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Objective:To evaluate the clinical efficacy of cannulated screws with sutures in the treatment of patellar transverse fractures.Methods:A retrospective analysis was performed of the data of 70 patients with patellar transverse fracture who had been admitted to Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital from January 2017 to March 2021. According to the construction methods for the tension band, the patients were divided into 3 groups. In group A of 21 cases subjected to fixation with cannulated screws with sutures (Fiber-Tape), there were 8 males and 13 females with a median age of 55.0 (48.0, 65.0) years; in group B of 32 cases subjected to fixation with Kirschner wire tension band, there were 15 males and 17 females with a median age of 52.5 (41.5, 63.0) years; in group C of 17 cases subjected to fixation with Cable-Pin system, there were 5 males and 12 females with a median age of 55.0 (37.0, 65.0) years. The 3 groups were compared in terms of complications, secondary surgery (removal of internal fixation), operation time, intraoperative blood loss and knee function rated by the Lysholm and B?stman scores at the last follow-up.Results:There were no significant differences in the preoperative general data between the 3 groups, showing they were comparable ( P > 0.05). There was no significant difference in the operation time, intraoperative blood transfusion or follow-up time among the 3 groups ( P > 0.05). The incidence of soft tissue irritation [4.8% (1/21)] and the secondary operation rate [4.8% (1/21)] in group A were significantly lower than those in group B [43.8% (14/32) and 37.5% (12/32)] and group C [41.2% (7/17) and 35.3% (6/17)] ( P < 0.05), but there was no statistically significant difference between group B and group C ( P > 0.05). In groups A, B and C, respectively, the Lysholm knee score was 84.0 (69.0, 88.0), 89.0 (71.5, 95.0) and 82.0 (63.0, 90.0), and the B?stman knee score 26.0 (23.0, 28.0), 26.5 (24.0, 27.5) and 26.0 (22.0, 28.0), showing no significant difference ( P > 0.05). There was no significant difference either in the incidence of other complications among the 3 groups ( P > 0.05). Conclusion:In the treatment of patellar transverse fractures, compared with the Kirschner wire tension band and Cable-Pin system, cannulated screws with sutures (Fiber-Tape) may lead to a lower incidence of soft tissue irritation and a lower rate of secondary surgery, but no significant differences in operation time, intraoperative blood loss, other complications or postoperative functional scores.
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Resumen Introducción: Venezuela cuenta con uno de los sistemas de teleférico más altos del mundo, sin embargo, no se han realizado investigaciones que infieran acerca de cómo la altura incide en antropometría y condiciones de salud generales de sus trabajadores. Objetivo: determinar la relación indicadores antropométricos y saturación de oxígeno en trabajadores del sistema teleférico Mukumbarí. Mérida, Venezuela. Materiales y método: investigación no experimental, transversal y descriptiva realizada en 100 empleados ubicados en alturas de 3.452-4.765 m.s.n.m. Se calculó Índice de Masa Corporal (IMC) y perímetro de cintura (PCi) para estimar riesgo cardiometabólico (RCM) con puntos de corte OMS. La saturación de oxígeno (SPO2) obtenida por Oxímetro. Se realizaron frecuencias, Chi Cuadrado y Odds Ratio (OR) con p<0,05. Resultados: 51% sexo masculino y 49% femenino. Grupo de edad más numeroso 25-34 años (88%). Al IMC: 88% normal, 7% déficit peso, 3% sobrepeso, 2% obesidad I. Sobrepeso más común en jóvenes y déficit en mayores de 35 años. RCM aumentado y muy aumentado 52%. RCM "aumentado" predominante en hombres y "muy aumentado" en mujeres; según grupo de edad de 25 a 34 años RCM aumentado (18%) y muy aumentado (26%). SPO2 baja y muy baja presente en 70% de los estudiados, predominando la baja en hombres y la muy baja en mujeres. Las frecuencias más altas se dieron entre RCM alto y muy alto con SPO2 baja y muy baja; con OR se observó que quienes presentan RCM alto tienen 2,2 veces más riesgo de presentar SPO2 baja con 95% de confianza. Conclusión: aunque la mayor parte de la población estudiada es joven y con IMC mayormente normal, se evidenció RCM aumentado y SPO2 bajas o hipoxia en casi la totalidad de los trabajadores; lo que se reflejó en la relación epidemiológica encontrada. Se recomienda disminuir la jornada laboral y realizar nuevas investigaciones en la temática.
Abstract Introduction: Venezuela has one of the highest cable car systems in the world; however, no research has been conducted to infer how height affects anthropometry and general health conditions of workers. Objective: to determine the relationship between anthropometric indicators and oxygen saturation in workers of the Mukumbarí cable car system. Merida, Venezuela. Materials and method: non-experimental, cross-sectional and descriptive research carried out on 100 employees located at heights of 3,452-4,765 m.a.s.l. Body Mass Index (BMI) and waist circumference (PCi) were calculated to estimate cardiometabolic risk (RCM) with WHO cut-off points. The oxygen saturation (SPO2) obtained by Oximeter. Frequencies, Chi Square and Odds Ratio (OR) were performed with p <0.05. Results: 51% male and 49% female. Largest age group 25-34 (88%). At BMI: 88% normal, 7% weight deficit, 3% overweight, 2% obesity I. Most common overweight in young people and deficit in people over 35 years of age. RCM increased and greatly increased 52%. RCM "increased" predominant in men and "very increased" in women; According to age group 25 to 34, RCM increased (18%) and greatly increased (26%). Low and very low SPO2 present in 70% of those studied, predominantly low in men and very low in women. The highest frequencies were between high and very high RCM with low and very low SPO2; with OR, it was observed that those with high RCM have 2.2 times the risk of presenting low SPO2 with 95% confidence. Conclusion: although most of the population studied is young and with a mostly normal BMI, increased RCM and low SPO2 or hypoxia were evidenced in almost all of the workers; which was reflected in the epidemiological relationship found. It is recommended to reduce working hours and carry out new research on the subject.
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Anthropometry , Oxygen , Research , Health , Health Status , HypoxiaABSTRACT
BACKGROUND: In the clinical treatment of distal tibiofibular syndesmosis injury, Suture-Button fixation technique can achieve similar results to, even better results than, those of screws, but it cannot fully recover the anatomical reduction and activity to those before injury. However, the optimal treatment of distal tibiofibular syndesmosis injury is still controversial. OBJECTIVE: To systematically evaluate Suture-Button fixation and screw fixation for the treatment of distal tibiofibular syndesmosis injury. METHODS: EMBASE, Cochrane database, PubMed database, Wanfang database, and CNKI were searched to retrieve randomized or non-randomized controlled trials regarding Suture-Button fixation and screw fixation for the treatment of distal tibiofibular syndesmosis injury published from January 2005 to January 2019. The quality of the included studies was strictly evaluated. Relevant data were extracted. A meta-analysis of all outcome measures was performed using RevMan 5. 3 software. RESULTS AND CONCLUSION: (1) Twelve studies were included, including 4 randomized controlled trials and 8 cohort studies, involving 564 patients. (2) Meta-analysis results showed that Suture-Button fixation had shorter full weight-bearing time [WMD=-1. 50, 95%CI(-2. 08, -0. 92), P 0. 05). (3) These findings suggest that compared with screw fixation, Suture-Button fixation for the treatment of distal tibiofibular syndesmosis injury leads to better recovery of ankle joint function and an earlier time point for full weight bearing and does not need to consider the risk of screw fracture during the surgery. In addition to screw fixation, Suture-Button fixation is an effective way to treat distal tibiofibular syndesmosis injury.
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PURPOSE: To analyze prognostic factors for the treatment of periprosthetic femoral fractures (PFFs) using the cable-plate construct. MATERIALS AND METHODS: A retrospective review of a consecutive series of 41 PFFs treated by osteosynthesis using the cable-plate system. The mean age of patients was 67.3±12.1 years (range, 42-86 years) and the mean follow-up period was 31.5±11.6 months (range, 12–58 months). Fresh frozen cortical strut allografts were leveraged in three cases for additional stability. Prognostic factors that may potentially affect clinical outcomes were analyzed. RESULTS: At the time of final follow-up, fracture union was obtained in 29 hips (70.7%; Group I) after an average of 13.5 weeks (range, 12–24 weeks). Healing failure after surgical treatment was observed in 12 cases (29.3%; Group II), including delayed union (n=10) cases and nonunion (n=2). Factors significantly associated with fracture union included fracture pattern (P=0.040), plate overlap percentage to stem length (P<0.001) and T-score at the preoperative bone mineral density (P=0.011). Transverse-type fractures around or just distal to a well-fixed femoral stem were observed in six cases (50.0%) of Group II. CONCLUSION: The cable-plate osteosynthesis of PFFs should be performed with caution in transverse-type fractures or in cases with severe osteoporosis. Fixation with sufficient plate overlap to stem length may be critical to prevent healing failure.
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Humans , Allografts , Arthroplasty, Replacement, Hip , Bone Density , Femoral Fractures , Follow-Up Studies , Hip , Osteoporosis , Periprosthetic Fractures , Retrospective StudiesABSTRACT
With the aging of the society, the number of stroke patients has been increasing year by year. Compared with the traditional rehabilitation therapy, the application of upper limb rehabilitation robot has higher efficiency and better rehabilitation effect, and has become an important development direction in the field of rehabilitation. In view of the current development status and the deficiency of upper limb rehabilitation robot system, combined with the development trend of all kinds of products of the upper limb rehabilitation robot, this paper designed a center-driven upper limb rehabilitation training robot for cable transmission which can help the patients complete 6 degrees of freedom (3 are driven, 3 are underactuated) training. Combined the structure of robot with more joints rehabilitation training, the paper choosed a cubic polynomial trajectory planning method in the joint space planning to design two trajectories of eating and lifting arm. According to the trajectory equation, the movement trajectory of each joint of the robot was drawn in MATLAB. It laid a foundation for scientific and effective rehabilitation training. Finally, the experimental prototype is built, and the mechanical structure and design trajectories are verified.
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This meta-analysis compared the therapeutic effect of cable pin system (CPS) with K-wire tension band (KTB) in the treatment of patella fractures among Chinese Han population.The databases of PubMed,Cochrane library,China National Knowledge Infrastructure (CNKI),Chinese WanFang and Chinese VIP were searched for studies on CPS versus KTB in the treatment of patella fractures among Chinese Han population.Literatures were screened according to the inclusion and exclusion criteria.The quality of the studies was assessed,and meta-analysis was performed using the Cochrane Collaboration's REVMAN 5.3 software.A total of 932 patients from 15 studies were included in this meta-analysis (426 fractures treated with CPS and 506 fractures treated with KTB).There were significant differences in duration of hospital stay [mean difference (MD)=-1.07;95％ confidence interval (CI):-1.71 to-0.43],fracture healing time (MD=-l.23;95％ CI:-1.68 to-0.77),flexion degree of knee joint at 6th month after operation (MD=14.82;95％ CI:10.93 to 18.71),incidence of postoperative complication [risk ratio (RR)=0.16;95％ CI:0.09 to 0.27] and excellent-good rate of B(o)stman score (RR=1.09;95％ CI:1.03 to 1.16) between the CPS group and KTB group,while no significant difference was found in operative time between the two groups (MD=-4.52;95％ CI:-11.70 to 2.67).For the treatment of patella tractures among Chinese Han population,limited evidence suggests that the CPS is more suitable than the KTB when considering the hospital stay,fracture healing time,flexion degree of knee at 6th month after operation,incidence of postoperative complication and excellent-good rate of B(o)stman joint score.Due to the limitation of high quality evidence and sample size,more large-scale randomized controlled trials are needed to validate the findings in the future.
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Objective:To develop a safety protection device for lead cable of equipment in order to reduce or avoid the skin burn of patient and the invalidation of monitoring data caused by the short circuited of lead cable, and enhance the comfortable level of patient, at the same time, and reduce the pain of patient and potential adverse events.Methods: The device was consisted of the fixed sleeve of cylinder-shape (protective shell) and fixed sleeve of packaged cable (fixed sleeve of wire and cable), and its component was carbon fiber reinforced polycarbonate and silicone rubber. The fragile, repaired part or the rupture rubber of shell in upside and bottom of device were clamped in fixed sleeve. And then, the upside and bottom were fixed in one device, and take them socket with lead cable of device.Results: After the safety protection device of leading cable were used, the cable were fixed in the interior of the device, and could be protected. Therefore, some risks of adverse event were reduced and avoided.Conclusion: The device is stable in performance, is simple and convenient in operation and installation. In the application, it avoids the risk which caused by short circuit of cable in therapy monitoring, and could enhance the comfortable feel. This device is appropriate to various installation and application of lead cable, and it can be repeated to apply. It has got national patent for utility models due to its favourable application value.
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El síndrome de "twiddler" se caracteriza por el enrollamiento y desplazamiento de los electrodos de un dispositivo de estimulación cardíaca debido a rotación a lo largo de su eje mayor, ya sea de manera espontánea o por manipulación del dispositivo. En la mayoría de los casos, dicho desplazamiento se acompaña de daño del electrodo; no obstante, no se ha descrito la ruptura total del electrodo. A continuación se describe el caso de un paciente con marcapasos unicameral implantado por fibrilación auricular lenta, en quien se documentó disfunción del mismo con falla en la detección y la captura; al interrogatorio el paciente manifestó astenia, adinamia, intolerancia al ejercicio y presíncope. La evaluación radiológica documentó enrollamiento del electrodo formando asas apretadas, con ruptura completa del electrodo y desplazamiento del generador del marcapasos en un bolsillo amplio. Según criterio de los autores, este es el primer caso de síndrome de twiddler en el que se documenta ruptura completa del electrodo.
Twiddler's syndrome is characterised by a twist and displacement of the electrodes of a cardiac stimulation device due to a rotation on its main axis, either spontaneously or when manipulating the pacemaker. In most cases this movement is accompanied by damage of the electrode; however, complete rupture of the lead has not been described. A case of a patient carrying a unicameral pacemaker required due to slow atrial fibrillation is now described, where a dysfunction of the device was documented as a failure to detect and capture. Upon interrogation the patient manifested asthenia, adynamia, exercise intolerance and pre-syncope. Radiological assessment documented a twisted electrode with the shape of tight handles, with complete electrode rupture and displacement of the pacemaker generator in a wide pocket. According to the authors’ criteria, this is the first Twiddler's syndrome case where total rupture of an electrode has been documented.
Subject(s)
Humans , Male , Aged, 80 and over , Biological Clocks , Atrial Fibrillation , Cardiac Pacing, Artificial , Electric StimulationABSTRACT
Objective The article aims at evaluating the biological properties of tibiofibular titanium cable fixation device in terms of both anti-separation and stress shielding by comparison to the interior fixation with lag screw based on experimental observation. Methods Six corpse ankle specimens were first tested of pressure-separation and stress measurement, the data from which were compared to the normal group, and then a syndesmosis injury model was established. All the samples are randomly divided into 2 groups of 3 specimens each, which were treated with tibiofibula locked titanium cable and lag screw fixation respectively for syndesmosis injury. Then, the samples were tested for pressure-separation and stress measurement. The biomechanical properties as anti-separation ability and stress shielding were analyzed and compared between the two fixation method. Results Both tibiofibula locked titanium cables and lag screws were able to provide enough strong lateral anti-separation ability, but strong fixation screws were inferior to tibiofibular titanium cable fixation device in fibular longitudinal stress transduction. Conclusion Tibiofibular titanium cable fixation device not only provide sufficient lateral anti-separation, but also reduces the tibial and fibular longitudinal stress shielding, thus being superior to the traditional lag screw in biomechanical properties.
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<p><b>OBJECTIVE</b>To explore the clinical effects of surgical treatment with cable dragged reduction and cantilever beam internal fixation by posterior approach for odontoid fracture associated with atlantoaxial dislocation.</p><p><b>METHODS</b>The clinical data of 12 patients with odontoid fracture associated with atlantoaxial dislocation from January 2008 to December 2013 were retrospectively analyzed. There were 8 males and 4 females, ranging in age from 21 to 53 years with an average of 37.2 years. Eleven cases were fresh fracture and 1 case was old fracture, all patients complicated with atlantoaxial anterior dislocation. According to Anderson-D' Alonzo typing method modified by Grauer, 3 cases were type IIA, 5 cases were type IIB, 3 cases were type IIC, and 1 case was type IIIA. All patients underwent surgical treatment with cable dragged reduction and cantilever beam internal fixation by posterior approach. JOA score and ADI method were respectively used to evaluate the nerve function and reductive condition of atlantoaxial dislocation.</p><p><b>RESULTS</b>All patients were followed up from 6 months to 2 years with an average of 1 year and 3 months. At 1 week, 6 months after operation, and final follow up, JOA scores were 13.2±1.3, 13.5±1.4, 14.3±1.5, respectively, and these data were obviously better than that of preoperative 8.3±1.4(<0.05). Postoperative X rays and CT showed satisfactory reduction of atlantoaxial dislocation. At 1 week, 6 months after operation, and final follow up, ADI were (2.2±0.4), (2.4±0.6), (2.3±0.5) mm, respectively, and these data were obviously better than that of preoperative.(5.8±1.2) mm(<0.05). All screws and cables had good location without looseness and breakage, and bone graft got fusion.</p><p><b>CONCLUSIONS</b>Surgical treatment with cable dragged reduction and cantilever beam internal fixation by posterior approach for odontoid fracture associated with atlantoaxial dislocation is a good method, with advantage of firm fixation and high safety. It could obtain good clinical effects.</p>
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Objective To investigate the application value of Atlas titanium cable in the treatment of comminuted patellar fractures (CPF).Methods 80 patients with CPF in our hospital from January, 2010 to January, 2013 were randomly selected and divided into observation group (n=40) and control group (n=40) by digital random method.Observation group adopted Atlas tita-nium cable internal fixation treatment while control group adopted the improved tension band steel wire in the hollow compression screws fixation treatment.Preoperative (t0), postoperative 1 month (t1), 6 months (t2) and 1 year (t3) Bostman patellar injury curative effect score (BPICES), operation time, intraoperative blood loss, postoperative knee joint exercise time for the first time, length of hospital stay, treatment costs and complications of two groups were compared.Results Preoperative BPICES of two groups had no statistical significant difference (p>0.05).Compared with t0, t2 and t3 BPICES and the rate of optimal curative effects, two groups increased; Compared with the control group, t2 and t3 BPICES and the rate of optimal curative effects of observation group also increased, and the difference was statistically significant (p<0.05).Operation time, intraoperative blood loss, postoperative knee joint exercise time for the first time, length of hospital stay of observation group were (52.26 ±10.29) min, (70.48 ±10.49) ml, (4.78 ±1.48) d and (5.98 ±1.06) d respectively, which were lower than the (79.95 ±8.42) min, (123.36 ±21.18) ml, (9.14 ±4.48) d and (11.18 ±2.68) d of the control group;Therapy cost of observation group was (16 284.47 ±2 145.78) Yuan, which was higher than the (9 892.48 ±1 456.42) Yuan of the control group (p <0.05).Compared with control group, peptide wire/wire Piercing the skin, pain, infection, skin irritation, slippery bursa phlogistic, internal fixation of fracture parted, fracture end separation and other complications total incidence of observation group were lower (p<0.05).Conclusion Atlas titanium wire trea-ting of patients with CPF had shorter operation time and hospitalization time , less postoperative complications.It can promote the rapid recovery of knee joint function, but its cost is higher.Thus it is suitable for CPF patients with better economic conditions .
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BACKGROUND: Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal closure in patients undergoing major cardiac surgery. METHODS: Data were collected retrospectively on 1,354 patients who underwent sternal closure after major cardiac surgery, using either the multifilament cable wiring system or conventional steel wires between January 2009 and October 2010. The surgical outcomes of these two groups of patients were compared using propensity score matching based on 18 baseline patient characteristics. RESULTS: Propensity score matching yielded 392 pairs of patients in the two groups whose baseline profiles showed no significant differences. No significant differences between the two groups were observed in the rates of early mortality (2.0% vs. 1.3%, p=0.578), major wound complications requiring reconstruction (1.3% vs. 1.3%, p>0.99), minor wound complications (3.6% vs. 2.0%, p=0.279), or mediastinitis (0.8% vs. 1.0%, p=1.00). Patients in the multifilament cable group had fewer sternal bleeding events than those in the conventional wire group, but this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068). CONCLUSION: The surgical outcomes of sternal closure using multifilament cable wires were comparable to those observed when conventional steel wires were used. Therefore, the multifilament cable wiring system may be considered a viable option for sternal closure in patients undergoing major cardiac surgery.
Subject(s)
Humans , Hemorrhage , Mediastinitis , Mortality , Propensity Score , Retrospective Studies , Stainless Steel , Steel , Thoracic Surgery , Wounds and InjuriesABSTRACT
Objective To investigate the clinical effect of tail hole needle combined with titanium cable tension band fixation for the treatment of patellar fracture.Methods Thirty-five patients with patella fracture were treated with the tail hole needle combined with titanium cable tension band fixation.Results All 35 patients were followed up for 6-24 months,average 11 months.The incisions were stage Ⅰ heal.Fractures were healed,the healing time was 4-10 weeks,average 6 weeks.The patients were evaluated according to the Bostman knee functional score standard:excellent in 30 cases,good in 5 cases,the excellent and good rate was 100％ (35/35).There was no complication such as fracture displacement,internal fixation loosening or fracture,infection of incision,etc.Conclusion The tail hole needle combined with titanium cable tension band fixation is simple,firm fixation,less complications and good functional recovery of knee joint for the treatment of patella fracture.
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183 Background More clinical Sdoctors tend to choose minimally invasive treatments for patella fracture. Because patients have lower complications, better function and perfect incision, which makes them early continue working and influences a little on their careers and life. Objective To explore the efficacy of minimally invasive treatment of patella transverse of young people, we choose percutaneous cannulated screw and titanium cable that we design to operate surgery.we observe the surgical incision, hemorrhage and function Methods From February 2009 to June 2012, we applied the minimally invasive technique of percutaneous cannulated screw and titanium cable to treat 30 cases of patella transverse, 16 males and 14 females. Aged 24-45 years, mean 35.4 years.injury mechanism:10 cases in the traffic accident, 6 cases in the fall s injury, 14 cases in the kneeling injury. fracture type:6 cases proximal pole fracture, 11 cases middle pole fracture and 13 cases distal pole fracture. Result All patients healed incision. 30 cases were followed up for mean 18 months. Fracture healed in mean 6.8 weeks. According to Lysholom function score, excellent in 27 cases, good in 2 cases, good rate of 100%. Conclusion Minimally invasive technique of percutaneous cannulated screw and titanium cable to treat the patella transverse fracture is the better choice. It fixes reliable, follow the biomechanical and have low surgical damage. Patients have less complication and get a good clinical efficacy. It is a better choice to treat patella transverse fracture of young fracture.
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Cytochrome c oxidase (COX) employs electrons obtained from cytochrome c to bring about the reduction of oxygen to water. It is known that the electrons originate from the haem edge of cytochrome c and enters bovine COX at Trp-104. It is also known that Tyr-105, Glu-198 and Asp-158 of COX subunit II play roles in the enzyme's catalysis but how these roles are linked to electron transfer remain unclear. Recently, we proposed that electrons travel from the haem edge of cytochrome c to CuA, the first metal redox centre of COX, by a hydrogen/hydride ion relay using six residues. Now using a similar computer assisted approach, we investigate the extent to which this hydride/hydrogen ion mechanism is common amongst oxidases. The crystal structures of COX from P denitrificans, R sphaeroides and T thermophilus and quinol oxidase from E coli were downloaded and their binding domains analysed. As with bovine, all four oxidases had only nine amino acid residues in that region and both the sequences and three-dimensional structures were highly conserved. We propose that these residues function as a hydrogen/hydride ion relay, participating directly in electron transfer to CuA. We further suggest that this electron transfer mechanism might be a common feature in oxidases.
La citocromo c oxidasa (COX) emplea electrones obtenidos del citocromo c para producir la reducción del oxígeno a agua. Se sabe que los electrones originan a partir del hemo del citocromo c, y entran en la COX bovina en Trp-104. También se conoce que Tyr-105, Glu-198 y Asp-158 de la subunidad II de COX, desempeñan papeles en la catálisis de la enzima, pero no hay todavía claridad en cuanto a cómo estos papeles se hallan vinculados con la transferencia de electrones. Recientemente, sugerimos que los electrones viajan del borde del hemo del citocromo c al CuA, el primer centro metálico de reacción redox de la COX, por un relé iónico hidrógeno-hidruro, usando seis residuos. Ahora, usando un enfoque similar computarizado, investigamos hasta que punto este mecanismo de iones hidrógeno/hidruro es común entre las oxidasas. Se bajaron y analizaron los dominios de unión de las estructuras cristalinas de la COX de P denitrificans, R sphaeroides, y T thermophilus, y de la quinol oxidasa de la E coli. Como en el caso de la bovina, las cuatro oxidasas tenían sólo nueve residuos de aminoácido en esa región, y tanto las secuencias como las estructuras tridimensionales presentaban un alto grado de conservación. Proponemos que estos residuos funcionan como un relé iónico hidrógeno-hidruro, participando directamente en una transferencia de electrones al CuA. Asimismo, sugerimos que este mecanismo de transferencia de electrones podría ser un rasgo común de las oxidasas.
Subject(s)
Animals , Cattle , Electron Transport Complex IV/metabolism , Cytochromes c/metabolism , Heme/chemistry , Hydrogen/metabolism , Oxidation-Reduction , Paracoccus denitrificans/enzymology , Protons , Rhodobacter sphaeroides/enzymology , Amino Acid Sequence , Thermus thermophilus/enzymology , Escherichia coli/enzymologyABSTRACT
Objective To discuss the effect of operations for comminuted patella fractures with cable cerclage and revised tension band. Method Retrospective study of clinical effects of 120 patella fractures cases which used cable(cable group,55 cases) or NT-PC (NT-PC group,65 cases) to internal fix.Results At 10 to 38 ( 19.50 ± 1.15 ) months follow-up, all cured well in 12 weeks. Compared with the operative time, the amount of blood loss, length of hospitalization, time for cure, the incidence of complications,there were no significant differences between two groups (P ＞ 0.05 ). The B (o)stman score of cable group [(27.0 ±0.2) scores] was better than that of NT-PC group [(25.1 ±0.6) scores](P＜0.05). Conclusion Using cable cerclage and revised tension band to internal fix for comminuted patella fractures,the operations are facile and the results are satisfactory.
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La endocarditis, relacionada con la infección del cable del resincronizador cardíaco, es una complicación rara asociada a los marcapasos endocavitarios. La incidencia de endocarditis que aparece tras el implante de un marcapasos endocavitario permanente oscila entre el 0,13% y el 7,9%. La historia natural de la infección en algunos casos es sombría, con un porcentaje de mortalidad alto, entre un 30-35%, según diferentes estudios. A continuación se presenta el caso de una paciente con endocarditis en el cable de un resincronizador implantable en la que no fue necesaria la extracción del mismo.
Endocarditis related to infection of the endocavitary wire is a rare complication associated with pacemakers endocavitaries. The incidence of endocarditis that appears after the implantation of a permanent endocardial pacemaker ranges between 0.13% and 7.9%. The natural history of infection in some cases is grim, with a high mortality rate, between 30-35%, according to various studies. We present a patient with endocarditis associated to a resynchronization wire in which it was not necessary its removal.
A endocardite relacionada com a infecção do cabo-eletrodo do ressincronizador cardíaco é uma complicação rara associada aos marcapassos endocavitários. A incidência da endocardite que aparece após o implante de um marcapasso endocavitário permanente oscila entre 0,13% e 7,9%. A história natural da infecção em alguns casos é sombria, com uma alta porcentagem de mortalidade, entre um 30-35%, segundo diferentes estudos. A seguir apresenta-se o caso de uma paciente com endocardite no cabo-eletrodo de um ressincronizador implantável em que não foi necessária a extração do mesmo.
Subject(s)
Pacemaker, Artificial , Endocarditis , InfectionsABSTRACT
PURPOSE: The purpose of this study was to assess the effect of a prophylactic cable fixation for prevention of femoral fractures in cementless bipolar hemiarthoplasties. MATERIALS AND METHODS: Forty-eight cementless bipolar hemiarthroplasties with prophylactic cable fixations on the femur were performed in patients >65 years of age between January 2004 and August 2008 (group 1). The control group which did not undergo prophylactic cable fixation included 48 cases (group 2). The mean age was 75.4 years (group 1) and 73.6 years (group 2). The patients were followed up for an average of 19.1 (group 1) and 18.3 months (group 2). The intra-operative fracture rates were compared. Additionally, operative time, estimated blood loss (EBL), and length of hospital stay were compared. Radiologic assessment for stem stability was performed. Clinical assessment was evaluated by the thigh pain and Jensen's functional score, and Parker & Palmer's mobility score. RESULTS: There was no fractures in the cabled group (1), and 4 fractures (8.3%) in the control group (2; p=0.041). The mean operative time was 172 minutes (1) and 162 minutes (2), the EBL was 866 cc (1) and 855 cc (2), and the duration of admission was 36 (1) and 35 days (2), respectively. Radiologically, subsidence was 1.59 mm (1) and 1.67 mm (2). Clinically, one (1) and two (2) thigh pains were recorded and the functional score of Jensen was 2 (1) and 2.2 points (2), and the mobility score of Parker and Palmer was 5.2 (1) and 5.3 points (2), respectively. CONCLUSION: Prophylactic cable fixation is effective for reducing intra-operative femoral fractures.
Subject(s)
Humans , Femoral Fractures , Femur , Hemiarthroplasty , Hip , Length of Stay , Operative Time , ThighABSTRACT
Objective To explore the possibility and effectiveness of minimally invasive osteotomy and cable osteosynthesis for the treatment of adolescent eubitus varus. Methods Eleven cases of adolescent cubitus varns(2 cases complicated with internal rotation of 10°)were treated with minimally invasive supracondylar wedged osteotomy to preserve the integrity of the contralateral codex and periosteum.Two screws were inserted above and below the fracture line.They were fixed with cable after the greenstick fracture and internal rotation were adjusted.Plastic bandage was applied for 1 week postoperatively before rehabilitation. Results Bone fractures healed in the 11 cases in 36.3 days averagely,without infection or nerve palsy.Before operation,the mean angles of varus,flexion and extension were 35°±5°,125°±10°and 10°±5°respectively.After a mean follow-up of 33.5 months,the mean valgus angle of the elbow was improved to 8°±2°(t=16.632,P<0.05),flexion to 130°±8°and extension to 8°±3°(P>0.05).Internal rotation deformity was also ameliorated in the 2 cases. Conclusion It is practical and effective to treat adolescent eubitus varus with minimally invasive osteotomy and cable osteosynthesis,for it can lead to stable fixation,short healing time,and does not affect the flexion and extension of the elbow joint.
ABSTRACT
PURPOSE: To evaluate the availability of cable fixation of the lesser trochanter in the treatment of unstable intertrochanter fractures using a sliding compressive hip screw (CHS) on the clinical and radiological results related to osteoporosis. MATERIALS AND METHODS: Fifty-four cases of Kyle-Gustilo type III unstable intertrochanter fractures between January 1999 to January 2005 were classified into 2 groups: groups 1(30 cases CHS) and 2(24 cases additional cable). The sliding distance of the lag screw, bony union, weight bearing time, and the loss of fixations related to osteoporosis in the two groups were compared retrospectively after a follow up of at least 1 year. RESULTS: The average sliding distances of the lag screw in groups 1 and 2 was 15.27 and 12.13 mm (p=0.0453), respectively. The time to bony union in groups 1 and 2 was 14.63 and 13.71 weeks (p=0.4623), respectively. The average weight bearing time in groups 1 and 2 was 3.03 and 2.83 weeks (p=0.1697), respectively. Early weight bearing was allowed in patients in group 2 with a Singh index greater than grade IV (p=0.0291), and a loss of fixation was encountered 5 cases in each group (p=0.9688), which increased significantly with increasing severity of osteoporosis (p<0.05). CONCLUSION: Additional cable fixation of the lesser trochanter for mild osteoporotic patients in unstable intertrochanter fractures is recommended for preventing the excessive sliding of lag screws and for allowing early ambulation. However, this procedure is not effective in patients with severe osteoporotic.