Percutaneous fixation of acetabular fractures: computer-assisted determination of safe zones, angles and lengths for screw insertion

Introduction

Percutaneous retrograde screw fixation for acetabular fractures is a demanding procedure due to the complex anatomy of the pelvis and the varying narrow safe bony corridors. Limited information is available on optimal screw placement and the geometry of safe zones for screw insertion in the pelvis.

Methods

Three-dimensional reconstructions of 50 consecutive CT scans of polytrauma patients (35 males, 15 females) were used to introduce three virtual CAD bolts (representing screws) into the anterior column (superior ramus of the pubic bone), posterior column (the ischial bone) and the supraacetabular region, as performed during percutaneous screw fixation. The three-dimensional (3D) position of these screws was evaluated with a computer software (MIMICS) after virtual optimal insertion. The 3D position, the narrowest zone and the distance to the hip joint of the two columns and the supraacetabular region were defined.

Results

The mean maximal screw length for the three virtual screws measured between 107.4 and 148?±?18.7?mm. The narrowest zone of the pelvic bone (superior pubic ramus) had a width of 9.2?±?2.4?mm. The average distances between the bolts and the hip joint were 3.9 and 19.4?±?7.4?mm. For the anterior column (superior pubic ramus) screw, the mean lateral angle to the sagittal midline plane was 39.0?±?3.2° and the mean posterior angle to the transversal midline plane was 15.1?±?4.0°. The mean supraacetabular screw angles measured 22.4?±?3.4° (medial), 35.3?±?4.6° (cranial) and the mean angles for the ischial screw were 12.0?±?5.4° (posterior) and 18.4?±?4.0° (lateral).

Conclusions

The zones for safe screw positioning are very narrow, making percutaneous screw fixation of the acetabulum a challenging procedure. The predefined angles for the most frequently positioned percutaneous screws may aid in preoperative planning, decrease operative and radiation times and help to increase safe insertion of screws.     

Transdermal Diagnosis of Malaria Using Vapor Nanobubbles

A fast, precise, noninvasive, high-throughput, and simple approach for detecting malaria in humans and mosquitoes is not possible with current techniques that depend on blood sampling, reagents, facilities, tedious procedures, and trained personnel. We designed a device for rapid (20-second) noninvasive diagnosis of Plasmodium falciparum infection in a malaria patient without drawing blood or using any reagent. This method uses transdermal optical excitation and acoustic detection of vapor nanobubbles around intraparasite hemozoin. The same device also identified individual malaria parasite–infected Anopheles mosquitoes in a few seconds and can be realized as a low-cost universal tool for clinical and field diagnoses.     

Aluminium hydroxide stabilised MnFe2O4 and Fe3O4 nanoparticles as dual-modality contrasts agent for MRI and PET imaging

Magnetic nanoparticles (NPs) MnFe₂O₄ and Fe₃O₄ were stabilised by depositing an Al(OH)₃ layer via a hydrolysis process. The particles displayed excellent colloidal stability in water and a high affinity to [¹⁸F]-fluoride and bisphosphonate groups. A high radiolabeling efficiency, 97% for ¹⁸F-fluoride and 100% for ⁶⁴Cu-bisphosphonate conjugate, was achieved by simply incubating NPs with radioactivity solution at room temperature for 5 min. The properties of particles were strongly dependant on the thickness and hardness of the Al(OH)₃ layer which could in turn be controlled by the hydrolysis method. The application of these Al(OH)₃ coated magnetic NPs in molecular imaging has been further explored. The results demonstrated that these NPs are potential candidates as dual modal probes for MR and PET. In vivo PET imaging showed a slow release of ¹⁸F from NPs, but no sign of efflux of ⁶⁴Cu.     

Spontaneous abortion in multiple pregnancy: focus on fetal pathology

Multiple pregnancy with its wide array of medical consequences poses an important condition during pregnancy. We performed perinatal autopsy in 49 cases of spontaneous abortion resulting from multiple pregnancies during the study period. Twenty-seven of the 44 twin pregnancies ending in miscarriage were conceived naturally, whereas 17 were conceived through assisted reproductive techniques. Each of the 5 triplet pregnancies ending in miscarriage was conceived through assisted reproductive techniques. There was a positive history of miscarriage in 22.4% of the cases. Monochorial placentation occurred more commonly in multiple pregnancies terminating with miscarriage than in multiple pregnancies without miscarriage. A fetal congenital malformation was found in 8 cases. Three of these cases were conceived through assisted reproductive techniques, and 5 were conceived naturally. Miscarriage was due to intrauterine infection in 36% of the cases. Our study confirms that spontaneous abortion is more common in multiple than in singleton pregnancies. Monochorial placentation predicted a higher fetal morbidity and mortality. In pregnancies where all fetuses were of male gender, miscarriage was more common than in pregnancies where all fetuses were female. Assisted reproductive techniques do not predispose to the development of fetal malformations.     

Detection of an Epstein-Barr virus-associated membrane antigen in Epstein-Barr virus-transformed nonproducer cells by leukocyte migration inhibition and blocking antibody.

Soluble membrane fractions derived from Raji cells trigger lymphocytes of Epstein-Barr virus (EBV)-seropositive, but not EBV-seronegative, individuals to release a lymphokine that inhibits leukocyte migration. The reaction can be blocked by the sera of patients with EBV-DNA-carrying tumors, Burkitt lymphoma, or nasopharyngeal carcinoma. Absorption of these sera with EBV-positive, but not EBV-negative, cells abrogates their blocking activity. These findings suggest that the antigen responsible for the leukocyte migration inhibition reaction is an EBV-encoded or an EBV-induced membrane component. The antigen is not identical with EBV-associated nuclear antigen or any other known antibody-detected EBV antigen.