Arthroscopic reduction and fixation of bony avulsion of the posterior cruciate ligament of the tibia

Bony avulsion fractures of the posterior cruciate ligament of the tibia have commonly been treated by open reduction and internal fixation using the posterior approach. However, this approach, using the prone position, makes it difficult to investigate and treat other combined injuries of the knee joint. We report a case of posterior cruciate ligament avulsion of the tibia that was arthroscopically reduced and firmly fixed with two cannulated screws. The posterior sag was absent after the operation and the result was excellent. By arthroscopy, we got rigid fixation of the avulsed fragment for early rehabilitation, and detection of a concomitant injury was also possible.     

Microfabricated Lamb wave device based on PZT sol-gel thin film formechanical transport of solid particles and liquids

The fabrication using silicon micromachining and characterization of an acoustic Lamb wave actuator is presented. The intended use of the device is for mass transport and sensor applications. The device consists of dual interdigitated transducers patterned on a thin-film composite membrane of silicon nitride, platinum, and a sol-gel-derived piezoelectric ceramic (PZT) thin film. The acoustic properties of the device are presented along with preliminary applications to mechanical transport and liquid delivery systems. Improved acoustic signals and improved mass transport are achieved with PZT over present Lamb wave devices utilizing ZnO or AlN as the piezoelectric transducer     

Fibrinolytic variables and cardiovascular prognosis in patients with stable angina pectoris treated with verapamil or metoprolol. Results from the Angina Prognosis study in Stockholm

BACKGROUND: Disturbed fibrinolytic function may influence the progression of coronary atherosclerosis and contribute to thrombotic cardiovascular (CV) events. METHODS AND RESULTS: In the Angina Prognosis Study in Stockholm (APSIS), patients with stable angina pectoris were studied prospectively during double-blind treatment with metoprolol or verapamil. Various measures of fibrinolytic function were studied in 631 (of 809) patients. During a median follow-up time of 3.2 years (2132 patient-years), 32 patients suffered a CV death, 21 had a nonfatal myocardial infarction (MI), and 77 underwent revascularization. Plasma levels of tissue plasminogen activator (TPA) activity and antigen (ag), plasminogen activator inhibitor (PAI-1) activity at test, and TPA responses to exercise were determined at baseline and after 1 month's treatment and were related to subsequent fatal and nonfatal CV events. Univariate Cox regression analysis revealed that elevated levels of TPA-ag at rest (P < .05), high PAI-1 activity (P < .05), and low TPA-ag responses to exercise (P < .05) were associated with increased risk of subsequent CV death. After adjustment for baseline risk factors, TPA-ag independently predicted CV death or MI. In addition, PAI-1 activity independently predicted CV death or MI in male patients. Verapamil treatment was associated with a 10% decrease of TPA-ag levels and metoprolol treatment with a 2% increase (P < .001 for treatment difference). CONCLUSIONS: Plasma TPA-ag levels at rest, and among male patients PAI-1 activity as well, independently predict subsequent CV death or MI in patients with stable angina pectoris.     

Reaction steady states and stationary states in modelling semi-batch enzyme hydrolysis

Dimensionless material balance equations describing an uninhibited enzyme hydrolysis process in a semi-batch reactor (i.e. fed-batch reactor) are formulated; numerical solution of these equations provided concentration profiles of the enzyme-substrate complex by using published kinetic parameters. The unrestricted values obtained are compared with estimates based separately on the reaction steady state and stationary state assumptions. Results are discussed in terms of the enzyme/substrate inventory used and it is found that the reaction steady state is a satisfactory approximation only when this ratio is sufficiently small. The stationary state may be a better approximation at other values, particularly when enzyme is added to substrate or when an empty tank is being filled. Reaction yields from semi-batch and batch operations are compared. Processing takes longer in the semi-batch operations and complete conversions are only practical in this mode when enzyme is added to substrate.     

Impossible and ambiguous shading patterns

A smooth object depicted in a monochrome image will often exhibit brightness variation, or shading. A problem much studied in computer vision has been that of how object shape may be recovered from image shading. When the imaging conditions are such that an overhead point-source illuminates a smooth Lambertian surface, the problem may be formulated as that of finding a solution to an eikonal equation. This article will focus on the existence and uniqueness of such solutions, reporting recent results obtained. With regard to existence, shading patterns are exhibited for which there is no corresponding object shape. Specifically, a necessary and sufficient condition is presented for a circularly symmetric eikonal equation to admit exclusively unbounded solutions; additionally, a sufficient condition is given for an eikonal equation to have no solution whatsoever. In connection with uniqueness, we consider eikonal equations, defined over a disc, such that the Euclidean norm of the gradient of any solution is circularly symmetric, vanishes exactly at the disc center, and diverges to infinity as the circumference of the disc is approached. Contrary to earlier influential work, a class of such eikonal equations is shown to possess simultaneously circularly symmetric and noncircularly symmetric bounded smooth solutions.     

Validation of a specific selection criterion for dental periapical radiography

We report three children with hemidystonia in whom anti-cardiolipin (aCL) antibodies were demonstrated. Systemic lupus erythematosus was excluded on the basis of both clinical and serological criteria, and the diagnosis of primary antiphospholipid syndrome (PAPS) was made. In two cases, aCL antibodies could be causally related to a presumed immune-mediated thrombotic event involving the basal ganglia as shown by magnetic resonance imaging (MRI). In the remaining patient the finding of white matter alteration on NMR might be due to cross-reactivity of anti-phospholipid (aPL) antibodies with cerebral phospholipids, resulting in demyelination. We suggest that PAPS must always be considered when isolated or recurrent focal cerebral ischaemia, and particularly hemidystonia, occur in childhood.     

Is urine leukocyte esterase test a useful screening method to predict Chlamydia trachomatis infection in women?

We evaluated the use of the leukocyte esterase test (LET) on first-catch urine specimens from women as a screening test to predict infection with Chlamydia trachomatis. For diagnosis, we used Abbott's ligase chain reaction (LCR) on urine specimens and isolation by tissue culture (TC) on cervical brushes. Of 4,053 women attending sexually transmitted disease and family planning clinics, 4.3% (n = 174) were positive by TC and 5.9% (n = 239) were positive by LCR. When LET was compared to TC, the sensitivity, specificity, positive predictive value, and negative predictive value were 54.0, 67.0, 6.8, and 97.0%, respectively. The corresponding performance of LET versus LCR was 53.1, 67.3, 10.1, and 95.8%. Almost half of the laboratory-confirmed chlamydial infections were negative by LET. The low specificity probably reflects multiple causes of pyuria in women and results in a low positive predictive value. LET is neither sensitive nor specific as a predictor of chlamydial infection and cannot be recommended for use as a screening test for C. trachomatis with first-catch urine samples from females from low- or moderate-prevalence populations.