A Novel Implant for Superior Pubic Ramus Fracture Fixation-Development and a Biomechanical Feasibility Study

Background and Objectives: Pubic ramus fractures are common in compound pelvic injuries known to have an increased rate of morbidity and mortality along with recurrent and chronic pain, impeding a patient's quality of life. The current standard treatment of these fractures is percutaneous screw fixation due to its reduced risk of blood loss and shorter surgery times. However, this is an intricate surgical technique associated with high failure rates of up to 15%, related to implant failure and loss of reduction. Therefore, the aim of this biomechanical feasibility study was to develop and test a novel intramedullary splinting implant for fixation of superior pubic ramus fractures (SPRF), and to evaluate its biomechanical viability in comparison with established fixation methods using conventional partially or fully threaded cannulated screws. Materials and Methods: A type II superior pubic ramus fracture according to the Nakatani classification was created in 18 composite hemi-pelvises via a vertical osteotomy with an additional osteotomy in the inferior pubic ramus to isolate the testing of three SPRF fixation techniques performed in 6 semi-pelvises each using either (1) a novel ramus intramedullary splint, (2) a partially threaded ramus screw, or (3) a fully threaded ramus screw. Results: No significant differences were detected among the fixation techniques in terms of initial construct stiffness and number of cycles to failure, p ≥ 0.213. Conclusion: The novel ramus intramedullary splint can be used as an alternative option for treatment of pubic ramus fractures and has the potential to decrease the rate of implant failures due to its minimally invasive implantation procedure.

Biomechanical evaluation of an allograft fixation system for ACL reconstruction

The purpose of this study was to compare the biomechanical stability, especially graft slippage of an allograft screw and a conventional interference screw for tibial implant fixation in ACL reconstruction. Twenty-four paired human proximal tibia specimens underwent ACL reconstruction, with the graft in one specimen of each pair fixed using the allograft screw and the other using the conventional interference screw. Specimens were subjected to cyclic tensile loading until failure. The two fixation methods did not show any statistical difference in load at graft slippage (p = 0.241) or estimated mean survival until slippage onset (p = 0.061). The ultimate load and the estimated mean survival until failure were higher for the interference screw (p = 0.04, and p = 0.018, respectively). Graft displacement at ultimate load reached values of up to 7.2 (interference screw) and 11.3 mm (allograft screw). The allograft screw for implant fixation in ACL reconstruction demonstrated comparable behavior in terms of graft slippage to the interference screw but underperformed in terms of ultimate load. However, the ultimate load, occurring at progressive graft slippage, may not be considered a direct indicator of clinical failure.

A free cyanohydrin as arms and armour of Marasmius oreades

Cyanogenic plants and fungi are widespread in nature. Although the origin of hydrocyanic acid in plants has been studied in detail, little is known about its origin in fungi. Here, we report the identification of the cyanohydrin of glyoxylic acid as the precursor of hydrocyanic acid in the fungus Marasmius oreades and several other cyanogenic fungi. Moreover, a feeding experiment revealed glycine as biosynthetic precursor of the cyanohydrin of glyoxylic acid. Thus, the cyanogenesis of M. oreades and other fungi is fundamentally different from cyanogenesis in plants.

Intraocular lens power calculation after laser in situ keratomileusis for myopia and hyperopia: a standardized approach

PURPOSE

(1) To determine the effect of myopic and hyperopic laser in situ keratomileusis (LASIK) on calculation of intraocular lens (IOL) power. (2) To determine a standard way to approach the IOL power determination after LASIK, and (3) To compare different suggested methods.

METHODS

Biometric analysis and theoretical calculation of IOL powers for eyes undergoing LASIK for myopia and hyperopia were performed.

RESULTS

Manual keratometry after LASIK for myopia resulted in underestimation of IOL power. Manual keratometry after hyperopic LASIK resulted in overestimation of IOL power. The amount of error was directly related to the amount of correction by LASIK.

CONCLUSION

The pre-LASIK refraction can be used theoretically to determine an accurate IOL power.

The effect of silicone ocular surgical devices on serum IgG binding to silicones

PURPOSE

To determine whether silicone materials used in retinal detachment repair and cataract surgery increase serum IgG binding to silicone and identify correlations with complications of ocular surgery.

METHODS

Serum from 49 patients who had ocular surgery using silicone materials was examined. Patient groups included scleral buckling (n = 25), silicone oil tamponade (n = 3), scleral buckling and silicone oil tamponade (n = 9), and silicone lens implants after cataract extraction (n = 12). Convalescent samples for all patients and preoperative samples from 19 patients (18 scleral buckling and one silicone oil tamponade) were examined. Postoperative complications were monitored for up to 108 months (mean, 10.7 months; mode, 1.5 months; range, 1 to 108 months). Samples were evaluated for the extent of IgG binding to silicones using a micromodification of a previously described enzyme-linked immunosorbent assay method.

RESULTS

In 19 patients, IgG binding levels in preoperative samples were 21 arbitrary units (AU) or less. Of the 25 buckling patients, one developed complications; however, in all patients the postoperative levels of IgG binding to silicone were low (2.2 to 20.0 AU). Although four silicone lens patients developed mild complications, none displayed postoperative IgG binding levels of greater than 20 AU. Three patients who underwent both scleral buckling and silicone oil tamponade developed complications; one of these patients, who was also noted to have systemic connective tissue disease, had a significant elevation in postoperative serum IgG binding to silicone.

CONCLUSIONS

Statistically significant elevations of serum IgG binding to silicone were noted postoperatively in only one patient who had a systemic connective tissue disease. The complication rate and frequency of enhanced serum IgG binding to silicone was low, making correlations to surgical complications difficult. Examination of matched samples suggested that if ocular exposure to silicone implants enhances the level of serum IgG binding to silicones, it must be a rare event that should not alter the clinical use of these important devices.

[Animal protection in constitutional law?--On the necessity of including animal protection in the constitution]

The inclusion of animal protection in the constitution poses a lengthy legal-political demand, which is again being vehemently discussed at the present time. Under consideration of juristic aspects, the following treatise attempts to clarify the legal requirements which presently exist for anchoring animal protection in constitutional law. It is therefore necessary in the first instance to explain the present situation regarding animal protection law. The legal situation in this respect is marked by a fundamental collision between special democratic rights guaranteed by the constitution on the one hand, and the norms of animal protection law on the other hand, which tend to restrict these rights. Based on concrete examples taken from court decisions, it is shown that constitutional vacuum surrounding a major part of animal protection law greatly complicates or even renders impossible the application and enforcement of the latter in practice. A prerequisite for a proper legal framework for animal protection is that the different special basic democratic rights governing animal use must be counterpoised by animal protection laws backed up by the constitution. Only by this means it is possible to prevent the ineffectiveness of animal protection legislative norms in the long term.