First Metatarsalphalangeal Joint Arthrodesis: Evaluation of Plate and Screw Fixation

2009 ◽  
Vol 30 (8) ◽  
pp. 752-757 ◽  
Author(s):  
Gordon L. Bennett ◽  
James Sabetta
Keyword(s):  
Screw Fixation ◽  
Ease Of Use ◽  
The Other ◽  
High Rate ◽  
Fusion System ◽  
Hardware Failure ◽  
Low Profile ◽  
Final Followup ◽  
Implant System ◽  
Very High

Background: First metatarsalphalangeal joint (MTPJ) arthrodesis is a commonly performed procedure for the treatment of a variety of conditions affecting the hallux. There are several different methods to accomplish the fusion. We utilized a method incorporating a ball and cup preparation of the joint, followed by stabilization of the arthrodesis site utilizing the Accutrak congruent first MTPJ fusion set. Materials and Methods: We prospectively evaluated two hundred consecutive patients who underwent first MTPJ arthrodeses utilizing the Accutrak congruent first MTPJ fusion set. Patients were evaluated preoperatively, postoperatively, and at a final followup, utilizing the AOFAS forefoot scoring system. Results: Two hundred consecutive patients underwent first MTPJ arthrodeses by the same surgeon. All but three feet (230/233) (98.7%) went on to solidly fuse. Three of the patients did not fuse solidly. One patient broke two of the screws, and the other two patients did not have hardware failure. All patients dramatically improved their AOFAS scores compared with pre-surgical values. There were three minor hardware problems in the group of patients who solidly fused their joint. Conclusion: We concluded that a solid first MTPJ fusion results in excellent function and pain relief. The Accutrak first MTPJ fusion system would appear to be an ideal implant system to accomplish a fusion because of its low profile, strength, and ease of use. Compared to other methods we have used, this procedure results in a very high rate of fusion, with minimal complications and excellent patient satisfaction.

scholarly journals Technique and nuances of an S-2 alar iliac screw for lumbosacral fixation in patients with transitional and normal anatomy

2016 ◽  
Vol 41 (videosuppl1) ◽  
pp. 1 ◽  
Author(s):  
Junichi Ohya ◽  
Todd D. Vogel ◽  
Sanjay S. Dhall ◽  
Sigurd Berven ◽  
Praveen V. Mummaneni
Keyword(s):  
Screw Fixation ◽  
Insufficiency Fracture ◽  
The Other ◽  
Rigid Fixation ◽  
Normal Anatomy ◽  
Sacral Insufficiency Fracture ◽  
Pelvic Fixation ◽  
Low Profile ◽  
Iliac Screw ◽  
Lumbosacral Fixation

S-2 alar iliac (S2AI) screw fixation has recently been recognized as a useful technique for pelvic fixation. The authors demonstrate two cases where S2AI fixation was indicated: one case was a sacral insufficiency fracture following a long-segment fusion in a patient with a transitional S-1 vertebra; the other case involved pseudarthrosis following lumbosacral fixation. S2AI screws offer rigid fixation, low profile, and allow easy connection to the lumbosacral rod. The authors describe and demonstrate the surgical technique and nuances for the S2AI screw in a case with transitional S-1 anatomy and in a case with normal S-1 anatomy.The video can be found here: https://youtu.be/Sj21lk13_aw.

scholarly journals Lack of influence of low temperature, light and growth substances on phytochrome resynthesis in coleoptiles of irradiated oat seedlings

2014 ◽  
Vol 53 (2) ◽  
pp. 271-278
Author(s):  
Jan Kopcewicz ◽  
Mariusz Cymerski ◽  
Kazimierz Madela
Keyword(s):  
Low Temperature ◽  
Large Fraction ◽  
Elongation Growth ◽  
The Other ◽  
High Rate ◽  
Growth Substances ◽  
Etiolated Seedlings ◽  
High Level ◽  
Very High

The photoconversion of phytochrome P<sub>R</sub> into the P<sub>FR</sub> form causes at the same time the destruction of the initial large fraction of phytochrome found in the coleoptiles of etiolated oat seedlings. Factors such as low temperature, light of different wavelengths or growth substances are not capable of preventing the progressive destruction and restore the synthesis of phytochrome. Thus an abnormally high level of phytochrome is found only in etiolated seedlings. Such seedlings, on the other hand, are characterized by a very high rate of elongation growth. The role of phytochrome in the control of deetiolation of seedlings is discussed.

Dorsal Modified Calcaneal Plate for Extensive Midfoot Arthrodesis

2005 ◽  
Vol 26 (7) ◽  
pp. 503-509 ◽  
Author(s):  
Jin-Soo Suh ◽  
Annunziato Amendola ◽  
Keun-Bae Lee ◽  
Lisa Wasserman ◽  
Charles L. Saltzman
Keyword(s):  
Bone Loss ◽  
Screw Fixation ◽  
Clinical Problem ◽  
Low Profile ◽  
Previous Infection ◽  
Secondary Procedures ◽  
A New Technique ◽  
Viable Method ◽  
Very High ◽  
Massive Bone

Background: Extensive midfoot fusions can be challenging because of bone loss, deformity, and soft tissue anatomy. Several options have been advocated, including multiple screw fixation, medial plating, and plantar plating. We report a new technique using a dorsally-placed, modified calcaneal plate for treatment of this difficult clinical problem. Methods: Patients undergoing extensive (more than four joints) midfoot arthrodeses with a dorsally-placed, modified calcaneal plate between 2000 and 2003 were retrospectively reviewed. Diagnoses included Charcot arthropathy (four), osteoarthritis (two), posttraumatic osteoarthritis (two), massive bone loss from previous infection (one), and residual clubfoot deformity (one). Patients with active midfoot infections were excluded. During the study period, midfoot arthrodeses with a dorsal calcaneal plate were done in 10 patients. Of these, nine patients were available for review. Arthrodeses were attempted in 62 joints in these nine patients. Autogenous grafting was used in three patients (23 joints), allograft was used in six patients (39 joints). Patients were maintained nonweightbearing until radiographs or computed tomography conclusively showed union. Results: One of the 10 patients died from an unrelated cause. In the nine remaining patents, 95% (59 of 62) of joints fused within 4 months of surgery. Postoperative complications included nonunion with broken screws in one patient, and three wound problems successfully treated with local dressings. Secondary procedures included one revision arthrodesis and two hardware removals. Patient satisfaction with this procedure was very high (eight of nine). Conclusions: The use of a dorsal calcaneal plate is a viable method of fixation for achieving fusion in extensive midfoot arthropathy. The plate is low-profile and easily moldable to conform to dorsal midfoot anatomy. It can be placed without extensive plantar or medial foot dissection and maintains midfoot alignment until bony fusion occurs. In patients with complex midfoot pathology requiring multijoint fusions, the results have been satisfactory.

The Specificity of Penicillopepsin

1971 ◽  
Vol 49 (10) ◽  
pp. 1134-1149 ◽  
Author(s):  
G. Mains ◽  
Miho Takahashi ◽  
J. Šodek ◽  
T. Hofmann
Keyword(s):  
Amino Acid ◽  
Glutamic Acid ◽  
Ph Dependence ◽  
Random Copolymer ◽  
The Other ◽  
High Rate ◽  
Hydrophobic Amino Acid ◽  
Peptide Bonds ◽  
Hydrolysis Of ◽  
Very High

The specificity of penicillopepsin was investigated with a number of different substrates. In agreement with earlier work (1), no action was observed on di- and tripeptide and ester substrates. However, the pepsin substrate carbobenzoxyglycylglycylphenylalanylphenylalanine 3-(4-pyridyl)propyl-1 ester was hydrolyzed between the two phenylalanine residues. No cleavage of homopolymers of glycine, alanine, and glutamic acid and the random copolymer of glutamic acid and tyrosine was observed. Polymers of lysine, lysine and tyrosine (2:1), and lysine, glutamic acid, and tyrosine (13:20:1) were, however, hydrolyzed giving mainly tripeptides to pentapeptides. Polylysine hydrolysis showed a pH dependence centering about a group of pK between 3 and 4. In glucagon and the S-sulfo B-chain of insulin, penicillopepsin hydrolyzed the same peptide bonds as the other acidic proteases, including pepsin and rennin, with very few exceptions. There are, however, distinct differences between the action of penicillopepsin and that of other proteases of low specificity. Peptide bonds which have a hydrophobic amino acid in the P1′ position (as defined by Berger and Schechter, Ref. 2) are preferentially cleaved by penicillopepsin. A kinetic study of the hydrolysis of bovine serum albumin showed very high rate constants for the initial cleavages. The present study shows the requirement for an extended binding site in penicillopepsin.

Thrombotic Thrombocytopenic Purpura: Mechanism for Effectiveness of Plasmapheresis

1979 ◽  
Author(s):  
J. G. Kelton ◽  
P. B. Neame ◽  
I. Walker ◽  
A. G. Turpie ◽  
J. McBride ◽  
...  
Keyword(s):  
Platelet Count ◽  
Thrombotic Thrombocytopenic Purpura ◽  
The Other ◽  
Unknown Etiology ◽  
Normal Range ◽  
Antiplatelet Antibody ◽  
Thrombocytopenic Purpura ◽  
Serious Illness ◽  
Normal Platelet ◽  
Very High

Thrombotic thrombocytopenic purpura (TTP) is a rare but serious illness of unknown etiology. Treatment by plasmapheresis has been reported to be effective but the mechanism for benefit is unknown. We have investigated the effect of plasmapheresis in 2 patients with TTP by quantitating platelet associated IgG (PAIgG) levels prior to and following plasmapheresis. Both patients had very high levels of PAIgG at presentation (90 and A8 fg IgG/platelet respectively, normal 0-5). in both, the PAIgG levels progressively fell to within the normal range and the platelet count rose following plasmapheresis. One patient remained in remission with normal platelet counts and PAIgG levels. The other relapsed after plasmapheresis and the PAIgG level rose prior to the fall in platelet count. Plasmapheresis was repeated and resulted in normalization of both the platelet count and PAIgG level. It is suggested that plasmapheresis removes antiplatelet antibody or immune complexes which may be of etiological importance in this illness.

Growth Characteristics of Activated Sludges Acclimated to para-Nitrophenol in Batch and Continuous Modes

1994 ◽  
Vol 29 (7) ◽  
pp. 327-333
Author(s):  
Y. Matsui ◽  
F. Yamaguchi ◽  
Y. Suwa ◽  
Y. Urushigawa
Keyword(s):  
Growth Characteristics ◽  
The Other ◽  
Operational Mode ◽  
Continuous Mode ◽  
Relative Resistance ◽  
Batch Mode ◽  
The Given ◽  
Operational Modes ◽  
Very High ◽  
Sensitive Group

Activated sludges were acclimated to p-nitrophenol (PNP) in two operational modes, a batch and a continuous. The operational mode of the PNP acclimation of activated sludges strongly affected the physiological characteristics of predominant microorganisms responsible for PNP degradation. Predominant PNP degraders in the sludge in batch mode (Sludge B) had lower PNP affinity and were relatively insensitive to PNP concentration. Those of the sludge in continuous mode (Sludge C), on the other hand, had very high PNP affinity and were sensitive to PNP. MPN enumeration of PNP degraders in sludge B and C using media with different PNP concentrations (0.05, 0.2,0.5 and 2.0 mM) supported the above results. Medium with 0.2 mM of PNP did not recover PNP degraders in sludge C well, while it recovered PNP degraders in sludge B as well as the medium with 0.05 mM did. When switching from one operational mode to the other, the predominant population in sludge B shifted to the sensitive group, but that of sludge C did not shift at the given loading of PNP, showing relative resistance to inhibitive concentration.

Islamic hedging for pilgrimage funds: case of Indonesia

2019 ◽  
Vol 11 (3) ◽  
pp. 328-341
Author(s):  
Rifki Ismal ◽  
Nurul Izzati Septiana
Keyword(s):  
Exchange Rate ◽  
The Other ◽  
Exchange Rate Risk ◽  
Content Type ◽  
Other Hand ◽  
Rate Risk ◽  
Risk Identify ◽  
Hajj Season ◽  
The Right ◽  
Very High

Purpose The demand for Saudi Arabian real (SAR) is very high in the pilgrimage (hajj) season while the authority, unfortunately, does not hedge the hajj funds. As such, the hajj funds are potentially exposed to exchange rate risk, which can impact the value of hajj funds and generate extra cost to the pilgrims. The purpose of this paper is to conduct simulations of Islamic hedging for pilgrimage funds to: mitigate and minimize exchange rate risk, identify and recommend the ideal time, amount and tenors of Islamic hedging for hajj funds, estimate cost saving by pursuing Islamic hedging and propose technical and general recommendations for the authority. Design/methodology/approach Forward transaction mechanism is adopted to compute Islamic forward between SAR and Rupiah (Indonesian currency) or IDR. Findings – based on simulations, the paper finds that: the longer the Islamic hedging tenors, the better is the result of Islamic hedging, the decreasing of IDR/USD is the right time to hedge the hajj funds and, on the other hand, the IDR/SAR appreciation is not the right time to hedge the hajj funds. Findings Based on simulations, the paper finds that: the longer the Islamic hedging tenors, the better is the result of Islamic hedging, the decreasing of IDR/USD is the right time to hedge the hajj funds and, on the other hand, the IDR/SAR appreciation is not the right time to hedge the hajj funds. Research limitations/implications The research suggests the authority to (and not to) hedge the hajj fund, depending on economic conditions and market indicators. Even though the assessment is for the Indonesian case, other countries maintaining hajj funds might also learn from this paper. Originality/value To the best of author’s knowledge, this is the first paper in Indonesia that attempts to simulate the optimal hedging of hajj funds.

scholarly journals First Report of blaNDM-1 Bearing IncX3 Plasmid in Clinically Isolated ST11 Klebsiella pneumoniae from Pakistan

2021 ◽  
Vol 9 (5) ◽  
pp. 951
Author(s):  
Hazrat Bilal ◽  
Gaojian Zhang ◽  
Tayyab Rehman ◽  
Jianxion Han ◽  
Sabir Khan ◽  
...  
Keyword(s):  
Sequence Type ◽  
The Other ◽  
High Rate ◽  
Antibiotics Resistance ◽  
New Delhi ◽  
Molecular Type ◽  
Plasmid Analysis ◽  
First Time ◽  
Encoding Genes ◽  
Sequence Types

The New Delhi Metallo-β-lactamase (NDM) is among the most threatening forms of carbapenemases produced by K. pneumoniae, well-known to cause severe worldwide infections. The molecular epidemiology of blaNDM-1-harboring K. pneumoniae is not well elucidated in Pakistan. Herein, we aim to determine the antibiotics-resistance profile, genes type, molecular type, and plasmid analysis of 125 clinically isolated K. pneumoniae strains from urine samples during July 2018 to January 2019 in Pakistan. A total of 34 (27.2%) K. pneumoniae isolates were carbapenemases producers, and 23 (18.4%) harbored the blaNDM-1 gene. The other carbapenemases encoding genes, i.e., blaIMP-1 (7.2%), blaVIM-1 (3.2%), and blaOXA-48 (2.4%) were also detected. The Multi Locus Sequence Typing (MLST) results revealed that all blaNDM-1-harboring isolates were ST11. The other sequence types detected were ST1, ST37, and ST105. The cluster analysis of Xbal Pulsed Field Gel Electrophoresis (PFGE) revealed variation amongst the clusters of the identical sequence type isolates. The blaNDM-1 gene in all of the isolates was located on a 45-kb IncX3 plasmid, successfully transconjugated. For the first time, blaNDM-1-bearing IncX3 plasmids were identified from Pakistan, and this might be a new primary vehicle for disseminating blaNDM-1 in Enterobacteriaceae as it has a high rate of transferability.

Rolling and Recrystallization Textures in High Purity Al Cold Rolled to Very High Rolling Reductions

2005 ◽  
Vol 495-497 ◽  
pp. 603-608 ◽  
Author(s):  
Atsushi Todayama ◽  
Hirosuke Inagaki
Keyword(s):  
Cold Rolling ◽  
High Purity ◽  
Work Hardening ◽  
Dynamic Recovery ◽  
The Other ◽  
Rolling Reduction ◽  
Theoretical Investigations ◽  
Theoretical Predictions ◽  
Cold Rolled ◽  
Very High

On the basis of Taylor-Bishop-Hill’s theory, many previous theoretical investigations have predicted that, at high rolling reductions, most of orientations should rotate along theβfiber from {110}<112> to {123}<634> and finally into the {112}<111> stable end orientations. Although some exceptions exist, experimental observations have shown, on the other hand, that the maximum on the β fiber is located still at about {123}<634> even after 97 % cold rolling. In the present paper, high purity Al containing 50 ppm Cu was cold rolled up to 99.4 % reduction in thickness and examined whether {112}<111> stable end orientation could be achieved experimentally. It was found that, with increasing rolling reduction above 98 %, {110}<112> decreased, while orientations in the range between {123}<634> and {112}<111> increased, suggesting that crystal rotation along the βfiber from {110}<112> toward {123}<634> and {112}<111> in fact took place. At higher rolling reductions, however, further rotation of this peak toward {112}<111> was extremely sluggish, and even at the highest rolling reduction, it could not arrive at {112}<111>. Such discrepancies between theoretical predictions and experimental observations should be ascribed to the development of dislocation substructures, which were formed by concurrent work hardening and dynamic recovery. Since such development of dislocation substructures are not taken into account in Taylor-Bishop-Hill’s theory, it seems that they can not correctly predict the development of rolling textures at very high rolling reductions, i. e. stable end orientations. On annealing specimens rolled above 98 % reduction in thickness, cube textures were very weak, suggesting that cube bands were almost completely rotated into other orientations during cold rolling. {325}<496>, which lay at an intermediate position between {123}<634> and {112}<111> along theβfiber, developed strongly in the recrystallization textures.

A Multiregion Model with Capital Accumulation and Endogenous Amenities

2007 ◽  
Vol 39 (9) ◽  
pp. 2248-2270 ◽  
Author(s):  
Wei-Bin Zhang
Keyword(s):  
Capital Accumulation ◽  
Comparative Statics ◽  
The Other ◽  
High Rate ◽  
Unique Equilibrium ◽  
Economic Activities ◽  
Technological Differences ◽  
National Output ◽  
Simulation Results ◽  
Wage Disparities

The author develops a multiregional growth model with endogenous amenity and capital accumulation for any number of regions. The simulation results demonstrate that the national dynamics have a unique equilibrium. Comparative statics analysis shows that, if environmental improvement occurs in the technologically advanced (less advanced) region, the national output rises (falls). As a region improves its technology, the other two regions' aggregated output levels fall—not only in relative, but also in absolute, terms. This implies that if any region has a high rate of technological change and the other regions remain technologically stationary, then economic activities will tend to be concentrated in the technologically advancing region. It is also shown that technological differences appear to play only a small role in accounting for spatial wage disparities and endowments.

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