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Sample records for total synthesis revised

  1. Remote Stereoinductive Intramolecular Nitrile Oxide Cycloaddition: Asymmetric Total Synthesis and Structure Revision of (-)-11β-Hydroxycurvularin.

    Science.gov (United States)

    Choe, Hyeonjeong; Pham, Thuy Trang; Lee, Joo Yun; Latif, Muhammad; Park, Haeil; Kang, Young Kee; Lee, Jongkook

    2016-03-18

    The first total synthesis and structure revision of (-)-11β-hydroxycurvularin (1b), a macrolide possessing a β-hydroxyketone moiety, were accomplished. The β-hydroxyketone moiety in this natural product was introduced by cleavage of the N-O bond in an isoxazoline ring that was formed diastereoselectively in a 1,5-remote stereocontrolled fashion by employing intramolecular nitrile oxide cycloaddition.

  2. Total synthesis and structural revision of TMG-chitotriomycin, a specific inhibitor of insect and fungal beta-N-acetylglucosaminidases.

    Science.gov (United States)

    Yang, You; Li, Yao; Yu, Biao

    2009-09-02

    TMG-chitotriomycin, a potent and selective inhibitor of the beta-N-acetylglucosaminidases that possesses an unique N,N,N-trimethyl-d-glucosamine (TMG) residue, is revised to be the TMG-beta-(1-->4)-chitotriose instead of the originally proposed alpha-anomer via its total synthesis, for which a highly convergent approach was developed in which the sterically demanding (1-->4)-glycosidic linkages are efficiently constructed by the Au(I)-catalyzed glycosylation protocol with glycosyl o-hexynylbenzoates as donors.

  3. Total synthesis of ciguatoxin.

    Science.gov (United States)

    Hamajima, Akinari; Isobe, Minoru

    2009-01-01

    Something fishy: Ciguatoxin (see structure) is one of the principal toxins involved in ciguatera poisoning and the target of a total synthesis involving the coupling of three segments. The key transformations in this synthesis feature acetylene-dicobalthexacarbonyl complexation.

  4. Failure of aseptic revision total knee arthroplasties.

    Science.gov (United States)

    Leta, Tesfaye H; Lygre, Stein Håkon L; Skredderstuen, Arne; Hallan, Geir; Furnes, Ove

    2015-02-01

    In Norway, the proportion of revision knee arthroplasties increased from 6.9% in 1994 to 8.5% in 2011. However, there is limited information on the epidemiology and causes of subsequent failure of revision knee arthroplasty. We therefore studied survival rate and determined the modes of failure of aseptic revision total knee arthroplasties. This study was based on 1,016 aseptic revision total knee arthroplasties reported to the Norwegian Arthroplasty Register between 1994 and 2011. Revisions done for infections were not included. Kaplan-Meier and Cox regression analyses were used to assess the survival rate and the relative risk of re-revision with all causes of re-revision as endpoint. 145 knees failed after revision total knee arthroplasty. Deep infection was the most frequent cause of re-revision (28%), followed by instability (26%), loose tibial component (17%), and pain (10%). The cumulative survival rate for revision total knee arthroplasties was 85% at 5 years, 78% at 10 years, and 71% at 15 years. Revision total knee arthroplasties with exchange of the femoral or tibial component exclusively had a higher risk of re-revision (RR = 1.7) than those with exchange of the whole prosthesis. The risk of re-revision was higher for men (RR = 2.0) and for patients aged less than 60 years (RR = 1.6). In terms of implant survival, revision of the whole implant was better than revision of 1 component only. Young age and male sex were risk factors for re-revision. Deep infection was the most frequent cause of failure of revision of aseptic total knee arthroplasties.

  5. Total Synthesis of Hyperforin.

    Science.gov (United States)

    Ting, Chi P; Maimone, Thomas J

    2015-08-26

    A 10-step total synthesis of the polycyclic polyprenylated acylphloroglucinol (PPAP) natural product hyperforin from 2-methylcyclopent-2-en-1-one is reported. This route was enabled by a diketene annulation reaction and an oxidative ring expansion strategy designed to complement the presumed biosynthesis of this complex meroterpene. The described work enables the preparation of a highly substituted bicyclo[3.3.1]nonane-1,3,5-trione motif in only six steps and thus serves as a platform for the construction of easily synthesized, highly diverse PPAPs modifiable at every position.

  6. First total synthesis of Boehmenan

    Indian Academy of Sciences (India)

    The first total synthesis of dilignan Boehmenan has been achieved. A biomimetic oxidative coupling of the ferulic acid methyl ester in the presence of silver oxide is the crucial step in the synthesis sequence, generating the dihydrobenzofuran skeleton. Hydroxyl group was protected with DHP and reducted with LiAlH4 to ...

  7. Conversion total hip arthroplasty: Primary or revision total hip arthroplasty

    Science.gov (United States)

    Schwarzkopf, Ran; Baghoolizadeh, Mahta

    2015-01-01

    Total hip arthroplasty (THA) is an increasingly common procedure among elderly individuals. Although conversion THA is currently bundled in a diagnosis related group (DRG) with primary THA, there is a lack of literature supporting this classification and it has yet to be identified whether conversion THA better resembles primary or revision THA. This editorial analyzed the intraoperative and postoperative factors and functional outcomes following conversion THA, primary THA, and revision THA to understand whether the characteristics of conversion THA resemble one procedure or the other, or are possibly somewhere in between. The analysis revealed that conversion THA requires more resources both intraoperatively and postoperatively than primary THA. Furthermore, patients undergoing conversion THA present with poorer functional outcomes in the long run. Patients undergoing conversion THA better resemble revision THA patients than primary THA patients. As such, patients undergoing conversion THA should not be likened to patients undergoing primary THA when determining risk stratification and reimbursement rates. Conversion THA procedures should be planned accordingly with proper anticipation of the greater needs both in the operating room, and for in-patient and follow-up care. We suggest that conversion THA be reclassified in the same DRG with revision THA as opposed to primary THA as a step towards better allocation of healthcare resources for conversion hip arthroplasties. PMID:26601055

  8. Total synthesis of (-)- and (+)-tedanalactam

    Digital Repository Service at National Institute of Oceanography (India)

    Majik, M.S.; Parameswaran, P.S.; Tilve, S.G.

    : The Journal of Organic Chemistry, vol.74(16); 6378-6381 1 Total Synthesis of (-) and (+)-Tedanalactam Mahesh S. Majik, † Peruninakulath S. Parameswaran, ‡ and Santosh G. Tilve* ,† Department of Chemistry, Goa University, Taleigao Plateau, Goa 403..., displaying a wide range of biological activities. 1 Piperidones are key synthetic intermediates 2 for the synthesis of piperidine ring due to the presence of keto function which allows the introduction of other groups. Piperidones are also known...

  9. Total Synthesis of Adunctin B.

    Science.gov (United States)

    Dethe, Dattatraya H; Dherange, Balu D

    2018-03-16

    Total synthesis of (±)-adunctin B, a natural product isolated from Piper aduncum (Piperaceae), has been achieved using two different strategies, in seven and three steps. The efficient approach features highly atom economical and diastereoselective Friedel-Crafts acylation, alkylation reaction and palladium catalyzed Wacker type oxidative cyclization.

  10. Total synthesis of nepetoidin B

    Science.gov (United States)

    The total synthesis of nepetoidin B (the 2-(3,4-dihydroxyphenyl)ethenyl ester of 3-(3,4-dihydroxy¬phenyl)-2-propenoic acid) has been achieved in two steps from commercially available 1,5-bis(3,4-dimethoxyphenyl)-1,4-pentadien-3-one. Tetramethylated nepetoidin B was prepared directly by Baeyer-Villig...

  11. Humeral windows in revision total elbow arthroplasty.

    Science.gov (United States)

    Peach, Chris A; Salama, Amir; Stanley, David

    2016-04-01

    The use of cortical windows for revision elbow arthroplasty has not previously been widely reported. Their use aids safe revision of a well fixed humeral prosthesis and can be used in the setting of dislocation, periprosthetic fracture or aseptic loosening of the ulnar component. We describe our technique and results of cortical windows in the distal humerus for revision elbow arthroplasty surgery.

  12. Revision Total Hip Arthoplasty: Factors Associated with Re-Revision Surgery

    OpenAIRE

    Khatod, M; Cafri, G; Inacio, MCS; Schepps, AL; Paxton, EW; Bini, SA

    2015-01-01

    The survivorship of implants after revision total hip arthroplasty and risk factors associated with re-revision are not well defined. We evaluated the re-revision rate with use of the institutional total joint replacement registry. The purpose of this study was to determine patient, implant, and surgeon factors associated with re-revision total hip arthroplasty.A retrospective cohort study was conducted. The total joint replacement registry was used to identify patients who had undergone revi...

  13. Total synthesis of mycalamide A.

    Science.gov (United States)

    Sohn, Jeong-Hun; Waizumi, Nobuaki; Zhong, H Marlon; Rawal, Viresh H

    2005-05-25

    This communication describes a concise and efficient total synthesis of mycalamide A by the convergent coupling of pederic acid unit with the mycalamine unit. The left-half, (+)-7-benzoylpederic acid, was synthesized from (2R,3R)-3-methylpent-4-en-2-ol in seven steps and 34.6% overall yield through a route that features a one-step Pd(II)-catalyzed tandem Wacker/Heck cyclization reaction to prepare the tetrahydropyran ring system. The right-half, the mycalamine unit, was synthesized in 21 steps and 10.5% overall yield from diethyl d-tartrate. Effective, stereoselective methods were developed for the assembly of the two parts to yield either mycalamide A or C(10)-epi-mycalamide A.

  14. Risk factors for total hip arthroplasty aseptic revision.

    Science.gov (United States)

    Khatod, Monti; Cafri, Guy; Namba, Robert S; Inacio, Maria C S; Paxton, Elizabeth W

    2014-07-01

    The purpose of this study was to evaluate patient, operative, implant, surgeon, and hospital factors associated with aseptic revision after primary THA in patients registered in a large US Total Joint Replacement Registry. A total of 35,960 THAs registered from 4/2001-12/2010 were evaluated. The 8-year survival rate was 96.7% (95% CI 96.4%-97.0%). Females had a higher risk of aseptic revision than males. Hispanic and Asian patients had a lower risk of revision than white patients. Ceramic-on-ceramic, ceramic-on-conventional polyethylene, and metal-on-conventional polyethylene bearing surfaces had a higher risk of revision than metal-on-highly cross-linked polyethylene. Body mass index, health status, diabetes, diagnosis, fixation, approach, bilateral procedures, head size, surgeon fellowship training, surgeon and hospital volume were not revision risk factors. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Total synthesis of solanoeclepin A

    Science.gov (United States)

    Tanino, Keiji; Takahashi, Motomasa; Tomata, Yoshihide; Tokura, Hiroshi; Uehara, Taketo; Narabu, Takashi; Miyashita, Masaaki

    2011-06-01

    Cyst nematodes are troublesome parasites that live on, and destroy, a range of important host vegetable plants. Damage caused by the potato cyst nematode has now been reported in over 50 countries. One approach to eliminating the problem is to stimulate early hatching of the nematodes, but key hatching stimuli are not naturally available in sufficient quantities to do so. Here, we report the first chemical synthesis of solanoeclepin A, the key hatch-stimulating substance for potato cyst nematode. The crucial steps in our synthesis are an intramolecular cyclization reaction for construction of the highly strained tricyclo[5.2.1.01,6]decane skeleton (DEF ring system) and an intramolecular Diels-Alder reaction of a furan derivative for the synthesis of the ABC carbon framework. The present synthesis has the potential to contribute to addressing one of the critical food issues of the twenty-first century.

  16. [The Use of Jumbo Cups in Revision Total Hip Arthroplasty].

    Science.gov (United States)

    von Roth, Philipp; Wassilew, Georgi I

    2017-10-01

    Extra-large uncemented jumbo cups are among the most common methods of acetabular revision. Jumbo cups do not contribute to bone stock restoration, and in the case of a subsequent revision, an even larger bone defect is to be expected. Thus, understanding long-term survival is essential. The present article discusses the literature relevant to this topic and addresses technical and implant-specific characteristics of jumbo cups. In summary, jumbo cups show an acceptable long-term survival rate, with aseptic loosening as the most common reason for revision and dislocation being the most common complication. Through the development of alternative revision systems, jumbo cups have lost their importance in today's practice. However, they can serve as a benchmark for studies of newer technologies in revision total hip arthroplasty. Georg Thieme Verlag KG Stuttgart · New York.

  17. Studies towards a total synthesis of tagetitoxin

    OpenAIRE

    Mahoney, Brian

    2017-01-01

    Tagetitoxin was first isolated over thirty five years ago and a total synthesis has not been achieved to date. A vast amount of research has been carried out on the biological activity of tagetitoxin with hundreds of literature reports. However, very few papers have been published regarding the synthesis and within this thesis we will explore a number of synthetic pathways some towards tagetitoxin. The first chapter reviews previous developments regarding the total synthesis of...

  18. Asymmetric total synthesis of cladosporin and isocladosporin.

    Science.gov (United States)

    Zheng, Huaiji; Zhao, Changgui; Fang, Bowen; Jing, Peng; Yang, Juan; Xie, Xingang; She, Xuegong

    2012-07-06

    The first asymmetric total syntheses of cladosporin and isocladosporin were accomplished in 8 steps with 8% overall yield and 10 steps with 26% overall yield, respectively. The relative configuration of isocladosporin was determined via this total synthesis.

  19. Revision total hip arthoplasty: factors associated with re-revision surgery.

    Science.gov (United States)

    Khatod, Monti; Cafri, Guy; Inacio, Maria C S; Schepps, Alan L; Paxton, Elizabeth W; Bini, Stefano A

    2015-03-04

    The survivorship of implants after revision total hip arthroplasty and risk factors associated with re-revision are not well defined. We evaluated the re-revision rate with use of the institutional total joint replacement registry. The purpose of this study was to determine patient, implant, and surgeon factors associated with re-revision total hip arthroplasty. A retrospective cohort study was conducted. The total joint replacement registry was used to identify patients who had undergone revision total hip arthroplasty for aseptic reasons from April 1, 2001, to December 31, 2010. The end point of interest was re-revision total hip arthroplasty. Risk factors evaluated for re-revision total hip arthroplasty included: patient risk factors (age, sex, body mass index, race, and general health status), implant risk factors (fixation type, bearing surface, femoral head size, and component replacement), and surgeon risk factors (volume and experience). A multivariable Cox proportional hazards model was used. Six hundred and twenty-nine revision total hip arthroplasties with sixty-three (10%) re-revisions were evaluated. The mean cohort age (and standard deviation) was 57.0 ± 12.4 years, the mean body mass index (and standard deviation) was 29.5 ± 6.1 kg/m(2), and most of the patients were women (64.5%) and white (81.9%) and had an American Society of Anesthesiologists score of associated with the risk of re-revision. For every ten-year increase in patient age, the hazard ratio for re-revision decreases by a factor of 0.72 (95% confidence interval, 0.58 to 0.90). For every five revision surgical procedures performed by a surgeon, the risk of revision decreases by a factor of 0.93 (95% confidence interval, 0.86 to 0.99). At the time of revision, a new or retained cemented femoral implant or all-cemented hip implant increases the risk of revision by a factor of 3.19 (95% confidence interval, 1.22 to 8.38) relative to a retained or new uncemented hip implant. A ceramic on a

  20. The Total Synthesis of Cephalosporin C

    Indian Academy of Sciences (India)

    IAS Admin

    The Total Synthesis of Cephalosporin C. Edited by Setty Mallikarjuna Babu and Subramania Ranganathan. Keywords. Cephalosporin C. The Nobel Prize in Chemistry for 1965 has been awarded for contributions to the art of chemical synthesis. It gives me much pleasure to record here my gratification with the citation, ...

  1. The First Total Synthesis of Isoliquiritin

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    A first total synthesis of isoliquiritin was accomplished starting from p-hydroxy- benzaldehyde and 2,4-dihydroxyacetylphenone. The key step is condensation reaction. In synthetic process need not protect the hydroxy group of reacting substance.

  2. The association between metal allergy, total knee arthroplasty, and revision

    DEFF Research Database (Denmark)

    Münch, Henrik J; Jakobsen, Stig Storgaard; Olesen, Jens T

    2015-01-01

    BACKGROUND AND PURPOSE: It is unclear whether delayed-type hypersensitivity reactions against implanted metals play a role in the etiopathogenesis of malfunctioning total knee arthroplasties. We therefore evaluated the association between metal allergy, defined as a positive patch test reaction...... to common metal allergens, and revision surgery in patients who underwent knee arthroplasty. PATIENTS AND METHODS: The nationwide Danish Knee Arthroplasty Register, including all knee-implanted patients and revisions in Denmark after 1997 (n = 46,407), was crosslinked with a contact allergy patch test......, the prevalence of cobalt and chromium allergy was markedly higher. Metal allergy that was diagnosed before implant surgery appeared not to increase the risk of implant failure and revision surgery. INTERPRETATION: While we could not confirm that a positive patch test reaction to common metals is associated...

  3. Total synthesis of (±)-antroquinonol d.

    Science.gov (United States)

    Sulake, Rohidas S; Jiang, Yan-Feng; Lin, Hsiao-Han; Chen, Chinpiao

    2014-11-21

    Total synthesis of (±)-antroquinonol D, which is isolated from very expensive and rarely found Antrodia camphorata and which has potential anticancer properties, was achieved from 4-methoxyphenol. In addition, a Michael addition to dimethoxy cyclohexadienones was studied. The main step involved chelation and substrate-controlled diastereoselective reduction of cyclohexenone and lactonization. Lactone synthesis facilitated the diastereoselective reduction of ketone, which help control the desired stereochemistry at the crucial stereogenic center in the natural product. Other key reactions in the synthesis involved a Michael addition of dimethyl malonate on cyclohexadienone, dihydroxylation, and Wittig olefination. A sesquiterpene side chain was synthesized through coupling with geranyl phenyl sulfide and Bouveault-Blanc reduction.

  4. Total Synthesis of balanol, Part 2

    DEFF Research Database (Denmark)

    Tanner, David Ackland; Kelly, Nicholas; Tedenborg, Lars

    1997-01-01

    A convergent enantioselective total synthesis of the natural product (-)-balanol (1) is described. In addition to benzophenone fragment 8, key intermediates are chiral bicyclic aziridine 3 and the corresponding epoxide 4, both of which undergo highly regio- and stereoselective nucleophilic ring...

  5. Total synthesis of insect antifeedant drimane sesquiterpenes

    NARCIS (Netherlands)

    Jansen, B.J.M.

    1993-01-01

    The investigations described in this thesis deal with the total synthesis of sesquiterpenes of the drimane family, named for their widespread occurrence in the stem bark of South American Drimys species. These compounds contain the bicyclofarnesol nucleus

  6. Efficient total synthesis of (S)-14-azacamptothecin.

    Science.gov (United States)

    Liu, Guan-Sai; Yao, Yuan-Shan; Xu, Peng; Wang, Shaozhong; Yao, Zhu-Jun

    2010-06-01

    An efficient total synthesis of (S)-14-azacamptothecin has been accomplished in 10 steps and 56% overall yield from 5H-pyrano[4,3-d]pyrimidine 8. A mild Hendrickson reagent-triggered intramolecular cascade cyclization, a highly enantioselective dihydroxylation, and an efficient palladium-catalyzed transformation of an O-allyl into N-allyl group are the key steps in the synthesis. This work provides a much higher overall yield than the previous achievement and shows sound flexibility for the further applications that will lead to new bioactive analogues.

  7. The First Total Synthesis of Dragmacidin D

    OpenAIRE

    Garg, Neil K.; Sarpong, Richmond; Stoltz, Brian M.

    2002-01-01

    The first total synthesis of the biologically significant bis-indole alkaloid dragmacidin D (5) has been achieved. Thermal and electronic modulation provides the key for a series of palladium-catalyzed Suzuki cross-coupling reactions that furnished the core structure of the complex guanidine- and aminoimidazole-containing dragmacidins. Following this crucial sequence, a succession of meticulously controlled final events was developed leading to the completion of the natural product.

  8. Total synthesis of (+)-antroquinonol and (+)-antroquinonol D.

    Science.gov (United States)

    Sulake, Rohidas S; Chen, Chinpiao

    2015-03-06

    The first total synthesis of (+)-antroquinonol and (+)-antroquinonol D, two structurally unique quinonols with a sesquiterpene side chain, is described. The route features an iridium-catalyzed olefin isomerization-Claisen rearrangement reaction (ICR), lactonization, and Grubbs olefin metathesis. The requisite α,β-unsaturation was achieved via the selenylation/oxidation protocol and elimination of β-methoxy group to provide two natural products from a common intermediate.

  9. Revision of failed shoulder hemiarthroplasty to reverse total arthroplasty: analysis of 157 revision implants.

    Science.gov (United States)

    Merolla, Giovanni; Wagner, Eric; Sperling, John W; Paladini, Paolo; Fabbri, Elisabetta; Porcellini, Giuseppe

    2018-01-01

    There remains a paucity of studies examining the conversion of failed hemiarthroplasty (HA) to reverse total shoulder arthroplasty (RTSA). Therefore, the purpose of this study was to examine a large series of revision HA to RTSA. A population of 157 patients who underwent conversion of a failed HA to a revision RTSA from 2006 through 2014 were included. The mean follow-up was 49 months (range, 24-121 months). The indications for revision surgery included instability with rotator cuff insufficiency (n = 127) and glenoid wear (n = 30); instability and glenoid wear were associated in 38 cases. Eight patients with infection underwent 2-stage reimplantation. Patients experienced significant improvements in their preoperative to postoperative pain and shoulder range of motion (P surgeries, secondary to glenoid component loosening (n = 3), instability (n = 3), humeral component disassembly (n = 2), humeral stem loosening (n = 1), and infection (n = 2). Implant survivorship was 95.5% at 2 years and 93.3% at 5 years. There were 4 reoperations including axillary nerve neurolysis (n = 2), heterotopic ossification removal (n = 1), and hardware removal for rupture of the metal cerclage for an acromial fracture (n = 1). At final follow-up, there were 5 "at-risk" glenoid components. Patients experience satisfactory pain relief and recovery of reasonable shoulder function after revision RTSA from a failed HA. There was a relatively low revision rate, with glenoid loosening and instability being the most common causes. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  10. The association between metal allergy, total hip arthroplasty, and revision

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Jakobsen, Stig Storgaard; Engkilde, Kåre

    2009-01-01

    BACKGROUND AND PURPOSE: It has been speculated that the prevalence of metal allergy may be higher in patients with implant failure. We compared the prevalence and cause of revisions following total hip arthroplasty (THA) in dermatitis patients suspected to have contact allergy and in patients...... in general with THA. Furthermore, we compared the prevalence of metal allergy in dermatitis patients with and without THA. MATERIALS AND METHODS: The Danish Hip Arthroplasty Registry (DHAR) contained detailed information on 90,697 operations. The Gentofte patch-test database contained test results...... was similar in cases (12%) and in patients from the DHAR (13%). The prevalence of metal allergy was similar in cases and controls. However, the prevalence of metal allergy was lower in cases who were patch-tested after operation (6%) than in those who were patch-tested before operation (16%) (OR = 2.9; 95% CI...

  11. Total synthesis and biological investigation of (-)-promysalin.

    Science.gov (United States)

    Steele, Andrew D; Knouse, Kyle W; Keohane, Colleen E; Wuest, William M

    2015-06-17

    Compounds that specifically target pathogenic bacteria are greatly needed, and identifying the method by which they act would provide new avenues of treatment. Herein we report the concise, high-yielding total synthesis (eight steps, 35% yield) of promysalin, a natural product that displays antivirulence phenotypes against pathogenic bacteria. Guided by bioinformatics, four diastereomers were synthesized, and the relative and absolute stereochemistries were confirmed by spectral and biological analysis. Finally, we show for the first time that promysalin displays two antivirulence phenotypes: the dispersion of mature biofilms and the inhibition of pyoverdine production, hinting at a unique pathogenic-specific mechanism of action.

  12. First total synthesis of (-)-AL-2.

    Science.gov (United States)

    Miyakoshi, Naoki; Mukai, Chisato

    2003-06-26

    Treatment of the 3,4-dioxygenated-9-hydroxy-1-nonyn-5-one derivative, derived from diethyl l-tartrate, with a palladium catalyst in methanol under a CO atmosphere effected an intramolecular acetalization and a stereoselective construction of the (E)-methoxycarbonylmethylidene functionality resulting in formation of the core framework of the diacetylenic spiroacetal enol ether natural products. Chemical transformations of the 1,6-dioxaspiro[4.5]decane derivative thus formed led to the first total synthesis of (-)-AL-2. [reaction: see text

  13. Total synthesis, structure, and oral absorption of a thiazole cyclic peptide, sanguinamide A

    DEFF Research Database (Denmark)

    Nielsen, Daniel S; Hoang, Huy N; Lohman, Rink-Jan

    2012-01-01

    The first total synthesis and three-dimensional solution structure are reported for sanguinamide A, a thiazole-containing cyclic peptide from the sea slug H. sanguineus. Solution phase fragment synthesis, solid phase fragment assembly, and solution macrocyclization were combined to give (1) in 10......% yield. Spectral properties were identical for the natural product, requiring revision of its structure from (2) to (1). Intramolecular transannular hydrogen bonds help to bury polar atoms, which enables oral absorption from the gut....

  14. Total synthesis of the putative structure of the novel triquinane natural product isocapnellenone

    OpenAIRE

    Mehta, Goverdhan; Murthy, Sai Krishna A; Umarye, Jayant D

    2002-01-01

    A total synthesis of the ‘putative structure’ 7, attributed to the novel triquinane sesquiterpene isolated recently from two Buddelia species has been accomplished. The spectral data for 7 is a complete mismatch with those reported for the natural product and warrants a revision of the assigned structure.

  15. Revision of reversed total shoulder arthroplasty. Indications and outcome

    Directory of Open Access Journals (Sweden)

    Farshad Mazda

    2012-08-01

    Full Text Available Abstract Background The complications of reversed total shoulder arthroplasty (RTSA requiring an additional intervention, their treatment options and outcome are poorly known. It was therefore the purpose of this retrospective study, to identify the reasons for revision of RTSA and to report outcomes. Methods Four hundred and forty-one performed RTSA implanted between 1999 and 2008 were screened. Sixty-seven of these cases had an additional intervention to treat a complication. Causes were identified in these 67 cases and the outcome of the first 37 patients who could be followed for more than two years after their first additional intervention was analyzed. Results Of 441 RTSA, 67 cases (15% needed at least one additional intervention to treat a complication, 30 of them needed a second, eleven a third and four a fourth additional intervention. The most common complication requiring a first intervention was instability (18% followed by hematoma or superficial wound complications (15% and complications of the glenoid component (12%. Patients benefitted from RTSA despite the need of additional interventions as indicated by a mean increase in total Constant-Murley score from 23 points before RTSA to 46 points at final follow-up (p  Conclusions Instability, hematoma or superficial wound complications and complications of the glenoid component are the most common reasons for an additional intervention after RTSA. Patients undergoing an additional intervention as treatment of these complications profit significantly as long as the prosthesis remains in place.

  16. Total Synthesis of (-)-Salvinorin A.

    Science.gov (United States)

    Line, Nathan J; Burns, Aaron C; Butler, Sean C; Casbohm, Jerry; Forsyth, Craig J

    2016-12-12

    Salvinorin A (1) is natural hallucinogen that binds the human κ-opioid receptor. A total synthesis has been developed that parlays the stereochemistry of l-(+)-tartaric acid into that of (-)-1 via an unprecedented allylic dithiane intramolecular Diels-Alder reaction to obtain the trans-decalin scaffold. Tsuji allylation set the C9 quaternary center and a late-stage stereoselective chiral ligand-assisted addition of a 3-titanium furan upon a C12 aldehyde/C17 methyl ester established the furanyl lactone moiety. The tartrate diol was finally converted into the C1,C2 keto-acetate. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. Poorer survival after a primary implant during revision total knee arthroplasty

    NARCIS (Netherlands)

    Meijer, Marrigje F.; Reininga, Inge H. F.; Boerboom, Alexander L.; Stevens, Martin; Bulstra, Sjoerd K.

    Revision total knee arthroplasty (rTKA) is a complex procedure. Depending on the degree of ligament and bone damage, either primary or revision implants are used. The purpose of this study was to compare survival rates of primary implants with revision implants when used during rTKA. A retrospective

  18. Closed Incision Negative Pressure Therapy Versus Standard of Care Surgical Dressing in Revision Total Knee Arthroplasty

    Science.gov (United States)

    2018-06-07

    Surgical Wound; Revision Total Knee Arthroplasty; Wounds and Injuries; Joint Disease; Musculoskeletal Disease; Prosthesis-Related Infections; Infection; Postoperative Complications; Pathologic Processes

  19. Current Epidemiology of Revision Total Knee Arthroplasty in the United States.

    Science.gov (United States)

    Delanois, Ronald E; Mistry, Jaydev B; Gwam, Chukwuweike U; Mohamed, Nequesha S; Choksi, Ujval S; Mont, Michael A

    2017-09-01

    Revision surgery for failed total knee arthroplasty (TKA) continues to pose a substantial burden for the United States healthcare system. The predominant etiology of TKA failure has changed over time and may vary between studies. This report aims to update the current literature on this topic by using a large national database. Specifically, we analyzed: (1) etiologies for revision TKA; (2) frequencies of revision TKA procedures; (3) various demographics including payer type and region; and (4) the length of stay (LOS) and total charges based on type of revision TKA procedure. The Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) database was used to identify all revision TKA procedures performed between 2009 and 2013. Clinical, economic, and demographic data were collected and analyzed for 337,597 procedures. Patients were stratified according to etiology of failure, age, sex, race, US census region, and primary payor class. The mean LOS and total charges were also calculated. Infection was the most common etiology for revision TKA (20.4%), closely followed by mechanical loosening (20.3%). The most common revision TKA procedure performed was all component revision (31.3%). Medicare was the primary payor for the greatest proportion of revisions (57.7%). The South census region performed the most revision TKAs (33.2%). The overall mean LOS was 4.5 days, with arthrotomy for removal of prosthesis without replacement procedures accounting for the longest stays (7.8 days). The mean total charge for revision TKAs was $75,028.07. Without appropriate measures in place, the burden of revision TKAs may become overwhelming and pose a strain on providers and institutions. Continued insight into the etiology and epidemiology of revision TKAs may be the principle step towards improving outcomes and mitigating the need for future revisions. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. 75 FR 42440 - Total Coliform Rule Revisions-Notice of Public Information Meetings

    Science.gov (United States)

    2010-07-21

    ... will be discussed include the cost and benefit information of the proposed rule and the planned... ENVIRONMENTAL PROTECTION AGENCY [FRL-9177-6] Total Coliform Rule Revisions--Notice of Public... Protection Agency (EPA) is hosting public information meetings on the proposed Revised Total Coliform Rule...

  1. 78 FR 10269 - National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule

    Science.gov (United States)

    2013-02-13

    ... Illness CWS--Community Water System DBP--Disinfection Byproduct DWC--Drinking Water Committee EA--Economic... 141 and 142 National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule; Final...-9684-8] RIN 2040-AD94 National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule...

  2. Revision total knee arthroplasty with the use of trabecular metal cones

    DEFF Research Database (Denmark)

    Jensen, Claus L; Petersen, Michael Mygind; Schrøder, Henrik

    2012-01-01

    "Trabecular Metal Cone" (TM Cone) (Zimmer, Inc, Warsaw, Ind) for reconstruction of bone loss in the proximal tibia during revision total knee arthroplasty is now optional. Forty patients were randomized to receive revision total knee arthroplasty with or without TM Cone (No TM Cone). The Anderson...

  3. Smoking is associated with earlier time to revision of total knee arthroplasty.

    Science.gov (United States)

    Lim, Chin Tat; Goodman, Stuart B; Huddleston, James I; Harris, Alex H S; Bhowmick, Subhrojyoti; Maloney, William J; Amanatullah, Derek F

    2017-10-01

    Smoking is associated with early postoperative complications, increased length of hospital stay, and an increased risk of revision after total knee arthroplasty (TKA). However, the effect of smoking on time to revision TKA is unknown. A total of 619 primary TKAs referred to an academic tertiary center for revision TKA were retrospectively stratified according to the patient smoking status. Smoking status was then analyzed for associations with time to revision TKA using a Chi square test. The association was also analyzed according to the indication for revision TKA. Smokers (37/41, 90%) have an increased risk of earlier revision for any reason compared to non-smokers (274/357, 77%, p=0.031). Smokers (37/41, 90%) have an increased risk of earlier revision for any reason compared to ex-smokers (168/221, 76%, p=0.028). Subgroup analysis did not reveal a difference in indication for revision TKA (p>0.05). Smokers are at increased risk of earlier revision TKA when compared to non-smokers and ex-smokers. The risk for ex-smokers was similar to that of non-smokers. Smoking appears to have an all-or-none effect on earlier revision TKA as patients who smoked more did not have higher risk of early revision TKA. These results highlight the need for clinicians to urge patients not to begin smoking and encourage smokers to quit smoking prior to primary TKA. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Collagen synthesis in CBA mouse heart after total thoracic irradiation

    International Nuclear Information System (INIS)

    Murray, J.C.; Parkins, C.S.; Institute of Cancer Research, Sutton

    1988-01-01

    CBA mice were irradiated to the whole thorax with single doses of 240 kVp X-rays in the dose range 8-16 Gy. Collagen and total protein synthesis rates in the heart were measured at 2-monthly intervals using a radio-isotope incorporation techniques. Doses of 10 Gy or greater caused a slight increase in collagen synthesis, followed by significantly reduced collagen synthesis by 16 weeks or longer after treatment. The depression in synthesis appeared correspondingly earlier with increasing dose. Total protein synthesis in heart followed similar patterns although changes were not statistically significant, indicating that the changes reflected alterations to collagen synthesis specifally, and not protein synthesis in geneal. Total hydroxyproline measurements showed no significant changes in heart collagen at any time as a result of X-irradiation. 18 refs.; 7 figs

  5. Total synthesis of sannanine and analogues thereof

    Indian Academy of Sciences (India)

    BADHER NAVEEN

    2018-03-02

    Mar 2, 2018 ... further characterized HRMS and IR spectral analysis. For all the newly synthesized by solid ..... Burst in a Model of Gouty Arthritis J. Nat. Prod. 70. 936. 3. ... Synthesis, Spectroscopic Characterisation, X-ray Struc- ture and DFT ...

  6. Total synthesis of (±)-divanillyltetrahydrofuran ferulate

    Indian Academy of Sciences (India)

    Administrator

    College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao 266042, China ... Synthesis; sesquilignan; stobbe reaction; divanillyltetrahydrofuran ferulate. 1. .... 500 MHz) δ: 2⋅44−2⋅50 (m, 4H, 2 × ArCH2CH),.

  7. Predictors of revision, prosthetic joint infection and mortality following total hip or total knee arthroplasty in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Cordtz, Rene Lindholm; Zobbe, Kristian; Højgaard, Pil

    2018-01-01

    OBJECTIVES: To investigate predictors of 10-year risk of revision and 1-year risk of prosthetic joint infection (PJI) and death following total hip/total knee arthroplasty (THA/TKA) in (1) patients with rheumatoid arthritis (RA) compared with patients with osteoarthritis (OA); and (2) patients...

  8. 75 FR 18205 - Total Coliform Rule Revisions-Notice of Stakeholder Meeting

    Science.gov (United States)

    2010-04-09

    ... ENVIRONMENTAL PROTECTION AGENCY [FRL-9135-8] Total Coliform Rule Revisions--Notice of Stakeholder... that EPA conduct stakeholder outreach as the Agency develops the proposed revisions. Today, EPA is...; opportunities for stakeholders to provide feedback on assessment and corrective action guidance related to the...

  9. The total synthesis of calcium atorvastatin.

    Science.gov (United States)

    Dias, Luiz C; Vieira, Adriano S; Barreiro, Eliezer J

    2016-02-21

    A practical and convergent asymmetric route to calcium atorvastatin (1) is reported. The synthesis of calcium atorvastatin (1) was performed using the remote 1,5-anti asymmetric induction in the boron-mediated aldol reaction of β-alkoxy methylketone (4) with pyrrolic aldehyde (3) as a key step. Calcium atorvastatin was obtained from aldehyde (3) after 6 steps, with a 41% overall yield.

  10. Age and Early Revision After Primary Total Hip Arthroplasty for Osteoarthritis.

    Science.gov (United States)

    Meyer, Zachary; Baca, Geneva; Rames, Richard; Barrack, Robert; Clohisy, John; Nam, Denis

    2017-11-01

    Prior reports have noted an increased risk of early revision among younger patients undergoing total hip arthroplasty (THA) but have been confounded by the inclusion of various diagnoses. The purpose of this study was to assess the revision rate and the time to revision for patients undergoing THA for osteoarthritis based on age. Patients with a diagnosis of osteoarthritis who underwent both primary and revision THA at the same institution were identified. The time between primary and revision surgery and the indication for revision were collected. Patients were stratified into 2 groups based on age at the time of primary THA: 64 years or younger (group 1) or 65 years or older (group 2). Between 1996 and 2016, a total of 4662 patients (5543 hips) underwent primary THA for a diagnosis of osteoarthritis. Of these, 100 patients (104 hips) received a revision THA (62 in group 1 and 42 in group 2). Mean age was 52.7±8.4 years in group 1 vs 73.4±6.3 years in group 2 (Pprimary to revision surgery was 3.0±3.2 years for group 1 and 1.1±2.1 years for group 2 (P=.001). Among patients undergoing primary THA for a diagnosis of osteoarthritis, younger age is not associated with an increased rate of early failure or revision. [Orthopedics. 2017; 40(6):e1069-e1073.]. Copyright 2017, SLACK Incorporated.

  11. Risk factors for revision of primary total hip arthroplasty: a systematic review

    Directory of Open Access Journals (Sweden)

    Prokopetz Julian JZ

    2012-12-01

    Full Text Available Abstract Background Numerous papers have been published examining risk factors for revision of primary total hip arthroplasty (THA, but there have been no comprehensive systematic literature reviews that summarize the most recent findings across a broad range of potential predictors. Methods We performed a PubMed search for papers published between January, 2000 and November, 2010 that provided data on risk factors for revision of primary THA. We collected data on revision for any reason, as well as on revision for aseptic loosening, infection, or dislocation. For each risk factor that was examined in at least three papers, we summarize the number and direction of statistically significant associations reported. Results Eighty-six papers were included in our review. Factors found to be associated with revision included younger age, greater comorbidity, a diagnosis of avascular necrosis (AVN as compared to osteoarthritis (OA, low surgeon volume, and larger femoral head size. Male sex was associated with revision due to aseptic loosening and infection. Longer operating time was associated with revision due to infection. Smaller femoral head size was associated with revision due to dislocation. Conclusions This systematic review of literature published between 2000 and 2010 identified a range of demographic, clinical, surgical, implant, and provider variables associated with the risk of revision following primary THA. These findings can inform discussions between surgeons and patients relating to the risks and benefits of undergoing total hip arthroplasty.

  12. Bioball universal modular neck adapter as a salvage for failed revision total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Raju Vaishya

    2013-01-01

    Full Text Available Management of recurrent dislocation of total hip arthroplasty is often a challenging and daunting task. Re-revision of such a total hip prosthesis may not be easy as the removal of a well-fixed, fully coated stem is extremely difficult. We managed to salvage instability in three revision hip cases in which the fully coated stem had subsided by using a bioball universal neck adapter without changing the femoral stem or acetabular cup.

  13. Managing infection in the revision total hip replacement patient.

    Science.gov (United States)

    Halley, D K

    1993-01-01

    Deep infection is one of the most devastating complications in total hip replacement. This dreaded complication is presented in considerable detail with special emphasis on prevention, diagnosis, and various methods of surgical and antibiotic treatment. Basic fundamentals of antibiotic therapy are reviewed. In addition, guidelines are given for the indications of surgical intervention, the type and staging of operative procedures, with detailed techniques of the various operative procedures used to treat the infected total hip implant patient.

  14. The Catalytic Enantioselective Total Synthesis of (+)‐Liphagal

    DEFF Research Database (Denmark)

    Day, Joshua J.; McFadden, Ryan M.; Virgil, Scott C.

    2011-01-01

    Ring a ding: The first catalytic enantioselective total synthesis of the meroterpenoid natural product (+)-liphagal is disclosed. The approach showcases a variety of technology including enantioselective enolate alkylation, a photochemical alkyne-alkene [2+2] reaction, microwaveassisted metal...

  15. International survey of primary and revision total knee replacement

    NARCIS (Netherlands)

    Kurtz, Steven M.; Ong, Kevin L.; Lau, Edmund; Widmer, Marcel; Maravic, Milka; Gomez-Barrena, Enrique; de Pina, Maria de Fatima; Manno, Valerio; Torre, Marina; Walter, William L.; de Steiger, Richard; Geesink, Rudolph G. T.; Peltola, Mikko; Roeder, Christoph

    2011-01-01

    Total knee arthroplasty (TKA) is currently the international standard of care for treating degenerative and rheumatologic knee joint disease, as well as certain knee joint fractures. We sought to answer the following three research questions: (1) What is the international variance in primary and

  16. Total Quality Management (TQM) Awareness Seminar. Revision 8

    Science.gov (United States)

    1990-04-18

    is underway. * Balances of power are shifting. * What you don’t know can hurt you. E.g., the real rate of obsolescence in equipment and methods has...us with skiled labor. 0 1-6 TOTAL QUALITY MANAGEMENT Awareness Seminar Problems (continued) Trade Deficit. From positive trade balance in 1980 to $154...repair assessment to obtain customer feedback. - Established a Quality of Worklife Committee. * IRS. Ogden Service Center - Adopted Juran approach to

  17. Asymmetric Total Synthesis of Ieodomycin B

    Directory of Open Access Journals (Sweden)

    Shuangjie Lin

    2017-01-01

    Full Text Available Ieodomycin B, which shows in vitro antimicrobial activity, was isolated from a marine Bacillus species. A novel asymmetric total synthetic approach to ieodomycin B using commercially available geraniol was achieved. The approach involves the generation of 1,3-trans-dihydroxyl at C-3 and C-5 positions via a Crimmins-modified Evans aldol reaction and a chelation-controlled Mukaiyama aldol reaction of a p-methoxybenzyl-protected aldehyde, as well as the generation of a lactone ring in a deprotection–lactonization one-pot reaction.

  18. Total Synthesis and Absolute Configuration of the Marine Norditerpenoid Xestenone

    Directory of Open Access Journals (Sweden)

    Hiroaki Miyaoka

    2009-11-01

    Full Text Available Xestenone is a marine norditerpenoid found in the northeastern Pacific sponge Xestospongia vanilla. The relative configuration of C-3 and C-7 in xestenone was determined by NOESY spectral analysis. However the relative configuration of C-12 and the absolute configuration of this compound were not determined. The authors have now achieved the total synthesis of xestenone using their developed one-pot synthesis of cyclopentane derivatives employing allyl phenyl sulfone and an epoxy iodide as a key step. The relative and absolute configurations of xestenone were thus successfully determined by this synthesis.

  19. Total synthesis of the proposed structure of trichodermatide A.

    Science.gov (United States)

    Myers, Eddie; Herrero-Gómez, Elena; Albrecht, Irina; Lachs, Jennifer; Mayer, Peter; Hanni, Matti; Ochsenfeld, Christian; Trauner, Dirk

    2014-10-17

    A short total synthesis of the published structure of racemic trichodermatide A is reported. Our synthesis involves a Knoevenagel condensation/Michael addition sequence, followed by the formation of tricyclic hexahydroxanthene-dione and a diastereoselective bis-hydroxylation. The final product, the structure of which was confirmed by X-ray crystallography, has NMR spectra that are very similar, but not identical, to those of the isolated natural product. Quantum chemically computed (13)C shifts agree well with the present NMR measurements.

  20. Midterm Clinical and Radiographic Results of Mobile-Bearing Revision Total Knee Arthroplasty.

    Science.gov (United States)

    Kim, Raymond H; Martin, J Ryan; Dennis, Douglas A; Yang, Charlie C; Jennings, Jason M; Lee, Gwo-Chin

    2017-06-01

    Constrained implants are frequently required in revision total knee arthroplasty (TKA) and are associated with an increase in aseptic component loosening and damage or wear to the constraining mechanisms, compared with primary TKA. The purpose of the following study was to evaluate the midterm clinical and radiographic results including the incidence of bearing complications in a group of patients undergoing revision TKA using mobile-bearing revision TKA implants. We retrospectively reviewed 316 consecutive mobile-bearing revision TKAs performed at 2 centers between 2006 and 2010. There were 183 women and 133 men with a mean age of 66 years. The patients were evaluated clinically using the Knee Society scores. A radiographic analysis was performed. Bearing specific complications (ie, instability or dislocation) were recorded. Patients were followed-up for a minimum of 24 months and a median of 59.88 months (range 24-121.2). The average Knee Society knee score and function scores increased from 40.8 and 47.9 points preoperatively to 80 points and 70.3 points, respectively (P bearing complications were observed. Revision TKA using mobile-bearing revision components demonstrated favorable midterm clinical and radiographic results with no occurrence of bearing instability or dislocation. Longer follow-up is required to evaluate for potential advantages of mobile-bearings over fixed-bearing revision components in terms of polyethylene wear reduction, reduced stress transmission across fixation interfaces, and reduced stress on the polyethylene post. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Increased risk of revision for infection in rheumatoid arthritis patients with total hip replacements

    DEFF Research Database (Denmark)

    Schrama, Johannes Cornelis; Fenstad, Anne M; Dale, Håvard

    2015-01-01

    Background and purpose-Medical treatment of rheumatoid arthritis (RA) has changed dramatically over the last 15 years, including immune modulation. We investigated the risk of revision for infection after primary total hip replacement (THR) in patients with rheumatoid arthritis over a 16-year...... period, and compared it with that in THR patients with osteoarthritis (OA).Patients and methods-We identified 13,384 THRs in RA patients and 377,287 THRs in OA patients from 1995 through 2010 in a dataset from the Nordic Arthroplasty Register Association (NARA). Kaplan-Meier survival curves......, with revision for infection as the endpoint, were constructed. Cox regression analyses were performed to calculate the relative risk (RR) of revision for infection adjusted for age, sex, fixation technique, and year of primary surgery.Results-RA patients had a 1.3 times (95% CI 1.0-1.6) higher risk of revision...

  2. Strategies for reducing implant costs in the revision total knee arthroplasty episode of care.

    Science.gov (United States)

    Elbuluk, Ameer M; Old, Andrew B; Bosco, Joseph A; Schwarzkopf, Ran; Iorio, Richard

    2017-12-01

    Implant price has been identified as a significant contributing factor to high costs associated with revision total knee arthroplasty (rTKA). The goal of this study is to analyze the cost of implants used in rTKAs and to compare this pricing with 2 alternative pricing models. Using our institutional database, we identified 52 patients from January 1, 2014 to December 31, 2014. Average cost of components for each case was calculated and compared to the total hospital cost for that admission. Costs for an all-component revision were then compared to a proposed "direct to hospital" (DTH) standardized pricing model and a fixed price revision option. Potential savings were calculated from these figures. On average, 28% of the total hospital cost was spent on implants for rTKA. The average cost for revision of all components was $13,640 and ranged from $3000 to $28,000. On average, this represented 32.7% of the total hospital cost. Direct to hospital implant pricing could potentially save approximately $7000 per rTKA, and the fixed pricing model could provide a further $1000 reduction per rTKA-potentially saving $8000 per case on implants alone. Alternative implant pricing models could help lower the total cost of rTKA, which would allow hospitals to achieve significant cost containment.

  3. The First Total Synthesis of Triprenylquinone and Hydroquinones

    Institute of Scientific and Technical Information of China (English)

    Chun Hong LI; Xue Song CHEN; Guang Lian ZHOU; Zhi Xiang XIE; Ying LI

    2005-01-01

    First total synthesis of triprenylquinone and hydroquinones, three naturally occurring compound 1, 2 and (±) 3, have been achieved from readily available 2-bromo-5-methyl-1,4-dimethoxybenzene 4 and geranyl bromide. The triprenylquinone and hydroquinones precursor were readily prepared with use of a Julia reaction.

  4. The total synthesis of 3Beta-hydroxynagilactone F

    NARCIS (Netherlands)

    Reuvers, J.T.A.

    1985-01-01

    The investigations described in this thesis deal with the total synthesis of physiologically active nor- and bisnorditerpenoid dilactones (fig.1).

    The goal was to design a synthetic route for this class of natural products and

  5. Total synthesis of putative 11-epi-lyngbouilloside aglycon

    Directory of Open Access Journals (Sweden)

    Amandine Kolleth

    2016-08-01

    Full Text Available We report here the total synthesis of 11-epi-lyngbouilloside aglycon. Our strategy features a Boeckman-type esterification followed by a RCM to form the 14-membered ring macrolactone and a late-stage side chain introduction via a Wittig olefination. Overall, the final product was obtained in 20 steps and 2% overall yield starting from commercially available 3-methyl-but-3-enol. Most importantly, the strategy employed is versatile enough to eventually allow us to complete the synthesis of the natural product and irrevocably confirm its structure.

  6. Satisfactory Results of the Exeter Revision Femoral Stem Used for Primary Total Hip Arthroplasty.

    Science.gov (United States)

    Desy, Nicholas M; Johnson, Joshua D; Sierra, Rafael J

    2017-02-01

    The Exeter cemented femoral stem has demonstrated excellent clinical and radiographic outcomes as well as long-term survivorship free from aseptic loosening. A shorter revision stem (125 mm) with a 44 offset became available for the purpose of cement-in-cement revision situations. In certain cases, this shorter revision stem may be used for various primary total hip arthroplasties (THAs) where the standard length stem would require distally reaming the femoral canal. We sought to report on the early to midterm results of this specific stem when used for primary THA regarding (1) clinical and radiographic outcomes, (2) complications, and (3) survivorship. Twenty-nine patients (33 hips) underwent a hybrid THA using the smaller revision Exeter cemented femoral stem. Twenty-five patients (28 hips) had at least 2 years of follow-up and were assessed for clinical and radiographic outcomes. All 33 hips were included in the analysis of complications and survivorship. The Kaplan-Meier survivorship was performed using revision for all causes and for aseptic loosening as the end points. The average clinical follow-up was 4 years (range, 2-7). Harris Hip Scores improved from a mean preoperative value of 56 (range, 23-96) to 90 (range, 51-100) at the latest follow-up. All patients demonstrated superior cement mantles with no signs of loosening. One patient suffered a B2 periprosthetic fracture and 1 patient experienced 2 episodes of instability. The 5-year Kaplan-Meier survivorship was 96.7% for all causes of revision and was 100% using aseptic loosening as the end point. The shorter Exeter revision cemented femoral stem has favorable early to midterm clinical and radiographic outcomes when used for primary THA with a low complication rate and is a viable option in patients with narrow femoral canals where uncemented stem fixation is not desired. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Are Bundled Payments a Viable Reimbursement Model for Revision Total Joint Arthroplasty?

    Science.gov (United States)

    Courtney, P Maxwell; Ashley, Blair S; Hume, Eric L; Kamath, Atul F

    2016-12-01

    Alternative payment models, such as the Centers for Medicare & Medicaid Services (CMS) Bundled Payment for Care Improvement (BPCI) initiative, aim to decrease overall costs for hip and knee arthroplasties. We asked: (1) Is there any difference in the CMS episode-of-care costs, hospital length of stay, and readmission rate from before and after implementation of our bundled-payment program? (2) Is there any difference in reimbursements and resource utilization between revision THA and TKA at our institution? (3) Are there any independent risk factors for patients with high costs who may not be appropriate for a bundled-payment system for revision total joint arthroplasty (TJA)? Between October 2013 and March 2015, 218 patients underwent revision TKA or THA in one health system. Two hundred seventeen patients were reviewed as part of this study, and one patient with hemophilia was excluded from the analysis as an outlier. Our institution began a BPCI program for revision TJA during this study period. Patients' procedures done before January 1, 2014 at one hospital and January 1, 2015 at another hospital were not included in the bundled-care arrangement (70 revision TKAs and 56 revision THAs), whereas 50 revision TKAs and 41 revision THAs were performed under the BPCI initiative. Patient demographics, medical comorbidities, episode-of-care reimbursement data derived directly from CMS, length of stay, and readmission proportions were compared between the bundled and nonbundled groups. Length of stay in the group that underwent surgery before the bundled-care arrangement was longer than for patients whose procedures were done under the BPCI (mean 4.02 [SD, 3.0 days] versus mean 5.27 days [SD, 3.6 days]; p = 0.001). Index hospitalization reimbursement for the bundled group was less than for the nonbundled group (mean USD 17,754 [SD, USD 2741] versus mean USD 18,316 [SD, USD 4732]; p = 0.030). There was no difference, with the numbers available, in total episode

  8. Total hip arthroplasty revision due to infection: a cost analysis approach.

    Science.gov (United States)

    Klouche, S; Sariali, E; Mamoudy, P

    2010-04-01

    The treatment of total hip arthroplasty (THA) infections is long and costly. However,the number of studies in the literature analysing the real cost of THA revision in relation to their etiology, including infection, is limited. The aim of this retrospective study was to determine the cost of revision of infected THA and to compare these costs to those of primary THA and revision of non-infected THA. We performed a retrospective cost analysis for the year 2006 using an identical analytic accounting system in each hospital department (according to internal criteria) based on allotment of direct costs and receipts for each department. From January to December 2006, 424 primary THA, 57 non-infected THA revisions and 40 THA revisions due to infection were performed. The different cost areas of the patient's treatment were identified.This included preoperative medical work-up, medicosurgical management during hospital stay,a second stay in an orthopedic rehabilitation hospital (ORH) and post-hospitalisation antibiotic therapy after revision due to infection, as well as home-based hospitalisation (HH) costs, if this was the selected alternative option. We used the national health insurance fee schedule found in the "Common classification of medical procedures" and the "General nomenclature of professional procedures" applicable in France since September 1, 2005. Hospital costs included direct costs (hospital overhead costs) and indirect costs, (medical, surgical, technical settings and net general service expenses). The calculation of HH costs and ORH costs were based on the average daily charge of these departments. The cost of primary THA was used as the reference.We then compared our surgical costs with those found for the corresponding comparable hospital stay groups (Groupes homogènes de séjour). The average hospital stay (AHS) was 7.5 +/- 1.8 days for primary THA, 8.9 +/- 2.2 days for non-infected revisions and 30.6 +/- 14.9 days for revisions due to infection

  9. Synthesis of derivatives of tetronic acid and pulvinic acid. Total synthesis of norbadione A

    International Nuclear Information System (INIS)

    Mallinger, A.

    2008-11-01

    When vegetables like mushrooms are contaminated by radioactive caesium 137, this radioactive caesium is associated to norbadione A, a natural pigment present in two mushroom species and which can be used as a caesium decorporation agent or maybe as protection agent against ionizing radiations. Within this perspective, this research report describes the biosynthesis and the structure and properties of the norbadione A and of pulvinic acids (physicochemical properties, anti-oxidizing properties). Then, it presents the various tetronic acids (3-acyl-, 3-alkyl-, 3-alkoxy-, 3-aryl-tetronic acids and non 3-substituted tetronic acids), their synthesis path as they are described in the literature, and presents a new synthesis approach using a tandem reaction (with different esters or hydroxy esters) and the synthesis of tetronic acids. The author also proposes a new synthesis way for methyl pulvinates, and finally reports the work on the development of a total synthesis of the norbadione A

  10. What Is the Impact of Smoking on Revision Total Knee Arthroplasty?

    Science.gov (United States)

    Bedard, Nicholas A; Dowdle, S Blake; Wilkinson, Brandon G; Duchman, Kyle R; Gao, Yubo; Callaghan, John J

    2018-07-01

    There is a paucity of literature evaluating the impact of smoking on revision arthroplasty procedures. The purpose of this study was to identify the effect of smoking on complications after revision total knee arthroplasty (rTKA). We queried the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database to identify patients who underwent rTKA between 2006 and 2014. Patients were divided into current smokers and nonsmokers according to the NSQIP definitions. Each cohort was compared in terms of demographic data, preoperative comorbidities, and operative time. Infection end points were created from composite surgical site infection variables defined by the NSQIP database. Multivariate logistic regression analysis was utilized to adjust for confounding variables and calculate adjusted odds ratios (ORs) and associated 95% confidence intervals (95% CIs). In total, 8776 patients underwent rTKA. Of these patients, 11.6% were current smokers. Univariate analyses demonstrated that smokers had a higher rate of any wound complication (3.8% vs 1.8%, P < .0001), deep infection (2.5% vs 1.0%, P < .0001), pneumonia (1.3% vs 0.4%, P < .0001), and reoperation (5.0% vs 3.1%, P = .001) compared to nonsmokers undergoing revision total knee arthroplasty. Multivariate analysis identified current smokers as being at a significantly increased risk of any wound complication (OR 2.1; 95% CI 1.4-3.1) and deep infection (OR 2.1, 95% CI 1.2-3.6) after rTKA. This study demonstrates that smoking significantly increases the risk of infection, wound complications, and reoperation after rTKA. The results are even more magnified for revision procedures compared to published effects of smoking on primary total knee arthroplasty complications. Further research is needed regarding the impact of smoking cessation on mitigation of these observed risks. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Total Synthesis of Marine Cyclic Enol-Phosphotriester Salinipostin Compounds

    Science.gov (United States)

    Zhao, Mingliang; Wei, Xianfeng; Liu, Xuemeng; Dong, Xueyang; Yu, Rilei; Wan, Shengbiao; Jiang, Tao

    2018-06-01

    Due to their structural diversity and variety of biological activities, marine natural products have been the subject of extensive study. These compounds, especially phospholipid polycyclic aromatic hydrocarbons, have a wide range of pharmacological applications, including embedded DNA and central nervous system, anti-tumor, anti-virus, anti-parasite, anti-bacterial, and antithrombotic effects. Unfortunately, the insufficient drug sources have limited the development of these compounds. In this study, we isolated salinpostin compounds from a fermentation solution of marine-derived Salinospora sp., which has a common bicyclic enol-phosphotriester core framework, as well as potent and selective antimalarial activities against P. falciparum with EC50 = 50 nmol L-1. The chemical synthesis of these compounds in greater quantities is necessary for their use in bioactivity studies. Thus we explored a short route with high yields and mild reaction conditions, which can generate combinatorial libraries for drug discovery and lead optimization. We developed a new total synthesis method for six cyclic enol-phosphotriester salinipotin compounds and their diastereomers. For the total synthesis of cyclipostin P, we prepared cyclic enol-phosphotriester salinipostin compounds in 10 steps from a readily accessible starting material, 1,3-dihydroxyacetone, and obtained an overall yield of 1.29%. We fully characterized these compounds by proton nuclear magnetic resonance (1H-NMR), carbon-13 NMR (13C-NMR), and high-resolution mass spectrometry (HRMS) analyses, and found they coincide absolutely with the same compounds reported previously.

  12. Revision of failed hemiarthroplasty for painful glenoid arthrosis to anatomic total shoulder arthroplasty.

    Science.gov (United States)

    Sheth, Mihir M; Sholder, Daniel; Abboud, Joseph; Lazarus, Mark D; Ramsey, Matthew L; Williams, Gerald R; Namdari, Surena

    2018-05-10

    The impending burden of revision shoulder arthroplasty has increased interest in outcomes of revision procedures. Painful glenoid arthrosis following hemiarthroplasty is a common cause of reoperation, and conversion to anatomic total shoulder arthroplasty is one option. We identified patients who underwent revision of painful hemiarthroplasty to total shoulder arthroplasty over a 15-year period in a single tertiary-care health system. Presurgical and operative data were analyzed for 28 patients who met the inclusion and exclusion criteria. Patients were contacted at a minimum of 2 years' follow-up after revision surgery for functional outcome scores, reoperations, and implant survival. The 2- and 5-year implant survival rates were 93% and 86%, respectively. Functional outcomes were obtained from 21 patients with surviving implants. The mean American Shoulder and Elbow Surgeons score, visual analog scale score for pain, and Single Assessment Numerical Evaluation score were 78 ± 20, 2.3 ± 2.6, and 71 ± 24, respectively. The mean Short Form 12 mental and physical scores were 49 ± 10 and 43 ± 9, respectively. Of the patients, 17 (81%) were either satisfied or very satisfied with their outcome. Complications were seen in 10 patients (36%), and 6 patients (21%) required reoperation. Anatomic total shoulder arthroplasty following hemiarthroplasty can achieve successful outcomes and implant survival rates. Given our poor understanding of reverse shoulder arthroplasty longevity, this procedure should remain an option for patients with glenoid arthrosis and an intact rotator cuff. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  13. [Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis].

    Science.gov (United States)

    Medenica, Ivica; Luković, Milan; Radoicić, Dragan

    2010-02-01

    The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score--7.1). We performed total rearthroplasty by a custom-made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score--87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specificaly for a patient) and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

  14. Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2010-01-01

    Full Text Available Background. The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. Case report. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score - 7.1. We performed total rearthroplasty by a custom- made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score - 87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Conclusion. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specifically for a patient and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

  15. Lawsuits After Primary and Revision Total Hip Arthroplasties: A Malpractice Claims Analysis.

    Science.gov (United States)

    Patterson, Diana C; Grelsamer, Ronald P; Bronson, Michael J; Moucha, Calin S

    2017-10-01

    As the prevalence of total hip arthroplasty (THA) expands, so too will complications and patient dissatisfaction. The goal of this study was to identify the common etiologies of malpractice suits and costs of claims after primary and revision THAs. Analysis of 115 malpractice claims filed for alleged neglectful primary and revision THA surgeries by orthopedic surgeons insured by a large New York state malpractice carrier between 1983 and 2011. The incidence of malpractice claims filed for negligent THA procedures is only 0.15% per year in our population. In primary cases, nerve injury ("foot drop") was the most frequent allegation with 27 claims. Negligent surgery causing dislocation was alleged in 18 and leg length discrepancy in 14. Medical complications were also reported, including 3 thromboembolic events and 6 deaths. In revision cases, dislocation and infection were the most common source of suits. The average indemnity payment was $386,153 and the largest single settlement was $4.1 million for an arterial injury resulting in amputation after a primary hip replacement. The average litigation cost to the insurer was $61,833. Nerve injury, dislocation, and leg length discrepancy are the most common reason for malpractice after primary THA. Orthopedic surgeons should continue to focus on minimizing the occurrence of these complications while adequately incorporating details about the risks and limitations of surgery into their preoperative education. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Revised

    DEFF Research Database (Denmark)

    Johannsen, Vivian Kvist; Nord-Larsen, Thomas; Riis-Nielsen, Torben

    This report is a revised analysis of the Danish data on CO2 emissions from forest, afforestation and deforestation for the period 1990 - 2008 and a prognosis for the period until 2020. Revision have included measurements from 2009 in the estimations. The report is funded by the Ministry of Climate...

  17. First total synthesis of (-)-ichthyothereol and its acetate.

    Science.gov (United States)

    Mukai, C; Miyakoshi, N; Hanaoka, M

    2001-08-24

    The first and stereoselective total syntheses of (-)-ichthyothereol (1) and its acetate ((+)-2) were achieved by incorporation of the two chiral centers of diethyl L-tartrate. The starting diethyl L-tartrate was converted into trans-2-ethynyl-3-hydroxytetrahydropyran 14 in a stereoselective manner via the endo mode cyclization of the epoxy-alkyne derivative 12. The alcohol 12 was then transformed into (E)-iodoolefin derivative 15, which was exposed to a coupling reaction with 1-tributylstannyl-1,3,5-heptyne (19), derived from the corresponding 1-trimethylsilyl-1,3,5-heptyne (18), under Stille conditions to produce the all-carbon framework of the target natural products. Chemical modification of the coupled product 20 under conventional conditions completed the first total synthesis of (-)-ichthyothereol (1) and its acetate ((+)-2).

  18. Preoperative diagnostic for periprosthetic joint infection prior to total knee revision arthroplasty

    Directory of Open Access Journals (Sweden)

    Leif Claassen

    2014-08-01

    Full Text Available Periprosthetic joint infection (PJI after total knee arthroplasty remains a challenging problem. The aim of this study was to evaluate the accuracy of diagnostic knee aspiration and serum inflammatory markers in diagnostic of a PJI after total knee arthroplasty. Within 2011 and 2012, 46 patients received a one- or two-stage revision arthroplasty of the knee joint. These patients received a total number of 77 operations. A preoperative aspiration was performed in each case. We analyzed the microbiological and histological examinations of the samples from the aspiration and from the revision operation and additionally estimated serum inflammatory markers. The diagnostic aspiration had a specificity of 0.87, a sensitivity of 0.39, a positive predictive value of 0.67 and a negative predictive value of 0.68. For C-reactive protein the specificity was 0.61 and the sensitivity was 0.48, the serum white blood cell count had a specificity of 0.98 and a sensitivity of 0.23. Our data queries whether diagnostic joint aspiration or serum inflammatory markers are sufficient to verify or exclude a PJI.

  19. Microwave-Assisted Synthesis of Phenylpropanoids and Coumarins: Total Synthesis of Osthol

    Czech Academy of Sciences Publication Activity Database

    Konrádová, Daniela; Kozubíková, H.; Doležal, Karel; Pospíšil, Jiří

    2017-01-01

    Roč. 2017, č. 35 (2017), s. 5204-5213 ISSN 1434-193X R&D Projects: GA MŠk(CZ) LO1204 Institutional support: RVO:61389030 Keywords : Cyclization * Microwave chemistry * Oxygen heterocycles * Synthetic methods * Total synthesis Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Organic chemistry Impact factor: 2.834, year: 2016

  20. Total femur arthroplasty for revision hip failure in osteogenesis imperfecta: limits of biology

    Directory of Open Access Journals (Sweden)

    Pablo Sanz-Ruiz, PhD, MD

    2017-09-01

    Full Text Available Osteogenesis imperfecta (OI is a rare congenital disease characterized by alterations in bone quality, with susceptibility to fractures, instability, deformities, and osteoarthrosis. Prosthetic surgery in these patients is associated with an abnormally high rate of implant failures. On the other hand, abnormal bone fragility adds to the complexity of revision surgery in such individuals—thus representing a genuine challenge for the orthopaedic surgeon. We present a case of femoral reconstruction in a patient with OI and prosthetic loosening after reconstruction secondary to femoral septic pseudoarthrosis. Intramedullary total femoral reconstruction was carried out after exceeding the biological reconstruction limits. This is the first reported instance of the use of an intramedullary total femur arthroplasty as salvage technique in an OI patient. This technique should be considered when we have exceeded biological limits for femoral fixation.

  1. Total Synthesis and Stereochemical Assignment of Nostosin B

    Directory of Open Access Journals (Sweden)

    Xiaoji Wang

    2017-02-01

    Full Text Available Nostosins A and B were isolated from a hydrophilic extract of Nostoc sp. strain from Iran, which exhibits excellent tryps inhibitory activity. Nostosin A was the most potent natural tripeptide aldehyde as trypsin inhibitor up to now. Both R‐ and S‐2‐hydroxy‐4‐(4‐hydroxy‐phenyl butanoic acid (Hhpba were prepared and incorporated into the total synthesis of nostosin B, respectively. Careful comparison of the NMR spectra and optical rotation data of synthetic nostosin B (1a and 1b with the natural product led to the unambiguous identification of the R‐configuration of the Hhpba fragment, which was further confirmed by co‐injection with the authentic sample on HPLC using both reversed phase column and the chiral AD‐RH column.

  2. Total synthesis of broussonetine F: the orthoamide Overman rearrangement of an allylic diol.

    Science.gov (United States)

    Hama, Naoto; Aoki, Toshihiro; Miwa, Shohei; Yamazaki, Miki; Sato, Takaaki; Chida, Noritaka

    2011-02-18

    A first total synthesis of broussonetine F from diethyl L-tartrate was achieved. The cornerstone of our synthesis was an orthoamide Overman rearrangement, which provided an allylic amino alcohol with complete diastereoselectivity.

  3. Fracture of the proximal tibia after revision total knee arthroplasty with an extensor mechanism allograft.

    Science.gov (United States)

    Klein, Gregg R; Levine, Harlan B; Sporer, Scott M; Hartzband, Mark A

    2013-02-01

    Extensor mechanism reconstruction with an extensor mechanism allograft (EMA) remains one of the most reliable methods for treating the extensor mechanism deficient total knee arthroplasty. We report 3 patients who were treated with an EMA who sustained a proximal tibial shaft fracture. In all 3 cases, a short tibial component was present that ended close to the level of the distal extent of the bone block. When performing an EMA, it is important to recognize that the tibial bone block creates a stress riser and revision to a long-stemmed tibial component should be strongly considered to bypass this point to minimize the risk of fracture. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Revision Total Hip Arthroplasty Using a Modular Tapered Stem With Distal Fixation Good Short-Term Results in 125 Revisions

    DEFF Research Database (Denmark)

    Ovesen, Ole; Emmeluth, Claus; Hofbauer, Christian

    2009-01-01

    After 2 to 7 years we reviewed 125 prosthetic hip arthroplasty stem revisions using a modular tapered stem with distal fixation. Median age of these patients was 68 (33-92) years. Baseline and follow-up data were registered prospectively according to the Danish Hip Arthroplasty Registry. Survival...... system is very versatile, can be used in most femoral revision cases, and allows rapid bone remodeling. We did not find an increased number of complications compared to the literature. Further long-term follow-up, however, is essential......., free of any rerevision, was 94%. Harris Hip Score improved from average 44 to 85. Bony regeneration was an early and significant finding in most cases. Complications included 4 (3%) fractures intraoperatively and 8 (6%) dislocations, 4 (3%) deep infections, and 1 (1%) stem fracture. This modular taper...

  5. Total Synthesis of Natural Products Using Hypervalent Iodine Reagents

    Directory of Open Access Journals (Sweden)

    Gaetan eMaertens

    2015-01-01

    Full Text Available We present a review of natural product syntheses accomplished in our laboratory during the last five years. Each synthetic route features a phenol dearomatization promoted by an environmentally benign hypervalent iodine reagent. The dearomatizations demonstrate the aromatic ring umpolung concept, and involve stereoselective remodeling of the inert unsaturations of a phenol into a highly functionalized key intermediate that may contain a quaternary carbon center and a prochiral dienone system. Several new oxidative strategies were employed, including transpositions (1,3-alkyl shift and Prins-pinacol, a polycyclization, an ipso rearrangement, and direct nucleophilic additions at the phenol para position. Several alkaloids, heterocyclic compounds, and a polycyclic core have been achieved, including sceletenone (a serotonin reuptake inhibitor, acetylaspidoalbidine (an antitumor agent, fortucine (antiviral and antitumor, erysotramidine (curare-like effect, platensimycin (an antibiotic, and the main core of a kaurane diterpene (immunosuppressive agent and stimulator of apoptosis. These concise and in some cases enantioselective syntheses effectively demonstrate the importance of hypervalent iodine reagents in the total synthesis of bioactive natural products.

  6. Total Synthesis of Bryostatins. Development of Methodology for Atom-Economic and Stereoselective Synthesis of the C-ring Subunit

    Science.gov (United States)

    Trost, Barry M.; Frontier, Alison J.; Thiel, Oliver R.; Yang, Hanbiao; Dong, Guangbin

    2012-01-01

    Bryostatins, a family of structurally complicated macrolides, exhibit an exceptional range of biological activities. The limited availability and structural complexity of these molecules makes development of an efficient total synthesis particularly important. This article describes our initial efforts towards the total synthesis of bryostatins, in which chemoselective and atom-economical methods for stereoselective assembly of the C-ring subunit were developed. A Pd-catalyzed tandem alkyne-alkyne coupling/6-endo-dig cyclization sequence was explored and successfully pursued in the synthesis of a dihydropyran ring system. Elaboration of this methodology ultimately led to a concise synthesis of the C-ring subunit of bryostatins. PMID:21793057

  7. Biomimetically inspired asymmetric total synthesis of (+)-19-dehydroxyl arisandilactone A

    Science.gov (United States)

    Han, Yi-Xin; Jiang, Yan-Long; Li, Yong; Yu, Hai-Xin; Tong, Bing-Qi; Niu, Zhe; Zhou, Shi-Jie; Liu, Song; Lan, Yu; Chen, Jia-Hua; Yang, Zhen

    2017-01-01

    Complex natural products are a proven and rich source of disease-modulating drugs and of efficient tools for the study of chemical biology and drug discovery. The architectures of complex natural products are generally considered to represent significant barriers to efficient chemical synthesis. Here we describe a concise and efficient asymmetric synthesis of 19-dehydroxyl arisandilactone A--which belongs to a family of architecturally unique, highly oxygenated nortriterpenoids isolated from the medicinal plant Schisandra arisanensis. This synthesis takes place by means of a homo-Michael reaction, a tandem retro-Michael/Michael reaction, and Cu-catalysed intramolecular cyclopropanation as key steps. The proposed mechanisms for the homo-Michael and tandem retro-Michael/Michael reactions are supported by density functional theory (DFT) calculation. The developed chemistry may find application for the synthesis of its other family members of Schisandraceae nortriterpenoids.

  8. Early failure mechanisms of constrained tripolar acetabular sockets used in revision total hip arthroplasty.

    Science.gov (United States)

    Cooke, Christopher C; Hozack, William; Lavernia, Carlos; Sharkey, Peter; Shastri, Shani; Rothman, Richard H

    2003-10-01

    Fifty-eight patients received an Osteonics constrained acetabular implant for recurrent instability (46), girdlestone reimplant (8), correction of leg lengthening (3), and periprosthetic fracture (1). The constrained liner was inserted into a cementless shell (49), cemented into a pre-existing cementless shell (6), cemented into a cage (2), and cemented directly into the acetabular bone (1). Eight patients (13.8%) required reoperation for failure of the constrained implant. Type I failure (bone-prosthesis interface) occurred in 3 cases. Two cementless shells became loose, and in 1 patient, the constrained liner was cemented into an acetabular cage, which then failed by pivoting laterally about the superior fixation screws. Type II failure (liner locking mechanism) occurred in 2 cases. Type III failure (femoral head locking mechanism) occurred in 3 patients. Seven of the 8 failures occurred in patients with recurrent instability. Constrained liners are an effective method for treatment during revision total hip arthroplasty but should be used in select cases only.

  9. Low revision rate after total hip arthroplasty in patients with pediatric hip diseases

    DEFF Research Database (Denmark)

    Engesæter, Lars B; Engesæter, Ingvild Ø; Fenstad, Anne Marie

    2012-01-01

    Background The results of primary total hip arthroplasties (THAs) after pediatric hip diseases such as developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), or Perthes' disease have been reported to be inferior to the results after primary osteoarthritis of the hip (OA.......9%) were operated due to pediatric hip diseases (3.1% for Denmark, 8.8% for Norway, and 1.9% for Sweden) and 288,435 THAs (77.8%) were operated due to OA. Unadjusted 10-year Kaplan-Meier survival of THAs after pediatric hip diseases (94.7% survival) was inferior to that after OA (96.6% survival......). Consequently, an increased risk of revision for hips with a previous pediatric hip disease was seen (risk ratio (RR) 1.4, 95% CI: 1.3-1.5). However, after adjustment for differences in sex and age of the patients, and in fixation of the prostheses, no difference in survival was found (93.6% after pediatric hip...

  10. Comparison of mode of failure between primary and revision total knee arthroplasties.

    Science.gov (United States)

    Liang, H; Bae, J K; Park, C H; Kim, K I; Bae, D K; Song, S J

    2018-04-01

    Cognizance of common reasons for failure in primary and revision TKA, together with their time course, facilitates prevention. However, there have been few reports specifically comparing modes of failure for primary vs. revision TKA using a single prosthesis. The goal of the study was to compare the survival rates, modes of failure, and time periods associated with each mode of failure, of primary vs. revision TKA. The survival rates, modes of failure, time period for each mode of failure, and risk factors would differ between primary and revision TKA. Data from a consecutive cohort comprising 1606 knees (1174 patients) of primary TKA patients, and 258 knees (224 patients) of revision TKA patients, in all of whom surgery involved a P.F.C ® prosthesis (Depuy, Johnson & Johnson, Warsaw, IN), was retrospectively reviewed. The mean follow-up periods of primary and revision TKAs were 9.2 and 9.8 years, respectively. The average 10- and 15-year survival rates for primary TKA were 96.7% (CI 95%,±0.7%) and 85.4% (CI 95%,±2.0%), and for revision TKA 91.4% (CI 95%,±2.5%) and 80.5% (CI 95%,±4.5%). Common modes of failure included polyethylene wear, loosening, and infection. The most common mode of failure was polyethylene wear in primary TKA, and infection in revision TKA. The mean periods (i.e., latencies) of polyethylene wear and loosening did not differ between primary and revision TKAs, but the mean period of infection was significantly longer for revision TKA (1.2 vs. 4.8 years, P=0.003). Survival rates decreased with time, particularly more than 10 years post-surgery, for both primary and revision TKAs. Continuous efforts are required to prevent and detect the various modes of failure during long-term follow-up. Greater attention is necessary to detect late infection-induced failure following revision TKA. Case-control study, Level III. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. The CP molecule labyrinth: a paradigm of how endeavors in total synthesis lead to discoveries and inventions in organic synthesis.

    Science.gov (United States)

    Nicolaou, K C; Baran, Phil S

    2002-08-02

    Imagine an artist carving a sculpture from a marble slab and finding gold nuggets in the process. This thought is not a far-fetched description of the work of a synthetic chemist pursuing the total synthesis of a natural product. At the end of the day, he or she will be judged by the artistry of the final work and the weight of the gold discovered in the process. However, as colorful as this description of total synthesis may be, it does not entirely capture the essence of the endeavor, for there is much more to be told, especially with regard to the contrast of frustrating failures and exhilarating moments of discovery. To fully appreciate the often Herculean nature of the task and the rewards that accompany it, one must sense the details of the enterprise behind the scenes. A more vivid description of total synthesis as a struggle against a tough opponent is perhaps appropriate to dramatize these elements of the experience. In this article we describe one such endeavor of total synthesis which, in addition to reaching the target molecule, resulted in a wealth of new synthetic strategies and technologies for chemical synthesis. The total synthesis of the CP molecules is compared to Theseus' most celebrated athlos (Greek for exploit, accomplishment): the conquest of the dreaded Minotaur, which he accomplished through brilliance, skill, and bravery having traversed the famous labyrinth with the help of Ariadne. This story from Greek mythology comes alive in modern synthetic expeditions toward natural products as exemplified by the total synthesis of the CP molecules which serve as a paradigm for modern total synthesis endeavors, where the objectives are discovery and invention in the broader sense of organic synthesis.

  12. Total synthesis of (7- sup 14 C)-(+-)-colchicine

    Energy Technology Data Exchange (ETDEWEB)

    Pontikis, Renee; Nguyenhoang Nam; Hoellinger, Henri (Paris-5 Univ., 75 (France). Lab. de Chimie et Biochimie Pharmacologiques et Toxicologiques)

    1989-08-01

    The synthesis of ({plus minus})-colchicine labelled with carbon-14 at the 7-position of the B ring was achieved by a sixteen step sequence with an overall radiochemical yield of 2.5% from (Ba{sup 14}CO{sub 3}) (Specific activity: 55 mCi-mmol{sup -1}). (author).

  13. Total synthesis of [7-14C]-(+-)-colchicine

    International Nuclear Information System (INIS)

    Pontikis, Renee; Nguyenhoang Nam; Hoellinger, Henri

    1989-01-01

    The synthesis of (±)-colchicine labelled with carbon-14 at the 7-position of the B ring was achieved by a sixteen step sequence with an overall radiochemical yield of 2.5% from [Ba 14 CO 3 ] (Specific activity: 55 mCi-mmol -1 ). (author)

  14. A Concise Total Synthesis of S-(+)-Tylophorine

    Institute of Scientific and Technical Information of China (English)

    JIN,Zhong; WANG,Qing-Min; LI,Hao; LIU,Yu-Xiu; LI,Shi-Pu; HUANG,Run-Qiu

    2004-01-01

    @@ Phenanthroindolizidine alkaloids, which exhibit extensively biological properties, are widely present at various plants of the Asclepiadaceae family.[1] The significantly biological importance of these natural products has attracted considerable synthetic efforts.[2] We herein report an efficiently asyinmetric synthesis of S-(+)-tylophorine (1), as a typically representative alkaloids.

  15. Outcomes of cup revision for ilio-psoas impingement after total hip arthroplasty: Retrospective study of 46 patients.

    Science.gov (United States)

    Batailler, C; Bonin, N; M Wettstein; Nogier, A; Martres, S; Ollier, E; May, O; Lustig, S

    2017-12-01

    Impingement of the ilio-psoas tendon on the acetabular component is a cause of pain after total hip arthroplasty (THA). Studies of cup revision for ilio-psoas impingement (IPI) are scarce and limited in size. We therefore conducted a large multicentre retrospective study with the following objectives: to assess the effectiveness of cup replacement in resolving the impingement syndrome, to determine the frequency and nature of complications after cup revision for IPI, and to identify pre-operative factors associated with good outcomes of cup revision for IPI. Cup revision is effective in resolving the pain due to IPI in selected patients. This retrospective multicentre study included 46 patients who underwent cup revision because of IPI. Before the revision, 38 (83%) patients had prominence of the anterior cup rim (mean, 9.9±4.5mm (range, 2-22mm) by radiography and 35 (76%) had cup malposition (anteversion50°). Mean follow-up was 21months (range, 6months to 6 years) and no patient was lost to follow-up. Outcomes at last follow-up were assessed based on the Oxford Hip Score (OHS), patient satisfaction index, complications, and revisions. At last follow-up, 39 (85%) patients were satisfied with the revision procedure, a significant improvement versus baseline was noted in the OHS (mean, 43±6; range, 25-48; P<0.001), and 41 patients were free of pain during hip flexion (P<0.001 versus baseline). Complications occurred in 3 (6.5%) patients, but only one complication was severe (deep infection). Recurrent groin pain was reported by 4 (8.7%) patients at last follow-up. None of the factors studied predicted the outcome of revision surgery. Cup revision for IPI after THA is effective in relieving the groin pain in 80% of patients with anterior cup rim prominence and/or cup malposition. However, complications can occur. Tenotomy may be preferable when the diagnosis is in doubt and/or cup position is acceptable. IV, retrospective observational study. Published by Elsevier

  16. Type 2 diabetes and in-hospital complications after revision of total hip and knee arthroplasty.

    Directory of Open Access Journals (Sweden)

    Ana López-de-Andrés

    Full Text Available To assess the effect of type 2 diabetes (T2DM on hospital outcomes such as in hospital postoperative complications (IHPC, length of hospital stay (LOHS and in-hospital mortality (IHM after the revision of total hip arthroplasty (RHA and total knee arthroplasty (RKA and to identify factors associated with IHPC among T2DM patients undergoing these procedures.We performed a retrospective study using the Spanish National Hospital Discharge Database, 2005-2014. We included patients who were ≥40 years old that had undergone RHA and RKA. For each T2DM patient, we selected a year-, gender-, age- and Charlson Comorbidity Index-matched non-diabetic patient.We identified 44,055 and 39,938 patients who underwent RHA (12.72% with T2DM and RKA (15.01% with T2DM. We matched 4,700 and 5,394 couples with RHA and RKA, respectively. Any IHPC was more frequent among patients with T2DM than among non-T2DM patients (19% vs. 15.64% in the RHA cohort and 12.94% vs. 11.09% in the RKA cohort, respectively. For patients who underwent RHA, postoperative infection (4.51% vs. 2.94%, p<0.001, acute post-hemorrhagic anemia (9.53% vs. 7.70%, p<0.001, mean LOHS and IHM were significantly higher in patients with T2DM. Among RKA patients, the incidence of acute posthemorrhagic anemia (7.21% vs. 5.62%; p = 0.001 and urinary tract infection (1.13% vs. 0.72%; p = 0.029 was significantly higher in patients with diabetes. Older age, obesity, infection due to internal joint prosthesis, myocardial infarction, congestive heart failure, mild liver disease and renal disease and emergency room admission were significantly associated with a higher risk of IHPC in T2DM patients. IHPC decreased over time only in T2DM patients who underwent RHA (OR 0.94, 95%CI 0.89-0.98.Patients with T2DM who underwent RHA and RKA procedures had more IHPC after controlling for the effects of possible confounders. LOHS and IHM were also higher among RHA patients with diabetes. Older age, comorbidity, obesity

  17. Coupling failure between stem and femoral component in a constrained revision total knee arthroplasty.

    LENUS (Irish Health Repository)

    Butt, Ahsan Javed

    2013-02-01

    Knee revision using constrained implants is associated with greater stresses on the implant and interface surfaces. The present report describes a case of failure of the screw coupling between the stem and the femoral component. The cause of the failure is surmised with outline of the treatment in this case with extensive femoral bone loss. Revision implant stability was augmented with the use of a cemented femoral stem, screw fixation and the metaphyseal sleeve of an S-ROM modular hip system (DePuy international Ltd).

  18. Total synthesis and allelopathic activity of cytosporones A-C

    Energy Technology Data Exchange (ETDEWEB)

    Zamberlam, Charles E.M.; Meza, Alisson; Lima, Denis P. de; Beatriz, Adilson [Centro de Ciencias Exatas e Tecnologia, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS (Brazil); Leite, Carla Braga; Marques, Maria Rita [Centro de Ciencias Biologicas e da Saude, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS (Brazil)

    2012-07-01

    The search for efficient, environmentally friendly herbicides has been the focus of numerous studies on the organic synthesis of compounds isolated from natural sources. Cytosporones, which are phenolic lipids isolated from fungi, exhibit noteworthy biological properties. This paper reports the preparation of cytosporones A-C from the same starting material through a short synthetic route, with good yields. All compounds were tested for allelopathic activity on lettuce (Lactuca sativa L) seeds. Cytosporone A and its methylated precursor showed remarkable allelopathic activity, inhibiting seed germination and plantule growth. (author)

  19. Total synthesis and allelopathic activity of cytosporones A-C

    International Nuclear Information System (INIS)

    Zamberlam, Charles E.M.; Meza, Alisson; Lima, Denis P. de; Beatriz, Adilson; Leite, Carla Braga; Marques, Maria Rita

    2012-01-01

    The search for efficient, environmentally friendly herbicides has been the focus of numerous studies on the organic synthesis of compounds isolated from natural sources. Cytosporones, which are phenolic lipids isolated from fungi, exhibit noteworthy biological properties. This paper reports the preparation of cytosporones A-C from the same starting material through a short synthetic route, with good yields. All compounds were tested for allelopathic activity on lettuce (Lactuca sativa L) seeds. Cytosporone A and its methylated precursor showed remarkable allelopathic activity, inhibiting seed germination and plantule growth. (author)

  20. Preservation of the Acetabular Cup During Revision Total Hip Arthroplasty Using a Novel Mini-navigation Tool: A Case Report.

    Science.gov (United States)

    Vincent, John; Alshaygy, Ibrahim; Muir, Jeffrey M; Kuzyk, Paul

    2018-01-01

    While intraoperative navigation systems have been shown to improve outcomes in primary total hip arthroplasty (THA), their use in the context of revision has been largely overlooked. This case report presents the first documented use of an imageless navigation tool in the context of revision THA, and an unexpected benefit to the surgical procedure as a result. An 84-year-old female patient presented following five episodes of dislocation of the left hip and with pain in the left buttock, groin, and posterior aspect of her hip. Relevant surgical history included primary hip arthroplasty in 1999 and the first revision in 2014. Preoperative analysis revealed a constrained liner that had become disengaged and migrated inferiorly, lodging at the distal aspect of the femoral neck. Acetabular protrusion was also noted. The pre-operative plan included the replacement of the fragmented liner and likely of the acetabular cup due to hardware failure. Intraoperative assessment, however, revealed that the cup was in good condition and would be difficult to remove due to substantial bony ingrowth. With the assistance of imageless navigation, the orientation of the acetabular cup was determined and a new constrained liner was cemented into the preexisting acetabular component at an altered orientation, correcting anteversion by 7°. In revision hip arthroplasty cases, image-based navigation is limited by the presence of existing implants and corresponding metal artefact. This case demonstrates the successful use of an imageless navigation tool for revision surgery. Use of navigation led to the unexpected intraoperative discovery that the acetabular cup was in an acceptable state, and allowed the surgical team to correct the position of the cup using a constrained liner, thus preserving the cup. This significantly benefitted patient outcome, due to the risks associated with the removal of a firmly fixated acetabular cup. While more extensive research is required, this case

  1. Total synthesis of (3S, 5R, 3'S, 5'R)-capsorubin

    International Nuclear Information System (INIS)

    Frederico, Daniel; Constantino, Mauricio G.; Donate, Paulo M.

    2009-01-01

    The total synthesis of enantiomerically enriched (3S, 5R, 3'S, 5'R)-capsorubin (1) by aldol condensation of (1R, 4S)-1-(4-hydroxy-1,2,2-trimethyl-cyclopentyl)ethanone (2a) and crocetindial (3) is described. An alternative, short eight-step synthesis of the optically active compound 2a (ee 89%) is also reported. (author)

  2. Total synthesis of 1-hydroxydehydroherbarin and ascomycones A, B, naphthoquinone antibiotics

    International Nuclear Information System (INIS)

    Dong, Wen-Kai; Huang, Xiong; Xu, Dong-Cheng; Li, Xin-Shengi; Xie, Jian-Wu

    2012-01-01

    The first total synthesis of 1-hydroxydehydroherbarin and ascomycones A and B is reported. The biologically interesting ascomycones A and B were obtained in 18% overall yield starting from 3-chloro-2,5-dimethoxybenzaldehyde as building block. (author)

  3. Divergent Synthesis of Revised Apratoxin E, 30-epi-Apratoxin E, and 30S/30R-Oxoapratoxin E.

    Science.gov (United States)

    Mao, Zhuo-Ya; Si, Chang-Mei; Liu, Yi-Wen; Dong, Han-Qing; Wei, Bang-Guo; Lin, Guo-Qiang

    2017-10-20

    In this report, originally proposed apratoxin E (30S-7), revised apratoxin E (30R-7), and (30S)/(30R)-oxoapratoxin E (30S)-38/(30R)-38 were efficiently prepared by two synthetic methods. The chiral lactone 10, recycled from the degradation of saponin glycosides, was utilized to prepare the key nonpeptide fragment 9. Our alternative convergent assembly strategy was applied to the divergent synthesis of revised apratoxin E and its three analogues. Moreover, ring-closing metathesis (RCM) was for the first time found to be an efficient strategy for the macrocyclization of apratoxins.

  4. The Total Synthesis Problem of linear multivariable control. II - Unity feedback and the design morphism

    Science.gov (United States)

    Sain, M. K.; Antsaklis, P. J.; Gejji, R. R.; Wyman, B. F.; Peczkowski, J. L.

    1981-01-01

    Zames (1981) has observed that there is, in general, no 'separation principle' to guarantee optimality of a division between control law design and filtering of plant uncertainty. Peczkowski and Sain (1978) have solved a model matching problem using transfer functions. Taking into consideration this investigation, Peczkowski et al. (1979) proposed the Total Synthesis Problem (TSP), wherein both the command/output-response and command/control-response are to be synthesized, subject to the plant constraint. The TSP concept can be subdivided into a Nominal Design Problem (NDP), which is not dependent upon specific controller structures, and a Feedback Synthesis Problem (FSP), which is. Gejji (1980) found that NDP was characterized in terms of the plant structural matrices and a single, 'good' transfer function matrix. Sain et al. (1981) have extended this NDP work. The present investigation is concerned with a study of FSP for the unity feedback case. NDP, together with feedback synthesis, is understood as a Total Synthesis Problem.

  5. Total synthesis of ciguatoxin CTX3C: a venture into the problems of ciguatera seafood poisoning.

    Science.gov (United States)

    Hirama, Masahiro

    2005-01-01

    After a twelve-year struggle, the total synthesis of ciguatoxin CTX3C has been achieved. Annually, more than 20,000 people worldwide suffer from ciguatera seafood poisoning. The extremely small amounts of the causative neurotoxin, ciguatoxin, in fish hampered the isolation, structural elucidation, detailed biological study, and preparation of anti-ciguatoxin antibodies for detecting these toxins. The large (3 nanometers long) and complicated molecular structure of ciguatoxins hindered chemists from completing a total synthesis. The chemical synthesis of CTX3C, determination of the absolute configuration, and synthesis-based preparation of the monoclonal antibodies as well as the effect of synthetic CTX3C on voltage-sensitive sodium channels are outlined. (c) 2005 The Japan Chemical Journal Forum and Wiley Periodicals, Inc.

  6. Total Synthesis of Ionic Liquid Systems for Dissolution of Lunar Simulant

    Science.gov (United States)

    Sharpe, Robert J.; Karr, Laurel J.; Paley, Mark S.

    2010-01-01

    For purposes of Space Resource Utilization, work in the total synthesis of a new ionic liquid system for the extraction of oxygen and metals from lunar soil is studied and described. Reactions were carried out according to procedures found in the chemical literature, analyzed via Thin-Layer Chromatography and 1H Nuclear Magnetic Resonance Spectroscopy and purified via vacuum distillation and rotary evaporation. Upon final analysis via 1H NMR, it was found that while the intermediates of the synthesis had been achieved, unexpected side products were also present. The mechanisms and constraints of the synthesis are described as well as the final results of the project and recommendations for continued study

  7. Total synthesis and stereochemical assignment of the salicylate antitumor macrolide lobatamide C(1).

    Science.gov (United States)

    Shen, Ruichao; Lin, Cheng Ting; Porco, John A

    2002-05-22

    The total synthesis and stereochemical assignment of the potent antitumor macrolide lobatamide C is reported. The synthesis involves Cu(I)-mediated enamide formation and Na(2)CO(3)-mediated esterification of a beta-hydroxy acid and a salicylate cyanomethyl ester. Macrolactonization was accomplished using a Mitsunobu protocol. The stereochemical assignment of lobatamide C was achieved by Mosher ester analysis and comparison with prepared stereoisomers.

  8. Stereoselective total synthesis of the potent anti-asthmatic compound CMI-977 (LDP-977)

    Energy Technology Data Exchange (ETDEWEB)

    Dias, Luiz Carlos; Farina, Lui Strambi; Ferreira, Marco Antonio Barbosa, E-mail: ldias@iqm.unicamp.br [Universidade de Campinas (UNICAMP), SP (Brazil). Instituto de Quimica

    2013-02-15

    A short and efficient stereoselective total synthesis of CMI-977 (LDP-977), a potent and orally active anti-asthmatic compound, was developed. The key steps involve a highly diastereoselective Mukaiyama oxidative cyclization, which provides the trans-THF (tetrahydrofuran) unit and a Seyferth-Gilbert homologation to construct the triple bond in the target molecule. The synthesis of the key chiral building block was performed using Jacobsen hydrolytic kinetic resolution. (author)

  9. Development of the Vinylogous Pictet-Spengler Cyclization and Total Synthesis of (±)-Lundurine A.

    Science.gov (United States)

    Nash, Aaron; Qi, Xiangbing; Maity, Pradip; Owens, Kyle; Tambar, Uttam K

    2018-04-16

    A novel vinylogous Pictet-Spengler cyclization has been developed for the generation of indole-annulated medium-sized rings. The method enables the synthesis of tetrahydroazocinoindoles with a fully substituted carbon center, a prevalent structural motif in many biologically active alkaloids. The strategy has been applied to the total synthesis of (±)-lundurine A. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Stereoselective total synthesis of the potent anti-asthmatic compound CMI-977 (LDP-977)

    International Nuclear Information System (INIS)

    Dias, Luiz Carlos; Farina, Lui Strambi; Ferreira, Marco Antonio Barbosa

    2013-01-01

    A short and efficient stereoselective total synthesis of CMI-977 (LDP-977), a potent and orally active anti-asthmatic compound, was developed. The key steps involve a highly diastereoselective Mukaiyama oxidative cyclization, which provides the trans-THF (tetrahydrofuran) unit and a Seyferth-Gilbert homologation to construct the triple bond in the target molecule. The synthesis of the key chiral building block was performed using Jacobsen hydrolytic kinetic resolution. (author)

  11. Total Synthesis of (+)-Cytosporolide A via a Biomimetic Hetero-Diels-Alder Reaction.

    Science.gov (United States)

    Takao, Ken-Ichi; Noguchi, Shuji; Sakamoto, Shu; Kimura, Mizuki; Yoshida, Keisuke; Tadano, Kin-Ichi

    2015-12-23

    The first total synthesis of (+)-cytosporolide A was achieved by a biomimetic hetero-Diels-Alder reaction of (-)-fuscoatrol A with o-quinone methide generated from (+)-CJ-12,373. The dienophile, highly oxygenated caryophyllene sesquiterpenoid (-)-fuscoatrol A, was synthesized from the synthetic intermediate in our previous total synthesis of (+)-pestalotiopsin A. The o-quinone methide precursor, isochroman carboxylic acid (+)-CJ-12,373, was synthesized through a Kolbe-Schmitt reaction and an oxa-Pictet-Spengler reaction. The hetero-Diels-Alder reaction of these two compounds proceeded with complete chemo-, regio-, and stereoselectivity to produce the complicated pentacyclic ring system of the cytosporolide skeleton. This total synthesis unambiguously demonstrates that natural cytosporolide A has the structure previously suggested.

  12. Evolution of a practical total synthesis of ciguatoxin CTX3C.

    Science.gov (United States)

    Inoue, Masayuki; Hirama, Masahiro

    2004-12-01

    More than 20 000 people suffer annually from ciguatera seafood poisoning in subtropical and tropical regions. The extremely low content of the causative neurotoxins, designated as ciguatoxins, in fish has hampered their isolation, detailed biological study, and preparation of anti-ciguatoxin antibodies for detecting these toxins. Ciguatoxins consist of 12 trans-fused polycyclic ethers, ranging from six- to nine-membered, and include a spirally attached five-membered cyclic ether at one end. The large (3 nm in length) and complicated molecular structure of ciguatoxins has impeded chemists from completing their total synthesis. In 2001, we achieved the first total synthesis of ciguatoxin CTX3C by assembly of four structural fragments. Since then, protocols to combine the fragments have significantly improved in terms of overall stereoselectivity, efficiency, and practicality. In this Account, we describe recently evolved methodologies for the total synthesis of CTX3C.

  13. Chemistry of Renieramycins. Part 14: Total Synthesis of Renieramycin I and Practical Synthesis of Cribrostatin 4 (Renieramycin H

    Directory of Open Access Journals (Sweden)

    Masashi Yokoya

    2015-08-01

    Full Text Available The first total synthesis of (±-renieramycin I, which was isolated from the Indian bright blue sponge Haliclona cribricutis, is described. The key step is the selenium oxide oxidation of pentacyclic bis-p-quinone derivative (3 stereo- and regioselectively. We also report a large-scale synthesis of cribrostatin 4 (renieramycin H via the C3-C4 double bond formation in an early stage based on the Avendaño’s protocol, from readily available 1-acetyl-3-(3-methyl-2,4,5-trimethylphenylmethyl-piperazine-2,5-dione (8 in 18 steps (8.3% overall yield. The synthesis provides unambiguous evidence supporting the original structure of renieramycin I.

  14. Biomechanical evaluation of tibial bone adaptation after revision total knee arthroplasty: A comparison of different implant systems.

    Directory of Open Access Journals (Sweden)

    María Paz Quilez

    Full Text Available The best methods to manage tibial bone defects following total knee arthroplasty remain under debate. Different fixation systems exist to help surgeons reconstruct knee osseous bone loss (such as tantalum cones, cement, modular metal augments, autografts, allografts and porous metaphyseal sleeves However, the effects of the various solutions on the long-term outcome remain unknown. In the present work, a bone remodeling mathematical model was used to predict bone remodeling after total knee arthroplasty (TKA revision. Five different types of prostheses were analyzed: one with a straight stem; two with offset stems, with and without supplements; and two with sleeves, with and without stems. Alterations in tibia bone density distribution and implant Von Mises stresses were quantified. In all cases, the bone density decreased in the proximal epiphysis and medullary channels, and an increase in bone density was predicted in the diaphysis and around stem tips. The highest bone resorption was predicted for the offset prosthesis without the supplement, and the highest bone formation was computed for the straight stem. The highest Von Mises stress was obtained for the straight tibial stem, and the lowest was observed for the stemless metaphyseal sleeves prosthesis. The computational model predicted different behaviors among the five systems. We were able to demonstrate the importance of choosing an adequate revision system and that in silico models may help surgeons choose patient-specific treatments.

  15. Intestinal mucosa in diabetes: synthesis of total proteins and sucrase-isomaltase

    International Nuclear Information System (INIS)

    Olsen, W.A.; Perchellet, E.; Malinowski, R.L.

    1986-01-01

    The effects of insulin deficiency on nitrogen metabolism in muscle and liver have been extensively studied with recent in vivo demonstration of impaired protein synthesis in rats with streptozotocin-induced diabetes. Despite the significant contribution of small intestinal mucosa to overall protein metabolism, the effect of insulin deficiency on intestinal protein synthesis have not been completely defined. The authors studied the effects of streptozotocin-induced diabetes on total protein synthesis by small intestinal mucosa and on synthesis of a single enzyme protein of the enterocyte brush-border membrane sucrase-isomaltase. They used the flood-dose technique to minimize the difficulties of measuring specific radioactivity of precursor phenylalanine and determined incorporation into mucosal proteins and sucrase-isomaltase 20 min after injection of the labeled amino acid. Diabetes did not alter mucosal mass as determined by weight and content of protein and DNA during the 5 days after injection of streptozotocin. Increased rates of sucrase-isomaltase synthesis developed beginning on day 3, and those of total protein developed on day 5. Thus intestinal mucosal protein synthesis is not an insulin-sensitive process

  16. The use of customized cages in revision total hip arthroplasty for Paprosky type III acetabular bone defects.

    Science.gov (United States)

    Mao, Yuanqing; Xu, Chen; Xu, Jiawei; Li, Huiwu; Liu, Fengxiang; Yu, Degang; Zhu, Zhenan

    2015-10-01

    Revision total hip arthroplasty (THA) is challenging if severe periacetabular bone loss is present. Here we describe a method that uses a customised cage to reconstruct an acetabulum with a massive bone defect. Designed with the aid of the rapid prototyping technique, a customised cage with a hook, crest and flange or braids was made, and then utilized to reconstruct severe compromised acetabulum in revision THA since 2001. Twenty-two patients (23 hips) were included in this study. The mean patient age at the time of surgery was 60.9 years (range, 38-80 years). Three hips had massive acetabular bone defects of Paprosky type IIIA and 20 of type IIIB. The Harris hip score was used to evaluate hip function. Radiographs were taken to evaluate loosening of the cage and resorption of allograft bone. The average follow up was 81.6 ± 24.9 months. The mean Harris hip score improved from 39.6 pre-operatively to 80.9 at the final follow-up. There were no instances of deep infection, severe venous thrombosis, and nerve palsy. One patient who had an intra-operative rupture of the superior acetabular artery was successfully treated using the haemostatic suturing technique. Two patients experienced dislocation at post-operative days four and six, respectively, and both were treated with closed reduction and skin traction for three weeks. The present study demonstrates that a customised cage may be a promising option for THA revision of severely compromised acetabula. Extended follow-up is necessary to evaluate the long-term performance of this approach.

  17. Short-term results of the reverse Total Evolutive Shoulder System (TESS) in cuff tear arthropathy and revision arthroplasty cases.

    Science.gov (United States)

    von Engelhardt, Lars Victor; Manzke, Michael; Filler, Timm J; Jerosch, Joerg

    2015-07-01

    The aim of this study was to evaluate the clinical and radiological outcome of the Total Evolutive Shoulder System (TESS) in patients with cuff tear arthropathy and patients in need of a revision arthroplasty. In this sequential study, 67 patients (56 non-stemmed, 11 stemmed) were evaluated after a mean follow-up of 17.5 months. The relative Constant and DASH scores, radiological joint geometry changes, complications and postoperative problems, which are not likely to affect the outcome, were evaluated. A significant increase was noticed for the relative Constant (11.3 vs. 78.8 %) and DASH scores (73.7 vs. 31.8) without significant differences between both etiology groups. Complication rates were similar to previous studies. An aseptic loosening of the non-stemmed humeral component was not noticed in the cuff tear arthropathy group, whereas one case with a loosening was noticed in the revision arthroplasty group. With nine cases (13.4 %), scapular notching rates were very low. On average, the acromiohumeral distance increased by 17 mm and the humeral offset by 13.9 mm; the height of the center of rotation decreased by 4.6 mm and the lateral glenohumeral offset by 6.1 mm, p TESS system provided adequate distalization and medialization of the humerus and the center of rotation. This corresponds to a good clinical outcome. The use of the surgical opportunity to implant the prosthesis with a relatively low neck-shaft angle might explain the low rates of scapular notching in our series. Regarding the case with a loosening of the humeral component, the surgeon should carefully indicate a stemless version for metaphyseal press-fit fixation in patients with revision arthroplasty.

  18. Estimation of total error in DWPF reported radionuclide inventories. Revision 1

    International Nuclear Information System (INIS)

    Edwards, T.B.

    1995-01-01

    The Defense Waste Processing Facility (DWPF) at the Savannah River Site is required to determine and report the radionuclide inventory of its glass product. For each macro-batch, the DWPF will report both the total amount (in curies) of each reportable radionuclide and the average concentration (in curies/gram of glass) of each reportable radionuclide. The DWPF is to provide the estimated error of these reported values of its radionuclide inventory as well. The objective of this document is to provide a framework for determining the estimated error in DWPF's reporting of these radionuclide inventories. This report investigates the impact of random errors due to measurement and sampling on the total amount of each reportable radionuclide in a given macro-batch. In addition, the impact of these measurement and sampling errors and process variation are evaluated to determine the uncertainty in the reported average concentrations of radionuclides in DWPF's filled canister inventory resulting from each macro-batch

  19. Total synthesis of 4-F3t-neuroprostane and its 4-epimer

    Czech Academy of Sciences Publication Activity Database

    Auvinet, A. L.; Eignerová, Barbara; Guy, A.; Kotora, Martin; Durand, T.

    2009-01-01

    Roč. 50, č. 13 (2009), s. 1498-1500 ISSN 0040-4039 R&D Projects: GA MŠk 1M0508 Institutional research plan: CEZ:AV0Z40550506 Keywords : DPA * oxidative stress * neuroprostane * total synthesis Subject RIV: CC - Organic Chemistry Impact factor: 2.660, year: 2009

  20. Stereoselective total synthesis of Oxylipin from open chain gluco-configured building block.

    Science.gov (United States)

    Borkar, Santosh Ramdas; Aidhen, Indrapal Singh

    2017-04-18

    Total synthesis of naturally occurring Oxylipin has been achieved from open chain gluco-configured building block which is readily assembled from inexpensive and commercially available D-(+)-gluconolactone. Grignard reaction and Wittig olefination reactions are key steps for the requisite CC bond formation. Copyright © 2017. Published by Elsevier Ltd.

  1. Cu-Mediated Stille Reactions of Sterically Congested Fragments: Towards the Total Synthesis of Zoanthamine

    DEFF Research Database (Denmark)

    Nielsen, Thomas E.; Le Quement, Sebastian; Juhl, Martin

    2005-01-01

    A study on the Stille reaction of alkenyl iodides and starmanes with structural resemblance to retrosynthetic fragments of a projected total synthesis of the marine alkaloid zoanthamine was carried out. A range of reaction conditions was examined, and a protocol developed by Corey utilizing excess...

  2. Nazarov cyclization initiated by peracid oxidation: the total synthesis of (+/-)-rocaglamide.

    Science.gov (United States)

    Malona, John A; Cariou, Kevin; Frontier, Alison J

    2009-06-10

    The total syntheses of aglafolin, rocagloic acid, and rocaglamide using Nazarov cyclization are described. Generation of the necessary oxyallyl cation intermediate was accomplished via peracid oxidation of an allenol ether to generate an unusual oxycarbenium ion species that undergoes cyclization. The synthesis is efficient, highly diastereoselective, and strategically distinct from previous syntheses of rocaglamide.

  3. Total chemical synthesis and X-ray structure of kaliotoxin by racemic protein crystallography.

    Science.gov (United States)

    Pentelute, Brad L; Mandal, Kalyaneswar; Gates, Zachary P; Sawaya, Michael R; Yeates, Todd O; Kent, Stephen B H

    2010-11-21

    Here we report the total synthesis of kaliotoxin by 'one pot' native chemical ligation of three synthetic peptides. A racemic mixture of D- and L-kaliotoxin synthetic protein molecules gave crystals in the centrosymmetric space group P1 that diffracted to atomic-resolution (0.95 Å), enabling the X-ray structure of kaliotoxin to be determined by direct methods.

  4. Total synthesis of all stereoisomers of eudesm-II-en-4-ol

    NARCIS (Netherlands)

    Kesselmans, R.P.W.

    1992-01-01

    In this thesis the total synthesis of all stereoisomers of eudesm-11-en-4-ol e.g. selin-11-en-4α-ol I , intermedeol II , neointermedeol III , paradisiol IV , amiteol

  5. Impaction grafting in the femur in cementless modular revision total hip arthroplasty: a descriptive outcome analysis of 243 cases with the MRP-TITAN revision implant

    Directory of Open Access Journals (Sweden)

    Wimmer Matthias D

    2013-01-01

    Full Text Available Abstract Background We present a descriptive and retrospective analysis of revision total hip arthroplasties (THA using the MRP-TITAN stem (Peter Brehm, Weisendorf, GER with distal diaphyseal fixation and metaphyseal defect augmentation. Our hypothesis was that the metaphyseal defect augmentation (Impaction Bone Grafting improves the stem survival. Methods We retrospectively analyzed the aggregated and anonymized data of 243 femoral stem revisions. 68 patients with 70 implants (28.8% received an allograft augmentation for metaphyseal defects; 165 patients with 173 implants (71.2% did not, and served as controls. The mean follow-up was 4.4 ± 1.8 years (range, 2.1–9.6 years. There were no significant differences (p > 0.05 between the study and control group regarding age, body mass index (BMI, femoral defects (types I-III as described by Paprosky, and preoperative Harris Hip Score (HHS. Postoperative clinical function was evaluated using the HHS. Postoperative radiologic examination evaluated implant stability, axial implant migration, signs of implant loosening, periprosthetic radiolucencies, as well as bone regeneration and resorption. Results There were comparable rates of intraoperative and postoperative complications in the study and control groups (p > 0.05. Clinical function, expressed as the increase in the postoperative HHS over the preoperative score, showed significantly greater improvement in the group with Impaction Bone Grafting (35.6 ± 14.3 vs. 30.8 ± 15.8; p ≤ 0.05. The study group showed better outcome especially for larger defects (types II C and III as described by Paprosky and stem diameters ≥ 17 mm. The two groups did not show significant differences in the rate of aseptic loosening (1.4% vs. 2.9% and the rate of revisions (8.6% vs. 11%. The Kaplan-Meier survival for the MRP-TITAN stem in both groups together was 93.8% after 8.8 years. [Study group 95.7% after 8.54 years ; control group 93

  6. Synthesis of total protein (TP) and myosin heavy chain (HC) isozymes in pressure overloaded rabbit hearts

    International Nuclear Information System (INIS)

    Nagai, R.; Martin, B.J.; Pritzl, N.; Zak, R.; Low, R.B.; Stirewalt, W.S.; Alpert, N.R.; Litten, R.Z.

    1986-01-01

    Pulmonary artery banding (PO) leads to a rapid increase in right ventricular (RV) weight as well as a shift toward β myosin isozyme. They determined: (1) the contributions of changes in the capacity (RNA content) and efficiency of total protein synthesis to the increase in RV weight; and (2) the relative contributions of translational and pretranslational mechanisms to the shift in myosin HC isotypes. The rates of synthesis in vivo of TP, α- and β-HC were measured by a constant infusion technique using 3 H-leucine. TP synthesis was 7 +/- 2(SD) mg/day in control (RV:367 +/- 70 mg) and was increased by 2.6 fold at day 2 and 2.9 fold at day 4 following PO (p < 0.01). RV RNA content was increased by 83% at day 2 and 103% at day 4 PO (p < 0.05). The efficiency of synthesis (rate/RNA) was also significantly higher at these time points (1.4- and 1.3-fold). β-HC synthesis was 0.6 +/- 0.2 mg/day in control and increased by 2.6 fold at day 2 and 3.5 fold at day 4 following PO. In contrast, the rate of synthesis of α-HC was unchanged. The relative rates of β-HC to total HC synthesis was correlated linearly with the relative levels of β-myosin mRNA as measured by S1 nuclease mapping. They conclude that increases in the proportion of β-HC myosin following PO is due to increases in the relative amount of β-myosin mRNA and therefore involves modulation of a pretranslational mechanism

  7. Difference in clinical outcome between total shoulder arthroplasty and reverse shoulder arthroplasty used in hemiarthroplasty revision surgery

    NARCIS (Netherlands)

    Hartel, B.P.; Alta, T.D.; Sewnath, M.E.; Willems, W.J.H.

    2015-01-01

    INTRODUCTION: The increase of shoulder replacements will lead to a higher revision rate of shoulder arthroplasties. The aim of this study is to evaluate the clinical results of revision surgery performed in our hospital, distinguish the differences in clinical outcome according to revision

  8. Sensitivity and Specificity of the Coma Recovery Scale--Revised Total Score in Detection of Conscious Awareness.

    Science.gov (United States)

    Bodien, Yelena G; Carlowicz, Cecilia A; Chatelle, Camille; Giacino, Joseph T

    2016-03-01

    To describe the sensitivity and specificity of Coma Recovery Scale-Revised (CRS-R) total scores in detecting conscious awareness. Data were retrospectively extracted from the medical records of patients enrolled in a specialized disorders of consciousness (DOC) program. Sensitivity and specificity analyses were completed using CRS-R-derived diagnoses of minimally conscious state (MCS) or emerged from minimally conscious state (EMCS) as the reference standard for conscious awareness and the total CRS-R score as the test criterion. A receiver operating characteristic curve was constructed to demonstrate the optimal CRS-R total cutoff score for maximizing sensitivity and specificity. Specialized DOC program. Patients enrolled in the DOC program (N=252, 157 men; mean age, 49y; mean time from injury, 48d; traumatic etiology, n=127; nontraumatic etiology, n=125; diagnosis of coma or vegetative state, n=70; diagnosis of MCS or EMCS, n=182). Not applicable. Sensitivity and specificity of CRS-R total scores in detecting conscious awareness. A CRS-R total score of 10 or higher yielded a sensitivity of .78 for correct identification of patients in MCS or EMCS, and a specificity of 1.00 for correct identification of patients who did not meet criteria for either of these diagnoses (ie, were diagnosed with vegetative state or coma). The area under the curve in the receiver operating characteristic curve analysis is .98. A total CRS-R score of 10 or higher provides strong evidence of conscious awareness but resulted in a false-negative diagnostic error in 22% of patients who demonstrated conscious awareness based on CRS-R diagnostic criteria. A cutoff score of 8 provides the best balance between sensitivity and specificity, accurately classifying 93% of cases. The optimal total score cutoff will vary depending on the user's objective. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  9. Asymmetric Total Synthesis of Four Stereoisomers of the Sex Pheromone of the Western Corn Rootworm

    Directory of Open Access Journals (Sweden)

    Zhi-Feng Sun

    2018-03-01

    Full Text Available A convergent synthesis of four stereoisomers of the sex pheromone of the western corn rootworm (8-methyldecan-2-yl propionate, 1 from commercially available chiral starting materials is reported. The key step was Julia–Kocienski olefination between chiral BT-sulfone and chiral aldehyde. This synthetic route provided the four stereoisomers of 1 in 24–29% total yield via a six-step sequence. The simple scale-up strategy provides a new way to achieve the asymmetric synthesis of the sex pheromone.

  10. First- and second-generation total synthesis of ciguatoxin CTX3C.

    Science.gov (United States)

    Inoue, Masayuki; Miyazaki, Keisuke; Uehara, Hisatoshi; Maruyama, Megumi; Hirama, Masahiro

    2004-08-17

    More than 20,000 people suffer annually from ciguatera seafood poisoning in subtropical and tropical regions. The extremely low content of the causative neurotoxins, designated as ciguatoxins, in fish has hampered isolation, detailed biological studies, and preparation of anti-ciguatoxin antibodies for detecting these toxins. Furthermore, the large (3 nm in length) and complex molecular structure of ciguatoxins has impeded chemists from completing their total synthesis. In this article, the full details of studies leading to the total synthesis of ciguatoxin CTX3C are provided. The key elements of the first-generation approach include O,O-acetal formation from the right and left wing fragments, conversion from O,O-acetal to O,S-acetal, a radical reaction to cyclize the G ring, a ring-closing metathesis reaction to close the F ring, and final removal of the 2-naphtylmethyl protective groups. Subsequent studies provided a second-generation total synthesis, which is more concise and results in a higher yield. Second-generation synthesis was accomplished by using a direct method of constructing the key intermediate O,S-acetal from alpha-chlorosulfide and a secondary alcohol. These syntheses ensure a practical supply of ciguatoxin for biological applications.

  11. Economic analysis of two-stage septic revision after total hip arthroplasty: What are the relevant costs for the hospital's orthopedic department?

    Science.gov (United States)

    Kasch, R; Assmann, G; Merk, S; Barz, T; Melloh, M; Hofer, A; Merk, H; Flessa, S

    2016-03-01

    The number of septic total hip arthroplasty (THA) revisions is increasing continuously, placing a growing financial burden on hospitals. Orthopedic departments performing septic THA revisions have no basis for decision making regarding resource allocation as the costs of this procedure for the departments are unknown. It is widely assumed that septic THA procedures can only be performed at a loss for the department. Therefore, the purpose of this study was to investigate whether this assumption is true by performing a detailed analysis of the costs and revenues for two-stage septic THA revision. Patients who underwent revision THA for septic loosening in two sessions from January 2009 through March 2012 were included in this retrospective, consecutive cost study from the orthopedic department's point of view. We analyzed variable and case-fixed costs for septic revision THA with special regard to implantation and explantation stay. By using marginal costing approach we neglected hospital-fixed costs. Outcome measures include reimbursement and daily contribution margins. The average direct costs (reimbursement) incurred for septic two-stage revision THA was €10,828 (€24,201). The difference in cost and contribution margins per day was significant (p cost for septic revision THA performed in two sessions. Disregarding hospital-fixed costs the included variable and case fixed-costs were covered by revenues. This study provides cost data, which will be guidance for health care decision makers.

  12. Studies of a Diazo Cyclopropanation Strategy for the Total Synthesis of (-)-Lundurine A.

    Science.gov (United States)

    Huang, Hong-Xiu; Jin, Shuai-Jiang; Gong, Jin; Zhang, Dan; Song, Hao; Qin, Yong

    2015-09-14

    The bioactive Kopsia alkaloids lundurines A-D are the only natural products known to contain indolylcyclopropane. Achieving their syntheses can provide important insights into their biogenesis, as well as novel synthetic routes for complex natural products. Asymmetric total synthesis of (-)-lundurine A has previously been achieved through a Simmons-Smith cyclopropanation strategy. Here, the total synthesis of (-)-lundurine A was carried out using a metal-catalyzed diazo cyclopropanation strategy. In order to avoid a carbene CH insertion side reaction during cyclopropanation of α-diazo- carboxylates or cyanides, a one-pot, copper-catalyzed Bamford-Stevens diazotization/diazo decomposition/cyclopropanation cascade was developed, involving hydrazone. This approach simultaneously generates the C/D/E ring system and the two chiral quaternary centers at C2 and C7. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Quinones as dienophiles in the Diels-Alder reaction: history and applications in total synthesis.

    Science.gov (United States)

    Nawrat, Christopher C; Moody, Christopher J

    2014-02-17

    In the canon of reactions available to the organic chemist engaged in total synthesis, the Diels-Alder reaction is among the most powerful and well understood. Its ability to rapidly generate molecular complexity through the simultaneous formation of two carbon-carbon bonds is almost unrivalled, and this is reflected in the great number of reported applications of this reaction. Historically, the use of quinones as dienophiles is highly significant, being the very first example investigated by Diels and Alder. Herein, we review the application of the Diels-Alder reaction of quinones in the total synthesis of natural products. The highlighted examples span some 60 years from the landmark syntheses of morphine (1952) and reserpine (1956) by Gates and Woodward, respectively, through to the present day examples, such as the tetracyclines. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Revision of failed hip resurfacing to total hip arthroplasty rapidly relieves pain and improves function in the early post operative period

    Directory of Open Access Journals (Sweden)

    Muirhead-Allwood Sarah K

    2010-11-01

    Full Text Available Abstract We reviewed the results of 25 consecutive patients who underwent revision of a hip resurfacing prosthesis to a total hip replacement. Revisions were performed for recurrent pain and effusion, infection and proximal femoral fractures. Both components were revised in 20 cases. There were 12 male and 13 female patients with average time to revision of 34.4 and 26.4 months respectively. The mean follow up period was 12.7 months (3 to 31. All patients reported relief of pain and excellent satisfaction scores. Two patients experienced stiffness up to three months post operatively. Pre operative Oxford, Harris and WOMAC hip scores were 39.1, 36.4 and 52.2 respectively. Mean post operative scores at last follow up were 17.4, 89.8 and 6.1 respectively (p

  15. First- and second-generation total synthesis of ciguatoxin CTX3C

    OpenAIRE

    Inoue, Masayuki; Miyazaki, Keisuke; Uehara, Hisatoshi; Maruyama, Megumi; Hirama, Masahiro

    2004-01-01

    More than 20,000 people suffer annually from ciguatera seafood poisoning in subtropical and tropical regions. The extremely low content of the causative neurotoxins, designated as ciguatoxins, in fish has hampered isolation, detailed biological studies, and preparation of anti-ciguatoxin antibodies for detecting these toxins. Furthermore, the large (3 nm in length) and complex molecular structure of ciguatoxins has impeded chemists from completing their total synthesis. In this article, the f...

  16. Total synthesis of Ivorenolide A following a base-induced elimination protocol.

    Science.gov (United States)

    Mohapatra, Debendra K; Umamaheshwar, Gonela; Rao, R Nageshwar; Rao, T Srinivasa; R, Sudheer Kumar; Yadav, Jhillu S

    2015-02-20

    A concise and stereocontrolled first total synthesis of Ivorenolide A (1) is reported in 16 longest linear steps with a 13.4% overall yield starting from (+)-diethyl tartrate (DET). Key features are base-induced elimination protocol for the construction of chiral propargyl alcohols in both fragments, Pd-catalyzed cross-coupling of terminal acetylenes, and Shiina's 2-methyl-6-nitrobezoic anhydride (MNBA) mediated macrolactonization.

  17. Total Synthesis of Ustiloxin D Utilizing an Ammonia-Ugi Reaction.

    Science.gov (United States)

    Brown, Aaron L; Churches, Quentin I; Hutton, Craig A

    2015-10-16

    Total synthesis of the highly functionalized cyclic peptide natural product, ustiloxin D, has been achieved in a convergent manner. Our strategy incorporates an asymmetric allylic alkylation to construct the tert-alkyl aryl ether linkage between the dopa and isoleucine residues. The elaborated β-hydroxydopa derivative is rapidly converted to a linear tripeptide through an ammonia-Ugi reaction. Subsequent cyclization and global deprotection affords ustiloxin D in six steps from a known β-hydroxydopa derivative.

  18. The asymmetric total synthesis of (+)- and (-)-trypargine via Noyori asymmetric transfer hydrogenation

    International Nuclear Information System (INIS)

    Pilli, Ronaldo A.; Rodrigues Junior, Manoel Trindade

    2009-01-01

    A concise and efficient total synthesis of (+)- and (-)-trypargine (6 steps and 38% overall yield), a 1-substituted β-carboline guanidine alkaloid isolated from the skin of the African frog K. senegalensis, was developed based on the construction of the b-carboline moiety via Bischler-Napieralski reaction and the enantioselective reduction of the dihydro-β-carboline intermediate via an asymmetric transfer hydrogenation reaction using Noyori's protocol. (author)

  19. Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry

    DEFF Research Database (Denmark)

    Paulsen, Aksel; Pedersen, Alma B; Johnsen, Søren P

    2007-01-01

    BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip Arthropla......BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip...

  20. The Impact of use of Double Set-up on Infection Rates in Revision Total Knee Replacement and Limb Salvage Procedures

    Directory of Open Access Journals (Sweden)

    Jennifer Waterman

    2015-03-01

    Full Text Available A retrospective analysis was performed to determine the impact of utilizing a double set-up procedure on reducing infection rates revision total knee and limb salvage procedures in patients with known joint infection.  Eighteen cases fit selection criteria.  The recurrence rate of infection was 5.5% which is less than reported recent literature review.   This suggests the use of a double set-up in combination with other infection reducing protocols may help further reduce recurrent infection.  Keywords: double set-up, infection, revision total knee arthroplasty, limb-salvage

  1. Natural Product Total Synthesis in the Organic Laboratory: Total Synthesis of Caffeic Acid Phenethyl Ester (CAPE), a Potent 5-Lipoxygenase Inhibitor from Honeybee Hives

    Science.gov (United States)

    Touaibia, Mohamed; Guay, Michel

    2011-01-01

    Natural products play a critical role in modern organic synthesis and learning synthetic techniques is an important component of the organic laboratory experience. In addition to traditional one-step organic synthesis laboratories, a multistep natural product synthesis is an interesting experiment to challenge students. The proposed three-step…

  2. The use of a tripolar articulation in revision total hip arthroplasty: a minimum of 24 months' follow-up.

    Science.gov (United States)

    Levine, Brett R; Della Valle, Craig J; Deirmengian, Carl A; Breien, Kristoffer M; Weeden, Steven H; Sporer, Scott M; Paprosky, Wayne G

    2008-12-01

    A retrospective cohort study of 31 hips revised with a tripolar articular construct was performed. Patient demographics and preoperative and postoperative information were recorded. Indications for a tripolar construct were recurrent dislocation and the inability to attain intraoperative stability during hip revision. Nine patients (29%) were revised to the tripolar construct after failure of a constrained liner. Twenty patients (65%) had at least one episode of instability before the most recent revision. At a mean follow-up of 38 months, modified Postel scores improved from a mean of 5.28 to 9.64 (P tripolar construct was effective in eliminating or preventing instability in 93% of the complex cases treated. These early results support the use of a tripolar construct in treating recurrent instability or instability encountered at the time of revision hip arthroplasty.

  3. Evaluation of the Painful Dual Taper Modular Neck Stem Total Hip Arthroplasty: Do They All Require Revision?

    Science.gov (United States)

    Kwon, Young-Min

    2016-07-01

    Although dual taper modular-neck total hip arthroplasty (THA) design with additional neck-stem modularity has the potential to optimize hip biomechanical parameters by facilitating adjustments of leg length, femoral neck version and offset, there is increasing concern regarding this stem design as a result of the growing numbers of adverse local tissue reactions due to fretting and corrosion at the neck-stem taper junction. Implant factors such as taper cone angle, taper surface roughness, taper contact area, modular neck taper metallurgy, and femoral head size play important roles in influencing extent of taper corrosion. There should be a low threshold to conduct a systematic clinical evaluation of patients with dual-taper modular-neck stem THA using systematic risk stratification algorithms as early recognition and diagnosis will ensure prompt and appropriate treatment. Although specialized tests such as metal ion analysis and cross-sectional imaging modalities such as metal artifact reduction sequence magnetic resonance imaging (MARS MRI) are useful in optimizing clinical decision-making, overreliance on any single investigative tool in the clinical decision-making process for revision surgery should be avoided. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Revisions to the original extent of the Devonian Shale-Middle and Upper Paleozoic Total Petroleum System

    Science.gov (United States)

    Enomoto, Catherine B.; Rouse, William A.; Trippi, Michael H.; Higley, Debra K.

    2016-04-11

    Technically recoverable undiscovered hydrocarbon resources in continuous accumulations are present in Upper Devonian and Lower Mississippian strata in the Appalachian Basin Petroleum Province. The province includes parts of New York, Pennsylvania, Ohio, Maryland, West Virginia, Virginia, Kentucky, Tennessee, Georgia, and Alabama. The Upper Devonian and Lower Mississippian strata are part of the previously defined Devonian Shale-Middle and Upper Paleozoic Total Petroleum System (TPS) that extends from New York to Tennessee. This publication presents a revision to the extent of the Devonian Shale-Middle and Upper Paleozoic TPS. The most significant modification to the maximum extent of the Devonian Shale-Middle and Upper Paleozoic TPS is to the south and southwest, adding areas in Tennessee, Georgia, Alabama, and Mississippi where Devonian strata, including potential petroleum source rocks, are present in the subsurface up to the outcrop. The Middle to Upper Devonian Chattanooga Shale extends from southeastern Kentucky to Alabama and eastern Mississippi. Production from Devonian shale has been established in the Appalachian fold and thrust belt of northeastern Alabama. Exploratory drilling has encountered Middle to Upper Devonian strata containing organic-rich shale in west-central Alabama. The areas added to the TPS are located in the Valley and Ridge, Interior Low Plateaus, and Appalachian Plateaus physiographic provinces, including the portion of the Appalachian fold and thrust belt buried beneath Cretaceous and younger sediments that were deposited on the U.S. Gulf Coastal Plain.

  5. Revision rates for metal-on-metal hip resurfacing and metal-on-metal total hip arthroplasty – a systematic review

    DEFF Research Database (Denmark)

    Ras Sørensen, Sofie-amalie L.; Jørgensen, Henrik L.; Sporing, Sune L.

    2016-01-01

    Purpose To compare revision rates of metal-on-metal (MoM) hip resurfacing (HRS) and MoM total hip arthroplasty (THA), as well as the primary causes for revisions. Methods The PubMed database was queried for potentially relevant articles addressing MoMTHA and MoMHRS, a total of 51 articles were....... The odds ratio was 1.25 (1.03:1.53) 95% CI (p = 0.03) (MoMHRS vs. MoMTHA). The studies of hip prostheses were separated into 2 categories of short- and long-term (more or less than 5 years). Short-term revision rate for MoMTHA was 4.5% after 4.8 years, and for MoMHRS 4.0% after 4.2 years. The odds ratio...

  6. Total synthesis of cytochrome b562 by native chemical ligation using a removable auxiliary

    Science.gov (United States)

    Low, Donald W.; Hill, Michael G.; Carrasco, Michael R.; Kent, Stephen B. H.; Botti, Paolo

    2001-01-01

    We have completed the total chemical synthesis of cytochrome b562 and an axial ligand analogue, [SeMet7]cyt b562, by thioester-mediated chemical ligation of unprotected peptide segments. A novel auxiliary-mediated native chemical ligation that enables peptide ligation to be applied to protein sequences lacking cysteine was used. A cleavable thiol-containing auxiliary group, 1-phenyl-2-mercaptoethyl, was added to the α-amino group of one peptide segment to facilitate amide bond-forming ligation. The amine-linked 1-phenyl-2-mercaptoethyl auxiliary was stable to anhydrous hydrogen fluoride used to cleave and deprotect peptides after solid-phase peptide synthesis. Following native chemical ligation with a thioester-containing segment, the auxiliary group was cleanly removed from the newly formed amide bond by treatment with anhydrous hydrogen fluoride, yielding a full-length unmodified polypeptide product. The resulting polypeptide was reconstituted with heme and folded to form the functional protein molecule. Synthetic wild-type cyt b562 exhibited spectroscopic and electrochemical properties identical to the recombinant protein, whereas the engineered [SeMet7]cyt b562 analogue protein was spectroscopically and functionally distinct, with a reduction potential shifted by ≈45 mV. The use of the 1-phenyl-2-mercaptoethyl removable auxiliary reported here will greatly expand the applicability of total protein synthesis by native chemical ligation of unprotected peptide segments. PMID:11390992

  7. Total synthesis of a Streptococcus pneumoniae serotype 12F CPS repeating unit hexasaccharide

    Directory of Open Access Journals (Sweden)

    Peter H. Seeberger

    2017-01-01

    Full Text Available The Gram-positive bacterium Streptococcus pneumoniae causes severe disease globally. Vaccines that prevent S. pneumoniae infections induce antibodies against epitopes within the bacterial capsular polysaccharide (CPS. A better immunological understanding of the epitopes that protect from bacterial infection requires defined oligosaccharides obtained by total synthesis. The key to the synthesis of the S. pneumoniae serotype 12F CPS hexasaccharide repeating unit that is not contained in currently used glycoconjugate vaccines is the assembly of the trisaccharide β-D-GalpNAc-(1→4-[α-D-Glcp-(1→3]-β-D-ManpNAcA, in which the branching points are equipped with orthogonal protecting groups. A linear approach relying on the sequential assembly of monosaccharide building blocks proved superior to a convergent [3 + 3] strategy that was not successful due to steric constraints. The synthetic hexasaccharide is the starting point for further immunological investigations.

  8. Lobatamide C: total synthesis, stereochemical assignment, preparation of simplified analogues, and V-ATPase inhibition studies.

    Science.gov (United States)

    Shen, Ruichao; Lin, Cheng Ting; Bowman, Emma Jean; Bowman, Barry J; Porco, John A

    2003-07-02

    The total synthesis and stereochemical assignment of the potent antitumor macrolide lobatamide C, as well as synthesis of simplified lobatamide analogues, is reported. Cu(I)-mediated enamide formation methodology has been developed to prepare the highly unsaturated enamide side chain of the natural product and analogues. A key fragment coupling employs base-mediated esterification of a beta-hydroxy acid and a salicylate cyanomethyl ester. Three additional stereoisomers of lobatamide C have been prepared using related synthetic routes. The stereochemistry at C8, C11, and C15 of lobatamide C was assigned by comparison of stereoisomers and X-ray analysis of a crystalline derivative. Synthetic lobatamide C, stereoisomers, and simplified analogues have been evaluated for inhibition of bovine chromaffin granule membrane V-ATPase. The salicylate phenol, enamide NH, and ortho-substitution of the salicylate ester have been shown to be important for V-ATPase inhibitory activity.

  9. Review of revised Klamath River Total Maximum Daily Load models from Link River Dam to Keno Dam, Oregon

    Science.gov (United States)

    Rounds, Stewart A.; Sullivan, Annett B.

    2013-01-01

    Flow and water-quality models are being used to support the development of Total Maximum Daily Load (TMDL) plans for the Klamath River downstream of Upper Klamath Lake (UKL) in south-central Oregon. For riverine reaches, the RMA-2 and RMA-11 models were used, whereas the CE-QUAL-W2 model was used to simulate pooled reaches. The U.S. Geological Survey (USGS) was asked to review the most upstream of these models, from Link River Dam at the outlet of UKL downstream through the first pooled reach of the Klamath River from Lake Ewauna to Keno Dam. Previous versions of these models were reviewed in 2009 by USGS. Since that time, important revisions were made to correct several problems and address other issues. This review documents an assessment of the revised models, with emphasis on the model revisions and any remaining issues. The primary focus of this review is the 19.7-mile Lake Ewauna to Keno Dam reach of the Klamath River that was simulated with the CE-QUAL-W2 model. Water spends far more time in the Lake Ewauna to Keno Dam reach than in the 1-mile Link River reach that connects UKL to the Klamath River, and most of the critical reactions affecting water quality upstream of Keno Dam occur in that pooled reach. This model review includes assessments of years 2000 and 2002 current conditions scenarios, which were used to calibrate the model, as well as a natural conditions scenario that was used as the reference condition for the TMDL and was based on the 2000 flow conditions. The natural conditions scenario included the removal of Keno Dam, restoration of the Keno reef (a shallow spot that was removed when the dam was built), removal of all point-source inputs, and derivation of upstream boundary water-quality inputs from a previously developed UKL TMDL model. This review examined the details of the models, including model algorithms, parameter values, and boundary conditions; the review did not assess the draft Klamath River TMDL or the TMDL allocations

  10. Total synthesis of TMG-chitotriomycin based on an automated electrochemical assembly of a disaccharide building block.

    Science.gov (United States)

    Isoda, Yuta; Sasaki, Norihiko; Kitamura, Kei; Takahashi, Shuji; Manmode, Sujit; Takeda-Okuda, Naoko; Tamura, Jun-Ichi; Nokami, Toshiki; Itoh, Toshiyuki

    2017-01-01

    The total synthesis of TMG-chitotriomycin using an automated electrochemical synthesizer for the assembly of carbohydrate building blocks is demonstrated. We have successfully prepared a precursor of TMG-chitotriomycin, which is a structurally-pure tetrasaccharide with typical protecting groups, through the methodology of automated electrochemical solution-phase synthesis developed by us. The synthesis of structurally well-defined TMG-chitotriomycin has been accomplished in 10-steps from a disaccharide building block.

  11. Total synthesis of TMG-chitotriomycin based on an automated electrochemical assembly of a disaccharide building block

    Directory of Open Access Journals (Sweden)

    Yuta Isoda

    2017-05-01

    Full Text Available The total synthesis of TMG-chitotriomycin using an automated electrochemical synthesizer for the assembly of carbohydrate building blocks is demonstrated. We have successfully prepared a precursor of TMG-chitotriomycin, which is a structurally-pure tetrasaccharide with typical protecting groups, through the methodology of automated electrochemical solution-phase synthesis developed by us. The synthesis of structurally well-defined TMG-chitotriomycin has been accomplished in 10-steps from a disaccharide building block.

  12. Bone Metabolism after Total Hip Revision Surgery with Impacted Grafting: Evaluation using H215O and [18F]fluoride PET; A Pilot Study

    NARCIS (Netherlands)

    Temmerman, Olivier; Raijmakers, Pieter; Heyligers, Ide; Comans, Emile; Lubberink, Mark; Teule, Gerrit; Lammertsma, Adriaan

    2008-01-01

    Purpose: To evaluate bone blood flow and bone formation in patients after total hip revision surgery with impacted bone grafting using H2 15O and [18F]fluoride positron emission tomography (PET). Procedures: To asses bone blood flow and bone metabolism in bone allograft after impaction grafting,

  13. Bone mineral density changes of the proximal tibia after revision total knee arthroplasty. A randomised study with the use of porous tantalum metaphyseal cones

    DEFF Research Database (Denmark)

    Jensen, Claus L; Petersen, Michael M; Schrøder, Henrik M

    2012-01-01

    Forty patients were enrolled in a prospective randomised study using conventional method or "Trabecular Metal Cone" (TM Cone) (Zimmer inc., Warsaw, USA) for reconstruction of bone loss of the proximal tibia during revision total knee arthroplasty (rTKA). The aim was to evaluate changes in bone mi...

  14. Total Synthesis, Proof of Absolute Configuration, and Biosynthetic Origin of Stylopsal, the First Isolated Sex Pheromone of Strepsiptera

    Czech Academy of Sciences Publication Activity Database

    Lagoutte, Roman; Šebesta, Petr; Jiroš, Pavel; Kalinová, Blanka; Jirošová, Anna; Straka, J.; Černá, K.; Šobotník, Jan; Cvačka, Josef; Jahn, Ullrich

    2013-01-01

    Roč. 19, č. 26 (2013), s. 8515-8524 ISSN 0947-6539 R&D Projects: GA ČR GAP506/10/1466 Institutional support: RVO:61388963 Keywords : asymmetric synthesis * configuration determination * pheromones * total synthesis * Wittig reactions Subject RIV: CC - Organic Chemistry Impact factor: 5.696, year: 2013

  15. Outcomes of different bearings in total hip arthroplasty - implant survival, revision causes, and patient-reported outcome

    DEFF Research Database (Denmark)

    Varnum, Claus

    2017-01-01

    ceramic-on-ceramic (CoC) THAs comparing them to those of "standard" metal-on-polyethylene (MoP) THAs. Study II: To compare the six-year revision risk for metal-on-metal (MoM) with that for MoP bearings in cementless stemmed THA, and further to study the revision risk for different designs of stemmed Mo...... for the outcome of THA is the type of bearings. This PhD thesis focuses on the influence of different types of bearings on implant survival, revision causes, PROMs, and noises from THA. The aims of the thesis were: Study I: To examine the revision risk and to investigate the causes of revision of cementless......M THAs and the causes of revision. Study III: To examine the association between CoC, MoM, and MoP bearings and both generic and disease-specific PROMs, and furthermore to examine the incidence and types of noises from the three types of bearings and identify the effect of noises on PROM scores. In study...

  16. Association between fixation technique and revision risk in total hip arthroplasty patients younger than 55 years of age. Results from the Nordic Arthroplasty Register Association

    DEFF Research Database (Denmark)

    Pedersen, A. B.; Mehnert, F.; Havelin, L. I.

    2014-01-01

    Objectives: To evaluate implant survival following primary total hip replacement (THR) in younger patients. To describe the diversity in use of cup-stem implant combinations. Design: 29,558 primary THRs osteoarthritis (OA) patients younger than 55 years of age performed from 1995 through 2011 were...... identified using the Nordic Arthroplasty Registry Association database. We estimated adjusted relative risk (aRR) of revision with 95% confidence interval (CI) using Cox regression. Results: In general, no difference was observed between uncemented and cemented implants in terms of risk of any revision...

  17. Catalytic Asymmetric Total Synthesis of (+)- and (-)-Paeoveitol via a Hetero-Diels-Alder Reaction.

    Science.gov (United States)

    Li, Tian-Ze; Geng, Chang-An; Yin, Xiu-Juan; Yang, Tong-Hua; Chen, Xing-Long; Huang, Xiao-Yan; Ma, Yun-Bao; Zhang, Xue-Mei; Chen, Ji-Jun

    2017-02-03

    The first catalytic asymmetric total synthesis of (+)- and (-)-paeoveitol has been accomplished in 42% overall yield via a biomimetic hetero-Diels-Alder reaction. The chiral phosphoric acid catalyzed hetero-Diels-Alder reaction showed excellent diastereo- and enantioselectivity (>99:1 dr and 90% ee); two rings and three stereocenters were constructed in a single step to produce (-)-paeoveitol on a scale of 452 mg. This strategy enabled us to selectively synthesize both paeoveitol enantiomers from the same substrates by simply changing the enantiomer of the catalyst.

  18. Unscheduled DNA synthesis in spleen cells of mice exposed to low doses of total body irradiation

    International Nuclear Information System (INIS)

    Tuschl, H.; Kovac, R.; Hruby, E.

    1983-07-01

    Unscheduled DNA synthesis was induced by UV irradiation of spleen cells obtained from C 57 Bl mice after repeated total body irradiation of 0.05 Gy 60 Co (0.00125 Gy/mice) and determined autoradiographically. An enhancement in the ability for repair of UV induced DNA lesions was observed in cells of gamma irradiated animals. While the amount of 3 H-thymidine incorporated per cell was increased, the percentage of labeled cells remained unchanged. The present results are compared with previous data on low dose radiation exposure in men. (Author) [de

  19. Biosynthesis and Total Synthesis of Pyrronazol B: a Secondary Metabolite from Nannocystis pusilla.

    Science.gov (United States)

    Witte, Swjatoslaw N R; Hug, Joachim J; Géraldy, Magalie N E; Müller, Rolf; Kalesse, Markus

    2017-11-13

    The first stereoselective total synthesis of the natural product pyrronazol B, which contains a chlorinated pyrrole-oxazole-pyrone framework, has been achieved. Genome sequencing of the myxobacterial producer strain Nannocystis pusilla Ari7 led to the identification of the putative biosynthetic gene cluster. The proposed biosynthetic pathway was supported by feeding experiments with stable isotopes of three biosynthetic building blocks, namely l-proline, l-serine, and l-methionine. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Total synthesis of leopolic acid A, a natural 2,3-pyrrolidinedione with antimicrobial activity

    Directory of Open Access Journals (Sweden)

    Atul A. Dhavan

    2016-07-01

    Full Text Available The first total synthesis of leopolic acid A, a fungal metabolite with a rare 2,3-pyrrolidinedione nucleus linked to an ureido dipeptide, was designed and carried out. Crucial steps for the strategy include a Dieckmann cyclization to obtain the 2,3-pyrrolidinedione ring and a Wittig olefination to install the polymethylene chain. An oxazolidinone-containing leopolic acid A analogue was also synthesized. The antibacterial activity showed by both compounds suggests that they could be considered as promising candidates for future developments.

  1. Total synthesis of crocacins A, C and D: new antibiotics isolated from Chondromyces crocatus and Chondromyces pediculatus

    International Nuclear Information System (INIS)

    Oliveira, Luciana G. de; Dias, Luiz C.; Rosso, Giovanni B.

    2008-01-01

    This review describes the endeavors that led to the total synthesis of a novel class of antibiotic compounds: the crocacins A-D. Other aspects such as isolation, structural elucidation as well as the biological activities are also presented. (author)

  2. Total synthesis of complestatin: development of a Pd(0)-mediated indole annulation for macrocyclization.

    Science.gov (United States)

    Shimamura, Hiroyuki; Breazzano, Steven P; Garfunkle, Joie; Kimball, F Scott; Trzupek, John D; Boger, Dale L

    2010-06-09

    Full details of the initial development and continued examination of a powerful intramolecular palladium(0)-mediated indole annulation for macrocyclization closure of the strained 16-membered biaryl ring system found in complestatin (1, chloropeptin II) and the definition of factors impacting its intrinsic atropodiastereoselectivity are described. Its examination and use in an alternative, second-generation total synthesis of complestatin are detailed in which the order of the macrocyclization reactions was reversed from our first-generation total synthesis. In this approach and with the ABCD biaryl ether ring system in place, the key Larock cyclization was conducted with substrate 36 (containing four phenols, five secondary amides, one carbamate, and four labile aryl chlorides) and provided the product 37 (56%) exclusively as a single atropisomer (>20:1, detection limits) possessing the natural (R)-configuration. In this instance, the complexity of the substrate and the reverse macrocyclization order did not diminish the atropodiastereoselectivity; rather, it provided an improvement over the 4:1 selectivity that was observed with the analogous substrate used to provide the isolated DEF ring system in our first-generation approach. Just as significant, the atroposelectivity represents a complete reversal of the diasteroselectivity observed with analogous macrocyclizations conducted using a Suzuki biaryl coupling.

  3. Synergistic effects of intravenous and intra-articular tranexamic acid on reducing hemoglobin loss in revision total knee arthroplasty: a prospective, randomized, controlled study.

    Science.gov (United States)

    Yuan, Xiangwei; Wang, Jiaxing; Wang, Qiaojie; Zhang, Xianlong

    2018-04-01

    Tranexamic acid decreases blood loss in primary total knee arthroplasty, and no related prospective randomized clinical trials have been conducted to evaluate the effectiveness and safety of tranexamic acid in revision total knee arthroplasty. Thus, we conducted this work to evaluate the synergistic effects of intravenous plus intra-articular tranexamic acid on reducing hemoglobin loss compared with intra-articular tranexamic acid alone in revision total knee arthroplasty. This prospective, controlled study randomized 96 patients undergoing revision total knee arthroplasty into two groups: an intravenous plus intra-articular tranexamic acid group (48 patients who received 20 mg/kg intravenous tranexamic acid and 3.0 g intra-articular tranexamic acid); and an intra-articular tranexamic acid alone group (48 patients who received the same intravenous volume of normal saline and 3.0 g intra-articular tranexamic acid). The primary outcome was hemoglobin loss. Secondary outcomes included the volume of drain output, the percentage of patients who received transfusions, the number of units transfused, and thromboembolic events. The baseline data, preoperative hemoglobin, and tourniquet time were similar in both groups. There was significantly less hemoglobin loss in the intravenous plus intra-articular tranexamic acid group compared with the intra-articular tranexamic acid alone group (2.7 ± 0.6 g/dL and 3.7 ± 0.7 g/dL; p tranexamic acid alone group, the intravenous plus intra-articular tranexamic acid group also had significantly less drain output, fewer patients who received transfusions, and fewer units transfused (all p tranexamic acid alone, combined intravenous plus intra-articular tranexamic acid significantly reduced hemoglobin loss and the need for transfusion without an apparent increase in thromboembolic events in patients who underwent revision total knee arthroplasty. © 2018 AABB.

  4. Total synthesis of bryostatins: the development of methodology for the atom-economic and stereoselective synthesis of the ring C subunit.

    Science.gov (United States)

    Trost, Barry M; Frontier, Alison J; Thiel, Oliver R; Yang, Hanbiao; Dong, Guangbin

    2011-08-22

    Bryostatins, a family of structurally complicated macrolides, exhibit an exceptional range of biological activities. The limited availability and structural complexity of these molecules makes development of an efficient total synthesis particularly important. This article describes our initial efforts towards the total synthesis of bryostatins, in which chemoselective and atom-economical methods for the stereoselective assembly of the ring C subunit were developed. A Pd-catalyzed tandem alkyne-alkyne coupling/6-endo-dig cyclization sequence was explored and successfully pursued in the synthesis of a dihydropyran ring system. Elaboration of this methodology ultimately led to a concise synthesis of the ring C subunit of bryostatins. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Total synthesis of five lipoteichoic acids of Clostridium difficile

    DEFF Research Database (Denmark)

    Hogendorf, Wouter Frederik Johan; Gisch, Nicolas; Schwudke, Dominik

    2014-01-01

    The emergence of hypervirulent resistant strains have made Clostridium difficile a notorious nosocomial pathogen and has resulted in a renewed interest in preventive strategies, such as vaccines based on (synthetic) cell wall antigens. Recently, the structure of the lipoteichoic acid (LTA......) of this species has been elucidated. Additionally, this LTA was found to induce the formation of protective antibodies against C. difficile in rabbits and mice. The LTA from C. difficile is isolated as a microheterogenous mixture, differing in size and composition, impeding any structure-activity relationship...... studies. To ensure reliable biological results, pure and well-defined synthetic samples are required. In this work the total synthesis of LTAs from C. difficile with defined chain length is described and the initial biological results are presented....

  6. Total synthesis of ciguatoxin and 51-hydroxyCTX3C.

    Science.gov (United States)

    Inoue, Masayuki; Miyazaki, Keisuke; Ishihara, Yuuki; Tatami, Atsushi; Ohnuma, Yuyu; Kawada, Yuuya; Komano, Kazuo; Yamashita, Shuji; Lee, Nayoung; Hirama, Masahiro

    2006-07-26

    Ciguatoxins, the principal causative toxins of ciguatera seafood poisoning, are large ladder-like polycyclic ethers with the 13 ether rings ranging from five- to nine-membered. In this paper, we describe the total synthesis of the two most toxic members of the ciguatoxin family, ciguatoxin 1 and 51-hydroxyCTX3C 2, based on a unified synthetic strategy. The key features in our syntheses were (i) direct construction of the O,S-acetal from the corresponding left and right wing fragments (3, 4, 14); (ii) stereo- and chemoselective radical reaction of the alpha-oxyradical with pentafluorophenyl acrylate to achieve cyclization of the seven-membered G-ring; (iii) ring-closing metathesis reaction to build the nine-membered F-ring; and (iv) an efficient protective group strategy using the oxidatively removable 2-naphthylmethyl groups.

  7. Total synthesis of fully tritiated Leu-enkephalin by enzymatic coupling

    Energy Technology Data Exchange (ETDEWEB)

    Hellio, F.; Lecocq, G.; Morgat, J.L.; Gueguen, P. (CEA Centre d' Etudes Nucleaires de Saclay, 91 - Gif-sur-Yvette (France). Service de Biochimie)

    1990-09-01

    This paper describes the total enzymatic synthesis of Leu-enkephalin (Tyr-Gly-Gly-Phe-Leu) in which all residues were labelled with tritium. Carboxypeptidase Y from Saccharomyces cerevisiae was the coupling enzyme. ({sup 3}H)-Tyr-NH{sub 2}, ({sup 3}H)-Gly-Oet, ({sup 3}H)-Phe-NH{sub 2} and ({sup 3}H)-Leu-NH{sub 2} were prepared with specific radioactivities ranging between 20 and 60 Ci/mmol (740 to 2220 GBq/mmol). Using a microscale procedure, we obtained a fully tritiated hormone having a specific radioactivity equal to 139 Ci/mmol (5143 GBq/mmol), in agreement with the summation of the specific radioactivities of constituting residue. The radioactive hormone had antigenic properties identical to those of native Leu-enkephalin. It also bound to rat brain opiate receptors like the parental hormone. (author).

  8. Stem cell engineered bone with calcium-phosphate coated porous titanium scaffold or silicon hydroxyapatite granules for revision total joint arthroplasty.

    Science.gov (United States)

    García-Gareta, Elena; Hua, Jia; Rayan, Faizal; Blunn, Gordon W

    2014-06-01

    Aseptic loosening in total joint replacements (TJRs) is mainly caused by osteolysis which leads to a reduction of the bone stock necessary for implant fixation in revision TJRs. Our aim was to develop bone tissue-engineered constructs based on scaffolds of clinical relevance in revision TJRs to reconstitute the bone stock at revision operations by using a perfusion bioreactor system (PBRS). The hypothesis was that a PBRS will enhance mesenchymal stem cells (MSCs) proliferation and osteogenic differentiation and will provide an even distribution of MSCs throughout the scaffolds when compared to static cultures. A PBRS was designed and implemented. Scaffolds, silicon substituted hydroxyapatite granules and calcium-phosphate coated porous TiAl6V4 cylinders, were seeded with MSCs and cultured either in static conditions or in the PBRS at 0.75 mL/min. Statistically significant increased cell proliferation and alkaline phosphatase activity was found in samples cultured in the PBRS. Histology revealed a more even cell distribution in the perfused constructs. SEM showed that cells arranged in sheets. Long cytoplasmic processes attached the cells to the scaffolds. We conclude that a novel tissue engineering approach to address the issue of poor bone stock at revision operations is feasible by using a PBRS.

  9. No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls.

    Science.gov (United States)

    Nielsen, Christian Skovgaard; Gromov, Kirill; Jans, Øivind; Troelsen, Anders; Husted, Henrik

    2017-01-01

    Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim of this study was therefore to evaluate the effect of a bipolar sealer on blood loss and transfusion in revision TKA. In this single-center prospective cohort study with retrospective controls, 51 patients were enrolled in a fast-track setup for revision TKA without the use of a tourniquet. Twenty-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group. No significant differences were found neither for calculated blood loss, with 1397 (standard deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up. The use of a bipolar sealer in a TKA revision setting without the use of a tourniquet did not reduce blood loss or blood transfusion rates. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Divergent solid-phase synthesis of natural product-inspired bipartite cyclodepsipeptides : total synthesis of seragamide A

    NARCIS (Netherlands)

    Arndt, H.-D.; Rizzo, S.; Nöcker, Chr.; Wackchaure, V.N.; Milroy, L.G.; Bieker, V.; Calderon, A.; Tran, T.T.N.; Brand, S.; Dehmelt, L.; Waldmann, H.

    2015-01-01

    Macrocyclic natural products (NPs) and analogues thereof often show high affinity, selectivity, and metabolic stability, and methods for the synthesis of NP-like macrocycle collections are of major current interest. We report an efficient solid-phase/cyclorelease method for the synthesis of a

  11. No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls

    DEFF Research Database (Denmark)

    Nielsen, Christian Skovgaard; Gromov, Kirill; Jans, Øivind

    2017-01-01

    deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up. CONCLUSION: The use of a bipolar sealer in a TKA revision setting without......BACKGROUND: Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim......-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group. RESULTS: No significant differences were found neither for calculated blood loss, with 1397 (standard...

  12. Patella tendon injuries secondary to cement spacers used at first-stage revision of infected total knee replacement

    Directory of Open Access Journals (Sweden)

    Wasim S Khan

    2015-04-01

    Full Text Available We describe a series of three patients who sustained patella tendon injuries in infected TKAs following the use of a static cement spacer at first-stage knee revision. The patella tendon injuries resulted in significant compromise to wound healing and knee stability requiring multiple surgeries. The mid-term function was poor with an Oxford score at 24 months ranging from 12-20. Based on our experience, we advise caution in the use of static cement spacer blocks. If they are to be used, we recommend that they should be keyed in the bone to prevent patella tendon injuries.

  13. Does a thrombin-based topical haemostatic agent reduce blood loss and transfusion requirements after total knee revision surgery? A randomized, controlled trial.

    Science.gov (United States)

    Romanò, Carlo L; Monti, Lorenzo; Logoluso, Nicola; Romanò, Delia; Drago, Lorenzo

    2015-11-01

    The aim of the present study was to assess the efficacy of a thrombin-based topical haemostatic in reducing blood requirements after total knee replacement (TKR) revision surgery. This prospective, randomized, controlled study was designed to evaluate the haemostatic efficacy and safety of a thrombin-based topical haemostatic (Floseal) versus standard treatment in patients receiving total knee revision arthroplasty. The decrease in haemoglobin values postsurgery and the blood units transfused were recorded. The decision to transfuse was made by a surgeon blinded to the patient's group allocation. Forty-eight patients were enroled in the study; twenty-four patients each were randomized to the treatment and control groups, respectively. The median decrease in haemoglobin concentration on the first postoperative day was 2.2 g/dL in the treatment group and 2.7 g/dL in the control group. A significant reduction in units of blood transfused was also observed in the treatment group compared with the control group [1.1 ± 1.13 (range 0-4) vs. 1.9 ± 1.41 (range 0-5) blood units; P = 0.04]. No major treatment-related adverse events were recorded in the study. This study shows that a thrombin-based topical haemostatic reduces the need for blood transfusion in TKR revision surgery. A thrombin-based topical haemostatic agent can be an appropriate solution to enhance haemostasis and vessel sealing at the operative site in TKR revision surgery, in order to reduce the need for blood transfusion after surgery. II.

  14. Resultados de revisão de artroplastia total do joelho com haste não cimentada "Press-fit" Results of revision total knee arthroplasty using press-fit cementless stem

    Directory of Open Access Journals (Sweden)

    Maurício Masasi Iamaguchi

    2013-02-01

    Full Text Available OBJETIVO: Mostrar nossa experiência com haste não-cimentadas press-fit e fixação metafisária com cimento em série selecionada de pacientes que realizaram revisão de artroplastia total do joelho. MÉTODOS: Trinta e quatro pacientes (35 joelhos foram submetidos a revisão de artroplastia total do joelho usando técnica "press-fit". Seguimento mínimo foi de um ano (média de 2,2 anos e máximo de três anos. RESULTADOS: Dos 34 pacientes, 20 foram mulheres e 14 foram homens. Houve um óbito por causa não relacionada a artroplastia e perda de seguimento de um paciente. Não houve nenhum caso em que fosse necessária nova revisão. Os pacientes que foram submetidos à revisão apresentaram melhora clínica e funcional demonstrado pelos resultados do KSS, resultados do questionário de qualidade de vida SF-36, através do ganho de amplitude de movimento e da melhora no alinhamento do membro. CONCLUSÃO: Houve melhora clínica e funcional no pós-operatório em relação ao pré-operatório na revisão de artroplastia total do Joelho com haste não cimentada "press-fit". Nível de Evidência IV, Série de casos.OBJECTIVE: To show our experience with press-fit cementless stem and metaphyseal fixation with cement in a selected series of patients who underwent revision total knee arthroplasty. METHODS: Thirty-four patients (35 knees underwent revision total knee arthroplasty using the press-fit technique. Minimum follow-up was one year (mean 2.2 years with a maximum length of three years. RESULTS: Of 34 patients, 20 were women and 14 were men. There was one death due to causes not related to arthroplasty and one patient dropout. There were no cases in which further review was necessary. Patients who underwent revision had clinical and functional improvement demonstrated by the results of the KSS, results of the SF-36 quality of life questionnaire, through gains in range of motion and improved limb alignment. CONCLUSION: There was postoperative

  15. Concise Total Synthesis of (-)-Affinisine Oxindole, (+)-Isoalstonisine, (+)-Alstofoline, (-)-Macrogentine, (+)-Na -Demethylalstonisine, (-)-Alstonoxine A, and (+)-Alstonisine.

    Science.gov (United States)

    Stephen, Michael Rajesh; Rahman, M Toufiqur; Tiruveedhula, V V N Phani Babu; Fonseca, German O; Deschamps, Jeffrey R; Cook, James M

    2017-11-07

    A highly enantio- and diastereoselective strategy to access any member of the sarpagine/macroline family of oxindole alkaloids via internal asymmetric induction was developed from readily available d-(+)-tryptophan. At the center of this approach was the diastereospecific generation of the spiro[pyrrolidine-3,3'-oxindole] moiety at an early stage via a tert-butyl hypochlorite-promoted oxidative rearrangement of a chiral tetrahydro-β-carboline derivative. This key branching point determined the spatial configuration at the C-7 spiro center to be entirely 7R or 7S. Other key stereospecific processes were the asymmetric Pictet-Spengler reaction and Dieckmann cyclization, which were scalable to the 600 and 150 gram levels, respectively. Execution of this approach resulted in first enantiospecific total synthesis of (+)-isoalstonisine and (-)-macrogentine from the chitosenine series (7R), as well as (+)-alstonisine, (+)-alstofoline, (-)-alstonoxine A and (+)-N a -demethylalstonisine from the alstonisine series (7S). © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Patient-reported Outcomes and Revision Rates at a Mean Follow-up of 10 Years After Lumbar Total Disc Replacement

    DEFF Research Database (Denmark)

    Laugesen, Line A.; Tendal Paulsen, Rune; Carreon, Leah

    2017-01-01

    STUDY DESIGN.: Prospective observational cohort study. OBJECTIVE.: To determine the long-term clinical results and prosthesis survival in patients treated with lumbar total disc replacement (TDR). SUMMARY OF BACKGROUND DATA.: Fusion has become the current standard surgical treatment for lumbar...... and statistically significant worse outcome scores at last follow-up compared to patients who had no revision. Thirty patients (52.6%) would choose the same treatment again if they were faced with the same problem. CONCLUSION.: This study demonstrated significant improvement in long-term clinical outcomes, similar...

  17. Application of cyclic phosphonamide reagents in the total synthesis of natural products and biologically active molecules

    Directory of Open Access Journals (Sweden)

    Thilo Focken

    2014-08-01

    Full Text Available A review of the synthesis of natural products and bioactive compounds adopting phosphonamide anion technology is presented highlighting the utility of phosphonamide reagents in stereocontrolled bond-forming reactions. Methodologies utilizing phosphonamide anions in asymmetric alkylations, Michael additions, olefinations, and cyclopropanations will be summarized, as well as an overview of the synthesis of the employed phosphonamide reagents.

  18. A Convergent Enantioselective Total Synthesis of (-)-Perhydrohistrionicotoxin with an Intramolecular Imino Ene-type Reaction as a Key Step

    DEFF Research Database (Denmark)

    Tanner, David Ackland; Hagberg, Lars

    1998-01-01

    A convergent enantioselective total synthesis of the neurotoxic spirocyclic alkaloid (-)-perhydrohistrionicotoxin (2) is described. A Lewis acid-mediated intramolecular imine ene-type reaction was used for the key spirocyclisation step (14 to 3, with 3 being obtained as a single diastereoisomer...

  19. Total synthesis of (-)-basiliskamide A and NMR studies on the conversion of basiliskamide A to basiliskamide B

    International Nuclear Information System (INIS)

    Dias, Luiz C.; Goncalves, Caroline C.S.

    2010-01-01

    We describe herein our approach to the total synthesis of the antifungal polyketide (-)-basiliskamide A, as well as 1 H NMR studies on the migration of the cinnamoyl side chain of basiliskamide A to form basiliskamide B in CDCl 3 solution. (author)

  20. Streamlined Total Synthesis of Trioxacarcins and Its Application to the Design, Synthesis, and Biological Evaluation of Analogues Thereof. Discovery of Simpler Designed and Potent Trioxacarcin Analogues.

    Science.gov (United States)

    Nicolaou, K C; Chen, Pengxi; Zhu, Shugao; Cai, Quan; Erande, Rohan D; Li, Ruofan; Sun, Hongbao; Pulukuri, Kiran Kumar; Rigol, Stephan; Aujay, Monette; Sandoval, Joseph; Gavrilyuk, Julia

    2017-11-01

    A streamlined total synthesis of the naturally occurring antitumor agents trioxacarcins is described, along with its application to the construction of a series of designed analogues of these complex natural products. Biological evaluation of the synthesized compounds revealed a number of highly potent, and yet structurally simpler, compounds that are effective against certain cancer cell lines, including a drug-resistant line. A novel one-step synthesis of anthraquinones and chloro anthraquinones from simple ketone precursors and phenylselenyl chloride is also described. The reported work, featuring novel chemistry and cascade reactions, has potential applications in cancer therapy, including targeted approaches as in antibody-drug conjugates.

  1. 12 CFR Appendix to Part 215 - Section 5200 of the Revised Statutes Total Loans and Extensions of Credit

    Science.gov (United States)

    2010-01-01

    ... extensions of credit and not upon any full or partial recourse endorsement or guarantee by the transferor... Loans and Extensions of Credit Appendix to Part 215 Banks and Banking FEDERAL RESERVE SYSTEM BOARD OF... Statutes Total Loans and Extensions of Credit (a)(1) The total loans and extensions of credit by a national...

  2. Application of diazene-directed fragment assembly to the total synthesis and stereochemical assignment of (+)-desmethyl-meso-chimonanthine and related heterodimeric alkaloids

    OpenAIRE

    Lathrop, Stephen; Movassaghi, Mohammad

    2013-01-01

    We describe the first application of our methodology for heterodimerization via diazene fragmentation towards the total synthesis of (−)-calycanthidine, meso-chimonanthine, and (+)-desmethyl-meso-chimonanthine. Our syntheses of these alkaloids feature an improved route to C3a-aminocyclotryptamines, an enhanced method for sulfamide synthesis and oxidation, in addition to a late-stage diversification leading to the first enantioselective total synthesis of (+)-desmethyl-meso-chimonanthine and i...

  3. Immobilization methods for the rapid total chemical synthesis of proteins on microtiter plates.

    Science.gov (United States)

    Zitterbart, Robert; Krumrey, Michael; Seitz, Oliver

    2017-07-01

    The chemical synthesis of proteins typically involves the solid-phase peptide synthesis of unprotected peptide fragments that are stitched together in solution by native chemical ligation (NCL). The process is slow, and throughput is limited because of the need for repeated high performance liquid chromatography purification steps after both solid-phase peptide synthesis and NCL. With an aim to provide faster access to functional proteins and to accelerate the functional analysis of synthetic proteins by parallelization, we developed a method for the high performance liquid chromatography-free synthesis of proteins on the surface of microtiter plates. The method relies on solid-phase synthesis of unprotected peptide fragments, immobilization of the C-terminal fragment and on-surface NCL with an unprotected peptide thioester in crude form. Herein, we describe the development of a suitable immobilization chemistry. We compared (i) formation of nickel(II)-oligohistidine complexes, (ii) Cu-based [2 + 3] alkine-azide cycloaddition and (iii) hydrazone ligation. The comparative study identified the hydrazone ligation as most suitable. The sequence of immobilization via hydrazone ligation, on-surface NCL and radical desulfurization furnished the targeted SH3 domains in near quantitative yield. The synthetic proteins were functional as demonstrated by an on-surface fluorescence-based saturation binding analysis. Copyright © 2017 European Peptide Society and John Wiley & Sons, Ltd. Copyright © 2017 European Peptide Society and John Wiley & Sons, Ltd.

  4. Studies on the Total Synthesis of Amphidinolide O (II): A Stereoselective Synthesis of C1-C11 Fragment

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Mi Yeon; Kim, Jong Woo; Lee, Duck Hyung [Sogang University, Seoul (Korea, Republic of)

    2005-10-15

    Two ketones and, the C1-C11 fragment of Amphidinolide O, were prepared stereoselectively via 14 and 16 step sequences in 8.7% and 2.0% overall yield, respectively. The amphidinolides were isolated from the marine dinoflagellate Amphidinium sp., which produces a host of secondary metabolites endowed with potent cytotoxicity against various cancer cell lines. Amphidinolide O displayed potent in vitro cytotoxicity against L1210 marine leukemia cells and human epidermoid carcinoma KB cells with 1.7 and 3.6 μg/mL of IC50s, respectively. In addition to our recent reports regarding to the synthesis of C12-C17 and C3-C11 fragments of amphidinolide O, we describe herein a new route to diastereoselective synthesis of C1-C11 fragment of. The retrosynthetic analysis of led to the C1-C11 fragment and C12-C17 fragment. The hemiketal was expected from acyclic precursor 4 which, in turn, would be derived by diastereoselective aldol reaction between ketone and aldehyde.

  5. A 11-Steps Total Synthesis of Magellanine through a Gold(I)-Catalyzed Dehydro Diels-Alder Reaction.

    Science.gov (United States)

    McGee, Philippe; Bétournay, Geneviève; Barabé, Francis; Barriault, Louis

    2017-05-22

    We have developed an innovative strategy for the formation of angular carbocycles via a gold(I)-catalyzed dehydro Diels-Alder reaction. This transformation provides rapid access to a variety of complex angular cores in excellent diastereoselectivities and high yields. The usefulness of this Au I -catalyzed cycloaddition was further demonstrated by accomplishing a 11-steps total synthesis of (±)-magellanine. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Cytotoxic 1,3-Thiazole and 1,2,4-Thiadiazole Alkaloids from Penicillium oxalicum: Structural Elucidation and Total Synthesis

    Directory of Open Access Journals (Sweden)

    Zheng Yang

    2016-02-01

    Full Text Available Two new thiazole and thiadiazole alkaloids, penicilliumthiamine A and B (2 and 3, were isolated from the culture broth of Penicillium oxalicum, a fungus found in Acrida cinerea. Their structures were elucidated mainly by spectroscopic analysis, total synthesis and X-ray crystallographic analysis. Biological evaluations indicated that compound 1, 3a and 3 exhibit potent cytotoxicity against different cancer cell lines through inhibiting the phosphorylation of AKT/PKB (Ser 473, one of important cancer drugs target.

  7. Total Synthesis of Natural Products of Microbial Origins(Recent Topics of the Agricultunal Biological Science in Tohoku University)

    OpenAIRE

    Hiromasa, KIYOTA; Shigefumi, KUWAHARA; Laboratory of Applied Bioorganic Chemistry, Division of Bioscience & Biotechnology for Future Bioindustries, Graduate School of Agricultural Science, Tohoku University; Laboratory of Applied Bioorganic Chemistry, Division of Bioscience & Biotechnology for Future Bioindustries, Graduate School of Agricultural Science, Tohoku University

    2008-01-01

    Microorganisms are an important rich source of secondary metabolites, which could be useful leads to valuable agrochemicals and/or medicinal drugs. This mini-review describes our recent achievements on the total synthesis of biologically active natural products of microbial origins: pteridic acids A and B (strong plant growth promoters), epoxyquinols A and B (anti-angiogenic compounds), communiols A-F, G, and H, and macrotetrolide α (antibiotics), pyricuol and tabtoxinine-β-lactam (phytotoxin...

  8. Highly Convergent Total Synthesis of (+)-Lithospermic Acid via a Late-Stage Intermolecular C–H Olefination

    Science.gov (United States)

    Wang, Dong-Hui; Yu, Jin-Quan

    2011-01-01

    The total synthesis of (+)-lithospermic acid is reported, which exploits two successive C–H activation reactions as the key steps. Rh-catalyzed carbene C–H insertion reaction using Davies’ catalyst built the dihydrobenzofuran core, and a late-stage intermolecular C–H olefination coupled the olefin unit with the dihydrobenzofuran core to construct the molecule in a highly convergent manner. PMID:21443224

  9. Outcome of revision total knee arthroplasty with the use of trabecular metal cone for reconstruction of severe bone loss at the proximal tibia

    DEFF Research Database (Denmark)

    Jensen, Claus L; Olsen, Nikolaj Winther; Schrøder, Henrik M

    2014-01-01

    technology (TMT) cones for the reconstruction of tibial bone loss at the time of rTKA. METHODS: Thirty-six patients had rTKA with the use of a TMT Cone. Bone loss was classified according to the AORI classification and 25% of the patients suffered from T3 AORI defects and 75% of the patients from T2 AORI...... defects. Implants used were from the NexGen series. At follow-up, radiographs were evaluated according to the Knee Society Roentgenographic Scoring System. Knee and function score was calculated using the Knee Society Clinical Rating System. Average follow-up time was 47 months (range 3-84 months......BACKGROUND: The relative effectiveness of different methods for reconstructing large bone loss at the proximal tibia in revision total knee arthroplasty (rTKA) has not been established. The aim of this study was to evaluate the clinical and radiological outcome after the use of trabecular metal...

  10. Total Synthesis of (-)-Doliculide, Structure-Activity Relationship Studies and Its Binding to F-Actin

    NARCIS (Netherlands)

    Matcha, Kiran; Madduri, Ashoka V. R.; Roy, Sayantani; Ziegler, Slava; Waldmann, Herbert; Hirsch, Anna K. H.; Minnaard, Adriaan J.

    2012-01-01

    Actin, an abundant protein in most eukaryotic cells, is one of the targets in cancer research. Recently, a great deal of attention has been paid to the synthesis and function of actin-targeting compounds and their use as effective molecular probes in chemical biology. In this study, we have

  11. Asymmetric total synthesis of a putative sex pheromone component from the parasitoid wasp Trichogramma turkestanica

    NARCIS (Netherlands)

    Geerdink, Danny; Buter, Jeffrey; van Beek, Teris A.; Minnaard, Adriaan J.

    2014-01-01

    Virgin females of the parasitoid wasp Trichogramma turkestanica produce minute amounts of a sex pheromone, the identity of which has not been fully established. The enantioselective synthesis of a putative component of this pheromone, (6S,8S,10S)-4,6,8,10-tetramethyltrideca-2E,4E-dien-1-ol (2), is

  12. Total synthesis and structural validation of cyclodepsipeptides solonamide A and B

    DEFF Research Database (Denmark)

    Kitir, Betül; Baldry, Mara; Ingmer, Hanne

    2014-01-01

    , autoinducing peptide I (AIP-I). To enable more comprehensive studies, we embarked on the chemical synthesis of solonamides A and B. The key synthetic steps were formation of the (R)-β-hydroxy-fatty-acids by stereo-selective aldol reactions and a cyclative macrolactamization, which proceeded under highly dilute...

  13. Total Synthesis of Two 4, 5-Dioxo-seco-eudesmane Sesquiterpenes

    Institute of Scientific and Technical Information of China (English)

    Li Jing FANG; Chen Xi ZHANG; Jin Chun CHEN; Guo Jun ZHENG; Yu Lin LI

    2005-01-01

    A facile synthetic route to two seco-eudesmane, 4, 5-dioxo-10-epi-4, 5-seco-γeudesmane (1) and 4, 5-dioxo-10-epi-4, 5-seco-γ-eudesmol (2) from (+)-dihydrocarvone has been described. Avoiding expensive reagents, this highly economic method especially suits for the synthesis of 4, 5-seco-eudesman-type and ophianon-type sesquiterpenes with a double bond at position 11 and 12.

  14. Total chemical synthesis of histones and their analogs, assisted by native chemical ligation and palladium complexes.

    Science.gov (United States)

    Maity, Suman Kumar; Jbara, Muhammad; Mann, Guy; Kamnesky, Guy; Brik, Ashraf

    2017-11-01

    Chemical synthesis of histones allows precise control of the installation of post-translational modifications via the coupling of derivatized amino acids. Shortcomings of other approaches for obtaining modified histones for epigenetic studies include heterogeneity of the obtained product and difficulties in incorporating multiple modifications on the same histone. In this protocol, unprotected peptide fragments are prepared by Fmoc solid-phase synthesis and coupled in aqueous buffers via native chemical ligation (NCL; in NCL, a peptide bond is formed between a peptide with an N-terminal Cys and another peptide having a C-terminal thioester). This task is challenging, with obstacles relating to the preparation and ligation of hydrophobic peptides, as well as the requirement for multiple purification steps due to protecting-group manipulations during the polypeptide assembly process. To address this, our approach uses an easily removable solubilizing tag for the synthesis and ligation of hydrophobic peptides, as well as a more efficient and better-yielding method to remove Cys-protecting groups that uses palladium chemistry (specifically [Pd(allyl)Cl] 2 and PdCl 2 complexes). The utility of this approach is demonstrated in the syntheses of ubiquitinated H2B at Lys34, phosphorylated H2A at Tyr57 and unmodified H4. Each of these analogs can be prepared in milligram quantities within ∼20-30 d.

  15. Enantioselective Total Synthesis of Antibiotic CJ-16,264, Synthesis and Biological Evaluation of Designed Analogues, and Discovery of Highly Potent and Simpler Antibacterial Agents.

    Science.gov (United States)

    Nicolaou, K C; Pulukuri, Kiran Kumar; Rigol, Stephan; Buchman, Marek; Shah, Akshay A; Cen, Nicholas; McCurry, Megan D; Beabout, Kathryn; Shamoo, Yousif

    2017-11-08

    An improved and enantioselective total synthesis of antibiotic CJ-16,264 through a practical kinetic resolution and an iodolactonization reaction to form the iodo pyrrolizidinone fragment of the molecule is described. A series of racemic and enantiopure analogues of CJ-16,264 was designed and synthesized through the developed synthetic technologies and tested against drug-resistant bacterial strains. These studies led to interesting structure-activity relationships and the identification of a number of simpler, and yet equipotent, or even more potent, antibacterial agents than the natural product, thereby setting the foundation for further investigations in the quest for new anti-infective drugs.

  16. Computer-guided total synthesis of natural products: Recent examples and future perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Della-Felice, Franco; Pilli, Ronaldo A. [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Instituto de Química; Sarotti, Ariel M., E-mail: pilli@iqm.unicamp.br, E-mail: sarotti@iquir-conicet.gov.ar [Instituto de Química, Universidad Nacional de Rosario-CONICET (Argentina)

    2018-05-01

    Quantum chemical calculations of nuclear magnetic resonance (NMR) shifts and coupling constants have been extensively employed in recent years mainly to facilitate structural elucidation of organic molecules. When the results of such calculations are used to determine the most likely structure of a natural product in advance, guiding the subsequent synthetic work, the term 'computer-guided synthesis' could be coined. This review article describes the most relevant examples from recent literature, highlighting the scope and limitations of this merged computational/experimental approach as well. (author)

  17. Computer-guided total synthesis of natural products: Recent examples and future perspectives

    International Nuclear Information System (INIS)

    Della-Felice, Franco; Pilli, Ronaldo A.

    2018-01-01

    Quantum chemical calculations of nuclear magnetic resonance (NMR) shifts and coupling constants have been extensively employed in recent years mainly to facilitate structural elucidation of organic molecules. When the results of such calculations are used to determine the most likely structure of a natural product in advance, guiding the subsequent synthetic work, the term 'computer-guided synthesis' could be coined. This review article describes the most relevant examples from recent literature, highlighting the scope and limitations of this merged computational/experimental approach as well. (author)

  18. Aligator: A computational tool for optimizing total chemical synthesis of large proteins.

    Science.gov (United States)

    Jacobsen, Michael T; Erickson, Patrick W; Kay, Michael S

    2017-09-15

    The scope of chemical protein synthesis (CPS) continues to expand, driven primarily by advances in chemical ligation tools (e.g., reversible solubilizing groups and novel ligation chemistries). However, the design of an optimal synthesis route can be an arduous and fickle task due to the large number of theoretically possible, and in many cases problematic, synthetic strategies. In this perspective, we highlight recent CPS tool advances and then introduce a new and easy-to-use program, Aligator (Automated Ligator), for analyzing and designing the most efficient strategies for constructing large targets using CPS. As a model set, we selected the E. coli ribosomal proteins and associated factors for computational analysis. Aligator systematically scores and ranks all feasible synthetic strategies for a particular CPS target. The Aligator script methodically evaluates potential peptide segments for a target using a scoring function that includes solubility, ligation site quality, segment lengths, and number of ligations to provide a ranked list of potential synthetic strategies. We demonstrate the utility of Aligator by analyzing three recent CPS projects from our lab: TNFα (157 aa), GroES (97 aa), and DapA (312 aa). As the limits of CPS are extended, we expect that computational tools will play an increasingly important role in the efficient execution of ambitious CPS projects such as production of a mirror-image ribosome. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. A convergent approach to the total synthesis of telmisartan via a Suzuki cross-coupling reaction between two functionalized benzimidazoles.

    Science.gov (United States)

    Martin, Alex D; Siamaki, Ali R; Belecki, Katherine; Gupton, B Frank

    2015-02-06

    A direct and efficient total synthesis has been developed for telmisartan, a widely prescribed treatment for hypertension. This approach brings together two functionalized benzimidazoles using a high-yielding Suzuki reaction that can be catalyzed by either a homogeneous palladium source or graphene-supported palladium nanoparticles. The ability to perform the cross-coupling reaction was facilitated by the regio-controlled preparation of the 2-bromo-1-methylbenzimidazole precursor. This convergent approach provides telmisartan in an overall yield of 72% while circumventing many issues associated with previously reported processes.

  20. Heronapyrrole D: A case of co-inspiration of natural product biosynthesis, total synthesis and biodiscovery

    Directory of Open Access Journals (Sweden)

    Jens Schmidt

    2014-05-01

    Full Text Available The heronapyrroles A–C have first been isolated from a marine-derived Streptomyces sp. (CMB-0423 in 2010. Structurally, these natural products feature an unusual nitropyrrole system to which a partially oxidized farnesyl chain is attached. The varying degree of oxidation of the sesquiterpenyl subunit in heronapyrroles A–C provoked the hypothesis that there might exist other hitherto unidentified metabolites. On biosynthetic grounds a mono-tetrahydrofuran-diol named heronapyrrole D appeared a possible candidate. We here describe a short asymmetric synthesis of heronapyrrole D, its detection in cultivations of CMB-0423 and finally the evaluation of its antibacterial activity. We thus demonstrate that biosynthetic considerations and the joint effort of synthetic and natural product chemists can result in the identification of new members of a rare class of natural products.

  1. Recent approaches to the total synthesis of phytoprostanes, isoprostanes and neuroprostanes as important products of lipid oxidative stress and biomarkers of disease

    Czech Academy of Sciences Publication Activity Database

    Jahn, Emanuela; Durand, T.; Galano, J. M.; Jahn, Ullrich

    2014-01-01

    Roč. 108, č. 4 (2014), s. 301-319 ISSN 0009-2770 Institutional support: RVO:61388963 Keywords : lipids * oxidative stress * phytoprostanes * isoprostanes * neuroprostanes * total synthesis Subject RIV: CC - Organic Chemistry Impact factor: 0.272, year: 2014

  2. A novel technique for impaction bone grafting in acetabular reconstruction of revision total hip arthroplasty using an ex vivo compaction device

    International Nuclear Information System (INIS)

    Akiyama, Haruhiko; Takemoto, Mitsuru; Morishima, Takkan

    2011-01-01

    Impaction bone grafting allows restoration of the acetabular bone stock in revision hip arthroplasty. The success of this technique depends largely on achieving adequate initial stability of the component. To obtain well-compacted, well-graded allograft aggregates, we developed an ex vivo compaction device to apply it in revision total hip arthroplasty on the acetabular side, and characterized mechanical properties and putative osteoconductivity of allograft aggregates. Morselized allograft bone chips were compacted ex vivo using the creep technique and subsequent impaction technique to form the bone aggregates. Impaction allograft reconstruction of the acetabulum using an ex vivo compaction device was performed on eight hips. The mechanical properties and three-dimensional micro-CT-based structural characteristics of the bone aggregates were investigated. In clinical practice, this technique offered good reproducibility in reconstructing the cavity and the segmental defects of the acetabulum, with no migration and no loosening of the component. In vitro analysis showed that the aggregates generated from 25 g fresh-frozen bone chips gained compression stiffness of 13.5-15.4 MPa under uniaxial consolidation strain. The recoil of the aggregates after compaction was 2.6-3.9%. The compression stiffness and the recoil did not differ significantly from those measured using a variety of proportions of large- and small-sized bone chips. Micro-CT-based structural analysis revealed average pore sizes of 268-299 μm and average throat diameter of pores in the bone aggregates of more than 100 μm. These sizes are desirable for osteoconduction, although large interconnected pores of more than 500 μm were detectable in association with the proportion of large-sized bone chips. Cement penetration into the aggregates was related to the proportion of large-sized bone chips. This study introduces the value of an ex vivo compaction device in bone graft compaction in clinical

  3. Total Synthesis of the Spirocyclic Oxindole Alkaloids Corynoxine, Corynoxine B, Corynoxeine, and Rhynchophylline

    NARCIS (Netherlands)

    Wanner, M.J.; Ingemann, S.; van Maarseveen, J.H.; Hiemstra, H.

    2013-01-01

    Racemic total syntheses of four spirocyclic oxindole alkaloids are reported. The general starting material was an N-2-butenylated 2-hydroxytryptamine, which underwent a base-mediated Mannich spirocyclisation with a functionalised aldehyde to generate the C-ring. The second key step was a

  4. A Concise Total Synthesis of (R)-Fluoxetine, a Potent and Selective Serotonin Reuptake Inhibitor

    OpenAIRE

    de Fátima, Ângelo; Lapis, Alexandre Augusto M.; Pilli, Ronaldo A.

    2005-01-01

    (R)-Fluoxetine, potent and selective serotonin reuptake inhibitor, has been synthesized in six steps, 50% overall yield and 99% ee from benzaldehyde via catalytic asymmetric allylation with Maruoka's catalyst. (R)-Fluoxetina, um inibidor potente e seletivo da recaptação da serotonina, foi sintetizada em seis etapas, 50% de rendimento total e 99% de excesso enantiomérico a partir do benzaldeído via alilação catalítica assimétrica empregando-se o sistema catalítico desenvolvido por Maruoka e...

  5. Extending the Glucosyl Ceramide Cassette Approach: Application in the Total Synthesis of Ganglioside GalNAc-GM1b

    Directory of Open Access Journals (Sweden)

    Miku Konishi

    2013-12-01

    Full Text Available The development of a novel cyclic glucosyl ceramide cassette acceptor for efficient glycolipid syntheses was investigated. p-Methoxybenzyl (PMB groups were selected as protecting groups at C2 and C3 of the glucose residue with the aim of improving the functionality of the cassette acceptor. The choice of the PMB group resulted in a loss of β-selectivity, which was corrected by using an appropriate tether to control the spatial arrangement and the nitrile solvent effect. To investigate the effect of linker structure on the β-selectivity of intramolecular glycosylation, several linkers for tethering the glucose and ceramide moiety were designed and prepared, namely, succinyl, glutaryl, dimethylmalonyl, and phthaloyl esters. The succinyl ester linker was the best for accessing the cassette form. The newly designed glucosyl ceramide cassette acceptor was then applied in the total synthesis of ganglioside GalNAc-GM1b.

  6. A Mixed-Ligand Chiral Rhodium(II) Catalyst Enables the Enantioselective Total Synthesis of Piperarborenine B.

    Science.gov (United States)

    Panish, Robert A; Chintala, Srinivasa R; Fox, Joseph M

    2016-04-11

    A novel, mixed-ligand chiral rhodium(II) catalyst, Rh2(S-NTTL)3(dCPA), has enabled the first enantioselective total synthesis of the natural product piperarborenine B. A crystal structure of Rh2(S-NTTL)3(dCPA) reveals a "chiral crown" conformation with a bulky dicyclohexylphenyl acetate ligand and three N-naphthalimido groups oriented on the same face of the catalyst. The natural product was prepared on large scale using rhodium-catalyzed bicyclobutanation/ copper-catalyzed homoconjugate addition chemistry in the key step. The route proceeds in ten steps with an 8% overall yield and 92% ee. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. A strategy for complex dimer formation when biomimicry fails: total synthesis of ten coccinellid alkaloids.

    Science.gov (United States)

    Sherwood, Trevor C; Trotta, Adam H; Snyder, Scott A

    2014-07-09

    Although dimeric natural products can often be synthesized in the laboratory by directly merging advanced monomers, these approaches sometimes fail, leading instead to non-natural architectures via incorrect unions. Such a situation arose during our studies of the coccinellid alkaloids, when attempts to directly dimerize Nature's presumed monomeric precursors in a putative biomimetic sequence afforded only a non-natural analogue through improper regiocontrol. Herein, we outline a unique strategy for dimer formation that obviates these difficulties, one which rapidly constructs the coccinellid dimers psylloborine A and isopsylloborine A through a terminating sequence of two reaction cascades that generate five bonds, five rings, and four stereocenters. In addition, a common synthetic intermediate is identified which allows for the rapid, asymmetric formal or complete total syntheses of eight monomeric members of the class.

  8. Total observed organic carbon (TOOC in the atmosphere: a synthesis of North American observations

    Directory of Open Access Journals (Sweden)

    C. L. Heald

    2008-04-01

    Full Text Available Measurements of organic carbon compounds in both the gas and particle phases made upwind, over and downwind of North America are synthesized to examine the total observed organic carbon (TOOC in the atmosphere over this region. These include measurements made aboard the NOAA WP-3 and BAe-146 aircraft, the NOAA research vessel Ronald H. Brown, and at the Thompson Farm and Chebogue Point surface sites during the summer 2004 ICARTT campaign. Both winter and summer 2002 measurements during the Pittsburgh Air Quality Study are also included. Lastly, the spring 2002 observations at Trinidad Head, CA, surface measurements made in March 2006 in Mexico City and coincidentally aboard the C-130 aircraft during the MILAGRO campaign and later during the IMPEX campaign off the northwestern United States are incorporated. Concentrations of TOOC in these datasets span more than two orders of magnitude. The daytime mean TOOC ranges from 4.0 to 456 μgC m−3 from the cleanest site (Trinidad Head to the most polluted (Mexico City. Organic aerosol makes up 3–17% of this mean TOOC, with highest fractions reported over the northeastern United States, where organic aerosol can comprise up to 50% of TOOC. Carbon monoxide concentrations explain 46 to 86% of the variability in TOOC, with highest TOOC/CO slopes in regions with fresh anthropogenic influence, where we also expect the highest degree of mass closure for TOOC. Correlation with isoprene, formaldehyde, methyl vinyl ketone and methacrolein also indicates that biogenic activity contributes substantially to the variability of TOOC, yet these tracers of biogenic oxidation sources do not explain the variability in organic aerosol observed over North America. We highlight the critical need to develop measurement techniques to routinely detect total gas phase VOCs, and to deploy comprehensive suites of TOOC instruments in diverse environments to quantify the ambient evolution of organic carbon from source

  9. Increasing Resistance of Coagulase-Negative Staphylococci in Total Hip Arthroplasty Infections: 278 THA-Revisions due to Infection Reported to the Norwegian Arthroplasty Register from 1993 to 2007

    Directory of Open Access Journals (Sweden)

    Olav Lutro

    2014-01-01

    Full Text Available We investigated bacterial findings from intraoperative tissue samples taken during revision due to infection after total hip arthroplasty (THA. The aim was to investigate whether the susceptibility patterns changed during the period from 1993 through 2007. Reported revisions due to infection in the Norwegian Arthroplasty Register (NAR were identified, and 10 representative hospitals in Norway were visited. All relevant information on patients reported to the NAR for a revision due to infection, including bacteriological findings, was collected from the medical records. A total of 278 revision surgeries with bacterial growth in more than 2 samples were identified and included. Differences between three 5-year time periods were tested by the chi-square test for linear trend. The most frequent isolates were coagulase-negative staphylococci (CoNS (41%, 113/278 and Staphylococcus aureus (19%, 53/278. The proportion of CoNS resistant to the methicillin-group increased from 57% (16/28 in the first period, 1993–1997, to 84% (52/62 in the last period, 2003–2007 (P = 0.003. There was also significant increase in resistance for CoNS to cotrimoxazole, quinolones, clindamycin, and macrolides. All S. aureus isolates were sensitive to both the methicillin-group and the aminoglycosides. For the other bacteria identified no changes in susceptibility patterns were found.

  10. Total Synthesis of Zoanthamine Alkaloids, Part 2. Construction of the C1-C5, C6-C10 and C11-C24 Fragments of Zoanthamine

    DEFF Research Database (Denmark)

    Tanner, David Ackland; Tedenborg, Lars; Somfai, Peter

    1997-01-01

    This paper describes the construction of three key intermediates for a projected total synthesis of the marine alkaloid zoanthamine. These building blocks, corresponding to the C1-C5, C6-C10 and C11-C24 fragments of the target molecule, are synthesised efficiently form (R)-hydroxymethyl-butyrolac......This paper describes the construction of three key intermediates for a projected total synthesis of the marine alkaloid zoanthamine. These building blocks, corresponding to the C1-C5, C6-C10 and C11-C24 fragments of the target molecule, are synthesised efficiently form (R...

  11. Functional outcome, revision rates and mortality after primary total hip replacement--a national comparison of nine prosthesis brands in England.

    Directory of Open Access Journals (Sweden)

    Mark Pennington

    Full Text Available The number of prosthesis brands used for hip replacement has increased rapidly, but there is little evidence on their effectiveness. We compared patient-reported outcomes, revision rates, and mortality for the three most frequently used brands within each prosthesis type: cemented (Exeter V40 Contemporary, Exeter V40 Duration and Exeter V40 Elite Plus Ogee, cementless (Corail Pinnacle, Accolade Trident, and Taperloc Exceed, and hybrid (Exeter V40 Trilogy, Exeter V40 Trilogy, and CPT Trilogy.We used three national databases of patients who had hip replacements between 2008 and 2011 in the English NHS to compare functional outcome (Oxford Hip Score (OHS ranging from 0 (worst to 48 (best in 43,524 patients at six months. We analysed revisions and mortality in 187,201 patients. We used multiple regression to adjust for pre-operative differences. Prosthesis type had an impact on post-operative OHS and revision rates (both p<0.001. Patients with hybrid prostheses had the best functional outcome (mean OHS 39.4, 95%CI 39.1 to 39.7 and those with cemented prostheses the worst (37.7, 37.3 to 38.1. Patients with cemented prostheses had the lowest reported 5-year revision rates (1.3%, 1.2% to 1.4% and those with cementless prostheses the highest (2.2%, 2.1% to 2.4%. Differences in mortality according to prosthesis type were small and not significant (p = 0.06. Functional outcome varied according to brand among cemented (p = 0.05, with Exeter V40 Duration having the best and cementless prostheses (p = 0.01, with Corail Pinnacle having the best. Revision rates varied according to brand among hybrids (p = 0.05, with Exeter V40 Trident having the lowest.Functional outcomes were better with cementless cups and revision rates were lower with cemented stems, which underlies the good overall performance of hybrids. The hybrid Exeter V40 Trident seemed to produce the best overall results. This brand should be considered as a benchmark in randomised trials.

  12. Solid-Phase Synthesis for the Construction of Biologically Interesting Molecules and the Total Synthesis of Trioxacarcin DC-45-A2

    DEFF Research Database (Denmark)

    Mikkelsen, Remi Jacob Thomsen

    . Furthermore a route to another key building block was developed featuring a Stille cross-coupling.Synthesis of Poly-fused Heterocycles. In the search for new biologically active compounds a methodology for the synthesis of polyfused heterocycles was investigated. This led to the development and optimization...

  13. Truly Absorbed Microbial Protein Synthesis, Rumen Bypass Protein, Endogenous Protein, and Total Metabolizable Protein from Starchy and Protein-Rich Raw Materials

    NARCIS (Netherlands)

    Parand, Ehsan; Vakili, Alireza; Mesgaran, Mohsen Danesh; Duinkerken, Van Gert; Yu, Peiqiang

    2015-01-01

    This study was carried out to measure truly absorbed microbial protein synthesis, rumen bypass protein, and endogenous protein loss, as well as total metabolizable protein, from starchy and protein-rich raw feed materials with model comparisons. Predictions by the DVE2010 system as a more

  14. Toward the Elucidation of the Metabolism of 15-E2-Isoprostane: The Total Synthesis of the Methyl Ester of a Potential Central Metabolite

    Czech Academy of Sciences Publication Activity Database

    Jahn, Ullrich; Dinca, E.

    2010-01-01

    Roč. 75, č. 13 (2010), s. 4480-4491 ISSN 0022-3263 Grant - others:DFG(DE) Ja896/3-1 Institutional research plan: CEZ:AV0Z40550506 Keywords : isoprostane * total synthesis * radical anion cyclization Subject RIV: CC - Organic Chemistry Impact factor: 4.002, year: 2010

  15. Total Synthesis of Zoanthamine Alkaloids, Part 2. Construction of the C1-C5, C6-C10 and C11-C24 Fragments of Zoanthamine

    DEFF Research Database (Denmark)

    Tanner, David Ackland; Tedenborg, Lars; Somfai, Peter

    1997-01-01

    This paper describes the construction of three key intermediates for a projected total synthesis of the marine alkaloid zoanthamine. These building blocks, corresponding to the C1-C5, C6-C10 and C11-C24 fragments of the target molecule, are synthesised efficiently form (R...

  16. Total synthesis of (+/-)-taiwaniaquinol B via a domino intramolecular friedel-crafts acylation/carbonyl alpha-tert-alkylation reaction.

    Science.gov (United States)

    Fillion, Eric; Fishlock, Dan

    2005-09-28

    The first synthesis of taiwaniaquinol B, a 6-nor-5(6-->7)abeoabietane-type diterpenoid exhibiting the uncommon fused 6-5-6 tricyclic carbon skeleton, was accomplished in 15 steps. A Lewis acid-promoted tandem intramolecular Friedel-Crafts/carbonyl alpha-tert-alkylation reaction was exploited as the core strategy for the synthesis of the sterically congested 1-indanone-containing tricyclic structure. This multiple carbon-carbon bond forming reaction exploits the unique reactivity of Meldrum's acid. The facile precursor synthesis makes this a useful methodology for the expedient modification and assembly of sterically congested 1-indanone-containing ring systems.

  17. Total syntheses of hyperforin and papuaforins A-C, and formal synthesis of nemorosone through a gold(I)-catalyzed carbocyclization.

    Science.gov (United States)

    Bellavance, Gabriel; Barriault, Louis

    2014-06-23

    The remarkable biological activities of polyprenylated polycyclic acylphloroglucinols (PPAPs) combined with their highly decorated bicyclo[3.3.1]nonane-2,4,9-trione frameworks have inspired synthetic organic chemists over the last decade. The concise total syntheses of four natural products PPAPs; hyperforin and papuaforins A-C, and the formal synthesis of nemorosone are reported. Key to the realization of this strategy is the short and scalable synthesis of densely substituted PPAP scaffolds through a gold(I)-catalyzed 6-endo-dig carbocyclization of cyclic enol ethers for late-stage functionalization. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. Total Synthesis and Antimicrobial Activity of (±-Laurelliptinhexadecan-1-one and (±-Laurelliptinoctadecan-1-one

    Directory of Open Access Journals (Sweden)

    Surachai Nimgirawath

    2008-11-01

    Full Text Available The structures previously assigned to (+-laurelliptinhexadecan-1-one (1a and (+-laurelliptinoctadecan-1-one (1b from Cocculus orbiculatus (L. DC. (Menispermaceae have been confirmed by total synthesis of the racemic alkaloids. The key step of the synthesis involved formation of ring C of the aporphines by a radical-intiated cyclisation. Both (±-laurelliptinhexadecan-1-one (1a and (±-laurelliptinoctadecan-1-one (1b were inactive against Staphylococcus aureus ATCC25932, Escherichia coli ATCC10536 and Candida albicans ATCC90028.

  19. Pharmacophore mapping in the laulimalide series: total synthesis of a vinylogue for a late-stage metathesis diversification strategy.

    Science.gov (United States)

    Wender, Paul A; Hilinski, Michael K; Skaanderup, Philip R; Soldermann, Nicolas G; Mooberry, Susan L

    2006-08-31

    An efficient synthesis of the macrocyclic core of laulimalide with a pendant vinyl group at C20 is described, allowing for late-stage introduction of various side chains through a selective and efficient cross metathesis diversification step. Representative analogues reported herein are the first to contain modifications to only the side chain dihydropyran of laulimalide and des-epoxy laulimalide. This step-economical strategy enables the rapid synthesis of new analogues using alkenes as an inexpensive, abundantly available diversification feedstock.

  20. Synthesis of Joint Volumes, Visualization of Paths, and Revision of Viewing Sequences in a Multi-dimensional Seismic Data Viewer

    Science.gov (United States)

    Chen, D. M.; Clapp, R. G.; Biondi, B.

    2006-12-01

    Ricksep is a freely-available interactive viewer for multi-dimensional data sets. The viewer is very useful for simultaneous display of multiple data sets from different viewing angles, animation of movement along a path through the data space, and selection of local regions for data processing and information extraction. Several new viewing features are added to enhance the program's functionality in the following three aspects. First, two new data synthesis algorithms are created to adaptively combine information from a data set with mostly high-frequency content, such as seismic data, and another data set with mainly low-frequency content, such as velocity data. Using the algorithms, these two data sets can be synthesized into a single data set which resembles the high-frequency data set on a local scale and at the same time resembles the low- frequency data set on a larger scale. As a result, the originally separated high and low-frequency details can now be more accurately and conveniently studied together. Second, a projection algorithm is developed to display paths through the data space. Paths are geophysically important because they represent wells into the ground. Two difficulties often associated with tracking paths are that they normally cannot be seen clearly inside multi-dimensional spaces and depth information is lost along the direction of projection when ordinary projection techniques are used. The new algorithm projects samples along the path in three orthogonal directions and effectively restores important depth information by using variable projection parameters which are functions of the distance away from the path. Multiple paths in the data space can be generated using different character symbols as positional markers, and users can easily create, modify, and view paths in real time. Third, a viewing history list is implemented which enables Ricksep's users to create, edit and save a recipe for the sequence of viewing states. Then, the recipe

  1. Nicholas reactions in the construction of cyclohepta[de]naphthalenes and cyclohepta[de]naphthalenones. The total synthesis of microstegiol.

    Science.gov (United States)

    Taj, Rafiq A; Green, James R

    2010-12-03

    The application of the Nicholas reaction chemistry of 2,7-dioxygenated naphthalenes in the synthesis of cyclohepta[de]napthalenes and in the synthesis of (±)-microstegiol (1) is presented. The substitution profile of Nicholas monosubstitution (predominantly C-1) and disubstitution reactions (predominantly 1,6-) on 2,7-dioxygenated napthalenes is reported. Application of a 1,8-dicondensation product and selected C-1 monocondensation products to the construction of cyclohepta[de]naphthalenes by way of ring closing metathesis and intramolecular Friedel-Crafts reactions, respectively, is described. Deprotection of the C-7 oxygen function to the corresponding naphthol allows tautomerization to cyclohepta[de]naphthalene-1-ones upon seven-membered-ring closure in most cases, and replacement of the C-2 oxygen function in the naphthalene by a methyl group ultimately allows the synthesis of (±)-microstegiol.

  2. Stimulation of glycogen synthesis in hepatocytes by added amino acids is related to the total intracellular content of amino acids

    NARCIS (Netherlands)

    Plomp, P. J.; Boon, L.; Caro, L. H.; van Woekom, G. M.; Meijer, A. J.

    1990-01-01

    Katz et al. [Katz, J., Golden, S. & Wals, P.A. (1976) Proc. Natl Acad. Sci. USA 73, 3433-3437] were the first to report that in hepatocytes isolated from fasted rats and incubated with either dihydroxyacetone, glucose or other sugars, glycogen synthesis was greatly accelerated by addition of amino

  3. Unified approach to catechin hetero-oligomers: first total synthesis of trimer EZ-EG-CA isolated from Ziziphus jujuba.

    Science.gov (United States)

    Yano, Takahisa; Ohmori, Ken; Takahashi, Haruko; Kusumi, Takenori; Suzuki, Keisuke

    2012-10-14

    A catechin hetero-trimer isolated from Ziziphus jujuba has been synthesized. Among three constituent monomers, (-)-epiafzelechin and (-)-epigallocatechin were prepared by de novo synthesis. Trimer formation relied on the unified approach to oligomers based on the bromo-capping and the orthogonal activation, reaching the reported structure of the natural product.

  4. Chemoenzymatic synthesis of statine side chain building blocks and application in the total synthesis of the cholesterol-lowering compound solistatin.

    Science.gov (United States)

    Rieder, Oliver; Wolberg, Michael; Foegen, Silke E; Müller, Michael

    2017-09-20

    The synthesis and enzymatic reduction of several 6-substituted dioxohexanoates are presented. Two-step syntheses of tert-butyl 6-bromo-3,5-dioxohexanoate and the corresponding 6-hydroxy compound have been achieved in 89% and 59% yield, respectively. Regio- and enantioselective reduction of these diketones and of the 6-chloro derivative with alcohol dehydrogenase from Lactobacillus brevis (LBADH) gave the (5S)-5-hydroxy-3-oxo products with enantiomeric excesses of 91%, 98.4%, and >99.5%, respectively. Chain elongation of the reduction products by one carbon via cyanide addition, and by more than one carbon by Julia-Kocienski olefination, gave access to well-established statine side-chain building blocks. Application in the synthesis of the cholesterol-lowering natural compound solistatin is given. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Revising Translations

    DEFF Research Database (Denmark)

    Rasmussen, Kirsten Wølch; Schjoldager, Anne

    2011-01-01

    The paper explains the theoretical background and findings of an empirical study of revision policies, using Denmark as a case in point. After an overview of important definitions, types and parameters, the paper explains the methods and data gathered from a questionnaire survey and an interview...... survey. Results clearly show that most translation companies regard both unilingual and comparative revisions as essential components of professional quality assurance. Data indicate that revision is rarely fully comparative, as the preferred procedure seems to be a unilingual revision followed by a more...... or less comparative rereading. Though questionnaire data seem to indicate that translation companies use linguistic correctness and presentation as the only revision parameters, interview data reveal that textual and communicative aspects are also considered. Generally speaking, revision is not carried...

  6. Bringing the science of proteins into the realm of organic chemistry: total chemical synthesis of SEP (synthetic erythropoiesis protein).

    Science.gov (United States)

    Kent, Stephen B H

    2013-11-11

    Erythropoietin, commonly known as EPO, is a glycoprotein hormone that stimulates the production of red blood cells. Recombinant EPO has been described as "arguably the most successful drug spawned by the revolution in recombinant DNA technology". Recently, the EPO glycoprotein molecule has re-emerged as a major target of synthetic organic chemistry. In this article I will give an account of an important body of earlier work on the chemical synthesis of a designed EPO analogue that had full biological activity and improved pharmacokinetic properties. The design and synthesis of this "synthetic erythropoiesis protein" was ahead of its time, but has gained new relevance in recent months. Here I will document the story of one of the major accomplishments of synthetic chemistry in a more complete way than is possible in the primary literature, and put the work in its contemporaneous context. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Solid-Phase Synthesis of Difficult Purine-Rich PNAs through Selective Hmb Incorporation: Application to the Total Synthesis of Cell Penetrating Peptide-PNAs

    Directory of Open Access Journals (Sweden)

    Julien Tailhades

    2017-10-01

    Full Text Available Antisense oligonucleotide (ASO-based drug development is gaining significant momentum following the recent FDA approval of Eteplirsen (an ASO based on phosphorodiamidate morpholino and Spinraza (2′-O-methoxyethyl-phosphorothioate in late 2016. Their attractiveness is mainly due to the backbone modifications which have improved the in vivo characteristics of oligonucleotide drugs. Another class of ASO, based on peptide nucleic acid (PNA chemistry, is also gaining popularity as a platform for development of gene-specific therapy for various disorders. However, the chemical synthesis of long PNAs, which are more target-specific, remains an ongoing challenge. Most of the reported methodology for the solid-phase synthesis of PNA suffer from poor coupling efficiency which limits production to short PNA sequences of less than 15 residues. Here, we have studied the effect of backbone modifications with Hmb (2-hydroxy-4-methoxybenzyl and Dmb (2,4-dimethoxybenzyl to ameliorate difficult couplings and reduce “on-resin” aggregation. We firstly synthesized a library of PNA dimers incorporating either Hmb or Dmb and identified that Hmb is superior to Dmb in terms of its ease of removal. Subsequently, we used Hmb backbone modification to synthesize a 22-mer purine-rich PNA, targeting dystrophin RNA splicing, which could not be synthesized by standard coupling methodology. Hmb backbone modification allowed this difficult PNA to be synthesized as well as to be continued to include a cell-penetrating peptide on the same solid support. This approach provides a novel and straightforward strategy for facile solid-phase synthesis of difficult purine-rich PNA sequences.

  8. Solid-phase synthesis of difficult purine-rich PNAs through selective Hmb incorporation: Application to the total synthesis of cell penetrating peptide-PNAs

    Science.gov (United States)

    Tailhades, Julien; Takizawa, Hotake; Gait, Michael J.; Wellings, Don A.; Wade, John D.; Aoki, Yoshitsugu; Shabanpoor, Fazel

    2017-10-01

    Antisense oligonucleotide (ASO)-based drug development is gaining significant momentum following the recent FDA approval of Eteplirsen (an ASO based on phosphorodiamidate morpholino) and Spinraza (2’-O-methoxyethyl-phosphorothioate) in late 2016. Their attractiveness is mainly due to the backbone modifications which have improved the in vivo characteristics of oligonucleotide drugs. Another class of ASO, based on peptide nucleic acid (PNA) chemistry, is also gaining popularity as a platform for development of gene-specific therapy for various disorders. However, the chemical synthesis of long PNAs, which are more target-specific, remains an ongoing challenge. Most of the reported methodology for the solid-phase synthesis of PNA suffer from poor coupling efficiency which limits production to short PNA sequences of less than 15 residues. Here we have studied the effect of backbone modifications with Hmb (2-hydroxy-4-methoxybenzyl) and Dmb (2,4-dimethoxybenzyl) to ameliorate difficult couplings and reduce “on-resin” aggregation. We firstly synthesized a library of PNA dimers incorporating either Hmb or Dmb and identified that Hmb is superior to Dmb in terms of its ease of removal. Subsequently, we used Hmb backbone modification to synthesize a 22-mer purine-rich PNA, targeting dystrophin RNA splicing, which could not be synthesized by standard coupling methodology. Hmb backbone modification allowed this difficult PNA to be synthesized as well as to be continued to include a cell-penetrating peptide on the same solid support. This approach provides a novel and straightforward strategy for facile solid-phase synthesis of difficult purine-rich PNA sequences.

  9. Diverted Total Synthesis of Promysalin Analogs Demonstrates That an Iron-Binding Motif Is Responsible for Its Narrow-Spectrum Antibacterial Activity.

    Science.gov (United States)

    Steele, Andrew D; Keohane, Colleen E; Knouse, Kyle W; Rossiter, Sean E; Williams, Sierra J; Wuest, William M

    2016-05-11

    Promysalin is a species-specific Pseudomonad metabolite with unique bioactivity. To better understand the mode of action of this natural product, we synthesized 16 analogs utilizing diverted total synthesis (DTS). Our analog studies revealed that the bioactivity of promysalin is sensitive to changes within its hydrogen bond network whereby alteration has drastic biological consequences. The DTS library not only yielded three analogs that retained potency but also provided insights that resulted in the identification of a previously unknown ability of promysalin to bind iron. These findings coupled with previous observations hint at a complex multifaceted role of the natural product within the rhizosphere.

  10. Rhodium-Catalyzed Asymmetric N-H Functionalization of Quinazolinones with Allenes and Allylic Carbonates: The First Enantioselective Formal Total Synthesis of (-)-Chaetominine.

    Science.gov (United States)

    Zhou, Yirong; Breit, Bernhard

    2017-12-22

    An unprecedented asymmetric N-H functionalization of quinazolinones with allenes and allylic carbonates was successfully achieved by rhodium catalysis with the assistance of chiral bidentate diphosphine ligands. The high efficiency and practicality of this method was demonstrated by a low catalyst loading of 1 mol % as well as excellent chemo-, regio-, and enantioselectivities with broad functional group compatibility. Furthermore, this newly developed strategy was applied as key step in the first enantioselective formal total synthesis of (-)-chaetominine. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Total synthesis of crocacins A, C and D: new antibiotics isolated from Chondromyces crocatus and Chondromyces pediculatus; Sinteses totais das crocacinas A, C e D: novos antibioticos isolados de Chondromyces crocatus e Chondromyces pediculatus

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Luciana G. de; Dias, Luiz C.; Rosso, Giovanni B. [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil). Inst. de Quimica]. E-mail: luciana@iqm.unicamp.br

    2008-07-01

    This review describes the endeavors that led to the total synthesis of a novel class of antibiotic compounds: the crocacins A-D. Other aspects such as isolation, structural elucidation as well as the biological activities are also presented. (author)

  12. Concise Stereocontrolled Formal Synthesis of (±)-Quinine and Total Synthesis of (±)-7-Hydroxyquinine via Merged Morita-Baylis-Hillman-Tsuji-Trost Cyclization

    Science.gov (United States)

    Webber, Peter; Krische, Michael J.

    2010-01-01

    Concise stereoselective syntheses of (±)-quinine and (±)-7-hydroxyquinine are achieved using a catalytic enone cycloallylation that combines the nucleophilic features of the Morita-Baylis-Hillman reaction and the electrophilic features of the Tsuji-Trost reaction. Cyclization of enone-allyl carbonate 11 delivers the product of cycloallylation 13 in 68% yield. Diastereoselective conjugate reduction of the enone 13 (>20:1 dr) followed by exchange of N-protecting groups provides the saturated N-Boc-protected methyl ketone 19, which upon aldol dehydration provides quinoline containing enone 15, possessing all carbon atoms of quinine. Exposure of ketone 15 to L-selectride enables diastereoselective carbonyl reduction (>20:1 dr) to furnish the allylic alcohol 16. Stereoselective hydroxyl-directed epoxidation using an oxovanadium catalyst modified by N-hydroxy-N-Me-pivalamide delivers epoxide 17 (17:1 dr). Cyclization of the resulting amine-epoxide 17 provides (±)-7-hydroxyquinine in 13 steps and 11% overall yield from aminoacetaldehyde diethyl acetal. Notably, highly stereoselective formation of five contiguous stereocenters is achieved through a series of 1,2-asymmetric induction events. A formal synthesis of (±)-quinine is achieved upon deoxygenation of the N-Cbz-protected allylic acetate 22 to provide olefin 23, which previously has been converted to quinine. Thus, (±)-quinine is accessible in 16 steps and 4% overall yield from commercial aminoacetaldehyde diethyl acetal, making this route the most concise approach to quinine, to date. PMID:18989927

  13. Aloenxerto circunferencial de femur proximal em cirurgia de revisäo de artroplastia total de quadril: relato de casos com seguimento mínimo de 20 anos Circumferential proximal femoral allografts in revision surgery on total hip arthroplasty: case reports with a minimum follow-up of 20 years

    Directory of Open Access Journals (Sweden)

    Bruno Dutra Roos

    2012-01-01

    Full Text Available Dentre as opções para reconstrução femoral em cirurgias de revisão de artroplastia total do quadril (RATQ em defeitos circunferenciais extensos está a utilização de aloenxerto de fêmur proximal. O seu uso permite a correção do mecanismo abdutor do quadril e da discrepância de comprimento dos membros inferiores, além de apresentar potencial osteocondutivo. Os autores relatam os achados clínicos e radiográficos de dois casos de RATQ com uso desta técnica, em seguimento mínimo de 20 anos.Among the options for femoral reconstruction in total hip arthroplasty (THA revision procedures, in cases of extensive circumferential defects, is the use of proximal femoral allografts. This technique makes it possible to correct the hip abductor mechanism and the leg length discrepancy, as well as presenting osteoconductive potential. The authors report the clinical and radiographic results from two cases of THA revision using this technique, with a minimum follow-up of 20 years.

  14. 24 CFR 968.225 - Budget revisions.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Budget revisions. 968.225 Section... Fewer Than 250 Units) § 968.225 Budget revisions. (a) A PHA shall not incur any modernization cost in excess of the total HUD-approved CIAP budget. A PHA shall submit a budget revision, in a form prescribed...

  15. Total synthesis of fluoxetine and duloxetine through an in situ imine formation/borylation/transimination and reduction approach.

    Science.gov (United States)

    Calow, Adam D J; Fernández, Elena; Whiting, Andrew

    2014-08-28

    We report efficient, catalytic, asymmetric total syntheses of both (R)-fluoxetine and (S)-duloxetine from α,β-unsaturated aldehydes conducting five sequential one-pot steps (imine formation/copper mediated β-borylation/transimination/reduction/oxidation) followed by the specific ether group formation which deliver the desired products (R)-fluoxetine in 45% yield (96% ee) and (S)-duloxetine in 47% yield (94% ee).

  16. Acetabular Cup Revision.

    Science.gov (United States)

    Kim, Young-Ho

    2017-09-01

    The use of acetabular cup revision arthroplasty is on the rise as demands for total hip arthroplasty, improved life expectancies, and the need for individual activity increase. For an acetabular cup revision to be successful, the cup should gain stable fixation within the remaining supportive bone of the acetabulum. Since the patient's remaining supportive acetabular bone stock plays an important role in the success of revision, accurate classification of the degree of acetabular bone defect is necessary. The Paprosky classification system is most commonly used when determining the location and degree of acetabular bone loss. Common treatment options include: acetabular liner exchange, high hip center, oblong cup, trabecular metal cup with augment, bipolar cup, bulk structural graft, cemented cup, uncemented cup including jumbo cup, acetabular reinforcement device (cage), trabecular metal cup cage. The optimal treatment option is dependent upon the degree of the discontinuity, the amount of available bone stock and the likelihood of achieving stable fixation upon supportive host bone. To achieve successful acetabular cup revision, accurate evaluation of bone defect preoperatively and intraoperatively, proper choice of method of acetabular revision according to the evaluation of acetabular bone deficiency, proper technique to get primary stability of implant such as precise grafting technique, and stable fixation of implant are mandatory.

  17. Autonomous assembly of synthetic oligonucleotides built from an expanded DNA alphabet. Total synthesis of a gene encoding kanamycin resistance

    Directory of Open Access Journals (Sweden)

    Kristen K. Merritt

    2014-10-01

    Full Text Available Background: Many synthetic biologists seek to increase the degree of autonomy in the assembly of long DNA (L-DNA constructs from short synthetic DNA fragments, which are today quite inexpensive because of automated solid-phase synthesis. However, the low information density of DNA built from just four nucleotide “letters”, the presence of strong (G:C and weak (A:T nucleobase pairs, the non-canonical folded structures that compete with Watson–Crick pairing, and other features intrinsic to natural DNA, generally prevent the autonomous assembly of short single-stranded oligonucleotides greater than a dozen or so.Results: We describe a new strategy to autonomously assemble L-DNA constructs from fragments of synthetic single-stranded DNA. This strategy uses an artificially expanded genetic information system (AEGIS that adds nucleotides to the four (G, A, C, and T found in standard DNA by shuffling hydrogen-bonding units on the nucleobases, all while retaining the overall Watson–Crick base-pairing geometry. The added information density allows larger numbers of synthetic fragments to self-assemble without off-target hybridization, hairpin formation, and non-canonical folding interactions. The AEGIS pairs are then converted into standard pairs to produce a fully natural L-DNA product. Here, we report the autonomous assembly of a gene encoding kanamycin resistance using this strategy. Synthetic fragments were built from a six-letter alphabet having two AEGIS components, 5-methyl-2’-deoxyisocytidine and 2’-deoxyisoguanosine (respectively S and B, at their overlapping ends. Gaps in the overlapped assembly were then filled in using DNA polymerases, and the nicks were sealed by ligase. The S:B pairs in the ligated construct were then converted to T:A pairs during PCR amplification. When cloned into a plasmid, the product was shown to make Escherichia coli resistant to kanamycin. A parallel study that attempted to assemble similarly sized genes

  18. How to revise a total preorder

    CSIR Research Space (South Africa)

    Booth, R

    2011-02-01

    Full Text Available were to replace individual i?s tpo ?i by any other tpo ??i which ranks x and y in exactly the same way as ?, then x and y would be ranked in exactly the same way in f (?1, . . . ,??i , . . . ?n) as in f (?1, . . . ,?i, . . . ?n). It turns out that our... compare two different worlds x and y according to preference, often we are able to imagine different contingencies, according to whether all goes well in x and y or not. Our idea is to associate to each world x two abstract objects x+ and x...

  19. Synthesis, structure and total conductivity of A-site doped LaTiO3−δ perovskites

    International Nuclear Information System (INIS)

    Bradha, M.; Hussain, S.; Chakravarty, Sujay; Amarendra, G.; Ashok, Anuradha

    2015-01-01

    Highlights: • A-site divalent alkaline earth metal doped LaTiO 3−δ perovskites were synthesised by sol–gel method. • Structural studies revealed no change in crystal symmetry but change in cell dimensions after doping. • After doping divalent cations in A-site, an enhancement in total conductivity was observed in LaTiO 3−δ . • Temperature dependent electrical property was observed in all synthesised perovskites. - Abstract: Oxygen deficient perovskites LaTiO 3−δ and La 0.8 A 0.2 TiO 3−δ (A = Ba, Sr, Ca) were synthesized by sol–gel method. The effect of divalent dopants on microstructure is investigated in detail using X-ray Diffraction (XRD) and Scanning Electron Microscopy (SEM). The oxidation states of La 3+ and Ti 3+ ions have been deduced using X-ray Photoelectron Spectroscopy (XPS). Impedance spectroscopy was used to analyze the total conductivity, an increase in conductivity was observed after doping in the A-site with divalent cations Ba, Ca and Sr. Among the investigated perovskites La 0.8 Ca 0.2 TiO 3−δ exhibited the maximum conductivity of 1.22 × 10 −2 S/cm in air atmosphere at 650 °C

  20. Synthesis, structure and total conductivity of A-site doped LaTiO{sub 3−δ} perovskites

    Energy Technology Data Exchange (ETDEWEB)

    Bradha, M. [Nanotech Research Facility, PSG Institute of Advanced Studies, Coimbatore 641 004, TN (India); Hussain, S.; Chakravarty, Sujay [UGC-DAE CSR, Kalpakkam Node, Kokilamedu 603 104, TN (India); Amarendra, G. [UGC-DAE CSR, Kalpakkam Node, Kokilamedu 603 104, TN (India); Indira Gandhi Centre for Atomic Research, Kalpakkam 603 102, TN (India); Ashok, Anuradha, E-mail: anu.machina@gmail.com [Nanotech Research Facility, PSG Institute of Advanced Studies, Coimbatore 641 004, TN (India)

    2015-03-25

    Highlights: • A-site divalent alkaline earth metal doped LaTiO{sub 3−δ} perovskites were synthesised by sol–gel method. • Structural studies revealed no change in crystal symmetry but change in cell dimensions after doping. • After doping divalent cations in A-site, an enhancement in total conductivity was observed in LaTiO{sub 3−δ}. • Temperature dependent electrical property was observed in all synthesised perovskites. - Abstract: Oxygen deficient perovskites LaTiO{sub 3−δ} and La{sub 0.8}A{sub 0.2}TiO{sub 3−δ} (A = Ba, Sr, Ca) were synthesized by sol–gel method. The effect of divalent dopants on microstructure is investigated in detail using X-ray Diffraction (XRD) and Scanning Electron Microscopy (SEM). The oxidation states of La{sup 3+} and Ti{sup 3+} ions have been deduced using X-ray Photoelectron Spectroscopy (XPS). Impedance spectroscopy was used to analyze the total conductivity, an increase in conductivity was observed after doping in the A-site with divalent cations Ba, Ca and Sr. Among the investigated perovskites La{sub 0.8}Ca{sub 0.2}TiO{sub 3−δ} exhibited the maximum conductivity of 1.22 × 10{sup −2} S/cm in air atmosphere at 650 °C.

  1. Determination of the X-ray structure of the snake venom protein omwaprin by total chemical synthesis and racemic protein crystallography.

    Science.gov (United States)

    Banigan, James R; Mandal, Kalyaneswar; Sawaya, Michael R; Thammavongsa, Vilasak; Hendrickx, Antoni P A; Schneewind, Olaf; Yeates, Todd O; Kent, Stephen B H

    2010-10-01

    The 50-residue snake venom protein L-omwaprin and its enantiomer D-omwaprin were prepared by total chemical synthesis. Radial diffusion assays were performed against Bacillus megaterium and Bacillus anthracis; both L- and D-omwaprin showed antibacterial activity against B. megaterium. The native protein enantiomer, made of L-amino acids, failed to crystallize readily. However, when a racemic mixture containing equal amounts of L- and D-omwaprin was used, diffraction quality crystals were obtained. The racemic protein sample crystallized in the centrosymmetric space group P2(1)/c and its structure was determined at atomic resolution (1.33 A) by a combination of Patterson and direct methods based on the strong scattering from the sulfur atoms in the eight cysteine residues per protein. Racemic crystallography once again proved to be a valuable method for obtaining crystals of recalcitrant proteins and for determining high-resolution X-ray structures by direct methods.

  2. Total replacement of corn by mesquite pod meal considering nutritional value, performance, feeding behavior, nitrogen balance, and microbial protein synthesis of Holstein-Zebu crossbred dairy steers.

    Science.gov (United States)

    de Oliveira Moraes, Gláucia Sabrine; de Souza, Evaristo Jorge Oliveira; Véras, Antonia Sherlânea Chaves; de Paula Almeida, Marina; da Cunha, Márcio Vieira; Torres, Thaysa Rodrigues; da Silva, Camila Sousa; Pereira, Gerfesson Felipe Cavalcanti

    2016-10-01

    The objective of the present study to assess the effects of mesquite pod addition replacing corn (0, 250, 500, 750, and 1000 g/kg in the dry matter basis) on nutrient intake, animal performance, feeding behavior, nutrient digestibility, nitrogen balance, and microbial protein synthesis. Twenty-five Holstein-Zebu crossbred dairy steers at 219 ± 22 kg initial body weight and 18 months of age were used. The experiment lasted 84 days, divided into three periods of 28 days. A completely randomized design was used, and data were submitted to analysis using PROC GLM for analysis of variance and PROC REG for regression analysis using the software Statistical Analysis Systems version 9.1. Experimental diets were composed of Tifton 85 hay, soybean meal, ground corn, mesquite pod meal, and mineral salt. Samples of food offered were collected during the last 3 days of each period, and the leftovers were collected daily, with samples bulked per week. At the end of each 28-day period, the remaining animals were weighed to determine total weight gain and average daily gain. The assessment of behavioral patterns was performed through instantaneous scans in 5-min intervals for three consecutive 12-h days. A single urine sample from each animal was collected on the last day of each collection period at about 4 h after the first feeding. The replacement of corn by mesquite pod meal did not significantly influence treatments regarding nutrients intake, animal performance, and feeding behavior. Retained and consumed nitrogen ratio did not statistically differ between replacement levels. Likewise, there were no statistical differences regarding microbial protein synthesis and efficiency between replacement levels. Mesquite pod meal can be used in Holstein-Zebu crossbred dairy steers' diet with total corn replacement.

  3. Lipase-catalyzed asymmetric synthesis of naphtho[2,3-c]furan-1(3H)-one derivatives by a one-pot dynamic kinetic resolution/intramolecular Diels-Alder reaction: Total synthesis of (-)-himbacine.

    Science.gov (United States)

    Sugiyama, Koji; Kawanishi, Shinji; Oki, Yasuhiro; Kamiya, Marin; Hanada, Ryosuke; Egi, Masahiro; Akai, Shuji

    2018-04-01

    One-pot sequential reactions using the acyl moieties installed by enzymatic dynamic kinetic resolution of alcohols have been little investigated. In this work, the acryloyl moiety installed via the lipase/oxovanadium combo-catalyzed dynamic kinetic resolution of a racemic dienol [4-(cyclohex-1-en-1-yl)but-3-en-2-ol or 1-(cyclohex-1-en-1-yl)but-2-en-1-ol] with a (Z)-3-(phenylsulfonyl)acrylate underwent an intramolecular Diels-Alder reaction in a one-pot procedure to produce an optically active naphtho[2,3-c]furan-1(3H)-one derivative (98% ee). This method was successfully applied to the asymmetric total synthesis of (-)-himbacine. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Natural occurrence, biological activities and synthesis of eight-, nine-, and eleven-membered ring lactones

    Directory of Open Access Journals (Sweden)

    Helena M. C. Ferraz

    2008-01-01

    Full Text Available The natural occurrence, biological activities and synthetic approaches to natural eight-, nine-, and eleven-membered lactones is reviewed. These medium ring lactones are grouped according to ring size, and their syntheses are discussed. The structures of some natural products early identified as medium-ring lactones were revised after total synthesis.

  5. Total protein synthesis in elderly people; a comparison of results with (/sup 15/N)glycine and (/sup 14/C)leucine

    Energy Technology Data Exchange (ETDEWEB)

    Golden, M H.N.; Waterlow, J C [London School of Hygiene and Tropical Medicine (UK)

    1977-09-01

    Total body protein turnover was studied in six elderly patients. During the study they were fed by continuous infusion of a liquid formula through a nasogastric tube. L-(1-/sup 14/C)leucine and (/sup 15/N)-glycine were infused at a constant rate for 30 h. The labelled glycine was infused into the intragastric line; the labelled leucine was given either by this route or intravenously. The specific radioactivity of free leucine in plasma and the rate of output of /sup 14/CO/sub 2/ in expired air both reached a plateau at 10 h, and remained constant until the end of the infusion at 30 h. The /sup 15/N abundance in urinary urea and total N was very similar. In neither was a plateau reached by 30 h but in four out of the six patients the abundance in urinary NH/sub 4//sup +/ had attained a plateau by the end of the infusion. Flux rates and rates of protein synthesis were calculated in four ways and a comparison of methods was used to examine the validity of the assumptions on which the different methods depended. The results suggest that the rate of protein turnover is reduced in the elderly, compared with younger subjects.

  6. [Ag67(SPhMe2)32(PPh3)8]3+: Synthesis, Total Structure, and Optical Properties of a Large Box-Shaped Silver Nanocluster

    KAUST Repository

    Alhilaly, Mohammad J.; Bootharaju, Megalamane Siddaramappa; Joshi, Chakra Prasad; Besong, Tabot M.D.; Emwas, Abdul-Hamid M.; Juarez-Mosqueda, Rosalba; Kaappa, Sami; Malola, Sami; Adil, Karim; Shkurenko, Aleksander; Hakkinen, Hannu; Eddaoudi, Mohamed; Bakr, Osman

    2016-01-01

    Engineering the surface ligands of metal nanoparticles is critical in designing unique arrangements of metal atoms. Here, we report the synthesis and total structure determination of a large box-shaped Ag-67 nanocluster (NC) protected by a mixed shell of thiolate (2,4-dimethylbenzenethiolate, SPhMe2) and phosphine (triphenylphosphine, PPh3) ligands. Single crystal X-ray diffraction (SCXRD) and electrospray ionization mass spectrometry (ESI-MS) revealed the cluster formula to be [Ag-67(SPhMe2)(32)(PPh3)(8)](3+). The crystal structure shows an Ag-23 metal core covered by a layer of Ag44S32P8 arranged in the shape of a box. The Ag-13, core was formed through an unprecedented centered cuboctahedron, i.e., Ag-13, unlike the common centered Ag-13 icosahedron geometry. Two types of ligand motifs, eight AgS3P and eight bridging thiols, were found to stabilize the whole cluster. The optical spectrum of this NC displayed highly structured multiple absorption peaks. The electronic structure and optical spectrum of Ag-67 were computed using time-dependent density functional theory (TDDFT) for both the full cluster [Ag-67(SPhMe2)(32)(PPh3)(8)](3+) and a reduced model [Ag-67(SH)(32)(PH3)(8)](3+). The lowest metal-to-metal transitions in the range 500-800 nm could be explained by considering the reduced model that shows almost identical electronic states to 32 free electrons in a jellium box. The successful synthesis of the large box-shaped Ag-67 NC facilitated by the combined use of phosphine and thiol paves the way for synthesizing other metal clusters with unprecedented shapes by judicious choice of thiols and phosphines.

  7. [Ag67(SPhMe2)32(PPh3)8]3+: Synthesis, Total Structure, and Optical Properties of a Large Box-Shaped Silver Nanocluster

    KAUST Repository

    Alhilaly, Mohammad J.

    2016-10-13

    Engineering the surface ligands of metal nanoparticles is critical in designing unique arrangements of metal atoms. Here, we report the synthesis and total structure determination of a large box-shaped Ag-67 nanocluster (NC) protected by a mixed shell of thiolate (2,4-dimethylbenzenethiolate, SPhMe2) and phosphine (triphenylphosphine, PPh3) ligands. Single crystal X-ray diffraction (SCXRD) and electrospray ionization mass spectrometry (ESI-MS) revealed the cluster formula to be [Ag-67(SPhMe2)(32)(PPh3)(8)](3+). The crystal structure shows an Ag-23 metal core covered by a layer of Ag44S32P8 arranged in the shape of a box. The Ag-13, core was formed through an unprecedented centered cuboctahedron, i.e., Ag-13, unlike the common centered Ag-13 icosahedron geometry. Two types of ligand motifs, eight AgS3P and eight bridging thiols, were found to stabilize the whole cluster. The optical spectrum of this NC displayed highly structured multiple absorption peaks. The electronic structure and optical spectrum of Ag-67 were computed using time-dependent density functional theory (TDDFT) for both the full cluster [Ag-67(SPhMe2)(32)(PPh3)(8)](3+) and a reduced model [Ag-67(SH)(32)(PH3)(8)](3+). The lowest metal-to-metal transitions in the range 500-800 nm could be explained by considering the reduced model that shows almost identical electronic states to 32 free electrons in a jellium box. The successful synthesis of the large box-shaped Ag-67 NC facilitated by the combined use of phosphine and thiol paves the way for synthesizing other metal clusters with unprecedented shapes by judicious choice of thiols and phosphines.

  8. Total Synthesis of Plukenetione A

    Science.gov (United States)

    Zhang, Qiang; Mitasev, Branko; Qi, Ji; Porco, John A.

    2010-01-01

    We describe an alkylative dearomatization/acid-mediated adamantane annulation sequence which allows facile access to type A polyprenylated acylphloroglucinol (PPAP) natural products including plukenetione A. Introduction of the 2-methyl-1-propenyl moiety was achieved via stereodivergent SN2 and SN1 cyclizations of allylic alcohol substrates. PMID:20843036

  9. The Total Synthesis of Chlorophyll

    Indian Academy of Sciences (India)

    IAS Admin

    led to the porphyrin14, which when held at 110oC in AcOH afforded the purpurine 15. This is the first example of porphyrin → purpurin change. Indeed Woodward anticipated this because such a change not only makes 7 and 8 tetrahedral, but also relieves the strain around the lower bridge! As the next step, the CH. 2. CH.

  10. The Total Synthesis of Strychnine

    Indian Academy of Sciences (India)

    IAS Admin

    Strychnine! No other molecule has captured the popular imagina- tion as strychnine, perhaps because thousands of writers of fiction have used it to dispatch the recipient and then several have made thrillers using ingenious deduction to catch the perpetrator! Known since the 16th century from the forests including the ...

  11. Total synthesis of amaminol A

    OpenAIRE

    Selkälä, Sami

    2003-01-01

    This thesis includes an extensive review of preparation of bicyclo[4.3.0]nonane derivatives. Bicyclo[4.3.0]nonanes can be prepared by several methods. The most important preparation method of bicyclo[4.3.0]nonanes is intramolecular Diels-Alder cycloaddition (IMDA). Several biologically active natural and unnatural compounds contain bicyclo[4.3.0]nonanes in their molecular framework. The synthetic efforts toward natural compounds such as pulo'upone, isopulo'upone, indanomycin, stawamycin, coch...

  12. Plant sterol ester diet supplementation increases serum plant sterols and markers of cholesterol synthesis, but has no effect on total cholesterol levels.

    Science.gov (United States)

    Weingärtner, Oliver; Bogeski, Ivan; Kummerow, Carsten; Schirmer, Stephan H; Husche, Constanze; Vanmierlo, Tim; Wagenpfeil, Gudrun; Hoth, Markus; Böhm, Michael; Lütjohann, Dieter; Laufs, Ulrich

    2017-05-01

    This double-blind, randomized, placebo-controlled, cross-over intervention-study was conducted in healthy volunteers to evaluate the effects of plant sterol ester supplemented margarine on cholesterol, non-cholesterol sterols and oxidative stress in serum and monocytes. Sixteen volunteers, average age 34 years, with no or mild hypercholesterolemia were subjected to a 4 week period of daily intake of 3g plant sterols per day supplied via a supplemented margarine on top of regular eating habits. After a wash-out period of one week, volunteers switched groups. Compared to placebo, a diet supplementation with plant sterols increased serum levels of plant sterols such as campesterol (+0.16±0.19mg/dL, p=0.005) and sitosterol (+0.27±0.18mg/dL, psynthesis such as desmosterol (+0.05±0.07mg/dL, p=0.006) as well as lathosterol (+0.11±0.16mg/dL, p=0.012). Cholesterol serum levels, however, were not changed significantly (+18.68±32.6mg/dL, p=0.052). These findings could not be verified in isolated circulating monocytes. Moreover, there was no effect on monocyte activation and no differences with regard to redox state after plant sterol supplemented diet. Therefore, in a population of healthy volunteers with no or mild hypercholesterolemia, consumption of plant sterol ester supplemented margarine results in increased concentrations of plant sterols and cholesterol synthesis markers without affecting total cholesterol in the serum, activation of circulating monocytes or redox state. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Total synthesis of a CD-ring: side-chain building block for preparing 17-epi-calcitriol derivatives from the Hajos-Parrish dione.

    Science.gov (United States)

    Michalak, Karol; Wicha, Jerzy

    2011-08-19

    An efficient synthesis of the key building block for 17-epi-calctriol from the Hajos-Parrish dione involving a sequence of diastereoselective transformation of the azulene core and the side-chain construction is presented.

  14. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

    Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise...... surgeon seems to positively influence the rate of surgical complications and implant survival. The painful TKA knee should be thoroughly evaluated, but not revised except if a relevant indication can be established. The most frequent indications for revision are: aseptic loosening, instability, infection...

  15. Bicyclic Guanidine Catalyzed Asymmetric Tandem Isomerization Intramolecular-Diels-Alder Reaction: The First Catalytic Enantioselective Total Synthesis of (+)-alpha-Yohimbine.

    Science.gov (United States)

    Feng, Wei; Jiang, Danfeng; Kee, Choon-Wee; Liu, Hongjun; Tan, Choon-Hong

    2016-02-04

    Hydroisoquinoline derivatives were prepared in moderate to good enantioselectivities via a bicyclic guanidine-catalyzed tandem isomerization intramolecular-Diels-Alder (IMDA) reaction of alkynes. With this synthetic method, the first enantioselective synthesis of (+)-alpha-yohimbine was completed in 9 steps from the IMDA products. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Total synthesis of [2-11C]thymidine from [11C]urea: A tracer of choice for measurement of cellular proliferation using PET

    International Nuclear Information System (INIS)

    Labar, D.; Vander Borght, T.

    1990-01-01

    In preliminary studies of cellular proliferation with [methyl- 11 C]thymidine, the labelled degradative products mask the progressive incorporation of the tracer into DNA. The authors have developed a procedure for the synthesis of [2- 11 C]thymidine to circumvent this difficulty, using a [ 11 C]urea precursor

  17. Peptide synthesis by enzymatic catalysis: new application to the total radiosynthesis of the tritiated leucine-enkephalin hormone, using Y carboxypeptidase

    International Nuclear Information System (INIS)

    Hellio, F.

    1986-01-01

    A new method of enzymatic labelling of peptide hormones is described. The enzyme used, a protease, Y carboxypeptidase is able, in some conditions, to catalyze the formation of peptide bounds. This property has been used for the synthesis of a pentapeptide, the tritiated leucine-enkephalin, with the incorporation of every radioactive amino acid. The specific radioactivity of the labelled molecule is 139 Ci/mmole and its biological properties (receptor binding and immunoreactivity) are identical with native leucine-enkephalin properties [fr

  18. Loosening After Acetabular Revision

    DEFF Research Database (Denmark)

    Beckmann, Nicholas A.; Weiss, Stefan; Klotz, Matthias C.M.

    2014-01-01

    The best method of revision acetabular arthroplasty remains unclear. Consequently, we reviewed the literature on the treatment of revision acetabular arthroplasty using revision rings (1541 cases; mean follow-up (FU) 5.7 years) and Trabecular Metal, or TM, implants (1959 cases; mean FU 3.7 years...

  19. First Total Synthesis of 4,5-Secoeudesmane-type and Iphionane-type Compounds- Synthesis of 4,5-Dioxo-seco-γ-eudesmol and 5β ,11-Dihydroxyiphionan-4-one

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@ 4, 5-Secoeudesmane-type and iphionane-type compounds are sesquiterpenes with new carbon skeletons found in natrual sources in recent years.1-6 The co-occurence of 4, 5-secoeudesmanes, iphionanes and eudesmanes as natrual products suggests that 4, 5-secoeudesmanes, iphionanes most likely are generated biogenetically from eudesmanes, and iphionanes are formed biogenetically by aldol reaction of 4, 5-dioxosecoeudesmanes1,4,6,7. The study on the synthesis of this two kind of new sesquiterpenes has not been reported in the literature.

  20. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  1. Imino Diels-Alder-Based Construction of a Piperidine A-Ring Unit for Total Synthesis of the Marine Hepatotoxin Cylindrospermopsin.

    Science.gov (United States)

    Heintzelman, Geoffrey R.; Weinreb, Steven M.; Parvez, Masood

    1996-07-12

    The synthesis of a piperidine A-ring precursor to the alkaloid cylindrospermopsin (1) is described. The initial approach to the A-ring precursor focused on the imino Diels-Alder reaction of diene 8 with ethyl (N-tosylimino)acetate (9) to form the cycloadduct 10 as a single stereoisomer. However, all attempts to convert ester 10 to a requisite diene such as 5 were unsuccessful. An alternative strategy involved the Diels-Alder cycloaddition of N-tosylimine 9 with oxygenated diene 19 under either thermal or Lewis acid-catalyzed conditions to produce a mixture of cis and trans enones 20 and 21. Although the undesired cis-enone 20 was the major product under all reaction conditions, it could be converted to the desired trans enone 21 by acid-catalyzed isomerization. Copper-mediated conjugate addition of vinylmagnesium bromide to cis-enone 20 followed by stereoselective ketone reduction with L-Selectride produced alcohol 23, whose structure was confirmed by X-ray crystallography. Similarly, trans-enone 21 was converted to alcohol 25 whose structure and stereochemistry were also established by X-ray analysis. Alcohol 25 was then protected as the silyl ether 26, which was hydroborated at the terminal olefin to produce primary alcohol ester 28having the stereochemistry and functionality needed for cylindrospermopsin.

  2. Total asymmetric synthesis of the putative structure of the cytotoxic diterpenoid (-)-sclerophytin a and of the authentic natural sclerophytins A and B.

    Science.gov (United States)

    Bernardelli, P; Moradei, O M; Friedrich, D; Yang, J; Gallou, F; Dyck, B P; Doskotch, R W; Lange, T; Paquette, L A

    2001-09-19

    An enantioselective synthetic route to the thermodynamically most stable diastereomer of the structure assigned to sclerophytin A (5) has been realized. The required tricyclic ketone 33 was prepared by sequential Tebbe-Claisen rearrangement of lactones 29 and 30, which originated from the Diels-Alder cycloaddition of Danishefsky's diene to (5S)-5-(d-menthyloxy)-2(5H)-furanone (14). An allyl and a cyano group were introduced into the resulting adduct by means of stereocontrolled allylindation under aqueous Barbier-like conditions and by way of cyanotrimethylsilane, respectively. Following stereocontrolled nucleophilic addition of a methyl group to 33, ring A was elaborated by formation of the silyl enol ether, ytterbium triflate-catalyzed condensation with formaldehyde, O-silylation, and Cu(I)-promoted 1,4-addition of isopropylmagnesium chloride. The superfluous ketone carbonyl was subsequently removed and the second ether bridge introduced by means of oxymercuration chemistry. Only then was the exocyclic methylene group unmasked via elimination. An alternative approach to the alpha-carbinol diastereomer proceeds by initial alpha-oxygenation of 37 and ensuing 1,2-carbonyl transposition. Neither this series of steps nor the Wittig olefination to follow induced epimerization at C10. Through deployment of oxymercuration chemistry, it was again possible to elaborate the dual oxygen-bridge network of the target ring system. Oxidation of the organomercurial products with O(2) in the presence of sodium borohydride furnished 72, which was readily separated from its isomer 73 after oxidation to 61. Hydride attack on this ketone proceeded with high selectivity from the beta-direction to deliver (-)-60. Comparison of the high-field (1)H and (13)C NMR properties and polarity of synthetic 5 with natural material required that structural revision be made. Following a complete spectral reassessment of the structural assignments to many sclerophytin diterpenes, a general approach

  3. Synthesis of 2,6-trans- and 3,3,6-trisubstituted tetrahydropyran-4-ones from Maitland-Japp derived 2H-dihydropyran-4-ones: a total synthesis of diospongin B.

    Science.gov (United States)

    Clarke, Paul A; Nasir, Nadiah Mad; Sellars, Philip B; Peter, Alejandra M; Lawson, Connor A; Burroughs, James L

    2016-07-12

    6-Substituted-2H-dihydropyran-4-one products of the Maitland-Japp reaction have been converted into tetrahydropyrans containing uncommon substitution patterns. Treatment of 6-substituted-2H-dihydropyran-4-ones with carbon nucleophiles led to the formation of tetrahydropyran rings with the 2,6-trans-stereochemical arrangement. Reaction of the same 6-substituted-2H-dihydropyran-4-ones with l-Selectride led to the formation of 3,6-disubstituted tetrahydropyran rings, while trapping of the intermediate enolate with carbon electrophiles in turn led to the formation 3,3,6-trisubstituted tetrahydropyran rings. The relative stereochemical configuration of the new substituents was controlled by the stereoelectronic preference for pseudo-axial addition of the nucleophile and trapping of the enolate from the opposite face. Application of these methods led to a synthesis of the potent anti-osteoporotic diarylheptanoid natural product diospongin B.

  4. Development and first validation of a simplified CT-based classification system of soft tissue changes in large-head metal-on-metal total hip replacement: intra- and interrater reliability and association with revision rates in a uniform cohort of 664 arthroplasties

    International Nuclear Information System (INIS)

    Boomsma, Martijn F.; Warringa, Niek; Edens, Mireille A.; Lingen, Christiaan P. van; Ettema, Harmen B.; Verheyen, Cees C.P.M.; Maas, Mario

    2015-01-01

    After implantation of a metal-on-metal total hip arthroplasty (MoM THA), a large incidence of pseudotumor formation has been described recently. Several centers have invited patients for follow-up in order to screen for pseudotumor formation. The spectrum of abnormalities found by CT in MoM THA patients can be unfamiliar to radiologists and orthopedic surgeons. Previously, a CT five-point grading scale has been published. In this paper, a simplification into a three-point classification system gives insight in the morphological distinction of abnormalities of the postoperative hip capsule in MoM implants in relation to the decision for revision. The reliability of this simplified classification regarding intra- and interrater reliability and its association with revision rate is investigated and discussed. All patients who underwent MoM THA in our hospital were invited for screening. Various clinical measures and CT scan were obtained in a cross-sectional fashion. A decision on revision surgery was made shortly after screening. CT scans were read in 582 patients, of which 82 patients were treated bilaterally. CT scans were independently single read by two board-certified radiologists and classified into categories I-V. In a second meeting, consensus was obtained. Categories were subsequently rubricated in class A (categories I and II), B (category III), and C (categories IV and V). Intra- and inter-radiologist agreement on MoM pathology was assessed by means of the weighted Cohen's kappa. Categorical data were presented as n (%), and tested by means of Fisher's exact test. Continuous data were presented as median (min-max) and tested by means of Mann-Whitney U test (two group comparison) or Kruskal-Wallis test (three group comparison). Logistic regression analysis was performed in order to study independence of CT class for association with revision surgery. Univariate statistically significant variables were entered in a multiple model. All statistical

  5. Development and first validation of a simplified CT-based classification system of soft tissue changes in large-head metal-on-metal total hip replacement: intra- and interrater reliability and association with revision rates in a uniform cohort of 664 arthroplasties

    Energy Technology Data Exchange (ETDEWEB)

    Boomsma, Martijn F.; Warringa, Niek [Isala Hospital, Department of Radiology, Zwolle (Netherlands); Edens, Mireille A. [Isala Hospital, Department of Innovation and Science, Zwolle (Netherlands); Lingen, Christiaan P. van; Ettema, Harmen B.; Verheyen, Cees C.P.M. [Isala Hospital, Department of Orthopaedics, Zwolle (Netherlands); Maas, Mario [AMC, Department of Radiology, Amsterdam (Netherlands)

    2015-08-15

    After implantation of a metal-on-metal total hip arthroplasty (MoM THA), a large incidence of pseudotumor formation has been described recently. Several centers have invited patients for follow-up in order to screen for pseudotumor formation. The spectrum of abnormalities found by CT in MoM THA patients can be unfamiliar to radiologists and orthopedic surgeons. Previously, a CT five-point grading scale has been published. In this paper, a simplification into a three-point classification system gives insight in the morphological distinction of abnormalities of the postoperative hip capsule in MoM implants in relation to the decision for revision. The reliability of this simplified classification regarding intra- and interrater reliability and its association with revision rate is investigated and discussed. All patients who underwent MoM THA in our hospital were invited for screening. Various clinical measures and CT scan were obtained in a cross-sectional fashion. A decision on revision surgery was made shortly after screening. CT scans were read in 582 patients, of which 82 patients were treated bilaterally. CT scans were independently single read by two board-certified radiologists and classified into categories I-V. In a second meeting, consensus was obtained. Categories were subsequently rubricated in class A (categories I and II), B (category III), and C (categories IV and V). Intra- and inter-radiologist agreement on MoM pathology was assessed by means of the weighted Cohen's kappa. Categorical data were presented as n (%), and tested by means of Fisher's exact test. Continuous data were presented as median (min-max) and tested by means of Mann-Whitney U test (two group comparison) or Kruskal-Wallis test (three group comparison). Logistic regression analysis was performed in order to study independence of CT class for association with revision surgery. Univariate statistically significant variables were entered in a multiple model. All statistical

  6. Bibliocable. Revised Edition.

    Science.gov (United States)

    Cable Television Information Center, Washington, DC.

    This selective, annotated bibliography is a revision of the original published in 1972 (ED 071 402). Some 104 books, articles, and reports included here deal with access, applications, franchising, regulation, technology, and other aspects of cable television. The listings are of two types in each category. First are revisions of the original…

  7. The economic impact of revision otologic surgery.

    Science.gov (United States)

    Nadimi, Sahar; Leonetti, John P; Pontikis, George

    2016-03-01

    Revision otologic surgery places a significant economic burden on patients and the healthcare system. We conducted a retrospective chart analysis to estimate the economic impact of revision canal-wall-down (CWD) mastoidectomy. We reviewed the medical records of all 189 adults who had undergone CWD mastoidectomy performed by the senior author between June 2006 and August 2011 at Loyola University Medical Center in Maywood, Ill. Institutional charges and collections for all patients were extrapolated to estimate the overall healthcare cost of revision surgery in Illinois and at the national level. Of the 189 CWD mastoidectomies, 89 were primary and 100 were revision procedures. The total charge for the revision cases was $2,783,700, and the net reimbursement (collections) was $846,289 (30.4%). Using Illinois Hospital Association data, we estimated that reimbursement for 387 revision CWD mastoidectomies that had been performed in fiscal year 2011 was nearly $3.3 million. By extrapolating our data to the national level, we estimated that 9,214 patients underwent revision CWD mastoidectomy in the United States during 2011, which cost the national healthcare system roughly $76 million, not including lost wages and productivity. Known causes of failed CWD mastoidectomies that often result in revision surgery include an inadequate meatoplasty, a facial ridge that is too high, residual diseased air cells, and recurrent cholesteatoma. A better understanding of these factors can reduce the need for revision surgery, which could have a positive impact on the economic strain related to this procedure at the local, state, and national levels.

  8. Microbiological diagnosis in revision of infected knee arthroplasties in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Pitter, Frederik Taylor; Voldstedlund, Marianne

    2017-01-01

    . METHODS: One hundred and two partial revisions (open debridement and exchange of tibial insert) and 213 two-stage procedures performed due to infection in 275 patients from 1 July 2011 to 30 June 2013 were included and analysed by linkage to data from a nationwide registry on microbiological test results....... RESULTS: 78 (24.8%) revisions were culture negative, 192 (60.9%) showed monomicrobial growth and 43 (14.3%) polymicrobial growth. Staphylococcus aureus was the most frequent isolate in mono-culture in 70 (22.2%) revisions and in polymicrobial culture in 15 revisions with a total frequency of 27.0%. Only...... one case (1.4%) of methicillin-resistance was registered. Coagulase-negative staphylococci (CoNS) were frequent, sole pathogen in 65 revisions and in polymicrobial cultures in 28 revisions with a total frequency of 29.5%. A pre-operative knee aspiration was performed in 50% and preoperative blood...

  9. The truth about false unicorn (Chamaelirium luteum): total synthesis of 23R,24S-chiograsterol B defines the structure and stereochemistry of the major saponins from this medicinal herb.

    Science.gov (United States)

    Matovic, Nicholas J; Stuthe, Julia M U; Challinor, Victoria L; Bernhardt, Paul V; Lehmann, Reginald P; Kitching, William; De Voss, James J

    2011-06-27

    Chamaelirium luteum is used in traditional medicine systems and commercial botanical dietary supplements for the treatment of female reproductive health problems. Despite the wide use of this herb, only very limited phytochemical characterisation is available. Our investigation of C. luteum roots led to the isolation of two new steroidal saponins 1 and 2 that contain an unusual aglycone 3. The absolute configurations of these molecules were unable to be determined spectroscopically and thus the total synthesis of 3 was undertaken and achieved in 16 steps and 1.6 % overall yield from pregnenolone. The key step in the synthesis was the stereoselective installation of the side chain at C-17 and C-20, which employed anion-accelerated oxy-Cope methodology. The relative configuration of aglycone 3 was determined by X-ray crystallography of an advanced synthetic intermediate. The absolute configuration was based upon that of the pregnenolone-derived steroidal skeleton and determined to be 23R,24S. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Total Synthesis and Stereochemical Assignment of Delavatine A: Rh-Catalyzed Asymmetric Hydrogenation of Indene-Type Tetrasubstituted Olefins and Kinetic Resolution through Pd-Catalyzed Triflamide-Directed C-H Olefination.

    Science.gov (United States)

    Zhang, Zhongyin; Wang, Jinxin; Li, Jian; Yang, Fan; Liu, Guodu; Tang, Wenjun; He, Weiwei; Fu, Jian-Jun; Shen, Yun-Heng; Li, Ang; Zhang, Wei-Dong

    2017-04-19

    Delavatine A (1) is a structurally unusual isoquinoline alkaloid isolated from Incarvillea delavayi. The first and gram-scale total synthesis of 1 was accomplished in 13 steps (the longest linear sequence) from commercially available starting materials. We exploited an isoquinoline construction strategy and developed two reactions, namely Rh-catalyzed asymmetric hydrogenation of indene-type tetrasubstituted olefins and kinetic resolution of β-alkyl phenylethylamine derivatives through Pd-catalyzed triflamide-directed C-H olefination. The substrate scope of the first reaction covered unfunctionalized olefins and those containing polar functionalities such as sulfonamides. The kinetic resolution provided a collection of enantioenriched indane- and tetralin-based triflamides, including those bearing quaternary chiral centers. The selectivity factor (s) exceeded 100 for a number of substrates. These reactions enabled two different yet related approaches to a key intermediate 28 in excellent enantiopurity. In the synthesis, the triflamide served as not only an effective directing group for C-H bond activation but also a versatile functional group for further elaborations. The relative and absolute configurations of delavatine A were unambiguously assigned by the syntheses of the natural product and its three stereoisomers. Their cytotoxicity against a series of cancer cell lines was evaluated.

  11. Rapid formation of complexity in the total synthesis of natural products enabled by oxabicyclo[2.2.1]heptene building blocks.

    Science.gov (United States)

    Schindler, Corinna S; Carreira, Erick M

    2009-11-01

    This critical review showcases examples of rapid formation of complexity in total syntheses starting from 7-oxabicyclo[2.2.1]hept-5-ene derivatives. An overview of methods allowing synthetic access to these building blocks is provided and their application in recently developed synthetic transformations to structurally complex systems is illustrated. In addition, the facile access to a novel oxabicyclo[2.2.1]heptene derived building block is presented which significantly enlarges the possibilities of previously known chemical transformations and is highlighted in the enantioselective route to the core of the banyaside and suomilide natural products (107 references).

  12. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  13. Effect of Different Light Intensities on Total Phenolics and Flavonoids Synthesis and Anti-oxidant Activities in Young Ginger Varieties (Zingiber officinale Roscoe)

    Science.gov (United States)

    Ghasemzadeh, Ali; Jaafar, Hawa Z. E.; Rahmat, Asmah; Wahab, Puteri Edaroyati Megat; Halim, Mohd Ridzwan Abd

    2010-01-01

    Nowadays, phytochemicals and antioxidants in plants are raising interest in consumers for their roles in the maintenance of human health. Phenolics and flavonoids are known for their health-promoting properties due to protective effects against cardiovascular disease, cancers and other disease. Ginger (Zingiber officinale) is one of the traditional folk medicinal plants and it is widely used in cooking in Malaysia. In this study, four levels of glasshouse light intensities (310, 460, 630 and 790 μmol m−2s−1) were used in order to consider the effect of light intensity on the production, accumulation and partitioning of total phenolics (TP), total flavonoids (TF) and antioxidant activities in two varieties of Malaysian young ginger (Zingiber officinale). TF biosynthesis was highest in the Halia Bara variety under 310 μmol m−2s−1 and TP was high in this variety under a light intensity of 790 μmol m−2s−1. The highest amount of these components accumulated in the leaves and after that in the rhizomes. Also, antioxidant activities determined by the 1,1-Diphenyl-2-picryl-hydrazyl (DPPH) assay in both of varieties, increased significantly (p ≤ 0.01) with increasing TF concentration, and high antioxidant activity was observed in the leaves of Halia Bara grown under 310 μmol m−2s−1. The ferric reducing (FRAP) activity of the rhizomes was higher than that of the leaves in 310 μmol m−2s−1 of sun light. This study indicates the ability of different light intensities to enhance the medicinal components and antioxidant activities of the leaves and young rhizomes of Zingiber officinale varieties. Additionally, this study also validated their medicinal potential based on TF and TP contents. PMID:21152306

  14. Effect of Different Light Intensities on Total Phenolics and Flavonoids Synthesis and Anti-oxidant Activities in Young Ginger Varieties (Zingiber officinale Roscoe

    Directory of Open Access Journals (Sweden)

    Ali Ghasemzadeh

    2010-10-01

    Full Text Available Nowadays, phytochemicals and antioxidants in plants are raising interest in consumers for their roles in the maintenance of human health. Phenolics and flavonoids are known for their health-promoting properties due to protective effects against cardiovascular disease, cancers and other disease. Ginger (Zingiber officinale is one of the traditional folk medicinal plants and it is widely used in cooking in Malaysia. In this study, four levels of glasshouse light intensities (310, 460, 630 and 790 μmol m−2s−1 were used in order to consider the effect of light intensity on the production, accumulation and partitioning of total phenolics (TP, total flavonoids (TF and antioxidant activities in two varieties of Malaysian young ginger (Zingiber officinale. TF biosynthesis was highest in the Halia Bara variety under 310 μmol m−2s−1 and TP was high in this variety under a light intensity of 790 μmol m−2s−1. The highest amount of these components accumulated in the leaves and after that in the rhizomes. Also, antioxidant activities determined by the 1,1-Diphenyl-2-picryl-hydrazyl (DPPH assay in both of varieties, increased significantly (p ≤ 0.01 with increasing TF concentration, and high antioxidant activity was observed in the leaves of Halia Bara grown under 310 μmol m−2s−1. The ferric reducing (FRAP activity of the rhizomes was higher than that of the leaves in 310 μmol m−2s−1 of sun light. This study indicates the ability of different light intensities to enhance the medicinal components and antioxidant activities of the leaves and young rhizomes of Zingiber officinale varieties. Additionally, this study also validated their medicinal potential based on TF and TP contents.

  15. Publishing and Revising Content

    Science.gov (United States)

    Editors and Webmasters can publish content without going through a workflow. Publishing times and dates can be set, and multiple pages can be published in bulk. Making an edit to published content created a revision.

  16. Letter of Map Revision

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — The National Flood Hazard Layer (NFHL) data incorporates all Digital Flood Insurance Rate Map(DFIRM) databases published by FEMA, and any Letters Of Map Revision...

  17. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  18. A revised Self- and Family Management Framework.

    Science.gov (United States)

    Grey, Margaret; Schulman-Green, Dena; Knafl, Kathleen; Reynolds, Nancy R

    2015-01-01

    Research on self- and family management of chronic conditions has advanced over the past 6 years, but the use of simple frameworks has hampered the understanding of the complexities involved. We sought to update our previously published model with new empirical, synthetic, and theoretical work. We used synthesis of previous studies to update the framework. We propose a revised framework that clarifies facilitators and barriers, processes, proximal outcomes, and distal outcomes of self- and family management and their relationships. We offer the revised framework as a model that can be used in studies aimed at advancing self- and family management science. The use of the framework to guide studies would allow for the design of studies that can address more clearly how self-management interventions work and under what conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Clinical and Economic Burden of Revision Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Mohit Bhandari

    2012-01-01

    Full Text Available Surgery is indicated for symptomatic knee osteoarthritis (OA when conservative measures are unsuccessful. High tibial osteotomy (HTO, unicompartmental knee arthroplasty (UKA, and total knee arthroplasty (TKA are surgical options intended to relieve knee OA pain and dysfunction. The choice of surgical intervention is dependent on several factors such as disease location, patient age, comorbidities, and activity levels. Regardless of surgical treatment, complications such as infection, loosening or lysis, periprosthetic fracture, and postoperative pain are known risks and are indications for revision surgery. The clinical and economic implications for revision surgery are underappreciated. Over 55,000 revision surgeries were performed in 2010 in the US, with 48% of these revisions in patients under 65 years. Total costs associated with each revision TKA surgery have been estimated to be in excess of $49,000. The current annual economic burden of revision knee OA surgery is $2.7 billion for hospital charges alone. By 2030, assuming a 5-fold increase in the number of revision procedures, this economic burden will exceed $13 billion annually. It is appealing to envision a therapy that could delay or obviate the need for arthroplasty. From an actuarial standpoint, this would have the theoretical downstream effect of substantially reducing the number of revision procedures. Although no known therapies currently meet these criteria, such a breakthrough would have a tremendous impact in lessening the clinical and economic burden of knee OA revision surgery.

  20. Effects of Synchronization of Carbohydrate and Protein Supply in Total Mixed Ration with Korean Rice Wine Residue on Ruminal Fermentation, Nitrogen Metabolism and Microbial Protein Synthesis in Holstein Steers

    Directory of Open Access Journals (Sweden)

    Min Yu Piao

    2012-11-01

    Full Text Available Three Holstein steers in the growing phase, each with a ruminal cannula, were used to test the hypothesis that the synchronization of the hourly rate of carbohydrate and nitrogen (N released in the rumen would increase the amount of retained nitrogen for growth and thus improve the efficiency of microbial protein synthesis (EMPS. In Experiment 1, in situ degradability coefficients of carbohydrate and N in feeds including Korean rice wine residue (RWR were determined. In Experiment 2, three total mixed ration (TMR diets having different rates of carbohydrate and N release in the rumen were formulated using the in situ degradability of the feeds. All diets were made to contain similar contents of crude protein (CP and neutral detergent fiber (NDF but varied in their hourly pattern of nutrient release. The synchrony index of the three TMRs was 0.51 (LS, 0.77 (MS and 0.95 (HS, respectively. The diets were fed at a restricted level (2% of the animal’s body weight in a 3×3 Latin-square design. Synchronizing the hourly supply of energy and N in the rumen did not significantly alter the digestibility of dry matter, organic matter, crude protein, NDF or acid detergent fiber (ADF (p>0.05. The ruminal NH3-N content of the LS group at three hours after feeding was significantly higher (p0.05. In addition, the purine derivative (PD excretion in urine and microbial-N production (MN among the three groups were not significantly different (p>0.05. In conclusion, synchronizing dietary energy and N supply to the rumen did not have a major effect on nutrient digestion or microbial protein synthesis (MPS in Holstein steers.

  1. Outcome, revision rate and indication for revision following resurfacing hemiarthroplasty for osteoarthritis of the shoulder

    DEFF Research Database (Denmark)

    Rasmussen, J V; Polk, A; Sorensen, A K

    2014-01-01

    In this study, we evaluated patient-reported outcomes, the rate of revision and the indications for revision following resurfacing hemiarthroplasty of the shoulder in patients with osteoarthritis. All patients with osteoarthritis who underwent primary resurfacing hemiarthroplasty and reported...... to the Danish Shoulder Arthroplasty Registry (DSR), between January 2006 and December 2010 were included. There were 772 patients (837 arthroplasties) in the study. The Western Ontario Osteoarthritis of the Shoulder (WOOS) index was used to evaluate patient-reported outcome 12 months (10 to 14) post......-operatively. The rates of revision were calculated from the revisions reported to the DSR up to December 2011 and by checking deaths with the Danish National Register of Persons. A complete questionnaire was returned by 688 patients (82.2%). The mean WOOS was 67 (0 to 100). A total of 63 hemiarthroplasties (7...

  2. The Catalytic Enantioselective Total Synthesis of (+)-Liphagal

    KAUST Repository

    Day, Joshua J.

    2011-06-10

    Ring a ding: The meroterpenoid natural product (+)-liphagal has been synthesized enantioselectively in 19 steps from commercially available materials. The trans-homodecalin system was achieved by ring expansion followed by stereoselective hydrogenation. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. The enantioselective total synthesis of (+)-clusianone.

    Science.gov (United States)

    Horeischi, Fiene; Guttroff, Claudia; Plietker, Bernd

    2015-02-11

    (+)-Clusianone, an exo-type B PPAP with reported anti-HIV and chemoprotective activities, was synthesized in eleven steps with 97% ee starting from acetylacetone. An enantioselective decarboxylative Tsuji-Trost-allylation and a Ru-catalyzed ring-closing metathesis-decarboxylative allylation were used to control both diastereo- and enantioselectivity.

  4. The Catalytic Enantioselective Total Synthesis of (+)-Liphagal

    KAUST Repository

    Day, Joshua J.; McFadden, Ryan M.; Virgil, Scott C.; Kolding, Helene; Alleva, Jennifer L.; Stoltz, Brian M.

    2011-01-01

    Ring a ding: The meroterpenoid natural product (+)-liphagal has been synthesized enantioselectively in 19 steps from commercially available materials. The trans-homodecalin system was achieved by ring expansion followed by stereoselective hydrogenation. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Total synthesis of lactarane and marasmane sesquiterpenes

    NARCIS (Netherlands)

    Bell, R.P.L.

    2000-01-01

    Lactarane and marasmane sesquiterpenes are mostly found in nature as metabolites from mushrooms of the genera Lactarius and Russula . Because a considerable number of these compounds possesses a variety of interesting biological activities, they are

  6. Maximum surgical blood ordering schedules for revision lower limb arthroplasty.

    Science.gov (United States)

    Mahadevan, Devendra; Challand, Christopher; Clarke, Andrew; Keenan, Jonathan

    2011-05-01

    Effective utilisation of blood products is fundamental. The introduction of maximum surgical blood ordering schedules (MSBOS) for operations has been shown to improve transfusion services. A retrospective analysis was undertaken to establish an evidence-based MSBOS for revision total hip replacement (THR) and total knee revision (TKR). The impact of this schedule on blood conservation was analysed. A retrospective analysis was undertaken on 397 patients who underwent revision THR and TKR over a 4-year period. The cross-match-to-transfusion ratio (CTR) and transfusion index (TI) were calculated. A MSBOS protocol was created based on the TIs and its' impact on transfusion services was assessed prospectively on 125 patients by comparing CTRs. In revision THR, TI was 1.19 for elective cases, 1.55 for emergency cases and 2.35 for infected cases. There was no difference in TI for revisions of cemented and uncemented components. Single component THR revision required less transfusion. In revision TKR, TI was 0.31 for elective cases, 2.0 for emergency cases and 1.23 for cases with infection. The introduction of the MSBOS protocol had resulted in a considerable improvement in blood ordering. Reductions in the CTR were seen for all types of revision surgery, but most evident in elective revision THR (3.24-2.18) and elective revision TKR (7.95-1.2). Analysis confirmed that excessive cross-matching occurred for revision lower limb arthroplasty. The introduction of our MSBOS protocol promoted blood conservation and compliance with established national guidelines.

  7. Revision of Pachycentria (Melastomataceae)

    NARCIS (Netherlands)

    Clausing, Gudrun

    2000-01-01

    A revision of Pachycentria Blume, which includes the monotypic Pogonanthera Blume, is presented. Pachycentria comprises eight species and one subspecies. Two species, P. vogelkopensis and P. hanseniana, are newly described. The genus is distinguished from other genera in the Medinillinae by a small

  8. Revision of Oxandra (Annonaceae)

    NARCIS (Netherlands)

    Junikka, L.; Maas, P.J.M.; Maas-van de Kamer, H.; Westra, L.Y.Th.

    2016-01-01

    A taxonomic revision is given of the Neotropical genus Oxandra (Annonaceae). Within the genus 27 species are recognized, 4 of which are new to science. Most of the species are occurring in tropical South America, whereas a few (6) are found in Mexico and Central America and two in the West Indies

  9. Revision without ordinals

    NARCIS (Netherlands)

    Rivello, Edoardo

    2013-01-01

    We show that Herzberger’s and Gupta’s revision theories of truth can be recast in purely inductive terms, without any appeal neither to the transfinite ordinal numbers nor to the axiom of Choice. The result is presented in an abstract and general setting, emphasising both its validity for a wide

  10. Revising and editing for translators

    CERN Document Server

    Mossop, Brian

    2014-01-01

    Revising and Editing for Translators provides guidance and learning materials for translation students learning to edit texts written by others, and professional translators wishing to improve their self-revision ability or learning to revise the work of others. Editing is understood as making corrections and improvements to texts, with particular attention to tailoring them to the given readership. Revising is this same task applied to draft translations. The linguistic work of editors and revisers is related to the professional situations in which they work. Mossop offers in-depth coverage of a wide range of topics, including copyediting, style editing, structural editing, checking for consistency, revising procedures and principles, and translation quality assessment. This third edition provides extended coverage of computer aids for revisers, and of the different degrees of revision suited to different texts. The inclusion of suggested activities and exercises, numerous real-world examples, a proposed gra...

  11. Hamiltonian Algorithm Sound Synthesis

    OpenAIRE

    大矢, 健一

    2013-01-01

    Hamiltonian Algorithm (HA) is an algorithm for searching solutions is optimization problems. This paper introduces a sound synthesis technique using Hamiltonian Algorithm and shows a simple example. "Hamiltonian Algorithm Sound Synthesis" uses phase transition effect in HA. Because of this transition effect, totally new waveforms are produced.

  12. Analogues of amphibian alkaloids: total synthesis of (5R,8S,8aS-(--8-methyl-5-pentyloctahydroindolizine (8-epi-indolizidine 209B and [(1S,4R,9aS-(--4-pentyloctahydro-2H-quinolizin-1-yl]methanol

    Directory of Open Access Journals (Sweden)

    de Koning Charles B

    2008-01-01

    Full Text Available Abstract Background Prior work from these laboratories has centred on the development of enaminones as versatile intermediates for the synthesis of alkaloids and other nitrogen-containing heterocycles. In this paper we describe the enantioselective synthesis of indolizidine and quinolizidine analogues of bicyclic amphibian alkaloids via pyrrolidinylidene- and piperidinylidene-containing enaminones. Results Our previously reported synthesis of racemic 8-epi-indolizidine 209B has been extended to the laevorotatory enantiomer, (--9. Attempts to adapt the synthetic route in order to obtain quinolizidine analogues revealed that a key piperidinylidene-containing enaminone intermediate (+-28 was less tractable than its pyrrolidinylidene counterpart, thereby necessitating modifications that included timing changes and additional protection-deprotection steps. A successful synthesis of [(1S,4R,9aS-4-pentyloctahydro-2H-quinolizin-1-yl]methanol (--41 from the chiral amine tert-butyl (3R-3-{benzyl [(1R-1-phenylethyl]amino}octanoate (+-14 was achieved in 14 steps and an overall yield of 20.4%. Conclusion The methodology reported in this article was successfully applied to the enantioselective synthesis of the title compounds. It paves the way for the total synthesis of a range of cis-5,8-disubstituted indolizidines and cis-1,4-disubstituted quinolizidines, as well as the naturally occurring trans-disubstituted alkaloids.

  13. Synthesis of Acetylhomoagmatine

    Directory of Open Access Journals (Sweden)

    Carmenza Duque

    2006-08-01

    Full Text Available Abstract: The first total synthesis of acetylhomoagmatine, a natural product isolated form the methanolic extracts from the sponge Cliona celata, is performed in four steps in a very high yield.

  14. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  15. Descriptive epidemiology of the Multicenter ACL Revision Study (MARS) cohort.

    Science.gov (United States)

    Wright, Rick W; Huston, Laura J; Spindler, Kurt P; Dunn, Warren R; Haas, Amanda K; Allen, Christina R; Cooper, Daniel E; DeBerardino, Thomas M; Lantz, Brett Brick A; Mann, Barton J; Stuart, Michael J

    2010-10-01

    Revision anterior cruciate ligament (ACL) reconstruction has worse outcomes than primary reconstructions. Predictors for these worse outcomes are not known. The Multicenter ACL Revision Study (MARS) Group was developed to perform a multisurgeon, multicenter prospective longitudinal study to obtain sufficient subjects to allow multivariable analysis to determine predictors of clinical outcome. To describe the formation of MARS and provide descriptive analysis of patient demographics and clinical features for the initial 460 enrolled patients to date in this prospective cohort. Cross-sectional study; Level of evidence, 2. After training and institutional review board approval, surgeons began enrolling patients undergoing revision ACL reconstruction, recording patient demographics, previous ACL reconstruction methods, intra-articular injuries, and current revision techniques. Enrolled subjects completed a questionnaire consisting of validated patient-based outcome measures. As of April 1, 2009, 87 surgeons have enrolled a total of 460 patients (57% men; median age, 26 years). For 89%, the reconstruction was the first revision. Mode of failure as deemed by the revising surgeon was traumatic (32%), technical (24%), biologic (7%), combination (37%), infection (MARS Group has been able to quickly accumulate the largest revision ACL reconstruction cohort reported to date. Traumatic reinjury is deemed by surgeons to be the most common single mode of failure, but a combination of factors represents the most common mode of failure. Allograft graft choice is more common in the revision setting than autograft. Concomitant knee injury is extremely common in this population.

  16. Revision hip preservation surgery with hip arthroscopy: clinical outcomes.

    Science.gov (United States)

    Domb, Benjamin G; Stake, Christine E; Lindner, Dror; El-Bitar, Youseff; Jackson, Timothy J

    2014-05-01

    To analyze and report the clinical outcomes of a cohort of patients who underwent revision hip preservation with arthroscopy and determine predictors of positive and negative outcomes. During the study period from April 2008 to December 2010, all patients who underwent revision hip preservation with arthroscopy were included. This included patients who had previous open surgery and underwent revision with arthroscopy. Patient-reported outcome (PRO) scores were obtained preoperatively and at 3-month, 1-year, 2-year, and 3-year follow-up time points. Any revision surgeries and conversions to total hip arthroplasty were noted. A multiple regression analysis was performed to look for positive and negative predictive factors for improvement in PROs after revision hip arthroscopy. Forty-seven hips in 43 patients had completed 2 years' follow-up or needed total hip arthroplasty. The mean length of follow-up was 29 months (range, 24 to 47 months). Of the hips, 31 (66%) had either unaddressed or incompletely treated femoroacetabular impingement. There was a significant improvement in all PRO scores at a mean of 29 months after revision (P arthroscopy can achieve moderately successful outcomes and remains a viable treatment strategy after failed primary hip preservation surgery. Preoperative predictors of success after revision hip arthroscopy include segmental labral defects, unaddressed or incompletely addressed femoroacetabular impingement, heterotopic ossification, and previous open surgery. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  17. Revised Site Index Curves for Balsam Fir and White Spruce in the Lake States

    Science.gov (United States)

    Willard H. Carmean; Jerold T. Hahn

    1981-01-01

    The original site index curves for balsam fir and white spruce are revised from a breast height age to a total age basis. Site index values from these revised curves are thus comparable to index values for other species that are based upon total tree age. This note also includes formulations for estimating site index by using computers or programmable, hand-...

  18. Mortality After Total Knee and Total Hip Arthroplasty in a Large Integrated Health Care System.

    Science.gov (United States)

    Inacio, Maria C S; Dillon, Mark T; Miric, Alex; Navarro, Ronald A; Paxton, Elizabeth W

    2017-01-01

    The number of excess deaths associated with elective total joint arthroplasty in the US is not well understood. To evaluate one-year postoperative mortality among patients with elective primary and revision arthroplasty procedures of the hip and knee. A retrospective analysis was conducted of hip and knee arthroplasties performed in 2010. Procedure type, procedure volume, patient age and sex, and mortality were obtained from an institutional total joint replacement registry. An integrated health care system population was the sampling frame for the study subjects and was the reference group for the study. Standardized 1-year mortality ratios (SMRs) and 95% confidence intervals (CIs) were calculated. A total of 10,163 primary total knee arthroplasties (TKAs), 4963 primary total hip arthroplasties (THAs), 606 revision TKAs, and 496 revision THAs were evaluated. Patients undergoing primary THA (SMR = 0.6, 95% CI = 0.4-0.7) and TKA (SMR = 0.4, 95% CI = 0.3-0.5) had lower odds of mortality than expected. Patients with revision TKA had higher-than-expected mortality odds (SMR = 1.8, 95% CI = 1.1-2.5), whereas patients with revision THA (SMR = 0.9, 95% CI = 0.4-1.5) did not have higher-than-expected odds of mortality. Understanding excess mortality after joint surgery allows clinicians to evaluate current practices and to determine whether certain groups are at higher-than-expected mortality risk after surgery.

  19. A concise synthesis of the cortistatin core

    OpenAIRE

    Dai, Mingji; Danishefsky, Samuel J.

    2008-01-01

    We describe a concise and convergent route to the core matrix of the cortistatin steroidal alkaloids. The salient features of the synthesis are the Snieckus cascade methodology and the Masamune alkylative dearomatization. This chemistry lends itself to a total synthesis of the cortistatins and to the development of a SAR program based on diverted total synthesis.

  20. Trends in Revision Elbow Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers.

    Science.gov (United States)

    Wilson, Alexander T; Pidgeon, Tyler S; Morrell, Nathan T; DaSilva, Manuel F

    2015-11-01

    To determine the frequency of revision elbow ulnar collateral ligament (UCL) reconstruction in professional baseball pitchers. Data were collected on 271 professional baseball pitchers who underwent primary UCL reconstruction. Each player was evaluated retrospectively for occurrence of revision UCL reconstructive surgery to treat failed primary reconstruction. Data on players who underwent revision UCL reconstruction were compiled to determine total surgical revision incidence and revision rate by year. The incidence of early revision was analyzed for trends. Average career length after primary UCL reconstruction was calculated and compared with that of players who underwent revision surgery. Logistic regression analysis was performed to assess risk factors for revision including handedness, pitching role, and age at the time of primary reconstruction. Between 1974 and 2014, the annual incidence of primary UCL reconstructions among professional pitchers increased, while the proportion of cases being revised per year decreased. Of the 271 pitchers included in the study, 40 (15%) required at least 1 revision procedure during their playing career. Three cases required a second UCL revision reconstruction. The average time from primary surgery to revision was 5.2 ± 3.2 years (range, 1-13 years). The average length of career following primary reconstruction for all players was 4.9 ± 4.3 years (range, 0-22 years). The average length of career following revision UCL reconstruction was 2.5 ± 2.4 years (range, 0-8 years). No risk factors for needing revision UCL reconstruction were identified. The incidence of primary UCL reconstructions among professional pitchers is increasing; however, the rate of primary reconstructions requiring revision is decreasing. Explanations for the decreased revision rate may include improved surgical technique and improved rehabilitation protocols. Therapeutic IV. Copyright © 2015 American Society for Surgery of the Hand. Published by

  1. Adapting Total Quality Management (TQM) to Government.

    Science.gov (United States)

    Swiss, James E.

    1992-01-01

    Total quality management will not work well in government agencies because of stress on products, not services; on well-defined consumer groups; on inputs/processes, not results; and on preoccupation with quality. An effective revised version emphasizes client feedback, performance monitoring, continuous improvement, and worker participation. (SK)

  2. Synthesis of pyrimidine carboxamide derivatives catalyzed by uranyl

    African Journals Online (AJOL)

    2014-09-02

    (Received September 2, 2014; revised January 1, 2016). ABSTRACT. An efficient and simple method was developed for the synthesis pyrimidine-5-carboxamides using. UO2(NO3)2.6H2O catalyst under conventional and microwave irradiation. The synthesis of dihydropyrimidine using uranyl nitrate had shown many ...

  3. Revised Rules for Concrete Bridges

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle; Jensen, F. M.; Middleton, C.

    This paper is based on research performed for the Highway Agency, London, UK under the project DPU/9/44 "Revision of Bridge Assessment Rules Based on Whole Life Performance: Concrete Bridges" It contains details of a methodology which can be used to generate Whole Life (WL) reliability profiles....... These WL reliability profiles may be used to establish revised rules for Concrete Bridges....

  4. Emotion Processes in Knowledge Revision

    Science.gov (United States)

    Trevors, Gregory J.; Kendeou, Panayiota; Butterfuss, Reese

    2017-01-01

    In recent years, a number of insights have been gained into the cognitive processes that explain how individuals overcome misconceptions and revise their previously acquired incorrect knowledge. The current study complements this line of research by investigating the moment-by-moment emotion processes that occur during knowledge revision using a…

  5. Philippines revises power plans

    Energy Technology Data Exchange (ETDEWEB)

    Hayes, D.

    1988-02-01

    Following an unexpected surge in electricity demand the Philippines has revised its medium term power development programme. The sharp increase in electricity consumption follows three years of slack demand due to civil disturbances before the end of the Macros administration and the election of Corazon Aquino as President in 1986. Originally, the Aquino government's medium term power development plans called for about 500MW of generating capacity to be installed between 1986 and 1992. The three proposed plants were scheduled for commissioning in 1991 and 1992. However, a spurt in power demand growth during the past nine months has caused concern among industrialists that power shortages could occur by the end of the decade. So additional capacity will be installed to prevent an anticipated shortfall in electricity supplies by the early 1990s.

  6. Revised SRAC code system

    International Nuclear Information System (INIS)

    Tsuchihashi, Keichiro; Ishiguro, Yukio; Kaneko, Kunio; Ido, Masaru.

    1986-09-01

    Since the publication of JAERI-1285 in 1983 for the preliminary version of the SRAC code system, a number of additions and modifications to the functions have been made to establish an overall neutronics code system. Major points are (1) addition of JENDL-2 version of data library, (2) a direct treatment of doubly heterogeneous effect on resonance absorption, (3) a generalized Dancoff factor, (4) a cell calculation based on the fixed boundary source problem, (5) the corresponding edit required for experimental analysis and reactor design, (6) a perturbation theory calculation for reactivity change, (7) an auxiliary code for core burnup and fuel management, etc. This report is a revision of the users manual which consists of the general description, input data requirements and their explanation, detailed information on usage, mathematics, contents of libraries and sample I/O. (author)

  7. Microcomputers and the Improvement of Revision Skills.

    Science.gov (United States)

    Balajthy, Ernest; And Others

    1987-01-01

    Discusses use of word processing software as an effective tool in writing and revision instruction, and describes the role of the teacher. Examples of exercises that encourage revision and of software designed to teach effective revision skills are reviewed. (MBR)

  8. Instability following total knee arthroplasty.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2011-10-01

    Background Knee prosthesis instability (KPI) is a frequent cause of failure of total knee arthroplasty. Moreover, the degree of constraint required to achieve immediate and long-term stability in total knee arthroplasty (TKA) is frequently debated. Questions This review aims to define the problem, analyze risk factors, and review strategies for prevention and treatment of KPI. Methods A PubMed (MEDLINE) search of the years 2000 to 2010 was performed using two key words: TKA and instability. One hundred and sixty-five initial articles were identified. The most important (17) articles as judged by the author were selected for this review. The main criteria for selection were that the articles addressed and provided solutions to the diagnosis and treatment of KPI. Results Patient-related risk factors predisposing to post-operative instability include deformity requiring a large surgical correction and aggressive ligament release, general or regional neuromuscular pathology, and hip or foot deformities. KPI can be prevented in most cases with appropriate selection of implants and good surgical technique. When ligament instability is anticipated post-operatively, the need for implants with a greater degree of constraint should be anticipated. In patients without significant varus or valgus malalignment and without significant flexion contracture, the posterior cruciate ligament (PCL) can be retained. However, the PCL should be sacrificed when deformity exists particularly in patients with rheumatoid arthritis, previous patellectomy, previous high tibial osteotomy or distal femoral osteotomy, and posttraumatic osteoarthritis with disruption of the PCL. In most cases, KPI requires revision surgery. Successful outcomes can only be obtained if the cause of KPI is identified and addressed. Conclusions Instability following TKA is a common cause of the need for revision. Typically, knees with deformity, rheumatoid arthritis, previous patellectomy or high tibial osteotomy, and

  9. Níveis de proteína na dieta de bovinos Nelore de três condições sexuais: consumo, digestibilidades total e parcial, produção microbiana e parâmetros ruminais Increasing crude protein levels in diets of Nellore cattle: intake, ruminal and total tract digestibility, microbial protein synthesis, and ruminal metabolism

    Directory of Open Access Journals (Sweden)

    Robson Magno Liberal Véras

    2007-08-01

    .Twelve Nellore cattle fitted with ruminal and duodenal cannulas were used to investigate the effects of increasing dietary crude protein level (7, 10, 13, and 15% on intake, ruminal and total tract digestibility of nutrients, microbial protein synthesis, degradabilities of corn silage, corn starch, and cottonseed meal, and ruminal metabolism. Animals were blocked by sexual category (heifers, bulls and steers averaging 254.8, 285.1, and 265.6 kg of body weight, respectively and then assigned to one out of three Latin squares. Samples were incubated in the rumen of one animal of each sexual category to estimate ingredient degradability after determination of DM, CP and NDF in the incubation residues. Ruminal fluid was collected before and after-feeding to determine pH and concentration of ammonia while ruminal samples for bacterial isolation were taken 6 hours post-feeding. Blood (BUN and urine (UU were also collected for measurement of urea concentration. The degradation rates of DM and CP were both lower in corn silage than on corn starch and cottonseed meal. The interaction sexual condition x dietary crude protein level was not significant for nutrient intake. With the exception of EE and NFC, no other significant effect of dietary CP level was observed for daily intake of nutrients. Increasing dietary CP level affected total tract digestibilities of DM, OM, CP, NDF, and NFC and also resulted in higher concentrations of BUN and UU. A significant dietary crude protein level x collection time interaction was observed for ruminal NH3 but not for ruminal pH. It was concluded that increasing dietary CP levels affected intake and total tract digestibility of most nutrients.

  10. A study on scar revision

    Directory of Open Access Journals (Sweden)

    Ashutosh Talwar

    2016-04-01

    Full Text Available Introduction: Scars are psychologically distressing for the patients and have an impact on the quality of life and self esteem of the patients. Scar revision is an aesthetic skill which is mastered by plastic surgeons and encroached now by dermatosurgeons. Scars on the face are aesthetically unacceptable and various techniques have been improvised for making a scar aesthetically acceptable. Various types of techniques are used for scar revision like W plasty, Z plasty and VY plasty. Aims: To see the efficacy of various scar revision techniques including Z plasty, VY plasty and W plasty in 30 patients with disfiguring scars. Methods: We selected twenty patients of disfiguring scars for the study. The scars from various causes including trauma and burns were included in our study. Various techniques of scar revision include Z plasty, W plasty and VY plasty were performed according to the type and site of scar. Results: Male: female was 1.5: 1. The scar revision surgery yielded excellent results with minimal complications including haematoma formation, secondary infection and delayed healing seen in 5% patients each. Regarding the efficacy of scar revision, excellent improvement was seen in 60% patients, moderate improvement was seen in 30% patients and mild improvement was seen in 10% patients. Conclusions: Dermatologists can employ a number of surgical scar revision techniques. While some are better suited to treat specific types of scars, they can be used in combination with each other or with adjunctive therapies to achieve optimal results.

  11. Clinical outcome after treatment of infected primary total knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Jensen, Tim Toftgaard

    2002-01-01

    Twenty-six consecutive cases of infected primary total knee arthroplasties were treated at our institution from 1989 through 2000. Eleven patients had debridement and irrigation performed within 2 months of index arthroplasty or hematogenous spread; only one infection was eradicated. Twenty......-five patients had their prostheses removed; 17 had two-stage revision arthroplasty, following which infection was eradicated in 15; one had a permanent spacer, 7 had arthrodesis (following failed revision arthroplasty in one) and 2 had a femur amputation (following failed revision arthroplasty in one) at follow......-up of mean 24 months. Infections were cured equally well with revision arthroplasty and arthrodesis. Among the 15 patients who ended up with revision arthroplasty, 11 had a better range of motion compared to the index arthroplasty, but 8 had daily pain. We present our treatment protocol, which eradicated 15...

  12. Revision of ASCE 4

    International Nuclear Information System (INIS)

    Nelson, T.A.; Murray, R.C.; Short, S.A.

    1995-01-01

    The original version of ASCE Standard 4, ''Seismic Analysis of Safety-Related Nuclear Structures'' was published in September 1986. It is ASCE policy to update its standards on a five year interval and the Working Group on Seismic Analysis of Safety Related Nuclear Structures was reconvened to formulate the revisions. The goal in updating the standard is to make sure that it is still relevant and that it incorporates the state of the practice in seismic engineering or, in some cases, where it has been demonstrated that state-of-the-art improvements need to be made to standard practice; new improvements are included. The contents of the new standard cover the same areas as the original version, with some additions. The contents are as follows: Input - response spectra and time histories; modeling of structures; analysis of structures; soil-structure interaction; input for subsystem analysis; special structures - buried pipes and conduits, earth-retaining walls, above-ground vertical tanks, raceways, and base-isolated structures; and an appendix providing seismic probabilistic risk assessment and margin assessment

  13. Contact activation: a revision.

    Science.gov (United States)

    Schmaier, A H

    1997-07-01

    In conclusion, a revised view of the contact system has been presented. This system has little to do with the initiation of hemostasis. Like lupus anticoagulants, deficiencies of contact proteins give prolonged APTTs but may be risk factors for thrombosis. BK from kininogens is a potent modulator of vascular biology inducing vasodilation, tissue plasminogen activator release, and prostacyclin liberation. Kininogens, themselves, are selective inhibitors of alpha-thrombin-induced platelet activation preventing alpha-thrombin from cleaving the cloned thrombin receptor after arginine41. Kininogens' alpha-thrombin inhibitory activity exists in intact kininogens, BK, and all of BK's breakdown products. HK also is the pivotal protein for contact protein assembly on endothelium. It is the receptor for prekallikrein which when bound to HK becomes activated to kallikrein by an endothelial cell enzyme system independent of activated forms of plasma factor XII. Prekallikrein activation on endothelial cells results in kinetically favorable single chain urokinase and plasminogen activation. Thus the "physiologic, negatively charged surface" for contact system activation is really the assembly of these proteins on cell membranes and activation by membrane-associated enzymes.

  14. Circumcision revision in male children

    Directory of Open Access Journals (Sweden)

    Mohammed A. Al-Ghazo

    2006-08-01

    Full Text Available OBJECTIVE: To determine indications for circumcision revision and to identify the specialty of the person who performed unsatisfactory primary circumcision. MATERIALS AND METHODS: The authors reviewed medical records of 52 cases that underwent circumcision revision over a 6-year period (1998 to 2004. Sleeve surgical technique was used for revision in patients with redundant foreskin or concealed penis, penoplasty for partial or complete degloving of the penis and meatotomy for external meatal stenosis. The mean age of children was 32 months (range 6 months to 9 years. RESULTS: Most of unsatisfactory primary circumcisions (86.7% were performed by laymen. All patients who underwent circumcision revision had good to excellent cosmetic results. CONCLUSION: Primary circumcision performed by laymen carry a high complication rate and serious complications may occur. A period of training and direct supervision by physicians is required before allowing laymen to perform circumcision independently.

  15. EPR first responders revision test

    International Nuclear Information System (INIS)

    2011-01-01

    In this revision test evaluates the acquired knowledge in case of radiological emergency confront. Actions to be taken in relation to people, equipment and the environment. Doses, radioactive sources, pollution

  16. Corporate Author Entries. Revision 5

    International Nuclear Information System (INIS)

    Hendricks, P.L.

    1986-05-01

    This reference authority has been created and is maintained to provide standard forms for recording the names of organizations consistently in bibliographic citations. This revision includes approximately 42,000 entries established since 1973

  17. The impact of subsidence on straight and curved modular cementless revision stems in hip revision surgery.

    Science.gov (United States)

    Fraile Suari, A; Gil González, S; Pérez Prieto, D; León García, A; Mestre Cortadellas, C; Tey Pons, M; Marqués López, F

    Subsidence is one of the potential complications in femoral stem revision total hip arthroplasty surgery, and can affect stability and osseointegration. A retrospective study was conducted on the outcomes at one year and 5 years (specifically subsidence and clinical relevance) of 40 consecutive femoral total hip arthroplasty revisions, comparing two modular cementless revision stems, Straight vs. Curved, with 20 patients in each group. No mechanical failure was observed, and there was an improvement in functional outcomes. Mean radiological subsidence was 9.9±4.9mm (straight=10.75mm vs. curved=9.03mm), with no statistically significant difference between groups (p=0,076). Fourteen patients (35%) had ≥10mm of subsidence, up to a maximum of 22mm. The subsidence found in this study is similar to published series, with no short-term clinical manifestations, or an increased number of complications or stem loosening in either the Straight or Curved group. No differences in subsidence were observed at one year and 5 years after surgery between the 2 types of stems. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Revision washout decreases implant capsule tissue culture positivity: a multicenter study.

    Science.gov (United States)

    Henry, Gerard D; Carson, Culley C; Wilson, Steven K; Wiygul, Jeremy; Tornehl, Chris; Cleves, Mario A; Simmons, Caroline J; Donatucci, Craig F

    2008-01-01

    Positive cultures, visible biofilm and confocal micrography confirm bacterial presence on clinically uninfected inflatable penile prostheses at revision surgery. Salvage irrigation has been proved to rescue patients with clinically infected inflatable penile prostheses. Similar washout at revision for noninfectious reasons significantly lowers subsequent infection rates. We investigated a larger series of patients for positive culture rates and evaluated implant capsule tissue culture rates before and after revision washout. At 4 institutions a total of 148 patients with inflatable penile prostheses underwent revision surgery for noninfectious reasons between June 2001 and September 2005. Swab cultures of the fluid around the pump and visible biofilm were obtained. Also, in 65 patients a wedge of tissue from the capsule that forms around the pump was cultured. After implant removal revision washout of the implant spaces was performed and a second wedge of tissue was cultured. Of the 148 patients 97 (66%) had positive bacterial swab cultures of the fluid around the pump or biofilm. A total of 124 isolates were cultured. Of the 65 implant capsule tissue cultures obtained before washout 28 (43%) were positive for bacteria, while 16 (25%) obtained after revision washout were positive. Positive cultures and visible bacterial biofilm are present on clinically uninfected inflatable penile prostheses at revision surgery in most patients. Revision washout appears to decrease the bacterial load on implant capsule tissue at revision surgery of inflatable penile prostheses for noninfectious reasons.

  19. Psychometric Validation of the Revised Family Affluence Scale

    DEFF Research Database (Denmark)

    Torsheim, Torbjorn; Cavallo, Franco; Levin, Kate Ann

    2016-01-01

    The aim was to develop and test a brief revised version of the family affluence scale. A total of 7120 students from Denmark, Greenland, Italy, Norway, Poland, Romania, Scotland and Slovakia reported on a list of 16 potential indicators of affluence. Responses were subject to item screening and t...

  20. 76 FR 20048 - Notice of Revised Determination on Reconsideration

    Science.gov (United States)

    2011-04-11

    ... DEPARTMENT OF LABOR Employment and Training Administration Notice of Revised Determination on... negative determination was based on the findings that the worker separations, or threat of separation, were... importantly to worker separations (total or partial), or threat of such separations, at NCR Corporation, Call...

  1. Asymmetric aminolytic kinetic resolution of racemic epoxides using recyclable chiral polymeric Co(III)-salen complexes: a protocol for total utilization of racemic epoxide in the synthesis of (R)-Naftopidil and (S)-Propranolol.

    Science.gov (United States)

    Kumar, Manish; Kureshy, Rukhsana I; Shah, Arpan K; Das, Anjan; Khan, Noor-ul H; Abdi, Sayed H R; Bajaj, Hari C

    2013-09-20

    Chiral polymeric Co(III) salen complexes with chiral ((R)/(S)-BINOL, diethyl tartrate) and achiral (piperazine and trigol) linkers with varying stereogenic centers were synthesized for the first time and used as catalysts for aminolytic kinetic resolution (AKR) of a variety of terminal epoxides and glycidyl ethers to get enantio-pure epoxides (ee, 99%) and N-protected β-amino alcohols (ee, 99%) with quantitative yield in 16 h at RT under optimized reaction conditions. This protocol was also used for the synthesis of two enantiomerically pure drug molecules (R)-Naftopidil (α1-blocker) and (S)-Propranolol (β-blocker) as a key step via AKR of single racemic naphthylglycidyl ether with Boc-protected isoproylamine with 100% epoxide utilization at 1 g level. The catalyst 1 was successfully recycled for a number of times.

  2. Instability after total hip arthroplasty

    Science.gov (United States)

    Werner, Brian C; Brown, Thomas E

    2012-01-01

    Instability following total hip arthroplasty (THA) is an unfortunately frequent and serious problem that requires thorough evaluation and preoperative planning before surgical intervention. Prevention through optimal index surgery is of great importance, as the management of an unstable THA is challenging even for an experienced joints surgeon. However, even after well-planned surgery, a significant incidence of recurrent instability still exists. Non-operative management is often successful if the components are well-fixed and correctly positioned in the absence of neurocognitive disorders. If conservative management fails, surgical options include revision of malpositioned components; exchange of modular components such as the femoral head and acetabular liner; bipolar arthroplasty; tripolar arthroplasty; use of a larger femoral head; use of a constrained liner; soft tissue reinforcement and advancement of the greater trochanter. PMID:22919568

  3. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes.

    Science.gov (United States)

    Borzych-Duzalka, Dagmara; Aki, T Fazil; Azocar, Marta; White, Colin; Harvey, Elizabeth; Mir, Sevgi; Adragna, Marta; Serdaroglu, Erkin; Sinha, Rajiv; Samaille, Charlotte; Vanegas, Juan Jose; Kari, Jameela; Barbosa, Lorena; Bagga, Arvind; Galanti, Monica; Yavascan, Onder; Leozappa, Giovanna; Szczepanska, Maria; Vondrak, Karel; Tse, Kei-Chiu; Schaefer, Franz; Warady, Bradley A

    2017-01-06

    Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P<0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1.10 to 1.65; P=0.003). Access dysfunction due to mechanical causes doubled the risk

  4. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes

    Science.gov (United States)

    Aki, T. Fazil; Azocar, Marta; White, Colin; Harvey, Elizabeth; Mir, Sevgi; Adragna, Marta; Serdaroglu, Erkin; Sinha, Rajiv; Samaille, Charlotte; Vanegas, Juan Jose; Kari, Jameela; Barbosa, Lorena; Bagga, Arvind; Galanti, Monica; Yavascan, Onder; Leozappa, Giovanna; Szczepanska, Maria; Vondrak, Karel; Tse, Kei-Chiu; Schaefer, Franz; Warady, Bradley A.

    2017-01-01

    Background and objectives Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Design, setting, participants, & measurements Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. Results In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P<0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1

  5. MITI revises outlooks for energy and power demand

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    The Ministry of International Trade and Industry has revised downward its long-term outlook on energy supply and demand, lowering the estimated primary energy demand for fiscal 2000 from 600 million tons in oil equivalent to 540 MTOE, and reducing total power demand for fiscal 2000 from 899.1 billion kWh to 838 billion. In this content, the outlook for installed nuclear capacity has been revised downward from 62,000 MW to 53,500 MW. This revision of the power supply-demand outlook was reported on Oct. 1 to the supply and demand committee (Chairman - Yoshihiko Morozumi, Adviser to Nippon Schlum-berger) of the Electric Utility Industry Council; the energy supply-demand outlook was decided on Oct. 14 by the MITI Supply and Demand Subcommittee of the Advisory Committee for Energy and reported on Oct. 16 to the conference of ministers concerned with energy. (author)

  6. Revised licensee event report system

    International Nuclear Information System (INIS)

    Mays, G.T.; Poore, W.P.

    1985-01-01

    Licensee Event Reports (LERs) provide the basis for evaluating and assessing operating experience information from nuclear power plants. The reporting requirements for submitting LERs to the Nuclear Regulatory Commission have been revised. Effective Jan. 1, 1984, all events were to be submitted in accordance with 10 CFR 50.73 of the Code of Federal Regulations. Report NUREG-1022, Licensee Event Report System-Description of System and Guidelines for Reporting, describes the guidelines on reportability of events. This article summarizes the reporting requirements as presented in NUREG-1022, high-lights differences in data reported between the revised and previous LER systems, and presents results from a preliminary assessment of LERs submitted under the revised LER reporting system

  7. Quantum interaction. Revised selected papers

    Energy Technology Data Exchange (ETDEWEB)

    Song, Dawei; Zhang, Peng; Wang, Lei [Aberdeen Univ. (United Kingdom). School of Computing; Melucci, Massimo [Padua Univ., Padova (Italy). Dept. of Information Engineering; Frommholz, Ingo [Bedfordshire Univ. (United Kingdom); Arafat, Sachi (eds.) [Glasgow Univ. (United Kingdom). School of Computing Science

    2011-07-01

    This book constitutes the thoroughly refereed post-conference proceedings of the 5th International Symposium on Quantum Interaction, QI 2011, held in Aberdeen, UK, in June 2011. The 26 revised full papers and 6 revised poster papers, presented together with 1 tutorial and 1 invited talk were carefully reviewed and selected from numerous submissions during two rounds of reviewing and improvement. The papers show the cross-disciplinary nature of quantum interaction covering topics such as computation, cognition, mechanics, social interaction, semantic space and information representation and retrieval. (orig.)

  8. HEDR modeling approach: Revision 1

    International Nuclear Information System (INIS)

    Shipler, D.B.; Napier, B.A.

    1994-05-01

    This report is a revision of the previous Hanford Environmental Dose Reconstruction (HEDR) Project modeling approach report. This revised report describes the methods used in performing scoping studies and estimating final radiation doses to real and representative individuals who lived in the vicinity of the Hanford Site. The scoping studies and dose estimates pertain to various environmental pathways during various periods of time. The original report discussed the concepts under consideration in 1991. The methods for estimating dose have been refined as understanding of existing data, the scope of pathways, and the magnitudes of dose estimates were evaluated through scoping studies

  9. Quantum interaction. Revised selected papers

    International Nuclear Information System (INIS)

    Song, Dawei; Zhang, Peng; Wang, Lei; Arafat, Sachi

    2011-01-01

    This book constitutes the thoroughly refereed post-conference proceedings of the 5th International Symposium on Quantum Interaction, QI 2011, held in Aberdeen, UK, in June 2011. The 26 revised full papers and 6 revised poster papers, presented together with 1 tutorial and 1 invited talk were carefully reviewed and selected from numerous submissions during two rounds of reviewing and improvement. The papers show the cross-disciplinary nature of quantum interaction covering topics such as computation, cognition, mechanics, social interaction, semantic space and information representation and retrieval. (orig.)

  10. Medical writing, revising and editing

    DEFF Research Database (Denmark)

    Pilegaard, Morten

    2006-01-01

    The globalization of science makes medical writing, editing and revision a rapidly growing field of linguistic study and practice. Medical science texts are written according to uniform, general guidelines and medical genres have become highly conventionalized in terms of structure and linguistic...... form. Medical editing often takes the form of peer review and mainly addresses issues of contents and overall validity. Medical revision incorporates the checking of the macrostructure and the microstructure of the text, its language and style and its suitability for the target reader or client...

  11. Revising Nabokov Revising”

    Directory of Open Access Journals (Sweden)

    Marie Bouchet

    2010-10-01

    Full Text Available Nabokov revised his works as he translated them and, on another plane, canon revisionism has been having its backlash and provoked other refracting waves. The purpose of the conference was to advance Nabokov studies through the discussion of how our view of Nabokov’s standing and his works today should be revised, especially after the publication of The Original of Laura. However the conference was not confined to just this theme, since “revising” is a word rich with implications. To borrow s...

  12. What Is the Rerevision Rate After Revising a Hip Resurfacing Arthroplasty? Analysis From the AOANJRR.

    Science.gov (United States)

    Wong, James Min-Leong; Liu, Yen-Liang; Graves, Stephen; de Steiger, Richard

    2015-11-01

    More than 15,000 primary hip resurfacing arthroplasties have been recorded by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) with 884 primary procedures requiring revision for reasons other than infection, a cumulative percent revision rate at 12 years of 11%. However, few studies have reported the survivorship of these revision procedures. (1) What is the cumulative percent rerevision rate for revision procedures for failed hip resurfacings? (2) Is there a difference in rerevision rate among different types of revision or bearing surfaces? The AOANJRR collects data on all primary and revision hip joint arthroplasties performed in Australia and after verification against health department data, checking of unmatched procedures, and subsequent retrieval of unreported procedures is able to obtain an almost complete data set relating to hip arthroplasty in Australia. Revision procedures are linked to the known primary hip arthroplasty. There were 15,360 primary resurfacing hip arthroplasties recorded of which 884 had undergone revision and this was the cohort available to study. The types of revisions were acetabular only, femoral only, or revision of both acetabular and femoral components. With the exception of the acetabular-only revisions, all revisions converted hip resurfacing arthroplasties to conventional (stemmed) total hip arthroplasties (THAs). All initial revisions for infection were excluded. The survivorship of the different types of revisions and that of the different bearing surfaces used were estimated using the Kaplan-Meier method and compared using Cox proportional hazard models. Cumulative percent revision was calculated by determining the complement of the Kaplan-Meier survivorship function at that time multiplied by 100. Of the 884 revisions recorded, 102 underwent further revision, a cumulative percent rerevision at 10 years of 26% (95% confidence interval, 19.6-33.5). There was no difference in the rate of

  13. Protective effect of a non specific inflammation on bone marrow protein synthesis in irradiated mice

    International Nuclear Information System (INIS)

    Herodin, F.; Roques, P.; Court, L.

    1988-01-01

    Gamma radiations exert a decrease in mouse bone marrow total protein synthesis. A non-specific inflammatory process induced with polyacrylamide microbeads stimulates spleen and marrow protein synthesis and protects the medullar protein synthesis in irradiated mice [fr

  14. Organic synthesis

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, S.E.

    1991-01-01

    This paper reports on reactions of organoboranes. Organoboron routes to unsaturated hydrocarbons. Boronic ester homologation. Properties of organosilicon compounds. Alkene synthesis (Peterson olefination). Allylsilanes and acylsilanes.

  15. The nuclear liability conventions revised

    International Nuclear Information System (INIS)

    Reyners, P.

    2004-01-01

    The signature on 12 February 2004 of the Protocols amending respectively the 1960 Paris Convention and the 1963 Brussels Supplementary Convention was the second step of the process of modernisation of the international nuclear liability regime after the adoption in September 1997 of a Protocol revising the 1963 Vienna Convention and of a new Convention on Supplementary Compensation for Nuclear Damage. The common objective of the new instruments is to provide more funds to compensate a larger number of potential victims in respect of a broader range of damage. Another goal of the revision exercise was to maintain the compatibility between the Paris and Vienna based systems, a commitment enshrined in the 1988 Joint Protocol, as well as to ascertain that Paris/Brussels countries could also become a Party to the Convention on Supplementary Compensation. However, while generally consistent vis a vis the Joint Protocol, the provisions of the Paris and Vienna Conventions, as revised, differ on some significant aspects. Another remaining issue is whether the improved international nuclear liability regime will succeed in attracting in the future a larger number of countries, particularly outside Europe, and will so become truly universal. Therefore, the need for international co-operation to address these issues, to facilitate the adoption of new implementing legislation and to ensure that this special regime keeps abreast of economic and technological developments, is in no way diminished after the revision of the Conventions.(author)

  16. Concise revision of the Sarcospermataceae

    NARCIS (Netherlands)

    Lam, H.J.; Royen, van P.

    1952-01-01

    After the senior writer, together with W. W. Varossieau, had published a revision of this monogeneric family (Blumea III, 1938—’39 and IV, 1941), some more material has been examined by us and, moreover, some new species have been described. Thanks to the courtesy of Prof. F. Gagnepain of Paris, and

  17. Guidelines for Curriculum Development. Revised.

    Science.gov (United States)

    Kistler, K.; And Others

    The curriculum development process explained in this booklet was first implemented at College of the Redwoods in May 1986 and then revised in June 1989. First, information on the college's Curriculum Committee is provided, indicating that the committee was formed to plan credit/non-credit courses; evaluate and approve additions, modifications, or…

  18. Revised Accounting for Business Combinations

    Science.gov (United States)

    Wilson, Arlette C.; Key, Kimberly

    2008-01-01

    The Financial Accounting Standards Board (FASB) has recently issued Statement of Financial Accounting Standards No. 141 (Revised 2007) Business Combinations. The object of this Statement is to improve the relevance, representational faithfulness, and comparability of reported information about a business combination and its effects. This Statement…

  19. How Adults Learn. Revised Edition.

    Science.gov (United States)

    Kidd, J. R.

    The book's emphasis is on learning during the years of adulthood and examines present-day practice of adult education for practitioners. This revised edition brings up to date advances in such areas of learning as controversial theory; the effects of environment; sensory processes; intellectual capacities; motivation and attitude; transactional…

  20. A revision of the Paronychiinae

    NARCIS (Netherlands)

    Chaudhri, Mohammad Nazeer

    1968-01-01

    This study was undertaken, in April 1964, at the suggestion of Prof. Dr. J. Lanjouw. The need for such a revision, was, however, stressed by the authors of the subtribe, viz. PAX et K. HOFFMANN, who, while delimiting these genera, remarked that the Systematics of both the (main) genera of this

  1. Diet History Questionnaire: Database Revision History

    Science.gov (United States)

    The following details all additions and revisions made to the DHQ nutrient and food database. This revision history is provided as a reference for investigators who may have performed analyses with a previous release of the database.

  2. [Revised practice guideline 'Anaemia in midwifery practice'

    NARCIS (Netherlands)

    Beentjes, M.; Jans, S.M.P.J.

    2012-01-01

    The practice guideline of the Royal Dutch Organization of Midwives 'Anaemia in primary care midwifery practice' published in 2000, has recently been revised. The revised guideline takes physiological haemodilution during pregnancy into consideration and provides gestation specific reference values

  3. Revised Human Health Risk Assessment on Chlorpyrifos

    Science.gov (United States)

    We have revised our human health risk assessment and drinking water exposure assessment for chlorpyrifos that supported our October 2015 proposal to revoke all food residue tolerances for chlorpyrifos. Learn about the revised analysis.

  4. 75 FR 60485 - NRC Enforcement Policy Revision

    Science.gov (United States)

    2010-09-30

    ... NUCLEAR REGULATORY COMMISSION [NRC-2008-0497] NRC Enforcement Policy Revision AGENCY: Nuclear Regulatory Commission. ACTION: Policy statement. SUMMARY: The Nuclear Regulatory Commission (NRC or Commission) is publishing a major revision to its Enforcement Policy (Enforcement Policy or Policy) to...

  5. Patterns of functional improvement after revision knee arthroplasty.

    Science.gov (United States)

    Ghomrawi, Hassan M K; Kane, Robert L; Eberly, Lynn E; Bershadsky, Boris; Saleh, Khaled J

    2009-12-01

    Despite the increase in the number of total knee arthroplasty revisions, outcomes of such surgery and their correlates are poorly understood. The aim of this study was to characterize patterns of functional improvement after revision total knee arthroplasty over a two-year period and to investigate factors that affect such improvement patterns. Three hundred and eight patients in need of revision surgery were enrolled into the study, conducted at seventeen centers, and 221 (71.8%) were followed for two years. Short Form-36 (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lower-Extremity Activity Scale (LEAS) scores were collected at baseline and every six months for two years postoperatively. A piecewise general linear mixed model, which models correlation between repeated measures and estimates separate slopes for different follow-up time periods, was employed to examine functional improvement patterns. Separate regression slopes were estimated for the zero to twelve-month and the twelve to twenty-four-month periods. The slopes for zero to twelve months showed significant improvement in all measures in the first year. The slopes for twelve to twenty-four months showed deterioration in the scores of the WOMAC pain subscale (slope = 0.67 +/- 0.21, p coefficient = -5.46 +/- 1.91, p coefficient = 5.41 +/- 2.35, p coefficient = 1.42 +/- 0.69, p < 0.05]). Factors related to the surgical technique did not predict outcomes. The onset of worsening pain and knee-specific function in the second year following revision total knee arthroplasty indicates the need to closely monitor patients, irrespective of the mode of failure of the primary procedure or the surgical technique for the revision. This information may be especially important for patients with multiple comorbidities.

  6. Revision Hip Arthroscopy Indications and Outcomes: A Systematic Review.

    Science.gov (United States)

    Sardana, Vandit; Philippon, Marc J; de Sa, Darren; Bedi, Asheesh; Ye, Lily; Simunovic, Nicole; Ayeni, Olufemi R

    2015-10-01

    To identify the indications and outcomes in patients undergoing revision hip arthroscopy. The electronic databases Embase, Medline, HealthStar, and PubMed were searched from 1946 to July 19, 2014. Two blinded reviewers searched, screened, and evaluated the data quality of the studies using the Methodological Index for Non-Randomized Studies scale. Data were abstracted in duplicate. Agreement and descriptive statistics are presented. Six studies were included (3 prospective case series and 3 retrospective chart reviews), with a total of 448 hips examined. The most common indications for revision hip arthroscopy included residual femoroacetabular impingement (FAI), labral tears, and chondral lesions. The mean interval between revision arthroscopy and the index procedure was 25.6 months. Overall, the modified Harris Hip Score improved by a mean of 33.6% (19.3 points) from the baseline score at 1-year follow-up. In 14.6% of patients, further surgical procedures were required, including re-revision hip arthroscopy (8.0%), total hip replacement (5.6%), and hip resurfacing (1.0%). Female patients more commonly underwent revision hip arthroscopy (59.7%). The current evidence examined in this review supports revision hip arthroscopy as a successful intervention to improve functional outcomes (modified Harris Hip Score) and relieve pain in patients with residual symptoms after primary FAI surgery, although the outcomes are inferior when compared with a matched cohort of patients undergoing primary hip arthroscopy for FAI. The main indication for revision is a candidate who has symptoms due to residual cam- or pincer-type deformity that was either unaddressed or under-resected during the index operation. However, it is important to consider that the studies included in this review are of low-quality evidence. Surgeons should consider incorporating a minimum 2-year follow-up for individuals after index hip-preservation surgery because revisions tended to occur within this

  7. OUTCOMES REVIEW OF TOTAL KNEE REPLACEMENT WITH GENESIS II TOTAL KNEE SYSTEM: AUSTRALIAN ORTHOPAEDIC ASSOCIATION NATIONAL JOINT REPLACEMENT REGISTRY DATA

    Directory of Open Access Journals (Sweden)

    N. L. Logvinov

    2014-01-01

    Full Text Available ABSTRACT. The goal of the article was to review Genesis II Total Knee System use according to AoA NJRR report. Genesis II has been widely used in Russian Federation since 1996. The AoA NJRR report was studied in order to learn connection between number of revision procedures and surgeon’s skills or type of the System, adequate choice among cemented, cementless and hybrid fixation, number of surgeries using Genesis II Total Knee System annually, average revision rate for Genesis II and early cumulative revision rate.CONCLUSION. The systematic study of AoA NJRR allows us to make a conclusion that cemented fixation of Genesis II Total Knee System is mostly effective, and this fact is confirmed by domestic experience. 

  8. A taxonomic revision of the genus Podocarpus

    NARCIS (Netherlands)

    Laubenfels, de D.J.

    1985-01-01

    In connection with the forthcoming revision of the Coniferae for the Flora Malesiana, the author thought it necessary to revise the genus Podocarpus. Although this genus has a substantial representation in Malesia (30 species), the revision is too involved to be appropriate with the Flora Malesiana

  9. 7 CFR 3015.115 - Budget revisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Budget revisions. 3015.115 Section 3015.115..., DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Programmatic Changes and Budget Revisions § 3015.115 Budget revisions. (a) Nonconstruction projects. (1) Except as provided in paragraph (a)(2) of...

  10. 48 CFR 15.307 - Proposal revisions.

    Science.gov (United States)

    2010-10-01

    ... AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Source Selection 15.307 Proposal revisions. (a) If an... allow proposal revisions to clarify and document understandings reached during negotiations. At the... submit a final proposal revision. The contracting officer is required to establish a common cut-off date...

  11. On the effect of small radiation doses: Desoxyribonucleic acid (DNA) synthesis and DNA repair of thymus, spleen, and bone marrow cells in the rat after fractionated total body X-ray irradiation. Zur Wirkung kleiner Strahlendosen: Desoxyribonukleinsaeure-(DNA-)Synthese und DNA-Reparatur von Thymus-, Milz- und Knochenmarkszellen der Ratte nach fraktionierter Ganzkoerperroentgenbestrahlung

    Energy Technology Data Exchange (ETDEWEB)

    Tempel, K.; Ehling, G. (Muenchen Univ. (Germany, F.R.). Inst. fuer Pharmakologie, Toxikologie und Pharmazie)

    1989-09-01

    After three to seven days following to fractionated total body X-ray irradiation (TBI) (four expositions with doses of 0.3 to 5.0 cGy per fraction at intervals of 24 hours), a maximum 50 percent stimulation of the semiconservative DNA synthesis (SDS) of spleen cells was measured in vitro. This was not dependent of the fact if an acute high-dose (400 and/or 800 cGy) unique irradiation was applied after the fractionated TBI at the moment of stimulation. A significant increase of {sup 3}H-thymidine incorporation into the DNA of bone marrow and thymus cells was only found when doses of 1.25 cGy per fraction had been used. After fractionated TBI with doses of {ge}5 cGy per fraction, an increase of DNA synthesis resistant to hydroxyurea ('unprogrammed' DNA synthesis, UDS) was demonstrated in spleen cells. The UV-simulated UDS decreased proportionately. The sedimentation of thymus, spleen, and bone marrow nucleoids in a neutral saccharose gradient gave no evidence of an increased DNA repair capacity after fractionated TBI. Whereas the SDS stimulation by fractionated TBI with small doses can be explained by a modified proliferation behavior of exposed cells, the UDS behavior of spleen cells after considerably higher radiation doses suggests regenerative processes correlated with an increased number of cells resistant to hydroxyurea and cells presenting an UV repair deficiency. These findings can be considered to be a further proof of the assumed immune-stimulating effect of small radiation doses. (orig.).

  12. Difficult acetabular revision. A preliminary report.

    Science.gov (United States)

    Newport, M L; Stuchin, S A; Frankel, V H; Zuckerman, J

    1986-01-01

    Thirteen patients (14 hips) underwent revision from conventional cemented total hip arthroplasty to uncemented acetabular threaded screw-in components and cementless femoral press-fit stems by means of the Autophor, Biofit, and Ti-Thread designs. The patients suffered from all forms of primary hip disease except rheumatoid arthritis; their average age was 34 years. The average preoperative Harris hip score was 39.4; the average postoperative score was 71.2 at six months, 90.6 at one year, and 91.6 at two years. Complications included two femoral shaft fractures, one femoral nerve palsy, and one dislocation. No signs have been observed of loosening or migration as of an early (6-24 months) follow-up.

  13. Revised spatially distributed global livestock emissions

    Science.gov (United States)

    Asrar, G.; Wolf, J.; West, T. O.

    2015-12-01

    Livestock play an important role in agricultural carbon cycling through consumption of biomass and emissions of methane. Quantification and spatial distribution of methane and carbon dioxide produced by livestock is needed to develop bottom-up estimates for carbon monitoring. These estimates serve as stand-alone international emissions estimates, as input to global emissions modeling, and as comparisons or constraints to flux estimates from atmospheric inversion models. Recent results for the US suggest that the 2006 IPCC default coefficients may underestimate livestock methane emissions. In this project, revised coefficients were calculated for cattle and swine in all global regions, based on reported changes in body mass, quality and quantity of feed, milk production, and management of living animals and manure for these regions. New estimates of livestock methane and carbon dioxide emissions were calculated using the revised coefficients and global livestock population data. Spatial distribution of population data and associated fluxes was conducted using the MODIS Land Cover Type 5, version 5.1 (i.e. MCD12Q1 data product), and a previously published downscaling algorithm for reconciling inventory and satellite-based land cover data at 0.05 degree resolution. Preliminary results for 2013 indicate greater emissions than those calculated using the IPCC 2006 coefficients. Global total enteric fermentation methane increased by 6%, while manure management methane increased by 38%, with variation among species and regions resulting in improved spatial distributions of livestock emissions. These new estimates of total livestock methane are comparable to other recently reported studies for the entire US and the State of California. These new regional/global estimates will improve the ability to reconcile top-down and bottom-up estimates of methane production as well as provide updated global estimates for use in development and evaluation of Earth system models.

  14. Synthesis of sulfadiazine and silver sulfadiazine in semi-micro scale, as an experimental practice in drug synthesis

    International Nuclear Information System (INIS)

    Borges, Aurea Donizete Lanchote; Del Ponte, Gino; Federman Neto, Alberto; Carvalho, Ivone

    2005-01-01

    The total synthesis of sulfadiazine and silver sulfadiazine from readily available starting materials was adapted to semi-micro laboratory scale and is proposed as an experiment in drug synthesis for undergraduate courses. (author)

  15. Major League pitching workload after primary ulnar collateral ligament reconstruction and risk for revision surgery.

    Science.gov (United States)

    Keller, Robert A; Mehran, Nima; Marshall, Nathan E; Okoroha, Kelechi R; Khalil, Lafi; Tibone, James E; Moutzouros, Vasilios

    2017-02-01

    Literature has attempted to correlate pitching workload with risk of ulnar collateral ligament (UCL) injury; however, limited data are available in evaluating workload and its relationship with the need for revision reconstruction in Major League Baseball (MLB) pitchers. We identified 29 MLB pitchers who underwent primary UCL reconstruction surgery and subsequently required revision reconstruction and compared them with 121 MLB pitchers who underwent primary reconstruction but did not later require revision surgery. Games pitched, pitch counts, and innings pitched were evaluated and compared for the seasons after returning from primary reconstruction and for the last season pitched before undergoing revision surgery. The difference in workload between pitchers who did and did not require revision reconstruction was not statistically significant in games pitched, innings pitched, and MLB-only pitch counts. The one significant difference in workload was in total pitch counts (combined MLB and minor league), with the pitchers who required revision surgery pitching less than those who did not (primary: 1413.6 pitches vs. revision: 959.0 pitches, P = .04). In addition, pitchers who required revision surgery underwent primary reconstruction at an early age (22.9 years vs. 27.3 years, P risk for injury after primary UCL reconstruction. However, correlations of risk may be younger age and less MLB experience at the time of the primary reconstruction. Copyright © 2017. Published by Elsevier Inc.

  16. ASSET guidelines. Revised 1991 Edition

    International Nuclear Information System (INIS)

    1991-12-01

    The present publication is an updated version of the IAEA Assessment of Safety Significant Events Team (ASSET) Guidelines, IAEA-TECDOC-573, published in 1990. Sections 5 and 6 include revised definitions and investigation guidelines for identification of both direct and root causes. These revisions were recommended by a Consultants Meeting held in Vienna on 3-7 December 1990. This guidance is not intended to infringe an expert's prerogative to investigate additional items. Its main purpose is to provide a basic structure and ensure consistency in the assessments. Use of the ASSET guidelines should also facilitate comparison between the observations made in different nuclear power plants and harmonize the reporting of generic ASSET results. The guidelines should always be used with a critical attitude and a view to possible improvements

  17. Trust Revision for Conflicting Sources

    Science.gov (United States)

    2017-02-01

    strategy is to first revise a priori trust assignments as a function of the degree of conflict, before the evidence is fused. This paper focuses on the...practical trust transitivity seems to be idiosyncratic for humans and animals, with no true analogue among non- living forms (and in the physical world ...visiting a foreign country Alice is looking for a restaurant where the locals go, because she would like to avoid places overrun by tourists. She meets a

  18. Clean Air Act. Revision 5

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-15

    This Reference Book contains a current copy of the Clean Air Act, as amended, and those regulations that implement the statute and appear to be most relevant to DOE activities. The document is provided to DOE and contractor staff for informational purposes only and should not be interpreted as legal guidance. This Reference Book has been completely revised and is current through February 15, 1994.

  19. Revised dietary guidelines for Koreans.

    Science.gov (United States)

    Jang, Young Ai; Lee, Haeng Shin; Kim, Bok Hee; Lee, Yoonna; Lee, Hae Jeung; Moon, Jae Jin; Kim, Cho-il

    2008-01-01

    With rapidly changing dietary environment, dietary guidelines for Koreans were revised and relevant action guides were developed. First, the Dietary Guidelines Advisory Committee was established with experts and government officials from the fields of nutrition, preventive medicine, health promotion, agriculture, education and environment. The Committee set dietary goals for Koreans aiming for a better nutrition state of all after a thorough review and analysis of recent information related to nutritional status and/or problems of Korean population, changes in food production/supply, disease pattern, health policy and agricultural policy. Then, the revised dietary guidelines were proposed to accomplish these goals in addition to 6 different sets of dietary action guides to accommodate specific nutrition and health problems of respective age groups. Subsequently, these guidelines and guides were subjected to the focus group review, consumer perception surveys, and a public hearing for general and professional comments. Lastly, the language was clarified in terms of public understanding and phraseology. The revised Dietary guidelines for Koreans are as follows: eat a variety of grains, vegetables, fruits, fish, meat, poultry and dairy products; choose salt-preserved foods less, and use less salt when you prepare foods; increase physical activity for a healthy weight, and balance what you eat with your activity; enjoy every meal, and do not skip breakfast; if you drink alcoholic beverages, do so in moderation; prepare foods properly, and order sensible amounts; enjoy our rice-based diet.

  20. Cement-in-cement acetabular revision with a constrained tripolar component.

    Science.gov (United States)

    Leonidou, Andreas; Pagkalos, Joseph; Luscombe, Jonathan

    2012-02-17

    Dislocation of a total hip replacement (THR) is common following total hip arthroplasty (THA). When nonoperative management fails to maintain reduction, revision surgery is considered. The use of constrained acetabular liners has been extensively described. Complete removal of the old cement mantle during revision THA can be challenging and is associated with significant complications. Cement-in-cement revision is an established technique. However, the available clinical and experimental studies focus on femoral stem revision. The purpose of this study was to present a case of cement-in-cement acetabular revision with a constrained component for recurrent dislocations and to investigate the current best evidence for this technique. This article describes the case of a 74-year-old woman who underwent revision of a Charnley THR for recurrent low-energy dislocations. A tripolar constrained acetabular component was cemented over the primary cement mantle following removal of the original liner by reaming, roughening the surface, and thoroughly irrigating and drying the primary cement. Clinical and radiological results were good, with the Oxford Hip Score improving from 11 preoperatively to 24 at 6 months postoperatively. The good short-term results of this case and the current clinical and biomechanical data encourage the use of the cement-in-cement technique for acetabular revision. Careful irrigation, drying, and roughening of the primary surface are necessary. Copyright 2012, SLACK Incorporated.

  1. Organic synthesis

    International Nuclear Information System (INIS)

    Lallemand, J.Y.; Fetizon, M.

    1988-01-01

    The 1988 progress report of the Organic Synthesis Chemistry laboratory (Polytechnic School, France), is presented. The laboratory activities are centered on the chemistry of natural products, which have a biological activity and on the development of new reactions, useful in the organic synthesis. The research works involve the following domains: the natural products chemistry which are applied in pharmacology, the plants and insects chemistry, the organic synthesis, the radical chemistry new reactions and the bio-organic physicochemistry. The published papers, the congress communications and the thesis are listed [fr

  2. TREATMENT OF INFECTION AFTER TOTAL KNEE ARTHROPLASTY.

    Science.gov (United States)

    Cury, Ricardo de Paula Leite; Cinagawa, Eduardo Hitoshi Tsuge; Camargo, Osmar Pedro Arbix; Honda, Emerson Kiyoshi; Klautau, Giselle Burlamaqui; Salles, Mauro José Costa

    2015-01-01

    To identify and compare the rate of success of therapeutic modalities applied in surgeries for the treatment of infections associated with total knee arthroplasty (TKA), and to evaluate the functional outcome and pain in different therapeutic modalities by means of quality of life scores. We evaluated all patients who developed periprosthetic infection after TKA for primary or secondary osteoarthritis, in the period from January 1(st), 2008 to December 31(st), 2010. In the study period, 29 patients with TKA had infection, and 12 of these underwent debridement and retention of the prosthesis (D+R), seven received two-stage and six one-stage exchange arthroplasties, and four patients were treated with suppressive antibiotic therapy because they could not undergo another surgical procedure. The D+R, one-stage revision and two-stage revision success rates were 75%, 83.3%, and 100%, respectively. The best results of quality of life (QoL) and function occur in patients undergoing D+R. In contrast, the worst QoL and functional results were obtained in patients treated with two-stage revision arthroplasty. Level of Evidence II, Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.

  3. Revision Hip Arthroscopy: A Systematic Review of Diagnoses, Operative Findings, and Outcomes.

    Science.gov (United States)

    Cvetanovich, Gregory L; Harris, Joshua D; Erickson, Brandon J; Bach, Bernard R; Bush-Joseph, Charles A; Nho, Shane J

    2015-07-01

    To determine indications for, operative findings of, and outcomes of revision hip arthroscopy. A systematic review was registered with PROSPERO and performed based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Therapeutic clinical outcome studies reporting the indications for, operative findings of, and outcomes of revision hip arthroscopy were eligible for inclusion. All study-, patient-, and hip-specific data were extracted and analyzed. The Modified Coleman Methodology Score was used to assess study quality. Five studies were included (348 revision hip arthroscopies; 333 patients; mean age, 31.4 ± 4.2 years; 60% female patients). All 5 studies were either Level III or IV evidence. The surgeon performing revision hip arthroscopy was the same as the primary hip surgeon in only 25% of cases. The mean time between primary and revision hip arthroscopy was 27.8 ± 7.0 months (range, 2 to 193 months). Residual femoroacetabular impingement was the most common indication for and operative finding of revision hip arthroscopy (81% of cases). The most commonly reported revision procedures were femoral osteochondroplasty (24%) and acetabuloplasty (18%). The modified Harris Hip Score was used in all 5 analyzed studies, with significant (P arthroscopy, subsequent reported operations were hip arthroplasty in 11 patients and re-revision hip arthroscopy in 8 patients (5% total reoperation rate). Revision hip arthroscopy is most commonly performed for residual femoroacetabular impingement, with statistically significant and clinically relevant improvements shown in multiple patient-reported clinical outcome scores at short-term follow-up. The reoperation rate after revision hip arthroscopy is 5% within 2 years, including further arthroscopy or conversion to hip arthroplasty. Level IV, systematic review of Level III and IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  4. Synthesis-on” and “synthesis-off” modes of carbon arc operation during synthesis of carbon nanotubes

    International Nuclear Information System (INIS)

    Yatom, Shurik; Selinsky, Rachel S.

    2017-01-01

    Arc discharge synthesis of single-walled carbon nanotubes (SWCNTs) remains largely uncontrollable, due to incomplete understanding of the synthetic process itself. Here, we show that synthesis of SWCNTs by a carbon arc may not constitute a single continuous process, but may instead consist of two distinct modes. One of these, a “synthesis-on” mode, produces the majority of the nanomaterials. During the synthesis-on mode, proportionally more carbon nanotubes are collected than in another mode, a “synthesis-off” mode. Both synthesis-on and synthesis-off modes for a typical arc configuration, employing a hollow anode filled with a mixture of powdered metal catalyst and graphite, were characterized by using in situ electrical, imaging, and spectroscopic diagnostics, along with ex situ imaging and spectroscopy. The synthesis-on mode duration is rare compared to the total arc run-time, helping to explain the poor selectivity found in the final collected products, a known inadequacy of arc synthesis. Finally, the rarity of the synthesis on mode occurence may be due to the synthesis off mode being more favorable energetically.

  5. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  6. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  7. Technique of total thyroidectomy

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

  8. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  9. Re-visions of rationality?

    Science.gov (United States)

    Newell, Ben R

    2005-01-01

    The appeal of simple algorithms that take account of both the constraints of human cognitive capacity and the structure of environments has been an enduring theme in cognitive science. A novel version of such a boundedly rational perspective views the mind as containing an 'adaptive toolbox' of specialized cognitive heuristics suited to different problems. Although intuitively appealing, when this version was proposed, empirical evidence for the use of such heuristics was scant. I argue that in the light of empirical studies carried out since then, it is time this 'vision of rationality' was revised. An alternative view based on integrative models rather than collections of heuristics is proposed.

  10. Revised hypothesis and future perspectives

    DEFF Research Database (Denmark)

    Norsk, P; Drummer, C; Christensen, N J

    2001-01-01

    Results from space have been unexpected and not predictable from the results of ground-based simulations. Therefore, the concept of how weightlessness and gravity modulates the regulation of body fluids must be revised and a new simulation model developed. The main questions to ask in the future...... are the following: Does weightlessness induce a diuresis and natriuresis during the initial hours of space flight leading to an extracellular and intravascular fluid volume deficit? Can sodium in excess be stored in a hitherto unknown way, particularly during space flight? Why are fluid and sodium retaining systems...

  11. A taxonomic revision of the genus Podocarpus

    OpenAIRE

    Laubenfels, de, D.J.

    1985-01-01

    In connection with the forthcoming revision of the Coniferae for the Flora Malesiana, the author thought it necessary to revise the genus Podocarpus. Although this genus has a substantial representation in Malesia (30 species), the revision is too involved to be appropriate with the Flora Malesiana per se. One new subgenus and 17 new sections are described, and 94 species are enumerated, of which 11 species and 1 variety are described as new, and 3 varieties have been raised to specific rank....

  12. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  13. CUSTOM TRIFLANGE ACETABULAR COMPONENTS IN REVISION HIP REPLACEMENT (EXPERIENCE REVIEW

    Directory of Open Access Journals (Sweden)

    A. A. Korytkin

    2017-01-01

    Full Text Available Extensive defects of acetabulum especially accompanied by pelvis discontinuity at the level of acetabulum pose a serious challenge in revision hip replacement and create additional complexity in fixing the acetabular component. One of the perspective options to solve the above issue is the use of custom triflange acetabular components (CTAC designed based on preoperative computer tomography given the specifics of bone defects of the patient. Purpose of the study — to evaluate the outcomes of CTAC use in revision hip replacement.Materials and methods. The authors analyzed treatment outcomes of 12 patients after revision hip replacement using additive techniques of computer simulation and 3D printing CTAC. Follow up period after the surgery averaged 7±3 months (from one to ten months. 7 out of 12 patients had acetabular defects of Paprosky 3B type, 4 patients had defects of Paprosky 3A and in one patient — of Paprosky 2C.Results. Two out of twelve patients had prosthesis dislocations that required revision hip surgery, one of those patients underwent open reduction of dislocation with wound debridement, another patient underwent replacement of articulating couple of acetabular component. Total scores under Harris Hip Score and paint VAS score prior to treatment was 28±7 and 7±1 points respectively, postoperative scores were 76±9 and 3±1 respectively.Conclusion. The application of additive techniques for revision hip replacement in patients with extensive acetabular and pelvic defects allows to make a precise preoperative planning, to restore joint rotation center, to reconstruct bone defects and to securely fix triflange acetabular component that altogether significantly improve treatment outcomes and patients satisfaction with the surgery.

  14. Revised nonstochastic health effects models

    International Nuclear Information System (INIS)

    Yaniv, S.S.; Scott, B.R.

    1991-01-01

    In 1989, the U.S. Nuclear Regulatory Commission (NRC) published a revision of the 1985 report, Health Effects Models for Nuclear Power Plant Accident Consequence Analysis, NUREG/CR-4214, that included models for early occurring and continuing nonstochastic effects, cancers and thyroid nodules, and genetic effects. This paper discusses specific models for lethality from early occurring and continuing effects. For brevity, hematopoietic-syndrome lethality is called hematopoietic death; pulmonary-syndrome lethality is called pulmonary death; and gastrointestinal syndrome lethality is called gastrointestinal death. Two-parameter Weibull risk functions are recommended for estimating the risk of hematopoietic, pulmonary, or gastrointestinal death. The risks are obtained indirectly by using hazard functions; as a result, this type of approach has been called hazard-function modeling and the models generated are called hazard-function models. In the 1989 NUREG/CR-4214 report, changes were made in the parameter values for a number of effects, and the models used to estimate hematopoietic and pulmonary deaths were substantially revised. Upper and lower estimates of model parameters are provided for all early health effects models. In this paper, we discuss the 1989 models for hematopoietic and pulmonary deaths, highlighting the differences between the 1989 and 1985 models. In addition, we give the reasons for which the 1985 models were modified

  15. Revising Lecture Notes: How Revision, Pauses, and Partners Affect Note Taking and Achievement

    Science.gov (United States)

    Luo, Linlin; Kiewra, Kenneth A.; Samuelson, Lydia

    2016-01-01

    Note taking has been categorized as a two-stage process: the recording of notes and the review of notes. We contend that note taking might best involve a three-stage process where the missing stage is revision. This study investigated the benefits of revising lecture notes and addressed two questions: First, is revision more effective than…

  16. Revision hip replacement for recurrent Hydatid disease of the pelvis: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Chandrasekar Coonoor R

    2010-03-01

    Full Text Available Abstract A case of a large recurrent hydatid cyst involving the right ilium and right hip treated with excision of the cyst, Total hip replacement and revision of the acetabular component with a Tripolar articulation for cyst recurrence and acetabular component loosening is presented along with a review of the relevant literature. To our knowledge there is no reported case of Total Hip replacement and revision for hydatid disease involving the bony pelvis.

  17. Total Radiosynthesis: Thinking outside "the box".

    Science.gov (United States)

    Liang, Steven H; Vasdev, Neil

    2015-09-01

    The logic of total synthesis transformed a stagnant state of medicinal and synthetic organic chemistry when there was a paucity of methods and reagents to synthesize drug molecules and/or natural products. Molecular imaging by positron emission tomography (PET) is now experiencing a renaissance in the way radiopharmaceuticals for molecular imaging are synthesized, however, a paradigm shift is desperately needed in the discovery pipeline to accelerate in vivo imaging studies. A significant challenge in radiochemistry is the limited choice of labeled reagents (or building blocks) available for the synthesis of novel radiopharmaceuticals with the most commonly used short-lived radionuclides carbon-11 ( 11 C; half-life ~20 minutes) and fluorine-18 ( 18 F; half-life ~2 hours). In fact, most drugs cannot be labeled with 11 C or 18 F due to a lack of efficient and diverse radiosynthetic methods. In general, routine radiopharmaceutical production relies on the incorporation of the isotope at the last or penultimate step of synthesis, ideally within one half-life of the radionuclide, to maximize radiochemical yields and specific activities thereby reducing losses due to radioactive decay. Reliance on radiochemistry conducted within the constraints of an automated synthesis unit ("box") has stifled the exploration of multi-step reactions with short-lived radionuclides. Radiopharmaceutical synthesis can be transformed by considering logic of total synthesis to develop novel approaches for 11 C- and 18 F-radiolabeling complex molecules via retrosynthetic analysis and multi-step reactions. As a result of such exploration, new methods, reagents and radiopharmaceuticals for in vivo imaging studies are discovered. A new avenue to develop radiotracers that were previously unattainable due to the lack of efficient radiosynthetic methods is necessary to work towards our ultimate, albeit impossible goal - the concept we term total radiosynthesis - to radiolabel virtually any molecule

  18. Revision for prosthetic joint infection following hip arthroplasty: Evidence from the National Joint Registry.

    Science.gov (United States)

    Lenguerrand, E; Whitehouse, M R; Beswick, A D; Jones, S A; Porter, M L; Blom, A W

    2017-06-01

    We used the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) to investigate the risk of revision due to prosthetic joint infection (PJI) for patients undergoing primary and revision hip arthroplasty, the changes in risk over time, and the overall burden created by PJI. We analysed revision total hip arthroplasties (THAs) performed due to a diagnosis of PJI and the linked index procedures recorded in the NJR between 2003 and 2014. The cohort analysed consisted of 623 253 index primary hip arthroplasties, 63 222 index revision hip arthroplasties and 7585 revision THAs performed due to a diagnosis of PJI. The prevalence, cumulative incidence functions and the burden of PJI (total procedures) were calculated. Overall linear trends were investigated with log-linear regression. We demonstrated a prevalence of revision THA due to prosthetic joint infection of 0.4/100 procedures following primary and 1.6/100 procedures following revision hip arthroplasty. The prevalence of revision due to PJI in the three months following primary hip arthroplasty has risen 2.3-fold (95% confidence interval (CI) 1.3 to 4.1) between 2005 and 2013, and 3.0-fold (95% CI 1.1 to 8.5) following revision hip arthroplasty. Over 1000 procedures are performed annually as a consequence of hip PJI, an increase of 2.6-fold between 2005 and 2013. Although the risk of revision due to PJI following hip arthroplasty is low, it is rising and, coupled with the established and further predicted increased incidence of both primary and revision hip arthroplasty, this represents a growing and substantial treatment burden. Cite this article : E. Lenguerrand, M. R. Whitehouse, A. D. Beswick, S. A. Jones, M. L. Porter, A. W. Blom. Revision for prosthetic joint infection following hip arthroplasty: Evidence from the National Joint Registry. Bone Joint Res 2017;6:391-398. DOI: 10.1302/2046-3758.66.BJR-2017-0003.R1. © 2017 Lenguerrand et al.

  19. Patient-reported outcome and risk of revision after shoulder replacement for osteoarthritis

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe V; Polk, Anne; Brorson, Stig

    2014-01-01

    PURPOSE: We used patient-reported outcome and risk of revision to compare hemiarthroplasty (HA) with total shoulder arthroplasty (TSA) and stemmed hemiarthroplasty (SHA) with resurfacing hemiarthroplasty (RHA) in patients with glenohumeral osteoarthritis. PATIENTS AND METHODS: We included all...... of presentation, the raw scores were converted to a percentage of the maximum score. Revision rates were calculated by checking reported revisions to the DSR until December 2011. WOOS and risk of revision were adjusted for age, sex, previous surgery, and type of osteoarthritis. RESULTS: There were 113 TSAs...... and 1096 HAs (837 RHAs and 259 SHAs). Patients treated with TSA generally had a better WOOS, exceeding the predefined minimal clinically important difference, at 1 year (mean difference 10, p

  20. First total synthesis and biological evaluation of halolitoralin A

    Directory of Open Access Journals (Sweden)

    RAJIV DAHIYA

    2007-02-01

    Full Text Available A new potent bioactive alanine-rich cyclic hexapeptide halolitoralin A(8, which was previously isolated from the marine sediment-derived bacterial strain Halobacillus litoralis YS3016, has been synthesized by the solution phase technique. All the coupling reactions were performed at room temperature utilizing dicyclohexylcarbodiimide (DCC as the coupling reagent and N-methylmorpholine (NMM as the base. The structure of the peptide was characterized by IR, 1H-NMR, 13C-NMR, FAB MS spectral data, as well as elemental analysis and DSC. The synthesized cyclopeptide was also screened for its antimicrobial and anthelmintic activities and found to exhibit potent antifungal activity against the pathogenic fungi Candida albicans and Trichophyton mentagrophytes along with potent antibacterial activity against the gram negative bacteria Pseudomonas aeruginosa and Escherichia coli. Gram negative bacteria were found to be more sensitive than gram positive bacteria towards the newly synthesized peptide. In addition, the peptide was also found to exhibit moderate anthelmintic activity against the earthworms Megascoplex konkanensis and Eudrilus sp.

  1. Strategy Toward the Total Synthesis of Epothilones A and B

    Science.gov (United States)

    1999-07-01

    would result in the formation of a secondary neopentyl center. Further evidence that the initial step in the annulation sequence is conjugate addition...0.37 mmol) was dissolved in anhydrous benzene (10 mL) and ethylene glycol (2.1 mL, 37 mmol) was added followed by p-toluenesulfonic acid (7 mg, 0.04

  2. Total Synthesis of Dolatrienoic Acid: A Subunit of Dolastatin 14.

    Science.gov (United States)

    Mouné, Sylvie; Niel, Gilles; Busquet, Magali; Eggleston, Ian; Jouin, Patrick

    1997-05-16

    The (7R,15R)- and (7S,15R)-diastereomers of dolatrienoic acid were synthesized using a convergent strategy. Fragment C5-C9 was obtained through enantiodifferentiation of racemic pentane-1,3,5-triol as the key step, fixing the chirality at C7 of fragments 4 and ent-4. The chirality at C15 of the fragment C10-C16 was introduced from L-glutamic acid. Coupling of these two fragments led to the aldehydes (7R,15R)- and (7S,15R)-2 which were homologated by Horner-Wadsworth-Emmons condensation to give (7R,15R)- and (7S,15R)-dolatrienoic acids.

  3. Sequenced Peer Revision: Creating Competence and Community

    Science.gov (United States)

    Bowman, Ingrid K.; Robertson, John

    2013-01-01

    Mastering techniques of self- and peer revision is a valuable tool for all writers, especially US-educated Generation 1.5 students, whose near fluency enables them to dialogue successfully about their writing. Using action research, 2 academic writing instructors systematically trained students to more responsibly and effectively revise their…

  4. Revised GCFR safety program plan

    International Nuclear Information System (INIS)

    Kelley, A.P.; Boyack, B.E.; Torri, A.

    1980-05-01

    This paper presents a summary of the recently revised gas-cooled fast breeder reactor (GCFR) safety program plan. The activities under this plan are organized to support six lines of protection (LOPs) for protection of the public from postulated GCFR accidents. Each LOP provides an independent, sequential, quantifiable risk barrier between the public and the radiological hazards associated with postulated GCFR accidents. To implement a quantitative risk-based approach in identifying the important technology requirements for each LOP, frequency and consequence-limiting goals are allocated to each. To ensure that all necessary tasks are covered to achieve these goals, the program plan is broken into a work breakdown structure (WBS). Finally, the means by which the plan is being implemented are discussed

  5. Radiological control manual. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Kloepping, R.

    1996-05-01

    This Lawrence Berkeley National Laboratory Radiological Control Manual (LBNL RCM) has been prepared to provide guidance for site-specific additions, supplements and interpretation of the DOE Radiological Control Manual. The guidance provided in this manual is one methodology to implement the requirements given in Title 10 Code of Federal Regulations Part 835 (10 CFR 835) and the DOE Radiological Control Manual. Information given in this manual is also intended to provide demonstration of compliance to specific requirements in 10 CFR 835. The LBNL RCM (Publication 3113) and LBNL Health and Safety Manual Publication-3000 form the technical basis for the LBNL RPP and will be revised as necessary to ensure that current requirements from Rules and Orders are represented. The LBNL RCM will form the standard for excellence in the implementation of the LBNL RPP.

  6. Potentialities of Revised Quantum Electrodynamics

    Directory of Open Access Journals (Sweden)

    Lehnert B.

    2013-10-01

    Full Text Available The potentialities of a revised quantum electrodynamic theory (RQED earlier established by the author are reconsidered, also in respect to other fundamental theories such as those by Dirac and Higgs. The RQED theory is characterized by intrinsic linear symmetry breaking due to a nonzero divergence of the electric field strength in the vacuum state, as supported by the Zero Point Energy and the experimentally confirmed Casimir force. It includes the results of electron spin and antimatter by Dirac, as well as the rest mass of elementary particles predicted by Higgs in terms of spontaneous nonlinear symmetry breaking. It will here be put into doubt whether the approach by Higgs is the only theory which becomes necessary for explaining the particle rest masses. In addition, RQED theory leads to new results beyond those being available from the theories by Dirac, Higgs and the Standard Model, such as in applications to leptons and the photon.

  7. Hot sample archiving. Revision 3

    International Nuclear Information System (INIS)

    McVey, C.B.

    1995-01-01

    This Engineering Study revision evaluated the alternatives to provide tank waste characterization analytical samples for a time period as recommended by the Tank Waste Remediation Systems Program. The recommendation of storing 40 ml segment samples for a period of approximately 18 months (6 months past the approval date of the Tank Characterization Report) and then composite the core segment material in 125 ml containers for a period of five years. The study considers storage at 222-S facility. It was determined that the critical storage problem was in the hot cell area. The 40 ml sample container has enough material for approximately 3 times the required amount for a complete laboratory re-analysis. The final result is that 222-S can meet the sample archive storage requirements. During the 100% capture rate the capacity is exceeded in the hot cell area, but quick, inexpensive options are available to meet the requirements

  8. Radiological control manual. Revision 1

    International Nuclear Information System (INIS)

    Kloepping, R.

    1996-05-01

    This Lawrence Berkeley National Laboratory Radiological Control Manual (LBNL RCM) has been prepared to provide guidance for site-specific additions, supplements and interpretation of the DOE Radiological Control Manual. The guidance provided in this manual is one methodology to implement the requirements given in Title 10 Code of Federal Regulations Part 835 (10 CFR 835) and the DOE Radiological Control Manual. Information given in this manual is also intended to provide demonstration of compliance to specific requirements in 10 CFR 835. The LBNL RCM (Publication 3113) and LBNL Health and Safety Manual Publication-3000 form the technical basis for the LBNL RPP and will be revised as necessary to ensure that current requirements from Rules and Orders are represented. The LBNL RCM will form the standard for excellence in the implementation of the LBNL RPP

  9. Total Quality Leadership

    Science.gov (United States)

    1991-01-01

    More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

  10. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...

  11. Laparoscopic total pancreatectomy

    Science.gov (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing

    2017-01-01

    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  12. Estonian total ozone climatology

    Directory of Open Access Journals (Sweden)

    K. Eerme

    Full Text Available The climatological characteristics of total ozone over Estonia based on the Total Ozone Mapping Spectrometer (TOMS data are discussed. The mean annual cycle during 1979–2000 for the site at 58.3° N and 26.5° E is compiled. The available ground-level data interpolated before TOMS, have been used for trend detection. During the last two decades, the quasi-biennial oscillation (QBO corrected systematic decrease of total ozone from February–April was 3 ± 2.6% per decade. Before 1980, a spring decrease was not detectable. No decreasing trend was found in either the late autumn ozone minimum or in the summer total ozone. The QBO related signal in the spring total ozone has an amplitude of ± 20 DU and phase lag of 20 months. Between 1987–1992, the lagged covariance between the Singapore wind and the studied total ozone was weak. The spring (April–May and summer (June–August total ozone have the best correlation (coefficient 0.7 in the yearly cycle. The correlation between the May and August total ozone is higher than the one between the other summer months. Seasonal power spectra of the total ozone variance show preferred periods with an over 95% significance level. Since 1986, during the winter/spring, the contribution period of 32 days prevails instead of the earlier dominating 26 days. The spectral densities of the periods from 4 days to 2 weeks exhibit high interannual variability.

    Key words. Atmospheric composition and structure (middle atmosphere – composition and chemistry; volcanic effects – Meteorology and atmospheric dynamics (climatology

  13. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-06-01

    The present discussion is limited to a presentation of the most recent total photonuclear absorption experiments performed with real photons at intermediate energy, and more precisely in the region of nucleon resonances. The main sources of real photons are briefly reviewed and the experimental procedures used for total photonuclear absorption cross section measurements. The main results obtained below 140 MeV photon energy as well as above 2 GeV are recalled. The experimental study of total photonuclear absorption in the nuclear resonance region (140 MeV< E<2 GeV) is still at its beginning and some results are presented

  14. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  15. SYNTHESIS, HIRSHFELD SURFACE ANALYSES AND ...

    African Journals Online (AJOL)

    2016 Chemical Society of Ethiopia ... We report here the synthesis of a dinuclear Mn(II) complex with mixed co-ligands. The ... The total lattice energy is partitioned .... The χMT value for the complex 1 was 8.51 cm3 K mol−1 at 300 K, and this is ...

  16. Outcomes of Ahmed Glaucoma Valve Revision in Pediatric Glaucoma.

    Science.gov (United States)

    Al-Omairi, Ahmed Mansour; Al Ameri, Aliah H; Al-Shahwan, Sami; Khan, Arif O; Al-Jadaan, Ibrahim; Mousa, Ahmed; Edward, Deepak P

    2017-11-01

    Encapsulation of the Ahmed glaucoma valve (AGV) plate is a common cause for postoperative elevation of intraocular pressure, especially in children. Many reports have described the outcomes of AGV revision in adults. However, the outcomes of AGV revision in children are poorly documented. The aim of this study was to determine the outcomes of AGV revision in children. Retrospective cross-sectional study. A retrospective chart review of patients less than 15 years of age who underwent AGV revision with a minimum postoperative follow-up of 6 months was conducted. Outcome measures included reduction in intraocular pressure from baseline, survival analysis, and reduction in the number of antiglaucoma medications. Postoperative complications were also noted. Complete success was defined as an IOP of 21 mm Hg or less without medications, while qualified success was defined as having an IOP of 21 mm Hg or less with medications. A total of 44 eyes met the inclusion criteria. Primary congenital glaucoma was present in 39 eyes (88.6%), aphakic glaucoma in 4 eyes (9.1%), and Peters anomaly-associated glaucoma in 1 eye (2.3%). The mean number of previous surgeries was 1.4, and the mean age was 6.7 years (range, 1.9-13 years) with a median follow-up of 12 months (range, 6-24 months). The IOP was reduced from a preoperative mean of 30.4 (± 10.3) to 24.9 (± 10.6) mm Hg at 6 months postoperatively. Kaplan-Meier analysis showed that the complete success rate at 1 month was 100% followed by a rapid decline at 6 months to 38.6%, 27.7% at 1 year, and 5.5% at 2 years. Qualified success rate was 100% at 1 month followed by a 6-month and 1-year survival rate of approximately 50% and a 2-year survival rate of approximately 16%. The median survival time was 14 months. No specific risk factors for failure were identified. Visual acuity remained unchanged following revision. The most common complication was recurrence of encapsulation with elevated IOP (15.9%). Other

  17. Comparative Analysis of Direct Hospital Care Costs between Aseptic and Two-Stage Septic Knee Revision

    Science.gov (United States)

    Kasch, Richard; Merk, Sebastian; Assmann, Grit; Lahm, Andreas; Napp, Matthias; Merk, Harry; Flessa, Steffen

    2017-01-01

    Background The most common intermediate and long-term complications of total knee arthroplasty (TKA) include aseptic and septic failure of prosthetic joints. These complications cause suffering, and their management is expensive. In the future the number of revision TKA will increase, which involves a greater financial burden. Little concrete data about direct costs for aseptic and two-stage septic knee revisions with an in depth-analysis of septic explantation and implantation is available. Questions/Purposes A retrospective consecutive analysis of the major partial costs involved in revision TKA for aseptic and septic failure was undertaken to compare 1) demographic and clinical characteristics, and 2) variable direct costs (from a hospital department’s perspective) between patients who underwent single-stage aseptic and two-stage septic revision of TKA in a hospital providing maximum care. We separately analyze the explantation and implantation procedures in septic revision cases and identify the major cost drivers of knee revision operations. Methods A total of 106 consecutive patients (71 aseptic and 35 septic) was included. All direct costs of diagnosis, surgery, and treatment from the hospital department’s perspective were calculated as real purchase prices. Personnel involvement was calculated in units of minutes. Results Aseptic versus septic revisions differed significantly in terms of length of hospital stay (15.2 vs. 39.9 days), number of reported secondary diagnoses (6.3 vs. 9.8) and incision-suture time (108.3 min vs. 193.2 min). The management of septic revision TKA was significantly more expensive than that of aseptic failure ($12,223.79 vs. $6,749.43) (p costs of explantation stage ($4,540.46) were lower than aseptic revision TKA ($6,749.43) which were again lower than those of the septic implantation stage ($7,683.33). All mean costs of stays were not comparable as they differ significantly (p cost drivers were the cost of the implant and

  18. A financial analysis of revision hip arthroplasty: the economic burden in relation to the national tariff.

    Science.gov (United States)

    Vanhegan, I S; Malik, A K; Jayakumar, P; Ul Islam, S; Haddad, F S

    2012-05-01

    Revision arthroplasty of the hip is expensive owing to the increased cost of pre-operative investigations, surgical implants and instrumentation, protracted hospital stay and drugs. We compared the costs of performing this surgery for aseptic loosening, dislocation, deep infection and peri-prosthetic fracture. Clinical, demographic and economic data were obtained for 305 consecutive revision total hip replacements in 286 patients performed at a tertiary referral centre between 1999 and 2008. The mean total costs for revision surgery in aseptic cases (n = 194) were £11 897 (sd 4629), for septic revision (n = 76) £21 937 (sd 10 965), for peri-prosthetic fracture (n = 24) £18 185 (sd 9124), and for dislocation (n = 11) £10 893 (sd 5476). Surgery for deep infection and peri-prosthetic fracture was associated with longer operating times, increased blood loss and an increase in complications compared to revisions for aseptic loosening. Total inpatient stay was also significantly longer on average (p < 0.001). Financial costs vary significantly by indication, which is not reflected in current National Health Service tariffs.

  19. Total 2004 results

    International Nuclear Information System (INIS)

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  20. Total 2004 results

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  1. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty....

  2. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty. Udgivelsesdato: 2009-Feb-23...

  3. Excisional Bleb Revision for Management of Failed Ahmed Glaucoma Valve.

    Science.gov (United States)

    Eslami, Yadollah; Fakhraie, Ghasem; Moghimi, Sasan; Zarei, Reza; Mohammadi, Masoud; Nabavi, Amin; Yaseri, Mehdi; Izadi, Ali

    2017-12-01

    To evaluate the outcome of excisonal bleb revision in patients with failed Ahmed glaucoma valve (AGV). In total, 29 patients with uncontrolled intraocular pressure (IOP) despite of maximal tolerated medical therapy at least 6 months after AGV implantation were enrolled in this prospective interventional case series. Excision of fibrotic tissue around the reservoir with application of mitomycin C 0.02% was performed. IOP, number of glaucoma medications were evaluated at baseline and 1 week and 1, 3, 6, and 12 months postoperatively. Complete and qualified success was defined as IOP≤21 mm Hg with or without glaucoma medications, respectively. Intraoperative and postopervative complications were also recorded. Mean IOP was reduced from 30±4.2 mm Hg at baseline to 19.2±3.1 mm Hg at 12-month follow-up visit (Pglaucoma medications was decrease from 3.2±0.5 at baseline to 1.9±0.7 at 12-month follow-up (Pglaucoma surgeries were significantly associated with the failure of excisonal bleb revision. Excisional bleb revision could be considered as a relatively effective alternative option for management of inadequate IOP control after AGV implantation.

  4. Revision of the Paris and Brussels Conventions of Nuclear Liability

    International Nuclear Information System (INIS)

    Reyners, P.

    2002-01-01

    The Contracting Parties to the 1960 Paris Convention on Third Party Liability in the Field of Nuclear Energy and to the 1963 Brussels Convention Supplementary to the Paris Convention, have concluded this Spring four years of negotiation on the revision of these instruments. This exercise was itself started as a logical consequence of the adoption in 1997 of a revised Vienna Convention on Civil Liability for Nuclear Damage and of a Convention on Supplementary Compensation for Nuclear Damage. The Contracting Parties have concluded that the existing regime established by these Conventions remains viable and sound but that it also warrants improvements to ensure that greater financial security will be available to compensate a potentially larger number of victims in respect of a broader range of nuclear damage. A number of more technical amendments have also been agreed, in particular to ensure compatibility with other existing Conventions in this field. When the revised Paris and Brussels Conventions come into force, the total amount of funds available for compensation, provided by the liable nuclear operator and by the States concerned, will be 1.5 billion euros. (author)

  5. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    There has been a decline in the rate of hysterectomies in Denmark in general over the last thirteen years, together with a rise in the number of supravaginal operations over the last two years. The literature concerning the relative merits of the supravaginal and the total abdominal operation is ...... indicate a reduced frequency of orgasm after the total hysterectomy compared with the supravaginal operation. When there are technical problems peroperatively with an increased urologic risk the supravaginal operation is recommended....

  6. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-01-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen

  7. Totally optimal decision rules

    KAUST Repository

    Amin, Talha

    2017-11-22

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  8. Totally optimal decision rules

    KAUST Repository

    Amin, Talha M.; Moshkov, Mikhail

    2017-01-01

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  9. Cochlear implant revision surgeries in children.

    Science.gov (United States)

    Amaral, Maria Stella Arantes do; Reis, Ana Cláudia Mirândola B; Massuda, Eduardo T; Hyppolito, Miguel Angelo

    2018-02-16

    The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. A retrospective study of patients under 18 years submitted to cochlear implant Surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after Cochlear Implant surgery and any need for surgical revision and the reason for it. Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subject's hearing and language performance, indicating that these surgeries are valid in most cases. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  10. Revision of infected knee arthroplasties in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Jørgensen, Christoffer C; Bagger, Jens

    2016-01-01

    Background and purpose - The surgical treatment of periprosthetic knee infection is generally either a partial revision procedure (open debridement and exchange of the tibial insert) or a 2-stage exchange arthroplasty procedure. We describe the failure rates of these procedures on a nationwide...... basis. Patients and methods - 105 partial revisions (100 patients) and 215 potential 2-stage revision procedures (205 patients) performed due to infection from July 1, 2011 to June 30, 2013 were identified from the Danish Knee Arthroplasty Register (DKR). Failure was defined as surgically related death...

  11. The effects of hydroxyapatite coating and bone allograft on fixation of loaded experimental primary and revision implants.

    Science.gov (United States)

    Søballe, Kjeld; Mouzin, Olivier R G; Kidder, Louis A; Overgaard, Søren; Bechtold, Joan E

    2003-06-01

    We used our established experimental model of revision joint replacement to examine the roles of hydroxyapatite coating and bone graft in improving the fixation of revision implants. The revision protocol uses the Søballe micromotion device in a preliminary 8-week period of implant instability for the presence of particulate polyethylene. During this procedure, a sclerotic endosteal bone rim forms, and a dense fibrous membrane is engendered, having macrophages with ingested polyethylene and high levels of inflammatory cytokines. At the time of revision after 8 weeks, the cavity is revised with either a titanium alloy (Ti) or a hydroxyapatite (HA) 6.0 mm plasma-sprayed implant, in the presence or absence of allograft packed into the initial 0.75 mm peri-implant gap. The contralateral limb is subjected to primary surgery with the same implant configuration, and serves as control. 8 implants were included in each of the 8 treatment groups (total 64 implants in 32 dogs). The observation period was 4 weeks after revision. Outcome measures are based on histomorphometry and mechanical pushout properties. The revision setting was always inferior to its primary counterpart. Bone graft improved the revision fixation in all treatment groups, as also did the HA coating. The sole exception was revision-grafted HA implants, which reached the same fixation as primary Ti and HA grafted implants. The revision, which was less active in general, seems to need the dual stimulation of bone graft and HA implant surface, to obtain the same level of fixation associated with primary implants. Our findings suggest that the combination of HA implant and bone graft may be of benefit in the clinical revision implant setting.

  12. Are the Outcomes of Revision Knee Arthroplasty for Flexion Instability the Same as for Other Major Failure Mechanisms?

    Science.gov (United States)

    Rajgopal, Ashok; Panjwani, Taufiq R; Rao, Arun; Dahiya, Vivek

    2017-10-01

    Aseptic loosening, infection, and flexion instability have emerged as the leading etiologies for revision after total knee arthroplasty (TKA). Although studies have reported improved outcomes after revision TKA, the relative functional and clinical outcomes of patients revised for flexion instability and other failure etiologies have not been extensively reported. The aim of the study was to compare the functional and patient-reported outcomes of revision TKA for the common failure etiologies. We retrospectively reviewed records of 228 consecutive cases of revision TKA from 2008 to 2014. Revisions performed for aseptic loosening (n = 53), septic revisions (n = 48), and isolated flexion instability (n = 45) with a minimum of 18 months follow-up were included for analysis. Revision for all other etiologies (n = 82) were excluded. The Modified Knee Society Score (KSS), KSS Function, and Western Ontario and McMaster Universities Osteoarthritis Index were recorded for all cases. A 7-point Likert scale was used to record patient's perception of outcomes after revision surgery and analyzed based on etiology. Although all groups showed improvement in outcome after revision TKA, the changes in Modified KSS and KSS-Function varied according to the etiology of failure of the primary procedure with the smallest improvement being reported by the flexion instability group. Patients undergoing revision for isolated flexion instability have less improvement in functional outcome as compared with other etiologies. We hypothesize this is due to a higher baseline preoperative knee function in the flexion instability group. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Individual questions of financial control and revision

    Directory of Open Access Journals (Sweden)

    В. М. Глібко

    2015-05-01

    Full Text Available Problem setting. In modern conditions at investigation and gathering of proofs in criminal proceedings according to item 93 CPC of Ukraine collecting of proofs which is carried out by the criminal proceedings parties, victim is important, the representative of the legal person, in which relation carries out manufacture, including a way истребования and receptions from public authorities, local governments, the enterprises, establishments and organisations, official and physical persons of things, documents, data, conclusions of experts, conclusions of revisions and certificates of checks. Recent research and publications analisis. In scientific sources questions of carrying out of revisions S. B.Zhivko, V.V.Akimov, G.Demjanchuk, J.Buzdugan is considered. Paper objective. Article purpose is studying and definition of a place of revision among forms of inspection of the state control and use of results of revision in criminal proceedings. Paper main body. Off-schedule exit revision that is revision which is not provided in plans of work of body of the state financial control is considered and is spent at presence at least one of the circumstances listed in item 11 of the Law of Ukraine «About main principles of realisation of the state financial control in Ukraine». If revision is carried out on request of investigating bodies it is spent on the basis of the petition of the inspector and accepted by the results of consideration of this petition of the decision of the investigatory judge. The primary goal of revision on request of investigating bodies or on the basis of court definition is reception of proofs on business. Therefore the revision certificate admits the written proof as on the basis of its conclusion of the inspector, the public prosecutor receives the information on a perfect crime, abusing, and also on the persons who have committed a crime, on the period of commission of crime and an amount of damage. In criminal

  14. Total volume versus bouts

    DEFF Research Database (Denmark)

    Chinapaw, Mai; Klakk, Heidi; Møller, Niels Christian

    2018-01-01

    BACKGROUND/OBJECTIVES: Examine the prospective relationship of total volume versus bouts of sedentary behaviour (SB) and moderate-to-vigorous physical activity (MVPA) with cardiometabolic risk in children. In addition, the moderating effects of weight status and MVPA were explored. SUBJECTS....../METHODS: Longitudinal study including 454 primary school children (mean age 10.3 years). Total volume and bouts (i.e. ≥10 min consecutive minutes) of MVPA and SB were assessed by accelerometry in Nov 2009/Jan 2010 (T1) and Aug/Oct 2010 (T2). Triglycerides, total cholesterol/HDL cholesterol ratio (TC:HDLC ratio......, with or without mutual adjustments between MVPA and SB. The moderating effects of weight status and MVPA (for SB only) were examined by adding interaction terms. RESULTS: Children engaged daily in about 60 min of total MVPA and 0-15 min/week in MVPA bouts. Mean total sedentary time was around 7 h/day with over 3...

  15. [Osteosynthesis and cup revision in periprosthetic acetabulum fractures using a Kocher-Langenbeck approach].

    Science.gov (United States)

    Schwabe, P; Märdian, S; Perka, C; Schaser, K-D

    2016-04-01

    Reconstruction/stable fixation of the acetabular columns to create an adequate periacetabular requirement for the implantation of a revision cup. Displaced/nondisplaced fractures with involvement of the posterior column. Resulting instability of the cup in an adequate bone stock situation. Periprosthetic acetabulum fractures with inadequate bone stock. Extended periacetabular defects with loss of anchorage options. Isolated periprosthetic fractures of the anterior column. Septic loosening. Dorsal approach. Dislocation of hip. Mechanical testing of inlaying acetabular cup. With unstable cup situation explantation of the cup, fracture fixation of acetabulum with dorsal double plate osteosynthesis along the posterior column. Cup revision. Hip joint reposition. Early mobilization; partial weight bearing for 12 weeks. Thrombosis prophylaxis. Clinical and radiological follow-ups. Periprosthetic acetabular fracture in 17 patients with 9 fractures after primary total hip replacement (THR), 8 after revision THR. Fractures: 12 due to trauma, 5 spontaneously; 7 anterior column fractures, 5 transverse fractures, 4 posterior column fractures, 1 two column fracture after hemiendoprosthesis. 5 type 1 fractures and 12 type 2 fractures. Operatively treated cases (10/17) received 3 reinforcement ring, 2 pedestal cup, 1 standard revision cup, cup-1 cage construct, 1 ventral plate osteosynthesis, 1 dorsal plate osteosynthesis, and 1 dorsal plate osteosynthesis plus cup revision (10-month Harris Hip Score 78 points). Radiological follow-up for 10 patients: consolidation of fractures without dislocation and a fixed acetabular cup. No revision surgeries during follow-up; 2 hip dislocations, 1 transient sciatic nerve palsy.

  16. Adjuvant Therapy for Revision Rhinoplasty of Contracted Nose Using Polydeoxyribonucleotide and Invasive Bipolar Radiofrequency

    Directory of Open Access Journals (Sweden)

    Tae Hwan Ahn, MD, PhD

    2018-01-01

    Full Text Available Summary:. Most cases of severely contracted nose require revision rhinoplasty and septoplasty, wherein preoperative and/or intraoperative expansion of nasal soft tissue is necessary for tension-free revision surgery. The present study aimed to evaluate the efficacy and safety of pre- and postoperative adjuvant therapy using polydeoxyribonucleotide (PDRN and invasive, pulsed-type, bipolar, alternating current radiofrequency (RF for revision surgery of a contracted nose. In total, 30 patients were treated with 16 sessions (8 preoperative sessions and 8 postoperative sessions of intralesional injection of PDRN and invasive RF treatment using microneedle electrodes at 1-week intervals. One week after the final combined pretreatment using PDRN and invasive bipolar RF, the skin of contracted noses was sufficiently softened, and nasal skin mobility was notably improved in all the patients. During revision rhinoplasty and septoplasty, the contracted nasal skin in each patient was adequately released for proper covering of the nasal tip without tension. Postoperatively, 8 sessions of adjuvant therapy elicited marked clinical improvements in persistent nasal tip dimpling and contracture, septal deviation, and warping from the incomplete recovery of nasal contracture after revision surgery. In conclusion, our pre- and postoperative adjuvant therapies using PDRN and invasive bipolar RF remarkably improved the therapeutic outcomes of revision rhinoplasty and septoplasty for contracted skin of the nose without major side effects.

  17. Revised ANL-reported tensile data for V-Ti and V-Cr-Ti alloys

    International Nuclear Information System (INIS)

    Billone, M.C.

    1997-01-01

    The tensile for all irradiated vanadium alloy samples and several unirradiated vanadium alloys tested at Argonne National Laboratory (ANL) have been critically reviewed and revised, as necessary. The review and revision are based on re-analyzing the original load-displacement strip-chart recording using a methodology consistent with current ASTM standards. No significant difference has been found between the newly-revised and previously-reported values of yield strength (YS) and ultimate tensile strength (UTS). However, by correctly subtracting the non-gauge-length displacement and linear gauge-length displacement from the total cross-head displacement, the uniform elongation (UE) of the gauge length decreases by 4-9% strain and the total elongation (TE) of the gauge length decreases by 1-7% strain. These differences are more significant for lower-ductility irradiated alloys than for higher-ductility alloys

  18. Revised ANL-reported tensile data for V-Ti and V-Cr-Ti alloys

    Energy Technology Data Exchange (ETDEWEB)

    Billone, M.C. [Argonne National Lab., IL (United States)

    1997-08-01

    The tensile for all irradiated vanadium alloy samples and several unirradiated vanadium alloys tested at Argonne National Laboratory (ANL) have been critically reviewed and revised, as necessary. The review and revision are based on re-analyzing the original load-displacement strip-chart recording using a methodology consistent with current ASTM standards. No significant difference has been found between the newly-revised and previously-reported values of yield strength (YS) and ultimate tensile strength (UTS). However, by correctly subtracting the non-gauge-length displacement and linear gauge-length displacement from the total cross-head displacement, the uniform elongation (UE) of the gauge length decreases by 4-9% strain and the total elongation (TE) of the gauge length decreases by 1-7% strain. These differences are more significant for lower-ductility irradiated alloys than for higher-ductility alloys.

  19. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...... women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had...

  20. Qualità totale e mobilità totale Total Quality and Total Mobility

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-05-01

    Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

  1. Students’ Perception toward the Implementation of Peer-Assessment in Writing; Before and After Revision

    Directory of Open Access Journals (Sweden)

    Husni Mubarok

    2017-10-01

    Full Text Available This study was aimed at elaborating students’ perception toward the implementation of peer assessment in writing class either before or after revision. Writing becomes one of skills which should be mastered by students in order to get higher level of literacy. Writing is a productive skill which asks students to arrange words and organize them into good writing which could be understood by readers. The success of writing is determined by the writing process itself starting from planning, first draft writing, revising, and editing. One of the strategies used in teaching writing is by implementing peer assessment. Peer assessment strategy becomes one of important parts in the process of writing because there will be feedback or suggestion from peers in doing a review. The number of the subject of this research was students in second semester of the English Education Department of UNISNU Jepara. This research was conducted on even semester. The total number of the students, which became respondents, was 37 students of English Education Department. The research design used was qualitative research which measured students’ perceptions of the implementation of peer assessment in writing: before and after revision. The result showed that before revision, students had negative perception toward their own writing. After revision, they had positive perceptions toward peer assessment strategy. Those included usefulness and meaningfulness, nature of feedback, reality of feedback, precision, validity, fairness, and personal goal-setting. Besides that, the score after revision (7.9 was higher than the score before revision (6.62. It meant that the result showed the increasing of students’ score after revision.

  2. Taxation and Welfare: A Revision Exercise.

    Science.gov (United States)

    Boden, Andrew

    1992-01-01

    Offers a revision exercise intended to remind students of some economic terminology associated with taxation and welfare. Provides a set of definitions for which students are to supply matching terms. Includes an answer list and suggests related exercises. (SG)

  3. Student-initiated revision in child health.

    Science.gov (United States)

    Alfaham, M; Gray, O P; Davies, D P

    1994-03-01

    Most teaching of child health in Cardiff takes place in block attachments of 8 weeks. There is an introductory seminar of 2 days followed by a 6-week clinical attachment in a district general hospital in Wales, and then a revision period of one week designed to help students formalize and structure their basic knowledge and to clarify aspects of child health which they may have had difficulty in understanding. The revision programme has to take into account: the short time available, the small number of teaching staff, the most relevant basic knowledge and active participation by the student. This paper describes how this week has been improved through the use of student-initiated revision (SIR). The students' appraisal of this revision and in particular SIR is presented.

  4. New and revised standards for coke production

    Energy Technology Data Exchange (ETDEWEB)

    G.A. Kotsyuba; M.I. Alpatov; Y.G. Shapoval [Giprokoks, the State Institute for the Design of Coke-Industry Enterprises, Kharkov (Ukraine)

    2009-07-15

    The need for new and revised standards for coke production in Ukraine and Russia is outlined. Such standards should address improvements in plant operation, working conditions, environmental protection, energy conservation, fire and explosion safety, and economic indices.

  5. FFTF operations procedures preparation guide. Revision 2

    International Nuclear Information System (INIS)

    1976-12-01

    The Guide is intended to provide guidelines for the initial preparation of FFTF Operating Procedures. The Procedures Preparation Guide was developed from the plan presented and approved in the FFTF Reactor Plant Procedures Plan, PC-1, Revision 3

  6. Revising incompletely specified convex probabilistic belief bases

    CSIR Research Space (South Africa)

    Rens, G

    2016-04-01

    Full Text Available revision employing the notion of optimum entropy, and point out some of the benefits and difficulties in those methods. Both the boundary distribution method and the optimum entropy method are reasonable, yet yield different results....

  7. Descriptor revision belief change through direct choice

    CERN Document Server

    Hansson, Sven Ove

    2017-01-01

    This book provides a critical examination of how the choice of what to believe is represented in the standard model of belief change. In particular the use of possible worlds and infinite remainders as objects of choice is critically examined. Descriptors are introduced as a versatile tool for expressing the success conditions of belief change, addressing both local and global descriptor revision. The book presents dynamic descriptors such as Ramsey descriptors that convey how an agent’s beliefs tend to be changed in response to different inputs. It also explores sentential revision and demonstrates how local and global operations of revision by a sentence can be derived as a special case of descriptor revision. Lastly, the book examines revocation, a generalization of contraction in which a specified sentence is removed in a process that may possibly also involve the addition of some new information to the belief set.

  8. CSF total protein

    Science.gov (United States)

    CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF). ... The normal protein range varies from lab to lab, but is typically about 15 to 60 milligrams per deciliter (mg/dL) ...

  9. Total body irradiation

    International Nuclear Information System (INIS)

    Novack, D.H.; Kiley, J.P.

    1987-01-01

    The multitude of papers and conferences in recent years on the use of very large megavoltage radiation fields indicates an increased interest in total body, hemibody, and total nodal radiotherapy for various clinical situations. These include high dose total body irradiation (TBI) to destroy the bone marrow and leukemic cells and provide immunosuppression prior to a bone marrow transplant, high dose total lymphoid irradiation (TLI) prior to bone marrow transplantation in severe aplastic anemia, low dose TBI in the treatment of lymphocytic leukemias or lymphomas, and hemibody irradiation (HBI) in the treatment of advanced multiple myeloma. Although accurate provision of a specific dose and the desired degree of dose homogeneity are two of the physicist's major considerations for all radiotherapy techniques, these tasks are even more demanding for large field radiotherapy. Because most large field radiotherapy is done at an extended distance for complex patient geometries, basic dosimetry data measured at the standard distance (isocenter) must be verified or supplemented. This paper discusses some of the special dosimetric problems of large field radiotherapy, with specific examples given of the dosimetry of the TBI program for bone marrow transplant at the authors' hospital

  10. Total design of participation

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2016-01-01

    The idea of design as an art made not only for the people, but also by the people is an old dream going back at least to William Morris. It is, however, reappearing vigoriously in many kinds of design activism and grows out of the visions of a Total Design of society. The ideas of participation b...

  11. Total Quality Management Simplified.

    Science.gov (United States)

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  12. Total Quality Management Seminar.

    Science.gov (United States)

    Massachusetts Career Development Inst., Springfield.

    This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

  13. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-01-01

    Experimental methods using real photon beams for measurements of total photonuclear absorption cross section σ(Tot : E/sub γ/) are recalled. Most recent σ(Tot : E/sub γ/)results for complex nuclei and in the nucleon resonance region are presented

  14. Total 2004 annual report

    International Nuclear Information System (INIS)

    2004-01-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  15. Total Water Management - Report

    Science.gov (United States)

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current operations put different stresses on the environment and urban infrastructure. Total Water Management (TWM) is an approac...

  16. NRC revision to 10 CFR Part 20

    International Nuclear Information System (INIS)

    Baker, R.E.; Cool, W.S.; Mills, W.A.

    1983-01-01

    The Nuclear Regulatory Commission's pollution standards have been revised since publication in the late 1950s, but the basic approach has not changed. The revisions resulted in inaccuracies, conflicts, and ambiguities in requirements. The need for comprehensive updating including radiation-protection principles, risk, occupational exposure dose limits, standards for the public (including de minimis level), surveys and monitoring, disposal into sewerage systems, and records is discussed. 2 tables

  17. Revised data taking schedule with ion beams

    CERN Document Server

    Gazdzicki, Marek; Aduszkiewicz, A; Andrieu, B; Anticic, T; Antoniou, N; Argyriades, J; Asryan, A G; Baatar, B; Blondel, A; Blumer, J; Boldizsar, L; Bravar, A; Brzychczyk, J; Bubak, A; Bunyatov, S A; Choi, K U; Christakoglou, P; Chung, P; Cleymans, J; Derkach, D A; Diakonos, F; Dominik, W; Dumarchez, J; Engel, R; Ereditato, A; Feofilov, G A; Fodor, Z; Ferrero, A; Gazdzicki, M; Golubeva, M; Grebieszkow, K; Grzeszczuk, A; Guber, F; Hasegawa, T; Haungs, A; Igolkin, S; Ivanov, A S; Ivashkin, A; Kadija, K; Katrynska, N; Kielczewska, D; Kikola, D; Kisiel, J; Kobayashi, T; Kolesnikov, V I; Kolev, D; Kolevatov, R S; Kondratiev, V P; Kowalski, S; Kurepin, A; Lacey, R; Laszlo, A; Lyubushkin, V V; Majka, Z; I Malakhov, A; Marchionni, A; Marcinek, A; Maris, I; Matveev, V; Melkumov, G L; Meregaglia, A; Messina, M; Mijakowski, P; Mitrovski, M; Montaruli, T; Mrówczynski, St; Murphy, S; Nakadaira, T; Naumenko, P A; Nikolic, V; Nishikawa, K; Palczewski, T; Pálla, G; Panagiotou, A D; Peryt, W; Planeta, R; Pluta, J; Popov, B A; Posiadala, M; Przewlocki, P; Rauch, W; Ravonel, M; Renfordt, R; Röhrich, D; Rondio, E; Rossi, B; Roth, M; Rubbia, A; Rybczynski, M; Sadovskii, A; Sakashita, K; Schuster, T; Sekiguchi, T; Seyboth, P; Shibata, M; Sissakian, A N; Skrzypczak, E; Slodkowski, M; Sorin, A S; Staszel, P; Stefanek, G; Stepaniak, J; Strabel, C; Ströbele, H; Susa, T; Szentpétery, I; Szuba, M; Tada, M; Taranenko, A; Tsenov, R; Ulrich, R; Unger, M; Vassiliou, M; Vechernin, V V; Vesztergombi, G; Wlodarczyk, Z; Wojtaszek, A; Zipper, W; CERN. Geneva. SPS and PS Experiments Committee; SPSC

    2009-01-01

    This document presents the revised data taking schedule of NA61 with ion beams. The revision takes into account limitations due to the new LHC schedule as well as final results concerning the physics performance with secondary ion beams. It is proposed to take data with primary Ar and Xe beams in 2012 and 2014, respectively, and to test and use for physics a secondary B beam from primary Pb beam fragmentation in 2010, 2011 and 2013.

  18. Revision of migrated pelvic acetabular components in THA with or without vascular involvement

    Directory of Open Access Journals (Sweden)

    Ștefan Cristea

    2016-05-01

    Full Text Available Purpose. The literature describes a high rate of mortality in cases of intrapelvic acetabular component migration, which is a rare but serious complication. Our aim is to establish and propose a treatment protocol according to our results and experience. Material and Methods. We performed eight (8 total hip revisions with acetabular cup migration between 2006 and 2012. A vascular graft was needed in four (4 of these cases. Two (2 cases were revisions after a spacer for infected arthroplasties. The protocol included the following: X-Ray examination (frontal and lateral views, CT angiography, a biological evaluation, a suitable pre-operative plan, at least six (6 units of blood stock, an experienced anesthesiologist, an experienced surgical team that included a vascular surgeon and a versatile arsenal of revision prostheses, bone grafts and vascular grafts. The anterolateral approach was generally used for hip revisions and the retroperitoneal approach in the dorsal decubitus position was used when vascular risk was involved. Results: The acetabular defect was reconstructed using bone grafts and tantalum revision cups in 4 cases, Burch-Schneider cages in 2 cases, a Kerboull ring in 1 case and a cementless oblong cup (Cotyle Espace in 1 case. In 4 cases, an iliac vessel graft procedure was conducted by the vascular surgeon. All patients survived the revision procedures and returned regularly for subsequent check-ups, during which they did not show any septic complications. Conclusions: Intrapelvic acetabular cup migration is a rare but serious complication that can occur after total hip arthroplasty in either septic or aseptic cases. An experienced, multidisciplinary team of surgeons should be involved in planning and conducting such complicated revisions.

  19. Introductory Business Textbook Revision Cycles: Are They Getting Shorter?

    Science.gov (United States)

    Zinser, Brian; Brunswick, Gary

    2010-01-01

    The rate of textbook revision cycles is examined in light of the recent trend towards more rapid revisions (and adoptions of textbooks). The authors conduct background research to better understand the context for textbook revision cycles and the environmental forces that have been influencing what appears to be more rapid textbook revisions. A…

  20. Nevada Test Site Radiological Control Manual. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2010-02-09

    This document supersedes DOE/NV/25946--801, “Nevada Test Site Radiological Control Manual,” Revision 0 issued in October 2009. Brief Description of Revision: A minor revision to correct oversights made during revision to incorporate the 10 CFR 835 Update; and for use as a reference document for Tenant Organization Radiological Protection Programs.

  1. Revision of the DELFIC Particle Activity Module

    Energy Technology Data Exchange (ETDEWEB)

    Hooper, David A [ORNL; Jodoin, Vincent J [ORNL

    2010-09-01

    The Defense Land Fallout Interpretive Code (DELFIC) was originally released in 1968 as a tool for modeling fallout patterns and for predicting exposure rates. Despite the continual advancement of knowledge of fission yields, decay behavior of fission products, and biological dosimetry, the decay data and logic of DELFIC have remained mostly unchanged since inception. Additionally, previous code revisions caused a loss of conservation of radioactive nuclides. In this report, a new revision of the decay database and the Particle Activity Module is introduced and explained. The database upgrades discussed are replacement of the fission yields with ENDF/B-VII data as formatted in the Oak Ridge Isotope Generation (ORIGEN) code, revised decay constants, revised exposure rate multipliers, revised decay modes and branching ratios, and revised boiling point data. Included decay logic upgrades represent a correction of a flaw in the treatment of the fission yields, extension of the logic to include more complex decay modes, conservation of nuclides (including stable nuclides) at all times, and conversion of key variables to double precision for nuclide conservation. Finally, recommended future work is discussed with an emphasis on completion of the overall radiation physics upgrade, particularly for dosimetry, induced activity, decay of the actinides, and fractionation.

  2. Revision surgery for failed thermal capsulorrhaphy.

    Science.gov (United States)

    Park, Hyung Bin; Yokota, Atsushi; Gill, Harpreet S; El Rassi, George; McFarland, Edward G

    2005-09-01

    With the failure of thermal capsulorrhaphy for shoulder instability, there have been concerns with capsular thinning and capsular necrosis affecting revision surgery. To report the findings at revision surgery for failed thermal capsulorrhaphy and to evaluate the technical effects on subsequent revision capsular plication. Case series; Level of evidence, 4. Fourteen patients underwent arthroscopic evaluation and open reconstruction for a failed thermal capsulorrhaphy. The cause of the failure, the quality of the capsule, and the ability to suture the capsule were recorded. The patients were evaluated at follow-up for failure, which was defined as recurrent subluxations or dislocations. The origin of the instability was traumatic (n = 6) or atraumatic (n = 8). At revision surgery in the traumatic group, 4 patients sustained failure of the Bankart repair with capsular laxity, and the others experienced capsular laxity alone. In the atraumatic group, all patients experienced capsular laxity as the cause of failure. Of the 14 patients, the capsule quality was judged to be thin in 5 patients and ablated in 1 patient. A glenoid-based capsular shift could be accomplished in all 14 patients. At follow-up (mean, 35.4 months; range, 22 to 48 months), 1 patient underwent revision surgery and 1 patient had a subluxation, resulting in a failure rate of 14%. Recurrent capsular laxity after failed thermal capsular shrinkage is common and frequently associated with capsular thinning. In most instances, the capsule quality does not appear to technically affect the revision procedure.

  3. Patients Unicondylar Knee Replacement vs. Total Knee Replacement

    OpenAIRE

    Hedra Eskander

    2017-01-01

    The aim of this review article is to analyse the clinical effectiveness of total knee replacement (TKR) compared to unicondylar knee replacement (UKR) on patients. In terms of survival rates, revision rates and postoperative complications. The keywords used were: knee arthroplasty. Nearly three thousand articles were found on 25 August 2016. Of those, only twenty-five were selected and reviewed because they were strictly focused on the topic of this article. Compared with those who have TKR, ...

  4. Use of antibiotic-loaded cement in total knee arthroplasty.

    OpenAIRE

    Hinarejos Gómez, Pedro Angel; Guirro Castellnou, Pau; Puig Verdié, Luís; Torres Claramunt, Raúl; Leal Blanquet, Joan; Sánchez Soler, JF.; Monllau García, Juan Carlos

    2015-01-01

    Bone cement has the capacity to release antibiotic molecules if any antibiotic is included in it, and these elution properties are improved as cement porosity is increased. In vitro studies have shown high local antibiotic concentration for many hours or few days after its use. Antibiotic loaded bone cement (ALBC) is helpful when treating an infection in total knee arthroplasty (TKA) revision surgery. The purpose of this paper was to review the evidence for the routine use of ALBC in TKA in t...

  5. 75 FR 40925 - National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule

    Science.gov (United States)

    2010-07-14

    ... Technology and Cost US United States UV Ultraviolet Radiation WRF Water Research Foundation Table of Contents..., in soil, and on vegetation. Coliform bacteria may be transported to surface water by run-off or to... of this preamble for detailed discussions of the routine monitoring and repeat sampling requirements...

  6. The Use of Epoetin-α in Revision Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Lawrence A. Delasotta

    2012-01-01

    Full Text Available Introduction. To evaluate the efficacy of epoetin-α prior to revision total knee arthroplasty, we hypothesized that epoetin-α will reduce blood transfusion. Methods. Eighty-one patients were compared in this retrospective review; twenty-eight patients received our dosing regimen. All patients were mildly anemic. Epoetin-α to control (1 : 2 patient matching occurred so that one of two attending surgeons, gender, BMI, complexity of surgery, ASA score, and age were similar between groups. The clinical triggers for blood transfusion during or after the procedure were determined based on peri- and postoperative hemoglobin levels, ASA score, and/or clinical symptoms consistent with anemia. Blood salvage was not used. Results. Blood transfusion and length of stay were lower in the study group. None of the patients who received epoetin-α underwent transfusion. Hemoglobin increased from 11.97 to 13.8, preoperatively. Hemoglobin at day of surgery and time of discharge were higher. Gender, BMI, ASA score, total and hidden blood losses, calculated blood loss, preop PLT, PT, PTT, and INR were similar between groups. One Epogen patient had an uncomplicated DVT (3.6%. Conclusions. Epoetin-α may have a role in the mildly anemic revision knee patient. It may also decrease patient length of stay allowing for earlier readiness to resume normal activities and/or meet short-term milestones. A randomized study to evaluate the direct and indirect costs of such a treatment methodology in the mildly anemic revision patient may be warranted.

  7. Total 2003 Results

    International Nuclear Information System (INIS)

    2003-01-01

    This document presents the 2003 results of Total Group: consolidated account, special items, number of shares, market environment, 4. quarter 2003 results, full year 2003 results, upstream (key figures, proved reserves), downstream key figures, chemicals key figures, parent company accounts and proposed dividends, 2004 sensitivities, summary and outlook, operating information by segment for the 4. quarter and full year 2003: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refinery throughput by region, refined product sales by region, chemicals), impact of allocating contribution of Cepsa to net operating income by business segment: equity in income (loss) and affiliates and other items, Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  8. TOTAL PERFORMANCE SCORECARD

    Directory of Open Access Journals (Sweden)

    Anca ȘERBAN

    2013-06-01

    Full Text Available The purpose of this paper is to present the evolution of the Balanced Scorecard from a measurement instrument to a strategic performance management tool and to highlight the advantages of implementing the Total Performance Scorecard, especially for Human Resource Management. The study has been accomplished using the methodology of bibliographic study and various secondary sources. Implementing the classical Balanced Scorecard indicated over the years, repeatedly failure. It can be indicated that the crucial level is determined by the learning and growth perspective. It has been developed from a human perspective, which focused on staff satisfaction, innovation perspective with focus on future developments. Integrating the Total Performance Scorecard in an overall framework assures the company’s success, by keeping track of the individual goals, the company’s objectives and strategic directions. Like this, individual identity can be linked to corporate brand, individual aspirations to business goals and individual learning objectives to needed organizational capabilities.

  9. Totally parallel multilevel algorithms

    Science.gov (United States)

    Frederickson, Paul O.

    1988-01-01

    Four totally parallel algorithms for the solution of a sparse linear system have common characteristics which become quite apparent when they are implemented on a highly parallel hypercube such as the CM2. These four algorithms are Parallel Superconvergent Multigrid (PSMG) of Frederickson and McBryan, Robust Multigrid (RMG) of Hackbusch, the FFT based Spectral Algorithm, and Parallel Cyclic Reduction. In fact, all four can be formulated as particular cases of the same totally parallel multilevel algorithm, which are referred to as TPMA. In certain cases the spectral radius of TPMA is zero, and it is recognized to be a direct algorithm. In many other cases the spectral radius, although not zero, is small enough that a single iteration per timestep keeps the local error within the required tolerance.

  10. 75 FR 49538 - Modine Manufacturing Company; Pemberville, OH; Notice of Revised Determination on Reconsideration

    Science.gov (United States)

    2010-08-13

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,291] Modine Manufacturing..., 2010 a petitioner requested administrative reconsideration of the Department's negative determination... of this revised certification, and all workers in the group threatened with total or partial...

  11. State of affairs regarding Flora Malesiana: progress in revision work and publication schedule

    NARCIS (Netherlands)

    Roos, M.C.

    1993-01-01

    The last two years I have made an inventory of the Flora Malesiana network and the revision work remaining. In total the network comprises c. 130 contributors working on 90 of the remaining 135 families (see Appendix). From an estimate by specialists on species numbers of vascular plants in Malesia

  12. Cross-Talk in Comp Theory: A Reader. Second Edition, Revised and Updated.

    Science.gov (United States)

    Villanueva, Victor, Ed.

    This revised and updated resource contains a total of 43 essays that serve to initiate graduate students and more experienced teachers into the theories that inform composition studies. Under Section One--The Givens in Our Conversations: The Writing Process--are these essays: "Teach Writing as a Process Not Product" (Donald M. Murray);…

  13. Revision of the subfamily Euphorinae (excluding the tribe Meteorini Cresson) (Hymenoptera: Braconidae) from China

    NARCIS (Netherlands)

    Chen, X.; Achterberg, van C.

    1997-01-01

    The subfamily Euphorinae (excluding the tribe Meteorini Cresson) (Hymenoptera: Braconidae) from China is revised. In total 150 species, belonging to 24 genera, are treated and keyed. One genus (Heia gen. nov.; type species: Heia robustipes spec. nov.) and 69 species are described as new to science.

  14. Total space in resolution

    Czech Academy of Sciences Publication Activity Database

    Bonacina, I.; Galesi, N.; Thapen, Neil

    2016-01-01

    Roč. 45, č. 5 (2016), s. 1894-1909 ISSN 0097-5397 R&D Projects: GA ČR GBP202/12/G061 EU Projects: European Commission(XE) 339691 - FEALORA Institutional support: RVO:67985840 Keywords : total space * resolution random CNFs * proof complexity Subject RIV: BA - General Mathematics Impact factor: 1.433, year: 2016 http://epubs.siam.org/doi/10.1137/15M1023269

  15. MFTF TOTAL benchmark

    International Nuclear Information System (INIS)

    Choy, J.H.

    1979-06-01

    A benchmark of the TOTAL data base management system as applied to the Mirror Fusion Test Facility (MFTF) data base was implemented and run in February and March of 1979. The benchmark was run on an Interdata 8/32 and involved the following tasks: (1) data base design, (2) data base generation, (3) data base load, and (4) develop and implement programs to simulate MFTF usage of the data base

  16. Total - annual report 2005

    International Nuclear Information System (INIS)

    2006-01-01

    This annual report presents the activities and results of TOTAL S.A., french society on oil and gas. It deals with statistics, the managers, key information on financial data and risk factors, information on the Company, unresolved Staff Comments, employees, major Shareholders, consolidated statements, markets, security, financial risks, defaults dividend arrearages and delinquencies, controls and procedures, code of ethics and financial statements. (A.L.B.)

  17. Total Absorption Spectroscopy

    International Nuclear Information System (INIS)

    Rubio, B.; Gelletly, W.

    2007-01-01

    The problem of determining the distribution of beta decay strength (B(GT)) as a function of excitation energy in the daughter nucleus is discussed. Total Absorption Spectroscopy is shown to provide a way of determining the B(GT) precisely. A brief history of such measurements and a discussion of the advantages and disadvantages of this technique, is followed by examples of two recent studies using the technique. (authors)

  18. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  19. Antibiotic impregnated total femur spacers: a technical tip

    Directory of Open Access Journals (Sweden)

    Colin D. Canham, MD

    2018-03-01

    Full Text Available Simultaneous prosthetic joint infection of ipsilateral hip and knee arthroplasties is often accompanied by significant bone loss and presents a challenging reconstructive problem. Two-stage reconstruction is favored and requires the placement of a total femur spacer, which is not a commercially available device. We describe a surgical technique, reporting on 2 cases in which a customized total femur antibiotic impregnated spacer was created by combining an articulating knee spacer and an articulating hip spacer with a reinforced cement dowel construct connecting the 2 spacers. Custom total femoral spacers are useful in the management of infected femoral megaprostheses and cases with ipsilateral injected hip and knee arthroplasties and severe femoral bone loss. Keywords: total femur spacer, revision arthroplasty, total hip arthroplasty, total knee arthroplasty, prosthetic joint infection

  20. Transuranic waste baseline inventory report. Revision No. 3

    International Nuclear Information System (INIS)

    1996-06-01

    The Transuranic Waste Baseline Inventory Report (TWBIR) establishes a methodology for grouping wastes of similar physical and chemical properties from across the U.S. Department of Energy (DOE) transuranic (TRU) waste system into a series of open-quotes waste profilesclose quotes that can be used as the basis for waste form discussions with regulatory agencies. The purpose of Revisions 0 and 1 of this report was to provide data to be included in the Sandia National Laboratories/New Mexico (SNL/NM) performance assessment (PA) processes for the Waste Isolation Pilot Plant (WIPP). Revision 2 of the document expanded the original purpose and was also intended to support the WIPP Land Withdrawal Act (LWA) requirement for providing the total DOE TRU waste inventory. The document included a chapter and an appendix that discussed the total DOE TRU waste inventory, including nondefense, commercial, polychlorinated biphenyls (PCB)-contaminated, and buried (predominately pre-1970) TRU wastes that are not planned to be disposed of at WIPP

  1. Revision of the International Pharmaceutical Federation's Basel Statements on the future of hospital pharmacy: From Basel to Bangkok.

    Science.gov (United States)

    Vermeulen, Lee C; Moles, Rebekah J; Collins, Jack C; Gray, Andy; Sheikh, Abdul Latif; Surugue, Jacqueline; Moss, Robert J; Ivey, Marianne F; Stevenson, James G; Takeda, Yasuo; Ranjit, Eurek; Chaar, Betty; Penm, Jonathan

    2016-07-15

    The processes used to revise the 2008 Basel Statements on the future of hospital pharmacy are summarized, and the revised statements are presented. The process for revising the Basel Statements followed an approach similar to that used during their initial development. The Hospital Pharmacy Section (HPS) of the International Pharmaceutical Federation (FIP) revised the 2008 FIP Basel Statements in four phases, including a survey of hospital pharmacists worldwide, an internal review, online forums, and a face-to-face "World Café" workshop in Bangkok, Thailand. The global survey on the initial Basel Statements included input from 334 respondents from 62 countries. The majority of respondents agreed that most of the initial Basel Statements were acceptable as written and did not require revision. In total, 11 statements were judged by more than 10% of respondents as needing revision or deletion. The FIP HPS executive committee used the survey results to develop 69 initial revised draft statements. After an online discussion with the international hospital pharmacy community, including individuals from 28 countries representing all six World Health Organization regions, a final set of draft statements was prepared for the live discussion involving participants from 20 countries. The final 65 revised Basel Statements were voted on and accepted. Systematic revision of the FIP Basel Statements resulted in an updated reflection of aspirational goals for the future of hospital pharmacy practice. While this revision reflects the development of new goals for hospital pharmacy practice, the core principles of the Basel Statements remain an essential foundation for the discipline. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  2. Increased Resistance of Skin Flora to Antimicrobial Prophylaxis in Patients Undergoing Hip Revision Arthroplasty.

    Science.gov (United States)

    Mühlhofer, Heinrich M L; Deiss, Lukas; Mayer-Kuckuk, Philipp; Pohlig, Florian; Harrasser, Norbert; Lenze, Ulrich; Gollwitzer, Hans; Suren, Christian; Prodinger, Peter; VON Eisenhart-Rothe, Rüdiger; Schauwecker, Johannes

    2017-01-01

    Prosthetic joint infection (PJI) remains a major complication after total joint replacement and is the primary indication for revision arthroplasty. Specifically, coagulase-negative Staphylococci (CNS) can cause low-grade infections. Despite the use of cephalosporin-based antimicrobial prophylaxis (AMP) and antiseptic treatment at the surgical site, evidence suggests that a significant number of cases of dermal CNS results in low-grade PJI. Thus, this study examined the bacterial colonization and resistance patterns at the surgical site. We hypothesized that the bacteria developed resistance to antibiotics that are frequently used in primary and revision total hip arthroplasty (THA) procedures. Ninety patients, including 63 primary and 27 revision THA patients, were enrolled in this study. For each patient, a single swab of the skin at the surgical site was subjected to clinical microbiology to assess bacterial colonization. Furthermore, resistance to a sentinel panel of antibiotics (benzylpenicillin, erythromycin, tetracycline, oxacillin, fusidic acid, clindamycin, gentamicin, levofloxacin/moxifloxacin, rifampicin, linezolid and vancomycin) was tested. In 96.7% of the patients, at least one bacterial strain was identified at the surgical site, with CNS strains comprising 93.1% of the total. The sentinel panel showed that 30.7% of the CNS strains exhibited maximal resistance to oxacillin, a commonly used cephalosporin. Additionally, oxacillin resistance increased 1.9-fold (p=0.042) between primary and revision THA. Notably, 8.1% of the CNS stains found on patients undergoing primary THA were resistant to gentamicin, an aminoglycoside, and this rate increased 4.7-fold (p=0.001) for patients undergoing revision THA. CNS strains have significant resistance to standard AMP, particularly in individuals undergoing revision THA. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  3. Loose glenoid components in revision shoulder arthroplasty: is there an association with positive cultures?

    Science.gov (United States)

    Lucas, Robert M; Hsu, Jason E; Whitney, Ian J; Wasserburger, Jory; Matsen, Frederick A

    2016-08-01

    Glenoid loosening is one of the most common causes of total shoulder failure. High rates of positive cultures of Propionibacterium and coagulase-negative staphylococcus have been found among shoulders having surgical revision for glenoid loosening. This study reviewed the culture results in a series of surgical revisions for failed total shoulder arthroplasty to determine the relationship between glenoid loosening and positive cultures. The medical records of 221 patients without obvious evidence of infection who underwent revision total shoulder arthroplasty were reviewed to examine the association between the security of fixation of the glenoid component and the results of cultures obtained at revision surgery. Of the revised shoulders, 53% had positive cultures; 153 of the shoulders (69%) had a loose glenoid component, whereas 68 (31%) had secure glenoid component fixation. Of the 153 loose glenoid components, 82 (54%) had at least 1 positive culture and 44 (29%) had 2 or more positive cultures of the same microorganism. Similarly, of the 68 secure glenoid components, 35 (51%) had at least 1 positive culture (P = .77) and 14 (21%) had 2 or more positive cultures of the same microorganism (P = .25). Explanted glenoid components that were loose had a higher rate of culture positivity (56% [24/43]) in comparison to explanted glenoid components that were well fixed (13% [1/8]) (P = .05). Propionibacterium and coagulase-negative staphylococcus are commonly recovered in revision shoulder arthroplasty, whether or not the glenoid components are loose. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  4. Total quality is people

    International Nuclear Information System (INIS)

    Vogel, C.E.

    1991-01-01

    Confronted by changing market conditions and increased global competition, in 1983 the Commercial Nuclear Fuel Division (CNFD) of Westinghouse Electric embarked on an ambitious plan to make total quality the centerpiece of its long-term business strategy. Five years later, the division's efforts in making continuous quality improvement a way of life among its more than 2,000 employees gained national recognition when it was named a charter recipient of the Malcolm Baldridge National Quality Award. What CNFD achieved during the 1980s was a cultural transformation, characterized by an empowered work force committed to a common vision. The company's quality program development strategy is described

  5. Total quality accounting

    Directory of Open Access Journals (Sweden)

    Andrijašević Maja

    2008-01-01

    Full Text Available The focus of competitive "battle" shifted from the price towards non-price instruments, above all, towards quality that became the key variable for profitability increase and achievement of better comparative position of a company. Under such conditions, management of a company, which, according to the established and certified system of total quality, strives towards achieving of a better market position, faces the problem of quality cost measurement and determination. Management, above all, cost accounting can help in solving of this problem, but the question is how much of its potential is being used for that purpose.

  6. Total_Aktion

    DEFF Research Database (Denmark)

    Søndergaard, Morten

    2008-01-01

    digitale medier er registreringen og muligheden for at opbevare og håndtere digital data uden begrænsninger. Oplevelse, registrering og bevaring knyttes sammen i en ny museal virkelighed, hvor samlingens særlige dokumentariske karakter og fokus, som er unikt for Museet for Samtidskunst, er i centrum...... at mikse deres personlige drinks. TOTAL_AKTION viser Hørbar#3, som er en videreudvikling af den første version. METASYN af Carl Emil Carlsen: Metadata er centralt for Carl Emil Carlsens projekt, der betragter museets samling som et ”univers” af værker (analoge og digitale), beskrivelser og relationer. I...

  7. Total Logistic Plant Solutions

    Directory of Open Access Journals (Sweden)

    Dusan Dorcak

    2016-02-01

    Full Text Available The Total Logistics Plant Solutions, plant logistics system - TLPS, based on the philosophy of advanced control processes enables complex coordination of business processes and flows and the management and scheduling of production in the appropriate production plans and planning periods. Main attributes of TLPS is to create a comprehensive, multi-level, enterprise logistics information system, with a certain degree of intelligence, which accepts the latest science and research results in the field of production technology and logistics. Logistic model of company understands as a system of mutually transforming flows of materials, energy, information, finance, which is realized by chain activities and operations

  8. Total Factbook 2003

    International Nuclear Information System (INIS)

    2003-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2003. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  9. Total 2004 fact book

    International Nuclear Information System (INIS)

    2004-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2004. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  10. TOTAL annual report 2003

    International Nuclear Information System (INIS)

    2004-01-01

    This 2003 annual report of the Group Total provides economical results and information of the society on the following topics: keys data, the corporate governance (Directors charter, board of directors, audit committee, nomination and remuneration committee, internal control procedures, compensation of directors and executive officers), the corporate social responsibility (environmental stewardship, the future of energy management, the safety enhancement, the human resources, ethics and local development), the investor relations, the management report, the upstream exploration and production, the downstream refining, marketing, trading and shipping, the chemicals and financial and legal information. (A.L.B.)

  11. Silent cries, dancing tears: the metapsychology of art revisited/revised.

    Science.gov (United States)

    Aragno, Anna

    2011-04-01

    Against the backdrop of a broad survey of the literature on applied psychoanalysis, a number of concepts underpinning the metapsychology of art are revisited and revised: sublimation; interrelationships between primary and secondary processes; symbolization; "fantasy"; and "cathexis." Concepts embedded in dichotomous or drive/energic contexts are examined and reformulated in terms of a continuum of semiotic processes. Freudian dream structure is viewed as a biological/natural template for nonrepressive artistic forms of sublimation. The synthesis presented proposes a model of continuous rather than discontinuous processes, in a nonenergic, biosemiotic metatheoretical framework.

  12. Comparison of dual mobility cup and other surgical construts used for three hundred and sixty two first time hip revisions due to recurrent dislocations: five year results from Lithuanian arthroplasty register.

    Science.gov (United States)

    Stucinskas, Justinas; Kalvaitis, Tomas; Smailys, Alfredas; Robertsson, Otto; Tarasevicius, Sarunas

    2018-05-01

    Recently, there has been increasing interest in the use of dual mobility systems in the treatment of hip instability. The aim of this study was to investigate the re-revision rate of dual mobility cup compared to different surgical concepts when used for first-time hip revisions due to recurrent dislocations. The data were derived from the Lithuanian Arthroplasty Register. For survival analysis, we used both re-revision for all reasons and for dislocations as an end-point. Cox proportional hazards models were used to analyze the influence of various covariates (age, gender, and implant concept). A total of 1388 revisions were recorded from 2011 to 2015, of which 362 were performed due to recurrent dislocation. Of the revisions, 247 were performed using dual mobility cups, while 115 were performed using a variety of other surgical constructs including constrained acetabular cups, conventional cups, femoral head exchanges, stem exchanges or anti-luxation rings. There were 27 re-revisions of which 15 were for additional dislocations. There were only 2% re-revisions due to dislocation with dual mobility vs 9% when using other surgical constructs. Cox regression adjusting for age and gender showed that in the short-term, dual mobility cup had a lower risk of revision due to dislocation as well as for all reasons compared to the other surgical constructs. In revision of total hip arthroplasties for dislocation, significantly lower short-term re-revision rate was observed for patients revised with dual mobility cup.

  13. Synthesis of allocolchicinoids: a 50 year journey

    International Nuclear Information System (INIS)

    Sitnikov, N S; Fedorov, A Yu

    2013-01-01

    Published data on the stereo- and enantioselective synthesis of allocolchicinoids, which are of interest as antitumour agents, are summarized. The stereochemistry of these compounds is described. Two key approaches to their preparation are considered, namely, the synthesis from natural colchicine and total synthesis from commercially available reagents. Various total syntheses of N-acetylcolchicinol are performed using biaryl oxidative and reductive coupling, cyclopropanation–ring expansion and Nicholas reaction. The synthetic routes to allocolchicine are based on Diels–Alder cycloaddition, combination of metathesis and Diels–Alder reaction and direct catalytic CH-arylation. Analogues of the colchicine site ligands incorporating heteroaromatic rings are briefly considered; their structural features and methods of synthesis are discussed. The bibliography includes 144 references.

  14. The revised Generalized Expectancy for Success Scale: a validity and reliability study.

    Science.gov (United States)

    Hale, W D; Fiedler, L R; Cochran, C D

    1992-07-01

    The Generalized Expectancy for Success Scale (GESS; Fibel & Hale, 1978) was revised and assessed for reliability and validity. The revised version was administered to 199 college students along with other conceptually related measures, including the Rosenberg Self-Esteem Scale, the Life Orientation Test, and Rotter's Internal-External Locus of Control Scale. One subsample of students also completed the Eysenck Personality Inventory, while another subsample performed a criterion-related task that involved risk taking. Item analysis yielded 25 items with correlations of .45 or higher with the total score. Results indicated high internal consistency and test-retest reliability.

  15. TOTAL user manual

    Science.gov (United States)

    Johnson, Sally C.; Boerschlein, David P.

    1994-01-01

    Semi-Markov models can be used to analyze the reliability of virtually any fault-tolerant system. However, the process of delineating all of the states and transitions in the model of a complex system can be devastatingly tedious and error-prone. Even with tools such as the Abstract Semi-Markov Specification Interface to the SURE Tool (ASSIST), the user must describe a system by specifying the rules governing the behavior of the system in order to generate the model. With the Table Oriented Translator to the ASSIST Language (TOTAL), the user can specify the components of a typical system and their attributes in the form of a table. The conditions that lead to system failure are also listed in a tabular form. The user can also abstractly specify dependencies with causes and effects. The level of information required is appropriate for system designers with little or no background in the details of reliability calculations. A menu-driven interface guides the user through the system description process, and the program updates the tables as new information is entered. The TOTAL program automatically generates an ASSIST input description to match the system description.

  16. Postoperative pain outcomes after transvaginal mesh revision.

    Science.gov (United States)

    Danford, Jill M; Osborn, David J; Reynolds, W Stuart; Biller, Daniel H; Dmochowski, Roger R

    2015-01-01

    Although the current literature discusses mesh complications including pain, as well as suggesting different techniques for removing mesh, there is little literature regarding pain outcomes after surgical removal or revision. The purpose of this study is to determine if surgical removal or revision of vaginal mesh improves patient's subjective complaints of pelvic pain associated with original placement of mesh. After obtaining approval from the Vanderbilt University Medical Center Institutional Review Board, a retrospective review of female patients with pain secondary to previous mesh placement who underwent excision or revision of vaginal mesh from January 2000 to August 2012 was performed. Patient age, relevant medical history including menopause status, previous hysterectomy, smoking status, and presence of diabetes, fibromyalgia, interstitial cystitis, and chronic pelvic pain, was obtained. Patients' postoperative pain complaints were assessed. Of the 481 patients who underwent surgery for mesh revision, removal or urethrolysis, 233 patients met our inclusion criteria. One hundred and sixty-nine patients (73 %) reported that their pain improved, 19 (8 %) reported that their pain worsened, and 45 (19 %) reported that their pain remained unchanged after surgery. Prior history of chronic pelvic pain was associated with increased risk of failure of the procedure to relieve pain (OR 0.28, 95 % CI 0.12-0.64, p = 0.003). Excision or revision of vaginal mesh appears to be effective in improving patients' pain symptoms most of the time. Patients with a history of chronic pelvic pain are at an increased risk of no improvement or of worsening pain.

  17. The Epidemiology of Revision Anterior Cruciate Ligament Reconstruction in Adults from Ontario, Canada

    Science.gov (United States)

    Leroux, Timothy; Wasserstein, David; Dwyer, Tim; Ogilvie-Harris, Darrell; Marks, Paul H.; Bach, Bernard R.; Townley, John; Mahomed, Nizar; Chahal, Jaskarndip

    2015-01-01

    Objectives: The morbidity associated with revision anterior cruciate ligament reconstruction (ACLR) is largely unknown. The objective of this study was to determine the rate of and risk factors for re-revision, re-operation, and re-admission following revision ACLR in the general population. Methods: All patients who underwent first revision ACLR in Ontario, Canada from January 2004 to December 2010 were identified and followed to December 2012. Exclusions included age (<16 years), previous osteotomy, or multi-ligament knee reconstruction. The main outcome was re-revision ACLR. Secondary outcomes included re-operation [irrigation and debridement (I&D), meniscectomy, manipulation under anesthesia (MUA), contralateral ACLR, and total knee arthroplasty (TKA)], and re-admission within 90 days of surgery. Survival to re-revision was determined using the Kaplan-Meier (KM) approach. A Cox proportional hazards model or logistic regression were used to determine the influence of patient factors (age, sex, neighborhood income quintile, and comorbidity), surgical factors (graft choice, concurrent meniscal procedure, and fixation method), and provider factors (surgeon volume, surgeon years in practice, and hospital status) on outcomes. A post-hoc analysis was performed to determine the influence of the aforementioned factors on overall post-operative infection risk, including both operative and non-operative cases. Results: Overall, 827 patients were included (median age: 30 years; 58.8% males). Single stage revisions comprised 92.9% of cases, and a meniscal procedure (repair or debridement) was performed in 45.3% of cases. The re-revision rate at a mean follow-up of 4.8±2.2 years was 4.4%, and the five-year survival rate was 95.4% (Figure 1). The rates of I&D, meniscectomy, contralateral ACLR, and re-admission were 0.8%, 3.1%, 3.4%, and 4.1%, respectively. MUA and TKA were rare. Young age significantly increased contralateral ACLR risk (risk decreased by 5.1% with each year

  18. Total process surveillance: (TOPS)

    International Nuclear Information System (INIS)

    Millar, J.H.P.

    1992-01-01

    A Total Process Surveillance system is under development which can provide, in real-time, additional process information from a limited number of raw measurement signals. This is achieved by using a robust model based observer to generate estimates of the process' internal states. The observer utilises the analytical reduncancy among a diverse range of transducers and can thus accommodate off-normal conditions which lead to transducer loss or damage. The modular hierarchical structure of the system enables the maximum amount of information to be assimilated from the available instrument signals no matter how diverse. This structure also constitutes a data reduction path thus reducing operator cognitive overload from a large number of varying, and possibly contradictory, raw plant signals. (orig.)

  19. Total and EDF invest

    International Nuclear Information System (INIS)

    Signoret, St.

    2008-01-01

    So as to prepare the future of their industrial sector,the Total company plans to invest (14 billion Euros in 2008) to increase its production capacities and strengthen in of other activities as the liquefied natural gas and the renewable energies; EDF plans to inject 35 billion Euros over three years to multiply the new projects of power plants (wind turbines, coal in Germany, gas in Great Britain and nuclear power in Flamanville). EDF wants to exploit its knowledge of leader to run more than ten E.P.R.(European pressurized water reactor) in the world before 2020, projects are in examination with China, Great Britain, South Africa and United States. (N.C.)

  20. Total quality at source

    International Nuclear Information System (INIS)

    Chiandone, A.C.

    1990-01-01

    The Total Quality at Source philosophy is based on optimizing the effectiveness of people in achieving ZERO-DEFECT results. In this paper a philosophy of what, I have come to perceive, it takes to get people to perform to the very best of their abilities and thereby achieve the best results they can, is presented. In the examples I shall describe I have played an instrumental role since it has become my belief that any job can always be done better provided that the people doing it can themselves become convinced that they can do better. Clearly there are many ideas on how to do this. The philosophy that I am presenting in this paper is based on my own experience, where I have both participated and observed it being applied; its effectiveness may be judged by the results. (author)

  1. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Selective application of revised source terms to operating nuclear power plants

    International Nuclear Information System (INIS)

    Moon, Joo Hyun; Song, Jae Hyuk; Lee, Young Wook; Ko, Hyun Seok; Kang, Chang Sun

    2001-01-01

    More than 30 years later since 1962 when TID-14844 was promulgated, there has been big change of the US NRC's regulatory position in using accident source terms for radiological assessment following a design basis accident (DBA). To replace the instantaneous source terms of TID-14844, the time-dependent source terms of NUREG-1465 was published in 1995. In the meantime, the radiological acceptance criteria for reactor site evaluation in 10 CFR Part 100 were also revised. In particular, the concept of total effective dose equivalent has been incorporated in accordance with the radiation protection standards set forth in revised 10 CFR Part 20. Subsequently, the publication of Regulatory Guide 1.183 and the revision of Standard Review Plan 15.0.1 followed in 2000, which provided the licensee of operating nuclear power reactor with the acceptable guidance of applying the revised source term. The guidance allowed the holder of an operating license issued prior to January 10, 1997 to voluntarily revise the accident source terms used in the radiological consequence analyses of DBA. Regarding to its type of application, there suggested full and selective applications, Whether it is full or selective, based upon the scope and nature of associated plant modifications being proposed, the actual application of the revised source terms to an operating plant is expected to give a large impact on its facility design basis. Considering scope and cost of the analyses required for licensing, selective application is seemed to be more appealing to an licensee of the operating plant rather than full application. In this paper, hence, the selective application methodology is reviewed and is actally applied to the assessment of offsite radiological consequence following a LOCA at Ulchin Unit 3 and 4, in order to identify and analyze the potential impacts due to application of revised source terms and to assess the considerations taken in each application prior to its actual

  3. Lactobacillus as a rare cause of an infected total knee replacement: a case report

    Science.gov (United States)

    2009-01-01

    Introduction We report a rare case of an infected revision total knee replacement as a result of a Lactobacillus species infection. Lactobacillus infections have been associated with prolonged broad-spectrum antibiotic use. This can have implications in revision surgery, especially when patients have been on previous long-term suppressive antibiotic therapy. Case presentation An 81-year-old British man with a previous history of complex revision knee arthroplasty for infection presented with a hot, swollen knee joint. He had previously been on long-term suppressive antibiotic therapy. Aspiration of the knee joint yielded a culture of Lactobacillus species. Conclusion In patients undergoing revision joint arthroplasty, especially for previous infection, the presence of common and uncommon bacterial species must be excluded and eradicated before further surgical intervention. PMID:19830207

  4. Hanford Site technical baseline database. Revision 1

    International Nuclear Information System (INIS)

    Porter, P.E.

    1995-01-01

    This report lists the Hanford specific files (Table 1) that make up the Hanford Site Technical Baseline Database. Table 2 includes the delta files that delineate the differences between this revision and revision 0 of the Hanford Site Technical Baseline Database. This information is being managed and maintained on the Hanford RDD-100 System, which uses the capabilities of RDD-100, a systems engineering software system of Ascent Logic Corporation (ALC). This revision of the Hanford Site Technical Baseline Database uses RDD-100 version 3.0.2.2 (see Table 3). Directories reflect those controlled by the Hanford RDD-100 System Administrator. Table 4 provides information regarding the platform. A cassette tape containing the Hanford Site Technical Baseline Database is available

  5. Synthesis of Polycyclic Natural Products

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Tuan Hoang [Iowa State Univ., Ames, IA (United States)

    2003-01-01

    With the continuous advancements in molecular biology and modern medicine, organic synthesis has become vital to the support and extension of those discoveries. The isolations of new natural products allow for the understanding of their biological activities and therapeutic value. Organic synthesis is employed to aid in the determination of the relationship between structure and function of these natural products. The development of synthetic methodologies in the course of total syntheses is imperative for the expansion of this highly interdisciplinary field of science. In addition to the practical applications of total syntheses, the structural complexity of natural products represents a worthwhile challenge in itself. The pursuit of concise and efficient syntheses of complex molecules is both gratifying and enjoyable.

  6. Towards the total synthesis of stawamycin. Synthesis of C11-C21 fragment.

    OpenAIRE

    Dias, LC; Jardim, LSA; Ferreira, AA; Soarez, HU

    2001-01-01

    The carbocyclic (C11-C21) fragment of Stawamycin has been prepared by a sequence involving 11 steps (10% overall yield) from methyl (R)-(-)-3-hydroxy-2-methylpropionate. Key steps are Pd-catalyzed Stille coupling reaction between a vinyl iodide and a vinylstannane followed by an intramolecular Diels-Alder cycloaddition reaction to afford the desired adduct as the major isomer together with three other possible adducts in 78% overall yield. A porção carbocíclica (C11-C21) da Estavamicina fo...

  7. Towards the total synthesis of Stawamycin. Synthesis of C11-C21 fragment

    Directory of Open Access Journals (Sweden)

    Dias Luiz C.

    2001-01-01

    Full Text Available The carbocyclic (C11-C21 fragment of Stawamycin has been prepared by a sequence involving 11 steps (10% overall yield from methyl (R-(--3-hydroxy-2-methylpropionate. Key steps are Pd-catalyzed Stille coupling reaction between a vinyl iodide and a vinylstannane followed by an intramolecular Diels-Alder cycloaddition reaction to afford the desired adduct as the major isomer together with three other possible adducts in 78% overall yield.

  8. Recurrent instability after revision anterior shoulder stabilization surgery.

    Science.gov (United States)

    Friedman, Lisa Genevra Mandeville; Griesser, Michael J; Miniaci, Anthony A; Jones, Morgan H

    2014-03-01

    The purpose of this study was to perform a systematic review of the literature to compare outcomes of revision anterior stabilization surgeries based on technique. This study also sought to compare the impact of bone defects on outcomes. A systematic review of the electronic databases PubMed, Cochrane Central Register of Controlled Trials, and Scopus was performed in July 2012 and March 2013. Of 345 articles identified in the search, 17 studies with Level I to IV Evidence satisfied the inclusion criteria and were analyzed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Recurrent instability was defined as redislocation, resubluxation, or a positive apprehensive test after revision surgery. Procedures were categorized as arthroscopic Bankart repair, open Bankart repair, Bristow-Latarjet procedure, and other open procedures. In total, 388 shoulders were studied. Male patients comprised 74.1% of patients, 66.7% of cases involved the dominant shoulder, the mean age was 28.2 years, and the mean follow-up period was 44.2 months. The surgical procedures classified as "other open procedures" had the highest rate of recurrent instability (42.7%), followed by arthroscopic Bankart repair (14.7%), the Bristow-Latarjet procedure (14.3%), and open Bankart repair (5.5%). Inconsistent reporting of bone defects precluded drawing significant conclusions. A number of different procedures are used to address recurrent instability after a primary operation for anterior shoulder instability has failed. There is significant variability in the rate of recurrent instability after revision anterior shoulder stabilization surgery. Level IV, systematic review of Level I to IV studies. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  9. Increasing risk of prosthetic joint infection after total hip arthroplasty

    DEFF Research Database (Denmark)

    Dale, Håvard; Fenstad, Anne M; Hallan, Geir

    2012-01-01

    Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods The...... explain this increase. We believe that there has been an actual increase in the incidence of prosthetic joint infections after THA.......Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods...... The study was based on the Nordic Arthroplasty Register Association (NARA) dataset. 432,168 primary THAs from 1995 to 2009 were included (Denmark: 83,853, Finland 78,106, Norway 88,455, and Sweden 181,754). Adjusted survival analyses were performed using Cox regression models with revision due to infection...

  10. Resource description and access 2013 revision

    CERN Document Server

    2013-01-01

    This e-book contains the 2013 Revision of RDA: Resource Description and Access, and includes the July 2013 Update. This e-book offers links within the RDA text and the capability of running rudimentary searches of RDA, but please note that this e-book does not have the full range of content or functionality provided by the subscription product RDA Toolkit. Included: A full accumulation of RDA- the revision contains a full set of all current RDA instructions. It replaces the previous version of RDA Print as opposed to being an update packet to that version. RDA has gone through many changes sin

  11. Revised Huang-Yang multipolar pseudopotential

    International Nuclear Information System (INIS)

    Derevianko, Andrei

    2005-01-01

    A number of authors have recently pointed out inconsistencies of results obtained with the Huang-Yang multipolar pseudopotential for low-energy scattering [K. Huang and K. C. Yang, Phys. Rev. 105, 767 (1957); later revised by Huang, Statistical Mechanics (Wiley, New York, 1963)]. The conceptual validity of their original derivation has been questioned. Here I show that these inconsistencies are rather due to an algebraic mistake made by Huang and Yang. With the corrected error, I present the revised version of the multipolar pseudopotential

  12. Plan-Belief Revision in Jason

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Villadsen, Jørgen

    2015-01-01

    When information is shared between agents of unknown reliability, it is possible that their belief bases become inconsistent. In such cases, the belief base must be revised to restore consistency, so that the agent is able to reason. In some cases the inconsistent information may be due to use of...... of incorrect plans. We extend work by Alechina et al. to revise belief bases in which plans can be dynamically added and removed. We present an implementation of the algorithm in the AgentSpeak implementation Jason....

  13. Fast-track revision knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B

    2011-01-01

    Abstract Background and purpose Fast-track surgery has reduced the length of hospital stay (LOS), morbidity, and convalescence in primary hip and knee arthroplasty (TKA). We assessed whether patients undergoing revision TKA for non-septic indications might also benefit from fast-track surgery....... Methods 29 patients were operated with 30 revision arthroplasties. Median age was 67 (34-84) years. All patients followed a standardized fast-track set-up designed for primary TKA. We determined the outcome regarding LOS, morbidity, mortality, and satisfaction. Results Median LOS was 2 (1-4) days...

  14. PWR secondary water chemistry guidelines: Revision 3

    International Nuclear Information System (INIS)

    Lurie, S.; Bucci, G.; Johnson, L.; King, M.; Lamanna, L.; Morgan, E.; Bates, J.; Burns, R.; Eaker, R.; Ward, G.; Linnenbom, V.; Millet, P.; Paine, J.P.; Wood, C.J.; Gatten, T.; Meatheany, D.; Seager, J.; Thompson, R.; Brobst, G.; Connor, W.; Lewis, G.; Shirmer, R.; Gillen, J.; Kerns, M.; Jones, V.; Lappegaard, S.; Sawochka, S.; Smith, F.; Spires, D.; Pagan, S.; Gardner, J.; Polidoroff, T.; Lambert, S.; Dahl, B.; Hundley, F.; Miller, B.; Andersson, P.; Briden, D.; Fellers, B.; Harvey, S.; Polchow, J.; Rootham, M.; Fredrichs, T.; Flint, W.

    1993-05-01

    An effective, state-of-the art secondary water chemistry control program is essential to maximize the availability and operating life of major PWR components. Furthermore, the costs related to maintaining secondary water chemistry will likely be less than the repair or replacement of steam generators or large turbine rotors, with resulting outages taken into account. The revised PWR secondary water chemistry guidelines in this report represent the latest field and laboratory data on steam generator corrosion phenomena. This document supersedes Interim PWR Secondary Water Chemistry Recommendations for IGA/SCC Control (EPRI report TR-101230) as well as PWR Secondary Water Chemistry Guidelines--Revision 2 (NP-6239)

  15. RSA migration of total knee replacements.

    Science.gov (United States)

    Pijls, Bart G; Plevier, José W M; Nelissen, Rob G H H

    2018-06-01

    Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies. Methods - Migration pattern was defined as at least 2 postoperative RSA follow-up moments. Maximal total point motion (MTPM) at 6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years, and 10 years were considered. Results - The literature search yielded 1,167 hits of which 53 studies were included, comprising 111 study groups and 2,470 knees. The majority of the early migration occurred in the first 6 months postoperatively followed by a period of stability, i.e., no or very little migration. Cemented and uncemented tibial components had different migration patterns. For cemented tibial components there was no difference in migration between all-poly and metal-backed components, between mobile bearing and fixed bearing, between cruciate retaining and posterior stabilized. Furthermore, no difference existed between TKR measured with model-based RSA or marker-based RSA methods. For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR. Interpretation - The results from this meta-analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses, thus providing further proof for the association between early migration and late revision for loosening. The pooled migration patterns can be used both as benchmarks and for defining migration thresholds for future evaluation of new TKR.

  16. Immunological Responses to Total Hip Arthroplasty.

    Science.gov (United States)

    Man, Kenny; Jiang, Lin-Hua; Foster, Richard; Yang, Xuebin B

    2017-08-01

    The use of total hip arthroplasties (THA) has been continuously rising to meet the demands of the increasingly ageing population. To date, this procedure has been highly successful in relieving pain and restoring the functionality of patients' joints, and has significantly improved their quality of life. However, these implants are expected to eventually fail after 15-25 years in situ due to slow progressive inflammatory responses at the bone-implant interface. Such inflammatory responses are primarily mediated by immune cells such as macrophages, triggered by implant wear particles. As a result, aseptic loosening is the main cause for revision surgery over the mid and long-term and is responsible for more than 70% of hip revisions. In some patients with a metal-on-metal (MoM) implant, metallic implant wear particles can give rise to metal sensitivity. Therefore, engineering biomaterials, which are immunologically inert or support the healing process, require an in-depth understanding of the host inflammatory and wound-healing response to implanted materials. This review discusses the immunological response initiated by biomaterials extensively used in THA, ultra-high-molecular-weight polyethylene (UHMWPE), cobalt chromium (CoCr), and alumina ceramics. The biological responses of these biomaterials in bulk and particulate forms are also discussed. In conclusion, the immunological responses to bulk and particulate biomaterials vary greatly depending on the implant material types, the size of particulate and its volume, and where the response to bulk forms of differing biomaterials are relatively acute and similar, while wear particles can initiate a variety of responses such as osteolysis, metal sensitivity, and so on.

  17. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    An outline review notes recent work on total lymphoid irradiation (TLI) as a means of preparing patients for grafts and particularly for bone-marrow transplantation. T.L.I. has proved immunosuppressive in rats, mice, dogs, monkeys and baboons; when given before bone-marrow transplantation, engraftment took place without, or with delayed rejection or graft-versus-host disease. Work with mice has indicated that the thymus needs to be included within the irradiation field, since screening of the thymus reduced skin-graft survival from 50 to 18 days, though irradiation of the thymus alone has proved ineffective. A more lasting tolerance has been observed when T.L.I. is followed by an injection of donor bone marrow. 50% of mice treated in this way accepted allogenic skin grafts for more than 100 days, the animals proving to be stable chimeras with 50% of their peripheral blood lymphocytes being of donor origin. Experiments of a similar nature with dogs and baboons were not so successful. (U.K.)

  18. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  19. Periprosthetic femoral fracture within two years after total hip replacement:

    DEFF Research Database (Denmark)

    Thien, T. M.; Chatziagorou, G.; Garellick, G.

    2014-01-01

    BACKGROUND: We used the Nordic Arthroplasty Register Association database to evaluate whether age, sex, preoperative diagnosis, fixation, and implant design influence the risk of revision arthroplasty due to periprosthetic fracture within two years from operation of a primary total hip replacement....... METHODS: Included in the study were 325,730 cemented femoral stems and 111,899 uncemented femoral stems inserted from 1995 to 2009. Seven frequently used stems (two cemented stems [Exeter and Lubinus SP II] and five uncemented stems [Bi-Metric, Corail, CLS Spotorno, ABG I, and ABG II]) were specifically...... studied. RESULTS: The incidence of revision at two years was low: 0.47% for uncemented stems and 0.07% for cemented stems. Uncemented stems were much more likely to have this complication (relative risk, 8.72 [95% confidence interval, 7.37 to 10.32]; p

  20. Protein synthesis in the growing rat lung

    International Nuclear Information System (INIS)

    Kelley, J.; Chrin, L.

    1986-01-01

    Developmental control of protein synthesis in the postnatal growth of the lung has not been systematically studied. In male Fischer 344 rats, lung growth continues linearly as a function of body weight (from 75 to 450 g body weight). To study total protein synthesis in lungs of growing rats, we used the technique of constant intravenous infusion of tritiated leucine, an essential amino acid. Lungs of sacrificed animals were used to determine the leucine incorporation rate into newly synthesized protein. The specific radioactivity of the leucine associated with tRNA extracted from the same lungs served as an absolute index of the precursor leucine pool used for lung protein synthesis. On the basis of these measurements, we were able to calculate the fractional synthesis rate (the proportion of total protein destroyed and replaced each day) of pulmonary proteins for each rat. Under the conditions of isotope infusion, leucyl-tRNA very rapidly equilibrates with free leucine of the plasma and of the extracellular space of the lung. Infusions lasting 30 minutes or less yielded linear rates of protein synthesis without evidence of contamination of lung proteins by newly labeled intravascular albumin. The fractional synthesis rate is considerably higher in juvenile animals (55% per day) than in adult rats (20% per day). After approximately 12 weeks of age, the fractional synthesis rate remains extremely constant in spite of continued slow growth of the lung. It is apparent from these data that in both young and adult rats the bulk of total protein synthesis is devoted to rapidly turning over proteins and that less than 4 percent of newly made protein is committed to tissue growth