod was left indefinitely. The evaluation of results included both bone results (union rate, angular deformity and limb shortening and functional outcome using the University of California, Los Angeles (UCLA rating scale. Results: The mean follow-up was 35 months (range 24 to 52 months. Bone union was obtained in all cases. The functional outcome was satisfactory in 15 cases (83% and unsatisfactory in 3 cases (17% due to joint stiffness. The time to bone healing averaged 4.2 months (range 3 to 7 months. The external fixator time averaged 4.5 months (range 3.2 to 8 months. Superficial pin tract infection occurred in 39% (28/72 of the pins. No cases of nerve palsy, refracture, or deep infection were encountered

Plant densities and modulation of symbiotic nitrogen fixation in soybean

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Marcos Javier de Luca

2014-06-01

Full Text Available Soybean nitrogen (N demands can be supplied to a large extent via biological nitrogen fixation, but the mechanisms of source/sink regulating photosynthesis/nitrogen fixation in high yielding cultivars and current crop management arrangements need to be investigated. We investigated the modulation of symbiotic nitrogen fixation in soybean [Glycine max (L. Merrill] at different plant densities. A field trial was performed in southern Brazil with six treatments, including non-inoculated controls without and with N-fertilizer, both at a density of 320,000 plants ha−1, and plants inoculated with Bradyrhizobium elkanii at four densities, ranging from 40,000 to 320,000 plants ha−1. Differences in nodulation, biomass production, N accumulation and partition were observed at stage R5, but not at stage V4, indicating that quantitative and qualitative factors (such as sunlight infrared/red ratio assume increasing importance during the later stages of plant growth. Decreases in density in the inoculated treatments stimulated photosynthesis and nitrogen fixation per plant. Similar yields were obtained at the different plant densities, with decreases only at the very low density level of 40,000 plants ha−1, which was also the only treatment to show differences in seed protein and oil contents. Results confirm a fine tuning of the mechanisms of source/sink, photosynthesis/nitrogen fixation under lower plant densities. Higher photosynthesis and nitrogen fixation rates are capable of sustaining increased plant growth.

Porcine intestinal mast cells. Evaluation of different fixatives for histochemical staining techniques considering tissue shrinkage

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J. Rieger

2013-07-01

Full Text Available Staining of mast cells (MCs, including porcine ones, is critically dependent upon the fixation and staining technique. In the pig, mucosal and submucosal MCs do not stain or stain only faintly after formalin fixation. Some fixation methods are particularly recommended for MC staining, for example the fixation with Carnoy or lead salts. Zinc salt fixation (ZSF has been reported to work excellently for the preservation of fixation-sensitive antigens. The aim of this study was to establish a reliable histological method for counting of MCs in the porcine intestinum. For this purpose, different tissue fixation and staining methods that also allow potential subsequent immunohistochemical investigations were evaluated in the porcine mucosa, as well as submucosa of small and large intestine. Tissues were fixed in Carnoy, lead acetate, lead nitrate, Zamboni and ZSF and stained subsequently with either polychromatic methylene blue, alcian blue or toluidine blue. For the first time our study reveals that ZSF, a heavy metal fixative, preserves metachromatic staining of porcine MCs. Zamboni fixation was not suitable for histochemical visualization of MCs in the pig intestine. All other tested fixatives were suitable. Alcian blue and toluidine blue co-stained intestinal goblet cells which made a prima facie identification of MCs difficult. The polychromatic methylene blue proved to be the optimal staining. In order to compare MC counting results of the different fixation methods, tissue shrinkage was taken into account. As even the same fixation caused shrinkage-differences between tissue from small and large intestine, different factors for each single fixation and intestinal localization had to be calculated. Tissue shrinkage varied between 19% and 57%, the highest tissue shrinkage was found after fixation with ZSF in the large intestine, the lowest one in the small intestine after lead acetate fixation. Our study emphasizes that MC counting results from

Ball-joint versus single monolateral external fixators for definitive treatment of tibial shaft fractures.

Science.gov (United States)

Beltsios, Michail; Mavrogenis, Andreas F; Savvidou, Olga D; Karamanis, Eirineos; Kokkalis, Zinon T; Papagelopoulos, Panayiotis J

2014-07-01

To compare modular monolateral external fixators with single monolateral external fixators for the treatment of open and complex tibial shaft fractures, to determine the optimal construct for fracture union. A total of 223 tibial shaft fractures in 212 patients were treated with a monolateral external fixator from 2005 to 2011; 112 fractures were treated with a modular external fixator with ball-joints (group A), and 111 fractures were treated with a single external fixator without ball-joints (group B). The mean follow-up was 2.9 years. We retrospectively evaluated the operative time for fracture reduction with the external fixator, pain and range of motion of the knee and ankle joints, time to union, rate of malunion, reoperations and revisions of the external fixators, and complications. The time for fracture reduction was statistically higher in group B; the rate of union was statistically higher in group B; the rate of nonunion was statistically higher in group A; the mean time to union was statistically higher in group A; the rate of reoperations was statistically higher in group A; and the rate of revision of the external fixator was statistically higher in group A. Pain, range of motion of the knee and ankle joints, rates of delayed union, malunion and complications were similar. Although modular external fixators are associated with faster intraoperative fracture reduction with the external fixator, single external fixators are associated with significantly better rates of union and reoperations; the rates of delayed union, malunion and complications are similar.

Spinopelvic Dissociation: Comparison of Outcomes of Percutaneous versus Open Fixation Strategies

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Jeffrey M. Pearson

2018-01-01

Full Text Available Introduction. Spinopelvic dissociation injuries are historically treated with open reduction with or without decompressive laminectomy. Recent technological advances have allowed for percutaneous fixation with indirect reduction. Herein, we evaluate outcomes and complications between patients treated with open reduction versus percutaneous spinopelvic fixation. Methods. Retrospective review of patients undergoing spinopelvic fixation from a single, level one trauma center from 2012 to 2017. Patient information regarding demographics, associated injuries, and treatment outcome measures was recorded and analyzed. All fractures were classified via the AO Spine classification system. Results. Thirty-one spinopelvic dissociations were identified: 15 treated with open and 16 with percutaneous techniques. The two treatment groups had similar preoperative characteristics including spinopelvic parameters (pelvic incidence and lumbar lordosis. Compared to open reduction internal fixation, percutaneous fixation of spinopelvic dissociation resulted in statistically significantly lower blood loss (171 cc versus 538 cc; p=0.0013. There were no significant differences in surgical site infections (p=0.48 or operating room time (p=0.66. Conclusion. Percutaneous fixation of spinopelvic dissociation is associated with significantly less blood loss. Treatment outcomes in terms of infection, length of stay, operative cost, and final alignment between the open and percutaneous group were similar.

Benthic Dinitrogen Fixation Traversing the Oxygen Minimum Zone Off Mauritania (NW Africa

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Jessica Gier

2017-12-01

Full Text Available Despite its potential to provide new nitrogen (N to the environment, knowledge on benthic dinitrogen (N2 fixation remains relatively sparse, and its contribution to the marine N budget is regarded as minor. Benthic N2 fixation is often observed in organic-rich sediments coupled to heterotrophic metabolisms, such as sulfate reduction. In the present study, benthic N2 fixation together with sulfate reduction and other heterotrophic metabolisms were investigated at six station between 47 and 1,108 m water depth along the 18°N transect traversing the highly productive upwelling region known as Mauritanian oxygen minimum zone (OMZ. Bottom water oxygen concentrations ranged between 30 and 138 μM. Benthic N2 fixation determined by the acetylene reduction assay was detected at all stations with highest rates (0.15 mmol m−2 d−1 on the shelf (47 and 90 m water depth and lowest rates (0.08 mmol m−2 d−1 below 412 m water depth. The biogeochemical data suggest that part of the N2 fixation could be linked to sulfate- and iron-reducing bacteria. Molecular analysis of the key functional marker gene for N2 fixation, nifH, confirmed the presence of sulfate- and iron-reducing diazotrophs. High N2 fixation further coincided with bioirrigation activity caused by burrowing macrofauna, both of which showed high rates at the shelf sites and low rates in deeper waters. However, statistical analyses proved that none of these processes and environmental variables were significantly correlated with benthic diazotrophy, which lead to the conclusion that either the key parameter controlling benthic N2 fixation in Mauritanian sediments remains unidentified or that a more complex interaction of control mechanisms exists. N2 fixation rates in Mauritanian sediments were 2.7 times lower than those from the anoxic Peruvian OMZ.

Hybrid fixation in the bilateral sagittal split osteotomy for lower jaw advancement

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Felipe Ladeira Pereira

2010-02-01

Full Text Available Miniplate and screw fixation has been widely used in bilateral sagittal split osteotomy, but some issues remain unclear concerning its lack of rigidity when compared to Spiessl's bicortical technique. This paper demonstrates the hybrid fixation technique in a case report. A 34-year-old female patient underwent a double jaw surgery with counter-clockwise rotation of the mandible fixed using the hybrid fixation technique. The patient evolved well in the postoperative period and is still under follow up after 14 months, reporting satisfaction with the results and no significant deviation from the treatment plan up to now. No damage to tooth roots was done, maxillomandibular range of motion was within normality and regression of the inferior alveolar nerve paresthesia was observed bilaterally. The hybrid mandibular fixation is clearly visible in the panoramic and cephalometric control radiographs. It seems that the hybrid fixation can sum the advantages of both monocortical and bicortical techniques in lower jaw advancement, increasing fixation stability without significant damage to the mandibular articulation and the inferior alveolar nerve. A statistical investigation seems necessary to prove its efficacy.

Fixation of strategies with the Moran and Fermi processes in evolutionary games

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Liu, Xuesong; He, Mingfeng; Kang, Yibin; Pan, Qiuhui

2017-10-01

A model of stochastic evolutionary game dynamics with finite population was built. It combines the standard Moran and Fermi rules with two strategies cooperation and defection. We obtain the expressions of fixation probabilities and fixation times. The one-third rule which has been found in the frequency dependent Moran process also holds for our model. We obtain the conditions of strategy being an evolutionarily stable strategy in our model, and then make a comparison with the standard Moran process. Besides, the analytical results show that compared with the standard Moran process, fixation occurs with higher probabilities under a prisoner's dilemma game and coordination game, but with lower probabilities under a coexistence game. The simulation result shows that the fixation time in our mixed process is lower than that in the standard Fermi process. In comparison with the standard Moran process, fixation always takes more time on average in spatial populations, regardless of the game. In addition, the fixation time decreases with the growth of the number of neighbors.

Comparison of /sup 15/N-aided methods for determining symbiotic dinitrogen fixation

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Rennie, R J [International Atomic Energy Agency, Vienna (Austria). Joint FAO/IAEA Div. of Atomic Energy in Food and Agriculture

1979-01-01

Three methods of calculating the amount of symbiotic dinitrogen fixation in navy beans (Phaseolus vulgaris cv. Sanilac) were compared in a greenhouse experiment. /sup 15/N-isotope dilution procedures yielded the most logical estimation of dinitrogen fixation. The classical difference method was not in agreement. Potential errors of the 'A'-value procedure to calculate dinitrogen fixation are discussed.

Positive Affect Is Associated With Reduced Fixation in a Realistic Medical Simulation.

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Crane, Monique F; Brouwers, Sue; Forrest, Kirsty; Tan, Suyin; Loveday, Thomas; Wiggins, Mark W; Munday, Chris; David, Leila

2017-08-01

This study extends previous research by exploring the association between mood states (i.e., positive and negative affect) and fixation in practicing anesthetists using a realistic medical simulation. The impact of practitioner emotional states on fixation is a neglected area of research. Emerging evidence is demonstrating the role of positive affect in facilitating problem solving and innovation, with demonstrated implications for practitioner fixation. Twelve practicing anesthetists (4 females; M age = 39 years; SD = 6.71) were involved in a medical simulation. Prior to the simulation, practitioners rated the frequency they had experienced various positive and negative emotions in the previous three days. During the simulation, the patient deteriorated rapidly, and anesthetists were observed for their degree of fixation. After the simulation, practitioners indicated the frequency of these same emotions during the simulation. Nonparametric correlations were used to explore the independent relationships between positive and negative affect and the behavioral measures. Only positive affect impacted the likelihood of fixation. Anesthetists who reported more frequent recent positive affect in the three days prior to the simulation and during the simulation tended to be less fixated as judged by independent raters, identified a decline in patient oxygen saturation more quickly, and more rapidly implemented the necessary intervention (surgical cricothyroidotomy). These findings have some real-world implications for positive affect in patient safety. This research has broad implications for professions where fixation may impair practice. This research suggests that professional training should teach practitioners to identify their emotions and understand the role of these emotions in fixation.

Biome-scale nitrogen fixation strategies selected by climatic constraints on nitrogen cycle.

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Sheffer, Efrat; Batterman, Sarah A; Levin, Simon A; Hedin, Lars O

2015-11-23

Dinitrogen fixation by plants (in symbiosis with root bacteria) is a major source of new nitrogen for land ecosystems(1). A long-standing puzzle(2) is that trees capable of nitrogen fixation are abundant in nitrogen-rich tropical forests, but absent or restricted to early successional stages in nitrogen-poor extra-tropical forests. This biome-scale pattern presents an evolutionary paradox(3), given that the physiological cost(4) of nitrogen fixation predicts the opposite pattern: fixers should be out-competed by non-fixers in nitrogen-rich conditions, but competitively superior in nitrogen-poor soils. Here we evaluate whether this paradox can be explained by the existence of different fixation strategies in tropical versus extra-tropical trees: facultative fixers (capable of downregulating fixation(5,6) by sanctioning mutualistic bacteria(7)) are common in the tropics, whereas obligate fixers (less able to downregulate fixation) dominate at higher latitudes. Using a game-theoretic approach, we assess the ecological and evolutionary conditions under which these fixation strategies emerge, and examine their dependence on climate-driven differences in the nitrogen cycle. We show that in the tropics, transient soil nitrogen deficits following disturbance and rapid tree growth favour a facultative strategy and the coexistence of fixers and non-fixers. In contrast, sustained nitrogen deficits following disturbance in extra-tropical forests favour an obligate fixation strategy, and cause fixers to be excluded in late successional stages. We conclude that biome-scale differences in the abundance of nitrogen fixers can be explained by the interaction between individual plant strategies and climatic constraints on the nitrogen cycle over evolutionary time.

[Usefullness of intrasacral fixation in an extremely unstable lumbosacral spine].

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Nishiura, Tsukasa; Nishiguchi, Mitsuhisa; Kusaka, Noboru; Takayama, Kazuhiro; Maeda, Yasuhiko; Ogihara, Kotaro; Nakagawa, Minoru

2007-04-01

Intrasacral fixation technique devised by Jackson is said to provide rigid lumbosacral fixation. We treated 3 cases of lumbosacral lesions using this technique in which lumbosacral segment had become extremely unstable during surgical intervention adding to the effect of original lesions. In all cases, surgeries were performed in 2 stages, intrasacral fixation and anterior stabilization. Case 1: A 52-year-old male was diagnosed fungal discitis and spondylitis at L4 and L5. X-ray showed destruction of the vertebral bodies. L2, L3 and sacrum were fixed posteriorly using the intrasacral fixation technique. One week after the first operation, L4 and L5 vertebral bodies were replaced by long fibula grafts through the extraperitoneal approach. Case 2: A 25-year-old female with cauda equina syndrome and abnormal body form diagnosed as having spondyloptosis in which the entire vertebral body of L5 had descended below the endplate of S1. MR imaging revealed marked canal stenosis at the S1 level. In the first surgery, L5 vertebral body was resected through the transperitoneal approach. After 1 week of bed rest, posterior segments of L5 were resected, L4 was affixed to the sacrum and anterior stabilization was achieved with 2 mesh cages and lumbosacral spine was fixed using the intrasacral fixation technique. Case 3: A 64-year-old female was diagnosed as having pyogenic discitis and osteomyelitis at the L5-S1 level. In spite of successful medical treatment for infection, low back pain continued. Radiologically, L5 vertebral body was shown to have collapsed and slipped anteriorly over the sacrum. L3, L4 and sacrum were fixed by intrasacral fixation. One week after the first operation, the L5/S1 disc and the suppurtive vertebral bodies were resected through the extraperitoneal approach and anterior stabilization was performed with iliac bone grafts. At follow-up for a minimum of 6 months, initial fixation was maintained in all 3 cases and bony fusion was obtained. The

Postinflammatory ossicular fixation: CT analysis with surgical correlation

International Nuclear Information System (INIS)

Swartz, J.D.; Wolfson, R.J.; Marlowe, F.I.; Popky, G.L.

1985-01-01

Postinflammatory ossicular fixation is a common problem encountered by the otologic surgeon upon exploration because of conductive hearing loss in patients with chronic otitis media. These nonotosclerotic noncongenital lesions take three pathologic forms: fibrous tissue fixation (chronic adhesive otitis media), hyalinization of collagen (tympanosclerosis), and new bone formation (fibro-osseous sclerosis). More than 300 patients with the clinical diagnosis of chronic otitis media have been examined. This study encompasses 23 proved cases

CARBON DIOXIDE FIXATION.

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FUJITA,E.

2000-01-12

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

Fixation and partitioning of heavy metals in slag after incineration of sewage sludge.

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Chen, Tao; Yan, Bo

2012-05-01

Fixation of heavy metals in the slag produced during incineration of sewage sludge will reduce emission of the metals to the atmosphere and make the incineration process more environmentally friendly. The effects of incineration conditions (incineration temperature 500-1100°C, furnace residence time 0-60min, mass fraction of water in the sludge 0-75%) on the fixation rates and species partitioning of Cd, Pb, Cr, Cu, Zn, Mn and Ni in slag were investigated. When the incineration temperature was increased from 500 to 1100°C, the fixation rate of Cd decreased from 87% to 49%, while the fixation rates of Cu and Mn were stable. The maximum fixation rates for Pb and Zn and for Ni and Cr were reached at 900 and 1100°C, respectively. The fixation rates of Cu, Ni, Cd, Cr and Zn decreased as the residence time increased. With a 20min residence time, the fixation rates of Pb and Mn were low. The maximum fixation rates of Ni, Mn, Zn, Cu and Cr were achieved when the mass fraction of water in the sludge was 55%. The fixation rate of Cd decreased as the water mass fraction increased, while the fixation rate of Pb increased. Partitioning analysis of the metals contained in the slag showed that increasing the incineration temperature and residence time promoted complete oxidation of the metals. This reduced the non-residual fractions of the metals, which would lower the bioavailability of the metals. The mass fraction of water in the sludge had little effect on the partitioning of the metals. Correlation analysis indicated that the fixation rates of heavy metals in the sludge and the forms of heavy metals in the incinerator slag could be controlled by optimization of the incineration conditions. These results show how the bioavailability of the metals can be reduced for environmentally friendly disposal of the incinerator slag. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

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Craig R Lareau

2015-01-01

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

[Domestic external fixator application in the treatment of limb deformities: 7 289 cases application report].

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Qin, S H; Guo, B F; Zheng, X J; Jiao, S F; Xia, H T; Peng, A M; Pan, Q; Zang, J C; Wang, Z J

2017-09-01

Objective: To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs. Methods: A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed. The patients were treated with domestic external fixator, including 4 033 males and 3 256 females, aging from 2 to 82 years with a mean age of 23.4 years. There were 2 732 patients using Ilizarov external fixator, 4 713 patients using hybrid external fixator, 57 patients using monobrachial external fixator, 232 patients using Ilizarov external fixator and hybrid external fixator. The Ilizarov, hybrid and monobrachial external fixator were used in 67, 65 and 0 patients on the upper limbs and in 2 665, 4 616 and 57 patients on the lower limbs. There were 3 028 patients operated on the left limbs, 3 260 patients operated on the right limbs and 1 001 patients operated on the bilateral limbs. The top three types of diseases were sequelae of poliomyelitis, cerebral palsy and post-traumatic stress disorder peromely. Deformity types inclued talipes equinovarus, knee flexion deformity, cavus foot and so on. Results: All the patients were followed up for a period of 2.5 months to 22.4 years, with an average follow-up time of 5.4 years. All of the external fixators were used for single once, and there was no substitute for external fixator quality problem. All the patients were completed surgery goal until removing external fixation except 1 patient gave up treatment and 1 removed the fixator because of metal allergy. The common complications included wire or pin infection and joint movement limitation and so on. Conclusions: The domestic external fixator developed and produced based on the characteristics of Chinese limb deformity disability. The domestic external fixator can be used to treat kinds of limb deformities with the advantages of practical

Relative strength of tailor's bunion osteotomies and fixation techniques.

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Haddon, Todd B; LaPointe, Stephan J

2013-01-01

A paucity of data is available on the mechanical strength of fifth metatarsal osteotomies. The present study was designed to provide that information. Five osteotomies were mechanically tested to failure using a materials testing machine and compared with an intact fifth metatarsal using a hollow saw bone model with a sample size of 10 for each construct. The osteotomies tested were the distal reverse chevron fixated with a Kirschner wire, the long plantar reverse chevron osteotomy fixated with 2 screws, a mid-diaphyseal sagittal plane osteotomy fixated with 2 screws, the mid-diaphyseal sagittal plane osteotomy fixated with 2 screws, and an additional cerclage wire and a transverse closing wedge osteotomy fixated with a box wire technique. Analysis of variance was performed, resulting in a statistically significant difference among the data at p chevron was statistically the strongest construct at 130 N, followed by the long plantar osteotomy at 78 N. The chevron compared well with the control at 114 N, and they both fractured at the proximal model to fixture interface. The other osteotomies were statistically and significantly weaker than both the chevron and the long plantar constructs, with no statistically significant difference among them at 36, 39, and 48 N. In conclusion, the chevron osteotomy was superior in strength to the sagittal and transverse plane osteotomies and similar in strength and failure to the intact model. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Hydrologic Control on Bacterial Nitrogen Fixation in the Holocene Black Sea

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Fulton, J. M.; Arthur, M. A.; Freeman, K. H.

2008-12-01

Stratified oceans of the Phanerozoic Oceanic Anoxic Events apparently were dominated by bacterial nitrogen fixation. Decreased marine N:P nutrient ratios resulting from increased denitrification and decreased phosphate burial efficiency under anoxic waters drove this nutrient regime. This model is upheld by the presence of cyanobacterial hopanoid biomarkers in sedimentary records and δ15N values indicative of nitrogen fixation. However, in the largest modern redox-stratified marine basin, the Black Sea, bacterial nitrogen fixation seems to be only a minor contributor to the nitrogen cycle. In this study, we use geochemical proxies to evaluate the role of bacterial nitrogen fixation during the deposition of the Holocene Black Sea sapropel, starting 7.8 ka. We report compound-specific nitrogen and carbon stable isotope values of pyropheophytin a, a chlorophyll degradation product, and bacteriochlorophyll e produced by green sulfur bacteria. We also present the surprising finding of scytonemin, a pigment produced only by filamentous cyanobacteria exposed to ultraviolet radiation, in certain intervals in these sediments. In the Holocene, nitrogen fixation in the Black Sea is most prominent during times of reduced river water influx. This directly decreases the external flux of nitrate into the surface waters. Reduced freshwater influx also decreases the volume of low salinity water dispersed around the sea by the Rim Current, allowing the chemocline to shoal along the margins. Previous geochemical studies have described this changing chemocline geometry. The exposure of shallow water sediments to anoxic waters further stimulates nitrogen fixation by releasing more phosphorus to the system. Nitrogen fixation is recorded in the sediments as bulk and compound-specific pyropheophytin a δ15N values near 0 ‰ and -5 ‰, respectively. We have also detected scytonemin in two intervals characterized by especially low δ15N values. This compound suggests abundant filamentous

Nitrogen fixation in Red Sea seagrass meadows

KAUST Repository

Abdallah, Malak

2017-05-01

Seagrasses are key coastal ecosystems, providing many ecosystem services. Seagrasses increase biodiversity as they provide habitat for a large set of organisms. In addition, their structure provides hiding places to avoid predation. Seagrasses can grow in shallow marine coastal areas, but several factors regulate their growth and distribution. Seagrasses can uptake different kinds of organic and inorganic nutrients through their leaves and roots. Nitrogen and phosphorous are the most important nutrients for seagrass growth. Biological nitrogen fixation is the conversion of atmospheric nitrogen into ammonia by diazotrophic bacteria. This process provides a significant source of nitrogen for seagrass growth. The nitrogen fixation is controlled by the nif genes which are found in diazotrophs. The main goal of the project is to measure nitrogen fixation rates on seagrass sediments, in order to compare among various seagrass species from the Red Sea. Moreover, we will compare the fixing rates of the Vegetated areas with the bare sediments. This project will help to ascertain the role of nitrogen fixing bacteria in the development of seagrass meadows.

Biomechanical Strength of Retrograde Fixation in Proximal Third Scaphoid Fractures.

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Daly, Charles A; Boden, Allison L; Hutton, William C; Gottschalk, Michael B

2018-04-01

Current techniques for fixation of proximal pole scaphoid fractures utilize antegrade fixation via a dorsal approach endangering the delicate vascular supply of the dorsal scaphoid. Volar and dorsal approaches demonstrate equivalent clinical outcomes in scaphoid wrist fractures, but no study has evaluated the biomechanical strength for fractures of the proximal pole. This study compares biomechanical strength of antegrade and retrograde fixation for fractures of the proximal pole of the scaphoid. A simulated proximal pole scaphoid fracture was produced in 22 matched cadaveric scaphoids, which were then assigned randomly to either antegrade or retrograde fixation with a cannulated headless compression screw. Cyclic loading and load to failure testing were performed and screw length, number of cycles, and maximum load sustained were recorded. There were no significant differences in average screw length (25.5 mm vs 25.6 mm, P = .934), average number of cyclic loading cycles (3738 vs 3847, P = .552), average load to failure (348 N vs 371 N, P = .357), and number of catastrophic failures observed between the antegrade and retrograde fixation groups (3 in each). Practical equivalence between the 2 groups was calculated and the 2 groups were demonstrated to be practically equivalent (upper threshold P = .010). For this model of proximal pole scaphoid wrist fractures, antegrade and retrograde screw configuration have been proven to be equivalent in terms of biomechanical strength. With further clinical study, we hope surgeons will be able to make their decision for fixation technique based on approaches to bone grafting, concern for tenuous blood supply, and surgeon preference without fear of poor biomechanical properties.

Dependence of carbon dioxide concentration on microalgal carbon dioxide fixation

Energy Technology Data Exchange (ETDEWEB)

Yun, Yeoung Sang; Park, Song Moon [Department of Chemical Engineering, School of Environmental Engineering, Pohang University of Science and Technology, Pohang (Korea); Bolesky, Bohumil [Department of Chemical Engineering, McGill University (Canada)

1999-10-01

Batch cultivation of chlorella vulgaris was carried out under various CO{sub 2} concentrations in order to understand and describe mathematically the CO{sub 2} inhibition of microalgal CO{sub 2} fixation. The volumetric CO{sub 2} transfer coefficient from mixture gas to culture medium was estimated from the volumetric O{sub 2} transfer coefficient obtained experimentally. Using this transfer coefficient and aquatic equilibrium relationship between dissolved inorganic carbons, the behavior of dissolved CO{sub 2} was calculated during microalgal culture. When air containing 0.035%(v/v) CO{sub 2} was supplied into microalgal culture, the fixation rate was limited by CO{sub 2} transfer rate. However, the limitation was disappeared by supplying mixture gas containing above 2%(v/v) CO{sub 2} and the dissolved CO{sub 2} concentration was maintained at the saturated value. In the range of CO{sub 2} partial pressure in the flue gases from thermal power sations and steel-making plants, the microalgal CO{sub 2} fixation rate was inhibited. The CO{sub 2} fixation rate was successfully formulated by a new empirical equation as a function of dissolved CO{sub 2} concentration, which could be useful for modeling and simulating the performance of photobioreaction with enriched CO{sub 2}. Also, it was found that the CO{sub 2} inhibition of microalgal CO{sub 2} fixation was reversible and that microalgal CO{sub 2} fixation process could be stable against a shock of unusually high CO{sub 2} concentration. 29 refs., 8 figs.

When the mean is not enough: Calculating fixation time distributions in birth-death processes.

Science.gov (United States)

Ashcroft, Peter; Traulsen, Arne; Galla, Tobias

2015-10-01

Studies of fixation dynamics in Markov processes predominantly focus on the mean time to absorption. This may be inadequate if the distribution is broad and skewed. We compute the distribution of fixation times in one-step birth-death processes with two absorbing states. These are expressed in terms of the spectrum of the process, and we provide different representations as forward-only processes in eigenspace. These allow efficient sampling of fixation time distributions. As an application we study evolutionary game dynamics, where invading mutants can reach fixation or go extinct. We also highlight the median fixation time as a possible analog of mixing times in systems with small mutation rates and no absorbing states, whereas the mean fixation time has no such interpretation.

A study for the biological CO2 fixation and utilization system

International Nuclear Information System (INIS)

Otsuki, T.

2001-01-01

Increased CO 2 in the atmosphere is such a serious problem for mankind that many research and development approaches are implemented to reduce CO 2 emissions. One is a biological CO 2 fixation using the photosynthetic function of microalgae like Chlorella and Synechocystis sp. The target of the project is to achieve a CO 2 fixation rate of 50 g CO 2 /m 2 ·d, which is 10 times as large as that of the temperate forest. The purpose of this study is to clarify the possibilities of the biological CO 2 fixation system in view of the CO 2 balance, energy balance, and payback period. The amount of CO 2 fixation of the system should be larger than the emission of CO 2 by operating. Furthermore, the energy consumption of the system should also be less than the biochemical energy (enthalpy) of glucose, which is made by photosynthesis. After CO 2 fixation was completed by the microalgae, the biomass must be utilized practically for many markets and the initial investment in the system construction could be regained

Comparison of cemented and uncemented fixation in total knee arthroplasty.

Science.gov (United States)

Brown, Thomas E; Harper, Benjamin L; Bjorgul, Kristian

2013-05-01

As a result of reading this article, physicians should be able to :1. Understand the rationale behind using uncemented fixation in total knee arthroplasty.2.Discuss the current literature comparing cemented and uncemented total knee arthroplasty3. Describe the value of radiostereographic analysis in assessing implant stability.4. Appreciate the limitations in the available literature advocating 1 mode of fixation in total knee arthroplasty. Total knee arthroplasty performed worldwide uses either cemented, cementless, or hybrid (cementless femur with a cemented tibia) fixation of the components. No recent literature review concerning the outcomes of cemented vs noncemented components has been performed. Noncemented components offer the potential advantage of a biologic interface between the bone and implants, which could demonstrate the greatest advantage in long-term durable fixation in the follow-up of young patients undergoing arthroplasty. Several advances have been made in the backing of the tibial components that have not been available long enough to yield long-term comparative follow-up studies. Short-term radiostereographic analysis studies have yielded differing results. Although long-term, high-quality studies are still needed, material advances in biologic fixation surfaces, such as trabecular metal and hydroxyapatite, may offer promising results for young and active patients undergoing total knee arthroplasty when compared with traditional cemented options. Copyright 2013, SLACK Incorporated.

Immunohistochemistry of colorectal cancer biomarker phosphorylation requires controlled tissue fixation.

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Abbey P Theiss

Full Text Available Phosphorylated signaling molecules are biomarkers of cancer pathophysiology and resistance to therapy, but because phosphoprotein analytes are often labile, poorly controlled clinical laboratory practices could prevent translation of research findings in this area from the bench to the bedside. We therefore compared multiple biomarker and phosphoprotein immunohistochemistry (IHC results in 23 clinical colorectal carcinoma samples after either a novel, rapid tissue fixation protocol or a standard tissue fixation protocol employed by clinical laboratories, and we also investigated the effect of a defined post-operative "cold" ischemia period on these IHC results. We found that a one-hour cold ischemia interval, allowed by ASCO/CAP guidelines for certain cancer biomarker assays, is highly deleterious to certain phosphoprotein analytes, specifically the phosphorylated epidermal growth factor receptor (pEGFR, but shorter ischemic intervals (less than 17 minutes facilitate preservation of phosphoproteins. Second, we found that a rapid 4-hour, two temperature, formalin fixation yielded superior staining in several cases with select markers (pEGFR, pBAD, pAKT compared to a standard overnight room temperature fixation protocol, despite taking less time. These findings indicate that the future research and clinical utilities of phosphoprotein IHC for assessing colorectal carcinoma pathophysiology absolutely depend upon attention to preanalytical factors and rigorously controlled tissue fixation protocols.

EXPERIMENTAL APPROVAL OF COMBINED FIXATION FOR FEMUR LENGTHENING

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M. A. Stepanov

2017-01-01

Full Text Available Elimination of congenital shortening of lower limb still remains a complex and unsolved orthopaedic task which requires an improved fixation technique as well as adjusted tactics of treatment and rehabilitation procedures.Purpose of the study — experimental approval of femur lengthening technique by external fixation with Ilizarov apparatus and internal fixation by plate.Materials and methods. Femur lengthening was performed in 6 mongrel dogs. Average animal age was 1,5±0,3 years, average weight — 20±5 kg, femur length — 22±2 sm. External apparatus with two supports and a titanium plate of an original design were applied under general anesthesia on the right femur of animals. Lengthening was performed manually at a rate of1 mm per day in 4 stages at a distance of 10% from initial segment length. External apparatus was removed on the last day of distraction after locking the plate. X-ray examination was done on the day of surgery, in 7, 14 and 25 days from the onset of distraction as well as in 14, 30, 60 and 90 days after completion of distraction and removal of external apparatus. Three animals were taken out of experiment in 30 days of fixation, remaining three animals — in 90 days. After euthanasia the authors performed autopsy of the organic femur complex and tissues contacting the plate.Results. The use of operated limb was not restricted during the whole distraction period. The authors observed first roentgenological signs of distraction osteogenesis on 7th day of lengthening. By the end of distraction period, at 25th day, shadows of regenerates demonstrated longitudinal striated structures in all cases. Median lucency area of 1–5 mm was located diagonally and across the regenerate or was intermittent. In 60 days of fixation X-rays demonstrated homogeneous regenerate. External fixation index was 13,9±1,5 days/sm (p≤0,05. The authors observed no cases of implants fracture or deformity during the experiment

Bilateral spontaneous subluxation of scleral-fixated intraocular lenses.

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Assia, Ehud I; Nemet, Arie; Sachs, Dani

2002-12-01

Two young men with primary ectopic lenses had intracapsular cataract extraction and scleral fixation of posterior chamber intraocular lenses (PC IOLs) using 10-0 polypropylene sutures tied to the IOL eyelets. Three to 9 years after implantation, spontaneous IOL vertical subluxation occurred in all 4 eyes (5 IOL loops), probably because of suture breakage. Late subluxation of a sutured IOL may occur several years after implantation. Double fixation and thicker sutures should be considered, especially in young patients.

Transforaminal lumbar interbody fusion using unilateral pedicle screw fixation plus contralateral translaminar facet screw fixation in lumbar degenerative diseases.

Science.gov (United States)

Liu, Fubing; Jiang, Chun; Cao, Yuanwu; Jiang, Xiaoxing; Feng, Zhenzhou

2014-07-01

Transforaminal lumbar interbody fusion (TLIF) has been used in lumbar degenerative diseases. Some researchers have applied unilateral fixation in TLIF to reduce operational trauma without compromising the clinical outcome, but it is always suspected biomechanically unstable. The supplementary contralateral translaminar facet screw (cTLFS) seemed to be able to overcome the inherent drawbacks of unilateral pedicle screw (uPS) fixation theoretically. This study evaluates the safety, feasibility and efficacy of TLIF using uPS with cTLFS fixation in the treatment of lumbar degenerative diseases (LDD). 50 patients (29 male) underwent the aforementioned surgical technique for their LDD between December 2009 and April 2012. The results were evaluated based on visual analogue scale (VAS) of the leg and back, Japanese Orthopedic Association (JOA) score and Oswestry Disability Index (ODI) were recorded. The radiographic examinations in form of X-ray, computed tomography (CT) or magnetic resonance imaging was done preoperatively and 1 week, 3 months, 6 months, 12 months and 24 months postoperatively. The student t-test was used for comparison between the preoperative values and postoperative counterparts. P degenerative diseases short termly.

Sacroiliac screw fixation: A mini review of surgical technique

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Hernando Raphael Alvis-Miranda

2014-01-01

Full Text Available The sacral percutaneous fixation has many advantages but can be associated with a significant exposure to X-ray radiation. Currently, sacroiliac screw fixation represents the only minimally invasive technique to stabilize the posterior pelvic ring. It is a technique that should be used by experienced surgeons. We present a practical review of important aspects of this technique.

Use of 15N methodology to assess biological nitrogen fixation

International Nuclear Information System (INIS)

Hardarson, G.

1990-01-01

One of the most important characteristics of legumes are their ability in symbiosis with Rhizobium bacteria to fix atmospheric nitrogen for growth. For proper management and a full realization of the benefits of this plant-microbial association, it is necessary to estimate how much nitrogen is fixed under different conditions in the field. It is only after this is known that various factors can be manipulated so as to increase the amount and proportion of N a plant derives from biological fixation. A suitable method for accurately measuring the amount of N crops derive from fixation is therefore an important requirement in any programme aimed at maximizing biological nitrogen fixation. There are several methods available to measure N 2 fixation (Bergersen, 1980) based on (1) increment in N yield and plant growth, (2) nitrogen balance (3) acetylene reduction and (4) the use of isotopes of N. Only isotopic methods will be illustrated here. 20 refs, 2 figs, 9 tabs

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

Science.gov (United States)

Reed, Sasha C.; Cleveland, Cory C.; Townsend, Alan R.

2011-01-01

Nitrogen (N) availability is thought to frequently limit terrestrial ecosystem processes, and explicit consideration of N biogeochemistry, including biological N2 fixation, is central to understanding ecosystem responses to environmental change. Yet, the importance of free-living N2 fixation—a process that occurs on a wide variety of substrates, is nearly ubiquitous in terrestrial ecosystems, and may often represent the dominant pathway for acquiring newly available N—is often underappreciated. Here, we draw from studies that investigate free-living N2 fixation from functional, physiological, genetic, and ecological perspectives. We show that recent research and analytical advances have generated a wealth of new information that provides novel insight into the ecology of N2 fixation as well as raises new questions and priorities for future work. These priorities include a need to better integrate free-living N2 fixation into conceptual and analytical evaluations of the N cycle's role in a variety of global change scenarios.

The role of eye fixation in memory enhancement under stress - An eye tracking study.

Science.gov (United States)

Herten, Nadja; Otto, Tobias; Wolf, Oliver T

2017-04-01

In a stressful situation, attention is shifted to potentially relevant stimuli. Recent studies from our laboratory revealed that participants stressed perform superior in a recognition task involving objects of the stressful episode. In order to characterize the role of a stress induced alteration in visual exploration, the present study investigated whether participants experiencing a laboratory social stress situation differ in their fixation from participants of a control group. Further, we aimed at shedding light on the relation of fixation behaviour with obtained memory measures. We randomly assigned 32 male and 31 female participants to a control or a stress condition consisting of the Trier Social Stress Test (TSST), a public speaking paradigm causing social evaluative threat. In an established 'friendly' control condition (f-TSST) participants talk to a friendly committee. During both conditions, the committee members used ten office items (central objects) while another ten objects were present without being used (peripheral objects). Participants wore eye tracking glasses recording their fixations. On the next day, participants performed free recall and recognition tasks involving the objects present the day before. Stressed participants showed enhanced memory for central objects, accompanied by longer fixation times and larger fixation amounts on these objects. Contrasting this, fixation towards the committee faces showed the reversed pattern; here, control participants exhibited longer fixations. Fixation indices and memory measures were, however, not correlated with each other. Psychosocial stress is associated with altered fixation behaviour. Longer fixation on objects related to the stressful situation may reflect enhanced encoding, whereas diminished face fixation suggests gaze avoidance of aversive, socially threatening stimuli. Modified visual exploration should be considered in future stress research, in particular when focussing on memory for a

Short Segment Fixation Versus Short Segment Fixation With Pedicle Screws at the Fracture Level for Thoracolumbar Burst Fracture

Directory of Open Access Journals (Sweden)

Anghel S

2014-04-01

Full Text Available Objective: The most prevailing surgical procedure in the treatment of thoracolumbar burst fractures, Short Segment Fixation (SSF, is often followed by loss of correction or hardware failure which may be significant enough to require another surgical intervention. In order to take advantage of its benefits but to avoid or diminish the risk and impact of associated drawbacks, some other alternatives have been lately developed among which we refer to short segment fixation with intermediate screws (SSF+IS. This article provides a comparative picture over the effectiveness of the two above-mentioned surgical treatments, focusing on their potential to prevent the loss of correction.

Fixation of a human rib by an intramedullary telescoping splint anchored by bone cement.

Science.gov (United States)

Liovic, Petar; Šutalo, Ilija D; Marasco, Silvana F

2016-09-01

A novel concept for rib fixation is presented that involves the use of a bioresorbable polymer intramedullary telescoping splint. Bone cement is used to anchor each end of the splint inside the medullary canal on each side of the fracture site. In this manner, rib fixation is achieved without fixation device protrusion from the rib, making the splint completely intramedullary. Finite element analysis is used to demonstrate that such a splint/cement composite can preserve rib fixation subjected to cough-intensity force loadings. Computational fluid dynamics and porcine rib experiments were used to study the anchor formation process required to complete the fixation.

Mean-field approximations of fixation time distributions of evolutionary game dynamics on graphs

Science.gov (United States)

Ying, Li-Min; Zhou, Jie; Tang, Ming; Guan, Shu-Guang; Zou, Yong

2018-02-01

The mean fixation time is often not accurate for describing the timescales of fixation probabilities of evolutionary games taking place on complex networks. We simulate the game dynamics on top of complex network topologies and approximate the fixation time distributions using a mean-field approach. We assume that there are two absorbing states. Numerically, we show that the mean fixation time is sufficient in characterizing the evolutionary timescales when network structures are close to the well-mixing condition. In contrast, the mean fixation time shows large inaccuracies when networks become sparse. The approximation accuracy is determined by the network structure, and hence by the suitability of the mean-field approach. The numerical results show good agreement with the theoretical predictions.

Treatment of complex osteoarticular injuries of the elbow with external unilateral articulated fixator

International Nuclear Information System (INIS)

Cuellar Gallo, Lazaro; Portilla Carrillo, Armando; Calderon Uribe, Oscar; Calvache Currea, Gustavo Adolfo; Satizabal Azuero, Carlos Arnulfo

2001-01-01

Previous observations suggest that conventional treatment of complex injuries about the elbow such as open; reduction and internal Fixation might lead, to bad functional outcome. The authors present a descriptive, observational and prospective study of a series of cases, on 8 patients, average age 37.8 years (25-28 years) 6 men and 2 women with complex injury of the elbow. Due to trauma which etiology is summarized as follows intraarticular comminuted open fracture secondary to gunshot wound 5 patients (62.5%); luxofracture 2 patients (25%), lntraarticular comminuted closed fracture 1 patient (12.5%). The patients where followed for 8 to 20 months. Were performed en 75% of patients open reduction, internal fixation of radial resection of radial head en 25% when comminute fracture of the head was found. All patients were treated with an external unilateral articulated fixation on the elbow, in order to protect the internal fixation, allow early joint motion and give early mobility. All patients were evaluated with Mayo scale, obtaining good results, with externals fixation treatment. In one case (12.5%) a dyaphiseal fracture of the humerus, occurred as an inherent complication secondary to the use of the external fixation, after it's withdrawal. This patient was treated with open reduction and internal fixation of the fracture, without significant impairment of the final result. Early results suggest that the use of unilateral articulated external fixator for the treatment of complex fractures about the elbow has great advantages over the other treatment techniques, such as the early motion of the elbow, dynamic protection of the internal fixation and preservation of the articulate stability, even when ligament injury is present

Management and quantification of nitrogen fixation in Leucaena leucocephala

International Nuclear Information System (INIS)

Safo, E.Y.

1998-01-01

The effects of pruning and age on N 2 fixation were studied using Leucaena leucocephala isoline K28, with Cassia siamea as the non-N 2 -fixing reference species, at a site of degraded soil fertility typical of much of the farming land in Ghana. The 15 N-dilution method was used to estimate N2 fixation. Cassia siamea consistently produced higher total biomass and total N yields than did L. leucocephala. The mean value for the fraction of N derived from fixation (%Ndfa) was higher for pruned L. leucocephala (36%) than for unpruned trees (18%). There was some underestimation of N 2 fixation as a result of using C. siamea as the reference, and because root N-contents were not determined. Strong, significant linear correlations were observed between foliar and whole-tree (weighted average) percent 15 N atom excess in unpruned L. leucocephala and C. siamea, suggesting that foliar 15 N enrichment can be used to accurately estimate %Ndfa. The results demonstrated that the 15 N-enrichment methodology can provide meaningful estimates of %Ndfa and total N 2 fixed for mixed tree plantations under field conditions, when adequate spacing is provided. (author)

Predicting Eye Fixations on Complex Visual Stimuli Using Local Symmetry

NARCIS (Netherlands)

Kootstra, Geert; de Boer, Bart; Schomaker, Lambertus

Most bottom-up models that predict human eye fixations are based on contrast features. The saliency model of Itti, Koch and Niebur is an example of such contrast-saliency models. Although the model has been successfully compared to human eye fixations, we show that it lacks preciseness in the

Predicting eye fixations on complex visual stimuli using local symmetry

NARCIS (Netherlands)

Kootstra, G.; de Boer, B.; Schomaker, L.R.B.

2011-01-01

Most bottom-up models that predict human eye fixations are based on contrast features. The saliency model of Itti, Koch and Niebur is an example of such contrast-saliency models. Although the model has been successfully compared to human eye fixations, we show that it lacks preciseness in the

Nonphotosynthetic CO2 fixation by alfalfa (Medicago sativa L.) roots and nodules

International Nuclear Information System (INIS)

Anderson, M.P.; Heichel, G.H.; Vance, C.P.

1987-01-01

The dependence of alfalfa (Medicago sativa L.) root and nodule nonphotosynthetic CO 2 fixation on the supply of currently produced photosynthate and nodule nitrogenase activity was examined a various times after phloem-girdling and exposure of nodules to Ar:O 2 . Phloem-girdling was effected 20 hours and exposure to Ar:O 2 was effected 2 to 3 hours before initiation of experiments. Nodule and root CO 2 fixation rates of phloem-girdled plants were reduced to 38 and 50%, respectively, of those of control plants. Exposure to Ar:O 2 decreased nodule CO 2 fixation rates to 45%, respiration rates to 55%, and nitrogenase activities to 51% of those of the controls. The products of nodule CO 2 fixation were exported through the xylem to the shoot mainly as amino acids within 30 to 60 minutes after exposure to 14 CO 2 . In contrast to nodules, roots exported very little radioactivity, and most of the 14 C was exported as organic acids. The nonphotosynthetic CO 2 fixation rate of roots and nodules averaged 26% of the gross respiration rate, i.e. the sum of net respiration and nonphotosynthetic CO 2 assimilation. Nodules fixed CO 2 at a rate 5.6 times that of roots, but since nodules comprised a small portion of root system mass, roots accounted for 76% of the nodulated roots system CO 2 fixation. The results indicate that nodule CO 2 fixation in alfalfa is associated with N assimilation

The necessity of clinical application of tibial reduction for detection of underestimated posterolateral rotatory instability in combined posterior cruciate ligament and posterolateral corner deficient knee.

Science.gov (United States)

Lee, Han-Jun; Park, Yong-Beom; Ko, Young-Bong; Kim, Seong-Hwan; Kwon, Hyeok-Bin; Yu, Dong-Seok; Jung, Young-Bok

2015-10-01

The purpose of this study was to evaluate the usefulness of tibial reduction during dial test for clinical detection of underestimated posterolateral rotatory instability (PLRI) in combined posterior cruciate ligament (PCL)-posterolateral corner (PLC) deficient knee in terms of external rotation laxity and clinical outcomes. Twenty-one patients who classified as grade I PLRI using dial test with subluxated tibia, but classified as grade II with tibial reduction evaluated retrospectively. The mean follow-up was 39.3 months (range 24-61 months). Each patient was evaluated by the following variables: posterior translation and varus laxity on radiograph, KT-1000 arthrometer, dial test (reduced and subluxated position), International Knee Documentation Committee, Orthopädische Arbeitsgruppe Knie scoring system and Tegner activity scale. There were significant improvements in posterior tibial translation (8.6 ± 2.0 to 2.1 ± 1.0 mm; P application of reduction of posteriorly subluxated tibia during the dial test was essential for an appropriate treatment of underestimated PLRI in combined PCL-PLC deficient knee. Retrospective case series, Level IV.

Nitrogen supply of crops by biological nitrogen fixation. 2

International Nuclear Information System (INIS)

Jensen, E.S.; Andersen, A.J.; Soerensen, H.; Thomsen, J.D.

1985-02-01

In the present work the contributions from combined N-sources and symbiotic nitrogen fixation to the nitrogen supply of field-grown peas and field beans were evaluated by means of 15 N fertilizer dilution. The effect of N-fertilizer, supplied at sowing and at different stages of plant development, on nitrogen fixation, yield and protein production in peas, was studied in pot experiments. (author)

[Treatment of femoral neck fracture--preference to internal fixation].

Science.gov (United States)

Minato, Izumi

2011-03-01

In the guidelines for the treatment of femoral neck fracture, prosthetic replacement is recommended in displaced one and internal fixation is in undisplaced one. However, in the long view, survived femoral head after internal fixation can be superior to prosthesis which will deteriorate as time goes by. Surgical method should be considered not only by type of fracture but general status of the patient.

Deepwater Nitrogen Fixation: Who's Doing it, Where, and Why?

Science.gov (United States)

Montoya, J. P.; Weber, S.; Vogts, A.; Voss, M.; Saxton, M.; Joye, S. B.

2016-02-01

Nitrogen availability frequently limits marine primary production and N2-fixation plays an important role in supporting biological production in surface waters of many oligotrophic regions. Although subsurface waters typically contain high concentrations of nitrate and other nutrients, measurements from a variety of oceanic settings show measurable, and at times high rates of N2-fixation in deep, dark waters below the mixed layer. We have explored the distribution of N2-fixation throughout the water column of the Gulf of Mexico (GoM) during a series of cruises beginning shortly after the Deepwater Horizon (DWH) spill in 2010 and continuing at roughly annual intervals. These cruises allowed us to sample oligotrophic waters across a range of depths, and to explore the connections between the C and N cycles mediated by release of oil and gas (petrocarbon) from natural seeps as well as anthropogenic sources (e.g., the DWH). We used stable isotope abundances (15N and 13C) in particles and zooplankton in combination with experimental measurements of N2-fixation and CH4 assimilation to assess the contribution of oil- and gas-derived C to the pelagic food web, and the impact of CH4 releases on the pelagic C and N cycles. Our isotopic measurements document the movement of petrocarbon into the pelagic food web, and our experiments revealed that high rates of N2-fixation were widespread in deep water immediately after the DWH incident, and restricted to the vicinity of natural seeps in subsequent years. Unfortunately, these approaches provided no insight into the organisms actually responsible for N2-fixation and CH4-assimilation. We used nano-scale Secondary Ion Mass Spectrometry (nanoSIMS) to image the organisms responsible for these processes, and molecular approaches to explore the diversity of methanotrophs and diazotrophs present in the system. The ability to resolve isotopic distributions on the scale of individual cells is a critical part of bridging the gap between

Benthic dinitrogen fixation traversing the oxygen minimum zone off Mauritania (NW Africa)

DEFF Research Database (Denmark)

Gier, Jessica; Löscher, Carolin R.; Dale, Andrew W.

2017-01-01

metabolisms, such as sulfate reduction. In the present study, benthic N2 fixation together with sulfate reduction and other heterotrophic metabolisms were investigated at six station between 47 and 1,108 m water depth along the 18°N transect traversing the highly productive upwelling region known...... as Mauritanian oxygen minimum zone (OMZ). Bottom water oxygen concentrations ranged between 30 and 138 μM. Benthic N2 fixation determined by the acetylene reduction assay was detected at all stations with highest rates (0.15 mmol m-2 d-1) on the shelf (47 and 90 m water depth) and lowest rates (0.08 mmol m-2 d-1......) below 412 m water depth. The biogeochemical data suggest that part of the N2 fixation could be linked to sulfate- and iron-reducing bacteria. Molecular analysis of the key functional marker gene for N2 fixation, nifH, confirmed the presence of sulfate- and iron-reducing diazotrophs. High N2 fixation...

Indications and outcome of Open Reduction and Internal Fixation of ...

African Journals Online (AJOL)

Background: Open reduction and internal fixation (ORIF) is a well-established surgical treatment of fractures worldwide. However, the indications and modes of stabilization of long bone fractures vary and are evolving .The general trend now is towards fixation with locked intramedullary nail (i.m nail) rather than plate and ...

Dynamic Programming for Re-Mapping Noisy Fixations in Translation Tasks

DEFF Research Database (Denmark)

Carl, Michael

2013-01-01

possible fixated symbols, including those on the line above and below the naïve fixation mapping. In a second step a dynamic programming algorithm applies a number of heuristics to find the best path through the lattice, based on the probable distance in characters, in words and in pixels between...

Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures

Directory of Open Access Journals (Sweden)

Rajasekhar Gali

2016-01-01

Full Text Available Introduction: Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications. Purpose: This retrospective clinical case record study was done to evaluate the preauricular transmasseteric anteroparotid (P-TMAP approach for open reduction and extracorporeal fixation of displaced and dislocated high condylar fractures of the mandible. Patients and Methods: This retrospective study involved search of clinical case records of seven patients with displaced and dislocated high condylar fractures treated by open reduction and extracorporeal fixation over a 3-year period. The parameters assessed were as follows: a the ease of access for retrieval, reimplantation and fixation of the proximal segment; b the postoperative approach related complications; c the adequacy of anatomical reduction and stability of fixation; d the occlusal changes; and the e TMJ function and radiological changes. Results: Accessibility and visibility were good. Accurate anatomical reduction and fixation were achieved in all the patients. The recorded complications were minimal and transient. Facial nerve (buccal branch palsy was noted in one patient with spontaneous resolution within 3 months. No cases of sialocele or Frey's syndrome were seen. Conclusion: The P-TMAP approach provides good access for open reduction and extracorporeal fixation of severely displaced condylar fractures. It facilitates retrieval, transplantation, repositioning, fixing the condyle and also reduces the chances of requirement of a vertical ramus osteotomy. It gives straight-line access to condylar head and ramus thereby

Experimental Fracture Model versus Osteotomy Model in Metacarpal Bone Plate Fixation

Directory of Open Access Journals (Sweden)

S. Ochman

2011-01-01

Full Text Available Introduction. Osteotomy or fracture models can be used to evaluate mechanical properties of fixation techniques of the hand skeleton in vitro. Although many studies make use of osteotomy models, fracture models simulate the clinical situation more realistically. This study investigates monocortical and bicortical plate fixation on metacarpal bones considering both aforementioned models to decide which method is best suited to test fixation techniques. Methods. Porcine metacarpal bones (=40 were randomized into 4 groups. In groups I and II bones were fractured with a modified 3-point bending test. The intact bones represented a further control group to which the other groups after fixation were compared. In groups III and IV a standard osteotomy was carried out. Bones were fixated with plates monocortically (group I, III and bicortically (group II, IV and tested for failure. Results. Bones fractured at a mean maximum load of 482.8 N ± 104.8 N with a relative standard deviation (RSD of 21.7%, mean stiffness was 122.3 ± 35 N/mm. In the fracture model, there was a significant difference (=0.01 for maximum load of monocortically and bicortically fixed bones in contrast to the osteotomy model (=0.9. Discussion. In the fracture model, because one can use the same bone for both measurements in the intact state and the bone-plate construct states, the impact of inter-individual differences is reduced. In contrast to the osteotomy model there are differences between monocortical and bicortical fixations in the fracture model. Thus simulation of the in vivo situation is better and seems to be suitable for the evaluation of mechanical properties of fixation techniques on metacarpals.

Management of Subcondylar Fracture through Intraoral Approach with Rigid Internal Fixation.

Science.gov (United States)

Patil, Ravi S; Gudi, Santosh S

2011-09-01

In Oral and Maxillofacial Surgery, the majority of the condylar fractures are treated by closed reduction with generally satisfactory long term results. But in such cases of closed reduction, patient will be uncomfortable owing to long term application of inter maxillary fixation (IMF). Where as, Disadvantages of extra oral open reduction and fixation of condylar fracture includes facial nerve damage, facial scars etc. which are surely eliminated by the intraoral reduction and rigid fixation. The present study was conducted to determine the efficacy of reduction and fixation of low sub-condylar fractures through intra-oral approach. In this study, ten patients with low sub-condylar fracture, reported to department of Oral and Maxillofacial Surgery. P.M.N.M. Dental College and Hospital Bagalkot were included. These patients were treated by open reduction and internal fixation through intra-oral approach. All the patients were evaluated postoperatively for mouth opening, occlusion and mandibular deviation with regular radiographic examination for 6 weeks. All operated patients followed for 6 weeks, maximum mouth opening was more than 40 mm in seven patients (range from 40 to 50 mm) and less than 40 mm in three patients. Occlusion was satisfactory in all and none of the patients showed deviation of mandible on mouth opening. Statistical analysis showed that postoperative mouth opening was significant ('t' value = 7.88, 'P' = (0.000) value = 1.96, 'P' value (0.081), 0.05]. For occlusion standard photographs were obtained at sixth week and found minor occlusal corrections in two patients are treated by elastic traction for few days. Open reduction with internal fixation through intraoral approach has proved to be safe for early function and also effective by avoiding the patient discomfort due to long term intermaxillary fixation, psychological effect, facial nerve damage, facial scar and weight loss.

Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures.

Science.gov (United States)

Gali, Rajasekhar; Devireddy, Sathya Kumar; Venkata, Kishore Kumar Rayadurgam; Kanubaddy, Sridhar Reddy; Nemaly, Chaithanyaa; Dasari, Mallikarjuna

2016-01-01

Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications. This retrospective clinical case record study was done to evaluate the preauricular transmasseteric anteroparotid (P-TMAP) approach for open reduction and extracorporeal fixation of displaced and dislocated high condylar fractures of the mandible. This retrospective study involved search of clinical case records of seven patients with displaced and dislocated high condylar fractures treated by open reduction and extracorporeal fixation over a 3-year period. The parameters assessed were as follows: a) the ease of access for retrieval, reimplantation and fixation of the proximal segment; b) the postoperative approach related complications; c) the adequacy of anatomical reduction and stability of fixation; d) the occlusal changes; and the e) TMJ function and radiological changes. Accessibility and visibility were good. Accurate anatomical reduction and fixation were achieved in all the patients. The recorded complications were minimal and transient. Facial nerve (buccal branch) palsy was noted in one patient with spontaneous resolution within 3 months. No cases of sialocele or Frey's syndrome were seen. The P-TMAP approach provides good access for open reduction and extracorporeal fixation of severely displaced condylar fractures. It facilitates retrieval, transplantation, repositioning, fixing the condyle and also reduces the chances of requirement of a vertical ramus osteotomy. It gives straight-line access to condylar head and ramus thereby permitting perpendicular placement of screws with minimal risk of damage to the facial

Primary fixation of mini slings: a comparative biomechanical study in vivo

Directory of Open Access Journals (Sweden)

Paulo Palma

2012-04-01

Full Text Available INTRODUCTION AND OBJECTIVES: The mini sling concept for stress urinary incontinence is an anatomical approach that involves placing a midurethral low-tension tape anchored to the obturator internus muscles bilaterally. They overcome the blind passage of long needles and all the related complications. There are many different devices available and because these are outpatient procedures, primary fixation plays an important role in the outcome. The objective is to evaluate the primary fixation of the various devices of attachment of the commercially available mini-slings through biomechanical tests. MATERIALS AND METHODS: A total of 45 Wistar rats were divided in 3 groups of 15 rats each. They underwent 5 subcutaneous implantation of different mini slings and one polipropilene mesh (control, as follows: TVT-Secur® (Gynecare, USA, Type 1 polypropylene mesh (control; Ophira Mini Sling System® (Promedon, Argentina, Tissue Fixation System® (TFS PTY, Australia, Zipper Sling® and "T device" (Prosurg, USA. The abdominal wall was removed on bloc at different times after implant for biomechanical evaluation, which consisted in application of unidirectional force to the extremity of the fixation system or mesh, until it was completely removed from the tissue using a tension meter (Nexygen 3.0 Universal Testing Machine - LLOYD Instruments. The force was measured in Newtons (N. RESULTS: There was significant difference in the resistance to extraction among the different fixation systems. At 7 days the Ophira Mini Sling System® presented the best fixation and "T dispositive" the worst. CONCLUSION: Ophira mini sling System® presented the best primary fixation at 7º, 14º and 30º days. The impact of this feature in the clinical setting needs to be verified.

Virtual haptic system for intuitive planning of bone fixation plate placement

Directory of Open Access Journals (Sweden)

Kup-Sze Choi

2017-01-01

Full Text Available Placement of pre-contoured fixation plate is a common treatment for bone fracture. Fitting of fixation plates on fractured bone can be preoperatively planned and evaluated in 3D virtual environment using virtual reality technology. However, conventional systems usually employ 2D mouse and virtual trackball as the user interface, which makes the process inconvenient and inefficient. In the paper, a preoperative planning system equipped with 3D haptic user interface is proposed to allow users to manipulate the virtual fixation plate intuitively to determine the optimal position for placement on distal medial tibia. The system provides interactive feedback forces and visual guidance based on the geometric requirements. Creation of 3D models from medical imaging data, collision detection, dynamics simulation and haptic rendering are discussed. The system was evaluated by 22 subjects. Results show that the time to achieve optimal placement using the proposed system was shorter than that by using 2D mouse and virtual trackball, and the satisfaction rating was also higher. The system shows potential to facilitate the process of fitting fixation plates on fractured bones as well as interactive fixation plate design.

Toward FRP-Based Brain-Machine Interfaces-Single-Trial Classification of Fixation-Related Potentials.

Directory of Open Access Journals (Sweden)

Andrea Finke

Full Text Available The co-registration of eye tracking and electroencephalography provides a holistic measure of ongoing cognitive processes. Recently, fixation-related potentials have been introduced to quantify the neural activity in such bi-modal recordings. Fixation-related potentials are time-locked to fixation onsets, just like event-related potentials are locked to stimulus onsets. Compared to existing electroencephalography-based brain-machine interfaces that depend on visual stimuli, fixation-related potentials have the advantages that they can be used in free, unconstrained viewing conditions and can also be classified on a single-trial level. Thus, fixation-related potentials have the potential to allow for conceptually different brain-machine interfaces that directly interpret cortical activity related to the visual processing of specific objects. However, existing research has investigated fixation-related potentials only with very restricted and highly unnatural stimuli in simple search tasks while participant's body movements were restricted. We present a study where we relieved many of these restrictions while retaining some control by using a gaze-contingent visual search task. In our study, participants had to find a target object out of 12 complex and everyday objects presented on a screen while the electrical activity of the brain and eye movements were recorded simultaneously. Our results show that our proposed method for the classification of fixation-related potentials can clearly discriminate between fixations on relevant, non-relevant and background areas. Furthermore, we show that our classification approach generalizes not only to different test sets from the same participant, but also across participants. These results promise to open novel avenues for exploiting fixation-related potentials in electroencephalography-based brain-machine interfaces and thus providing a novel means for intuitive human-machine interaction.

An in-vitro biomechanical study of different fixation techniques for the extended trochanteric osteotomy in revision THA.

Science.gov (United States)

Zhu, Zhonglin; Ding, Hui; Shao, Hongyi; Zhou, Yixin; Wang, Guangzhi

2013-04-09

The wire fixation and the cable grip fixation have been developed for the extended trochanteric osteotomy (ETO) in the revision of total hip arthroplasty (THA). Many studies reported the postoperative performance of the patients, but with little quantitative biomechanical comparison of the two fixation systems. An in-vitro testing approach was designed to record the loosening between the femoral bed and the greater trochanter after fixations. Ten cadaveric femurs were chosen in this study. Each femur underwent the THA, revision by ETO and fixations. The tension to the greater trochanter was from 0 to 500N in vertical and lateral direction, respectively. The translation and rotation of the greater trochanter with respect to the bony bed were captured by an optical tracking system. In the vertical tension tests, the overall translation of the greater trochanter was observed 0.4 mm in the cable fixations and 7.0 mm in the wire fixations. In the lateral tension tests, the overall motion of the greater trochanter was 2.0 mm and 1.2° in the cable fixations, while it was 6.2 mm and 5.3° in the wire fixations. The result was significantly different between the two fixation systems. The stability of the proximal femur after ETO using different fixations in the revision THA was investigated. The cable grip fixation was significantly more stable than the wire fixation.

Taxonomic identity determines N2 fixation by canopy trees across lowland tropical forests.

Science.gov (United States)

Wurzburger, Nina; Hedin, Lars O

2016-01-01

Legumes capable of fixing atmospheric N2 are abundant and diverse in many tropical forests, but the factors determining ecological patterns in fixation are unresolved. A long-standing idea is that fixation depends on soil nutrients (N, P or Mo), but recent evidence shows that fixation may also differ among N2-fixing species. We sampled canopy-height trees across five species and one species group of N2-fixers along a landscape P gradient, and manipulated P and Mo to seedlings in a shadehouse. Our results identify taxonomy as the major determinant of fixation, with P (and possibly Mo) only influencing fixation following tree-fall disturbances. While 44% of trees did not fix N2, other trees fixed at high rates, with two species functioning as superfixers across the landscape. Our results raise the possibility that fixation is determined by biodiversity, evolutionary history and species-specific traits (tree growth rate, canopy stature and response to disturbance) in the tropical biome. © 2015 John Wiley & Sons Ltd/CNRS.

High level waste fixation in cermet form

International Nuclear Information System (INIS)

Kobisk, E.H.; Aaron, W.S.; Quinby, T.C.; Ramey, D.W.

1981-01-01

Commercial and defense high level waste fixation in cermet form is being studied by personnel of the Isotopes Research Materials Laboratory, Solid State Division (ORNL). As a corollary to earlier research and development in forming high density ceramic and cermet rods, disks, and other shapes using separated isotopes, similar chemical and physical processing methods have been applied to synthetic and real waste fixation. Generally, experimental products resulting from this approach have shown physical and chemical characteristics which are deemed suitable for long-term storage, shipping, corrosive environments, high temperature environments, high waste loading, decay heat dissipation, and radiation damage. Although leach tests are not conclusive, what little comparative data are available show cermet to withstand hydrothermal conditions in water and brine solutions. The Soxhlet leach test, using radioactive cesium as a tracer, showed that leaching of cermet was about X100 less than that of 78 to 68 glass. Using essentially uncooled, untreated waste, cermet fixation was found to accommodate up to 75% waste loading and yet, because of its high thermal conductivity, a monolith of 0.6 m diameter and 3.3 m-length would have only a maximum centerline temperature of 29 K above the ambient value

N2 Fixation by Grain Legume Varieties as Affected By Rhizobia ...

African Journals Online (AJOL)

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Capture of fixation by rotational flow; a deterministic hypothesis regarding scaling and stochasticity in fixational eye movements

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Nicholas Mansel Wilkinson

2014-02-01

Full Text Available Visual scan paths exhibit complex, stochastic dynamics. Even during visual fixation, the eye is in constant motion. Fixational drift and tremor are thought to reflect fluctuations in the persistent neural activity of neural integrators in the oculomotor brainstem, which integrate sequences of transient saccadic velocity signals into a short term memory of eye position. Despite intensive research and much progress, the precise mechanisms by which oculomotor posture is maintained remain elusive. Drift exhibits a stochastic statistical profile which has been modelled using random walk formalisms. Tremor is widely dismissed as noise. Here we focus on the dynamical profile of fixational tremor, and argue that tremor may be a signal which usefully reflects the workings of the oculomotor postural control. We identify signatures reminiscent of a certain flavour of transient neurodynamics; toric travelling waves which rotate around a central phase singularity. Spiral waves play an organisational role in dynamical systems at many scales throughout nature, though their potential functional role in brain activity remains a matter of educated speculation. Spiral waves have a repertoire of functionally interesting dynamical properties, including persistence, which suggest that they could in theory contribute to persistent neural activity in the oculomotor postural control system. Whilst speculative, the singularity hypothesis of oculomotor postural control implies testable predictions, and could provide the beginnings of an integrated dynamical framework for eye movements across scales.

Contributions of retinal input and phenomenal representation of a fixation object to the saccadic gap effect.

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Ueda, Hiroshi; Takahashi, Kohske; Watanabe, Katsumi

2013-04-19

The saccadic "gap effect" refers to a phenomenon whereby saccadic reaction times (SRTs) are shortened by the removal of a visual fixation stimulus prior to target presentation. In the current study, we investigated whether the gap effect was influenced by retinal input of a fixation stimulus, as well as phenomenal permanence and/or expectation of the re-emergence of a fixation stimulus. In Experiment 1, we used an occluded fixation stimulus that was gradually hidden by a moving plate prior to the target presentation, which produced the impression that the fixation stimulus still remained and would reappear from behind the plate. We found that the gap effect was significantly weakened with the occluded fixation stimulus. However, the SRT with the occluded fixation stimulus was still shorter in comparison to when the fixation stimulus physically remained on the screen. In Experiment 2, we investigated whether this effect was due to phenomenal maintenance or expectation of the reappearance of the fixation stimulus; this was achieved by using occluding plates that were an identical color to the background screen, giving the impression of reappearance of the fixation stimulus but not of its maintenance. The result showed that the gap effect was still weakened by the same degree even without phenomenal maintenance of the fixation stimulus. These results suggest that the saccadic gap effect is modulated by both retinal input and subjective expectation of re-emergence of the fixation stimulus. In addition to oculomotor mechanisms, other components, such as attentional mechanisms, likely contribute to facilitation of the subsequent action. Copyright © 2013 Elsevier Ltd. All rights reserved.

Fixations on objects in natural scenes: dissociating importance from salience

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Bernard Marius e’t Hart

2013-07-01

Full Text Available The relation of selective attention to understanding of natural scenes has been subject to intense behavioral research and computational modeling, and gaze is often used as a proxy for such attention. The probability of an image region to be fixated typically correlates with its contrast. However, this relation does not imply a causal role of contrast. Rather, contrast may relate to an object’s importance for a scene, which in turn drives attention. Here we operationalize importance by the probability that an observer names the object as characteristic for a scene. We modify luminance contrast of either a frequently named (common/important or a rarely named (rare/unimportant object, track the observers’ eye movements during scene viewing and ask them to provide keywords describing the scene immediately after.When no object is modified relative to the background, important objects draw more fixations than unimportant ones. Increases of contrast make an object more likely to be fixated, irrespective of whether it was important for the original scene, while decreases in contrast have little effect on fixations. Any contrast modification makes originally unimportant objects more important for the scene. Finally, important objects are fixated more centrally than unimportant objects, irrespective of contrast.Our data suggest a dissociation between object importance (relevance for the scene and salience (relevance for attention. If an object obeys natural scene statistics, important objects are also salient. However, when natural scene statistics are violated, importance and salience are differentially affected. Object salience is modulated by the expectation about object properties (e.g., formed by context or gist, and importance by the violation of such expectations. In addition, the dependence of fixated locations within an object on the object’s importance suggests an analogy to the effects of word frequency on landing positions in reading.

Accuracy of a hexapod parallel robot kinematics based external fixator.

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Faschingbauer, Maximilian; Heuer, Hinrich J D; Seide, Klaus; Wendlandt, Robert; Münch, Matthias; Jürgens, Christian; Kirchner, Rainer

2015-12-01

Different hexapod-based external fixators are increasingly used to treat bone deformities and fractures. Accuracy has not been measured sufficiently for all models. An infrared tracking system was applied to measure positioning maneuvers with a motorized Precision Hexapod® fixator, detecting three-dimensional positions of reflective balls mounted in an L-arrangement on the fixator, simulating bone directions. By omitting one dimension of the coordinates, projections were simulated as if measured on standard radiographs. Accuracy was calculated as the absolute difference between targeted and measured positioning values. In 149 positioning maneuvers, the median values for positioning accuracy of translations and rotations (torsions/angulations) were below 0.3 mm and 0.2° with quartiles ranging from -0.5 mm to 0.5 mm and -1.0° to 0.9°, respectively. The experimental setup was found to be precise and reliable. It can be applied to compare different hexapod-based fixators. Accuracy of the investigated hexapod system was high. Copyright © 2014 John Wiley & Sons, Ltd.

Features of Recent Codon Evolution: A Comparative Polymorphism-Fixation Study

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Zhongming Zhao

2010-01-01

Full Text Available Features of amino-acid and codon changes can provide us important insights on protein evolution. So far, investigators have often examined mutation patterns at either interspecies fixed substitution or intraspecies nucleotide polymorphism level, but not both. Here, we performed a unique analysis of a combined set of intra-species polymorphisms and inter-species substitutions in human codons. Strong difference in mutational pattern was found at codon positions 1, 2, and 3 between the polymorphism and fixation data. Fixation had strong bias towards increasing the rarest codons but decreasing the most frequently used codons, suggesting that codon equilibrium has not been reached yet. We detected strong CpG effect on CG-containing codons and subsequent suppression by fixation. Finally, we detected the signature of purifying selection against A∣U dinucleotides at synonymous dicodon boundaries. Overall, fixation process could effectively and quickly correct the volatile changes introduced by polymorphisms so that codon changes could be gradual and directional and that codon composition could be kept relatively stable during evolution.

Single absorbable polydioxanone pin fixation for distal chevron bunion osteotomies.

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Deorio, J K; Ware, A W

2001-10-01

The distal chevron osteotomy is a well-established technique for correction of symptomatic mild to moderate metatarsus primus varus with hallux valgus deformity. Fixation of the osteotomy ranges from none to bone pegs, Kirschner wires, screws, or absorbable pins. We evaluated one surgeon's (J.K.D.) results of distal chevron osteotomy fixation with a single, nonpredrilled, 1.3-mm poly-p-dioxanone pin and analyzed any differences in patients with unilateral or bilateral symptomatic metatarsus primus varus with hallux valgus deformities. All osteotomies healed without evidence of infection, osteolysis, nonunion, or necrosis. Equal correction was achieved in unilateral and bilateral procedures. The technique is quick and easy, and adequate fixation is achieved.

Sulfur Fixation by Chemically Modified Red Mud Samples Containing Inorganic Additives: A Parametric Study

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Yang Liu

2016-01-01

Full Text Available Sulfur retention ability of Bayer red mud from alumina plant was investigated. Bayer red mud modified by fusel salt and waste mother liquor of sodium ferrocyanide as the main sulfur fixation agent and the calcium based natural mineral materials as servicing additives; the experimental results showed the following: (1 Through 10 wt% waste mother liquor of sodium ferrocyanide modifying Bayer red mud, sulfur fixation rate can increase by 13 wt%. (2 Magnesium oxide can obviously improve the sulfur fixation performance of Bayer red mud and up to a maximum sulfur fixation rate of 47 wt% at adding 1 wt% magnesium oxide. (3 Dolomite enhanced the sulfur fixation performances with the sulfur fixation rate of 68 wt% in optimized condition. (4 Vermiculite dust reduced sulfur dioxide during the fixed-sulfur process of modified Bayer red mud, and the desulphurization ration could reach up to a maximum 76 wt% at 950°C. (5 An advanced three-component sulfur fixation agent was investigated, in which the optimized mass ratio of modified Bayer red mud, dolomite, and vermiculite dust was 70 : 28 : 2 in order, and its sulfur fixation efficiency has reached to a maximum 87 wt% under its 20 wt% dosage in the coal.

Flanged Intrascleral Intraocular Lens Fixation with Double-Needle Technique.

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Yamane, Shin; Sato, Shimpei; Maruyama-Inoue, Maiko; Kadonosono, Kazuaki

2017-08-01

To report the clinical outcomes of a new technique for transconjunctival intrascleral fixation of an intraocular lens (IOL). Prospective, noncomparative, interventional case series. One hundred eyes of 97 consecutive patients with aphakia, dislocated IOL, or subluxated crystalline lens who underwent posterior chamber sutureless implantation of an IOL were studied. Two angled incisions parallel to the limbus were made by 30-gauge thin-wall needles. Haptics of an IOL were externalized with the needles and cauterized to make a flange of the haptics. The flange of the haptics were pushed back and fixed into the scleral tunnels. Best-corrected visual acuity (VA), corneal endothelial cell density, IOL tilt, and complications were determined. The IOLs were fixed with exact centration and axial stability. The mean preoperative best-corrected VA was 0.25 logarithm of the minimum angle of resolution (logMAR) units; after surgery, it improved significantly to 0.11 logMAR, 0.09 logMAR, 0.12 logMAR, and 0.04 logMAR at 6, 12, 24, and 36 months, respectively (P IOL tilt was 3.4°±2.5°. The postoperative complications included iris capture by the IOL in 8 eyes (8%), vitreous hemorrhage in 5 eyes (5%), and cystoid macular edema in 1 eye (1%). There were no incidents of postoperative retinal detachment, endophthalmitis, or IOL dislocation. We have developed a new technique for intrascleral IOL fixation. The flanged IOL fixation technique is a simple and minimally invasive method for achieving good IOL fixation with firm haptic fixation. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Operative fixation of chest wall fractures: an underused procedure?

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Richardson, J David; Franklin, Glen A; Heffley, Susan; Seligson, David

2007-06-01

Chest wall fractures, including injuries to the ribs and sternum, usually heal spontaneously without specific treatment. However, a small subset of patients have fractures that produce overlying bone fragments that may produce severe pain, respiratory compromise, and, if untreated mechanically, result in nonunion. We performed open reduction and internal fixation on seven patients with multiple rib fractures-five in the initial hospitalization and two delayed--as well as 35 sternal fractures (19 immediate fixation and 16 delayed). Operative fixation was accomplished using titanium plates and screws in both groups of patients. All patients with rib fractures did well; there were no major complications or infections, and no plates required removal. Clinical results were excellent. There was one death in the sternal fracture group in a patient who was ventilator-dependent preoperatively and extubated himself in the early postoperative period. Otherwise, the results were excellent, with no complications occurring in this group. Three patients had their plates removed after boney union was achieved. No evidence of infection or nonunion occurred. The excellent results achieved in the subset of patients with severe chest wall deformities treated initially at our institution and those referred from outside suggest that operative fixation is a useful modality that is likely underused.

Intraocular lens iris fixation. Clinical and macular OCT outcomes

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2012-01-01

Background To assess the efficacy, clinical outcomes, visual acuity (VA), incidence of adverse effects, and complications of peripheral iris fixation of 3-piece acrylic IOLs in eyes lacking capsular support. Thirteen patients who underwent implantation and peripheral iris fixation of a 3-piece foldable acrylic PC IOL for aphakia in the absence of capsular support were followed after surgery. Clinical outcomes and macular SD-OCT (Cirrus OCT; Carl Zeiss Meditec, Germany) were analyzed. Findings The final CDVA was 20/40 or better in 8 eyes (62%), 20/60 or better in 12 eyes (92%), and one case of 20/80 due to corneal astigmatism and mild persistent edema. No intraoperative complications were reported. There were seven cases of medically controlled ocular hypertension after surgery due to the presence of viscoelastic in the AC. There were no cases of cystoid macular edema, chronic iridocyclitis, IOL subluxation, pigment dispersion, or glaucoma. Macular edema did not develop in any case by means of SD-OCT. Conclusions We think that this technique for iris suture fixation provides safe and effective results. Patients had substantial improvements in UDVA and CDVA. This surgical strategy may be individualized however; age, cornea status, angle structures, iris anatomy, and glaucoma are important considerations in selecting candidates for an appropriate IOL fixation method. PMID:23050659

Fixation probability of a nonmutator in a large population of asexual mutators.

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Jain, Kavita; James, Ananthu

2017-11-21

In an adapted population of mutators in which most mutations are deleterious, a nonmutator that lowers the mutation rate is under indirect selection and can sweep to fixation. Using a multitype branching process, we calculate the fixation probability of a rare nonmutator in a large population of asexual mutators. We show that when beneficial mutations are absent, the fixation probability is a nonmonotonic function of the mutation rate of the mutator: it first increases sublinearly and then decreases exponentially. We also find that beneficial mutations can enhance the fixation probability of a nonmutator. Our analysis is relevant to an understanding of recent experiments in which a reduction in the mutation rates has been observed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Nitrogen Fixation in the Intertidal Sediments of the Yangtze Estuary: Occurrence and Environmental Implications

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Hou, Lijun; Wang, Rong; Yin, Guoyu; Liu, Min; Zheng, Yanling

2018-03-01

Nitrogen fixation is a microbial-mediated process converting atmospheric dinitrogen gas to biologically available ammonia or other molecules, and it plays an important role in regulating nitrogen budgets in coastal marine ecosystems. In this study, nitrogen fixation in the intertidal sediments of the Yangtze Estuary was investigated using nitrogen isotope tracing technique. The abundance of nitrogen fixation functional gene (nifH) was also quantified. The measured rates of sediment nitrogen fixation ranged from 0.37 to 7.91 nmol N g-1 hr-1, while the abundance of nifH gene varied from 2.28 × 106 to 1.28 × 108 copies g-1 in the study area. The benthic nitrogen fixation was correlated closely to the abundance of nifH gene and was affected significantly by salinity, pH, and availability of sediment organic carbon and ammonium. It is estimated that sediment nitrogen fixation contributed approximately 9.3% of the total terrigenous inorganic nitrogen transported annually into the Yangtze estuarine and coastal environment. This result implies that the occurrence of benthic nitrogen fixation acts as an important internal source of reactive nitrogen and to some extent exacerbates nitrogen pollution in this aquatic ecosystem.

Operative Fixation of Rib Fractures Indications, Techniques, and Outcomes.

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Galos, David; Taylor, Benjamin; McLaurin, Toni

2017-01-01

Rib fractures are extremely common injuries and vary in there severity from single nondisplaced fractures to multiple segmental fractures resulting in flail chest and respiratory compromise. Historically, rib fractures have been treated conservatively with pain control and respiratory therapy. However this method may not be the best treatment modality in all situations. Operative fixation of select rib fractures has been increasing in popularity especially in patients with flail chest and respiratory compromise. Newer techniques use muscle sparing approaches and precontoured locking plate technology to obtain stable fixation and allow improved respiration. Current reports shows that rib fracture fixation offers the benefits of improved respiratory mechanics and improved pain control in the severe chest wall injury with resultant improvement in patient outcomes by decreasing time on the ventilator, time in the intensive care unit, and overall hospital length of stay.

Outcome of 28 open pilon fractures with injury severity-based fixation.

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Danoff, Jonathan R; Saifi, Comron; Goodspeed, David C; Reid, J Spence

2015-04-01

Open pilon fracture management and treatment poses a significant challenge to orthopedic surgeons. The purpose of this study was to determine patient outcomes for open pilon fractures based on wound complication and infection rates, as well as subjective outcome instruments. This was a retrospective consecutive case series of 28 fractures with Orthopaedic Trauma Association (OTA)-type 43-B and 43-C open pilon fractures. Mean length of follow-up was 36 months and minimum of 1 year. Ten fractures were Gustilo and Anderson grade IIIB, and the remaining fractures were grades I-IIIA. Patients were initially treated with spanning external fixation and staged wound debridement followed by osteosynthesis of the articular surface. Metaphyseal fixation was by either plate fixation or Ilizarov frame. The primary outcome was the incidence of deep tissue infection requiring surgery. Secondary outcomes included the incidence of other complications (nonunion, malunion, amputation) and functional outcomes (Short Musculoskeletal Functional Assessment Questionnaire and AAOS Foot and Ankle Questionnaire). Four patients developed deep tissue infections, three in the internal fixation group and one in the Ilizarov group, and all were treated successfully with staged debridement. There were two delayed unions required bone grafting, and infection-free union was ultimately achieved in all fractures. Two patients underwent arthrodesis secondary to post-traumatic arthritis, while no patients experienced malunions or amputations. The use of staged wound debridement in conjunction with either plate fixation or Ilizarov frame achieves low rates of wound infection and stable fixation after anatomic joint reconstruction for OTA-type 43-B and 43-C open pilon fractures.

Ethanol-Glycerin Fixation with Thymol Conservation: A Potential Alternative to Formaldehyde and Phenol Embalming

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Hammer, Niels; Loffler, Sabine; Feja, Christine; Sandrock, Mara; Schmidt, Wolfgang; Bechmann, Ingo; Steinke, Hanno

2012-01-01

Anatomical fixation and conservation are required to prevent specimens from undergoing autolysis and decomposition. While fixation is the primary arrest of the structures responsible for autolysis and decomposition, conservation preserves the state of fixation. Although commonly used, formaldehyde has been classified as carcinogenic to humans. For…

Adjacent-segment disease after thoracic pedicle screw fixation.

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Agarwal, Nitin; Heary, Robert F; Agarwal, Prateek

2018-03-01

OBJECTIVE Pedicle screw fixation is a technique widely used to treat conditions ranging from spine deformity to fracture stabilization. Pedicle screws have been used traditionally in the lumbar spine; however, they are now being used with increasing frequency in the thoracic spine as a more favorable alternative to hooks, wires, or cables. Although safety concerns, such as the incidence of adjacent-segment disease (ASD) after cervical and lumbar fusions, have been reported, such issues in the thoracic spine have yet to be addressed thoroughly. Here, the authors review the literature on ASD after thoracic pedicle screw fixation and report their own experience specifically involving the use of pedicle screws in the thoracic spine. METHODS Select references from online databases, such as PubMed (provided by the US National Library of Medicine at the National Institutes of Health), were used to survey the literature concerning ASD after thoracic pedicle screw fixation. To include the authors' experience at Rutgers New Jersey Medical School, a retrospective review of a prospectively maintained database was performed to determine the incidence of complications over a 13-year period in 123 consecutive adult patients who underwent thoracic pedicle screw fixation. Children, pregnant or lactating women, and prisoners were excluded from the review. By comparing preoperative and postoperative radiographic images, the occurrence of thoracic ASD and disease within the surgical construct was determined. RESULTS Definitive radiographic fusion was detected in 115 (93.5%) patients. Seven incidences of instrumentation failure and 8 lucencies surrounding the screws were observed. One patient was observed to have ASD of the thoracic spine. The mean follow-up duration was 50 months. CONCLUSIONS This long-term radiographic evaluation revealed the use of pedicle screws for thoracic fixation to be an effective stabilization modality. In particular, ASD seems to be less of a problem in the

Effects of SO/sub 2/ on photosynthesis and nitrogen fixation

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Haellgren, J E; Huss, K

1975-06-15

Responses of photosynthesis and nitrogen fixation to NaHSO/sub 3/ (10/sup -5/ to 5 x 10/sup -3/ M) were investigated in the lichen Stereocaulon paschale (L.) Fr. and the blue-green alga Anabaena cylindrica Lemmermann. The treatments were performed in buffered media with varying pH (5.8 to 8.1) and light conditions (0 to 32 W x m/sup -2/). The activities of the intact organisms were investigated, under the same environmental conditions, with /sup 14/C liquid scintillation and acetylene reduction techniques respectively. The nitrogen fixation proved to be more susceptible than photosynthesis, in both organisms, and in all cases treatments at pH 5.8 were more inhibitory than at higher pH-values. Treatment with 5 x 10/sup -4/ M NaHSO/sub 3/ at pH 5.8 caused no reduction of photosynthesis in S. paschale, while the inhibition of nitrogen fixation was 97%. For A. cylindrica the corresponding values were 40% and 75% respectively. Short-time treatments of A. cylindrica showed that the nitrogen fixation was more rapidly affected than photosynthesis. The inhibition of nitrogenase activity and CO/sub 2/-fixation was smaller in the dark and increased at higher light intensities. Both processes showed a good capacity for recovery after removal of the NaHSO/sub 3/ solution. Also the clumping ability of A. cylindrica was disturbed by NaHSO/sub 3/ treatments.

[Staple fixation for the treatment of hamate metacarpal joint injury].

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Tang, Yang-Hua; Zeng, Lin-Ru; Huang, Zhong-Ming; Yue, Zhen-Shuang; Xin, Da-Wei; Xu, Can-Da

2014-03-01

To investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury. From May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing, joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA (TAM) system evaluation method. All incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of (10.0 +/- 2.7) months. No dislocation recurred, the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases, moderate in 1 case. The application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation, small trauma, reliable fixation, early postoperative function exercise and other advantages, which is the ideal operation mode for hamatometacarpal joint injury.

Calculation of the time fixation accuracy for Si(Li)-detectors

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Kondrat'ev, V.P.; Krasnov, L.V.

1981-01-01

An accuracy of time fixation to pulses of changing shape for li-frifted si detectors with thickness over 1 mm is evaluated. The method of the comparison of main and converted signal shapes is the most universal method of time fixation. The idea of the method consists in shaping a bipolar pulse using a single-polar input Rulse and recording the point of the bipolar signal intersection with the zero level. The combination of an analytical method with numerical computer calculations is used for evaluating the time fixation fluctuations. Analysis of the results obtained shows that the value of delay p=tausub(d)/tausub(n) (where tausub(d) is delay time for the main part of a signal, tausub(n) is the maximum time of electron collection) affects most strongly the time shift. The parameter K=tausub(i)/tausub(n) (tausub(i) is a constant of integrating circuit) affects slightly the maximum value of time shift. For the li-drifted si detector 2 mm thick with dispattacement vottage of 400 V the moment of the time fixation will be equal to 47 is in the case of K--1, p=0.4 and x=0.25 (x=R/i, where R is a particle range in the detector, l is the thickness of the detector depleted area. The fluctuations in time fixation don't exceed 2.3 ns for the whole particle energy range

Ultrastructure of the endolymphatic duct in the rat. Fixation and preservation

DEFF Research Database (Denmark)

Qvortrup, K; Rostgaard, J

1993-01-01

Ten rats were vascular-perfused at subphysiologic as well as physiologic pressures, 80 mmHg and 120 mmHg, respectively, employing a pressure feed-back controlled peristaltic pump and an isotonic perfusate/fixative with colloids (2% Dextran) and a hypertonic perfusate/fixative without colloids, 300...

DISTRACTION EXTERNAL FIXATIONS OF PELVIC FRACTURES CAUSED BY A LATERAL COMPRESSION.

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Pavlin Apostolov

2011-11-01

Full Text Available The authors represent a distraction external pelvic fixation technique, which they use in pelvic fractures caused by a lateral compression. They consider the indications and mounting techniques. The authors recommend the early movement activities (on the 3rd - 5th day after the external fixator placement. This method had been used in 8 patients and 3 cases are analyzed in details. The priority of this technique over open reduction and internal fixation (ORIF mainly are: (1 the implementation of good reduction of the fracture preventing the risk of ORIF; (2 the possibility for early movement activities for the patient.

Interpretation of Post-operative Distal Humerus Radiographs After Internal Fixation: Prediction of Later Loss of Fixation

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Claessen, F.M.; Stoop, N.; Doornberg, J.N.; Guitton, T.G.; Bekerom, M.P. van den; Ring, D.; Biert, J.; et al.,

2016-01-01

PURPOSE: Stable fixation of distal humerus fracture fragments is necessary for adequate healing and maintenance of reduction. The purpose of this study was to measure the reliability and accuracy of interpretation of postoperative radiographs to predict which implants will loosen or break after

[Automated analysis of bacterial preparations manufactured on automatic heat fixation and staining equipment].

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2012-01-01

Heat fixation of preparations was made in the fixation bath designed by EMKO (Russia). Programmable "Emkosteiner" (EMKO, Russia) was used for trial staining. Reagents set Micko-GRAM-NITsF was applied for Gram's method of staining. It was demostrated that automatic smear fixation equipment and programmable staining ensure high-quality imaging (1% chromaticity variation) good enough for standardization of Gram's staining of microbial preparations.

Closed External Fixation for Failing or Failed Femoral Shaft Plating in a Developing Country.

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Aliakbar, Adil; Witwit, Ibrahim; Al-Algawy, Alaa A Hussein

2017-08-01

Femoral shaft fractures are one of the common injuries that is treated by open reduction, with internal fixation by plate and screws or intramedullary nailing, which can achieve a high union rate. To evaluate the outcome of using closed external fixation to augment a failing plate; with signs of screw loosening and increasing bone/plate gap; a failed plate; broken plate; screws completely out of bone with redisplacement of fracture. A retrospective study on 18 patients, aged between 17-42 years, who presented between 6-18 weeks after initial surgical fixation, with pain, difficulty in limb function, deformity and abnormal movement at fracture site, was done. X-Rays showed plating failure with acceptable amount of callus, which unfortunately had refractured. Cases associated with infection and no radiological evidence of callus formation were excluded from this study. Closed reduction was done by manipulation, then fracture fixation by AO external fixator. The patients were encouraged for full weight bearing as early as possible with dynamization later on. Of the 18 patients who underwent external fixation after close reduction, 15 cases showed bone healing in a period between 11-18 weeks (mean of 14.27 weeks) with good alignment (Radiologically). Removal of external fixator was done followed by physical therapy thereafter. Closed external fixation for treatment of failing or failed femoral plating, achieves good success rate and has less complications, is a short time procedure, especially in a hospital with limited resources.

Novel anterior cruciate ligament graft fixation device reduces slippage

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Lopez MJ

2013-05-01

Full Text Available Mandi J Lopez,1 Allen Borne,2 W Todd Monroe,3 Prakash Bommala,1 Laura Kelly,1 Nan Zhang11Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, 2Louisiana State University, New Orleans Health Sciences Center, School of Medicine, New Orleans, 3Department of Biological and Agricultural Engineering, Agricultural Center, Louisiana State University, Baton Rouge, LA, USAAbstract: Clinically significant laxity occurs in 10%–30% of knees after anterior cruciate ligament reconstruction. Graft slippage and tension loss at the hamstring graft tibial fixation site during and after reconstruction surgery contribute to postoperative joint laxity and are detrimental to long-term knee stability and graft properties. Limiting graft slippage will reduce associated complications. We sought to compare the in vitro mechanical properties and in vivo joint stabilization, postoperative limb use, and graft incorporation of the novel GraftGrab™ (GG device designed to reduce hamstring graft tibial fixation slippage with the commercially available bioabsorbable Bio-Post™ and spiked washer (BP. Mechanical testing was performed on canine tibia-hamstring graft constructs to quantify initial fixation properties. In vivo joint stabilization, postoperative limb use and graft incorporation of hamstring graft reconstructions were determined in a canine model. Outcomes included tibial translation and ground reaction forces preoperatively and 4 and 8 weeks postoperatively, three-dimensional graft and bone tunnel dimensions at the latter two time points, and graft-bone microstructure, as well as mechanical properties 8 weeks after implantation. Immediately after fixation, all grafts slipped from the BP constructs versus about 30% of GG constructs. In vivo limb use remained low, and tibial translation increased with time in the BP cohort. These results together

Seasonal patterns of periphyton nitrogen fixation in calcareous wetlands

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Liao, X.; Inglett, P.

2011-12-01

Periphyton mats are an ecologically important component of the Everglades ecosystem and plays various vital ecological functions. However, nitrogen fixation of periphyton, has received little attention throughout much of the Everglades system. The objective of this study was to characterize the seasonal pattern of periphyton N2 fixation in the Hole-in-the-Donut (HID) of Florida Everglades, where farmed marl prairie wetlands have been restored through complete soil removal (CSR) to reduce nutrient levels. Two restored areas (i.e., cleared in 2000 and 2003) and a reference (natural and unfarmed) marl prairie wetland sites were selected in the HID. Seven times of sampling were performed across the wet and dry season during the 2010 and 2011. The annual fixed nitrogen was approximately 0.4gN m-2 yr-1 in the restored sites which was higher in the reference site (~0.2gN m-2 yr-1). All the three sites showed similar seasonal patterns of N2 fixation that is higher values were observed in the wet season; but the peak value was one month later in reference sits (i.e., September) comparing to the restored areas (i.e., July). The peak of periphyton AR rates in the 2000- and 2003-restored areas appeared in July (i.e., wet season) within the range of 20-79 nmols g-1dw h-1 and 31-53nmols g-1dw h-1, respectively. In contrast, the peak of reference site was observed in September with the range of 2-5 nmols g-1dw h-1. Stable N isotopic ratios (i.e., δ15N) also varied with time but didn't show consistent seasonal pattern as nitrogen fixation. N2 fixation positively correlated with periphyton total phosphorus (TP) and negatively correlated with total nitrogen and phosphorus molar ratios (TN:TP), indicating that N2 fixation would be a indicator of nutrient limitation. In general, δ15N was negatively correlated with nitrogenase activity but the correlation became weakened in the wet season, especially in the flooded July and September, which would be explained by other environmental

Use of low enriched 15N2 for symbiotic fixation tests

International Nuclear Information System (INIS)

Victoria, R.L.

1975-01-01

Gaseous atmospheres containing 15 N 2 with low enrichment were used to test symbiotic nitrogen fixation in beans (Phaseolus vulgari, L.). The tests of fixation in nodulated roots and the tests of fixation in the whole plant, in which the plants were placed inside a specially constructed growth chamber, gave positive results and suggest that the methodology used can be very helpfull in more detailed studies on symbiotic fixation. Samples of atmospheric air were purified by absorption of O 2 and CO 2 by two methods. The purified N 2 obtained was analysed and the results were compared. Samples of bean plant material were collected in natural conditions and analysed for 15 N natural variation. Several samples were prepared for 15 N isotopic analysis by two methods. The results obtained were compared. All samples were analysed in an Atlas-Varian Ch-4 model mass spectrometer, and the results were given in delta 15 N 0 / 00 variation in relation to a standard gas

Chasing red herrings: Memory of distractors causes fixation in creative problem solving.

Science.gov (United States)

Beda, Zsolt; Smith, Steven M

2018-03-07

Two experiments tested the red herring retrieval hypothesis, which states that fixation in creative problem solving is worse when memory for red herrings (i.e., inappropriate or incorrect solutions) is strengthened. In Experiment 1, when associations between Remote Associates Test (RAT) problem words (e.g., COTTAGE, SWISS, CAKE) and related red herring words (e.g., hut, chocolate, icing) were strengthened via repetition, an encoding variable, fixation was found to increase. In Experiment 2, when associations were formed between RAT problem contexts and red herrings, then subsequent reinstatement of problem contexts during RAT problem solving trials (as compared with showing new contexts) also worsened fixation effects. Our results add to the increasing body of research that connects memory with creative problem solving, and they suggest possible ways for overcoming fixation effects.

Management of paediatric tibial fractures using two types of circular external fixator: Taylor spatial frame and Ilizarov circular fixator.

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Tafazal, Suhayl; Madan, Sanjeev S; Ali, Farhan; Padman, Manoj; Swift, Simone; Jones, Stanley; Fernandes, James A

2014-05-01

The use of circular fixators for the treatment of tibial fractures is well established in the literature. The aim of this study was to compare the Ilizarov circular fixator (ICF) with the Taylor spatial frame (TSF) in terms of treatment results in consecutive patients with tibial fractures that required operative management. A retrospective analysis of patient records and radiographs was performed to obtain patient data, information on injury sustained, the operative technique used, time duration in frame, healing time and complications of treatment. The minimum follow-up was 24 months. Ten patients were treated with ICF between 2000 and 2005, while 15 patients have been treated with TSF since 2005. Two of the 10 treated with ICF and 5 of the 15 treated with TSF were open fractures. All patients went on to achieve complete union. Mean duration in the frame was 12.7 weeks for ICF and 14.8 weeks for the TSF group. Two patients in the TSF group had delayed union and required additional procedures including adjustment of fixator and bone grafting. There was one malunion in the TSF group that required osteotomy and reapplication of frame. There were seven and nine pin-site infections in the ICF and TSF groups, respectively, all of which responded to antibiotics. There were no refractures in either group. In an appropriate patient, both types of circular fixator are equally effective but have different characteristics, with TSF allowing for postoperative deformity correction. Of concern are the two cases of delayed union in the TSF group, all in patients with high-energy injuries. We feel another larger study is required to provide further clarity in this matter. Level II-comparative study.

UK DRAFFT - A randomised controlled trial of percutaneous fixation with kirschner wires versus volar locking-plate fixation in the treatment of adult patients with a dorsally displaced fracture of the distal radius

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Brown Jaclyn

2011-09-01

Full Text Available Abstract Background Fractures of the distal radius are extremely common injuries in adults. However, the optimal management remains controversial. In general, fractures of the distal radius are treated non-operatively if the bone fragments can be held in anatomical alignment by a plaster cast or orthotic. However, if this is not possible, then operative fixation is required. There are several operative options but the two most common in the UK, are Kirschner-wire fixation (K-wires and volar plate fixation using fixed-angle screws (locking-plates. The primary aim of this trial is to determine if there is a difference in the Patient-Reported Wrist Evaluation one year following K-wire fixation versus locking-plate fixation for adult patients with a dorsally-displaced fracture of the distal radius. Methods/design All adult patients with an acute, dorsally-displaced fracture of the distal radius, requiring operative fixation are potentially eligible to take part in this study. A total of 390 consenting patients will be randomly allocated to either K-wire fixation or locking-plate fixation. The surgery will be performed in trauma units across the UK using the preferred technique of the treating surgeon. Data regarding wrist function, quality of life, complications and costs will be collected at six weeks and three, six and twelve months following the injury. The primary outcome measure will be wrist function with a parallel economic analysis. Discussion This pragmatic, multi-centre trial is due to deliver results in December 2013. Trial registration Current Controlled Trials ISRCTN31379280 UKCRN portfolio ID 8956

Rapid maxillary distraction protocol utilizing the halo distraction system and rigid internal fixation.

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Baker, Stephen B; Reid, Russell R; Burkey, Brooke; Bartlett, Scott P

2007-09-01

To shorten head frame wear time associated with external halo distraction (HD), we have adapted a protocol for maxillary distraction with the halo system that integrates plate fixation. All patients had a history of cleft lip and/or palate and maxillary retrusion > or = 8 mm. Five patients treated with this protocol and followed for at least 1 year were included in this study. The protocol included a 3-day latency period, variable maxillary distraction, and removal of the halo device with simultaneous rigid internal fixation. Two patients had a variable period of maxillomandibular fixation (MMF), which maintained the maxillary advancement and idealized intercuspal position while permitting further callus maturation. Cephalographs were obtained preoperatively, immediately following distractor removal, and 1 year after rigid internal fixation. The mean age at time of surgery was 18.7 years. The maxillary deficiency ranged from 8 to 15 mm (mean = 10.6 mm). All five patients demonstrated excellent occlusion. Cephalometric analysis 1-year post rigid internal fixation revealed minimal (maxillary distraction followed by MMF to maintain maxillary advancement may reduce halo device wear to 1 to 2 weeks. MMF optimizes occlusion by forcing the maxillary teeth into maximal intercuspal position. Rigid fixation is not only associated with less long-term relapse compared to nonrigid forms of fixation, but also minimizes the incidence of nonunion. This treatment protocol provides the advancement possible with distraction osteogenesis and the accuracy of orthognathic surgery, thereby minimizing external head frame wear.

Plasma catalysis for nitrogen fixation reactions

NARCIS (Netherlands)

Patil, B.S.; Wang, Q.; Hessel, V.; Lang, J.; Stankiewicz, A.; Stefanidis, G.

2016-01-01

The preferences for localized chemicals production and changing scenarios of renewable electricity cost gives a renewed boost to plasma-assisted valuable chemicals production. Especially, plasma-assisted nitrogen fixation for fertilizer production has the potential to largely change the energy

Four quadrant parallel peripheral screw fixation for displaced femoral neck fractures in elderly patients

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Bhava RJ Satish

2013-01-01

Conclusion: Closed reduction and cannulated cancellous screw fixation gives satisfactory functional results in large group of elderly patients. The four quadrant parallel peripheral (FQPP screw fixation technique gives good stability, allows controlled collapse, avoids fixation failure and achieves predictable bone healing in displaced femoral neck fracture in patients ≥50 years of age.

Complications Using Bioabsorbable Cross-Pin Femoral Fixation: A Case Report and Review of the Literature

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Saqib Hasan

2011-01-01

Full Text Available The use of bioabsorbable cross-pin transcondylar fixation has remained a viable option for femoral fixation in anterior cruciate ligament reconstruction. Although numerous biomechanical studies have demonstrated high fixation strength and minimal slippage with use of this method of fixation, there have been increasing reports of a variety of clinical complications associated with these implants. We reviewed the literature for all complications associated with the Bio-TransFix implant and present a case report of a patient status after ACL reconstruction using Bio-TransFix cross-pin femoral fixation with iliotibial band friction syndrome from a broken cross-pin four month post-operatively.

Design Fixation and Cooperative Learning in Elementary Engineering Design Project: A Case Study

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Yi Luo

2015-09-01

Full Text Available This paper presents a case study examining 3rd, 4th and 5th graders’ design fixation and cooperative learning in an engineering design project. A mixed methods instrument, the Cooperative Learning Observation Protocol (CLOP, was adapted to record frequency and class observation on cooperative learning engagement through detailed field notes. Students’ design journals and reflections were also analyzed for an inductive qualitative analysis. The findings indicate three major themes of design fixation: 1 fixation on common features of things; 2 fixation on popular teenage culture; 3 fixation on the first design idea. In the cooperative learning process of elementary engineering design project, although pupils had demonstrated some abilities to solve concrete problems in a logical fashion, the participants encountered a number of obstacles in the group. Dominance, social loafing, and other problems occurring in the group process might have offset certain benefits of cooperative learning. Implications of the findings are also discussed.

Design fixation and cooperative learning in elementary engineering design project: A case study

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Yi Luo

2015-09-01

Full Text Available This paper presents a case study examining 3rd, 4th and 5th graders’ design fixation and cooperative learning in an engineering design project. A mixed methods instrument, the Cooperative Learning Observation Protocol (CLOP, was adapted to record frequency and class observation on cooperative learning engagement through detailed field notes. Students’ design journals and reflections were also analyzed for an inductive qualitative analysis. The findings indicate three major themes of design fixation: 1 fixation on common features of things; 2 fixation on popular teenage culture; 3 fixation on the first design idea. In the cooperative learning process of elementary engineering design project, although pupils had demonstrated some abilities to solve concrete problems in a logical fashion, the participants encountered a number of obstacles in the group. Dominance, social loafing, and other problems occurring in the group process might have offset certain benefits of cooperative learning. Implications of the findings are also discussed.

Mechanical comparison between lengthened and short sacroiliac screws in sacral fracture fixation: a finite element analysis.

Science.gov (United States)

Zhao, Y; Zhang, S; Sun, T; Wang, D; Lian, W; Tan, J; Zou, D; Zhao, Y

2013-09-01

To compare the stability of lengthened sacroiliac screw and standard sacroiliac screw for the treatment of unilateral vertical sacral fractures; to provide reference for clinical applications. A finite element model of Tile type C pelvic ring injury (unilateral Denis type II fracture of the sacrum) was produced. The unilateral sacral fractures were fixed with lengthened sacroiliac screw and sacroiliac screw in six different types of models respectively. The translation and angle displacement of the superior surface of the sacrum (in standing position on both feet) were measured and compared. The stability of one lengthened sacroiliac screw fixation in S1 or S2 segment is superior to that of one sacroiliac screw fixation in the same sacral segment. The stability of one lengthened sacroiliac screw fixation in S1 and S2 segments respectively is superior to that of one sacroiliac screw fixation in S1 and S2 segments respectively. The stability of one lengthened sacroiliac screw fixation in S1 and S2 segments respectively is superior to that of one lengthened sacroiliac screw fixation in S1 or S2 segment. The stability of one sacroiliac screw fixation in S1 and S2 segments respectively is markedly superior to that of one sacroiliac screw fixation in S1 or S2 segment. The vertical and rotational stability of lengthened sacroiliac screw fixation and sacroiliac screw fixation in S2 is superior to that of S1. In a finite element model of type C pelvic ring disruption, S1 and S2 lengthened sacroiliac screws should be utilized for the fixation as regularly as possible and the most stable fixation is the combination of the lengthened sacroiliac screws of S1 and S2 segments. Even if lengthened sacroiliac screws cannot be systematically used due to specific conditions, one sacroiliac screw fixation in S1 and S2 segments respectively is recommended. No matter which kind of sacroiliac screw is used, if only one screw can be implanted, the fixation in S2 segment is more recommended

Intermediate results of sutureless intrascleral posterior chamber intraocular lens fixation.

Science.gov (United States)

Scharioth, Gabor B; Prasad, Som; Georgalas, Ilias; Tataru, Calin; Pavlidis, Mitrofanis

2010-02-01

To report the intermediate multicenter results of a technique of sutureless intrascleral fixation of a standard 3-piece posterior chamber intraocular lens (PC IOL) in the ciliary sulcus. Four European ophthalmology centers. A technique for sutureless intrascleral fixation of the haptics of a standard 3-piece PC IOL was retrospectively evaluated. The technique uses standardized maneuvers to fixate the PC IOL without need for special haptic architecture or preparation or haptic suturing. All patients having IOL implantation by the technique were evaluated for preoperative status (visual acuity, refractive error, preexisting ocular conditions, optical biometry), postoperative status, complications, and need for further surgery. The study evaluated 63 consecutive patients from 4 institutions (4 surgeons). The median follow-up was 7 months. Two dislocated PC IOLs (3.6%) were decentered; the other 61 IOLs (96.8%) were stable and well centered. There were no cases of recurrent dislocation, endophthalmitis, retinal detachment, or glaucoma. Fixation of PC IOL haptics in a limbus-parallel scleral tunnel provided exact centration and axial stability of the IOL and prevented distortion and subluxation in most cases. Copyright 2010 ASCRS and ESCRS. All rights reserved.

Breeding for traits supportive of nitrogen fixation in legumes

International Nuclear Information System (INIS)

Herridge, David F.

2001-01-01

As the potential economic benefits of enhancing dinitrogen (N 2 ) fixation of crop, pasture and forage legumes are substantial, the idea that legume breeding could play a role in enhancing N 2 fixation was advanced more than 50 years ago. Various programmes have sought to genetically improve a wide range of species, from pasture legumes such as red clover (Trifolium pratense) to the crop legumes like soybean (Glycine max) and common bean (Phaseolus vulgaris). In some the selection trait was yield, whilst in others it was high plant reliance on N 2 fixation (%Ndfa). A third strategy was to optimise legume nodulation through specific nodulation traits, e.g. mass, duration, promiscuous and selective nodulation. Plant genetic variation was sought from natural populations or created through mutagenesis. Although methods for assessing single plants and populations of plants for yield and %Ndfa varied over the years, it is now clear that measurements based on either 15 N or xylem solute analysis are the most reliable. Methodological issues as well as poor focus plagued many of the earlier programmes, since enhancing N 2 fixation essentially involves adapting legumes to fix more N when growing in N-poor soils. Programmes in which plant genotypes are inoculated with effective rhizobia and screened under conditions of low soil N maximise the symbiotic potential of the legume. (author)

Intraocular lens iris fixation. Clinical and macular OCT outcomes

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Garcia-Rojas Leonardo

2012-10-01

Full Text Available Abstract Background To assess the efficacy, clinical outcomes, visual acuity (VA, incidence of adverse effects, and complications of peripheral iris fixation of 3-piece acrylic IOLs in eyes lacking capsular support. Thirteen patients who underwent implantation and peripheral iris fixation of a 3-piece foldable acrylic PC IOL for aphakia in the absence of capsular support were followed after surgery. Clinical outcomes and macular SD-OCT (Cirrus OCT; Carl Zeiss Meditec, Germany were analyzed. Findings The final CDVA was 20/40 or better in 8 eyes (62%, 20/60 or better in 12 eyes (92%, and one case of 20/80 due to corneal astigmatism and mild persistent edema. No intraoperative complications were reported. There were seven cases of medically controlled ocular hypertension after surgery due to the presence of viscoelastic in the AC. There were no cases of cystoid macular edema, chronic iridocyclitis, IOL subluxation, pigment dispersion, or glaucoma. Macular edema did not develop in any case by means of SD-OCT. Conclusions We think that this technique for iris suture fixation provides safe and effective results. Patients had substantial improvements in UDVA and CDVA. This surgical strategy may be individualized however; age, cornea status, angle structures, iris anatomy, and glaucoma are important considerations in selecting candidates for an appropriate IOL fixation method.

Single-suture scleral fixation of subluxated foldable intraocular lenses.

Science.gov (United States)

Yarangumeli, Alper; Alp, Mehmet Numan; Kural, Gulcan

2012-01-01

To evaluate the results of single-suture scleral fixation of subluxated foldable intraocular lenses (IOL) in eyes with sufficient residual capsular support. The results of IOL repositioning by single-suture scleral fixation in 6 eyes of 6 patients with IOL subluxation were included. All subluxated IOLs were single-piece hydrophilic acrylic. Subluxation resulted from posterior capsule tears in 3 eyes, zonular dialyses in 2 eyes, and zonular dialysis with a capsulorhexis tear in 1 eye. A similar technique was used in all eyes in which one haptic was externalized through a superior clear corneal incision and tied with a Pair-PAK 10-0 polypropylene suture, and was finally retracted and fixated behind the iris close to the ciliary sulcus at the 12:00 meridian. All patients were followed up for at least 6 months. Best-corrected visual acuities ranged between finger counting and 20/70 (mean logMAR 1.02±0.64) preoperatively, and between 20/100 and 20/20 (mean logMAR 0.22±0.26) at the final postoperative visit. All IOLs remained centered and no significant postoperative complications were encountered except for an IOL tilt which resulted in a considerable oblique astigmatism in one eye. Subluxated foldable IOLs may safely be repositioned and secured with a single scleral fixation suture in selected cases with adequate amount of capsular remnants.

Biomechanical evaluation of arthroscopic rotator cuff repairs: double-row compared with single-row fixation.

Science.gov (United States)

Ma, C Benjamin; Comerford, Lyn; Wilson, Joseph; Puttlitz, Christian M

2006-02-01

Recent studies have shown that arthroscopic rotator cuff repairs can have higher rates of failure than do open repairs. Current methods of rotator cuff repair have been limited to single-row fixation of simple and horizontal stitches, which is very different from open repairs. The objective of this study was to compare the initial cyclic loading and load-to-failure properties of double-row fixation with those of three commonly used single-row techniques. Ten paired human supraspinatus tendons were split in half, yielding four tendons per cadaver. The bone mineral content at the greater tuberosity was assessed. Four stitch configurations (two-simple, massive cuff, arthroscopic Mason-Allen, and double-row fixation) were randomized and tested on each set of tendons. Specimens were cyclically loaded between 5 and 100 N at 0.25 Hz for fifty cycles and then loaded to failure under displacement control at 1 mm/sec. Conditioning elongation, peak-to-peak elongation, ultimate tensile load, and stiffness were measured with use of a three-dimensional tracking system and compared, and the failure type (suture or anchor pull-out) was recorded. No significant differences were found among the stitches with respect to conditioning elongation. The mean peak-to-peak elongation (and standard error of the mean) was significantly lower for the massive cuff (1.1 +/- 0.1 mm) and double-row stitches (1.1 +/- 0.1 mm) than for the arthroscopic Mason-Allen stitch (1.5 +/- 0.2 mm) (p row fixation (287 +/- 24 N) than for all of the single-row fixations (p row fixation had a significantly higher ultimate tensile load than the three types of single-row fixation stitches. Of the single-row fixations, the massive cuff stitch had cyclic and load-to-failure characteristics similar to the double-row fixation. Anterior repairs of the supraspinatus tendon had significantly stronger biomechanical behavior than posterior repairs.

Posibilidad de identificar defectos en máquinas rotatorias utilizando la medición de nivel total de la señal vibratoria // Possibility of identification of defects in rotatory machinery by means of total level mesurations.

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L. M. Véliz Marrero

2000-03-01

Full Text Available Se expone una herramienta propuesta por el Dr. C. Cempel, poco difundida para identificar algunos defectos al realizar eldiagnóstico de máquinas rotatorias utilizando la medición de Nivel Total. Se ilustra a modo de ejemplo el diagnóstico de unreductor de velocidad.Palabras claves: Medición, vibraciones, nivel total, diagnóstico, engranaje, reductor de velocidad.________________________________________________________________________________AbstractIn this paper is exposed a not much divulged tool proposed by Dr. C. Cempel for the identification of some defects by meansof the measurement of Total Level of vibration in diagnosis of rotatory machinery. As example, a speed reducer diagnostic ispresented.Key words: Vibration measurement, total level, diagnostic, gears, speed reducer.

Congenital Spondylolytic Spondylolisthesis of C2 Vertebra Associated With Atlanto-Axial Dislocation, Chiari Type I Malformation, and Anomalous Vertebral Artery: Case Report With Review Literature.

Science.gov (United States)

Sardhara, Jayesh; Pavaman, Sindgikar; Das, Kuntal; Srivastava, Arun; Mehrotra, Anant; Behari, Sanjay

2016-11-01

Congenital spondylolytic spondylolisthesis of C2 vertebra resulting from deficient posterior element of the axis is rarely described in the literature. We describe a unique case of agenesis of posterior elements of C2 with craniovertebral junction anomalies consisting of osseous, vascular, and soft tissue anomalies. A 26-year-old man presented with symptoms of upper cervical myelopathy of 12 months' duration. A computed tomography scan of the cervical spine including the craniovertebral junction revealed spondylolisthesis of C2 over C3, atlantoaxial dislocation, occipitalization of the atlas, hypoplasia of the odontoid, and cleft posterior C1 arch. Additionally, the axis vertebra was found devoid of its posterior elements except bilaterally rudimentary pedicles. Magnetic resonance imaging revealed tonsilar herniation, suggesting associated Chiari type I malformation. CT angiogram of the vertebral arteries displayed persistent bilateral first intersegmental arteries crossing the posterior aspect of the C1/2 facet joint. This patient underwent foramen magnum decompression, C3 laminectomy with occipito-C3/C4 posterior fusion using screw and rod to maintain the cervical alignment and stability. We report this rare constellation of congenital craniovertebral junction anomaly and review the relevant literature. Copyright © 2016 Elsevier Inc. All rights reserved.

[Application of polyguanidine solution for fixation of biological and anatomical specimens].

Science.gov (United States)

Anichkov, N M; Danilova, I A; Riabinin, I A; Kipenko, A V

2010-01-01

A new method for fixation of biological material is described, and its effectiveness is compared to that one of formalin fixation. As an embalming agent, polyhexamethylenguanidine (PHMG) hydrochloride was used. Using the proposed method of fixation, the anatomical and histological preparations of human organs and of chick embryos at developmental 12 days, were produced. The anatomical preparations obtained show the appearance, similar to that of the recently removed organs. Histological preparations were free from significant distortions of the microscopic characteristics of the specimens, which are typical to the material fixed with formalin. The results of the study suggest the possibility of PHMG application in the morphological studies.

Is prophylactic fixation a cost-effective method to prevent a future contralateral fragility hip fracture?

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Faucett, Scott C; Genuario, James W; Tosteson, Anna N A; Koval, Kenneth J

2010-02-01

: A previous hip fracture more than doubles the risk of a contralateral hip fracture. Pharmacologic and environmental interventions to prevent hip fracture have documented poor compliance. The purpose of this study was to examine the cost-effectiveness of prophylactic fixation of the uninjured hip to prevent contralateral hip fracture. : A Markov state-transition model was used to evaluate the cost and quality-adjusted life-years (QALYs) for unilateral fixation of hip fracture alone (including internal fixation or arthroplasty) compared with unilateral fixation and contralateral prophylactic hip fixation performed at the time of hip fracture or unilateral fixation and bilateral hip pad protection. Prophylactic fixation involved placement of a cephalomedullary nail in the uninjured hip and was initially assumed to have a relative risk of a contralateral fracture of 1%. Health states included good health, surgery-related complications requiring a second operation (infection, osteonecrosis, nonunion, and malunion), fracture of the uninjured hip, and death. The primary outcome measure was the incremental cost-effectiveness ratio estimated as cost per QALY gained in 2006 US dollars with incremental cost-effectiveness ratios below $50,000 per QALY gained considered cost-effective. Sensitivity analyses evaluated the impact of patient age, annual mortality and complication rates, intervention effectiveness, utilities, and costs on the value of prophylactic fixation. : In the baseline analysis, in a 79-year-old woman, prophylactic fixation was not found to be cost-effective (incremental cost-effectiveness ratio = $142,795/QALY). However, prophylactic fixation was found to be a cost-effective method to prevent contralateral hip fracture in: 1) women 71 to 75 years old who had 30% greater relative risk for a contralateral fracture; and 2) women younger than age 70 years. Cost-effectiveness was greater when the additional costs of prophylaxis were less than $6000. However, for

Fixation of Soil Using PEC and Separation of Fixed Soil

Energy Technology Data Exchange (ETDEWEB)

Choi, Yong Suk; Yang, Hee-Man; Lee, Kune Woo; Seo, Bum-Kyoung; Moon, Jei Kwon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2014-10-15

Radioactive cesium (Cs-137) is the most apprehensive element due to its long half-lives, high solubility in water, and strong radiation emission in the form of gamma rays. Because the radioactivity is localized within topsoil, soil surface on topsoil should be fixed to prevent the spreading of the contaminated soils by wind and water erosion. Many methods have been developing for soil fixation to remove radioactive contaminants in soil and prevent to diffuse radioactive materials. Various materials have been used as fixatives such as clays, molecular sieves, polymer, and petroleum based products. One of the methods is a soil fixation or solidification using polyelectrolyte. Polyelectrolytes have many ionic groups and form the polyelectrolyte complex (PEC) due to electrostatic interaction of anion and cation in an aqueous solution. polyelectrolyte complex can fix soil particles by flocculation and formation of crust between soil. The method can prevent a spread of radioactive material by floating on a soil surface. The decontamination efficiency of the surface soils reached about 90%, and dust release was effectively suppressed during the removal of surface soils. However it has a problem that the removed soil must separate soil and polymer to treat as the waste. In this study, the fixation of soil by polyelectrolyte complex to suppress the spread of contaminant and the separation method of soil and polymer was investigated. The properties of polyelectrolyte complex solution and the stability of fixed soil by polyelectrolyte complex were investigated. The concentration of salt in the polyelectrolyte complex solution is a very important parameter for the soil fixation.

Surface fixation of dried blood by glutaraldehyde and peracetic acid.

Science.gov (United States)

Kampf, G; Bloss, R; Martiny, H

2004-06-01

The difficulties of successful prion inactivation by chemical agents has led to changes in recommendations regarding the reprocessing of instruments including flexible endoscopes. One of the changes is the preference for peracetic acid instead of glutaraldehyde in order to avoid fixation of organic material, but the surface fixation by various active agents has not been fully investigated. We used a standardized amount of dried blood soil on metal carriers (on average 22 mg). One part of the carriers was exposed to different disinfectants (four based on peracetic acid, three based on glutaraldehyde, two based on quaternary ammonium compounds (QAC), one based on QAC and amines, one based on phenols and one cleaning agent) and air dried. The difference compared with the non-exposed soiled carrier was taken as the measure of blood removal by exposure to the disinfectants. In addition the other part of the carriers was exposed to a cleaning agent and air dried. The cleaning agent itself was capable of removing more than 99% of the dried blood and served as a control for non-fixation. The rate of fixation of dried blood was calculated as the ratio of the weight of residual soil on 'soiled, disinfected and cleaned' carriers and on 'soiled and disinfected' carriers. All experiments were repeated eight times. Blood removal varied between 90.3% +/- 1.5% (phenol-based disinfectant) and peracetic acid. No other preparations showed a potential for blood fixation (peracetic acid, and support the evidence that effective cleaning should precede the chemical disinfection. Copyright 2004 The Hospital Infection Society

Effect of lentil cultivar on N2 fixation and N partitioning

International Nuclear Information System (INIS)

Kurdali, F.; Kalifa, K.; Al-Shamma, M.

1996-12-01

The study conducted on five lentil cultivars. the results showed that dry matter production, nodulation and N sup 2 fixation were influenced by the cultivar. Beyond flowering, N sup 2 fixation, soil N uptake, and N and P remobilization differed by the cultivar. (author). 32 Refs., 7 Figs., 9 Tabs

The C4-pathway of C-fixation in Spinacea oleracea. Pt. 1

International Nuclear Information System (INIS)

Boecher, M.; Kluge, M.

1977-01-01

Spinach leaf slices readily fix 14 C supplied from a suspension medium. The pattern of label distribution after 14 C-fixation in the light depends on the pH of the suspension medium. In the range of pH 3.5 leaf slices show labelling patterns of the C 3 type as do intact leaves or leaf slices incubated with 14 CO 2 in a gas cuvette. In contrast, if the tissue slices were suspended at pH 7.5 substantially more label appears in malate and other compounds of the C 4 -pathway. Under these conditions also the malate content of the tissue increases. The addition of NaHCO 3 at pH 3.5 increases the rate of C-fixation and nearly the whole fixed carbon is metabolized in the Calvin-cycle. The C-fixation is also increased, if NaHCO 3 is added at pH 7.5. Here both, the C 3 - and the C 4 -pathway contribute to an enhancement of the C-fixation. It is assumed, that increasing amounts of bicarbonate (substrate of PEP carboxylase) become available to the cells when the pH of the external medium is raised. This could increase an operation of the C 4 -pathway of C-fixation. This view is supported by the finding, that in contrast to low pH, the C-fixation at high pH results in a dominant labelling of the C 4 -atoms of malate. (orig.) [de

Unicortical self-drilling external fixator pins reduce thermal effects during pin insertion.

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Greinwald, Markus; Varady, Patrick A; Augat, Peter

2017-12-14

External fixation is associated with the risk of pin loosening and pin infection potentially associated to thermal bone necrosis during pin insertion. This study aims to investigate if the use of external fixator systems with unicortical pins reduces the heat production during pin insertion compared to fixators with bicortical pins. Porcine bone specimens were employed to determine bone temperatures during insertion of fixator pins. Two thermographic cameras were used for a simultaneous temperature measurement on the bone surface (top view) and a bone cross-section (front view). Self-drilling unicortical and bicortical pins were inserted at different rotational speeds: (30-600) rpm. Maximum and mean temperatures of the emerging bone debris, bone surface and bone cross-section were analyzed. Maximum temperatures of up to 77 ± 26 °C were measured during pin insertion in the emerging debris and up to 42 ± 2 °C on the bone surface. Temperatures of the emerging debris increased with increasing rotational speeds. Bicortical pin insertion generated significantly higher temperatures at low insertion speed (30 rpm) CONCLUSION: The insertion of external fixator pins can generate a considerable amount of heat around the pins, primarily emerging from bone debris and at higher insertion speeds. Our findings suggest that unicortical, self-drilling fixator pins have a decreased risk for thermal damage, both to the surrounding tissue and to the bone itself.

Gaze3DFix: Detecting 3D fixations with an ellipsoidal bounding volume.

Science.gov (United States)

Weber, Sascha; Schubert, Rebekka S; Vogt, Stefan; Velichkovsky, Boris M; Pannasch, Sebastian

2017-10-26

Nowadays, the use of eyetracking to determine 2-D gaze positions is common practice, and several approaches to the detection of 2-D fixations exist, but ready-to-use algorithms to determine eye movements in three dimensions are still missing. Here we present a dispersion-based algorithm with an ellipsoidal bounding volume that estimates 3D fixations. Therefore, 3D gaze points are obtained using a vector-based approach and are further processed with our algorithm. To evaluate the accuracy of our method, we performed experimental studies with real and virtual stimuli. We obtained good congruence between stimulus position and both the 3D gaze points and the 3D fixation locations within the tested range of 200-600 mm. The mean deviation of the 3D fixations from the stimulus positions was 17 mm for the real as well as for the virtual stimuli, with larger variances at increasing stimulus distances. The described algorithms are implemented in two dynamic linked libraries (Gaze3D.dll and Fixation3D.dll), and we provide a graphical user interface (Gaze3DFixGUI.exe) that is designed for importing 2-D binocular eyetracking data and calculating both 3D gaze points and 3D fixations using the libraries. The Gaze3DFix toolkit, including both libraries and the graphical user interface, is available as open-source software at https://github.com/applied-cognition-research/Gaze3DFix .

Nonunion of the humerus following intramedullary nailing treated by Ilizarov hybrid fixation.

Science.gov (United States)

Raschke, M; Khodadadyan, C; Maitino, P D; Hoffmann, R; Südkamp, N P

1998-02-01

A case of a posttraumatic humeral shaft nonunion, after intramedullary stabilization with a Seidel nail, is presented. Severe osteoporosis, an oligotrophic nonunion, subclinical infection, and adhesive capsulitis of the glenohumeral joint were present. Due to the subclinical infection and severe osteoporosis, other major invasive therapeutic options such as intramedullary nailing or compression plating and bone grafting were not applicable. Nonoperative treatment was also not indicated secondary to the pain and disability present. External fixation with the Ilizarov hybrid fixator seemed to offer a minimally invasive treatment modality without the need of additional bone grafting. After fourteen weeks of "callus massage," consisting of closed alternating compression and distraction with an Ilizarov hybrid fixator, osseous consolidation was achieved. Eight months after Ilizarov treatment the patient had returned to work as a mechanic. At the one-year follow-up examination, the patient presented pain free and with near normal shoulder and elbow motion, with stable osseous consolidation of the humerus. In some cases of nonunion of the humerus shaft, when standard treatment options are not recommended, external fixation with an Ilizarov hybrid fixator may offer a salvage procedure with a successful clinical outcome.

The effects of fixation of the ulna to the radius in young foals

International Nuclear Information System (INIS)

Clem, M.F.; DeBowes, R.M.; Douglass, J.P.; Leipold, H.W.; Chalman, J.A.

1988-01-01

The effects of radioulnar fixation were studied in 21 Quarter horse foals by applying a bone plate to the caudal aspect of the proximal part of the ulna, with screws engaging both the radius and the ulna. The plates were applied at 1 month of age in six foals (group I), 5 months of age in six foals (group II), and 7 months of age in three foals (group III). Six foals underwent sham operations at 1 month of age to serve as controls (group IV). Ulnar dysplasia and elbow subluxation developed in all treated foals. The magnitude of ulnar dysplasia was inversely related to the patient's age at fixation and was accompanied by degenerative joint disease and lameness in foals undergoing fixation at 1 and 5 months of age. Removal of the fixation appliances 16 weeks after implantation in three foals from each of groups I and II failed to reverse the degree of ulnar dysplasia. Although foals undergoing fixation at 7 months of age (group III) were not lame, radiographic evidence of subluxation and subtle degenerative changes in the articular cartilage of the treated elbow did develop. Recommendations for avoidance of radioulnar fixation were developed from these observations

[Comparison study on locking compress plate external fixator and standard external fixator for treatment of tibial open fractures].

Science.gov (United States)

Wu, Gang; Luo, Xiaozhong; Tan, Lun; Lin, Xu; Wu, Chao; Guo, Yong; Zhong, Zewei

2013-11-01

To compare the clinical results of locking compress plate (LCP) as an external fixator and standard external fixator for treatment of tibial open fractures. Between May 2009 and June 2012, 59 patients with tibial open fractures were treated with LCP as an external fixator in 36 patients (group A), and with standard external fixator in 23 patients (group B). There was no significant difference in gender, age, cause of injury, affected side, type of fracture, location, and interval between injury and surgery between 2 groups (P > 0.05). The time of fracture healing and incision healing, the time of partial weight-bearing, the range of motion (ROM) of knee and ankle, and complications were compared between 2 groups. The incidence of pin-track infection in group A (0) was significantly lower than that in group B (21.7%) (P=0.007). No significant difference was found in the incidence of superficial infection and deep infection of incision, and the time of incision healing between 2 groups (P > 0.05). Deep vein thrombosis occurred in 5 cases of group A and 2 cases of group B, showing no significant difference (Chi(2)=0.036, P=0.085). All patients were followed up 15.2 months on average (range, 9-28 months) in group A, and 18.6 months on average (range, 9-47 months) in group B. The malunion rate and nonunion rate showed no significant difference between groups A and B (0 versus 13.0% and 0 versus 8.7%, P > 0.05); the delayed union rate of group A (2.8%) was significantly lower than that of group B (21.7%) (Chi(2)=5.573, P=0.018). Group A had shorter time of fracture healing, quicker partial weight-bearing, greater ROM of the knee and ankle than group B (P fracture, and has good patients' compliance, so it is helpful to do functional exercise, improve fracture healing and function recovery, and reduce the complication incidence.

Ilizarov fixator in management of nonunited and infected tibial shaft fractures

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Abhinay Singh

2015-01-01

Full Text Available Background: Management of nonunion with bony defect and infection in long bones is a challenging problem for orthopedic surgeons. Objectives: Evaluation of Ilizarov circular fixation method of treatment for the management of nonunited and infected fractures of tibia. Materials and Methods: This prospective study was conducted in a tertiary care hospital of eastern region of India on 30 subjects in a time span of 3 years after taking clearance of the Institutional Ethical Committee and informed consent of the patients. Results: All the patients had infected nonunion before undergoing Ilizarov procedure. Following initial injury, 22 patients were treated with external fixation and 8 cases were treated with internal fixation. At the time of presentation, 18 patients had infected gap nonunion, 5 patients had infected hypertrophic and 2 patients had atrophic nonunion. The Ilizarov fixator was kept for an average period of 303.7 days. Based on Association for the Study and Application of Methods of Ilizarov scoring system, bony and functional results were assessed. The bony result was excellent in 16 patients, good in eight, fair in four and poor in two. The functional result was excellent in 10 patients, good in 16, fair in two, poor in two. Conclusion: Ilizarov ring fixator still remains an excellent treatment modality for tibial nonunion with a defect, regarding bone union, deformity correction, infection eradication, limb-length achievement, and limb function.

Macular sensitivity and fixation patterns in patients with autosomal dominant optic atrophy

DEFF Research Database (Denmark)

Rönnbäck, Cecilia; Larsen, Michael

2014-01-01

in the nasal macula (13.6 (± 5.7) dB versus 19.7 (± 0.7) dB) and in the central macula (14.2 (± 5.1) dB versus 19.9 (± 0.3) dB). The average sensitivity decreased with decreasing BCVA in ADOA (p ... fixation was observed in 35% of ADOA patients versus 14% of controls. Unstable fixation was found only in ADOA, where its prevalence was 7%. CONCLUSION: ADOA was associated with unstable fixation and subnormal microperimetric sensitivity, especially in the central and nasal macula where the ganglion cell...

Cortical bone trajectory screw fixation versus traditional pedicle screw fixation for 2-level posterior lumbar interbody fusion: comparison of surgical outcomes for 2-level degenerative lumbar spondylolisthesis.

Science.gov (United States)

Sakaura, Hironobu; Miwa, Toshitada; Yamashita, Tomoya; Kuroda, Yusuke; Ohwada, Tetsuo

2018-01-01

OBJECTIVE The cortical bone trajectory (CBT) screw technique is a new nontraditional pedicle screw (PS) insertion method. However, the biomechanical behavior of multilevel CBT screw/rod fixation remains unclear, and surgical outcomes in patients after 2-level posterior lumbar interbody fusion (PLIF) using CBT screw fixation have not been reported. Thus, the purposes of this study were to examine the clinical and radiological outcomes after 2-level PLIF using CBT screw fixation for 2-level degenerative lumbar spondylolisthesis (DS) and to compare these outcomes with those after 2-level PLIF using traditional PS fixation. METHODS The study included 22 consecutively treated patients who underwent 2-level PLIF with CBT screw fixation for 2-level DS (CBT group, mean follow-up 39 months) and a historical control group of 20 consecutively treated patients who underwent 2-level PLIF using traditional PS fixation for 2-level DS (PS group, mean follow-up 35 months). Clinical symptoms were evaluated using the Japanese Orthopaedic Association (JOA) scoring system. Bony union was assessed by dynamic plain radiographs and CT images. Surgery-related complications, including symptomatic adjacent-segment disease (ASD), were examined. RESULTS The mean operative duration and intraoperative blood loss were 192 minutes and 495 ml in the CBT group and 218 minutes and 612 ml in the PS group, respectively (p 0.05, respectively). The mean JOA score improved significantly from 12.3 points before surgery to 21.1 points (mean recovery rate 54.4%) at the latest follow-up in the CBT group and from 12.8 points before surgery to 20.4 points (mean recovery rate 51.8%) at the latest follow-up in the PS group (p > 0.05). Solid bony union was achieved at 90.9% of segments in the CBT group and 95.0% of segments in the PS group (p > 0.05). Symptomatic ASD developed in 2 patients in the CBT group (9.1%) and 4 patients in the PS group (20.0%, p > 0.05). CONCLUSIONS Two-level PLIF with CBT screw fixation

Biodegradable interlocking nails for fracture fixation

NARCIS (Netherlands)

van der Elst, M.; Bramer, J. A.; Klein, C. P.; de Lange, E. S.; Patka, P.; Haarman, H. J.

1998-01-01

Serious problems such as stress shielding, allergic reactions, and corrosion are associated with the use of metallic fracture fixation devices in fractured long bones. Metal implants often are removed during a second retrieval operation after fracture healing has completed. A biocompatible implant

Can we improve fixation and outcomes? Use of bone substitutes.

Science.gov (United States)

Moroni, Antonio; Larsson, Sune; Hoang Kim, Amy; Gelsomini, Letizia; Giannoudis, Peter V

2009-07-01

Hip fractures secondary to osteoporosis are common in the elderly. Stabilizing these fractures until union is achieved is a challenge due to poor bone stock and insufficient purchase of the implant to the bone. The reported high rate of complications has prompted extensive research in the development of fixation techniques. Furthermore, manipulation of both the local fracture environment in terms of application of growth factors, scaffolds, and mesenchymal cells and the systemic administration of agents promoting bone formation and bone strength has been considered as a treatment option with promising results. There are only a few evidence-based studies reporting on fixation augmentation techniques. This article reports on the efficacy of bone graft substitutes for the fixation of hip fractures, in particular calcium phosphates, which have been used as granules, cements, and implant coatings.

Photosynthetic and nitrogen fixation capability in several soybean mutant lines

International Nuclear Information System (INIS)

Gandanegara, S.; Hendratno, K.

1987-01-01

Photosynthetic and nitrogen fixation capability in several soybean mutant lines. A greenhouse experiment has been carried out to study photosynthetic and nitrogen fixation capability of five mutant lines and two soybean varieties. An amount of 330 uCi of 14 CO 2 was fed to the plants including of the non-fixing reference crop (Chippewa non-nodulating isoline). Nitrogen fixation measurements was carried out using 15 N isotope dilution technique according to A-value concept. Results showed that beside variety/mutant lines, plant growth also has important role in photosynthetic and N fixing capability. Better growth and a higher photosynthetic capability in Orba, mutant lines nos. 63 and 65 resulted in a greater amount of N 2 fixed (mg N/plant) than other mutant lines. (author). 12 refs.; 5 figs

Early Experience with Biodegradable Fixation of Pediatric Mandibular Fractures.

Science.gov (United States)

Mazeed, Ahmed Salah; Shoeib, Mohammed Abdel-Raheem; Saied, Samia Mohammed Ahmed; Elsherbiny, Ahmed

2015-09-01

This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-l/dl-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3-12 years old) with 14 mandibular fractures. They were treated by open reduction and internal fixation by SR-PLDLA plates and screws. Maxillomandibular fixation was maintained for 1 week postoperatively. Clinical follow-up was performed at 1 week, 6 weeks, 3 months, and 12 months postoperatively. Radiographs were done at 1 week, 3 months, and 12 months postoperatively to observe any displacement and fracture healing. All fractures healed both clinically and radiologically. No serious complications were reported in the patients. Normal occlusion was achieved in all cases. Biodegradable osteofixation of mandibular fractures offers a valuable clinical solution for pediatric patients getting the benefit of avoiding secondary surgery to remove plates, decreasing the hospital stay, further painful procedures, and psychological impact.

Glue versus suture for mesh fixation in inguinal hernia repair.

Science.gov (United States)

Chandrasekar, Shruthi; Jeyakumar, S; Ganapathy, Tharun

2018-03-22

Inguinal hernia is one of the most common surgical problem presenting to the surgical OPD. Surgery is the mainstay of treatment for inguinal hernia today. Surgery for inguinal hernia has undergone a great evolution over a period of several centuries. Lichenstein's tension free hernioplasty is the one of the first surgeries taught to a surgical resident. The main aim of surgeries in this era is to give the best possible results with the least possible pain, scar and time. This has given rise to so many modifications to the classical Lichenstein's procedure and also to laparoscopic hernioplasty. Pain after inguinal hernia surgery is found to be debilitating and altering the quality of life in several patients, which has been attributed to the traumatic fixation of the mesh with sutures. This has paved way to the development of various atraumatic methods of fixation, tissue glue is one such development. Hence this study, to compare traumatic and atraumatic methods of mesh fixation in inguinal hernia repair. The aim of this study was to compare suture fixation versus tissue glue fixation of the mesh in inguinal hernia repair. Primary objective was to compare the immediate and chronic post-operative pain. Secondary objective was to compare the time taken for the procedure by the two methods in use and also to compare the presence of any complications. and methodology: This study was done in the General Surgery department of XXX hospital, medical college and research centre, kattangulathur after Ethics committee clearance. It is a single blinded study. The study was done on 51 patients consenting for the study and meeting the inclusion criterias from the period of March 2016 to August 2017 out of which 26 were selected for glue mesh fixation and 25 for suture mesh fixation according to simple randomization. The suture group patients underwent classical Lichenstein's tension free hernioplasty and the glue group underwent Lichenstein's hernioplasty with glue where dots of

Nitrogen fixation improvement in Faidherbia albida

International Nuclear Information System (INIS)

Toure, O.; Dasilva, M.C.; Badji, S.; Dianda, M.; Ndoye, I.; Gueye, M.

1998-01-01

A greenhouse experiment investigated growth, N accumulation and N 2 fixation (using the 15 N-dilution method) by Faidherbia albida in comparison with three species of Acacia, with Parkia biglobosa and Tamarindus indica as non-fixing reference plants. Faidherbia albida was mediocre in comparison with A. seyel, therefore seven provenances of the former were examined in a second pot experiment to investigate within-species variability for the same performance components; a provenance from Kabrousse, Senegal, showed particular promise in terms of dry weight and N accumulation, and fixation of N. This promise was confirmed with a 15-month field experiment, but revealed that there is opportunity for further improvement in N 2 -fixing ability. Faidherbia albida is a slow-growing tree, therefore further field experiments with provenance Kabrousse should be longer term in scope. The data indicate that trenching of the 15 N-labelled area may not be necessary. (author)

Stiffness Analysis of the Sarafix External Fixator based on Stainless Steel and Composite Material

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Nedim Pervan

2015-11-01

Full Text Available This paper describes a structural analysis of the CAD model three versions fixators Sarafix which is to explore the possibility of introducing composite materials in the construction of the connecting rod fixators comparing values of displacement and stiffness at characteristic structure points. Namely, we have investigated the constructional performance of fixators Sarafix with a connecting rod formed from three different composite materials, the same matrix (epoxy resin with three different types of fibers (E glass, kevlar 49 and carbonM55J. The results of the structural analysis fixators Sarafix with a connecting rod made of composite materials are compared with the results of tubular connecting rod fixators made of stainless steel. After comparing the results, from the aspect of stiffness, we gave the final considerations about composite material which provides an adequate substitution for the existing material.

Fixation and utilization of CO2 by biological and/or chemical processes

International Nuclear Information System (INIS)

Hiromichi, N.

1994-01-01

This paper presents the carbon dioxide fixation and utilisation by biological and/or chemical processes. It presents research objectives and program contents for the effective fixation of carbon dioxide by micro-organism and its hydrogenation. (TEC). 5 figs., 2 tabs

Mesh fixation in laparoscopic incisional hernia repair: glue fixation provides attachment strength similar to absorbable tacks but differs substantially in different meshes.

Science.gov (United States)

Rieder, Erwin; Stoiber, Martin; Scheikl, Verena; Poglitsch, Marcus; Dal Borgo, Andrea; Prager, Gerhard; Schima, Heinrich

2011-01-01

Laparoscopic ventral hernia repair has gained popularity among minimally invasive surgeons. However, mesh fixation remains a matter of discussion. This study was designed to compare noninvasive fibrin-glue attachment with tack fixation of meshes developed primarily for intra-abdominal use. It was hypothesized that particular mesh structures would substantially influence detachment force. For initial evaluation, specimens of laminated polypropylene/polydioxanone meshes were anchored to porcine abdominal walls by either helical titanium tacks or absorbable tacks in vitro. A universal tensile-testing machine was used to measure tangential detachment forces (TF). For subsequent experiments of glue fixation, polypropylene/polydioxanone mesh and 4 additional meshes with diverse particular mesh structure, ie, polyvinylidene fluoride/polypropylene mesh, a titanium-coated polypropylene mesh, a polyester mesh bonded with a resorbable collagen, and a macroporous condensed PTFE mesh were evaluated. TF tests revealed that fibrin-glue attachment was not substantially different from that achieved with absorbable tacks (median TF 7.8 Newton [N], range 1.3 to 15.8 N), but only when certain open porous meshes (polyvinylidene fluoride/polypropylene mesh: median 6.2 N, range 3.4 to 10.3 N; titanium-coated polypropylene mesh: median 5.2 N, range 2.1 to 11.7 N) were used. Meshes coated by an anti-adhesive barrier (polypropylene/polydioxanone mesh: median 3.1 N, range 1.7 to 5.8 N; polyester mesh bonded with a resorbable collagen: median 1.3 N, range 0.5 to 1.9 N), or the condensed PTFE mesh (median 3.1 N, range 2.1 to 7.0 N) provided a significantly lower TF (p < 0.01). Fibrin glue appears to be an appealing noninvasive option for mesh fixation in laparoscopic ventral hernia repair, but only if appropriate meshes are used. Glue can also serve as an adjunct to mechanical fixation to reduce the number of invasive tacks. Copyright © 2010 American College of Surgeons. Published by Elsevier

Is mask-based stereotactic head-and-neck fixation as precise as stereotactic head fixation for precision radiotherapy?

International Nuclear Information System (INIS)

Georg, Dietmar; Bogner, Joachim; Dieckmann, Karin; Poetter, Richard

2006-01-01

Background: The aim of this study was to compare setup accuracy and reproducibility of a stereotactic head and a head-and-neck fixation system, both based on thermoplastic material. Methods and Material: Ten patients were immobilized with a head and a head-and-neck fixation system (both BrainLAB, Germany). Both mask systems were modified with a custom-made mouthpiece and a strip of thermoplastic material attached to the lower part of the mask. During the first treatment session, after positioning patients using room lasers, two orthogonal portal images were taken as reference. Later on, at least five sets of orthogonal portal images were acquired for each patient. The isocentric setup accuracy was determined by comparing field edges and anatomic landmarks and the repositioning accuracy in the mask was obtained by comparing individual anatomic landmarks with respect to the metal balls, fixed on the masks. Systematic and random deviations and resulting three-dimensional (3D) vectors were calculated. Additionally, margins were derived from the systematic and random component of the isocentric setup accuracy. Finally, inter- and intraobserver variations were analyzed. Results: The systematic variation of the isocentric setup accuracy was very similar for the two mask systems, but the random variations were slightly larger for the head-and-neck system, resulting in a 0.4-mm larger 3D vector. The repositioning variations for the head mask were smaller compared with the head-and-neck mask, resulting in smaller 3D vectors for the random (∼0.4 mm) and systematic variations (∼0.6 mm). For both mask systems, a 2-mm margin can be used in lateral and anteroposterior direction, whereas in craniocaudal direction, this margin should be extended to 2.5 mm for the head mask and to 3 mm for the head-and-neck mask. The average absolute differences between two observers were within 0.5 mm, maximum deviations around 1 mm. Conclusion: Thermoplastic mask-based stereotactic head

Modificação da técnica de abordagem ventral à articulação atlantoxial sem a secção do músculo esternotireóideo Modification of ventral technique approach to the articulation atlantoxial with no section of the muscle sternothyreoid

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Rafael Festugatto

2009-07-01

Full Text Available O objetivo deste trabalho foi apresentar uma variação na técnica de acesso ventral à articulação atlantoaxial para tratamento da instabilidade atlantoaxial sem a secção do músculo esternotireóideo. Foram utilizados 15 cães, pesando entre oito e 12kg, sem raça definida, independente do sexo, distribuídos aleatoriamente em três grupos iguais de acordo com o período pós-operatório (PO denominados de I (30dias, II (60 dias e III (90 dias para avaliações clínicas diárias. A articulação atlantoaxial foi submetida à artrodese por meio do acesso ventral utilizando pinos de Steinmann associados à resina acrílica autopolimerizável. O acesso e a exposição da articulação atlantoaxial sem a secção do músculo esternotireóideo foram realizados sem complicações ou limitações adicionais. Nenhum cão desta pesquisa apresentou tosse, dispnéia, regurgitação, paralisia laríngea ou Síndrome de Horner. Pode-se concluir que a secção do músculo esternotireóideo é um procedimento desnecessário e que não interfere na exposição da articulação atlantoaxial e na realização da artrodese em cães por meio do acesso ventral.The aim of this research was to present a variation of the ventral technique access to the atlantoaxial joint, for treatment of atlantoaxial instability with no section of sternothyreoid muscle. Fifteen dogs, with weight between 8 and 12kg, were randomly distributed in three groups denominated one (30 days, two (60 days and three (90 days for daily clinical evaluations. The atlantoaxial joint was submitted to the arthrodesis through the ventral access using pins of Steinmann associated to acrylic resin. The access and exhibition of the atlantoaxial joint with no section of the sternothyreoid muscle was obtained without complications or additional limitations. No dog of this research presented coughing, dyspnea, regurgitation, laryngeal paralysis or Horner's syndrome. It can be concluded that the

The interactive effects of temperature and moisture on nitrogen fixation in two temperate-arctic mosses

DEFF Research Database (Denmark)

Rousk, Kathrin; Pedersen, Pia Agerlund; Dyrnum, Kristine

2017-01-01

fixation in mosses under controlled conditions have rarely been investigated separately, rendering the interactive effects of the two climatic factors on N2 fixation unknown. Here, we tested the interactive effects of temperature and moisture on N2 fixation in the two most dominant moss species...

A clinical evaluation of alternative fixation techniques for medial malleolus fractures.

Science.gov (United States)

Barnes, Hayley; Cannada, Lisa K; Watson, J Tracy

2014-09-01

Medial malleolus fractures have traditionally been managed using partially threaded screws and/or Kirschner wire fixation. Using these conventional techniques, a non-union rate of as high as 20% has been reported. In addition too many patients complaining of prominent hardware as a source of pain post-fixation. This study was designed to assess the outcomes of medial malleolar fixation using a headless compression screw in terms of union rate, the need for hardware removal, and pain over the hardware site. Saint Louis University and Mercy Medical Center, Level 1 Trauma Centers, St. Louis, MO. After IRB approval, we used billing records to identify all patients with ankle fractures involving the medial malleolus. Medical records and radiographs were reviewed to identify patients with medial malleolar fractures treated with headless compression screw fixation. Our inclusion criteria included follow-up until full weight bearing and a healed fracture. Follow-up clinical records and radiographs were reviewed to determine union, complication rate and perception of pain over the site of medial malleolus fixation. Sixty-four ankles were fixed via headless compression screws and 44 had adequate follow-up for additional evaluation. Seven patients had isolated medial malleolar fractures, 23 patients had bimalleolar fractures, and 14 patients had trimalleolar fractures. One patient (2%) required hardware removal due to cellulitis. One patient (2%) had a delayed union, which healed without additional intervention. Ten patients (23%) reported mild discomfort to palpation over the medial malleolus. The median follow-up was 35 weeks (range: 12-208 weeks). There were no screw removals for painful hardware and no cases of non-union. Headless compression screws provide effective compression of medial malleolus fractures and result in good clinical outcomes. The headless compression screw is a beneficial alternative to the conventional methods of medial malleolus fixation. Copyright �

Fixation of patients during irradiations of the neurocranium and visceral cranium

Energy Technology Data Exchange (ETDEWEB)

Bohndorf, W.; Richter, E.

1983-12-01

Only few patients are able to exactly maintain during the irradiation a given position of the head without fixation. However, every movement of the head leads to a dose decrease up to 50% within the target volume. Today, fixation and reproducable field adjustment are the conditions of curative radiotherapy. The Wuerzburg model is presented.

[Fixation of patients during irradiation of the neurocranium and visceral cranium].

Science.gov (United States)

Bohndorf, W; Richter, E

1983-12-01

Only few patients are able to exactly maintain during the irradiation a given position of the head without fixation. However, every movement of the head leads to a dose decrease up to 50% within the target volume. Today, fixation and reproducible field adjustment are the conditions of curative radiotherapy. The Würzburg model is presented.

The effect of fixation on esterases

DEFF Research Database (Denmark)

Kirkeby, S; Moe, D

1984-01-01

The localization of reaction product for non-specific esterase from fresh and aldehyde treated glandular tissue was examined. The electrophoretical studies showed a selective inhibition of certain isoenzymes and a change in mobility of some bands caused by aldehyde fixation. In sections a granular...

Nitrogen fixation and molecular oxygen: comparative genomic reconstruction of transcription regulation in Alphaproteobacteria

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Olga V Tsoy

2016-08-01

Full Text Available Biological nitrogen fixation plays a crucial role in the nitrogen cycle. An ability to fix atmospheric nitrogen, reducing it to ammonium, was described for multiple species of Bacteria and Archaea. Being a complex and sensitive process, nitrogen fixation requires a complicated regulatory system, also, on the level of transcription. The transcriptional regulatory network for nitrogen fixation was extensively studied in several representatives of the class Alphaproteobacteria. This regulatory network includes the activator of nitrogen fixation NifA, working in tandem with the alternative sigma-factor RpoN as well as oxygen-responsive regulatory systems, one-component regulators FnrN/FixK and two-component system FixLJ. Here we used a comparative genomics analysis for in silico study of the transcriptional regulatory network in 50 genomes of Alphaproteobacteria. We extended the known regulons and proposed the scenario for the evolution of the nitrogen fixation transcriptional network. The reconstructed network substantially expands the existing knowledge of transcriptional regulation in nitrogen-fixing microorganisms and can be used for genetic experiments, metabolic reconstruction, and evolutionary analysis.

A COMPARATIVE STUDY OF CONSERVATIVE MANAGEMENT VS. EXTERNAL FIXATION OF COMMINUTED DISTAL RADIUS FRACTURES

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Sanjeev Kumar Kare

2016-12-01

Full Text Available BACKGROUND Fracture of the distal radius (‘broken wrist’ is a common clinical problem. It can be treated conservatively usually involving wrist immobilisation in a plaster cast or surgically. A key method of surgical fixation is external fixation. MATERIALS AND METHODS A prospective study was carried out on 66 patients admitted between June 2014 to May 2016 for evaluation of conservative and surgical management of distal radius fractures. RESULTS Excellent, fair or good result was noticed in around 85% of cases managed conservatively and in above 90% of cases managed by external fixator. CONCLUSION There is some evidence to support the use of external fixation for dorsally displaced fractures of the distal radius in adults. Though, there is insufficient evidence to confirm a better functional outcome, external fixation reduces redisplacement gives improved anatomical results and most of the excess surgically-related complications are minor.

Reduction of atlantoaxial dislocation prevented by pathological position of the transverse ligament in fixed, irreducible os odontoideum: operative illustrations and radiographic correlates in 41 patients.

Science.gov (United States)

Dlouhy, Brian J; Policeni, Bruno A; Menezes, Arnold H

2017-07-01

OBJECTIVE Os odontoideum (OO) is a craniovertebral junction (CVJ) abnormality in which an ossicle (small bone) is cranial to a hypoplastic dens by a variable gap. This abnormality can result in instability, which may be reducible or irreducible. What leads to irreducibility in OO is unclear. Therefore, the authors sought to better understand the causes of irreducibility in OO. METHODS A retrospective review was conducted, which identified more than 200 patients who had undergone surgical treatment for OO between 1978 and 2015 at the University of Iowa Hospitals and Clinics. Only the 41 patients who had irreducible OO were included in this study. All inpatient and outpatient records were retrospectively reviewed, and patient demographics, clinical presentation, radiographic findings, surgical treatment, and operative findings were recorded and analyzed. RESULTS The cohort of 41 patients who were found to have irreducible OO included both children and adults. A majority of patients were adults (61% were 18 years or older). Clinical presentation included neck pain and headache in the majority of patients (93%). Weakness, sensory disturbances, and myelopathy were invariably present in all 41 patients (100%). Down syndrome was much more common in the pediatric cohort than in the adult cohort; of the 16 pediatric patients, 6 had Down syndrome (38%), and none of the adults did. Of the 16 pediatric patients, 5 had segmentation failure (31%) in the subaxial spine, and none of the adults did. A form of atlantoaxial dislocation was seen in all cases. On CT imaging, atlantoaxial facets were dislocated in all 41 cases but did not have osseous changes that would have prevented reduction. On MRI, the transverse ligament was identified anterior and inferior to the ossicle and superior to the hypoplastic odontoid process in all cases in which these studies were available (i.e., post-MRI era; 36 of 36 cases). The ligament was hypointense on T2-weighted images but also had an

The lingual splint: an often forgotten method for fixating pediatric mandibular fractures.

Science.gov (United States)

Binahmed, Abdulaziz; Sansalone, Claudio; Garbedian, Justin; Sándor, George K B

2007-01-01

Maxillofacial fractures are uncommon in the pediatric population, and their treatment is unique due to the psychological, physiological, developmental and anatomical characteristics of children. We present the case of a boy who was treated in an outpatient dental clinic using a lingual splint for the reduction, stabilization and fixation of a mandibular body fracture. This technique is a reliable, noninvasive procedure that dentists may consider in selected cases by referral to an oral and maxillofacial surgeon. It also limits the discomfort and morbidity that can be associated with maxillomandibular fixation or open reduction and internal fixation in pediatric patients.

Intraocular pressure variations during zygomatic fracture reduction and fixation: a clinical study.

LENUS (Irish Health Repository)

Murray, Dylan J

2012-02-03

BACKGROUND: The reduction of midface fractures has been associated with the rare but devastating complication of blindness. An increase in intraocular pressure is important in the mechanism of blindness in this setting. In this study, the authors assessed the intraocular pressure in patients who underwent zygomatic fracture reduction (with or without fixation). METHODS: Using applanation tonometry, 29 patients underwent intraocular pressure measurements before, during, and after fracture fixation. The contralateral pressures were measured and used as the control. RESULTS: There were 29 patients with a mean age of 35 years, and the mean time to surgery was 5 days. Preoperatively, all patients had normal intraocular pressures and normal visual acuity. All patients underwent a Gillies lift and 18 patients required open reduction and fixation of the frontozygomatic suture (n = 4) or the infraorbital margin (n = 2), and the remainder (n = 12) required fixation of both points. There was no statistically significant increase in the intraocular pressures following the reduction of uncomplicated zygomatic fractures. Statistically significant pressure reductions were noted immediately after reduction and fixation. CONCLUSIONS: The surgical reduction of uncomplicated zygomatic fractures has no adverse effect on the intraocular pressure. It is the authors\\' opinion that adjunctive measures to reduce the pressures are unnecessary.

Alternative technique of cervical spinal stabilization employing lateral mass plate and screw and intra-articular spacer fixation

Directory of Open Access Journals (Sweden)

Atul Goel

2013-01-01

Full Text Available Aim: The author discusses an alternative technique of segmental cervical spinal fixation. Material and Methods: The subtleties of the technique are discussed on the basis of experience with 3 cases with a follow-up of between 30 and 36 months. Technique: The technique involves debridement of facetal articular cartilage, distraction of facets, jamming of ′Goel spacer′ into the articular cavity and fortification of the fixation by lateral mass plate and screw fixation. The ′double-insurance′ method of fixation is safe for vertebral artery, nerve roots and spinal neural structures and the fixation is strong. Conclusions: The discussed technique is safe and provides a strong fixation and a ground for ultimate arthrodesis.

Comparative study of fixation density maps

NARCIS (Netherlands)

Engelke, U.; Liu, H.; Wang, Junle; Callet, Le P.; Heynderickx, I.E.J.; Zepernick, H.-J.; Maeder, A.

2013-01-01

Fixation density maps (FDM) created from eye tracking experiments are widely used in image processing applications. The FDM are assumed to be reliable ground truths of human visual attention and as such, one expects a high similarity between FDM created in different laboratories. So far, no studies

Soaking morselized allograft in bisphosphonate can impair implant fixation

DEFF Research Database (Denmark)

Jakobsen, Thomas; Baas, Jørgen; Bechtold, Joan E

2007-01-01

biomechanical implant fixation and graft incorporation. In 10 dogs, a pair of titanium implants surrounded by a 2.5-mm gap was inserted into the proximal part of each humerus during two separate surgeries to allow two observation periods. The gap was filled with impacted, morselized allograft soaked in either...... of implants was observed for 12 weeks and the second pair for 4 weeks. Implants were evaluated by histomorphometry and biomechanical pushout test. We found substantially decreased biomechanical implant fixation for all implants surrounded by impacted, morselized allograft that had been soaked in alendronate...

Fibrin sealant for mesh fixation in laparoscopic groin hernia repair does not increase long-term recurrence

DEFF Research Database (Denmark)

Fenger, Andreas Qwist; Helvind, Neel Maria; Pommergaard, Hans-Christian

2016-01-01

BACKGROUND: Methods of groin hernia repair include laparoscopic techniques using tissue-penetrating mesh fixation or non-penetrating fixation. Concerns regarding hernia repair include postoperative chronic pain, sexual dysfunction, and recurrence. Earlier estimations of recurrence rates have......) laparoscopic groin hernia repair using either fibrin sealant or tacks for mesh fixation. METHODS: This study used data from the Danish Hernia Database to create the following cohort: All patients operated laparoscopically for primary groin hernia with a TAPP procedure using fibrin sealant for mesh fixation...... difference in long-term reoperation rates and clinical recurrences in patients undergoing TAPP repair with meshes fixated with fibrin sealant compared with tacks....

Fixation Probabilities of Evolutionary Graphs Based on the Positions of New Appearing Mutants

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Pei-ai Zhang

2014-01-01

Full Text Available Evolutionary graph theory is a nice measure to implement evolutionary dynamics on spatial structures of populations. To calculate the fixation probability is usually regarded as a Markov chain process, which is affected by the number of the individuals, the fitness of the mutant, the game strategy, and the structure of the population. However the position of the new mutant is important to its fixation probability. Here the position of the new mutant is laid emphasis on. The method is put forward to calculate the fixation probability of an evolutionary graph (EG of single level. Then for a class of bilevel EGs, their fixation probabilities are calculated and some propositions are discussed. The conclusion is obtained showing that the bilevel EG is more stable than the corresponding one-rooted EG.

Biomechanical effect of interspinous process distraction height after lumbar fixation surgery: An in vitro model.

Science.gov (United States)

Fu, Lin; Ma, Jianxiong; Lu, Bin; Jia, Haobo; Zhao, Jie; Kuang, Mingjie; Feng, Rui; Xu, Liyan; Bai, Haohao; Sun, Lei; Wang, Ying; Ma, Xinlong

2017-07-01

Pedicle screw fixation may induce abnormal activity at adjacent segment and accelerate the degeneration of lumbar vertebrae. Dynamic stabilizers could provide an intermediate solution between conservative treatment and fusion surgery. Lumbar vertebral segment cephalad to instrumented fixation was the most common localization of adjacent segment degeneration. The aim of this study is to explore the use of interspinous process devices in the lumbar vertebral segment cephalad to fixation segment in changing the mechanical distribution and limiting abnormal activity of the spine. Eight specimens were tested in the following groups: intact group, instability group (bilateral facetectomy at L3-L4), fixation group (bilateral facetectomy and pedicle screw fixation at L3-L4), and hybrid fixation group (fixation at L3-L4 and simulating interspinous device implantation of 6, 8, 10, 12, 14, 16, and 18 mm at L2-L3). Range of motion, motion of vertebral body, and strain distribution change were recorded. The range of motion in extension with 16- and 18-mm hybrid constructs was significantly lower than intact, instability, and fixation groups. In flexion and lateral bending, the strain values of L4 inferior articular process with 18-mm hybrid construct have a significant difference compared with other groups. In axial rotation, under the condition of a contralateral state, the strain values of L2 superior articular process with 18-mm hybrid construct have a significant difference compared with intact and fixation groups. The strain value of the L4 inferior articular process had negative correlation with height distraction in three dimensions, except extension. A negative correlation between the strain value of the L2 superior articular process and distraction height was found in contralateral bending and contralateral axial rotation. Interspinous process devices above the fixation segment can change the mechanical distribution of the spine and limit activity in some of the

Fixation strength analysis of cup to bone material using finite element simulation

NARCIS (Netherlands)

Anwar, Iwan Budiwan; Saputra, Eko; Ismail, Rifky; Jamari, J.; Van Der Heide, Emile

2016-01-01

Fixation of acetabular cup to bone material is an important initial stability for artificial hip joint. In general, the fixation in cement less-type acetabular cup uses press-fit and screw methods. These methods can be applied alone or together. Based on literature survey, the additional screw

The saccadic flow baseline: Accounting for image-independent biases in fixation behavior.

Science.gov (United States)

Clarke, Alasdair D F; Stainer, Matthew J; Tatler, Benjamin W; Hunt, Amelia R

2017-09-01

Much effort has been made to explain eye guidance during natural scene viewing. However, a substantial component of fixation placement appears to be a set of consistent biases in eye movement behavior. We introduce the concept of saccadic flow, a generalization of the central bias that describes the image-independent conditional probability of making a saccade to (xi+1, yi+1), given a fixation at (xi, yi). We suggest that saccadic flow can be a useful prior when carrying out analyses of fixation locations, and can be used as a submodule in models of eye movements during scene viewing. We demonstrate the utility of this idea by presenting bias-weighted gaze landscapes, and show that there is a link between the likelihood of a saccade under the flow model, and the salience of the following fixation. We also present a minor improvement to our central bias model (based on using a multivariate truncated Gaussian), and investigate the leftwards and coarse-to-fine biases in scene viewing.

Shape memory alloy fixator system for suturing tissue in minimal access surgery.

Science.gov (United States)

Xu, W; Frank, T G; Stockham, G; Cuschieri, A

1999-01-01

A new technique for suturing human tissue is described in which tissue closure is achieved by means of small fixators made from shape memory alloy. The aim of the development is to provide an alternative to thread suturing in minimal access surgery, which is quicker and requires less skill to achieve the required suturing quality. The design of the fixators is described in terms of the thermal shape recovery of shape memory alloy and a novel form of finite element analysis, which uses a nonlinear elastic element for the material property. Thermal analysis of the fixators and surrounding tissue is used to predict the temperature distribution during and after the application of electric current heating. This was checked in an in vitro experiment, which confirmed that deployment caused no detectable collateral damage to surrounding tissue. In vivo animal studies on the use of the shape memory alloy fixator for suturing tissue are ongoing to establish safety and healing effects.

[DESIGN AND CLINICAL APPLICATION OF LESSER TROCHANTERIC REDUCTION FIXATION SYSTEM].

Science.gov (United States)

Guo, Xiaoze; Zhang, Ying; Xiao, Jin; Xie, Huibin; Yu, Jiefeng

2015-02-01

To design and produce a lesser trochanteric reduction fixation system and verify its value and effectiveness. A lesser trochanteric reduction fixation system was designed and produced according to the anatomical features of the lesser trochanteric fractures. Sixty-six patients with intertrochanteric fractures of Evans type III were included between January 2010 and July 2012. Of 66 patients, 32 were treated with dynamic hip screw (DHS) assisted with the lesser trochanteric reduction fixation system (study group), and 34 cases were treated with DHS only (control group). The 2 groups were comparable with no significant difference in gender, age, the reasons, and the types of the fractures (P > 0.05). The operation time, intraoperative blood loss, neck-shaft angle, bone healing time, ratio of successful fixations, and the functional evaluation of the hip joint after operation were compared between 2 groups. The study group had shorter operation time [(58.4 ± 5.3) minutes] and less intraoperative blood loss [(186.3 ± 6.6) mL than the control group [(78.5 ± 6.2)minutes and (246.2 ± 8.7) mL], showing significant differences (t = -14.040, P = 0.000; t = -31.145, P = 0.000). There was no significant difference in neck-shaft angle between study group [(138.6 ± 3.0)] and control group [(139.4 ± 2.9) degrees] (t = -1.044, P = 0.301). The wounds healed by first intention in both groups. The 30 and 31 patients were followed up 12 to 24 months (mean, 15 months) in the study group, and 13 to 25 months (mean, 16 months) in the control group, respectively. All fractures healed well in 2 groups. The study group had significantly shorter healing time [(8.8 ± 2.0) weeks] than the control group [(10.7 ± 3.4) weeks] (t = -2.871, P = 0.006). At 12 months after operation, coxa vara happened in 2 cases of the study group with a successful fixation ratio of 93.3% and in 10 cases of the control group with a successful fixation ratio of 67.7%, showing significant difference (Χ2 = 6

Report About the Design of External Fixator for Treatment of Pelvis and Acetabulum Fractures

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Martin JANEČKA

2012-06-01

Full Text Available Main point in this contribution is the design of external fixators applied in traumatology and orthopaedics. These fixators can be used in the treatment of open and unstable (i.e. complicated fractures of pelvis and its acetabulum. Numerical modelling (i.e. Finite Element Method, together with CAD modelling, experiments, material engineering, and nanotechnology are presented as a support for developing of a new design of external fixators.

QTL analysis of symbiotic nitrogen fixation in a black bean RIL population

Science.gov (United States)

Dry bean (Phaseolus vulgaris L) acquires nitrogen (N) from the atmosphere through symbiotic nitrogen fixation (SNF) but it has a low efficiency to fix nitrogen. The objective of this study is to map the genes controlling nitrogen fixation in common bean. A mapping population consisting of 122 recomb...

Field evaluation of N2 fixation by seventeen mung bean genotypes in the Philippines

International Nuclear Information System (INIS)

Rosales, C.M.; Rivera, F.; Hautia, R.A.; Del Rosario, E.

1994-12-01

Seventeen mung bean genotypes were screened for biological nitrogen fixation (BNF) during the late dry (March-May) and early dry (October-December) seasons of 1992 in the Philippines. The 15 N isotope dilution method was used to measure N 2 fixation. Performances were quantified based on both indirect and direct measurements of N 2 fixation. Genetic variation was observed among varieties tested for some BNF characteristic. However, genetic variability for percent N derived from fixation (%Ndfa) was not evident. PAEC 3 mutant, Taiwan Green, Acc 687 and Pagasa 7 were the best performers. Whereas Acc 2041 consistently performed poorly for most of the BNF characters tested. (author). 14 refs., 1 fig., 2 tabs

Arthroplasty of hip resection, handling with external fixation - Experience in the central military hospital

International Nuclear Information System (INIS)

Satizabal Azuero, Carlos E; Calderon Uribe, Oscar; Naquira Escobar, Luis F

2006-01-01

This is an observational retrospective study series of cases carried out between January 1998 and July 2004 in the central military hospital, 13 patients were treated with Girdlestone arthroplasty with external fixation, with a pursuit average of 53 months. Function, return to the daily activities and associate complications was evaluated. They were as complication; pain in the fixator site, osteitis, and fixator broke. All patients report at the end of the treatment no pain in the hip. Shortening in the patient without lenghting was 3,5 cm and in the group with lenghting was 1.5 cm. the obtained results demonstrate that Girdlestone arthroplasty with external fixation, is option, to improve the patient's pain and function of the hip

Measures and limits of models of fixation selection.

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Niklas Wilming

Full Text Available Models of fixation selection are a central tool in the quest to understand how the human mind selects relevant information. Using this tool in the evaluation of competing claims often requires comparing different models' relative performance in predicting eye movements. However, studies use a wide variety of performance measures with markedly different properties, which makes a comparison difficult. We make three main contributions to this line of research: First we argue for a set of desirable properties, review commonly used measures, and conclude that no single measure unites all desirable properties. However the area under the ROC curve (a classification measure and the KL-divergence (a distance measure of probability distributions combine many desirable properties and allow a meaningful comparison of critical model performance. We give an analytical proof of the linearity of the ROC measure with respect to averaging over subjects and demonstrate an appropriate correction of entropy-based measures like KL-divergence for small sample sizes in the context of eye-tracking data. Second, we provide a lower bound and an upper bound of these measures, based on image-independent properties of fixation data and between subject consistency respectively. Based on these bounds it is possible to give a reference frame to judge the predictive power of a model of fixation selection. We provide open-source python code to compute the reference frame. Third, we show that the upper, between subject consistency bound holds only for models that predict averages of subject populations. Departing from this we show that incorporating subject-specific viewing behavior can generate predictions which surpass that upper bound. Taken together, these findings lay out the required information that allow a well-founded judgment of the quality of any model of fixation selection and should therefore be reported when a new model is introduced.

Less-invasive stabilization of rib fractures by intramedullary fixation: a biomechanical evaluation.

Science.gov (United States)

Bottlang, Michael; Helzel, Inga; Long, William; Fitzpatrick, Daniel; Madey, Steven

2010-05-01

This study evaluated intramedullary fixation of rib fractures with Kirschner wires and novel ribs splints. We hypothesized that rib splints can provide equivalent fixation strength while avoiding complications associated with Kirschner wires, namely wire migration and cutout. The durability, strength, and failure modes of rib fracture fixation with Kirschner wires and rib splints were evaluated in 22 paired human ribs. First, intact ribs were loaded to failure to determine their strength. After fracture fixation with Kirschner wires and rib splints, fixation constructs were dynamically loaded to 360,000 cycles at five times the respiratory load to determine their durability. Finally, constructs were loaded to failure to determine residual strength and failure modes. All constructs sustained dynamic loading without failure. Dynamic loading caused three times more subsidence in Kirschner wire constructs (1.2 mm +/- 1.4 mm) than in rib splint constructs (0.4 mm +/- 0.2 mm, p = 0.09). After dynamic loading, rib splint constructs remained 48% stronger than Kirschner wire constructs (p = 0.001). Five of 11 Kirschner wire constructs failed catastrophically by cutting through the medial cortex, leading to complete loss of stability and wire migration through the lateral cortex. The remaining six constructs failed by wire bending. Rib splint constructs failed by development of fracture lines along the superior and interior cortices. No splint construct failed catastrophically, and all splint constructs retained functional reduction and fixation. Because of their superior strength and absence of catastrophic failure mode, rib splints can serve as an attractive alternative to Kirschner wires for intramedullary stabilization of rib fractures, especially in the case of posterior rib fractures where access for plating is limited.

Visual encoding and fixation target selection in free viewing: presaccadic brain potentials

Directory of Open Access Journals (Sweden)

Andrey R Nikolaev

2013-06-01

Full Text Available In scrutinizing a scene, the eyes alternate between fixations and saccades. During a fixation, two component processes can be distinguished: visual encoding and selection of the next fixation target. We aimed to distinguish the neural correlates of these processes in the electrical brain activity prior to a saccade onset. Participants viewed color photographs of natural scenes, in preparation for a change detection task. Then, for each participant and each scene we computed an image heat map, with temperature representing the duration and density of fixations. The temperature difference between the start and end points of saccades was taken as a measure of the expected task-relevance of the information concentrated in specific regions of a scene. Visual encoding was evaluated according to whether subsequent change was correctly detected. Saccades with larger temperature difference were more likely to be followed by correct detection than ones with smaller temperature differences. The amplitude of presaccadic activity over anterior brain areas was larger for correct detection than for detection failure. This difference was observed for short scrutinizing but not for long explorative saccades, suggesting that presaccadic activity reflects top-down saccade guidance. Thus, successful encoding requires local scanning of scene regions which are expected to be task-relevant. Next, we evaluated fixation target selection. Saccades moving up in temperature were preceded by presaccadic activity of higher amplitude than those moving down. This finding suggests that presaccadic activity reflects attention deployed to the following fixation location. Our findings illustrate how presaccadic activity can elucidate concurrent brain processes related to the immediate goal of planning the next saccade and the larger-scale goal of constructing a robust representation of the visual scene.

Modification of bifunctional epoxy resin using CO2 fixation process and nanoclay

International Nuclear Information System (INIS)

Khoshkish, Morteza; Bouhendi, Hosein; Vafayan, Mehdi

2014-01-01

A bifunctional epoxy resin was modified by using a CO 2 fixation solution process in the presence of tetra n-butyl ammonium bromide (TBAB) as catalyst and the modified treated resin was treated by cloisite 30B as nano additive. The Unmodified epoxy resin (UME), CO 2 fixated modified epoxy resin (CFME), and CFME/clay nano composite (CFMEN), were cured by diethylenetriamine (DETA). A cycloaliphatic compound as a reactive diluent was used to control the viscosity of high viscose CFME. The exfoliation of organoclay in UME and CFME was investigated by X-ray diffraction and activation energy was computed using the advanced integral isoconversional method. The activation energy dependency demonstrated that the mechanism of UME curing did not change in the presence of nanoclay. In contrast, the CO 2 fixation results showed a significant change in the activation energy dependency. The Thermal stability parameters include the initial degradation temperature (IDT), the temperature at the maximum rate of weight loss (T max ), and the decomposition activation energy (E d ) were determined by thermal gravimetry analysis. Dynamic mechanical thermal analysis measurements showed that the presence of organoclay in CFME increases the T g of nano composite in contrast to UME. The fracture roughness of UME, CFME and CFNE were determined by scanning electron microscope. The exfoliated UME/1%clay nanocomposite was confirmed by TEM image. - Highlights: • A new epoxy resin was synthesized using CO 2 fixation reaction. • The synthesized epoxy resin was modified by an organo nano-clay. • CO 2 fixation noticeably changed the curing mechanism. • CO 2 fixation reaction consumes CO 2 which is a harmful greenhouse gas

CT-guided fixation of sacral fractures and sacrolilac joint disruptions

International Nuclear Information System (INIS)

Nelson, D.W.; Duwelius, P.

1990-01-01

Placement of sacral fixation screws at surgery is performed blindly (ie, by palpation). The authors of this paper employed CT to localize the screw between the neutral foramina and anterior sacral cortex and to decrease the morbidity associated with general anesthesia and surgery. Six patients underwent CT-guided sacral fixation performed by means of the 7.0 mm A0 cannulated screw system. All patients had reducible vertical sacral fractures or sacroiliac joint disruptions. Following placement of an epidural catheter for anesthesia, patients were scanned in the prone or decubitus position. Measurements for placement of the guide pin were made from the preliminary scans. Following CT confirmation of satisfactory guide pin placement across the fracture, the screw track was drilled, the screw length was determined, and the fixation screw was placed in position. A CT scan was obtained to evaluate the final position of the screw

How Life History Can Sway the Fixation Probability of Mutants

Science.gov (United States)

Li, Xiang-Yi; Kurokawa, Shun; Giaimo, Stefano; Traulsen, Arne

2016-01-01

In this work, we study the effects of demographic structure on evolutionary dynamics when selection acts on reproduction, survival, or both. In contrast to the previously discovered pattern that the fixation probability of a neutral mutant decreases while the population becomes younger, we show that a mutant with a constant selective advantage may have a maximum or a minimum of the fixation probability in populations with an intermediate fraction of young individuals. This highlights the importance of life history and demographic structure in studying evolutionary dynamics. We also illustrate the fundamental differences between selection on reproduction and selection on survival when age structure is present. In addition, we evaluate the relative importance of size and structure of the population in determining the fixation probability of the mutant. Our work lays the foundation for also studying density- and frequency-dependent effects in populations when demographic structures cannot be neglected. PMID:27129737

Direct lexical control of eye movements in reading: Evidence from a survival analysis of fixation durations

Science.gov (United States)

Reingold, Eyal M.; Reichle, Erik D.; Glaholt, Mackenzie G.; Sheridan, Heather

2013-01-01

Participants’ eye movements were monitored in an experiment that manipulated the frequency of target words (high vs. low) as well as their availability for parafoveal processing during fixations on the pre-target word (valid vs. invalid preview). The influence of the word-frequency by preview validity manipulation on the distributions of first fixation duration was examined by using ex-Gaussian fitting as well as a novel survival analysis technique which provided precise estimates of the timing of the first discernible influence of word frequency on first fixation duration. Using this technique, we found a significant influence of word frequency on fixation duration in normal reading (valid preview) as early as 145 ms from the start of fixation. We also demonstrated an equally rapid non-lexical influence on first fixation duration as a function of initial landing position (location) on target words. The time-course of frequency effects, but not location effects was strongly influenced by preview validity, demonstrating the crucial role of parafoveal processing in enabling direct lexical control of reading fixation times. Implications for models of eye-movement control are discussed. PMID:22542804

Comparison of Internal Fixations for Distal Clavicular Fractures Based on Loading Tests and Finite Element Analyses

Directory of Open Access Journals (Sweden)

Rina Sakai

2014-01-01

Full Text Available It is difficult to apply strong and stable internal fixation to a fracture of the distal end of the clavicle because it is unstable, the distal clavicle fragment is small, and the fractured region is near the acromioclavicular joint. In this study, to identify a superior internal fixation method for unstable distal clavicular fracture, we compared three types of internal fixation (tension band wiring, scorpion, and LCP clavicle hook plate. Firstly, loading tests were performed, in which fixations were evaluated using bending stiffness and torsional stiffness as indices, followed by finite element analysis to evaluate fixability using the stress and strain as indices. The bending and torsional stiffness were significantly higher in the artificial clavicles fixed with the two types of plate than in that fixed by tension band wiring (P<0.05. No marked stress concentration on the clavicle was noted in the scorpion because the arm plate did not interfere with the acromioclavicular joint, suggesting that favorable shoulder joint function can be achieved. The stability of fixation with the LCP clavicle hook plate and the scorpion was similar, and plate fixations were stronger than fixation by tension band wiring.

Fixation method does not affect restoration of rotation center in hip replacements: A single-site retrospective study

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Wegner Alexander

2012-06-01

Full Text Available Abstract Background Aseptic loosening is one of the greatest problems in hip replacement surgery. The rotation center of the hip is believed to influence the longevity of fixation. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique. Methods We retrospectively compared pre- and post-operative positions of the hip rotation center in 25 and 68 patients who underwent artificial hip replacements in our department in 2007 using cemented or cementless cup fixation, respectively, with digital radiographic image analysis. Results The mean horizontal and vertical distances between the rotation center and the acetabular teardrop were compared in radiographic images taken pre- and post-operatively. The mean horizontal difference was −2.63 mm (range: -11.00 mm to 10.46 mm, standard deviation 4.23 mm for patients who underwent cementless fixation, and −2.84 mm (range: -10.87 to 5.30 mm, standard deviation 4.59 mm for patients who underwent cemented fixation. The mean vertical difference was 0.60 mm (range: -20.15 mm to 10.00 mm, standard deviation 3.93 mm and 0.41 mm (range: -9.26 mm to 6.54 mm, standard deviation 3.58 mm for the cementless and cemented fixation groups, respectively. The two fixation techniques had no significant difference on the position of the hip rotation center in the 93 patients in this study. Conclusions The hip rotation center was similarly restored using either the cemented or cementless fixation techniques in this patient cohort, indicating that the fixation technique itself does not interfere with the position of the center of rotation. To completely answer this question further studies with more patients are needed.

External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis.

Science.gov (United States)

Metcalfe, David; Hickson, Craig J; McKee, Lesley; Griffin, Xavier L

2015-12-01

It is uncertain whether external fixation or open reduction internal fixation (ORIF) is optimal for patients with bicondylar tibial plateau fractures. A systematic review using Ovid MEDLINE, Embase Classic, Embase, AMED, the Cochrane Library, Open Grey, Orthopaedic Proceedings, WHO International Clinical Trials Registry Platform, Current Controlled Trials, US National Institute for Health Trials Registry, and the Cochrane Central Register of Controlled Trials. The search was conducted on 3rd October 2014 and no language limits were applied. Inclusion criteria were all clinical study designs comparing external fixation with open reduction internal fixation of bicondylar tibial plateau fractures. Studies of only one treatment modality were excluded, as were those that included unicondylar tibial plateau fractures. Treatment effects from studies reporting dichotomous outcomes were summarised using odds ratios. Continuous outcomes were converted to standardized mean differences to assess the treatment effect, and inverse variance methods used to combine data. A fixed effect model was used for meta-analyses. Patients undergoing external fixation were more likely to have returned to preinjury activities by six and twelve months (P = 0.030) but not at 24 months follow-up. However, external fixation was complicated by a greater number of infections (OR 2.59, 95 % CI 1.25-5.36, P = 0.01). There were no statistically significant differences in the rates of deep infection, venous thromboembolism, compartment syndrome, or need for re-operation between the two groups. Although external fixation and ORIF are associated with different complication profiles, both are acceptable strategies for managing bicondylar tibial plateau fractures.

Fixation of zygomatic and mandibular fractures with biodegradable plates.

Science.gov (United States)

Degala, Saikrishna; Shetty, Sujeeth; Ramya, S

2013-01-01

In this prospective study, 13 randomly selected patients underwent treatment for zygomatic-complex fractures (2 site fractures) and mandibular fractures using 1.5 / 2 / 2.5-mm INION CPS biodegradable plates and screws. To assess the fixation of zygomatic-complex and mandibular fractures with biodegradable copolymer osteosynthesis system. In randomly selected 13 patients, zygomatic-complex and mandibular fractures were plated using resorbable plates and screws using Champy's principle. All the cases were evaluated clinically and radiologically for the type of fracture, need for the intermaxillary fixation (IMF) and its duration, duration of surgery, fixation at operation, state of reduction at operation, state of bone union after operation, anatomic reduction, paresthesia, occlusal discrepancies, soft tissue infection, immediate and late inflammatory reactions related to biodegradation process, and any need for the removal of the plates. Descriptives, Frequencies, and Chi-square test were used. In our study, the age group range was 5 to 55 years. Road traffic accidents accounted for the majority of patients six, (46.2%). Postoperative occlusal discrepancies were found in seven patients as mild to moderate, which resolved with IMF for 1-8 weeks. There were minimal complications seen and only as soft tissue infection. Use of biodegradable osteosynthesis system is a reliable alternative method for the fixation of zygomatic-complex and mandibular fractures. The biodegradable system still needs to be refined in material quality and handling to match the stability achieved with metal system. Biodegradable plates and screws is an ideal system for pediatric fractures with favorable outcome.

Fixation-free assessment of the Hirschberg ratio.

Science.gov (United States)

Model, Dmitri; Eizenman, Moshe; Sturm, Veit

2010-08-01

To describe a novel methodology by which to measure the Hirschberg ratio (HR) in infants. The methodology does not require fixation on specific points, and measurements are made while infants look naturally at a display. The HR is calculated automatically from measurements of the direction of the optical axis, the position of the pupil center, and corneal reflexes in video images from an advanced two-camera eye-tracking system. The performance of the novel fixation-free procedure (FFP) was evaluated in 43 adults by measuring the average difference and the 95% limits of agreement with the standard fixation-based procedure (FBP). Repeatability of the HR measurements was evaluated by assessing the 95% limits of agreement between two independent measurements. Performance of the FFP was also evaluated in five infants. In adults, the average HR was 12.89 +/- 1.22 degrees/mm for FFP and 12.81 +/- 1.22 degrees/mm for FBP. FFP and FBP measurements were highly correlated (r = 0.95; P limits of agreement between FFP and FBP were +/-0.86 degrees/mm. The 95% limits of agreement of repeated measurements were +/-0.66 degrees/mm for FFP and +/-0.77 degrees/mm for FBP. In infants, the 95% limits of agreement of repeated measurements by FFP were +/-0.63 degrees/mm. In adults, the FFP provides accurate measurements of the HR that are in excellent agreement with measurements by FBP. In infants, measurements of HR by FFP show the same repeatability and consistency.

Distal femoral osteotomy in genovalgum: internal fixation with blade plate versus casting.

Science.gov (United States)

Makhmalbaf, Hadi; Moradi, Ali; Ganji, Saeid

2014-10-01

To compare the results of two different ways of distal femoral osteotomy stabilization in patients suffering from genuvalgum: internal fixation with plate, and casting. In a non-randomized prospective study, after distal femoral osteotomy with the zigzag method, patients were divided into two groups: long leg casting, and internal fixation with blade plate. For all patients, questionnaires were filled to obtain data. Information such as range of motion, tibiofemoral anatomical angle and complications were recorded. 38 knees with valgus deformity underwent distal femoral supracondylar osteotomy. (8 with plaster cast and 30 with internal fixation using a blade plate). Preoperative range of motion was 129±6° and six months later it was 120±14°. The preoperative tibiofemoral angle was 32±6°; postoperative tibiofemoral angles were 3±3°, 6±2°, and 7±3° just after operation, six months, and two years later, respectively. Although this angle was greater among the group stabilized with a cast, this difference was not statistically significant. In postoperative complications, over-correction was found in five, recorvatom deformity in one, knee stiffness in three and superficial wound infection was recorded in three knees. There is no prominent difference in final range of motion and alignment whether fixation is done with casting or internal fixation. However, the complication rate seems higher in the casting method.

Evaluation of body image and self-esteem in patients with external fixation devices: a Turkish perspective.

Science.gov (United States)

Büyükyilmaz, Funda; Sendir, Merdiye; Salmond, Susan

2009-01-01

This descriptive study aimed to describe the body image and self-esteem of patients with external fixation devices. Fifty patients with external fixation devices who came for follow-up to the Ilizarov Outpatient Clinic of a university hospital in Turkey were included in this study. Data were collected by using a Demographic Questionnaire Form, Multidimensional Body-Self Relations Questionnaire (MBSRQ), and Coppersmith Self-Esteem Inventory. The perceived body image (197.58 +/- 25.14) and self-esteem (65.28 +/- 17.97) of the patients with external fixation devices were in the moderate range. There was no significant correlation between body image and self-esteem. Self-esteem was correlated with one's perception of whether external fixation impacted one's appearance and whether one wanted to avoid being seen by certain individuals because of the appearance of the external fixator. The study highlighted that body image disturbance and threats to self-esteem are not universal with the use of external fixation and need to be assessed individually.

Intrasacral rod fixation for pediatric lumbopelvic fusion.

Science.gov (United States)

Ilharreborde, Brice; Mazda, Keyvan

2014-07-01

This paper reports the authors' 19 years experience with pediatric intrasacral rod fixation. After insertion of two cannulated screws in S1 with and an original template guiding them into the anterior third of the endplate, two short fusion rods were inserted into the sacrum according to Jackson's technique distally to S3. In neuromuscular scoliosis, pelvic obliquity was reduced by connecting the proximal and distal constructs, distraction or compression, and in situ rod bending. In children with high-grade spondylolisthesis, lumbosacral kyphosis was reduced by rotation of the sacrum and in situ bending. There were no direct neurological or vascular injuries. The main complication was infection (7%). No pseudarthrosis or significant loss of correction at the lumbosacral junction was observed during follow-up. Intrasacral rod fixation appears to be safe and reliable for lumbopelvic fusion in pediatric patients.

The effect of cement on hip stem fixation: a biomechanical study.

Science.gov (United States)

Çelik, Talip; Mutlu, İbrahim; Özkan, Arif; Kişioğlu, Yasin

2017-06-01

This study presents the numerical analysis of stem fixation in hip surgery using with/without cement methods since the use of cement is still controversial based on the clinical studies in the literature. Many different factors such as stress shielding, aseptic loosening, material properties of the stem, surgeon experiences etc. play an important role in the failure of the stem fixations. The stem fixation methods, cemented and uncemented, were evaluated in terms of mechanical failure aspects using computerized finite element method. For the modeling processes, three dimensional (3D) femur model was generated from computerized tomography (CT) images taken from a patient using the MIMICS Software. The design of the stem was also generated as 3D CAD model using the design parameters taken from the manufacturer catalogue. These 3D CAD models were generated and combined with/without cement considering the surgical procedure using SolidWorks program and then imported into ANSYS Workbench Software. Two different material properties, CoCrMo and Ti6Al4V, for the stem model and Poly Methyl Methacrylate (PMMA) for the cement were assigned. The material properties of the femur were described according to a density calculated from the CT images. Body weight and muscle forces were applied on the femur and the distal femur was fixed for the boundary conditions. The calculations of the stress distributions of the models including cement and relative movements of the contacts examined to evaluate the effects of the cement and different stem material usage on the failure of stem fixation. According to the results, the use of cement for the stem fixation reduces the stress shielding but increases the aseptic loosening depending on the cement crack formations. Additionally, using the stiffer material for the stem reduces the cement stress but increases the stress shielding. Based on the results obtained in the study, even when taking the disadvantages into account, the cement usage

Impact of Crab Bioturbation on Nitrogen-Fixation Rates in Red Sea Mangrove Sediment

KAUST Repository

Qashqari, Maryam S.

2017-01-01

be uptaken by plants. Hence, biological nitrogen fixation increases the input of nitrogen in the mangrove ecosystem. In this project, we focus on measuring the rates of nitrogen fixation on Red Sea mangrove (Avicennia marina) located at Thuwal, Saudi Arabia

Relocatable fixation systems in intracranial stereotactic radiotherapy. Accuracy of serial CT scans and patient acceptance in a randomized design.

Science.gov (United States)

Theelen, A; Martens, J; Bosmans, G; Houben, R; Jager, J J; Rutten, I; Lambin, P; Minken, A W; Baumert, B G

2012-01-01

The goal was to provide a quantitative evaluation of the accuracy of three different fixation systems for stereotactic radiotherapy and to evaluate patients' acceptance for all fixations. A total of 16 consecutive patients with brain tumours undergoing fractionated stereotactic radiotherapy (SCRT) were enrolled after informed consent (Clinical trials.gov: NCT00181350). Fixation systems evaluated were the BrainLAB® mask, with and without custom made bite-block (fixations S and A) and a homemade neck support with bite-block (fixation B) based on the BrainLAB® frame. The sequence of measurements was evaluated in a randomized manner with a cross-over design and patients' acceptance by a questionnaire. The mean three-dimensional (3D) displacement and standard deviations were 1.16 ± 0.68 mm for fixation S, 1.92 ± 1.28 and 1.70 ± 0.83 mm for fixations A and B, respectively. There was a significant improvement of the overall alignment (3D vector) when using the standard fixation instead of fixation A or B in the craniocaudal direction (p = 0.037). Rotational deviations were significantly less for the standard fixation S in relation to fixations A (p = 0.005) and B (p = 0.03). EPI imaging with off-line correction further improved reproducibility. Five out of 8 patients preferred the neck support with the bite-block. The mask fixation system in conjunction with a bite-block is the most accurate fixation for SCRT reducing craniocaudal and rotational movements. Patients favoured the more comfortable but less accurate neck support. To optimize the accuracy of SCRT, additional regular portal imaging is warranted.

Relocatable fixation systems in intracranial stereotactic radiotherapy. Accuracy of serial CT scans and patient acceptance in a randomized design

International Nuclear Information System (INIS)

Theelen, A.; Martens, J.; Bosmans, G.; Houben, R.; Jager, J.J.; Rutten, I.; Lambin, P.; Baumert, B.G.; Minken, A.W.; Radiotherapeutic Inst. RISO, Deventer

2012-01-01

The goal was to provide a quantitative evaluation of the accuracy of three different fixation systems for stereotactic radiotherapy and to evaluate patients' acceptance for all fixations. Methods A total of 16 consecutive patients with brain tumours undergoing fractionated stereotactic radiotherapy (SCRT) were enrolled after informed consent (Clinical trials.gov: NCT00181350). Fixation systems evaluated were the BrainLAB registered mask, with and without custom made bite-block (fixations S and A) and a homemade neck support with bite-block (fixation B) based on the BrainLAB registered frame. The sequence of measurements was evaluated in a randomized manner with a cross-over design and patients' acceptance by a questionnaire. Results The mean three-dimensional (3D) displacement and standard deviations were 1.16 ± 0.68 mm for fixation S, 1.92 ± 1.28 and 1.70 ± 0.83 mm for fixations A and B, respectively. There was a significant improvement of the overall alignment (3D vector) when using the standard fixation instead of fixation A or B in the craniocaudal direction (p = 0.037). Rotational deviations were significantly less for the standard fixation S in relation to fixations A (p = 0.005) and B (p = 0.03). EPI imaging with off-line correction further improved reproducibility. Five out of 8 patients preferred the neck support with the bite-block. Conclusion The mask fixation system in conjunction with a bite-block is the most accurate fixation for SCRT reducing craniocaudal and rotational movements. Patients favoured the more comfortable but less accurate neck support. To optimize the accuracy of SCRT, additional regular portal imaging is warranted. (orig.)

Locking plate fixation provides superior fixation of humerus split type greater tuberosity fractures than tension bands and double row suture bridges.

Science.gov (United States)

Gaudelli, Cinzia; Ménard, Jérémie; Mutch, Jennifer; Laflamme, G-Yves; Petit, Yvan; Rouleau, Dominique M

2014-11-01

This paper aims to determine the strongest fixation method for split type greater tuberosity fractures of the proximal humerus by testing and comparing three fixation methods: a tension band with No. 2 wire suture, a double-row suture bridge with suture anchors, and a manually contoured calcaneal locking plate. Each method was tested on eight porcine humeri. A osteotomy of the greater tuberosity was performed 50° to the humeral shaft and then fixed according to one of three methods. The humeri were then placed in a testing apparatus and tension was applied along the supraspinatus tendon using a thermoelectric cooling clamp. The load required to produce 3mm and 5mm of displacement, as well as complete failure, was recorded using an axial load cell. The average load required to produce 3mm and 5mm of displacement was 658N and 1112N for the locking plate, 199N and 247N for the double row, and 75N and 105N for the tension band. The difference between the three groups was significant (Prow (456N) and tension band (279N) (Prow (71N/mm) and tension band (33N/mm) (Pbiomechanical fixation for split type greater tuberosity fractures. Copyright © 2014 Elsevier Ltd. All rights reserved.

Use of 15N dilution method for screening soybean lines with high yield and high nitrogen fixation ability

International Nuclear Information System (INIS)

Li Haixian; Li Xinmin; Danso, S.K.A.

1998-01-01

15 N dilution method was used for screening soybean lines with high nitrogen fixation ability. Screened lines 1005, 8502, 2096, 943, 1454 and Dongnong-42 have high nitrogen fixation ability with their % Ndfa of about 70%. 1454 and 1555 are both high yield and high nitrogen fixation lines. The ability of nitrogen fixation was not related to the yield, but related to maturing time. The cultivars with different maturing time have different levels of nitrogen fixation ability. The longer the maturing period is, the greater the ability of nitrogen fixation it has. There were ten cultivars or lines used in the test of 1992 and 1994. Although the weather condition were greatly different between the two years the results of seven cultivars or lines were the same, indicating that nitrogen fixation ability of the soybean is stable with years. Using 15 N dilution method to estimate nitrogen fixation ability of soybean is reliable, however, the % Ndfa of lines 8502 and 2096 increased by 19% in 1994, a rainy year, indicating that a change in % Ndfa with a few varieties maybe caused by weather

Screening with nuclear techniques for yield and N2 fixation in mung bean in Thailand

International Nuclear Information System (INIS)

Boonkerd, N.; Wadisrisuk, P.; Siripin, S.; Murakami, T.; Danso, S.K.A.

1998-01-01

For a farmer to reap benefit from mung bean's (Vigna radiata) capacity to fix N 2 , the crop's requirement for N must come mainly from the atmosphere through symbiotic fixation in the root nodules. The aim of this study was to evaluate recommended mung-bean cultivars and advanced breeding lines, and identify high fixers. Preliminary investigations with the 15 N natural-abundance method indicated its utility for measuring N 2 fixation, and the examination of five recommended cultivars and two advanced breeding lines of mung using the 15 N-dilution method showed diversity in N 2 fixation and yield. More than 400 lines of mung bean were screened in soil in cement containers for growth, nodulation, N accumulation and N 2 fixation at 35 days after planting, with the natural-abundance method used to determine N 2 fixation. Genetic variability was observed for all characteristics. Estimates of fixed N ranged from 0-300 mg N/plant. Whereas some lines obtained N mainly from fixation, recommended cultivars apparently obtained their N mainly from soil. The data are discussed in terms of reliability of the 15 N natural-abundance method

21 CFR 888.3030 - Single/multiple component metallic bone fixation appliances and accessories.

Science.gov (United States)

2010-04-01

... appliances and accessories. 888.3030 Section 888.3030 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT....3030 Single/multiple component metallic bone fixation appliances and accessories. (a) Identification. Single/multiple component metallic bone fixation appliances and accessories are devices intended to be...

Nitrogen fixation in four dryland tree species in central Chile

International Nuclear Information System (INIS)

Ovalle, C.; Arredondo, S.; Aronson, J.; Longeri, L.; Avendano, J.

1998-01-01

Results are presented from a 5-year experiment using 15 N-enriched fertilizer to determine N 2 fixation in four tree species on degraded soils in a Mediterranean-climate region of central Chile in which there are 5 months of drought. Species tested included three slow-growing but long-lived savannah trees native to southers South America, (acacia caven, Prosopic alba and P. chilensis; Mimosoideae), and Tagasaste (Chamaecytisus proliferus ssp. palmensis; Papilonoideae), a fast-growing but medium-lived tree from the Canary Islands. Tagasaste produced four- to twenty-fold more biomass than the other species, but showed declining N 2 fixation and biomass accumulation during the 5th year, corresponding to the juvenile-to-adult developmental transition. Nitrogen content was significantly higher in Tagasaste and Acacia caven than in the other species. The data revealed inter-specific differences in resource allocation and phenology of N 2 fixation rarely detailed for woody plants in dryland regions. (author)

Parafuso de massa lateral do atlas para fixação da coluna cervical superior: resultados cirúrgicos Tornillos de masa lateral del atlas para la fijación de la columna cervical superior: resultados quirúrgicos Lateral mass screws of the atlas for upper cervical spine fixation: surgical results

Directory of Open Access Journals (Sweden)

Enrico Ghizoni

2011-01-01

alcanzar la fusión y la estabilidad de la columna cervical, y con el conocimiento de la anatomía y de la técnica quirúrgica es posible obtenerse excelentes resultados.OBJECTIVE: To present the surgical results of a case series of upper cervical spine stabilization with the use of lateral mass screws of the atlas. METHODS: Retrospective review of the surgical results of patients submitted to upper cervical spine stabilization with the use of lateral mass screws of the atlas. RESULTS: Six patients were operated in the period between January 2009 to April 2010, four men and two women. There was no permanent morbidity or mortality in the presented series. The main cause of atlanto-axial instability was trauma and there was just one case of odontoid pathologic fracture from a prostate metastasis. Axis fixation was achieved with the use of three different screw techniques (pars, pedicle and laminar, with equal distribution among the patients. CONCLUSIONS: The use of lateral mass screws of the atlas is an important technique to achieve fusion and stability of the upper cervical spine and with the knowledge of the anatomy and of the surgical technique good results can be achieved.

Possibility of high CO{sub 2} fixation rate by coral reef ecosystems

Energy Technology Data Exchange (ETDEWEB)

K. Yamada; Y. Suzuki; B.E. Casareto; H. Komiyama [Shinshu University, Tokida (Japan). Dept. of Fine Materials Engineering

2003-07-01

Previous net rates of CO{sub 2} fixation by coral reef ecosystems have been said to be nearly zero due to a balance between CO{sub 2} fixed by organic carbon production and CO{sub 2} released by both organic carbon decomposition and inorganic carbon formation. But this study, conducted in Bora Bay, Miyako Island, Japan showed net rates of about 7 gC m{sup -2} d{sup -1} inside a coral reef and on a coral reef. It was found by experiment that the photosynthetic rate of coral increased with the increase of the flow rate of seawater. The authors tried to calculate net primary production (= net rates of CO{sub 2} fixation) outside a coral reef with flow rate. A flow rate on the coral reef of the open seaside is much higher than that in a lagoon. As an example, the CO{sub 2} fixation rates at the flow rates of 6 and 30 cm/s are compared. When it is assumed that the length of the whole coral reef facing the ocean is 50,000 km and its width is 100 m, and the flow rate is 30cm/s, the CO{sub 2} fixation rate is calculated to be 6.3 x 10{sup 6} t-C/y (3.5g-C/m{sup 2}d). This value is 2.2 times higher than that at the flow rate of 6 cm/s. This fixation rate is only by the coral itself. It means that the CO{sub 2} fixation rate by coral reef ecosystems can be much higher and the magnitude for worldwide ecosystems can be in the order of 10{sup 6}-10{sup 7} t-C/y. 14 refs., 5 tabs.

Minimally invasive treatment of tibial pilon fractures through arthroscopy and external fixator-assisted reduction.

Science.gov (United States)

Luo, Huasong; Chen, Liaobin; Liu, Kebin; Peng, Songming; Zhang, Jien; Yi, Yang

2016-01-01

The aim of this study was to evaluate the clinical outcome of tibial pilon fractures treated with arthroscopy and assisted reduction with an external fixator. Thirteen patients with tibial pilon fractures underwent assisted reduction for limited lower internal fixation with an external fixator under arthroscopic guidance. The weight-bearing time was decided on the basis of repeat radiography of the tibia 3 months after surgery. Postoperative ankle function was evaluated according to the Mazur scoring system. Healing of fractures was achieved in all cases, with no complications such as severe infection, skin necrosis, or an exposed plate. There were 9 excellent, 2 good, and 2 poor outcomes, scored according to the Mazur system. The acceptance rate was 85%. Arthroscopy and external fixator-assisted reduction for the minimally invasive treatment of tibial pilon fractures not only produced less trauma but also protected the soft tissues and blood supply surrounding the fractures. External fixation could indirectly provide reduction and effective operative space for arthroscopic implantation, especially for AO type B fractures and partial AO type C1 fractures.

Axial loading screw fixation for chevron type osteotomies of the distal first metatarsal: a retrospective outcomes analysis.

Science.gov (United States)

Murphy, Ryan M; Fallat, Lawrence M; Kish, John P

2014-01-01

The distal chevron osteotomy is a widely accepted technique for the treatment of hallux abductovalgus deformity. Although the osteotomy is considered to be stable, displacements of the capital fragment has been described. We propose a new method for fixation of the osteotomy involving the axial loading screw (ALS) used in addition to single screw fixation. We believe this method will provide a more mechanically stable construct. We reviewed the charts of 46 patients in whom 52 feet underwent a distal chevron osteotomy that was fixated with either 1 screw or 2 screws that included the ALS. We hypothesized that the ALS group would have fewer displacements and would heal more quickly than the single screw fixation group. We found that the group with ALS fixation had healed at a mean of 6.5 weeks and that the group with single screw fixation had healed at 9.53 weeks (p = .001). Also, 8 cases occurred of displacement of the capital fragment in the single screw, control group compared with 2 cases of displacement in the ALS group. However, this finding was not statistically significant. The addition of the ALS to single screw fixation allowed the patients to heal approximately 3 weeks earlier than single screw fixation alone. The ALS is a fixation option for the surgeon to consider when osseous correction of hallux abducto valgus is performed. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Results of Operative Fixation of Fractures of the Ankle at a Tertiary ...

African Journals Online (AJOL)

Background: Operative fixation of ankle fractures is becoming popular in developing countries. The concern however is the outcome of care. The objective was to evaluate the results of open reduction and internal fixation (ORIF) of fractures of the ankle in our hospital. Methods: All cases ORIF of fractures of the ankle at the ...

Stress corrosion cracking of an aluminum alloy used in external fixation devices.

Science.gov (United States)

Cartner, Jacob L; Haggard, Warren O; Ong, Joo L; Bumgardner, Joel D

2008-08-01

Treatment for compound and/or comminuted fractures is frequently accomplished via external fixation. To achieve stability, the compositions of external fixators generally include aluminum alloy components due to their high strength-to-weight ratios. These alloys are particularly susceptible to corrosion in chloride environments. There have been several clinical cases of fixator failure in which corrosion was cited as a potential mechanism. The aim of this study was to evaluate the effects of physiological environments on the corrosion susceptibility of aluminum 7075-T6, since it is used in orthopedic external fixation devices. Electrochemical corrosion curves and alternate immersion stress corrosion cracking tests indicated aluminum 7075-T6 is susceptible to corrosive attack when placed in physiological environments. Pit initiated stress corrosion cracking was the primary form of alloy corrosion, and subsequent fracture, in this study. Anodization of the alloy provided a protective layer, but also caused a decrease in passivity ranges. These data suggest that once the anodization layer is disrupted, accelerated corrosion processes occur. (c) 2007 Wiley Periodicals, Inc.

Nitrogen fixation in arctic marine sediments: effect of oil and hydrocarbon fractions

Energy Technology Data Exchange (ETDEWEB)

Knowles, R; Wishart, C

1977-06-01

Nitrogen fixation (acetylene reduction) was measured in grab and core samples of sediments from the Beaufort Sea and Eskimo Lakes, Northwest Territories, Canada. Very low rates (about 25 mg N/m/sup 2/.year) were detected in untreated sediments. Activity was markedly stimulated by the addition of glucose, sucrose, lactose, mannitol and malate but much less so by acetate; negligible activity was supported by N-acetylglucosamine. There was no consistent effect of the presence or absence of oxygen. Nitrogen fixation potentials in glucose-supplemented sediment samples showed large variation between stations, between samples from the same station and between depths within single cores down to 18 cm. Weathered Normal Wells crude oil, hexane, decane, dodecane and hexadecane had no effect, stimulatory or inhibitory, on nitrogen fixation or carbon dioxide evolution. 1,2,4-trimethylbenzene caused complete inhibition of nitrogen fixation but only partial inhibition of CO/sub 2/ evolution. There was no evidence of utilization of any of the hydrocarbons tested during periods of over 30 days under the experimental conditions employed.

Breeding food and forge legumes for enhancement of nitrogen fixation: a review

International Nuclear Information System (INIS)

Ali, A.; Hussain, S.; Qamar, I.A.; Khan, B.R.

2000-01-01

Nitrogen fixation in legume - root nodules requires the functioning of genes present in the Rhizobia that induce nodule-formation. The plant produces the nodules and the energy required for respiration. Genes in both Rhizobium and the plant are responsible for the efficient use of photosynthesis for N/sub 2/ fixation and assimilation of nitrogen. Genes from Rhizobium and legume hosts that are involved in the symbiosis are being identified, isolated and cloned, to facilitate the manipulation of either partner. The amounts of nitrogen fixed by grain-legumes vary appreciably, between and within, species and are also influenced by environment. With few exceptions, most legumes fix insufficient N/sub 2/ to support substantial seed-yields. Deficits between required N and the combined amounts provide by soil and fertilizer help in estimating the improvements in N/sub 2/ fixation which is possible through breeding. Since the symbiosis is a complex process, heritability of traits is weak, and most methods which estimate fixation are destructive, a breeding method that allows selection of replicated families rather than single plants is preferred. (author)

Unique paradoxical atlantoaxial dislocation with C1-C2 facet diastases and isolated ligamentous injury to the craniovertebral junction without neurological deficits: A case report

Directory of Open Access Journals (Sweden)

Aniruddha Thekkatte Jagannatha

2013-01-01

Full Text Available Study design: Retrospective review of the case file. Objective: The primary objective was to report this rare case and discuss the mechanism of dislocation and technique of manual closed reduction of C1-C2 vertebrae in such scenarios. Summary of background data: Posterior atlantoaxial dislocation (AAD is extremely rare and a few cases have been reported in English literature. This young man sustained a high speed car accident and survived an extreme hyperextension injury to the craniovertebral junction (CVJ without any neurological deficits. On evaluation for neck pain he was noted with a dislocated odontoid lying in front of Atlas. There was C1-C2 facet diastases. No bony injury was noted at CVJ. Transverse axial ligament (TAL was intact. He underwent a successful awake reduction of the dislocation. The joint had to be manually distracted, realigned, and released under the guidance of fluoroscopy. This was followed by single stage C1-C2 Goel′s fusion with awake prone positioning. This patient was able to go back to work at the end of 3 months (GOS 5. Conclusions: This condition is extremely rare, can be carefully reduced manually under adequate neuromonitoring, and requires C1-C2 fusion in the same sitting.

When do anterior external or internal fixators provide additional stability in an unstable (Tile C) pelvic fracture? A biomechanical study.

Science.gov (United States)

Mcdonald, E; Theologis, A A; Horst, P; Kandemir, U; Pekmezci, M

2015-12-01

This study aimed at evaluating the additional stability that is provided by anterior external and internal fixators in an unstable pelvic fracture model (OTA 61-C). An unstable pelvic fracture (OTA 61-C) was created in 27 synthetic pelves by making a 5-mm gap through the sacral foramina (posterior injury) and an ipsilateral pubic rami fracture (anterior injury). The posterior injury was fixed with either a single iliosacral (IS) screw, a single trans-iliac, trans-sacral (TS) screw, or two iliosacral screws (S1S2). Two anterior fixation techniques were utilized: external fixation (Ex-Fix) and supra-acetabular external fixation and internal fixation (In-Fix); supra-acetabular pedicle screws connected with a single subcutaneous spinal rod. The specimens were tested using a nondestructive single-leg stance model. Peak-to-peak (P2P) displacement and rotation and conditioning displacement (CD) were calculated. The Ex-Fix group failed in 83.3 % of specimens with concomitant single-level posterior fixation (Total: 15/18-7 of 9 IS fixation, 8 of 9 TS fixation), and 0 % (0/9) of specimens with concomitant two-level (S1S2) posterior fixation. All specimens with the In-Fix survived testing except for two specimens treated with In-Fix combined with IS fixation. Trans-sacral fixation had higher pubic rotation and greater sacral and pubic displacement than S1S2 (p < 0.05). Rotation of the pubis and sacrum was not different between In-Fix constructs combined with single-level IS and TS fixation. In this model of an unstable pelvic fracture (OTA 61-C), anterior fixation with an In-Fix was biomechanically superior to an anterior Ex-Fix in the setting of single-level posterior fixation. There was no biomechanical difference between the In-Fix and Ex-Fix when each was combined with two levels of posterior sacral fixation.

Evaluation of the syndesmotic-only fixation for Weber-C ankle fractures with syndesmotic injury.

Science.gov (United States)

Mohammed, R; Syed, S; Metikala, S; Ali, Sa

2011-09-01

With the length of the fibula restored and the syndesmosis reduced anatomically, internal fixation using a plating device may not be necessary for supra-syndesmotic fibular fractures combined with diastasis of inferior tibio-fibular joint. A retrospective observational study was performed in patients who had this injury pattern treated with syndesmosis-only fixation. 12 patients who had Weber type-C injury pattern were treated with syndesmosis only fixation. The treatment plan was followed only if the fibular length could be restored and if the syndesmosis could be anatomically reduced. Through a percutaneous or mini-open reduction and clamp stabilization of the syndesmosis, all but one patient had a single tricortical screw fixation across the syndesmosis. Patients were kept non-weight-bearing for 6 weeks, followed by screw removal at an average of 8 weeks. Outcomes were assessed using an objective ankle scoring system (Olerud and Molander scale) and by radiographic assessment of the ankle mortise. At a mean follow-up of 13 months, the functional outcome score was 75. Excellent to good outcomes were noted in 83% of the patients. Ankle mortise was reduced in all cases, and all but one fibular fracture united without loss of fixation. Six patients had more than one malleolar injury, needing either screw or anchor fixations. One patient had late diastasis after removal of the syndesmotic screw and underwent revision surgery with bone grafting of the fibula. This was probably due to early screw removal, before union of the fibular fracture had occurred. We recommend syndesmosis-only fixation as an effective treatment option for a combination of syndesmosis disruption and Weber type-C lateral malleolar fractures.

Start Position Strongly Influences Fixation Patterns during Face Processing: Difficulties with Eye Movements as a Measure of Information Use

Science.gov (United States)

Arizpe, Joseph; Kravitz, Dwight J.; Yovel, Galit; Baker, Chris I.

2012-01-01

Fixation patterns are thought to reflect cognitive processing and, thus, index the most informative stimulus features for task performance. During face recognition, initial fixations to the center of the nose have been taken to indicate this location is optimal for information extraction. However, the use of fixations as a marker for information use rests on the assumption that fixation patterns are predominantly determined by stimulus and task, despite the fact that fixations are also influenced by visuo-motor factors. Here, we tested the effect of starting position on fixation patterns during a face recognition task with upright and inverted faces. While we observed differences in fixations between upright and inverted faces, likely reflecting differences in cognitive processing, there was also a strong effect of start position. Over the first five saccades, fixation patterns across start positions were only coarsely similar, with most fixations around the eyes. Importantly, however, the precise fixation pattern was highly dependent on start position with a strong tendency toward facial features furthest from the start position. For example, the often-reported tendency toward the left over right eye was reversed for the left starting position. Further, delayed initial saccades for central versus peripheral start positions suggest greater information processing prior to the initial saccade, highlighting the experimental bias introduced by the commonly used center start position. Finally, the precise effect of face inversion on fixation patterns was also dependent on start position. These results demonstrate the importance of a non-stimulus, non-task factor in determining fixation patterns. The patterns observed likely reflect a complex combination of visuo-motor effects and simple sampling strategies as well as cognitive factors. These different factors are very difficult to tease apart and therefore great caution must be applied when interpreting absolute

Molecular nitrogen fixation and nitrogen cycle in nature

Energy Technology Data Exchange (ETDEWEB)

Virtanen, A I

1952-01-01

The origin of nitrogen oxides in the atmosphere is discussed. Evidently only a small proportion of the nitrate-and nitrite-nitrogen found in the precipitation is formed through electric discharges from molecular nitrogen, photochemical nitrogen fixation being probably of greater importance. Formation of nitrate nitrogen through atmospheric oxidation of nitrous oxide (N/sub 2/O) evaporating from the soil is also considered likely. Determination of nitrogen compounds at different altitudes is indispensable for gaining information of the N/sub 2/-fixation in the atmosphere and, in general, of the origin of nitrogen oxides and their decomposition. International cooperation is needed for this as well as for the quantitative determination of the nitrogen compounds removed from the soil by leaching and brought by waters into the seas.

15N in biological nitrogen fixation studies

International Nuclear Information System (INIS)

Faust, H.

1986-05-01

A bibliography with 298 references on the use of the stable nitrogen isotope 15 N in the research on the biological fixation of dinitrogen is presented. The literature pertaining to this bibliography covers the period from 1975 to the middle of 1985. (author)

Osteomyelitis in burn patients requiring skeletal fixation

NARCIS (Netherlands)

Barret, JP; Desai, MH; Herndon, DN

Deep and severe burns often present with the exposure of musculoskeletal structures and severe deformities. Skeletal fixation, suspension and/or traction are part of their comprehensive treatment. Several factors put burn patients at risk for osteomyelitis, osteosynthesis material being one of them.

Cyanobacteria Occurrence and Nitrogen Fixation Rates in the ...

African Journals Online (AJOL)

Keywords: Cyanobacteria, Nitrogen Fixation, Seagrass, Seaweed Farming. Abstract—The .... during every sampling period, using a mercury thermometer and a ..... Capone, D.G. (1993) Determination of nitrogenase activity in aquatic samples ...

Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel

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