Compartment Syndrome following Intramedullary Nail Fixation in Closed Tibial Shaft Fractures.

Introduction: Compartment syndrome complicating intramedullary nailing of closed tibia fractures has been described as early as the 1980s, but currently remains less described in literature compared to compartment syndrome directly following trauma. This study aims to review this potentially disabling complication and highlight the importance of timely diagnosis and management of compartment syndrome following fracture fixation, not just after fracture itself, via a review of three cases. Material and methods: A retrospective study of a series of three cases was conducted. The type of fracture, wait time to fixation, surgery duration, reaming, size of nail implant used, tourniquet time, and surgical technique were recorded. Time to diagnosis of compartment syndrome, compartment pressure if available, extent of muscle necrosis, reconstructive procedures performed, and post-operative complications were analysed. Results: The three cases following high-energy trauma from road traffic accidents presented from January to May 2010. Compartment syndrome was diagnosed clinically for all cases, between one to six days post-operatively and supported by elevated compartment pressure measurements in two of the three cases. Conclusion: This study advocates thorough clinical monitoring and maintaining strong clinical suspicion of compartment syndrome in patients even after intramedullary nail fixation of tibial shaft fractures to achieve timely limb-salvaging intervention. While intercompartmental pressure can be used to aid in diagnosis, we do not advise using it in isolation to diagnose compartment syndrome. Tendon transfer improves functional mobility and provides a good result in patients with severe muscle damage, while skin grafting sufficient in patients with minimal muscle damage.

Refinements in the design and division of the thenar flap to achieve better functional results.

Though the thenar flap has been described since 1926, its use has not been widespread. The main criticisms are donor site morbidity and proximal interphalangeal joint (PIPJ) stiffness. In this paper, we describe a standard design technique for flap design and division to address these two issues. From July 2018 to April 2019, a total of ten patients underwent thenar flap reconstruction of the fingertip. The flap dimensions ranged from 10 mm × 10 mm to 25 mm × 15 mm. All the flaps survived. One patient developed wound infection post division. All donor sites were closed primarily without skin graft. We are using mirror image technique to elevate the flap to ensure that it is inset in the position as we planned without displacement. It largely reduced the chance of rotation and extensive tension when fix the finger to the thenar region. Our technique allows for the flap design to be individually customized based on the orientation of the defect, making it simpler and more replicable. We have also emphasized how care during division of the thenar flap can help prevent complications.

Investigation of the characteristics of platinum group metal modified alumina nanofibers.

Alumina nanofibers containing either platinum or rhodium crystalline nanoparticles have been successfully fabricated by electrospinning a solution of polyvinylpyrrolidone mixed with platinum or rhodium chloride and subsequent calcination and hydrogen reduction. Transmission electron microscopy images indicate that the platinum and rhodium nanoparticles are well dispersed on the electrospun alumina nanofibers. X-ray diffraction results demonstrate that the platinum and rhodium nanoparticles are crystalline, while the alumina matrix is amorphous. Furthermore, X-ray photoelectron spectroscopy was used to investigate the chemical nature of these nanofibers containing noble metals before and after calcination and hydrogen processing.

Serum bioactive lysophospholipids prevent TRAIL-induced apoptosis via PI3K/Akt-dependent cFLIP expression and Bad phosphorylation.

Serum contains a variety of biomolecules, which play an important role in cell proliferation and survival. We sought to identify the serum factor responsible for mitigating tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced apoptosis and to investigate its molecular mechanism. TRAIL induced effective apoptosis without serum, whereas bovine serum decreased apoptosis by suppressing cytochrome c release and caspase activation. Indeed, albumin-bound lysophosphatidic acid (LPA) and sphingosine-1-phosphate (S1P) inhibited TRAIL-induced apoptosis by suppressing caspase activation and cytochrome c release. LPA increased phosphatidylinositol 3-kinase (PI3K)-dependent Akt activation, cellular FLICE-inhibitory protein (cFLIP) expression, and Bad phosphorylation, resulting in inhibition of caspase-8 activation and Bad translocation to mitochondria. The antiapoptotic effect of LPA was abrogated by PI3K inhibitor, transfection with dominant-negative Akt, and specific downregulation of cFLIP expression using siRNA and further increased by siRNA-mediated suppression of Bad expression. Moreover, sera from ovarian cancer patients showed more protective effect against TRAIL-induced apoptosis than those from healthy donors, and this protection was suppressed by PI3K inhibitor. Our results indicate that albumin-bound LPA and S1P prevent TRAIL-induced apoptosis by upregulation of cFLIP expression and in part by Bad phosphorylation, through the activation of PI3K/Akt pathway.

Sodium-ion storage properties of nickel sulfide hollow nanospheres/reduced graphene oxide composite powders prepared by a spray drying process and the nanoscale Kirkendall effect.

Spray-drying and the nanoscale Kirkendall diffusion process are used to prepare nickel sulfide hollow nanospheres/reduced graphene oxide (rGO) composite powders with excellent Na-ion storage properties. Metallic Ni nanopowder-decorated rGO powders, formed as intermediate products, are transformed into composite powders of nickel sulfide hollow nanospheres/rGO with mixed crystal structures of Ni3S2 and Ni9S8 phases by the sulfidation process under H2S gas. Nickel sulfide/rGO composite powders with the main crystal structure of Ni3S2 are also prepared as comparison samples by the direct sulfidation of nickel acetate-graphene oxide (GO) composite powders obtained by spray-drying. In electrochemical properties, the discharge capacities at the 150(th) cycle of the nickel sulfide/rGO composite powders prepared by sulfidation of the Ni/rGO composite and nickel acetate/GO composite powders at a current density of 0.3 A g(-1) are 449 and 363 mA h g(-1), respectively; their capacity retentions, calculated from the tenth cycle, are 100 and 87%. The nickel sulfide hollow nanospheres/rGO composite powders possess structural stability over repeated Na-ion insertion and extraction processes, and also show excellent rate performance for Na-ion storage.

Cloning and nucleotide sequence of the bovine beta-lactoglobulin gene.

A clone coding for beta-lactoglobulin A has been isolated from a cDNA bank constructed from poly(A+)mRNA isolated from the bovine mammary gland. Its nucleotide sequence codes for the beta-lactoglobulin A, from amino acid residues Leu-11 to Ile-162, as based on the amino acid sequence reported by Braunitzer et al. [Z. Physiol. Chem. 354 (1973) 867-878]. In addition to the 455-bp coding sequence, our clone pB beta L4-10 contains a 3'-nontranslated region of approx. 270 bp.

The effects of epidural blockade on the acute pain in herpes zoster.

OBJECTIVE: To evaluate the relief of acute pain and possible preventive effects on postherpetic neuralgia through the use of an epidural blockade in the acute stage of herpes zoster. DESIGN: Prospective, nonrandomized, comparative clinical trial. SETTING: A dermatologic clinic in a university hospital. PATIENTS: Sixty-five consecutive patients with pain due to acute herpes zoster were treated for a 7-day hospitalization period from July 1, 1996, through June 30, 1997. INTERVENTION: The consecutive patients were divided into 2 groups. Group A consisted of 30 patients who were seen from July 1, 1996, through December 31, 1996, and who were treated with intravenous acyclovir (5 mg/kg) for 7 days. Group B consisted of 35 patients who were seen from January 1, 1997, through June 30, 1997, and who were treated with intravenous acyclovir (5 mg/kg) and an epidural blockade for 7 days. The changes in the intensity of pain and the total duration of pain in both groups were assessed for 12 to 18 months. MAIN OUTCOME MEASURES: The number of days required for relief of pain and the total duration of pain. RESULTS: The mean +/- SD number of days required for relief of pain, which was rated on a scale of 100 (worst pain) to 0 (no pain), was significantly fewer in group B than in group A: it took 2.6 +/- 1.1 days to go from 100 to 50 on the relief-of-pain scale in group B, but 3.8 +/- 1.1 days in group A (P = .03), and 12.5 +/- 6.4 days to go from 100 to 10 in group B, but 20.1 +/- 14.6 days in group A (P = .04). The duration of late residual pain was significantly shorter in group B (5.9 +/- 5.8 days) than in group A (11.9 +/- 7.5 days) (P = .03). The total duration of pain was also significantly shorter in group B (18.5 +/- 9.3 days) than in group A (31.6 +/- 17.6 days) (P = .04). CONCLUSIONS: We believe that an epidural blockade combined with an antiviral agent is a very effective treatment modality for the pain of acute herpes zoster, and we recommend its use for the prevention of postherpetic neuralgia, with a view to shortening the total duration of pain, especially late residual pain.

Acne mechanica due to an orthopedic crutch.

Acne mechanica describes local irritation due to the skin being pressured, occluded, rubbed, squeezed, stretched, or heated. Examples of various physical traumas that provoke lesions in acne patients are given. Users of orthopedic crutches are at particular risk for such conditions. A crutch is another extrinsic factor to be added to the list of causes of acne mechanica.

Egg production capacity of one-pair worms of Schistosoma japonicum in albino mice.

In the present study, a series of procedures of egg count were carried out to determine the egg production capacity in 21 ICR mice each infected with one-pair of Schistosoma japonicum. The egg count began from the first day, they were detected in the feces, which was based on a stool collection over 24 hours, twice a week. Each female S. japonicum produced an average of 2,198 eggs/day during the study period of 99 days after infection (ranged 61-147 days). Fourty-seven percent of the eggs were in the feces and 53% in tissues (45% in large intestine, 31% in small intestine, 23% in liver, 0.4% in pancreas, 0.2% in lungs, 0.1% in spleen, 0.1% in lymph nodes, 0.06% in stomach and 0.05% in heart, kidney, diaphragm and brain).

Superior electrochemical properties of MoS2 powders with a MoS2@void@MoS2 configuration.

Yolk-shell MoS2 powders with a distinct configuration of MoS2@void@MoS2 were prepared for the first time by applying spray pyrolysis. The yolk-shell MoO3 powders prepared by spray pyrolysis were converted into MoS2 powders by a simple sulfidation process at 400 °C without altering the morphology. Dense structured MoS2 powders were also prepared by a similar process. The respective initial discharge capacities of the yolk-shell and dense structured MoS2 powders at a current density of 1000 mA g(-1) were 651 and 490 mA h g(-1), and the corresponding capacity retentions after 100 cycles measured from the second cycle were 100 and 72%.

Hierarchical MoSe2 yolk-shell microspheres with superior Na-ion storage properties.

Yolk-shell-structured MoSe2 microspheres were prepared via a simple selenization process of MoO3 microspheres. The yolk-shell-structured MoSe2 and MoO3 microspheres delivered initial discharge capacities of 527 and 465 mA h g(-1) in the voltage range of 0.001-3 V vs. Na/Na(+) at a current density of 0.2 A g(-1), respectively, and their discharge capacities after 50 cycles were 433 and 141 mA h g(-1), respectively. The yolk-shell-structured MoSe2 microspheres also exhibited outstanding high rate capabilities. The hierarchical yolk-shell structure comprised of wrinkled nanosheets facilitated fast Na-ion and electron kinetics, and buffered the large volume changes encountered during cycling.

Air-stable silver-coated copper particles of sub-micrometer size.

Silver-coated copper particles with various silver loading were prepared by a direct liquid-to-particle conversion process in spray pyrolysis reactor system. The prepared particles were completely densified at 900°C within a residence time of 2.1 s and had core-shell structure, of which formation mechanism was proposed. The mean diameter of particles was 0.45 µm. Copper particles of 20 wt.% of silver loading were stable under air and 95% of copper remained as metallic copper even after 1 month of exposure to air. This enhanced air-stability contributed to the enhanced electrical property of conductive film obtained from the coated particles. The conductive film obtained from 15 wt.% of silver-coated copper particles had a sheet resistance of 1.2 mΩ square(-1). This low resistance resulted from the lack of oxide layer and low sintering temperature of silver layer.

Electrical and morphological properties of conducting layers formed from the silver-glass composite conducting powders prepared by spray pyrolysis.

Ag-glass composite powders with various glass contents and excellent conducting properties were prepared by spray pyrolysis. Irrespective of the glass content, all the prepared powders were found to comprise spherical particles with nonaggregation characteristics. The crystal structure of the powder particles resembled that of pure Ag particles, irrespective of the glass content. Conducting layers formed from pure Ag did not melt even when sintered at 400 degrees C. On the other hand, conducting layers formed from composite powders containing 3 and 5 wt% glass melted when sintered at 400 degrees C. The optimum glass content of the composite powders was 3 wt% at sintering temperatures of 400 and 450 degrees C. However, the optimum glass content decreased to 1 wt% when the sintering temperature was increased to 550 degrees C. The lowest specific resistances of the conducting layers formed from the composite powders were 5.3 and 2.3 microohms-cm at sintering temperatures of 400 and 550 degrees C, respectively.

Molecular cloning and expression of bovine kappa-casein in Escherichia coli.

A cDNA library was constructed using poly(A) +RNA from bovine mammary gland. This cDNA library of 6000 clones was screened employing colony hybridization using 32P-labelled oligonucleotide probes and restriction endonuclease mapping. The cDNA from the selected plasmid, pKR76, was sequenced using the dideoxy-chain termination method. The cDNA insert of pKR76 carries the full-length sequence, which codes for mature kappa-casein protein. The amino acid sequence deduced from the cDNA sequence fits the published amino acid sequence with three exceptions; the reported pyroglutamic acid at position 1, tyrosine at position 35, and aspartic acid at position 81 are, respectively, a glutamine, a histidine, and an asparagine in the clone containing pKR76. The MspI-, NlaIV-cleaved fragment (630 base pair) from the kappa-casein cDNA insert has been subcloned into expression vectors pUC18 and pKK233-2, which contain a lac promoter and a trc promoter, respectively. Escherichia coli cells carrying the recombinant expression plasmids were shown to produce kappa-casein protein having the expected mobility on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and being recognized by specific antibodies raised against natural bovine kappa-casein.

Cloning and sequence analysis of bovine beta-casein cDNA.

A bovine beta-casein cDNA clone was isolated from a cDNA library prepared from mammary gland mRNA. Sequence analysis revealed 25 nucleotides (nt) of the 5' noncoding region, 672 nt of the complete sequence coding and a 3' region of approximately 500 nt. When the nucleotide sequence of bovine beta-casein cDNA is compared to rat beta-casein cDNA (5), a high degree of homology is observed in the first 100 nt corresponding to the signal peptide of the pre-beta-caseins.

Dimethyl methylphosphonate decomposition on Cu surfaces: supported Cu nanoclusters and films on TiO2(110).

The thermal decomposition of dimethyl methylphosphonate (DMMP), which is a simulant molecule for organophosphorus nerve agents, has been investigated on Cu clusters as well as on Cu films deposited on a TiO(2)(110) surface. Scanning tunneling microscopy studies were conducted to characterize the cluster sizes and surface morphologies of the deposited Cu clusters and films. Temperature-programmed desorption experiments demonstrated that the surface chemistry of DMMP is not sensitive to the size of the Cu clusters over the range studied in this work. DMMP reaction on an annealed 40 monolayer Cu film resulted in the desorption of H(2), methane, methyl, formaldehyde, methanol, and molecular DMMP, and reaction on the small (4.4 +/- 0.9 nm diameter, 1.8 +/- 0.6 nm height) and large (10.7 +/- 1.9 nm diameter, 4.8 +/- 1.0 nm height) Cu clusters generated similar products. Formaldehyde and methane production is believed to occur via a methoxy intermediate on the Cu surface. These products are favored on the higher coverage Cu films that completely cover the TiO(2) surface since competing reaction pathways on TiO(2) are suppressed. X-ray photoelectron spectroscopy studies showed that DMMP begins to decompose on the Cu clusters upon adsorption at room temperature and that atomic carbon, atomic phosphorus, and PO(x) remain on the surface after DMMP decomposition.

The effects of topical alpha-hydroxyacids on the normal skin barrier of hairless mice.

BACKGROUND: alpha-hydroxyacids (AHA), such as glycolic acid and lactic acid, have recently been used in cosmetic and dermatological formulations. However, the mechanisms of action of these substances have not been well documented. OBJECTIVES: This study was done to investigate the effects of AHA on the skin barrier of hairless mice and to clarify the contribution of AHA to the formation and secretion of the lamellar bodies (LB), which are known to be the critical structure for barrier function in the epidermis. METHODS: 5% Lactic acid and 5% glycolic acid were applied to normal skin of the mice daily for 14 days. RESULTS: Changes in transepidermal water loss (TEWL), capacitance and electron microscopic findings of the epidermis of hairless mice were compared with those in which only the vehicle was applied. CONCLUSIONS: There were no significant differences in TEWL, capacitance or epidermal thickness between the epidermis of the mice to which AHA or vehicle only had been applied. On electron micrographs, the normal epidermis to which AHA had been applied showed an increase in the number and secretion of LB and a decrease in the number of stratum corneum (SC) layers in comparison with the epidermis to which the vehicle only had been applied. The lipid layers of the SC intercellular spaces and calcium gradient in both the epidermis with application of AHA and that with vehicle only were normal. These results suggest that AHA, in low concentration (5%), may improve the skin barrier in hairless mice by inducing enhanced desquamation, and by increasing the number and secretion of LB without increasing TEWL.