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Prehospital stabilization of pelvic dislocations: a new strap belt to provide temporary hemodynamic stabilization.

High energy pelvic fractures or dislocations are associated with a high rate of early complications, due to the associated intrapelvic organs. The high rate of early mortality is mostly due to the intrapelvic, retroperitoneal bleeding caused by the laceration of vascular structures located in the presacral area. External compression of the pelvic ring, using such devices as PASG or external fixators may prevent the intrapelvic collection of large hematomas by providing indirect tamponade. Unfortunately, these devices are either unavailable on the accident site, or the complexity of their handling is discouraging for the primary care-taker. A simple system of external pelvic compression which could be applied on the scene of trauma consisting of a pelvic strap-belt was therefore developed. The application of the device is easy, quick (30 seconds) and straightforward. Its use does not induce any known complications and requires minimal training. The cost and transportability of the system are further advantages. The system has already been used in 19 patients equipped on accident scene. Our first experiences using this device are reviewed.

Adult↗

Stability of the hexagonal lattice structure formed by an R-form lipopolysaccharide of Klebsiella: decrease in the stability by electrodialysis and recovery by addition of the magnesium.

The R-form lipopolysaccharide (LPS) from Klebsiella strain LEN-111 (O3-:K1-) forms a hexagonal lattice structure with a lattice constant of 14 to 15 nm when it is precipitated by addition of two volumes of 10 mM MgCl2-ethanol. When the LPS was suspended in various buffers (50 mM) at pH 2 to 12 for 24 hr at 4 C, at pH 2 and 3 pits of the hexagonal lattice structure markedly disappeared, at pH 4 to 8.5 the lattice structure was stable, and at pH 9 to 12 it tended to loosen somewhat. The LPS from which cations were removed by electrodialysis retained the ability of hexagonal assembly, although the lattice constant of the hexagonal lattice of the electrodialyzed LPS was large. The lattice structure of the electrodialyzed LPS was much more labile than that of the non-electrodialyzed LPS at alkaline pH levels and the former was completely disintegrated into ribbon-like structures when the LPS was suspended in 50 mM Tris buffer at pH 7.7 or higher. However, the electrodialyzed LPS formed a hexagonal lattice structure in Tris buffer at pH 8.5 containing 0.1 to 100 mM MgCl2. The lattice constants of the hexagonal lattice formed by the electrodialyzed LPS at 10 or 100 mM MgCl2 were very similar to that of the lattice of the non-electrodialyzed LPS. From these results it is concluded that the lability of the hexagonal lattice structure of the electrodialyzed LPS at alkaline conditions is due to removal of Mg2+ by electrodialysis.

Chemical Phenomena↗

The stability of temporary prosthetic base materials. I: Introduction, angular changes and dimensional stability.

The bases of occlusal rims and trial dentures should fit both the cast and the mouth accurately. The retention of shape and dimension of strips and sheets of grey and pink shellac, filled cold cure acrylic resin and wax were tested following moulding over stylised upper edentulous casts. The thermoplastic materials were softened over a flame or in a water bath. Specimens were prepared with and without folding along the long axes of the strips. The angles formed by the strips, the gap between the palate of the baseplates and casts and the linear dimension of the sheets were measured after moulding, after immersion in water at 37 and 45 degrees C and after 24 h at room temperature. The least angular change was shown by unfolded grey shellac, softened over a flame and moulded by finger pressure over an unwarmed cast, followed by folded specimens softened in water and moulded with the fingers over a prewarmed cast. The least gap developed beneath pink shellac softened in water and moulded by finger pressure over a warmed cast. The smallest dimensional change was shown by grey shellac softened in water and moulded by finger pressure over a warmed cast. Thus, optimally manipulated shellac materials exhibit less change after moulding than cold cure acrylic resin or modelling wax.

Acrylic Resins↗