Mechanisms of fractures in ankle and hind-foot injuries to front seat car occupants - an in-depth accident data analysis

An in-depth analysis of 200 Abbreviated Injury Score (AIS) 2+ injuries to the lower extremity in frontal collisions has been performed using impairment scales devised by the American Orthopaedic Foot and Ankle Society. The most important subgroup of injuries were identified as ankle/hindfoot injuries. There were 63 such injuries sustained by 53 occupants and these were analyzed in greater depth. Inversion or eversion was identified as the mechanism of injury for 40 % of injuries. However in 70% of these fractures caused by inversion or eversion, minimal or no long term impairment would be expected Injuries associated with significant long-term impairment were attributed to axial forces (i.e. loads perpendicular to the foot). Combined vehicle/injury analysis demonstrated a strong association between toe-pan intrusion and these injuries. Interaction between the occupant and the pedals was identified as a probable injury source in only 25% of injuries to the ankle and hindfoot. The results of this study are being used to plan a program of biomechanical research to establish injury risk functions for the ankle and hindfoot. © Copyright 1997 Society of Automotive Engineers, Inc

The Isolation and Partial Characterization of Two Novel Sphingolipids from Neurospora crassa: Di(Inositolphosphoryl)ceramide and [(gal)_3glu]ceramide

Neurospora crassa strains labeled uniformly with ^(32)P_i and [^3H]inositol exhibit at least six phospholipid components containing ^3H when separated by paper chromatography. One of the major components is phosphatidylinositol. Other components, which account for 40 to 60% of the lipid-extractable ^3H in various strains, are stable to mild alkaline methanolysis and appear to be sphingolipids with equivalent amounts of inositol and phosphorus. The major phosphosphingolipid was purified by means of differential solubility and by column chromatography on porous silica beads. This substance contains equivalent amounts of hydroxysphinganine and hydroxytetracosanoic acid and 2 eq each of myoinositol, phosphorus, and sodium. Alkaline degradation yielded 2 eq of inositol monophosphate and periodate degradation gave a C-15 fragment. The elemental composition of this compound also fits the formulation, (inositol-P)_2-ceramide. A [^3H]inositol pulse-chase experiment carried out with an inositol-requiring mutant in exponential growth shows labeled inositol accumulating in the sphingolipid accompanied by decreased labeling in phosphatidylinositol and the acid-soluble fraction. These changes also occur when the chase is carried out during inositol starvation suggesting that degradation of phosphatidylinositol and formation of sphingolipid occurs in the absence of growth. A neutral glycosphingolipid was also obtained as a by-product of the phospholipid purification. This substance is provisionally formulated as the ceramide tetrahexoside: [(gal)_3glu]-N-hydroxytetracosonyl-hydroxysphinganine

Improvements in survival of the uncemented Nottingham Total Shoulder prosthesis: a prospective comparative study

<p>Abstract</p> <p>Background</p> <p>The uncemented Nottingham Total Shoulder Replacement prosthesis system (Nottingham TSR) was developed from the previous BioModular^®shoulder prosthesis taking into consideration the causes of the initial implant's failure.</p> <p>We investigated the impact of changes in the design of Nottingham TSR prosthesis on its survivorship rate.</p> <p>Methods</p> <p>Survivorship analyses of three types of uncemented total shoulder arthroplasty prostheses (BioModular^®, initial Nottingham TSR and current Nottingham TSR systems with 11, 8 and 4 year survivorship data respectively) were compared. All these prostheses were implanted for the treatment of disabling pain in the shoulder due to primary and secondary osteoarthritis or rheumatoid arthritis. Each type of the prosthesis studied was implanted in consecutive group of patients – 90 patients with BioModular^®system, 103 with the initial Nottingham TSR and 34 patients with the current Nottingham TSR system.</p> <p>The comparison of the annual cumulative survivorship values in the compatible time range between the three groups was done according to the paired <it>t </it>test.</p> <p>Results</p> <p>The 8-year and 11-year survivorship rates for the initially used modified BioModular^®uncemented prosthesis were relatively low (75.6% and 71.7% respectively) comparing to the reported survivorship of the conventional cemented implants. The 8-year survivorship for the uncemented Nottingham TSR prosthesis was significantly higher (81.8%), but still not in the desired range of above 90%, that is found in other cemented designs. Glenoid component loosening was the main factor of prosthesis failure in both prostheses and mainly occurred in the first 4 postoperative years. The 4-year survivorship of the currently re-designed Nottingham TSR prosthesis, with hydroxylapatite coating of the glenoid baseplate, was significantly higher, 93.1% as compared to 85.1% of the previous Nottingham TSR.</p> <p>Conclusion</p> <p>The initial Nottingham shoulder prosthesis showed significantly higher survivorship than the BioModular^®uncemented prosthesis, but lower than expected. Subsequently re-designed Nottingham TSR system presented a high short term survivorship rate that encourages its ongoing use</p

A validation of the Nottingham Clavicle Score: a clavicle, acromioclavicular joint and sternoclavicular joint–specific patient-reported outcome measure

Background Patients with acromioclavicular joint (ACJ) and sternoclavicular joint (SCJ) injuries and with clavicle fractures are typically younger and more active than those with other shoulder pathologies. We developed the Nottingham Clavicle Score (NCS) specifically for this group of patients to improve sensitivity for assessing the outcomes of treatment of these conditions compared with the more commonly used Constant Score (CS) and Oxford Shoulder Score (OSS). Materials and methods This was a cohort study in which the preoperative and 6-month postoperative NCS evaluations of outcome in 90 patients were compared with the CS, OSS, Imatani Score (IS), and the EQ-5D scores. Reliability was assessed using the Cronbach α. Reproducibility of the NCS was assessed using the test/retest method. Effect sizes were calculated for each score to assess sensitivity to change. Validity was examined by correlations between the NCS and the CS, OSS, IS, and EQ-5D scores obtained preoperatively and postoperatively. Results Significant correlations were demonstrated preoperatively with the OSS (P = .025) and all subcategories of the EQ-5D (P < .05) and postoperatively with the OSS (P < .001), CS (P = .008), IS (P < .001), and all subcategories of EQ-5D (P < .02). The NCS had the largest effect size (1.92) of the compared scores. Internal consistency was excellent (Cronbach α = 0.87). Conclusion The NCS has been proven to be a valid, reliable and sensitive outcome measure that accurately measures the level of function and disability in the ACJ, SCJ and clavicle after traumatic injury and in degenerative disease

Multinational survey of osteoporotic fracture management

Abstract Osteoporosis is characterized by a decreased bone mass and an increased bone fragility and susceptibility to fracture

A Cryogenic Silicon Interferometer for Gravitational-wave Detection

The detection of gravitational waves from compact binary mergers by LIGO has opened the era of gravitational wave astronomy, revealing a previously hidden side of the cosmos. To maximize the reach of the existing LIGO observatory facilities, we have designed a new instrument able to detect gravitational waves at distances 5 times further away than possible with Advanced LIGO, or at greater than 100 times the event rate. Observations with this new instrument will make possible dramatic steps toward understanding the physics of the nearby Universe, as well as observing the Universe out to cosmological distances by the detection of binary black hole coalescences. This article presents the instrument design and a quantitative analysis of the anticipated noise floor