Using rapid prototyping molds to create patient specific polymethylmethacrylate implants in cranioplasty.

Cranioplasty is a commonly performed procedure. Outcomes can be improved by the use of patient specific implants, however, high costs limit their accessibility. This paper presents a low cost alternative technique to create patient specific polymethylmethacrylate (PMMA) implants using rapid prototyped mold template. We used available patient's CT-scans, one dataset without craniotomy and one with craniotomy, for computer-assisted design of a 3D mold template, which itself can be brought into the operating room and be used for fast and easy building of a PMMA implant. We applied our solution to three patients with positive outcomes and no complications.

MRI-based breast volumetry-evaluation of three different software solutions.

As lipofilling of the female breast is becoming more popular in plastic surgery, the use of MRI to assess breast volume has been employed to control postoperative results. Therefore, we sought to evaluate the accuracy of magnetic resonance imaging (MRI)-based breast volumetry software tools by comparing the measurements of silicone implant augmented breasts with the actual implant volume specified by the manufacturer. MRI-based volume analysis was performed in eight bilaterally augmented patients (46 ± 9 years) with three different software programs (Brainlab© I plan 2.6 neuronavigation software; mass analysis, version 5.3, Medis©; and OsiriX© v.3.0.2. 32-bit). The implant volumes analysed by the BrainLab© software had a mean deviation of 2.2 ± 1.7% (r = 0.99) relative to the implanted prosthesis. OsiriX© software analysis resulted in a mean deviation of 2.8 ± 3.0% (r = 0.99) and the Medis© software had a mean deviation of 3.1 ± 3.0% (r = 0.99). Overall, the volumes of all analysed breast implants correlated very well with the real implant volumes. Processing time was 10 min per breast with each system and 30 s (OsiriX©) to 5 min (BrainLab© and Medis©) per silicone implant. MRI-based volumetry is a powerful tool to calculate both native breast and silicone implant volume in situ. All software solutions performed well and the measurements were close to the actual implant sizes. The use of MRI breast volumetry may be helpful in: (1) planning reconstructive and aesthetic surgery of asymmetric breasts, (2) calculating implant size in patients with missing documentation of a previously implanted device and (3) assessing post-operative results objectively.

Mechanistic aspects of the de-novo synthesis of PCDD/PCDF on model mixtures and MSWI fly ashes using amorphous 12C- and 13C-labeled carbon.

The formation of polychlorinated dibenzo-p-dioxins (PCDD) and dibenzofurans (PCDF) from amorphous 12C- and 13C-labeled carbon was studied on model mixtures and real fly ashes. PCDD/F can either be formed directly (de-novo) from carbon already present in fly ash or step-by-step via condensation of two aromatic rings. Using model mixtures containing 12C- and 13C-labeled carbon in various ratios we observed the formation of the following compound classes: 12C6-PCPh, -PCBz, 13C6-PCPh, -PCBz, 12C12-PCDD/ F, 13C12-PCDD/F, and 12C6 13C6-PCDD/F. By examining the fraction of the mixed PCDD/F (one of the two aromatic ring is composed solely of 12C-atoms while the other contains only 13C-atoms) in the total concentration of PCDD/F, conclusions on the formation of these three ring structures are possible. From the experimental results, it can be concluded that both reaction mechanisms are operative in the formation of PCDD/F from carbon. On fly ashes approximately half of the total amount of PCDD is formed via condensation of de-novo created C6-precursors e.g. chlorophenols, while the remainder is directly released (de-novo) from the carbon i.e., formed from a related C12-structure. However, the condensation of intermediate aromatic C6-precursors is of minor importance in the formation of PCDF. With increasing temperature the relative amount of the 12C6 13C6-PCDD formed by condensation decreases due to the faster evaporation of chlorophenols. At a constant reaction temperature, the ratio of both reaction pathways is hardly influenced by reaction time. In experiments with fly ashes doped with 13C-labeled carbon, this carbon isotope shows a similar reactivity as the native carbon present on the fly ash. Thus, the used amorphous carbons are suitable models for this investigation.

The role of copper(II) chloride in the formation of organic chlorine in fly ash.

In the de-novo synthesis and formation of PCDD/PCDF, the transfer of inorganic chlorine to the carbonaceous material of fly ash plays an important role. Here, copper acts as a catalyst in the chlorination reaction. In experiments in the range of 250-350 degrees C under helium, we determined the stoichiometry of the chlorination reaction with model systems. Therefore, it was necessary to develop a method to quantify the copper(II) and copper(I) ions. In a combination of solid electron paramagnetic (spin) resonance spectroscopy (EPR) for Cu(I), and X-ray fluorescence spectroscopy (XRFA) analysis for Cu (total), we found a way for the quantification of copper(I) and (II). With these experiments, we can show that the chlorination reaction is relatively fast and comes to a stop under helium, after the copper(II) is reduced. The ratio between the organic chlorine formed and copper(II) reduced is, at the end of the reaction, 0.5, which is in agreement with the following reaction: 2CuCl2 + R-H-->2CuCl + R-Cl + HCl.

Dioxins from thermal and metallurgical processes: recent studies for the iron and steel industry.

In thermal metallurgical processes such as iron ore sintering and metal smelting operations, large flows of off-gases are generated. Mainly due to residue recycling in such processes, chlorine and volatile organics are always present in the feed. As a consequence of "de novo" formation, the off-gases from such processes typically contain dioxins in the range 0.3-30 ng I-TEQ/Nm3. So far there are only very few studies about the mechanisms of dioxin formation and destruction in these metallurgical processes. In an European Union (EU) research project "Minimization of dioxins in thermal industrial processes: mechanisms, monitoring and abatement (MINIDIP)", integrated iron and steel plant has been selected as one of the industrial sectors for further investigation. A large number of particulate samples (feed, belt siftings, electrofilter) were collected from the iron ore sintering installations from various steel plants and analyzed for their organochlorocompound contents. Measurable amounts of PCDD/F, PCBz, PCB were found for all samples. The various parameters influencing their de novo synthesis activity were also evaluated in laboratory experiments, and such activity was found to be moderate for samples from the ore sinter belt, but extremely high for some ESP dusts. Fine dust is active in a wide range of temperatures starting at 200 degrees C and declining above 450 degrees C; the optimal temperature for de novo synthesis was found to be around 350 degrees C; some inhibitors, such as triethanolamine, may reduce de novo activity by 50%, and lowering the O2 concentration in the gas stream leads to a much lower amount of PCDD/F formation. On the basis of their relative mass, typical operating conditions and specific activity of the different samples, the regions in the sintering plant where de novo synthesis may take place were tentatively established.

Reactions of 2,4,6-trichlorophenol on model fly ash: oxidation to CO and CO2, condensation to PCDD/F and conversion into related compounds.

Thermal treatment of 2,4,6-trichlorophenol on a magnesium silicate-based model fly ash in the temperature range between 250 degrees C and 400 degrees C leads predominantly to carbon monoxide and carbon dioxide. The fraction of 2,4,6-trichlorophenol which is oxidized to CO and CO2 increases from 3% at 250 degrees C to 75% at 400 degrees C. Further products are polychlorinated benzenes, dibenzo-p-dioxins, dibenzofurans and phenols. The homologue and isomer patterns of the chlorobenzenes suggest chlorination in the ipso-position of the trichlorophenol. The formation of PCDD from 2,4,6-trichlorophenol and 2,3,4,6-tetrachlorophenol on municipal solid waste incinerator fly ashes and model fly ash were compared and the reaction order calculated.

Mechanistic studies on the role of PAHs and related compounds in PCDD/F formation on model fly ashes.

Model fly ashes containing Florisil, CuCl2.2H2O and PAHs with structures similar to dibenzo-p-dioxin or dibenzofuran were heated at 250 degrees C in He/O2 with regard to a supposed intramolecular reaction mechanism for oxygen incorporation. Highest reactivities in PCDF formation could be found for model compounds containing a biphenyl structure, while condensed pi-systems lead to a decrease in reactivity for such compounds. Biphenyl is almost completely converted to dibenzofuran. PCDD formation from six-membered rings like xanthene/9,10-dihydroanthracene is of minor importance. 18O-labeling of gaseous oxygen reveals no common reaction step for oxygen incorporation using 9-fluorenone, xanthene, diphenyl ether and diphenyl-2-carboxylic acid as model compounds. Pre-existing oxygen in reactants is a major source for ether groups in PCDD and PCDF. Determination of labeled and unlabeled CO and CO2 besides He/O2 reflects higher reactivities towards oxidation for model compounds containing ether groups than for compounds with carbonyl groups.

Sorption of selected polycyclic aromatic hydrocarbons on soils in oil-contaminated systems.

The adsorption and desorption behaviour of selected polycyclic aromatic hydrocarbons (PAHs) on different soils was investigated by static and dynamic methods. On the basis of a system including the four phases of soil, water, oil adsorbed and oil in emulsion, a model for the description of the adsorption behaviour in the presence of oil was developed. In systems without oil a similar partitioning behaviour in the batch and column experiments was observed for all PAHs. Thus the distribution coefficients can be calculated from the octanol/water coefficient of the aromatic compounds and the organic carbon content of the soils. The presence of a lipophilic phase had a significant influence on the sorption of the PAHs, usually resulting in a drastic decrease of adsorption with increasing oil content in the system. For the oil-contaminated system the modelling of the adsorption behaviour enabled a more detailed interpretation of the experimental observations as well as the calculation of the sorption behaviour for the PAHs from characteristic parameters of the components involved.

Comparison of 2,4,6-trichlorophenol conversion to PCDD/ PCDF on a MSWI-fly ash and a model fly ash.

We performed experiments on two different matrices with 2,4,6-trichlorophenol as precursor to Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD)/F. A municipal solid waste incinerators (MSWI) and a model fly ash were spiked in two different ways. The experiments demonstrated a three times higher formation potential of the trichlorophenol to PCDD on MSWI fly ash compared with the model fly ash used. For both fly ashes the PCDD yield was higher when gaseous trichlorophenol was fed continuously compared to mixing the fly ashes prior to the experiments with the total amount of the precursor. Despite dilution of the fly ashes tenfold with an inactive matrix the conversion of the chlorophenol was very high.

Keratitis with hypoparathyroidism.

Chronic kiratitis developed in two children with nonsurgical hypoparathyroidism, as part of an autosomal recessive syndrome that included adrenal insufficiency and moniliasis in what was postulated to be an autoimmune disease. The corneal changes may also have been caused by autoimmune mechanism. Activity of the keratitis diminished once the hypoparathyroidism had been brought under control. However, these patients were thought to be at risk for adrenal insufficiency: neither had moniliasis or adrenocortical insufficiency at present, but the features of the hypoparathyroidism adrenal insufficiency-moniliasis syndrome appeared at different ages and in differing sequences.