Quiste gaseoso intrarraquídeo lumbar con síndrome radicular asociado: aportación de cuatro casos

Los autores aportan cuatro casos de síndrome radicular secundarios a una compresión radicular por quiste gaseosos intrarraquídeo extradural. El método de diagnóstico ha sido exploración con TAC y con RM. La presencia de gas intrarraquídeo es discutido en la bibliografía revisada.The authors describe four cases of secondary radicular syndrome due to radicular compression by a gas-containing cyst in the extradural space. The diagnosis was made by CT-Scan and MR imaging. The pathogenesis of the presence of epidural gas is discussed in the literature reviewed

DIRECT Distances to Nearby Galaxies Using Detached Eclipsing Binaries and Cepheids. III. Variables in the Field M31C

We undertook a long term project, DIRECT, to obtain the direct distances to two important galaxies in the cosmological distance ladder -- M31 and M33 -- using detached eclipsing binaries (DEBs) and Cepheids. While rare and difficult to detect, DEBs provide us with the potential to determine these distances with an accuracy better than 5%. The extensive photometry obtained in order to detect DEBs provides us with good light curves for the Cepheid variables. These are essential to the parallel project to derive direct Baade-Wesselink distances to Cepheids in M31 and M33. For both Cepheids and eclipsing binaries, the distance estimates will be free of any intermediate steps. As a first step in the DIRECT project, between September 1996 and October 1997 we obtained 95 full/partial nights on the F. L. Whipple Observatory 1.2 m telescope and 36 full nights on the Michigan-Dartmouth-MIT 1.3 m telescope to search for DEBs and new Cepheids in the M31 and M33 galaxies. In this paper, third in the series, we present the catalog of variable stars, most of them newly detected, found in the field M31C [(alpha,delta)=(11.10, 41.42) deg, J2000.0}]. We have found 115 variable stars: 12 eclipsing binaries, 35 Cepheids and 68 other periodic, possible long period or non-periodic variables. The catalog of variables, as well as their photometry and finding charts, is available via anonymous ftp and the World Wide Web. The complete set of the CCD frames is available upon request.Comment: submitted to the Astronomical Journal, 39 pages, 27 figures; paper and data available at ftp://cfa-ftp.harvard.edu/pub/kstanek/DIRECT/ and through WWW at http://cfa-www.harvard.edu/~kstanek/DIRECT

The use of Barthel index for the assessment of the functional recovery after osteoporotic hip fracture: One year follow-up

The Barthel index evolution was analyzed in a sample of older people with osteoporotic hip fracture in order to verify the influence of comorbidities and cognitive impairment on the physical recovery of those patients, during the first year following the fracture. A prospective observational study was carried out between October 1, 2012 and March 31, 2013. A sample of 247 individuals was initially selected. After a primary revision, 39 participants were excluded (clearly not meeting inclusion criteria, lack of data, or not agree to participate in the study), and finally a total of 208 participants were included in the analysis, 166 women, with an average age of 84.59 years, and 42 men, with an average age of 82.05. 54.80% of all cases were older than 85 years. The mean Barthel index value prior to fracture was 76.63, decreasing to 64.91 at one-year follow-up. Only 22.12% of patients achieved a full recovery for activities of daily living. A statistical analysis was performed by comparing Barthel index recovery depending on the values of Charlson and Pfeiffer indexes, respectively. The mean differences in Barthel index drop between the one-year follow-up and the hospital admission values were found statistical significant (p<0.01). These findings indicate that Charlson and Pfeiffer indexes clearly influence the Barthel index recovery. Low values of Charlson and Pfeiffer indexes resulted in better Barthel index recovery. In conclusion, the Barthel index is a good tool to evaluate the physical recovery after osteoporotic hip fracture

Composition Mixing during Blue Straggler Formation and Evolution

We use smoothed-particle hydrodynamics to examine differences between direct collisions of single stars and binary star mergers in their roles as possible blue straggler star formation mechanisms. We find in all cases that core helium in the progenitor stars is largely retained in the core of the remnant, almost independent of the type of interaction or the central concentration of the progenitor stars. We have also modelled the subsequent evolution of the hydrostatic remnants, including mass loss and energy input from the hydrodynamical interaction. The combination of the hydrodynamical and hydrostatic models enables us to predict that little mixing will occur during the merger of two globular cluster stars of equal mass. In contrast to the results of Proctor Sills, Bailyn, & Demarque (1995), we find that neither completely mixed nor unmixed models can match the absolute colors of observed blue stragglers in NGC 6397 at all luminosity levels. We also find that the color distribution is probably the crucial test for explanations of BSS formation - if stellar collisions or mergers are the correct mechanisms, a large fraction of the lifetime of the straggler must be spent away from the main sequence. This constraint appears to rule out the possibility of completely mixed models. For NGC 6397, unmixed models predict blue straggler lifetimes ranging from about 0.1 to 4 Gyr, while completely mixed models predict a range from about 0.6 to 4 Gyr.Comment: AASTeX, 28 pg., accepted for ApJ, also available at http://ucowww.ucsc.edu/~erics/bspaper.htm

Protein folding kinetics: barrier effects in chemical and thermal denaturation experiments

10 pages, 5 figures.-- PMID: 17419630 [PubMed].-- PMCID: PMC2527040.-- Author manuscript available in PMC: http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17419630Printed version published on May 2, 2007.Recent experimental work on fast protein folding brings about an intriguing paradox. Microsecond-folding proteins are supposed to fold near or at the folding speed limit (downhill folding), but yet their folding behavior seems to comply with classical two-state analyses, which imply the crossing of high free energy barriers. However, close inspection of chemical and thermal denaturation kinetic experiments in fast-folding proteins reveals systematic deviations from two-state behavior. Using a simple one-dimensional free energy surface approach we find that such deviations are indeed diagnostic of marginal folding barriers. Furthermore, the quantitative analysis of available fast-kinetic data indicates that many microsecond-folding proteins fold downhill in native conditions. All of these proteins are then promising candidates for an atom-by-atom analysis of protein folding using nuclear magnetic resonance. We also find that the diffusion coefficient for protein folding is strongly temperature dependent, corresponding to an activation energy of ~1 kJ·mol-1 per protein residue. As a consequence, the folding speed limit at room temperature is about an order of magnitude slower than the ~ 1 μs estimates from high-temperature T-jump experiments. Our analysis is quantitatively consistent with the available thermodynamic and kinetic data on slow two-state folding proteins and provides a straightforward explanation for the apparent fast-folding paradox.This research has been supported by NIH grant GM066800-1 and NSF grant MCB-0317294.Peer reviewe

Comparative analysis of the biomechanical behavior of anterograde/retrograde nailing in supracondylar femoral fractures

Supracondylar femoral fractures account for a noticeable percentage of the femoral shaft fractures, affecting two etiological groups: high energy trauma in young men, with good bone quality, and older women with osteoporotic femur. Surgical treatment of those kind of fractures remains controversial, with different surgical options such as plate and sliding barrel locking condylar plate, less invasive stabilization system (LISS) or intramedullary nailing, which has emerged as a new fixation choice in the treatment of that type of fractures. The present work performs a comparative study about the biomechanical behavior of anterograde and retrograde nailing in supracondylar femoral fractures type A, in order to determine the best choice of nailing and locking configuration. A three-dimensional finite element model of the femur was developed, modeling femoral supracondylar fracture and different nailing configurations, both for anterograde and retrograde nails. The study was focused on the immediately post-operative stage, verifying the appropriate stability of the osteosynthesis. The obtained results show a better biomechanical behavior for anterograde nails, providing a better stability from the point of view of global movements, lower stresses in screws, and less stress concentration in cortical bone. So, for the analyzed fractures and osteosyntheses types, anterograde nailing has demonstrated to be a better surgical option, being an excellent indication in supracondylar fractures of femur, with clear benefits compared to retrograde nailing, providing a better stabilization which enables for a more satisfactory fracture healing

Error induced by the estimation of the corneal power and the effective lens position with a rotationally asymmetric refractive multifocal intraocular lens

AIM: To evaluate the prediction error in intraocular lens (IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position (ELP). METHODS: Retrospective study including a total of 25 eyes of 13 patients (age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL (Oculentis GmbH, Germany). In all cases, an adjusted IOL power (PIOLadj) was calculated based on Gaussian optics using a variable keratometric index value (nkadj) for the estimation of the corneal power (Pkadj) and on a new value for ELP (ELPadj) obtained by multiple regression analysis. This PIOLadj was compared with the IOL power implanted (PIOLReal) and the value proposed by three conventional formulas (Haigis, Hoffer Q and Holladay). RESULTS: PIOLReal was not significantly different than PIOLadj and Holladay IOL power (P>0.05). In the Bland and Altman analysis, PIOLadj showed lower mean difference (-0.07 D) and limits of agreement (of 1.47 and -1.61 D) when compared to PIOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELPadj was significantly lower than ELP calculated with other conventional formulas (P<0.01) and was found to be dependent on axial length, anterior chamber depth and Pkadj. CONCLUSION: Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing the keratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors

Positional accommodative intraocular lens power error induced by the estimation of the corneal power and the effective lens position

Purpose: To evaluate the predictability of the refractive correction achieved with a positional accommodating intraocular lenses (IOL) and to develop a potential optimization of it by minimizing the error associated with the keratometric estimation of the corneal power and by developing a predictive formula for the effective lens position (ELP). Materials and Methods: Clinical data from 25 eyes of 14 patients (age range, 52–77 years) and undergoing cataract surgery with implantation of the accommodating IOL Crystalens HD (Bausch and Lomb) were retrospectively reviewed. In all cases, the calculation of an adjusted IOL power (PIOLadj) based on Gaussian optics considering the residual refractive error was done using a variable keratometric index value (nkadj) for corneal power estimation with and without using an estimation algorithm for ELP obtained by multiple regression analysis (ELPadj). PIOLadj was compared to the real IOL power implanted (PIOLReal, calculated with the SRK-T formula) and also to the values estimated by the Haigis, HofferQ, and Holladay I formulas. Results: No statistically significant differences were found between PIOLReal and PIOLadj when ELPadj was used (P = 0.10), with a range of agreement between calculations of 1.23 D. In contrast, PIOLReal was significantly higher when compared to PIOLadj without using ELPadj and also compared to the values estimated by the other formulas. Conclusions: Predictable refractive outcomes can be obtained with the accommodating IOL Crystalens HD using a variable keratometric index for corneal power estimation and by estimating ELP with an algorithm dependent on anatomical factors and age