Surgical management of pilon fractures with large segmental bone defects using fibular strut allografts: a report of two cases

We present two patients with open pilon fractures with large bone defects treated successfully with fibular strut allografts. The patients were initially treated by massive irrigation, wound debridement, and temporary external fixation. After complete wound healing, the bone defects were managed. Because autologous iliac crest or fibular bone grafts were impossible to be harvested due to multiple fractures, the bone defects were reconstructed with fibular strut allografts. Fixation was performed with a periarticular distal tibia locking plate. At 2 months postoperatively, the patients ambulated with partial weight-bearing; at 6 months, they had full range of motion of the ankle joint and full weight-bearing

A versatile photoanode-driven photoelectrochemical system for conversion of CO2 to fuels with high faradaic efficiencies at low bias potentials

A photoanode-driven photoelectrochemical system consisting of a WO 3 photoanode under bias potential and Cu or Sn/SnOx as the cathode for the reduction of CO2 has been studied under visible light irradiation. The bias potentials typically required for the onset of oxygen evolution current at the photoanode were sufficient for the efficient reduction of CO2 at the metallic/composite counter electrodes. Using Cu as a cathode electrocatalyst, faradaic efficiencies of 67% for CH4 and 71.6% for all carbon-containing products were achieved. With Sn/SnO x, a combined faradaic efficiency (CO + HCOOH) of 44.3% was obtained at +0.8 V. The 2-electrode potential between the counter electrode and working electrode for the WO3 driven system was less than the lowest bias potential reported so far for conventional photocathode-driven systems. The results demonstrate for the first time that the intrinsically more stable photoanode-driven systems could accomplish the reduction of CO2 with higher efficiencies relative to the conventional photocathode-driven systems.close2

Availability of the Pediatric Emergency Care Applied Research Network (PECARN) rule for computed tomography scanning decision in children younger than 2 years with minor head injury

Purpose Traumatic brain injury is the most common cause of pediatric injury. Although computed tomography (CT) scan is an effective modality for screening fatal craniocerebral trauma, there is growing concern about radiation exposure associated with the consequent cancer particularly in children. We assessed validity of previous large prospective study named Pediatric Emergency Care Applied Research Network (PECARN) retrospectively to determine the necessity of CT scans for children younger than 2 years with minor head injury. Methods We reviewed medical records of children younger than 2 years discharged from our emergency department with S00–09 diagnosis code of ICD-10 from August 2008 to December 2014. Patients who had only soft tissue injury without blunt trauma, did not CT scan take brain CT, whose head trauma was not mild, and who was uncertain to meet the rule were excluded. All included patients were divided into the PECARN rule positive group and negative group. Each group was compared by sensitivity, specificity, positive predictive value and negative predictive value to predict four outcomes of clinically important traumatic brain injury (ciTBI), abnormal CT findings, intracranial hemorrhage, and isolated simple skull fracture. Results A total of 1,491 patients were included, 656 PECARN rule positive and 835 negative patients. There is statistical difference between PECARN rule positive and negative the 2 group for ciTBI (P < 0.001), abnormal CT findings (P < 0.001), intracranial hemorrhage (P < 0.001), and isolated simple skull fracture (P < 0.001) with high sensitivity (100.0%, 89.5%, 91.7%,85.7%) and negative predictive value (100.0%, 99.3%, 99.6%, 99.6%). Conclusion We confirmed that PECARN rule is a useful tool to determine the necessity of CT scan and reduce unnecessary CT scan for children younger than 2 years with minor head injury

Comparison of Conventional Excision via a Sublabial Approach and Transnasal Marsupialization for the Treatment of Nasolabial Cysts: A Prospective Randomized Study

ObjectivesSurgical excision via a sublabial approach is considered the standard treatment for nasolabial cysts. Although transnasal marsupialization has been proposed as an alternative method, no prospective study has compared the effectiveness of these techniques. We thus compared the surgical procedure, operating time, postoperative pain, complications, and recurrence rate between the two surgical methods.MethodsTwenty patients diagnosed with nasolabial cysts were allocated randomly into two groups according to the surgical technique. In the sublabial approach group, the cysts were excised completely using a sublabial approach, while in the transnasal marsupialization group, the cysts were marsupialized transnasally under the guidance of nasal endoscopes. The pure operating time was measured and postoperative pain was evaluated using a visual analog scale. Complications after the procedure were assessed and recurrence was determined according to the clinical symptoms and postoperative radiologic findings.ResultsThe transnasal marsupialization group had significantly shorter operating times, less postoperative pain, lower complication rates, and shorter duration of side effects than the sublabial approach group. No recurrence occurred in either group after a 1-yr follow-up period.ConclusionAlthough both methods are effective for treating nasolabial cysts, the transnasal marsupialization of nasolabial cysts has many benefits over the conventional sublabial approach. Therefore, we propose that transnasal marsupialization be the treatment of choice for nasolabial cysts

MR Imaging of Shaken Baby Syndrome Manifested as Chronic Subdural Hematoma

Shaken baby syndrome (SBS) is a form of child abuse that can cause significant head injuries, of which subdural hematoma (SDH) is the most common manifestation. We report the MRI findings of chronic SDH in three cases of SBS, involving two-, three- and eight-month-old babies. The SDH signal was mostly low on T1-weighted images and high on T2-weighted images, suggesting chronic SDH. In chronic SDH, a focal high signal on T1-weighted images was also noted, suggesting rebleeding. Contrast-enhanced MRI revealed diffuse dural enhancement

THE POSSIBILITY OF CLASSIFYING V1 AND V2 SUB-TECHNIQUES OF A SINGLE IMU SENSOR THROUGH COMPARISON OF MOTION-SPECIFIC DATA(PITCH, YAW AND ROLL ANGLE VALUES-ORIENTATION ANGLE VALUE) IN XC SKI

The purpose of this study is to confirm whether the single IMU sensor module(LGE developing and providing for the experiments) that attached to the pelvis can distinguish the motion of the sub-techniques (V1, V2, V2A) with the accuracy of commercial XSENS(equipment consisting of 17 sensors) in freestyle(skate) xc skiing. Therefore, one elite male xc skier with eleven years experience was investigated by measuring the three-directional rotation angle for each of the three sub-techniques used in XC ski freestyle. Through this method, we could found not only the difference of motion patterns of each sub-techniques but also the possibility for replacement of multiple sensor system by a single IMU sensor module from LGE. Thus, it is expected that a single LGE IMU sensor module could be applied to repetitive and periodic sports such as XC ski