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Introduction Fractures of the humeral shaft account for about 3% to 5% of all fractures. Although conservative treatment remains the first choice, there are a number of surgical indications. Minimally invasive plate osteosynthesis shows good functional results. However, complications have been reported, such as non-union. Objective To assess the prevalence and risk factors for non-union after treatment of humeral shaft fractures using minimally invasive plate osteosynthesis. Materials and methods This retrospective study was carried out in patients treated by minimally invasive plate osteosynthesis between 2009 and 2019. Demographic data and variables related to the fracture that could influence bone healing were analysed. The unpaired t-test and Mann–Whitney test were used for the statistical analyses. Categorical variables were analysed using the chi-square test or Fisher's exact test Results The study population showed a male predominance (53 of 75, 70.7%). The average time for fracture healing was 19.8 ± 15.3 weeks. Seven patients developed non-union. Only the presence of an open fracture increased the likelihood of non-union. Conclusions The prevalence of non-union in patients treated by minimally invasive plate osteosynthesis was 9.3%. Patients with open fractures were six times more likely to progress to non-union. Fracture characteristics (Arbeitsgemeinschaft für Osteosynthesefragen classification, fracture location and plate working length) did not influence progression to non-union.

In this paper, we investigated the effect of impurity (aluminum; Al) doping on the resistivity of damascene copper (Cu) interconnects by categorizing it into surface, grain-boundary, and impurity-scattering factors by means of a comprehensive scattering model. Segregation of Al dopant atoms to the interface of the lines increases the resistivity through increased surface scattering. Electromigration (EM)-induced Cu drift is suppressed as the Al concentration increases. The EM lifetime is improved by the suppression of Cu diffusion due to the piled-up Al at the top surface of the Cu interconnects.

Described herein is the technique of performing assisting low-speed and high-speed extra-intracranial bypass, followed by a clinical case report concerning successful application of this technique in trapping of a giant aneurysm of the cavernous portion of the internal carotid artery in a female patient after endured transitory ischaemic attack during the test with temporary balloon-mediated occlusion of the internal carotid artery.

Exploration in neuroendoscopic surgery is occasionally insufficient because of the structural limitations in endoscope. It is not easy to identify the precise position of the endoscope during an operation. We here show a coaxial technique for neuroendoscopic exploration with monitoring by means of a microfiberscope. The endoscopic coaxial technique consists of two scopes. The microfiberscope has a diameter of 0.75 mm, flexible body and high-quality image system. We tested its ability to visualize the subject at several distances and applied this coaxial technique in neuroendoscopic surgery. The microfiberscope not only visualizes the object but also magnifies it by a distance. The scope was easy to handle with monitoring of its movement in the endoscopic view. The technique allowed us to safely explore details which are difficult to approach with an ordinary fiberscope or rigid-rod scope. The microfiberscope also adjusts to the neuronal anatomy and many clinical situations. Taken together, the microfiber coaxial technique might offer new advantages to modern neuroendoscopic surgery.

A 67-year-old man died of subarachnoid hemorrhage (SAH) resulting from dissection of the distal part of the anterior cerebral artery (ACA). A saccular aneurysm in the anterior communicating artery had ruptured and was successfully clipped on Day 0. The patient recovered consciousness after surgery but his condition deteriorated due to another SAH on Day 1. A second surgical procedure disclosed bleeding from a laceration in the opposite wall of the ACA distal to the clipped aneurysm. Histological examination of the autopsy specimens revealed damage to the internal elastic lamina and inflammatory infiltration of leukocytes. The fatal dissection may have resulted from atherosclerosis, hemodynamic stress caused by hypertension, or trauma due to surgical manipulation.

We performed carotid stenting with Wallstent for 22 cases. The mean stenosis was 74.3 ± 11.2% before stenting and 14.2 ± 8.8% after stenting. The technical success (

In a continuous accumulation game on a continuous region, a Hider distributes material over a continuous region at each instant of discrete time, and a Seeker examines the region. If the Seeker locates any of the material hidden, the Seeker confiscates it. The goal of the Hider is to accumulate a certain amount of material before a given time, and the goal of the Seeker is to prevent this. In previous works, we have studied accumulation games involving discrete objects and continuous material over discrete locations. The issues raised when the region is continuous are substantially different. In this paper, we study accumulation of continuous material over two types of continuous regions: the interval and the circle.

A 24-year-old female presented with Terson syndrome secondary to bilateral ventricular hemorrhage as a complication of moyamoya disease. Ophthalmoscopy and magnetic resonance imaging clearly demonstrated vitreous hemorrhage in the left eye globe. Various visual symptoms are associated with moyamoya disease, almost all of which result from ischemic lesions in the visual cortex and optic pathways. In this case, the visual disturbance was caused by Terson syndrome secondary to ventricular hemorrhage. Close ophthalmological and radiological evaluation is mandatory even in patients with moyamoya disease and hemorrhagic manifestation located in the intracerebral, subarachnoid, or intraventricular space.

Functional ceramic films have been receiving great attention because of their potentials for emerging applications, which include integrated sensors, actuators and other devices responding to magnetic, electric, optic and stress fields. Many methods, such as liquid phase epitaxial growth, chemical vapor deposition, melocular beam epitaxial growth, sputtering, lase ablation and chemical solution deposition, have been develped to fabricate thin films with desired properties. Among these methods, the chemical solution deposition method has the advantages of good homogeneity, ease of compositional control, low temperature processing, and large area and versatile csaping with integrated functionalities over vacuum deposition techniques. This paper reviews a part of the authors' results on the chemical processing of some epitaxial ferroelectric, pyroelectirc, and piezoelectric films as well as nonlinear opic films. In addition, the processing and properties of nano-sized functional ceramic perticles/organic hybrids is presented as an examples of novel and promising materials, which are expected to create a emerging area.

In an accumulation game, a hider places objects at locations, and a seeker examines these locations. If the seeker discovers an object, the seeker confiscates it. The goal of the hider is to accumulate a certain number of objects before a given time, and the goal of the seeker is to prevent this. In this paper, we first classify various possible variations on the accumulation game. Next, we discuss the so-called noisy accumulation game in which the hider can observe each action of the seeker. We present the solution of this game for all but some marginal cases and illustrate it with computational examples.

We propose a simple and efficient off-chip coupler for vertical coupling between optical fibers and InP-based slab waveguides. Etching angle of the waveguide edge is controlled by an etching jig made of SiO 2 -coated aluminum for ICP-RIE. Simulation shows that maximum 71% coupling efficiency would be obtained by matrix expansion methods.

Hydrotermal synthesis of calcite single crystals; crystalline morphologie, defects and optical properties.

High- T c superconducting thin films in the Bi Pb Sr Ca Cu O system were prepared through reaction controls in organic solution by a metal-organic route. Thin films with preferred orientation were successfully prepared on MgO (100) single crystal substrates by a dip coating method. The films of the (243) phase (high- T c phase) and the (232) phase (low- T c phase) were synthesized from solutions with composition of Bi:Pb:Sr:Ca:Cu = 2:0.35:2:2:3 and Bi:Sr:Ca:Cu = 2:2:1:2, respectively. The J c of films was much improved through the UV irradiation during calcination as well as the proper selection of composition for starting solutions. A film prepared from a solution composition of Bi:Pb:Sr:Ca:Cu = 2:0.35:2:2:3 with UV irradiation showed the sharp onset of T c at 117 K, zero resistance at 79.5 K and J c of 840 A/cm 2 (77.3 K) after heat treatment at 845°C.

To examine the effectiveness of magnetic resonance (MR) tractography in surgery for cerebral arteriovenous malformations (AVMs).A preoperative evaluation of major neural tracts around the nidus was carried out with 3-tesla (3 T) MR tractography in 25 consecutive patients with cerebral AVMs. The patients were 12 men and 13 women ranging in age from 4 to 60 years of age (mean age: 31.2 +/- 14.1 years). Twelve presented with hemorrhage. Images were obtained with T2-weighted turbo spin echo sequences, axial T1-weighted three-dimensional magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequences, three-dimensional time-of-flight MR angiography (3D TOF MRA), and thin-section diffusion-tensor imaging (DTI).The AVMs were obliterated in 22 of the 25 patients. A postoperative study of the MR tractography was carried out in 24 patients. In 21 patients, tracts were preserved and no postoperative neurological worsening was observed. Disruption of the tracts was found in 3 patients, and postoperative worsening was observed in 2 patients. However, no deterioration occurred in 1 patient with cerebellar AVM.Notwithstanding the limitations of this method, MR tractography can be considered useful for confirming the integrity of deviated tracts, for localizing deviated tracts, and for evaluating surgical risk, especially in cases of non-hemorrhagic AVM.

To introduce our initial experiences using 3-tesla (3T) magnetic resonance (MR) imaging in the treatment of moyamoya disease (MMD).3T MR imaging was used to study 63 consecutive patients with MMD. Evaluation of regional cerebral blood flow (rCBF) was performed with 123IMP-SPECT or 15O2 gas steady-state PET. T2*-weighted gradient-echo imaging was used to study the incidence of asymptomatic cerebral microbleeds (MBs) in the 63 patients. Preoperative targeting of a recipient artery in 12 recent operations for STA-MCA anastomosis on 9 patients was performed as follows. The MR angiography (MRA) and rCBF data sets were registered with the MPRAGE data set through the coregistration function of the SPM2 software in order to obtain a fusion of all images. In the fusion images of the MRA and rCBF images, we selected the cortical artery with the largest diameter as the target recipient artery from the candidates located on or near the cortex where the rCBF was markedly decreased.Asymptomatic MBs were found in 25 (40%) of the 63 patients and a successful bypass to the target was achieved in all 12 operations.Use of 3T MR imaging provides new types of information for the treatment of MMD.

The silicide formation characteristics from composition profiles created on Si by codepositions was investigated. It was shown that a thin interfacial amorphous TiSix layer, with x∼0.5–1, deposited between Si and the Ti film led to a significant reduction in the observed C49→C54 TiSi2 transformation temperature. The presence of the amorphous interfacial TiSix layer slowed down the initial silicidation rate, but promoted the nucleation of the final C54 TiSi2 phase. Predeposition and preannealing were also found to facilitate the growth of C54 TiSi2, as was growth from codeposited full TiSix layers with Ti-rich compositions. The efficacy of the (interfacial) TiSix layer was demonstrated for different temperature ramp rates and for a variety of substrates including undoped α-Si, preamorphized n+-Si, and preamorphized p+-Si. But this effect was found to be absent on single crystal Si. Possible mechanisms of the observed effects were discussed.

Nanocomposites have been prepared through the intercalation of poly(amido amine) dendrimers with carboxylate terminals into hydrotalcite clays. The formation of nanocomposites by anion exchange during incubating at 70 °C was investigated at various compositions with increasing dendrimer content in water and was assessed by Fourier transform IR absorption spectroscopy, X-ray diffraction, small-angle X-ray scattering, and elemental analysis. The dendrimer diffused into the clay galleries: the spacing between the clay layers (sheets) increased from its intrinsic value of 3.2 to 20–23 A, and the mass fraction of the dendrimer in the composite was around 0.50 for mixing ratios (charge of clay to carboxylate of the dendrimer) higher than 1:2, indicating the saturated intercalation of the dendrimer in the clay. The dendrimers are densely packed with an ellipsoidal structure in the interlayer. At a mixing ratio of 1:8, there was excess adsorption of the dendrimer on the clay surface besides the intercalation and initial adsorption.

0.1 /spl mu/m rule magnetic random access memory (MRAM) was developed using double-layered hard mask of SiO/sub 2//metal. 30% magnetoresistance ratio under switching operation, read and write characteristics for MRAM cell with 0.1/spl times/0.6 /spl mu/m/sup 2/ were observed using current induced magnetic field. It is found that switching current of tunneling magnetoresistance (TMR) device with 0.1 /spl mu/m length can be reduced by thinning free layer and reduction of TMR aspect ratio.

The purpose of this study was to describe the findings of sequential magnetic resonance imaging (MRI) in postresuscitation encephalopathy. Although its outcome is known to be overwhelming, but its acute findings by variable imaging methods are subtle and show only limited values. The correlation of the findings of MRI with clinical outcome were also analyzed.Twelve patients with global cerebral anoxia who underwent MRI with conventional and diffusion-weighted imaging were enrolled in this study. Compared with normal MRI images, abnormal signal regions were checked and described in cortex, basal ganglia and white matter. Also medical records were carefully reviewed to study the cause, the time necessary for resuscitation and long term clinical outcome.The earliest finding was obtained by diffusion-weighted image less than 24 hours (acute period) in bilateral cerebral cortex as bright high signal intensity regions. Similar abnormality of bright high signal area in FLAIR and T 2 was followed according to the time elapsed in early subacute period (1-13 days). Succeedingly, white matter was involved and laminar necrosis in cortical area was observed in late subacute period (14-20 days). Finally, diffuse brain atrophy and obtundation of gray-white matter junction were seen in chronic stage (after 21 days). These MR findings were coincided well with histopathological findings reported in literatures. The poor outcome was closely and significantly correlated with abnormality in MR images.MRI was a useful diagnostic modality to diagnose the whole brain ischemic encephalopathy and to predict the prognosis.

A 61-year-old man was admitted to our hospital for mild left hemiparesis and speech disturbance. An initial angiogram revealed occlusion of the right internal carotid artery (ICA) but with sufficient collateral flow by compensated the contralateral carotid artery. Severe stenosis (70%) in the intracavernous (C4-5) portion was identified in the left ICA. Cerebral blood flow was remarkably decreased in both hemispheres. The patient's hemiparesis fluctuated according to the systemic blood pressure in such a manner that induced hypertension therapy was mandatory. On the 19th hospital day, we performed stenting of the left ICA stenosis using a coronary stent. A flexible coronary stent, NIR PRIMO stent 3.0 mm/16 mm (SCIMED, Boston Scientific) was deployed after the predilatation (2.5 mm/10 atm). The initial 70% stenosis was reduced to 6% after the postdilatation (3.75 mm/8 atm). The neurological status was stable after the procedure and we stopped the induced hypertension therapy the next day. We consider that intracranial artery stenting will be a common therapeutic modality in the near future.

A 24-year-old female presented with Terson syndrome secondary to bilateral ventricular hemorrhage as a complication of moyamoya disease. Ophthalmoscopy and magnetic resonance imaging clearly demonstrated vitreous hemorrhage in the left eye globe. Various visual symptoms are associated with moyamoya disease, almost all of which result from ischemic lesions in the visual cortex and optic pathways. In this case, the visual disturbance was caused by Terson syndrome secondary to ventricular hemorrhage. Close ophthalmological and radiological evaluation is mandatory even in patients with moyamoya disease and hemorrhagic manifestation located in the intracerebral, subarachnoid, or intraventricular space.

We report herein the case of a 56-year-old woman who presented with repeated transient ischemic attacks (TIAs). Cerebral angiography revealed that the left redundant internal carotid artery (ICA) uncharacteristically curved medially. These findings were highly suggestive of an internal carotid artery aneurysm at the level between the first and second cervical vertebral bodies. The lesion was presumed to be difficult to access by the surgical procedure usually adopted in carotid endarterectomy. Thus, we decided to employ a modified vertical mandibular osteotomy. The operative view revealed that the lesion was atherosclerotic stenosis with ulceration, so carotid endarterectomy was indicated. This mandibular osteotomy not only provided us with wide, satisfactory exposure of the distal cervical internal carotid artery but also afforded good mandibular stability during the postoperative period.

We reported the preliminary results of percutaneous transluminal angioplasty (PTA) supported with a self-expanding stent (Wallstent) for the cervical internal carotid artery (i.c.) stenosis in 6 patients (7 lesions). All were male aged from 60 to 79 (mean 70.8). Three patients were symptomatic and 3 were asymptomatic. The procedure was attempted in patients with severe i.c. stenosis according to criteria of NASCET, ECST or ACAS studies and with high risk if carotid endarterectomy (CEA) were performed. In all cases, vascular access was from the femoral artery and angioplasty was performed without cerebral protection. Successful angioplasty was obtained in all cases with no mortality. Stenosis was improved from 82.7% (74-90%) to 17.4% (10-33%). Perioperative complications were seen in only one case with TIA during the postdilatation period, which was supposed to be due to a distal embolism. The preliminary results of PTA supported with self-expanding stent for severe i.c. stenosis were excellent. These results suggested that some patients with severe i.c. stenosis can be treated safely and effectively by stent-supported PTA. However, it is necessary to mark the indications clear and strict, and to follow up these lesions after the procedure, because of the possibility of perioperative ischemic complications and restenosis.

It is very important to make a prompt and accurate diagnosis and to commence pertinent treatment for patients suffering from acute cerebrovascular occlusive disease. Thirteen patients (mean age: 67.1 years) with basilar artery occlusion (BAO) were enrolled in this study. Dynamic computed tomography functional images (FID-CT) were analysed to determine whether this method could diagnose BAO in the acute phase. The functional images were categorized into 3 groups: (1) group A (n = 5) showed abnormalities on corrected mean transit time (cMTT) images and time-to-peak (TP) images in the territory of the posterior cerebral artery (PCA) and in the thalamus, (2) group B (n = 6) only showed abnormalities on TP images, and (3) group C (n = 2) had no abnormalities on either cMTT or TP images. The group C patients had poor time-density curves because of heart disease. Although the results may sometimes be false negative and this limitation should be kept in mind, FID-CT seem to be useful not only for defining patients who need angiography but also those who need thrombolytic therapy for acute BAO.

BACKGROUND--Plasma concentrations of A type or atrial natriuretic peptide (ANP) and B type or brain natriuretic peptide (BNP) are increased in patients with congestive heart failure (CHF). OBJECTIVE--To examine the haemodynamic and hormonal responses, especially of ANP and BNP, to oral administration of an angiotensin-converting enzyme (ACE) inhibitor in patients with CHF and in controls. PATIENTS--12 patients with CHF and 11 controls. METHODS--Haemodynamic variables and plasma concentrations of ANP, BNP, and other hormones were serially measured for 24 hours after alacepril (37.5 mg) was given by mouth. RESULTS--Pulmonary capillary wedge pressure and systemic vascular resistance decreased significantly in both groups. The cardiac index increased only in the CHF group. In patients with CHF pulmonary capillary wedge pressure, systemic vascular resistance, and cardiac index were significantly changed from 1 to 12 hours after alacepril administration. Plasma ANP and BNP decreased significantly after alacepril was given to the CHF group: neither concentration changed in the control group. In the CHF group plasma ANP was significantly lower between 1 and 6 hours and was highly significantly correlated with pulmonary capillary wedge pressure. Plasma BNP, however, was significantly lower between 6 and 24 hours after alacepril and was not correlated with pulmonary capillary wedge pressure. CONCLUSIONS--The response of plasma BNP after alacepril administration occurred later and lasted longer than the plasma ANP response. This may indicate that the mechanisms of synthesis, secretion, or degradation of the two peptides are different.

In ann-person game, corresponding toMilnor's upper bound,b (i), a quantitym (i) is defined, which is a lower bound ofXi whenx belongs to the kernel. In the case of the bargaining set, it is shown for particular games thatb (i),m (i) are bounds ofxi.

The phase transition and critical behaviour of the site-diluted three-dimensional antiferromagnet Mn0.45Zn0.55F2 have been studied using magnetisation and specific heat measurements. The measurement of the static susceptibility under an extremely weak external field shows a divergence at the Neel temperature, which originates from the coupling between uniform and staggered fluctuations. On increasing the external field, the transition peak reveals a rounding and the remanent magnetisation increases, which is consistent with the destruction of the phase transition under random magnetic fields. The specific heat in zero field reveals the usual lambda -shaped transition, and the peak of the transition shows a remarkable rounding with increasing external field. These results are consistent with recent neutron scattering studies and prove that the long-range order in a three-dimensional system with Ising symmetry is destroyed in a random field.

Magnetic susceptibility measurements have been made of the effect of applying a field on the critical divergence of the parallel susceptibility of the dilute antiferromagnets MncZn1-cF2 (c=0.45 and 0.6). The diverging susceptibility at the Neel temperature under an extremely weak external field, which originates from the coupling between uniform and staggered fluctuations, is suppressed with increasing magnetic field. This and the appearance of the remnant magnetisation below the Neel temperature suggest that the phase transition in these systems is destroyed by the induced random magnetic fields and the system splits into micro-domains.

Objective The intra-arterial infusion of papaverine has been used for dilation of spastic cerebral vessels after aneurysmal subarachnoid hemorrhage, although its efficacy is controversial. Milrinone is an inotropic drug that dilates vessels by phosphodiesterase inhibition in a mechanism similar to that of papaverine. We examined the effects of intra-arterial and subsequent intravenous administration of milrinone on patients with symptomatic cerebral vasospasm. Methods Seven patients with cerebral vasospasm were enrolled in this study. Milrinone was delivered intra-arterially via catheter at a rate of 0.25 mg/min. The total delivered dose was between 2.5 and 15 mg. Radiological measurement of the middle cerebral artery diameter and cerebral blood flow was carried out before and after arterial infusion. Intravenous treatment followed at 0.50 or 0.75 microg/kg/min for up to 2 weeks from the onset of subarachnoid hemorrhage. Results Dilation of the vasospastic vessels occurred in all patients. The rate of cerebral blood flow was calculated in six patients and was increased in all. Subsequent intravenous infusion was effective in preventing a recurrence of symptomatic vasospasm in four of the seven patients. Conclusion It is suggested that milrinone was effective and safe for the treatment of cerebral vasospasm after subarachnoid hemorrhage in the patients in this series. Intra-arterial infusion with adjunctive intravenous infusion holds promise as a clinically advantageous treatment regimen.