Top PDF What is the Optimal Treatment of Atrophic Scaphoid Non-Union?

What is the Optimal Treatment of Atrophic Scaphoid Non-Union?

What is the Optimal Treatment of Atrophic Scaphoid Non-Union?

Aim: To evaluate the eicacy of the treatment method of autogenous iliac wing or radius bone grat and ixation with screw applied to cases of scaph- oid non-union. Material and Method: A retrospective evaluation was made of 89 cases between 2000 and 2014. Postoperative measurements were taken of both wrists’ movement with a goniometer and muscle strength was assessed with a dynamometer. Fractures were evaluated radiologically ac- cording to the Herbert-Fisher System and the functional results according to the Herbert-Fisher Classiication System and the Mayo Clinic Modiied Wrist Scoring System. The data were input to the SPSS system and evaluated with the Shapiro-Wilk test. Results: Non-union were on the right side in 47 and the let side in 42 cases. The fracture was seen to be in the waist in 60 cases (67.5%), in the proximal third in 27 cases (30.3%) and in the distal third in two cases (2.2%). The mean follow-up period was 16.4 months (range, 5-72 months). Deinitive indings of union were observed in 71 cases. The mean time to union was 14.9 weeks (range, 8-40 weeks). Discussion: The grating procedure applied is an invasive technique but if it is considered that there are negative efects of open surgery on the feeding of the scaphoid bone, then in the treatment of scaphoid non-union which is atrophic non-union, ultimately autogenous bone grating and screw ixation is a safe and suc- cessful method and because of the pain created by an iliac wing grat, radius distal bone grat can be considered more appropriate.
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Local inhibition of angiogenesis results in an atrophic non-union in a rat osteotomy model

Local inhibition of angiogenesis results in an atrophic non-union in a rat osteotomy model

inhibitor of the vascular endothelial growth factor (VEGF)- receptor 2 tyrosine kinase. It inhibits VEGF-dependent endothelial cell proliferation in vitro and in vivo (Ye et al ., 2006) and was the fi rst VEGF-receptor 2 inhibitor to enter clinical development. Artesunate, a derivative of Artemisinin, has a long tradition in the treatment of fever and malaria (Klayman, 1985), but also possess antitumor activity and antiangiogenic potential (Efferth et al., 2003; Chen et al., 2004; Dell´Eva et al., 2004) by lowering VEGF and VEGF-receptor expression (Chen et al., 2004; Zhou et al., 2007). 3,5,4´-Trimethoxystilbene is a herbal antioxidant present in high concentrations in red wine (Frémont, 2000; Belleri et al., 2005). This factor acts through down regulation of VEGF-receptor 2 and cell- cycle modulation (Alex et al., 2010) causing microtubule disorganization in vitro as well as inhibition of blood vessel growth in ovo and in vivo (Belleri et al., 2005). A disturbed revascularisation after bone lesion has been so far created in different animal models by intensive mechanical interference, e.g. destruction of the periosteum, endosteum or the medullary canal or a combination of these techniques (Triffi t et al., 1993; Hietaniemi et al., 1995; Brownlow et al., 2002; Reed et al., 2003) or an induction of a unilateral total hind limb ischemia (Lu et al., 2007). One study applied systemically a synthetic Fumagillin analogue (TNP-470) in a rat femur fracture model, but they did not analyse the effect on revascularisation (Hausman et al., 2001). Until there is no causal clinical therapy for the treatment of non- unions available, reliable animal models, which mimic the clinical situation and investigate the role of blood supply after bone trauma, are essential. In this study we aimed fi rstly to select a substance which inhibits selectively endothelial proliferation without having an impact on bone forming cells. For this purpose in vitro experiments were performed to test the infl uences of Fumagillin, SU5416, Artesunate and 3,5,4´-Trimethoxystilbene on endothelial cells and osteoblast like cells and on the vascularisation in an in-ovo model. Further on, the selected substance was tested in vivo after tibia osteotomy. For this purpose we used an impaired healing model, which had already been established by our group (Kratzel et al., 2008) as control. Bone healing parameters were compared between the PDLLA control group (tibia osteotomy and stabilisation with inhibitor-free PDLLA coated wires) and the treatment group (tibia osteotomy and stabilisation with PDLLA/ inhibitor coated wires).
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MANAGEMENT OF INFECTED NON UNION TIBIAL FRACTURES WITH  ILIZAROV EXTERNAL FIXATION

MANAGEMENT OF INFECTED NON UNION TIBIAL FRACTURES WITH ILIZAROV EXTERNAL FIXATION

MATERIALS AND METHODS: 23 patients admitted and treated in Government General Hospital under the Department of Orthopaedics were included in the study. Inclusion criteria included infected on union tibia fractures in age group of 15 to 75 years between May 2010 to December2012. Exclusion criteria included patients under the age group of 15 years and above 75 years. The patient admitted with fracture of tibial shaft with infected non-union were thoroughly examined and questioned. Patients were shown the fixator and informed in detail as to what procedures we are going to perform on him and period of treatment was informed to all patients. Pre-operative X-rays, investigations, etc., were done and documented. Pre-operative planning according to the site of infected non-union and pre-planning the site of corticotomy if needed were done as per standard procedure. Patients were operated under regional anaesthesia. Postoperatively the pin tracts are sealed with Povidone -Iodine soaked gauze pieces. Patient is encouraged to ambulate himself from the first post-operative day with crutch walking and partial weight bearing. Sutures are removed on the 10 th post-operative day and corticotomy
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Rev. bras. ortop.  vol.52 número6

Rev. bras. ortop. vol.52 número6

There is a preference for the use of VBG in relation to NVBG, despite the fact that the surgical technique is more detailed and demands specific training, especially in cases where vas- cular microsurgery is required. The studies using the VBG technique observed a better reproduction of positive results when compared with conventional bone grafts. Thus, accord- ing to this literature review, there is no consensus as to whether the use of the VBG can be effective in all cases to consolidate the scaphoid with proximal pole necrosis.
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The Influence of Small Amounts of Aluminium on the Spheroidization of Cast Iron with Cerium Mischmetal

The Influence of Small Amounts of Aluminium on the Spheroidization of Cast Iron with Cerium Mischmetal

Molten charge cast iron, after being overheated up to 1400°C, was treated with aluminium introduced beneath the metal mirror. The melt was heated again up to 1360- 1380°C, then cerium mischmetal was added, and the roasted ferrosilicon was introduced five minutes later. The quantities of cerium mischmetal and ferrosilicon were equal to 0.11% and 1.29% of the achieved cast iron mass. Such quantities had been found optimal in the case of spheroidization process of low-aluminium cast iron containing about 3% Al [14]. Five minutes after the graphitizing modification with ferrosilicon, sand moulds were poured with molten metal directly from the crucible. The specimens were cast in the shape of truncated cones, their average diameter (measured halfway along their test parts) being equal to 20 mm.
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What is anthroponomy?

What is anthroponomy?

Kljuène reèi: antroponomija, antroponomijsko pitanje, moral, obrazovanje, Kant, Nièe, Sloterdajk.. „Èovek izmišlja bolji deo ivota, time što izmišlja sebe“.[r]

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What is ideology?

What is ideology?

Here I am going to use the United States as my running example, in part for reasons of familiarity, but also because its two-party system highlights some of the more fundamental dynamics involved in political contestation, as this seems to be the form that most politics spontaneously develop, when there is not a well developed system deliberately designed to channel party formation in a particu- lar direction (for an example of such spontaneous dualistic politics, see Barth, 1965). The US, like the UK, had its governmental system designed before the exis- tence of stable party organizations, while the parliamentary systems that support multi-party systems were designed after the development of mass suffrage and the existence of parties, and these were taken for granted by constitution writers. Now it is not necessarily the case that a two-party system leads to a division into “liberals” and “conservatives,” though I will argue below that there is actually good reason to expect the development of a “unidimensional” understanding of partisan differences. However, as this is the case in the United States, I use these terms to describe the consensual self-understanding of actors. Thus if ideology leads to political choice, it does through “liberalism” and “conservatism.” But the question is what these terms mean—what the “ideologies” are. The conven- tional approach assumed that these were, above all else, oppositions of packages of values.
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 What is in

What is in

A 49-year-old woman presented to the emergency department with severe abdominal pain after vigor- ous sexual intercourse. The patient had a history of hysterectomy (due to cervix carcinoma) 3 months before and due to postoperative haematic losses, the patient frequently used tampons. The patient claimed she had a tampon within the abdominal cavity after sexual intercourse. An initial gynaeco- logical examination showed no evidence of vagina vault damage and foreign body. Since abdominal pain persisted, the patient was submitted to an abdominal–pelvic CT scan that revealed a pneumo- peritoneum and the presence of a foreign body in the abdominal cavity (arrow in figure 1A). The patient underwent minilaparotomy, and a tampon was found among intestine ansae (figure 1B); this occurred due to the total rupture of the vaginal vault, which was repaired through colporrhaphy. There were no significant events in the post- operative period. This case serves to highlight the
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A Method To Find The Area Of Sector Without The Usage Of Angle Made By The Chord

A Method To Find The Area Of Sector Without The Usage Of Angle Made By The Chord

As we know that to find the area of sector the angle made by the chord (that is chord which divides the circle) is required. But in the below method we find the ratio of the segments of the circle. Thus by relating the area of segment to the area of sector the area of sector could be found. The ratio of area of segments is related to tangents that are drawn through diameter on either side.
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Ethnic minorities’ and immigrants’ therapeutic (non)adherence: what is the role of social and cultural contexts?

Ethnic minorities’ and immigrants’ therapeutic (non)adherence: what is the role of social and cultural contexts?

However, social relationships may also have their negative side, especially when cultural values of the significant others contrast with health-care providers’ recommendations or with the general cultural values of the host country (see Figure 1-Level III). For example, a study conducted with New Zealand Chinese citizens have found that they felt stigmatized when taking their psychiatric medications near their Chinese friends, who they believed were more discriminatory of people with mental illnesses than Western people were (Wang & Henning, 2010). On the other hand, a study conducted with Chinese, Malay and Indian immigrants in Singapore, treated by hemodialysis, has indicated that they felt social pressure to eat contra-indicated food, which influenced their adherence to the prescribed diet (Griva et al., 2013). Thus, it seems important that families and close relationships are aware of their potential influence in order to try to minimize their negative impact on TA. But what is the role of health-care providers in this scenario, considering their “expertise”?
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Selection of the temperature of casting the bronzes to plaster moulds

Selection of the temperature of casting the bronzes to plaster moulds

Bronzes after melting were overheated to the temperature suita- bly: 1200 °C, 1180 °C, 1160 °C and 1140 °C, and then the mould was casted - probe TDAg and plaster mould with thin-walled, so- called casts test slats about dimensions: the length L=100 mm, width A=15 mm, thickness B ={4,0.8,0.5} mm (Fig. 2). Plaster moulds were executed from the mixture PRIMA-CAST about the water-plaster relation 0.4. The solidification modulus of the sections of casts, shaped in the niches of the plaster mould imitat- ing test slats were qualified from example (4):
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Skinner and Merleau-Ponty’s Criticism of Causality

Skinner and Merleau-Ponty’s Criticism of Causality

As mentioned by Hidalgo (2017), despite their distinct objectives, Skinner and Merleau- Ponty share not only the elaboration of refl ec- tions “on the philosophical status of the notion of behavior,” but also sensitivity “to similar theoretical questions, such as the inadequacy of the principles of classical refl exology to ex- plain behavior,” likewise proposing to elaborate a “notion of behavior in its own territory [and thus incapable of being reduced to physiology]” (Hidalgo, 2017, p. 161). Along these lines, in both Merleau-Ponty and Skinner’s research, one fi nds the development of an understanding of behavior that, seeking to repel the phantasms of intellectualistic approaches (mentalism), criti- cizes the insuffi ciencies and limitations of the early twentieth century’s theories as to refl ex- ology and conditioned behavior. Among such criticisms, we highlight, in the following sec- tions, those that are relevant to the causal ex- planatory model.
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Heat treatment of AlSi9Mg alloy

Heat treatment of AlSi9Mg alloy

Processes of crystallization of alloys have decisive impact on structure of castings, and the same their utility characteristics. Knowledge about those processes constitutes a source of information to development of preparation of liquid metal and control of alloy preparation process within industry. Method of Thermal-Voltage-Derivative Analysis (ATND), developed by Faculty of Chipless Forming Technology enables registration of temperature and voltage curves, on which one can observe thermal and voltage effects being result of crystallization of phases and eutectic mixtures present on these curves in form of characteristic “peaks”. Temperature value read offs for these characteristic points become a basis to taking regression analysis aimed at obtaining of mathematical dependences illustrating effect of changes of these values on change of impact resistance of dispersion hardened AK9 alloy. The paper presents an attempt of implementation of Thermal-Voltage-Derivative Analysis method to determination of temperature of hyperquenching and ageing processes of AK9 (AlSi9Mg) silumin. Investigated alloy had undergone typical treatments of refining and modification, and next the heat treatment. Temperature range for the heat treatment has been determined on base of ATND melting curves.
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MEDIA JUSTIFICATIONS: STRATEGIES FOR ENVIRONMENTALIZATION OF ETHANOL PRODUCTION THROUGH ADVERTISING

MEDIA JUSTIFICATIONS: STRATEGIES FOR ENVIRONMENTALIZATION OF ETHANOL PRODUCTION THROUGH ADVERTISING

The final piece of the advertisement also presents some similarities with President Lula’s foreign speeches: “While sugarcane production has increased steadily in recent years, Brazil has doubled its grain production in the last decade and become the top global exporter of several key commodities. The Brazilian experience proves that food, fuel, feed and fiber can all be produced simultaneously and sustainably”. This advertisement can be read/seen as indicative of the degree of involvement between the bioethanol-sugar sector and the State. They are both seeking to develop a business case based on the ap- propriation and the dismissal of the environmental concerns with capitalism. The use of the hegemonic conception of sustainable development, disseminated since the publication of the Brudtland Report, preaching the compatibility between capitalist exploitation of natural resources and the preservation of nature, is evoked both by the bioethanol and sugar sector and in the dismissive position adopted by the Brazilian government. Con- flicting dynamics used by the different expansion of agribusiness fronts, soya, sugarcane, cattle-farming and eucalyptus are obscured by the discourse of harmonious co-habitation as described by the advertisement, in a panorama where there is a significant increase in the production of agricultural commodities. The large availability of land for agrofuel expansion, suggested in the advertisement headline, reappears here implicitly as a list of harmonious and sustainable products which reconcile the production of food, fuel, feed and fibers.
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The effects of heat treatment on the physical properties of juvenile wood and mature wood of Eucalyptus grandis

The effects of heat treatment on the physical properties of juvenile wood and mature wood of Eucalyptus grandis

The heat treatment method for modifying wood increases dimensional stability and is more environmentally friendly than methods that use chemical treatments (Poncsak et al. 2006; Kocaefe et al. 2008; Gunduz et al. 2009; Garcia et al. 2012). Heat treatment results in significant changes in the properties of wood, but it also causes undesirable reductions in the mechanical properties of the wood. Different species of trees are affected differently by heat treatment, so it is important to determine the optimal conditions (e.g. duration and temperature) for heat treatment to achieve the best balance of physical and mechanical properties. To do this, tests must be conducted to determine the resulting properties of wood that has been heat treated at different durations and temperatures.
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Operating characteristics of turbine mixers based on the analysis of power demand of the mixer’s drive

Operating characteristics of turbine mixers based on the analysis of power demand of the mixer’s drive

Mixing processes involve the blending of silica sand, bentonite, coal dust (or mixture) and water. The purpose of mixing is to homogenise the mixture and ensure that the rebonding agent should be uniformly distributed over the grains. This unit was designed for separating casts from the runner system. the number of casts in a batch ranges from 1 to 4 on the given level, there are 1-48 of them on 1-12 levels. The mass of the batch varies from 5 to 12 kg.

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The comparison of the structure and microhardness of the tool steel C90 and HS 6-5-2 remelted with the electric arc

The comparison of the structure and microhardness of the tool steel C90 and HS 6-5-2 remelted with the electric arc

The samples were remelted on the surface with the electric arc with the use of the FALTIG 315AC/DC apparatus. The single remelting was applied. The treatment parameters were used: amperage of the electric arc I = 100 A, speed of the electrode movement v=200 mm/min. As the plasma formative gas, the argon was used. The treatment has been conducted at the depart- ment of Foundry and Welding of Rzeszow University of Tech- nology. After the remelting, there has been the conventional tempering done 1x1 hour in a temperature of 200°C for the steel C90 and 2x2 hours in the temperature of 560 °C for the steel HS 6- 5-2. Parameters of tempering (temperature, time and multiplicity) of the tested steels were selected according to the standard PN-EN ISO 4957:2002U. The microhardeness measurements were made with the Hanemanna objective mph 100. The load used was 0,064 N, the operating time of the load was 10 s. Metallographic tests were conducted on the optical microscope - Neophot 2 and Tesla BS-340 electronic scanning microscope.
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The modification process of AlSi21CuNi silumin and its effect on change of mechanical properties of the alloy

The modification process of AlSi21CuNi silumin and its effect on change of mechanical properties of the alloy

Considering mechanism of modification of these precipitations one should take into account that effect of modification of hypereutectic silumins depends on earlier transition to liquid phase of sparingly soluble crystals of primary silicon [1-3]. Tests performed by authors of the studies [4-10] enable utilization of modification treatments together with making use of a various micro additives in order to improve properties of hypereutectoid alloys.

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SOCIAL ECONOMY – A FORM OF INCLUSION AND OF ''REACTIVATING'' OF LABOR IN THE CONTEXT OF THE CURRENT CRISIS

SOCIAL ECONOMY – A FORM OF INCLUSION AND OF ''REACTIVATING'' OF LABOR IN THE CONTEXT OF THE CURRENT CRISIS

)n the context of the cohesion policy, solidarity must represent a support for development . For that purpose, solidarity can be seen as a help for self‐help and its success depends a great deal on the capacity and the training of the people to whom the support of making maximum profit out of these addresses to. This support does not mean exclusively financial support, although it is necessary and important but, of all things, it means an exchange of experiences and cooperation, the development of capacity through training, open discussions with the interested factors and last but not least a critic, but a constructive dialogue between the various levels of government: European, national, regional, local. )n other words, a functional labor market should represent a catalyst for the general objective of the European Union – social and economical cohesion – because it has in view the connections with the different markets of the services and of the goods and generates the necessary income for supporting the participation of the individuals, bringing them together, placing them in collaborations. )n this context, the starting points for promoting the inclusion through the activities of social economy have in view: adapting the institutional environment, developing the public‐private partnership, developing the social dialogue between players, investments in the human capital and supporting the exchange of good practices within the European Union.
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Non-asymptotic confidence bounds for the optimal value of a stochastic program

Non-asymptotic confidence bounds for the optimal value of a stochastic program

The resulting optimization problem has been extensively studied theoretically and numerically (see, e.g., [8, 10, 11, 19, 21, 23], among many others). In particular, it was shown that the SAA method (coupled with a deterministic algorithm for minimizing the SAA) is often efficient for solving large classes of Stochastic Programs. The alternative SA approach was also exten- sively studied since the pioneering work by Robbins and Monro [16]. Though possessing better theoretical accuracy estimates, SA was long time believed to underperform numerically. It was recently demonstrated (cf., [12, 2, 22]) that a proper modification of the SA approach, based on the ideas behind the Mirror Descent algorithm [13] can be competitive and can even significantly outperform the SAA method on a large class of convex stochastic programs.
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