Outcome of transmetatarsal amputations in diabetics using antibiotic beads

BACKGROUND: Diabetic patients with transmetatarsal amputation (TMA) for chronic forefoot ulceration or necrosis are at high risk for postoperative skin breakdown and subsequent amputation. Locally applied antibiotics may reduce the revision rate and improve the outcome. MATERIAL AND METHODS: In a retrospective comparative study, 60 diabetic patients (65 feet) with forefoot ulceration or necrosis were treated with TMA by three surgeons in three hospitals. In the "beads group'' (46 patients, 49 feet) TMA was combined with local application of bioabsorbable, tobramycin impregnated calcium sulphate beads (OsteoSet-T beads, Wright Medical, Memphis, TN) as a single-stage procedure. The remaining 16 patients had transmetatarsal amputation without beads at the surgeon's discretion and acted as a control group. For all patients, time to healing, length of hospital stay, number of revisions for wound breakdown and conversions to a higher-level amputation were retrospectively reviewed. Of the 60 patients 17 had died and three were lost to followup, leaving 40 patients available for latest followup at 29 months. The Foot ; Ankle Outcome Score, Foot Function index, SF-36, and Comorbidity score were recorded. RESULTS: The revision rate for wound breakdown after TMA was 8.2% (4/49) in the beads group, and 25% (4/16) in the control group (p<0.05). At latest followup, 27% (13/49) in the beads group, and 25% (4/16) in the control group had to be converted to transtibial amputation. Patients in the beads group scored worse for activities of daily living in the FAOS and SF-36 (p < 0.05), and demonstrated more health problems in the Comorbidity scores (not significant), indicating sicker individuals in the beads group. CONCLUSION: Bioabsorbable calcium sulphate antibiotic beads may be a useful addition for TMA for patients with non-healing diabetic ulcerations of the forefoot. The single-stage procedure could have a significant impact on the management of diabetic forefoot ulcerations by preventing additional hospital stays, improving the patient's quality of life and minimizing cost.

Description and chemical composition of manganese deposits during the deep-sea expedition of the streamer Valdivia in 1898-1899

This monograph forms the fourth part of the tenth volume of the scientific results of the voyage of the German exploring ship Valdivia in the Atlantic and Indian Oceans, made during the years 1898-1899. These volumes are published under the editorship of Prof. Chun, the zoologist of Leipzig, who was leader of the expedition ; and Prof. E. Philippi with the cooperation of Sir John Murray. The nature of the materials brought up at various points during the voyage is well illustrated by a series of plates, similar to those accompanying the Challenger volumes. Among the concretions from the Agulhas Bank were found phosphatic nodules containing 33 per cent, of calcium carbonate, 28 of calcium phosphate, 14.6 of calcium sulphate, and 4.8 of magnesium carbonate, with some ferric oxide, alumina, and silica. These nodules were dredged at a depth of 155 metres. Off the coast of Namibia, a large quantity of manganese nodules were also dredged. Their chemical analysis performed at the Mineralogical Institute of the University Jena show similar composition as the nodules recovered by the "Challenger" at station 253 in the Pacific Ocean.

Characterization of diagenetic fluids at ODP Site 103-639

Site 639, drilled during Leg 103 of the Ocean Drilling Program, penetrated an Upper Jurassic to Lower Cretaceous carbonate platform on a tilted fault block along the Galicia margin off the northwest Iberian Peninsula. The carbonate platform is composed primarily of a sequence of dolomite overlying limestone. Samples were analyzed for mineral chemistry, stable isotope geochemistry, fluid inclusion microthermometry, and volatile contents and by dolomite pyrolysis mass spectrometry for trace sulfate minerals. The dolomite recovered from the Galicia margin at Site 639 formed during shallow burial from sulfate-bearing, hypersaline brines at slightly elevated temperatures. The light oxygen isotopic signatures of the dolomite are interpreted as the result of the evaporative loop and slightly elevated temperatures during dolomite formation or from reequilibration at higher temperatures during deeper burial. The hypersalinity is interpreted to be associated with a nearby, shallow restricted basin that formed during rifting of the Iberian margin from Newfoundland. The dolomitization of the platform is therefore a by-product of the rifting.

Chemical and mineral compositions of sedimentary deposits and magmatic rocks from DSDP Legs 41, 45, 48, and 49

This collective monography by a group of lithologists from the Geological Institute of the USSR Academy of Sciences summarizes materials of the Deep-Sea Drilling Project from the Atlantic Ocean. It gives results of processing materials on the sequences drilled during DSDP Legs 41, 45, 48 and 49. These studies were based on lithological-facial analysis combined with detailed mineralogical-petrographic description. Its chapters give a number of ideas on formation of the Earth sedimentary cover, which can be used for compilation of regional and global schemes of ocean paleogeography, reconstruction of history of some structures in the World Ocean, correlation between sedimentary processes on continents and in oceans, estimation of perspectives for oil and gas fields and ore formation.

Geochemistry of evaporite in the Red Sea

One of the major shipboard findings during Leg 23 drilling in the Red Sea was the presence of late Miocene evaporites at Sites 225, 227, and 228. The top of the evaporite sequence correlates with a strong reflector (Reflector S) which has been mapped over much of the Red Sea (Ross et al., 1969, Phillips and Ross, 1970). This indicates that the Red Sea appears to be extent. Miocene sediments, including evaporites, are known from a few outcrops along the coastal plains of the Gulf of Suez to lat 14°N (Sadek, 1959, cited in Friedman, 1972; Heybroek, 1965; Friedman, 1972). Along the length of the Red Sea, the presence of Miocene salt is indicated by seismic reflection studies (Lowell and Genik, 1972) and confirmed by drilling. The recently published data from deep exploratory wells (Ahmed, 1972) demonstrate the great thickness of elastics and evaporites which were deposited in the Red Sea depression during Miocene time. The Red Sea evaporites are of the same age as the evaporites found by deep sea drilling (DSDP Leg 13) in the Mediterranean Sea. Therefore, Reflector S in the Red Sea is comparable to Reflector M in the Mediterranean. It is assumed that during Miocene time a connection between these two basins was established (Coleman, this volume) resulting in a similar origin for the evaporites deposited in the Red Sea and in the Mediterranean Sea. The origin of the Mediterranean evaporites has been discussed in great detail (Hsü et al., 1973; Nesteroff, 1973; Friedman, 1973). The formation of evaporites may be interpreted by three different hypotheses. 1) Evaporation of a shallow restricted shelf sea or lagoon which receives inflows from the open ocean. 2) Evaporation of a deep-water basin which is separated from the open ocean by a shallow sill (Schmalz, 1969). 3) Evaporation of playas or salt lakes which are situated in desiccated deep basins isolated from the open ocean (Hsü et al., 1973). The purpose of this study is to show whether one of these models might apply to the formation and deposition of the Red Sea evaporites. Therefore, a detailed petrographic and geochemical investigation was carried out.

Nanocompósito de poliestireno reciclado, bentonita sódica e hemi-hidrato de sulfato de cálcio: obtenção e caracterização.

Nesta Tese foram preparados, em solução, filmes híbridos de argila e poliestireno provenientes de copos descartáveis comercializados no mercado brasileiro, com acetato de etila e glicerol. Posteriormente, foi adicionado o Hemi-hidrato de sulfato de cálcio como carga de reforço. Tanto a argila quanto o glicerol, assim como o hemihidrato de sulfato de cálcio, foram utilizados nos percentuais relativos à massa do poliestireno fragmentado correspondendo a 1%,2%, 3%,4%, 5% e 7%. Dos filmes, nos percentuais 3, 4, 5 e 7, exclui-se o percentual de 4% e os demais foram fragmentados e submetidos a extrusão, com resfriamento natural, à seco, produzindo-se grãos com os quais foi avaliado o índice de fluidez e injetados para a moldagem de corpos de prova rígidos. O desempenho dos corpos rígidos, foi comparado com os resultados do HIPS 484, e o GPPS comercializados no mercado brasileiro. Os filmes foram caracterizados por difração de raios X, microscopia eletrônica de varredura (MEV), calorimetria exploratória diferencial (DSC), além dos testes de resistência à tração, fluorescência de raios X, EDS e FTIR. Amostra do filme, ultrafino, obtido a partir da solução com o percentual de 5% foi observada ao microscópio ótico e no microscópio eletrônico de transmissão, assim como amostras de corpos rígidos microtomizadas. Nos corpos rígidos, além das análises instrumentais citadas, foram avaliadas a resistência à flexão, modulo de flexão, resistência à tração, alongamento e resistência ao impacto Izod. O desempenho sob chama foi avaliado em amostras de filme e também do corpo rígido. Resultados do DRX, e da MET foram coerentes com a bibliografia para nanocompósitos argila-polímero e, associado às respostas dos demais ensaios, indicaram um material de boa qualidade morfológica e boas propriedades mecânicas comparadas ao HIPS 484 e ao GPPS. Sob a chama o material produzido apresentou maior resistência à queima avaliado pela quantidade aparente de material residual para um mesmo tempo sob fogo. Constatou-se, também, uma boa dispersão das cargas na matriz polimérica, assim como uma adequada interação entre os elementos orgânicos e inorgânicos do material, a delaminação parcial da argila e quebra da estrutura do hemi-hidrato. Isto resultou em um bom desempenho mecânico e térmico do compósito que pode ser atribuído, tanto a uma forte influência dos íons metálicos presentes nas cargas inorgânicas, quanto às adições presentes na formulação dos copos descartáveis.

Incrustação em poço produtor de petróleo e gás natural: um estudo de caso

Water and gas is a common by - product of the oil production process. Production may be compromised by the precipitation of inorganic salts in both the reservoir and producing well, through scale formation. This precipitation is likely the cause of the formation damage. High temperatures and h igh pressures (HTHP) may favor the precipitation of insoluble salts. The most common types of scale in oil fields are calcium carbonate and calcium sulphate, strontium and barium sulphate. New types of scale formation have attracted special attention such as zinc sulphide and lead. This precipitation may occur in the pores of reservoir rocks, in the production string and in equipment, causing obstructions and consequent production losses. In this study, the influence of well depth on incrustation compositio n was investigated to design removal treatments and assess the behavior of these deposits along the string, through the analysis of pressure and temperature. Scale residues were recovered from the inside of the production string of an oil and gas well duri ng the string removal operation. A total of 10 samples from different depths (15.4 m to 4061.5 m) were obtained. Initially a dissolution test was conducted in weak acid, similar to that used in removal operations with this type of scale formation. Majority composition was defined and confirmed by dissolution tests using X - Ray Fluorescence Spectroscopy (XRF), X - Ray Diffraction (XRD) and Scanning Electron Microscope (SEM) techniques. Residues with distinct characteristics were observed in different proportion s, showing a tendency toward increased and/or decreased mass with depth. In the samples closest to the surface, typical sandstone residues were found, with calcium (45% Ca) as the metal of highest concentration. The obtained results indicate correlations o f the scale types studied with the depth and, consequently, with the thermodynamic conditions of pressure and temperature.

Polarisation studies on the Raman spectra of cubic crystals - Part II: Calcium fluoride and potassium aluminium sulphate

Polarisation characters of the Raman lines of calcium fluoride (fluorspar) and potassium aluminium sulphate (alum) were investigated under the following conditions. Unpolarised light was incident normally on a face of the crystal making an angle 22.5° with a cubic face and the light scattered transversely along a cubic axis was analysed by a double image prism kept with its principal axes inclined at 45° to the vertical. Under these conditions the depolarisation factors of the Raman lines belonging to the totally symmetric (A), the doubly degenerate (E) and the triply degenerate (F) modes should be respectively =1, >1 and <1. The characteristic Raman line of CaF2 at 322 cm-1 exhibited a depolarisation value less than 1, showing thereby that the corresponding mode is a triply degenerate one (F). The Raman lines observed in the spectrum of K-alum were also classified and the results were compared with those given by previous investigators using standard crystal orientations.

Infrared and Raman spectroscopic characterisation of the sulphate mineral creedite – Ca3Al2SO4(F,OH)·2H2O – and in comparison with the alums

The mineral creedite is a fluorinated hydroxy hydrated sulphate of aluminium and calcium of formula Ca3Al2SO4(F,OH)·2H2O. The mineral has been studied by a combination of electron probe analysis to determine the molecular formula of the mineral and the structure assessed by vibrational spectroscopy. The spectroscopy of creedite may be compared with that of the alums. The Raman spectrum of creedite is characterised by an intense sharp band at 986 cm−1 assigned to the View the MathML source ν1 (Ag) symmetric stretching mode. Multiple bands of creedite in the antisymmetric stretching region support the concept of a reduction in symmetry of the sulphate anion. Multiple bands are also observed in the bending region with the three bands at 601, 629 and 663 cm−1 assigned to the View the MathML source ν4 (Ag) bending modes. The observation of multiple bands at 440, 457 and 483 cm−1 attributed to the View the MathML source ν2 (Bg) bending modes supports the concept that the symmetry of the sulphate is reduced by coordination to the water bonded to the Al3+ in the creedite structure. The splitting of the ν2, ν3 and ν4 modes is attributed to the reduction of symmetry of the SO4 and it is proposed that the sulphate coordinates to water in the hydrated aluminium in bidentate chelation.