bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revision Hip Arthroplasty with an Extensively Porous-coated Stem - Excellent Long-term Results Also in Severe Femoral Bone Stock Loss
Authors: Thomsen Per B. , Jensen Niels J.F. , Kampmann Jens , Hansen Torben Bæk 
Published: May 2013

During the last 25 years uncemented hip stem revision relying on diaphyseal fixation has shown improving clinical results and stem survival. The purpose of this study was to present the long-term results of hip revision with the SOLUTION stem (DePuy Warsaw Indiana). Ninety-three consecutive SOLUTION hip stem revisions in 84 patients with a mean age of 69 years (range 33-86 years) were reviewed. Of these, clinical and radiographic follow-up examination by an independent observer was possible in 36 hips/29 patients after mean 14 years (range 10-18 years). Stem re-revision was documented by our own files and by the Danish Hip Arthroplasty Registry. Stem re-revision had been performed in two hips for aseptic loosening, one due to deep infection and in one patient due to stem fracture. The 18 years cumulative survival, free of re-revision for any reason was calculated as 94.4% (88.9-99.8)% and for aseptic loosening to 97.6% (94.3-100%). Intraoperative complications were frequent with incidence of shaft fractures (14/93) and perforations (9/93) showing a significant learning curve. Mean Harris Hip Score was 85 (range 53-99). Osseointegration was seen in 34/36 stems with two stems fibrous fixated. Stress shielding was significant associated with stem diameters ≥15 mm. Severe preoperative bone deficiency had no negative bearing on stem survival and no significant influence on osseointegration of the stem or on Harris Hip Score. Conclusion: Femoral stem revision with an extensively porous-coated monoblock chrome-cobalt stem seems to be a reliable and reproducible technique resulting in excellent long-term survivorship and clinical outcome. It can be used in femurs with deficient bone stock.
Predicting the risk of recurrent venous thromboembolism
Authors: Eischer L. , Kyrle P. A. 
Published: May 2013

SummaryVenous thromboembolism (VTE) is a disease, which often recurs. The recurrence risk is highest in patients with unprovoked proximal deep-vein thrombosis (VT) or pulmonary embolism. Men have a higher risk than women. The risk is low in patients with VTE related to a temporary risk factor such as surgery or estrogen use. Other risk factors include overweight, post-thrombotic syndrome, history of VTE, residual VT or a vena cava filter.Both factor V Leiden and the prothrombin mutation confer a negligible increase in recurrence risk. High clotting factor levels, deficiency of a natural coagulation inhibitor, or hyperhomocysteinaemia are also associated with an increased risk. Reasons why routine laboratory thrombophilia screening however is no longer warranted are addressed in this article. Prediction rules combining clinical characteristics and coagulation assays have recently been developed. One such model, the Vienna Prediction Model, allows predicting recurrent VTE on the basis of VTE location, sex and D-dimer. This article describes strategies to distinguish between patients with high risk of recurrent VTE from those with a lower risk, who might not benefit from long-term antithrombotic therapy.
The Importance of a Conchal Bowl Element in the Fabrication of a Three-Dimensional Framework in Total Auricular Reconstruction
Authors: Kim Young Soo 
Published: May 2013

Background To construct a sophisticated three-dimensional framework, numerous modifications have been reported in the literature. However, most surgeons have paid little attention to the anatomical configuration of the concha and more to its deepness and hollowness, leading to unsatisfactory outcomes.
Methods For a configuration of the concha that is definitely anatomical, the author further developed and employed the conchal bowl element, which has been used by several surgeons although the results have not been published elsewhere. The author constructed the conchal bowl element in one of three patterns according to the amount of available cartilages: one block, two-pieces, or a cymba bowl element only. A total of 20 patients underwent auricular reconstruction using a costal cartilage framework between 2009 and 2012. The 8 earliest reconstructions were performed without a conchal bowl element and the latter 12 with a conchal bowl element. The patients were followed up for more than 1 year. The aesthetic results were scored by evaluating characteristics involving the stability of the crus helicis, the conchal definition, and the smoothness of the helical curve.
Results The ears reconstructed early without a conchal bowl element showed a shallow and one or two incompletely separated concha with an obliterated cymba conchal space. They also did not have a realistic or smooth curve of the helix because of an unstable crus helicis. However, ears reconstructed later with the concha bowl element showed a definite crus helicis, deep cymba conchal space, and smooth helical curve.
Conclusions The construction of the conchal bowl element is simple, not time-consuming procedure. It is suggested that the conchal bowl element must be constructed and attached to the main framework for natural configuration of the reconstructed ear.
Impact of Disturbed Wound Healing after Surgery on the Prognosis of Marjolin's Ulcer
Authors: Choi Jae Yeon , Bae Yong Chan , Nam Su Bong , Bae Seong Hwan 
Published: May 2013

Background Marjolin's ulcer is known to present a high proportion of recurrence and poor prognosis compared to other kinds of skin cancer. Based on our experience, Marjolin's ulcer patients who have received reconstructive surgery present a higher proportion of recurrence when there was disturbed wound healing after surgery. The impact of disturbed wound healing after surgery on the prognosis was examined in this study.
Methods A retrospective study was carried out on 26 patients who were diagnosed with Marjolin's ulcer and received surgery in this hospital from 1996 to 2011. Histologic grading, lymph node metastasis at diagnosis, and the wound healing process were evaluated and chi-squared analysis applied in order to determine the correlation with recurrence.
Results The proportion of recurrence increases in patients with a low histologic grade or lymph node metastasis at diagnosis. The proportion of recurrence is even higher when the problem occurs during the wound healing process after surgery.
Conclusions Disturbed wound healing after surgery could be used as a sign to quickly identify the recurrence of carcinoma. Therefore, in the event a problem occurs in the wound healing process after surgery, one should keep in mind that this could be a sign of the possibility of recurrence and proceed with careful observation and active diagnosis through additional physical examinations, general X-ray tests, computed tomographys, magnetic resonance imagings, and so on, to obtain an early diagnosis of recurrence.
Magnetic Resonance Imaging-Based Volumetric Analysis and Its Relationship to Actual Breast Weight
Authors: Yoo Anna , Minn Kyung Won , Jin Ung Sik 
Published: May 2013

Background Preoperative volume assessment is useful in breast reconstruction. Magnetic resonance imaging (MRI) and mammography are commonly available to reconstructive surgeons in the care of a patient with breast cancer. This study aimed to verify the accuracy of breast volume measured by MRI, and to identify any factor affecting the relationship between measured breast volume and actual breast weight to derive a new model for accurate breast volume estimation.
Methods From January 2012 to January 2013, a retrospective review was performed on a total of 101 breasts from 99 patients who had undergone total mastectomy. The mastectomy specimen weight was obtained for each breast. Mammographic and MRI data were used to estimate the volume and density. A standard statistical analysis was performed.
Results The mean mastectomy specimen weight was 340.8 g (range, 95 to 795 g). The mean MRI-estimated volume was 322.2 mL3. When divided into three groups by the "difference percentage value", the underestimated group showed a significantly higher fibroglandular volume, higher percent density, and included significantly more Breast Imaging, Reporting and Data System mammographic density grade 4 breasts than the other groups. We derived a new model considering both fibroglandular tissue volume and fat tissue volume for accurate breast volume estimation.
Conclusions MRI-based breast volume assessment showed a significant correlation with actual breast weight; however, in the case of dense breasts, the reconstructive surgeon should note that the mastectomy specimen weight tends to overestimate the volume. We suggested a new model for accurate breast volume assessment considering fibroglandular and fat tissue volume.
Evaluation of the Microvascular Research Center Training Program for Assessing Microsurgical Skills in Trainee Surgeons
Authors: Komatsu Seiji , Yamada Kiyoshi , Yamashita Shuji , Sugiyama Narushi , Tokuyama Eijiro , Matsumoto Kumiko , Takara Ayumi , Kimata Yoshihiro 
Published: May 2013

Background We established the Microvascular Research Center Training Program (MRCP) to help trainee surgeons acquire and develop microsurgical skills. Medical students were recruited to undergo the MRCP to assess the effectiveness of the MRCP for trainee surgeons.
Methods Twenty-two medical students with no prior microsurgical experience, who completed the course from 2005 to 2012, were included. The MRCP comprises 5 stages of training, each with specific passing requirements. Stages 1 and 2 involve anastomosing silicone tubes and blood vessels of chicken carcasses, respectively, within 20 minutes. Stage 3 involves anastomosing the femoral artery and vein of live rats with a 1-day patency rate of >80%. Stage 4 requires replantation of free superficial inferior epigastric artery flaps in rats with a 7-day success rate of >80%. Stage 5 involves successful completion of one case of rat replantation/transplantation. We calculated the passing rate for each stage and recorded the number of anastomoses required to pass stages 3 and 4.
Results The passing rates were 100% (22/22) for stages 1 and 2, 86.4% (19/22) for stage 3, 59.1% (13/22) for stage 4, and 55.0% (11/20) for stage 5. The number of anastomoses performed was 17.2±12.2 in stage 3 and 11.3±8.1 in stage 4.
Conclusions Majority of the medical students who undertook the MRCP acquired basic microsurgical skills. Thus, we conclude that the MRCP is an effective microsurgery training program for trainee surgeons.
Versatility of the Distally-Based Sural Artery Fasciocutaneous Flap on the Lower Leg and Foot in Patients with Chronic Disease
Authors: Park Jin-Su , Roh Si-Gyun , Lee Nae-Ho , Yang Kyoung-Moo 
Published: May 2013

Background A recent advancement in microsurgery, the free flap is widely used in the reconstruction of the lower leg and foot. The simple and effective methods of local flaps, including transposition and advancement flaps, have been considered for patients with chronic debilitation who are unable to endure long surgical procedures or general anesthesia. However, the location and size of the wound may restrict the clinical application of a local flap. Under these circumstances, a sural flap can be an excellent alternative, rendering satisfying clinical outcomes in chronically debilitated patients.
Methods Between 2008 and 2012, 39 patients underwent soft tissue defect treatment by sural artery flap as a final method. All of the patients had at least one chronic disease or more (diabetes, hypertension, vascular disease, etc.). Also, all of the patients had a history of chronic lower extremity ulceration, which revealed no response to several months of conservative treatment.
Results The results of the 39 cases had a success rate of 100% with 39 complete recoveries. Nine cases suffered complications: partial necrosis (n=4), wound dehiscence without necrosis (n=3), hematoma (n=1), and infection (n=1).
Conclusions The sural artery flap is not only useful for the lower leg but also for the heel, and other various parts. Furthermore, it is a relatively simple surgical technique for reconstructing the defect area for patients with various chronic conditions with a high surgical risk or contraindications to surgery.
New Classification of Polydactyly of the Foot on the Basis of Syndactylism, Axis Deviation, and Metatarsal Extent of Extra Digit
Authors: Seok Hyo Hyun , Park Ji Ung , Kwon Sung Tack 
Published: May 2013

Background Polydactyly of the foot is one of the most frequent anomalies of the limbs. However, most classification systems are based solely on morphology and tend to be inaccurate and less relevant to surgical methods and results. The purpose of this study is to present our new classification of polydactyly of the foot, which can serve as a predictor of treatment and prognosis.
Methods To find a correlation between the various morphologic traits of polydactyly of the foot and the treatment plan and outcomes, we reviewed 532 cases of polydactyly of the foot in 431 patients treated in our hospital, expanding on our previous study that described polydactyly based on the importance of metatarsal bone status and varus deformity. The records of patients were evaluated and compared with previous studies at other centers.
Results Unsatisfactory results were seen in 36 cases, which included 5 cases of incomplete separation due to syndactylism, 23 cases of axis deviation, and 8 cases of remnants of extra-digit metatarsal bones. The locus of the polydactyly, or the digit which was involved, did not seem to affect the final postoperative outcomes in our study. Three factors-syndactylism, axis deviation, and metatarsal extension-are the major factors related to treatment strategy and prognosis. Therefore, we developed a new classification system using three characters (S, A, M) followed by three groups (0, 1, 2), to describe the complexity of polydactyly of the foot, such as S1A2M2.
Conclusions Our new classification could provide a communicable description to help determine the surgical plan and predict outcomes.
Surgical Options for Malignant Skin Tumors of the Hand
Authors: Yun Min Ji , Park Ji Ung , Kwon Sung Tack 
Published: May 2013

Background Primary malignant tumors of the hand, although unusual, may present varied and often complex clinical problems. The main treatment modality of skin cancer of the hand has changed.
Methods We retrospectively reviewed the medical records of 43 patients who underwent surgery for malignant skin tumors of the hand during an 18-year period, from September 1994 to February 2012. The characteristics of the tumor, methods of reconstruction, and long-term results were reviewed.
Results We had 43 patients with 27 melanomas, 14 squamous cell carcinomas, and 2 sarcomas. Their ages ranged from 19 to 74 years (mean, 53.4±14.5 years), from 46 to 79 years (mean, 59.7±9.6 years), and from 15 to 43 years (mean, 29±19.8 years), respectively. Thirty-four cases occurred on the fingertip (16 of those cases on the thumb), 5 cases occurred on the palm, and 4 cases on the dorsum of the hand. Amputation was most frequently used in early cases, but recently, tissue-sparing excision has been performed frequently. The incidence of local recurrence was 3 cases and distant metastasis was 1 case, and the 5-year survival rate was 100%, except in 4 cases due to follow-up loss.
Conclusions The principles of treatment-to be curative and to preserve function and appearance-are important points. "Preservative surgery" preserves function and cosmesis of the involved finger or hand dorsum or palm. Preservative surgery not only emphasizes less resection and surgery of a smaller scale, but also optimal reconstruction of the soft tissue defect of the digit.
Considérations méthodologiques pour aborder la compétence à « réfléchir » ou à « faire réfléchir » sur sa pratique en enseignement
Authors: Chaubet Philippe , Correa Molina Enrique , Gervais Colette 
Published: May 2013

L’article propose une démarche méthodologique permettant d’identifier la réflexion professionnelle chez des stagiaires en formation à l’enseignement. En effet, la capacité d’analyser sa pratique de façon réflexive est une composante d’une compétence professionnelle à développer selon le ministère de l’Éducation du Québec. Une certaine forme de réflexion chez les étudiants est donc à acquérir et, du point de vue des tuteurs de stage, à faire acquérir. Quels sont les critères implicites que les enseignants associés des écoles ou les superviseurs universitaires identifient afin d’évaluer la présence ainsi que la qualité de la compétence réflexive chez le stagiaire ? L’étude identifie une dizaine de points de repère afin de favoriser chez les tuteurs de stage l’évaluation de la compétence réflexive de leurs stagiaires. L’article valide ces critères à partir d’un extrait de discours de stagiaire, puis confronte cet extrait à une autre approche, consistant à détecter des reconceptualisations chez les stagiaires pour dépister de la réflexion. Une certaine cohérence s’établit avec les critères empiriques d’identification de la réflexion identifiés par induction chez les tuteurs de stage. S’ensuit une discussion sur ces critères en lien avec les approches méthodologiques adoptées. La recherche utilise un devis qualitatif et s’appuie sur des entretiens semi-structurés.
Changing the Paradigm of Response to Coastal Storms
Authors: Hapke Cheryl J. , Stockdon Hilary F. , Schwab William C. , Foley Mary K. 
Published: May 2013

AbstractFederal, state, and local agencies mounted a massive preparation and response to post–tropical storm Sandy, which made landfall along the northern New Jersey coast on 29 October 2012. The data collected and knowledge gained in response to Sandy are unprecedented and provide critical information to agencies, local emergency responders, and coastal managers and planners.
Another “Great Tolbachik” Eruption?
Authors: Edwards Ben , Belousov Alexander , Belousova Marina , Volynets Anna , Melnikov Dmitry , Chirkov Sergey , Senyukov Sergey , Gordeev Evgenii , Muraviev Yaroslav , Izbekov Pavel , Demianchuk Yury 
Published: May 2013

AbstractOn 27 November 2012 at 1715 local time, a focused swarm of earthquakes was interpreted as the start of a new ongoing eruption on the south flank (Tolbachinsky Dol) of Plosky Tolbachik volcano in east central Kamchatka, Russia (Figure 1a) [Samoylenko et al., 2012]. Visual observations on 29 November showed ash shooting from two fractures as well as long, rapidly moving lava flows. Although the initial ash clouds reached 6 kilometers in height, subsequent ashfall has been limited to the area around the main vents, and no permanent settlements are in danger from advancing lava flows (the closest settlements are about 40 kilometers from the volcano). Including this eruption, six different volcanoes are presently active in Kamchatka.
Mars Summit Explores Options for Human Missions to the Red Planet
Authors: Showstack Randy 
Published: May 2013

AbstractThe United States “needs to begin the homesteading and settlement of Mars,” Edwin “Buzz” Aldrin told participants at the Humans to Mars Summit on 8 May in Washington, D. C. “It is within reach technically and budgetarily. Even in a period of fiscal challenges, the United States needs to consider this program with long‐term planning.”
Multiple Structural Coloring of Silk‐Fibroin Photonic Crystals and Humidity‐Responsive Color Sensing
Authors: Diao Ying Ying , Liu Xiang Yang , Toh Guoyang William , Shi Lei , Zi Jian 
Published: May 2013

AbstractIn the biological world, numerous creatures such as butterflies, insects, and birds have exploited photonic structures to produce bicolor reflections with important biofunctions in addition to unique brilliant structural coloration. Although the mimicking of bistructural color reflection is possible, the fabrication involves a process of combined layer deposition techniques, which is complicated and less flexible. Here, a bistructural color mimicking, based on silk fibroin, is reported using a simple and inexpensive self‐assembly method. Silk‐fibroin inverse opals with different spectral positions of bistructural color reflection (i.e., ultraviolet and visible peaks, ultraviolet and near infrared peaks, and visible and near infrared peaks) are obtained by simply controlling their lattice constants. Furthermore, the inline and continuous tuning of the peak positions of bistructural color reflection can be achieved by the humidity‐induced cyclic contraction of silk fibroin. The potential applications of silk‐fibroin photonic structures in eco‐dying and multifunctional silk fabrics are also demonstrated.
Inwards Interweaving of Polymeric Layers within Hydrogels: Assembly of Spherical Multi‐Shells with Discrete Porosity Differences
Authors: Pan Houwen Matthew , Beyer Sebastian , Zhu Qingdi , Trau Dieter 
Published: May 2013

AbstractThe unique inwards interweaving morphology of polyamines and polyacids within agarose hydrogels that leads to the formation of striated shells with different porosities within the spherical scaffold is reported. Microcompartments with sophisticated structures are commonly used in drug delivery, tissue engineering, and other biomedical applications. However, a method capable of producing well‐defined, multiporous shells within a single compartment is still lacking. By the alternating deposition of polyallylamine (PA) and polystyrenesulfonic acid (PSS) in 1‐butanol, at equal mass ratios, multiple levels of porosity are generated within an agarose microsphere. Each level of porosity is represented by a well‐defined, concentric shell of interweaving PA and PSS layers. The number, thickness, and porosity of the striated shells can be easily controlled by varying the number of PA/PSS bilayers and the polymer concentration, respectively. The feasibility of utilizing this morphology for the assembly of a multi‐shell porous spherical scaffold is validated by trapping different molecular weight dextrans within different regions of porosity. The unique interaction of polyacids and polyamines in hydrogels represents a facile and inexpensive approach to the development of intricate scaffold architectures.
Scalable One‐Step Wet‐Spinning of Graphene Fibers and Yarns from Liquid Crystalline Dispersions of Graphene Oxide: Towards Multifunctional Textiles
Authors: Jalili Rouhollah , Aboutalebi Seyed Hamed , Esrafilzadeh Dorna , Shepherd Roderick L. , Chen Jun , Aminorroaya‐Yamini Sima , Konstantinov Konstantin , Minett Andrew I. , Razal Joselito M. , Wallace Gordon G. 
Published: May 2013

AbstractKey points in the formation of liquid crystalline (LC) dispersions of graphene oxide (GO) and their processability via wet‐spinning to produce long lengths of micrometer‐dimensional fibers and yarns are addressed. Based on rheological and polarized optical microscopy investigations, a rational relation between GO sheet size and polydispersity, concentration, liquid crystallinity, and spinnability is proposed, leading to an understanding of lyotropic LC behavior and fiber spinnability. The knowledge gained from the straightforward formulation of LC GO “inks” in a range of processable concentrations enables the spinning of continuous conducting, strong, and robust fibers at concentrations as low as 0.075 wt%, eliminating the need for relatively concentrated spinning dope dispersions. The dilute LC GO dispersion is proven to be suitable for fiber spinning using a number of coagulation strategies, including non‐solvent precipitation, dispersion destabilization, ionic cross‐linking, and polyelectrolyte complexation. One‐step continuous spinning of graphene fibers and yarns is introduced for the first time by in situ spinning of LC GO in basic coagulation baths (i.e., NaOH or KOH), eliminating the need for post‐treatment processes. The thermal conductivity of these graphene fibers is found to be much higher than polycrystalline graphite and other types of 3D carbon based materials.