Evolution in design of integral leg prosthesis leads to improved outcomes

Developments of surgical attachments for bone-anchored prostheses are slowly but surely winning over the initial disbelief in the orthopedic community. Clearly, this option is becoming accessible to a wide range of individuals with limb loss. Seminal studies have demonstrated that the pioneering procedure relying on screw-type fixation engenders major clinical benefits and acceptable safety. The surgical procedure for press-fit implants, such as the Integral-Leg-Prosthesis (ILP) has been described Dr Aschoff and his team. Some clinical benefits of press-fit implants have been also established. Here, his team is once again taking a leading role by sharing the progression over 15 years of the rate of deep infections for 69 individuals with transfemoral amputation fitted with three successive refined versions of the ILP. By definition, a double-blind randomized clinical trial to test the effect of different fixation’s design is difficult. Alternatively, Juhnke and colleagues are reporting the outcomes of action-research study for a cohort of participants. The first and foremost important outcome of this study is the confirmation that the current design of the IPL and rehabilitation program are altogether leading to an acceptable rate of deep infection and other adverse events (e.g., structural failure of implant, periprosthetic factures). This study is also providing a strong insight onto the effect of major phases in redesign of an implant on the risk of infection. This is an important reminder that the development of a successful osseointegrated implant is unlikely to be immediate but the results of a learning curve made of empirical and sequential changes led by a reflective clinical practice. Clearly, this study provided better understanding of the safety of the ILP surgical and rehabilitation procedure while establishing standards and benchmark data for future studies focusing on design and infection of press-fit implants. Complementary observations of relationship between infection and cofounders such as loading of the prosthesis and prosthetic components used would be beneficial.Further definitive evidences of the clinical benefits with the latest design would be valuable, although an increase in health related quality of life and functional outcomes are likely to be confirmed. Altogether, the authors are providing compelling evidence that bone-anchored attachments particularly those relying on press-fit implants are an established alternative to socket prostheses.

Physio-chemical assessment of beauty leaf (Calophyllum inophyllum) as second-generation biodiesel feedstock

Recently, second-generation (non-vegetable oil) feedstocks for biodiesel production are receiving significant attention due to the cost and social effects connected with utilising food products for the production of energy products. The Beauty leaf tree (Calophyllum inophyllum) is a potential source of non-edible oil for producing second-generation biodiesel because of its suitability for production in an extensive variety of atmospheric condition, easy cultivation, high fruit production rate, and the high oil content in the seed. In this study, oil was extracted from Beauty leaf tree seeds through three different oil extraction methods. The important physical and chemical properties of these extracted Beauty leaf oils were experimentally analysed and compared with other commercially available vegetable oils. Biodiesel was produced using a two-stage esterification process combining of an acid catalysed pre-esterification process and an alkali catalysed transesterification process. Fatty acid methyl ester (FAME) profiles and important physicochemical properties were experimentally measured and estimated using equations based on the FAME analysis. The quality of Beauty leaf biodiesels was assessed and compared with commercially available biodiesels through multivariate data analysis using PROMETHEE-GAIA software. The results show that mechanical extraction using a screw press produces oil at a low cost, however, results in low oil yields compared with chemical oil extraction. High pressure and temperature in the extraction process increase oil extraction performance. On the contrary, this process increases the free fatty acid content in the oil. A clear difference was found in the physical properties of Beauty leaf oils, which eventually affected the oil to biodiesel conversion process. However, Beauty leaf oils methyl esters (biodiesel) were very consistent physicochemical properties and able to meet almost all indicators of biodiesel standards. Overall this study found that Beauty leaf is a suitable feedstock for producing second-generation biodiesel in commercial scale. Therefore, the findings of this study are expected to serve as the basis for further development of Beauty leaf as a feedstock for industrial scale second-generation biodiesel production.

N-Acetylglycyl-L-lysine methyl ester acetate

C llH22 N 30 + . C2H302, orthorhombic, P2~2~2~, a = 5.511(2), b = 14.588(4), c = 21.109 (4)A, Z = 4. The structure has been solved using MULTAN and refined to R = 0.079 for 993 observed reflections. The fully extended lysine side chain in the molecule is staggered between the main-chain amino and carbonyl groups. The dipeptide molecules in the crystal structure are arranged in twofold helices centred on 21 screw axes. These helices are interconnected through interactions involving the acetate and the side-chain amino groups. Each acetate group bridges two adjacent side-chain amino groups, related by an a translation, giving rise to an infinitely long chain of alternating negatively charged carboxylate and positively charged amino groups.

N-Acetylglycyl-L-lysine methyl ester acetate

C llH22 N 30 + . C2H302, orthorhombic, P2~2~2~, a = 5.511(2), b = 14.588(4), c = 21.109 (4)A, Z = 4. The structure has been solved using MULTAN and refined to R = 0.079 for 993 observed reflections. The fully extended lysine side chain in the molecule is staggered between the main-chain amino and carbonyl groups. The dipeptide molecules in the crystal structure are arranged in twofold helices centred on 21 screw axes. These helices are interconnected through interactions involving the acetate and the side-chain amino groups. Each acetate group bridges two adjacent side-chain amino groups, related by an a translation, giving rise to an infinitely long chain of alternating negatively charged carboxylate and positively charged amino groups.

The effects of low-intensity ultrasound in bioabsorbable self-reinforced poly-L-lactide -fixed cancellous bone fracture

The purpose of the present study was to investigate the effects of low-intensity ultrasound on bioabsorbable self-reinforced poly-L-lactide (SR-PLLA) screws and on fracture healing after SR-PLLA device fixation in experimental and clinical cancellous bone fracture. In the first experimental study, the assessment of the mechanical strengths of the SR-PLLA screws was performed after 12 weeks of daily 20-minute ultrasound exposure in vitro. In the second experimental study, 32 male Wistar rats with an experimental distal femur osteotomy fixed with an SR-PLLA rod were exposed for daily low-intensity ultrasound treatment for 21 days. The effects on the healing bone were assessed. The clinical studies consist of three prospective, randomized, and placebo-controlled series of dislocated lateral malleolar fractures fixed with one SR-PLLA screw. The total number of the patients in these series was 52. Half of the patients were provided randomly with a sham ultrasound device. The patients underwent ultrasound therapy 20 minutes daily for six weeks. Radiological bone healing was assessed both by radiographs at two, six, nine, and 12 weeks and by multidetector computed tomography (MDCT) scans at two weeks, nine weeks, and 18 months. Bone mineral density was assessed by dual-energy X-ray absorptiometry (DXA). The clinical outcome was assessed by both Olerud-Molander scoring and clinical examination of the ankle. Low-intensity ultrasound had no effects on the mechanical properties and degradation behaviour of the SR-PLLA screws in vitro. There were no obvious signs of low-intensity ultrasound-induced enhancement in the bone healing in SR-PLLA-rod-fixed metaphyseal distal femur osteotomy in rats. The biocompatibility of low-intensity ultrasound treatment and SR-PLLA was found to be good. In the clinical series low-intensity ultrasound was observed to have no obvious effects on the bone mineral density of the fractured lateral malleolus. There were no obvious differences in the radiological bone healing times of the SR-PLLA-screw-fixed lateral malleolar fractures after low-intensity ultrasound treatment. Low-intensity ultrasound did not have any effects on radiological bone morphology, bone mineral density or clinical outcome 18 months after the injury. There were no obvious findings in the present study to support the hypothesis that low-intensity pulsed ultrasound enhances bone healing in SR-PLLA-rod-fixed experimental metaphyseal distal femur osteotomy in rats or in clinical SR-PLLA-screw-fixed lateral malleolar fractures. It is important to limit the conclusions of the present set of studies only to lateral malleolar fractures fixed with an SR-PLLA screw.

Anterior cruciate ligament reconstruction with special reference to magnetic resonance imaging of the postoperative outcome

Anterior cruciate ligament (ACL) tear is a common sports injury of the knee. Arthroscopic reconstruction using autogenous graft material is widely used for patients with ACL instability. The grafts most commonly used are the patellar and the hamstring tendons, by various fixation techniques. Although clinical evaluation and conventional radiography are routinely used in follow-up after ACL surgery, magnetic resonance imaging (MRI) plays an important role in the diagnosis of complications after ACL surgery. The aim of this thesis was to study the clinical outcome of patellar and hamstring tendon ACL reconstruction techniques. In addition, the postoperative appearance of the ACL graft was evaluated using several MRI sequences. Of the 175 patients who underwent an arthroscopically assisted ACL reconstruction, 99 patients were randomized into patellar tendon (n=51) or hamstring tendon (n=48) groups. In addition, 62 patients with hamstring graft ACL reconstruction were randomized into either cross-pin (n=31) or interference screw (n=31) fixation groups. Follow-up evaluation determined knee laxity, isokinetic muscle performance and several knee scores. Lateral and anteroposterior view radiographs were obtained. Several MRI sequences were obtained with a 1.5-T imager. The appearance and enhancement pattern of the graft and periligamentous tissue, and the location of bone tunnels were evaluated. After MRI, arthroscopy was performed on 14 symptomatic knees. The results revealed no significant differences in the 2-year outcome between the groups. In the hamstring tendon group, the average femoral and tibial bone tunnel diameter increased during 2 years follow-up by 33% and 23%, respectively. In the asymptomatic knees, the graft showed homogeneous and low signal intensity with periligamentous streaks of intermediate signal intensity on T2-weighted MR images. In the symptomatic knees, arthroscopy revealed 12 abnormal grafts and two meniscal tears, each with an intact graft. Among 3 lax grafts visible on arthroscopy, MRI showed an intact graft and improper bone tunnel placement. For diagnosing graft failure, all MRI findings combined gave a specificity of 90% and a sensitivity of 81%. In conclusion, all techniques appeared to improve patients' performance, and were therefore considered as good choices for ACL reconstruction. In follow-up, MRI permits direct evaluation of the ACL graft, the bone tunnels, and additional disorders of the knee. Bone tunnel enlargement and periligamentous tissue showing contrast enhancement were non-specific MRI findings that did not signify ACL deficiency. With an intact graft and optimal femoral bone tunnel placement, graft deficiency is unlikely, and the MRI examination should be carefully scrutinized for possible other causes for the patients symptoms.

Tris(tert-butyl 3-oxobutanoato-kappa O-2(1),O- )-aluminium(III) at 153 K

In the title complex, [Al(C8H13O3)(3)], a potential metal-organic chemical vapour deposition (MOCVD) precursor, three bidentate ligand molecules are bound to the metal atom, forming an octahedral geometry. Two non-planar six-membered chelate rings adopt screw-boat conformations, while the third ring has a conformation that lies about halfway between an envelope and a screw-boat.

Density-wave theory of dislocations in crystals

The density-wave theory of Ramakrishnan and Yussouff is extended to provide a scheme for describing dislocations and other topological defects in crystals. Quantitative calculations are presented for the order-parameter profiles, the atomic configuration, and the free energy of a screw dislocation with Burgers vector b=(a/2, a/2, a/2) in a bcc solid. These calculations are done using a simple parametrization of the direct correlation function and a gradient expansion. It is conventional to express the free energy of the dislocation in a crystal of size R as (λb2/4π)ln(αR/‖b‖), where λ is the shear elastic constant, and α is a measure of the core energy. Our results yield for Na the value α≃1.94a/(‖c1’’‖)1/2 (≃1.85) at the freezing temperature (371 K) and α≃2.48a/(‖c1’’‖)1/2 at 271 K, where c1’’ is the curvature of the first peak of the direct correlation function c(q). Detailed results for the density distribution in the dislocation, particularly the core region, are also presented. These show that the dislocation core has a columnar character. To our knowledge, this study represents the first calculation of dislocation structure, including the core, within the framework of an order-parameter theory and incorporating thermal effects.

Topological defects in crystals: A density-wave theory

A new approach for describing dislocations and other topological defects in crystals, based on the density wave theory of Ramakrishnan and Yussouff is presented. Quantitative calculations are discussed in brief for the order parameter profiles, the atomic configuration and the free energy of a screw dislocation with Burgers vector b = (a/2, a/2,a/2 ) in a bcc solid. Our results for the free energy of the dislocation in a crystal of sizeR, when expressed as (λb 2/4π) ln (αR/|b|) whereλ is the shear elastic constant, yield, for example, the valueα ⋍ 1·85 for sodium at its freezing temperature (371°K). The density distribution in the presence of the dislocation shows that the dislocation core has a columnar character. To our knowledge, this study represents the first calculation of dislocation structure, including the core, within the framework of an order parameter theory incorporating thermal effects.

Anomalin. A Dihydropyranocoumarin Derivative from the Plant Lingusticum elatum

The title compound, 9,10-dihydro-8,8-dimethyl-2-oxo-2H,8H-benzo[1,2-b:3,4-b']dipyran-9,10-diyl 2-methyl-2-butenoate, C24H26O7, contains a highly planar coumarin nucleus and a substituted dihydropyran ring (C), which has a distorted half-chair conformation, with an 8 alpha,9 beta orientation. The conformation of ring C is further supported by the two angelyloxy (2-methyl-2-butenoyloxy) substituents at positions C9 and C10, which are cis oriented and thus cannot both occupy equatorial positions with respect to the plane of ring C. The conformations of the two angelyloxy substituents are different, as indicated by their endocyclic torsion angles. The most striking of these angles are O1'-C2'-C4'=C6' and O1'-C2'-C4'-C5' [-137.7 (5) and 43.7 (5)degrees, respectively, in the chain at C10 and 155.8 (5) and -24.7 (9)degrees, respectively in the chain at C9]. These variations are due to two intramolecular hydrogen bonds, namely, C16-H161 ... O1' [C16 ... O1' 3.056 (7) Angstrom] and C7''-H7Y ... O3'' [C7'' ... O3'' 2.955 (12) Angstrom]. The methyl substituents, C15 and C16, at position C8 are alpha and beta oriented, respectively. The crystal structure is stabilized by a weak C4-H41 ... O3' hydrogen bond [C4 ... O3' 3.297 (6) Angstrom] between the screw-related molecules.

Dynamic recrystallisation during hot working of Zr-2 center dot 5Nb: Characterisation using processing maps

The characteristics of the hot deformation of Zr-2.5Nb (wt-%) in the temperature range 650-950 degrees C and in the strain rate range 0.001-100 s(-1) have been studied using hot compression testing. Two different preform microstructures: equiaxed (alpha + beta) and beta transformed have been investigated. For this study, the approach of processing maps has been adopted and their interpretation carried out using the dynamic materials model. The efficiency of power dissipation given by [2m/(m + 1)], where m is the strain rate sensitivity, is plotted as a function of temperature and strain rate to obtain a processing map. A domain of dynamic recrystallisation has been identified in the maps of equiaxed (alpha + beta) and beta transformed preforms. In the case of equiaxed (alpha + beta), the stress-strain curves are steady state and the dynamic recrystallisation domain in the map occurs with a peak efficiency of 45% at 850 degrees C and 0.001 s(-1). On the other hand the beta transformed preform exhibits stress-strain curves with continuous flow softening. The corresponding processing map shows a domain of dynamic recrystallisation occurring by the shearing of alpha platelets followed by globularisation with a peak efficiency of 54% at 750 degrees C and 0.001 s(-1). The characteristics of dynamic recrystallisation are analysed on the basis of a simple model which considers the rates of nucleation and growth of recrystallised gains. Calculations show that these two rates are nearly equal and that the nucleation of dynamic recrystallisation is essentially controlled by mechanical recovery involving the cross-slip of screw dislocations. Analysis of flow instabilities using a continuum criterion revealed that Zi-2.5Nb exhibits flow localisation at temperatures lower than 700 degrees C and strain rates higher than 1 s(-1).

Dehydrophenylalanine zippers: strong helix-helix clamping through a network of weak interactions

A decapeptide Boc-L-Ala-(DeltaPhe)(4)-L-Ala-(DeltaPhe)(3)-Gly-OMe (Peptide I) was synthesized to study the preferred screw sense of consecutive alpha,beta-dehydrophenylalanine (DeltaPhe) residues. Crystallographic and CD studies suggest that, despite the presence of two L-Ala residues in the sequence, the decapeptide does not have a preferred screw sense. The peptide crystallizes with two conformers per asymmetric unit, one of them a slightly distorted right-handed 3(10)-helix (X) and the other a left-handed 3(10)-helix (Y) with X and Y being antiparallel to each other. An unanticipated and interesting observation is that in the solid state, the two shape-complement molecules self-assemble and interact with an extensive network of C-H...O hydrogen bonds and pi-pi interactions, directed laterally to the helix axis with amazing regularity. Here, we present an atomic resolution picture of the weak interaction mediated mutual recognition of two secondary structural elements and its possible implication in understanding the specific folding of the hydrophobic core of globular proteins and exploitation in future work on de novo design.

Helical structures: The geometry of protein helices and nanotubes

In nature, helical structures arise when identical structural subunits combine sequentially, the orientational and translational relation between each unit and its predecessor remaining constant. A helical structure is thus generated by the repeated action of a screw transformation acting on a subunit. A plane hexagonal lattice wrapped round a cylinder provides a useful starting point for describing the helical conformations of protein molecules, for investigating the geometrical properties of carbon nanotubes, and for certain types of dense packings of equal spheres.

Effect of nanoclay content and compatibilizer on viscoelastic properties of montmorillonite/polypropylene nanocomposites

This paper deals with preparation of nanocomposites using modified nanoclay (organoclay) and polypropylene (PP), with, and without compatibilizer (m-TMI-g-PP) to study the effects of modified nanoclay and compatibilizer on viscoelastic properties. Nanocomposites were prepared in two steps; compounding of master batch of nanoclay, polypropylene and m-TMI-g-PP in a torque rheometer and blending of this master-batch with polypropylene in a twin-screw extruder in the specific proportions to yield 3-9% nanoclay by weight in the composite. Dynamic Mechanical Analysis (DMA) tests were carried out to investigate the viscoelastic behavior of virgin polypropylene and nanocomposites. The dynamic mechanical properties such as storage modulus (E'), loss modulus (E `') and damping coefficient (tand) of PP and nano-composites were investigated with and without compatibilizer in the temperature range of -40 degrees C to 140 degrees C at a step of 5 degrees C and frequency range of 5 Hz to 100 Hz at a step of 10 Hz. Storage modulus and loss modulus of the nano-composites was significantly higher than virgin polypropylene throughout the temperature range. Storage modulus of the composites increased continuously with increasing nano-content from 3% to 9%. Composites prepared with compatibilizer exhibited inferior storage modulus than the composites without compatibilizer. Surface morphology such as dispersion of nanoclay in the composites with and without compatibilizer was analyzed through Atomic Force Microscope (AFM) that explained the differences in viscoelastic behavior of composites. (C) 2011 Elsevier Ltd. All rights reserved.

C-H center dot center dot center dot O-nitrate synthon assisted molecular assembly of hydrogen bonded Ni(II) and Cu(II) complexes

Two Schiff base metal complexes Cu-SPETNNO3 (1) and Ni-SPETNNO3 (2) SPETN=2,2-propane,1,3-diylbis(nitrilomethyldyne)pyridyl,phenolate] ] with hydrogen bonding groups have been synthesized and characterized by single-crystal X-ray diffraction. In both of the compounds nitrates occupy a crystallographic general position. In 1 the lattice nitrates are on the 2(1) screw axis while in 2 they are at the crystallographic inversion center. C-HOnitrate synthons (formed by the nitrate anions and peripheral hydrogen bonding groups of the metal complexes) are non-covalent building blocks in molecular-assembly and packing of the cationic Schiff base metal complexes (M=Ni2+, Cu2+), resulting in 2-D hydrogen bonded networks. The CuCu non-bonding contact in 1 is 3.268 angstrom while the Ni-Ni bonding distance in 2 is 3.437 angstrom.