Treatment of acromioclavicular separations. A retrospective study.

A retrospective study of 134 patients with Types I, II, and III acromioclavicular separations was carried out. The average followup was 6.3 years, with the longest being 19 years, and the shortest being 1 year. The mechanism of injury was a direct blow in 92% of the patients. The average age of the patients was 30.1 years, with a range from 13 to 68 years. All patients were evaluated using a standard rating system for the shoulder and humerus, the total for perfect recovery being 100. Twenty-four patients with Type I separations were immobilized 19.5 days, with a disability period of 6 weeks, and rated 94 points. Twenty-five patients with Type II separations were immobilized 27 days for the conservative groups, had a disability period of 6 weeks, and rated 90 points. Eighty-five patients with Type III acromioclavicular separations were followed. Seven patients had conservative treatment, were immobilized an average of 22 days, with a disability period of 13 weeks, and rated 82. Of those patients who underwent surgical repair, excluding Dacron graft substitution, the immobilization period was 6 weeks, with a disability period of 12 weeks, and a rating of 80. Fifty-eight patients underwent repair with double velour Dacron prosthetic substitution for the coracoclavicular ligaments, combined with distal clavicular resection in all but two patients. The average immobilization period was 1 week, with the average disability period being 3 weeks. The average rating was 96, with 24 patients rating 100. The major cause for a rating less than 100 was light to moderate pain that persisted in a few cases, which was only occasional and associated with a particular activity. One infection occurred requiring graft removal 5 months after surgery. Calcification in the area of the coracoclavicular ligaments did not affect the final rating and recurrence of deformity was not noted.

A high-strength Dacron augmentation for cruciate ligament reconstruction. A two-year canine study.

Augmentation and substitution grafting was performed in 48 adult canine stifles after anterior cruciate ligament resection. Four surgical reconstructions were performed: substitution in over-the-top fashion intra-articularly with just the Dacron implant; intra-articular substitution with tibial and femoral drill holes; over-the-top substitution intra-articularly and extra-articularly with the Dacron graft augmenting the iliotibial band wraparound transfer; and two-band extra-articular Dacron substitution with the Coker modification of the MacIntosh extra-articular reconstruction without iliotibial band. Sacrifice was performed at six, 12, 24, and 36 weeks postoperation with each specimen submitted for histologic or tensile strength testing. Four canines incurred infection and were omitted from follow-up study. Examination at six and 12 weeks revealed no graft breakage, stable knees, and no evidence of degenerative change radiographically in stifles. Fibrous ingrowth was present in the intra-articular substitution and augmentation stifles. No loss of ultimate failure strength was noted during failure mode testing. The direct substitution procedure revealed some evidence of cutting-edge disruption in 24-week canines. Beveling the drill holes could eliminate this problem. Follow-up evaluation of the augmentation techniques at 24 weeks revealed increased preservation of the iliotibial band-wrapped graft by a higher degree of fibrous ingrowth. No further loss in tensile strength of the graft was noted; concurrently, no increase in tensile strength was appreciated. The use of high-tensile-strength Dacron as an augmentation to biologic transfer appears to offer significant promise as a technique for human application. The study is continuing for long-term durability of the augmentation graft.

Changes in morphology of Paecilomyces japonica and their effect on broth rheology during production of exo-biopolymers.

The influence of Paecilomyces japonica pellet morphology on fermentation broth rheology and exobiopolymer production was investigated in a 5-1 jar fermenter. Rapid formation of pellets was observed after the first day of fermentation; and these slowly increased in size and roughness. This, together with the increase in biomass concentration, altered the transport characteristics and broth rheology towards a pseudoplastic nature which, in turn, influenced cell growth and exo-biopolymer production. At mild agitation, high aeration and optimum substrate concentration, pellets were the most predominant morphological form, compared with free mycelia. The broth rheology showed pseudoplastic behavior; and the fungal morphology was closely related to the rheological properties.

Mycelial growth and exo-biopolymer production by submerged culture of various edible mushrooms under different media.

AIMS: The effect of synthetic media on the submerged mycelial growth and exo-biopolymer production in various edible mushrooms was investigated in shake flask culture. METHODS AND RESULTS: Among 19 mushrooms examined, the relatively high yield in mycelial biomass and exo-biopolymer production was achieved in potato malt peptone (PMP) medium. In particular, Ganoderma lucidum NO. 1 and Phellinus linteus KCTC 6190 showed favourable growth in PMP medium with exo-biopolymer concentration of 1170 and 1520 mg l(-1), respectively. CONCLUSIONS: Enhanced exo-biopolymer production was achieved from Ganoderma lucidum NO. 1 and Phellinus linteus KCTC 6190 in a 5L batch fermentor, indicating approximately 5000 and 2410 mg l(-1), respectively. SIGNIFICANCE AND IMPACT OF THE STUDY: The exo-biopolymer production and mycelial growth from various mushrooms were found to be strongly controlled by different complex media.

Effect of agitation intensity on the exo-biopolymer production and mycelial morphology in Cordyceps militaris.

AIMS: The influence of agitation intensity on Cordyceps militaris morphology and exo-biopolymer production was investigated in a 5 litre stirred vessel using a six-blade Rushton turbine impeller. METHODS AND RESULTS: The mycelial morphology of C. militaris was characterized by means of image analysis, which included mean diameter, circularity, roughness and compactness of the pellets. The morphological parameters of the pellets grown under different stirring conditions were significantly different, which correspondingly altered exo-biopolymer production yields. CONCLUSIONS: The compactness of the pellets was found to be the most critical parameter affecting exo-biopolymer biosynthesis; more compact pellets were formed at 150 rev min(-1) with maximum exo-biopolymer production (15 g l(-1)). SIGNIFICANCE AND IMPACT OF THE STUDY: The results of this study suggest that morphological change of pellets is a good indicator for identifying the cell activity for exo-biopolymer production.