Contrast-Enhanced Ultrasound Quantifies the Perfusion Within Tibial Non-Unions and Predicts the Outcome of Revision Surgery

Vascularity is one of the factors determining successful bone regeneration. This prospective study focused on quantifying the microperfusion of tibial non-unions with contrast-enhanced ultrasound (CEUS) 12?wk after revision surgery and comparing it with the osseous consolidation at a maximum of 24?mo assessed with standard radiography and computed tomography. Of 36 patients with tibial non-unions, 28 (77.8%) manifested consolidation, and 8 patients required further revision surgery. CEUS revealed significantly higher perfusion in consolidated versus persistent non-unions for all quantification parameters (e.g., wash-in perfusion index p?=?0.036). Receiver operating characteristic analysis revealed a sensitivity of 82.1% and specificity of 75.0% with a wash-in perfusion index cutoff at 19.9 a.u. for diagnosing persisting non-unions. More than 1 y ahead of the final radiologic diagnostic examination, CEUS could predict eventual consolidation based on the osseous perfusion as soon as 12?wk postoperatively. This information can be crucial for the decision-making process for re-revision at an early stage.     

Cystic Optic Chiasm Lesion: Atypical Magnetic Resonance Imaging Findings

Intrinsic cystic lesions in the optic chiasm are an uncommon cause of bitemporal hemianopia compared with compressive lesions extrinsic to the chiasm. A 40-year-old man presented with difficulty driving. Clinical assessment revealed a bitemporal hemianopia. Magnetic resonance imaging showed an unusual cystic appearance of the chiasm. The appearance was felt to be most likely secondary to previous infective or inflammatory disease, but biopsy was not undertaken given the very significant risk of further visual loss.     

Effects of poly-2-methoxyethylacrylate (PMEA)-coating on CPB circuits

Objectives. In this study, the immuno- and neuroprotective effect of a novel cardiopulmonary bypass coating was investigated. Design. Thirty nine patients scheduled for elective coronary artery bypass grafting were randomly assigned to either PMEA-coated (n?=?19) or non-coated CPB circuits (n?=?20). Pericardial suction blood was separated and retransfused only if needed at the end of operation. Neurocognitive functions were examined preoperatively and 7–10 days postoperatively using a standard neuropsychological test battery. Assuming an inflammatory etiology, the most cogent inflammatory markers were perioperatively analyzed. Results. Postoperatively, patients of the PMEA-coated group performed better in Go/NoGo and Mini-Mental-test than patients of the non-coated group (p?<?0.04). Other neurocognitive testing did not reveal significant differences between the groups. Although most inflammatory parameters showed a significant intraindividual increase during or shortly after CPB, there was no difference in inflammatory alteration between the groups. Conclusions. PMEA-coating of cardiopulmonary bypass surfaces revealed some minor benefits in preservation of neurocognitive functions after surgery. The immediate inflammatory response remained mostly unaffected. Suction blood separation may additionally contribute to proper postoperative outcome.     

Starch-encapsulated chlorpyrifos: release rate,insecticidal activity and degradation in soil

Incorporation of chlorpyrifos into starch matrices was achieved by thermal gelatinization. The level of amylose content in the starch matrices (10 and 52%) and the addition of auxiliary agents, i.e. solvent, emulsifiers or both, were varied and eight different formulations were prepared. According to differential scanning calorimetry (DSC) and X-ray diffraction measurements, chlorpyrifos was partly present in a crystalline form in all the starch formulations. The formulations had controlled release properties, and the release rate into water could be described by a linear model. In a bioassay, the formulations killed all larvae of the cabbage root fly at a dosing of 1.4 kg a.i. per ha. The degradation of chlorpyrifos in soil from the starch formulations could be described in a nonlinear logistic model and the half-life was predicted to be 88 days. Differences in the amount of amylose in the starch as well as the addition of solvent and emulsifiers in the preparation procedure had no systematic influence on the release rate, the insecticidal effect and the degradation rate. No correlation between release rate into water and degradation in soil could be established. Two commercial chlorpyrifos formulations Lorsban#174; 15 G (granular) and Cyfos#174; 500 gl -1 (emulsifiable concentrate), were included in the study for comparison.