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

Operative versus non-operative management of pediatric medial epicondyle fractures: a systematic review

There is ongoing debate about the management of medial epicondyle fractures in the pediatric population. This systematic review evaluated non-operative versus operative treatment of medial epicondyle fractures in pediatric and adolescent patients over the last six decades. A systematic review of the available literature was performed. Frequency-weighted mean union times were used to compare union rates for closed versus open treatments. Moreover, functional outcomes and range-of-motion variables were correlated with varying treatment modalities. Any complications, including ulnar nerve symptoms, pain, instability, infection, and residual deformity, were cataloged. Fourteen studies, encompassing 498 patients, met the inclusion/exclusion criteria. There were 261 males and 132 female patients; the frequency-weighted average age was 11.93 years. The follow-up range was 6–216 months. Under the cumulative random effects model, the odds of union with operative fixation was 9.33 times the odds of union with non-operative treatment (P < 0.0001). There was no significant difference between operative and non-operative treatments in terms of pain at final follow-up (P = 0.73) or ulnar nerve symptoms (P = 0.412). Operative treatment affords a significantly higher union rate over the non-operative management of medial epicondyle fractures. There was no difference in pain at final follow-up between operative and non-operative treatments. As surgical indications evolve, and the functional demands of pediatric patients increase, surgical fixation should be strongly considered to achieve stable fixation and bony union

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)