Minimal incision surgery for tibiotalocalcaneal arthrodesis.

BACKGROUND: Tibiotalocalcaneal arthrodesis (TTCA) is a salvage procedure for severe diseases involving ankle and subtalar joints. However, this procedure is often associated with postoperative complications related to preoperative comorbidities. The purpose of this study was to present the clinical and functional outcomes of a consecutive series of TTCA using an original operative approach based on minimal incision surgery (MIS). METHODS: Forty patients were followed prospectively for a mean (SD) of 31 (12.5) months. Clinical data, which included x-rays, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, SF-36 scores, and a patient satisfaction survey, were collected. A further 25 patients were examined retrospectively. RESULTS: In the prospective group (n = 40), the mean AOFAS score improved by 44.8 points 1 year after the intervention (95% confidence interval [CI], 40.6-48.9), and the SF-36 improved by a mean of 17.5 points (95% CI, 1.4-20.9) in the mental component summary (MCS) score and 11.5 points (95% CI, 8.3-14.7) in the physical component summary (PCS) score. In the prospective group, postsurgical pain correlated with MCS score (r = 0.47, P < .001). In the entire group, bony union (defined as radiographic consolidation and absence of clinical symptoms) was observed in 86% of cases. Two deep infections, 2 nonunions in patients with preoperative persistent ulcers, and 7 delayed unions were the major complications observed in the entire group. One patient required amputation. No cases of superficial infection, wound dehiscence, or deep venous thrombosis were recorded. CONCLUSION: To our knowledge, the present series represents the largest study on TTCA using MIS. The data obtained in the present study showed clinical and functional improvement after surgery and similar bony union rates as previously reported in the literature but with fewer complications related to the surgical wounds. LEVEL OF EVIDENCE: Level IV, case series.

Cardiac autonomic response during recovery from a maximal exercise using whole body vibration.

OBJECTIVE: To examine the effect of passive whole-body vibration (WBV) on heart rate (HR) variability (HRV) during the recovery from intense exercise. DESIGN: Randomized, counterbalanced, crossover design SETTING: Laboratory. INTERVENTIONS: Twenty-three healthy male performed a bicycle exercise test to exhaustion followed by an active recovery period using WBV (25Hz and peak to peak displacement of 4mm) or passive recovery period (noWBV; 0Hz-0mm) on two separate days in random order. The recovery protocol consisted of six 1-min sets separated by 1-min inter-set rest periods in the seated position with the feet on the vibration platform. ECG recordings were made at baseline and during recovery at min 2, 4, 6, 8, 10 and 12 in both conditions. Frequency-domain measures of HRV were determined via power spectral analysis using fast-Fourier transform. Low frequency (LF; 0.04-0.15Hz) and high frequency bandwidths (HF; 0.15-0.4Hz) were determined. RESULTS: HR was increased in both groups (P<0.01) throughout the recovery. At min 2, HR was lower (P=0.05) after WVB compared to the noWBV trial. At min 3, the increase (P<0.05) in total power after WBV was significantly different (P<0.01) compared to noWBV. Normalized (nu) LF and LF/HF were increased (P<0.01), whereas HF nu was reduced (P<0.001) in both conditions without a significant group-by-time interaction (P=0.08). CONCLUSION: Passive WBV reduces HR and increases total power during the early recovery of intense exercise, despite no effect on power spectral components of HRV.

Exposure setup for animal experiments using a parabolic reflector.

The exposure setup presented is intended for a controlled, long-term and continuous exposition (20 Months, 24 h/day) of a large number of animals (100 rats at minimum) with standard GSM and UMTS signals, at 900 MHz and 1966 MHz, respectively. To obtain a homogeneous field within a large volume, the setup is based on the 'compact range' principle well known from antenna measurement facilities to produce a plane wave at relatively short ranges from the reflector. All requirements imposed due to the in vivo nature of the experiment, i.e. air-conditioning and easy access to the cages can be fulfilled.

Opiate microinjections in the locus coeruleus area of the cat enhance slow wave sleep.

The effects on sleep/wakefulness states of morphine, morphiceptin (specific mu agonist), DPDPE (delta agonist) and U-50,488H (kappa agonist) microinjections in the Locus coeruleus area (LC) were studied in cats. Morphine (0.8-1.75 nmols in 50 nl of saline) and morphiceptin (1.75 nmols) in LC significantly increased the total time spent in slow wave sleep (SWS) and the mean duration of SWS episodes. Prior naloxone administration blocked the morphine hypnogenic effects. The total time spent in SWS was unaffected by delivery of equimolar doses of DPDPE or U-50,488H in LC; however, the mean duration of the SWS episodes increased significantly after U-50,488H microinjections in LC. Thus, when acting in the LC, opiates have a SWS-enhancing effect and this effect appears to be mediated by mu receptors, although kappa receptors may have a subsidiary action.