Complications of limb salvage surgery in childhood tumors and recommended solutions

Bone and soft tissue malignancies are associated with serious diagnostic and therapeutic problems in every level of pubertal growth in children. Current treatment modality preferred in bone and soft tissue tumors is wide resection of tumor followed by the reconstruction of consequent defect by various methods. Chemotherapy and radiotherapy are applied for systemic effects to the patient pre- and post-operatively and for local effects that facilitate the surgical procedure. Mostly, it is very difficult to control problems following wide resection and reconstruction. In this study, our aim is to discuss the problems encountered in different resection and reconstruction approaches in childhood bone and soft tissue tumors, and the recommended solutions addressed to these problems. From 1990 to 2003, a total of 68 patients (38 female, 30 male) with a mean age of 13.1 (1.5–18) were included in the study. 85.3% of patients were diagnosed as osteosarcoma and the rest was Ewing’s sarcoma. Seventy-five percent of patients had stage IIB disease. The lesions of 34 patients were detected to be in distal femur, 26 in proximal tibia and fibula, 4 in foot and ankle joint, and the remaining 4 in pelvis. As reconstructive surgery, 40 patients had modular prosthesis, vascularized fibular graft was performed in 13 patients, and 10 patients underwent arthrodesis with vascularized fibular graft. 20.6% of patients had shortened limb, infection was detected in 4 patients, laxity in 5, and restricted motion in 4 as complication of prosthesis. With sacrificed physis, 13 patients had a mean value of 4.6 cm limb shortness. Limb salvage surgery has been considered as the gold standard treatment in orthopedic oncological surgery. More understanding of the biology of sarcoma, introduction of new effective chemotherapeutic agents, development of new techniques concerning the surgical resection, advances in diagnostic methods, and improvements in reconstructive surgery all make a major contribution to limb salvage surgery. Since some problems are still encountered, we offer a therapeutic algorithm for complications in the management of childhood tumors that we have encountered so far

Phase and frequency entrainment in locally coupled phase oscillators with repulsive interactions

Recent experiments in one and two-dimensional microfluidic arrays of droplets containing Belousov -Zhabotinsky reactants show a rich variety of spatial patterns [J. Phys. Chem. Lett. 1, 1241-1246 (2010)]. The dominant coupling between these droplets is inhibitory. Motivated by this experimental system, we study repulsively coupled Kuramoto oscillators with nearest neighbor interactions, on a linear chain as well as a ring in one dimension, and on a triangular lattice in two dimensions. In one dimension, we show using linear stability analysis as well as numerical study, that the stable phase patterns depend on the geometry of the lattice. We show that a transition to the ordered state does not exist in the thermodynamic limit. In two dimensions, we show that the geometry of the lattice constrains the phase difference between two neighbouring oscillators to 120 degrees. We report the existence of domains with either clockwise or anti-clockwise helicity, leading to defects in the lattice. We study the time dependence of these domains and show that at large coupling strengths, the domains freeze due to frequency synchronization. Signatures of the above phenomena can be seen in the spatial correlation functions.Comment: 9 pages, 12 figure

Influence of protein concentration and coagulation temperature on rennet-induced gelation characteristics and curd microstructure

peer-reviewedThis study characterized the coagulation properties and defined the cutting window (CW; time between storage modulus values of 35 and 70 Pa) using rheometry for milk standardized to 4, 5, or 6% protein and set at 28, 32, or 36°C. Milks were standardized to a protein-to-fat ratio of approximately 1 by blending ultrafiltration retentate, skim milk, and whole milk. The internal curd microstructure for selected curd samples was analyzed with transmission electron microscopy and scanning electron microscopy. Lowering the coagulation temperature caused longer rennet coagulation time and time to reach storage modulus of 35 Pa, translating into a wider CW. It also led to a lower maximum curd-firming rate (MCFR) with lower firmness at 40 min at a given protein level. Increasing protein levels resulted in the opposite effect, although without an effect on rennet coagulation time at a given temperature. On coagulation at 28°C, milk with 5% protein resulted in a similar MCFR (∼4 Pa/min) and CW (∼8.25 min) compared with milk with 4% protein at 32°C, which reflects more standard conditions, whereas increasing milk to 6% protein resulted in more than doubling of the curd-firming rate (MCFR = 9.20 Pa/min) and a shorter CW (4.60 min). Gels set at 28°C had lower levels of rearrangement of protein network after 40 min compared with those set at 36°C. Protein levels, on the other hand, had no influence on the levels of protein network rearrangement, as indicated by loss tangent values. The internal structure of curd particles, as investigated by both scanning electron microscopy and transmission electron microscopy, appeared to have less cross-linking and smaller casein aggregates when coagulated at 28°C compared with 36°C, whereas varying protein levels did not show a marked effect on aggregate formation. Overall, this study showed a marked interactive effect between coagulation temperature and protein standardization of milk on coagulation properties, which subsequently requires adjustment of the CW during cheesemaking. Lowering of the coagulation temperature greatly altered the curd microstructure, with a tendency for less syneresis during cutting. Further research is required to quantify the changes in syneresis and in fat and protein losses to whey due to changes in the microstructure of curd particles arising from the different coagulation conditions applied to the protein-fortified milk

Evaluation and comparison of clinical and para clinical diagnosis of Candida vaginitis in women referred to Shahrood city health care centers years between 2004-2007

Background and aim: Candida vaginitis is the second common cause of vaginitis and Candida albicans is cause of 90 percent of vaginal fungal infections. Because antifungal drugs are among the cheapest vaginal drugs this study was performed to evaluate and compare clinical and paraclinical diagnosis of candida vaginitis in women referred to health care centers in Shahrood cityfrom 2004 to 2007. Methods: This deh1ive-analytic research was performed on 300 women with vaginitis infections who were referred to the Shahrood city health care centers. Two samples of secretions were taken from both endocervix and exocervix using speculum and spread on two glass slides and then one sample was taken from posterior culdesac secretions with a cotton soup and entered into a tube containing sterilized physiological serum. A questionnaire was filled out by a midwife for every patient. Standard laboratory methods (cultures Pap smear wet smear and etc.) were used to evaluate the samples and the second questionnaire was filled out by the midwife. Finally results were analyzed by statistical methods. Results: Based on clinical results 132 persons (44%) had candida infection but the infection was not proved by cell culture in 30 patients ((10%) and wet smear in 111 persons (37%). No candida infection was found in cytology survey. Based on clinical results vaginal pH was measured 5.01. The amount of pH was found 5.52 5.8 and 5.71 based on wet smear cell cultures and Pap smear respectively. The physical examination sensitivity for detecting vaginal candidiasis was 63.33% compared to the cell culture. Conclusion: The results of this study show that some para-clinical examinations should be considered for diagnosis of vaginal candidiasis. These para-clinical experiments help to prevent and reduce the side effects of some unnecessary medications

Shapes of Semiflexible Polymers in Confined Spaces

We investigate the conformations of a semiflexible polymer confined to a square box. Results of Monte Carlo simulations show the existence of a shape transition when the persistence length of the polymer becomes comparable to the dimensions of box. An order parameter is introduced to quantify this behavior. A simple mean-field model is constructed to study the effect of the shape transition on the effective persistence length of the polymer.Comment: 8 pages, 20 figure

A linear programming-based method for job shop scheduling

We present a decomposition heuristic for a large class of job shop scheduling problems. This heuristic utilizes information from the linear programming formulation of the associated optimal timing problem to solve subproblems, can be used for any objective function whose associated optimal timing problem can be expressed as a linear program (LP), and is particularly effective for objectives that include a component that is a function of individual operation completion times. Using the proposed heuristic framework, we address job shop scheduling problems with a variety of objectives where intermediate holding costs need to be explicitly considered. In computational testing, we demonstrate the performance of our proposed solution approach

Segregation of Polymers in Confined Spaces

We investigate the motion of two overlapping polymers with self-avoidance confined in a narrow 2d box. A statistical model is constructed using blob free-energy arguments. We find spontaneous segregation under the condition: $L > R_{//}$, and mixing under $L < R_{//}$, where L is the length of the box, and $R_{//}$ the polymer extension in an infinite slit. Segregation time scales are determined by solving a mean first-passage time problem, and by performing Monte Carlo simulations. Predictions of the two methods show good agreement. Our results may elucidate a driving force for chromosomes segregation in bacteria

Microscopic Modeling of the Growth of Order in an Alloy: Nucleated and Continuous Ordering

We study the early-stages of ordering in $Cu_3 Au$ using a model Hamiltonian derived from the effective medium theory of cohesion in metals: an approach providing a microscopic description of interatomic interactions in alloys. Our simulations show a crossover from a nucleated growth regime to a region where the ordering does not follow any simple growth laws. This mirrors the experimental observations in $Cu_3 Au$. The kinetics of growth, obtained from the simulations, is in semi-quantitative agreement with experiments. The real-space structures observed in our simulations offer some insight into the nature of early-stage kineticsComment: 13 pages, Revtex, 3 postscript figures in a second file