The Lausanne experience with the Wichita fusion nail for arthrodesis of the knee

Background: Arthrodesis of the knee by intramedullary fixation hasbeen reported to have a higher rate of success than external fixationor compression plating. Antegrade nailing however can lead to complicationsdue to the different diameters of the medullary canals, fracturesduring insertion, poor rotational stability, breakage of the IM-nailand insufficient compression at the fusion site.Method: This retrospective study reports all knee fusions performedby the same orthopaedic surgeon with the Wichita (Stryker) fusion nail(WFN) from 2004 to 2010. The Wichita nail is a short nail with a deviceat the knee which allows for coupling of differently sized and interlockedfemoral and tibial components and at the same time for compression.Results: We report of 18 patients with a mean follow up of 28 months(range 3-71 months). Infected TKA was the most common indicationfor arthrodesis in 9 cases. The remaining reasons included asepticfailed TKA in 3 cases, 2 patients after fracture, 1 patient with neurologicalinstability after knee dislocation, 1 patient after tumoral resectionand 1 non union after failed arthrodesis with long antegrade nail.Finally 1 patient with bilateral congenital knee dislocation operated onboth sides. As expected, patients receiving the WFN had undergonea large number of previous knee surgeries with a mean of 3.8 (range0-8) procedures per patient. The complication rate was 27% (5 of 18).Two patients had persistent pain requiring revision surgery to increasestability with plating. One case of periprosthetic fracture needed openreduction and internal fixation. 2 patients with superficial hematomawere treated one with open drainage and the other with physiotherapy.Infection was erradicated in all septic cases, we found no new infectionand the fusion rate was 100%.Conclusion: The results in these often difficult cases are satisfyingand we think that this technique is a valid alternative to the otherknown techniques of knee fusion in patients with a poor bone stockand fragile soft tissues.

Thin silicon films ranging from amorphous to nanocrystalline obtained by Hot-Wire CVD

In this paper, we have presented results on silicon thin films deposited by hot-wire CVD at low substrate temperatures (200 °C). Films ranging from amorphous to nanocrystalline were obtained by varying the filament temperature from 1500 to 1800 °C. A crystalline fraction of 50% was obtained for the sample deposited at 1700 °C. The results obtained seemed to indicate that atomic hydrogen plays a leading role in the obtaining of nanocrystalline silicon. The optoelectronic properties of the amorphous material obtained in these conditions are slightly poorer than the ones observed in device-grade films grown by plasma-enhanced CVD due to a higher hydrogen incorporation (13%).

Fingerlike aggregates in thin-layer electrodeposition

Electrodeposition experiments conducted in a thin-layer horizontal cell containing a nonbinary aqueous electrolyte prepared with cupric sulfate and sodium sulfate gave rise to fingerlike deposits, a novel and unexpected growth mode in this context. Both the leading instability from which fingers emerge and some distinctive features of their steady evolution are interpreted in terms of a simple model based on the existing theory of fingering in fluids.

Growth rate of fractal copper electrodeposits: Potential and concentration effects

Experiments are reported on fractal copper electrodeposits. An electrochemical cell was designed in order to obtain a potentiostatic control on the quasi-two-dimensional electrodeposition process. The aim was focused on the analysis of the growth rate of the electrodeposited phase, in particular its dependence on the electrode potential and electrolyte concentration.

Fingerlike aggregates in thin-layer electrodeposition

Electrodeposition experiments conducted in a thin-layer horizontal cell containing a nonbinary aqueous electrolyte prepared with cupric sulfate and sodium sulfate gave rise to fingerlike deposits, a novel and unexpected growth mode in this context. Both the leading instability from which fingers emerge and some distinctive features of their steady evolution are interpreted in terms of a simple model based on the existing theory of fingering in fluids.

Citrobacter rodentium Requires Intestinal Neural Wiskott-Aldrich Syndrome Protein (N-WASp) for Actin Pedestal Formation, Colonization and Epithelial Barrier Disruption In Vivo

Background: Citrobacter rodentium is a natural mouse pathogen that is genetically closelyrelated to the human enteric pathogens enteropathogenic and enterohemorrhagic E. coli.Among the repertoire of conserved virulence factors that these pathogens deliver via typeIII secretion, Tir and EspF are responsible for the formation of characteristic actin-richpedestals and disruption of tight junction integrity, respectively. There is evidence In Vitrothese effectors accomplish this, at least in part, by subverting the normal host cellularfunctions of N-WASP, a critical regulator of branched chain actin assembly. Although NWASPhas been shown to be involved in pedestal formation In Vitro, the requirements ofN-WASP-mediated actin pedestals for intestinal colonization by attaching/effacing (A/E)pathogens In Vivo is not known. Furthermore, it is not known whether N-WASP is requiredfor EspF-mediated tight junction disruption. Methods: To investigate the role of N-WASPin the gut epithelium, we generated mice with intestine-specific deletion of N-WASP(iNWKO), by mating mice homozygous for a floxed N-WASP allele (N-WASPL2L/L2L) tomice expressing Cre recombinase under the villin promoter. Separately housed groups ofWT and iNWKO mice were inoculated with 5x108 GFP-expressing C. rodentium by intragastriclavage. Stool was collected 2, 4, 7, and 12 days after infection, and recoverablecolony forming units (CFUs) of C. rodentium were quantified by plating serial dilutions ofhomogenized stool on MacConkey's agar. GFP+ colonies were counted after 24 hoursincubation at 37°C. The presence of actin pedestals was investigated by electron microscopy(EM), and tight junction morphology was assessed by immunofluorescence staining ofoccludin, ZO-1 and claudin-2. Results: C. rodentium infection did not result in mortalityin WT or iNWKO mice. Compared to controls, iNWKO mice exhibited higher levels ofbacterial shedding during the first 4 days of infection (day 4 average: WT 5.2x104 CFU/gvs. iNWKO 4.7x105 CFU/g, p=0.08), followed by a more rapid clearance of C. rodentium, (day7-12 average: WT 2x106 CFU/g vs. iNWKO 2.7x105, p=0.01). EM and immunofluorescencerevealed the complete lack of actin pedestals in iNWKO mice and no mucosa-associatedGFP+ C. rodentium by day 7. WT controls exhibited tight junction disruption, reflected byaltered distribution of ZO-1, whereas iNWKO mice had no change in the pattern of ZO-1.Conclusion: Intestinal N-WASP is required for actin pedestal formation by C. rodentium InVivo, and ablation of N-WASP is associated with more rapid bacterial clearance and decreasedability of C. rodentium to disrupt intercellular junctions.

Résultats préliminaires de l'enclouage rétrograde de l'humérus [Preliminary results of retrograde nailing of the humerus]

A group of nine patients with a diaphyseal fracture of the humerus and treated with retrograde nailing were studied with a mean follow-up of 15.3 months. Six patients with a humeral fracture without neurological deficit showed a good shoulder and elbow mobility at the last visit. Three patients with neurological lesion preoperatively suffer from a diminished range of movement not related to the surgical procedure. During the operation and postoperatively we found no complication related to the implant and more precisely we could not find a iatrogenic fracture or nervous lesion except one intraoperative lesion of the radial nerve probably related to an important traction movement during reduction with complete remission. Consolidation has been achieved for all fractures but one. This patient suffers from a lesion of the brachial plexus with complete plegia of the arm and a vascular lesion. This patient had to be reoperated for an atrophic non-union by bone grafting and plate fixation. The retrograde nail is a good implant and must be considered in our treatment plans as much as conservative treatment or surgical treatment with plating, anterograde nailing or the use of an external fixator. Only then will we be able to give to the patient the most adapted treatment for his fracture.

Results and harmonization guidelines from two large-scale international Elispot proficiency panels conducted by the Cancer Vaccine Consortium (CVC/SVI).

The Cancer Vaccine Consortium of the Sabin Vaccine Institute (CVC/SVI) is conducting an ongoing large-scale immune monitoring harmonization program through its members and affiliated associations. This effort was brought to life as an external validation program by conducting an international Elispot proficiency panel with 36 laboratories in 2005, and was followed by a second panel with 29 participating laboratories in 2006 allowing for application of learnings from the first panel. Critical protocol choices, as well as standardization and validation practices among laboratories were assessed through detailed surveys. Although panel participants had to follow general guidelines in order to allow comparison of results, each laboratory was able to use its own protocols, materials and reagents. The second panel recorded an overall significantly improved performance, as measured by the ability to detect all predefined responses correctly. Protocol choices and laboratory practices, which can have a dramatic effect on the overall assay outcome, were identified and lead to the following recommendations: (A) Establish a laboratory SOP for Elispot testing procedures including (A1) a counting method for apoptotic cells for determining adequate cell dilution for plating, and (A2) overnight rest of cells prior to plating and incubation, (B) Use only pre-tested serum optimized for low background: high signal ratio, (C) Establish a laboratory SOP for plate reading including (C1) human auditing during the reading process and (C2) adequate adjustments for technical artifacts, and (D) Only allow trained personnel, which is certified per laboratory SOPs to conduct assays. Recommendations described under (A) were found to make a statistically significant difference in assay performance, while the remaining recommendations are based on practical experiences confirmed by the panel results, which could not be statistically tested. These results provide initial harmonization guidelines to optimize Elispot assay performance to the immunotherapy community. Further optimization is in process with ongoing panels.

Four-corner bone arthrodesis with dorsal rectangular plate: series and personal technique.

Controversy exists about the best method to achieve bone fusion in four-corner arthrodesis. Thirty-five patients who underwent this procedure by our technique were included in the study. Surgical indications were stage II-III SLAC wrist, stage II SNAC wrist and severe traumatic midcarpal joint injury. Mean follow-up was 4.6 years. Mean active flexion and extension were 34 degrees and 30 degrees respectively; grip strength recovery was 79%. Radiological consolidation was achieved in all cases. The mean DASH score was 23 and the postoperative pain improvement by visual analogue scale was statistically significant. Return to work was possible at 4 months for the average patient. Complications were a capitate fracture in one patient and the need for hardware removal in four cases. Four-corner bone wrist arthrodesis by dorsal rectangular plating achieves an acceptable preservation of range of motion with good pain relief, an excellent consolidation rate and minimal complications.

Spirometric alterations in workers in the chromium electroplating industry.

The spirometric values (VC, FeV1, FEF25-75%) were studied in 44 workers of 17 chromium electroplating plants. Urinary chromium was also measured. The dynamic values of spirometry are lower amongst the workers who have higher urinary chromium. The part that can be attributed to tobacco smoking is much lower than that of chromium. The workers dealing with chromium electroplating in poor conditions seem to be subjects at risk in developing obstructive respiratory syndrome. The hazard seems to be especially high in plants dealing with hard chromium plating.

Mitta-anturin mittauselektroniikan kehittäminen teräksen puutislepinnoituksen ohjaukseen

Työn tarkoituksena oli kehittää mittauselektroniikka puutislepinnoitusprosessin ohjaukseen. Mittauselektroniikalla on tarkoitus mitata pikoampeeriluokan virtoja mittaanturilta, jossa virtaa kuuma, noin 250 ºC asteinen kaasu. Mitta-anturin toiminta perustuu ioniliikkuvuusspektrometriaan. Työssä tutkitaan pikoampeeriluokan virtojen mittaamista sekä mittauskytkennöissä käytetyn virta-jännitemuuntimen ominaisuuksia ja mitoittamista. Työ tarkastelee myös T-kytkennän käyttöä vahvistimen takaisinkytkennässä. Jännitekertojakytkentöjä käsitellään teoreettisesti mitta-anturin biasjännitteiden luomiseksi vähäisellä piirilevypinta-alalla. Työssä suunniteltiin mittauselektroniikan esivahvistinprototyypit sekä mitta-anturin biasjännitekytkentä. Mitta-anturin kuumien olosuhteiden vuoksi on mittauselektroniikka siirrettävä etäämmäksi mitta-anturista. Prototyyppikytkennöillä sekä laboratoriomittauksilla selvitettiin mittauselektroniikan esivahvistimien siirtämiseen liittyviä ongelmia. Biasjännitekytkennän suunnittelussa pyrittiin kytkentä toteuttamaan mahdollisimman vähällä piirilevypinta-alalla. Mittauselektroniikka todettiin laboratoriomittausten perusteella toimivaksi puutislepinnoitusprosessissa suoritettavia koemittauksia varten.

Tuotannonohjauksen kehittäminen liittimiä valmistavassa yrityksessä

Diplomityön tarkoituksena oli kehittää ja yksinkertaistaa tuotannonohjausta. Teoriaosassa selvitettiin erilaisia tuotannonohjaustekniikoita sekä vertailtiin niitä toisiinsa. Käytännön osassa perehdyttiin ensin toimitusajan varmistamisen ja tuotannonsuunnittelun rutiineihin. Niitä analysoimalla etsittiin kehityskohteita. Toimitusvarmuutta analysoimalla löydettiin järjestelmän kapeikko. Läpäisyaikoja analysoimalla tutustuttiin kuinka toimitusvastaavien tuotannon kuormittamisen erot vaikuttavat läpäisyaikoihin. ABC-analyysillä löydettiin meisto- ja pinnoitusosastoa kuormittavimmat puolivalmisteet. Järjestelmän pullonkaulana on pintakäsittely ja liikkuvana pullonkaulana meisto. Kehityskohteita arvioitiin kriittisten menestystekijöiden perusteella. Kehitettävien kohteiden lopullinen valinta tehtiin yhdessä työn ohjausryhmän kanssa. Kiireisimmät kehityskohteet olivat uuden tuotannonohjausmallin rakentaminen, tuotteiden ja puolivalmisteiden jakaminen eri ohjaustavoille, Excel-taulukoiden käytön laajentaminen ja monipuolistaminen sekä tuotannon osittainen visualisointi. Näiden toteuttaminen aloitettiin työn aikana ja sitä tullaan vielä jatkamaan.

Estudo eletroquímico de um novo banho galvânico de zinco alcalino livre de cianetos

A systematic electrochemical study of a novel cyanide free galvanic plating solution of alkaline zinc is presented. Cell Hull tests and potentiodynamic linear polarization measurements were carried out to evaluate the influence of operational parameters, such as concentration, current efficiency and degradation of additives. The stability of the bath was assessed by a long term test during 40 h at 200 A m-2. The morphology of the coatings was characterized by scanning electron microscopy. The results showed good performance of the plating solution. The cost is similar to that of the commercial cyanide bath and lower than that of the commercial cyanide free bath.

Otimização do banho eletrolítico da liga Fe-W-B resistente à corrosão

A study on optimization of bath parameters for electrodeposition of Fe-W-B alloys from plating baths containing ammonia and citrate is reported. A 2³ full factorial design was successfully employed for experimental design analysis of the results. The corrosion resistance and amorphous character were evaluated. The bath conditions obtained for depositing the alloy with good corrosion resistance were: 0.01 M iron sulfate, 0.10 M sodium tungstate and 0.60 M ammonium citrate. The alloy was deposited at 12% current efficiency. The alloy obtained had Ecorr -0.841 V and Rp 1.463 x 10(4) Ohm cm². The deposit obtained under these conditions had an amorphous character and no microcracks were observed on its surface. Besides this, the bath conditions obtained for depositing the alloy with the highest deposition efficiency were: 0.09 M iron sulfate, 0.30 M sodium tungstate and 0.50 M ammonium citrate. The alloy was deposited at 50% current efficiency, with an average composition of 34 wt% W, 66 wt% Fe and traces of boron. The alloy obtained had Ecorr -0.800 V and Rp 1.895 x 10³ Ohm cm². Electrochemical corrosion tests verified that the Fe-W-B alloy deposited under both conditions had better corrosion resistance than Fe-Mo-B.

Efecto de la naturaleza del precursor sobre las caracteristicas de las nanoparticulas de SnO2 sintetizadas

Tin oxide (SnO2) is widely used in industry as raw material for electronic devices, plating of different types of materials, for dyes and pigments, for electroplating, heterogeneous catalysis, etc. In this work SnO2 was obtained by a controlled precipitation method with special attention to the effects the tin precursor has on the microstructure of the final product. The most appropriate pH for obtaining SnO2 with the rutile structure as the main phase is 6.25 for SnCl2 and 6.40 for SnSO4. After heat treatment at 600 °C, particles of nanometric order (~10 - 30 nm approx) were obtained. The characterization of the solid phase was made by X-ray diffraction (XRD), thermal analysis (DTA/TG), transmission electron microscopy (TEM) and Fourier transformed infrared spectroscopy (FTIR).