Time-dependent response of scoliotic curvature to orthotic intervention: when should a radiograph be obtained after putting on or taking off a spinal orthosis?

STUDY DESIGN: A prospective study; 2-group design. OBJECTIVE: This study aims to assess the time response of scoliotic spines to orthotic intervention using clinical ultrasound. SUMMARY OF BACKGROUND DATA: Patients with moderate adolescent idiopathic scoliosis are generally advised orthotic treatment. However, the time to reach maximum correction after donning spinal orthosis or the time to return to pretreatment curvature after doffing spinal orthosis is not fully understood. METHOD: Subjects were divided into 2 groups, the don-orthosis group and the doff-orthosis group where the time reaching maximum correction and the time returning to pretreatment curvature were investigated accordingly. To avoid excessive radiation exposure via obtaining repeated radiographs, a validated method of estimating Cobb angle using radiation-free clinical ultrasound was applied at an interval of every 30 minutes up to 180 minutes. The spinal flexibility (estimated from supine radiographs) and body mass index were collected from the subjects for analyses. RESULT: Nine female patients with adolescent idiopathic scoliosis were recruited. There was no immediate change in the Cobb angles. A change of more than 5° could be observed in both groups only after 30 minutes and maximum change was found at/after 120 minutes. In the doff-orthosis group, the subject with the lowest body mass index took the longest time to increase more than 5° after doffing spinal orthosis. In the don-orthosis group, the subject with the highest body mass index took the longest time to achieve curve correction more than 5°. CONCLUSION: This investigation demonstrated that there is a time lag between application of spinal orthosis and its effect on scoliotic curvature. This is likely due to the low-stiff and viscoelastic properties of the spine. The clinical relevance of this study is that for patients with scoliosis undergoing orthotic treatment, radiograph should not be obtained within 2 hours of putting on or taking off spinal orthosis because it may not show the maximum effect. LEVEL OF EVIDENCE: 4.postprin

A rare postoperative complication of anterior lower thoracic instrumentation: diaphragmatic laceration with hemothorax

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Amphiphilic Anionic Pt(II) Complexes: from spectroscopic to morphological changes

A new class of amphiphilic anionic platinum(II) bzimpy complexes has been demonstrated to show aggregation in water through PtfflfflfflPt and π–π stacking interactions. An interesting aggregation–partial deaggregation–aggregation process and a morphological transformation from vesicles to nanofibers have been demonstrated. These changes can be systematically controlled by the variation of solvent composition and could readily be probed by UV-vis absorption, emission, NMR, transmission electron microscopy and even with our naked eyes ...postprin

The value of radiographs obtained during forced traction under general anaesthesia in predicting flexibility in idiopathic scoliosis with Cobb angles exceeding 60 degree

Our aim in this prospective radiological study was to determine whether the flexibility rate calculated from radiographs obtained during forced traction under general anaesthesia, was better than that of fulcrum-bending radiographs before corrective surgery in predicting the extent of the available correction in patients with idiopathic scoliosis. We evaluated 33 patients with a Cobb angle > 60 degrees on a standing posteroanterior radiograph, who had been treated by posterior correction. Pre-operative standing fulcrum-bending radiographs and those with forced-traction under general anaesthesia were obtained. Post-operative standing radiographs were taken after surgical correction. The mean forced-traction flexibility rate was 55% (SD 11.3) which was significantly higher than the mean fulcrum-bending flexibility rate of 32% (SD 16.1) (p 60 degrees in the standing position and may identify those patients for whom supplementary anterior surgery can be avoided.published_or_final_versio

Bipolar gold(III) complexes for solution-processable organic light-emitting devices with a small efficiency roll-off

Poster: no. 12A new class of bipolar alkynylgold(III) complexes containing triphenylamine and benzimidazole moieties has been synthesized and fully characterized. The incorporation of methyl groups in the central phenyl unit has been found to rigidify the molecule to reduce non-radiative decay, yielding a high photoluminescence quantum yield of up to 75 % in spin-coated thin films. More importantly, this class of alkynylgold(III) complexes exhibits excellent solubility in various organic solvents and is capable of serving as phosphorescent dopants in the fabrication of solution-processable organic lightemitting devices (OLEDs). Efficient solution-processable OLEDs with high external quantum efficiency (EQE) of up to 10 % and an extremely small efficiency roll-off of less than 1 % at a practical brightness of 1000 cd m–2 have been demonstrated.published_or_final_versio

The mechanical and biological properties of a novel biodegradable polycaprolactone-magnesium porous scaffold for bone tissue engineering

Session: Biomaterial-based Tissue Regeneration: abstract no. 150INTRODUCTION: Bone tissue engineering offers an alternative solution to the traditional methods of bone replacement including allografts and autografts. Tissue grafting has been used since 1660s1. However, there are concerns of tissue shortage and transmission of disease. Therefore, the use of scaffold is the most common technique and good approach to regenerate diseased or damaged bone tissue. Polycaprolactone (PCL) is one of the suitable candidates to be used as the scaffold material since it has a low degradation rate when compared with other polymers. However, the low mechanical strength and intrinsic …postprintThe 2010 North America Conference of the Tissue Engineering and Regenerative Medicine International Society (TERMIS-NA 2010), Orlando, FL., 5-8 December 2010

Traditional growing rod versus magnetically controlled growing rod for treatment of early onset scoliosis: Cost analysis from implantation till skeletal maturity

Purpose: To compare the yearly cost involved per patient in the use of magnetically controlled growing rod (MCGR) and traditional growing rods (TGRs) in the treatment of early onset scoliosis (EOS) and to assess the overall cost burden of MCGR with reference to patient and health-care infrastructure. Methods: For a hypothetical case of a 5-year-old girl with a diagnosis of EOS, a decision-tree model using TreeAge Software was developed to simulate annual health state transitions and compare the 8-year accumulative direct, indirect, and total cost among the four groups: (1) dual MCGRs with exchange every 2 years, (2) dual MCGRs with exchange every 3 years, (3) TGR with surgical distraction every year, and (4) TGR with surgical distraction every 6 months. Base-case values and ranges of clinical parameters reflecting complication rate after each type of surgical distraction were determined from a review of literature and expert opinion. Government gazette and expert opinion provided cost estimation of growing rods, surgeries, surgical complications, and routine follow-up. Microsimulation of 1000 individuals was conducted to test the variation in total direct costs (in 2016 Hong Kong dollars (HKD)) between individuals, and estimated the standard deviations of total direct costs for each group. Results: Over the projected treatment period, indirect costs incurred by patients and family were higher for the MCGR as compared to the TGR. However, the total costs incurred by MCGR groups (group 1: HKD164k; group 2: HKD138k) were lower than those incurred by TGR groups (group 3: HKD191k; group 4: HKD290k). Although the accumulative costs of three groups (TGR with distraction every year and MCGR replacing every 2 and 3 years) were approaching each other in the first 2 years after initial implantation, at year 3 the accumulative cost of MCGR exchange every 2 years was HKD36k more than the yearly TGR surgery due to the cost of implant exchange. The cost incurred by both the MCGR groups was less than that incurred by the TGR groups from year 4 to skeletal maturity. Conclusions: The use of dual MCGRs, regardless of its 2- or 3-year exchange, was only cost saving and less expensive than the dual TGRs for EOS treatment from the fourth year of continuous treatment. Despite higher patient-related costs during MCGR treatment, it is important to consider the reduced risks and mental burden suffered by these children during repeat surgeries. With improved knowledge of the costs associated with long-term MCGR use, better constructed cost-effectiveness studies can be performed in the future.published_or_final_versio

Engineered magnesium-based resorbable porous scaffold for bone tissue engineering

INTRODUCTION: Bone tissue engineering offers an alternative solution to the traditional methods of bone replacement including allografts and autografts [1]. Although these biological materials possess good osteoinductive and osteoconductive properties, both of them have limitations in terms of the availability, donor site morbidity and the risk of disease transmission with the use of allografts [2]. Therefore, the use of synthetic scaffold is the most common technique and good approach to regenerate diseased or damaged bone tissue. An ideal bone substitute should possess certain properties including ...postprin

Magnesium plasma modified bone allograft for Large Bone Defect Treatment

Invited TalkBone allograft is the most widely accepted approach in treating patients suffering from large segmental bone defect regardless of the advancement of synthetic bone substitutes[ I, 2]. However, the long-term complications of allograft application in term of delayed union or even nonunion were reported due to the stringent sterilization process prior to clinical implantation[3, 4]. Our previous studies demonstrated that the incorporation of magnesium ions (Mg2+) into biomaterials could …postprin

Reduction of corrosion behavior of magnesium alloy by PCL surface treatment

Poster no. 2282INTRODUCTION: Metallic implants are often used for fracture fixation. However, stress-shielding effect may be resulted in some cases and thereby leading to bone loss around the implant1. Therefore those metallic implants may need to be removed after the tissues have healed. The use of degradable metallic materials such as magnesium alloy is a promising candidate that may avoid second surgery. Hence, it helps reduce costs to health care system and morbidity to the patients. However, the major obstacles are the rapid degradation inside the human body and hydrogen gas release upon degradation. The corrosion rate has to be carefully controlled so as to make the alloys available for orthopaedic implantation. Surface modification is used since this method will not alter the bulk properties of magnesium alloy. Various surface treatments such as Plasma Immersion Ion Implantation and Deposition (PIII&D)2 and plasma anodisation3 are applied so that the corrosion resistance of material can be enhanced. Our group has recently developed a unique method to deposit a biodegradable polymer named polycaprolactone (PCL) on the magnesium surface. Previous in-vitro studies suggested that the rate …postprin