Upper extremity replantation: current concepts and patient selection

Dramatic advances in replantation and microsurgery have somewhat altered the criteria we use in selecting patients to be candidates for upper extremity replantation surgery. We suggest that contraindications for such replantation are: presence of associated life-threatening injuries; serious anesthetic risk; preexisting medical or psychiatric problems; previous injury or disease of the amputated part; warm ischemic time greater than 6-8 hours for extremities or greater than 10-12 hours for digits; and single-digit amputations (except thumb, for grasp). Replantation is feasible when: amputated part is properly preserved; injury type is sharp amputation, mild to moderate crush, or selected avulsion, and amputation is proximal to the DIP joint. Careful preservation of the amputated part, not in dry ice, is mandatory. On an individual basis, the decision to attempt replantation rests on the prediction that the patient may have better function with such surgery than with a prosthesis.     

Design approach to low-cost process control

The design of a control package for industrial use on small-scale processes is discussed. A modular system is described, made up of intelligent satellite and peripheral controllers plus various cards to provide communication with the industrial plant itself. The design is intended for operators who have little or no experience of computing. It is based on a language called paracode, an interpretive language structured to provide a number of control sequences which can run independently of each other or in parallel. Two applications of the design—a clean-in-place system and a beer-fermentation controller—are used as illustrations.     

Bilateral femoral neck fractures as a complication of myelography

This paper discusses two cases of bilateral subcapital fracture of the proximal femur as a complication of myelography with Conray 60. The literature is reviewed.     

Enhanced dynamic credential generation scheme for protection of user identity in mobile-cloud computing

To improve the resource limitation of mobile devices, mobile users may utilize cloud-computational and storage services. Although the utilization of the cloud services improves the processing and storage capacity of mobile devices, the migration of confidential information on untrusted cloud raises security and privacy issues. Considering the security of mobile-cloud-computing subscribers’ information, a mechanism to authenticate legitimate mobile users in the cloud environment is sought. Usually, the mobile users are authenticated in the cloud environment through digital credential methods, such as password. Once the users’ credential information theft occurs, the adversary can use the hacked information for impersonating the mobile user later on. The alarming situation is that the mobile user is unaware about adversary’s malicious activities. In this paper, a light-weight security scheme is proposed for mobile user in cloud environment to protect the mobile user’s identity with dynamic credentials. The proposed scheme offloads the frequently occurring dynamic credential generation operations on a trusted entity to keep minimum processing burden on the mobile device. To enhance the security and reliability of the scheme, the credential information is updated frequently on the basis of mobile-cloud packets exchange. Furthermore, the proposed scheme is compared with the existing scheme on the basis of performance metrics i.e. turnaround time and energy consumption. The experimental results for the proposed scheme showed significant improvement in turnaround time and energy consumption as compared to the existing scheme.     

Normal lung function in subjects heterozygous for surfactant protein-B deficiency

OBJECTIVE AND IMPORTANCE: We present a case report of a patient with a left frontal brain abscess. Cultures obtained from the abscess at the time of surgery were identified as dental flora known to establish a synergistic relationship in polymicrobial infections. This type of synergistic relationship makes the clearance of an infection more difficult for an intact immune system. A serum immunoglobulin (Ig) Type A deficiency was identified postoperatively. This immunodeficiency may have contributed to the development of the abscess. CLINICAL PRESENTATION: The patient presented with headaches and photophobia. Computed tomography of the head performed with intravenously administered contrast demonstrated a left frontal brain abscess. INTERVENTION: The patient was operated on through a left frontal approach, carefully avoiding the frontal sinus. The abscess was aspirated, and the patient was treated with intravenous antibiotics for several weeks. Postoperatively, the patient did well. There were no signs of enhancement on follow-up computed tomographic scans at 7 and 12 months postoperatively. CONCLUSION: Through a comprehensive immunological workup, an IgA deficiency was identified postoperatively. Although the deficiency of a single type of Ig may be asymptomatic, complications from recurrent or chronic bacterial infections may occur. The deficiency of IgA, combined with a synergistic polymicrobial infection, contributed to the development of an intracranial abscess. A patient presenting with a brain abscess without any predisposing medical history should be evaluated for an underlying immune deficiency.     

Characterization of stabilized porous magnetite core–shell nanogel composites based on crosslinked acrylamide/sodium acrylate copolymers

Stabilized and dispersed superparamagnetic porous nanogels based on sodium acrylate (AA‐Na) and acrylamide (AM) in a surfactant‐free aqueous system were synthesized via solution polymerization at room temperature. The formation of magnetite nanoparticles was confirmed and their properties characterized using Fourier transform infrared spectroscopy. Extensive characterization of the magnetic polymer particles using transmission electron microscopy (TEM), dynamic light scattering and zeta potential measurements revealed that Fe₃O₄ nanoparticles were incorporated into the shells of poly(AM/AA‐Na). The average particle size was 5–8 nm as determined from TEM. AM/AA‐Na nanoparticles with a diameter of about 11 nm were effectively assembled onto the negatively charged surface of the as‐synthesized Fe₃O₄ nanoparticles via electrostatic interaction. Crosslinked magnetite nanocomposites were prepared by in situ development of surface‐modified magnetite nanoparticles in an AM/AA‐Na hydrogel. Scanning electron microscopy was used to study the surface morphology of the prepared composites. The morphology, phase composition and crystallinity of the prepared nanocomposites were characterized. Atomic force microscopy and argon adsorption–desorption measurements of Fe₃O₄.AM/AA indicated that the architecture of the polymer network can be a hollow porous sphere or a solid phase, depending on the AA‐Na content. © 2013 Society of Chemical Industry