Stereotactic guidance for navigated percutaneous sacroiliac joint fusion.

Arthrodesis of the sacroiliac joint (SIJ) for surgical treatment of SIJ dysfunction has regained interest among spine specialists. Current techniques described in the literature most often utilize intraoperative fluoroscopy to aid in implant placement; however, image guidance for SIJ fusion may allow for minimally invasive percutaneous instrumentation with more precise implant placement. In the following cases, we performed percutaneous stereotactic navigated sacroiliac instrumentation using O-arm® multidimensional surgical imaging with StealthStation® navigation (Medtronic, Inc. Minneapolis, MN). Patients were positioned prone and an image-guidance reference frame was placed contralateral to the surgical site. O-arm® integrated with StealthStation® allowed immediate auto-registration. The skin incision was planned with an image-guidance probe. An image-guided awl, drill and tap were utilized to choose a starting point and trajectory. Threaded titanium cage(s) packed with autograft and/or allograft were then placed. O-arm® image-guidance allowed for implant placement in the SIJ with a small skin incision. However, we could not track the cage depth position with our current system, and in one patient, the SIJ cage had to be revised secondary to the anterior breach of sacrum

To retain or remove the syndesmotic screw: a review of literature

Introduction: Syndesmotic positioning screws are frequently placed in unstable ankle fractures. Many facets of adequate placement techniques have been the subject of various studies. Whether or not the syndesmosis screw should be removed prior to weight-bearing is still debated. In this study, the recent literature is reviewed concerning the need for removal of the syndesmotic screw. Materials and methods: A comprehensive literature search was conducted in the electronic databases of the Cochrane Library, Pubmed Medline and EMbase from January 2000 to October 2010. Results: A total of seven studies were identified in the literature. Most studies found no difference in outcome between retained or removed screws. Patients with screws that were broken, or showed loosening, had similar or improved outcome compared to patients with removed screws. Removal of the syndesmotic screws, when deemed necessary, is usually not performed before 8-12 weeks. Conclusion: There is paucity in randomized controlled trials on the absolute need for removal of the syndesmotic screw. However, current literature suggests that it might be reserved for intact screws that cause hardware irritation or reduced range of motion after 4-6 months

THE INFLUENCE OF JURIDICAL REGULATIONS UPON TOURIST TOWN-PLANNING

Urban tourism, if correctly planned, developed and managed, may create advantages and benefits both to urban communities and overall society. By systematically implementing planning based on intelligent management and town-planning regulations complying with the organizing and long-lasting growth requirements of towns, local and national communities, benefits can be maximized, whereas troubles minimized. Town planning should pursue the juridical requirements of the legislation in force, based on a flexible, comprehensive, integrated and ecological approach, being implementable on the principles of keeping the tourist sector’s long life.town planning, town-planning law, town plans, tourist town planning.

A new genus of nemonychid weevil from Burmese amber (Coleoptera, Curculionoidea)

The first fossil nemonychid (Nemonychidae) in Burmese amber, belonging to the subfamily Rhinorhynchinae, is described and figured as Burmonyx zigrasi Davis & Engel, gen. n. and sp. n. While this specimen also comprises the first definitive record of the subfamily in the Asian continent, other compression fossils exist at least from the Yixian Formation of China and the Karatau site of Kazakhstan which may also deserve placement within this group. Although several important areas of the body are obscured by the shape and fragmented condition of the amber piece, a sufficient number of features are visible to consider adequate placement within Rhinorhynchinae, including the fairly strongly punctate elytral striae and appendiculate, nearly bifid pretarsal claws.Much appreciation is given to James S. Zigras who provided the opportunity to study this specimen and has generally supported amber research at the AMNH. Partial support for this work was provided by the Byers Opportunity Fund, Division of Entomology, University of Kansas Natural History Museum (to SRD), and US National Science Foundation grants DEB-0542909 (to MSE) and DEB-1110590 (to MSE, P. Cartwright, and SRD). This is a contribution of the Division of Entomology, University of Kansas Natural History Museum

The American Crime Factory

A response to three critical essays concerning The Antisocial Personalities (1995) and a further analysis of the causes of the epidemic of crime and violence that began in the United States in the 1960s and will continue into the next millenium

Anterior Capsulolabral Reconstruction with Semitendinosus Autograft after Latarjet Failure. A Case Report

Introduction: The treatment of chronic shoulder instability, associated with poor tissue quality, remains challenging in the setting of anterior capsular deficiency. There are a few viable alternatives in the end-stage shoulder instability when multiple surgical attempts to correct the pathology have failed. The purpose of the present paper is to demonstrate the efficacy of anterior capsular reconstruction with semitendinosus autograft for the management of capsulolabral deficiency without associated bone loss. Case report: A 39-year-old female admitted in our institution with a history of recurrent atraumatic anterior dislocation of the left shoulder after three unsuccessful surgical attempts: Arthroscopic and open capsulorrhaphy and a Latarjet coracoid transfer. CT scan images showed adequate placement (flush) of the coracoid transfer without any sign of reabsorption. Reconstruction of anterior capsulolabral structure was performed using a Semitendinosus autograft. The middle and inferior glenohumeral ligaments, the more crucial ligaments for anterior-inferior shoulder stability, were effectively recreated. The patient did not suffer any recurrent dislocation or subjective symptoms of instability at the time of the final follow-up, 2 years after surgery, and the ASES score increased from 36 preoperatively to 86. Conclusion: This technique, described for the first time as a salvage procedure after Latarjet failure, could represent a safe and viable treatment option in the context of multiple ineffective surgeries

On error sources during airborne measurements of the ambient electric field

The principal sources of errors during airborne measurements of the ambient electric field and charge are addressed. Results of their analysis are presented for critical survey. It is demonstrated that the volume electric charge has to be accounted for during such measurements, that charge being generated at the airframe and wing surface by droplets of clouds and precipitation colliding with the aircraft. The local effect of that space charge depends on the flight regime (air speed, altitude, particle size, and cloud elevation). Such a dependence is displayed in the relation between the collector conductivity of the aircraft discharging circuit - on one hand, and the sum of all the residual conductivities contributing to aircraft discharge - on the other. Arguments are given in favor of variability in the aircraft electric capacitance. Techniques are suggested for measuring from factors to describe the aircraft charge