Noninvasive measurement of distal radius instability

Except for subjective clinical criteria, there is no formal definition of distal radius fracture instability in the literature. The purposes of this ex vivo biomechanical study were (1) to provide an objective mechanical definition of fracture instability and (2) to demonstrate a noninvasive method that allows for direct measurement of instability. The following 3 questions are addressed: (1) Can the stability of distal radius fractures be measured using computed tomography (CT)? (2) Are the stability measurements reproducible? (3) How does external fixation change stability? A CT technique is described that was used to measure displacement of fracture fragments and measure the compliance of ex vivo distal radius fractures before and after external fixation. Validation studies of the CT technique revealed a mean coefficient of variation of 0.38. There was a linear relationship between measured and known displacements for all 3 orthogonal planes (coefficient of determination 0.99; p < .01). There was significant fracture displacement with loads as small as 20 N. The slope of the load-displacement curve (structural compliance) provided a quantitative measure of fracture instability. Fracture compliance decreased up to 69% after application of an external fixator.     

Aortopulmonary fistula in an infected Dacron graft for coarctation of the aorta: an uncommon cause of hemoptysis

Hemoptysis secondary to an aortobronchial fistula is rare and uniformly fatal when left untreated. The authors describe a case of massive hemoptysis caused by an aortopulmonary fistula in an infected Dacron graft used successfully to repair a coarctation of the aorta.     

Langerhans cell density in normal human oral mucosa and skin: relationship to age, smoking and alcohol consumption

Hyperthyroidism is a common endocrinologic disorder affecting many organ systems. Musculoskeletal and neurological involvement present themselves as fatigue, muscle weakness and paralysis. Electromyography (EMG) is essential for differential diagnosis of muscle weakness. Well defined neuropathy and myopathy have been described in these patients. In the present study 17 hyperthyroid patients were evaluated with electrophysiological tests in addition to physical and neurological examinations and biochemical laboratory studies. Needle EMG, motor and sensory conduction velocities, median and tibial somatosensory evoked potentials (SEP) were studied. For assessment of the activity of disease clinical status, neurological symptom and disability scores and serum T3, T4 and TSH levels were examined. Statistical analysis of neuroelectrophysiological findings of the patient and the control groups yielded meaningful difference in the needle EMG, sensory conduction velocity and evoked potential findings. Abnormalities were observed in 80% of the proximal muscles besides polyphasic potentials that were seen in 20% of the extensor digitorum brevis muscle. Median, ulnar and sural nerve sensory action potential amplitudes were found to be lower than that of the control group. Sural sensory nerve conduction velocity of patients was decreased in 35.5%, prolongation of median SEP latencies and increase in the amplitudes were not however statistically significant. Prolongation of Tibial SEP N1, P2 latencies were seen in 47%, amplitudes of N1 were increased in 88.2%, P2 in 58.8%, N2 in 47%. The thyroid clinical status score was correlated with Tibial SEPs amplitude. These findings suggest the presence of an initial axonal type of mild polyneuropathy. As a conclusion electrophysiological studies can be useful in the diagnosis of asymptomatic polyneuropathy in hyperthyroid patients.     

Three-dimensional convection in an inclined layer heated from below

Longitudinal rolls aligned with the component of gravity parallel to the layer represent the preferred mode of convection at onset for a wide range of parameters of the inclined layer problem. As the Rayleigh number is increased beyond the critical value the longitudinal rolls tend to become unstable with respect to the wavy instability. The three-dimensional convection flows evolving from this instability are studied in this paper by numerical computations. The main effect of the wavy distortions of the longitudinal rolls is a decrease of the heat transport. The stability of the steady three-dimensional convection flow with respect to disturbances with the same periodicity interval in the plane of the layer is also investigated. Various instabilities are found in dependence on the Prandtl number P and the angle of inclination and their evolution is studied in a few cases.     

Nitrogen transformations during hydrolysis and nitrification of urea

Nitrogen transformations occurring in ten soils fertilized with urea were determined during incubation in the laboratory for four weeks. Urea was applied at one rate, but with different placement methods. Urea was applied in solution, as prills with a 1 cm grid spacing and as prills with no spacing. Unfertilized soils and soils amended with KNO₃ solution were included as controls.Nitrite accumulated in the majority of soils treated with urea, and the maximum nitrite concentration measured was directly related to initial soil pH. Cumulative gaseous N losses as percentages of applied N were: NH₃, 0-59.6; N₂, 0-4.9; N₂O, 0-9.9; KMnO₄-N, 0-1.3; CH₃ONO, 0-<0.1. No gaseous N evolution was detected in control treatments. Gaseous N losses were correlated with soil pH (NH₃) maximum NO ₂ ^- concentration (N₂, N₂O, KMnO₄-N) and organic C content (N₂, N₂O). Fertilizer placement effects were generally not significant and were small in comparison with differences between soils.

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Resumo Foram determinadas, durante incubação em laboratório por quatro semanas, as transformações do nitrogênio ocorridas em dez solos fertilizados com uréia. A uréia foi aplicada a um só nivel, mas com diferentes métodos de aplicação: em solução e em grânulos com 1 cm de espaçamento de grade e em grânulos sem espaçamento. Solos não fertilizados e solos corrigidos com solução de KNO₃ foram incluidos como controles.O nitrito acumulado na maioria dos solos tratados com uréia e a concentração máxima de nitrito medido foram diretamente relacionados ao pH inicial do solo. As perdas cumulativas de N gasoso tomadas em percentagens de N aplicado foram: NH₃, 0-59.6; N₂, 0-4.9; N₂O; 0-9.9; KMnO₄-N, 0-1.3; CH₃ONO, 0-<0.1. Não foi detectada liberação de N gasoso nos tratamentos de controle. As perdas de N gasoso foram relacionadas com o pH do solo (NH₃), concentração máxima de NO ₂ ^- (N₂, N₂O, KMnO₄-N) e teor de C orgânico (N₂, N₂O). Efeitos da aplicação de fertilizante não foram de um modo geral significativos e foram pequenos em comparação com as diferenças entre os solos.

     

Investigations on the adhesion and interfacial properties of polyurethane foam/thermoplastic materials

The adhesion and interfacial properties of polyurethane (PU) foams with thermoplastic (TP) materials were investigated using different techniques. The adhesion performance of PU foam with TP materials was evaluated using the peel test method, and the adhesion durability was checked after different climate treatments. X‐ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM), and contact angle measurements were used to study the surface and interface morphology of PU foam and TP material system. Three types of PU foam samples which differ in their composition and also five commercially available TP blends systems, based on poly(carbonate), poly(styrene‐co‐maleic anhydride), poly(acrylonitrile‐butadiene‐styrene), and silicone acrylate rubber have been used. The slow reacting foam shows the best adhesion properties with all the TP materials. The climate treatments strongly effected the PU foam adhesion durability with poly(carbonate) containing TP materials (70–80% loss in adhesion), but nearly no effect with poly(styrene‐co‐maleic anhydride). The samples with lowered adhesion could be separated by peeling without visible foam residues on the TP surface. AFM, XPS, and surface tension studies have shown that the surface properties of the TP material are still governed by the PU foam. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci 104: 479–488, 2007     

Description and evaluation of a new 3-D computerized treatment planning dose compensator system

Evaluation has been performed of compensators generated by means of a computerized three-dimensional treatment planning system that can utilize either digitized slice profiles or CT scans. Two methods of calculating compensator thickness are used: the modified Batho power law (dSAR) method for digitized profiles and the equivalent TAR (eqTAR) method for CT scans. This system not only compensates for patient surface contours but also compensates for internal inhomogeneities. In addition, any required wedging will be incorporated in the compensator generation. This system has been tested for a number of extreme cases with inhomogeneities and sloping contours. Good agreement was obtained between the measured and computer calculated dose profiles especially along the central axis of the beam. A "Profile Uniformity Index" was defined to quantify the goodness of dose compensation in three dimensions. Compensation using this system can achieve good dose uniformity within the target volume in all clinical cases and is definitely an improvement over systems based solely on tissue deficit.     

Islet amyloid polypeptide in patients with pancreatic cancer and diabetes

Population-based psychiatric admission rates vary across geographic areas, but reasons for this variation are unknown. Insofar as Community Mental Health Centers (CMHCs) provide outpatient services that may deter the need for hospitalization, the presence and structural characteristics of CMHCs may have an impact on a population's psychiatric admission rates. This study uses small area analysis to examine how general hospital psychiatric admission rates are associated with CMHC characteristics. Based on a survey of all CMHCs in Iowa and corresponding small area variation data, it was found that population admission rates were higher in areas closer to the CMHC and lower in outlying catchment areas, adjusting for age, sex, and urban/rural differences in populations. There was little evidence that differences in staffing and service variables influenced admission rates, although greater CMHC staff coverage by social workers and psychiatric residents was associated with lower admission rates. The results suggest that CMHCs do not lower an area's hospitalization rate, and in fact, the presence of CMHCs may promote a "supplier-induced demand" phenomenon of higher admissions.     

The effects of smoking schedules on cessation outcome: can we improve on common methods of gradual and abrupt nicotine withdrawal?

This study compared the efficacy of 2 traditional methods of smoking cessation, gradual reduction and "cold turkey," with a new approach involving variation in the intercigarette interval. One hundred twenty-eight participants quit smoking on a target date, after a 3-week period of (a) scheduled reduced smoking (progressive increase in the intercigarette interval), (b) nonscheduled reduced smoking (gradual reduction, no specific change in the intercigarette interval), (c) scheduled nonreduced smoking (fixed intercigarette interval, no reductions in frequency), or (c) nonscheduled nonreduced smoking (no change in intercigarette interval or smoking frequency). Participants also received cognitive-behavioral relapse prevention training. Abstinence at 1 year averaged 44%, 18%, 32%, and 22% for the 4 groups, respectively. Overall, the scheduled reduced group performed the best and the nonscheduled reduced group performed the worst. Both scheduled groups performed better than nonscheduled ones. Scheduled reduced smoking was associated with reduced tension, fatigue, urges to smoke, withdrawal symptoms, increased coping effort (ratio of coping behavior to urges), and self-efficacy, suggesting an improved adaptation to nonsmoking and reduced vulnerability to relapse.     

The Formation of Calcified Nanospherites during Micropetrosis Represents a Unique Mineralization Mechanism in Aged Human Bone

Osteocytes—the central regulators of bone remodeling—are enclosed in a network of microcavities (lacunae) and nanocanals (canaliculi) pervading the mineralized bone. In a hitherto obscure process related to aging and disease, local plugs in the lacuno‐canalicular network disrupt cellular communication and impede bone homeostasis. By utilizing a suite of high‐resolution imaging and physics‐based techniques, it is shown here that the local plugs develop by accumulation and fusion of calcified nanospherites in lacunae and canaliculi (micropetrosis). Two distinctive nanospherites phenotypes are found to originate from different osteocytic elements. A substantial deviation in the spherites' composition in comparison to mineralized bone further suggests a mineralization process unlike regular bone mineralization. Clearly, mineralization of osteocyte lacunae qualifies as a strong marker for degrading bone material quality in skeletal aging. The understanding of micropetrosis may guide future therapeutics toward preserving osteocyte viability to maintain mechanical competence and fracture resistance of bone in elderly individuals.