Posterior cruciate ligament mediated avulsion fracture of the lateral tibial condyle: a case report

Avulsion fractures of the posterior cruciate ligament (PCL) are uncommon. On the basis of the site of damage of the PCL, hyperflexion, pretibial trauma, and hyperextension are proposed as mechanisms of PCL injuries. On the other hand, avulsion fractures of the tibial condyle are also rare. We report a PCL-mediated avulsion fracture of the lateral tibial condyle along with the tibial insertion of the PCL by extension-distraction force on the knee that has not been previously described in any study. This rare case may imply that application of an extension-distraction force to the PCL cause the avulsion fracture

Current bonding systems for resin-bonded restorations and fixed partial dentures made of silver–palladium–copper–gold alloy

SummaryThis review article describes about the bonding systems for noble metal alloys, bonding techniques of restorations and fixed partial dentures (FPDs) made of Ag–Pd–Cu–Au alloys, and their clinical performance. Thione monomers, 6-(4-vinylbenzyl-n-propyl) amino-1,3,5-triazine-2,4-dithione (VTD), 6-methacryloyloxyhexyl-2-thiouracil-5-carboxylate (MTU-6), and 10-methacryloxydecyl 6,8-dithiooctanoate (MDDT), has been proved effective for bonding noble metal alloys. An acrylic adhesive consists of the tri-n-butylborane (TBB) initiator, methyl methacrylate (MMA) monomer liquid with 5% 4-methacryloyloxyethyl trimellitate anhydride (4-META), and poly(methyl methacrylate) (PMMA), is being used for bonding metallic restorations to abutment surfaces. Clinical performance of restorations and FPDs made of Ag–Pd–Cu–Au alloys is overall excellent when they are seated with the currently available noble metal bonding systems

High-pressure Raman study of the Ba-doped silicon clathrate Ba 24Si100 up to 27 GPa

High-pressure Raman scattering of type-III silicon clathrate Ba 24Si100 has been measured up to 27 GPa at room temperature. Low-frequency vibrational modes associated with Ba atoms inside three kinds of cages were found around 45-90 cm-1. The Si framework Raman bands were observed around 115-415 cm-1, which are altogether shifted toward lower frequencies as compared to those of type-I Ba 8Si46. High-pressure phase transition occurs at 6.5 GPa, which seems to be due to the structural distortion induced by the increasing guest(Ba)-host(Si) couplings. Ba24Si100 becomes irreversibly amorphous above 23 GPa. This pressure is lower than those of type-I Si clathrates, which suggests that type-III structure is less stable than type-I under high pressures

High-pressure Raman study of the iodine-doped silicon clathrate I8Si44I2

Raman scattering measurements of an iodine-doped I8Si44I2 clathrate have been performed at pressures up to 28 GPa and 296 K. We found two Raman peaks at 75 and 101 cm-1 associated with the vibrations of guest I atoms inside the host Si cages, and observed some framework vibrations around 120–500 cm-1. These characteristic Raman bands and their pressure dependence are investigated in consideration of our recent Ba8Si46 studies. The lowest-frequency framework vibration at 133 cm-1 shows the softening with pressure, which seems to be the common feature of Si clathrates. A strong and broad Raman band centered at 461 cm-1 is identified to the highest-frequency framework vibration, which is likely intensified and broadened by the considerable framework distortion due to the replacement of framework Si with larger I atom. No obvious pressure-induced phase transition was found up to 28 GPa. The guest-host interactions are investigated by the present vibrational properties and are compared with those of previous neutron studies of I8Si44I2

Dynapenia and sarcopenia diabetes

Aims/Introduction: The present study aimed to clarify the prevalence and clinical characteristics of sarcopenia and dynapenia, which are muscle weakness with and without low muscle mass, respectively, in Japanese patients with type 1 diabetes mellitus and type 2 diabetes mellitus. Materials and Methods: This cross-sectional study enrolled 1,328 participants with type 1 diabetes (n = 177), type 2 diabetes (n = 645) and without diabetes (n = 506). Sarcopenia was defined as a low grip strength and slow gait speed with low skeletal muscle mass index, whereas dynapenia was defined as low strengths of grip and knee extension with a normal skeletal muscle mass index. Participants without sarcopenia and dynapenia were defined as robust. Results: Among participants aged ≥65 years, sarcopenia and dynapenia were observed in 12.2% and 0.5% of individuals without diabetes, 42.9% and 11.4% of type 1 diabetes patients, and 20.9% and 13.9% of type 2 diabetes patients. In both type 1 diabetes and type 2 diabetes patients, sarcopenic patients were significantly older and thinner, and showed a significantly higher rate of diabetic neuropathy than robust patients. In patients with type 1 diabetes and type 2 diabetes, dynapenic patients were older, and showed a higher rate of diabetic neuropathy and lower estimated glomerular filtration rate than robust patients. Patients complicated with sarcopenia and dynapenia showed a significantly lower physical quality of life and higher rate of incidental falls than robust patients. Conclusions: Sarcopenia and dynapenia were more frequent in patients with type 1 diabetes and type 2 diabetes than in individuals without diabetes, which might contribute to their impaired quality of life and incidental falls

Safety of Silk-elastin Sponges in Patients with Chronic Skin Ulcers: A Phase I/II, Single-center, Open-label, Single-arm Clinical Trial

Background: Although traditional wound dressings such as collagen scaffolds promote granulation tissue formation, the efficacy of these dressings in chronic wounds is limited because of high susceptibility to bacterial growth. Biomaterials that can be applied to chronic wounds should have an anti-bacterial function. We previously reported that administering a silk-elastin solution that forms moisturizing hydrogels to wound surfaces of diabetic mice reduced bacterial growth and promoted granulation tissue formation compared with control or carboxymethyl cellulose hydrogels. We hypothesized that silk-elastin promotes wound healing in human chronic wounds by suppressing bacterial growth. Methods: An open-label, clinical case series was conducted with a prospective, single-arm design at Kyoto University Hospital in Kyoto, Japan. In this study, 6 patients with chronic skin ulcers of any origin (2 < ulcer area (cm2) < 25) on their lower extremities were included; patients with critical ischemia were excluded. Silk-elastin sponges were applied and covered with a polyurethane film without changing the dressing for 14 days. Inflammation triggered treatment discontinuation due to fear of infection. The primary study endpoint was adverse events, including inflammation and infection. Results: Poor hydrogel formation, possibly due to continuous exudation, was observed. No serious adverse events were noted. Two patients discontinued treatment on day 6 and day 7, respectively, due to inflammation, but they were not infected. The other 4 patients completed the 14-day silk-elastin sponge treatment without infection. Conclusion: Silk-elastin sponge is safe for chronic skin ulcers, and its ability to promote wound healing should be determined by confirmatory clinical trials

ヘキチ イリョウ キョテン ビョウイン ニオケル センモン ガイライ ノ カンジャ ジュリョウ ドウコウ ニ オヨボス エイキョウ

There were few reports about the role of medical specialists in community medicine organizations such as hospitals in rural area where the number of doctors is insufficient. The aim of this study was to investigate the effect of a medical specialist for collagen vascular diseases having started periodically ambulatory care in the medical institution of the area where the specialist was absent. We examined the trend of outpatients with a collagen vascular disease about moving the hospital comparing before and after the specialist started to work in the medical institution. The number of outpatients with a collagen vascular disease in the medical institution became 95 at 3 years and a half after the specialist started to work there. There were many transfer patients from medical institutions other than the area, and the distance from their home to the hospital was shortened by changing the hospital in most of patients. The ambulatory care performed periodically and continuously by the specialist in a community medicine organization showed significances that patients became to receive the special medical care by the specialist