Seatbelt Anterior Cruciate Ligament Reconstruction: A Variant of Internal Brace in Anterior Cruciate Ligament Reconstruction With an Adjustable Loop.

In recent years, there has been a growing interest in primary anterior cruciate ligament repair with the help of mechanical reinforcement techniques that employ synthetic grafting. The concept of ligament augmentation with reinforcement suture or internal bracing consists of stabilizing the repaired ligament and augmenting it with an ultra-high molecular weight polyethylene suture or tape, which guarantees greater resistance, safety during healing, and a more accelerated rehabilitation. In this work, we propose a variant of anterior cruciate ligament augmentation with suture, replacing the suture tape with an adjustable-loop reinforcement system, which is connected to the adjustable suspension devices for the graft in the femur and the tibia, surrounding the graft as a seatbelt.

Recovery of cellulose acetate bioplastic from cigarette butts: realization of a sustainable sorbent for water remediation.

Cigarette butts, one of the most common forms of litter in the world, represent a source of chemical and plastic pollution releasing thousands of toxic compounds and microfibers of cellulose acetate (CA). Besides the correct waste management, the recovery of CA from cigarette filters is a way to cushion their negative effects on the environment. Thus far, recycling strategies have been limited to industrial applications, while not many solutions have designed for water remediation. This work describes a strategy to valorize this harmful waste and to reverse its environmental impact, proposing a simple and effective procedure of reclamation of CA and its reuse to prepare a composite sorbent for the treatment of polluted water. The first step entails the washing of filters with hot water (T = 90 °C) and hot ethanol (T = 58-68 °C) to remove the impurities produced during cigarette burning, as verified by means of UV and attenuated total reflection-Fourier-transform infrared (ATR-FTIR) spectroscopy, thermal gravimetric analysis (TGA), and differential scanning calorimetry (DSC). The second step involves the use of the regenerated CA to prepare porous cylinder-shaped cryogels (15 mm × 10 mm) whose sorption properties are enhanced by the combination with AC (15 % w/w). The synthesis takes advantage of the sol-gel transition of the polymer dispersion (5 % w/V) in a solution acetone/water 5 mM in NH3 (60/40, v/v). After characterization by dynamic mechanical analysis (DMA), TGA, FT-IR, and scanning electron microscopy (SEM), the adsorption capability of the physical cryogel was studied in terms of treated environmental water volume, contact time and concentration of the selected pollutants. The results have shown that the proposed strategy is a low-cost way to recycle CA from cigarette butts and that the designed sorbent is a promising material for water treatment, allowing quick removal times and yields >79.6 %.

Enantiomeric analysis of drugs in water samples by using liquid-liquid microextraction and nano-liquid chromatography.

The nano-LC technique is increasingly used for both fast studies on enantiomeric analysis and test beds of novel stationary phases due to the small volumes involved and the short conditioning and analysis times. In this study, the enantioseparation of 10 drugs from different families was carried out by nano-LC, utilizing silica with immobilized amylose tris(3-chloro-5-methylphenylcarbamate) column. The effect on chiral separation caused by the addition of different salts to the mobile phase was evaluated. To simultaneously separate as many enantiomers as possible, the effect of buffer concentration in the mobile phase was studied, and, to increase the sensitivity, a liquid-liquid microextraction based on the use of isoamyl acetate as sustainable extraction solvent was applied to pre-concentrate four chiral drugs from tap and environmental waters, achieving satisfactory recoveries (>70%).

Fast Arthroscopic Biceps Tenodesis Without Penetrating Grasper.

Long head of the biceps pathology is a common cause of shoulder pain and dysfunction. Surgical treatment can be either a tenotomy or a tenodesis. Long-term results may be similar in both surgical techniques; however, the latest systematic reviews indicate that tenodesis offers superior clinical and functional results in young patients and athletes. Considering the favorable results with the biceps tenodesis, we present this arthroscopic tenodesis in which the long head of the biceps is fixed in the bicipital groove with an all-suture anchor passed directly through the tendon, providing a stable and fast fixation without using penetrating grasper.

Enantioseparation of selected chiral agrochemicals by using nano-liquid chromatography and capillary electrochromatography with amylose tris(3­chloro-5-methylphenylcarbamate) covalently immobilized onto silica.

In this paper enantiomers of selected chiral agrochemicals representing various structural classes were separated by using nano-liquid chromatography (nano-LC) and capillary electrochromatography (CEC) employing a capillary column packed with silica particles containing immobilized amylose tris(3­chloro-5-methylphenylcarbamate) (i-ADMPC) as a chiral selector (CS). Special attention was paid to peak dispersion in nano-LC and CEC instruments used in order to make comparison between these two techniques more reliable. Enantioseparations were studied utilizing methanol (MeOH) or acetonitrile-water (ACNH2O), both containing 5 mM of ammonium acetate as the mobile phases (MPs). The tested chiral stationary phase (CSP), containing 20% (w/w) of the neutral CS onto native silica, allowed the generation of sufficiently strong electroosmotic flow (EOF) to observe separation of enantiomers of studied agrochemicals in a reasonable time also in CEC mode. Modestly higher efficiencies and enantioresolutions were obtained in CEC than in nano-LC. Just a moderate preference of CEC over nano-LC in this particular study can be explained with a significant mass transfer resistance through the CSP that is caused due to high content of the CS in CSP.

Potentiality of miniaturized techniques for the analysis of drugs of abuse.

Capillary electromigration (CE) and liquid chromatographic techniques (CLC/nano-LC) are miniaturized techniques offering distinct advantages over conventional ones in the field of separation science. Among these, high efficiency, high chromatographic resolution, and use of minute volumes of both mobile phase and sample volumes are the most important. CE and CLC/nano-LC have been applied to the analysis of many compounds including peptides, proteins, drugs, enantiomers, ions, etc. Over the years, the methods described here have also been used for the analysis of compounds of clinical, forensic, and toxicological interest. In this review article, the main features of the mentioned techniques are summarized. Their potentiality for the analysis of drugs of abuse are discussed. Some selected applications in this field in the period of 2015-present are also reported.

Chiral Nano-Liquid Chromatography and Dispersive Liquid-Liquid Microextraction Applied to the Analysis of Antifungal Drugs in Milk.

A novel chromatographic application in chiral separation by using the nano-LC technique is here reported. The chiral recognition of 12 antifungal drugs was obtained through a 75 µm I.D. fused-silica capillary, which was packed with a CSP-cellulose 3,5-dichlorophenylcarbamate (CDCPC), by means of a lab-made slurry packing procedure. The mobile phase composition and the experimental conditions were optimized in order to find the optimum chiral separation for some selected racemic mixtures of imidazole and triazole derivatives. Some important parameters, such as retention faction, enantioresolution, peak efficiency, and peak shape, were investigated as a function of the mobile phase (pH, water content, type and concentration of both the buffer and the organic modifier, and solvent dilution composition). Within one run lasting 25 min, at a flow rate of approximately 400 nL min-1, eight couples of enantiomers were baseline-resolved and four of them were separated in less than 25 min. The method was then applied to milk samples, which were pretreated using a classical dispersive liquid-liquid microextraction technique preceded by protein precipitation. Finally, the DLLME-nano-LC-UV method was validated in a matrix following the main FDA guidelines for bioanalytical methods.

Application of a Low Transition Temperature Mixture for the Dispersive Liquid-Liquid Microextraction of Illicit Drugs from Urine Samples.

The use of psychoactive substances is a serious problem in today's society and reliable methods of analysis are necessary to confirm their occurrence in biological matrices. In this work, a green sample preparation technique prior to HPLC-MS analysis was successfully applied to the extraction of 14 illicit drugs from urine samples. The isolation procedure was a dispersive liquid-liquid microextraction based on the use of a low transition temperature mixture (LTTM), composed of choline chloride and sesamol in a molar ratio 1:3 as the extracting solvent. This mixture was classified as LTTM after a thorough investigation carried out by FTIR and DSC, which recorded a glass transition temperature at -71 °C. The extraction procedure was optimized and validated according to the main Food and Drug Administration (FDA) guidelines for bioanalytical methods, obtaining good figures of merit for all parameters: the estimated lower limit of quantitation (LLOQ) values were between 0.01 µg L-1 (bk-MMBDB) and 0.37 µg L-1 (PMA); recoveries, evaluated at very low spike levels (in the ng-µg L-1 range), spanned from 55% (MBDB) to 100% (bk-MMBDB and MDPV); finally, both within-run and between-run precisions were lower than 20% (LLOQ) and 15% (10xLLOQ).

Dispersive liquid-liquid microextraction using a low transition temperature mixture and liquid chromatography-mass spectrometry analysis of pesticides in urine samples.

Biomonitoring is a potent tool to control the health risk of people occupationally and non-occupationally exposed. The latest trend in bioanalytical chemistry is to develop quick, cheap, easy, safe and reliable green analytical procedures to analyse a large number of chemicals in easily accessible biomatrices such as urine. In this paper, a new dispersive liquid-liquid microextraction (DLLME) procedure, conceived to treat urine samples and based on the use of a low transition temperature mixture (LTTM), was developed and validated to analyse twenty pesticides commonly used in farm practises. The LTTM was composed of choline chloride and sesamol in molar ratio 1:3 (ChCl:Ses 1:3); its characterization via differential scanning calorimetry identified it as an LTTM and not as a deep eutectic solvent due to the occurrence of a glass transition at -71 °C. The prepared mixture was used as the extraction solvent in the DLLME procedure, while ethyl acetate as the dispersing solvent. The salting out effect (50 mg mL-1 of NaCl in a diluted urine sample) improved the separation phase and the analyte transfer to the extractant. Due to the high ionic strength and despite the density of ChCl:Ses 1:3 (1.25 g mL-1), the LTTM layer floated on the top of the sample solution after centrifugation. All extracts were analysed by high-performance liquid chromatography coupled to mass spectrometry. After optimization and validation of the whole method, lower limits of quantitation were in the range of 0.02 - 0.76 µg  L-1. Extraction recoveries spanned from 50 to 101 % depending on the spike level and analytes. Precision and accuracy ranges were 3-18% and 5-20%, respectively. The extraction procedure was also compared with other methods, showing to be advantageous for rapidity, simplicity, efficiency, and low cost. Finally, urine samples from ten volunteers were effectively analysed using the developed method.

A Lasso-Loop Traction Technique for Arthroscopic Superior Capsular Reconstruction.

Irreparable rotator cuff tears (RCTs) cause shoulder pain and disfunction. Management of RCT patients has classically been difficult due to few treatment options. Since Mihata et al. in 2013 introduced the superior capsular reconstruction (SCR) technique as a treatment option, it has become widespread among surgeons, especially for young active patients in whom reverse shoulder arthroplasty is not recommended. With SCR, a reduced humeral head can be maintained and superior displacement is avoided, improving shoulder pain and restoring active shoulder motion. A variety of grafts may be used, but the surgery can be technically complicated. An arthroscopic lasso-loop traction technique for SCR is described here, which simplifies graft shoulder reduction by traction from the anteromedial and posteromedial portals.

Further study on enantiomer resolving ability of amylose tris(3-chloro-5-methylphenylcarbamate) covalently immobilized onto silica in nano-liquid chromatography and capillary electrochromatography.

In the present study separation of enantiomers of some chiral neutral, basic and weakly acidic analytes was investigated on the chiral stationary phase (CSP) made by covalent immobilization of amylose tris(3-chloro-5-methylphenylcarbamate) onto aminopropylsilanized (APS) silica in nano-liquid chromatography (nano-LC) in aqueous methanol or acetonitrile mixtures. It has been shown that similar to high-performance liquid chromatography (HPLC) and supercritical fluid chromatography (SFC) this chiral selector is useful for separation of enantiomers of neutral, basic and acidic analytes also in nano-LC. In comparison to our previous research, in which the chiral selector (CS) was bonded on native silica, in this study, the CS was immobilized on APS silica in order to improve chromatographic performance towards basic analytes. In fact, some improvement was observed and surprisingly not only for basic but also for neutral and acidic analytes. Again, quite unexpectedly almost no electroosmotic flow (EOF) was observed in capillaries packed with ca. 20% (w/w) amylose tris(3-chloro-5-methylphenylcarbamate) immobilized onto APS silica although the same APS silica before attachment of chiral selector exhibited significant EOF. In order to generate EOF in the capillaries with the CSP and enable capillary electrochromatographic (CEC) experiment on it, the short segment of the capillary column was packed with APS silica without chiral selector. The EOF in such capillary enabled CEC experiment and some preliminary results are reported here.

Nano-liquid chromatography combined with a sustainable microextraction based on natural deep eutectic solvents for analysis of phthalate esters.

The separation of 11 phthalic acid ester (PAEs) was carried out by nano-liquid chromatography coupled to ultraviolet and MS detection. Preliminary experiments were achieved in order to select suitable stationary phases and chromatographic conditions. The baseline separation was obtained, for all compounds, with an XBridgeTM C18 column in less than 15 min, working in step gradient mode. The sensitivity of the method was improved by on-column focusing. PAEs were extracted from alcoholic and nonalcoholic beverages using vortex-assisted emulsification dispersive liquid-liquid microextration and natural deep eutectic solvents. The whole method was validated in terms of linearity, sensitivity, precision, recovery, and repeatability. Combination of both off-line sample preparation preconcentration and large injection volume led to obtain LOQs in the range 5-47 ng/mL. The developed nano-LC-UV method was extended to MS detection to confirm the presence of PAEs in some beverages commercialized in different types of packaging.

Comparative study on enantiomer resolving ability of amylose tris(3-chloro-5-methylphenylcarbamate) covalently immobilized onto silica in nano-liquid chromatography and capillary electrochromatography.

In the present study separation of enantiomers of some chiral neutral and weakly acidic analytes was investigated on the chiral stationary phase (CSP) made by covalent immobilization of amylose tris(3-chloro-5-methylphenylcarbamate) onto silica in nano-liquid chromatography (nano-LC) and capillary electrochromatography (CEC) in acetonitrile and aqueous acetonitrile. Few comparisons were made also between the enantioseparations in nano-LC and high-performance liquid chromatography (HPLC) with the chiral column of 4.6 × 250 mm dimension. Slightly better separation of enantiomers was observed in HPLC mode compared to nano-LC mode. It was shown that in the capillary columns packed with the CSP containing about 20% (w/w) of a covalently immobilized neutral chiral selector, amylose tris(3-chloro-5-methylphenylcarbamate), sufficient electroosmotic flow has been generated and enantioseparations with reasonable analysis time were performed also in CEC mode. It was shown once again that CEC offers a clear advantage over nano-LC from the viewpoint of plate numbers and peak resolution.

A Modified Arthroscopic Technique of Gracilis Tendon Graft with Double Fixation System for Treatment of Type V Acromioclavicular Injuries: A Case Report.

CASE: A 48-year-old male patient with a type V acromioclavicular injury with a 3-tendon acute cuff tear, anterior glenohumeral dislocation, and an axillary posttraumatic neuropathy is presented. The rotator cuff tear was sutured and an all-arthroscopic-modified coracoclavicular ligaments (CCLs) reconstruction technique was performed with a gracilis tendon graft and a double knotless suture fixation system. CONCLUSIONS: An arthroscopic approach allows the surgeon to identify and treat associated glenohumeral lesions in type V acromioclavicular dislocations. In addition, the modified CCL reconstruction technique addresses effectively the AC instability.

Nano-liquid chromatography for enantiomers separation of baclofen by using vancomycin silica stationary phase.

The chiral separation of baclofen (Bac) was obtained by nano-liquid chromatography tandem mass spectrometry (nano-LC-MS/MS) using a 100 µm I.D. fused silica capillary column packed with silica particles chemically modified with vancomycin. Various experimental parameters, such as composition (buffer concentration, water content, organic modifier) and pH of the mobile phase and sample solvent were investigated for method optimization. In order to increase the sensitivity an on-column focusing procedure was applied. Acceptable separation of Bac enantiomers was obtained in less than 11 min eluting in isocratic mode, with 90:10 MeOH/water (v/v) containing 10 mM ammonium acetate at pH 4.5. These optimized experimental conditions were applied to the analysis of human plasma samples spiked with racemic mixture of Bac. The use of a Buckypaper disc as sorbent membrane allows one to recover both enantiomers with yields ≥ 65%. The method was fully validated, following the identification criteria of the European Commission Decision 2002/657/EC.

Analysis of Enantiomers in Products of Food Interest.

The separation of enantiomers has been started in the past and continues to be a topic of great interest in various fields of research, mainly because these compounds could be involved in biological processes such as, for example, those related to human health. Great attention has been devoted to studies for the analysis of enantiomers present in food products in order to assess authenticity and safety. The separation of these compounds can be carried out utilizing analytical techniques such as gas chromatography, high-performance liquid chromatography, supercritical fluid chromatography, and other methods. The separation is performed mainly employing chromatographic columns containing particles modified with chiral selectors (CS). Among the CS used, modified polysaccharides, glycopeptide antibiotics, and cyclodextrins are currently applied.

Enantioseparation of tryptophan and its unnatural derivatives by nano-LC on CSP-teicoplanin silica based.

This work deals with the potentiality of nano liquid chromatography (Nano-LC) for the chiral separation of racemic mixture of tryptophan and some selected derivatives by using 100 µm i.d. fused silica capillary packed with teicoplanin bonded to 5 µm diol silica stationary phase. The experiments were carried out by using a cheap and laboratory-assembled nano-LC-UV system. Elution was done in an isocratic mode using a polar organic mobile phase. In order to find the optimum chiral separation of the studied enantiomers, some chromatographic experimental parameters were systematically studied and optimized. Among them, mobile phase composition, namely organic modifier type and concentration, buffer type and pH and aqueous content and sample solvent dilution on retention time, retention factor and enantioresolution factor were studied. Baseline enantioresolution and good peak shape was achieved utilizing the mobile phase containing 40 mM ammonium formate at pH pH 2.5 in ACN/water/acetone (60:30:10, v/v/v) at 520 nL/min in less than 8 min analysis time.

Enantiomers separation by capillary electrochromatography using polysaccharide-based stationary phases.

The separation of chiral compounds is an interesting and important topic of research because these compounds are involved in some biological processes, fundamentally in human health. Among the various application fields where enantiomers are remarkable, drug analysis has to be considered. Most of the drugs contain enantiomers and very often one of the two isomers could be pharmacologically more active or even dangerous. Therefore, the separation of these compounds is very important. Among the different analytical techniques usually employed, capillary electrochromatography has demonstrated great capability in enantiomers resolution. The great potential of this electromigration technique stands mainly in its high efficiency due to the use of an electrosmotic flow (flat flow profile) and on the high selectivity because of the use of a stationary phase. Chiral separation can be obtained utilizing several chiral stationary phases including a polysaccharide derivative. The aim of this review paper is to summarize the main features of capillary electrochromatography and polysaccharide derivatives of chiral stationary phase. It also report examples of practical applications utilizing this approach.

Enantiomeric separation of some chiral analytes using amylose 3,5-dimethylphenylcarbamate covalently immobilized on silica by nano-liquid chromatography and capillary electrochromatography.

A new experimental chiral stationary phase containing amylose 3,5-dimethylphenylcarbamate immobilized onto silica gel (i-ADMPC) was packed in 100µm I.D. fused silica capillary and used for the chiral separation of eight selected flavanone derivatives in polar organic mobile phase by using different miniaturized techniques, such as nano-liquid chromatography (nano-LC), capillary electrochromatography (CEC) and pressure-assisted CEC (pCEC). A comparative study of different elution modes in terms of chromatographic efficiency, analysis time and enantiomeric resolution was carried out. In pCEC mode, the highest chromatography performance was obtained applying +2.5kV voltage and inlet pressure 10bar. Under these conditions, the analysis times were shorter than 20min, and chromatographic efficiencies were in the range 33,000-49,000 plates/m (first eluted peak). The solvent versatility of packed i- ADMPC capillary column was also investigated. In nano-LC, the CSP was stressed under the use of strong organic solvents such as ethyl acetate, acetone and methyl t-butyl ether (MTBE). After at least 40 working hours and over 50 sample injections, the CSP resulted to be very stable allowing to achieve good repeatability employing again the mobile phase containing polar organic solvent. Enantioresolutions and chromatographic efficiencies decreased by 1.60 and 10%, respectively as the result of using above mentioned strong solvents.

An attempt for fast separation of enantiomers in nano-liquid chromatography and capillary electrochromatography.

In the present study, an attempt was made to achieve separation of enantiomers within a minute in nano-LC and CEC. In order to achieve this goal several parameters were optimized from the viewpoint of the property of chiral analytes, concentration of the chiral selector in the packing material, capillary dimensions, and separation mode. The enantiomers of several of the applied chiral sulfoxides could be resolved with the analysis time <1 min. Some instrumental obstacles hindering further reduction of analysis time are also highlighted.