Long-term behaviour of Cs-137, Cs-133 and K in beech trees of French forests.

In the long-term after atmospheric deposit onto a forest ecosystem, Cs-137 becomes incorporated into the biogeochemical cycle of stable elements and progressively reaches a quasi-equilibrium state. This study aimed at determining to what extent Cs-137 activity distribution in tree vegetation could be predicted from that of stable caesium (Cs-133) and potassium (K), which are known to be stable chemical analogues and competitors for Cs-137 intake in tree organs. Field campaigns that focused on beech trees (Fagus sylvatica L.) were conducted in 2021 in three French forest stands with contrasted characteristics regarding either the contribution of global vs. Chornobyl fallouts, soil or climatic conditions. Decades after Cs-137 fallouts, it was found that more than 80% of the total radioactive inventory in the system remained confined in the top 20 cm mineral layers, while organic layers and beech vegetation (including roots) contributed each to less than 1.5%. The enhanced downward migration of Cs-137 in cambisol than podzol forest sites was presumably due to migration of clay particles and bioturbation. The distribution of Cs-137 and Cs-133 inventories in beech trees was very similar among sites but differed from that of K due a higher accumulation of Cs isotopes in roots (40-50% vs. < 25% for K). The aggregated transfer factor (Tag) of Cs-137 calculated for aerial beech organs were all lower than those reported in literature more than 20 years ago, this suggesting a decrease of bioavailability in soil due to ageing processes. Regarding their variability, Tags were generally lower by a factor 5 at the cambisol site, which was fairly well explained by a much higher value of RIP (radiocesium immobilisation potential). Cs-137 concentrations in trees organs normalized by the soil exchangeable fractions were linearly correlated to those of Cs-133 and the best fit was found for the linear regression model without intercept indicating that no more contribution of the foliar uptake could be observed on long term. Provided that the vertical distribution of caesium concentrations and fine root density are properly measured or estimated, Cs-133 was shown to be a much better proxy than K to estimate the root transfer of Cs-137.

[Acute abdomen-Rare cause in an 80-year-old female patient under immunosuppressive treatment]. / Akutes Abdomen ­ seltene Ursache bei einer 80-jährigen Patientin unter immunsuppressiver Therapie.

An 80-year-old woman presented to the emergency department due to abdominal pain. She had a history of opportunistic pneumonia under the effects of immunosuppression after the diagnosis of autoimmune hepatitis. The imaging showed an omental cake formation and the suspicion of peritoneal carcinomatosis. The patient developed an acute abdomen during the hospital stay, followed by exploratory laparotomy. In the presence of extensive intra-abdominal abscess formation both surgically acquired material and blood culture revealed disseminated nocardiosis. The course was fatal due to fulminant septic shock.

Influence of ponds on hazardous metal distribution in sediments at a catchment scale (agricultural critical zone, S-W France).

Eight potentially toxic trace elements were investigated together with the physicochemical characteristics of sediments collected upstream, downstream, and from various ponds from three adjacent carbonated agricultural catchments in southwestern France. Geochemical indices with local references and multivariate data analysis revealed a significant enrichment of Cd, followed by Ni and Cu in sediments, originating from agricultural practices, especially in the upper catchments sensitive to erosion processes. Five other PTEs (As, Pb, Co, Cr, and Zn) mostly originated from the weathering process of the molasse. Clay minerals and/or iron oxides were the main controlling factors for most PTEs. In ponds, Cd was regulated by Ca co-precipitation favoured by the long hydraulic retention time and increased pH, whereas it was mostly controlled by silicates in stream sediments. Copper, Pb, and Cd were the highly extractable metals, suggesting the risk of a hazardous environment. Multivariate analysis revealed that several environmental factors affected the spatial variation of PTE concentrations in sediments as well as the trapping role of ponds (texture, slope, soil erosion, pond size and position, discharge, hydraulic retention time) in this area of intensive agricultural practices. Our conclusions are useful for pond management in a context of increasing water demand and climate warming.

Double-endoscope assisted endoscopic submucosal dissection for treating tumors in rectum and distal colon by expert endoscopists: a feasibility study.

BACKGROUND: Colorectal endoscopic submucosal dissection (ESD) is an effective but challenging procedure. To facilitate ESD, several methods that apply traction are available; however, the optimal one remains to be established. The aim of this study was to evaluate the feasibility and safety of the double-endoscope assisted ESD (DEA-ESD) by improving traction to treat complex colorectal lesions. METHODS: Naïve or previously treated lesions in the rectum and sigmoid colon were included. A grasping forceps advanced through a small-caliber endoscope (GIF-XP190N, Olympus Medical Systems, Tokyo, Japan, 5.4 mm outer diameter) was used to apply traction to the mucosal flap. Lesions were deemed complex when they exceeded a total of nine points on the SMSA scoring system (size, morphology, site, and access) and recurrent when they were previously treated with endoscopic mucosal resection (EMR). Outcome measures included procedural success, total procedure time, complications, and recurrence rate at 3-month follow-up. RESULTS: Nine patients (mean age 62.3 ± 14.5 years) were included; five had rectal and four had tumors in the sigmoid colon. The median SMSA score was 14 (SMSA Level IV-complex polyp), while three patients were pre-treated with EMR. DEA-ESD was technically feasible in all cases. En bloc resection and R0 resection rates were 100%, respectively, with a mean procedure time of 128.4 ± 54.1 min. No immediate or delayed complications occurred. CONCLUSIONS: DEA-ESD is a feasible and safe method for treating complex or recurrent tumors in the rectum and distal colon.

[Mesothelial proliferation of the tunica vaginalis testis]. / Mesotheliale Proliferate der Tunica vaginalis testis.

Proliferative changes seen in reactive mesothelial hyperplasia of a hydrocele sac may mimic malignant mesothelioma. There is no immunohistochemical staining that reliably separates benign from malignant mesothelial proliferations. However, the combined analysis of BAP1 by immunohistochemistry and CDKN2A by FISH has been reported to yield both a high specificity and sensitivity in this differential diagnosis. In addition, the evaluation of risk factors such as asbestos exposure or prior traumata may be helpful for the correct diagnosis. Exclusion of stromal invasion, which is diagnostic for malign mesothelioma, is of utmost importance. Therefore, extended histological workup is essential.

Anthropogenic contribution and influencing factors on metal features in fluvial sediments from a semi-arid Mediterranean river basin (Tafna River, Algeria): A multi-indices approach.

Metals in river sediments from a semi-arid Mediterranean basin were investigated from upstream to downstream during contrasting hydrological conditions in 2014 and 2015. The level and origin of the contamination were evaluated using several geochemical and isotopic indicators. Elements were grouped by their level of contamination: high (Pb > Cd > Zn > Cu) and low (Al, Fe, Cr, Co, Ni). Multiple local sources of contamination were identified (industrial, agricultural and domestic waste), as well as very specific ones (gasoline station) and diffuse pollution from atmospheric deposition (gasoline, ores, aerosols). During storm events, the upstream dams can either be secondary sources of contamination or dilutors through particles derived from natural erosion. The contamination was slowed downstream due to the river geomorphology, but eventually washed into the Mediterranean Sea by intense storm events. Naturally derived elements (Co, Ni, Cr, As) were associated with Al, Fe and Mn oxides or clays, and anthropogenic originated metals with phosphorus (Cd and Zn), sulphur (Cu) and POC (Pb enrichment). Cadmium and Pb were the most available metals upstream and at the outlet, but their availability was not strictly related to their degree of contamination. These conclusions could be drawn thanks to an approach by multiple indicators.

[Endoscopic techniques for early stage cancer of the upper and lower gastrointestinal tract : Possibilities and limitations]. / Endoskopische Techniken bei Frühkarzinomen im oberen und unteren Gastrointestinaltrakt : Möglichkeiten und Grenzen.

BACKGROUND: Endoscopic resection (ER) provides a minimally invasive treatment option for early gastrointestinal cancers. OBJECTIVE: Presentation of current guideline recommendations. Presentation and discussion of published data regarding ER of early esophageal cancer, early gastric cancer and early colorectal cancer. MATERIAL AND METHODS: Analysis of the current literature. Presentation of endoscopic case reports. RESULTS: New technologies, e. g. narrow-band imaging (NBI) have improved the endoscopic diagnosis of early gastrointestinal neoplasms. The development of endoscopic submucosal dissection (ESD) allowed higher R0 resection rates and minimized the recurrence risk leading to higher rates of curative endoscopic resection. Resection criteria are defined in national and international guidelines. Resection criteria for early gastric cancer are different between German (guideline criteria) and Asian guidelines (expanded criteria). New German data did not show a difference in long-term survival after ESD of early gastric cancers fulfilling the guideline criteria or the expanded criteria. In early colorectal cancer submucosal invasion exceeding 1000 µm is defined as the limit for ER in current guidelines. This threshold might be too strict for subgroups without further risk factors but further data are awaited. CONCLUSION: Substantial progress has been made in endoscopic diagnostics and treatment of early gastrointestinal cancers. First European data could confirm previous Asian results; however, further studies are urgently needed for a better definition of the possibilities and limitations of ER.

[Geriatric Proximal Femoral Fracture and Urinary Tract Infection - Considerations for Perioperative Infection Prophylaxis]. / Geriatrische proximale Femurfraktur und Harnwegsinfekt ­ Überlegungen zur perioperativen Infektionsprophylaxe.

Background: Perioperative infection prophylaxis with cephalosporins is standard in surgical treatment of proximal femoral fractures (PFF). Geriatric patients (pat.) are at risk of chronic infections and the bacteria from these can lead to unknown hygienic problems in an early operation. We therefore characterised the colonisation of the urinary tract in pat. (≥ 65 years) with PFF and observed bacterial development in deep wound infections over a period of 10 years. The aim was to discover gaps in perioperative infection prophylaxis. Patients and Methods: Between September 2013 and November 2015, colonisation of the urinary tract and microbial resistance were investigated on admission of all pat. (≥ 65 years) with the diagnosis of PFF (n = 351; f/m 263/88; median age [∅] 83.57 [65-100] years). Between 2005 and 2014, 2161 pat. with a PFF were operated in our clinic (f/m 1623/538; ∅ 82.35 [65-101] years). 991 pat. (∅ 81.84 [65-101] years) with femoral neck fracture [FNF] were treated with endoprosthesis/osteosynthesis, 1170 pat. (∅ 82,78 [65-101] years) with per-/subtrochanteric fracture [PTF] were treated with osteosynthesis. In a retrospective data analysis, deep wound infections, microbiological composition and changes in microbial resistances over time were identified. Results: Bacteriuria (BU) was detected in the urine sediment of 35.61 % (n = 125) of our pat. In 47.2 % of these pat., BU was accompanied by laboratory signs of manifest urinary tract infection. In 10.4 % of these pat., colonisation of the urinary tract with multi-resistant pathogens was detected; 26.4 % were resistant to cefuroxime. The rate of deep infections in pat. with endoprosthesis/osteosynthesis in FNF was 2.8 % (n = 28; f/m 19/9; ∅ 81.35 [67-92] years), with osteosynthesis in PTF 1,1 % (n = 14; f/m 10/4; ∅ 81.0 [70-91] years). A comparison of the periods 2005-2009 and 2010-2014 showed a shift in the spectrum of pathogens from cephalosporin-sensitive to cephalosporin-resistant enterococci. Resistance of pathogens against cephalosporins increased from 43 to 81 %. Conclusion: We found an increasing risk in geriatric pat. from multiresistant pathogens in the urinary tract and from an increase in the cephalosporin resistance of pathogens in urinary tract infections and in deep wound infections. This indicates that perioperative infection prophylaxis with a cephalosporin is not effective. Especially in nursing homes, development of resistance to antibiotics is an increasing problem. Thus, concepts of perioperative infection prophylaxis in geriatric patients should be reconsidered.

Trace elements and Pb isotopes in soils and sediments impacted by uranium mining.

The purpose of this study is to evaluate the contamination in As, Ba, Co, Cu, Mn, Ni, Sr, V, Zn and REE, in a high uranium activity (up to 21,000Bq∙kg(-1)) area, downstream of a former uranium mine. Different geochemical proxies like enrichment factor and fractions from a sequential extraction procedure are used to evaluate the level of contamination, the mobility and the availability of the potential contaminants. Pb isotope ratios are determined in the total samples and in the sequential leachates to identify the sources of the contaminants and to determine the mobility of radiogenic Pb in the context of uranium mining. In spite of the large uranium contamination measured in the soils and the sediments (EF≫40), trace element contamination is low to moderate (2

Co-expression of truncated and full-length tau induces severe neurotoxicity.

Abundant tau inclusions are a defining hallmark of several human neurodegenerative diseases, including Alzheimer's disease. Protein fragmentation is a widely observed event in neurodegenerative proteinopathies. The relevance of tau fragmentation for the neurodegenerative process in tauopathies has yet remained unclear. Here we found that co-expression of truncated and full-length human tau in mice provoked the formation of soluble high-molecular-weight tau, the failure of axonal transport, clumping of mitochondria, disruption of the Golgi apparatus and missorting of synaptic proteins. This was associated with extensive nerve cell dysfunction and severe paralysis by the age of 3 weeks. When the expression of truncated tau was halted, most mice recovered behaviorally and functionally. In contrast, co-expression of full-length tau isoforms did not result in paralysis. Truncated tau thus induces extensive but reversible neurotoxicity in the presence of full-length tau through the formation of nonfilamentous high-molecular-weight tau aggregates, in the absence of tau filaments. Targeting tau fragmentation may provide a novel approach for the treatment of human tauopathies.

[Intramedullary Stabilisation of Displaced Midshaft Clavicular Fractures in Heavy Workers and Complex Fracture Pattern]. / Intramedulläre Stabilisation von dislozierten Klavikulaschaftfrakturen bei Schwerarbeitern und komplexen Frakturen.

BACKGROUND: The medical literature recommends plate osteosynthesis (PO) for complex displaced midshaft clavicular fractures (DMCF) OTA type 15B3 and for heavy workers with displaced clavicular fractures. Recovery of DMCF treated with intramedullary stabilisation (IMS) will be examined and compared to published data for duration of inability to work (DIW) after conservative treatment as well as after PO, with respect to the DIW. PATIENTS AND METHODS: Between 09/2009 and 07/2015, the DIW of 58 patients (8 f, 50 m, mean age 38.4 [20-59] years) with DMCF treated with open reduction and IMS (Titanium Elastic Nail [TEN], Synthes, Umkirch, Germany) was determined. Inclusion criteria were the presence of closed unilateral DMCF and presence of a job with national insurance at the time of accident. DIW was counted in days, starting with the accident, and ending on the last day before resumption of full work. All patients were functionally treated for 6 weeks postoperatively without weights for the shoulder and with a maximum of 90° abduction/flexion. The workload was classified in accordance with REFA criteria: group 0-1 (low physical workload) and group 2-4 (high physical workload). Fracture patterns (simple vs. complex) and postoperative physiotherapy (yes vs. no) were investigated for both REFA groups, as these factors may influence DIW. Fracture classification was performed in accordance with the OTA classification, as simple fractures (OTA type 15B1 and 15B2), and complex fractures (OTA type 15B3). Effects were concerned significant if p ≤ 0.05. RESULTS: Median DIW was independent of physical workload, with 39.86 (3-150) days (n = 58). Patients with low physical workload (REFA 0-1; n = 33) had shorter duration of DIW, with an average of 32.48 (3-136) days than patients with higher physical workload (REFA 2-4; n = 25), with 49.6 (14-150) days (p = 0.02). The fracture type did not influence this significantly (simple fractures [n = 35]: average 40.54 [3-150] days; complex fractures [n = 23]: average 38.82 [14-136] days, p = 0.85). Within each REFA group, differences in DIW for each fracture type were greater, but did not attain statistical significance. Patients without postoperative PT (n = 30) had a shorter DIW, with an average of 30.5 (3-84) days, than patients with postoperative PT (n = 28), with an average of 49.89 (14-150) days (p = 0.021). Within both REFA groups, DIW changed similarly with postoperative PT, in some cases with statistical significance. CONCLUSION: DIW after IMS of DMCF does not depend on the complexity of the fracture. For heavy workers, DIW after IMS is significantly longer than for light physical workers. IMS of DMCF permits immediate pain-adapted movement of the shoulder, with a maximal abduction/flexion up to 90°, no matter what the fracture type. Patients given additional professional PT showed longer DIW than those without such treatment.

Investigation of spatial and temporal metal atmospheric deposition in France through lichen and moss bioaccumulation over one century.

Lichens and mosses were used as biomonitors to assess the atmospheric deposition of metals in forested ecosystems in various regions of France. The concentrations of 17 metals/metalloids (Al, As, Cd, Co, Cr, Cs, Cu, Fe, Mn, Ni, Pb, Sb, Sn, Sr, Ti, V, and Zn) indicated overall low atmospheric contamination in these forested environments, but a regionalism emerged from local contributions (anthropogenic activities, as well as local lithology). Taking into account the geochemical background and comparing to Italian data, the elements from both natural and anthropogenic activities, such as Cd, Pb, or Zn, did not show any obvious anomalies. However, elements mainly originating from lithogenic dust (e.g., Al, Fe, Ti) were more prevalent in sparse forests and in the Southern regions of France, whereas samples from dense forests showed an accumulation of elements from biological recycling (Mn and Zn). The combination of enrichment factors and Pb isotope ratios between current and herbarium samples indicated the historical evolution of metal atmospheric contamination: the high contribution of coal combustion beginning 150 years ago decreased at the end of the 20th century, and the influence of car traffic during the latter observed period decreased in the last few decades. In the South of France, obvious local influences were well preserved during the last century.

[A Problematic Case: Removal of a Broken Cannulated Tibial Nail]. / Problemfall: Entfernung eines gebrochenen kanülierten Tibiamarknagels.

We present a case illustrating a simple and safe technique for the removal of a broken cannulated tibial nail after a pseudarthrosis of a lower leg shaft fracture. A 3 mm Ball-Tip guide wire was inserted into the proximal and the distal segment of the nail. A 2.5 mm tip-flattened second wire was forwarded into the distal segment pushing the Ball-Tip guide wire out of the axis and blocking it. This way the Ball-Tip could act as a hook and consecutively could be knocked back with an impactor forceps removing the complete nail. An exchange nailing was performed with a reamed AO standard nail and the further course was uneventful with a healed fracture after 12 months.

Gyration of the feline brain: localization, terminology and variability.

The terminology of feline brain gyration is not consistent and individual variability has not been systematically examined. The aim of the study was to identify the gyri and sulci of cat brains and describe them using the current terminology. The brains of 15 cats including 10 European shorthairs, 2 Siamese, 2 Maine coons and one Norvegian forest cat without clinical evidence of brain disease were examined post-mortem and photographed for documentation. For description, the terms of the most recent Nomina Anatomica Veterinaria (NAV, 2012) were used, and comparisons with previous anatomical texts were also performed. In addition to the lack of comparative morphology in the NAV, veterinary and human nomenclature are used interchangeably and inconsistently in the literature. This presents a challenge for neurologists and anatomists in localizing gyri and sulci. A comparative analysis of brain gyration showed only minor individual variability among the cats. High-quality labelled figures are provided to facilitate the identification of cat brain gyration. Our work consolidates the current and more consistent gyration terminology for reporting the localization of a cortical lesion based on magnetic resonance imaging or histopathology. This will facilitate not only morphological but also functional research using accurate anatomical reporting.

[Intramedullary stabilisation of displaced midshaft clavicular fractures: does the fracture pattern (simple vs. complex) influence the anatomic and functional result]. / Intramedulläre Stabilisation von dislozierten Klavikulaschaftfrakturen - Hat die Frakturform (einfach vs. komplex) Einfluss auf das anatomische und funktionelle Ergebnis?

BACKGROUND: Displaced midshaft clavicular fractures are often treated operatively. The most common way of treatment is plating. Elastic stable intramedullary nailing (ESIN) is an alternative, but seldom used. Studies showed comparable or even better results for intramedullary nailing than for plating in simple 2- or 3-fragment midshaft fractures. The indication of ESIN for multifragmentary clavicular fractures is discussed critically in the literature because of reduced primary stability and danger of secondary shortening. Until now only few studies report functional results after fracture healing depending on the fracture type. To the best of our knowledge there is no study showing significantly worse functional scores for ESIN in complex displaced midshaft fractures. The objective of this study was to examine anatomic and functional results of simple (2 or 3 fragments, OTA type 15B1 and 15B2) and complex (multifragmentary, OTA type 15B3) displaced midshaft clavicula fractures after internal fixation. PATIENTS AND METHODS: Between 2009 and 2012, 40 patients (female/male 10/30; mean age 33 [16-60] years) with closed displaced midshaft clavicular fractures were treated by open reduction and ESIN (Titanium Elastic Nail [TEN], Synthes, Umkirch, Germany). Thirty-seven patients were retrospectively analysed after a mean of 27 (12-43) months. Twenty patients (group A) had simple fractures (OTA type 15B1 and 15B2), 17 patients (group B) had complex fractures (OTA type 15B3). All shoulder joints were postoperatively treated functionally for six weeks without weight limited to 90° abduction/flexion. Both groups were comparable in gender, age, body mass index, months until metal removal, number of physiotherapy sessions and time until follow-up examination. Joint function (neutral zero method) and strength (standing patient with arm in 90° abduction, holding 1-12 kg for 5 sec) in both shoulders were documented. The distance between the centre of the jugulum and the lateral acromial border was measured for both sides. The DASH, Constant-Murley, Oxford shoulder and clavicular scores (Jubel) were calculated. Patients documented contentedness of outcome by VAS between 0 (absolute discontented) and 10 (very contented). Complications were recorded. RESULTS: Operatively treated displaced midshaft clavicular fractures. in comparison to the healthy side in group A had an average shortening of 5 (0-20) mm and in group B of 10 (3-25) mm, with a statistical significance between both groups. Patients of both groups were very contented with the results (VAS group A: 9.6; B: 9.5). DASH score (group A: 28; B: 3.1), Constant-Murley score (group A: 95.0; B: 93.8), Oxford shoulder score (group A: 46.2; B: 45.9) and the clavicula score (Jubel) (group A: 1.2; B: 2.1) were comparable between both groups without significance. In 4 patients (11%) complications occurred. Once (group B) an infection was seen, three times (group B) the ESIN had to be shortened on the medial side because of telescoping. CONCLUSION: Open ESIN of simple and complex displaced midshaft clavicular fractures leads after an average of 27 months to good or even excellent results. Healing of the clavicle in a modestly shortened position does not impair the patient.

Origin and distribution of rare earth elements in various lichen and moss species over the last century in France.

Rare earth elements (REE) are known to be powerful environmental tracers in natural biogeochemical compartments. In this study, the atmospheric deposition of REE was investigated using various lichens and mosses as well as herbarium samples from 1870 to 1998 from six major forested areas in France. The comparison between the REE distribution patterns in organisms and bedrocks showed a regional uniformity influence from dust particles originating from the bedrock and/or soil weathering that were entrapped by lichens and mosses. These lithological signatures were consistent over the last century. The REE patterns of different organism species allowed minor influence of the species to be highlighted compared to the regional lithology. This was even true where the morphological features played a role in the bioaccumulation levels, which were related to the variable efficiency in trapping atmospheric dust particles. A comparison between REE profiles in the organisms and bark indicated a lack of influence of the substrate on lichen REE content. Lichens and mosses appear to be robust passive monitors of REE atmospheric deposition over decades because the mineral data was preserved in herbarium samples despite organic degradation being shown by carbon isotopes and SEM observations. To overcome the bias of REE concentration that resulted from organic degradation, the use of a normalized method is recommended to interpret the historical samples.

Critical behaviour of nanocrystalline gadolinium: evidence for random uniaxial dipolar universality class.

We report on how nanocrystal size affects the critical behaviour of the rare-earth metal Gd near the ferromagnetic-to-paramagnetic phase transition. The asymptotic critical behaviour of the coarse-grained polycrystalline sample (with an average crystallite size of L≅100 µm) is that of a (pure) uniaxial dipolar ferromagnet, as is the case with single crystal Gd, albeit the width of the asymptotic critical region (ACR) is reduced. As the grain size approaches ∼30 nm, the ACR is so narrow that it could not be accessed in the present experiments. Inaccessibly narrow ACR for L ∼ 30 nm and continuous increase in the width of the ACR as L decreases from 16 to 9.5 nm basically reflect a crossover to the random uniaxial dipolar fixed point caused by the quenched random exchange disorder prevalent at the internal interfaces (grain boundaries).

[Simultaneous bilateral humeral head disclocation and acetabular fracture. A rare manifestation after hypoglycemia-induced seizures]. / Simultane beidseitige Humeruskopfluxations- und Acetabulumfraktur. Eine seltene Folge eines hypoglykämieinduzierten Krampfanfalls.

Seizures can cause severe musculoskeletal injuries and posterior shoulder dislocation is a typical result of a seizure. Bilateral posterior shoulder dislocation is rare and acetabular fractures caused by a seizure are also a rarity. We present the case of a 48-year-old man with simultaneous bilateral posterior shoulder fracture dislocations and bilateral acetabular fractures as a result of hypoglycemia-induced seizures.

Trapeziectomy and ligament reconstruction tendon interposition for isolated scaphotrapeziotrapezoid osteoarthritis of the wrist.

Isolated osteoarthritis of the scaphotrapeziotrapezoid joint is rather rare compared with thumb trapeziometacarpal osteoarthritis. The aim of this retrospective study was to evaluate the outcome of 15 consecutive patients treated with trapeziectomy/ligament reconstruction tendon interposition for isolated scaphotrapeziotrapezoid osteoarthritis of the wrist. After a mean follow-up of 54 months, 14 patients (15 wrists) were available for clinical and radiological examination. The median pain intensity was 0 on a 0-10 visual analogue scale, both at rest and with activity, mean grip strength averaged 24 kg, pinch strength 5 kg. The disabilities of the arm, shoulder and hand (DASH) score was 16, and a modified Mayo Wrist Score 84. Correlation between the degree of scaphotrapezoid osteoarthritis and pain at rest, pain with activity, and DASH score was not significant. The findings from our study suggest that trapeziectomy/ligament reconstruction tendon interposition is an effective procedure for treating isolated scaphotrapeziotrapezoid osteoarthritis, and that additional partial trapezoid excision is not necessary.

Origin and fate of copper in a small Mediterranean vineyard catchment: new insights from combined chemical extraction and δ65Cu isotopic composition.

For centuries, many Mediterranean catchments were covered with vineyards in which copper was widely applied to protect grapevines against fungus. In the Mediterranean-type flow regime, brief and intense flood events increase the stream water discharge by up to 10 times and cause soil leaching and storm runoff. Because vineyards are primarily cultivated on steep slopes, high Cu fluxes are discharged by surface water runoff into the rivers. The purpose of this work was to investigate the riverine behavior and transport of anthropogenic Cu by coupling a sequential chemical extraction (SCE) procedure, used to determine Cu partitioning between residual and non-residual fractions, with δ(65)Cu isotopic measurements in each fraction. In the Baillaury catchment, France, we sampled soils (cultivated and abandoned), river bed sediments (BS), suspended particulate matter (SPM), and river water during the flash flood event of February 2009. Copper partitioning using SCE show that most of Cu in abandoned vineyard soil was in the residual phase (>60%) whereas in cultivated soil, BS and SPM, Cu was mostly (>25%) in non-residual fractions, mainly adsorbed onto iron oxide fractions. A small fraction of Cu was associated with organic matter (5 to 10%). Calculated enrichment factors (EF) are higher than 2 and the anthropogenic contribution was estimated between 50 to 85%. Values for δ(65)Cu in bulk samples were similar to bedrock therefore; δ(65)Cu on SCE fractions of superficial soils and SPM allowed for discrimination between Cu origin and distribution. Copper in residual fractions was of natural mineral origin (δ(65)Cu close to local bedrock, +0.07‰). Copper in water soluble fraction of SPM (δ(65)Cu=+0.26‰) was similar to dissolved river Cu (δ(65)Cu=+0.31‰). Copper from fungicide treatment (δ(65)Cu=-0.35‰) was bound to organic matter (δ(65)Cu=-0.20‰) without or with slight isotopic fractioning. A preferential adsorption of (65)Cu onto iron oxides (δ(65)Cu=+0.5‰) is shown.