Importance of arterial blood supply to the femur and tibia for transplantation of vascularized femoral diaphyses and knee joints

The role of the periosteal and intraosseous blood supply to the femur and the proximal tibia was investigated to improve the operating technique for transplantation of allogenic vascularized femoral diaphyses and knee joints in humans. Altogether 48 limbs were injected with gelatin, red latex milk, or Revertex and macroscopically prepared; 41 limbs were studied for the variation and division of the truncus profundo-circumflexus. In 200 femurs and 200 tibias the location of the nutrient foramen was determined. The arteries supplying the periosteum of the distal femur and the proximal tibia have defined nutritive areas. The following technique should be followed: If the femoral artery alone is prepared as the vascular pedicle, the optimal section for resection of the femur in knee joint transplantations is 6 to 12 cm above the level of the femur condyles and 5 to 7 cm below the tibial plateau. For the transplantation of femoral diaphyses, the deep femoral artery can be used if the lateral femoral circumflex artery is protected. The Proximal line of resection is defined between the greater and lesser trochanter. For shorter grafts one must consider the number and location of nutrient foramens. For longer grafts the distal branches of the femoral artery must be respected as the intraosseous blood supply reaches distally down to the level of about 8 cm above the femoral condyles. In all these operations of the variation of the truncus profundo-circumflexus and the trifurcation of the popliteal artery must be considered.     

Interlocking compression nailing: a report on 402 applications

Nailing techniques have changed tremendously in recent years. One significant development has been the interlocking compression nail (ICN) which provides active interfragmentary compression. Apart from its beneficial effect in the treatment of acute fractures, allowing early weight-bearing and mobilization of the patient the ICN is useful in many types of revision operations: resection and stabilization of pseudarthroses without cancellous bone grafts, corrective operations of malalignments through a minimally invasive technique, as well as the readaptation of the resection sites in arthrodeses. Between April 1993 and September 1996, 402 consecutive applications of an ICN were followed prospectively to evaluate the practibility and reliability of the system. A special focus was placed on the active compression device. Along with 153 acute fractures, 112 non-unions and 41 cases of malalignment were treated; 96 arthrodeses were performed. Even for difficult courses of healing only a low complication rate was observed, and a remarkably high percentage was managed successfully.     

Postoperative irradiation treatment and bioresorbable implants in orthopaedic surgery: an experimental in vitro study

The influence of applied radiation on the degradation of a polyglycolide (PGA) test specimen was studied in vitro. There was no significant difference in the time-dependent degradation behaviour between the irradiated test specimen and controls. Mandatory irradiation of an operation site following surgery therefore does not contradict the employment of bioresorbable implants in orthopaedic surgery.     

The early history of boundary violations in psychoanalysis

The notion of professional boundaries is a relatively recent addition to psychoanalytic practice. Freud and his early disciples indulged in a good deal of trial and error as they evolved psychoanalytic technique. The study of these early boundary violations illuminates the study of the evolution of the concepts of transference and countertransference. The recent publication of the correspondence between Freud and Jung, between Freud and Ferenczi, and between Freud and Jones has provided us with extraordinary insights into the boundary transgressions that occurred in the early days of psychoanalysis. The boundary violations of the analytic pioneers have contributed to the legacy inherited by future generations of analysts. Institutional resistance to addressing these difficulties in contemporary psychoanalytic practice may relate in part to the ambiguities surrounding boundaries in the training analysis itself.     

Pharmacokinetic basis of nifedipine-digoxin interaction: a commentary

Elevation of plasma digoxin levels following concurrent administration of nifedipine have previously been reported. The mechanism for this interaction has not been fully explained, but may include a reduction in volume of distribution of digoxin and/or reduction in the renal or non-renal clearance of digoxin by nifedipine. The end result is probably an elevation of plasma concentrations of free (pharmacologically active) digoxin, which may lead to manifestation of side effects of digoxin. This communication highlights the possible pharmacokinetic basis of the reported digoxin-nifedipine interaction.     

Clinical heterogeneity of non-Hodgkin's lymphoma of the eye with extraocular manifestations

Primary, ocular Non-Hodgkin lymphoma is a multicentric disease. The prognosis is mostly determined by involvement of the central nervous system and/or visceral organs. Since ocular symptoms often precede accompanying manifestations and since the eye is easily accessible to diagnostic measures, the ophthalmological diagnosis is essential for early detection and treatment of this complex disease, which has a poor prognosis. To illustrate the extraordinary heterogeneity of the clinical symptoms, four case reports have been selected which demonstrate various ocular symptoms and extraocular localizations. The ophthalmological variability ranges from typical uveitis to retinitis and vasculitis with varying symptoms during the progression of the disease. Completely different extraocular features were induced by long-standing, local infiltrates within basal ganglia, a diffuse infiltration of the brain leading to an acute increase in intracranial pressure, a peripheral tumour within the spinal channel or massive infiltrates of liver, lung and kidneys. Lack of pathognomonic features, high clinical variability and the limited value of imaging techniques and histopathological measures often lead to serious delays in diagnosis.     

Dynamic damping property of magnetorheological elastomer

Magnetorheological elastomer(MRE) is a new kind of smart materials,its dynamic mechanic performances can be controlled by an applied magnetic field.MRE is usually used as a stiffness-changeable spring in the semi-active vibration absorber.In order to get perfect vibration control effect,low dynamic damping of MRE is need.But the dynamic damping of MRE was not studied deeply in the past.The dynamic damping of MRE was studied and analyzed.The influences of different test conditions including test strain amplitude,test frequency and test magnetic field were deeply studied.MRE sample and pure silicone rubber sample were prepared and tested under different conditions.The test results show that the main source of dynamic damping is the friction between iron particles and rubber matrix.And the friction is mainly influenced by the strain amplitude and test magnetic field.     

微沟道内两相流速比对液滴形成的影响

研究了流聚焦微沟道内不同两相流速比对单分散性液滴形成的影响.不相混容的两相系统能够快速、周期性地形成液滴,液滴的形态和生成率随着油相速度的变化而改变.研究采用模拟软件COMSOL Mutiphysics,模拟了不同流速下液滴的形成过程,并通过实验进行了验证,从流体动力学的角度解释了其物理机制.所得结论为在流聚焦微沟道内获得分散性良好且大小可控的液滴提供了理论和数据支持.