Mutational Studies of Aldose Reductase to Trace a Transient Pocket Opening and to Explain Ligand Affinity Cliffs.

Human aldose reductase, a target for the development of inhibitors for preventing diabetic complications, displays a transient specificity pocket which opens upon binding with specific, potent inhibitors. We investigated the opening mechanism of this pocket by mutating leucine residues involved in the gate keeping mechanism to alanine. Two isostructural inhibitors distinguished only by a single nitro to carboxy group replacement, have a 1000-fold difference in their binding affinity to the wild type.

Connection of a hip prosthesis and an intramedullary nail as a special solution in a subtrochanteric femoral fracture with fibrous dysplasia.

Treatment of fractures associated with fibrous dysplasia is difficult because of poor bone quality. In a brief report we present a case in which a hip prosthesis is connected with the distal part of a broken cannulated intramedullary femur nail. Postoperatively, the patient was mobilized with full weight bearing.

Effects of a WLAN-based real time location system on outpatient contentment in a Level I trauma center.

Background: Pre-existing wireless local area network (WLAN) infrastructures enable the implementation of a real-time location system (RTLS) in the clinical setting. RTLS enable clinics to capture and process patient position data and link it with clinical data. The improvements in workflow and treatment brought about by RTLS may improve patient satisfaction.

Improvement in the workflow efficiency of treating non-emergency outpatients by using a WLAN-based real-time location system in a level I trauma center.

Background: Patient localization can improve workflow in outpatient settings, which might lead to lower costs. The existing wireless local area network (WLAN) architecture in many hospitals opens up the possibility of adopting real-time patient tracking systems for capturing and processing position data; once captured, these data can be linked with clinical patient data.

Objective: To analyze the effect of a WLAN-based real-time patient localization system for tracking outpatients in our level I trauma center.

Development of a WLAN-based real time localization system for patient tracking in a Level I Trauma center.

Background: Patient tracking helps improve workflow, decrease wait times, optimize costs, and enhance medical treatment in the outpatient setting. In that regard, real-time patient tracking may serve as a potential way to perform efficient patient care. In recent years, the increasing popularity of wireless local area networks (WLANs) has led to a growing number of devices utilizing wireless fidelity (WiFi) networks.

Two-stage multilevel en bloc spondylectomy with resection and replacement of the aorta.

Objective: We report a case of multilevel spondylectomy in which resection and replacement of the adjacent aorta were done. Although spondylectomy is nowadays an established technique, no report on a combined aortic resection and replacement has been reported so far.

Methods: The case of a 43-year-old man with a primary chondrosarcoma of the thoracic spine is presented.

Navigated femoral shaft fracture treatment: current status.

Femoral malrotation is a common complication after internal fixation of a femoral shaft fracture. The only valid, objective monitoring method is computer tomography-assisted torsion measurement between the proximal and distal femur; unfortunately, this can only be carried out postoperatively. A difference of 15° compared to the contralateral femur is seen as an indication for revision.

The aseptic femoral and tibial shaft non-union in healthy patients - an analysis of the health-related quality of life and the socioeconomic outcome.

Unlabelled: Long bone non-unions may lead to recurrent surgical procedures and in-hospital stays. Thus, restrictions of the health-related quality of life and of socioeconomic parameters might be expected. Knowledge of the impact on several parameters of professional life is sparse.

Are polymorphisms of molecules involved in bone healing correlated to aseptic femoral and tibial shaft non-unions?

Fracture healing is a well-organized process between several molecules and mediators. As known from other diseases, genetic polymorphisms may exhibit different expression patterns in these mediators. Concerning fracture healing, this may lead to an extended healing process or non-union.

Femoral malrotation after unreamed intramedullary nailing: an evaluation of influencing operative factors.

Objective: The objective of this study was to determine which clinical factors influence the presence and extent of femoral malrotation during unreamed nail insertion performed without a fracture table.

Design: Retrospective chart review.

Setting: Academic trauma center.

Femoral malrotation following intramedullary nailing in bilateral femoral shaft fractures.

Introduction: This study was designed to evaluate the incidence of femoral malrotation in bilateral femoral shaft fractures.

Materials And Methods: All closed bilateral femoral shaft fractures in patients aged 18 or over treated between April 2000 and December 2009 were included in the current study. All patients received a postoperative CT-scan to estimate femoral antetorsion and leg length.

Mechanical stability analysis of reference clamp fixation in computer-assisted spine surgery.

Background: Pedicle screw misplacement is a common complication, while 7% may result in neurological complications. Computer-assisted navigation improves the rate of ideally placed screws. Inappropriate reference marker attachment can cause major problems in the outcome and duration of surgery.

Influence of femoral malrotation on knee joint alignment and intra-articular contract pressures.

Introduction: The standard treatment of femoral diaphyseal fractures is intramedullary nailing. Torsion error remains a largely unsolved problem. We hypothesized that femoral malrotation would change the coronal alignment of the lower extremity and the center of force (COF) in the tibiofemoral joint as compared to the native state.

Reliability of computer-assisted surgery as an intraoperative ruler in navigated high tibial osteotomy.

Background: Computer-assisted surgery (CAS) can act as an intraoperative ruler in high tibial osteotomy (HTO) to visualize continuously the leg during surgery.

Questions: The aim of the study is to evaluate the accuracy of CAS with respect to preoperative planning and postoperative deviation from the planned leg axis in HTO. In addition, the influence of surgeon experience as well as operation time and perioperative complications are analyzed.

Navigated reconstruction of a tibial plateau compression fracture post-virtual reconstruction: a case report.

Post-traumatic arthrosis is a common problem following tibial plateau fractures. Computed tomography (CT) with 3D reconstruction is essential in facilitating accurate analysis of the fracture type and depth of compression, but is typically only available pre- or postoperatively. Special reconstruction software tools, based on 3D imaging, have been developed.

Complete dislocation of the talus: a case report using intraoperative 3D fluoroscopy.

Introduction: In a complete dislocation of the talus, the talus is stripped of all its ligament connections in the triple articulated ankle joint. This case report describes the treatment and the 3-year follow-up of a complete dislocation of the talus with the use of intraoperative 3D imaging.

Patients And Methods: The 19-year-old patient was involved as a driver in a car accident.

Navigated minimally invasive thoracolumbar pedicle screw placement with flat panel 3-D imaging. A feasibility study.

Study Design: The current study involves a cadaveric specimen with navigated pedicle screw placement using conventional reference markers and isocentric 3D fluoroscopy and also minimally invasive reference marker use with a flat panel 3D scanner.

Objective: To test the feasibility of a novel minimally invasive reference marker system for navigated pedicle screw placement in combination the use of a new imaging modality i.e.

Robot-assisted fracture reduction using three-dimensional intraoperative fracture visualization: an experimental study on human cadaver femora.

Closed fracture reduction can be a challenging task. Robot-assisted reduction of the femur is a newly developed technique that could minimize potential complications and pitfalls associated with fracture reduction and fixation. We conducted an experimental study using 11 human cadaver femora with intact soft tissues.

Navigated scaphoid screw placement using customized scaphoid splint: an anatomical study.

Introduction: Accuracy in navigated surgery depends on placement and registration of stable reference markers close to the anatomic region of interest. Navigation in small and complex anatomic regions, such as the scaphoid, is challenging due to difficulties in placing a stable reference marker. In the current paper, we describe the use of a customized wrist-positioning device "Scaph-splint" with a built-in reference marker that facilitates navigated scaphoid screw insertion in combination with a 3D imaging device.

Use of a virtual 3D software for planning of tibial plateau fracture reconstruction.

Objective: Anatomical reconstruction of tibial plateau fractures is necessary to prevent pain, axial malalignment, knee join instability and posttraumatic arthritis. Computed tomography (CT) with 3D reconstruction is helpful in the accurate preoperative evaluation and reduction planning of the fracture site. The aim of this study was to describe the application of a virtual 3D reconstruction and segmentation software in the preoperative planning of tibial plateau fractures.

Estimation of pretraumatic femoral antetorsion in bilateral femoral shaft fractures.

Objective: To describe a system for measurement of the pretraumatic femoral antetorsion angle post-bilateral femoral shaft fracture with the use of new imaging software which allows segmentation and three dimensional (3D) reconstruction of DICOM (digital imaging and communications in medicine) images.

Material And Methods: This case involved a 20-year-old patient with bilateral femoral shaft fractures. Following initial clinical examination, CT scans of both femurs were performed.

Three-dimensional measurement of femoral antetorsion: comparison to a conventional radiological method.

Purpose: The aim of our study was to produce a 3-D reconstruction of a CT dataset and compare it to the conventional method, with that same dataset, in terms of precision and the influence of femoral positioning.

Methods: A mechanical support was developed to rigidly fix the femur in a designated position. After measuring the real AT, a CT scan with different femur positions was performed.