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PubMedDate not supplied

The Modular Propad and the Softform mattress.

Constant low-pressure supports such as soft mattresses can feel comfortable because they conform well to the shape of the body. When such mattresses are provided with a highly convoluted surface made up of contiguous foam pillars, their efficacy is improved. The Modular Propad is a highly convoluted, but shallow, foam mattress. It is used as an overlay for an ordinary mattress and seems to be superior to earlier forms of convoluted foam overlay. The Softform is a new mattress which has replaceable sections. The outermost sections of the Softform are convoluted foam sheets similar to the Modular Propad. This article discusses the advantages and disadvantages of these products and some potential problems with their covers. It also suggests that the use of a pressure sore risk assessment tool can facilitate the allocation of patients to these special supports.

Beds↗

PubMed1991

Corrosion of modular hip prostheses.

Nine uncemented hip prostheses of modular design were revised because of late infection (2 cases), femoral stem loosening or fracture (2), loosening of threaded cups (3) and protrusion of bipolar cups (2). At surgery we found tissue discoloration and macroscopic corrosion in four of the nine prostheses, located at the head-neck junction. Histological examination in most cases showed extensive necrosis associated with metal particles, indicating metal toxicity. Metallographic examination of the prosthetic heads revealed structural imperfections and inhomogeneity of the metal. We suggest that the crevice between the head and neck is a potential site of corrosion in modular designs.

Adolescent↗

PubMed2025

Modularization of the type II secretion gene cluster from Xanthomonas euvesicatoria facilitates the identification of a structurally conserved XpsCLM assembly platform complex.

Many bacterial pathogens depend on a type II secretion (T2S) system to secrete virulence factors from the periplasm into the extracellular milieu. T2S systems consist of an outer membrane secretin channel, a periplasmic pseudopilus and an inner membrane-associated assembly platform including a cytoplasmic ATPase. The components of T2S systems are often conserved in different bacterial species, however, the architecture of the assembly platform is largely unknown. Here, we analysed predicted assembly platform components of the Xps-T2S system from the plant-pathogenic bacterium Xanthomonas euvesicatoria. To facilitate these studies, we generated a modular xps-T2S gene cluster by Golden Gate assembly of single promoter and gene fragments. The modular design allowed the efficient deletion and replacement of T2S genes and the insertion of reporter fusions. Mutant approaches as well as interaction and crosslinking studies showed that the predicted assembly platform components XpsC, XpsL and XpsM form a trimeric complex which is essential for T2S and associates with the cytoplasmic ATPase XpsE and the secretin XpsD. Structural modeling revealed a similar trimeric architecture of XpsCLM homologs from Pseudomonas, Vibrio and Klebsiella species, despite overall low amino acid sequence similarities. In X. euvesicatoria, crosslinking and fluorescence microscopy studies showed that the formation of the XpsCLM complex is independent of the secretin and vice versa, suggesting that the assembly of the T2S system is a dynamic process which involves the association of preformed subcomplexes.

Xanthomonas↗

PubMed1997

Modular organization of Pax/homeodomain proteins in transcriptional regulation.

Specificity in transcriptional regulation lies in a large part in the specificity of DNA binding by transcription factors. One group of transcription factors which are of great interest for studying transcriptional specificity is the Pax/Homeodomain (Pax/HD) proteins which contain two conserved DNA binding domains, a paired domain (PD) and a Paired-class homeodomain (HD). The Pax/HD proteins can bind to at least three types of specific DNA sequences: the PD binding sites, the dimeric HD binding sites and a composite HD and PD binding site. We propose that Pax/HD proteins regulate different subsets of their target genes through modular binding to one of these three specific sequences. We show that, in a tissue culture system, a member of the Pax/HD family, Paired, is able to activate transcription after binding through either its PD or its HD. The transactivation mediated by one domain does not require DNA binding of the other domain. Furthermore, binding sites specific for the PD of Paired are sufficient to mediate embryonic expression of a reporter gene in a paired-like pattern. The expression of the reporter gene is dependent on wild type paired function and, in a prd mutant background, it can be rescued by an exogenous paired gene encoding a protein whose HD is not able to bind to DNA. Finally, we show that the Paired protein uses differently its C-terminal activation domain when transactivation is mediated through its PD or its HD. These results and recent evidence from other Pax/HD proteins strongly suggest that this class of proteins is able to achieve specific and modular transcriptional regulation through its multiple DNA binding domains.

Animals↗

PubMed1997

Horizontal projections of area 17 in Cebus monkeys: metric features, and modular and laminar distribution.

Metric features and modular and laminar distributions of intrinsic projections of area 17 were studied in Cebus apella. Anterogradely and retrogradely labeled cell appendages were obtained using both saturated pellets and iontophoretic injections of biocytin into the operculum. Laminar and modular distributions of the labeled processes were analyzed using Nissl counterstaining, and/or cytochrome oxidase and/or NADPH-diaphorase histochemistry. We distinguished three labeled cell types: pyramidal, star pyramidal and stellate cells located in supragranular cortical layers (principally in layers IIIa, IIIb alpha, IIIb beta and IIIc). Three distinct axon terminal morphologies were found, i.e., Ia, Ib and II located in granular and supragranular layers. Both complete and partial segregation of group I axon terminals relative to the limits of the blobs of V1 were found. The results are compatible with recent evidence of incomplete segregation of visual information flow in V1 of Old and New World primates.

Animals↗

PubMed1994

Migration of corrosion products from modular hip prostheses. Particle microanalysis and histopathological findings.

Migration of solid corrosion products from the modular head-neck junction of fifteen total hip replacements to the periprosthetic tissues was studied. The devices and tissues were recovered at the time of a revision procedure or at autopsy after a mean of sixty-four months (range, eight to ninety-seven months). The prostheses had a cobalt-chromium-alloy head coupled with a cobalt-chromium-alloy or a titanium-alloy stem. The solid corrosion product was identified by electron microprobe analysis and Fourier transform infrared microprobe spectroscopy as a chromium orthophosphate hydrate-rich material. The product was present at the junction of the modular head and neck and as particles within the periprosthetic tissues as early as eight months postoperatively. In several hips, it was also present on the polyethylene bearing surface. The particles in the tissues ranged in size from less than one to 500 micrometers. They were present within histiocytes or were surrounded by foreign-body giant cells in the pseudocapsule of the hip joint; in the membranes of the femoral bone-implant interface; and at sites of femoral endosteal erosions, with and without loosening of the femoral component.

Adult↗

PubMed1997

The press-fit condylar modular total knee system. Four-to-six-year results with a posterior-cruciate-substituting design.

One hundred and eighteen patients who had had 150 consecutive primary total knee replacements (sixteen bilateral procedures) between February 1988 and February 1990, with insertion of the press-fit condylar modular total knee system with cement, were enrolled in a prospective study. Ninety-six patients (125 knees) were followed for an adequate interval (mean, 4.8 years; range, 3.8 to 6.2 years). Thirteen patients (fifteen knees) died, and nine patients (ten knees) were lost to follow-up. The mean age of the patients at the time of the index arthroplasty was seventy years (range, twenty-nine to eighty-five years). The patients were evaluated clinically and radiographically, according to the scoring system of the Knee Society, and the results on a self-administered questionnaire were used to evaluate pain, function, satisfaction, and patellofemoral symptoms. A Kaplan-Meier survivorship analysis was performed with a revision operation as the end point. The mean functional and clinical scores, according to the system of the Knee Society, were 78 and 93 points, respectively, at the most recent follow-up examination. The result was excellent for 103 knees, good for thirteen, fair for three, and poor for six. Three revision operations were necessary: two because of infection and one because of instability. The over-all rate of patellofemoral symptoms was 8 per cent (ten knees). Three knees had tibiofemoral instability; subsequent modification of the design of the tibial cam decreased the prevalence of this problem. Non-progressive radiolucent lines were present at the cement-bone interface in 39 per cent (thirty-nine) of the ninety-nine knees that had complete radiographic follow-up. No prosthesis had loosened by the time of the most recent follow-up examination. The rate of survival of the implant was 97 per cent at six years, and the standard error of the mean was 1.6 per cent. In the present series, total knee arthroplasties with the press-fit condylar modular knee system resulted in excellent relief of pain, an excellent range of motion, and restoration of function. They were also associated with a low prevalence of patellofemoral problems.

Adult↗

PubMed1983

Isometric muscle strength and endurance after knee arthroplasty with the modular knee in patients with osteoarthrosis and rheumatoid arthritis.

Maximum isometric muscle strength and endurance were used in an investigation of knee extension and knee flexion in patients with rheumatoid arthritis (RA) and osteoarthrosis (OA) with such severe changes of the joint that arthroplasty with the Modular prosthesis was performed. The measurements were done preoperatively and 3, 12, 24 and 36 months postoperatively. Muscle strength preoperatively was very weak compared with that of a group of healthy persons. The muscle strength 3 months postoperatively remained unchanged, which could mean a very slight trauma from the operation, very good pain relief and efficient physiotherapy. During the first 2 years the maximum isometric muscle strength was significantly increased both in patients with RA and in those with OA. Thereafter there was no increase in the RA patients, whereas in women with OA there was an improvement up to 3 years postoperatively. The improvement in the flexion strength was greater than that of the extension strength, thus indicating the importance of postoperative training of extension strength. Isometric muscle strength measurements show that there is an equalization between the non-diseased knee and the one operated with the Modular knee.

Aged↗

PubMed1997

A modular endoprosthetic system for tumor and non-tumor reconstruction: preliminary experience.

Though originally designed to facilitate the management of primary malignant bone tumors, the indications for the Howmedica Oncology modular endoprostheses have expanded to include the reconstruction of metastatic lesions, failed internal fixation of difficult trauma problems, and failed conventional and custom tumor endoprostheses. Between July 1989 and August 1992, 24 patients underwent 25 procedures, either proximal humeral replacement (7), proximal femoral replacement (5), distal femoral replacement (9), or total femoral replacement (4). Diagnoses included primary bone tumor (6), metastases (5), and failed previous orthopedic intervention (14). Two early and four late complications in five patients were all treated successfully with surgical or nonoperative treatment. Preliminary functional results indicate very satisfactory results. Modular endoprostheses appear to be effective in the treatment of a wide range of diagnoses, not limited to the reconstruction following primary malignant bone tumor resections.

Adolescent↗

PubMedDate not supplied

The canine cemented modular total hip prosthesis.

Total hip replacement (THR) is well established as a treatment modality for dogs with noninfectious, nonneoplastic, disabling conditions of the coxofemoral joint. Since the mid 1970s, a fixed-head prosthesis has been used in this procedure. A modular prosthesis, which is based on many of the technical advances found in human prostheses, now is available for use in veterinary medicine. The prosthesis, surgical instrumentation, surgical technique, and clinical results have been evaluated in a prospective study conducted at The Ohio State University's College of Veterinary Medicine. The modular prosthesis provides results equal to or better than the fixed-head prosthesis.

Animals↗

PubMed1993

Optimum pressfit and proximal stress transfer with an improved modular design in total hip arthroplasty.

Femoral stem pressfit fixation depends on optimal proximal fit and stress transfer for long-term function. Newer modular designs offer improvements that enhance proximal-distal sizing, anatomical canal fill in the proximal metaphysis, and better stress transfer resulting from more intimate cortical contact. The Infinity modular femoral stem has the unique advantage of very proximal loading and gains fixation with a flexible stem that allows matching the variables of anteversion and proximal metaphyseal bow.

Body Constitution↗

PubMed1994

Clinical and laboratory investigations of fretting and corrosion of a three-component modular femoral stem design.

A retrieval analysis of three modular femoral stems in vivo up to 25 months were examined using laboratory-based comparisons of similar devices as controls. The internal taper connection of each retrieved femoral component, and the laboratory controls were evaluated using SEM, EDAX, and epoxy vacuum infiltration. No corrosion of the substrate was detected for any of the retrievals. Fretting was mild on one retrieval and the in vitro-fatigued component, whereas minor fretting was observed for the other retrievals. Particulate debris was not evident as revealed by the epoxy infiltrate of the modular junction.

Adult↗

PubMedDate not supplied

Impact on human resources: Core Laboratory versus laboratory information system versus modular robotics.

Technological advances in laboratory systems have had a great impact on human resources. Surviving the changes requires an in-depth understanding of the technology to implement the appropriate operational model. St. Mary's is a 414-bed, acute care hospital. For 18 months, the laboratories went through the process of moving from a noncomputerized traditional model laboratory (i.e., by discipline) to a fully computerized Core Lab. The Core Lab concept fully integrates biochemistry, hematology, blood bank, and microbiology into two sections (not physically separated): tests processed by automation and tests processed manually. This approach led to a 15% reduction in staff while the volume doubled. The transitions occurred sequentially: from traditional laboratory to Core Lab (noncomputerized), from manual Core Lab to fully computerized Core Lab, and ultimately from a simulation of manual preanalytical phase to automated preanalytical phase (modular robotics). The findings show that Core Lab and computerization have almost the same impact on human resources, 35% and 30% respectively, and modular robotics the least impact with 17%.

Clinical Laboratory Information Systems↗

PubMed1999

Patellofemoral complications after total knee arthroplasty: a comparison of Modular Porous-Coated Anatomic with Duracon prostheses.

Clinical and radiographic analyses were used to compare results obtained in 45 patients who underwent a Modular Porous-Coated Anatomic total knee arthroplasty with results in a similar group of 45 patients who underwent a Duracon total knee arthroplasty. The surgeries were consecutively performed over an 8-month period, and follow-up evaluation averaged 63 months. The two patient groups were similar with regard to the following variables: age, sex, diagnosis, height, weight, and preoperative and postoperative activity levels. Whereas both Duracon and Modular total knee arthroplasty prostheses yielded similar results approximately 5 years after surgery, the data suggest that Duracon appears to minimize patellofemoral complications.

Adult↗

PubMed1992

Modular hemiarthroplasty for fractures of the proximal part of the humerus.

A new biomodular prosthesis was used for the treatment of a displaced fracture of the proximal part of the humerus in twenty-two shoulders in twenty-two patients. The fractures were classified according to the Neer system; there were thirteen four-part, five three-part, and four head-splitting fractures. There were fifteen women and seven men, and the mean age was seventy years (range, forty-nine to eighty-seven years). The hemiarthroplasty was performed an average of eleven days (range, one to forty-five days) after the injury. The deltopectoral interval was used in all patients, and the prosthesis was implanted with cement in twenty of the shoulders. All of the patients participated in a supervised program of rehabilitation. The patients were followed for an average of thirty-six months (range, twenty-six to forty-nine months). Twenty of the twenty-two patients had a good or excellent result. The active forward elevation averaged 119 degrees; external rotation, 40 degrees; and internal rotation, to the twelfth thoracic vertebra. All of the patients except for the two who had a poor result had satisfactory relief of pain. The two patients who had a poor result had a successful revision with a modular prosthesis of the same design. The modular head could be removed, enabling the surgeon to gain access to the glenoid and to adjust the soft tissues. The over-all scores correlated inversely with the age of the patients and the interval from the injury to the operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1991

Resection of malignant bone tumors about the shoulder. A preliminary report of reconstruction with a new modular spacer.

Reconstruction after resection of malignant bone tumors about the shoulder is difficult. Twelve patients had reconstruction using a new titanium modular spacer. This modular system allows the surgeon to reconstruct variable lengths of the proximal humerus. Although the patient has no active shoulder motion, excellent hand and elbow function is preserved. The spacer serves as a temporary device in the young active patient. A more definitive reconstructive procedure can be performed after the completion of chemotherapy and a sufficient disease-free interval.

Adolescent↗

PubMedDate not supplied

[Preparation of and stability studies on enteral modular diets at the Pharmacy Service].

It is generally admitted fact in daily medical practice in some patients who require to be fed artificially, the treatment must always be directed, whenever possible, through "enteral route". There are patients whose nutritional needs cannot adapt to the standardized diets available in the market. In these cases it is necessary to draw up individualized diets for them, planned derived from the modules. It is equally known that there is always a problem to obtain, at the available means in the pharmaceutical services, established modular diets. It is described in this report a method of planning a modular enteral diets, physic-chemically stable and contaminating bacteria free. It is also detailed the election of adequate emulsion and stabilizer and the final concentration of each of these in the diets of different composition quali and quantitatively.

Enteral Nutrition↗

PubMed1989

Intrastriatal grafts derived from fetal striatal primordia. I. Phenotypy and modular organization.

Fetal striatal grafts display a striking modularity of composition. With acetylcholinesterase (AChE) histochemistry, the tissue of such grafts can be divided into regions with strong AChE staining of the neuropil and regions in which AChE staining of the neuropil is weak. In the experiments reported here, we reexamined the nature of this modularity. Striatal grafts were made by injecting dissociated cells of E15 ganglionic eminence into the striatum of adult rats, which 7 days before had recived intrastriatal deposits of ibotenic acid. Some donors had been exposed to 3H-thymidine at E11-E15. After 9-17 month survivals, the anatomical organization of the grafts was studied by histochemistry, immunohistochemistry, and autoradiography. In every graft, the AChE-rich regions formed patches (P regions) in a larger AChE-poor surround (NP regions). Neurons labeled with 3H-thymidine appeared in both P and NP regions, suggesting that donor cells were distributed in each type of region and that neither type of tissue, P or NP, was composed exclusively of host tissue. In the AChE-rich P regions, markers characteristic of normal perinatal and mature rat striatum were expressed by medium-sized cells: calcium-binding protein (calbindin D28k) immunostaining, metenkephalin (mENK) immunostaining, and, more rarely, somatostatin (SOM) immunostaining. In the NP regions, however, medium-sized cells expressing calbindin and mENK immunostaining were very rare, and there was an abundance of neuronal types not found in normal mature striatal tissue. These included (1) large, multipolar, calbindin-positive neurons with well-ramified, densely stained dendrites, (2) large, SOM-positive neurons with prominent dendritic trees, and (3) mENK-positive cells smaller than typical striatal, medium-sized, mENK-immunoreactive neurons. In Nissl stains, the AChE-rich P regions resembled the normal striatum of mature animals, whereas the AChE-poor NP regions did not. These findings suggest that the P regions of fetal striatal grafts achieve a phenotypy similar to that of normal striatum at maturity and during much of postnatal development. The dominant expression of perikaryal calbindin-like immunoreactivity in the P regions further suggests that these zones have a high proportion of tissue resembling striatal matrix. By contrast, expression of marker antigens in the NP zones of the grafts suggests that these zones are predominantly composed of nonstriatal tissue or that they have the phenotypy of immature striatum intermixed with some nonstriatal cells.(ABSTRACT TRUNCATED AT 400 WORDS)

Acetylcholinesterase↗