Surgical debridement of infected pubic symphysitis supports optimal outcome

INTRODUCTION Infected pubic symphysitis (IPS) is a rare bacterial infection of the pubic symphysis that causes subpubic pain, disability and ultimately permanent immobility. Due to difficult diagnosis, patients present with long-standing complaints and consult several doctors. To date, no validated treatment protocol exists and most patients are treated conservatively with antibiotics. This study was aimed to assess the results after careful surgical debridement and pathogen-specific antibiotic treatment in IPS. MATERIALS AND METHODS A chart review of eight patients with proven IPS was performed. Five of eight patients filled in a specific own-developed questionnaire and could be examined clinically and radiologically at a mean of 13 months (range: 6–30 months) postoperatively. RESULTS There were six males and two females with an average age of 69 years (range: 55–80 years). The mean duration of symptoms before surgical treatment was 10.5 months (range: 1–30 months). There were no complications due to the surgical debridement. There was no recurrence of infection at the pubic symphysis during the follow-up period. The most common pathogen was Pseudomonas aeruginosa in three patients. Mean preoperative pain, measured on the visual analogue scale (VAS, range: 0–10) for the four analysed categories in the five follow-up patients was 7.2, 30 days postoperatively 2.7 and 13 months postoperatively 0.4. There was a steady increase in the quality of life (QoL) 30 days postoperatively and at the 13 months follow-up when compared to preoperative values. CONCLUSIONS Surgical debridement is the keystone for treatment of IPS and should be combined with local and systemic antibiotic therapy

8-(Biphenyl-2-yl)-7,9-diphenyl-8H-cyclo­penta­[a]acenaphthylen-8-ol

In the title compound, C39H26O, the cyclo­penta­[a]acenaphthyl­ene skeleton displays the expected distortions, with formal sp 2 bond angles as high as C—C—C = 142.50 (10)°. The OH group forms inter­molecular hydrogen bonds via x-axis translation to the centroid (Cg) of the pendant phenyl ring of the biphenyl system, with H⋯Cg = 2.41 Å and O—H⋯Cg = 153°

Event-related potential correlates of spatiotemporal regularities in vision

Spatiotemporal regularities in stimulus structure have been shown to influence visual target detection and discrimination. Here we investigate whether the influence of spatiotemporal regularity is associated with the modulation of early components (P1/N1) in Event-Related Potentials (ERP). Stimuli consisted of five horizontal bars (predictors) appearing successively towards the fovea followed by a target bar at fixation, and participants performed a key-press on target detection. Results showed that compared to the condition where five predictors were presented in a temporally regular but spatially randomised order, target detection-times were faster and contralateral N1 peak latencies were shorter when the predictors and the target were presented with spatial and temporal regularity. Both measures were most prolonged when only the target was presented. In this latter condition, an additional latency prolongation was observed for the P1 peak compared to the conditions where the target was preceded by the predictors. The latency shifts associated with early ERP components provides additional support for involvement of early visual processing stages in the coding of spatiotemporal regularities in humans

Nailing of diaphyseal ulna fractures in adults : biomechanical evaluation of a novel implant in comparison with locked plating

Abstract Background: Adult forearm fractures require surgical treatment in most cases. Open reduction and internal fixation with plate osteosynthesis is the therapy of choice. Intramedullary fixation offers several advantages compared to plate fixation but is not routinely used. The aim of our study was to compare a newly designed ulna nail with angular stable plating in a biomechanical testing setup of an ulna shaft fracture with a diaphyseal defect. Methods: Ten pairs of sawbones with a defect osteotomy of the ulna shaft (OTA 2U2C3) were fixed with an interlocked nail or locked plate osteosynthesis. The constructs were tested under four-point bending, torsional loading and axial loading in a servo-pneumatic testing machine to compare the stiffness of both stabilization methods. Results: The nail constructs show lower yet sufficient bending stiffness (62.25 ± 6.64 N/mm) compared to the plate constructs (71.2 ± 5.98 N/mm, p = 0.005). The torsional loading test shows superior stiffness of the plate constructs (0.24 ± 0.03 Nm/deg vs. 0.1 ± 0.01 Nm/deg; p < 0.001), while the axial loading shows superior stiffness of the nail constructs (1028.9 ± 402.1 N/mm vs. 343.9 ± 112.6 N/mm; p < 0.001). Conclusions: Intramedullary nailing of ulna shaft fractures obtains sufficient but lower stability in bending and torsional loading when compared to rigid angular stable plating and could be an alternative technique to plate fixation. The lower stability and the closed stabilization technique allow for a rapid periosteal healing, which is not present in stiffer constructs. Keywords: Nailing, Ulna shaft, Biomechanical stud

Nailing vs. plating in comminuted proximal ulna fractures : a biomechanical analysis

BACKGROUND Comminuted proximal ulna fractures are severe injuries with a high degree of instability. These injuries require surgical treatment, usually angular stable plating or double plating is performed. Nailing of proximal ulna fracture is described but not performed regularly. The aim of this study was to compare a newly developed, locked proximal ulna nail with an angular stable plate in an unstable fracture of the proximal ulna. We hypothesize, that locked nailing of the proximal ulna will provide non-inferior stability compared to locked plating. METHODS A defect fracture distal to the coronoid was simulated in 20 sawbones. After nailing or plate osteosynthesis the constructs were tested in a servo-pneumatic testing machine under physiological joint motion (0°-90°) and cyclic loading (30 N – 300 N). Intercyclic osteotomy gap motion and plastic deformation of the constructs were analyzed using micromotion video-analysis. RESULTS The locked nail showed lower osteotomy gap motion (0.50 ± 0.15 mm) compared to the angular stable plate (1.57 ± 0.37 mm, p < 0.001). At the anterior cortex the plastic deformation of the constructs was significantly lower for the locked nail (0.09 ± 0.17 mm vs. 0.39 ± 0.27 mm, p = 0.003). No statistically significant differences were observed at the posterior cortex for both parameters. CONCLUSIONS Nail osteosynthesis in comminuted proximal ulna fractures shows lower osteotomy gap motion and lower amount of plastic deformation compared to locking plate osteosynthesis under laboratory conditions

Anatomical evaluation of the transpubic screw corridor based on a 3D statistical model of the pelvic ring

Retrograde transpubic screw fixation is a common procedure for the treatment of anterior pelvic ring fractures. With its sparing surgical approach and significant pain relief after screw fixations allowing early mobilisation, it has gained importance especially in the treatment of insufficiency fractures in elderly patients. However, positioning of transpubic screw osteosynthesis is not always possible due to narrowness and curvature of the screw corridor. The aim of the present study was to evaluate availability and length of the screw corridor using a 3D statistical model of the pelvic ring consisting out of 150 uninjured pelves. Virtual bore probes with a diameter of 7.5 mm were analysed as to accessibility, length and grey value distribution in Hounsfield Unit (HU). A transpubic corridor with a diameter of ≥ 7.5 mm was available in 185 of 300 investigated superior pubic rami with mean screw length of 131.7 mm. Accessibility of the screw corridor was higher in males than in females. However, screw length showed no systematic differences between the sexes or ethnicities. Analysis of the grey value distribution demonstrated the strongest bone to be located at the lateral ilium and the supraacetabular region

mer-Bis[3,5-difluoro-2-(2-pyrid­yl)phenyl-κ2 C 1,N]{5-(2-pyridyl-κN)-3-[3-(4-vinyl­benz­yloxy)phen­yl]-1,2,4-triazol-1-ido}iridium(III) methanol solvate

In the title compound, [Ir(C11H6F2N)2(C22H17N4O)]·CH3OH, the coordination at iridium is essentially octa­hedral, but with distortions associated with the bite angles of the ligands [76.25 (9)–80.71 (12)°] and the differing trans influences of C and N ligands [Ir—N = 2.04 Å (average) trans to N but 2.14 Å trans to C]. All three bidentate ligands have coordinating ring systems that are almost coplanar [inter­planar angles = 1.7 (1)–3.8 (2)°]. The vinyl­benzyl group is disordered over two positions with occupations of 0.653 (4) and 0.347 (4). The methanol solvent mol­ecule is involved in a classical O—H⋯N hydrogen bond to a triazole N atom

Algebraic Relations Between Harmonic Sums and Associated Quantities

We derive the algebraic relations of alternating and non-alternating finite harmonic sums up to the sums of depth~6. All relations for the sums up to weight~6 are given in explicit form. These relations depend on the structure of the index sets of the harmonic sums only, but not on their value. They are therefore valid for all other mathematical objects which obey the same multiplication relation or can be obtained as a special case thereof, as the harmonic polylogarithms. We verify that the number of independent elements for a given index set can be determined by counting the Lyndon words which are associated to this set. The algebraic relations between the finite harmonic sums can be used to reduce the high complexity of the expressions for the Mellin moments of the Wilson coefficients and splitting functions significantly for massless field theories as QED and QCD up to three loop and higher orders in the coupling constant and are also of importance for processes depending on more scales. The ratio of the number of independent sums thus obtained to the number of all sums for a given index set is found to be $\leq 1/d$ with $d$ the depth of the sum independently of the weight. The corresponding counting relations are given in analytic form for all classes of harmonic sums to arbitrary depth and are tabulated up to depth $d=10$.Comment: 39 pages LATEX, 1 style fil

Colour terms affect detection of colour and colour-associated objects suppressed from visual awareness

The idea that language can affect how we see the world continues to create controversy. A potentially important study in this field has shown that when an object is suppressed from visual awareness using continuous flash suppression (a form of binocular rivalry), detection of the object is differently affected by a preceding word prime depending on whether the prime matches or does not match the object. This may suggest that language can affect early stages of vision. We replicated this paradigm and further investigated whether colour terms likewise influence the detection of colours or colour-associated object images suppressed from visual awareness by continuous flash suppression. This method presents rapidly changing visual noise to one eye while the target stimulus is presented to the other. It has been shown to delay conscious perception of a target for up to several minutes. In Experiment 1 we presented greyscale photos of objects. They were either preceded by a congruent object label, an incongruent label, or white noise. Detection sensitivity (d’) and hit rates were significantly poorer for suppressed objects preceded by an incongruent label compared to a congruent label or noise. In Experiment 2, targets were coloured discs preceded by a colour term. Detection sensitivity was significantly worse for suppressed colour patches preceded by an incongruent colour term as compared to a congruent term or white noise. In Experiment 3 targets were suppressed greyscale object images preceded by an auditory presentation of a colour term. On congruent trials the colour term matched the object’s stereotypical colour and on incongruent trials the colour term mismatched. Detection sensitivity was significantly poorer on incongruent trials than congruent trials. Overall, these findings suggest that colour terms affect awareness of coloured stimuli and colour- associated objects, and provide new evidence for language-perception interaction in the brain