Posterolateral Lumbar Spinal Fusion with Autogenous Bone Chips from Laminectomy Extended with OsteoSet®

BackgroundThis study was conducted to evaluate posterolateral lumbar fusion with autogenous corticocancellous bone chips from the laminae and spinous processes extended with OsteoSet® instead of cancellous bone from the iliac crest.MethodsA total of 124 patients who underwent posterior decompression and posterolateral fusion with instrumentation between May 2001 and December 2003 were analyzed retrospectively. The study population comprised 49 males and 75 females with a mean age of 66 ± 9.5 years. In all the patients, corticocancellous bone chips from laminectomy and OsteoSet® were used as the graft material. There was no cancellous bone harvested from the iliac crest. The follow-up period was 28 + 7.1 months.ResultsThe overall union rate was 91%, and the average union time was 3.9 months. There were 3 complications, including 2 patients with dura tear, and 1 with deep infection. At the final follow-up, the good and excellent results were up to 83.9%.ConclusionGraft material from laminae and spinous processes extended with OsteoSet® is reliable and effective enough to replace the graft from the posterior iliac crest

Purple urine bag syndrome in nursing homes: Ten elderly case reports and a literature review

Purple urine bag syndrome (PUBS) is a rare occurrence, in which the patient has a purple-colored urine bag following urinary catheterization for hours to days. Most of authors believe it is a mixture of indigo (blue) and indirubin (red) that becomes purple. Previous study showed that PUBS occurred predominantly in chronically catheterized, constipated women. We collected 10 elderly patients with PUBS in two nursing homes. The first two cases were identified by chart review in 1987 and 2003, and then later eight cases (42.1%) were collected among 19 urinary catheterized elderly in the period between January 2007 and June 2007. In the present report, PUBS probably can occur in any patients with the right elements, namely urinary tract infection (UTI) with bacteria possessing these enzymes, diet with enough tryptophan, and being catheterized. Associations with bed-bound state, Alzheimer’s, or dementia from other causes are reflections of the state of such patients who are at higher risk for UTI, and hence PUBS occurred. Although we presented PUBS as a harmless problem, prevention and control of the nosocomial catheter-associated UTIs (CAUTIs) has become very important in the new patient-centered medical era. Thus, we should decrease the duration of catheterization, improve catheter care, and deploy technological advances designed for prevention, especially in the elderly cared for in nursing homes

Simulation and Measurement Analysis of an Integrated Flow Battery Energy-Storage System with Hybrid Wind/Wave Power Generation

This study aims to evaluate the power-system stability and the mitigation of fluctuations in a hybrid wind/wave power-generation system (HWWPGS) under different operating and disturbance conditions. This evaluation is performed by employing a vanadium redox flow battery-based energy storage system (VRFB-ESS) as proposed. The measurement results obtained from a laboratory-scale HWWPGS platform integrated with the VRFB-ESS, operating under specific conditions, are used to develop the laboratory-scale simulation model. The capacity rating of this laboratory-scale simulation model is then enlarged to develop an MW-scale power-system model of the HWWPGS. Both operating characteristics and power-system stability of the MW-scale HWWPGS power system model are evaluated through frequency-domain analysis (based on eigenvalue) and time-domain analysis (based on nonlinear-model simulations) under various operating conditions and disturbance conditions. The simulation results demonstrate that the fluctuations and stability of the studied HWWPGS under different operating and disturbance conditions can be effectively smoothed and stabilized by the proposed VRFB-ESS

Gold-catalyzed cycloisomerization and Diels-Alder reaction of 1,4,9-Dienyne Esters to 3 a,6-Methanoisoindole Esters with pro-inflammatory cytokine antagonist activity

A synthetic method to prepare 3a,6-methanoisoindole esters efficiently by gold(I)-catalyzed tandem 1,2-acyloxy migration/Nazarov cyclization followed by Diels–Alder reaction of 1,4,9-dienyne esters is described. We also report the ability of one example to inhibit binding of tumor necrosis factor-α (TNF-α) to the tumor necrosis factor receptor 1 (TNFR1) site and TNF-α-induced nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB) activation in cell at a half-maximal inhibitory concentration (IC50) value of 6.6 μM. Along with this is a study showing the isoindolyl derivative to exhibit low toxicity toward human hepatocellular liver carcinoma (HepG2) cells and its possible mode of activity based on molecular modeling analysis

Differential Presentations of Arterial Thromboembolic Events Between Venous Thromboembolism and Atrial Fibrillation Patients

Objective: Atrial fibrillation (AF) and venous thromboembolism (VTE) share several risk factors related to arterial thromboembolism. No study has reported the differential contribution to arterial thromboembolic events and mortality between these two conditions in the same population. We therefore assessed the differential arterial thromboembolic events between AF and VTE. Methods: We included AF and VTE national cohorts derived from Taiwan National Health Insurance Research Database between 2001 and 2013. The eligible population was 314,861 patients in the AF cohort and 41,102 patients in the VTE cohort. The primary outcome was arterial thromboembolic events, including ischemic stroke, extracranial arterial thromboembolism (ECATE) and myocardial infarction (MI). Secondary outcomes were all-cause mortality and cardiovascular death. Results: After a 1:1 propensity matching, 32,688 patients in either group were analyzed. The risk of arterial thromboembolic events was lower in the VTE cohort than that in the AF cohort (subdistribution hazard ratio [SHR], 0.60; 95% confidence interval [CI], 0.57–0.62). The risk of ischemic stroke (SHR, 0.44; 95% CI, 0.42–0.46) and MI (SHR, 0.80; 95% CI, 0.72–0.89) were lower in the VTE cohort, while the risk of ECATE (SHR, 1.23; 95% CI, 1.14–1.33; particularly lower extremities) was higher in the VTE cohort. All-cause mortality rate was higher in the VTE cohort (HR, 1.18; 95% CI, 1.15–1.21) while the risk of cardiovascular death was lower in the VTE cohort (HR, 0.96; 95% CI, 0.93–0.995). Conclusions: Patients with AF had higher risks of arterial thromboembolic events compared to patients with VTE, despite having risk factors in common. The VTE cohort had higher risks of all-cause mortality and ECATE, particularly lower extremity events, compared to AF patients. The differential manifestations of thromboembolism sequelae and mortality between AF and VTE patients merit further investigation

Nanoscale Zero-Valent Iron for Sulfide Removal from Digested Piggery Wastewater

The removal of dissolved sulfides in water and wastewater by nanoscale zero-valent iron (nZVI) was examined in the study. Both laboratory batch studies and a pilot test in a 50,000-pig farm were conducted. Laboratory studies indicated that the sulfide removal with nZVI was a function of pH where an increase in pH decreased removal rates. The pH effect on the sulfide removal with nZVI is attributed to the formation of FeS through the precipitation of Fe(II) and sulfide. The saturated adsorption capacities determined by the Langmuir model were 821.2, 486.3, and 359.7 mg/g at pH values 4, 7, and 12, respectively, for nZVI, largely higher than conventional adsorbents such as activated carbon and impregnated activated carbon. The surface characterization of sulfide-laden nZVI using XPS and TGA indicated the formation of iron sulfide, disulfide, and polysulfide that may account for the high adsorption capacity of nZVI towards sulfide. The pilot study showed the effectiveness of nZVI for sulfide removal; however, the adsorption capacity is almost 50 times less than that determined in the laboratory studies during the testing period of 30 d. The complexity of digested wastewater constituents may limit the effectiveness of nZVI. Microbial analysis suggested that the impact of nZVI on the change of microbial species distribution was relatively noticeable after the addition of nZVI