RESUMEN
BACKGROUND: Minimal invasive screw fixation is common for treating posterior pelvic ring pathologies, but lack of bone quality may cause anchorage problems. The aim of this study was to report in detail a new technique combining iliosacral screw fixation with in-screw cement augmentation (ISFICA). DESCRIPTION OF TECHNIQUE: The patient was put under general anesthesia and placed in the supine position. A K-wire was inserted under inlet-outlet view to guide the fully threaded screw. The screw placement followed in adequate position. Cement was applied through a bone filler device, inserted at the screwdriver. The immediate control of cement distribution, accurate screw placement and potential leakage were obtained via intraoperative CT scan. PATIENTS AND METHODS: Twenty consecutive patients treated with ISFICA were included in this study. The mean age was 74.4 years (range 48-98). Screw placement, possible cement leakage and screw positioning were evaluated via intraoperative CT scan. Postoperative neurologic deficits, pain reduction and immediate postoperative mobilization were clinically evaluated. RESULTS: Twenty-six screws were implanted. All patients were postoperatively, instantly mobilized with reduced pain. No neurologic deficits were apparent postoperatively. No cement leakage occurred. One breach of the iliac cortical bone was noted due to severe osteoporosis. One screw migration was seen after 1 year and two patients showed iliosacral joint arthropathy, which led to screw removal. CONCLUSION: ISFICA is a very promising technique in terms of safety, precision and initial postoperative outcome. Long-term outcomes such as lasting mechanical stability or pain reduction and screw loosening despite cement augmentation should be investigated in further studies with larger patient numbers.
Asunto(s)
Tornillos Óseos , Fracturas Óseas/cirugía , Huesos Pélvicos/lesiones , Sacro/lesiones , Anciano , Anciano de 80 o más Años , Cementos para Huesos , Femenino , Fijación Interna de Fracturas , Fracturas Óseas/diagnóstico por imagen , Humanos , Ilion/lesiones , Cuidados Intraoperatorios , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
We report a strategy to push the limits of solid-state NMR sensitivity far beyond its current state-of-the-art. The approach relies on the use of dynamic nuclear polarization and demonstrates unprecedented DNP enhancement factors for experiments performed at sample temperatures much lower than 100 K, and can translate into 6 orders of magnitude of experimental time-savings. This leap-forward was made possible thanks to the employment of cryogenic helium as the gas to power magic angle sample spinning (MAS) for dynamic nuclear polarization (DNP) enhanced NMR experiments. These experimental conditions far exceed what is currently possible and allows currently reaching sample temperatures down to 30 K while conducting experiments with improved resolution (thanks to faster spinning frequencies, up to 25 kHz) and highly polarized nuclear spins. The impressive associated gains were used to hyperpolarize the surface of an industrial catalyst as well as to hyperpolarize organic nano-assemblies (self-assembling peptides in our case), for whom structures cannot be solved using diffraction techniques. Sustainable cryogenic helium sample spinning significantly enlarges the realm and possibilities of the MAS-DNP technique and is the route to transform NMR into a versatile but also sensitive atomic-level characterization tool.
RESUMEN
We have realised a microsystem for the culture and electrical characterisation of epithelial cell layers for cell-based diagnostic applications. The main goal of this work is to achieve both cell culture and impedimetric and potentiometric characterisation on a single device. The miniaturised cell culture system enables the uses of scarce epithelial cells, as obtained from transgenic mice or from human biopsies. The device is completely modular and offers high flexibility: a polycarbonate membrane used as cell substrate is glued in between two moulded Polydimethylsiloxane (PDMS) layers to form a sandwich, which is placed between two stacks, containing the microfluidic channels and integrated measurement electrodes. The polycarbonate membrane sandwich can be removed, replaced or analysed at any time. We have characterised the impedimetric properties of our microsystem, demonstrated epithelial cell layer growth within it, and have done the initial electrical characterisation of epithelial cell layers.