Two year follow up of supercapsular percutaneously assisted total hip arthroplasty.

BACKGROUND: Dislocation after primary total hip arthroplasty (THA) has an incidence of 2-3%. Approximately 77% of dislocations occur within the first year after surgery. The SuperPATH technique is a minimally invasive approach for THA that preserves soft tissue attachments. The purpose of this study is to describe the dislocation rate at 1 year after SuperPATH primary THA. METHODS: All elective primary THAs performed by the senior author using the SuperPATH approach. Exclusion criteria were acute femoral neck fracture, revision surgery, or malignancy. There were 214 of 279 eligible patients available for telephone interviews (76.7%). Medical records were reviewed for secondary outcomes including early and late complications, cup positioning, distance ambulated on postoperative day one, discharge destination, and blood transfusions. RESULTS: Mean age at surgery was 64 ± 10.8 years and mean time to telephone follow up was 773 ± 269.7 days. There were 104 female and 110 male patients. There were zero dislocations reported. Blood transfusions were performed in 3.7% of patients, and 75.7% were discharged to home at an average of 2.3 ± 1.0 days. Cup position averaged 43.6 ± 5.2° abduction and 20.9 ± 6.2° anteversion, with an average leg length discrepancy of 3.6 ± 3.32 mm. Complications included three intraoperative calcar fractures, one periprosthetic femur fracture, one early femoral revision, three superficial infections, and one instance of wound necrosis. CONCLUSION: SuperPATH approach is safe for use in primary THA resulting in a low dislocation rate.

A Role for Modern Primary Cementless Femoral Stems in Revision Hip Arthroplasty.

BACKGROUND: In revision total hip arthroplasty (THA) cases with preserved femoral metaphyseal bone, tapered proximally porous-coated "primary" femoral stems may be an option. The objective of this study was to compare outcomes of patients with Paprosky I or II femoral bone loss undergoing revision THA with either a primary metaphyseal-engaging cementless stem or a revision diaphyseal-engaging stem. METHODS: This was a retrospective analysis of 70 patients with Paprosky I or II femoral bone loss who underwent femoral revision. 35 patients who were revised using a primary cementless femoral stem were compared with 35 patients who underwent femoral revision using a revision diaphyseal-engaging stem. The groups were similar regarding age, gender, body mass index, and American Society of Anesthesiologists. Clinical and radiographic outcomes and complications were compared over an average follow-up of 2.9 years (SD 1.4). RESULTS: Revision THA was most commonly performed for periprosthetic joint infection (N = 27, 38.6%). The groups were similar with regards to Paprosky femoral classification (P = .56), length of stay (P = .68), discharge disposition (P = .461), operative time (P = .20), and complications (P = .164). There were no significant differences between primary and revision femoral stem subsidence (0.12 vs. 0.75 mm, P = .18), leg length discrepancy (2.3 vs. 4.05 mm, P = .37), and Hip Disability and Osteoarthritis Outcome Score Jr (73.1 [SD 21.1] vs. 62.8 [SD 21.7], P = .088). No patient underwent additional revision surgery involving the femoral component. CONCLUSION: Use of modern primary cementless femoral stems is a viable option for revision hip arthroplasty in the setting of preserved proximal femoral metaphyseal bone. Outcomes are not inferior to those of revision stems and offer potential benefits.

Modern Techniques for the Management of Metastatic Spine Disease.

The management of metastatic spine disease has evolved substantially in the past 5 years. Early treatment approaches with more aggressive surgical indications were based on studies that misinterpreted or overemphasized the advantages of the surgical management of metastatic spine disease. However, substantial advantages in radiation therapy, chemotherapy, and biologic agents have led to considerable improvements in patient outcomes and have, in many patients, shifted the paradigm back to nonsurgical or less invasive treatment modalities. Surgeons should be aware of critiques of earlier treatment strategies and associated frameworks for the management of metastatic spine disease. The Medical, Oncologic, Stenosis, and Stability framework was developed to address some of the shortcomings of early metastatic spine disease treatment approaches.

Light losses from scattering in luminescent solar concentrator waveguides.

The reductions in the transmission of emission originating from a fluorophore dissolved in a polymer matrix due to light scattering were compared in two forms of planar waveguides used as luminescent solar concentrators: a thin film of poly(methylmethacrylate) (PMMA) spin-coated on a glass plate and a solid PMMA plate of the same dimensions. The losses attributable to light scattering encountered in the waveguide consisting of the thin film of polymer coated on a glass plate were not detectable within experimental uncertainty, whereas the losses in the solid polymer plate were significant. The losses in the solid plate are interpreted as arising from light-scattering centers comprising minute bubbles of vapor/gas, incomplete polymerization or water clusters that are introduced during or after the thermally induced polymerization process.

The photophysics of phenylenevinylene oligomers and self-absorption of their fluorescence in polymer films.

The fluorescence spectra, quantum yields and lifetimes of a series of alkoxy-substituted phenylenevinylene molecules, which serve as short chain oligomer models for poly(p-phenylenevinylene), have been determined in fluid solvents and in a high viscosity polymer matrix. The effects of solvent polarity and a high viscosity molecular environment on the fluorescence yields and spectral shapes have been established. Alkoxy group substitution on the phenyl ring moieties of the molecules has an important effect on the vibronic structures and profiles of the absorption spectra. This was interpreted in terms of hot-band, ground to excited singlet state transitions from energetically closely-spaced torsional vibrational levels of the vinylene double bond in the ground state. The shapes of the absorption bands affect the overlaps of the absorption and fluorescence spectra. This has been quantified as the probability of fluorescence reabsorption in solid polymer films as a function of pathlength. This is an important determinant of the efficacies of these compounds for "harvesting" solar energy in luminescent solar concentrator systems. The reabsorption probabilities of these compounds are lower for all pathlengths than those determined in the same polymer film for the fluorophores, perylene and perylene diimide, which have been considered for concentrating spatially diffuse sunlight.

Synthesis and solution aggregation studies of a suite of mixed neutral and zwitterionic chromophores for second-order nonlinear optics.

We report details of the synthesis of a series of bi- and trichromophores. These compounds contain mixtures of chromophores that have zwitterionic (ZWI) and neutral ground state (NGS) components covalently attached to each other. The neutral ground state moieties are based on dyes with aniline donors--such as Disperse Red 1--whereas the zwitterionic components are derived from chromophores with pro-aromatic donors such as 1,4-dihydropyridinylidene. By combining both ZWI and NGS components, we aim to develop novel compounds for nonlinear optics in which there is an enhancement of the overall hyperpolarizability coupled with a decrease in the net dipole moment. Thus, this approach should eliminate the electrostatic effects that result when only one type of chromophore is used, and so reduce the likelihood of undesirable aggregation occurring. This, in turn, should enable us to realize organic materials with large macroscopic optical nonlinearities. An analysis of the UV-vis results suggests that there is a strong dependence on solvent polarity that determines whether the embedded constituents should be treated as discrete elements; in low polarity solvents, there appear to be strong intramolecular interactions occurring, particularly when a 1,4-quinolinylidene-based donor is used in the ZWI component.

2-{2-[5-(4-Cyano-5-di-cyano-methyl-idene-2,2-dimethyl-2,5-di-hydro-furan-3-yl)penta-2,4-dienyl-idene]-3,3-dimethyl-2,3-di-hydro-1H-indol-1-yl}ethyl 3,5-bis-(benz-yloxy)benzoate.

In the title mol-ecule, C48H42N4O5, a potential non-linear optical compound, the furan ring [r.m.s. deviation = 0.010 (1) Å] and the indolyl-idene ring system [r.m.s. deviation = 0.013 (2) Å] are inclined to one another by 18.52 (6)°. This is similar to the arrangement [16.51 (18)°] found for the N-hy-droxy-ethyl adduct of the title compound [Bhuiyan et al. (2011 ▶). Mol. Cryst. Liq. Cryst. 548, 1-12]. Replacing the hy-droxy-ethyl group with 3,5-di-benzyl-oxybenzoate has not resulted in a non-centrosymmetric lattice arrangement or significant changes to the basic mol-ecular structure. In the crystal, mol-ecules are linked via pairs of C-H⋯N hydrogen bonds, forming inversion dimers with an R (2) 2(20) ring motif. The dimers are linked via C-H⋯O hydrogen bonds, forming C(17) chains along [010]. The chains are linked by further C-H⋯N hydrogen bonds, forming layers parallel to (001) and enclosing R 2 (2)(44) ring motifs. There are also C-H⋯π inter-actions present, stabilizing the inter-layer orientation of the pendant bis-(benz-yloxy)benzo-yloxy group.

2-(3-Cyano-4-{3-[1-(2-hy-droxy-eth-yl)-3,3-dimethyl-1,3-di-hydro-indol-2-yl-idene]prop-2-en-yl}-5,5-dimethyl-5H-furan-2-yl-idene)malono-nitrile.

The title compound, C25H24N4O2, adopts a cisoid configuration and has twofold orientational disorder of the 2-hy-droxy-ethyl group. The mol-ecule is twisted from planarity so that the dihedral angle between the terminating indol-2-yl-idene and the furan-2-yl-idene moiety mean planes is 12.75 (7)°. Conformational disorder occurs at the indol-2-yl-idene N atom, which results in two orientations for the hy-droxy-ethyl group [occupancy ratio = 0.896 (2):0.104 (2)], and the hy-droxy O atom of the 2-hy-droxy-ethyl group is located over three sites [occupancy ratio = 0.548 (2):0.348 (2):0.104 (2)]. An intra-molecular C-H⋯O hydrogen bond involving the lowest occupancy hy-droxy O atom is observed. In the crystal, the mol-ecules pack in parallel dimeric sheets about centres of symmetry, utilizing O-H⋯N(cyano), C-H⋯N(cyano) and O-H⋯O hydrogen bonds, in two sets parallel to (02-1) and (021) planes.

1-(2,3-Di-hydroxy-prop-yl)-4-{2-[4-(di-methyl-amino)-phen-yl]vin-yl}pyridinium chloride.

The title compound, C18H23N2O2 (+)·Cl(-), crystallizes with two independent cations and anions per cell. Each cation has twofold rotational disorder about the linking vinyl groups but with unequal occupancies [0.963 (5):0.037 (5) and 0.860 (8):0.140 (8)]. The two independent cations are close to being related by an inversion centre but the data does not support the expected centrosymmetric space-group assignment. The conclusion is that the differing rotational disorder has lead to an overall non-centrosymmetric lattice. In the crystal, the mol-ecules pack in layers parallel to (133) and (-13-3), chain-linked with motif C (1) 2(7) by the di-hydroxy-propyl O-H⋯Cl⋯H-O hydrogen bonds. Other lattice binding is provided by O-H⋯Cl, C-H⋯Cl and C-H⋯N inter-actions.

Facile Synthesis of a Novel Furanic Monomer and Its ADMET Polymerization toward Fully Renewable Functional Polymers.

Efficient and sustainable transformation of biomass-derived chemicals to materials with the potential to replace conventional fossil-derived polymers is considered a major challenge. In this work, we disclose the synthesis of a novel furan-based α,ω-diene monomer following a facile, green, and energy-efficient process from fully renewable starting materials. The multifunctional monomer was produced by the base-catalyzed cross-aldol condensation of 10-undecenal (UA) and 2,5-diformylfuran (DFF) under mild conditions, providing the desired product in good yields. By employing the new monomer, fully biobased polymers were prepared in good molecular weights (M n up to 31 kg/mol) by acyclic diene metathesis (ADMET) polymerization using Grubb's second-generation catalysts. The structure-property investigation of the polymers revealed T g in the range of -16 to 5 °C, high thermal stability, good hydrophobicity, and photoactive properties. Owning to the presence of amenable functional groups, the resultant polymer was also subjected to postpolymerization modifications. The effect of these modifications on the polymer properties showed enhanced crystallization attributed to hydrogen bonding interactions. This work demonstrates a scalable and environmentally benign approach to access structurally novel and versatile materials exhibiting interesting properties from 100% biobased resources.

Lyophilized brain tumor specimens can be used for histologic, nucleic acid, and protein analyses after 1 year of room temperature storage.

Frozen tissue, a gold standard biospecimen, can yield well preserved nucleic acids and proteins after over a decade but is vulnerable to thawing and has substantial fiscal, spatial, and environmental costs. A long-term room temperature biospecimen storage alternative that preserves broad analytical utility can potentially empower tissue-based research. As there is scant data on the analytical utility of lyophilized brain tumor biospecimens, we evaluated lyophilized (freeze-dried) samples stored for 1 year at room temperature. Lyophilized tumor tissue processed into paraffin sections produced good histology. Yields of extracted DNA, RNA, and protein approximated those of frozen tissue. After 1 year, lyophilized samples yielded high molecular weight DNA that permitted copy number variation analysis, IDH 1 mutation detection, and MGMT promoter methylation PCR. A 27 % decrease in RIN scores over the 1 year suggests that RNA degradation was inhibited though incompletely. Nevertheless, RT-PCR studies on lyophilized tissue performed similarly to frozen tissue. In contrast to FFPE tissues where protein bands were absent or shifted to a lower molecular weight, lyophilized samples showed similar protein bands as frozen tissue on SDS-PAGE analysis. Lyophilized tissue performed similarly to frozen tissue for Western blots and enzyme activity assays. Immunohistochemistry of lyophilized tissue that were processed into FFPE blocks often required longer incubation times for staining than standard FFPE samples but generally provided robust antigen detection. This preliminary study suggests that lyophilization has promise for long-term room temperature storage while permitting varied tests; however, further work is required to better stabilize nucleic acids particularly RNA.

Multiple cerebral abscesses in Papillon-Lefèvre syndrome.

Papillon-Lefèvre syndrome is characterised by palmoplantar keratoderma, periodontitis and pyogenic infections. We describe the first case of brain abscess in a child with this syndrome. We highlight the importance of recognising any associated diagnosis, however rare or apparently irrelevant, in an acutely and critically ill child.

(E)-5-[3-Cyano-2-(dicyano-methyl-ene)-1-oxaspiro-[4.5]dec-3-en-4-yl]-3-(1-methyl-1,4-dihydro-pyridin-4-yl-idene)pent-4-en-1-yl 3,5-bis-(benz-yloxy)benzoate.

In the title compound, C45H40N4O5, the cyclo-hexane entity on the (3-cyano-2,5-dihydro-furan-2-yl-idene)propane-dinitrile group, which replaces the usual dimethyl substituents, has not perturbed the delocalization geometry significantly. Weak inter-molecular inter-actions, viz. C-H⋯N(cyano), C-H⋯O(ether), C-H⋯π and π-π [between the aromatic rings with the shortest centroid-centroid distance of 3.603 (3) Å], consolidate the crystal packing, which exhibits voids of 57 Å(3).

2-[4-(2-{5-tert-Butyl-2-chloro-3-[2-(3-pentyl-1,3-benzothia-zol-2-yl-idene)ethyl-idene]cyclo-hex-1-en-yl}ethen-yl)-3-cyano-5,5-dimethyl-furan-2-yl-idene]malono-nitrile.

In the title mol-ecule, C36H39ClN4OS, the non-aromatic part of the cyclo-hex-1-enyl ring and the attached tert-butyl group are disordered over two conformations with occupancy ratios of 0.52 (3):0.48 (3) and 0.53 (3):0.47 (3), respectively. The polyene chain single- and double-bond dimensions contrast with a closely related compound [Bouit et al. (2007 ▶). Chem. Mater.19, 5325-5335] with an approximate 19° twist between donor and acceptor ends of the mol-ecule, related to the additional intra-molecular C-H⋯S inter-action. In the title compound, the mol-ecules pack into dimeric units about centres of symmetry utilizing weak C-H⋯N(cyano) and C-H⋯O attractive inter-actions, building both chain and ring motifs about the centres [R2(2)(8) and R2(2)(9)]. Adjacent dimeric sets then form a herringbone configuration.

Bis(2-carb-oxy-N-{[1-(2-hy-droxy-eth-yl)-3,3-dimethyl-indolin-2-yl-idene]methyl-imino}-anilinium) sulfate monohydrate.

The asymmetric unit of the title compound, 2C20H22N3O3(+)·SO4(2-)·H2O, contains four cations, two sulfate anions and two lattice water mol-ecules. One of the four cations shows a different conformation of the hy-droxy-ethyl group; the remaining three are all essentially superimposable. Two cations exhibit two-site orientational disorder [ratios = 0.524 (5):0.476 (5) and 0.616 (6):0.384 (6)] of the last two atoms of their hy-droxy-ethyl groups, and one water mol-ecule is disordered over two positions in a 0.634 (13):0.366 (13) ratio. Each imine H atom is intra-molecularly in contact with the adjacent carboxyl O atom, forming an S(6) motif, while all the carb-oxy-lic acid H atoms are hydrogen bonded to O atoms of the sulfate anions. Other notable hydrogen-bond inter-actions involve (methyl-ene, phenyl and imine chain) C-H⋯O (sulfate and carbox-yl) and O-H⋯O(water) contacts, making up a comprehensive three-dimensional network involving D2(2)(n), with n = 4-6 and 15-16, and C2(2)(17) classical hydrogen-bond motifs. The crystal investigated was twinned by pseudomerohedry with a twin component ratio of 0.4745 (12):0.5255 (12).

2-(3-Cyano-4-methyl-5,5-diphenyl-5H-furan-2-yl-idene)malono-nitrile.

The title compound, C21H13N3O, crystallizes with two independent molecules with similar conformations per asymmetric unit. The dihydrofuran rings are essentially planar with maximum deviations of 0.017 (1) and 0.006 (1) Šfor the O atoms. The dihedral angles between the di-hydro-furan ring and the attached phenyl rings are 79.90 (6) and 82.07 (6)° in one mol-ecule and 79.36 (6) and 72.26 (6)° in the other. In the crystal, the molecules are linked by weak C-H⋯π and C-H⋯N inter-actions similar to those in other closely related crystals. The replacement of appended methyl by phenyl groups has not significantly affected the dihydrofuran ring structure or the crystal packing interactions.

4-Methyl-5-(4-nitro-benzyl-idene)-2-oxo-2,5-di-hydro-1H-pyrrole-3-carbo-nitrile.

Mol-ecules of the potential non-linear optical title compound, C13H9N3O3, form dimeric stacks of mol-ecules along the a axis cross-linked around inversion centers by N-H⋯O hydrogen bonds and weak (phen-yl)C-H⋯O inter-molecular inter-actions, forming a 'collaboration' of R 2 (2)(8) and R 2 (2)(16) ring motifs. The mol-ecules are then further linked by weak C-H⋯O and C-H⋯N inter-actions into sheets parallel to (121).

1-(4-{[(1,3,3-Tri-methyl-indolin-2-yl-idene)meth-yl]diazen-yl}phen-yl)ethanone.

The title compound, C20H21N3O, has crystallographic mirror symmetry with all non-H atoms apart from the methyl C atom of the CMe2 group lying on the mirror plane. Mol-ecules are linked into planar sheets parallel to (010) by phen-yl-azo C-H⋯N and phen-yl-ethanone C-H⋯O inter-actions. Methyl C-H⋯π inter-actions provide crosslinking between the planes.

Testing computational models of hyperpolarizability in a merocyanine dye using spectroscopic and DFT methods.

The structural and electronic properties of a highly solvatochromic merocyanine dye, 2-(3-cyano-5,5-dimethyl-4-(3-(1-octadecylpyridin-4(1H)-ylidene)prop-1-enyl)furan-2(5H)-ylidene)malononitrile (pyr3pi), have been investigated using UV-vis, NMR, hyper-Rayleigh scattering, and Raman spectroscopies and further interpreted using computational chemistry. Spectroscopic data indicate that pyr3pi exists in its zwitterionic form even in low polarity solvents with electronic absorption spectra showing a hypsochromic shift with an increase in solvent polarity and NMR experiments indicating an increasingly zwitterionic structure in chloroform as the temperature is lowered. Raman spectra in increasingly polar solvents show small variations of the structure that are consistent with a change toward a structure with more zwitterionic character. However, comparison of the calculated and experimental vibrational energies and intensities and comparison of NMR coupling constants with calculated bond order indicate that calculations underestimate the amount of charge separation seen in low polarity solvents. Although for this system density functional theory (DFT) calculations and the two-state model qualitatively reproduce negative solvatochromism, they fail to reproduce the trends in hyperpolarizability seen experimentally. This is attributed to solvent field DFT calculations underestimating the degree of charge separation in reaction fields representing low polarity solvents.