TREATMENT OF EARLY PERIPROSTHETIC INFECTION AT HIP REPLACEMENT

We carried out the analysis of results of treatment of patients with early periprosthetic infection after total hip replacement with use of tactics aimed at the preservation of an implant and function of the operated joint, based on a multi-stage surgical rehabilitation, clinical and. laboratory monitoring of the wound healing process. The efficiency of chosen tactics in 83 % of cases was shown. Based on these results an algorithm for treatment of early periprosthetic infection at the hip replacement that can be recommended for widespread use in clinical practice was offered

Reconstruction of Acetabular and Femoral Bone Defects With Impaction Bone Grafting in Revision Hip Arthroplasty: A Case Report

Background. For many years, the main reasons for revision surgeries after hip arthroplasty remain aseptic loosening and osteolysis, which lead to formation of bone defects of various size and localization. Given the relatively young age of patients undergoing revision, the methods of biological restoration of the bone tissue, such as impaction bone grafting (IBG), are of particular interest. Aim of the report to demonstrate the delayed outcome of impaction bone grafting using compacted morselized bone allograft. Case presentation. Complicated clinical case of a 62-year-old patient with Paprosky type IIA bone deficiency in the acetabulum and Paprosky type II bone deficiency in the proximal femur with aseptic loosening of the acetabular and femoral components of the hip prosthesis is presented. During revision arthroplasty with cemented components, IBG of the acetabulum and femur was performed with a reconstructive mesh augmentation of the acetabulum using Stryker X-Change technology. Bone allograft prepared with the use of heat disinfection method served as an osteoplastic material. Follow-up period was 4 years. Control X-rays demonstrate restoration of the center of rotation of the hip, presence of bone masses in the areas of pelvic and femoral bone defects, absence of osteoplastic material resorption and migration of implants during the follow-up period. Clinical assessment shows an improvement of the Harris Hip Score from 34 to 85 points. Conclusion. Obtained results showed the efficacy of impaction bone grafting with the bone allograft prepared with the use of heat disinfection method in the mid-term period

The problems associated with the monitoring of complex workplace radiation fields at European high-energy accelerators and thermonuclear fusion facilities

The European Commission is funding within its Sixth Framework Programme a three-year project (2005-2007) called CONRAD, COordinated Network for RAdiation Dosimetry. The organisational framework for this project is provided by the European Radiation Dosimetry Group EURADOS. One task within the CONRAD project, Work Package 6 (WP6), was to provide a report outlining research needs and research activities within Europe to develop new and improved methods and techniques for the characterisation of complex radiation fields at workplaces around high-energy accelerators, but also at the next generation of thermonuclear fusion facilities. The paper provides an overview of the report, which will be available as CERN Yellow Repor

Anomalous peak in the superconducting condensate density of cuprate high T_{c} superconductors at a unique critical doping state

The doping dependence of the superconducting condensate density, n_{s}^{o}, has been studied by muon-spin-rotation for Y_{0.8}Ca_{0.2}Ba_{2}(Cu_{1-z}Zn_{z})_{3}O_{7-\delta} and Tl_{0.5-y}Pb_{0.5+y}Sr_{2}Ca_{1-x}Y_{x}Cu_{2}O_{7}. We find that n_{s}^{o} exhibits a pronounced peak at a unique doping state in the slightly overdoped regime. Its position coincides with the critical doping state where the normal state pseudogap first appears depleting the electronic density of states. A surprising correlation between n_{s}^{o} and the condensation energy U_{o} is observed which suggests unconventional behavior even in the overdoped region.Comment: 10 pages, 3 figure

Correlation between the Josephson coupling energy and the condensation energy in bilayer cuprate superconductors

We review some previous studies concerning the intra-bilayer Josephson plasmons and present new ellipsometric data of the c-axis infrared response of almost optimally doped Bi_{2}Sr_{2}CaCu_{2}O_{8}. The c-axis conductivity of this compound exhibits the same kind of anomalies as that of underdoped YBa_{2}Cu_{3}O_{7-delta}. We analyze these anomalies in detail and show that they can be explained within a model involving the intra-bilayer Josephson effect and variations of the electric field inside the unit cell. The Josephson coupling energies of different bilayer compounds obtained from the optical data are compared with the condensation energies and it is shown that there is a reasonable agreement between the values of the two quantities. We argue that the Josephson coupling energy, as determined by the frequency of the intra-bilayer Josephson plasmon, represents a reasonable estimate of the change of the effective c-axis kinetic energy upon entering the superconducting state. It is further explained that this is not the case for the estimate based on the use of the simplest ``tight-binding'' sum rule. We discuss possible interpretations of the remarkable agreement between the Josephson coupling energies and the condensation energies. The most plausible interpretation is that the interlayer tunneling of the Cooper pairs provides the dominant contribution to the condensation energy of the bilayer compounds; in other words that the condensation energy of these compounds can be accounted for by the interlayer tunneling theory. We suggest an extension of this theory, which may also explain the high values of T_{c} in the single layer compounds Tl_{2}Ba_{2}CuO_{6} and HgBa_{2}CuO_{4}, and we make several experimentally verifiable predictions.Comment: 16 pages (including Tables) and 7 figures; accepted for publication in Physical Review

Influence of retrieved hip- and knee-prosthesis biomaterials on microbial detection by sonication

Microorganisms' ability to adhere and form a biofilm differs among biomaterials; however, clinical data are conflicting. Microbial adherence and biofilm formation on different biomaterials of explanted joint prosthesis components were investigated. Consecutive patients with explanted joint prosthesis were prospectively included. The bacterial load dislodged from retrieved prosthetic components was evaluated qualitatively and quantitatively in sonication-fluid cultures. For comparison between groups, one-way ANOVA and Wilcoxon signed-rank test were used. A total of 112 components originating from 58 knee and 54 hip prostheses were retrieved from 40 patients. Components were made of titanium alloy in 42 cases, cobalt-chromium alloy in 38 and polyethylene in 32. Bacteria in sonication-fluid cultures grew in all polyethylene components (100 %), followed by titanium alloy (79 %) and cobalt-chromium components (71 %). Larger bacterial counts were found on polyethylene than on titanium (p < 0.013) or cobalt-chromium alloy (p = 0.028). Coagulase-negative Staphylococcus aureus and Streptococcus species were most commonly isolated. In conclusion, polyethylene showed larger biofilm burden than metal alloys, indicating their higher microbial adhesion affinity in vivo. Sonication of polyethylene liners, rather than the whole prosthesis, was sufficient for diagnosis of prosthetic joint infection. Moreover, bacterial counts were larger after sonication of polyethylene liners than of metal alloys, suggesting intrinsic differences in the ability for biofilm formation on various biomaterials. Polyethylene liners allowed the diagnosis of prosthetic joint infections (PJIs) in all investigated cases, suggesting that sonication of polyethylene liners rather than of the complete prosthesis was sufficient for pathogen detection in PJIs

Isolated progressive visual loss after coiling of paraclinoid aneurysms

BACKGROUND AND PURPOSE: The proximity of the paraclinoid segment of the internal carotid artery to the visual pathways may result in visual deficits when patients present with aneurysms in this segment. Although surgical clip ligation of these aneurysms has been the standard of care for decades, the advent of coil embolization has permitted endovascular therapy in those aneurysms with favorable dome-to-neck ratios. Although immediate nonprogressive visual loss after coil embolization of paraclinoid aneurysms has been well described, isolated progressive visual loss immediately or shortly following coil embolization, to our knowledge, has not. We have identified 8 patients who experienced progressive loss of vision, unassociated with any other neurologic deficits, developing immediately or shortly after apparently uncomplicated coil embolization of a paraclinoid aneurysm. MATERIALS AND METHODS: This study is a retrospective case series of 8 patients seen at 4 separate academic institutions. Inpatient and outpatient records were examined to determine patient demographics, previous ocular and medical history, and ophthalmic status before endovascular embolization. In addition, details of the primary endovascular therapy and subsequent surgical and nonsurgical interventions were recorded. Follow-up data, including most recent best-corrected visual acuity, postoperative course, and duration of follow-up were documented. RESULTS: Eight patients developed progressive visual loss in 1 or both eyes immediately or shortly after apparently uncomplicated coiling of a paraclinoid aneurysm. MR imaging findings suggested that the visual loss was most likely caused by perianeurysmal inflammation related to the coils used to embolize the aneurysm, enlargement or persistence of the aneurysm despite coiling, or a combination of these mechanisms. Most patients experienced improvement in vision, 2 apparently related to treatment with systemic corticosteroids. CONCLUSION: Patients in whom endovascular treatment of a paraclinoid aneurysm is contemplated should be warned about the potential for both isolated nonprogressive and progressive visual loss in 1 or both eyes. Patients in whom progressive visual loss occurs may benefit from treatment with systemic corticosteroids

The problems associated with the monitoring of complex workplace radiation fields at European high-energy accelerators and thermonuclear fusion facilities

The European Commission is funding within its Sixth Framework Programme a three-year project (2005-2007) called CONRAD, COordinated Network for RAdiation Dosimetry. The organisational framework for this project is provided by the European Radiation Dosimetry Group EURADOS. One task within the CONRAD project, Work Package 6 (WP6), was to provide a report outlining research needs and research activities within Europe to develop new and improved methods and techniques for the characterisation of complex radiation fields at workplaces around high-energy accelerators, but also at the next generation of thermonuclear fusion facilities. The paper provides an overview of the report, which will be available as CERN Yellow Report. © The Author 2007. Published by Oxford University Press. All rights reserved