Consequences of reaming with flat and convex reamers for bone volume and surface area of the glenoid : a basic science study

Background: The effect of reaming on bone volume and surface area of the glenoid is not precisely known. We hypothesize that (1) convex reamers create a larger surface area than flat reamers, (2) flat reamers cause less bone loss than convex reamers, and (3) the amount of bone loss increases with the amount of version correction. Methods: Reaming procedures with different types of reamers are performed on similar-sized uniconcave and biconcave glenoids created from Sawbones foam blocks. The loss of bone volume, the size of the remaining surface area, and the reaming depth are measured and evaluated. Results: Reaming with convex reamers results in a significantly larger surface area than with flat reamers for both uniconcave and biconcave glenoids (p = 0.013 and p = 0.001). Convex reamers cause more bone loss than flat reamers, but the difference is only significant for uniconcave glenoids (p = 0.007). Conclusions: In biconcave glenoids, convex reamers remove a similar amount of bone as flat reamers, but offer a larger surface area while maximizing the correction of the retroversion. In pathological uniconcave glenoids, convex reamers are preferred because of the conforming shape

Biodelignification of agricultural and forest wastes: Effect on anaerobic digestion

Four lignocellulosic wastes (wood fiber, grass, corn stover and wheat straw) were treated with the ligninolytic fungus Phanerochaete flavido-alba to improve their anaerobic digestion. After 21 days solid substrate culture, lignin content was depleted in all materials by fungus in a range between 5 and 20%, but cellulose and hemicellulose were also biodegraded. Anaerobic biodegradability of corn stover, grass and wood fiber increased as a consequence of fungal treatment. Biogas production was enhanced only in wood fiber. Fungal delignified wood fiber produced 124 NL biogas kg 1 dry wood fiber with a 64% methane, after 21 days anaerobic digestion; while non-inoculated controls did not produce any biogas. Predigestion of agricultural wastes (corn stover, grass and wheat straw) before biodelignification treatment failed to improve subsequent biogas production

Ontwikkeling van innovatief platform en meetinstrument ter bevordering van het correct gebruik van online bronnen door studenten en docenten

Een intern tussentijds rapport betreffende het OOF-project: Ontwikkeling van innovatief platform en meetinstrument ter bevordering van het correct gebruik van online bronnen door studenten en docenten.status: publishe

Ontwikkeling van innovatief platform en meetinstrument ter bevordering van het correct gebruik van online bronnen door studenten en docenten

nrpages: 54status: publishe

Cardiac Angiofibroma: A Rare Primary Cardiac Tumor

Cardiac angiofibromas are rare tumors. We report a patient with an angiofibroma of the mitral valve and discuss the management of these tumors

Prevention of suboptimal assembly of glenoidal component in reverse schoulder arthroplasty: development of an intra-operative measurement protocol

status: publishe

Renal Cell Carcinoma Presenting as Syncope due to Saddle Pulmonary Tumor Embolism

Pulmonary embolism (PE) is defined as the obstruction of the pulmonary artery or one of its branches by a blood clot, tumor, air, or fat emboli originating elsewhere in the body. A saddle PE occurs when the obstruction affects the bifurcation of the main pulmonary artery trunk. We present a case of a 46-year-old man who presented to our hospital due to an episode of syncope. Computed tomography angiography (CTA) of the chest showed extensive PE and abdominal CT scan showed a large 8 cm left renal mass with inferior vena cava (IVC) thrombus. Emergent embolectomy, left total nephrectomy, and IVC tumor removal were performed yielding the diagnosis of clear cell renal cell carcinoma (RCC). Interestingly, our patient did not experience any symptoms related to his RCC until the diagnosis of PE due to syncope, and the asymptomatic tumor was found out to be the possible cause of this PE due to the presence of tumor cells constituting the tumor embolus. It is thus recommended to improve the early screening process for RCC. Besides, clinicians should pay attention to patients presenting with uncharacteristic symptoms of RCC who might present with symptoms of saddle PE

Consequences of reaming with flat and convex reamers for bone volume and surface area of the glenoid.

Background The effect of reaming on bone volume and surface area of the glenoid is not precisely known. We hypothesize that (1) convex reamers create a larger surface area than flat reamers, (2) flat reamers cause less bone loss than convex reamers, and (3) the amount of bone loss increases with the amount of version correction. Methods Reaming procedures with different types of reamers are performed on similar-sized uniconcave and biconcave glenoids created from Sawbones foam blocks. The loss of bone volume, the size of the remaining surface area, and the reaming depth are measured and evaluated. Results Reaming with convex reamers results in a significantly larger surface area than with flat reamers for both uniconcave and biconcave glenoids (p = 0.013 and p = 0.001). Convex reamers cause more bone loss than flat reamers, but the difference is only significant for uniconcave glenoids (p = 0.007). Conclusions In biconcave glenoids, convex reamers remove a similar amount of bone as flat reamers, but offer a larger surface area while maximizing the correction of the retroversion. In pathological uniconcave glenoids, convex reamers are preferred because of the conforming shape.status: publishe

Incidence of cerebrovascular accidents in patients undergoing minimally invasive valve surgery

Objectives: Minimally invasive valve surgery has been associated with increased cerebrovascular complications. Our objective was to evaluate the incidence of cerebrovascular accidents in patients undergoing minimally invasive valve surgery. Methods: We retrospectively reviewed all the minimally invasive valve surgery performed at our institution from January 2009 to June 2012. The operative times, lengths of stay, postoperative complications, and mortality were analyzed. Results: A total of 1501 consecutive patients were identified. The mean age was 73 +/- 13 years, and 808 patients (54%) were male. Of the 1501 patients, 206 (13.7%) had a history of a cerebrovascular accident, and 225 (15%) had undergone previous heart surgery. The procedures performed were 617 isolated aortic valve replacements (41.1%), 658 isolated mitral valve operations (43.8%), 6 tricuspid valve repairs (0.4%), 216 double valve surgery (14.4%), and 4 triple valve surgery (0.3%). Femoral cannulation was used in 1359 patients (90.5%) and central cannulation in 142 (9.5%). In 1392 patients (92.7%), the aorta was clamped, and in 109 (7.3%), the surgery was performed with the heart fibrillating. The median aortic crossclamp and cardiopulmonary bypass times were 86 minutes (interquartile range [IQR], 70-107) minutes and 116 minutes (IQR, 96-143), respectively. The median intensive care unit length of stay was 47 hours (IQR, 29-74), and the median postoperative hospital length of stay was 7 days (IQR, 5-10). A total of 23 cerebrovascular accidents (1.53%) and 38 deaths (2.53%) had occurred at 30 days postoperatively. Conclusions: Minimally invasive valve surgery was associated with an acceptable stroke rate, regardless of the cannulation technique