Absorbable versus nonabsorbable sutures for the Krackow suture repair of acute Achilles tendon rupture: a prospective randomized controlled trial.

AIMS: Although absorbable sutures for the repair of acute Achilles tendon rupture (ATR) have been attracting attention, the rationale for their use remains insufficient. This study prospectively compared the outcomes of absorbable and nonabsorbable sutures for the repair of acute ATR. METHODS: A total of 40 patients were randomly assigned to either braided absorbable polyglactin suture or braided nonabsorbable polyethylene terephthalate suture groups. ATR was then repaired using the Krackow suture method. At three and six months after surgery, the isokinetic muscle strength of ankle plantar flexion was measured using a computer-based Cybex dynamometer. At six and 12 months after surgery, patient-reported outcomes were measured using the Achilles tendon Total Rupture Score (ATRS), visual analogue scale for pain (VAS pain), and EuroQoL five-dimension health questionnaire (EQ-5D). RESULTS: Overall, 37 patients completed 12 months of follow-up. No difference was observed between the two groups in terms of isokinetic plantar flexion strength, ATRS, VAS pain, or EQ-5D. No re-rupture was observed in either group. CONCLUSION: The use of absorbable sutures for the repair of acute ATR was not inferior to that of nonabsorbable sutures. This finding suggests that absorbable sutures can be considered for the repair of acute ATRs. Cite this article: Bone Joint J 2022;104-B(8):938-945.

Micromechanical Modeling for Tensile Properties of Wood Plastic Composites: Use of Pruned Waste from Pecan Orchards as Sustainable Material for Reinforcement of Thermoplastic Composite.

Wood plastic composites (WPCs) specimens containing high-density polyethylene (HDPE) and wood pruning waste were manufactured and evaluated for their mechanical properties. Pecan waste was used as an accessible and sustainable source in this study, and the effects of its particle size and concentration on WPC strengths were evaluated. Pecan waste was milled and sieved to various particle sizes, and testing samples were fabricated by mixing them in a twin-screw extruder and injection molding. A coupling agent was used to create a stable bond between the HDPE and wood. Both tensile modulus and strength were increased with an increasing pecan flour concentration up to about 60 weigh percent. A micromechanical model is proposed for predicting the mechanical properties of the wood flour/fiber reinforce composite. This model uses a correction factor of an elliptical of carried sizes and shapes. The preliminary results of the model have a high correlation with the experimental values of the composite in all mesh sizes.

Influence of nutritional deficiency on prognosis of renal cell carcinoma (RCC).

OBJECTIVE: To evaluate the prognosis of patients with renal cell carcinoma (RCC) by nutritional status defined by body mass index (BMI), serum albumin and cholesterol. PATIENTS AND METHODS: This study retrospectively enrolled 1437 patients who underwent radical nephrectomy (932) or partial nephrectomy (505) for RCC. We assigned nutritional status according to the presence of none or one nutritional risk factor (control group) and two or all three of the following nutritional risk factors (nutritional deficiency group). The nutritional factors and thresholds were preoperative albumin level (<3.5 g/dL), preoperative cholesterol level (<220 mg/dL), and preoperative BMI (<23 kg/m(2) ) RESULTS: The patients' mean (sd) age was 55.23 (12.41) years and BMI was 24.36 (3.17) kg/m(2) . The mean (sd) serum cholesterol level was 180.07 (38.24) mg/dL, and the albumin level was 4.2 (0.45) g/dL. In all, 141 (9.8%) patients had none of the nutritional deficiency criteria, 802 (55.8%) had one, 429 (29.9%) had two, and 65 (4.5%) had all three. Clinicopathological variables, i.e. female gender, high tumour stage, positive lymph node metastasis, positive distant metastasis, high nuclear grade and non-clear cell type histopathology were associated with the nutritional deficiency group. In multivariate Cox analysis, nutritional deficiency was an independent predictor for RCC recurrence (hazard ratio [HR] 1.39, 95% confidence interval [CI] 1.05-1.83, P = 0.020) and RCC-related mortality (HR 2.06, 95% CI 1.39-3.03, P < 0.001). CONCLUSION: Nutritional deficiency defined by BMI, serum albumin and cholesterol is an important factor that predicts postoperative prognosis of patients with RCC who have undergone radical or partial nephrectomy.

Barrier isolator/glovebox glove dexterity study.

In response to new, stricter safety requirements set out by the federal government, compounding pharmacists are investigating applications and processes appropriate for their facilities. One application, currently used by many industries, was developed by Los Alamos National Laboratories in the early days of defense work. A barrier isolator or "glovebox" is a containment device that allows work within a sealed space while providing protection for people and the environment. The operations at Plutonium Facility (TA-55) in Los Alamos National Laboratories involve various amounts of plutonium. Gloveboxes are used to handle plutonium, and glovebox gloves are the weakest part of this engineering control. Currently a lead-loaded glove made from Hypalon is used. The lead-loaded gloves are compared to unleaded gloves with respect to dexterity and its effect on the outcome of any task performance. Experiments have been conducted on two models of unleaded gloves (15-mil thick Hypalon gloves and 30-mil thick Hypalon gloves), as well as 30-mil thick lead-loaded gloves. The objective of this research is to study the effect of lead-loaded gloves versus unleaded gloves on task performance. We use inferential statistical analysis of this data to support scientific judgment of the probability that the observed difference between tested gloves is dependable or that any difference noted might have happened by chance.

Statistical analysis of barrier isolator/glovebox glove failure.

In response to new, stricter safety requirements set out by the federal government, compounding pharmacists are investigating applications and processes appropriate for their facilities. One application, cutrrently used by many industries, was developed by Los Alamos National Laboratories for defense work. A barrier isolator or "glovebox" is a containment device that allows work within a sealed space while providing protection for people and the environment. Though knowledge of glove box use and maintenance has grown, unplanned breaches (e.g., glove failures) remain a concern. Recognizing that effective maintenance procedures can minimize breaches, we analyzed data drawn from glove failure records of Los Alamos National Laboratory's Nuclear Materials Technology Division to evaluate current inventory strategy in light of actual performance of the various types of gloves. This report includes a description of the statistical methods employed. The results of our analysis pinpointed the most frequently occurring causes of glove failure and revealed a significant imbalance between the current glove replacement schedule and the rate of glove failures in a much shorter period. We concluded that, to minimize unplanned breaches, either the replacement period needs to be adjusted or causes of failure eliminated or reduced.

Dissolution of Bombyx mori silk fibroin in the calcium nitrate tetrahydrate-methanol system and aspects of wet spinning of fibroin solution.

There are still several problems associated with the spinning of dialyzed silk fibroin solutions. In this work some of these problems have been examined. The calcium nitrate tetrahydrate-methanol system was used to dissolve the silk fibroin. A compositional phase diagram was constructed at various concentrations of the solvent system. Regenerated fibroin powders from undialyzed fibroin solution in several coagulants showed different conformations. Regenerated powders from several coagulants except methanol and ethanol were resoluble in water. Atomic absorption analysis revealed that the calcium cations strongly interact with fibroin molecules in dialyzed fibroin solution, which may interfere with the regeneration of a strong fiber. Kinetic studies to determine the diffusion coefficient of methanol into dialyzed and concentrated fibroin solution were reported. The properties of both original and regenerated fibroin such as solubility in water and thermal behaviors using DSC were compared. Regenerated fibroin fiber was spun by the wet spinning method. An X-ray diffractogram showed that the regeneration process decreased the crystallinity of regenerated fibroin fiber. SEM images of the surface and cross section of the regenerated fibroin fibers were discussed.

Influence of age, anthropometry, and hepatic and renal function on serum prostate-specific antigen levels in healthy middle-age men.

OBJECTIVES: To test the hypothesis of a causal relationship between clinical parameters, including age, anthropometry, and hepatic or renal function tests and serum prostate-specific antigen (PSA) levels and to determine the predictors of high serum PSA concentrations in healthy middle-age men. METHODS: Between January 1999 and December 2000, 6005 healthy men 40 to 59 years old who visited our hospital for a routine health checkup were entered into the study. The association between the clinical parameters and a high serum PSA level (greater than 2.5, 3.0, 3.5, or 4.0 ng/mL) was studied in three groups: the 10% with low clinical parameters, the 10% with high clinical parameters, and the remainder as a reference group. RESULTS: The univariate logistic regression analysis indicated that high or low age, body weight, body mass index, creatinine, and creatinine clearance were significant factors in relation to serum PSA concentration compared with the reference group. In the multivariate model used, only older age was positively related to the serum PSA concentration. CONCLUSIONS: The results of anthropometry and hepatic and renal function tests do not influence the serum PSA level in this population. Our findings suggest that serum PSA may be a reliable marker in middle-age men without severe hepatic or renal disease.

Management of bulbous urethral disruption by blunt external trauma: the sooner, the better?

OBJECTIVES: To investigate whether the incidence of urethral stricture is different according to the primary mode of management, we retrospectively reviewed the record of patients with bulbous urethral disruption by external blunt trauma. METHODS: A total of 95 patients with blunt bulbous urethral injuries were included in the study. Sixty-five underwent immediate urethral realignment and 30 underwent initial suprapubic tube placement followed by delayed management. The urethral injuries were interpreted as partial or complete disruption on the basis of the retrograde urethrographic findings. RESULTS: Urethral stricture developed in 12 patients (18.5%) who underwent immediate management and in 12 patients (40.0%) who underwent delayed management (P = 0.025). Of the patients with partial disruption, no significant difference was found in the urethral stricture incidence between the two groups. However, of the patients with complete disruption, urethral stricture developed in 10 (31.3%) of 32 patients who underwent immediate management and 11 (68.8%) of 16 patients who underwent delayed management (P = 0.014). In addition, the degree of urethral stricture in the patients who underwent delayed management was more severe than in those who underwent immediate urethral realignment (P = 0.023). CONCLUSIONS: Our findings suggest that better outcomes can be obtained when immediate urethral realignment is successful in patients with bulbous urethral disruption. Additional research, including prospective randomized trials, is needed to confirm these findings.