The Size of the Radial Tuberosity is Not Related to the Occurrence of Distal Biceps Tendon Ruptures: A Case-Control Study!

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Abstract

Introduction:

Hypertrophic changes at the radial tuberosity have traditionally been related to distal biceps tendon degeneration and rupture. From supination to pronation of the forearm, the space available for the distal biceps tendon between de lateral ulna and radial bicipital tuberosity (RBT) decreases by almost 50%. A hypertrophic change at the radial tuberosity further reduces this space with impingement of the distal biceps tendon as a result. The purpose of this study was to evaluate whether the size of the RBT plays a role in the pathophysiology of distal biceps tendon ruptures.

Materials and Methods:

Twenty-two consecutive patients with a surgically proven distal biceps tendon rupture were matched to controls, in a 1:1 ratio. The size of the RBT was expressed as a ratio of the maximum diameter of the radius at the RBT to the diameter of the diaphysis just distal to the RBT (RD ratio), measured on standard radiographs of the elbow. The RD ratio of patients and matched controls were compared.

Results:

The mean RD ratio in control group was 1.25 and not significantly different from the mean 1.30 in the group of patients with a distal biceps tendon rupture. Each 0.1 point increase in RD ratio results in an estimated 60% increase of the rupture odds, which was not significant either.

Conclusion:

Based on the RD ratio on conventional radiographs of the elbow, there was no significant difference in RBT size between patients with a distal biceps tendon rupture and matched controls without biceps tendon pathology.

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Pseudomonas aeruginosa Infective Endocarditis Following Aortic Valve Implantation: A Note of Caution!

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Abstract

Transcatheter aortic valve implantation (TAVI) is an alternative treatment for severe aortic valve stenosis (AS) in patients with prohibitive risk for surgical aortic valve replacement (SAVR). Prosthetic valve endocarditis (PVE) is a rare complication of this relatively novel procedure and current guidelines do not include specific recommendations for its treatment.

We report a case of PVE due to Pseudomonas aeruginosa after TAVI that required SAVR, with successful outcome.

PVE usually occurs during the first year after TAVI and entails a high mortality risk because patients eligible for this min-imally invasive procedure are fragile (i.e. advanced age and/or severe comorbidities). Additionally, clinical presentation may be atypical or subtle and transesophageal echocardiogram (TEE) may not be conclusive, which delays diagnosis and treatment worsening the prognosis. This case highlights that open SAVR might be ultimately indicated as part of treatment for TAVI-PVE despite a high-risk surgery score.

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Multi-Fixed-Bed Bioreactor System Applied for Bioprocess Development of Immobilized Lactic Acid Bacteria!

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Abstract

The multi-fixed-bed bioreactor “Multiferm” provides a downscaled system for the development of fixed-bed processes with immobilized microorganisms or cells. It consists of twelve single fixed-bed units that can be operated independently. Different bacterial strains, carriers used for immobilization, media or flow rates can be studied in one compact experimental set-up. Experiments can be run in parallel to allow for determination of experimental errors. In these studies several continuous cultivations were carried out with Lactobacillus delbrueckii ssp. bulgaricus using different dilution rates and culture durations as proof-of-concept for the Multiferm. Parameters relevant for process design such as reproducibility of simultaneously performed cultures, optimal dilution rate and long-term performance were determined by means of volume specific lactate and biomass productivity. First indications on a reduced growth rate of the cells due to immobilization were found.

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Green Roofs in the Tropics Conserve Energy!

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Abstract

Background: Concrete buildings on Guam are exceptionally strong but also accumulate large amounts of heat. In the tropical environment of Guam, where 24 h average temperature ranges from 28 to 29°C year round, air conditioning is used every day and continuously. Concrete roofs are often painted light colors, which make them more reflective and accumulate less heat. They are also suitable for establishment of vegetation, which results in a large decrease in roof temperature and therefore decreases the need for cooling.

Objective: The objective was to determine the magnitude of temperature reductions resulting from light color and from vegetation covering roof tops and to use this information to estimate energy savings.

Method: Temperature was measured on the undersides of concrete model roofs in both sunny and rainy weather.

Results: The temperatures on the undersides of light-colored concrete model roofs rose up to 3°C less in the course of the day than did those of dark-colored ones. The temperatures of “green” (vegetation-covered) model roofs rose up to 12°C less than did those of either of the bare concrete models.

Conclusion: The differences were so large that use of green roofs on the tropical island of Guam, where most buildings are concrete and air-conditioning is needed year round, could cut a typical household’s electric consumption in half.

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Vehicle Effect on Vortex-induced Vibration of Flat Steel Box Girder!

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Abstract

Vortex-induced vibration (VIV) occurs at low wind speed under normal condition, affected greatly by section type of bridge and its ancillary facilities. Few researches on VIV of vehicle-bridge system are conducted, and many researchers pointed that vehicle-bridge system should be paid attention to in wind tunnel test. In this paper, type of vehicle, number of vehicle and distance of traffic flow’s influence on VIV were studied with a flat steel box girder model. Results obtained from wind tunnel tests were displayed in order to prove the following rules: First of all, compared with conditions without vehicles, response of VIV is reduced severely when a vehicle is placed on the bridge. Secondly, response of VIV and range of VIV with three vehicles are greater than one vehicle on the bridge. At last, VIV is reduced when distance of traffic flow increases. Mechanism from fluid dynamic point view is given by simulating the working conditions with ANSYS 14.5.

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Early Inspection of Weld Seams on Gas Pipelines Based on Metal Magnetic Memory Method!

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Abstract

In order to investigate the magnetic abnormality influenced by stress in weld seams, experiments on three types of weld seams were carried out and a stress concentration detection instrument – metal magnetic memory (MMM) tester was used. MMM tests on gas pipelines in Puguang initial station in China were conducted and compared MMM wave diagram and mathematical analysis of MMM data and the quantitative MMM characteristics of T weld, straight weld and girth weld. The experiment results showed that different weld seams have different MMM characteristics, types of defects can be identified based on magnetic anomaly signal waveform characteristics and quantitative MMM features which evaluate the pipeline defects quantitatively.

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Acquired-Hypernatraemia in the Intensive Care Units!

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Abstract:

Objectives: Determine the incidence and predisposing factors of acquired-hypernatraemia in the intensive care units (ICU) and its impact on the outcome.

Design: Observational cross-sectional study with prospective analysis. Setting: Surgical, medical and trauma intensive care units of National Hospital of Sri Lanka.

Study Population: 174 consecutive patients were included in this study.

Definition: Hypernatraemia was defined as serum sodium concentration > 145 mmol/l. Results: 74 patients (42.5%) developed hypernatraemia after admission to the intensive care units. Incidence in medical, surgical and trauma ICUs were 47%, 48% and 31% respectively. Significantly lower incidence was reported in patients with trauma compared to the patients from the other two ICUs. High APACHE II (Acute Physiology and Chronic Health Evaluation) score, low GCS (Glasgow Coma Scale), organ dysfunction, transfusion of blood and blood products were associated with an increased incidence of hypernatraemia. Hypernatraemic patients had received significantly greater volume of intravenous fluids exceeding their daily fluid requirement. Compared to normonatraemic patients, hypernatraemic patients demonstrated a longer length of stay (LOS) in the ICU (mean 4.8 days versus 11 days, p< 0.001) and a higher ICU-mortality rate (15% versus 43%, p<0.001).

Conclusions: Severity of the illness, inappropriate intravenous fluid therapy and blood transfusions contribute to the incidence of hypernatraemia in intensive care units. It is associated with increased risk of ICU-mortality and longer length of stay in the ICU.

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Kidney Disease and Gout: The Role of the Innate Immune System!

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The clinical manifestations and consequence of acute and chronic gout are closely associated with the activation of the innate immune system, stimulation of the NLP3 inflammasome and secretion of interleukin-1β and interleukin-18 viacaspace-1 activity. This leads to cytokine release and an inflammatory response. It is now clear that a similar involvement of the innate immune system occurs in many forms of acute and chronic kidney disease with accentuation of renal tubular injury and stimulation of tubulointerstitial fibrosis. The local and systemic activation of the innate immune system may help explain the close association of these conditions and provide a target for therapeutic interdiction.

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Forgetting the City: Tactics of Transformation of the City in Motion!

We conceive the city not only as a material creation but also as a collective memory created in time and through time. While the material aspect is susceptible to continuous changes, the conceptual aspect is the one that permanently reconstructs the image of the city.

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But, what if the physical transformations of the city become too large, too deviant? What if the collective memory cannot reconstruct the images of the city in that continuously metastable context? What if the city loses its memory, what if it loses the ability for creating a new memory, partial or total inability to recall recent memory. Using the recent history of Skopje as an example, the dramatic history of forgetting the city will be presented. The entire twentieth century was marked by a series of innovative attempts toward reformulation of the city. The result of a century of modernization is a city composed from different cities, different sections, scales, figures these are the different traces of ideas about the city, witnessing a continuous forgetting of the city. Can forgetting be the model of perception and transformation of the city? Can forgetting as an expression of destruction become a model of reconstruction of the city? Can forgetting bring reading the city again? The subject of the present paper IS the forgotten urban pockets and the possible tactics of transformation. In absence of master procedures, through a series of everyday tactics, we shall explore the possibilities of forgetting as a motion toward essential images of space.

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Restless Space Narratives of Change Around Landscapes of Rupture!

For a project cooperation in landscape architecture, supported by the German Research Foundation (DFG), we looked at small strips of urban land in Germany and Israel that carry the marks of a violent political rupture. Two areas symptomatic of this condition in the cities of Berlin and Jerusalem were studied in terms of their disciplinary, social, and political changes:

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an area around the former Luisenstädtischer Kanal which was part of the Berlin wall and the Musrara neighborhood in Jerusalem where the pre1967 border to Jordan ran through. The first goal was to lay bare the narratives embedded in these sites and analyse the interventions that had created them. In a second step, the attempts of healing the topographical wounds left after the disappearance of the political border were studied. While in Jerusalem the measures taken were mainly infrastructural – a highway and a light rail track were built acting again as barriers – , the Berlin site became remade through a grinding process of give-and-take between different stakeholders. This paper presents the first results of the study about the Berlin area.

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