Development of an AlCl3-Urea Ionic Liquid for the Electroless Deposition of Aluminum on Carbon Nanotubes.

Unlike the easy electroless deposition of other metals, the deposition of aluminum can be challenging. This is because the standard reduction potential of aluminum lies outside the electrochemical window (EW) of water. Ionic liquids such as AlCl3-1-ethyl-3-methylimidazolium chloride (EMIC) have been used because of their wide EW. Here, we introduce a novel ionic liquid for electroless deposition of aluminum by reacting AlCl3 and urea, with lithium aluminum hydride (LAH) as a reducing agent. Additionally, we report the first successful effort in coating carbon nanotubes (CNTs), as an example of nanostructures with high surface area to volume ratio, with aluminum using electroless deposition. The produced aluminum coating was found to be nanostructured, uniformly covering the CNTs and in close contact with their surfaces.

Predictive value of preoperative clinical examination for subacromial decompression in impingement syndrome.

PURPOSE: Subacromial decompression is the standard surgical treatment of subacromial impingement syndrome. Unsatisfactory results have been reported for concomitant lesions as well as inadequate diagnosis. We sought to determine the predictive value of the preoperative examination for the results of arthroscopic subacromial decompression in impingement syndrome. METHODS: Forty-nine shoulder joints in 47 patients receiving arthroscopic subacromial decompression were prospectively followed for a mean 3.7 ± 0.4 years. Prior to surgery, the impingement tests according to Neer, Hawkins-Kennedy (in the neutral as well as abducted position), and the Jobe test (empty can position) were evaluated as well as the presence of a painful arc. The association between the presence of these sings, success of the operation, and improvement in Constant scores as well as WORC indices was analysed. RESULTS: Pre- to postoperative improvement in Constant scores as well as WORC indices was greater in case of a positive test result for every test studied. With the numbers available, significant greater improvements in Constant scores were observed only for patients with a positive Hawkins-Kennedy sign in the neutral position, Neer and Jobe tests, compared to patients with negative signs, respectively. No significant differences were observed for the improvement in WORC indices. Patients with at least four positive tests out of the five studied had greater improvement in Constant scores than patients with three or less positive test results. Five patients went on to receive subsequent shoulder surgery. There was no association between the necessity for revision surgery and the presence or absence of impingement signs. CONCLUSION: The impingement tests according to Hawkins-Kennedy, Neer, and Jobe are valid predictors of outcome after subacromial decompression, as is the presence of multiple impingement tests. This study may aid in improving patient outcome and especially patient selection for subacromial decompression. LEVEL OF EVIDENCE: Prognostic, Level I.

Reliability of radiologic glenohumeral osteoarthritis classifications.

BACKGROUND: This study was conducted to determine the intraobserver and interobserver reliability of glenohumeral osteoarthritis classification schemes. MATERIALS AND METHODS: The plain radiographs of 108 shoulder joints from 96 consecutive patients with glenohumeral osteoarthritis treated at our institution were graded into 6 classification systems by 2 observers on 2 occasions. The intraobserver and interobserver reliability of the classification schemes were determined by using Cohen's κ coefficient and weighted according to Landis and Koch. RESULTS: The intraobserver and interobserver reliabilities were 0.907 (observer 1), 0.965 (observer 2), and 0.851 (interobserver) for the Samilson-Prieto grading system; 0.954, 0.948, and 0.869 for the Allain modification; 0.936, 0.830, and 0.791 for the Gerber modification; 0.887, 0.892, and 0.744 for the Kellgren and Lawrence classification; 0.873, 0.964, and 0.935 for the Weinstein; and 0.854, 0.934, and 0.797 for the Guyette grading system. CONCLUSION: The classification systems according to Weinstein and Guyette and the modifications of the Samilson-Prieto classification according to Allain and Gerber showed a comparable reliability with the commonly used glenohumeral osteoarthritis grading systems according to Samilson-Prieto and Kellgren-Lawrence. Thus, they are recommended for clinical and especially scientific purposes.

Observer agreement on the Dejour trochlear dysplasia classification: a comparison of true lateral radiographs and axial magnetic resonance images.

BACKGROUND: Trochlear dysplasia is known to be an important cause of patellofemoral instability. D. Dejour's radiographic and magnetic resonance imaging (MRI) classifications are widely used in clinical practice and in the orthopaedic literature to assess the severity of trochlear dysplasia. The indication for deepening trochleoplasty to treat trochlear dysplasia is also mainly based on the severity of trochlear dysplasia according to Dejour's criteria. PURPOSE: To our knowledge, there is no study evaluating the efficacy of the Dejour classification. The aim of this study was to assess the intraobserver and interobserver agreements of the radiographic and MRI-based classification as described by Dejour. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: From 50 patients, 50 lateral radiographs as well as 50 MRI scans were read twice independently within 4 weeks by 4 surgeons (2 senior and 2 junior examiners). Analysis was made according to Dejour's 4 grades of radiological criteria of trochlear dysplasia as well as differentiating between 2 grades: low-grade (type A) and high-grade trochlear dysplasia (types B-D). RESULTS: The 4-grade analysis showed fair intraobserver and interobserver agreements (24%-78%), while the 2-grade analysis showed good to excellent agreement (56%-96%). The best overall agreement was found for the 2-grade analysis on MRI scans (62%-96%). The lateral radiographs tended to underestimate the severity of trochlear dysplasia compared with axial MRI. CONCLUSION: D. Dejour's classification is valid for typing trochlear dysplasia and is particularly useful in separating low-grade from high-grade dysplasia.

Cemented humeral surface replacement for a locked posterior fracture-dislocation: a case report.

Posterior fracture-dislocations of the shoulder are uncommon and challenging lesions. We present the case of a 76-year-old male patient who sustained a locked posterior humeral head fracture-dislocation during a convulsion. Because more than 40% of the articular surface was involved, preserving the head was not possible. We treated the fracture with a cemented humeral surface replacement. The patient demonstrated good shoulder function and no instability on short-term follow-up. Surface replacement may be a valuable treatment option for fracture-dislocations of the shoulder with articular surface involvement.

Reliability of radiologic classification for cuff tear arthropathy.

BACKGROUND: Several classification schemes have been proposed for cuff tear arthropathy and used for scientific and clinical purposes, even though their reliability has not been established and compared as of yet. MATERIALS AND METHODS: Two observers (O1 and O2) twice independently classified 52 shoulder radiographs into the cuff arthropathy schemes of Favard, Visotsky-Seebauer, Hamada, and Sirveaux. The schemes of Samilson and Prieto as well as Kellgren and Lawrence, commonly used for osteoarthritis of the shoulder, were also used for comparison. Reliability was tested with the κ coefficient. RESULTS: The intraobserver and interobserver reliabilities were 0.812 for O1, 0.710 for O2, and 0.305 for O1 versus O2 for the Favard classification; 0.868, 0.583, and 0.551, respectively, for the Visotsky-Seebauer classification; 1.000, 0.491, and 0.407, respectively, for the Hamada classification; and 0.852, 0.602, and 0.598, respectively, for the Sirveaux classification. For comparison, the Samilson-Prieto classification reached 0.815, 0.710, and 0.507, respectively, and the Kellgren-Lawrence scheme reached 0.815, 0.713, and 0.430, respectively. DISCUSSION: Of the classification schemes tested, the Sirveaux classification displayed the best reliability overall. The Sirveaux classification only respects alterations of the glenoid, however. Among the schemes respecting both the glenoid and the humerus, the Hamada and Visotsky-Seebauer schemes showed similar reliability compared with the Samilson-Prieto and Kellgren-Lawrence systems, whereas the Favard classification was not as reliable. We therefore recommend the Visotsky-Seebauer or Hamada classification scheme.

Intraarticular lesions in calcifying tendinitis: incidence and association with the acromion index.

INTRODUCTION: Intraarticular pathologies are a common finding during arthroscopy for rotator cuff lesions. Both rotator cuff tears as well as cartilage lesions have been described as correlating with the acromion index. METHODS: In the current study, we aimed to determine the incidence of intraarticular lesions in calcifying tendinitis, to compare the incidence in patients with partial- and full-thickness tears of the rotator cuff, and to determine the acromion index in these groups. The incidence and type of accompanying intraarticular lesions were compared between three consecutive, age-matched groups of 64 patients each: those with calcifying tendinitis (group A), and those with partial- (group B) and full-thickness rotator cuff tears (group C). Also, the acromion index was measured from plain radiographs and compared between the groups. RESULTS: The incidence of intraarticular pathology was 43% in group A, 41% in group B and 84% in group C. The differences between groups A and C as well as B and C were significant (p < 0.0001), but not between groups A and B (p = 0.858). Even though the acromion index was larger in group C than in the other two groups, the difference was not significant (A vs. B, p = 0.505; A vs. C, p = 0.180; and B vs. C p = 0.446). The incidence and type of intraarticular lesions in calcifying tendinitis are comparable to age-matched shoulders with partial- rather than full-thickness rotator cuff tears. CONCLUSION: The acromion index is not different between shoulders with calcifying tendinitis, and partial- or full-thickness rotator cuff tears.

Plain radiographs have limited sensitivity for glenohumeral cartilage lesions.

Glenohumeral cartilage lesions are frequently encountered during shoulder arthroscopy, but are not always represented on radiographs. We intended to define the diagnostic value of plain shoulder radiographs in detecting glenohumeral cartilage lesions. The radiographs of 167 patients undergoing shoulder arthroscopy were analyzed for signs of degenerative joint disease. Formal criteria indicating osteoarthritis (osteophytes, joint space narrowing, and sclerosis) were registered and correlated to cartilage lesions diagnosed during shoulder arthroscopy. The intrarater reliabilities were .920 (T.K.) and .953 (M.E.) and the interrater reliabilities were .802 (T.K. 1, M.E. 1), .909 (T.K. 2, M.E. 1), .922 (T.K. 1, M.E. 2), and .953 (T.K. 2, M.E. 2), indicating excellent agreement. There were 35 correct positive, 91 correct negative, 34 false negative, and 7 false positive radiographs. The sensitivity and specificity for any degree of cartilage lesion were 50.7% and 92.9%, respectively, and the positive and negative predictive values were 83.3% and 72.8%, respectively. For third- and fourth-grade cartilage lesions, the sensitivity was 76.0% and the positive and negative predictive values were 73.1% and 93.8%, respectively. While plain radiographs can often detect severe cartilage lesions, the sensitivity and negative predictive value are too low to reliably exclude cartilage lesions overall. In case of doubt, we recommend further radiological workup.

Transient leukocytosis, granulocyte colony-stimulating factor plasma concentrations, and apoptosis determined by binding of annexin V by peripheral leukocytes in patients with severe sepsis.

This study was undertaken to clarify the relation between transient increases in the numbers of leukocytes and granulocyte colony-stimulating factor (G-CSF) plasma concentrations as well as the degree of apoptosis, as determined by binding of annexin V by these cells in patients with severe sepsis and septic shock. Over a 6-month period, annexin V binding by leukocytes was determined daily using flow cytometry and FITC-labeled annexin V in 33 postoperative patients with severe sepsis or septic shock during their intensive care unit stay. The percentage of annexin V binding neutrophils, monocytes, and lymphocytes was significantly lower, and G-CSF plasma concentrations were higher in patients than in controls on most days. Nine, 19, and 18 peaks in neutrophil, monocyte, and lymphocyte counts (increase of >/=30% within 2 days, followed by a decrease of >/=30% within 2 days) occurred in 6, 11, and 16 patients. During leukocyte peaks, the absolute numbers of annexin V binding neutrophils, monocytes, and lymphocytes paralleled those of neutrophil, monocyte, and lymphocyte numbers. However, the percentage of annexin V binding neutrophils, monocytes, and lymphocytes did not differ significantly from one day to another. Increased G-CSF serum concentrations preceded neutrophil and monocyte peaks. In conclusion, apoptosis of leukocytes is lowered during severe sepsis and septic shock in critically ill patients. Moreover, the degree of apoptosis does not increase during transient leukocytosis. G-CSF might contribute to the low degree of apoptosis of neutrophils and monocytes in those patients.