A newly discovered muscle: The tensor of the vastus intermedius

The quadriceps femoris is traditionally described as a muscle group composed of the rectus femoris and the three vasti. However, clinical experience and investigations of anatomical specimens are not consistent with the textbook description. We have found a second tensor-like muscle between the vastus lateralis (VL) and the vastus intermedius (VI), hereafter named the tensor VI (TVI). The aim of this study was to clarify whether this intervening muscle was a variation of the VL or the VI, or a separate head of the extensor apparatus. Twenty-six cadaveric lower limbs were investigated. The architecture of the quadriceps femoris was examined with special attention to innervation and vascularization patterns. All muscle components were traced from origin to insertion and their affiliations were determined. A TVI was found in all dissections. It was supplied by independent muscular and vascular branches of the femoral nerve and lateral circumflex femoral artery. Further distally, the TVI combined with an aponeurosis merging separately into the quadriceps tendon and inserting on the medial aspect of the patella. Four morphological types of TVI were distinguished: Independent-type (11/26), VI-type (6/26), VL-type (5/26), and Common-type (4/26). This study demonstrated that the quadriceps femoris is architecturally different from previous descriptions: there is an additional muscle belly between the VI and VL, which cannot be clearly assigned to the former or the latter. Distal exposure shows that this muscle belly becomes its own aponeurosis, which continues distally as part of the quadriceps tendon

Ipso nitration studies

Reaction of pentamethylphenol (19) with nitrogen dioxide in benzene gives the 4-nitrodienone (21), the four isomeric 2,5,6,-trinitrocyclohex-3-enones (23-26), three isomeric 4,5,6-trinitrocyclohex-2-enones (32), (33), [(34) or (35)] and a 2-hydroxy-5,6-dinitrocyclohex-3-enone (36). Nitration of pentamethylphenol (19) with fuming nitric acid in dichloromethane, in contrast, gives no 4-nitrodienone (21) but yields instead the 4-nitratomethy1-2,5,6-trinitrocyclohex-3-enones (49-52), in addition to compounds (23), (24), (26), (32) and (36). The 4-nitratomethyl-2,5,6-trinitrocyclohex-3-enones (49-52) are formed via the quinonemethide (56). Reaction of 4-nitrodurenol (58) with nitrogen dioxide in benzene gives the four isomeric 2,4,5,6-tetranitrocyclohex-3-enones (67-70) and hydroxynitrocyclohex-3-enones (71-73) and (77).The mode of formation of the 6-hydroxy ketones (72), (73) and (77) was demonstrated by addition of nitrogen dioxide to the 6-hydroxycyclohexa-2,4-dienone (66). The mode of formation of the above compounds and the acyloin rearrangement products (74-76) are discussed Nitration of 4,6-dibromo-2-phenylphenol (105a) and 4-bromo-6-methyl-2-phenylphenol (106a) with fuming nitric acid in acetic acid, results in extensive nitro-debromination. The fuming nitric acid nitration of 6-methyl-4-nitro-2-phenylphenol (106c) gives complex mixtures, but reaction with nitrogen dioxide gives only six compounds, two of which (114,115) were isolated from the reaction mixture. The remaining four compounds (116), (121-123) were identified tentatively by spectroscopic methods. The mode of formation of compounds (114-116) and (121-123) are discussed. Reaction of 4-methyl-2,6-diphenylpheno1 (125) with nitrogen dioxide in benzene gives a complex mixture, from which the cyclohex-2-enones (126-131) were isolated. The mode of formation of these compounds is discussed. In the above reaction studies, the structures of products were assigned on the basis of their spectroscopic data and single-crystal X-ray analyses of selected compounds. X-ray crystal structures are reported for twenty compounds viz. (23), (24), (25), (32), (33), (36), (49), (67), (68), (71), (72), (74), (77), (114), (115), (126), (127), (128), (130) and (131)

Early results in the treatment of proximal humeral fractures with a polyaxial locking plate

Objectives: We report early results using a second generation locking plate, non-contact bridging plate (NCB PH®, Zimmer Inc. Warsaw, IN, USA), for the treatment of proximal humeral fractures. The NCB PH® combines conventional plating technique with polyaxial screw placement and angular stability. Design: Prospective case series. Setting: A single level-1 trauma center. Patients: A total of 50 patients with proximal humeral fractures were treated from May 2004 to December 2005. Intervention: Surgery was performed in open technique in all cases. Main outcome measures: Implant-related complications, clinical parameters (duration of surgery, range of motion, Constant-Murley Score, subjective patient satisfaction, complications) and radiographic evaluation [union, implant loosening, implant-related complications and avascular necrosis (AVN) of the humeral head] at 6, 12 and 24weeks. Results: All fractures available to follow-up (48 of 50) went to union within the follow-up period of 6months. One patient was lost to follow-up, one patient died of a cause unrelated to the trauma, four patients developed AVN with cutout, one patient had implant loosening, three patients experienced cutout and one patient had an axillary nerve lesion (onset unknown). The average age- and gender-related Constant Score (n=35) was 76. Conclusions: The NCB PH® combines conventional plating technique with polyaxial screw placement and angular stability. Although the complication rate was 19%, with a reoperation rate of 12%, the early results show that the NCB PH® is a safe implant for the treatment of proximal humeral fracture

Influence of ion implantation on the magnetic and transport properties of manganite films

We have used oxygen ions irradiation to generate controlled structural disorder in thin manganite films. Conductive atomic force microscopy CAFM), transport and magnetic measurements were performed to analyze the influence of the implantation process in the physical properties of the films. CAFM images show regions with different conductivity values, probably due to the random distribution of point defect or inhomogeneous changes of the local Mn3+/4+ ratio to reduce lattice strains of the irradiated areas. The transport and magnetic properties of these systems are interpreted in this context. Metal-insulator transition can be described in the frame of a percolative model. Disorder increases the distance between conducting regions, lowering the observed TMI. Point defect disorder increases localization of the carriers due to increased disorder and locally enhanced strain field. Remarkably, even with the inhomogeneous nature of the samples, no sign of low field magnetoresistance was found. Point defect disorder decreases the system magnetization but doesn t seem to change the magnetic transition temperature. As a consequence, an important decoupling between the magnetic and the metal-insulator transition is found for ion irradiated films as opposed to the classical double exchange model scenario.Comment: 27 pages, 11 Figure

Synaptic proteins promote calcium-triggered fast transition from point contact to full fusion.

The molecular underpinnings of synaptic vesicle fusion for fast neurotransmitter release are still unclear. Here, we used a single vesicle-vesicle system with reconstituted SNARE and synaptotagmin-1 proteoliposomes to decipher the temporal sequence of membrane states upon Ca(2+)-injection at 250-500 μM on a 100-ms timescale. Furthermore, detailed membrane morphologies were imaged with cryo-electron microscopy before and after Ca(2+)-injection. We discovered a heterogeneous network of immediate and delayed fusion pathways. Remarkably, all instances of Ca(2+)-triggered immediate fusion started from a membrane-membrane point-contact and proceeded to complete fusion without discernible hemifusion intermediates. In contrast, pathways that involved a stable hemifusion diaphragm only resulted in fusion after many seconds, if at all. When complexin was included, the Ca(2+)-triggered fusion network shifted towards the immediate pathway, effectively synchronizing fusion, especially at lower Ca(2+)-concentration. Synaptic proteins may have evolved to select this immediate pathway out of a heterogeneous network of possible membrane fusion pathways.DOI:http://dx.doi.org/10.7554/eLife.00109.001

How to Tango: a manual for implementing Spine Tango

The generic approach of the Spine Tango documentation system, which uses web-based technologies, is a necessity for reaching a maximum number of participants. This, in turn, reduces the potential for customising the Tango according to the individual needs of each user. However, a number of possibilities still exist for tailoring the data collection processes to the user's own hospital workflow. One can choose between a purely paper-based set-up (with in-house scanning, data punching or mailing of forms to the data centre at the University of Bern) and completely paper-free online data entry. Many users work in a hybrid mode with online entry of surgical data and paper-based recording of the patients' perspectives using the Core Outcome Measures Index (COMI) questionnaires. Preoperatively, patients can complete their questionnaires in the outpatient clinic at the time of taking the decision about surgery or simply at the time of hospitalisation. Postoperative administration of patient data can involve questionnaire completion in the outpatient clinic, the handing over the forms at the time of discharge for their mailing back to the hospital later, sending out of questionnaires by post with a stamped addressed envelope for their return or, in exceptional circumstances, conducting telephone interviews. Eurospine encourages documentation of patient-based information before the hospitalisation period and surgeon-based information both before and during hospitalisation; both patient and surgeon data should be acquired for at least one follow-up, at a minimum of three to six months after surgery. In addition, all complications that occur after discharge, and their consequences should be recorde

Determination of Stiffness and the Elastic Modulus of 3D-Printed Micropillars with Atomic Force Microscopy-Force Spectroscopy

Nowadays, many applications in diverse fields are taking advantage of micropillars such as optics, tribology, biology, and biomedical engineering. Among them, one of the most attractive is three-dimensional microelectrode arrays for in vivo and in vitro studies, such as cellular recording, biosensors, and drug delivery. Depending on the application, the micropillar's optimal mechanical response ranges from soft to stiff. For long-term implantable devices, a mechanical mismatch between the micropillars and the biological tissue must be avoided. For drug delivery patches, micropillars must penetrate the skin without breaking or bending. The accurate mechanical characterization of the micropillar is pivotal in the fabrication and optimization of such devices, as it determines whether the device will fail or not. In this work, we demonstrate an experimental method based only on atomic force microscopy-force spectroscopy that allows us to measure the stiffness of a micropillar and the elastic modulus of its constituent material. We test our method with four different types of 3D inkjet-printed micropillars: silver micropillars sintered at 100 and 150 °C and polyacrylate microstructures with and without a metallic coating. The estimated elastic moduli are found to be comparable with the corresponding bulk values. Furthermore, our findings show that neither the sintering temperature nor the presence of a thin metal coating plays a major role in defining the mechanical properties of the micropillar

Isomer shift and magnetic moment of the long-lived 1/2+^{+} isomer in 3079^{79}_{30}Zn49_{49}: signature of shape coexistence near 78^{78}Ni

Collinear laser spectroscopy has been performed on the $^{79}_{30}$Zn$_{49}$ isotope at ISOLDE-CERN. The existence of a long-lived isomer with a few hundred milliseconds half-life was confirmed, and the nuclear spins and moments of the ground and isomeric states in $^{79}$Zn as well as the isomer shift were measured. From the observed hyperfine structures, spins $I = 9/2$ and $I = 1/2$ are firmly assigned to the ground and isomeric states. The magnetic moment $\mu$ ($^{79}$Zn) = $-$1.1866(10) $\mu_{\rm{N}}$, confirms the spin-parity $9/2^{+}$ with a $\nu g_{9/2}^{-1}$ shell-model configuration, in excellent agreement with the prediction from large scale shell-model theories. The magnetic moment $\mu$ ($^{79m}$Zn) = $-$1.0180(12) $\mu_{\rm{N}}$ supports a positive parity for the isomer, with a wave function dominated by a 2h-1p neutron excitation across the $N = 50$ shell gap. The large isomer shift reveals an increase of the intruder isomer mean square charge radius with respect to that of the ground state: $\delta \langle r^{2}_{c}\rangle^{79,79m}$ = +0.204(6) fm$^{2}$, providing first evidence of shape coexistence.Comment: 5 pages, 4 figures, 1 table, Accepeted by Phys. Rev. Lett. (2016

Measurement properties of quality of life measurement instruments for infants, children and adolescents with eczema: protocol for a systematic review

Background: Eczema is a common chronic or chronically relapsing skin disease that has a substantial impact on quality of life (QoL). By means of a consensus-based process, the Harmonising Outcome Measures in Eczema (HOME) initiative has identified QoL as one of the four core outcome domains to be assessed in all eczema trials. Few measurement instruments exist to measure QoL in infants and children with eczema, but there is a great variability in both content and quality (for example, reliability and validity) of the instruments used, and it is not always clear if the best instrument is being used. Therefore, the aim of the proposed research is a comprehensive systematic assessment of the measurement properties of the existing measurement instruments that were developed and/or validated for the measurement of patient-reported QoL in infants and children with eczema. Methods/Design: This study is a systematic review of the measurement properties of patient-reported measures of QoL developed and/or validated for infants and children with eczema. Medline via PubMed and EMBASE will be searched using a selection of relevant search terms. Eligible studies will be primary empirical studies evaluating, describing, or comparing measurement properties of QoL instruments for infants and children with eczema. Eligibility assessment and data abstraction will be performed independently by two reviewers. Evidence tables will be generated for study characteristics, instrument characteristics, measurement properties, and interpretability. The adequacy of the measurement properties will be assessed using predefined criteria. Methodological quality of studies will be assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. A best evidence synthesis will be undertaken if more than one study has investigated a particular measurement property. Discussion: The proposed systematic review will produce a comprehensive assessment of measurement properties of existing QoL instruments in infants and children with eczema. We aim to identify one best currently available instrument to measure QoL in infants and/or children with eczema