Stryker (Japan)

Diamond is a promising next-generation semiconductor because of its wide bandgap, high thermal conductivity, and excellent electrical properties. Microwave Plasma Chemical Vapor Deposition (MPCVD) method has been widely used for high-quality diamond epitaxial growth, but the process involves complex interactions among electromagnetic field, plasma dynamics, heat transfer, mass transport, and chemical reactions in the reactor. To analyze these phenomena, we developed a specialized simulation software, DiaDeMoTM, for modeling diamond epitaxial growth using MPCVD method. This software enables quantitative prediction of growth rate of diamond, and support reactor and process optimization. Using DiaDeMo, we investigated effect of pressure and microwave power to plasma density, temperature, radical species distributions, and growth rate on the substrate. Moreover, the simulation results were validated through comparison with optical emission spectroscopy measurements.

Surgical site infections remain a dreaded complication of orthopaedic surgery, affecting both patient economics and quality of life. It is important to note that infections are multifactorial, involving both surgical and patient factors. To decrease the occurrence of infections, surgeons frequently use local modalities, such as methicillin-resistant Staphylococcus aureus screening; preoperative bathing; intraoperative povidone-iodine lavage; and application of vancomycin powder, silver-impregnated dressings, and incisional negative-pressure wound therapy. These modalities can be applied individually or in concert to reduce the incidence of surgical site infections. Despite their frequent use, however, these interventions have limited support in the literature.

The null hypothesis of this study states that routine axial computed tomography (CT) images are obtained at a consistent and reproducible orientation relative to the sacrum. The secondary null hypothesis states that there is no difference in the measurement of the safe zone for placement of iliosacral screws when using routine axial CT images and standardized reconstructions in defined planes perpendicular and parallel to the sacrum. Retrospective review. University Level 1 Trauma Center. Sixty-eight consecutive trauma patients evaluated with routine pelvic CT, without pelvic ring injury. Retrospective radiographic review and measurement. Sixty-eight consecutive adult patients with routine axial pelvic CT scans, without injury to the pelvic ring, and obtained as part of a trauma evaluation were retrospectively identified. The orientation of the axial slices relative to the sacrum was measured for each patient and compared. The maximal cross-sectional distance at the smallest section of the sacral ala (safe zone) was measured using the routine axial CT images, and these measurements were compared with similar measurements taken on standardized images perpendicular (CT inlet) and parallel (CT outlet) to the body of the sacrum. Additional data referencing the orientation of multiple sacral radiographic landmarks were also collected. The orientation of routine axial CT image planes relative to the sacrum spanned a wide range. The angle between the routine axial CT plane and the sacrum varied from 43.5 to 82.0 degrees (SD = 9 degrees). Significant differences were found in measured safe zones of routine axial CT images compared with standardized CT inlet and CT outlet images. Compared with CT inlet images, routine axial CT images underestimated safe zones for transverse sacral screws at both S1 (P < 0.01) and S2 (P < 0.01). When compared with CT outlet images, routine axial CT images overestimated safe zones for oblique sacroiliac screws (P < 0.01) and underestimated the safe zone for S2 transverse sacral style screws (P < 0.01). No significant differences in measured variables were found between genders and sacral morphology. Our null hypotheses were rejected: routine axial CT images were found to be at widely ranging orientations relative to the sacrum, and standardized CT images (CT inlet and CT outlet) demonstrated statistically significant differences in measurements of safe zones compared with routine axial CT images. Furthermore, the CT inlet and CT outlet views provide additional information regarding sacral landmarks that could be useful for preoperative planning.

This guideline supersedes a prior one from 2007 on a similar topic. The work group evaluated the available literature concerning various aspects of patient screening, risk factor assessment, and prophylactic treatment against venous thromboembolic disease (VTED), as well as the use of postoperative mobilization, neuraxial agents, and vena cava filters. The group recommended further assessment of patients who have had a previous venous thromboembolism but not for other potential risk factors. Patients should be assessed for known bleeding disorders, such as hemophilia, and for the presence of active liver disease. Patients who are not at elevated risk of VTED or for bleeding should receive pharmacologic prophylaxis and mechanical compressive devices for the prevention of VTED. The group did not recommend specific pharmacologic agents and/or mechanical devices. The work group recommends, by consensus opinion, early mobilization for patients following elective hip and knee arthroplasty. The use of neuraxial anesthesia can help limit blood loss but was not found to affect the occurrence of VTED. No clear evidence was established regarding whether inferior vena cava filters can prevent pulmonary embolism in patients who have a contraindication to chemoprophylaxis and/or known VTED.

During the past 10 years, there has been a worldwide effort in all medical fields to base clinical health care decisions on available evidence as described by thorough reviews of the literature. Hip fractures pose a significant health care problem worldwide, with an annual incidence of approximately 1.7 million. Globally, the mean age of the population is increasing, and the number of hip fractures is expected to triple in the next 50 years. One-year mortality rates currently range from 14% to 36%, and care for these patients represents a major global economic burden. Surgical options for the management of femoral neck fractures are closely linked to individual patient factors and to the location and degree of fracture displacement. Nonsurgical management of intracapsular hip fractures is limited. Based on a critical, evidence-based review of the current literature, we have found minimal differences between implants used for internal fixation of displaced fractures. Cemented, unipolar hemiarthroplasty remains a good option with reasonable results. In the appropriate patient population, outcomes following total hip arthroplasty are favorable and appear to be superior to those of internal fixation.