Induced membrane technique using beta-tricalcium phosphate for reconstruction of clavicle bone defect after fracture related infection - A case report.

The induced membrane technique (IMT) is among the most innovative reconstructive methods for clavicle defects after fracture-related infection (FRI). Herein, we report a case in which a clavicle bone defect after FRI was reconstructed with an autogenous cancellous bone graft mixed with ß-tricalcium phosphate (ß-TCP) in the second stage of the IMT. A 62-year-old male patient with left clavicle fracture underwent open reduction and internal fixation. Refracture occurred immediately after the implant was removed. The patient was diagnosed with FRI after reopen reduction and internal fixation and was then referred to our hospital. The surgery was performed using the IMT. In the second stage of the IMT, the bone defect was filled with an autogenous cancellous bone mixed with wool-type ß-TCP. At 8 months after surgery, the nonunion area had fused, and the patient had no restrictions in activities of daily living. The IMT with ß-TCP can be a reconstructive method for bone defects after clavicular nonunion.

Validity of simplified, calibration-less exercise intensity measurement using resting heart rate during sleep: a method-comparison study with respiratory gas analysis.

BACKGROUND: The recent development of wearable devices has enabled easy and continuous measurement of heart rate (HR). Exercise intensity can be calculated from HR with indices such as percent HR reserve (%HRR); however, this requires an accurate measurement of resting HR, which can be time-consuming. The use of HR during sleep may be a substitute that considers the calibration-less measurement of %HRR. This study examined the validity of %HRR on resting HR during sleep in comparison to percent oxygen consumption reserve (%VO2R) as a gold standard. Additionally, a 24/7%HRR measurement using this method is demonstrated. METHODS: Twelve healthy adults aged 29 ± 5 years underwent treadmill testing using the Bruce protocol and a 6-min walk test (6MWT). The %VO2R during each test was calculated according to a standard protocol. The %HRR during each exercise test was calculated either from resting HR in a sitting position (%HRRsitting), when lying awake (%HRRlying), or during sleep (%HRRsleeping). Differences between %VO2R and %HRR values were examined using Bland-Altman plots. A 180-day, 24/7%HRR measurement with three healthy adults was also conducted. The %HRR values during working days and holidays were compared. RESULTS: In the treadmill testing, the mean difference between %VO2R and %HRRsleeping was 1.7% (95% confidence interval [CI], - 0.2 to 3.6%). The %HRRsitting and %HRRlying values were 10.8% (95% CI, 8.8 to 12.7%) and 7.7% (95% CI, 5.4 to 9.9%), respectively. In the 6MWT, mean differences between %VO2R and %HRRsitting, %HRRlying and %HRRsleeping were 12.7% (95% CI, 10.0 to 15.5%), 7.0% (95% CI, 4.0 to 10.0%) and - 2.9% (95% CI, - 5.0% to - 0.7%), respectively. The 180-day, 24/7%HRR measurement presented significant differences in %HRR patterns between working days and holidays in all three participants. CONCLUSIONS: The results suggest %HRRsleeping is valid in comparison to %VO2R. The results may encourage a calibration-less, 24/7 measurement model of exercise intensity using wearable devices. TRIAL REGISTRATION: UMIN000034967.Registered 21 November 2018 (retrospectively registered).

Implantable arterial port-related bloodstream infection in patients with primary or metastatic hepatic malignancies.

The incidence of implantable arterial post-related bloodstream infections (IAP-RBSI) among patients with unresectable hepatic malignancies is not well defined. We reviewed the 9-year incidence of implantable arterial post-related bloodstream infections in patients with hepatic malignancies, at a tertiary care center in Japan. The incidence was 1.9 infections per 10,000 catheter-days.

Speciation of mercury in salmon egg cell cytoplasm in relation with metallomics research.

Speciation of mercury in salmon egg cell cytoplasm was investigated by surfactant-mediated high-performance liquid chromatography/inductively coupled plasma mass spectrometry (HPLC/ICP-MS), where an ODS (octadecylsilica) column coated with a bile acid derivative, CHAPS (3-[(3-cholamidopropyl)-dimethylammonio]-1-propane sulfonate), was used for species separation. Prior to the speciation analysis, total Hg in the cell cytoplasm was determined by ICP-MS at m/z 202 in a flow injection mode. For the precise measurement, salmon egg cell cytoplasm was diluted five-fold with 0.1M Tris (Tris(hydroxymethyl)aminomethane)-HNO(3) buffer solution, and the standard addition method was employed. Thus, the total concentration of Hg in cell cytoplasm was estimated to be 12.4ngg(-1) on the wet weight basis. Next, the cell cytoplasm diluted five-fold with 0.1M Tris-HNO(3) buffer solution was analyzed by surfactant-mediated HPLC with the dual detection system of a UV absorption detector and an ICP-MS instrument. Two peaks corresponding to some proteins and small molecules were mainly observed in those chromatograms. When salmon egg cell cytoplasm was diluted five-fold with 0.01M Tris buffer solution or pure water, some precipitates appeared probably because of precipitation of hydrophobic proteins in cytoplasm. After the precipitates were eliminated with a membrane filter, the filtrate was subjected to the analysis by surfactant-mediated HPLC/UV/ICP-MS. As a result, the peaks for small molecular species of Hg were clearly observed at the retention time near 4.0min (corresponding to low-molecular weight zone) in the chromatograms with UV absorption detection as well as with Hg- and S-specific ICP-MS detections. The small molecule bound with Hg was identified as cysteine through the cysteine-spiked experiment. In addition, the protein fraction on the chromatogram obtained by using the CHAPS-coated ODS column was further analyzed by SEC (size exclusion chromatography). Consequently, several protein peaks with molecular weight of 300, 50 and 12kDa were observed in all the detections of UV absorption, Hg and Se, although two peaks among them were coincident in the case of S. These results indicate that Hg in salmon egg cell cytoplasm binds with proteins containing selenocysteine and/or cysteine residues in proteins.

Major-to-ultratrace elements in bone-marrow fluid as determined by ICP-AES and ICP-MS.

The major-to-ultratrace elements in human bone-marrow fluid were determined by ICP-AES (inductively coupled plasma atomic emission spectrometry), and ICP-MS (inductively coupled plasma mass spectrometry). The bone-marrow fluid sample was centrifuged prior to acid digestion to exclude the bone piece from bone marrow, and then digested with nitric acid. As a result, 20 elements could be determined over the concentration range from 1610 microg g(-1) for Na to 0.00043 microg g(-1) for W. It was found that Fe, Zn and Sb were enriched by ca. 264-, 7- and 15-fold, respectively, in bone-marrow fluid, compared to those in human blood serum. Alkali metals (K, Rb, Cs), except for Na, were also significantly enriched in bone-marrow fluid. Furthermore, the concentrations of various elements, such as Fe, P, Al, Zn, Cu, Se, Zr, Sn, Ag and W, were significantly higher than those in open seawater.