Bone bruise of the knee associated with the lesions of anterior cruciate ligament and menisci on magnetic resonance imaging

Background/Aim. Bone bruise is a common finding in acutely injured knee examined by magnetic resonance (MR). The aim of the study was to determine the association of bone bruise frequency with postinjury lesions of anterior cruciate ligament (ACL) and menisci. Bone bruise involves posttraumatic bone marrow change with hemorrhages, edema and microtrabecular fractures without disruption of adjacent cortices or articular cartilage. MR imaging is a method of choice for detecting bone bruises which can not be seen on conventional radiographic techniques. Methods. A representative review of 120 MR examinations for the acute knee trauma was conducted. All the patients were examined within one month of trauma. All MR examinations were performed by using a 0.3T MR unit. Results. Posttraumatic bone bruise was seen in 39 (32.5%) patients out of 120. Three patients had fracture of the cortex, so-called “occult” fracture (not seen on plain radiography). We analyzed only bone bruises without these fractures of the cortex. Bone bruise was associated with the lesion of ACL in 27 (69%) patients. In 28 (72%) patients bone bruise was in combination with the lesion of menisci. Only two patients with bone bruise had neither ACL nor menisci lesions. There were 78 patients without bone bruise but 33 (43%) of them had lesions of ACL and 49 (63%) had lesions of menisci. Conclusion. Bone bruise is best seen in STIR (Short TI Inversion Recovery) images and is very often found in acute knee trauma. Very often it is associated with posttraumatic lesions of ACL and menisci, so attention must be paid to this when bone bruise is seen. The difference in frequency of internal structures of the knee lesions in patients with bone bruise is highly statistically significant as compared to patients with no bone bruise

Finding of bone bruise on magnetic resonance imaging in acute knee trauma in STIR comparing to T1 sequence in anterior cruciate ligament and menisci lesions

Magnetna rezonanca (MR) je metoda izbora za dijagnostikovanje povreda unutrašnjih mekotkivnih struktura, kao što su meniskusi, ukrštene veze i zglobna hrskavica. Osim toga, MR je jedina dijagnostička metoda koja prikazuje i posttraumatske promene koštane srži, zvane koštane modrice (KM). Preciznom analizom prisustva i lokacije KM se može razjasniti mehanizam traume kolena, što omogućava bolji uvid u očekivane, udružene, povrede unutrašnjih struktura kolena. Cilj : Cilj disertacije je da se utvrdi razlika u stepenu senzitivnosti STIR u odnosu na T1 sekvencu u detekciji koštanih modrica. Potom da se analizom stepena udruženosti KM i lezija prednjeg ukrštenog ligamenta(ACL) i meniskusa utvrdi značaj KM kao pomoćnog znaka za dijagnostikovanje povreda prednjeg ukrštenog ligamenta i meniskusa. Utvrditi učestalost KM i lezija ACL po sportovima.Introduction: Magnetic resonance (MR) imaging is a method of choice in diagnosing internal soft tissue injuries of the knee, such as menisci, cruciate ligaments and joint cartilage. It is, as well, the only method for detecting posttraumatic changes in bone marrow, so called bone bruises. Precise analysis of presence and location of bone bruise can explain the pattern of the knee trauma which enables better insight into internal knee lesions. Aim : The aim of the dissertation is to determine the difference in sensitivity of STIR sequence comparing to T1 on MR imaging for detecting bone bruises. The second aim is to determine the importance of bone bruise as the additional sign for detecting postinjury lesions of anterior cruciate ligament (ACL) and menisci by determing their association. The additional aim is to determine the association of bone bruise frequency with injuries of ACL regarding the sport. Material and methods: A representative review of 100 MR examinations for the acute knee trauma in different sports was conducted. All the patients were examined within one month of trauma. All MR examinations were performed by using MRP 7000 0.3 T Hitachi MR unit. The standard imaging protocol with SE T1 sagital, FS T2 sagital,coronal, axial and STIR sequence was used. The presence and site of bone bruises were analyzed as well as the difference in bone bruise frequency on STIR and T1 sequence and the level of sensitivity of these sequencies in detecting bone bruises. The frequency of soft tissue lesions of the knee especially ACl and menisci and their association with bone bruises was also analyzed. We have also analyzed the frequency of bone bruises in different sports which led to the knee trauma

Pharmaceutical and technological characteristics of barium sulphate tablets -the screening of various formulation factors

Introduction The study examined the development of barium sulphate tablets that do not dissolve in the digestive tract and are used as a contrasting agent for measuring transit time through the column. The main problem for obtaining non-degradable tablets is the formation of a compact polymer matrix that does not disintegrate in digestive fluids over a long period of time (Chaussade et al., 1986; Felder et al., 1984). In pharmaceutical technology, thermal techniques of granulation, extrusion, and the like, polymers and active pharmaceutical ingredients (APIs) are known for achieving better solubility of low soluble substances or for achieving slow release of highly soluble substances from solid preparations (Obradović et al., 2016) Several different formulations were tested in which they were varied: the presence of different polymers Eudragit® RS PO and/or PMMA, wet granulation and direct compression procedure, different granulation of filler calcium hydrogen phosphate dihydrate, and the time of sintering in a pair of organic solvents of acetone or IPA at different time intervals. The results of the tensile strength of the tablets that are important for the further sintering process and the degradability of sintered tablets were monitored as the output parameter. In the final manufacturing process - tablet sintering, only formulations in which the tensile strength of the tablet was ≥20 MPa were used. For this reason, direct compression tablets, as well as wet granulation formulations with PMMA, are not sintered. The tensile strength of the tablet before and after sintering indicates that the "wet" granulation is more efficient with IPA because it produces better compacted granules (higher tensile strengths), while acetone is more efficient in the sintering process at 35oC , which is expected due to the higher vapor pressure at that temperature compared to the IPA. Materials and Methods The tablets are made by the wet granulation process, and the direct compression process, and the pharmaceutical and technological characteristics of the tablets have been compared. The API Barium sulphate (Merck, Germany) was used. The essence of the formulation is based on the use of two polymers: polymethyl methacrylate (PMMA DP 300 U) and copolymers of ammonium methacrylic acid (Eudragit® RS PO).The role of PMMA DP 300 U is to with Eudragit® RS PO synergistically form in physiological media an insoluble, completely impermeable and non- swelling martix regardless of the pH value of the media. Calcium hydrogen phosphate dihydrate, an insoluble excipient, was selected as the filler. Two types of this filler were selected, powder and fine granular (Emcompress®) intended for direct compression due to improved flowing and compressible properties. Magnesium stearate was used in order to achieve adequate lubrication and to eject the tablets from the matrix. Acetone and/or IPA were chosen as solvents in combination with concentrated ethanol and water. Wet granulation In laboratory tests, mixing and wet granulation were carried out in a high shear mixer and dried at 50 °C in a fluidization oven. A vacuum processor was used for the pilot test. In the vacuum processor homogeneous mixing of the previously measured barium sulphate, calcium hydrogen phosphate dihydrate, Eudragit RS PO, and PMMA DP 300 U. The granulation solution is a mixture of acetone or isopropanol, concentrated ethanol, and purified water, i.e. isopropanol and purified water and purified water. The wet agglomerated mass is dried in a vacuum processor by heating to a temperature of 50 °C., and the vacuum is included with occasional stirring until is achieved loss on drying of not more than 1% (at 105 oC). Magnesium stearate was added to the diluted granulate and further stirred. Tableting Compression of laboratory trials was performed on an eccentric tablet press EKO type, and pilot trials were performed on a Kilian rotary tablet press Synthesis 500. For the 80 mg dose, the characteristics of the tablets were: mass: 0.268 g, diameter: 8.8 - 9.2 mm, and hardness: at least 20.0 MPa. Sintering Tablets were sintered in a sealed chamber saturated with either acetone vapor or isopropanol vapor at 35ºC (± 2 ºC) for 8h, 16h, 24h, 32h, and 40h. Drying After sintering, the tablets were dried or residual acetone or isopropanol is removed to a maximum of 2.5 mg/tablet. The sintered tablets were dried according to the scheme: 1) Temperatures 22 ºC for 16 h, 2) 40ºC for 24 h, 3) 50 ºC for 8 h and 4) 55ºC for 8 h. Results and discussion In the case of tablets made by direct compression, it was not possible to achieve the corresponding mechanical characteristics of the tablets: the strength and friability, which were necessary for the further process and manipulation, or consolidation, by sintering in an organic solvent vapor. Formulation made with PMMA DP 300 U, without the addition of the Eudragit® RS PO polymer, could not be compressed due to the spherical shape of PMMA DP 300 U which is extremely unfavorable for compression. The results of tablet tensile strengths before and after sintering indicate, for IPA and acetone solvents, that IPA solvent is more effective for wet granulation because it produces better compacting granules (higher tensile strengths are obtained), while acetone is in the sintering process at 35 °C a more efficient solvent, as expected given the higher vapor pressure at that temperature compared to IPA. The time interval during which the disintegration was tested was up to 7 days because it is the interval during which the transit of the tablet through the column in subjects with slow passage is examined in vivo. When it comes to the efficiency of the organic solvent in the process of polymer matrix consolidation by sintering, the slightly lower efficiency of isopropanol compared to acetone is observed. The sintering time has a significantly greater effect on matrix consolidation. The criteria for intact barium sulphate tablets within a 7-day time interval was fulfilled only by formulations with a mixture of Eudragit® RS PO and PMMA DP 300 U polymers obtained by granulation with acetone or isopropanol using a sintered process during 35h. Conclusion Tests of various formulations and technological parameters in the production process have shown that in order to obtain a contrast agent for testing the functional radiology of the colon, rectum and anal canal, i.e. measuring the transit time through the colon, which meets the defined criteria, optimal formulation is with calcium hydrogen phosphate dihydrate powder, an equivalent amount of Eudragit RS PO and PMMA DP 300 U polymers, isopropanol as solvent in addition to ethanol and water in the process of wet granulation, and sintering process in an organic acetone solvent vapor at 35°C.7th Congress of Pharmacy in Macedonia with international participation, Ohrid, North Macedonia, October 5-9 2022

Apparent energy of activation for hot working of vanadium microalloyed steel

Two-stage linear In [sinh(ασca)] vs.1/T plots, based on isothermal continuous and anisothermal multipass torsion curves, indicate the double Q HW behaviour of a V-steel. Above T nr , Q HW is independent of all variables but strain. Below T nr (which is interpass time dependent), i.e., in a temperature range in which interpass recrystallization is supressed, Q HW is not only increased but that based on multipass curves is also interpass time dependent, and only valid for multipass working operations

DES Selection for Left Main and Coronary Bifurcation Stenting

Coronary bifurcation lesions present a challenging lesion subset regarding procedural complexity and worse patient outcomes as compared to simple lesions. Drug eluting stents (DES), as the current standard of care for percutaneous myocardial revascularization, have tubular design and uniform diameter, and therefore, need to be subjected to a standardized set of procedural modifications, to optimally fit and reconstruct underlying bifurcation anatomy. Since contemporary DES have various design platforms, with diverse mechanical properties, we must be aware of the device’s favorable characteristics and limitations, to ensure maximal procedural safety and success. This is especially true for bifurcation lesion stenting, during which device integrity will often be eventually tested by undergoing specific procedural steps, such as proximal balloon optimization, kissing-balloon inflations, or even intentional stent crushing. In this review we address the design characteristics of contemporary DES, their bifurcation-specific experimental testing data, and reported clinical results, in an attempt to provide relevant information and help in device selection for bifurcation stenting procedures