New osseous soft markers for trisomy 13, 18 and 21

INTRODUCTION For ultrasonographic diagnosis of a fetal trisomy so-called "soft markers" (=ultrasonographically detectable morphological variants) are used. Detection of a certain number of them increases the diagnostic certainty of a fetal trisomy. Up to now there are very few diagnostically accepted osseous soft markers for trisomy. Hence potential osseous soft markers applicable for first and second trimester ultrasound screening for trisomy 21, 18 or 13 were studied. METHODS Postmortal fetal X-rays (ap, lateral) of 358 fetuses (trisomy 21: n = 109, trisomy 18: n = 46; trisomy 13: n = 38, control group: n = 165). RESULTS Not yet described but with trisomy 21 statistically associated soft markers were un-timely os sternale ossification, delayed os sacrum ossification, shortened os maxillare, reduced os maxillare-jaw-corner distance, augmented orbita height, premature os calcaneus ossification, bell-shaped thorax, coronal clefts, trend to wider binocular as well as wider intraocular distances; for trisomy 18: elevated clavicula slope, reduced number of ribs, bell-shaped thorax, coronal clefts, reduced os maxillare-jaw-corner distance, shortened ramus mandibulare, shortened os metacarpale IV and V, augmented ratio between biparietal diameter and (osseus and soft-tissue) shoulder width; for trisomy 13: longer os nasale, elevated clavicula slope, premature sternum, delayed os sacrum ossification, delayed/premature cranium ossification, reduced number of ribs, coronal clefts, reduced os maxillare-jaw-corner distance, shortened ramus mandibulare, augmented orbita height, shortened os metacarpale V and a tendency for a shortened os metacarpale IV. CONCLUSION We found several not yet published osseous soft markers statistically associated with trisomy 21, 18 and 13, which can help to ensure sonographically these aneuploidy diagnoses.

Stiffness, Strength, and Failure Modes of Implant-Supported Monolithic Lithium Disilicate Crowns: Influence of Titanium and Zirconia Abutments

PURPOSE The objective of this study was to evaluate stiffness, strength, and failure modes of monolithic crowns produced using computer-aided design/computer-assisted manufacture, which are connected to diverse titanium and zirconia abutments on an implant system with tapered, internal connections. MATERIALS AND METHODS Twenty monolithic lithium disilicate (LS2) crowns were constructed and loaded on bone level-type implants in a universal testing machine under quasistatic conditions according to DIN ISO 14801. Comparative analysis included a 2 × 2 format: prefabricated titanium abutments using proprietary bonding bases (group A) vs nonproprietary bonding bases (group B), and customized zirconia abutments using proprietary Straumann CARES (group C) vs nonproprietary Astra Atlantis (group D) material. Stiffness and strength were assessed and calculated statistically with the Wilcoxon rank sum test. Cross-sections of each tested group were inspected microscopically. RESULTS Loaded LS2 crowns, implants, and abutment screws in all tested specimens (groups A, B, C, and D) did not show any visible fractures. For an analysis of titanium abutments (groups A and B), stiffness and strength showed equally high stability. In contrast, proprietary and nonproprietary customized zirconia abutments exhibited statistically significant differences with a mean strength of 366 N (Astra) and 541 N (CARES) (P < .05); as well as a mean stiffness of 884 N/mm (Astra) and 1,751 N/mm (CARES) (P < .05), respectively. Microscopic cross-sections revealed cracks in all zirconia abutments (groups C and D) below the implant shoulder. CONCLUSION Depending on the abutment design, prefabricated titanium abutment and proprietary customized zirconia implant-abutment connections in conjunction with monolithic LS2 crowns had the best results in this laboratory investigation.

Ultrastructure and Pathoanatomy of the Rotator Cuff

The rotator cuff is a complex musculotendinous unit, which plays a major role in glenohumeral joint stability and mobilization. Tears of the rotator cuff tendon and its subsequent changes of the rotator cuff muscle are common, and the incidence increases with age. Several structures such as the muscle, tendon, and bone may contribute to the development of a tear as well as on the outcome following a rotator cuff repair. Knowledge of these structures may help to improve rotator cuff healing after rotator cuff tear. The goal of this chapter is to discuss the evidence which exists with regard to the pathophysiological changes in the muscle, tendon, and bone that lead to a rotator cuff rupture as well as the changes that occur in these structures after a tear has occurred.

Peri-implant bone loss of dental implants with platform-switching design after 5 years of loading: a cross-sectional study

OBJECTIVE The aim of this cross-sectional study was to estimate bone loss of implants with platform-switching design and analyze possible risk indicators after 5 years of loading in a multi-centered private practice network. METHOD AND MATERIALS Peri-implant bone loss was measured radiographically as the distance from the implant shoulder to the mesial and distal alveolar crest, respectively. Risk factor analysis for marginal bone loss included type of implant prosthetic treatment concept and dental status of the opposite arch. RESULTS A total of 316 implants in 98 study patients after 5 years of loading were examined. The overall mean value for radiographic bone loss was 1.02 mm (SD ± 1.25 mm, 95% CI 0.90- 1.14). Correlation analyses indicated a strong association of peri-implant bone loss > 2 mm for removable implant-retained prostheses with an odds ratio of 53.8. CONCLUSION The 5-year-results of the study show clinically acceptable values of mean bone loss after 5 years of loading. Implant-supported removable prostheses seem to be a strong co-factor for extensive bone level changes compared to fixed reconstructions. However, these results have to be considered for evaluation of the included special cohort under private dental office conditions.

Glenohumeral dislocation. Injury patterns and combination injuries

Hintergrund Begleitverletzungen können in bis zu 90 % der Fälle nach erstmaliger Schulterluxation auftreten. Auch wenn sie nicht immer einen Einfluss auf die Therapiewahl haben, so ist eine sorgfältige Diagnostik entscheidend. Einteilung In der Akutsituation ist eine konventionelle Bildgebung in mindestens 2 Ebenen (a.-p./Neer/evtl. axial) vor und nach Reposition zwingend. Luxationsfrakturen dürfen nicht übersehen bzw. durch das Manöver der geschlossenen Reposition sekundär disloziert werden. Bestehen ossäre glenoidale, humerale oder kombinierte Verletzungen, sollten sie gemäß Stabilitätskriterien versorgt werden. Dies kann umgehend, nach manifester Dezentrierung oder Instabilität entweder mittels Osteosythese oder als glenohumerale Stabilisation im Verlauf erfolgen. Bei einer Instabilität ist prinzipiell zur Bilanzierung einer ossären Ursache das Arthro-CT die Untersuchung der Wahl, welche auch eine Beurteilung der kapsulolabroligamentären Verletzung sowie einer traumatischen Rotatorenmanschettenläsion ermöglicht. Letztere ist jedoch besser mittels Arthro-MRT zu beurteilen. Diskussion Eine signifikante frische, meist größere oder massive, Rotatorenmanschettenläsion sollte rasch operativ angegangen werden. Medial reichende „off the track“ Hill-Sachs-Läsionen können mittels einer Hill-Sachs-Remplissage oder, wie auch glenoidale Defekte, mittels einer Kochenaugmentation versorgt werden. Langzeitresultate des Latarjet-Verfahrens zeigen 25 Jahre nach dem Eingriff die niedrigste Reluxationsrate < 4 %, eine gute Außenrotation, eine sehr hohe Patientenzufriedenheit und degenerative Veränderungen, welche vergleichbar mit der natürlichen Entwicklung nach erstmaliger Schulterluxation ohne Rezidiv sind.

Immediate implant placement with simultaneous guided bone regeneration in the esthetic zone: 10-year clinical and radiographic outcomes.

AIM To associate the dimension of the facial bone wall with clinical, radiological, and patient-centered outcomes at least 10 years after immediate implant placement with simultaneous guided bone regeneration in a retrospective study. MATERIAL AND METHODS Primary endpoint was the distance from the implant shoulder (IS) to the first bone-to-implant contact (IS-BIC10y ). Secondary endpoints included the facial bone thickness (BT10y ) 2, 4, and 6 mm apical to the IS, and the implant position. At baseline, the horizontal defect width (HDWBL ) from the implant surface to the alveolar wall was recorded. At recall, distance from the IS to the mucosal margin (IS-MM10y ), degree of soft tissue coverage of the mesial and distal aspects of the implants (PISm10y , PISd10y ; Papilla Index), pocket probing depth (PPD10y ), and patient-centered outcomes were determined. Width of the keratinized mucosa (KM), Full-Mouth Plaque and Bleeding Score (FMPS, FMBS) were available for both time points. RESULTS Of the 20 patients who underwent immediate implant placement with simultaneous guided bone regeneration and transmucosal healing, nine males and eight females with a median age of 62 years (42 min, 84 max) were followed up for a median period of 10.5 y (min 10.1 max 11.5). The 10-year implant survival rate was 100%. Multivariate regression analysis revealed a correlation of the IS-BIC10y , controlled for age and gender, with four parameters: HDWBL (P = 0.03), KMBL -10 (P = 0.02), BT10 4 mm (P = 0.01), and BT10 6 mm (P = 0.01). CONCLUSION Within the conditions of the present study, the horizontal defect width was the main indicator for the vertical dimension of the facial bone. The facial bone dimension was further associated with a reduction in the width of the keratinized mucosa and the dimension of the buccal bone.

Evaluación de metales pesados en suelos de los oasis irrigados de la Provincia de Mendoza : concentraciones totales de Zn, Pb, Cd y Cu

En Mendoza, Argentina, no existen antecedentes respecto de la presencia de elementos trazas, totales y disponibles, relacionados con el uso de los suelos en los oasis irrigados. El objetivo del trabajo, en esta etapa, fue determinar los contenidos totales de plomo (Pb), cadmio (Cd), cinc (Zn) y cobre (Cu) en la capa superficial de suelos (0-25 cm), diferenciados en siete tipos según una clasificación utilitaria: suelos vírgenes (SV); suelos de banquina (SB); suelos vecinos a banquina (SVB); suelos de agricultura intensiva (SAI); suelos de agricultura protegidos por lucha antigranizo (SLAG); suelos afectados por actividad industrial (SI) y suelos urbanos (SU). Sobre un total de 200 muestras se efectuó una digestión ácida en caliente y en los extractos se determinaron los metales en su fracción total, mediante espectrofotometría de absorción atómica (AAS). El análisis estadístico de los datos muestra que los niveles más elevados de Cu y Cd se detectan en SAI, con medias de 39,3 y 2,5 mg kg-1 respectivamente. En SI se observan los mayores valores de Pb, con una media de 80,6 mg kg-1 y en SU los mayores tenores de Zn, con un valor medio de 740 mg kg-1. La Ciudad de Mendoza, con mayor densidad poblacional, presentó los mayores contenidos de Zn, Pb y Cd. Las concentraciones encontradas se ubican por debajo de las exigencias de la legislación argentina y la mayoría de los suelos pueden clasificarse como no contaminados (SNC) o ligeramente contaminados (SLC). Se prevé completar este estudio con la determinación de las fracciones disponibles de los elementos estudiados, correlacionándolos con variables edáficas físico-químicas como textura, pH y materia orgánica.

El peronismo y la opción partidaria en Jujuy durante la Revolución Libertadora

La Revolución Libertadora, instaurada en septiembre de 1955 luego del derrocamiento del peronismo, ejecutó un proceso expulsivo de los peronistas y estableció la proscripción como mecanismo para evitar su reingreso. Recuperando los planteos sugeridos por Chartier y Spinelli, en el presente artículo se determinan las características de las tácticas que el peronismo jujeño puso en operación a fin de gravitar en el escenario partidario, signado por su proscripción. La participación y el peso ejercido por el peronismo jujeño dieron cuenta de la persistencia de la identidad peronista y del uso de los escasos márgenes de legitimidad

El peronismo y la opción partidaria en Jujuy durante la Revolución Libertadora

La Revolución Libertadora, instaurada en septiembre de 1955 luego del derrocamiento del peronismo, ejecutó un proceso expulsivo de los peronistas y estableció la proscripción como mecanismo para evitar su reingreso. Recuperando los planteos sugeridos por Chartier y Spinelli, en el presente artículo se determinan las características de las tácticas que el peronismo jujeño puso en operación a fin de gravitar en el escenario partidario, signado por su proscripción. La participación y el peso ejercido por el peronismo jujeño dieron cuenta de la persistencia de la identidad peronista y del uso de los escasos márgenes de legitimidad

El peronismo y la opción partidaria en Jujuy durante la Revolución Libertadora

La Revolución Libertadora, instaurada en septiembre de 1955 luego del derrocamiento del peronismo, ejecutó un proceso expulsivo de los peronistas y estableció la proscripción como mecanismo para evitar su reingreso. Recuperando los planteos sugeridos por Chartier y Spinelli, en el presente artículo se determinan las características de las tácticas que el peronismo jujeño puso en operación a fin de gravitar en el escenario partidario, signado por su proscripción. La participación y el peso ejercido por el peronismo jujeño dieron cuenta de la persistencia de la identidad peronista y del uso de los escasos márgenes de legitimidad

El peronismo y la opción partidaria en Jujuy durante la Revolución Libertadora

La Revolución Libertadora, instaurada en septiembre de 1955 luego del derrocamiento del peronismo, ejecutó un proceso expulsivo de los peronistas y estableció la proscripción como mecanismo para evitar su reingreso. Recuperando los planteos sugeridos por Chartier y Spinelli, en el presente artículo se determinan las características de las tácticas que el peronismo jujeño puso en operación a fin de gravitar en el escenario partidario, signado por su proscripción. La participación y el peso ejercido por el peronismo jujeño dieron cuenta de la persistencia de la identidad peronista y del uso de los escasos márgenes de legitimidad

Vegetation, soil and site characteristics of samples taken along the Yamal Transet in 2007-2008

The overarching goal of the Yamal portion of the Greening of the Arctic project is to examine how the terrain and anthropogenic factors of reindeer herding and resource development combined with the climate variations on the Yamal Peninsula affect the spatial and temporal patterns of vegetation change and how these changes are in turn affecting traditional herding of the indigenous people of the region. The purpose of the expeditions was to collect groundobservations in support of remote sensing studies at four locations along a transect that traverses all the major bioclimate subzones of the Yamal Peninsula. This data report is a summary of information collected during the 2007 and 2008 expeditions. It includes all the information from the 2008 data report (Walker et al. 2008) plus new information collected at Kharasavey in Aug 2008. The locations included in this report are Nadym (northern taiga subzone), Laborovaya (southern tundra = subzone E of the Circumpolar Arctic Vegetation Map (CAVM), Vaskiny Dachi (southern typical tundra = subzone D), and Kharasavey (northern typical tundra = subzone C). Another expedition is planned for summer 2009 to the northernmost site at Belyy Ostrov (Arctic tundra = subzone B). Data are reported from 10 study sites - 2 at Nadym, 2 at Laborovaya, and 3 at Vaskiny Dachi and 3 at Kharasavey. The sites are representative of the zonal soils and vegetation, but also include variation related to substrate (clayey vs. sandy soils). Most of the information was collected along 5 transects at each sample site, 5 permanent vegetation study plots, and 1-2 soil pits at each site. The expedition also established soil and permafrost monitoring sites at each location. This data report includes: (1) background for the project, (2) general descriptions and photographs of each locality and sample site, (3) maps of the sites, study plots, and transects at each location, (4) summary of sampling methods used, (5) tabular summaries of the vegetation data (species lists, estimates of cover abundance for each species within vegetation plots, measured percent ground cover of species along transects, site factors for each study plot), (6) summaries of the Normalized Difference Vegetation Index (NDVI) and leaf area index (LAI) along each transect, (7) soil descriptions and photos of the soil pits at each study site, (8) summaries of thaw measurements along each transect, and (9) contact information for each of the participants. One of the primary objectives was to provide the Russian partners with full documentation of the methods so that Russian observers in future years could repeat the observations independently.

Methane, helium isotope and hydrogen data from the Nibelungen hydrothermal area, Mid Atlantic Ridge

Hydrothermal emission of mantle helium appears to be directly related to magma production rate, but other processes can generate methane and hydrogen on mid-ocean ridges. In an on-going effort to characterize these processes in the South Atlantic, the flux and distribution of these gases were investigated in the vicinity of a powerful black smoker recently discovered at 8°17.9' S, 13°30.4' W. The vent lies on the shoulder of an oblique offset in the Mid-Atlantic Ridge and discharges high concentrations of methane and hydrogen. Measurements during expeditions in 2004 and 2006 show that the ratio of CH4 to 3He in the neutrally buoyant plume is quite high, 4 x 10**8. The CTD stations were accompanied by velocity measurements with lowered acoustic Doppler current profilers (LADCP), and from these data we estimate the methane transport to have been 0.5 mol/sec in a WSW-trending plume that seems to develop during the ebb tidal phase. This transport is an order of magnitude greater than the source of CH4 calculated from its concentration in the vent fluid and the rise height of the plume. From this range of methane fluxes, the source of 3He is estimated to be between 0.14 and 1.2 nmol/sec. In either case, the 3He source is significantly lower than expected from the spreading rate of the Mid-Atlantic Ridge. From the inventory of methane in the rift valley adjacent to the vent, it appears that the average specific rate of oxidation is 2.6 to 23/yr, corresponding to a turnover time between 140 and 16 days. Vertical profiles of methane in the surrounding region often exhibited Gaussian-like distributions, and the variances appear to increase with distance from the vent. Using a Gaussian plume model, we obtained a range of vertical eddy diffusivities between 0.009 and 0.08 m2m2/sec. These high values may be due to tidally driven internal waves across the promontory on which the vent is located.

Strength and stiffness of repaired tendons

Rotator cuff tears of the shoulder are a common cause of pain and disability. Although surgery is frequently beneficial, re-tearing of the tendons is likely to re-occur. In many cases even if the reparation is successful it will still generate discomfort, problems with mobility, as well as a sharp pain. This project is funded in the cooperation with the Hospital Clinico San Carlos de Madrid. The purpose of this work is to analyze the effect of the surgical repair and the application of different therapies, including mesenchymal stem cell therapy on the biomechanical properties (strength and stiffness) of the repaired tendon. An animal model of rotator cuff tendon reparations has been developed on laboratory rats.To obtain the mechanical response of the healthy and repaired tendons, it was necessary to develop an experimental set up to reproduce the in-vivo working conditions of the tendons (37 ºC, immersed in physiological serum), and especially the load transfer. The biomechanical properties (maximum load and stiffness) have been measured in healthy and repaired tendons. A total of 70 rats are used in this particular study. It has been found that the repaired tendon is stronger than the original on. However, the repaired tendons demonstrate less flexibility than the healthy (original) ones prior to the damage

Mejora de la seguridad de las presas de escollera frente a percolación accidental mediante protecciones tipo repié

Esta tesis doctoral es el fruto de un trabajo de investigación cuyo objetivo principal es definir criterios de diseño de protecciones en forma de repié en presas de materiales sueltos cuyo espaldón de aguas abajo esté formado por escollera. La protección propuesta consiste en un relleno de material granular situado sobre el pie de aguas abajo de la presa y formado a su vez por una escollera con características diferenciadas respecto de la escollera que integra el espaldón de la presa. La función de esta protección es evitar que se produzcan deslizamientos en masa cuando una cantidad de agua anormalmente elevada circula accidentalmente por el espaldón de aguas abajo de la presa por distintos motivos como pueden ser el vertido por coronación de la presa o la pérdida de estanqueidad del elemento impermeable o del cimiento. Según los datos de la International Commission on Large Dams (ICOLD 1995) el 70% de las causas de rotura o avería grave en presas de materiales sueltos en el mundo están dentro de las que se han indicado con anterioridad. Esta circulación accidental de agua a través del espaldón de escollera, típicamente turbulenta, se ha denominado en esta tesis percolación (“through flow”, en inglés) para diferenciarla del término filtración, habitualmente utilizada para el flujo laminar a través de un material fino. El fenómeno físico que origina la rotura de presas de materiales sueltos sometidas a percolación accidental es complejo, entrando en juego diversidad de parámetros, muchas veces no deterministas, y con acoplamiento entre procesos, tanto de filtración como de arrastre y deslizamiento. En esta tesis se han realizado diferentes estudios experimentales y numéricos con objeto de analizar el efecto sobre el nivel de protección frente al deslizamiento en masa que producen los principales parámetros geométricos que definen el repié: la anchura de la berma, el talud exterior y su altura máxima desde la base. También se han realizado estudios sobre factores con gran influencia en el fenómeno de la percolación como son la anisotropía del material y el incremento de los caudales unitarios en el pie de presa debidos a la forma de la cerrada. A partir de los resultados obtenidos en las distintas campañas de modelación física y numérica se han obtenido conclusiones respecto a la efectividad de este tipo de protección para evitar parcial o totalmente los daños provocados por percolación accidental en presas de escollera. El resultado final de la tesis es un procedimiento de diseño para este tipo de protecciones. Con objeto de completar los criterios de dimensionamiento, teniendo en cuenta los mecanismos de rotura por erosión interna y arrastre, se han incluido dentro del procedimiento recomendaciones adicionales basadas en investigaciones existentes en la bibliografía técnica. Finalmente, se han sugerido posibles líneas de investigación futuras para ampliar el conocimiento de fenómenos complejos que influyen en el comportamiento de este tipo de protección como son el efecto de escala, la anisotropía de la escollera, las leyes de resistencia que rigen la filtración turbulenta a través de medios granulares, los efectos de cimentaciones poco competentes o la propia caracterización de las propiedades de la escollera de presas. This thesis is the result of a research project that had the main objective of defining criteria to design rockfill toe protections for dams with a highly‐permeable downstream shoulder. The proposed protection consists of a rockfill toe berm situated downstream from the dam with specific characteristics with respect to the rockfill that integrates the shoulder of the main dam. The function of these protections is to prevent mass slides due to an abnormally high water flow circulation through the dam shoulder. This accidental seepage flow may be caused by such reasons as overtopping or the loss of sealing at the impervious element of the dam or its foundation. According to data from the International Commission on Large Dams (ICOLD 1995), 70% of the causes of failure or serious damage in embankment dams in the world are within that described previously. This accidental seepage of water through the rockfill shoulder, typically turbulent, is usually called through‐flow. The physical phenomenon which causes the breakage of the rockfill shoulder during such through‐flow processes is complex, involving diversity of parameters (often not deterministic) and coupling among processes, not only seepage but also internal erosion, drag or mass slide. In this thesis, numerical and experimental research is conducted in order to analyze the effects of the main parameters that define the toe protection, i.e. the toe crest length, its slope and maximum height. Additional studies on significant factors which influence the seepage, such as the anisotropy of the material and the increase of the unit flows at the dam toe due to the valley shape are also performed. In addition, conclusions regarding the effectiveness of this type of protection are obtained based on the results of physical and numerical models. The main result of the thesis is a design procedure for this type of protection to avoid mass sliding. In order to complete the design criteria, additional recommendations about internal and external erosion based on the state of the art are included. Finally, new lines of research are suggested for the future to expand the level of knowledge of the complex phenomena that influence the behavior of this type of protection, such as the effects of scale, rockfill anisotropy, non‐linear seepage laws in turbulent seepage through granular media, effects of erodible foundations, or new procedures to characterize the properties of dam rockfill as a construction material.