Geoscience at the nanometre scale: review of analytical transmission electron microscopy applications

This paper describes applications of analytical Transmission Electron Microscopy (TEM) in the geosciences. The topics include: 1) sulphide-mineral oxidation; 2) trace-metal attenuation by secondary Mn oxides; 3) silicate weathering; 4) transition-metal valence in minerals; and 5) secondary Hg minerals in stream sediments. The main advantage of the analytical TEM is the ability to obtain images, chemical information, and electron diffraction patterns at the nanometre scale. With such high spatial resolution, it is possible to observe physical and chemical features in samples that cannot be resolved with most other techniques. This information can lead to significant improvement in our understanding of the system under investigation. Sample preparation techniques that are used in each study are also described in this paper. The preparation of samples for TEM analysis can be challenging because of the heterogeneity commonly encountered in geological materials, the fragility of some geological samples (e.g., low-temperature minerals), and the need to maintain spatial relationships present in the samples. The sample preparation techniques presented are specific to the needs of the study and the appropriateness of these methods is demonstrated by the high quality analytical TEM data that are obtained. RÉSUMÉ Cet exposé décrit des applications de la microscopie électronique à transmission analytique dans les sciences de la terre. Les aspects étudiés comprennent : 1) l'oxydation des minéraux sulfurés; 2) l'atténuation des métaux-traces par des oxydes de Mn secondaires; 3) la silicatisation météorique; 4) la valence des métaux de transition dans les minéraux; et 5) les minéraux de Hg secondaires dans les sédiments fluviatiles. Le principal avantage qu'offre la MET analytique est la possibilité d'obtenir des images, des données chimiques et des figures de diffraction des électrons à l'échelle nanométrique. Une résolution spatiale aussi élevée permet l'observation dans les échantillons de propriétés physiques et chimiques impossibles à éclaircir au moyen de la majorité des autres techniques. De tels renseignements peuvent mener à une amélioration marquée de notre compréhension du système à l'étude. Cet exposé décrit en plus les techniques de préparation des échantillons utilisées lors de chaque étude. La préparation des échantillons à une analyse MET peut s'avérer compliquée en raison de l'hétérogénéité que présentent communément les matières géologiques, de la fragilité de certains échantillons géologiques (p. ex. minéraux à basse température) et de la nécessité de maintenir les liens spatiaux présents dans les échantillons. Les techniques de préparation des échantillons présentées sont propres aux besoins de l'étude; les données de haute qualité obtenues des analyses MET témoignent de la pertinence de ces méthodes. [Traduit par la rédaction

Tumor markers in breast cancer - European Group on Tumor Markers recommendations

Recommendations are presented for the routine clinical use of serum and tissue-based markers in the diagnosis and management of patients with breast cancer. Their low sensitivity and specificity preclude the use of serum markers such as the MUC-1 mucin glycoproteins ( CA 15.3, BR 27.29) and carcinoembryonic antigen in the diagnosis of early breast cancer. However, serial measurement of these markers can result in the early detection of recurrent disease as well as indicate the efficacy of therapy. Of the tissue-based markers, measurement of estrogen and progesterone receptors is mandatory in the selection of patients for treatment with hormone therapy, while HER-2 is essential in selecting patients with advanced breast cancer for treatment with Herceptin ( trastuzumab). Urokinase plasminogen activator and plasminogen activator inhibitor 1 are recently validated prognostic markers for lymph node-negative breast cancer patients and thus may be of value in selecting node-negative patients that do not require adjuvant chemotherapy. Copyright (C) 2005 S. Karger AG, Basel

Pulsed electromagnetic fields after arthroscopic treatment for osteochondral defects of the talus: double-blind randomized controlled multicenter trial

Background. Osteochondral talar defects usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracturing. Although this is mostly successful, early sport resumption is difficult to achieve, and it can take up to one year to obtain clinical improvement. Pulsed electromagnetic fields (PEMFs) may be effective for talar defects after arthroscopic treatment by promoting tissue healing, suppressing inflammation, and relieving pain. We hypothesize that PEMF-treatment compared to sham-treatment after arthroscopy will lead to earlier resumption of sports, and aim at 25% increase in patients that resume sports. Methods/Design. A prospective, double-blind, randomized, placebo-controlled trial (RCT) will be conducted in five centers throughout the Netherlands and Belgium. 68 patients will be randomized to either active PEMF-treatment or sham-treatment for 60 days, four hours daily. They will be followed-up for one year. The combined primary outcome measures are (a) the percentage of patients that resume and maintain sports, and (b) the time to resumption of sports, defined by the Ankle Activity Score. Secondary outcome measures include resumption of work, subjective and objective scoring systems (American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale, Foot Ankle Outcome Score, Numeric Rating Scales of pain and satisfaction, EuroQol-5D), and computed tomography. Time to resumption of sports will be analyzed using Kaplan-Meier curves and log-rank tests. Discussion. This trial will provide level-1 evidence on the effectiveness of PEMFs in the management of osteochondral ankle lesions after arthroscopy. Trial registration. Netherlands Trial Register (NTR1636)

Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner

High tibial osteotomy (HTO) is a surgical procedure used to change the mechanical weight-bearing axis and alter the loads carried through the knee. Conventional indications for HTO are medial compartment osteoarthritis and varus malalignment of the knee causing pain and dysfunction. Traditionally, knee instability associated with varus thrust has been considered a contraindication. However, today the indications include patients with chronic ligament deficiencies and malalignment, because an HTO procedure can change not only the coronal but also the sagittal plane of the knee. The sagittal plane has generally been ignored in HTO literature, but its modification has a significant impact on biomechanics and joint stability. Indeed, decreased posterior tibial slope causes posterior tibia translation and helps the anterior cruciate ligament (ACL)-deficient knee. Vice versa, increased tibial slope causes anterior tibia translation and helps the posterior cruciate ligament (PCL)-deficient knee. A review of literature shows that soft tissue procedures alone are often unsatisfactory for chronic posterior instability if alignment is not corrected. Since limb alignment is the most important factor to consider in lower limb reconstructive surgery, diagnosis and treatment of limb malalignment should not be ignored in management of chronic ligamentous instabilities. This paper reviews the effects of chronic posterior instability and tibial slope alteration on knee and soft tissues, in addition to planning and surgical technique for chronic posterior and posterolateral instability with HTO

A competency matrix for global oral health.

The Lancet Commission on Education of Health Professionals for the 21(st) Century calls for enhancing health education for the needs and challenges of the 21st century to improve health status globally. To complement the Lancet report, this article makes recommendations for including core global health competencies in the education of health care professionals and specific groups of the public who are relevant to oral health in a global context in order to tackle the burden of oral diseases. Experts from various professional backgrounds developed global oral health competencies for four target groups: Group 1 was defined as dental students, residents/trainee specialists (or equivalent), and dentists; Group 2 was community health workers, dental hygienists, and dental therapists (or the equivalent); Group 3 was health professionals such as physicians, physician assistants, nurses, nurse practitioners, and pharmacists; and Group 4 was non-health professionals in the public arena such as parents, teachers, decision makers, key opinion leaders, and health and consumer advocates. Key competencies for members of each of the four target groups are presented in a matrix. The suggested competency matrix shows that many other health professions and groups in society have potentially crucial roles in the prevention, control, and management of oral diseases globally. Workforce models including a wider range of professionals working together as a team will be needed to tackle the burden of oral diseases in an integrated way in the broader context of non-communicable diseases. Further discussion and research should be conducted to validate or improve the competencies proposed here with regard to their relevance, appropriateness, and completeness