WorldWideScience

Sample records for acutely acl injured

  1. The acutely ACL injured knee assessed by MRI

    Frobell, R B; Roos, H P; Roos, E M;

    2008-01-01

    OBJECTIVES: To map by magnetic resonance imaging (MRI) and quantitative MRI (qMRI) concomitant fractures and meniscal injuries, and location and volume of traumatic bone marrow lesions (BMLs) in the acutely anterior cruciate ligament (ACL) injured knee. To relate BML location and volume to cortical...... depression fractures, meniscal injuries and patient characteristics. METHODS: One hundred and twenty-one subjects (26% women, mean age 26 years) with an ACL rupture to a previously un-injured knee were studied using a 1.5T MR imager within 3 weeks from trauma. Meniscal injuries and fractures were classified...... by type, size and location. BML location and volume were quantified using a multi-spectral image data set analyzed by computer software, edited by an expert radiologist. RESULTS: Fractures were found in 73 (60%) knees. In 67 (92%) of these knees at least one cortical depression fracture was found...

  2. The acutely ACL injured knee assessed by MRI: changes in joint fluid, bone marrow lesions, and cartilage during the first year

    Frobell, R B; Le Graverand, M-P; Buck, R;

    2008-01-01

    OBJECTIVES: To investigate changes in the knee during the first year after acute rupture of the anterior cruciate ligament (ACL) of volumes of joint fluid (JF), bone marrow lesions (BMLs), and cartilage volume (VC), and cartilage thickness (ThCcAB) and cartilage surface area (AC). To identify...

  3. Measurement of Knee Morphometrics Using MRI: A Comparative Study between ACL-Injured and Non-Injured Knees

    Park, Jin Sung; Nam, Dae Chul; Kim, Dong Hee; Kim, Hyung Kan; Hwang, Sun Chul

    2012-01-01

    Purpose The purpose of this study is to find out the differences of distal femur morphology between the anterior cruciate ligament (ACL)-injured and the non-ACL injured on an magnetic resonance imaging (MRI), and the difference of bone structure by gender. Materials and Methods MRI Measurements of notch width (NW), bicondylar width (BCW), medial condyle width (MCW), lateral condyle width (LCW), medial-to-lateral condyle ratio (M:L ratio), and notch entrance width (NE) were taken from 120 subj...

  4. A Case-Control Study Of Anterior Cruciate Ligament Volume, Tibial Plateau Slopes and Intercondylar Notch Dimensions In ACL-Injured Knees

    Simon, RA; Everhart, J; Nagaraja, HN; Chaudhari, AM

    2010-01-01

    The role played by anatomic factors in ACL injury remains elusive. In this study, objective methods were used to characterize ACL volume, tibial slopes, and notch geometry from ACL-injured and matched control subjects. The study tested four hypotheses: 1) the medial tibial plateau slope is steeper posteriorly in the injured group compared to the non-injured group, 2) the lateral tibial plateau slope is steeper posteriorly in the injured group compared to the non-injured group, 3) the femoral ...

  5. Do ACL-injured copers exhibit differences in knee kinematics?: An MRI study.

    Barrance, Peter J; Williams, Glenn N; Snyder-Mackler, Lynn; Buchanan, Thomas S

    2007-01-01

    Kinematic changes after anterior cruciate ligament (ACL) injury may play a role in the long-term development of osteoarthritis (OA). Some ACL-injured patients (copers) successfully return to demanding activities without the reconstructive surgery usually recommended for functionally unstable patients (noncopers). We determined whether copers exhibit less disruption to kinematics than noncopers, perhaps because of lower impairment of muscular control as observed in earlier studies. We used dynamic magnetic resonance imaging and model-based tracking to investigate anteroposterior (AP) and internal-external tibial positioning in copers, presurgical noncopers, and uninjured control subjects during dynamic nonloaded knee extension. Copers and control subjects showed similar levels of side-to-side differences in AP tibial positioning (1.1 +/- 4.9 mm and 1.4 +/- 2.7 mm, respectively), whereas noncopers exhibited anterior tibial positioning in their injured knees (2.6 +/- 3 mm) that differed from control subjects. Copers were the most variable of the three groups, and contrary to our hypothesis, tibial positioning in copers was not different from that of noncopers. Differences in tibial positioning did not correlate with side-to-side differences in AP laxity in any of the groups, and we identified no changes to tibial axial rotation patterns associated with ACL deficiency. PMID:17091013

  6. Incidence of Hyperpronation in the ACL Injured Knee: A Clinical Perspective

    Beckett, Mark E.; Massie, Denise L.; Bowers, K. Douglas; Stoll, David A.

    1992-01-01

    Assessing abnormal biomechanics when treating various lower extremity pathologies provides the athlete with comprehensive management and promotes injury prevention. However, there have been few previous investigations of abnormal biomechanical forces on ligamentous pathologies of the knee. During this clinical study we investigated the incidence of hyperpronation in subjects who have had an anterior cruciate ligament (ACL) injury. Fifty subjects with a past medical history of ACL rupture and ...

  7. Knee kinematic and kinetic characteristics of landing after hop : ACL injured subjects before and after rehabilitation

    Storevold, Annika

    2009-01-01

    BACKGROUND: Dynamic knee stability strategies of anterior cruciate ligament deficient (ACL) subjects have previously been reported in gait analysis studies. Few studies have investigated these strategies during a more strenuous sport related activity such as a single leg hop. Joint stiffness may be an important functional performance parameter, to our knowledge no one have looked into knee joint stiffness after an ACL injury. Furthermore, too few studies have examined changes i...

  8. Principal component modeling of isokinetic moment curves for discriminating between the injured and healthy knees of unilateral ACL deficient patients.

    Almosnino, Sivan; Brandon, Scott C E; Day, Andrew G; Stevenson, Joan M; Dvir, Zeevi; Bardana, Davide D

    2014-02-01

    Bilateral knee strength evaluations of unilateral anterior cruciate ligament (ACL) deficient patients using isokinetic dynamometry are commonly performed in rehabilitation settings. The most frequently-used outcome measure is the peak moment value attained by the knee extensor and flexor muscle groups. However, other strength curve features may also be of clinical interest and utility. The purpose of this investigation was to identify, using Principal Component Analysis (PCA), strength curve features that explain the majority of variation between the injured and uninjured knee, and to assess the capabilities of these features to detect the presence of injury. A mixed gender cohort of 43 unilateral ACL deficient patients performed 6 continuous concentric knee extension and flexion repetitions bilaterally at 60°s(-1) and 180°s(-1) within a 90° range of motion. Moment waveforms were analyzed using PCA, and binary logistic regression was used to develop a discriminatory decision rule. For all directions and speeds, a statistically significant overall reduction in strength was noted for the involved knee in comparison to the uninvolved knee. The discriminatory decision rule yielded a specificity and sensitivity of 60.5% and 60.5%, respectively, corresponding to an accuracy of ∼62%. As such, the curve features extracted using PCA enabled only limited clinical usefulness in discerning between the ACL deficient and contra lateral, healthy knee. Improvement in discrimination capabilities may perhaps be achieved by consideration of different testing speeds and contraction modes, as well as utilization of other data analysis techniques. PMID:24280243

  9. Radiography of the acutely injured shoulder

    Routine radiological examination of the acute shoulder has been unchanged in radiology departments for many years. At UCLH (University College London Hospitals, UK) this examination consists of two projections, an AP (antero-posterior) and an LS (lateral scapula). Following a review of the related literature and the possible advantages of an axial style projection, a study was performed to evaluate whether a new projection named modified trauma axial (MTA) shoulder projection could replace the existing LS projection in the routine examination of the acute shoulder. A retrospective analysis of 244 acute shoulder examinations over a 5-month period was performed. AP, LS and MTA projections were taken with paired AP and LS, and AP and MTA radiographs were reported separately. 97 traumatic abnormalities were reported using AP and MTA whilst only 64 abnormalities were reported using AP and LS views. The MTA projection demonstrated it was significant for evaluating articular surfaces of the humeral head and glenoid, defects in the humeral head, greater tuberosity fractures, glenoid fractures and fractures of the acromion. It was established that if the LS projection was replaced with the MTA view no traumatic pathologies would have been overlooked and in fact there was a 52% increase in traumatic abnormalities detected. Use of a chi-squared test demonstrated a highly significant difference in the number of traumatic abnormalities detected between the two pairs of projection combinations (p = 0.0004). Based on this study and the examined literature the routine examination of the acutely injured shoulder is recommended to include the AP and MTA projections only.

  10. Multicenter Orthopaedic Outcome Network Early Anti-inflammatory Treatment in Patients with Acute ACL Tear” (MOON-AAA) Clinical Trial

    Lattermann, Christian; Proffitt, Mary; Huston, Laura J.; Gammon, Lee; Johnson, Darren L.; Kraus, Virginia B.; Spindler, Kurt P.

    2016-01-01

    Objectives: We present the early results from the “Multicenter Orthopaedic Outcome Network Early Anti-inflammatory Treatment in Patients with Acute ACL Tear and Painful Effusions” (MOON-AAA) clinical trial (figure 1). This trial allows for a well controlled prospective cohort of patients with isolated ACL injury at risk for OA. We compared the effect of a single versus a repeated dosage of Kenalog within the first two weeks after ACL injury and its effect on chondral degradation in the first 4 weeks prior to surgical reconstruction of the ACL. Methods: 49 patients with isolated ACL tears were enrolled. Knee joints were aspirated and patients received an injection with 40 mg Kenalog either within 4 days, 10 days, both time points or not at all (saline injection control). Serum, synovial fluid and urine were collected at 3 time points. Permutated block randomization, triple blinding, independent monitoring and standardized x-ray was performed to comply with GCP standards. Patient reported outcomes were collected at 6 time points up to 6 months post-ACL reconstruction(IKDC, KOOS and Marx activity level). A standardized synovial fluid biomarker panel was analyzed according to OARSI guidelines. Statistical analysis were performed using SAS mixed models analysis. Results: Serum analysis shows significant change after injury. Chondrodegradatory markers such as CTX-II, MMP-1 and MMP-3 as well as COMP indicate a progressive destruction of chondral matrix and collagen breakdown . There is a dramatic (250%) increase of CTX-II in the first 4 weeks. Matrix proteins such as MMP-1 and 3 as well as COMP show an initial increase and then a steep decline (see figure 1). Inflammatory markers (IL-1 alpha, IL-1beta, IRAP) show a decline from the time of injury. IL-1 alpha, however shows a dramatic uptake after week 2. This longitudinal data confirms a dramatic onset of early osteoarthritic biomarker profiles immediately after ACL injury as measured in synovial fluid

  11. Clinical measurements of proprioception, muscle strength and laxity in relation to function in the ACL-injured knee.

    Roberts, David; Ageberg, Eva; Andersson, Gert; Fridén, Thomas

    2007-01-01

    A knee injury with anterior cruciate ligament (ACL) rupture may cause deficits in proprioception, increased laxity and decreased muscle strength. Although it may be common knowledge that these factors affect knee function, only a few studies have been performed where this has been investigated in the clinical situation, and the results are not conclusive. The purpose of this study was therefore to investigate how and to what extent proprioception, laxity and strength affect knee joint functio...

  12. Magnetic resonance imaging of bone bruising in the acutely injured knee--short-term outcome

    AIM: To investigate the short-term outcome and associated injuries of bone bruising in the acutely injured knee. METHOD AND MATERIALS: Thirty patients (age range 17-39 years, mean 28 years) with bone bruising identified on magnetic resonance imaging (MRI) after an acute knee injury were rescanned 12-14 weeks post-injury. The volume of bone bruising was measured on coronal STIR (short TI inversion recovery) images and correlation made with the presence and type of ligamentous and osteochondral injuries. RESULTS: All bone bruises were present on repeat MRI. Twenty of the 30 patients (67%) had associated anterior cruciate ligament (ACL) injuries, seven of the 30 (23%) had collateral ligament injuries and three of the 30 (10%) had no associated ligamentous injuries. Greater than 50% reduction in bone bruise volume was demonstrated at repeat scanning in 24 of the 30 patients (80%) and less than 50% in five of the 30 patients (17%). One patient showed an increase in volume of bone bruising at follow-up. There was no correlation between initial size or size reduction of bone bruising and the presence/absence or type of associated injuries. In 21 patients the bone bruises resolved from the periphery, whilst eight patients showed bone bruises that resolved towards the joint margin, all of whom had associated osteochondral injuries. Of the 30 patients, 17 showed bone bruising that extended to the joint margin, 10 of whom had associated osteochondral injuries on MRI. On clinical review some degree of knee pain was still present in all but one of the patients reviewed. The single patient who reported complete resolution of symptoms was one of the three patients with isolated bone bruising CONCLUSION: Bone bruises persist for at least 12-14 weeks, which is longer than previously quoted. Two discrete patterns of bone bruise resolution have been demonstrated. The size and persistence of bone bruising is not related to the presence or absence or type of associated ligamentous

  13. Magnetic resonance imaging of bone bruising in the acutely injured knee--short-term outcome

    Davies, N.H.; Niall, D.; King, L.J.; Lavelle, J.; Healy, J.C. E-mail: j.healy@ic.ac.uk

    2004-05-01

    AIM: To investigate the short-term outcome and associated injuries of bone bruising in the acutely injured knee. METHOD AND MATERIALS: Thirty patients (age range 17-39 years, mean 28 years) with bone bruising identified on magnetic resonance imaging (MRI) after an acute knee injury were rescanned 12-14 weeks post-injury. The volume of bone bruising was measured on coronal STIR (short TI inversion recovery) images and correlation made with the presence and type of ligamentous and osteochondral injuries. RESULTS: All bone bruises were present on repeat MRI. Twenty of the 30 patients (67%) had associated anterior cruciate ligament (ACL) injuries, seven of the 30 (23%) had collateral ligament injuries and three of the 30 (10%) had no associated ligamentous injuries. Greater than 50% reduction in bone bruise volume was demonstrated at repeat scanning in 24 of the 30 patients (80%) and less than 50% in five of the 30 patients (17%). One patient showed an increase in volume of bone bruising at follow-up. There was no correlation between initial size or size reduction of bone bruising and the presence/absence or type of associated injuries. In 21 patients the bone bruises resolved from the periphery, whilst eight patients showed bone bruises that resolved towards the joint margin, all of whom had associated osteochondral injuries. Of the 30 patients, 17 showed bone bruising that extended to the joint margin, 10 of whom had associated osteochondral injuries on MRI. On clinical review some degree of knee pain was still present in all but one of the patients reviewed. The single patient who reported complete resolution of symptoms was one of the three patients with isolated bone bruising CONCLUSION: Bone bruises persist for at least 12-14 weeks, which is longer than previously quoted. Two discrete patterns of bone bruise resolution have been demonstrated. The size and persistence of bone bruising is not related to the presence or absence or type of associated ligamentous

  14. Transfusion-Related Acute Lung Injured (TRALI): Current Concepts

    Álvarez, P; Carrasco, R; Romero-Dapueto, C; Castillo, R.L

    2015-01-01

    Transfusion-related acute lung injury (TRALI) is a life-threatening intervention that develops within 6 hours of transfusion of one or more units of blood, and is an important cause of morbidity and mortality resulting from transfusion. It is necessary to dismiss other causes of acute lung injury (ALI), like sepsis, acute cardiogenic edema, acute respiratory distress syndrome (ARDS) or bacterial infection. There are two mechanisms that lead to the development of this syndrome: immune-mediated...

  15. Transfusion-Related Acute Lung Injured (TRALI): Current Concepts.

    Álvarez, P; Carrasco, R; Romero-Dapueto, C; Castillo, R L

    2015-01-01

    Transfusion-related acute lung injury (TRALI) is a life-threatening intervention that develops within 6 hours of transfusion of one or more units of blood, and is an important cause of morbidity and mortality resulting from transfusion. It is necessary to dismiss other causes of acute lung injury (ALI), like sepsis, acute cardiogenic edema, acute respiratory distress syndrome (ARDS) or bacterial infection. There are two mechanisms that lead to the development of this syndrome: immune-mediated and no immune- mediated TRALI. A common theme among the experimental TRALI models is the central importance of neutrophils in mediating the early immune response, and lung vascular injury. Central clinical symptoms are dyspnea, tachypnea, tachycardia, cyanosis and pulmonary secretions, altogether with other hemodynamic alterations, such as hypotension and fever. Complementary to these clinical findings, long-term validated animal models for TRALI should allow the determination of the cellular targets for TRALI-inducing alloantibodies as well as delineation of the underlying pathogenic molecular mechanisms, and key molecular mediators of the pathology. Diagnostic criteria have been established and preventive measures have been implemented. These actions have contributed to the reduction in the overallnumber of fatalities. However, TRALI still remains a clinical problem. Any complication suspected of TRALI should immediately be reported. PMID:26312100

  16. Protective effects of parmelia tinctorum preparations on acute radiation-injured mice

    Objective: To investigate the radiation protection effect of Parmelia tinctorum preparations in dosage, drug administration time, administration methods and different preparation methods on acute radiation-injured mice, and find out the best therapeutic project. Methods: Kunming mice were injected (ip) with 10 mg/kg, 20 mg/kg, 40 mg/kg, 80 mg/kg of Parmelia tinctorum preparations before irradiation respectively, then irradiated by 9 Gy 60Co γ-ray. The 30-day survival rates and the protection factors were observed. By the same method, another group of mice were injected (ip) with Parmelia tinctorum preparations at 15 min, 30 min, 1 h, 2 h, 4 h before irradiation respectively, the 30-day survival rates and the protection factors were observed. The protective effect of Parmelia tinctorum preparations from intramuscular and oral routes were compared with the same method. The protective effect of Parmelia tinctorum water extract preparations and alcohol extract preparations were compared. Results: A certain dosage (20-80 mg/kg) of Parmelia tinctorum preparations could greatly improve the 30-day survival rates and the protection factors of radiation-injured mice. Parmelia tinctorum preparations had significant therapeutic effect on 60Co γ-ray radiation-injured mice at 15 min-1 h before irradiation. Administration of Parmelia tinctorum preparations by intramuscular injection showed a little lower efficacy than by intraperitoneal injection, but administration the same dose orally had no significant radiation protective effect. Parmelia tinctorum preparations extracted by water injected (ip) before irradiation had the same radiation protective effect with those extracted by 50% alcohol. Conclusion: Parmelia tinctorum preparations have a certain protective effect on acute radiation-injured mice. The best therapeutic project is injected (ip) with 40 mg/kg of Parmelia tinctorum preparations at 30 min before irradiation. (authors)

  17. Management of Acute Combined ACL-Medial and Posteromedial Instability of the Knee.

    Medvecky, Michael J; Tomaszewski, Paul

    2015-06-01

    Medial collateral ligament (MCL) injuries are the most common ligamentous injury of the knee. The extent of injury can range from a minor first-degree (1-degree) sprain to an extensive third-degree (3-degree) sprain that can propagate across the knee, rupturing one or both cruciate ligaments, and result in a knee subluxation or dislocation. A common pattern involves the combined anterior cruciate ligament (ACL) and MCL injury that is the focus of this chapter. The vast majority of these combined medial-sided injuries are treated nonoperatively with delayed reconstruction of the ACL injury in athletically active individuals. The MCL and associated medial structures are carefully assessed on physical examination, and classification of injury is based upon abnormal limits of joint motion. In vitro cadaveric biomechanical testing has given us a better understanding of ligament deficiency and altered joint motion. Consistency in terminology is necessary for proper classification of injury and reproducible categorization of injury patterns to be able to compare both nonoperative and operative treatment of various injury patterns. PMID:25932883

  18. Clearance of aerosolized Tc-99m DTPA from normal vs. acutely smoke-injured dog lungs

    Acute cigarette smoke exposure is known to reversibly increase the clearance rate of aerosolized DTPA from human lungs. The authors studied DTPA clearance after acute severe plywood smoke exposure, on the order of that experienced by burn victims, since current diagnostic methods (Xe-133 and radiographs) for major inhalation injury are insensitive and/or non-specific. Smoke generated from burning plywood sawdust and kerosene was delivered via endotracheal tube at 370C. Skin burns were not inflicted (so the pulmonary consequences of thermal injury were not factors). Chest radiographs and Xe-133 studies were obtained before and after smoke injury but before DTPA aerosol delivery. Six normal and 7 smoke-exposed anesthetized mongrel dogs were studied with 3 mCi of Tc-99m DTPA delivered by aerosol for 5 minutes. Pulmonary Tc-99m DTPA activity was quantitated by computer. Data were acquired over the lungs at 1 frame per 10 secs. for 16 minutes, and the t/sub 1/2/ of DTPA washout from the lungs was calculated. The mean t/sub 1/2/ of 6 normal dogs was 36.52 min. (S.D. 17.73), while the t/sub 1/2/ of 7 smoke-injured dogs was 6.08 min. (S.D. 1.99). The longest t/sub 1/2/ of an injured lung (9.68 min.) was slightly more than half of the shortest t/sub 1/2/ of a normal lung (15.36 min). Thus, acutely smoke-injured dog lungs clear Tc-99m DTPA much faster than normal lungs, consistent with an increase in lung epithelial permeability. This technique may be promising clinically, since early diagnosis of inhalation injury is important for optimal therapy

  19. Repair of acutely injured spinal cord through constructing tissue-engineered neural complex in adult rats

    PU Yu; GUO Qing-shan; WANG Ai-min; WU Si-yu; XING Shu-xing; ZHANG Zhong-rong

    2007-01-01

    Objective: To construct tissue-engineered neural complex in vitro and study its effect in repairing acutely injured spinal cord in adult rats. Methods: Neural stem cells were harvested from the spinal cord of embryo rats and propagated in vitro. Then the neural stem cells were seeded into polyglycolic acid scaffolds and co-cultured with extract of embryonic spinal cord in vitro. Immunofluorescence histochemistry and scanning electron microscope were used to observe the microstructure of this complex. Animal model of spine semi-transection was made and tissue-engineered neural complex was implanted by surgical intervention. Six weeks after transplantation, functional evaluation and histochemistry were applied to evaluate the functional recovery and anatomic reconstruction. Results: The tissue-engineered neural complex had a distinct structure, which contained neonatal neurons, oligodendrocytes and astrocytes. After tissue-engineered neural complex was implanted into the injured spinal cord, the cell components such as neurons, astrocytes and oligodendrocytes, could survive and keep on developing. The adult rats suffering from spinal cord injury got an obvious neurological recovery in motor skills. Conclusions: The tissue-engineered neural complex appears to have therapeutic effects on the functional recovery and anatomic reconstruction of the adult rats with spinal cord injury.

  20. Mitochondrial fission is an acute and adaptive response in injured motor neurons

    Kiryu-Seo, Sumiko; Tamada, Hiromi; Kato, Yukina; Yasuda, Katsura; Ishihara, Naotada; Nomura, Masatoshi; Mihara, Katsuyoshi; Kiyama, Hiroshi

    2016-01-01

    Successful recovery from neuronal damage requires a huge energy supply, which is provided by mitochondria. However, the physiological relevance of mitochondrial dynamics in damaged neurons in vivo is poorly understood. To address this issue, we established unique bacterial artificial chromosome transgenic (BAC Tg) mice, which develop and function normally, but in which neuronal injury induces labelling of mitochondria with green fluorescent protein (GFP) and expression of cre recombinase. GFP-labelled mitochondria in BAC Tg mice appear shorter in regenerating motor axons soon after nerve injury compared with mitochondria in non-injured axons, suggesting the importance of increased mitochondrial fission during the early phase of nerve regeneration. Crossing the BAC Tg mice with mice carrying a floxed dynamin-related protein 1 gene (Drp1), which is necessary for mitochondrial fission, ablates mitochondrial fission specifically in injured neurons. Injury-induced Drp1-deficient motor neurons show elongated or abnormally gigantic mitochondria, which have impaired membrane potential and axonal transport velocity during the early phase after injury, and eventually promote neuronal death. Our in vivo data suggest that acute and prominent mitochondrial fission during the early stage after nerve injury is an adaptive response and is involved in the maintenance of mitochondrial and neuronal integrity to prevent neurodegeneration. PMID:27319806

  1. Mitochondrial fission is an acute and adaptive response in injured motor neurons.

    Kiryu-Seo, Sumiko; Tamada, Hiromi; Kato, Yukina; Yasuda, Katsura; Ishihara, Naotada; Nomura, Masatoshi; Mihara, Katsuyoshi; Kiyama, Hiroshi

    2016-01-01

    Successful recovery from neuronal damage requires a huge energy supply, which is provided by mitochondria. However, the physiological relevance of mitochondrial dynamics in damaged neurons in vivo is poorly understood. To address this issue, we established unique bacterial artificial chromosome transgenic (BAC Tg) mice, which develop and function normally, but in which neuronal injury induces labelling of mitochondria with green fluorescent protein (GFP) and expression of cre recombinase. GFP-labelled mitochondria in BAC Tg mice appear shorter in regenerating motor axons soon after nerve injury compared with mitochondria in non-injured axons, suggesting the importance of increased mitochondrial fission during the early phase of nerve regeneration. Crossing the BAC Tg mice with mice carrying a floxed dynamin-related protein 1 gene (Drp1), which is necessary for mitochondrial fission, ablates mitochondrial fission specifically in injured neurons. Injury-induced Drp1-deficient motor neurons show elongated or abnormally gigantic mitochondria, which have impaired membrane potential and axonal transport velocity during the early phase after injury, and eventually promote neuronal death. Our in vivo data suggest that acute and prominent mitochondrial fission during the early stage after nerve injury is an adaptive response and is involved in the maintenance of mitochondrial and neuronal integrity to prevent neurodegeneration. PMID:27319806

  2. Cultured mycelium Cordyceps sinensis protects liver sinusoidal endothelial cells in acute liver injured mice.

    Peng, Yuan; Chen, Qian; Yang, Tao; Tao, Yanyan; Lu, Xiong; Liu, Chenghai

    2014-03-01

    control. Compared with the model group, CMCS and 1,10-phenanthroline significantly improved serum ALT/AST, attenuated hepatic inflammation and improved peroxidative injury in liver, decreased MMP-2/9 activities in liver tissue, improved integration of scaffold structure, and decreased protein expression of VCAM-1 and ICAM-1. CMCS could protect LSECs from injury and maintain the microvasculature integration in acute injured liver of mice induced by LPS/D-GalN. Its action mechanism was associated with the down-regulation of MMP-2/9 activities and inhibition of peroxidation in injured liver. PMID:24442316

  3. Multiple-ligament injured knee

    SUN Lei; NING Zhi-jie; ZHANG Hui; TIAN Min; NING Tin-min

    2006-01-01

    Objective: To explore the clinical characteristic of the multiple-ligament injured knee and evaluate the protocol,technique and outcome of treatment for the multipleligament injured knee.Methods: From October 2001 to March 2005, 9 knees with combined anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears in 9 patients were identified with clinical and arthroscopic examinations. Of them, 5 knees were combined with ruptures of posteromedial corner (PMC) and medial collateral ligament (MCL), 4 with disruptions of posterolateral corner ( PLC), 2 with popliteal vascular injuries and 1 with peroneal nerve injuries. Six patients were hospitalized in acute phase of trauma, 2 received repairs of popliteal artery and 4 had repairs of PMC and MCL. Reconstructions of ACL and PCL with autografts under arthroscope were performed in all patients at 4 to 10 weeks after trauma,including reconstruction of PLC with the posterior half of biceps femoris tendon tenodesis in 4 patients and reconstructions of PMC and MCL with femoral fascia in 1 patient.Results: No severe complications occurred at early stage after operation in the 9 patients. All of them were followed up for 10-39 months with an average of 23. 00 months ± 9.46 months. Lysholm score was 70-95 with an average of 85.00 ± 8.29. International Knee Documentation Committee (IKDC) score was from severely abnormal (Grade D) in 9 knees at initial examination to normal (Grade A) in 2 knees, nearly normal (Grade B ) in 6 knees and abnormal in 1 knee at the last follow-up. Of the 9 patients, 7 returned to the same activity level before injury and 2 were under the level.Conclusions: The multiple-ligament injured knee with severe instability is usually combined with other important structure damages. Therefore, careful assessment and treatment of the combined injuries are essential. Reconstructions of ACL and PCL under arthroscope, combined with repairs or reconstructions of the extraarticular ligaments

  4. ACL reconstruction - discharge

    Anterior cruciate ligament reconstruction - discharge; ACL reconstruction - discharge ... had surgery to reconstruct your anterior cruciate ligament (ACL). The surgeon drilled holes in the bones of ...

  5. Anterior Cruciate Ligament (ACL) Injuries

    ... Help a Friend Who Cuts? Anterior Cruciate Ligament (ACL) Injuries KidsHealth > For Teens > Anterior Cruciate Ligament (ACL) ... and Recovery Coping With an ACL Injury About ACL Injuries A torn anterior cruciate ligament (ACL) is ...

  6. Does the lateral intercondylar ridge disappear in ACL deficient patients?

    van Eck, Carola F.; Morse, Kenneth R.; Lesniak, Bryson P.; Kropf, Eric J.; Tranovich, Michael J.; van Dijk, C. Niek; Fu, Freddie H

    2010-01-01

    The aim of this study was to determine whether there is a difference in the presence of the lateral intercondylar ridge and the lateral bifurcate ridge between patients with sub-acute and chronic ACL injuries. We hypothesized that the ridges would be present less often with chronic ACL deficiency. Twenty-five patients with a chronic ACL injury were matched for age and gender to 25 patients with a sub-acute ACL injury. The lateral intercondylar ridge and lateral bifurcate ridge were scored as ...

  7. Failure to visualize acutely injured kidneys with technetium-99m DMSA does not preclude recoverable function

    A 35-yr-old patient developed severe acute tubular necrosis requiring hemodialysis. A [99mTc]dimercaptosuccinic acid scan of the kidneys showed no renal uptake at 4 or 24 hr, but the patient subsequently recovered normal renal function as judged by a normal serum creatinine. Based on this case report and a review of the literature, one cannot assume irreversible loss of function in patients with acute renal failure, based on the absence of radiopharmaceutical uptake by the kidneys

  8. Greater fear of re-injury and increased tibial translation in patients who later sustain an ACL graft rupture or a contralateral ACL rupture: a pilot study.

    Tagesson, Sofi; Kvist, Joanna

    2016-01-01

    The aim was to compare fear of re-injury, patient reported function, static and dynamic tibial translation and muscle strength assessed before and 5 weeks after an anterior cruciate ligament (ACL) reconstruction between individuals who sustained a subsequent ACL graft rupture or a contralateral ACL injury within 5 years after the reconstruction, and individuals with no subsequent injury. Nineteen patients were investigated before, and 5 weeks after an ACL reconstruction with a quadruple hamstring tendon graft. At 5 years follow up, 3 patients had sustained an ACL graft rupture and 2 patients had sustained a contralateral ACL rupture. Fear of re-injury, confidence with the knee, patient reported function, activity level, static and dynamic tibial translation and muscle strength were assessed. The re-injured group reported greater fear of re-injury and had greater static tibial translation in both knees before the ACL reconstruction compared to those who did not sustain another ACL injury. There were no other differences between groups. In conclusion, fear of re-injury and static tibial translation before the index ACL reconstruction were greater in patients who later on suffered an ACL graft rupture or a contralateral ACL rupture. These factors may predict a subsequent ACL injury. PMID:25894209

  9. Differences among mechanoreceptors in healthy and injured anterior cruciate ligaments and their clinical importance

    Dhillon, Mandeep Sing; Bali, Kamal; Prabhakar, Sharad

    2012-01-01

    Mechanoreceptors in an intact Anterior Cruciate Ligament (ACL) contribute towards functional stability of the knee joint. Injury to the ACL not only causes mechanical instability, but also leads to a disturbance in the neuromuscular control of the injured knee due to loss or damage to mechanoreceptors. ACL reconstruction restores proprioceptive potential of the knee to some extent, but the results vary. Although the remnant ACL contains residual mechanoreceptors, the number and functionality ...

  10. Anterior cruciate ligament (ACL) injury

    Cruciate ligament injury - anterior; ACL injury; Knee injury - anterior cruciate ligament (ACL) ... confirm the diagnosis. It may also show other knee injuries. First aid for an ACL injury may include: ...

  11. MR diffusion tensor imaging in the evaluation of neural progenitor cells transplantation to acute injured canine spinal cord

    Objective: To observe the effect of transplantation of telomerase immortalized human neural progenitor cells to acute injured canine spinal cord by using MR diffusion tensor imaging (DTI). Methods: Telomerase immortalized human neural progenitor cells with expression of green fluorescent protein were prepared for transplantation. Eight adult canines with left spinal cord hemisection at the level of T13 were examined by MR diffusion tensor imaging four times sequentially: prior to injury, one week after injury, one week after transplantation (two weeks after injury), and four weeks after transplantation. Results: The ADC values of the injured spinal cord were (1.00 ± 0.15) x 10-3 mm2/s, (1.65 ± 0.45) x 10-3 mm2/s, (1.44 ± 0.48) xl0-3 mm2/s, and (1.43 ± 0.26) x 10-3 mm2/s, respectively. There was statistically significant difference between the data obtained at different times (F= 6.038, P=0.005). The FA values of the injured spinal cord were 0.59±0.11, 0.30±0.17, 0.36±0.25, and 0.34±0.11, respectively. There was also statistically significant difference between the data obtained at different times (F=5.221, P=0.009). The ADC values of the intact spinal cord were (1.01±0.17) x 10-3 mm2/s, (1.32±0.06) x 10-3 mm2/s, (1.10±0.24) x 10-3 mm2/s, and (1.14±0.22) x 10-3 mm2/s, respectively. There was no statistically significant difference between the data obtained at different times (F=1.303, P=0.306). The FA values of the intact spinal cord were 0.60 ± 0.09, 0.38 ± 0.25, 0.46 ± 0.15, and 0.50 ± 0.21, respectively. There was also no statistically significant difference between the data obtained at different times (F=2.797, P=0.072). Conclusion: DTI can provide useful information for spinal cord injury and regeneration in experimental spinal cord injury. (authors)

  12. Cultured mycelium Cordyceps sinensis protects liver sinusoidal endothelial cells in acute liver injured mice

    Peng, Yuan; Chen, Qian; Yang, Tao; Tao, Yanyan; Lu, Xiong; Liu, Chenghai

    2014-01-01

    Cultured mycelium Cordyceps sinensis (CMCS) was widely used for a variety of diseases including liver injury, the current study aims to investigate the protective effects of CMCS on liver sinusoidal endothelial cells (LSECs) in acute injury liver and related action mechanisms. The mice were injected intraperitoneally with lipopolysaccharide (LPS) and d-galactosamine (D-GalN). 39 male BABL/c mice were randomly divided into four groups: normal control, model control, CMCS treatment and 1,10-phe...

  13. Effects of osteoblasts on recovery of hematopoiesis and angiogenesis in acute irradiation injured mice

    Objective: To explore the effects of osteoblasts on the recovery of hematopoiesis and angiogenesis in acute irradiation injury mice. Methods: The femurs of 18 male BALB/c mice were used to prepare the bone marrow osteoblasts, and the rest mice were divided into 3 groups as normal group, saline group and osteoblast group. The mice in normal group received no treatment, and the other two groups were received 6.0 Gy 60Co γ-ray irradiation. After irradiation each mouse of osteoblast group was administered with 2 × 106 osteoblasts through tail vein injection, and equal volume saline was given to each mouse of saline group by the same way. The following factors were measured at 7, 14, 21 d after irradiation, they were the counts of peripheral blood cells and bone marrow mononuclear cells (BMMNC), the percentage of CD34 + cells in BMMNC, the histology changes and micro vascular density (MVD) of bone marrow tissue. Results: The counts of peripheral blood cells, BMMNC and hematopoietic tissue area in osteoblast group were higher than those in saline group.The percentage of CD34 + cells in BMMNC and the MVD of bone marrow in osteoblast group were also higher than those in saline group at 7, 14, 21 d after irradiation (t=2.46-64.51, P<0.05). Conclusions: Osteoblasts could significantly promote the recovery of hematopoiesis and angiogenesis in mice after acute irradiation injury. (authors)

  14. ACL2(ml): Machine-Learning for ACL2

    Heras, Jónathan; Komendantskaya, Ekaterina

    2014-01-01

    ACL2(ml) is an extension for the Emacs interface of ACL2. This tool uses machine-learning to help the ACL2 user during the proof-development. Namely, ACL2(ml) gives hints to the user in the form of families of similar theorems, and generates auxiliary lemmas automatically. In this paper, we present the two most recent extensions for ACL2(ml). First, ACL2(ml) can suggest now families of similar function definitions, in addition to the families of similar theorems. Second, the lemma generation ...

  15. Update on rehabilitation following ACL reconstruction

    John Nyland

    2010-09-01

    Full Text Available John Nyland, Emily Brand, Brent FisherDepartment of Orthopaedic Surgery, Division of Sports Medicine, University of Louisville, Louisville, KY, USAAbstract: As anterior cruciate ligament (ACL reconstruction has evolved to less invasive, more anatomical approaches, rehabilitation of the injured athlete has likewise become more progressive and innovative, with a sound understanding of graft and fixation strength and biologic healing-remodeling constraints. This review discusses these innovations including specific considerations before surgery, when planning rehabilitation timetables, and the importance of reestablishing nonimpaired active and passive knee range of motion and biarticular musculotendinous extensibility in positions of function. Concepts of self-efficacy or confidence and reestablishing the “athlete role” are also addressed. Since ACL injury and reinjury are largely related to the influence of structure-form-function on dynamic knee joint stability, the interrelationships between sensorimotor, neuromuscular, and conventional resistance training are also discussed. Although pivot shift “giving way” relates to function loss following ACL injury, anterior translational laxity often does not. Although there is growing evidence that progressive eccentric training may benefit the patient following ACL reconstruction, there is less evidence supporting the use of functional ACL knee braces. Of considerable importance is selecting and achieving a criteria-based progression to sports-specific training, reestablishing osseous homeostasis and improved bone density, blending open and closed kinetic chain exercises at the appropriate time period, and appreciating the influence of the trunk, upper extremities, and sports equipment use on knee loads. We believe that knee dysfunction and functional recovery should be considered from a local, regional, and global perspective. These concepts are consolidated into our approach to prepare

  16. Body Mass Index, Modulated by Lateral Posterior Tibial Slope, Predicts ACL Injury Risk

    Bojicic, Katherine M.; Beaulieu, Melanie L.; Krieger, Daniel Imaizumi; Ashton-Miller, James A.; Wojtys, Edward M.

    2016-01-01

    Objectives: Intervention strategies to prevent ACL injury rely on increasing knowledge of risk factors. While several modifiable and non-modifiable risk factors for ACL rupture have been identified, the interaction between them remains unknown. The aim of this study was to quantify the relationship between BMI and several knee geometries as potential risk factors for ACL injury. We hypothesized that an increased BMI in the presence of an increased posterior tibial slope or middle cartilage slope would increase risk of ACL injury. We also hypothesized that an increased BMI in the presence of a decreased posterior meniscal height or meniscal bone angle would result in an increased risk of ACL injury. Methods: Sagittal knee MRI files from 76 ACL-injured and 42 non-injured subjects were gathered from the institution’s archive. The PTS, MCS, PMH, and MBA were measured using the circle method and compared with BMI from the subject demographic. Data were analyzed using univariate and multivariate logistical regression. Figure 1 details measurements made for each knee geometry. Results: Univariate analysis of PTS showed increases in PTS significantly increase the odds of ACL tear (p = 0.043, OR =1.12). Univariate analysis of MCS showed increases of MCS significantly increase the odds of ACL tear (p = 0.037, OR = 1.12). Multivariate analysis of PTS and BMI centered around the mean (PTS*cBMI) showed increases of PTS in combination with increases in cBMI significantly increases the odds of ACL rupture (p value = .050, OR = 1.03). Table 1 shows predicted increases in ACL injury risk for combinations of increases in PTS and BMI. Conclusion: An increase in BMI will increase the risk of ACL tear when an increase in lateral posterior tibial slope is present. An increase in lateral posterior tibial slope or lateral middle cartilage slope increases the risk of an ACL tear.

  17. Current Concepts in ACL Reconstruction

    Fu, Freddie H; Cohen, Steven B.

    2008-01-01

    Current Concepts in ACL Reconstruction is a complete reference text composed of the most thorough collection of topics on the ACL and its surgical reconstruction compiled, with contributions from some of the world's experts and most experienced ACL surgeons. Various procedures mentioned throughout the text are also demonstrated in an accompanying video CD-ROM. PURPOSE Composing a single, comprehensive and complete information source on ACL including basic sciences, clinical issues, latest con...

  18. CURRENT CONCEPTS IN ACL RECONSTRUCTION

    Freddie H. Fu

    2008-09-01

    Full Text Available Current Concepts in ACL Reconstruction is a complete reference text composed of the most thorough collection of topics on the ACL and its surgical reconstruction compiled, with contributions from some of the world's experts and most experienced ACL surgeons. Various procedures mentioned throughout the text are also demonstrated in an accompanying video CD-ROM. PURPOSE Composing a single, comprehensive and complete information source on ACL including basic sciences, clinical issues, latest concepts and surgical techniques, from evaluation to outcome, from history to future, editors and contributors have targeted to keep the audience pace with the latest concepts and techniques for the evaluation and the treatment of ACL injuries. FEATURES The text is composed of 27 chapters in 6 sections. The first section is mostly about basic sciences, also history of the ACL, imaging, clinical approach to adolescent and pediatric patients are subjected. In the second section, Graft Choices and Arthroscopy Portals for ACL Reconstruction are mentioned. The third section is about the technique and the outcome of the single-bundle ACL reconstruction. The fourth chapter includes the techniques and outcome of the double-bundle ACL reconstruction. In the fifth chapter revision, navigation technology, rehabilitation and the evaluation of the outcome of ACL reconstruction is subjected. The sixth/the last chapter is about the future advances to reach: What We Have Learned and the Future of ACL Reconstruction. AUDIENCE Orthopedic residents, sports traumatology and knee surgery fellows, orthopedic surgeons, also scientists in basic sciences or clinicians who are studying or planning a research on ACL forms the audience group of this book. ASSESSMENT This is the latest, the most complete and comprehensive textbook of ACL reconstruction produced by the editorial work up of two pioneer and masters "Freddie H. Fu MD and Steven B. Cohen MD" with the contribution of world

  19. Derivation of injury-responsive dendritic cells for acute brain targeting and therapeutic protein delivery in the stroke-injured rat.

    Nathan C Manley

    Full Text Available Research with experimental stroke models has identified a wide range of therapeutic proteins that can prevent the brain damage caused by this form of acute neurological injury. Despite this, we do not yet have safe and effective ways to deliver therapeutic proteins to the injured brain, and this remains a major obstacle for clinical translation. Current targeted strategies typically involve invasive neurosurgery, whereas systemic approaches produce the undesirable outcome of non-specific protein delivery to the entire brain, rather than solely to the injury site. As a potential way to address this, we developed a protein delivery system modeled after the endogenous immune cell response to brain injury. Using ex-vivo-engineered dendritic cells (DCs, we find that these cells can transiently home to brain injury in a rat model of stroke with both temporal and spatial selectivity. We present a standardized method to derive injury-responsive DCs from bone marrow and show that injury targeting is dependent on culture conditions that maintain an immature DC phenotype. Further, we find evidence that when loaded with therapeutic cargo, cultured DCs can suppress initial neuron death caused by an ischemic injury. These results demonstrate a non-invasive method to target ischemic brain injury and may ultimately provide a way to selectively deliver therapeutic compounds to the injured brain.

  20. Two-dimensional electrophoretogram of acute brain injury-associated proteins Comparison between Injured and normal cerebral cortex

    Xuejun Li; Xianrui Yuan; Cui Li; Zefeng Peng; Dun Yuan

    2008-01-01

    BACKGROUND:To this date,specific molecular markers for early diagnosis and prognosis monitoring ofcraniocerebral injury in clinical medicine do not exist.Therefore,differential detection of specific proteinsmight play an important role in diagnosis and treatment of this type of brain injury.OBJECTIVE:To compare differential cerebral cortical protein expression of craniocerebral injury patientsand normal subjects through the use of proteomics.DESIGN:Contrast observation.SETTING:Department of Neurosurgery,Xiangya Hospital of Central South University.PARTICIPANTS:Ten patients(6 males and 4 females,20-58 years old),with severe craniocerebral injury,were selected at the Department of Neurosurgery,Xiangya Hospital of Central South University,from June2004 to December 2006.All patients were diagnosed with CT test and Glasgow test(scores <8).Surgery was performed 4-12 hours after craniocerebral injury,and injured cortical tissues of the frontal and temporal lobes were resected for sampling.At the same time,control cortical tissues were collected from frontal and temporal lobes of 2 epileptic patients who underwent hippocampus-nucleus amygdala resection,and 2 lateral ventricular tumor patients who underwent tumor resection.The participants and their relatives provided confirmed consent,and this study received confirmed consent from the local ethics committee. METHODS:Ten samples from injured patients and 4 normal samples were compared through the use of proteomics.Total protein was separated by using two-dimensional electrophoresis with immobilized pH gradients,and the differential protein expressions were compared using image analysis after blue-sliver staining. Differential protein spot expressions were analyzed with a matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI/TOF MS) and electrospray ionization-quadrupole time of flight mass spectrometry(ESI-Qq TOF MS).MAIN OUTCOME MEASURES: ①Two-dimensional electrophoresis of protein from

  1. Blockade of peroxynitrite-induced neural stem cell death in the acutely injured spinal cord by drug-releasing polymer

    YU, DOU; Neeley, William L.; Pritchard, Christopher D.; Slotkin, Jonathan R.; Woodard, Eric J.; Langer, Robert; Teng, Yang D.

    2009-01-01

    Therapeutic impact of neural stem cells (NSCs) for acute spinal cord injury (SCI) has been limited by the rapid loss of donor cells. Neuroinflammation is likely the cause. Since there are close temporal-spatial correlations between the inducible nitric oxide (NO) synthase expression and the donor NSC death after neurotrauma, we reasoned that NO-associated radical species might be the inflammatory effectors which eliminate NSC grafts and kill host neurons. To test this hypothesis, human NSCs (...

  2. Rehabilitation of severely injured children.

    Gans, B. M.; di Scala, C.

    1991-01-01

    Injury is the leading cause of death and disability in childhood. Ideal systems of care integrate comprehensive management of acutely injured children with rehabilitation. We review the nature of childhood injury, its disabling consequences, and the best ways to manage the care of children with serious injuries.

  3. Extending ACL2 with SMT Solvers

    Peng, Yan; Greenstreet, Mark

    2015-01-01

    We present our extension of ACL2 with Satisfiability Modulo Theories (SMT) solvers using ACL2's trusted clause processor mechanism. We are particularly interested in the verification of physical systems including Analog and Mixed-Signal (AMS) designs. ACL2 offers strong induction abilities for reasoning about sequences and SMT complements deduction methods like ACL2 with fast nonlinear arithmetic solving procedures. While SAT solvers have been integrated into ACL2 in previous work, SMT method...

  4. Interaction of dependent and non-dependent regions of the acutely injured lung during a stepwise recruitment manoeuvre

    The benefit of treating acute lung injury with recruitment manoeuvres is controversial. An impediment to settling this debate is the difficulty in visualizing how distinct lung regions respond to the manoeuvre. Here, regional lung mechanics were studied by electrical impedance tomography (EIT) during a stepwise recruitment manoeuvre in a porcine model with acute lung injury. The following interaction between dependent and non-dependent regions consistently occurred: atelectasis in the most dependent region was reversed only after the non-dependent region became overdistended. EIT estimates of overdistension and atelectasis were validated by histological examination of lung tissue, confirming that the dependent region was primarily atelectatic and the non-dependent region was primarily overdistended. The pulmonary pressure–volume equation, originally designed for modelling measurements at the airway opening, was adapted for EIT-based regional estimates of overdistension and atelectasis. The adaptation accurately modelled the regional EIT data from dependent and non-dependent regions (R2 > 0.93, P < 0.0001) and predicted their interaction during recruitment. In conclusion, EIT imaging of regional lung mechanics reveals that overdistension in the non-dependent region precedes atelectasis reversal in the dependent region during a stepwise recruitment manoeuvre. (paper)

  5. Hydrogen-rich saline injection into the subarachnoid cavity within 2 weeks promotes recovery after acute spinal cord injur y

    Jian-long Wang; Qing-shan Zhang; Kai-di Zhu; Jian-feng Sun; Ze-peng Zhang; Jian-wen Sun; Ke-xiang Zhang

    2015-01-01

    Hydrogen can relieve tissue-damaging oxidative stress, inlfammation and apoptosis. Injection of hydrogen-rich saline is an effective method for transporting molecular hydrogen. We hypothe-sized that hydrogen-rich saline would promote the repair of spinal cord injury induced by Allen’s method in rats. At 0.5, 1, 2, 4, 8, 12 and 24 hours after injury, then once daily for 2 weeks, 0.25 mL/kg hydrogen-rich saline was infused into the subarachnoid space through a catheter. Results at 24 hours, 48 hours, 1 week and 2 weeks after injury showed that hydrogen-rich saline marked-ly reduced cell death, inlfammatory cell inifltration, serum malondialdehyde content, and caspa se-3 immunoreactivity, elevated serum superoxide dismutase activity and calcitonin gene-related peptide immunoreactivity, and improved motor function in the hindlimb. The present study conifrms that hydrogen-rich saline injected within 2 weeks of injury effectively contributes to the repair of spinal cord injury in the acute stage.

  6. Biomechanical risk factors of non-contact ACL injuries:A stochastic biomechanical modeling study

    Cheng-Feng; Lin; Hui; Liu; Michael; T.Gros; Paul; Weinhold; William; E.Garrett; Bing; Yu

    2012-01-01

    <正>Background:Significant efforts have been made to identify modifiable risk factors of non-contact anterior cruciate ligament(ACL) injuries in male and female athletes.However,current literature on the risk factors for ACL injury are purely descriptive.An understanding of biomechanical relationship between risk and risk factors of the non-contact ACL injury is necessary to develop effective prevention programs. Purpose:To compare lower extremity kinematics and kinetics between trials with and without non-contact ACL injuries and to determine if any difference exists between male and female trials with non-contact ACL injuries regarding the lower extremity motion patterns. Methods:In this computer simulation study,a stochastic biomechanical model was used to estimate the ACL loading at the time of peak posterior ground reaction force(GRF) during landing of the stop-jump task.Monte Carlo simulations were performed to simulate the ACL injuries with repeated random samples of independent variables.The distributions of independent variables were determined from in vivo laboratory data of 40 male and 40 female recreational athletes. Results:In the simulated injured trials,both male and female athletes had significantly smaller knee flexion angles,greater normalized peak posterior and vertical GRF.greater knee valgus moment,greater patella tendon force,greater quadriceps force,greater knee extension moment. and greater proximal tibia anterior shear force in comparison to the simulated uninjured trials.No significant difference was found between genders in any of the selected biomechanical variables in the trials with simulated non-contact ACL injuries. Conclusion:Small knee flexion angle,large posterior GRF.and large knee valgus moment are risk factors of non-contact ACL injury determined by a stochastic biomechanical model with a cause-and-effect relationship.

  7. Experimental Strategies to Bridge Large Tissue Gaps in the Injured Spinal Cord after Acute and Chronic Lesion.

    Brazda, Nicole; Estrada, Veronica; Voss, Christian; Seide, Klaus; Trieu, Hoc Khiem; Müller, Hans Werner

    2016-01-01

    After a spinal cord injury (SCI) a scar forms in the lesion core which hinders axonal regeneration. Bridging the site of injury after an insult to the spinal cord, tumor resections, or tissue defects resulting from traumatic accidents can aid in facilitating general tissue repair as well as regenerative growth of nerve fibers into and beyond the affected area. Two experimental treatment strategies are presented: (1) implantation of a novel microconnector device into an acutely and completely transected thoracic rat spinal cord to readapt severed spinal cord tissue stumps, and (2) polyethylene glycol filling of the SCI site in chronically lesioned rats after scar resection. The chronic spinal cord lesion in this model is a complete spinal cord transection which was inflicted 5 weeks before treatment. Both methods have recently achieved very promising outcomes and promoted axonal regrowth, beneficial cellular invasion and functional improvements in rodent models of spinal cord injury. The mechanical microconnector system (mMS) is a multi-channel system composed of polymethylmethacrylate (PMMA) with an outlet tubing system to apply negative pressure to the mMS lumen thus pulling the spinal cord stumps into the honeycomb-structured holes. After its implantation into the 1 mm tissue gap the tissue is sucked into the device. Furthermore, the inner walls of the mMS are microstructured for better tissue adhesion. In the case of the chronic spinal cord injury approach, spinal cord tissue - including the scar-filled lesion area - is resected over an area of 4 mm in length. After the microsurgical scar resection the resulting cavity is filled with polyethylene glycol (PEG 600) which was found to provide an excellent substratum for cellular invasion, revascularization, axonal regeneration and even compact remyelination in vivo. PMID:27077921

  8. Activation of TLR-4 and liver injur y via NF-kappa B in rat with acute cholangitis

    Hong Yu; Shuo-Dong Wu

    2008-01-01

    BACKGROUND:Toll-like receptors (TLRs) are a family of type 1 transmembrane receptors, which can recognize different pathogen-associated molecular patterns. Among them, TLR-4 is speciifc to lipopolysaccharide. It transfers the infection signal into the cell and promotes the translocation of nuclear factor kappa B (NF-κB) to the nucleus and the subsequent transcriptional activation of genes encoding pro-and anti-inlfammatory cytokines and chemokines. Acute cholangitis (AC) is a common biliary tract infection in oriental countries, and often leads to liver injury. The activation of TLR-4 and its signiifcance in liver injury in rats with AC remain unclear. METHODS:Rat models of AC (biliary tract obstruction+E. coli injection, n=36) and control models (biliary tract obstruction+saline, n=18) were made. Liver tissue injury was investigated by pathological examination. The levels of serum TNF-α and IL-10 were measured by enzyme-linked immunosorbent assay, and the expressions of TLR-4, NF-κB mRNAs and proteins in the liver were detected by RT-PCR, immunohistochemical staining and Western blotting, respectively. RESULTS: Severe liver tissue injury in rats with AC was evident as shown by pathological examination. TLR-4 and NF-κB were strongly expressed in the cytoplasm of hepatocytes in the AC group. They were negative or slightly positive in the control group. TLR-4 mRNA and protein in the liver of rats with AC increased 1 hour after biliary tract ligation and E. coli injection, and peaked at 6 hours after surgery. Twenty-four hours later, they began to decrease. The expression of TLR-4 was paralleled by that of NF-κB in the liver and TNF-αin serum. CONCLUSION:The higher expression of TLR-4 in the liver of rats with AC may be involved in liver injury through the activation of NF-κB and release of cytokines such as TNF-α.

  9. Partial ACL rupture: an MR diagnosis?

    We sought to clarify the ability of magnetic resonance imaging (MR) to show partial anterior cruciate ligament (ACL) ruptures and to allow distinction of partial from complete ACL ruptures. Eighty-eight patients were studied by arthroscopy and MR (36 with normal ACLs, 21 with partial ACL ruptures, and 31 with complete ACL ruptures). MR studies were interpreted by an experienced, blinded reader. MR examinations were also independently scored with respect to four primary and seven secondary signs, and these data were analyzed using discriminant analysis. The sensitivity of MR is lower for partial than for complete ACL ruptures. Most detected partial ACL ruptures resemble complete ruptures on MR. Secondary signs do not significantly improve detection of partial ACL ruptures, but they do help to distinguish partial from complete ACL ruptures. Displacement of the posterior horn of the lateral meniscus and popliteus muscle injury are indicative of complete ACL rupture. The majority of partial ACL ruptures are shown by MR, but MR is less sensitive for partial than for complete ACL rupture. The distinction of partial from complete ACL rupture on MR examination, while problematic, is slightly improved by assessment of secondary signs. (orig.)

  10. Partial ACL rupture: an MR diagnosis?

    Yao, L. [Dept. of Radiological Sciences, UCLA Center for the Health Sciences, Los Angeles, CA (United States); Gentili, A. [Dept. of Radiology, UCLA-Wadsworth Medical Center, Los Angeles, CA (United States); Petrus, L. [Dept. of Radiology, UCLA-Olive View Medical Center, Sylmar, CA (United States); Lee, J.K. [Dept. of Radiology, Samaritan Hospital, Troy, NY (United States)

    1995-05-01

    We sought to clarify the ability of magnetic resonance imaging (MR) to show partial anterior cruciate ligament (ACL) ruptures and to allow distinction of partial from complete ACL ruptures. Eighty-eight patients were studied by arthroscopy and MR (36 with normal ACLs, 21 with partial ACL ruptures, and 31 with complete ACL ruptures). MR studies were interpreted by an experienced, blinded reader. MR examinations were also independently scored with respect to four primary and seven secondary signs, and these data were analyzed using discriminant analysis. The sensitivity of MR is lower for partial than for complete ACL ruptures. Most detected partial ACL ruptures resemble complete ruptures on MR. Secondary signs do not significantly improve detection of partial ACL ruptures, but they do help to distinguish partial from complete ACL ruptures. Displacement of the posterior horn of the lateral meniscus and popliteus muscle injury are indicative of complete ACL rupture. The majority of partial ACL ruptures are shown by MR, but MR is less sensitive for partial than for complete ACL rupture. The distinction of partial from complete ACL rupture on MR examination, while problematic, is slightly improved by assessment of secondary signs. (orig.)

  11. Biomechanical Evaluation of Knee Kinematics after ACL Reconstructions in Anatomic SB and DB - Technique with Additional Medial Meniscus Suture

    Lorbach, Olaf; Herbort, Mirco; Engelhardt, Martin; Kieb, Matthias

    2013-01-01

    Objectives: Biomechanical evaluation of knee laxity after single- and double-bundle ACL reconstruction with additional medial meniscus suture. Methods: Kinematics of the intact knee were determined in 12 human cadaver specimens in response to a 134-N anterior tibial load (aTT) and a combined rotatory load of 10 Nm valgus and 4 Nm internal tibial rotation using a robotic/universal force moment sensor testing system. Subsequently, the ACL was resected following the creation of a bucket-handle tear of the medial meniscus. A standard repair of the medial meniscus was performed using 3 inside-out horizontal sutures. Finally, The ACL was reconstructed using an anatomic single-bundle (6) or double-bundle technique (6). Knee kinematics were determined following every sub-step. Results: Significant increase of aTT in the ACL-deficient knee was found with significant increase in the ACL-deficient knee with additional medial meniscal injury (p=.003; p=.009). ACL reconstructions significantly decreased aTT compared to the ACL-deficient knee. No significant differences were found between the intact knee and the ACL reconstructed knee with additional meniscal repair. In response to a simulated pivot shift, aTT in the intact knee significantly increased in the ACL-deficient knee as well as in the meniscus injured/meniscus-sutured knee (p=.003;p=.007). No significant differences were found between the ACL-deficient and ACL reconstructed knee with additional meniscal repair. SB as well as DB ACL reconstruction with additional medial meniscal repair restored knee kinematics compared to the intact knee. Comparison of SB versus DB ACL reconstruction did not reveal any significant differences neither in a simulated Lachman test nor in response to a simulated pivot shift (p=.05). Conclusion: aTT as well as aTT in response to a combined rotatory load significantly increased with ACL deficiency compared to the intact knee, additional medial meniscal injury further increased aTT. Anatomic

  12. An Athlete's Nightmare: Tearing the ACL

    ... Issue Past Issues An Athlete's Nightmare : Tearing the ACL Past Issues / Summer 2008 Table of Contents For ... years after successful surgery to repair a torn ACL, Michelle Backus of Gaithersburg, Md., is once again ...

  13. Pediatric ACL injuries: evaluation and management

    Mall, Nathan A.; Paletta, George A.

    2013-01-01

    The anterior cruciate ligament (ACL) is a stabilizing structure to both anterior translation of the tibia with respect to the femur as well as rotation of the knee joint. Children and adolescents are susceptible to these injuries, and there are some who believe the incidence of ACL injuries in this population is increasing due to year round single sport participation. Pediatric ACL injuries are typically seen in several forms: tibial avulsion fractures, partial ACL tears, and full thickness l...

  14. Mechanisms of non‐contact ACL injuries

    Yu, Bing; Garrett, William E.

    2007-01-01

    In soccer one of the most common knee injuries is the anterior cruciate ligament (ACL) tear, which usually occurs through non‐contact mechanisms. Female soccer players are at higher risk of sustaining non‐contact ACL injuries than male soccer players. A good understanding of ACL loading mechanisms is the basis for a good understanding of the mechanisms of non‐contact ACL injuries, which in turn is essential for identifying risk factors and developing prevention strategies. Current literature ...

  15. Motor learning in ACL injury prevention

    Benjaminse, Anne

    2015-01-01

    Motor learning in ACL injury prevention
Anne Benjaminse

The physical and psychosocial consequences of an anterior cruciate ligament (ACL) injury are large, for example limitations in daily life, reduction of sports participation, development of osteoarthritis in the knee and increased risk for re-rupture. The importance of prevention is clear, however we have not been able yet to reduce the ACL injury incidence. The aim of this dissertation was therefore to examine how current ACL injury pre...

  16. Evidence-Based ACL Reconstruction

    E. Carlos RODRIGUEZ-MERCHAN

    2015-01-01

    Full Text Available There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACLreconstruction. The purpose of this article is to answer the following questions: 1 Bone patellar tendon bone (BPTB reconstruction or hamstring reconstruction (HR; 2 Double bundle or single bundle; 3 Allograft or authograft; 4 Early or late reconstruction; 5 Rate of return to sports after ACL reconstruction; 6 Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analysesfocused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years.

  17. Imaging biopsy composition at ACL reconstruction

    Pedersen DR

    2013-04-01

    Full Text Available Douglas R Pedersen,1,2 James A Martin,1,2 Daniel R Thedens,3 Noelle F Klocke,1,2 Nathaniel H Roberts,1 Jessica E Goetz,1 Annunziato Amendola1 1Department of Orthopaedics and Rehabilitation, 2Department of Biomedical Engineering, 3Department of Radiology, University of Iowa, Iowa City, IA, USA Purpose: Early-stage osteoarthritis (OA includes glycosaminoglycan (GAG loss and collagen disruption that cannot be seen on morphological magnetic resonance imaging (MRI. T1ρ MRI is a measurement that probes the low-frequency rate of exchange between protons of free water and those from water associated with macromolecules in the cartilage's extracellular matrix. While it has been hypothesized that increased water mobility resulting from early osteoarthritic changes cause elevated T1ρ MRI values, there remain several unknown mechanisms influencing T1ρ measurements in cartilage. The purpose of this work was to relate histological and biochemical metrics directly measured from osteochondral biopsies and fluid specimens with quantitative MRI-detected changes of in vivo cartilage composition. Patients and methods: Six young patients were enrolled an average of 41 days after acute anterior cruciate ligament (ACL rupture. Femoral trochlear groove osteochondral biopsies, serum, and synovial fluid were harvested during ACL reconstruction to complement a presurgery quantitative MRI study (T1ρ, T2, delayed gadolinium-enhanced MRI of cartilage [dGEMRIC] relaxation times. A high-resolution MRI scan of the excised osteochondral biopsy was also collected. Analyses of in vivo T1ρ images were compared with ex vivo T1ρ imaging, GAG assays and histological GAG distribution in the osteochondral biopsies, and direct measures of bone and cartilage turnover markers and "OA marker" 3B3 in serum and synovial fluid samples. Conclusion: T1ρ relaxation times in patients with a torn ACL were elevated from normal, indicating changes consistent with general fluid effusion after

  18. The effect of protein and carbohydrate supplementation on strength training outcome of rehabilitation in ACL patients

    Holm, Lars; Esmarck, B.; Mizuno, M.;

    2006-01-01

    therefore to investigate if nutrient supplementation during 12 weeks of conservative rehabilitation strength training could enhance hypertrophy and strength of the quadriceps muscle in ACL-injured patients. Twenty-six ACL-injured men and women were included and randomly distributed into three...... supplementation groups: Protein+Carbohydrate (PC), Isocaloric-Carbohydrate (IC), or Placebo (PL), ingesting the supplementation immediately after each of 36 training sessions. Determined from images of thigh cross-sections (magnetic resonance imaging) the hypertrophy of the quadriceps muscle differed...... significantly between groups at the distal part, with the PC group demonstrating the largest hypertrophy. Peak torque of the quadriceps muscle at constant velocity 60 degrees.s-1 was significantly elevated in the PC group only, and the time to reach peak torque tended to decrease as well only in the PC group...

  19. Differential properties of human ACL and MCL stem cells may be responsible for their differential healing capacity

    Fu Freddie H

    2011-06-01

    Full Text Available Abstract Background The human anterior cruciate ligament (hACL and medial collateral ligament (hMCL of the knee joint are frequently injured, especially in athletic settings. It has been known that, while injuries to the MCL typically heal with conservative treatment, ACL injuries usually do not heal. As adult stem cells repair injured tissues through proliferation and differentiation, we hypothesized that the hACL and hMCL contain stem cells exhibiting unique properties that could be responsible for the differential healing capacity of the two ligaments. Methods To test the above hypothesis, we derived ligament stem cells from normal hACL and hMCL samples from the same adult donors using tissue culture techniques and characterized their properties using immunocytochemistry, RT-PCR, and flow cytometry. Results We found that both hACL stem cells (hACL-SCs and hMCL stem cells (hMCL-SCs formed colonies in culture and expressed stem cell markers nucleostemin and stage-specific embryonic antigen-4 (SSEA-4. Moreover, both hACL-SCs and hMCL-SCs expressed CD surface markers for mesenchymal stem cells, including CD44 and CD90, but not those markers for vascular cells, CD31, CD34, CD45, and CD146. However, hACL-SCs differed from hMCL-SCs in that the size and number of hACL-SC colonies in culture were much smaller and grew more slowly than hMCL-SC colonies. Moreover, fewer hACL-SCs in cell colonies expressed stem cell markers STRO-1 and octamer-binding transcription factor-4 (Oct-4 than hMCL-SCs. Finally, hACL-SCs had less multi-differentiation potential than hMCL-SCs, evidenced by differing extents of adipogenesis, chondrogenesis, and osteogenesis in the respective induction media. Conclusions This study shows for the first time that hACL-SCs are intrinsically different from hMCL-SCs. We suggest that the differences in their properties contribute to the known disparity in healing capabilities between the two ligaments.

  20. LYCAT, a homologue of C. elegans acl-8, acl-9, and acl-10, determines the fatty acid composition of phosphatidylinositol in mice[S

    Imae, Rieko; Inoue, Takao; Nakasaki, Yasuko; Uchida, Yasunori; Ohba, Yohsuke; Kono, Nozomu; Nakanishi, Hiroki; Sasaki, Takehiko; Mitani, Shohei; Arai, Hiroyuki

    2012-01-01

    Mammalian phosphatidylinositol (PI) has a unique fatty acid composition in that 1-stearoyl-2-arachidonoyl species is predominant. This fatty acid composition is formed through fatty acid remodeling by sequential deacylation and reacylation. We recently identified three Caenorhabditis elegans acyltransferases (ACL-8, ACL-9, and ACL-10) that incorporate stearic acid into the sn-1 position of PI. Mammalian LYCAT, which is the closest homolog of ACL-8, ACL-9, and ACL-10, was originally identified...

  1. Treatment for acute anterior cruciate ligament tear

    Frobell, Richard B; Roos, Harald P; Roos, Ewa M; Roemer, Frank W; Ranstam, Jonas; Lohmander, Stefan

    2013-01-01

    To compare, in young active adults with an acute anterior cruciate ligament (ACL) tear, the mid-term (five year) patient reported and radiographic outcomes between those treated with rehabilitation plus early ACL reconstruction and those treated with rehabilitation and optional delayed ACL...

  2. Data Definitions in the ACL2 Sedan

    Chamarthi, Harsh Raju; Dillinger, Peter C.; Manolios, Panagiotis

    2014-01-01

    We present a data definition framework that enables the convenient specification of data types in ACL2s, the ACL2 Sedan. Our primary motivation for developing the data definition framework was pedagogical. We were teaching undergraduate students how to reason about programs using ACL2s and wanted to provide them with an effective method for defining, testing, and reasoning about data types in the context of an untyped theorem prover. Our framework is now routinely used not only for pedagogica...

  3. Anatomic Double-Bundle Reinsertion After Acute Proximal Anterior Cruciate Ligament Injury Using Knotless PushLock Anchors

    Weninger, Patrick; Wepner, Florian; Kissler, Florian; Enenkel, Michael; Wurnig, Christian

    2015-01-01

    Direct anterior cruciate ligament (ACL) repair has been described with different suture techniques after acute ACL injury, but these procedures showed high failure rates. Recent studies, however, led to a better understanding of the biology of primary ACL healing. This article describes a novel technique combining the “healing response technique” with primary anatomic double-bundle ACL reinsertion after an acute proximal ACL tear using nonabsorbable No. 2 FiberWire (Arthrex, Naples, FL) and P...

  4. ACL RECONSTRUCTION ‐ IT'S ALL ABOUT TIMING

    Evans, Stephanie; Shaginaw, Justin; Bartolozzi, Arthur

    2014-01-01

    Injury to the anterior cruciate ligament (ACL) is the most common ligamentous injury, ranging from up to 200,000 injuries per year in the United States. Sports such as soccer, football, and skiing have been reported to be high‐risk sports that can cause injury to the ACL when compared to other sport activities. Due to the high incidence of ACL injuries, approximately 100,000 ACL reconstructions are performed each year. Although conservative treatment can potentially be successful in the appro...

  5. Rehabilitation after ACL Injury: A Fluoroscopic Study on the Effects of Type of Exercise on the Knee Sagittal Plane Arthrokinematics

    Sadegh Norouzi

    2013-01-01

    Full Text Available A safe rehabilitation exercise for anterior cruciate ligament (ACL injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference points, at seven knee flexion angles, from 0° to 90°. No significant differences were found between the ATTs of the ACL-deficient and intact knees at all flexion angles during forward lunge and unloaded open kinetic knee extension (. During loaded open kinetic knee extension, however, the ATTs of the ACL deficient knees were significantly larger than those of the intact knees at 0° (. It was suggested that the forward lunge, as a weight-bearing closed kinetic chain exercise, provides a safer approach for developing muscle strength and functional stability in rehabilitation program of ACL-deficient knees, in comparison with open kinetic knee extension exercise.

  6. Transplantation of the meniscus and the ACL

    Binnet, Mehmet S.

    2004-01-01

    As the last step in the preservation of the menisci, transplantation of this organ is developing. After the pioneering work of Fu, ACL transplantation of these organs have come info routine practice. In this paper we presented a case in which we had performed an allograft meniskus and ACL transplantation with a short review of contemporary literature.

  7. MR imaging of bone bruise associated with ACL tear

    The authors reviewed 56 MR studies of the knee performed for suspected cruciate ligament tear at the Tokyo Metropolitan Hiroo Hospital from April 1990 to March 1991. There were 10 patients with abnormal signal in the subcortical bone marrow. Eight of these patients had concomitant anterior cruciate ligament (ACL) tear with no evidence of fracture on plain radiographs of the knee. The abnormal signals were all seen in the lateral compartment, almost invariably in the middle third of the lateral femoral condyle and posterolateral aspect of the tibial plateau, and were of low intensity on T1-weighted and proton density images and of high intensity on T2-weighted images. It was speculated that these abnormalities resulted from impaction of the lateral femoral condyle into the posterior lip of the tibial plateau due to rotary subluxation of the tibia. One patient had a follow-up study three months later, which revealed complete resolution of bone bruise. It was concluded that bone bruise associated with ACL tear is seen specific locations, which may be a useful secondary sign of acute ACL tear. (author)

  8. Effects of ACL Reconstructive Surgery on Temporal Variations of Cytokine Levels in Synovial Fluid

    Bigoni, Marco; Gandolla, Marta; Sacerdote, Paola; Piatti, Massimiliano; Castelnuovo, Alberto; Franchi, Silvia; Gorla, Massimo; Munegato, Daniele; Gaddi, Diego; Pedrocchi, Alessandra; Omeljaniuk, Robert J.; Locatelli, Vittorio; Torsello, Antonio

    2016-01-01

    Anterior cruciate ligament (ACL) reconstruction restores knee stability but does not reduce the incidence of posttraumatic osteoarthritis induced by inflammatory cytokines. The aim of this research was to longitudinally measure IL-1β, IL-6, IL-8, IL-10, and TNF-α levels in patients subjected to ACL reconstruction using bone-patellar tendon-bone graft. Synovial fluid was collected within 24–72 hours of ACL rupture (acute), 1 month after injury immediately prior to surgery (presurgery), and 1 month thereafter (postsurgery). For comparison, a “control” group consisted of individuals presenting chronic ACL tears. Our results indicate that levels of IL-6, IL-8, and IL-10 vary significantly over time in reconstruction patients. In the acute phase, the levels of these cytokines in reconstruction patients were significantly greater than those in controls. In the presurgery phase, cytokine levels in reconstruction patients were reduced and comparable with those in controls. Finally, cytokine levels increased again with respect to control group in the postsurgery phase. The levels of IL-1β and TNF-α showed no temporal variation. Our data show that the history of an ACL injury, including trauma and reconstruction, has a significant impact on levels of IL-6, IL-8, and IL-10 in synovial fluid but does not affect levels of TNF-α and IL-1β. PMID:27313403

  9. ACL command with forward converter

    Morard, Julien; Biner, Hans-Peter

    2009-01-01

    Objectif: Les ACL sont des lampes 28V/250W utilisées dans le domaine de l’éclairage scénique. Jusqu’à présent 8 lampes sont branchées en série sur le réseau ce qui interdit toute commande individuelle. L’appareil conçu dans ce projet contient un « Power Factor Corrector PFC » pour pouvoir créer un bus de tension à 400V et un convertisseur de type « Forward » pour chaque lampe qui réduit la tension à 28 Volts efficace. Le convertisseur Forward a été conçu lors du travail de semestre. L’objecti...

  10. Proprioceptive deficits after ACL injury : are they clinically relevant?

    Gokeler, Alli; Benjaminse, Anne; Hewett, Timothy E.; Lephart, Scott M.; Engebretsen, Lars; Ageberg, Eva; Engelhardt, Martin; Arnold, Markus P.; Postema, Klaas; Otten, Egbert; Dijkstra, Pieter U.

    2012-01-01

    Objective To establish the clinical relevance of proprioceptive deficits reported after anterior cruciate ligament (ACL) injury. Material and methods A literature search was done in electronic databases from January 1990 to June 2009. Inclusion criteria for studies were ACL deficient (ACL-D) and ACL

  11. Proprioceptive deficits after ACL injury: are they clinically relevant?

    Gokeler, Alli; Benjaminse, Anne; Hewett, Timothy E.; Lephart, Scott M.; Engebretsen, Lars; Ageberg, Eva; Engelhardt, Martin; Arnold, Markus P; Postema, Klaas; Otten, Egbert; Dijkstra, Pieter U.

    2012-01-01

    Objective To establish the clinical relevance of proprioceptive deficits reported after anterior cruciate ligament (ACL) injury. Material and methods A literature search was done in electronic databases from January 1990 to June 2009. Inclusion criteria for studies were ACL deficient (ACL-D) and ACL reconstruction (ACL-R) articles written in English, Dutch or German and calculation of correlation(s) between proprioception tests and clinical outcome measures. Clinical outcome measures were mus...

  12. MRI Study of the ACL in Children and Adolescents

    Cvjetko, Ivan; Dovžak, Ivana; Banić, Tihomir; Bakota, Bore; Borić, Igor

    2011-01-01

    Reconstruction of the ACL (anterior cruciate ligament) requires precise anatomical placement of the tendon graft. Anatomic variations may increase/decrease risk of the ACL rupture. Twenty-eight children with clinical, MRI and arthroscopic verified ACL ruptures were compared with match case control group. MRI was done one to 12 months after trauma. The thresholds values for identifying the ACL rupture were set; ACL angle 0°, and the PCL angle

  13. ACL TRAUMATIC INJURIES AND POST OPERATIVE CHANGES

    Leila Aghaghazvini

    2012-05-01

    Full Text Available Purpose: The objective of this exhibit is to explain imaging of ACL traumatic injuries and post operative changes.Content: Cruciate ligaments have an extra-synovial and intra-capsular location between which fatty tissue lies. The ACL is best seen on sagittal oblique images with slices oriented parallel to the cortex of the lateral femoral condyle so with extension during examination the ligament should therefore appear taut with an approximate 60 degree angle to the tibial plateau. Following injury, there are primary and secondary signs of ACL tearing which will discussed.Summary: In this exhibit, we present imaging findings of ACL injuries. Information about these findings may permit the radiologist to play a significant role in the diagnosis of the problem and prevention of any additional procedures.

  14. Anterior cruciate ligament- specialized post-operative return-to-sports (ACL-SPORTS) training: a randomized control trial

    White, Kathleen; Di Stasi, Stephanie L.; Smith, Angela H; Snyder-Mackler, Lynn

    2013-01-01

    Background Anterior cruciate ligament reconstruction (ACLR) is standard practice for athletes that wish to return to high-level activities; however functional outcomes after ACLR are poor. Quadriceps strength weakness, abnormal movement patterns and below normal knee function is reported in the months and years after ACLR. Second ACL injuries are common with even worse outcomes than primary ACLR. Modifiable limb-to-limb asymmetries have been identified in individuals who re-injure after prima...

  15. Strategies to avoid a missed diagnosis of co-occurring concussion in post-acute patients having a spinal cord injur y

    David S. Kushner

    2015-01-01

    Research scientists and clinicians should be aware that missed diagnoses of mild-moderate trau-matic brain injuries in post-acute patients having spinal cord injuries may approach 60–74%with certain risk factors, potentially causing clinical consequences for patients, and confounding the results of clinical research studies. Factors leading to a missed diagnosis may include acute trau-ma-related life-threatening issues, sedation/intubation, subtle neuropathology on neuroimaging, failure to collect Glasgow Coma Scale scores or duration of posttraumatic amnesia, or lack of va-lidity of this information, and overlap in neuro-cognitive symptoms with emotional responses to spinal cord injuries. Strategies for avoiding a missed diagnosis of mild-moderate traumatic brain injuries in patients having a spinal cord injuries are highlighted in this perspective.

  16. The risk assessment score in acute whiplash injury predicts outcome and reflects biopsychosocial factors

    Kasch, Helge; Qerama, Erisela; Kongsted, Alice;

    2011-01-01

    One-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle-injured controls.......One-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle-injured controls....

  17. How Can I Do That with ACL2? Recent Enhancements to ACL2

    Matt Kaufmann; J Strother Moore

    2011-01-01

    The last several years have seen major enhancements to ACL2 functionality, largely driven by requests from its user community, including utilities now in common use such as 'make-event', 'mbe', and trust tags. In this paper we provide user-level summaries of some ACL2 enhancements introduced after the release of Version 3.5 (in May, 2009, at about the time of the 2009 ACL2 workshop) up through the release of Version 4.3 in July, 2011, roughly a couple of years later. Many of these features ar...

  18. The potential for primary repair of the ACL

    Vavken, Patrick; Murray, Martha M.

    2011-01-01

    The objective of this work is to assess the feasibility of successfully repairing the torn ACL. Two major motivators for developing a new treatment for ACL injuries are the recently reported high rates of osteoarthritis after conventional ACL reconstruction as well as the problem of how to safely treat skeletally immature patients. A key factor in developing such a technique was the identification of the main inhibitor of intrinsic ACL healing – the lack of clot formation between the two torn...

  19. Dynamic intraligamentary stabilization: novel technique for preserving the ruptured ACL

    Eggli, S; Kohlhof, H.; Zumstein, M.; Henle, P; Hartel, M; Evangelopoulos, D. S.; Bonel, H; Kohl, S.

    2015-01-01

    PURPOSE Replacement of the torn anterior cruciate ligament (ACL) with a transplant is today`s gold standard. A new technique for preserving and healing the torn ACL is presented. HYPOTHESIS a dynamic intraligamentary stabilization (DIS) that provides continuous postinjury stability of the knee and ACL in combination with biological improvement of the healing environment [leucocyte- and platelet-rich fibrin (L-PRF) and microfracturing] should enable biomechanically stable ACL self-...

  20. Dynamic intraligamentary stabilization: novel technique for preserving the ruptured ACL

    Eggli, S; Kohlhof, H.; Zumstein, M.; Henle, P; Hartel, M; Evangelopoulos, D. S.; Bonel, H; Kohl, S.

    2014-01-01

    Purpose Replacement of the torn anterior cruciate ligament (ACL) with a transplant is today`s gold standard. A new technique for preserving and healing the torn ACL is presented. Hypothesis: a dynamic intraligamentary stabilization (DIS) that provides continuous postinjury stability of the knee and ACL in combination with biological improvement of the healing environment [leucocyte- and platelet-rich fibrin (L-PRF) and microfracturing] should enable biomechanically stable ACL self-healing. Me...

  1. Reducing the Risk of ACL Injury in Female Athletes

    McDaniel, Larry W.; Rasche, Adrienna; Gaudet, Laura; Jackson, Allen

    2010-01-01

    The Anterior Cruciate Ligament (ACL) is located behind the kneecap (patella) and connects the thigh bone (femur) to the shin bone (tibia). Stabilizing the knee joint is the primary responsibility of the ACL. Injuries that affect the ACL are three to five times more common in females than males. This is a result of anatomical, biomechanical,…

  2. How Can I Do That with ACL2? Recent Enhancements to ACL2

    Kaufmann, Matt; 10.4204/EPTCS.70.4

    2011-01-01

    The last several years have seen major enhancements to ACL2 functionality, largely driven by requests from its user community, including utilities now in common use such as 'make-event', 'mbe', and trust tags. In this paper we provide user-level summaries of some ACL2 enhancements introduced after the release of Version 3.5 (in May, 2009, at about the time of the 2009 ACL2 workshop) up through the release of Version 4.3 in July, 2011, roughly a couple of years later. Many of these features are not particularly well known yet, but most ACL2 users could take advantage of at least some of them. Some of the changes could affect existing proof efforts, such as a change that treats pairs of functions such as 'member' and 'member-equal' as the same function.

  3. 急性颅脑损伤病人免感染营养支持的分析%The acute brain injured the patient to exempt the infection nutrition support to analyze

    李道佩; 零达尚

    2005-01-01

    OBJECTIVE Understood the domestic and foreign acute skulls damage patient's nutrition support, and how on achieves avoids or reduce infection illness complication occurrence makes the suitable analysis. MATERIAL AND METHOD Draws support specialized database: Medline、wanfang data digitization periodical, Qinghuatongfang CHKD periodical entire library. In the comparison, in the induction related content foundation carries on the analysis. RESULTS Altogether searches to is discussing 6,Special study 5,Special course 8,Related report 13. The acute brain injures patient's nutrition support way mainly for to pass through outside the stomach and intestines the nutrition (PN), outside the entire intestines the nutrition (TPN) and in the stomach and intestines the nutrition (EN). Carries on the nutrition support in the acute brain injure early time to achieve the mutual recognition, how but arranges outside the intestines in the nutrition and the intestines the nutrition use, always has the different position. CONCLUSION In the intestines the nutrition support compares outside the intestines the nutrition support to be possible to avoid, to reduce this kind of patient because the nutrition support to cause the infection illness complication the occurrence; carries on the nutrition support regarding this kind of patient to be possible to divide into two stages: outside the first stage intestines in the nutrition support and the intestines also the nutrition support carries on, after waits the brain damage condition to be stable transits to the second stage entire stomach and intestines in the nutrition support.%目的了解国内外急性颅脑损伤病人的营养支持,并就如何做到避免、减少感染并发症的发生作适当分析.资料与方法所借助的专业数据库:Medline、万方数据库数字化期刊、清华同方CHKD期刊全文库.在比较、归纳有关内容的基础上进行分析.结果共搜索到论著6篇,专题研究5篇,专题讲座8

  4. Psychopathological responses of physically injured persons

    Lešić Aleksandar

    2003-01-01

    seriousness of injuries but also to the circumstances of their occurrence. The proneness to develop PTSD symptoms was not in correlation with the preparedness for accident, it being much poorer in peacetime injuries, as opposed to wartime patients, who had been prepared to the possibility of injury occurrence. The highest value of family homogeneity (FHI was established in the wartime injured, which led us to conclude that the injury contributed to the cohesion of the family from which the patient came. By extracting some questions related to psychopathological entities such as insomnia, depression, somatization, anxiety, and cognitive disorders, the following results were obtained. Depression was the most frequent in both groups of injuries. Anxiety was also present in the control group; and insomnia and somatization, that is, conversion symptoms, were present in both groups of the injured. By examining narrower psychological characteristics of the wartime injured revealed dissociation problems derangement to be the most frequent. Then follow the symptoms of depression which occur significantly more frequently in the wartime injured in comparison to the peacetime injured. The phenomenological symptoms of derangement and depression proved to be reliable parameters of physical trauma. It is also significant that the three characteristics showed correlation to psychopathological responses: severity of surgery, paralysis and acute injury.

  5. A Comparison of Dynamic Postural Stability Between Asymptomatic Controls and Male Patients One Year After ACL Reconstruction (Pilot Study)

    Ataoglu, Muhammed Baybars; Hazar, Zeynep; Kafa, Nihan; Özer, Mustafa; Citaker, Seyit

    2014-01-01

    Objectives: The purpose of this study was to determine if dynamic postural stability gained one year after ACL reconstruction in patients who received rehabilitation. Methods: Seven male patients (mean age=32,66 ±6,47) who had previously undergone ACL reconstruction (ACL-R) and 7 sex-and general physical activity matched uninjured controls included to study. Mean time since original injury was 13±3,31 months. Dynamic postural control was assessed with 20° knee flexion with Star Excursion Balance test. Each participant performed 3 trials of the anterior, posterior-medial, and posterior-lateral directional components of the SEBT. Reach distances for each directional component were compared with non-injured leg and healthy controls’. Results: There was no significant difference in all directions of Star Excursion Balance test between neither the operated and uninjured knees of patients nor between patients and healthy controls (p>0,05). Conclusion: No deficits in dynamic postural stability were present average one year after ACL reconstruction in patients who received rehabilitation. It can be said that rehabilitation is effective in the recovery of dynamic postural stability.

  6. Functional and muscle morphometric effects of ACL reconstruction. A prospective CT study with 1 year follow-up.

    Lindström, M; Strandberg, S; Wredmark, T; Felländer-Tsai, L; Henriksson, M

    2013-08-01

    Computed tomography (CT) was used to explore if changes in muscle cross-sectional area and quality after anterior cruciate ligament (ACL) injury and reconstruction would be related to knee function. Fourteen females and 23 males (16-54 years) underwent clinical tests, subjective questionnaires, and CT 1 week before and 1 year after ACL surgery with semitendinosus-gracilis (STG) graft and rehabilitation. Postoperatively, knee laxity was decreased and functional knee measures and subjective patient scores improved. The most obvious remaining deficit was the quadriceps atrophy, which was significantly larger if the right leg was injured. Right-leg injury also tended to cause larger compensatory hypertrophy of the combined knee flexor and tibial internal rotator muscles (preoperatively). The quadriceps atrophy was significantly correlated with the scores and functional tests, the latter also being related to the remaining size of the gracilis muscle. Biceps femoris hypertrophy and, in males only, semimembranosus hypertrophy was observed following the ACL reconstruction. The lack of semimembranosus hypertrophy in the women could, via tibial internal rotation torque deficit, contribute to the less favorable functional and subjective outcome recorded for the women. The results indicate that the quadriceps, the combined knee flexor/tibial internal rotator muscles, side of ACL injury, and sex are important to consider in rehabilitation after STG graft. PMID:22107159

  7. The Risk Assessment Score in acute whiplash injury predicts outcome and reflects bio-psycho-social factors

    Kasch, Helge; Qerama, Erisela; Kongsted, Alice;

    2011-01-01

    One-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle-injured controls.......One-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle-injured controls....

  8. Schwann cells generated from neonatal skin-derived precursors or neonatal peripheral nerve improve functional recovery after acute transplantation into the partially injured cervical spinal cord of the rat.

    Sparling, Joseph S; Bretzner, Frederic; Biernaskie, Jeff; Assinck, Peggy; Jiang, Yuan; Arisato, Hiroki; Plunet, Ward T; Borisoff, Jaimie; Liu, Jie; Miller, Freda D; Tetzlaff, Wolfram

    2015-04-29

    The transplantation of Schwann cells (SCs) holds considerable promise as a therapy for spinal cord injury, but the optimal source of these cells and the best timing for intervention remains debatable. Previously, we demonstrated that delayed transplantation of SCs generated from neonatal mouse skin-derived precursors (SKP-SCs) promoted repair and functional recovery in rats with thoracic contusions. Here, we conducted two experiments using neonatal rat cells and an incomplete cervical injury model to examine the efficacy of acute SKP-SC transplantation versus media control (Experiment 1) and versus nerve-derived SC or dermal fibroblast (Fibro) transplantation (Experiment 2). Despite limited graft survival, by 10 weeks after injury, rats that received SCs from either source showed improved functional recovery compared with media- or fibroblast-treated animals. Compared with media treatment, SKP-SC-transplanted rats showed enhanced rubrospinal tract (RST) sparing/plasticity in the gray matter (GM) rostral to injury, particularly in the absence of immunosuppression. The functional benefits of SC transplantations over fibroblast treatment correlated with the enhanced preservation of host tissue, reduced RST atrophy, and/or increased RST sparing/plasticity in the GM. In summary, our results indicate that: (1) early transplantation of neonatal SCs generated from skin or nerve promotes repair and functional recovery after incomplete cervical crush injury; (2) either of these cell types is preferable to Fibros for these purposes; and (3) age-matched SCs from these two sources do not differ in terms of their reparative effects or functional efficacy after transplantation into the injured cervical spinal cord. PMID:25926450

  9. Reliability and validity of videotaped functional performance tests in ACL-injured subjects

    von Porat, Anette; Holmström, Eva; Roos, Ewa

    2008-01-01

    , crossover hop on one leg and one-leg hop. The videos were observed by four physiotherapists, and the knee movement pattern quality, a feature of the loading strategy of the lower extremity, was scored on an 11-point rating scale. To assess the criterion validity, the observational rating was correlated...... with the maximum knee flexion angle in landing during the crossover hop determined by a three-dimensional motion analysis system (VICON). RESULTS: Inter-observer agreement between the four physiotherapists was moderate to good, ICC(1,2) 0.57-0.76 for the four test situations. Fair to good correlations were...

  10. In vitro comparison of human fibroblasts from intact and ruptured ACL for use in tissue engineering

    Brune, T.; Borel, A.; Gilbert, T. W.; J P Franceschi; Badylak, S.F.; Sommer, P.

    2007-01-01

    The present study compares fibroblasts extracted from intact and ruptured human anterior cruciate ligaments (ACL) for creation of a tissue engineered ACL-construct, made of porcine small intestinal submucosal extracellular matrix (SIS-ECM) seeded with these ACL cells. The comparison is based on histological, immunohistochemical and RT-PCR analyses. Differences were observed between cells in a ruptured ACL (rACL) and cells in an intact ACL (iACL), particularly with regard to the expression of ...

  11. Persistent Biomechanical Alterations After ACL Reconstruction Are Associated With Early Cartilage Matrix Changes Detected by Quantitative MR

    Amano, Keiko; Pedoia, Valentina; Su, Favian; Souza, Richard B.; Li, Xiaojuan; Ma, C. Benjamin

    2016-01-01

    Background: The effectiveness of anterior cruciate ligament (ACL) reconstruction in preventing early osteoarthritis is debated. Restoring the original biomechanics may potentially prevent degeneration, but apparent pathomechanisms have yet to be described. Newer quantitative magnetic resonance (qMR) imaging techniques, specifically T1ρ and T2, offer novel, noninvasive methods of visualizing and quantifying early cartilage degeneration. Purpose: To determine the tibiofemoral biomechanical alterations before and after ACL reconstruction using magnetic resonance imaging (MRI) and to evaluate the association between biomechanics and cartilage degeneration using T1ρ and T2. Study Design: Cohort study; Level of evidence, 2. Methods: Knee MRIs of 51 individuals (mean age, 29.5 ± 8.4 years) with unilateral ACL injuries were obtained prior to surgery; 19 control subjects (mean age, 30.7 ± 5.3 years) were also scanned. Follow-up MRIs were obtained at 6 months and 1 year. Tibial position (TP), internal tibial rotation (ITR), and T1ρ and T2 were calculated using an in-house Matlab program. Student t tests, repeated measures, and regression models were used to compare differences between injured and uninjured sides, observe longitudinal changes, and evaluate correlations between TP, ITR, and T1ρ and T2. Results: TP was significantly more anterior on the injured side at all time points (P < .001). ITR was significantly increased on the injured side prior to surgery (P = .033). At 1 year, a more anterior TP was associated with elevated T1ρ (P = .002) and T2 (P = .026) in the posterolateral tibia and with decreased T2 in the central lateral femur (P = .048); ITR was associated with increased T1ρ in the posteromedial femur (P = .009). ITR at 6 months was associated with increased T1ρ at 1 year in the posteromedial tibia (P = .029). Conclusion: Persistent biomechanical alterations after ACL reconstruction are related to significant changes in cartilage T1ρ and T2 at 1 year

  12. CURRENT STATUS AND POTENTIAL FOR PRIMARY ACL REPAIR

    Murray, Martha M.

    2009-01-01

    ACL rupture occurs in hundreds of thousands active adolescents and young adults each year. Despite current treatment, post-traumatic osteoarthritis following these injuries is commonplace within a decade of injury in these young patients. Thus, there is widespread clinical and scientific interest in improving patient outcomes and preventing osteoarthritis. The current emphasis on the removal of the torn ACL and subsequent replacement with a tendon graft (ACL reconstruction) stems from adheren...

  13. PROPRIOCEPTION, BODY BALANCE AND FUNCTIONALITY IN INDIVIDUALS WITH ACL RECONSTRUCTION

    Furlanetto, Tássia Silveira; Peyré-Tartaruga, Leonardo Alexandre; do Pinho, Alexandre Severo; Bernardes, Emanuele da Silva; Zaro, Milton Antonio

    2016-01-01

    Objective : To evaluate and compare proprioception, body balance and knee functionality of individuals with or without unilateral anterior cruciate ligament (ACL) reconstruction. Methods : Forty individuals were divided in two groups: Experimental group, 20 individuals with ACL reconstruction at six months postoperative, and control group, 20 individuals with no history of lower limb pathologies. In the experimental group, we assessed lower limbs with reconstructed ACL and contralateral limb;...

  14. The iliotibial band in acute knee trauma: patterns of injury on MR imaging

    Mansour, Ramy; Yoong, Philip; McKean, David; Teh, James L. [Oxford University Hospitals NHS Trust, Department of Radiology, Nuffield Orthopaedic Centre, Oxford (United Kingdom)

    2014-10-15

    To delineate the spectrum of knee injuries associated with sprains and tears of the distal iliotibial band (ITB). A retrospective review of 200 random MRI scans undertaken for acute knee trauma was performed. Scans were excluded if there was a history of injury over 4 weeks from the time of the scan, septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. In each scan, the ITB was scored as normal, minor sprain (grade 1), severe sprain (grade 2), and torn (grade 3). The menisci, ligaments, and tendons of each knee were also assessed. The mean age was 27.4 years (range, 9-69 years) and 71.5 % (n = 143) of the patients were male. The ITB was injured in 115 cases (57.5 %). The next most common soft tissue structure injured was the anterior cruciate ligament (ACL) in 53.5 % of cases (n = 107). Grade 1 ITB injury was seen in 90 of these 115 cases (45 %), grade 2 injury in 20 cases, and grade 3 injury in only five cases. There is a significant association between ITB injury and ACL rupture (p < 0.05), as well as acute patellar dislocation (p < 0.05). There were ten cases of significant posterolateral corner injury, and all were associated with ITB injury, including four ITB tears. Only two cases of isolated ITB injury were seen (1 %). ITB injury is common in acute knee trauma and is associated with significant internal derangement of the knee, especially cruciate ligament rupture, posterolateral corner injury, and patellar dislocation. (orig.)

  15. The iliotibial band in acute knee trauma: patterns of injury on MR imaging

    To delineate the spectrum of knee injuries associated with sprains and tears of the distal iliotibial band (ITB). A retrospective review of 200 random MRI scans undertaken for acute knee trauma was performed. Scans were excluded if there was a history of injury over 4 weeks from the time of the scan, septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. In each scan, the ITB was scored as normal, minor sprain (grade 1), severe sprain (grade 2), and torn (grade 3). The menisci, ligaments, and tendons of each knee were also assessed. The mean age was 27.4 years (range, 9-69 years) and 71.5 % (n = 143) of the patients were male. The ITB was injured in 115 cases (57.5 %). The next most common soft tissue structure injured was the anterior cruciate ligament (ACL) in 53.5 % of cases (n = 107). Grade 1 ITB injury was seen in 90 of these 115 cases (45 %), grade 2 injury in 20 cases, and grade 3 injury in only five cases. There is a significant association between ITB injury and ACL rupture (p < 0.05), as well as acute patellar dislocation (p < 0.05). There were ten cases of significant posterolateral corner injury, and all were associated with ITB injury, including four ITB tears. Only two cases of isolated ITB injury were seen (1 %). ITB injury is common in acute knee trauma and is associated with significant internal derangement of the knee, especially cruciate ligament rupture, posterolateral corner injury, and patellar dislocation. (orig.)

  16. Proof Pad: A New Development Environment for ACL2

    Caleb Eggensperger

    2013-04-01

    Full Text Available Most software development projects rely on Integrated Development Environments (IDEs based on the desktop paradigm, with an interactive, mouse-driven user interface. The standard installation of ACL2, on the other hand, is designed to work closely with Emacs. ACL2 experts, on the whole, like this mode of operation, but students and other new programmers who have learned to program with desktop IDEs often react negatively to the process of adapting to an unfamiliar form of interaction. This paper discusses Proof Pad, a new IDE for ACL2. Proof Pad is not the only attempt to provide ACL2 IDEs catering to students and beginning programmers. The ACL2 Sedan and DrACuLa systems arose from similar motivations. Proof Pad builds on the work of those systems, while also taking into account the unique workflow of the ACL2 theorem proving system. The design of Proof Pad incorporated user feedback from the outset, and that process continued through all stages of development. Feedback took the form of direct observation of users interacting with the IDE as well as questionnaires completed by users of Proof Pad and other ACL2 IDEs. The result is a streamlined interface and fast, responsive system that supports using ACL2 as a programming language and a theorem proving system. Proof Pad also provides a property-based testing environment with random data generation and automated interpretation of properties as ACL2 theorem definitions.

  17. ACL Injury prevention in female athletes: review of the literature and practical considerations in implementing an ACL prevention program

    Voskanian, Natalie

    2013-01-01

    Female athletes are at 3.5 times risk of sustaining a non-contact ACL injury compared with males. Research has shown that this gender discrepancy results from differences in neuromuscular adaptations and biomechanics related to landing techniques. Studies have examined the preventative effect of ACL prevention programs, which have been designed to address these risky neuromuscular and biomechanical patterns. We review the key studies on ACL prevention in female athletes and summarize the crit...

  18. Incidence of Second Anterior Cruciate Ligament (ACL) Injury 2 Years after Primary ACL Reconstruction and Return to Sport

    Paterno, Mark V.; Rauh, Mitchell; SCHMITT, LAURA C.; Ford, Kevin R.; Hewett, Timothy E.

    2013-01-01

    Objectives: The incidence of second anterior cruciate ligament (ACL) injury in the first 12 months after ACL reconstruction (ACLR) and return to sport in a young, active population has been reported to be 15 times greater than a previously uninjured cohort. It is unknown if this high relative rate of injury continues beyond the first year after return to sport following ACLR. The tested hypothesis was that the incidence rate of a subsequent ACL injury in the 2 years following ACLR and return ...

  19. Medial portal technique for single-bundle anatomical Anterior Cruciate Ligament (ACL) reconstruction

    Brown, Charles H.; Spalding, Tim; Robb, Curtis

    2013-01-01

    The aim of the paper is to describe the medial portal technique for anatomical single-bundle anterior cruciate ligament (ACL) reconstruction. Placement of an ACL graft within the anatomical femoral and tibial attachment sites is critical to the success and clinical outcome of ACL reconstruction. Non-anatomical ACL graft placement is the most common technical error leading to recurrent instability following ACL reconstruction. ACL reconstruction has commonly been performed using a transtibial ...

  20. Bit-Blasting ACL2 Theorems

    Sol Swords

    2011-10-01

    Full Text Available Interactive theorem proving requires a lot of human guidance. Proving a property involves (1 figuring out why it holds, then (2 coaxing the theorem prover into believing it. Both steps can take a long time. We explain how to use GL, a framework for proving finite ACL2 theorems with BDD- or SAT-based reasoning. This approach makes it unnecessary to deeply understand why a property is true, and automates the process of admitting it as a theorem. We use GL at Centaur Technology to verify execution units for x86 integer, MMX, SSE, and floating-point arithmetic.

  1. Histological Predictors of Maximum Failure Loads Differ Between the Healing ACL and ACL Grafts After 6 and 12 Months In Vivo

    Proffen, B. L.; Proffen, Benedikt L.; Fleming, Braden C.; Fleming, B C; Murray, M. M.; Murray, Martha M.

    2013-01-01

    Background: Bioenhanced anterior cruciate ligament (ACL) repair, where the suture repair is supplemented with a biological scaffold, is a promising novel technique to stimulate healing after ACL rupture. However, the histological properties of a successfully healing ACL and how they relate to the mechanical properties have not been fully described. Purpose: To determine which histological features best correlate with the mechanical properties of the healing ACL repairs and ACL grafts in a por...

  2. Effect of culture complex of BMSCs and sodium hydroxide- and GRGDSPC-treated PET on the reconstruction of injured anterior cruciate ligament in a rabbit model.

    Huang, Jianming; Chen, Fengrong; Jian, Guojian; Ye, Zhiyang; Wang, Zimin; Liu, Haoyuan; Kang, Yifan

    2015-01-01

    Ligament reconstruction is an effective therapy for anterior cruciate ligament (ACL) rupture. Polyethylene terephthalate (PET) artificial ligaments have recently gained popularity in clinical ACL reconstruction for its advantage in the improvement of keen function. However, the application of PET in clinical treatment is limited by its poor bioactivity and biocompatibility. Recently, bone marrow-derived mesenchymal stem cells (BMSCs) have been widely studied in regenerative medical therapy due to their multi-lineage differentiation. Previous study also indicated that BMSCs may promote the healing of tendon-bone interface of injured ligament. We speculate that BMSCs may enhance the curative effect of PET artificial ligament on the tendon-bone-healing in ligament reconstruction. In this study, the PET materials were first modified with sodium hydroxide hydrolysis and GRGDSPC peptide which was able to improve its bioactivity and biocompatibility. Then, the effects of modified PET materials on the adhesion, proliferation and differentiation of BMSCs were examined. The in vitro co-culture of BMSCs and modified PET showed the modified PET promoted the adhesion, proliferation and differentiation of BMSCs. Further, the effect of culture complex of BMSCs and modified PET artificial ligament co-culture system on the injured ligament reconstruction was investigated in vivo. Results showed not only better growth and differentiation of BMSCs but also satisfactory healing of the injured ligament was observed after implantation of this culture complex into the injured ligament of rabbits. Our study provides a brand-new solution for ACL reconstruction. PMID:26221227

  3. ACL-RSI and KOOS Measures Predict Normal Knee Function after ACL-SPORTS Training

    White, Kathleen; Zeni, Joseph; Snyder-Mackler, Lynn

    2014-01-01

    Objectives: After anterior cruciate ligament reconstruction (ACLR) athletes commonly report increased fear of re-injury and below normal knee function. Implementing a post-operative training protocol (ACL-SPORTS Training) to improve patient perceived knee function, may improve short term outcomes after surgery. Identifying pre-training measures that predict normal knee function after training may allow us to determine who may respond to the treatment intervention. The purpose of this study wa...

  4. Knee instability scores for ACL reconstruction.

    Rahnemai-Azar, Ata A; Naendrup, Jan-Hendrik; Soni, Ashish; Olsen, Adam; Zlotnicki, Jason; Musahl, Volker

    2016-06-01

    Despite abundant biological, biomechanical, and clinical research, return to sport after anterior cruciate ligament (ACL) injury remains a significant challenge. Residual rotatory knee laxity has been identified as one of the factors responsible for poor functional outcome. To improve and standardize the assessment of knee instability, a variety of instability scoring systems is available. Recently, devices to objectively quantify static and dynamic clinical exams have been developed to complement traditional subjective grading systems. These devices enable an improved evaluation of knee instability and possible associated injuries. This additional information may promote the development of new treatment algorithms and allow for individualized treatment. In this review, the different subjective laxity scores as well as complementary objective measuring systems are discussed, along with an introduction of injury to an individualized treatment algorithm. PMID:26980119

  5. ACL-rupturer hos fotbollstjejer – riskfaktorer och prevention

    Ågren, Andreas

    2013-01-01

    Non-contact anterior cruciate ligament (ACL) injuries is a serius and traumatic injury to the knee that is common in female soccer players and often force the player to quit or lower the level of activity because of lost stability in the knee or from fear to suffer  a new injury. Female soccerplayers have a higher risk than their male counterparts to get an ACL rupture and especially adolescent females have a high risk. The most common causes to a non-contact ACL rupture is side-cutting manuv...

  6. A randomized trial of treatment for acute anterior cruciate ligament tears

    Frobell, Richard B; Roos, Ewa M; Roos, Harald P; Ranstam, Jonas; Lohmander, L Stefan

    2010-01-01

    BACKGROUND: The optimal management of a torn anterior cruciate ligament (ACL) of the knee is unknown. METHODS: We conducted a randomized, controlled trial involving 121 young, active adults with acute ACL injury in which we compared two strategies: structured rehabilitation plus early ACL...... reconstruction and structured rehabilitation with the option of later ACL reconstruction if needed. The primary outcome was the change from baseline to 2 years in the average score on four subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS) - pain, symptoms, function in sports and recreation...... rehabilitation plus early ACL reconstruction, 1 did not undergo surgery. Of 59 assigned to rehabilitation plus optional delayed ACL reconstruction, 23 underwent delayed ACL reconstruction; the other 36 underwent rehabilitation alone. The absolute change in the mean KOOS(4) score from baseline to 2 years was 39...

  7. The Effects of a Valgus Collapse Knee Position on In Vivo ACL Elongation

    Utturkar, G. M.; Irribarra, L.A.; Taylor, K A; Spritzer, C.E.; Taylor, D. C.; Garrett, W E; DeFrate, Louis E.

    2012-01-01

    There are conflicting data regarding what motions increase ACL injury risk. More specifically, the mechanical role of valgus collapse positions during ACL injury remains controversial. Our objective was to evaluate ACL elongation in a model that mimics knee movements thought to occur during ACL injury. Eight healthy male subjects were imaged using MR and biplanar fluoroscopy to measure the in vivo elongation of the ACL and its functional bundles during three static knee positions: full extens...

  8. Case Series: Cyclops lesion - extension loss after ACL reconstruction

    Localized anterior arthrofibrosis (cyclops lesion) is the second most common cause of extension loss after anterior cruciate ligament (ACL) reconstruction. We present and discuss two patients with prior ACL reconstructions, who presented with pain and loss of extension following surgery. MRI and arthroscopy of the knee revealed typical features of a cyclops lesion. The patients showed significant symptomatic improvement following arthroscopic resection of these lesions

  9. Fetal ACL Fibroblasts Exhibit Enhanced Cellular Properties Compared with Adults

    Stalling, Simone S.; Nicoll, Steven B.

    2008-01-01

    Fetal tendons and skin heal regeneratively without scar formation. Cells isolated from these fetal tissues exhibit enhanced cellular migration and collagen production in comparison to cells from adult tissue. We determined whether fetal and adult fibroblasts isolated from the anterior cruciate ligament (ACL), a tissue that does not heal regeneratively, exhibit differences in cell migration rates and collagen elaboration. An in vitro migration assay showed fetal ACL fibroblasts migrated twice ...

  10. Proof Pad: A New Development Environment for ACL2

    Caleb Eggensperger

    2013-01-01

    Most software development projects rely on Integrated Development Environments (IDEs) based on the desktop paradigm, with an interactive, mouse-driven user interface. The standard installation of ACL2, on the other hand, is designed to work closely with Emacs. ACL2 experts, on the whole, like this mode of operation, but students and other new programmers who have learned to program with desktop IDEs often react negatively to the process of adapting to an unfamiliar form of interaction. This p...

  11. Non-contact ACL Injuries: Mechanisms and Risk Factors

    Boden, Barry P.; Sheehan, Frances T.; Torg, Joseph S.; Hewett, Timothy E.

    2010-01-01

    Significant advances have recently been made in understanding the mechanisms involved in noncontact anterior cruciate ligament (ACL) injury. Most ACL injuries involve minimal to no contact. Female athletes sustain a two- to eightfold greater rate of injury than do their male counterparts. Recent videotape analyses demonstrate significant differences in average leg and trunk positions during injury compared with control subjects. These findings as well as those of cadaveric and MRI studies ind...

  12. Healing Cocktail Therapy for Non-healing Tissue-ACL

    Paul; Kuo-Li; SUNG

    2005-01-01

    1IntroductionThe incidence of the injury in the anterior cruciateligament (ACL) ,a majorligament contributingtothe sta-bility andfunctionality of the knee joint ,has beensteadi-lyincreasing as a result of increased participation in thesports activity. Currently, ACL injuries are recognizedwith greaterfrequencyinchildrenand adolescents .Tradi-tional methods for young patients are bracing, muscle re-habilitation,and activity modification.However ,as a re-sult of the poor outcome of non-operative treatment ,op...

  13. Greater fear of re-injury and increased tibial translation in patients who later sustain an ACL graft rupture or a contralateral ACL rupture : a pilot study

    Tagesson (Sonesson), Sofi; Kvist, Joanna

    2016-01-01

    The aim was to compare fear of re-injury, patient reported function, static and dynamic tibial translation and muscle strength assessed before and 5 weeks after an anterior cruciate ligament (ACL) reconstruction between individuals who sustained a subsequent ACL graft rupture or a contralateral ACL injury within 5 years after the reconstruction, and individuals with no subsequent injury. Nineteen patients were investigated before, and 5 weeks after an ACL reconstruction with a quadruple hamst...

  14. Outcome of ACL Reconstruction and Concomitant Articular Injury Treatment

    Seyed Mohammad Tahami

    2015-09-01

    Full Text Available Background: Articular cartilage injuries are a common clinical problem at the time of ACL reconstruction with an incidence rate of 16-46%. Good results of ACL reconstruction combined with the treatment of chondral lesions have been published in some studies. Method: After statistical analysis 30 patients were selected and divided in 2 groups. TheFfirst group consisted of 15 patients wite isolated ACL tear without any other concomitant injuries and the second group consisted of 15 patients with ACL tear and concomitant high grade (grade 3 or 4 of outerbridge classification contained articular cartilage injuries during arthroscopy. Group 1 underwent ACL reconstruction and group 2 underwent ACL reconstruction combined with chondroplasty via the drilling and microfracture technique. For each patient the Lysholm knee score questionnaire was completed before surgery, 6 months and 1 year after surgery. Results: The mean Lysholm knee score in both groups improves: 9.6 points after 6 months and 16.06 points after 1 year in group 1 and 23.26 points after 6 months and 30.66 after 1 year in group 2, whict was statistically significant (Pvalue

  15. The Dutch language anterior cruciate ligament return to sport after injury scale (ACL-RSI) - validity and reliability

    Slagers, Anton J; Reininga, Inge H F; van den Akker-Scheek, Inge

    2016-01-01

    The ACL-Return to Sport after Injury scale (ACL-RSI) measures athletes' emotions, confidence in performance, and risk appraisal in relation to return to sport after ACL reconstruction. Aim of this study was to study the validity and reliability of the Dutch version of the ACL-RSI (ACL-RSI (NL)). Tot

  16. A Novel First Aid Stretcher for Immobilization and Transportation of Spine Injured Patients

    Yan-Sheng Liu; Ya-Ping Feng; Jia-Xin Xie; Zhuo-Jing Luo; Cai-Hong Shen; Fang Niu; Jian Zou; Shao-Feng Tang; Jiang Hao; Jia-Xiang Xu; Li-Ping Xiao; Xiao-Ming Xu; Hui Zhu

    2012-01-01

    Effective immobilization and transportation are vital to the life-saving acute medical care needed when treating critically injured people. However, the most common types of stretchers used today are wrought with problems that can lead to further medical complications, difficulty in employment and rescue, and ineffective transitions to hospital treatment. Here we report a novel first aid stretcher called the "emergency carpet", which solves these problems with a unique design for spine injure...

  17. Long-Term Data Reveal Rate and Risk Factors for Subsequent Surgeries Following Initial ACL Reconstruction

    ... and Risk Factors for Subsequent Surgeries Following Initial ACL Reconstruction Nearly one-fifth of patients who undergo ... surgery to reconstruct a torn anterior cruciate ligament (ACL) eventually need to have additional surgery on the ...

  18. Reconstruction of ACL Ligament rupture: results of 96 operation

    Tahmasebi MN

    2009-04-01

    Full Text Available "nBackground: Anterior Cruciate Ligament (ACL is one of the main knee stabilizing ligaments. Because of high incidence of ACL tearing especially in young athletes its reconstruction is very important. The aim of this study was to evaluate short-term results of anterior cruciate ligament ruptures using four strand hamstring auto graft and Bone patellar tendon autograph. "nMethods: The study group included 96 patients (3 female and 93 male with ACL teared who had been referred to our center in 5 years period (2002-2007. The subject which were Accessed in this study included meniscal injury concomitant chondral injury, determine the most common cause of ACL tearing, comparision of IKDC and lysholm score in all patients before and after surgery, and limitation of rang of motion of knee post operation. "nResults: Involvement was in the right knee in 38 patients and in the left knee in 58 patients. Mean age of patients was 27.6 years (19-48. Mean surgical delay was 18 month (1-77. The most common cause of tear was playing soccer. Meniscal injury was in 78 patients. (Medial meniscus in 63 patients, lateral meniscus in 29 patients Concommitent chondral injury was in 54 patients (56.25%. 68% of patients returned to preoperative functions sport activity. There was no limitation in extension and there was 6 patients limitation in flexion about 20º. In last visit of patients IKDS in class A and B was 96. "nConclusion: It is seem that arthroscopic reconstruction of ACL is a safe and good method in treatment of Knee stability. Use of IKDC and lysholm score for comparision of patients before and after surgery is helpful. The operation should be done early after injury. Reconstruction of ACL in older patients in the abscense of DJD is effective.

  19. In vivo measurement of ACL length and relative strain during walking

    Taylor, K A; Cutcliffe, H C; Queen, R.M.; Utturkar, G. M.; Spritzer, C.E.; Garrett, W E; DeFrate, L.E.

    2012-01-01

    Although numerous studies have addressed the effects of ACL injury and reconstruction on knee joint motion, there is currently little data available describing in vivo ACL strain during activities of daily living. Data describing in vivo ACL strain during activities such as gait is critical to understanding the biomechanical function of the ligament, and ultimately, to improving the surgical treatment of patients with ACL rupture. Thus, our objective was to characterize the relative strain in...

  20. Knee rotational laxity and proprioceptive function 2 years after partial ACL reconstruction

    Chouteau, Julien; Testa, Rodolphe; Viste, Anthony; MOYEN, Bernard

    2012-01-01

    The aim of our study was to evaluate knee rotational laxity and proprioceptive function 2 years after partial anterior cruciate ligament (ACL) reconstruction. According to our hypothesis, partial ACL reconstruction could restore knee laxity and function to the intact level. Methods : We conducted a study in fifteen consecutive patients undergoing partial ACL reconstruction. Fifteen anteromedial bundle tears were identified intra-operatively. Partial ACL reconstructions were performed by the s...

  1. Sagittal Plane Knee Biomechanics and Vertical Ground Reaction Forces Are Modified Following ACL Injury Prevention Programs

    Padua, Darin A.; DiStefano, Lindsay J.

    2009-01-01

    Context: Injuries to the anterior cruciate ligament (ACL) occur because of excessive loading on the knee. ACL injury prevention programs can influence sagittal plane ACL loading factors and vertical ground reaction force (VGRF). Objective: To determine the influence of ACL injury prevention programs on sagittal plane knee biomechanics (anterior tibial shear force, knee flexion angle/moments) and VGRF. Data Sources: The PubMed database was searched for studies published between January 1988 an...

  2. Efficacy of a metalloproteinase inhibitor in spinal cord injured dogs.

    Jonathan M Levine

    Full Text Available Matrix metalloproteinase-9 is elevated within the acutely injured murine spinal cord and blockade of this early proteolytic activity with GM6001, a broad-spectrum matrix metalloproteinase inhibitor, results in improved recovery after spinal cord injury. As matrix metalloproteinase-9 is likewise acutely elevated in dogs with naturally occurring spinal cord injuries, we evaluated efficacy of GM6001 solubilized in dimethyl sulfoxide in this second species. Safety and pharmacokinetic studies were conducted in naïve dogs. After confirming safety, subsequent pharmacokinetic analyses demonstrated that a 100 mg/kg subcutaneous dose of GM6001 resulted in plasma concentrations that peaked shortly after administration and were sustained for at least 4 days at levels that produced robust in vitro inhibition of matrix metalloproteinase-9. A randomized, blinded, placebo-controlled study was then conducted to assess efficacy of GM6001 given within 48 hours of spinal cord injury. Dogs were enrolled in 3 groups: GM6001 dissolved in dimethyl sulfoxide (n = 35, dimethyl sulfoxide (n = 37, or saline (n = 41. Matrix metalloproteinase activity was increased in the serum of injured dogs and GM6001 reduced this serum protease activity compared to the other two groups. To assess recovery, dogs were a priori stratified into a severely injured group and a mild-to-moderate injured group, using a Modified Frankel Scale. The Texas Spinal Cord Injury Score was then used to assess long-term motor/sensory function. In dogs with severe spinal cord injuries, those treated with saline had a mean motor score of 2 (95% CI 0-4.0 that was significantly (P<0.05; generalized linear model less than the estimated mean motor score for dogs receiving dimethyl sulfoxide (mean, 5; 95% CI 2.0-8.0 or GM6001 (mean, 5; 95% CI 2.0-8.0. As there was no independent effect of GM6001, we attribute improved neurological outcomes to dimethyl sulfoxide, a pleotropic agent that may target diverse

  3. Preventing ACL Injuries in Females: What Physical Educators Need to Know

    Toscano, Lisa; Carroll, Brianne

    2015-01-01

    Anterior cruciate ligament (ACL) injuries happen at a frequent rate, especially in girls and women. While there are many factors that contribute to ACL tears, teaching proper landing techniques and strengthening certain muscles can decrease the incidence of ACL tears, especially in women. This article reviews some of the high-risk factors that…

  4. Enhancements to ACL2 in Versions 5.0, 6.0, and 6.1

    Matt Kaufmann; J Strother Moore

    2013-01-01

    We report on highlights of the ACL2 enhancements introduced in ACL2 releases since the 2011 ACL2 Workshop. Although many enhancements are critical for soundness or robustness, we focus in this paper on those improvements that could benefit users who are aware of them, but that might not be discovered in everyday practice.

  5. The role of the anterolateral ligament in ACL insufficient and reconstructed knees on rotary stability

    Tavlo, Mette; Eljaja, S; Tranum-Jensen, Jørgen;

    2016-01-01

    -posterior stability in ACL-insufficient knees. Reconstruction of ACL and ALL reestablished knee stability. The appearance of the ALL was not uniform. The ALL was an internal rotational stabilizer. Anatomical ALL reconstruction in combination with ACL reconstruction could reestablish stability. ALL reconstruction...

  6. Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement

    Renstrom, P; Ljungqvist, A; Arendt, E;

    2008-01-01

    The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert...

  7. ACL2 Meets the GPU: Formalizing a CUDA-based Parallelizable All-Pairs Shortest Path Algorithm in ACL2

    David S. Hardin

    2013-04-01

    Full Text Available As Graphics Processing Units (GPUs have gained in capability and GPU development environments have matured, developers are increasingly turning to the GPU to off-load the main host CPU of numerically-intensive, parallelizable computations. Modern GPUs feature hundreds of cores, and offer programming niceties such as double-precision floating point, and even limited recursion. This shift from CPU to GPU, however, raises the question: how do we know that these new GPU-based algorithms are correct? In order to explore this new verification frontier, we formalized a parallelizable all-pairs shortest path (APSP algorithm for weighted graphs, originally coded in NVIDIA's CUDA language, in ACL2. The ACL2 specification is written using a single-threaded object (stobj and tail recursion, as the stobj/tail recursion combination yields the most straightforward translation from imperative programming languages, as well as efficient, scalable executable specifications within ACL2 itself. The ACL2 version of the APSP algorithm can process millions of vertices and edges with little to no garbage generation, and executes at one-sixth the speed of a host-based version of APSP coded in C – a very respectable result for a theorem prover. In addition to formalizing the APSP algorithm (which uses Dijkstra's shortest path algorithm at its core, we have also provided capability that the original APSP code lacked, namely shortest path recovery. Path recovery is accomplished using a secondary ACL2 stobj implementing a LIFO stack, which is proven correct. To conclude the experiment, we ported the ACL2 version of the APSP kernels back to C, resulting in a less than 5% slowdown, and also performed a partial back-port to CUDA, which, surprisingly, yielded a slight performance increase.

  8. Wounded, Ill, and Injured Challenges.

    Jones, Stephen L

    2016-01-01

    The Washington Post articles of February 2007 led to a close examination of the care provided Wounded Warriors at Walter Reed Army Medical Center. Subsequent reports by the President's Commission, Independent Review Group, and Defense Health Board all recommended ways to improve care. Joint Task Force National Capital Region Medical was established to implement the recommended improvements in Warrior care, and the recommendations of the Base Realignment and Closure Commission to close Walter Reed and realign the staff into a new Walter Reed National Military Medical Center and Fort Belvoir Community Hospital. It accomplished these tasks, maintained existing wounded, ill, and injured care, and safely transferred patients during the height of the fighting season in Afghanistan. It successfully accomplished its mission through engaged leadership, establishing an appropriate environment for Warrior care, careful management of casualty flow, and robust communication with all parties affected by the changes. The lessons learned in Warrior care should be considered when planning future military medical operations. PMID:27215871

  9. Aircast Award for Basic Science - The Effect of Dynamic Changes in ACL Graft Force on Soft Tissue ACL Graft-Tunnel Incorporation

    Ma, Richard; Schaer, Michael; Chen, Tina; Sisto, Marco; Voigt, Clifford; Nguyen, Joseph; Ying, Lilly; Deng, Xiang-hua; Rodeo, Scott A.

    2014-01-01

    Objectives: Anterior cruciate ligament grafts that are placed for reconstruction are subject to complex forces with joint motion. Current “anatomic” ACL reconstructions result in greater in situ graft forces. The biologic effect of changing magnitudes of ACL graft force on graft-tunnel osseointegration is not completely understood. The objective of the present study is to determine the effects of dynamic mechanical ACL graft tension or load on graft-tunnel incorporation. Methods: One hundred ...

  10. Preferential Loading of the ACL Compared to the MCL during Landing: A Novel In Sim Approach Yields the Multi-Planar Mechanism of Dynamic Valgus during ACL Injury

    Quatman, Carmen E.; Kiapour, Ata; Demetropoulos, Constantine K.; Kiapour, Ali; Wordeman, Samuel Clayton; Levine, Jason W.; Goel, Vijay K.; Hewett, Timothy E.

    2013-01-01

    Objectives: Strong biomechanical and epidemiologic evidence associates knee valgus collapse with isolated non-contact ACL injury. However, the predominance of isolated non-contact anterior cruciate ligament (ACL) injuries is challenging for clinicians and researchers to explain, as the medial collateral ligament (MCL) has been reported to be the primary restraint against knee valgus. The purpose of this study was to investigate the relative ACL to MCL strain patterns during physiologic simula...

  11. A Review of metabolic staging in severely injured patients

    Alonso-Poza Alfredo

    2010-05-01

    Full Text Available Abstract An interpretation of the metabolic response to injury in patients with severe accidental or surgical trauma is made. In the last century, various authors attributed a meaning to the post-traumatic inflammatory response by using teleological arguments. Their interpretations of this response, not only facilitates integrating the knowledge, but also the flow from the bench to the bedside, which is the main objective of modern translational research. The goal of the current review is to correlate the metabolic changes with the three phenotypes -ischemia-reperfusion, leukocytic and angiogenic- that the patients express during the evolution of the systemic inflammatory response. The sequence in the expression of multiple metabolic systems that becomes progressively more elaborate and complex in severe injured patients urges for more detailed knowledge in order to establish the most adequate metabolic support according to the evolutive phase. Thus, clinicians must employ different treatment strategies based on the different metabolic phases when caring for this challenging patient population. Perhaps, the best therapeutic option would be to favor early hypometabolism during the ischemia-reperfusion phase, to boost the antienzymatic metabolism and to reduce hypermetabolism during the leukocytic phase through the early administration of enteral nutrition and the modulation of the acute phase response. Lastly, the early epithelial regeneration of the injured organs and tissues by means of an oxidative metabolism would reduce the fibrotic sequelae in these severely injured patients.

  12. Proceedings 10th International Workshop on the ACL2 Theorem Prover and its Applications

    Hardin, David; Schmaltz, Julien

    2011-01-01

    This volume contains the proceedings of ACL2 2011, the International Workshop on the ACL2 Theorem Prover and its Applications. The workshop was held in Austin, Texas, USA, on November 3-4 2011. ACL2 2011 is the tenth in a series of workshops on the ACL2 Theorem Prover and its Applications. The workshop was co-located with the eleventh Conference on Formal Methods in Computer Aided Design (FMCAD'11). The ACL2 Workshop series provide a major technical forum for researchers to present and discus...

  13. Decreased femoral head–neck offset: a possible risk factor for ACL injury

    Philippon, Marc; Dewing, Christopher; Briggs, Karen; Steadman, J. Richard

    2012-01-01

    Purpose Reduction in anterior cruciate ligament (ACL) injuries in young, active individuals continues to be a major goal in sports medicine. The purpose of this study was to determine the head–neck offset, as measured by AP pelvis alpha angles, in patients presenting to a single surgeon with isolated ACL and non-ACL knee injuries. Methods In a group of 48 patients with complete, primary ACL rupture and 42 controls with non-ACL injury (i.e., meniscus tear, cartilage defect), a single surgeon, ...

  14. Rehabilitation of Patients Following Autogenic Bone-Patellar Tendon-Bone ACL Reconstruction: A 20-Year Perspective

    De Carlo, Mark S.; McDivitt, Ryan

    2006-01-01

    Rehabilitation of patients following anterior cruciate ligament (ACL) reconstruction has undergone remarkable improvements over the past two decades. During this time, ACL research has been at the forefront of many orthopaedic and sports physical therapy clinics. With over 20 years of ACL rehabilitation experience (senior author) and prior collaboration with accelerated ACL rehabilitation pioneer K. Donald Shelbourne, the authors wish to present a unique perspective on the evolution of ACL re...

  15. ACL reconstruction and the implication of its tibial attachment for stability of the joint: anthropometric and biomechanical study

    Papachristou, George; Sourlas, John; Magnissalis, Evangelos; Plessas, Spyros; Papachristou, Konstantinos

    2006-01-01

    The planar topography of the anterior cruciate ligament (ACL) insertion was investigated and correlated to the use of the double-bundle/double tibial tunnel ACL reconstruction technique within the ACL tibial insertion area. The anteroposterior and mediolateral length of the tibial ACL attachment and the distances of the tibial insertion area from the anterior and posterior tibial borders were measured and the stability of the joint was tested using the double-bundle/double tibial tunnel ACL r...

  16. MRI of normal anterior cruciate ligament (ACL) and reconstructed ACL: comparison of when the knee is extended with when the knee is flexed

    The purpose of this study was to evaluate, using MRI, the morphology of normal anterior cruciate ligament (ACL) and ACL grafts when the knee was extended compared with when the knee was flexed. Eighteen normal controls and 22 ACL graft patients were studied. Spin-echo (SE) T1-weighted images (TR 330 ms/TE 15 ms, NEX 1) were obtained with a slice thickness of 3 mm. Oblique sagittal images parallel to the ACL were obtained at various flexed angles of the knee joint. In 12 of the 18 normal controls the ACL appeared convex toward the posterior side when the knee was extended and gradually became straight when the knee was flexed. In 15 of the 22 ACL graft patients the grafts appeared straight when the knee was extended and became convex toward the anterior side when the knee was flexed. It is concluded that the morphological changes seen on MR images of ACL grafts from when the knee is extended to when the knee is flexed are different from those in the normal ACL. (orig.). With 7 figs., 1 tab

  17. MRI of normal anterior cruciate ligament (ACL) and reconstructed ACL: comparison of when the knee is extended with when the knee is flexed

    Nakanishi, K. [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-City, Osaka 565 (Japan); Horibe, S. [Department of Orthopedic Surgery, Osaka University Medical School, Osaka (Japan); Shiozaki, Y. [Department of Orthopedic Surgery, Osaka University Medical School, Osaka (Japan); Ishida, T. [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-City, Osaka 565 (Japan); Narumi, Y. [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-City, Osaka 565 (Japan); Ikezoe, J. [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-City, Osaka 565 (Japan); Nakamura, H. [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-City, Osaka 565 (Japan)

    1997-09-01

    The purpose of this study was to evaluate, using MRI, the morphology of normal anterior cruciate ligament (ACL) and ACL grafts when the knee was extended compared with when the knee was flexed. Eighteen normal controls and 22 ACL graft patients were studied. Spin-echo (SE) T1-weighted images (TR 330 ms/TE 15 ms, NEX 1) were obtained with a slice thickness of 3 mm. Oblique sagittal images parallel to the ACL were obtained at various flexed angles of the knee joint. In 12 of the 18 normal controls the ACL appeared convex toward the posterior side when the knee was extended and gradually became straight when the knee was flexed. In 15 of the 22 ACL graft patients the grafts appeared straight when the knee was extended and became convex toward the anterior side when the knee was flexed. It is concluded that the morphological changes seen on MR images of ACL grafts from when the knee is extended to when the knee is flexed are different from those in the normal ACL. (orig.). With 7 figs., 1 tab.

  18. Rapid Hamstrings/Quadriceps strength in ACL-reconstructed elite alpine ski racers

    Jordan, Matthew J; Aagaard, Per; Herzog, Walter

    2015-01-01

    PURPOSE: Due to the importance of hamstrings (HAM) and quadriceps (QUAD) strength for anterior cruciate ligament (ACL) injury prevention, and the high incidence of ACL injury in ski racing, HAM and QUAD maximal and explosive strength was assessed in ski racers with and without ACL reconstruction ...... QUAD strength assessments in the physical evaluation of uninjured skiers. Further, HAM and QUAD strength should be assessed over a long-term period following surgery to identify chronic strength deficits in ACL-R ski racers.......PURPOSE: Due to the importance of hamstrings (HAM) and quadriceps (QUAD) strength for anterior cruciate ligament (ACL) injury prevention, and the high incidence of ACL injury in ski racing, HAM and QUAD maximal and explosive strength was assessed in ski racers with and without ACL reconstruction...... and RTD (per kg body mass) were calculated for the uninjured group to compare between sexes, and to compare the control group with the ACL-R limb and unaffected limb of the ACL-R skiers. H/Q MVC and RTD strength ratios were also compared RESULTS: The ACL-R limb demonstrated significant HAM and QUAD...

  19. Electrospinning polymer blends for biomimetic scaffolds for ACL tissue engineering

    Garcia, Vanessa Lizeth

    The anterior cruciate ligament (ACL) rupture is one of the most common knee injuries. Current ACL reconstructive strategies consist of using an autograft or an allograft to replace the ligament. However, limitations have led researchers to create tissue engineered grafts, known as scaffolds, through electrospinning. Scaffolds made of natural and synthetic polymer blends have the potential to promote cell adhesion while having strong mechanical properties. However, enzymes found in the knee are known to degrade tissues and affect the healing of intra-articular injuries. Results suggest that the natural polymers used in this study modify the thermal properties and tensile strength of the synthetic polymers when blended. Scanning electron microscopy display bead-free and enzyme biodegradability of the fibers. Raman spectroscopy confirms the presence of the natural and synthetic polymers in the scaffolds while, amino acid analysis present the types of amino acids and their concentrations found in the natural polymers.

  20. Knee kinematics and kinetics in former soccer players with a 16-year-old ACL injury – the effects of twelve weeks of knee-specific training

    Holmström Eva

    2007-04-01

    Full Text Available Abstract Background Training of neuromuscular control has become increasingly important and plays a major role in rehabilitation of subjects with an injury to the anterior cruciate ligament (ACL. Little is known, however, of the influence of this training on knee stiffness during loading. Increased knee stiffness occurs as a loading strategy of ACL-injured subjects and is associated with increased joint contact forces. Increased or altered joint loads contribute to the development of osteoarthritis. The aim of the study was to determine if knee stiffness, defined by changes in knee kinetics and kinematics of gait, step activity and cross-over hop could be reduced through a knee-specific 12-week training programme. Methods A 3-dimensional motion analysis system (VICON and a force plate (AMTI were used to calculate knee kinetics and kinematics before and after 12 weeks of knee-specific training in 12 males recruited from a cohort with ACL injury 16 years earlier. Twelve uninjured males matched for age, sex, BMI and activity level served as a reference group. Self-reported patient-relevant data were obtained by the KOOS questionnaire. Results There were no significant changes in knee stiffness during gait and step activity after training. For the cross-over hop, increased peak knee flexion during landing (from 44 to 48 degrees, p = 0.031 and increased internal knee extensor moment (1.28 to 1.55 Nm/kg, p = 0.017 were seen after training, indicating reduced knee stiffness. The KOOS sport and recreation score improved from 70 to 77 (p = 0.005 and was significantly correlated with the changes in knee flexion during landing for the cross-over hop (r = 0.6, p = 0.039. Conclusion Knee-specific training improved lower extremity kinetics and kinematics, indicating reduced knee stiffness during demanding hop activity. Self-reported sport and recreational function correlated positively with the biomechanical changes supporting a clinical importance of the

  1. ACL mismatch reconstructions: influence of different tunnel placement strategies in single-bundle ACL reconstructions on the knee kinematics.

    Herbort, Mirco; Lenschow, Simon; Fu, Freddie H; Petersen, Wolf; Zantop, Thore

    2010-11-01

    To evaluate the influence of tibial and femoral tunnel position in ACL reconstruction on knee kinematics, we compared ACL reconstruction with a tibial and femoral tunnel in anteromedial (AM-AM reconstruction) and in posterolateral footprint (PL-PL reconstruction) with a reconstruction technique with tibial posterolateral and femoral anteromedial tunnel placement (PL-AM reconstruction). In 9 fresh-frozen human cadaveric knees, the knee kinematics under simulated Lachman (134 N anterior tibial load) and a simulated pivot shift test (10 N/m valgus and 4 N/m internal tibial torque) were determined at 0°, 30°, 60°, and 90° of flexion. Kinematics were recorded for intact, ACL-deficient, and single-bundle ACL reconstructed knees using three different reconstruction strategies in randomized order: (1) PL-AM, (2) AM-AM and (3) PL-PL reconstructions. Under simulated Lachman test, single-bundle PL-AM reconstruction and PL-PL reconstructions both showed significantly increased anterior tibial translation (ATT) at 60° and 90° when compared to the intact knee. At all flexion angles, AM-AM reconstruction did not show any statistical significant differences in ATT compared to the intact knee. Under simulated pivot shift, PL-AM reconstruction resulted in significantly higher ATT at 0°, 30°, and 60° knee flexion and AM-AM reconstructions showed significantly higher ATT at 30° compared to the intact knee. PL-PL reconstructions did not show any significant differences to the intact knee. AM-AM reconstructions restore the intact knee kinematics more closely when compared to a PL-AM technique resembling a transtibial approach. PL-PL reconstructions showed increased ATT at higher flexion angles, however, secured the rotational stability at all flexion angles. Due to the independent tibial and femoral tunnel location, a medial portal technique may be superior to a transtibial approach. PMID:20461359

  2. Anterior Cruciate Ligament Tear in an Athlete: Does Increased Heel Loading Contribute to ACL Rupture?

    Burkhart, Bradd; Ford, Kevin R.; Myer, Gregory D; Heidt, Robert S.; Hewett, Timothy E.

    2008-01-01

    Rupture to the anterior cruciate ligament is a common athletic injury in American football. The lower extremity biomechanics related to increased ACL injury risk are not completely understood. However, foot landing has been purported to be a significant contributing factor to the ACL injury mechanism. In this case report, information is presented on an athlete previously tested for in-shoe loading patterns on artificial turf and subsequently went on to non-contact ACL rupture on the same surf...

  3. The evolution of ACL reconstruction over the last fifty years

    Chambat, Pierre; Guier, Christian; Sonnery-Cottet, Bertrand; Fayard, Jean-Marie; Thaunat, Mathieu

    2013-01-01

    Anterior cruciate ligament (ACL) reconstruction has evolved considerably over the past 30 years. This has largely been due to a better understanding of ACL anatomy and in particular a precise description of the femoral and tibial insertions of its two bundles. In the 1980s, the gold standard was anteromedial bundle reconstruction using the middle third of the patellar ligament. Insufficient control of rotational laxity led to the development of double bundle ACL reconstruction. This concept, ...

  4. A tale of 10 European centres – 2010 APOSSM travelling fellowship review in ACL surgery

    Lee Yee Han; Kuroda Ryosuke; Zhao Jinzhong; Chan Kai

    2012-01-01

    Abstract The purpose of ESSKA- APOSSM Travelling fellowship is to better understand the epidemiology, management and surgical techniques for sports across continents. There has been a progressive evolution in ACL reconstruction and there is variation in technique in ACL reconstruction amongst the most experienced surgeons in different continents. During this one month fellowship, we saw various ACL reconstruction techniques using different graft sources, with a variety of graft fixation metho...

  5. Injury Risk Estimation Expertise: Interdisciplinary Differences in Performance on the ACL Injury Risk Estimation Quiz

    Petushek, Erich J.; Ward, Paul; Cokely, Edward T.; Myer, Gregory D

    2015-01-01

    Background: Simple observational assessment of movement is a potentially low-cost method for anterior cruciate ligament (ACL) injury screening and prevention. Although many individuals utilize some form of observational assessment of movement, there are currently no substantial data on group skill differences in observational screening of ACL injury risk. Purpose/Hypothesis: The purpose of this study was to compare various groups’ abilities to visually assess ACL injury risk as well as the as...

  6. Visual estimation of ACL injury risk: Efficient assessment method, group differences, and expertise mechanisms

    Petushek, Erich J.; Cokely, Edward T.; Ward, Paul; Durocher, John; Wallace, Sean; Myer, Gregory D

    2015-01-01

    Simple observational assessment of movement quality (e.g., drop vertical jump biomechanics) is an efficient and low cost method for anterior cruciate ligament (ACL) injury screening and prevention. A recently developed test (see www.ACL-IQ.org) has revealed substantial cross-professional/group differences in visual ACL injury risk estimation skill. Specifically, parents, sport coaches, and to some degree sports medicine physicians, would likely benefit from training or the use of decision sup...

  7. Spectrum of injuries associated with paediatric ACL tears: an MRI pictorial review

    Jacob L Jaremko; Ghuenter, Zachary D; Jans, Lennart; MacMahon, Peter J

    2013-01-01

    Objective Magnetic resonance imaging (MRI) findings in anterior cruciate ligament (ACL) injury are well known, but most published reviews show obvious examples of associated injuries and give little focus to paediatric patients. Here, we demonstrate the spectrum of MRI appearances at common sites of associated injury in adolescents with ACL tears, emphasising age-specific issues. Methods Pictorial review using images from children with surgically confirmed ACL tears after athletic injury. Res...

  8. Comparison of Two Methods to Measure Return to Sports after Anterior Cruciate Ligament (ACL) Reconstruction

    Yabroudi, Mohammad A.; Muller, Bart; Lai, Chung-Liang; Andrew, Lynch; Oostdyk, Alicia; Fu, Freddie H; Harner, Christopher D.; Irrgang, James J.

    2013-01-01

    Objectives: Return to sports (RTS) is a primary goal for ACL reconstruction. Recent studies indicate that return to prior level of sports participation is poor with only 45% of patients having returned to sport.1 The purpose of this study was to evaluate return to pre-injury level of sports participation after ACL reconstruction using a strict comprehensive definition for RTS. Methods: Participants who were 1 to 5 years after ACL reconstruction completed a survey to determine their pre-and po...

  9. The popliteal fibular ligament in acute knee trauma: patterns of injury on MR imaging

    McKean, D.; Thomee, E.; Grant, D.; Teh, J.L.; Mansour, R. [Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Headington, Oxford (United Kingdom); Yoong, P. [Royal Berkshire NHS Foundation Trust, Royal Berkshire Hospital, Reading (United Kingdom); Yanny, S. [Buckinghamshire Healthcare NHS Trust, Stoke Mandeville Hospital, Aylesbury (United Kingdom)

    2015-10-15

    To describe the patterns of injury associated with injury to the popliteofibular ligament injury. A retrospective review was performed of 180 MRI scans undertaken for acute knee trauma. Scans were excluded if the time of injury was over 4 weeks from the time of the scan, or if there was a history of septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. An agreed criterion for assessing the structures of the posterolateral ligamentous complex was defined and in each scan, the popliteofibular ligament (PFL) was scored as normal or injured. The menisci, ligaments, and tendons of each knee were also assessed. The mean age was 25.7 years (range, 9-65 years) and 72.2 % (n = 130) patients were male. The PFL was injured in 36 cases (20 %). There is a significant association between PFL injury and ACL rupture (p = 0.0001), ITB injury (p = 0.0001), PCL injury (p = 0.0373), in addition to associations with injury to other posterolateral corner structures including the lateral collateral ligament (p = 0.0001), biceps femoris tendon (p = 0.0014), and popliteus tendon (p = 0.0014). Of our series of PFL injuries, nine cases (25 %) were associated with further injuries of posterolateral corner structures and in 27 cases (75 %) the PFL was the only posterolateral corner structure torn. PFL injury is not uncommon in acute knee trauma and is associated with significant internal derangement of the knee, especially anterior cruciate ligament rupture, ITB sprain, and injury to other structures within the posterolateral corner. (orig.)

  10. The popliteal fibular ligament in acute knee trauma: patterns of injury on MR imaging

    To describe the patterns of injury associated with injury to the popliteofibular ligament injury. A retrospective review was performed of 180 MRI scans undertaken for acute knee trauma. Scans were excluded if the time of injury was over 4 weeks from the time of the scan, or if there was a history of septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. An agreed criterion for assessing the structures of the posterolateral ligamentous complex was defined and in each scan, the popliteofibular ligament (PFL) was scored as normal or injured. The menisci, ligaments, and tendons of each knee were also assessed. The mean age was 25.7 years (range, 9-65 years) and 72.2 % (n = 130) patients were male. The PFL was injured in 36 cases (20 %). There is a significant association between PFL injury and ACL rupture (p = 0.0001), ITB injury (p = 0.0001), PCL injury (p = 0.0373), in addition to associations with injury to other posterolateral corner structures including the lateral collateral ligament (p = 0.0001), biceps femoris tendon (p = 0.0014), and popliteus tendon (p = 0.0014). Of our series of PFL injuries, nine cases (25 %) were associated with further injuries of posterolateral corner structures and in 27 cases (75 %) the PFL was the only posterolateral corner structure torn. PFL injury is not uncommon in acute knee trauma and is associated with significant internal derangement of the knee, especially anterior cruciate ligament rupture, ITB sprain, and injury to other structures within the posterolateral corner. (orig.)

  11. In vitro comparison of human fibroblasts from intact and ruptured ACL for use in tissue engineering

    T Brune

    2007-12-01

    Full Text Available The present study compares fibroblasts extracted from intact and ruptured human anterior cruciate ligaments (ACL for creation of a tissue engineered ACL-construct, made of porcine small intestinal submucosal extracellular matrix (SIS-ECM seeded with these ACL cells. The comparison is based on histological, immunohistochemical and RT-PCR analyses. Differences were observed between cells in a ruptured ACL (rACL and cells in an intact ACL (iACL, particularly with regard to the expression of integrin subunits and smooth muscle actin (SMA. Despite these differences in the cell source, both cell populations behaved similarly when seeded on an SIS-ECM scaffold, with similar cell morphology, connective tissue organization and composition, SMA and integrin expression. This study shows the usefulness of naturally occurring scaffolds such as SIS-ECM for the study of cell behaviour in vitro, and illustrates the possibility to use autologous cells extracted from ruptured ACL biopsies as a source for tissue engineered ACL constructs.

  12. Full-thickness cartilage lesion do not affect knee function in patients with ACL injury

    2011-01-01

    Full-thickness cartilage lesion do not affect knee function in patients with ACL injury Abstract There is debate in the literature regarding the impact of full-thickness cartilage lesion on knee function in patients with ACL injury. The hypothesis of this study is that a full-thickness cartilage lesion at the time of ACL reconstruction does not influence knee function as measured by the Knee injury and Osteoarthritis Outcome Score (KOOS) in patients with ACL injury. Of the 4,849 prim...

  13. Pain analgesia among adolescent self-injurers.

    Glenn, Jeffrey J; Michel, Bethany D; Franklin, Joseph C; Hooley, Jill M; Nock, Matthew K

    2014-12-30

    Although non-suicidal self-injury (NSSI) involves self-inflicted physical harm, many self-injurers report feeling little or no pain during the act. Here we test: (1) whether the pain analgesia effects observed among adult self-injurers are also present among adolescents, and (2) three potential explanatory models proposing that habituation, dissociation, and/or self-criticism help explain the association between NSSI and pain analgesia among adolescents. Participants were 79 adolescents (12-19 years) recruited from the community who took part in a laboratory-based pain study. Results revealed that adolescent self-injurers have a higher pain threshold and greater pain endurance than non-injurers. Statistical mediation models revealed that the habituation and dissociation models were not supported; however, a self-critical style does mediate the association between NSSI and pain analgesia. The present findings extend earlier work by highlighting that a self-critical style may help to explain why self-injurers exhibit pain analgesia. Specifically, the tendency to experience self-critical thoughts in response to stressful events may represent a third variable that increases the likelihood of both NSSI and pain analgesia. Prospective experimental studies are needed to replicate and tease apart the direction of these associations, and may provide valuable leads in the development of effective treatments for this dangerous behavior problem. PMID:25172611

  14. Computerized tomography examination of injured spleen

    In blunt abdominal injury, the spleen is most frequently injured. A rapid and accurate diagnosis of the injured spleen is therefore of great importance for early and correct therapeutic management. A group is discussed of 56 patients who were examined in the years 1981-1987 after blunt injury of the abdomen by computerized tomography. Computerized tomography is a very useful method which allows rapid and accurate noninvasive diagnosis of different degrees of spleen injury and its possible complications. In comparison with other methods, computerized tomography is the most effective method providing comprehensive information on other organs in the abdominal cavity. It also allows noninvasive examination of severely injured patients and of non-cooperating patients. (author). 6 figs., 1 tab., 15 refs

  15. ATP released by injured neurons activates Schwann cells

    Samuele eNegro

    2016-05-01

    Full Text Available Injured nerve terminals of neuromuscular junctions (NMJs can regenerate. This remarkable and complex response is governed by molecular signals that are exchanged among the cellular components of this synapse: motor axon nerve terminal (MAT, perisynaptic Schwann cells (PSCs, and muscle fibre. The nature of signals that govern MAT regeneration is ill-known. In the present study the spider toxin α-Latrotoxin has been used as tool to investigate the mechanisms underlying peripheral neuroregeneration. Indeed this neurotoxin induces an acute, specific, localized and fully reversible damage of the presynaptic nerve terminal, and its action mimics the cascade of events that leads to nerve terminal degeneration in injured patients and in many neurodegenerative conditions. Here we provide evidence of an early release by degenerating neurons of ATP as alarm messenger, that contributes to the activation of a series of intracellular pathways within SCs that are crucial for nerve regeneration: Ca2+, cAMP, ERK1/2, and CREB. These results contribute to define the cross-talk taking place among degenerating nerve terminals and PSCs, involved in the functional recovery of the NMJ.

  16. Dual ACL Ganglion Cysts: Significance of Detailed Arthroscopy

    Samarth Mittal; Amit Singla; Nag, H. L.; Sanjay Meena; Ramprakash Lohiya; Abhinav Agarwal

    2014-01-01

    Intra-articular ganglion cysts of the knee joint are rare and most frequently are an incidental finding on MRI and arthroscopy. Most of the previous studies have reported a single ganglion cyst in the knee. There have been previous reports of more than one cyst in the same knee but not in the same structure within the knee. We are reporting a case of dual ACL (anterior cruciate ligament) ganglion cysts one of which was missed on radiological examination but later detected during arthroscopy. ...

  17. Dual ACL Ganglion Cysts: Significance of Detailed Arthroscopy

    Samarth Mittal

    2014-01-01

    Full Text Available Intra-articular ganglion cysts of the knee joint are rare and most frequently are an incidental finding on MRI and arthroscopy. Most of the previous studies have reported a single ganglion cyst in the knee. There have been previous reports of more than one cyst in the same knee but not in the same structure within the knee. We are reporting a case of dual ACL (anterior cruciate ligament ganglion cysts one of which was missed on radiological examination but later detected during arthroscopy. To the best of our knowledge, no such case has been reported in the indexed English literature till date.

  18. Quality of Movement for Athletes Six Months Post ACL Reconstruction

    deMille, Polly; Nguyen, Joseph; Brown, Allison; Do, Huong; Selvaggio, Elizabeth; Chiaia, Theresa

    2016-01-01

    Objectives: Anterior cruciate ligament (ACL) injury prevention programs evaluate quality of movement (QM) to identify and correct high-risk movement patterns. However, return to play (RTP) decisions post-ACL reconstruction (ACLR) are often based on non-sport relatedquantitative measures such as isokinetic tests and/or time from surgery, with six months post-ACLR being a common expectation for RTP. The purpose of this study was to evaluate whether athletes are ready to RTP 6 months post ACLR using a QM assessment (QMA). Methods: A QMA including nine dynamic tasks (squat, single leg [SL] stance, step down, SL squat, jump in place, side to side jump, broad jump, hop to opposite, SL hop) progressing from double- to single-limb vertical and horizontal movements was administered to 136 athletes at five to seven months post-ACLR. Tasks were viewed from the frontal and sagittal planes by a physical therapist and performance specialist. Movements were evaluated live for risk factors associated with ACL injury (strategy, depth, control, symmetry, and alignment). The proportion of patients exhibiting risky movement patterns for each task was calculated. Fisher’s Exact test was used to determine if there were differences in movement patterns between males and females. Results: The proportion of patients demonstrating risky movement patterns for a task ranged from 48% to 100%. All 136 patients exhibited risky movement patterns for at least one task and 60% of patients displayed risky movement patterns in five or more of the nine tasks. Rates of risky movement patterns were not different between males and females for all tasks (P>0.1 for all tasks). Conclusion: Six months has been cited as a probable time for RTP post-ACLR; thus this is the expectation of the athlete. Our data show that athletes demonstrate multiple QM patterns associated with initial ACL injury, as well as 2nd injury at five to seven months post-operatively. Altered movement patterns evident in tasks as

  19. Initial Experiments with TPTP-style Automated Theorem Provers on ACL2 Problems

    Joosten, SJC Sebastiaan; Kaliszyk, C.; Urban, J.

    2014-01-01

    This paper reports our initial experiments with using external ATP on some corpora built with the ACL2 system. This is intended to provide the first estimate about the usefulness of such external reasoning and AI systems for solving ACL2 problems.

  20. The role of oblique axial MR imaging in the diagnosis of ACL bundle lesions

    Heba Ahmed Kamal

    2015-09-01

    Conclusion: Compared with standard MR imaging, the addition of oblique axial imaging improves the diagnostic accuracy for detecting lesions of the ACL, including both bundles’ delineation. This imaging plane seems to provide a useful adjunct to standard MR imaging when ACL lesion is suspected.

  1. MRI diagnosis of ACL bundle tears: value of oblique axial imaging

    Ng, Alex W.H.; Griffith, James F.; Hung, Esther H.Y. [Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR (China); Law, Kan Yip; Yung, Patrick S.H. [Chinese University of Hong Kong, Department of Orthopedics and Traumatology, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR (China)

    2013-02-15

    To investigate the diagnostic accuracy of oblique axial intermediate weighting MR imaging in detecting partial thickness anterior cruciate ligament (ACL) bundle tears. The study protocol was approved by the institutional ethics committee. Sixty-one subjects (43 male, 18 female; mean age 27.4 years; range 9 to 57 years) with clinically suspected ACL tear or meniscal tear between September 2009 and January 2011 were studied with MRI and arthroscopy. Detection of partial tear for the ACL as a whole and for each ACL bundle by protocol A (standard orthogonal sequences) and protocol B (standard orthogonal sequences plus oblique axial intermediate weighted imaging) was compared in a blinded fashion. Performance characteristics for protocol A and protocol B were compared using sensitivity, specificity, accuracy and ROC curves. A two-tailed p value of <0.05 indicated statistical significance. Fifteen (24.6%) normal, 15 (24.6%) partial and 31 complete tears were diagnosed by arthroscopy. Sensitivity, specificity and accuracy of protocol A for the diagnosis of partial tear of the ACL was 33%, 87% and 74%, while for protocol B the values were 87%, 87% and 87% respectively. The area under the curve (AUC) for the diagnosis of partial ACL tear and individual bundle tear was higher for protocol B, although this difference did not reach statistical significance (p > 0.05). The addition of oblique axial imaging to standard MR imaging improves diagnostic accuracy for detecting partial tears of the ACL as well as individual bundle tears of the ACL. (orig.)

  2. Proceedings 10th International Workshop on the ACL2 Theorem Prover and its Applications

    Hardin, David; 10.4204/EPTCS.70

    2011-01-01

    This volume contains the proceedings of ACL2 2011, the International Workshop on the ACL2 Theorem Prover and its Applications. The workshop was held in Austin, Texas, USA, on November 3-4 2011. ACL2 2011 is the tenth in a series of workshops on the ACL2 Theorem Prover and its Applications. The workshop was co-located with the eleventh Conference on Formal Methods in Computer Aided Design (FMCAD'11). The ACL2 Workshop series provide a major technical forum for researchers to present and discuss improvements and extensions to the theorem prover, comparisons of ACL2 with other systems, and applications of ACL2 in formal verification or formalized mathematics. Workshops have been held at approxiamately 18 month intervals since 1999. ACL2 is the most recent incarnation of the Boyer-Moore family of theorem provers, for which, Robert Boyer, Matt Kaufmann and J Strother Moore received the 2005 ACM Software System Award. It is state-of-the-art automated reasoning system that has been successfully used in academia, gov...

  3. Evaluating ACLS Algorithms for the International Space Station (ISS) - A Paradigm Revisited

    Alexander, Dave; Brandt, Keith; Locke, James; Hurst, Victor, IV; Mack, Michael D.; Pettys, Marianne; Smart, Kieran

    2007-01-01

    The ISS may have communication gaps of up to 45 minutes during each orbit and therefore it is imperative to have medical protocols, including an effective ACLS algorithm, that can be reliably autonomously executed during flight. The aim of this project was to compare the effectiveness of the current ACLS algorithm with an improved algorithm having a new navigation format.

  4. Lower extremity performance following ACL rehabilitation in the KANON-trial

    Ericsson, Ylva B; Roos, Ewa M.; Frobell, Richard B

    2013-01-01

    The additional effect of anterior cruciate ligament (ACL) reconstruction on muscle strength and physical performance after a structured exercise programme is not well understood.......The additional effect of anterior cruciate ligament (ACL) reconstruction on muscle strength and physical performance after a structured exercise programme is not well understood....

  5. THE EFFECTS OF MODIFIED POSTERIOR TIBIAL SLOPE ON ACL STRAIN AND KNEE KINEMATICS: A HUMAN CADAVERIC STUDY

    Fening, Stephen D.; Kovacic, Jeffrey; Kambic, Helen; McLean, Scott; Scott, Jacob; Miniaci, Anthony

    2008-01-01

    Increases to the posterior tibial slope can lead to an anterior shift in tibial resting position. However, the effect of this shift on anterior cruciate ligament (ACL) strain has not been investigated sufficiently. This study examined the relationship between increased tibial slope and ACL strain, as well as the subsequent kinematics of the tibiofemoral joint. We hypothesized increases in slope would shift the tibia anterior relative to the femur and increase ACL strain. ACL strain measuremen...

  6. Stress During ACLS Courses: Is it Important for Learning Skills?

    Emilton Lima Júnior

    2002-12-01

    Full Text Available OBJECTIVE: To determine the influence of stress on teaching medical emergencies in an Advanced Cardiac Life Support (ACLS course and to verify this influence on learning, and the efficiency of emergency care training. METHODS: Seventeen physicians signed up for an ACLS course. Their pulses were taken and blood pressure (BP verified on the first day, before the beginning of the course, and on the second day, during the theoretical and practical test (TPT. Variations in pulse rates and BP were compared with students' test grades. Then, students answered a questionnaire of variables (QV about the amount of sleep they had during the course, the quantity of study material and the time spent studying for the course, and a stress scale graphic. RESULTS: Seven students had a pulse variation less than 10% between the 2 periods and 10 had a 10% or more variation. Grades on TPT were, respectively, 91.4±2.4 and 87.3±5.2 (p<0.05. Six students had a BP variation less than 20 mmHg, and in 11 it varied more than 21 mmHg. Grades on the TPT were 92.3±3.3 and 86.2± 8.1, respectively (p<0.05. The QV dates did not significantly influence grades. CONCLUSION: Stress, as an isolated variable, had a negative influence on the learning process and on the efficiency of emergency training in this situation.

  7. 76 FR 61061 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    2011-10-03

    ... is 38,146 mt and 0 mt of the sub-ACL is set aside for research (75 FR 48874, August 12, 2010). The... Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch Limit) Harvested for Management... day until January 1, 2012, when the 2012 sub-ACL (annual catch limit) for Area 3 becomes...

  8. 76 FR 66654 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    2011-10-27

    ... 1A is 26,546 mt, and 0 mt of the sub-ACL is set aside for research (75 FR 48874, August 12, 2010... Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch Limit) Harvested for Management... specification of the overfishing limit, acceptable biological catch, annual catch limit (ACL), optimum...

  9. 78 FR 21071 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    2013-04-09

    ...-ACL is set aside for research (75 FR 48874, August 12, 2010). The regulations at Sec. 648.201 require... Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch Limit) Harvested for Management..., acceptable biological catch, annual catch limit (ACL), optimum yield, domestic harvest and processing,...

  10. 77 FR 10668 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    2012-02-23

    ... 22,146 mt, and 0 mt of the sub-ACL is set aside for research (75 FR 48874, August 12, 2010). Section... Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch Limit) Harvested for Management... the overfishing limit, acceptable biological catch, annual catch limit (ACL), optimum yield,...

  11. 76 FR 61059 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    2011-10-03

    ...,362 mt and 0 mt of the sub-ACL is set aside for research (75 FR 48874, August 12, 2010). The... Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch Limit) Harvested for Management... calendar day until January 1, 2012, when the 2012 sub-ACL for Area 1B becomes available, except...

  12. Lymph is not a Plasma Ultrafiltrate: A Proteomic Analysis of Injured Patients

    Dzieciatkowska, Monika; D'Alessandro, Angelo; Moore, Ernest E; Wohlauer, Max; Banerjee, Anirban; Silliman, Christopher C.; Hansen, Kirk C.

    2014-01-01

    Studies on animal models have documented a role for the water soluble protein fraction of mesenteric lymph as a conduit from hemorrhagic shock to acute lung injury and post-injury multiple organ failure. We hypothesize that mesenteric lymph is not an ultrafiltrate of plasma and contains specific protein mediators that may predispose patients to ALI/MOF. Mesenteric lymph and plasma were collected from critically ill or injured patients and from nine patients with lymphatic injuries, during sem...

  13. Accuracy of nonorthogonal MR imaging in acute disruption of the anterior cruciate ligament

    This paper reports on a prospective study of 120 patients with suspected acute internal derangement of the knee undertaken to compare orthogonal, sagittal, T1-weighted MR imaging with nonorthogonal (oblique), sagittal, T2-weighted MR imaging in the evaluation of injuries of the anterior cruciated ligament (ACL). When an unidentified ACL (13%) was regarded as presenting a complete ACL disruption, orthogonal and nonorthogonal MR imaging had sensitivities of 70.5% and 100% specificities of 94.2% and 100%, accuracies of 87.1% and 100% positive predictive values of 80% and 100% and negative predictive values of 81.5% and 100%, respectively

  14. Knee functional recovery and limb-to-limb symmetry restoration after anterior cruciate ligament (ACL) rupture and ACL reconstruction

    Nawasreh, Zakariya Hussein

    Anterior cruciate ligament (ACL) rupture is a common sport injury of young athletes who participate in jumping, cutting, and pivoting activities. Although ACL reconstruction (ACLR) surgery has the goal of enabling athletes to return to preinjury activity levels, treatment results often fall short of this goal. The outcomes after ACLR are variable and less than optimal with low rate of return to preinjury activity level and high risk for second ACL injury. Factors related to the knee functional limitations, strength deficits, and limb-to-limb movement asymmetry may be associated with poor outcomes after ACLR. Additionally, the criteria that are used to determine a patient's readiness to return to the preinjury activity level are undefined which may also be associated with poor outcomes after ACLR. The clinical decision-making to clear patients' for safe and successful return to high physical activities should be based on a universal comprehensive set of objective criteria that ensure normal knee function and limb-to-limb symmetry. A battery of return to activity criteria (RTAC) that emphases normal knee function and limb-to-limb movement symmetry has been constituted to better ensure safe and successful return to preinjury activity level. Yet, only variables related to patients' demographics, concomitant injuries, and treatment measures have been used to predict return to preinjury activity levels after ACLR. However, the ability of RTAC variables that ensure normal knee function and limb movement symmetry to predict the return to participate in the same preinjury activity level after ACLR has not been investigated. In light of this background, the first aim of the present study was to compare functional knee performance-based and patient-reported measures of those who PASS and who FAIL on RTAC at 6 months (6-M) following ACLR with those at 12 months (12-M) and 24 months (24-M) following ACLR and to determine how performance-based and patient-reported measures

  15. A Note on Optimal Care by Wealth-Constrained Injurers

    Thomas J. Miceli; Kathleen Segerson

    2001-01-01

    This paper clarifies the relationship between an injurer's wealth level and his care choice by highlighting the distinction between monetary and non-monetary care. When care is non-monetary, wealth-constrained injurers generally take less than optimal care, and care is increasing in their wealth level under both strict liability and negligence. In contrast, when care is monetary, injurers may take too much or too little care under strict liability, and care is not strictly increasing in injur...

  16. Translation and measurement properties of the Swedish version of ACL-Return to Sports after Injury questionnaire

    Kvist, Joanna; Österberg, Annika; Gauffin, Håkan; Tagesson (Sonesson), Sofi; Webster, K.; Ardern, C.

    2013-01-01

    Psychological factors may be a hindrance for returning to sport after an anterior cruciate ligament (ACL) reconstruction. The ACL-Return to Sport after Injury scale (ACL-RSI) measures athletes emotions, confidence in performance, and risk appraisal in relation to return to sport. The aim of this study was to translate the ACL-RSI scale from English to Swedish and to examine some of the measurement properties of the Swedish version. The ACL-RSI was translated and culturally adapted. A professi...

  17. A-B Hourglass Technique in Anterior Cruciate Ligament (ACL) Reconstruction

    Within a period of 2 years starting from April 2000 to November 2002, fifty (50) cases of torn anterior cruciate ligament (ACL) were treated and followed up using our simple modified technique in a retrospective non-randomized study conducted in Saudi-German Hospital, Saudi Arabia. All of which had torn ACL either isolated or associated with meniscal tear. Some of our study group was subjected arthroscopic interference in the same knee before either in the form of ACL reconstruction using P-T-B graft or for menisectomy. During this study per-operative evaluation, intra-operative technique and post-operative follow-up were standardized, with maximum follow-up period of 19 months and minimum follow-up period of 9 month. The final outcome was graded according to Lyshom knee score (1982). The mean age at surgery was 26.5 (from 17 to 36 years). The study group included 11 isolated torn ACL, 29 torn ACL with tear in the medial meniscus, 4 torn ACL with lateral meniscus tear and 6 cases with torn ACL associated with tear in both menisci. All of the cases were treated using the same technique. (author)

  18. Prognosis and predictors of ACL reconstructions using the MOON cohort: a model for comparative effectiveness studies.

    Spindler, Kurt P; Parker, Richard D; Andrish, Jack T; Kaeding, Christopher C; Wright, Rick W; Marx, Robert G; McCarty, Eric C; Amendola, Annunziato; Dunn, Warren R; Huston, Laura J; Harrell, Frank E

    2013-01-01

    Injury to the anterior cruciate ligament (ACL) threatens an active lifestyle and exposes the patient to risk of early osteoarthritis (OA). ACL reconstruction is typically chosen by individuals to allow a return to their previous work and sports activities. Primary ACL reconstruction (ACLR) has in general been effective at restoring functional stability, but patients' modifiable predictors of both short- and long-term validated outcomes and OA are largely unknown. The Multicenter Orthopaedic Outcomes Network (MOON) consortium was established in 2002 to enroll and longitudinally follow a population cohort of ACL reconstructed patients. The objective was to establish patient-specific predictive models of clinically important outcomes. Over the past 10 years, the overarching aims of this NIAMS-funded prospective multicenter cohort of ACL reconstructions has been threefold: (1) to identify both short- and long-term prognosis and predictors of sports function, activity level, and general health through validated patient-reported outcomes, (2) to identify the symptoms and signs of OA, and (3) to quantify the incidence of ACL reconstruction graft and/or contralateral ACL failures and additional surgical procedures. This manuscript summarizes the Kappa Delta Ann Doner Vaughan Award paper and presentation at the 2012 ORS/AAOS Annual Meeting. PMID:22912340

  19. Exciting innovations for the spinally injured

    Hunt, K.J.; McLean, A.N.

    2002-01-01

    Spinal injury can be devastating, resulting, as it often does, in some paralysis and loss of sensation. Engineering plays an important role in spinal cord injury rehabilitation. Here, the authors survey current research into the uses of functional electrical stimulation to improve the quality of life of spinally injured people. Touching on the area of spinal cord repair and nerve regeneration, they also consider the question of whether technology can help paraplegics to take steps again.

  20. Psychopathological responses of physically injured persons

    Lešić Aleksandar; Opalić Petar D.

    2003-01-01

    The idea to monitor and research psychopathological responses of physically injured persons in a more systematic manner has come from our observation of huge differences in patient behavior, whose psychological responses were noticeably changed and often inappropriate. The behavior aberrations were all the more striking because we treated wartime injuries in addition to peacetime ones. Our sample had 175 patient subjects, of both sexes different ages, marital status and professions. A group o...

  1. Transportation of the Critically Ill and Injured

    Ailsby, R L

    1987-01-01

    The introduction of cookbook-style protocols to emergency treatment of critically ill and injured patients has significantly improved the quality of pre-hospital care and the organization of transportation of these patients. The systematic implementation of pre-planned protocols by physicians, nursing staff, and ambulance personnel, combined with regular post-incident performance evaluations, will enhance the level of medical care both in large and small community settings.

  2. Narrating the self-injured body

    Chandler, Amy

    2014-01-01

    Illness narratives have traditionally been used as a conceptual tool for exploring experiences of chronic illness or disease. In this paper, I suggest that Frank's typology of illness narratives (chaos, restitution and quest) also offers an illuminating approach to analysing accounts of self-injury, demonstrating the diverse ways in which self-injury is practiced, experienced and narrated. Drawing on 24 narrative interviews with 12 people who had self-injured, I focus on participants’ account...

  3. Comparison of ACL strain estimated via a data-driven model with in vitro measurements.

    Weinhandl, Joshua T; Hoch, Matthew C; Bawab, Sebastian Y; Ringleb, Stacie I

    2016-11-01

    Computer modeling and simulation techniques have been increasingly used to investigate anterior cruciate ligament (ACL) loading during dynamic activities in an attempt to improve our understanding of injury mechanisms and development of injury prevention programs. However, the accuracy of many of these models remains unknown and thus the purpose of this study was to compare estimates of ACL strain from a previously developed three-dimensional, data-driven model with those obtained via in vitro measurements. ACL strain was measured as the knee was cycled from approximately 10° to 120° of flexion at 20 deg s(-1) with static loads of 100, 50, and 50 N applied to the quadriceps, biceps femoris and medial hamstrings (semimembranosus and semitendinosus) tendons, respectively. A two segment, five-degree-of-freedom musculoskeletal knee model was then scaled to match the cadaver's anthropometry and in silico ACL strains were then determined based on the knee joint kinematics and moments of force. Maximum and minimum ACL strains estimated in silico were within 0.2 and 0.42% of that measured in vitro, respectively. Additionally, the model estimated ACL strain with a bias (mean difference) of -0.03% and dynamic accuracy (rms error) of 0.36% across the flexion-extension cycle. These preliminary results suggest that the proposed model was capable of estimating ACL strains during a simple flexion-extension cycle. Future studies should validate the model under more dynamic conditions with variable muscle loading. This model could then be used to estimate ACL strains during dynamic sporting activities where ACL injuries are more common. PMID:27030937

  4. Developing a 6-DOF robot to investigate multi-axis ACL injuries under valgus loading coupled with tibia internal rotation.

    Ren, Yupeng; Jacobs, Benjamin J; Nuber, Gordon W; Koh, Jason L; Zhang, Li-Qun

    2010-01-01

    Anterior cruciate ligament (ACL) injuries have become more common in recent years as more young people participate in risky sporting activities [1]. Most ACL injuries occur as a result of noncontact mechanisms. Previous in vitro studies of ACL strain have found significant increases in ACL strain primarily with anterior directed force on the tibia relative to the femur and with internal rotation and often with valgus torque [2,3]. However, there remains significant controversy over the mechanisms of ACL failure and the forces on the knee that lead to injury. Some studies have also shown that isolated valgus loading may not load the ACL strongly. The goal of this study was to investigate the mechanism underlying valgus-related ACL injuries. An improved understanding of ACL failure may lead to improved ACL injury prevention programs. A novel 6 degrees of freedom (DOF) knee driving robot was developed in this study with a unique multi-axis simultaneous torque/position control. It was found that pure valgus torque caused a torque that internally rotated the tibia and thus increased ACL strain markedly, which may be an important mechanism underlying the rather common seemingly valgus-related ACL injuries. PMID:21097089

  5. Prevalens av kneartrose hos fotballspillere, og relasjonen til ACL-skade

    2012-01-01

    Objectives: Football is the world biggest sport (7), and the estimates for ACL(Anterior Cruciate Ligament)-injuries varies; 0,06-3,7 for each 1000 playing-hours. (5,44) In Scandinavia football is the most common activity that leads to ACL-injury. (35) The objectives for this article are to investigate the radiological prevalence of osteoarthritis among former footballplayers, and the relation to ACL-injury. Methods: The data and material are mainly from unsystematic searches in PubMed and...

  6. Traumatically injured astrocytes release a proteomic signature modulated by STAT3-dependent cell survival.

    Levine, Jaclynn; Kwon, Eunice; Paez, Pablo; Yan, Weihong; Czerwieniec, Gregg; Loo, Joseph A; Sofroniew, Michael V; Wanner, Ina-Beate

    2016-05-01

    Molecular markers associated with CNS injury are of diagnostic interest. Mechanical trauma generates cellular deformation associated with membrane permeability with unknown molecular consequences. We used an in vitro model of stretch-injury and proteomic analyses to determine protein changes in murine astrocytes and their surrounding fluids. Abrupt pressure-pulse stretching resulted in the rapid release of 59 astrocytic proteins with profiles reflecting cell injury and cell death, i.e., mechanoporation and cell lysis. This acute trauma-release proteome was overrepresented with metabolic proteins compared with the uninjured cellular proteome, bearing relevance for post-traumatic metabolic depression. Astrocyte-specific deletion of signal transducer and activator of transcription 3 (STAT3-CKO) resulted in reduced stretch-injury tolerance, elevated necrosis and increased protein release. Consistent with more lysed cells, more protein complexes, nuclear and transport proteins were released from STAT3-CKO versus nontransgenic astrocytes. STAT3-CKO astrocytes had reduced basal expression of GFAP, lactate dehydrogenase B (LDHB), aldolase C (ALDOC), and astrocytic phosphoprotein 15 (PEA15), and elevated levels of tropomyosin (TPM4) and α actinin 4 (ACTN4). Stretching caused STAT3-dependent cellular depletion of PEA15 and GFAP, and its filament disassembly in subpopulations of injured astrocytes. PEA15 and ALDOC signals were low in injured astrocytes acutely after mouse spinal cord crush injury and were robustly expressed in reactive astrocytes 1 day postinjury. In contrast, α crystallin (CRYAB) was present in acutely injured astrocytes, and absent from uninjured and reactive astrocytes, demonstrating novel marker differences among postinjury astrocytes. These findings reveal a proteomic signature of traumatically-injured astrocytes reflecting STAT3-dependent cellular survival with potential diagnostic value. GLIA 2016;64:668-694. PMID:26683444

  7. Magnetic resonance imaging of the normal and chronically injured adult rat spinal cord in vivo

    Guizar-Sahagun, G. (Centro de Investigacion del Proyecto Camina, Mexico City (Mexico) Dept. of Clinical Research in Neurology and Neurosurgery, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Inst. Mexicano del Seguro Social, Mexico City (Mexico)); Rivera, F. (Centro de Investigacion del Proyecto Camina, Mexico City (Mexico)); Babinski, E. (Centro de Investigacion del Proyecto Camina, Mexico City (Mexico)); Berlanga, E. (Dept. of Magnetic Resonance Imaging, Hospital Angeles del Pedregal, Mexico City (Mexico)); Madrazo, M. (Dept. of Magnetic Resonance Imaging, Hospital Angeles del Pedregal, Mexico City (Mexico)); Franco-Bourland, R. (Centro de Investigacion del Proyecto Camina, Mexico City (Mexico) Dept. of Biochemistry, Inst. Nacional de la Nutricion, Mexico City (Mexico)); Grijalva, I. (Centro de Investigacion del Proyecto Camina, Mexico City (Mexico) Dept. of Clinical Research in Neurology and Neurosurgery, Hospital de Especialidades, Centro Medico Nacional Siglo

    1994-08-01

    We assessed the capacity of MRI to show and characterise the spinal cord (SC) in vivo in normal and chronically injured adult rats. In the chronically injured animals the SC was studied by MRI and histological examination. MRI was performed at 1.5 T, using gradient-echo and spin-echo (SE) sequences, the latter with and without gadolinium-DTPA (Gd-DTPA). Several positions were tried for good alignment and to diminish interference by respiratory movements. Images of the SC were obtained in sagittal, coronal, and axial planes. Normal SC was observed as a continuous intensity in both sequences, although contrast resolution was better using SE; it was not possible to differentiate the grey and white matter. Low signal was seen in the damaged area in chronically injured rats, which corresponded to cysts, trabeculae, mononuclear infiltrate, and fibroglial wall on histological examination. Gd-DTPA failed to enhance the SC in normal or chronically injured rats. It did, however, cause enhancement of the lesion after acute SC injury. (orig.)

  8. Magnetic resonance imaging of the normal and chronically injured adult rat spinal cord in vivo

    We assessed the capacity of MRI to show and characterise the spinal cord (SC) in vivo in normal and chronically injured adult rats. In the chronically injured animals the SC was studied by MRI and histological examination. MRI was performed at 1.5 T, using gradient-echo and spin-echo (SE) sequences, the latter with and without gadolinium-DTPA (Gd-DTPA). Several positions were tried for good alignment and to diminish interference by respiratory movements. Images of the SC were obtained in sagittal, coronal, and axial planes. Normal SC was observed as a continuous intensity in both sequences, although contrast resolution was better using SE; it was not possible to differentiate the grey and white matter. Low signal was seen in the damaged area in chronically injured rats, which corresponded to cysts, trabeculae, mononuclear infiltrate, and fibroglial wall on histological examination. Gd-DTPA failed to enhance the SC in normal or chronically injured rats. It did, however, cause enhancement of the lesion after acute SC injury. (orig.)

  9. Can MRI distinguish between acute partial and complete anterior cruciate ligament tear?

    A study to elucidate the title problem was done. Subjects were 8 patients with partial anterior cruciate ligament (ACL) tear diagnosed by both MRI and arthroscopy within 6 weeks after trauma, 14 patients with complete ACL tear diagnosed similarly and 10 control patients with arthroscopically intact ACL. Proton density-and T2-weighted MRI imaging of the sagittal section of the knee was performed with 1.5 T magnets (Siemens Magnetom H15, Shimadzu SMT150GUX) by using a dedicated knee coil, with slice thickness of 4-5 mm and 14-16 cm field of view. The examination was done on the primary (discontinuity of low signal band, abnormal axis of the ligament and focal or diffuse increased signal intensity) and secondary (bone bruise, anterior translocation of the tibia and PCL curvature value) signs of ACL tear. In proton density-weighted sagittal images, it was found easy to distinguish acute partial ACL tear from normal ligament but not from complete ACL tear. In T2-weighted images, partial ACL tear was suggested to keep continuity of the ligament. (H.O.)

  10. Increased Posterior Tibial Slope and its Association with ACL Rupture in the Pediatric Population

    O'Malley, Michael P.; Milewski, Matthew David; Solomito, Matthew; Erwteman, Andrew; Nissen, Carl W.

    2014-01-01

    Objectives: Particular interest has been placed in identifying risk factors for sports related injuries in younger populations. In regards to the relationship between posterior sagittal slope of the tibia as a potential risk factor for ACL injury in the pediatric population, studies at this time remain limited.The purpose of our study is to investigate this relationship between posterior tibial slope and ACL rupture in the pediatric population. Our null hypothesis states that an increased pos...

  11. Diagnostic Value of Knee Arthrometry in the Prediction of ACL Strain During Landing

    Kiapour, Ata; Wordeman, Samuel Clayton; Paterno, Mark V.; Quatman, Carmen E.; Levine, Jason W.; Goel, Vijay K.; Hewett, Timothy E.

    2013-01-01

    Objectives: Excessive knee joint laxity may decrease overall joint stability and increase the risk of anterior cruciate ligament (ACL) injury during high risk activities. Despite the frequent clinical use of knee arthrometry, as an accurate and valid method for evaluation of knee laxity, no data exists to correlate instrumented laxity measures and ACL strain during dynamic high-risk activities. The purpose of this study was to evaluate relationships between instrumented anterior knee laxity m...

  12. Cross-professional differences in real-time assessment of ACL injury risk

    Petushek, Erich J.; Ward, Paul; Cokely, Edward T.; Myer, Gregory D

    2015-01-01

    Simple visual inspection of movement is a potentially low cost method for anterior cruciate ligament (ACL) injury screening and prevention. Although many professionals, athletes, and coaches utilize some form of visual inspection of movement/injury risk, there is currently no substantial data on group skill differences. Sports medicine professionals, exercise science students/academics, and strength and conditioning coaches exhibited consistently superior ACL injury risk estima...

  13. An Unusual Case of Acl Cyst with Multiple Melon Seed Bodies of the Knee

    Vaish, Abhishek; Sancheti, Parag; Vaishya, Raju

    2016-01-01

    Introduction: The cyst of anterior cruciate ligament (ACL) is a known clinical entity, but its association with knee synovitis and melon or rice bodies is not documented. Case Report: We report a rare case of ganglionic cyst of of the knee in association with diffuse synovitis and multiple melon or rice bodies in a 36 year old male. The case was treated arthroscopically with removal ofthe cyst of ACL and multiple melon seed bodies. Conclusion: Information regarding incidence, treatment, and o...

  14. KNEE SYNERGISM DURING GAIT REMAIN ALTERED ONE YEAR AFTER ACL RECONSTRUCTION

    LEPORACE, GUSTAVO; METSAVAHT, LEONARDO; PEREIRA, GLAUBER RIBEIRO; OLIVEIRA, LISZT PALMEIRA DE; Crespo, Bernardo; BATISTA, LUIZ ALBERTO

    2016-01-01

    ABSTRACT Objective: To compare the activation of the vastus lateralis (VL) and biceps femoris (BF) muscles during gait, as well VL/BF muscular co-contraction (MCC) between healthy (CG) and anterior cruciate ligament reconstructed (ACL-R) subjects. Methods: Nineteen subjects, ten controls and nine ACL-R patients had a VL and BF electromyogram (EMG) captured to calculate the MCC ratio. A Principal Component (PC) Analysis was applied to reduce the dimensionality effect of each of the MCC, VL and...

  15. Different knee joint loading patterns in ACL deficient copers and non-copers during walking

    Alkjaer, Tine; Henriksen, Marius; Simonsen, Erik B

    2011-01-01

    Rupture of the anterior cruciate ligament (ACL) causes changes in the walking pattern. ACL deficient subjects classified as copers and non-copers have been observed to adopt different post-injury walking patterns. How these different patterns affect the knee compression and shear forces is...... unresolved. Thus, the aim of the present study was to investigate how different walking patterns observed between copers, non-copers, and controls affect the knee compression and shear forces during walking....

  16. Intra-articular bupivacaine or bupivacaine and morphine after ACL reconstruction

    Danieli, Marcus Vinicius; Cavazzani Neto, Antonio; Herrera, Paulo Adilson

    2012-01-01

    Objective Reconstructive surgery of the ACL is one of the most commonly performed surgeries today and the control of postoperative pain is part of the priorities of the surgeon. Within the arsenal of analgesia we have the intra-articular application of drugs, and the most studied one is bupivacaine with or without morphine. This study compared the application of bupivacaine with or without morphine with a control group after ACL reconstruction with flexor tendon graft. Methods Forty-five pati...

  17. Incidence and Outcome of Early Acute Kidney Injury in Critically-Ill Trauma Patients

    Amber S Podoll; Kozar, Rosemary; Holcomb, John B; Kevin W Finkel

    2013-01-01

    Objective To determine the incidence and effect on mortality of early acute kidney injury in severely injured trauma patients using the Acute Kidney Injury Network creatinine criteria. Design A retrospective cohort study of severely injured trauma patients admitted to the shock trauma intensive care unit. Setting Texas Trauma Institute, a state designated level I trauma unit certified by the American College of Surgeons Committee on Trauma. Patients 901 severely injured trauma patients admitt...

  18. MRI diagnosis of ACL bundle tears: value of oblique axial imaging

    To investigate the diagnostic accuracy of oblique axial intermediate weighting MR imaging in detecting partial thickness anterior cruciate ligament (ACL) bundle tears. The study protocol was approved by the institutional ethics committee. Sixty-one subjects (43 male, 18 female; mean age 27.4 years; range 9 to 57 years) with clinically suspected ACL tear or meniscal tear between September 2009 and January 2011 were studied with MRI and arthroscopy. Detection of partial tear for the ACL as a whole and for each ACL bundle by protocol A (standard orthogonal sequences) and protocol B (standard orthogonal sequences plus oblique axial intermediate weighted imaging) was compared in a blinded fashion. Performance characteristics for protocol A and protocol B were compared using sensitivity, specificity, accuracy and ROC curves. A two-tailed p value of 0.05). The addition of oblique axial imaging to standard MR imaging improves diagnostic accuracy for detecting partial tears of the ACL as well as individual bundle tears of the ACL. (orig.)

  19. A novel first aid stretcher for immobilization and transportation of spine injured patients.

    Yan-Sheng Liu

    Full Text Available Effective immobilization and transportation are vital to the life-saving acute medical care needed when treating critically injured people. However, the most common types of stretchers used today are wrought with problems that can lead to further medical complications, difficulty in employment and rescue, and ineffective transitions to hospital treatment. Here we report a novel first aid stretcher called the "emergency carpet", which solves these problems with a unique design for spine injured patients. Polyurethane composite material, obtained by a novel process of manually mixing isocyanate and additives, can be poured into a specially designed fabric bag and allowed to harden to form a rigid human-shaped stretcher. The effectiveness of the emergency carpet was examined in the pre-hospital management of victims with spinal fractures. Additionally, it was tested on flat ground and complex terrain as well as in the sea and air. We demonstrated that the emergency carpet can be assembled and solidified on the scene in 5 minutes, providing effective immobilization to the entire injured body. With the protection of the emergency carpet, none of the 20 patients, who were finally confirmed to have spinal column fracture or dislocation, had any neurological deterioration during transportation. Furthermore, the carpet can be handled and transported by multiple means under differing conditions, without compromising immobilization. Finally, the emergency carpet allows the critically injured patient to receive multiple examinations such as X-ray, CT, and MRI without being removed from the carpet. Our results demonstrate that the emergency carpet has ideal capabilities for immobilization, extrication, and transportation of the spine injured patients. Compared with other stretchers, it allows for better mobility, effective immobilization, remarkable conformity to the body, and various means for transportation. The emergency carpet is promising for its

  20. A novel first aid stretcher for immobilization and transportation of spine injured patients.

    Liu, Yan-Sheng; Feng, Ya-Ping; Xie, Jia-Xin; Luo, Zhuo-Jing; Shen, Cai-Hong; Niu, Fang; Zou, Jian; Tang, Shao-Feng; Hao, Jiang; Xu, Jia-Xiang; Xiao, Li-Ping; Xu, Xiao-Ming; Zhu, Hui

    2012-01-01

    Effective immobilization and transportation are vital to the life-saving acute medical care needed when treating critically injured people. However, the most common types of stretchers used today are wrought with problems that can lead to further medical complications, difficulty in employment and rescue, and ineffective transitions to hospital treatment. Here we report a novel first aid stretcher called the "emergency carpet", which solves these problems with a unique design for spine injured patients. Polyurethane composite material, obtained by a novel process of manually mixing isocyanate and additives, can be poured into a specially designed fabric bag and allowed to harden to form a rigid human-shaped stretcher. The effectiveness of the emergency carpet was examined in the pre-hospital management of victims with spinal fractures. Additionally, it was tested on flat ground and complex terrain as well as in the sea and air. We demonstrated that the emergency carpet can be assembled and solidified on the scene in 5 minutes, providing effective immobilization to the entire injured body. With the protection of the emergency carpet, none of the 20 patients, who were finally confirmed to have spinal column fracture or dislocation, had any neurological deterioration during transportation. Furthermore, the carpet can be handled and transported by multiple means under differing conditions, without compromising immobilization. Finally, the emergency carpet allows the critically injured patient to receive multiple examinations such as X-ray, CT, and MRI without being removed from the carpet. Our results demonstrate that the emergency carpet has ideal capabilities for immobilization, extrication, and transportation of the spine injured patients. Compared with other stretchers, it allows for better mobility, effective immobilization, remarkable conformity to the body, and various means for transportation. The emergency carpet is promising for its intrinsic advantages in

  1. A Novel First Aid Stretcher for Immobilization and Transportation of Spine Injured Patients

    Liu, Yan-Sheng; Feng, Ya-Ping; Xie, Jia-Xin; Luo, Zhuo-Jing; Shen, Cai-Hong; Niu, Fang; Zou, Jian; Tang, Shao-Feng; Hao, Jiang; Xu, Jia-Xiang; Xiao, Li-Ping; Xu, Xiao-Ming; Zhu, Hui

    2012-01-01

    Effective immobilization and transportation are vital to the life-saving acute medical care needed when treating critically injured people. However, the most common types of stretchers used today are wrought with problems that can lead to further medical complications, difficulty in employment and rescue, and ineffective transitions to hospital treatment. Here we report a novel first aid stretcher called the “emergency carpet”, which solves these problems with a unique design for spine injured patients. Polyurethane composite material, obtained by a novel process of manually mixing isocyanate and additives, can be poured into a specially designed fabric bag and allowed to harden to form a rigid human-shaped stretcher. The effectiveness of the emergency carpet was examined in the pre-hospital management of victims with spinal fractures. Additionally, it was tested on flat ground and complex terrain as well as in the sea and air. We demonstrated that the emergency carpet can be assembled and solidified on the scene in 5 minutes, providing effective immobilization to the entire injured body. With the protection of the emergency carpet, none of the 20 patients, who were finally confirmed to have spinal column fracture or dislocation, had any neurological deterioration during transportation. Furthermore, the carpet can be handled and transported by multiple means under differing conditions, without compromising immobilization. Finally, the emergency carpet allows the critically injured patient to receive multiple examinations such as X-ray, CT, and MRI without being removed from the carpet. Our results demonstrate that the emergency carpet has ideal capabilities for immobilization, extrication, and transportation of the spine injured patients. Compared with other stretchers, it allows for better mobility, effective immobilization, remarkable conformity to the body, and various means for transportation. The emergency carpet is promising for its intrinsic advantages

  2. Magnetic Resonance Imaging of Cartilage Contact and Bound Water in ACL-Deficient and ACL Reconstructed Knees

    Baer, Geoffrey Scott; Kaiser, Jarred; Vignos, Michael; Liu, Fang; Smith, Colin Robert; Kijowski, Richard; Thelen, Darryl

    2016-01-01

    Objectives: Osteoarthritis (OA) is common following ACL-reconstructive (ACLR) surgery (6). The cause of early OA is not understood, but theories have focused on osteochondral damage at the time of injury (2) and abnormal joint mechanics following surgical repair (7). In this study, we investigate the inter-relationship of cartilage mechanics and biomarkers of OA in both ACL-deficient (ACLD) and ACLR knees. Our approach employs a novel dynamic MR sequence to measure joint mechanics (3) and the recently developed mcDESPOT to assess regional variations in water bound to proteoglycan (PG) (5). We hypothesize that bound water will be diminished in the cartilage of ACLD knees and, after surgery, will continue to adapt in a manner that reflects altered cartilage loading. This abstract presents initial observations on a cross-section of healthy, ACLD and ACLR knees. Methods: The dominant knees of 8 healthy controls, ACLD knees of 5 patients and ACLR knees of 8 patients were imaged in a 3 T MRI scanner (Table). Controls had no history of pain, injury, or surgery to their knee. Patients had no additional ligament injury and no meniscal damage. ACLD subjects were imaged prior to reconstructive surgery. Femoral and tibial cartilage were segmented from MR images and cartilage thickness was calculated. The mcDESPOT sequence provided a fraction map of water bound to PG (Fpg). Subjects flexed their knee against an inertial load at 0.5 Hz, while a SPGR-VIPR sequence continuously acquired volumetric data. Kinematics were obtained using model tracking of the dynamic images (3). Cartilage was registered to the bone segments for all frames, and contact patterns were characterized by the proximity between surfaces. Spatial representations of tibial cartilage contact, thickness and Fpg were co-registered for each subject. Results: Our initial images suggest lower Fpg values in ACLD knees, primarily on the posterior-lateral tibia. This is also observed in ACLR knees, with additional

  3. Blood pressure in head‐injured patients

    Mitchell, Patrick; Gregson, Barbara A; Piper, Ian; Citerio, Giuseppe; Mendelow, A David; Chambers, Iain R

    2007-01-01

    Objective To determine the statistical characteristics of blood pressure (BP) readings from a large number of head‐injured patients. Methods The BrainIT group has collected high time‐resolution physiological and clinical data from head‐injured patients who require intracranial pressure (ICP) monitoring. The statistical features of this dataset of BP measurements with time resolution of 1 min from 200 patients is examined. The distributions of BP measurements and their relationship with simultaneous ICP measurements are described. Results The distributions of mean, systolic and diastolic readings are close to normal with modest skewing towards higher values. There is a trend towards an increase in blood pressure with advancing age, but this is not significant. Simultaneous blood pressure and ICP values suggest a triphasic relationship with a BP rising at 0.28 mm Hg/mm Hg of ICP, for ICP up to 32 mm Hg, and 0.9 mm Hg/mm Hg of ICP for ICP from 33 to 55 mm Hg, and falling sharply with rising ICP for ICP >55 mm Hg. Conclusions Patients with head injury appear to have a near normal distribution of blood pressure readings that are skewed towards higher values. The relationship between BP and ICP may be triphasic. PMID:17138594

  4. The concept of double bundle ACL simulation with a single bundle patellar tendon graft. A cadaveric feasibility study

    Jacobi Matthias; Magnussen Robert A; Villa Vincent; Demey Guillaume; Neyret Philippe

    2012-01-01

    Abstract Background There is significant interest in the restoration of the double-bundle anatomy of the native ACL when performing ACL reconstruction. Possible techniques include those utilizing two separate grafts with independent tunnels and those that attempt to mimic this anatomy with a single graft and fewer tunnels. Many of the latter techniques require specific instrumentation and are technically challenging. We demonstrate that the double-bundle anatomy of the native ACL can theoreti...

  5. ACL graft re-rupture after double-bundle reconstruction: factors that influence the intra-articular pattern of injury

    van Eck, Carola F.; Kropf, Eric J.; Romanowski, James R.; Lesniak, Bryson P.; Tranovich, Michael J.; van Dijk, C. Niek; Fu, Freddie H

    2010-01-01

    Purpose To determine the most common rupture patterns of previously reconstructed DB-ACL cases, seen at the time of revision surgery, and to determine the influence of age, gender, time between the initial ACL reconstruction and re-injury, tunnel angle and etiology of failure. Methods Forty patients who presented for revision surgery after previous double-bundle ACL reconstruction were enrolled. Three orthopedic surgeons independently reviewed the arthroscopic videos and determined the ruptur...

  6. Normalized motor function but impaired sensory function after unilateral non-reconstructed ACL injury: patients compared with uninjured controls.

    Ageberg, Eva; Fridén, Thomas

    2008-01-01

    Improvement in motor function after anterior cruciate ligament (ACL) injury is achieved by appropriate rehabilitation. However, it has been questioned whether training after injury can lead to sensory improvement. We hypothesized that motor function can be restored after unilateral non-reconstructed ACL injury, whereas the sensory function cannot, i.e., there would be no difference in functional performance or knee muscle strength between subjects with ACL injury and uninjured controls, but t...

  7. T2* MR Relaxometry and Ligament Volume are Associated with the Structural Properties of the Healing ACL

    Biercevicz, Alison M.; Murray, Martha M.; Walsh, Edward G; Miranda, Danny L.; Machan, Jason T.; Fleming, Braden C.

    2013-01-01

    Our objective was to develop a non-invasive magnetic resonance (MR) method to predict the structural properties of a healing anterior cruciate ligament (ACL) using volume and T2* relaxation time. We also compared our T2*-based structural property prediction model to a previous model utilizing signal intensity, an acquisition-dependent variable. Surgical ACL transection followed by no treatment (i.e., natural healing) or bio-enhanced ACL repair was performed in a porcine model. After 52 weeks ...

  8. The effect of isolated valgus moments on ACL strain during single-leg landing: A simulation study

    Shin, Choongsoo S.; Chaudhari, Ajit M.; Andriacchi, Thomas P.

    2008-01-01

    Valgus moments on the knee joint during single-leg landing have been suggested as a risk factor for anterior cruciate ligament (ACL) injury. The purpose of this study was to test the influence of isolated valgus moment on ACL strain during single-leg landing. Physiologic levels of valgus moments from an in vivo study of single-leg landing were applied to a three-dimensional dynamic knee model, previously developed and tested for ACL strain measurement during simulated landing. The ACL strain,...

  9. Case study: Muscle atrophy and hypertrophy in a premier league soccer player during rehabilitation from ACL injury.

    Milsom, Jordan; Barreira, Paulo; Burgess, Darren J; Iqbal, Zafar; Morton, James P

    2014-10-01

    The onset of injury and subsequent period of immobilization and disuse present major challenges to maintenance of skeletal muscle mass and function. Although the characteristics of immobilization-induced muscle atrophy are well documented in laboratory studies, comparable data from elite athletes in free-living conditions are not readily available. We present a 6-month case-study account from a professional soccer player of the English Premier League characterizing rates of muscle atrophy and hypertrophy (as assessed by DXA) during immobilization and rehabilitation after ACL injury. During 8 weeks of inactivity and immobilization, where the athlete adhered to a low carbohydrate-high protein diet, total body mass decreased by 5 kg attributable to 5.8 kg loss and 0.8 kg gain in lean and fat mass, respectively. Changes in whole-body lean mass was attributable to comparable relative decreases in the trunk (12%, 3.8 kg) and immobilized limb (13%, 1.4 kg) whereas the nonimmobilized limb exhibited smaller declines (7%, 0.8 kg). In Weeks 8 to 24, the athlete adhered to a moderate carbohydrate-high protein diet combined with structured resistance and field based training for both the lower and upper-body that resulted in whole-body muscle hypertrophy (varying from 0.5 to 1 kg per week). Regional hypertrophy was particularly pronounced in the trunk and nonimmobilized limb during weeks 8 to 12 (2.6 kg) and 13 to 16 (1.3 kg), respectively, whereas the previously immobilized limb exhibited slower but progressive increases in lean mass from Week 12 to 24 (1.2 kg). The athlete presented after the totality of the injured period with an improved anthropometrical and physical profile. PMID:24458224

  10. Displaced Medial and Lateral Bucket Handle Meniscal Tears With Intact ACL and PCL.

    Boody, Barrett S; Omar, Imran M; Hill, James A

    2015-08-01

    Bucket handle lesions are vertical longitudinal tears in the meniscus that may displace centrally into the respective medial or lateral compartment, frequently causing mechanical symptoms, including pain, perceived instability, and mechanical locking. Bucket handle meniscal tears are most commonly from a traumatic etiology and are frequently found with concomitant anterior cruciate ligament (ACL) injuries. Multiple imaging signs and associations have been described for the diagnosis of bucket handle meniscus tears, including coronal truncation, absent bow tie sign, double posterior cruciate ligament (PCL), double ACL, displacement of the bucket handle fragment, and disproportionate posterior horn signs. Among meniscal pathology encountered on magnetic resonance imaging or during arthroscopy, bucket handle meniscal tears are infrequent occurrences. Furthermore, the occurrence of displaced medial and lateral bucket handle tears found on imaging and during arthroscopy is very uncommon and is only sparsely reported in the literature. When displaced medial and lateral bucket handle meniscal segments are visualized within the intercondylar notch along with the ACL and PCL, the radiologic findings are referred to as the "quadruple cruciate" sign or the "Jack and Jill lesion." Of the few case reports described in the literature, only one noted displaced medial and lateral bucket handle meniscus tears with an intact ACL and PCL. The current case report outlines a similar rare case of the quadruple cruciate sign: displaced medial and lateral bucket handle meniscal tears located within the intercondylar notch and an intact ACL and PCL. PMID:26270763

  11. KNEE SYNERGISM DURING GAIT REMAIN ALTERED ONE YEAR AFTER ACL RECONSTRUCTION

    LEPORACE, GUSTAVO; METSAVAHT, LEONARDO; PEREIRA, GLAUBER RIBEIRO; OLIVEIRA, LISZT PALMEIRA DE; CRESPO, BERNARDO; BATISTA, LUIZ ALBERTO

    2016-01-01

    ABSTRACT Objective: To compare the activation of the vastus lateralis (VL) and biceps femoris (BF) muscles during gait, as well VL/BF muscular co-contraction (MCC) between healthy (CG) and anterior cruciate ligament reconstructed (ACL-R) subjects. Methods: Nineteen subjects, ten controls and nine ACL-R patients had a VL and BF electromyogram (EMG) captured to calculate the MCC ratio. A Principal Component (PC) Analysis was applied to reduce the dimensionality effect of each of the MCC, VL and BF curves for both healthy and ACL reconstructed groups. The PC scores were used to calculate the standard distance (SD). SD values were employed in order to compare each dependent variable (MCC, VL and BF) between the two groups using unpaired t-test. Results: ACL-R group presented a lower VL activation at the beginning and at the end of the gait cycle, as compared to the control group. However, no difference was found for BF or VL/BF MCC. Conclusion: The gait analysis of ACL reconstructed patients demonstrated a persistent deficit in VL activation when compared to the control group, even one year after surgery. Level of Evidence III. Case Control Study PMID:27217814

  12. Psychoactive substances in seriously injured drivers in Denmark

    Simonsen, Kirsten Wiese; Steentoft, Anni; Bernhoft, Inger Marie;

    2013-01-01

    found to be above the Danish legal limit in 4.9% of injured drivers. Young men (median age 31 years) were over-represented among injured drivers who violated Danish law for alcohol and drugs. Diazepam (4.4%), tramadol (3.2%), and clonazepam (3.0%) were the medicinal drugs most frequently detected at...

  13. The experience of being a partner to a spinal cord injured person

    Angel, Sanne; Buus, Niels

    2011-01-01

    This qualitative focuses on the personal experiences of partners to a spinal cord injured person. Using a Ricoeurian phenomenological-hermeneutic approach, we analysed seven partners' narratives 1 and 2 years after their partner's injury. The study revealed how the injury was experienced from the...... partners' perspective through the aftermath. In the acute phase after the injury, partners also felt harmed, and support was needed in relation to their own daily activities, eating, resting, and managing distress. During the institutionalized rehabilitation, partners felt torn between supporting the...

  14. Preventive effect of phycocyanin from Spirulina platensis on alloxan-injured mice.

    Ou, Yu; Lin, Lin; Pan, Qin; Yang, Xuegan; Cheng, Xiaodong

    2012-11-01

    The preventive effect of phycocyanin (obtained from Spirulina platensis) on alloxan-injured mice is investigated. Oral administration of phycocyanin was started two weeks before an alloxan injury and continued until four weeks later. Tests resulted in the following positive results of oral phycocyanin administration on alloxan-injured mice: decrease fasting blood glucose and glycosylated serum protein (GSP); maintain total antioxidative capability (T-AOC); avert malondialdehyde (MDA) formation in the liver, kidney, and pancreas; decrease total cholesterol (TC) level and triglycerides (TG) level in serum and liver; increase the levels of hepatic glycogen level; maintain glucokinase (GK) expression in the liver and decrease p53 expression in the pancreas at mRNA level. The histological observations also supported the above results. Acute toxicity study further shows that phycocyanin is relatively safe. These results led to the conclusion that phycocyanin has significant preventive effect on alloxan-injured mice. The inhibition of p53 pathway could be one of the mechanisms that led to the protection of pancreatic islets from alloxan injury. We also proposed that GK expression that functions to promote liver glycogen synthesis could be the reason for reduced blood glucose level. The encouraging results are the first step in studying the potential of phycocyanin as a clinical measure in preventing diabetes. PMID:23121873

  15. Internet-based prevention of posttraumatic stress symptoms in injured trauma patients: design of a randomized controlled trial

    Joanne Mouthaan

    2011-11-01

    Full Text Available Background: Injured trauma victims are at risk of developing Posttraumatic Stress Disorder (PTSD and other post-trauma psychopathology. So far, interventions using cognitive behavioral techniques (CBT have proven most efficacious in treating early PTSD in highly symptomatic individuals. No early intervention for the prevention of PTSD for all victims has yet proven effective. In the acute psychosocial care for trauma victims, there is a clear need for easily applicable, accessible, cost-efficient early interventions. Objective: To describe the design of a randomized controlled trial (RCT evaluating the effectiveness of a brief Internet-based early intervention that incorporates CBT techniques with the aim of reducing acute psychological distress and preventing long-term PTSD symptoms in injured trauma victims. Method: In a two armed RCT, 300 injured trauma victims from two Level-1 trauma centers in Amsterdam, the Netherlands, will be assigned to an intervention or a control group. Inclusion criteria are: being 18 years of age or older, having experienced a traumatic event according to the diagnostic criteria of the DSM-IV and understanding the Dutch language. The intervention group will be given access to the intervention's website (www.traumatips.nl, and are specifically requested to login within the first month postinjury. The primary clinical study outcome is PTSD symptom severity. Secondary outcomes include symptoms of depression and anxiety, quality of life, and social support. In addition, a cost-effectiveness analysis of the intervention will be performed. Data are collected at one week post-injury, prior to first login (baseline, and at 1, 3, 6 and 12 months. Analyses will be on an intention-to-treat basis. Discussion: The results will provide more insight into the effects of preventive interventions in general, and Internet-based early interventions specifically, on acute stress reactions and PTSD, in an injured population, during the

  16. Antagonist muscle moment is increased in ACL deficient subjects during maximal dynamic knee extension

    Alkjær, Tine; Simonsen, Erik B; Magnusson, S Peter; Dyhre-Poulsen, Poul; Aagaard, Per

    2012-01-01

    INTRODUCTION: Coactivation of the hamstring muscles during dynamic knee extension may compensate for increased knee joint laxity in anterior cruciate ligament (ACL) deficient subjects. This study examined if antagonist muscle coactivation during maximal dynamic knee extension was elevated in...... subjects with anterior cruciate ligament (ACL) deficiency compared to age-matched healthy controls. METHODS: Electromyography (EMG) and net knee joint moments were recorded during maximal concentric quadriceps and eccentric hamstring contractions, performed in an isokinetic dynamometer (ROM: 90......-10°, angular speed: 30°/s). Hamstring antagonist EMG recorded during concentric quadriceps contraction was converted into antagonist moment based on the EMG-moment relationship observed during eccentric agonist contractions. RESULTS: The magnitude of antagonist hamstring EMG was 65.5% higher in ACL deficient...

  17. Fluoroscopic Analysis of Tibial Translation in Anterior Cruciate Ligament Injured Knees With and Without Bracing During Forward Lunge

    Jalali

    2015-07-01

    Full Text Available Background Despite several studies with different methods, the effect of functional knee braces on knee joint kinematics is not clear. Direct visualization of joint components through medical imaging modalities may provide the clinicians with more useful information. Objectives In this study, for the first time in the literature, video fluoroscopy was used to investigate the effect of knee bracing on the sagittal plane kinematics of anterior cruciate ligament (ACL injured patients. Patients and Methods For twelve male unilateral ACL deficient subjects, the anterior tibial translation was measured during lunge exercise in non-braced and braced conditions. Fluoroscopic images were acquired from the subjects using a digital fluoroscopy system with a rate of 10 fps. The image of each frame was scaled using a calibration coin and analyzed in AutoCAD environment. The angle between the two lines, tangent to the posterior cortexes of the femoral and tibial shafts was measured as the flexion angle. For the fluoroscopic images associated with 0°, 15°, 30°, 45° and 60° knee flexion angles, the relative anterior-posterior configuration of the tibiofemoral joint was assessed by measuring the position of landmarks on the tibia and femur. Results Results indicated that the overall anterior translations of the tibia during the eccentric (down and concentric (up phases of lunge exercise were 10.4 ± 1.7 mm and 9.0 ± 2.2 mm for non-braced, and 10.1 ± 3.4 mm and 7.4 ± 2.5 mm, for braced conditions, respectively. The difference of the tibial anterior-posterior translation behaviors of the braced and non-braced knees was not statistically significant. Conclusion Fluoroscopic imaging provides an effective tool to measure the dynamic behavior of the knee joint in the sagittal plane and within the limitations of this study, the pure mechanical stabilizing effect of functional knee bracing is not sufficient to control the anterior tibial translation of the ACL

  18. 77 FR 61299 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    2012-10-09

    ... research in the 2010-2012 specifications (75 FR 48874, August 12, 2010). Section 648.201 requires the... Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch Limit) Harvested for Management... specification of the overfishing ] limit, acceptable biological catch, annual catch limit (ACL), optimum...

  19. 77 FR 66746 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    2012-11-07

    ... research in the 2010-2012 specifications (75 FR 48874, August 12, 2010). However, due to an over-harvest in Area 1A in 2010, the FY 2012 sub-ACL in Area 1A was revised to 24,668 mt on February 24, 2012 (77 FR... Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch Limit) Harvested for...

  20. Musculoskeletal Modeling of a Forward Lunge Movement:Implications for ACL Loading

    Alkjaer, T; Wieland, MR; Andersen, MS;

    2010-01-01

    Body Modeling System. The model and the pelvis. The hips were modeled as spherical joints, the knees as hinge joints, and the ankles as universal joints. Each according to a minimum fatigue criterion. Main Outcome Measures: Muscle and joint reaction forces that pulled the tibia in anterior or posterior...... never required any stabilization by the ACL. The forward lunge explored the muscle and reaction forces, which can be used for further examination of ACL injury mechanisms and prevention strategies by applying parameter and optimization studies to the model....

  1. Comparison of the Insall-Salvati ratio of the patella in patients with and without an ACL tear.

    Lin, Chien-Fu Jeff; Wu, Jiunn-Jer; Chen, Teng-Shung; Huang, Tung-Fu

    2005-01-01

    The object of this prospective study is to compare the Insall-Salvati ratio between the patients who have an anterior cruciate ligament (ACL) tear and receive arthroscopic-assistant ACL reconstruction and the patients who have no ACL tear but do have an internal disorder of the knee and receive arthroscopic surgery. We prospectively and consecutively collected into two groups a total of 217 patients who had sport injuries and received arthroscopic surgery. The study group included 115 patients who had an ACL tear and received arthroscopic-assistant ACL reconstruction with middle-third bone-patella tendon-bone graft. The control group included 102 patients with internal disorders of the knee joint, including meniscus tear, plicae, or other chondral lesion, but without an ACL tear. We measured the patellar Insall-Salvati ratio [12] on the pre-operative X-ray films for all patients. The Insall-Salvati ratio in the ACL-tear study group is significantly smaller than the control group of internal disorders of the knee (0.99+/-0.11 vs 1.05+/-0.12, p=0.001). There is no significant difference in age, gender, the side of the involved knee, duration of symptoms, patella length and patella tendon length between the two groups. In conclusion, our study shows that patella infra has an association with ACL tears, and patella infra may be a risk factor for ACL tears. In patients with an ACL tear who had patella baja, the middle-third patellar tendon may not be an ideal graft for reconstruction. PMID:15654645

  2. Olfactory impairment and traumatic brain injury in blast-injured combat troops

    Mulligan, Lisa P.; Smith, Alice B.; Olsen, Cara H.; Lyon, Dina M.; Belluscio, Leonardo

    2015-01-01

    Objective: To determine whether a structured and quantitative assessment of differential olfactory performance—recognized between a blast-injured traumatic brain injury (TBI) group and a demographically comparable blast-injured control group—can serve as a reliable antecedent marker for preclinical detection of intracranial neurotrauma. Methods: We prospectively and consecutively enrolled 231 polytrauma inpatients, acutely injured from explosions during combat operations in either Afghanistan or Iraq and requiring immediate stateside evacuation and sequential admission to our tertiary care medical center over a 2½-year period. This study correlates olfactometric scores with both contemporaneous neuroimaging findings as well as the clinical diagnosis of TBI, tabulates population-specific incidence data, and investigates return of olfactory function. Results: Olfactometric score predicted abnormal neuroimaging significantly better than chance alone (area under the curve = 0.78, 95% confidence interval [CI] 0.70–0.87). Normosmia was present in all troops with mild TBI (i.e., concussion) and all control subjects. Troops with radiographic evidence of frontal lobe injuries were 3 times more likely to have olfactory impairment than troops with injuries to other brain regions (relative risk 3.0, 95% CI 0.98–9.14). Normalization of scores occurred in all anosmic troops available for follow-up testing. Conclusion: Quantitative identification olfactometry has limited sensitivity but high specificity as a marker for detecting acute structural neuropathology from trauma. When considering whether to order advanced neuroimaging, a functional disturbance with central olfactory impairment should be regarded as an important tool to inform the decision process. Classification of evidence: This study provides Class III evidence that central olfactory dysfunction identifies patients with TBI who have intracranial radiographic abnormalities with a sensitivity of 35% (95% CI 20

  3. Acute Concomitant Anterior Cruciate Ligament and Patellar Tendon Tears in a Non-dislocated Knee

    Robert D Wissman

    2012-01-01

    Full Text Available Anterior cruciate ligament (ACL tears are common and may occur in isolation or with other internal derangements of the joint. Tears of the patellar tendon (PT occur less frequently and are rarely associated with intra-articular pathology. Acute combined tears of both the ACL and PT are known complications of high-energy traumatic knee dislocations. We present a case of an acute concomitant ACL and PT tears in a low-energy non-dislocated knee. To our knowledge, this injury has only been described in a limited number of case reports in the orthopedic literature. We present the imaging findings of this combined injury and discuss the importance of magnetic resonance (MR in diagnosis.

  4. Purinergic signaling on leukocytes infiltrating the LPS-injured lung.

    Daniela Friebe

    Full Text Available Extracellular nucleotides and nucleosides have been implicated as important signaling molecules in the pathogenesis of acute lung injury (ALI. While adenosine is known to inhibit T cell activation, little information is available as to ATP and NAD degrading enzymes, the expression of ATP and adenosine receptors/transporters in different T cell subsets. ALI was induced by challenging mice with intra-tracheal instillation of 60 µl (3 µg/g LPS. After 3 d and 7 d blood, lung tissue and bronchoalveolar lavage was collected and immune cells were analyzed using flow cytometry. The transcriptional phenotype of T helper cells, cytotoxic and regulatory T cells sorted by FACS was assessed by measuring the expression profile of 28 genes related to purinergic signaling using TaqMan Array Micro Fluidic Cards. Catabolism of ATP, NAD and cAMP by activated CD4+ T cells was evaluated by HPLC. CD73 was found to be highly abundant on lymphoid cells with little abundance on myeloid cells, while the opposite was true for CD39. After ALI, the abundance of CD39 and CD73 significantly increased on all T cell subsets derived from lung tissue and bronchoalveolar space. Expression analysis in T cell subsets of the lung revealed ATP (Cd39, Cd73 and NAD (Cd38, Cd157, Cd296, Pc-1 degrading enzymes. However, only transcription of Cd38, Cd39, Cd73, Ent1 and A2a receptor was significantly upregulated after ALI in T helper cells. CD4+ T cells from injured lung rapidly metabolized extracellular ATP to AMP and adenosine but not NAD or cAMP. These findings show that lung T cells--the dominant cell fraction in the later phase of ALI--exhibit a unique expression pattern of purinergic signaling molecules. Adenosine is formed by T cells at an enhanced rate from ATP but not from NAD and together with upregulated A2a receptor is likely to modulate the healing process after acute lung injury.

  5. ACL Report. A Report of the Activities of the American Classical League 1977-1978.

    Lawall, Gilbert

    Five topics of interest to persons involved in classical studies are discussed in this report: (1) "A Survey of the Classical Scene" focusses on the future of classical studies in elementary and secondary schools with some mention of the situation in colleges and universities. (2) "ACL: The State of the League" includes officers, agenda and…

  6. Iliotibial band autograft versus bone-patella-tendon-bone autograft, a possible alternative for ACL reconstruction

    Stensbirk, Frederik; Thorborg, Kristian; Konradsen, Lars; Jørgensen, Uffe; Hölmich, Per

    2014-01-01

    PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi-ligament......PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi......-ligament reconstruction. The purpose is to assess whether the ITB autograft is a long-term reliable alternative to the bone-patella-tendon-bone (BPTB) autograft, using a prospective randomized controlled trial design. METHODS: From 1995 to 1996, sixty patients scheduled for primary ACL reconstruction were included in a...... prospective randomized controlled trial. Three senior knee surgeons, experienced in both types of ACL surgery, performed all the operations. A standardized and supervised rehabilitation programme was used for both groups for 6 months. Thirty patients received the ITB reconstruction, and 30 received the BPTB...

  7. Forward lunge as a functional performance test in ACL deficient subjects: test-retest reliability

    Alkjaer, Tine; Henriksen, Marius; Dyhre-Poulsen, Poul; Simonsen, Erik B

    2009-01-01

    The forward lunge movement may be used as a functional performance test of anterior cruciate ligament (ACL) deficient and reconstructed subjects. The purposes were 1) to determine the test-retest reliability of a forward lunge in healthy subjects and 2) to determine the required numbers of...

  8. Pseudocyclops: two cases of ACL graft partial tears mimicking cyclops lesions on MRI

    Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is a common surgical procedure, particularly in young athletes. Although the procedure has excellent success rates, complications such as mechanical impingement, graft rupture, and arthrofibrosis can occur, often necessitating additional surgery. Magnetic resonance (MR) imaging has become a valuable tool in evaluating complications after ACL reconstruction. We report two cases of ACL reconstruction complicated by arthroscopically proven partial graft tears. In both cases the torn anterior graft fibers were flipped into the intercondylar notch, mimicking anterior arthrofibrosis, i.e., a ''cyclops lesion,'' on MR imaging. Careful review of the direction of graft fibers on MR imaging in the ''pseudocyclops'' lesions can help differentiate these partial tears from the fibrosis of a true cyclops. The ''pseudocyclops'' lesion is a previously undescribed MR imaging sign of partial ACL graft tear. Larger studies are required to determine the sensitivity and specificity of the sign, as well as the clinical importance of these partial graft tears. (orig.)

  9. Pseudocyclops: two cases of ACL graft partial tears mimicking cyclops lesions on MRI.

    Simpfendorfer, Claus; Miniaci, Anthony; Subhas, Naveen; Winalski, Carl S; Ilaslan, Hakan

    2015-08-01

    Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is a common surgical procedure, particularly in young athletes. Although the procedure has excellent success rates, complications such as mechanical impingement, graft rupture, and arthrofibrosis can occur, often necessitating additional surgery. Magnetic resonance (MR) imaging has become a valuable tool in evaluating complications after ACL reconstruction. We report two cases of ACL reconstruction complicated by arthroscopically proven partial graft tears. In both cases the torn anterior graft fibers were flipped into the intercondylar notch, mimicking anterior arthrofibrosis, i.e., a "cyclops lesion," on MR imaging. Careful review of the direction of graft fibers on MR imaging in the "pseudocyclops" lesions can help differentiate these partial tears from the fibrosis of a true cyclops. The "pseudocyclops" lesion is a previously undescribed MR imaging sign of partial ACL graft tear. Larger studies are required to determine the sensitivity and specificity of the sign, as well as the clinical importance of these partial graft tears. PMID:25620690

  10. Pseudocyclops: two cases of ACL graft partial tears mimicking cyclops lesions on MRI

    Simpfendorfer, Claus; Subhas, Naveen; Winalski, Carl S.; Ilaslan, Hakan [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States); Miniaci, Anthony [Cleveland Clinic, Department of Orthopedics, Cleveland, OH (United States)

    2015-08-15

    Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is a common surgical procedure, particularly in young athletes. Although the procedure has excellent success rates, complications such as mechanical impingement, graft rupture, and arthrofibrosis can occur, often necessitating additional surgery. Magnetic resonance (MR) imaging has become a valuable tool in evaluating complications after ACL reconstruction. We report two cases of ACL reconstruction complicated by arthroscopically proven partial graft tears. In both cases the torn anterior graft fibers were flipped into the intercondylar notch, mimicking anterior arthrofibrosis, i.e., a ''cyclops lesion,'' on MR imaging. Careful review of the direction of graft fibers on MR imaging in the ''pseudocyclops'' lesions can help differentiate these partial tears from the fibrosis of a true cyclops. The ''pseudocyclops'' lesion is a previously undescribed MR imaging sign of partial ACL graft tear. Larger studies are required to determine the sensitivity and specificity of the sign, as well as the clinical importance of these partial graft tears. (orig.)

  11. Dimensionality of the Knee Numeric-Entity Evaluation Score (KNEES-ACL)

    Comins, J D; Krogsgaard, M R; Kreiner, Svend;

    2013-01-01

    The benefit of anterior cruciate ligament (ACL) reconstruction has been questioned based on patient-reported outcome measures (PROMs). Valid interpretation of such results requires confirmation of the psychometric properties of the PROM. Rasch analysis is the gold standard for validation of PROMs...

  12. Anterior Cruciate Ligament Reconstruction using Bone Patellar Tendon Bone autograft in ACL deficient Knee

    Navin Kumar Karn

    2015-12-01

    Full Text Available Background & Objectives: Injury to Anterior Cruciate Ligament (ACL reconstruction has increased because of increased interest in sports. There are various grafts used for reconstruction of ACL, for example, Bone Patellar Tendon Bone, Hamstring etc. The study was conducted to evaluate the results of Bone Patellar Tendon Bone graft used for reconstruction of Anterior Cruciate Ligament.Materials & Methods: 40 patients with chronic ACL deficient knee presenting to Neuro Hospital from July 2011 to June 2013 were included in the study. The patients with intraarticular fracture of knee, severe OA knee, local active or suspected infection and systemic disease that might influence the study results were excluded from the study. Bone patellar tendon bone graft was harvested from ipsilateral knee in all the cases. The patient was followed till 2 year with specified programme of rehabilitation. The pain was assessed using VAS and the function of the knee was assessed using Modified WOMAC knee index.Results: The long term satisfactory results in terms of functional stability, symptom relief and return to preinjury level of activity was seen in 32 cases (80%. Two knees got infected out of which one required arthroscopic debridement. Mean visual analogue scale was 8 and modified WOMAC knee score was 3 at 2 year follow up.Conclusion: Bone patellar tendon bone graft is useful in high demand patients and cost effective option with high patient satisfaction rate for reconstruction of ACL.JCMS Nepal. 2015;11(3:12-15.

  13. Electromyographic evaluation of functional electrical stimulation to injured oculomotor nerve

    Min Yang; Shiting Li; Youqiang Meng; Ningxi Zhu; Xuhui Wang; Liang Wan; Wenchuan Zhang; Jun Zhong; Shugan Zhu; Massimiliano Visocchi

    2011-01-01

    Functional electrical stimulation delivered early after injury to the proximal nerve stump has been proposed as a therapeutic approach for enhancing the speed and specificity of axonal regeneration following nerve injury. In this study, the injured oculomotor nerve was stimulated functionally by an implantable electrode. Electromyographic monitoring of the motor unit potential of the inferior oblique muscle was conducted for 12 weeks in two injury groups, one with and one without electric stimulation. The results revealed that, at 2, 4, 6, 8 weeks after functional electric stimulation of the injured oculomotor nerve, motor unit potentials significantly increased, such that amplitude was longer and spike duration gradually shortened. These findings indicate that the injured oculomotor nerve has the potential for regeneration and repair, but this ability is not sufficient for full functional recovery to occur. Importantly, the current results indicated that recovery and regeneration of the injured oculomotor nerve can be promoted with functional electrical stimulation.

  14. Multi-ligand nanoparticles for targeted drug delivery to the injured vascular wall

    Kona, Soujanya

    Pathological conditions like coronary artery disease, acute myocardial infarction, stroke, and peripheral artery diseases as well as cardiovascular interventions used in the treatment of coronary artery diseases such as angioplasty and stenting damage/injure the blood vessel wall, leading to inflamed or activated endothelial cells that have been implicated in events leading to thrombosis, inflammation, and restenosis. Oral administration of anti-coagulant and anti-inflammatory drugs causes systemic toxicity, bleeding, patient incompliance, and inadequate amounts of drugs at the injured area. Though drug-eluting stents have shown therapeutic benefits, complications such as in-stent restenosis and late thrombosis still remain and are a cause for concern. Rapid growth in the field of nanotechnology and nanoscience in recent years has paved the way for new targeted and controlled drug delivery strategies. In this perspective, the development of biodegradable nanoparticles for targeted intracellular drug delivery to the inflamed endothelial cells may offer an improved avenue for treatment of cardiovascular diseases. The major objective of this research was to develop "novel multi-ligand nanoparticles," as drug carriers that can efficiently target and deliver therapeutic agents to the injured/inflamed vascular cells under dynamic flow conditions. Our approach mimics the natural binding ability of platelets to injured/activated endothelial cells through glycoprotein Ib (GPIb) bound to P-selectin expressed on inflamed endothelial cells and to the subendothelium through GPIb binding to von Willebrand factor (vWF) deposited onto the injured vascular wall. Our design also exploits the natural cell membrane translocation ability of the internalizing cell peptide - trans-activating transcriptor (TAT) to enhance the nanoparticle uptake by the targeted cells. Our hypothesis is that these multi-ligand nanoparticles would show an increased accumulation at the injury site since GPIb

  15. Comparison between clinical grading and navigation data of knee laxity in ACL-deficient knees

    Yamamoto Yuji

    2010-11-01

    Full Text Available Abstract Background The latest version of the navigation system for anterior cruciate ligament (ACL reconstruction has the supplementary ability to assess knee stability before and after ACL reconstruction. In this study, we compared navigation data between clinical grades in ACL-deficient knees and also analyzed correlation between clinical grading and navigation data. Methods 150 ACL deficient knees that received primary ACL reconstruction using an image-free navigation system were included. For clinical evaluation, the Lachman, anterior drawer, and pivot shift tests were performed under general anesthesia and were graded by an examiner. For the assessment of knee stability using the navigation system, manual tests were performed again before ACL reconstruction. Navigation data were recorded as anteroposterior (AP displacement of the tibia for the Lachman and anterior drawer tests, and both AP displacement and tibial rotation for the pivot shift test. Results Navigation data of each clinical grade were as follows; Lachman test grade 1+: 10.0 mm, grade 2+: 13.2 ± 3.1 mm, grade 3+: 14.5 ± 3.3 mm, anterior drawer test grade 1+: 6.8 ± 1.4 mm, grade 2+: 7.4 ± 1.8 mm, grade 3+: 9.1 ± 2.3 mm, pivot shift test grade 1+: 3.9 ± 1.8 mm/21.5° ± 7.8°, grade 2+: 4.8 ± 2.1 mm/21.8° ± 7.1°, and grade 3+: 6.0 ± 3.2 mm/21.1° ± 7.1°. There were positive correlations between clinical grading and AP displacement in the Lachman, and anterior drawer tests. Although positive correlations between clinical grading and AP displacement in pivot shift test were found, there were no correlations between clinical grading and tibial rotation in pivot shift test. Conclusions In response to AP force, the navigation system can provide the surgeon with correct objective data for knee laxity in ACL deficient knees. During the pivot shift test, physicians may grade according to the displacement of the tibia, rather than rotation.

  16. Visual-Spatial Therapeutic Rehabilitation for the Brain Injured Patient

    Karen Love, OD

    2014-01-01

    Therapeutic vision rehabilitation is a significantly underutilized component of the multidisciplinary rehabilitation program for the brain injured patient population. The purpose of this paper is to present the impact of visual dysfunction in brain injury, to demonstrate the benefit of therapeutic vision rehabilitation on the activities of daily life for the brain injured patient, and to give practical activity instructions for the vision therapist. This paper discusses the importanc...

  17. Risks of intracranial haematoma in head injured adults.

    Mendelow, A D; Teasdale, G; Jennett, B; Bryden, J; Hessett, C; Murray, G.

    1983-01-01

    A study was conducted to estimate the risk that an adult (age 15 or over) will develop a surgically significant intracranial haematoma after a head injury. Two simple features were used that can be recognised by clinicians with minimal training: a skull fracture and the conscious level. The risks were calculated from samples of 545 patients with haematomas, 2773 head injured patients in accident and emergency departments, and 2783 head injured patients in primary surgical wards. With radiolog...

  18. Nurses' experience of caring for burn injured children in pain.

    Olsson, Andrea

    2011-01-01

    Abstract: Aim: To illuminate how nurses working with burn injured children describe their care for burn injured children in pain during dressing procedures and which conditions and obstacles nurses express they are working under in order to proceed with giving care. Method: Semi-structured qualitative interviews with eight nurses at a pediatric burn ward in Dar es Salaam. Interviews were recorded, transcribed and processed by manifest content analysis. Result: Three themes were derived and i...

  19. Multiple sites of vasopressin synthesis in the injured brain

    Szmydynger-Chodobska, Joanna; Zink, Brian J.; Chodobski, Adam

    2010-01-01

    Previous studies have indicated that the primary targets for vasopressin actions on the injured brain are the cerebrovascular endothelium and astrocytes, and that vasopressin amplifies the posttraumatic production of proinflammatory mediators. Here, the controlled cortical impact model of traumatic brain injury in rats was used to identify the sources of vasopressin in the injured brain. Injury increased vasopressin synthesis in the hypothalamus and cerebral cortex adjacent to the posttraumat...

  20. Health significance and occurrence of injured bacteria in drinking water

    McFeters, G. A.; LeChevallier, M. W.; Singh, A.; Kippin, J. S.

    1986-01-01

    Enteropathogenic and indicator bacteria become injured in drinking water with exposure to sublethal levels of various biological, chemical and physical factors. One manifestation of this injury is the inability to grow and form colonies on selective media containing surfactants. The resulting underestimation of indicator bacteria can lead to a false estimation of water potability. m-T7 medium was developed specifically for the recovery of injured coliforms (both "total" and fecal) in drinking water. The m-T7 method was used to survey operating drinking water treatment and distribution systems for the presence of injured coliforms that were undetected with currently used media. The mean recovery with m-Endo LES medium was less than 1/100 ml while it ranged between 6 and 68/100ml with m-T7 agar. The majority of samples giving positive results with m-T7 medium yielded no detectable coliforms with m-Endo LES agar. Over 95% of the coliform bacteria in these samples were injured. Laboratory experiments were also done to ascribe the virulence of injured waterborne pathogens. Enteropathogens including Salmonella typhimurium, Yersinia enterocolitica and Shigella spp. required up to 20 times the chlorine levels to produce the same injury in enterotoxigenic Escherichia coli (ETEC) and nonpathogenic coliforms. Similar results were seen with Y. enterocolitica exposed to copper. The recovery of ETEC was followed by delayed enterotoxin production, both in vitro and in the gut of experimental animals. This indicates that injured waterborne enteropathogenic bacteria can be virulent.

  1. Use of ultra-high molecular weight polycaprolactone scaffolds for ACL reconstruction.

    Leong, Natalie L; Kabir, Nima; Arshi, Armin; Nazemi, Azadeh; Jiang, Jie; Wu, Ben M; Petrigliano, Frank A; McAllister, David R

    2016-05-01

    Previously, we reported on the implantation of electrospun polycaprolactone (PCL) grafts for use in ACL tissue engineering in a small animal model. In the present study, we hypothesized that grafts fabricated from ultra-high molecular weight polycaprolactone (UHMWPCL) would have similarly favorable biologic properties but superior mechanical properties as compared to grafts fabricated from PCL. Two forms of polycaprolactone were obtained (UHMWPCL, MW = 500 kD, and PCL, MW = 80 kD) and electrospun into scaffolds that were used to perform ACL reconstruction in 7-8 week old male Lewis rats. The following groups were examined: UHMWPCL, PCL, flexor digitorum longus (FDL) allograft, native ACL, as well as sham surgery in which the ACL was transsected. At 16 weeks post-operatively, biomechanical testing, histology, and immunohistochemistry (IHC) were performed. Analysis of cellularity indicated that there was no significant difference among the UHMWPCL, PCL, and FDL allograft groups. Quantification of birefringence from picrosirius red staining demonstrated significantly more aligned collagen fibers in the allograft than the PCL group, but no difference between the UHMWPCL and allograft groups. The peak load to failure of the UHMWPCL grafts was significantly higher than PCL, and not significantly different from FDL allograft. This in vivo study establishes the superiority of the higher molecular weight version of polycaprolactone over PCL as a scaffold material for ACL reconstruction. By 16 weeks after implantation, the UHMWPCL grafts were not significantly different from the FDL allografts in terms of cellularity, peak load to failure, stiffness, and collagen fiber alignment. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:828-835, 2016. PMID:26497133

  2. Fifteen Year Prospective Comparison of Patellar & Hamstring Tendon Grafts for ACL Reconstruction

    Roe, Justin; Salmon, Lucy; Kok, Alison; Linklater, James; Pinczewski, Leo

    2016-01-01

    Objective: This prospective longitudinal study compares isolated endoscopic ACL reconstruction utilizing 4-strand hamstring tendon (HT) or patellar tendon (PT) autograft over a 15-year period with respect to clinical outcomes and the development of osteoarthritis. Method: 90 consecutive patients with isolated ACL rupture were reconstructed with a PT autograft and 90 patients received HT autograft, with an identical surgical technique. Patients were assessed at 2, 5, 7, 10 and 15 years. Assessment included the IKDC Knee Ligament Evaluation including radiographic evaluation, KT1000, kneeling pain, and clinical outcomes. Results: Subjects who received the PT graft had significantly worse outcomes at 15 years for the variables of radiologically detectable osteoarthritis (p=0.001), motion loss (p=0.02), single leg hop test (p=0.002), participation in strenuous activity (p=0.03), knee related decrease in activity level (p=0.002) and kneeling pain (p=0.03). There was no significant difference between the HT and PT groups in overall IKDC grade (p=0.28). ACL graft rupture occurred in 16% of HT group and 8% of the PT group (p=0.10). Contralateral ACL rupture occurred in significantly more PT patients (24%) than HT patients (12%) (p=0.03). Conclusion: Significant differences have developed at 15 years after surgery which were not seen at earlier reviews. Compared to the HT Group, the PT group had significantly worse outcomes with respect to radiological osteoarthritis, range of motion and functional tests but no significant difference in laxity was identified. There was a high incidence of ACL injury after reconstruction, to both the reconstructed and the contralateral knee.

  3. Evaluation of the ability of primary selective enrichment to resuscitate heat-injured and freeze-injured Listeria monocytogenes cells.

    Budu-Amoako, E; Toora, S; Ablett, R F; J. Smith

    1992-01-01

    Resuscitation rates of injured Listeria monocytogenes on conventional selective Listeria enrichment broth and nonselective Trypticase soy broth containing 0.6% yeast extract were compared. Cells were heated to 60 degrees C for 5 min or frozen at -20 degrees C for 7 days. Inoculation of Trypticase soy broth-yeast extract with the stressed cells resulted in growth that was superior to that in Listeria enrichment broth. Injured cells were fully recovered at 6 to 8 h.

  4. A Comparison of Dynamic Postural Stability Between Asymptomatic Controls and Male Patients One Year After ACL Reconstruction (Pilot Study)

    Ataoglu, Muhammed Baybars; Hazar, Zeynep; Kafa, Nihan; ÖZER, Mustafa; Citaker, Seyit

    2014-01-01

    Objectives: The purpose of this study was to determine if dynamic postural stability gained one year after ACL reconstruction in patients who received rehabilitation. Methods: Seven male patients (mean age=32,66 ±6,47) who had previously undergone ACL reconstruction (ACL-R) and 7 sex-and general physical activity matched uninjured controls included to study. Mean time since original injury was 13±3,31 months. Dynamic postural control was assessed with 20° knee flexion with Star Excursion Bala...

  5. Ways of experiencing participation and factors affecting the current activity level after non-reconstructed ACL injury

    Österberg, Annika; Kvist, Joanna; Abrandt Dahlgren, Madeleine

    2011-01-01

    Current assessment methods after an ACL injury do not consider how the individuals themselves experience their participation in activities or what factors they think have affected their current activity level.

  6. An Integrated Approach To Change the Outcome Part I: Neuromuscular Screening Methods To Identify High Acl Injury Risk Athletes

    Myer, Gregory D; Ford, Kevin R.; Brent, Jensen L.; Hewett, Timothy E.

    2012-01-01

    An important step for treatment of a particular injury etiology is the appropriate application of a treatment targeted to the population at risk. An anterior cruciate ligament (ACL) injury risk algorithm has been defined that employs field-based techniques in lieu of laboratory-based motion analysis systems to identify athletes with high ACL injury risk landing strategies. The resultant field-based assessment techniques, in combination with the developed prediction algorithm, allow for low-co...

  7. Simultaneous reconstruction of anterior cruciate ligament (ACL) with autologous graft and of medial collateral ligament (MCL) with allograft

    Aparicio, José Luis; Nardin, Lisandro; Savá, Matías S.

    2015-01-01

    Introduction: Over the last years, the incidence of multiple ligament injuries has increased significantly due to the rising number of traffic accidents in relation to their kinetics and due to higher sports demands. Among their various combinations, one of them is the lesion of anterior cruciate ligament (ACL) which is associated to medial collateral ligament responsible for them in a 13 %. Nowadays several techniques to the reconstruction of Anterior Cruciate Ligament (ACL) and Medial Colla...

  8. Biomechanical Evaluation of Knee Kinematics after ACL Reconstructions in Anatomic SB and DB - Technique with Additional Medial Meniscus Suture

    Lorbach, Olaf; Herbort, Mirco; Engelhardt, Martin; Kieb, Matthias

    2013-01-01

    Objectives: Biomechanical evaluation of knee laxity after single- and double-bundle ACL reconstruction with additional medial meniscus suture. Methods: Kinematics of the intact knee were determined in 12 human cadaver specimens in response to a 134-N anterior tibial load (aTT) and a combined rotatory load of 10 Nm valgus and 4 Nm internal tibial rotation using a robotic/universal force moment sensor testing system. Subsequently, the ACL was resected following the creation of a bucket-handle t...

  9. Acute care management of spinal cord injuries.

    Mitcho, K; Yanko, J R

    1999-08-01

    Meeting the health care needs of the spinal cord-injured patient is an immense challenge for the acute care multidisciplinary team. The critical care nurse clinician, as well as other members of the team, needs to maintain a comprehensive knowledge base to provide the care management that is essential to the care of the spinal cord-injured patient. With the active participation of the patient and family in care delivery decisions, the health care professionals can help to meet the psychosocial and physical needs of the patient/family unit. This article provides an evidence-based, comprehensive review of the needs of the spinal cord-injured patient in the acute care setting including optimal patient outcomes, methods to prevent complications, and a plan that provides an expeditious transition to rehabilitation. PMID:10646444

  10. An Unusual Case of Acl Cyst with Multiple Melon Seed Bodies of the Knee

    Vaish, Abhishek; Sancheti, Parag; Vaishya, Raju

    2016-01-01

    Introduction: The cyst of anterior cruciate ligament (ACL) is a known clinical entity, but its association with knee synovitis and melon or rice bodies is not documented. Case Report: We report a rare case of ganglionic cyst of of the knee in association with diffuse synovitis and multiple melon or rice bodies in a 36 year old male. The case was treated arthroscopically with removal ofthe cyst of ACL and multiple melon seed bodies. Conclusion: Information regarding incidence, treatment, and outcomes for patients with synovial cysts and melon seed bodies is lacking. Arthroscopic examination of joint gives the opportunity to diagnose such rare entity of the joint and also provide minimally invasive effective treatment of such pathology. PMID:27299116

  11. Synchronous quadriceps tendon rupture and unilateral ACL tear in a weightlifter, associated with anabolic steroid use.

    Fenelon, Christopher; Dalton, David M; Galbraith, John G; Masterson, Eric L

    2016-01-01

    Synchronous quadriceps tendon rupture is rare. A 29-year-old man, an amateur weight lifter, taking androgenic-anabolic steroids (AAS), developed sudden onset bilateral pain and swelling of his anterior thighs when attempting to squat 280 kg (620 lb). Examination revealed gross swelling superior to the patella and palpable gaps in both quadriceps tendons. He underwent successful operative repair. MRI revealed a partial tear of the anterior cruciate ligament (ACL) of the right knee. This was not reconstructed. Only a few case reports of the association between AAS and quadriceps rupture exist in the literature, with none to the best of our knowledge in the past 10 years. ACL rupture coexisting is very rare, with only two reported cases. PMID:27154985

  12. Acute acalculous cholecystitis.

    Barie, Philip S; Eachempati, Soumitra R

    2003-08-01

    Acute cholecystitis can develop without gallstones in critically ill or injured patients. However, the development of acute acalculous cholecystitis is not limited to surgical or injured patients, or even to the intensive care unit. Diabetes, malignant disease, abdominal vasculitis, congestive heart failure, cholesterol embolization, and shock or cardiac arrest have been associated with acute acalculous cholecystitis. Children may also be affected, especially after a viral illness. The pathogenesis of acute acalculous cholecystitis is a paradigm of complexity. Ischemia and reperfusion injury, or the effects of eicosanoid proinflammatory mediators, appear to be the central mechanisms, but bile stasis, opioid therapy, positive-pressure ventilation, and total parenteral nutrition have all been implicated. Ultrasound of the gallbladder is the most accurate diagnostic modality in the critically ill patient, with gallbladder wall thickness of 3.5 mm or greater and pericholecystic fluid being the two most reliable criteria. The historical treatment of choice for acute acalculous cholecystitis has been cholecystectomy, but percutaneous cholecystostomy is now the mainstay of therapy, controlling the disease in about 85% of patients. Rapid improvement can be expected when the procedure is performed properly. The mortality rates (historically about 30%) for percutaneous and open cholecystostomy appear to be similar, reflecting the severity of illness, but improved resuscitation and critical care may portend a decreased risk of death. Interval cholecystectomy is usually not indicated after acute acalculous cholecystitis in survivors; if the absence of gallstones is confirmed and the precipitating disorder has been controlled, the cholecystostomy tube can be pulled out after the patient has recovered. PMID:12864960

  13. Perceptions of Supervision Among Injured and Non-Injured Teens Working in the Retail or Service Industry.

    Zierold, Kristina M

    2016-04-01

    According to the National Institute for Occupational Safety and Health (NIOSH), a teen is injured every 9 minutes at work. Workplace supervision may affect whether teens are injured on the job. Because research on workplace supervision among teens is limited, the objectives of this study were to characterize the perceptions of supervision among injured and non-injured teen workers and assess the characteristics and perceptions of supervisors that may be associated with work-related injuries. In 2011, a cross-sectional survey was conducted among high school students. Teens who worked in retail or service industries (n= 270) were included in the sample. Non-injured teens were more likely to have reported that their supervisors cared about their safety, were helpful, listened well, and ensured that teen workers understood workplace safety. Most teens (70%) did not feel comfortable talking about safety issues with their supervisors. The importance of supervision and how supervisors are perceived in the workplace may be significant in creating a safety culture that leaves a lasting impression. PMID:26563967

  14. Injury Risk Estimation Expertise Assessing the ACL Injury Risk Estimation Quiz

    Petushek, Erich J.; Cokely, Edward; Ward, Paul; Durocher, John; Wallace, Sean; Myer, Gregory D

    2015-01-01

    Background: Available methods for screening anterior cruciate ligament (ACL) injury risk are effective but limited in application as they generally rely on expensive and time-consuming biomechanical movement analysis. A potential efficient alternative to biomechanical screening is skilled movement analysis via visual inspection (ie, having experts estimate injury risk factors based on observations of athletes’ movements). Purpose: To develop a brief, valid psychometric assessment ...

  15. Regulation and supervision of the decommissioning of the Active Central Laboratory (ACL) in Studsvik, Sweden

    The paper aims at presenting the experiences made by the Swedish Radiation Protection Authority (SSI) during the decommissioning of the Active Central Laboratory (ACL) in Studsvik, Sweden. As a background, the facility and the decommissioning activities that have been performed are described. This is followed by a description of the regulation and supervision by the SSI. Finally, the main experiences are listed and conclusions are drawn. (author)

  16. Real-time assessment and neuromuscular training feedback techniques to prevent ACL injury in female athletes

    Myer, Gregory D.; BRENT, JENSEN L.; Ford, Kevin R.; Hewett, Timothy E.

    2011-01-01

    Some athletes may be more susceptible to at-risk knee positions during sports activities, but the underlying causes are not clearly defined. This manuscripts synthesizes in vivo, in vitro and in-silica (computer simulated) data to delineate likely risk factors to the mechanism(s) of non-contact ACL injuries. From these identified risk factors, we will discuss newly developed real-time screening techniques that can be used in training sessions to identify modifiable risk factors. Techniques pr...

  17. EVALUATION OF THE RESULTS OF ARTHROSCOPIC ACL RECONSTRUCTION WITH AUTOGENOUS FLEXOR TENDONS

    Almeida, Alexandre; Valin, Múrcio Rangel; Ferreira, Ramon; Roveda, Gilberto; de Almeida, Nayvaldo Couto; Agostini, Ana Paula

    2015-01-01

    Objective: To evaluate the results from reconstruction of the anterior cruciate ligament (ACL) using with flexor tendon autografts from the thigh, with analysis on data relating to sex, body mass index (BMI) and associations with lower limb fracture. Methods: A group of 265 patients who underwent knee arthroscopy for the purposes of ACL reconstruction using an ipsilateral graft from the flexor tendon of the thigh between July 6, 2000, and November 19, 2007, were evaluated. Results: One hundred and seventy-six patients were evaluated over a mean period of 34.95 ± 18.8 months (median: 31 months) (IQR: 20-48 months). The minimum evaluation period was 12 months and the maximum was 87 months. One hundred and thirty-eight patients (78.4%) had excellent results, 22 (12.5%) had good results, eight (4.5%) had fair results and eight (4.5%) had poor results. Higher incidence of good and excellent results for the following categories was not considered to be significant: males (p = 0.128), patients with BMI < 25 (p = 0.848), or patients with ACL injuries unrelated to an initial traumatic episode of lower-limb fracture (p = 0.656). Conclusion: The ACL reconstruction technique using tendon autografts from the thigh showed good and excellent results for 91.4% of the sample. Male patients seemed to present a greater tendency towards good and excellent results. No statistically significant difference was found when the results were analyzed in relation to BMI or associations with initial traumatic fracture episodes in the lower limbs. PMID:27022571

  18. Effect of Plyometric Training on Prevention of ACL Injuries in Females Volleyball Players

    Enginsu, Müjdat; Lokmaoğlu, Recep; Korkmaz, Erol; Arıbaş, İlker; Selimoğlu, Şafak

    2014-01-01

    Objectives: To verify the effects of plyometric training on prevention of ACL injuries with lower limp kinematics,eccentric hip and knee torques,and functional performance. Methods: 36 females volleyball players were divided into a training group (TG no:18) that carried out the plyometric training for 12 weeks,and a control group (CG no:18)that carried out no physical training.24 plyometric trainin sessions during approximately 12 weeks with 3 sessions ,30 minutes per week on alternate days. ...

  19. Visual-Spatial Therapeutic Rehabilitation for the Brain Injured Patient

    Karen Love, OD

    2014-03-01

    Full Text Available Therapeutic vision rehabilitation is a significantly underutilized component of the multidisciplinary rehabilitation program for the brain injured patient population. The purpose of this paper is to present the impact of visual dysfunction in brain injury, to demonstrate the benefit of therapeutic vision rehabilitation on the activities of daily life for the brain injured patient, and to give practical activity instructions for the vision therapist. This paper discusses the importance of inclusion of therapeutic vision exercises into the multidisciplinary and visual rehabilitation program with the goal of increasing the potential for reintegration into society and reduction of the social and economic impact of brain injury on society.

  20. Press-fit Femoral Fixation in ACL Reconstruction using Bone-Patellar Tendon-Bone Graft

    Kaseb Mohammad Hasan

    2009-05-01

    Full Text Available Bone-patellar tendon auto graft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra-articular hardware we adopt biological fixation with a femoral trapezoidal press-fit fixation. A prospective study was performed on 30 consecutive active people who underwent ACL reconstruction with this technique by two surgeons between september2004 and march2007 (mean follow-up 15.2 months. Results were evaluated by an independent examiner using radiography, subjective and objective evaluation. Assessment using the IKDC knee scoring revealed 92% of the patients with a normal or nearly normal knee joint. Lysholm's score was 63.6(40- 86 preoperatively and 91.88(73-100 at the latest follow up (P < 0.005. No patient complained of instability at latest follow up. The quadriceps muscle showed mild atrophy at 3 and 6 months and at final follow-up. Five Patients complained of anterior knee pain and had a positive kneeling test. We found no graft displacement on follow up radiographs. All cases showed radiological evidence of graft osteointegration at last follow up. Our results show that press-fit fixation of trapezoidal bone graft in femoral tunnel is a simple, reliable, and cost-effective alternative for ACL recon-struction using bone-patellar tendon-bone graft.

  1. [Intra-articular reinforcement of a partially torn anterior cruciate ligament (ACL) using newly developed UHMWPE biomaterial in combination with Hexalon ACL/PCL screws: ex-vivo mechanical testing of an animal knee model].

    Fedorová, P; Srnec, R; Pěnčík, J; Dvořák, M; Krbec, M; Nečas, A

    2015-01-01

    PURPOSE OF THE STUDY Recent trends in the experimental surgical management of a partial anterior cruciate ligament (ACL) rupture in animals show repair of an ACL lesion using novel biomaterials both for biomechanical reinforcement of a partially unstable knee and as suitable scaffolds for bone marrow stem cell therapy in a partial ACL tear. The study deals with mechanical testing of the newly developed ultra-high-molecular-weight polyethylene (UHMWPE) biomaterial anchored to bone with Hexalon biodegradable ACL/PCL screws, as a new possibility of intra-articular reinforcement of a partial ACL tear. MATERIAL AND METHODS Two groups of ex vivo pig knee models were prepared and tested as follows: the model of an ACL tear stabilised with UHMWPE biomaterial using a Hexalon ACL/PCL screw (group 1; n = 10) and the model of an ACL tear stabilised with the traditional, and in veterinary medicine used, extracapsular technique involving a monofilament nylon fibre, a clamp and a Securos bone anchor (group 2; n = 11). The models were loaded at a standing angle of 100° and the maximum load (N) and shift (mm) values were recorded. RESULTS In group 1 the average maximal peak force was 167.6 ± 21.7 N and the shift was on average 19.0 ± 4.0 mm. In all 10 specimens, the maximum load made the UHMWPE implant break close to its fixation to the femur but the construct/fixation never failed at the site where the material was anchored to the bone. In group 2, the average maximal peak force was 207.3 ± 49.2 N and the shift was on average 24.1 ± 9.5 mm. The Securos stabilisation failed by pullout of the anchor from the femoral bone in nine out of 11 cases; the monofilament fibre ruptured in two cases. CONCLUSIONS It can be concluded that a UHMWPE substitute used in ex-vivo pig knee models has mechanical properties comparable with clinically used extracapsular Securos stabilisation and, because of its potential to carry stem cells and bioactive substances, it can meet the requirements for

  2. Three-dimensional analysis of injured lateral ligaments of the ankle with FISP MR imaging

    In a series of 150 acutely injured or chronically unstable ankles, oblique reconstructions of the anterior talo-fibular (TFA) and calcaneo-fibular (CF) ligaments were performed. Fast three-dimensional (3D) imaging with a flip angle of 40 degrees, a TR/TE of 30/10 msec, and 128 1-mm-thick sections allowed the evaluation of the whole ankle joint in 16 minutes. Partial or complete ruptures of TFA and/or CF ligaments as well as associated bone or cartilage occult fractures are detected. The authors discuss how, by enabling assessment of the severity of ankle sprains, 3D imaging was found to be helpful in defining when surgical therapy was necessary

  3. Optimization of MR imaging of the most commonly injured structures of the ankle

    MR images of the ankles of seven cadavers, nine healthy volunteers, and seven injured patients were correlated with cadaver dissections and cryosections to determine the optimum imaging plane and foot position for demonstrating each ligament's injury parameters. Axial images of the neutral-positioned foot allowed full-length visualization of the anterior and posterior talofibular ligaments, while the calcaneofibular ligament was paraxially imaged in 400 of plantar flexion. Coronal images allowed paraaxial visualization of major parts of the deltoid ligament: the tibionavicular ligament in 400 of plantar flexion and the tibospring and posterior tibiotalar ligaments in 150 of plantar flexion. Acute ligament rupture was well delineated on T2-weighted images by the high signal intensity of the overlying subcutaneous edema and hemorrhage and the underlying joint effusion. In chronically unstable ankles, ligament rupture, thinning, and lengthening were best demonstrated by placing that ligament in its stress position

  4. INFLUENCE OF ACUPUNCTURE ON BRAIN-TAXIS OF TETRAMETHYLPYRAZINE IN ACUTE CEREBRAL INFARCTION RATS

    崔荣秀; 陈以国; 谷雨

    2003-01-01

    Purpose: To observe the effect of acupuncture on the brain-taxis of tetrarmethylpyrazine (TMP) and toexplore into the underlying mechanisms of combined action of acupuncture and medicine in the treatment of acute cere-bral ischemia. Methods: 37 male Wistar rats were randomly divided into normal control group (n= 10), sham-operationgroup (n= 10), acute cerebral ischemia (ACI) + drug group (model group, n=8)and ACl+drug+acupuncture group(acupuncture group, n=9). Rat ACl model was established by using photochemical method. "Neiguan"(PC 6) and"Shuigou"(GV 26) were punctured and stimulated with both hand manipulation and electroacupuncture, 30 min and16hrs after ACI. TMP was given to the rats of the later 2 groups using gastric perfusion method. High pressure chro-matography (HPLC) was used to detect the target absorption level of TMP in the brain. Results: The content of TMP inthe brain in acupuncture group was significantly higher than that in model group (P<0.01), suggesting that acupunc-ture can strengthen the brain-taxis of TMP in ACl rats, and combined administration of acupuncture and Chinese drugmaybe work better for treatment of acute cerebral infarction. Conclusion: Acupuncture can strengthen the chano-taxisof TMP to the brain in ACl rats.

  5. ACL Injury, Return To Play And Reinjury In The Elite, Collegiate Athlete: An Analysis Of A Single, Division I NCAA Cohort

    Kamath, Ganesh V.; Murphy, Timothy; Creighton, Robert A.; Taft, Timothy N.; Spang, Jeffrey T.

    2014-01-01

    Objectives: Graft survivorship, reinjury rates, and career length are poorly understood after ACL reconstruction in the elite, NCAA Division-I athlete. The purpose of this study was to examine the outcomes of ACL reconstruction in a Division-I athlete cohort. Methods: Retrospective chart review was performed of all Division-I athletes at a single, public university from 2000 to 2009 until completion of eligibility. Athletes with a Pre-collegiate (PC) and Intra-collegiate (IC) ACL reconstructi...

  6. Restriction in Hip Internal Rotation is Associated with an Increased Risk of ACL Injury in NFL Combine Athletes: A Clinical and Biomechanical Study

    Bedi, Asheesh; Warren, Russell F.; Oh, Youkeun K.; Wojtys, Edward M.; Oltean, Hanna N.; Ashton-Miller, James A.; Kelly, Bryan T.

    2013-01-01

    Objectives: A deficiency in hip internal rotation secondary to femoroacetabular impingement (FAI) may result in compensatory increases in rotational stresses applied to the ACL with cutting and pivoting activities, thereby increasing the risk of ACL failure in athletes. The purpose of this study was to correlate ACL injury with hip range of motion in a consecutive series of elite, contact athletes and to test the hypothesis that a restriction in the available hip axial rotation in a dynamic i...

  7. Role of biomechanics in the understanding of normal, injured, and healing ligaments and tendons

    Jung Ho-Joong

    2009-05-01

    Full Text Available Abstract Ligaments and tendons are soft connective tissues which serve essential roles for biomechanical function of the musculoskeletal system by stabilizing and guiding the motion of diarthrodial joints. Nevertheless, these tissues are frequently injured due to repetition and overuse as well as quick cutting motions that involve acceleration and deceleration. These injuries often upset this balance between mobility and stability of the joint which causes damage to other soft tissues manifested as pain and other morbidity, such as osteoarthritis. The healing of ligament and tendon injuries varies from tissue to tissue. Tendinopathies are ubiquitous and can take up to 12 months for the pain to subside before one could return to normal activity. A ruptured medial collateral ligament (MCL can generally heal spontaneously; however, its remodeling process takes years and its biomechanical properties remain inferior when compared to the normal MCL. It is also known that a midsubstance anterior cruciate ligament (ACL tear has limited healing capability, and reconstruction by soft tissue grafts has been regularly performed to regain knee function. However, long term follow-up studies have revealed that 20–25% of patients experience unsatisfactory results. Thus, a better understanding of the function of ligaments and tendons, together with knowledge on their healing potential, may help investigators to develop novel strategies to accelerate and improve the healing process of ligaments and tendons. With thousands of new papers published in the last ten years that involve biomechanics of ligaments and tendons, there is an increasing appreciation of this subject area. Such attention has positively impacted clinical practice. On the other hand, biomechanical data are complex in nature, and there is a danger of misinterpreting them. Thus, in these review, we will provide the readers with a brief overview of ligaments and tendons and refer them to

  8. Assessment of the Impacts of ACLS on the ISS Life Support System using Dynamic Simulations in V-HAB

    Puetz, Daniel; Olthoff, Claas; Ewert, Michael K.; Anderson, Molly S.

    2016-01-01

    The Advanced Closed Loop System (ACLS) is currently under development by Airbus Defense and Space and is slated for launch to the International Space Station (ISS) in 2017. The addition of new hardware into an already complex system such as the ISS life support system (LSS) always poses operational risks. It is therefore important to understand the impacts ACLS will have on the existing systems to ensure smooth operations for the ISS. This analysis can be done by using dynamic computer simulations and one possible tool for such a simulation is Virtual Habitat (V-HAB). Based on Matlab (Registered Trademark) V-HAB has been under development at the Institute of Astronautics of the Technical University Munich (TUM) since 2006 and in the past has been successfully used to simulate the ISS life support systems. The existing V-HAB ISS simulation model treated the interior volume of the space station as one large ideally-stirred container. This model was improved to allow the calculation of the atmospheric composition inside the individual modules of the ISS by splitting it into ten distinct volumes. The virtual volumes are connected by a simulation of the inter-module ventilation flows. This allows for a combined simulation of the LSS hardware and the atmospheric composition aboard the ISS. A dynamic model of ACLS is added to the ISS simulation and different operating modes for both ACLS and the existing ISS life support systems are studied to determine the impacts of ACLS on the rest of the system. The results suggest that the US, Russian and ACLS CO2 systems can operate at the same time without impeding each other. Furthermore, based on the results of this analysis, the US and ACLS Sabatier systems can be operated in parallel as well to achieve the highest possible CO2 recycling together with a low CO2 concentration.

  9. The ACL GTA, an advanced turbo alternator for marine application; L'ACL GTA, un turboalternateur de conception avancee pour applications navales

    Poumarede, V. [Turbomeca, Groupe Safran, 64 - Bordes (France)

    2006-04-15

    In December 2000, the British Ministry of Defence and french DGA awarded Turbomeca the development contract of a new turbogenerator rated at 1,8 MW, designed for auxiliary power generation on board of the latest 'All Electric' warships generation. The prime mover of this generator set is an industrial gas turbine using a recuperated cycle whose heat recuperator significantly increases the engine efficiency, further improved at part load thanks to a variable speed control. The voltage supplied by the permanent magnets alternator, directly driven by the gas turbine at a speed of 22 500 rpm, is rectified by a power electronics cabinet and supplies the ship's grid with 800 V DC voltage. Particularly lightweight and compact, the ACL GTA has a reduced specific fuel consumption of around 225 g/kWhe at nominal load, while also offering high performances in terms of vibration levels, reliability, maintenance requirements, transient stability and exhaust emissions. (author)

  10. Identification and functional characterization of AclB, a novel cell-separating enzyme from Lactobacillus casei.

    Xu, Yi; Wang, Ting; Kong, Jian; Wang, Hui-Li

    2015-06-16

    Autolysis of nonstarter lactic acid bacteria (NSLAB) was favorable for the development of flavor compounds during cheese manufacture. Among these bacteria, Lb. casei was regarded as the most important microbiota involved in cheese processes. In this study, a novel autolysin named AclB was identified in the genome of Lb. casei BL23 and its modular structure was predicted through bioinformatic approaches. Subsequently, its transcription profile in the exponential phase, hydrolytic activities against cell walls, enzymatic properties under different conditions, physiological function via gene inactivation and upregulation assays, as well as potential applications to NSLAB's autolysis were fully investigated. According to the results, AclB was recognized as a species-specific cell-separating enzyme, responsible for cell separation after cell division in Lb. casei BL23. The purified AclB showed considerable hydrolyzing activities towards cell walls, indicating its enzymatic nature as peptidoglycan hydrolase, or autolysin. The highest activity of AclB was determined at pH5.0 and 37°C, and the expression vector constructed based on AclB was shown to facilitate the controlled lysis of Lb. casei BL23 hosts. In summary, this study provided insight into the enzymatic properties of a novel autolysin involved in cell separation of Lb. casei BL23, which is promising to accelerate cheese ripening and improve cheese quality. PMID:25797034

  11. Lower limb asymmetry in mechanical muscle function: A comparison between ski racers with and without ACL reconstruction.

    Jordan, M J; Aagaard, P; Herzog, W

    2015-06-01

    Due to a high incidence of anterior cruciate ligament (ACL) re-injury in alpine ski racers, this study aims to assess functional asymmetry in the countermovement jump (CMJ), squat jump (SJ), and leg muscle mass in elite ski racers with and without anterior cruciate ligament reconstruction (ACL-R). Elite alpine skiers with ACL-R (n = 9; 26.2 ± 11.8 months post-op) and uninjured skiers (n = 9) participated in neuromuscular screening. Vertical ground reaction force during the CMJ and SJ was assessed using dual force plate methodology to obtain phase-specific bilateral asymmetry indices (AIs) for kinetic impulse (CMJ and SJ phase-specific kinetic impulse AI). Dual x-ray absorptiometry scanning was used to assess asymmetry in lower body muscle mass. Compared with controls, ACL-R skiers had increased AI in muscle mass (P approach for improving outcome following ACL-R in elite ski racers. PMID:25212216

  12. Sex, Age, and Graft Size as Predictors of ACL Re-tear

    Nguyen, Duong

    2016-01-01

    Objectives: The minimum size required for a successful quadrupled hamstring autograft ACL reconstruction remains controversial. The risks of ACL re-tear in younger patients who tend to participate in a higher level of sports activity, and female athletes who have numerous predisposing factors, are poorly defined. Purpose: To identify risk factors for graft re-tears within 2 years of ACL surgery. The hypotheses are that female sex, a smaller size graft, and younger patients will increase the odds of failure. Study Design Cohort Study. Level of evidence, 3. Methods: A cohort of 503 athletes undergoing primary, autograft hamstring ACL reconstruction, performed by a single surgeon using the same surgical technique and rehabilitation protocol, between September-December 2012, was followed for a total duration of 2 years. Return to play was allowed between 6 and 12 months post-surgery upon completion of functional testing. Exclusion criteria included infections, revisions, double bundle techniques, multi-ligament injuries, non-compliance, BTB/allografts/hybrid grafts. Primary outcome consisted of binary data (ACL graft re-tear or no tear) as measured on physical exam (Lachman and pivot shift) and MRI. Multivariate logistic regression statistical analysis with model fitting was used to investigate the predictive value of sex, age, and graft size on ACL re-tear. Secondary sensitivity analyses were performed on the adolescent subgroup, age and graft size as categorical variables, and testing for interactions among variables. Sample size was calculated based on the rule of 10 events per independent variable for logistic regression. Results: The mean age of the 503 athletes was 27.5 (SD 10.6; range = 12-61). There were 235 females (47%) and 268 males (53%) with a 6% rate of re-tears (28 patients; 17 females). Mean graft size was 7.9 (SD 0.6; range = 6-10). Univariate analyses of graft size, sex, and age only in the model showed that younger age (odds ratio [OR] = 0.86; 95

  13. Hypoxic culture conditions induce increased metabolic rate and collagen gene expression in ACL-derived cells.

    Kowalski, Tomasz J; Leong, Natalie L; Dar, Ayelet; Wu, Ling; Kabir, Nima; Khan, Adam Z; Eliasberg, Claire D; Pedron, Andrew; Karayan, Ashant; Lee, Siyoung; Di Pauli von Treuheim, Theodor; Jiacheng, Jin; Wu, Ben M; Evseenko, Denis; McAllister, David R; Petrigliano, Frank A

    2016-06-01

    There has been substantial effort directed toward the application of bone marrow and adipose-derived mesenchymal stromal cells (MSCs) in the regeneration of musculoskeletal tissue. Recently, resident tissue-specific stem cells have been described in a variety of mesenchymal structures including ligament, tendon, muscle, cartilage, and bone. In the current study, we systematically characterize three novel anterior cruciate ligament (ACL)-derived cell populations with the potential for ligament regeneration: ligament-forming fibroblasts (LFF: CD146(neg) , CD34(neg) CD44(pos) , CD31(neg) , CD45(neg) ), ligament perivascular cells (LPC: CD146(pos) CD34(neg) CD44(pos) , CD31(neg) , CD45(neg) ) and ligament interstitial cells (LIC: CD34(pos) CD146(neg) , CD44(pos) , CD31(neg) , CD45(neg) )-and describe their proliferative and differentiation potential, collagen gene expression and metabolism in both normoxic and hypoxic environments, and their trophic potential in vitro. All three groups of cells (LIC, LPC, and LFF) isolated from adult human ACL exhibited progenitor cell characteristics with regard to proliferation and differentiation potential in vitro. Culture in low oxygen tension enhanced the collagen I and III gene expression in LICs (by 2.8- and 3.3-fold, respectively) and LFFs (by 3- and 3.5-fold, respectively) and increased oxygen consumption rate and extracellular acidification rate in LICs (by 4- and 3.5-fold, respectively), LFFs (by 5.5- and 3-fold, respectively), LPCs (by 10- and 4.5-fold, respectively) as compared to normal oxygen concentration. In summary, this study demonstrates for the first time the presence of three novel progenitor cell populations in the adult ACL that demonstrate robust proliferative and matrix synthetic capacity; these cells may play a role in local ligament regeneration, and consequently represent a potential cell source for ligament engineering applications. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc

  14. Differences in muscle strength after ACL reconstruction do not influence cardiorespiratory responses to isometabolic exercise

    Marília S. Andrade

    2014-05-01

    Full Text Available Objectives: To investigate whether the muscle strength decrease that follows anterior cruciate ligament (ACL reconstruction would lead to different cardiorespiratory adjustments during dynamic exercise. Method: Eighteen active male subjects were submitted to isokinetic evaluation of knee flexor and extensor muscles four months after ACL surgery. Thigh circumference was also measured and an incremental unilateral cardiopulmonary exercise test was performed separately for both involved and uninvolved lower limbs in order to compare heart rate, oxygen consumption, minute ventilation, and ventilatory pattern (breath rate, tidal volume, inspiratory time, expiratory time, tidal volume/inspiratory time at three different workloads (moderate, anaerobic threshold, and maximal. Results: There was a significant difference between isokinetic extensor peak torque measured in the involved (116.5±29.1 Nm and uninvolved (220.8±40.4 Nm limbs, p=0.000. Isokinetic flexor peak torque was also lower in the involved limb than in the uninvolved limb (107.8±15.4 and 132.5±26.3 Nm, p=0.004, respectively. Lower values were also found in involved thigh circumference as compared with uninvolved limb (46.9±4.3 and 48.5±3.9 cm, p=0.005, respectively. No differences were found between the lower limbs in any of the variables of the incremental cardiopulmonary tests at all exercise intensities. Conclusions: Our findings indicate that, four months after ACL surgery, there is a significant deficit in isokinetic strength in the involved limb, but these differences in muscle strength requirement do not produce differences in the cardiorespiratory adjustments to exercise. Based on the hypotheses from the literature which explain the differences in the physiological responses to exercise for different muscle masses, we can deduce that, after 4 months of a rehabilitation program after an ACL reconstruction, individuals probably do not present differences in muscle oxidative and

  15. A comparison of hamstring muscle activity during different screening tests for non-contact ACL injury

    Husted, Rasmus S.; Bencke, Jesper; Andersen, Lars L.;

    2016-01-01

    phenomenon and thereby observable independently of the type of clinical screening tests used is not known. This cross sectional study investigated the rank correlation of knee joint neuromuscular activity between three different ACL injury risk screening tests. METHODS: Sixty-two adolescent female elite...... football and handball players (16.7±1.3years) participated in the study. Using surface electromyography (EMG) assessment, the neuromuscular activity of medial hamstring muscle (semitendinosus, ST), lateral hamstring muscle (biceps femoris, BF) and quadriceps muscle (vastus lateralis, VL) were monitored...

  16. Development of the Knee Numeric-Entity Evaluation Score (KNEES – ACL)

    Comins, J D; Krogsgaard, M R; Brodersen, J

    2013-01-01

    patients, item relevance and comprehensiveness can only be confirmed by the patient (content validity). Focus group and single interviews were conducted with patients' pre- and post-ACL reconstruction in order to construct a condition-specific PROM for the target patients. One hundred fifty-seven items...... from a previously conducted literature search were used as a basis for content genesis. Content saturation was achieved after three focus groups and seven single interviews. Thirty-eight items from the literature search were directly endorsed, and five modified items were endorsed. Twelve new item...

  17. Psychoactive substances in seriously injured drivers in Denmark

    Simonsen, Kirsten Wiese; Steentoft, Anni; Bernhoft, IM;

    2013-01-01

    This study assesses the presence of a number of psychoactive substances, including alcohol, based on blood samples from 840 seriously injured drivers admitted to five selected hospitals located in five different regions of Denmark. The study was a part of the EU 6th framework program DRUID (Driving...... Under the Influence of Drugs, Alcohol and Medicines). Blood samples were screened for 30 illegal and legal psychoactive substances and metabolites as well as ethanol. Danish legal limits were used to evaluate the frequency of drivers violating the Danish legislation while limit of quantification (LOQ......, which is 0.53 g/l in Denmark. The percentage of seriously injured drivers testing positive for medicinal drugs at levels above the Danish legal limit was 6.8%. Benzodiazepines and Z-drugs (6.4%) comprised the majority of this group. One or more illegal drugs (primarily amphetamines and cannabis) were...

  18. Caring for the injured child in settings of limited resource.

    Stephenson, Jacob

    2016-02-01

    Children represent the most vulnerable members of our global society, a truth that is magnified when they are physically wounded. In much of the developed world, society has responded by offering protection in the form of law, injury prevention guidelines, and effective trauma systems to provide care for the injured child. Much of our world, though, remains afflicted by poverty and a lack of protective measures. As the globe becomes smaller by way of ease of travel and technology, surgeons are increasingly able to meet these children where they live and in doing so offer their hands and voices to care and protect these young ones. This article is intended as an overview of current issues in pediatric trauma care in the developing world as well as to offer some tips for the volunteer surgeon who may be involved in the care of the injured child in a setting of limited resource availability. PMID:26831134

  19. Effect of endothelium on glycosaminoglycan accumulation in injured rabbit aorta.

    Wight, T N; Curwen, K. D.; Litrenta, M. M.; Alonso, D. R.; Minick, C. R.

    1983-01-01

    Previous studies have indicated that reendothelialized regions of injured rabbit aortas are more susceptible to diet-induced atherosclerosis than persistently deendothelialized regions or uninjured aortas. However, the mechanism responsible for this selective lipid deposition is not understood. One possibility is that these regions differ with respect to the quantity and type of glycosaminoglycan-containing proteoglycans which are known to interact with lipoproteins. To determine whether thes...

  20. Characteristics and outcomes of injured older adults after hospital admission

    Aitken, L. M.; Burmeister, E.; Lang, J; Chaboyer, W.; Richmond, T. S.

    2010-01-01

    OBJECTIVES: To describe the seriously injured adult population aged 65 and older; compare the differences in injury characteristics and outcomes in three subgroups aged 65 to 74, 75 to 84, and 85 and older; and identify predictors of death, complications, and hospital discharge destination. DESIGN: Retrospective secondary analysis of data from the Queensland Trauma Registry (QTR) using all patients aged 65 and older admitted from 2003 through 2006. SETTING: Data from 15 regional and t...

  1. Mammillary bodies and fornix fibers are injured in heart failure

    Kumar, Rajesh; Woo, Mary A.; Birrer, Bramley V.X.; Macey, Paul M.; Fonarow, Gregg C.; Hamilton, Michele A.; Ronald M Harper

    2008-01-01

    Cognitive abnormalities, including memory deficits, are common in heart failure (HF). Brain structures, including the hippocampus, fornix, and thalamus participate in memory processing, and most show structural injury and functional deficits in HF. The mammillary bodies and fornix play essential roles in spatial and working memory processing, interact with other structures, and may also be injured in HF. We assessed mammillary body volumes and cross-sectional fornix areas in 17 HF and 50 cont...

  2. Psychiatric History and Adaptation in Burn Injured Patients

    Dyster-Aas, Johan

    2006-01-01

    The intertwined relationship between physical and psychological problems is a topic of much interest in the rehabilitation of severely injured patients, e.g. after a burn. The present study aims at gaining further knowledge concerning the impact of psychological factors and psychiatric morbidity on short and long-term adaptation after burn injury. Outcome was assessed for three main areas: pruritus, return to work and psychiatric health. Three separate samples of previous or current adult pat...

  3. Relationship between knee kinetic outcome measures in vertical counter movement jumps and self-reported function in ACL reconstructed subjects

    Brekke, Anders Falk

    2014-01-01

    Relationship between knee kinetic outcome measures in counter movement jumps and self-reported function in ACL reconstructed subjects Brekke AF1,2, Nielsen DB2, Holsgaard-Larsen A2 1School of physiotherapy, University College Zealand, Denmark 2Orthopaedic Research Unit, Department of Orthopaedics...... and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark Introduction: Altered loading pattern of the medial aspect of the knee has been associated with the development of knee osteoarthritis (OA). Anterior cruciate ligament (ACL) injuries are...... associated with early-onset OA with associated pain, functional limitations, and decreased quality of life. However, specific knee loading pattern of the medial aspect has not been investigated during different jump-tasks in ACL-reconstructed patients. The purpose was to investigate potential kinetic...

  4. Effects of evidence-based prevention training on neuromuscular and biomechanical risk factors for ACL injury in adolescent female athletes

    Zebis, Mette K.; Andersen, Lars L.; Brandt, Mikkel;

    2016-01-01

    BACKGROUND: Adolescent female football and handball players are among the athletes with the highest risk of sustaining anterior cruciate ligament (ACL) injuries. AIM: This study evaluated the effects of evidence-based lower extremity injury prevention training on neuromuscular and biomechanical...... risk factors for non-contact ACL injury. METHODS: 40 adolescent female football and handball players (15-16 years) were randomly allocated to a control group (CON, n=20) or neuromuscular training group (NMT, n=20). The NMT group performed an injury prevention programme as a warm-up before their usual....... CONCLUSIONS: A 12-week injury prevention programme in addition to training and match play in adolescent females altered the pattern of agonist-antagonist muscle preactivity during side cutting. This may represent a more ACL-protective motor strategy....

  5. Posterior horn lateral meniscal tears simulating meniscofemoral ligament attachment in the setting of ACL tear: MRI findings

    We have noted apparent far lateral meniscal attachment of the meniscofemoral ligament (MFL) with an anterior cruciate ligament (ACL) tear. This study evaluates MFL attachment and association with posterior horn lateral meniscus (PHLM) tear. Nine months of knee arthroscopy reports were reviewed to classify the PHLM and ACL as torn or normal. After excluding those with prior knee surgery, MR images were reviewed by two radiologists to determine the number of images lateral to PCL, which showed the ligaments of Humphrey and Wrisberg visible as structures separate from the PHLM. Any patient with abnormal PHLM surface signal not continuous with the MFL was excluded. MRI findings were compared with arthroscopy using Student's t test and Fisher's exact test. Of the 54 participants, 5 had PHLM tears and 49 were normal. Twenty-one had ACL tears; all those with an PHLM tear had an ACL tear. The ligament of Humphrey inserted on average 0.9 consecutive images lateral to the PCL without an PHLM tear and 4.7 with an PHLM tear; the ligament of Wrisberg inserted on average 3.0 consecutive images without an PHLM tear and 4.5 with an PHLM tear (slice thickness/gap = 3 mm/0.5 mm). There was a significant association between PHLM tear and number of images (p = 0.0028), and between ACL tear and this type of PHLM tear (p = 0.0064). Apparent far lateral meniscal extension of a meniscofemoral ligament (greater than or equal to four images lateral to the PCL) should be considered as a possible PHLM tear, especially in the setting of an ACL tear. (orig.)

  6. Posterior horn lateral meniscal tears simulating meniscofemoral ligament attachment in the setting of ACL tear: MRI findings

    Park, Lawrence S.; Jacobson, Jon A.; Jamadar, David A.; Caoili, Elaine; Kalume-Brigido, Monica [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Wojtys, Edward [University of Michigan, Department of Orthopaedic Surgery, 24 Frank Lloyd Wright Drive, Box 391, Ann Arbor, MI (United States); University of Michigan Sports Medicine Program, Department of MedSport, 24 Frank Lloyd Wright Drive, Box 391, Ann Arbor, MI (United States)

    2007-05-15

    We have noted apparent far lateral meniscal attachment of the meniscofemoral ligament (MFL) with an anterior cruciate ligament (ACL) tear. This study evaluates MFL attachment and association with posterior horn lateral meniscus (PHLM) tear. Nine months of knee arthroscopy reports were reviewed to classify the PHLM and ACL as torn or normal. After excluding those with prior knee surgery, MR images were reviewed by two radiologists to determine the number of images lateral to PCL, which showed the ligaments of Humphrey and Wrisberg visible as structures separate from the PHLM. Any patient with abnormal PHLM surface signal not continuous with the MFL was excluded. MRI findings were compared with arthroscopy using Student's t test and Fisher's exact test. Of the 54 participants, 5 had PHLM tears and 49 were normal. Twenty-one had ACL tears; all those with an PHLM tear had an ACL tear. The ligament of Humphrey inserted on average 0.9 consecutive images lateral to the PCL without an PHLM tear and 4.7 with an PHLM tear; the ligament of Wrisberg inserted on average 3.0 consecutive images without an PHLM tear and 4.5 with an PHLM tear (slice thickness/gap = 3 mm/0.5 mm). There was a significant association between PHLM tear and number of images (p = 0.0028), and between ACL tear and this type of PHLM tear (p = 0.0064). Apparent far lateral meniscal extension of a meniscofemoral ligament (greater than or equal to four images lateral to the PCL) should be considered as a possible PHLM tear, especially in the setting of an ACL tear. (orig.)

  7. Concurrent assessments of lower limb loading patterns, mechanical muscle strength and functional performance in ACL-patients - A cross-sectional study

    Holsgaard-Larsen, Anders; Jensen, C; Mortensen, N H M; Aagaard, P

    2014-01-01

    Full recovery in muscle strength and functional performance may not be achieved after ACL-injury. Aim: The aim of this study is to investigate loading patterns during jumping, muscle function and functional performance in ACL-reconstructed patients and to investigate the origin of between...

  8. Association between maximal hamstring strength and hamstring muscle pre-activity during a movement associated with non-contact ACL injury

    Skov Husted, Rasmus; Bencke, Jesper; Thorborg, Kristian;

    2014-01-01

    Introduction Reduced hamstring pre-activity during side-cutting may predispose for non-contact ACL injury. During the last decade resistance training of the lower limb muscles has become an integral part of ACL injury prevention in e.g. soccer and handball. However, it is not known whether a stro...

  9. Optimization and Calculation of TbCl3-ACl (A=Li, Na, K, Rb, Cs) Phase Diagrams

    Sun Yimin; Zhang Jing; Guan Mingyun; Qiao Zhiyu

    2005-01-01

    By using CALPHAD (Calculation of Phase Diagram) technique the optimization and calculation of the binary systems of TbCl3-ACl (A= Li, Na, K, Rb, Cs) were carried out. For describing the Gibbs free energy of liquid phase in these systems the new modified quasichemical model in the pair-approximation for short-range ordering was used. From measured phase equilibria data and experimental integral properties the TbCl3-ACl phase diagrams were optimized and calculated. A set of thermodynamic functions was optimized based on an interactive computer-assisted analysis. The calculated phase diagrams and thermodynamic data are self-consistent.

  10. Development of spin-on carbon hardmasks with comparable etch resistance to Amorphous Carbon Layer (ACL)

    Cheon, Hwan-Sung; Yoon, Kyong-Ho; Kim, Min-Soo; Oh, Seung Bae; Song, Jee-Yun; Tokareva, Nataliya; Kim, Jong-Seob; Chang, Tuwon

    2008-11-01

    In recent microlithography of semiconductor fabrication, spin-on hardmask (SOH) process continue to gain popularity as it replaces the traditional SiON/ACL hardmask scheme which suffers from high CoO, low productivity, particle contamination, and layer alignment issues. In the SOH process, organic polymer with high carbon content is spin-cast to form a carbon hardmask film. In the previous papers, we reported the development of organic SOH materials and their application in sub-70 nm lithography. In this paper, we describe the synthesis of organic polymers with very high carbon contents (>92 wt.%) and the evaluation of the spin-coated films for the hardmask application. The high carbon content of the polymer ensures improved etch resistance which amounts to >90% of ACL's resistance. However, as the carbon content of the polymers increases, the solubility in common organic solvents becomes lower. Here we report the strategies to improve the solubility of the high carbon content resins and optimization of the film properties for the SOH application.

  11. MRI of double-bundle ACL reconstruction: evaluation of graft findings

    To demonstrate the magnetic resonance imaging (MRI) findings of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction grafts. Sixty-six patients with DB ACL reconstruction were evaluated with MRI 2 years postoperatively. Graft thickness was measured separately by two musculoskeletal radiologists. The MRI findings of graft disruption, signal intensity (SI) changes, cystic degeneration, arthrofibrosis, and impingement were analyzed. The statistical significance of the association between MRI findings was calculated. The mean anteromedial (AM) graft thickness was reduced 9% and the mean posterolateral (PL) graft thickness was reduced 18% from the original graft thickness. Disruption was seen in 3% of AM grafts and 6% of PL grafts and a partial tear in 8 and 23%, respectively. Both grafts were disrupted in 3% of patients. Increased SI was seen in 14% of intact AM grafts and in 60% of partially torn AM grafts (p = 0.032). In PL grafts the increased SI was seen in 51% of the intact grafts and in 93% of the partially torn grafts (p = 0.005). Cystic degeneration was seen in 8% of AM grafts and in 5% of PL grafts. Diffuse arthrofibrosis was seen in 5% of patients and a localized cyclops lesion in 3% of patients. Impingement of the AM graft was seen in 8% of patients. Both grafts were disrupted in 3% of patients. Also, the frequencies of other complications were low. The use of orthogonal sequences in the evaluation of the PL graft SI seems to cause volume-averaging artefacts. (orig.)

  12. Stability of double chlorides in the systems ACl/PrCl3 (A = Na-Cs)

    The pseudobinary systems ACl/PrCl3 (A = Na-Cs) were reinvestigated by means of DTA. The following chlorides were found. Na3Pr5Cl18; K3PrCl6, K2PrCl5; Rb3PrCl6, Rb2PrCl5, RbPr2Cl7; Cs3PrCl6, Cs2PrCl5; CsPr2Cl7. Measurements of the solution enthalpies and of the free (Gibbs) enthalpies of formation from ACl and PrCl3 together with the free enthalpies of synproportionation from the adjacent compounds in the phase diagrams with a galvanic cell for solid electrolytes revealed, that only the chlorides A2PrCl5 are stable at ambient temperature. All other compounds high temperature forms. The crystal structures of the compounds were determined by X-ray analysis on powders; the compounds are isotypic with the analogous double chlorides of La and Ce. Magnetic susceptibilities in the range from 80-300 K were measured with a Gouy-balance. (author)

  13. MRI of double-bundle ACL reconstruction: evaluation of graft findings

    Kiekara, Tommi; Paakkala, Antti [Tampere University Hospital, Medical Imaging Centre, Tampere (Finland); Jaervelae, Timo [Sports Clinic and Hospital Mehilaeinen, Tampere (Finland); Huhtala, Heini [University of Tampere, School of Health Sciences, Tampere (Finland)

    2012-07-15

    To demonstrate the magnetic resonance imaging (MRI) findings of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction grafts. Sixty-six patients with DB ACL reconstruction were evaluated with MRI 2 years postoperatively. Graft thickness was measured separately by two musculoskeletal radiologists. The MRI findings of graft disruption, signal intensity (SI) changes, cystic degeneration, arthrofibrosis, and impingement were analyzed. The statistical significance of the association between MRI findings was calculated. The mean anteromedial (AM) graft thickness was reduced 9% and the mean posterolateral (PL) graft thickness was reduced 18% from the original graft thickness. Disruption was seen in 3% of AM grafts and 6% of PL grafts and a partial tear in 8 and 23%, respectively. Both grafts were disrupted in 3% of patients. Increased SI was seen in 14% of intact AM grafts and in 60% of partially torn AM grafts (p = 0.032). In PL grafts the increased SI was seen in 51% of the intact grafts and in 93% of the partially torn grafts (p = 0.005). Cystic degeneration was seen in 8% of AM grafts and in 5% of PL grafts. Diffuse arthrofibrosis was seen in 5% of patients and a localized cyclops lesion in 3% of patients. Impingement of the AM graft was seen in 8% of patients. Both grafts were disrupted in 3% of patients. Also, the frequencies of other complications were low. The use of orthogonal sequences in the evaluation of the PL graft SI seems to cause volume-averaging artefacts. (orig.)

  14. Septic arthritis with Staphylococcus lugdunensis following arthroscopic ACL revision with BPTB allograft.

    Mei-Dan, Omer; Mann, Gideon; Steinbacher, Gilbert; Ballester, Soleda J; Cugat, Ramon Bertomeu; Alvarez, Pedro Diaz

    2008-01-01

    Septic arthritis following anterior cruciate ligament reconstruction is an uncommon but a serious complication resulting in six times greater hospital costs than that of uncomplicated ACL surgery and an inferior postoperative activity level. Promptly initiating a specific antibiotic therapy is the most critical treatment, followed by open or arthroscopic joint decompression, debridement and lavage. Staphylococcus lugdunensis is a coagulase-negative staphylococcus predominantly infecting the skin and soft tissue. The few reported cases of bone and joint infections by S. lugdunensis indicate that the clinical manifestations were severe, the diagnosis elusive, and the treatment difficult. If the microbiology laboratory does not use the tube coagulase (long) test to confirm the slide coagulase test result, the organism might be misidentified as Staphylococcus aureus. S. lugdunensis is more virulent than other coagulase-negative staphylococcus; in many clinical situations it behaves like S. aureus, further increasing the confusion and worsening the expected outcome. S. lugdunensis is known to cause infective endocarditis with a worse outcome, septicemia, deep tissue infection, vascular and joint prosthesis infection, osteomyelitis, discitis, breast abscess, urine tract infections, toxic shock and osteitis pubis. We present the first case report in the literature of septic arthritis with S. lugdunensis following arthroscopic ACL revision with bone-patellar-tendon-bone allograft. PMID:17684731

  15. Persons with reconstructed ACL exhibit altered knee mechanics during high-speed maneuvers.

    Lee, S-P; Chow, J W; Tillman, M D

    2014-06-01

    Anterior cruciate ligament (ACL) injury is a sports trauma that causes long-term disability. The function of the knee during dynamic activities can be severely limited even after successful surgical reconstruction. This study examined the effects of approach velocity during side-step cutting on knee joint mechanics in persons with reconstructed ACL (ACLR). 22 participants (11 with unilateral ACLR, 11 matched-controls) participated. Knee joint mechanics were tested in 3 approach conditions: counter-movement, one-step, and running. Dependent variables, including peak knee flexion, extension, valgus, varus, internal rotation, external rotation angles and corresponding peak joint moments, were assessed during the stance phase of cutting. Two 2×3 ("group" by "approach condition") mixed MANOVA tests were used to examine the effects of ACLR and approach velocity on knee mechanics. ACLR participants exhibited higher knee internal rotator moment (0.22 vs. 0.13 Nm/kg, p=0.003). Inter-group comparisons revealed that the ACLR participants exhibited significantly higher abductor and internal rotator moments only in the running condition (1.86 vs. 1.16 Nm/kg, p=0.018; 0.28 vs. 0.17 Nm/kg, p=0.010, respectively). Our findings suggested that patients with ACLR may be at increased risk of re-injury when participating in high-demand physical activities. Task demand should be considered when prescribing progressive therapeutic interventions to ACLR patients. PMID:24408765

  16. Psychology of Sport Injury: A Holistic Approach to Rehabilitating the Injured Athlete%Psychology of Sport Injury:A Holistic Approach to Rehabilitating the Injured Athlete

    J. Jordan Hamson-Utley

    2010-01-01

    @@ Sports medicine practitioners must consider both physical and mental aspects of injury to fully rehabilitate the injured athlete. The psychological distress that follows injury has been well documented and calls for a change in the rehabilitation of injured athletes~ ([1-3]).

  17. A Life of Learning: Nancy Siraisi. Charles Homer Haskins Prize Lecture for 2010. ACLS Occasional Paper, No. 67

    American Council of Learned Societies, 2010

    2010-01-01

    Nancy Siraisi has been a prolific and leading scholar in the history of medicine and science of the Middle Ages and the Renaissance. This lecture of hers is the twenty-eighth of series of lectures named for Charles Homer Haskins, first chairman of the American Council of Learned Societies (ACLS) and himself a famed medievalist who brought…

  18. T2 * MR relaxometry and ligament volume are associated with the structural properties of the healing ACL.

    Biercevicz, Alison M; Murray, Martha M; Walsh, Edward G; Miranda, Danny L; Machan, Jason T; Fleming, Braden C

    2014-04-01

    Our objective was to develop a non-invasive magnetic resonance (MR) method to predict the structural properties of a healing anterior cruciate ligament (ACL) using volume and T2 * relaxation time. We also compared our T2 *-based structural property prediction model to a previous model utilizing signal intensity, an acquisition-dependent variable. Surgical ACL transection followed by no treatment (i.e., natural healing) or bio-enhanced ACL repair was performed in a porcine model. After 52 weeks of healing, high-resolution MR images of the ACL tissue were collected. From these images, ligament volumes and T2 * maps were established. The structural properties of the ligaments were determined via tensile testing. Using the T2 * histogram profile, each ligament voxel was binned based on its T2 * value into four discrete tissue sub-volumes defined by specific T2 * intervals. The linear combination of the ligament sub-volumes binned by T2 * value significantly predicted maximum load, yield load, and linear stiffness (R(2)  = 0.92, 0.82, 0.88; p ligament healing across scanners, studies, and institutions. PMID:24338640

  19. Sialic acid accelerates the electrophoretic velocity of injured dorsal root ganglion neurons

    Chen-xu Li

    2015-01-01

    Full Text Available Peripheral nerve injury has been shown to result in ectopic spontaneous discharges on soma and injured sites of sensory neurons, thereby inducing neuropathic pain. With the increase of membrane proteins on soma and injured site neurons, the negatively charged sialic acids bind to the external domains of membrane proteins, resulting in an increase of this charge. We therefore speculate that the electrophoretic velocity of injured neurons may be faster than non-injured neurons. The present study established rat models of neuropathic pain via chronic constriction injury. Results of the cell electrophoresis test revealed that the electrophoretic velocity of injured neuronal cells was faster than that of non-injured (control cells. We then treated cells with divalent cations of Ca 2+ and organic compounds with positive charges, polylysine to counteract the negatively charged sialic acids, or neuraminidase to specifically remove sialic acids from the membrane surface of injured neurons. All three treatments significantly reduced the electrophoretic velocity of injured neuronal cells. These findings suggest that enhanced sialic acids on injured neurons may accelerate the electrophoretic velocity of injured neurons.

  20. [Case Report: prehospital treatment on a major injured motorcycle driver].

    Gräsner, Jan-Thorsten; Knacke, Peer G; Heller, Gilbert; Naguschewski, Jörg; Scholz, Jens

    2008-09-01

    This case report describes the prehospital care of a 42-year-old person damaged by a severe motorcycle accident in a rural scene. The injured person was unconscious, one pupil was dilated and rib fractures were palpable. Purposeful therapy without delay was necessary. The prehospital therapy took 35 minutes in total. The time benefit by using a rescue helicopter is illustrated: time to initial treatment is minimized and duration of transport as well - direct transport to a trauma center is possible. PMID:18792860

  1. Spinal cord response to laser treatment of injured peripheral nerve

    Rochkind, S.; Vogler, I.; Barr-Nea, L. (Ichilov Hospital, Tel-Aviv Medical Center (Israel))

    1990-01-01

    The authors describe the changes occurring in the spinal cord of rats subjected to crush injury of the sciatic nerve followed by low-power laser irradiation of the injured nerve. Such laser treatment of the crushed peripheral nerve has been found to mitigate the degenerative changes in the corresponding neurons of the spinal cord and induce proliferation of neuroglia both in astrocytes and oligodendrocytes. This suggests a higher metabolism in neurons and a better ability for myelin production under the influence of laser treatment.

  2. Early preventive treatment for severe acute pancreatitis combined with lung injury

    刘学民; 刘青光; 潘承恩

    2002-01-01

    @@ Severe acute pancreatitis (SAP) can cause systematic inflammatory response syndrome (SIRS),which leads to injury or failure of the internal organs and systems.1 Among them,acute respiratory distress syndrome(ARDS)is a severe or fatal complication.In this article,the early preventive treatment for SAP combined with lung injure is studied.

  3. Verifying Sierpiński and Riesel Numbers in ACL2

    John R. Cowles

    2011-10-01

    Full Text Available A Sierpinski number is an odd positive integer, k, such that no positive integer of the form k * 2^n + 1 is prime. Similar to a Sierpinski number, a Riesel number is an odd positive integer, k, such that no positive integer of the form k * 2^n + 1 is prime. A cover for such a k is a finite list of positive integers such that each integer j of the appropriate form has a factor, d, in the cover, with 1 < d < j. Given a k and its cover, ACL2 is used to systematically verify that each integer of the given form has a non-trivial factor in the cover.

  4. Return to sport after ACL reconstruction: how, when and why? A narrative review of current evidence.

    Zaffagnini, Stefano; Grassi, Alberto; Serra, Margherita; Marcacci, Maurilio

    2015-01-01

    Allowing a patient to return to sport and unrestricted physical activity after ACL injury and reconstruction is one of the most challenging and difficult decisions an orthopaedic surgeon has to make. Indeed, many factors have to be taken into account before it can be considered safe for a patients to load a reconstructed knee. The current literature contains plenty of studies aimed at evaluating return to sport, and the factors that may affect or predict this outcome, e.g. intrinsic factors like genetics, biology, type of lesion, anatomical features, motivation and psychology, and extrinsic factors such as graft type, surgical technique, rehabilitation protocols, and biological support. It is possible that awareness of these issues could help the clinician to optimise outcomes, and possibly avoid failures too, although as yet no universal criteria for resuming sport have been produced. PMID:26151036

  5. Diagnostic radiology on multiple injured patients: interdisciplinary management

    The presence of a radiologist within the admitting area of an emergency department and his capability as a member of the trauma team have a major impact on the role of diagnostic radiology in trauma care. The knowledge of clinical decision criteria, algorithms, and standards of patient care are essential for the acceptance within a trauma team. We present an interdisciplinary management concept of diagnostic radiology for trauma patients, which comprises basic diagnosis, organ diagnosis, radiological ABC, and algorithms of early clinical care. It is the result of a prospective study comprising over 2000 documented multiple injured patients. The radiologist on a trauma team should support trauma surgery and anesthesia in diagnostic and clinical work-up. The radiological ABC provides a structured approach for diagnostic imaging in all steps of the early clinical care of the multiple injured patient. Radiological ABC requires a reevaluation in cases of equivocal findings or difficulties in the clinical course. Direct communication of radiological findings with the trauma team enables quick clinical decisions. In addition, the radiologist can priority-oriented influence the therapy by using interventional procedures. The clinical radiologist is an active member of the interdisciplinary trauma team, not only providing diagnostic imaging but also participating in clinical decisions. (orig.)

  6. Echocardiography integrated ACLS protocol versus conventional cardiopulmonary resuscitation in patients with pulseless electrical activity cardiac arrest

    Mojtaba Chardoli; Farhad Heidari; Helaleh Rabiee; Mahdi Sharif-Alhoseini; Hamid Shokoohi; Vafa Rahimi-Movaghar

    2012-01-01

    Objective: To examine the utility of bedside echocardiography in detecting the reversible causes of pulseless electrical activity (PEA) cardiac arrest and predicting the resuscitation outcomes.Methods: In this prospective interventional study,patients presenting with PEA cardiac arrest were randomized into two groups.In Group A,ultrasound trained emergency physicians performed echocardiography evaluating cardiac activity,right ventricle dilation,left ventricle function,pericardial effusion/tamponade and ⅣC size along with the advanced cardiac life support (ACLS) protocol.Patients in Group B solely underwent ACLS protocol without applying echocardiography.The presence or absence of mechanical ventricular activity (MVA) and evidences of PEA reversible causes were recorded.The return of spontaneous circulation (ROSC) and death were evaluated in both groups.Results: One hundred patients with the mean age of (58±6.1) years were enrolled in this study.Fifty patients (Group A) had echocardiography detected in parallel with cardiopulmonary resuscitation (CPR).Among them,7 patients (14%) had pericardial effusion,11 (22%) had hypovolemia,and 39 (78%) were revealed the presence of MVA.In the pseudo PEA subgroup (presence of MVA),43% had ROSC (positive predictive value) and in the true PEA subgroup with cardiac standstill (absence of MVA),there was no recorded ROSC (negative predictive value).Among patients in Group B,no reversible etiology was detected.There was no significant difference in resuscitation results between Groups A and B observed (P=0.52).Conclusion: Bedside echocardiography can identify some reversible causes of PEA.However,there are no significant changes in survival outcome between the echo group and those with traditional CPR.

  7. Time-dependent changes in the microenvironment of injured spinal cord affects the therapeutic potential of neural stem cell transplantation for spinal cord injury

    Nishimura Soraya

    2013-01-01

    Full Text Available Abstract Background The transplantation of neural stem/progenitor cells (NS/PCs at the sub-acute phase of spinal cord injury, but not at the chronic phase, can promote functional recovery. However, the reasons for this difference and whether it involves the survival and/or fate of grafted cells under these two conditions remain unclear. To address this question, NS/PC transplantation was performed after contusive spinal cord injury in adult mice at the sub-acute and chronic phases. Results Quantitative analyses using bio-imaging, which can noninvasively detect surviving grafted cells in living animals, revealed no significant difference in the survival rate of grafted cells between the sub-acute and chronic transplantation groups. Additionally, immunohistology revealed no significant difference in the differentiation phenotypes of grafted cells between the two groups. Microarray analysis revealed no significant differences in the expression of genes encoding inflammatory cytokines or growth factors, which affect the survival and/or fate of grafted cells, in the injured spinal cord between the sub-acute and chronic phases. By contrast, the distribution of chronically grafted NS/PCs was restricted compared to NS/PCs grafted at the sub-acute phase because a more prominent glial scar located around the lesion epicenter enclosed the grafted cells. Furthermore, microarray and histological analysis revealed that the infiltration of macrophages, especially M2 macrophages, which have anti-inflammatory role, was significantly higher at the sub-acute phase than the chronic phase. Ultimately, NS/PCs that were transplanted in the sub-acute phase, but not the chronic phase, promoted functional recovery compared with the vehicle control group. Conclusions The extent of glial scar formation and the characteristics of inflammation is the most remarkable difference in the injured spinal cord microenvironment between the sub-acute and chronic phases. To achieve

  8. Clinical and Arthroscopic Findings of Acute Anterior Cruciate Ligament Tears of the Knee

    Kenji Shirakura

    1995-01-01

    Full Text Available Clinical, arthrographic, and arthroscopic findings in 53 patients with acutely torn anterior cruciate ligaments (ACLs were documented. Arthroscopy and instability tests under anesthesia were performed on all patients within 2 weeks after the initial injury. Twenty-three patients complained of extension blocks, and localized tenderness on the medial side was revealed in 26 patients at the initial examination. Aspiration from joints exhibited hemarthrosis in 52 patients. Arthroscopy revealed ACL ruptures in all patients. Four Segond's fractures, 26 meniscus tears (8 medial and 18 lateral, 1 osteochondral fracture, and 19 medial collateral ligament ruptures were revealed. Arthroscopy detected only 1 of the 5 ruptures of the posteromedial corner of the medial meniscus, which were noted on arthrography. Three ACL stumps were protruding among the femorotibial joint, which seemed to be restricting full extension. Statistical analysis showed that tenderness on the medial side was not revealed more frequently in knees with medial collateral ligament injuries than in the others. The volume of aspirated fluids in knees with no leakage in arthrography significantly increased over those with leakages (p < 0.05. Diagnosis of ACL injuries should be completed by clinical, arthrographic, and arthroscopic examinations.

  9. Gene expression changes in the injured spinal cord following transplantation of mesenchymal stem cells or olfactory ensheathing cells.

    Abel Torres-Espín

    Full Text Available Transplantation of bone marrow derived mesenchymal stromal cells (MSC or olfactory ensheathing cells (OEC have demonstrated beneficial effects after spinal cord injury (SCI, providing tissue protection and improving the functional recovery. However, the changes induced by these cells after their transplantation into the injured spinal cord remain largely unknown. We analyzed the changes in the spinal cord transcriptome after a contusion injury and MSC or OEC transplantation. The cells were injected immediately or 7 days after the injury. The mRNA of the spinal cord injured segment was extracted and analyzed by microarray at 2 and 7 days after cell grafting. The gene profiles were analyzed by clustering and functional enrichment analysis based on the Gene Ontology database. We found that both MSC and OEC transplanted acutely after injury induce an early up-regulation of genes related to tissue protection and regeneration. In contrast, cells transplanted at 7 days after injury down-regulate genes related to tissue regeneration. The most important change after MSC or OEC transplant was a marked increase in expression of genes associated with foreign body response and adaptive immune response. These data suggest a regulatory effect of MSC and OEC transplantation after SCI regarding tissue repair processes, but a fast rejection response to the grafted cells. Our results provide an initial step to determine the mechanisms of action and to optimize cell therapy for SCI.

  10. Acute phase response in Wistar rats after controlled hemorrhage

    Stepanović Predrag; Maličević Ž.; Andrić N.; Nikolovski-Stefanović Zorica

    2011-01-01

    After injury the acute-phase response of the organism activates mechanisms which imply the release of cytokines, stress hormones, and mediators of pain and inflammation. The main function of the acutephase response is to hinder further damage of the injured tissue by activating reparative processes. The increase in the concentration of acute phase proteins and the concurrent decrease in albumins and prealbumins indicate that there is a strong link between t...

  11. Adult Stem Cells for Acute Lung Injury: Remaining Questions & Concerns

    Zhu, Ying-Gang; Hao, Qi; Monsel, Antoine; Feng, Xiao-mei; Lee, Jae W.

    2013-01-01

    Acute lung injury (ALI) or acute respiratory distress syndrome remains a major cause of morbidity and mortality in hospitalized patients. The pathophysiology of ALI involves complex interactions between the inciting event, such as pneumonia, sepsis or aspiration, and the host immune response resulting in lung protein permeability, impaired resolution of pulmonary edema, an intense inflammatory response in the injured alveolus and hypoxemia. In multiple pre-clinical studies, adult stem cells h...

  12. Acute lung injury/acute respiratory distress syndrome (ALI/ARDS): the mechanism, present strategies and future perspectives of therapies

    Luh, Shi-Ping; Chiang, Chi-huei

    2006-01-01

    Acute lung injury/acute respiratory distress syndrome (ALI/ARDS), which manifests as non-cardiogenic pulmonary edema, respiratory distress and hypoxemia, could be resulted from various processes that directly or indirectly injure the lung. Extensive investigations in experimental models and humans with ALI/ARDS have revealed many molecular mechanisms that offer therapeutic opportunities for cell or gene therapy. Herein the present strategies and future perspectives of the treatment for ALI/AR...

  13. Sex-dimorphic landing mechanics and their role within the noncontact ACL injury mechanism: evidence, limitations and directions

    Beaulieu Mélanie L

    2012-03-01

    Full Text Available Abstract Anterior cruciate ligament (ACL injuries continue to present in epidemic-like proportions, carrying significant short- and longer-term debilitative effects. With females suffering these injuries at a higher rate than males, an abundance of research focuses on delineating the sex-specific nature of the underlying injury mechanism. Examinations of sex-dimorphic lower-limb landing mechanics are common since such factors are readily screenable and modifiable. The purpose of this paper was to critically review the published literature that currently exists in this area to gain greater insight into the aetiology of ACL injuries in females and males. Using strict search criteria, 31 articles investigating sex-based differences in explicit knee and/or hip landing biomechanical variables exhibited during vertical landings were selected and subsequently examined. Study outcomes did not support the generally accepted view that significant sex-based differences exist in lower-limb landing mechanics. In fact, a lack of agreement was evident in the literature for the majority of variables examined, with no sex differences evident when consensus was reached. The one exception was that women were typically found to land with greater peak knee abduction angles than males. Considering knee abduction increases ACL loading and prospectively predicts female ACL injury risk, its contribution to sex-specific injury mechanisms and resultant injury rates seems plausible. As for the lack of consensus observed for most variables, it may arise from study-based variations in test populations and landing tasks, in conjunction with the limited ability to accurately measure lower-limb mechanics via standard motion capture methods. Regardless, laboratory-based comparisons of male and female landing mechanics do not appear sufficient to elucidate causes of injury and their potential sex-specificity. Sex-specific in vivo joint mechanical data, if collected accurately

  14. S100A4 is upregulated in injured myocardium and promotes growth and survival of cardiac myocytes

    Schneider, Mikael; Kostin, Sawa; Strøm, Claes C;

    2007-01-01

    RNA expression was increased in hypertrophic rat hearts and that it has pro-cardiomyogenic effects in embryonic stem cell-derived embryoid bodies. We therefore hypothesized that S100A4 could play a supportive role in the injured heart. METHODS AND RESULTS: Here we verify by quantitative real-time PCR and...... immunoblotting that S100A4 mRNA and protein is upregulated in hypertrophic rat and human hearts and show by way of confocal microscopy that S100A4 protein, but not mRNA, appears in cardiac myocytes only in the border zone after an acute ischemic event in rat and human hearts. In normal rat and human hearts, S100...

  15. Factors influencing cerebral plasticity in the normal and injured brain

    Bryan Kolb

    2010-11-01

    Full Text Available An important development in behavioural neuroscience in the past 20 years has been the demonstration that it is possible to stimulate functional recovery after cerebral injury in laboratory animals. Rodent models of cerebral injury provide an important tool for developing such rehabilitation programs. The models include analysis at different levels including detailed behavioural paradigms, electrophysiology, neuronal morphology, protein chemistry, and epigenetics. A significant challenge for the next 20 years will be the translation of this work to improve the outcome from brain injury and disease in humans. Our goal in the article will be to synthesize the multidisciplinary laboratory work on brain plasticity and behaviour in the injured brain to inform the development of rehabilitation programs.

  16. Cell death in the injured brain: roles of metallothioneins

    Pedersen, Mie Ø; Larsen, Agnete; Stoltenberg, Meredin; Penkowa, Milena

    2009-01-01

    In traumatic brain injury (TBI), the primary, irreversible damage associated with the moment of impact consists of cells dying from necrosis. This contributes to fuelling a chronic central nervous system (CNS) inflammation with increased formation of proinflammatory cytokines, enzymes and reactive...... provides an overview of the TBI pathophysiology leading to cell death and neurological impairment. We also discuss endogenously expressed neuroprotectants and drug candidates, which at this stage may still hold the potential for treating brain injured patients....... oxygen species (ROS). ROS promote oxidative stress, which leads to neurodegeneration and ultimately results in programmed cell death (secondary injury). Since this delayed, secondary tissue loss occurs days to months following the primary injury it provides a therapeutic window where potential...

  17. Endovascular transplantation of stem cells to the injured rat CNS

    Transplantation procedures using intraparenchymal injection of stem cells result in tissue injury in addition to associated surgical risks. Intravenous injection of mesenchymal stem cells gives engraftment to lesions, but the method has low efficiency and specificity. In traumatic brain injuries (TBI), there is a transient breakdown of the blood-brain barrier and an inflammatory response, which increase migration of cells from blood to parenchyma. The aim of this investigation was to analyze the effect of intra-arterial administration on cellular engraftment. Experimental TBI was produced in a rat model. Endovascular technique was used to administer human mesenchymal stem cells in the ipsilateral internal carotid artery. Evaluation of engraftment and side effects were performed by immunohistochemical analysis of the brain and several other organs. The results were compared to intravenous administration of stem cells. Intra-arterial transplantion of mesenchymal stem cells resulted in central nervous system (CNS) engraftment without thromboembolic ischemia. We observed a significantly higher number of transplanted cells in the injured hemisphere after intra-arterial compared to intravenous administration both 1 day (p<0.01) and 5 days (p<0.05) after the transplantation. Some cells were also detected in the spleen but not in the other organs analyzed. Selective intra-arterial administration of mesenchymal stem cells to the injured CNS is a minimally invasive method for transplantation. The method is significantly more efficient than the intravenous route and causes no side effects in the current model. The technique can potentially be used for repeated transplantation to the CNS after TBI and in other diseases. (orig.)

  18. Endovascular transplantation of stem cells to the injured rat CNS

    Lundberg, Johan; Soederman, Mikael; Andersson, Tommy; Holmin, Staffan [Karolinska University Hospital, Department of Clinical Neuroscience, Karolinska Institutet, Department of Neuroradiology, Stockholm (Sweden); Le Blanc, Katarina [Karolinska University Hospital, Department of Stem Cell Research, Karolinska Institutet, Department of Clinical Immunology, Stockholm (Sweden)

    2009-10-15

    Transplantation procedures using intraparenchymal injection of stem cells result in tissue injury in addition to associated surgical risks. Intravenous injection of mesenchymal stem cells gives engraftment to lesions, but the method has low efficiency and specificity. In traumatic brain injuries (TBI), there is a transient breakdown of the blood-brain barrier and an inflammatory response, which increase migration of cells from blood to parenchyma. The aim of this investigation was to analyze the effect of intra-arterial administration on cellular engraftment. Experimental TBI was produced in a rat model. Endovascular technique was used to administer human mesenchymal stem cells in the ipsilateral internal carotid artery. Evaluation of engraftment and side effects were performed by immunohistochemical analysis of the brain and several other organs. The results were compared to intravenous administration of stem cells. Intra-arterial transplantion of mesenchymal stem cells resulted in central nervous system (CNS) engraftment without thromboembolic ischemia. We observed a significantly higher number of transplanted cells in the injured hemisphere after intra-arterial compared to intravenous administration both 1 day (p<0.01) and 5 days (p<0.05) after the transplantation. Some cells were also detected in the spleen but not in the other organs analyzed. Selective intra-arterial administration of mesenchymal stem cells to the injured CNS is a minimally invasive method for transplantation. The method is significantly more efficient than the intravenous route and causes no side effects in the current model. The technique can potentially be used for repeated transplantation to the CNS after TBI and in other diseases. (orig.)

  19. Treatment of Type 3 Arthrofibrosis Following Arthroscopic Reconstruction of ACL and Posterolateral Corner Injury with Tibia Plateau Fracture in a Professional Dancer

    Aksu, Neslihan; Abay, Burak; Soydan, Ramazan; Atansay, Vefa

    2014-01-01

    Objectives: Arthrofibrosis is a serious complication following the reconstruction of anterior cruciate ligament (ACL) and posterolateral corner (PLC) injury. Loss of motion caused by arthrofibrosis can be disabling in young and active patients. We report the clinical results of the treatment of arthrofibrosis following arthroscopic reconstruction of ACL with ipsilateral hamstring tendon graft and surgically repairing PLC with 2 suture anchors in a 30 year-old professional dancer, treated with...

  20. Effects of ACL reconstruction surgery on muscle activity of the lower limb during a jump-cut maneuver in males and females

    Coats-Thomas, Margaret S.; Miranda, Daniel L; Gary J Badger; Fleming, Braden C.

    2013-01-01

    We compared muscle activity of the quadriceps, hamstring, and gastrocnemius muscles when ACL-intact (ACLINT) and ACL-reconstructed (ACLREC) male and female subjects performed a jump-cut task. Surface electromyography sensors were used to evaluate time to peak muscle activity and muscle activity ratios. Rectus femoris (RF) and vastus medialis (VM) peak timing was 71 ms and 78 ms earlier in ACLINT than in ACLREC subjects, respectively. Biceps femoris (BF) peak timing was 90 ms earlier in ACLINT...

  1. Acute Bronchitis

    ... of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your cough ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people ...

  2. 9 CFR 311.27 - Injured animals slaughtered at unusual hours.

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Injured animals slaughtered at unusual hours. 311.27 Section 311.27 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT... PARTS § 311.27 Injured animals slaughtered at unusual hours. When it is necessary for humane reasons...

  3. Alcohol and drugs in seriously injured drivers in six European countries

    Legrand, Sara-Ann; Isalberti, Cristina; Van der Linden, Trudy;

    2013-01-01

    The objective of this study was to determine the presence of alcohol and drugs in drivers severely injured in traffic crashes in six European countries. Data were collected from 2492 seriously injured drivers of cars and vans in Belgium, Denmark, Finland, Italy, Lithuania, and the Netherlands, be...

  4. Quantitative Study of Vibrational Symmetry of Injured Vocal Folds via Digital Kymography in Excised Canine Larynges

    Krausert, Christopher R.; Ying, Di; Zhang, Yu; Jiang, Jack J.

    2011-01-01

    Purpose: Digital kymography and vocal fold curve fitting are blended with detailed symmetry analysis of kymograms to provide a comprehensive characterization of the vibratory properties of injured vocal folds. Method: Vocal fold vibration of 12 excised canine larynges was recorded under uninjured, unilaterally injured, and bilaterally injured…

  5. Educating families and caretakers of traumatically brain injured patients in the new health care environment: a three phase model and bibliography.

    Holland, D; Shigaki, C L

    1998-12-01

    Shorter inpatient stays for traumatically brain injured patients frequently allow less time for comprehensive education of families and caretakers. What is needed to compensate for the shortened duration of brain injury rehabilitation in many settings is a family educational programme that (1) satisfies the family's acute information needs as they arise, and (2) standardizes the delivery of information so that certain knowledge criteria are met. The following article proposes a three phase model of family and caretaker education with an accompanying bibliographical index. PMID:9876860

  6. The Effects of High-Intensity versus Low-Intensity Resistance Training on Leg Extensor Power and Recovery of Knee Function after ACL-Reconstruction

    Bieler, Theresa; Sobol, Nanna Aue; Andersen, Lars L; Kiel, Peter; Løfholm, Peter; Aagaard, Per; Magnusson, S Peter; Krogsgaard, Michael R; Beyer, Nina

    2014-01-01

    OBJECTIVE: Persistent weakness is a common problem after anterior cruciate ligament- (ACL-) reconstruction. This study investigated the effects of high-intensity (HRT) versus low-intensity (LRT) resistance training on leg extensor power and recovery of knee function after ACL-reconstruction. METH......OBJECTIVE: Persistent weakness is a common problem after anterior cruciate ligament- (ACL-) reconstruction. This study investigated the effects of high-intensity (HRT) versus low-intensity (LRT) resistance training on leg extensor power and recovery of knee function after ACL......-reconstruction. METHODS: 31 males and 19 females were randomized to HRT (n = 24) or LRT (n = 26) from week 8-20 after ACL-reconstruction. Leg extensor power, joint laxity, and self-reported knee function were measured before and 7, 14, and 20 weeks after surgery. Hop tests were assessed before and after 20 weeks. RESULTS......% versus 73% of noninjured leg, resp.; P = 0.027) and at week 20 (98% versus 83% of noninjured leg, resp.; P = 0.006) without adverse effects on joint laxity. No other between-group differences were found. CONCLUSION: High-intensity resistance training during rehabilitation after ACL-reconstruction can...

  7. Complete ACL/MCL deficiency induces variable degrees of instability in sheep with specific kinematic abnormalities correlating with degrees of early osteoarthritis.

    Frank, Cyril B; Beveridge, Jillian E; Huebner, Kyla D; Heard, Bryan J; Tapper, Janet E; O'Brien, Etienne J O; Shrive, Nigel G

    2012-03-01

    People are not equally disabled by combined anterior cruciate ligament (ACL)/medial collateral ligament (MCL) injuries, nor do they all develop osteoarthritis (OA). Although biological/biomechanical causes are not clear, some association presumably exists between joint instability and OA development. We hypothesized that degree of OA development following standardized complete ACL/MCL injuries will vary directly with the degree of biomechanical abnormality between individuals. Three groups of sheep were used to test the hypothesis: 17 normal, 9 ACL/MCL transected, and 7 sham animals. Normal joints were assessed morphologically while sham and experimental animals had gait assessment pre- and at 4 and 20 weeks post-surgery, with cartilage and bone changes being mapped and graded at sacrifice at 20 weeks. Sham joints were morphologically normal and had only one minor kinematic change at 20 weeks. Although variable, ACL/MCL deficient animals showed significant kinematic abnormalities in 4/6 degrees of freedom (DOFs), as well as cartilage/bone damage by 20 weeks (p analysis revealed that changes in medial-lateral (ML) translation were related to the current level of joint degradation as represented by total gross OA score (p = 0.0044, R(2)  = 0.71) in the ACL/MCL transected group. Even identical ACL/MCL injuries result in inter-animal variations in instability and OA, however significant kinematic abnormalities in ML translation do relate to early OA in sheep. PMID:21919045

  8. Muscle strength after ACL reconstruction with bone tendon-bone patellar autograft tested by Cybex II dynamometer

    Gogus, Abdullah; Taser, Omer; Eralp, Levent

    2004-01-01

    The Cybex II dynamometer is a device which offers isokinetic testing of different body joints and muscle groups, allowing precise, reproducible control of joint range of motion in keeping with specific rehabilitation goals. This system collects torque, work and power data, thus it can be used to identify and quantify functional musculoskeletal deficits. 25 patients with chronic anterolateral knee instability have been treated with ACL reconstruction using bone-tendon-bone patellar autograft a...

  9. The Influence of Peracetic Acid Sterilization on Tendon Bone Healing of Soft-Tissue Allografts in ACL Reconstruction

    Böhm, Tassilo

    2010-01-01

    Allogenic tissue has become an important graft option for the reconstruction of the anterior cruciate ligament. Recent reports of disease transmission following ACL reconstruction with fresh-frozen non-sterilized allografts have highlighted the need for new sterilization techniques that do not impair the mechanical or biological properties as it was shown for most of the current sterilization techniques. Peracetic acid (PAA) has been successfully used to sterilize bone allografts without thes...

  10. Dual-energy computed tomography of cruciate ligament injuries in acute knee trauma

    To examine dual-energy computed tomography (DECT) in evaluating cruciate ligament injuries. More specifically, the purpose was to assess the optimal keV level in DECT gemstone spectral imaging (GSI) images and to examine the usefulness of collagen-specific color mapping and dual-energy bone removal in the evaluation of cruciate ligaments and the popliteus tendon. At a level 1 trauma center, a 29-month period of emergency department DECT examinations for acute knee trauma was reviewed by two radiologists for presence of cruciate ligament injuries, visualization of the popliteus tendon and the optimal keV level in GSI images. Three different evaluating protocols (GSI, bone removal and collagen-specific color mapping) were rated. Subsequent MRI served as a reference standard for intraarticular injuries. A total of 18 patients who had an acute knee trauma, DECT and MRI were found. On MRI, six patients had an ACL rupture. DECT's sensitivity and specificity to detect ACL rupture were 79 % and 100 %, respectively. The DECT vs. MRI intra- and interobserver proportions of agreement for ACL rupture were excellent or good (kappa values 0.72-0.87). Only one patient had a PCL rupture. In GSI images, the optimal keV level was 63 keV. GSI of 40-140 keV was considered to be the best evaluation protocol in the majority of cases. DECT is a usable method to evaluate ACL in acute knee trauma patients with rather good sensitivity and high specificity. GSI is generally a better evaluation protocol than bone removal or collagen-specific color mapping in the evaluation of cruciate ligaments and popliteus tendon. (orig.)

  11. Dual-energy computed tomography of cruciate ligament injuries in acute knee trauma

    Peltola, Erno K. [Helsinki University Hospital, Toeoeloe Trauma Center, Department of Radiology, Helsinki Medical Imaging Center, Helsinki (Finland); Koskinen, Seppo K. [Karolinska Universitetssjukhuset, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden)

    2015-09-15

    To examine dual-energy computed tomography (DECT) in evaluating cruciate ligament injuries. More specifically, the purpose was to assess the optimal keV level in DECT gemstone spectral imaging (GSI) images and to examine the usefulness of collagen-specific color mapping and dual-energy bone removal in the evaluation of cruciate ligaments and the popliteus tendon. At a level 1 trauma center, a 29-month period of emergency department DECT examinations for acute knee trauma was reviewed by two radiologists for presence of cruciate ligament injuries, visualization of the popliteus tendon and the optimal keV level in GSI images. Three different evaluating protocols (GSI, bone removal and collagen-specific color mapping) were rated. Subsequent MRI served as a reference standard for intraarticular injuries. A total of 18 patients who had an acute knee trauma, DECT and MRI were found. On MRI, six patients had an ACL rupture. DECT's sensitivity and specificity to detect ACL rupture were 79 % and 100 %, respectively. The DECT vs. MRI intra- and interobserver proportions of agreement for ACL rupture were excellent or good (kappa values 0.72-0.87). Only one patient had a PCL rupture. In GSI images, the optimal keV level was 63 keV. GSI of 40-140 keV was considered to be the best evaluation protocol in the majority of cases. DECT is a usable method to evaluate ACL in acute knee trauma patients with rather good sensitivity and high specificity. GSI is generally a better evaluation protocol than bone removal or collagen-specific color mapping in the evaluation of cruciate ligaments and popliteus tendon. (orig.)

  12. The effects of core muscle activation on dynamic trunk position and knee abduction moments: implications for ACL injury.

    Jamison, Steve T; McNally, Michael P; Schmitt, Laura C; Chaudhari, Ajit M W

    2013-09-01

    Anterior cruciate ligament (ACL) injury is one of the most common serious lower-extremity injuries experienced by athletes participating in field and court sports and often occurs during a sudden change in direction or pivot. Both lateral trunk positioning during cutting and peak external knee abduction moments have been associated with ACL injury risk, though it is not known how core muscle activation influences these variables. In this study, the association between core muscle pre-activation and trunk position as well as the association between core muscle pre-activation and peak knee abduction moment during an unanticipated run-to-cut maneuver were investigated in 46 uninjured individuals. Average co-contraction indices and percent differences between muscle pairs were calculated prior to initial contact for internal obliques, external obliques, and L5 extensors using surface electromyography. Outside tilt of the trunk was defined as positive when the trunk was angled away from the cutting direction. No significant associations were found between pre-activations of core muscles and outside tilt of the trunk. Greater average co-contraction index of the L5 extensors was associated with greater peak knee abduction moment (p=0.0107). Increased co-contraction of the L5 extensors before foot contact could influence peak knee abduction moment by stiffening the spine, limiting sagittal plane trunk flexion (a motion pattern previously linked to ACL injury risk) and upper body kinetic energy absorption by the core during weight acceptance. PMID:23891313

  13. MRI based volumetric assessment of knee cartilage after ACL-reconstruction, correlated with qualitative morphologic changes in the joint and with clinical outcome. Is there evidence for early posttraumatic degeneration?

    Purpose: The purpose of this study was to analyze potential quantitative and qualitative changes of the knee cartilage and joint indicative of early posttraumatic OA 4 years after ACL-reconstruction and to correlate the MRI-findings with the clinical outcome (CO). Materials and Methods: 1.5 T MRI-scans were performed on 9 patients post-op and 4 years later. Using a high-resolution T 1-w-fs-FLASH-3D-sequence cartilage volume (cVol) and thickness (mTh) were quantified. Using standard PD-w fs and T 1-w sequences qualitative changes of the joint structures were analyzed based on the WORMS-score. CO was rated by an orthopaedic surgeon using Lysholm-score, OAK-score, Tegner-activity-score (TAS), and Arthrometer KT-1000 testing. Results: Mean changes of cVol were -1.8 % (range: -5.9 %; + 0.7 %) and of mTh -0.8 % (range: -3.0 %; + 1.1 %). No significant change (95 %-CI) could be identified for any compartment. Three patients developed new peripatellar ostheophytes, acute trauma related changes mostly decreased. Mean outcome of Lysholm-score and OAK-score were 90 pts and 86 pts, mean TAS was 4.3 pts. Average maximum tibial translation reached 5.2 mm comparing to 6.7 mm on the healthy contralateral side. Conclusion: Despite a tendency towards decreased cVol and mTh 4 years after ACL-reconstruction qMRI revealed no significant cartilage loss. Newly developing osteophytes did not match with the observed good CO. This small pilot study motivates future quantitative and qualitative-structural MRI-based assessment of articular cartilage and other joint structures in order to improve diagnostic tools for the detection of early OA. (orig.)

  14. Raman spectroscopic study of molten SmCl3-ACl systems (A=Li,Na,K)

    Raman spectra of molten SmCl3-ACl systems (A=Li, Na, K) were measured at different compositions and temperatures. The spectra showed polarized peaks centered at about 256 cm-1 in the whole range of concentration and depolarized peaks at about 120 cm-1 in the low concentration range of SmCl3. These Raman shifts were identified as the totally symmetric stretching vibration υ1 and the degenerate bending vibration υ5 of octahedral SmCl63- complex anion, respectively. Peak splitting of the isotropic component was recognized clearly in the reduced Raman spectra of mixtures. Clustering of complex anions is thought to occur in the melts. However, the clustering might be restrained when the SmCl3 concentration became relatively low by adding LiCl, NaCl or KCl. The υ5 peak was the strongest at the SmCl3 concentration of 25 mol% in the SmCl3-KCl system among the three systems. The temperature effect on the Raman shift, reflecting the structural change, was negligibly small between 823 K and 1023 K. (orig.)

  15. Preventing ACL injuries in team-sport athletes: a systematic review of training interventions.

    Stojanovic, Marko D; Ostojic, Sergej M

    2012-07-01

    The purpose of this systematic review was to assess the efficacy of training interventions aimed to prevent and to reduce anterior cruciate ligament injury (ACLI) rates in team sport players. We searched MEDLINE from January 1991 to July 2011 using the terms knee, ACL, anterior cruciate ligament, injury, prevention, training, exercise, and intervention. Nine out of 708 articles met the inclusion criteria and were independently rated by two reviewers using the McMaster Occupational Therapy Evidence-Based Practice Research Group scale. Consensus scores ranged from 3 to 8 out of 10. Seven out of nine studies demonstrated that training interventions have a preventive effect on ACLI. Collectively, the studies indicate there is moderate evidence to support the use of multifaceted training interventions, which consisted of stretching, proprioception, strength, plyometric and agility drills with additional verbal and/or visual feedback on proper landing technique to decrease the rate of ACLIs in team sport female athletes, while the paucity of data preclude any conclusions for male athletes. PMID:22742077

  16. Acute mechanical injury of the human intervertebral disc: link to degeneration and pain

    B Alkhatib

    2014-09-01

    Full Text Available Excessive mechanical loading or acute trauma to intervertebral discs (IVDs is thought to contribute to degeneration and pain. However, the exact mechanisms by which mechanical injury initiates and promotes degeneration remain unclear. This study investigates biochemical changes and extracellular matrix disruption in whole-organ human IVD cultures following acute mechanical injury. Isolated healthy human IVDs were rapidly compressed by 5 % (non-injured or 30 % (injured of disc height. 30 % strain consistently cracked cartilage endplates, confirming disc trauma. Three days post-loading, conditioned media were assessed for proteoglycan content and released cytokines. Tissue extracts were assessed for proteoglycan content and for aggrecan integrity. Conditioned media were applied to PC12 cells to evaluate if factors inducing neurite growth were released. Compared to controls, IVD injury caused significant cell death. Injury also caused significantly reduced tissue proteoglycan content with a reciprocal increase of proteoglycan content in culture media. Increased aggrecan fragmentation was observed in injured tissue due to increased matrix metalloproteinase and aggrecanase activity. Injured-IVD conditioned media contained significantly elevated interleukin (IL-5, IL-6, IL-7, IL-8, MCP-2, GROα, and MIG, and ELISA analysis showed significantly increased nerve growth factor levels compared to non-injured media. Injured-disc media caused significant neurite sprouting in PC12 cells compared to non-injured media. Acute mechanical injury of human IVDs ex vivo initiates release of factors and enzyme activity associated with degeneration and back pain. This work provides direct evidence linking acute trauma, inflammatory factors, neo-innervation and potential degeneration and discogenic pain in vivo.

  17. Maxillofacial fractures of pedestrians injured in a motor vehicle accident.

    Yamamoto, Kazuhiko; Matsusue, Yumiko; Horita, Satoshi; Murakami, Kazuhiro; Ueyama, Yoshihiro; Sugiura, Tsutomu; Kirita, Tadaaki

    2013-03-01

    Maxillofacial fractures of pedestrians injured in a motor vehicle accident were retrospectively analyzed. The patients were 38 males and 26 females, and their age was distributed almost evenly from 1 to 91 years old (average 45.9 ± 24.8 years old). Motor vehicle collisions were with an automobile in 46 patients (71.9%), a motorcycle in 17 (26.6%), and a train in 1 (1.6%). The midface was involved in 32 patients (50.0%), the mandible in 19 (29.7%), and both the mandible and the midface in 13 (20.3%). Fractures were frequently observed in the zygoma and alveolus in the midface and in the condyle, symphysis, and body in the mandible. The facial injury severity scale (FISS) rating ranged from 1 to 9 (average 2.30 ± 1.79). Injuries to other sites of the body occurred in 29 patients (45.3%). Observation was most frequently chosen in 26 patients (40.6%), followed by open reduction and internal fixation (ORIF) in 18 (28.1%), and maxillomandibular fixation (MMF) in 8 (12.5%). The FISS rating was higher in patients treated with ORIF and MMF. Injuries to other sites of the body were observed at a higher rate in patients who collided with an automobile and were also treated by ORIF. PMID:24436734

  18. Relationship between stress ankle radiographs and injured ligaments on MRI

    This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

  19. Relationship between stress ankle radiographs and injured ligaments on MRI

    Lee, Kyoung Min; Chung, Chin Youb; Chung, Myung Ki; Won, Sung Hun; Lee, Seung Yeol; Park, Moon Seok [Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, Kyungki (Korea, Republic of); Kwon, Soon-Sun [Seoul National University Bundang Hospital, Biomedical Research Institute, Kyungki (Korea, Republic of)

    2013-11-15

    This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

  20. Acute traumatic patellar dislocation.

    Duthon, V B

    2015-02-01

    Inaugural traumatic patellar dislocation is most often due to trauma sustained during physical or sports activity. Two-thirds of acute patellar dislocations occur in young active patients (less than 20 years old). Non-contact knee sprain in flexion and valgus is the leading mechanism in patellar dislocation, accounting for as many as 93% of all cases. The strong displacement of the patella tears the medial stabilizing structures, and notably the medial patellofemoral ligament (MPFL), which is almost always injured in acute patellar dislocation, most frequently at its femoral attachment. Lateral patellar glide can be assessed with the knee in extension or 20° flexion. Displacement by more than 50% of the patellar width is considered abnormal and may induce apprehension. Plain X-ray and CT are mandatory to diagnose bony risk factors for patellar dislocation, such as trochlear dysplasia or increased tibial tubercle-trochlear groove distance (TT-TG), and plan correction. MRI gives information on cartilage and capsulo-ligamentous status for treatment planning: free bodies or osteochondral fracture have to be treated surgically. If patellar dislocation occurs in an anatomically normal knee and osteochondral fracture is ruled out on MRI, non-operative treatment is usually recommended. PMID:25592052

  1. The Effects of Ligustrazine on the Expression of bFGF and bFGFR in Bone Marrow in Radiation Injured Mice

    吴宁; 孙汉英; 刘文励; 徐慧珍; 路武

    2003-01-01

    To study the expression of the bFGF and its receptor in the mouse bone marrow by treatment with acute radioactive injury and Ligustrazine, 56 mice were divided into 3 groups: normal group, radiation-injured group and Ligustrazine group. After irradiation by 6.0 Gy 60 Co y-ray,each mouse was orally given 0.1 ml Ligustrazine twice a day for 13 days in Ligustrazine group, and each mouse in radiation injured group was orally given equal amount of saline. On the 3rd, 7th,14th day after irradiation, bone marrow mono-nuclear cells (BMMNC) were counted, and the expression levels of bFGF and bFGFR in bone marrow were evaluated by immunohistochemistry and flow cytometry analysis respectively. On the 3rd, 7th, 14th day after irradiation, expression of bFGF in bone marrow were significantly lower than in normal group (P<0.05 or P<0.01). Expressions of bFGF and bFGFR were much higher in Ligustrazine treated group than that in the control group (P<0.05 or P<0.01). Ligustrazine potentiate the expression of bFGF and bFGFR in bone marrow MNC to recover the bone marrow hematopoiesis inductive microenvironment, which is one of the mechanisms by which Ligustrazine rebuild the bone marrow hematopoiesis after acute radioactive injury.

  2. Benchmarking Outcomes in the Critically Injured Burn Patient

    Klein, Matthew B.; Goverman, Jeremy; Hayden, Douglas L.; Fagan, Shawn P.; McDonald-Smith, Grace P.; Alexander, Andrew K.; Gamelli, Richard L.; Gibran, Nicole S.; Finnerty, Celeste C.; Jeschke, Marc G.; Arnoldo, Brett; Wispelwey, Bram; Mindrinos, Michael N.; Xiao, Wenzhong; Honari, Shari E.; Mason, Philip H.; Schoenfeld, David A.; Herndon, David N.; Tompkins, Ronald G.

    2014-01-01

    Objective To determine and compare outcomes with accepted benchmarks in burn care at six academic burn centers. Background Since the 1960s, U.S. morbidity and mortality rates have declined tremendously for burn patients, likely related to improvements in surgical and critical care treatment. We describe the baseline patient characteristics and well-defined outcomes for major burn injuries. Methods We followed 300 adults and 241 children from 2003–2009 through hospitalization using standard operating procedures developed at study onset. We created an extensive database on patient and injury characteristics, anatomic and physiological derangement, clinical treatment, and outcomes. These data were compared with existing benchmarks in burn care. Results Study patients were critically injured as demonstrated by mean %TBSA (41.2±18.3 for adults and 57.8±18.2 for children) and presence of inhalation injury in 38% of the adults and 54.8% of the children. Mortality in adults was 14.1% for those less than 55 years old and 38.5% for those age ≥55 years. Mortality in patients less than 17 years old was 7.9%. Overall, the multiple organ failure rate was 27%. When controlling for age and %TBSA, presence of inhalation injury was not significant. Conclusions This study provides the current benchmark for major burn patients. Mortality rates, notwithstanding significant % TBSA and presence of inhalation injury, have significantly declined compared to previous benchmarks. Modern day surgical and medically intensive management has markedly improved to the point where we can expect patients less than 55 years old with severe burn injuries and inhalation injury to survive these devastating conditions. PMID:24722222

  3. Can molecular motors drive distance measurements in injured neurons?

    Naaman Kam

    2009-08-01

    Full Text Available Injury to nerve axons induces diverse responses in neuronal cell bodies, some of which are influenced by the distance from the site of injury. This suggests that neurons have the capacity to estimate the distance of the injury site from their cell body. Recent work has shown that the molecular motor dynein transports importin-mediated retrograde signaling complexes from axonal lesion sites to cell bodies, raising the question whether dynein-based mechanisms enable axonal distance estimations in injured neurons? We used computer simulations to examine mechanisms that may provide nerve cells with dynein-dependent distance assessment capabilities. A multiple-signals model was postulated based on the time delay between the arrival of two or more signals produced at the site of injury-a rapid signal carried by action potentials or similar mechanisms and slower signals carried by dynein. The time delay between the arrivals of these two types of signals should reflect the distance traversed, and simulations of this model show that it can indeed provide a basis for distance measurements in the context of nerve injuries. The analyses indicate that the suggested mechanism can allow nerve cells to discriminate between distances differing by 10% or more of their total axon length, and suggest that dynein-based retrograde signaling in neurons can be utilized for this purpose over different scales of nerves and organisms. Moreover, such a mechanism might also function in synapse to nucleus signaling in uninjured neurons. This could potentially allow a neuron to dynamically sense the relative lengths of its processes on an ongoing basis, enabling appropriate metabolic output from cell body to processes.

  4. Evaluation of selective direct plating media for their suitability to recover uninjured, heat-injured, and freeze-injured Listeria monocytogenes from foods.

    Golden, D A; Beuchat, L R; Brackett, R E

    1988-01-01

    Six direct plating media were evaluated for their suitability to recover uninjured, heat-injured, and freeze-injured cells of four strains of Listeria monocytogenes from four foods. Cells were inoculated into foods to achieve ca. 10(2) to 10(3), 10(4) to 10(5), or 10(5) to 10(6) viable cells per ml or g (low, medium, and high populations, respectively). No appreciable differences in recovery of the four test strains within a treatment were observed. Generally, recovery on all test media was s...

  5. Differences between Current and Past Self-Injurers: How and Why Do People Stop?

    Horgan, Michelle; Martin, Graham

    2016-01-01

    This research sought to clarify how some self-injurers cease the behavior, maintaining this for at least 1 year. Using the Experiential Avoidance Model (EAM), we examined whether characteristics of self-injurers remain in people who have successfully ceased self-injury and what, by implication, might be targeted to improve therapeutic efficacy. The study was conducted using an online cross-sectional survey of 215 first-year university students. Past self-injurers (34) scored significantly better on subscales of the General Health Questionnaire, as well as Distress Tolerance, Experiential Avoidance, and Self-blame compared to Current self-injurers (29). The Experiential Avoidance Model is a useful basis for understanding self-injury, and informing therapeutic approaches. Reducing Anxiety, and developing Tolerance and Positive Emotional Intensity may be keys to ceasing self-injury. PMID:25764153

  6. Acute Pancreatitis and Pregnancy

    ... Acute Pancreatitis > Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is ... of acute pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for ...

  7. Influence of diluents, media, and membrane filters on detection fo injured waterborne coliform bacteria.

    McFeters, G A; Cameron, S C; LeChevallier, M W

    1982-01-01

    Pure cultures of Escherichia coli, Klebsiella pneumoniae, Enterobacter aerogenes, and Citrobacter freundii were injured ( greater than 90%) in water from a dead-end section of the Bozeman, Montana, distribution system. The effects of the following laboratory variables on the enumeration efficiency of injured and undamaged control cells were examined: (i) diluent composition, temperature, and time of exposure; (ii) media, using various formulations employed in enumerating gram-negative bacteri...

  8. Electrical Stimulation of the Suprahyoid Muscles in Brain-injured Patients with Dysphagia: A Pilot Study

    Beom, Jaewon; Kim, Sang Jun; Han, Tai Ryoon

    2011-01-01

    Objective To investigate the therapeutic effects of repetitive electrical stimulation of the suprahyoid muscles in brain-injured patients with dysphagia. Method Twenty-eight brain-injured patients who showed reduced laryngeal elevation and supraglottic penetration or subglottic aspiration during a videofluoroscopic swallowing study (VFSS) were selected. The patients received either conventional dysphagia management (CDM) or CDM with repetitive electrical stimulation of the suprahyoid muscles ...

  9. An injured tissue affects the opposite intact peritoneum during postoperative adhesion formation

    Suzuki, Tatsuya; Kono, Toru; Bochimoto, Hiroki; Hira, Yoshiki; Watanabe, Tsuyoshi; Furukawa, Hiroyuki

    2015-01-01

    The pathophysiology of adhesion formation needs to be clarified to reduce the adhesion-related morbidity. The epithelial characteristics of the peritoneum suggest a protective role against adhesion formation, yet how the peritoneum is involved in adhesion formation is not well characterized. We microscopically observed an experimental model of adhesion formation to investigate the effects of an injured tissue on the opposite intact peritoneum. Adhesions were induced between injured and intact...

  10. Microcurrent Electrical Neuromuscular Stimulation Facilitates Regeneration of Injured Skeletal Muscle in Mice

    Fujiya, Hiroto; Ogura, Yuji; Ohno, Yoshitaka; Goto, Ayumi; Nakamura, Ayane; Ohashi, Kazuya; Uematsu, Daiki; Aoki, Haruhito; Musha, Haruki; Goto, Katsumasa

    2015-01-01

    Conservative therapies, mainly resting care for the damaged muscle, are generally used as a treatment for skeletal muscle injuries (such as muscle fragmentation). Several past studies reported that microcurrent electrical neuromuscular stimulation (MENS) facilitates a repair of injured soft tissues and shortens the recovery period. However, the effects of MENS on the regeneration in injured skeletal muscle are still unclear. The purpose of this study was to investigate the effect of MENS on t...

  11. Analysis of the Completion of the Certificate of First Medical Assistance to an Injured Person

    Manuel Rodríguez González; Illovis Arteaga Ramírez; Osmel Rodríguez González; Yusleyvi González Dueñas

    2014-01-01

    Background: the certificate of first medical assistance to an injured person is a medicolegal document that every medical professional should know how to complete. Any problem with the data requested in this form can cause a number of limitations on the prosecution of injury-related offenses. Objective: to characterize the process for completing the certificate of first medical assistance to an injured person. Methods: A descriptive cross-sectional study was conducted at the consultation for ...

  12. Prevalence and consequences of positive blood alcohol levels among patients injured at work

    Caitlin A Foster; Dissanaike, Sharmila D.

    2014-01-01

    Aims: The aim of this study was to characterize positive blood alcohol among patients injured at work, and to compare the severity of injury and outcome of blood alcohol concentration (BAC) positive and negative patients. Settings and Design: A retrospective cohort study was performed at a Level 1 academic trauma center. Patients injured at work between 01/01/07 and 01/01/12 and admitted with positive (BAC+) vs negative (BAC-) blood alcohol were compared using bivariate analysis. Results: Out...

  13. Effectiveness of a web-based intervention for injured claimants: A randomized controlled trial

    Elbers, N.A.; Akkermans, A.J.; Cuijpers, P.; Bruinvels, D.J.

    2013-01-01

    Background There is considerable evidence showing that injured people who are involved in a compensation process show poorer physical and mental recovery than those with similar injuries who are not involved in a compensation process. One explanation for this reduced recovery is that the legal process and the associated retraumatization are very stressful for the claimant. The aim of this study was to empower injured claimants in order to facilitate recovery. Methods Participants were recruit...

  14. Man`s search for meaning : Applying existential psychology to rehabilitate seriously ill or injured people

    2004-01-01

    MAN`S SEARCH FOR MEANING Applying existential psychology to rehabilitate seriously ill or injured people Background During life a number of people are exposed to extreme strains in one way or another. Among these strains, serious illness or injury constitute major threats to people`s existence. When people are threatened the question about meaning may become essential. As future doctors, working with seriously ill or injured people, we wanted to find out how people cope with these conditions....

  15. Assessing 3D tunnel position in ACL reconstruction using a novel single image 3D-2D registration

    Kang, X.; Yau, W. P.; Otake, Y.; Cheung, P. Y. S.; Hu, Y.; Taylor, R. H.

    2012-02-01

    The routinely used procedure for evaluating tunnel positions following anterior cruciate ligament (ACL) reconstructions based on standard X-ray images is known to pose difficulties in terms of obtaining accurate measures, especially in providing three-dimensional tunnel positions. This is largely due to the variability in individual knee joint pose relative to X-ray plates. Accurate results were reported using postoperative CT. However, its extensive usage in clinical routine is hampered by its major requirement of having CT scans of individual patients, which is not available for most ACL reconstructions. These difficulties are addressed through the proposed method, which aligns a knee model to X-ray images using our novel single-image 3D-2D registration method and then estimates the 3D tunnel position. In the proposed method, the alignment is achieved by using a novel contour-based 3D-2D registration method wherein image contours are treated as a set of oriented points. However, instead of using some form of orientation weighting function and multiplying it with a distance function, we formulate the 3D-2D registration as a probability density estimation using a mixture of von Mises-Fisher-Gaussian (vMFG) distributions and solve it through an expectation maximization (EM) algorithm. Compared with the ground-truth established from postoperative CT, our registration method in an experiment using a plastic phantom showed accurate results with errors of (-0.43°+/-1.19°, 0.45°+/-2.17°, 0.23°+/-1.05°) and (0.03+/-0.55, -0.03+/-0.54, -2.73+/-1.64) mm. As for the entry point of the ACL tunnel, one of the key measurements, it was obtained with high accuracy of 0.53+/-0.30 mm distance errors.

  16. MUSCLE STRENGTH AND QUALITATIVE JUMP-LANDING DIFFERENCES IN MALE AND FEMALE MILITARY CADETS: THE JUMP-ACL STUDY

    Barry P. Boden

    2009-12-01

    Full Text Available Recent studies have focused on gender differences in movement patterns as risk factors for ACL injury. Understanding intrinsic and extrinsic factors which contribute to movement patterns is critical to ACL injury prevention efforts. Isometric lower- extremity muscular strength, anthropometrics, and jump-landing technique were analyzed for 2,753 cadets (1,046 female, 1,707 male from the U.S. Air Force, Military and Naval Academies. Jump- landings were evaluated using the Landing Error Scoring System (LESS, a valid qualitative movement screening tool. We hypothesized that distinct anthropometric factors (Q-angle, navicular drop, bodyweight and muscle strength would predict poor jump-landing technique in males versus females, and that female cadets would have higher scores (more errors on a qualitative movement screen (LESS than males. Mean LESS scores were significantly higher in female (5.34 ± 1.51 versus male (4.65 ± 1.69 cadets (p < 0.001. Qualitative movement scores were analyzed using factor analyses, yielding five factors, or "patterns", contributing to poor landing technique. Females were significantly more likely to have poor technique due to landing with less hip and knee flexion at initial contact (p < 0.001, more knee valgus with wider landing stance (p < 0. 001, and less flexion displacement over the entire landing (p < 0.001. Males were more likely to have poor technique due to landing toe-out (p < 0.001, with heels first, and with an asymmetric foot landing (p < 0.001. Many of the identified factor patterns have been previously proposed to contribute to ACL injury risk. However, univariate and multivariate analyses of muscular strength and anthropometric factors did not strongly predict LESS scores for either gender, suggesting that changing an athlete's alignment, BMI, or muscle strength may not directly improve his or her movement patterns

  17. Characterization of thigh and shank segment angular velocity during jump landing tasks commonly used to evaluate risk for ACL injury.

    Dowling, Ariel V; Favre, Julien; Andriacchi, Thomas P

    2012-09-01

    The dynamic movements associated with anterior cruciate ligament (ACL) injury during jump landing suggest that limb segment angular velocity can provide important information for understanding the conditions that lead to an injury. Angular velocity measures could provide a quick and simple method of assessing injury risk without the constraints of a laboratory. The objective of this study was to assess the inter-subject variations and the sensitivity of the thigh and shank segment angular velocity in order to determine if these measures could be used to characterize jump landing mechanisms. Additionally, this study tested the correlation between angular velocity and the knee abduction moment. Thirty-six healthy participants (18 male) performed drop jumps with bilateral and unilateral landing. Thigh and shank angular velocities were measured by a wearable inertial-based system, and external knee moments were measured using a marker-based system. Discrete parameters were extracted from the data and compared between systems. For both jumping tasks, the angular velocity curves were well defined movement patterns with high inter-subject similarity in the sagittal plane and moderate to good similarity in the coronal and transverse planes. The angular velocity parameters were also able to detect differences between the two jumping tasks that were consistent across subjects. Furthermore, the coronal angular velocities were significantly correlated with the knee abduction moment (R of 0.28-0.51), which is a strong indicator of ACL injury risk. This study suggested that the thigh and shank angular velocities, which describe the angular dynamics of the movement, should be considered in future studies about ACL injury mechanisms. PMID:22938373

  18. Single Wake Meandering, Advection and Expansion - An analysis using an adapted Pulsed Lidar and CFD LES-ACL simulations

    wake, and it is compared to the predictions from the Dynamic Wake Meandering model, for a selected 10 minutes dataset. Secondly, the average wake expansion in the fixed frame of reference is determined from measurements and compared to results from CFD simulations. The CFD simulations were conducted...... using the EllipSys3D flow solver using Large Eddy Simulation (LES) and Actuator Line Technique (ACL) to model the rotor. Discrepancies due to the uncertainties on the wake advection velocity are observed and discussed....

  19. Single Wake Meandering, Advection and Expansion - An analysis using an adapted Pulsed Lidar and CFD LES-ACL simulations

    Machefaux, Ewan; Larsen, Gunner Chr.; Troldborg, Niels;

    2013-01-01

    wake, and it is compared to the predictions from the Dynamic Wake Meandering model, for a selected 10 minutes dataset. Secondly, the average wake expansion in the fixed frame of reference is determined from measurements and compared to results from CFD simulations. The CFD simulations were conducted...... using the EllipSys3D flow solver using Large Eddy Simulation (LES) and Actuator Line Technique (ACL) to model the rotor. Discrepancies due to the uncertainties on the wake advection velocity are observed and discussed....

  20. Bronchitis - acute

    ... sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflammation in the main passages ... present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a ...

  1. Bronchitis - acute

    Acute bronchitis is swelling and inflammation in the main passages that carry air to the lungs. The swelling narrows ... makes it harder to breathe. Another symptom of bronchitis is a cough. Acute means the symptoms have ...

  2. Acute Bronchitis

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis ...

  3. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline) addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingest...

  4. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline) addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion....

  5. Association between maximal hamstring muscle strength and hamstring muscle pre-activity during a movement associated with non-contact ACL injury

    Zebis, M. K.; Sorensen, R. S.; Thorborg, K.; Bandholm, T.; Holmich, P.; Andersen, L. L.; Myklebust, G.; Lauridsen, H. B.; Aagaard, Per; Bencke, J.

    Background: Reduced hamstring pre-activity during sidecutting increases the risk for non-contact ACL injury. During the last decade resistance training of the lower limb muscles has become an integral part ofACLinjury prevention in e.g. soccer and handball. However, it is not known whether a strong...... hamstring (ACL-agonist) musculature is associated with a high level of hamstring muscle pre-activity during high risk movements such as sidecutting. Purpose: The purpose of this study was to examine the relationship between hamstring muscle pre-activity recorded during a standardized sidecutting maneuver...... translate into high levels of muscle pre-activity during movements like the sidecutting maneuver. Implications: Other exercise modalities (i.e. neuromuscular training) are needed to optimize hamstring muscle pre-activity during movements associated with non-contact ACL injury....

  6. Research on System Access Control Based on Spring Security ACL%基于Spring Security ACL的系统访问控制研究

    张朝日

    2011-01-01

    Spring Security ACL is an access control security framework, it can control all kinds of resource authority. This article introduces the concept and mechanism of Spring Security ACL, at the same time describes the implementation and process of Spring Security ACL security framework by example.%Spring Security ACL是一个权限访问控制框架,主要用采控制各种资源的访问权限.本文讲述Spring Security ACL的机制原理和理论研究,同时也通过一个简单的权限控制实现的例子演示Spring Security ACL的安全框架的实现方法和过程.

  7. Evaluation of selective direct plating media for their suitability to recover uninjured, heat-injured, and freeze-injured Listeria monocytogenes from foods.

    Golden, D A; Beuchat, L R; Brackett, R E

    1988-06-01

    Six direct plating media were evaluated for their suitability to recover uninjured, heat-injured, and freeze-injured cells of four strains of Listeria monocytogenes from four foods. Cells were inoculated into foods to achieve ca. 10(2) to 10(3), 10(4) to 10(5), or 10(5) to 10(6) viable cells per ml or g (low, medium, and high populations, respectively). No appreciable differences in recovery of the four test strains within a treatment were observed. Generally, recovery on all test media was similar and not markedly affected by freeze treatment. Modified Despierres agar and modified McBride Listeria agar yielded poorer recovery of heat-injured cells than did McBride Listeria agar and gum base-nalidixic acid-tryptone soya agar. Overall, gum base-nalidixic acid-tryptone soya agar was best for recovering L. monocytogenes from pasteurized milk and chocolate ice cream mix. Enumeration was complicated by the growth of background microflora present in Brie cheese and cabbage, especially at the low inoculum. Dominguez Rodriguez isolation agar was superior for recovering L. monocytogenes from Brie cheese, whereas modified Despierres agar was best for recovering the organism from cabbage. Direct plating procedures can successfully be utilized for recovering healthy and injured L. monocytogenes from foods containing low populations of background microflora. PMID:3137864

  8. Relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch: MRI and arthroscopy correlation

    The purpose of this study was to evaluate the relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch. We retrospectively reviewed the 105 patients with knee magnetic resonance imaging (MRI) with or without knee arthroscopy [group 1: patients with arthroscopic notchplasty (N = 47), group 2: knee arthroscopy demonstrating intact ACL (N = 33), and group 3: patients with normal knee MRI but no arthroscopy (N = 25)]. Groups 2 and 3 served as an arthroscopic and MR control group, respectively. Two musculoskeletal radiologists reviewed all MR examinations. The intercondylar notch width, notch index (width of intercondylar notch/width of femoral condyle), transverse notch angle (TNA), sagittal notch angle (SNA), and notch area were recorded on axial and sagittal MR images at the midpoint of Blumensaat's line which was identified on sagittal images. The diameter of the ACL was recorded on coronal MR images at the posterior end of Blumensaat's line. The mean values of the intercondylar notch width, notch index, TNA, SNA, notch area, and ACL diameter for the three groups were 16.0 mm/0.2/50.3 /36.5 /249.0 mm2/7.7 mm (group 1); 19.3 mm/0.3/52.9 /40.2 /323.4 mm2/4.8 mm (group 2); and 20.3 mm/0.3/51.4 /39.1 /350.8 mm2/4.5 mm (group 3). The intercondylar notch width, notch index, SNA, and notch area were smaller, and ACL diameter was thicker in group 1 compared with the other groups (p < 0.05). Patients with mucoid ACL hypertrophy show a narrower notch, a steeper notch angle, and a smaller notch area than control groups. (orig.)

  9. Relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch: MRI and arthroscopy correlation

    Cha, Ji Hyeon; Shin, Myung Jin; Choi, Byeong Kyoo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); Lee, Sang Hoon [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); University of Ulsan College of Medicine, Department of Radiology, Asan Medical Center, Seoul (Korea); Bin, Sung Il [University of Ulsan College of Medicine, Department of Orthopedic Surgery, Asan Medical Center, Seoul (Korea)

    2008-09-15

    The purpose of this study was to evaluate the relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch. We retrospectively reviewed the 105 patients with knee magnetic resonance imaging (MRI) with or without knee arthroscopy [group 1: patients with arthroscopic notchplasty (N = 47), group 2: knee arthroscopy demonstrating intact ACL (N = 33), and group 3: patients with normal knee MRI but no arthroscopy (N = 25)]. Groups 2 and 3 served as an arthroscopic and MR control group, respectively. Two musculoskeletal radiologists reviewed all MR examinations. The intercondylar notch width, notch index (width of intercondylar notch/width of femoral condyle), transverse notch angle (TNA), sagittal notch angle (SNA), and notch area were recorded on axial and sagittal MR images at the midpoint of Blumensaat's line which was identified on sagittal images. The diameter of the ACL was recorded on coronal MR images at the posterior end of Blumensaat's line. The mean values of the intercondylar notch width, notch index, TNA, SNA, notch area, and ACL diameter for the three groups were 16.0 mm/0.2/50.3 /36.5 /249.0 mm{sup 2}/7.7 mm (group 1); 19.3 mm/0.3/52.9 /40.2 /323.4 mm{sup 2}/4.8 mm (group 2); and 20.3 mm/0.3/51.4 /39.1 /350.8 mm{sup 2}/4.5 mm (group 3). The intercondylar notch width, notch index, SNA, and notch area were smaller, and ACL diameter was thicker in group 1 compared with the other groups (p < 0.05). Patients with mucoid ACL hypertrophy show a narrower notch, a steeper notch angle, and a smaller notch area than control groups. (orig.)

  10. Low-intensity ultrasound for regeneration of injured peripheral nerve

    Wei Zhou; Wenzhi Chen; Kun Zhou; Zhibiao Wang

    2006-01-01

    BACKGROUND: Ultrasound is a kind of mechanical wave and characterized by mechanical effect,heat affect and physical and chemical effect.Ultrasound can promote regeneration of peripheral nerves after a slight injury based on its mechanical effect.However,whether it can promote regeneration of peripheral nerves after a severe injury or not is still unclear.OBJECTIVE: To study the effect of low-intensity ultrasound(LIU)on regeneration of injured peripheral nerve,throgh examining sciatic nerve function index,the sensory nerve conduction velocity and the thickness of myelin sheath.DESIGN: Single factor design of contrast observation.SETTING: Institute of Ultrasound Engineering,Chongqing Medical University.MATERIALS:A total of 64 female Wistar rats,of clean grade,age 3 moths,weighing 200-250g ,were provided by Experimental Animal Center of Chongqing Medical University. All rats were randomly divided into treatment group and control group with 32 in each group. In addition rats were observed at 4 time points, including 2,4,6 and 8 weeks,with 8 at each time point.The main equipments were detailed as follows:forceps (Medical Treatment Apparatus Company,Chongqing),low-intensity ultrasound treatment instrument(Institute of Ulrasound Engineering in Medicine),the analysis instrument of diagram resembles and arithmetic figure(the United States Bio-RAD Company),ultrasound coupling agent(Xunde Image material factory,Hangzhou),Osmium Tetraoxide(Next Chimicam,South Africa).METHODS:The experiment was carried out in Institute of Ultrasound Engineering of Chongqing Medical University from December 2003 to May 2004.The right sciatic nerves of 64 rats were crushed with forceps for 30 s to form the experimental animal models.Then they were treated at 3 days after operation.Rats in the treatment group received the LIU exposure.LIU was applied every other day to the crush site of rats,which had a spatial peak,time-averaged intensity of 0.25 W/cm2 operated at 1 MHz for 1 minute per

  11. Assessing the progress of rehabilitation in patients with ACL reconstruction using the International Knee Documentation Committee Subjective Knee Form

    Leguizamon, J. H.; Braidot, A.; Catalfamo Formento, P.

    2011-12-01

    There are numerous assessment tools designed to provide information on the results of reconstructive surgery of anterior cruciate ligament (ACL). They are also used for monitoring progress and facilitating clinical decision-making during the rehabilitation process. A brief summary of some existing tools specifically designed to evaluate knee ligament injuries is presented in this article. Then, one of those outcome measures, the International Knee Documentation Committee Subjective Knee Form (IKDC) was applied to a group of patients (N = 10) who had undergone surgery for ACL reconstruction. The patients attended the same physiotherapy service and followed a unified rehabilitation protocol. The assessment was performed twice: four and six months after surgery. The results showed an improvement in the rehabilitation of most patients tested (verified by a difference equal to or greater than 9 points on the IKDC outcome between measurements 1 and 2). The IKDC probed to be an instrument of quick and easy application. It provided quantitative data about the progress of rehabilitation and could be applied in everyday clinical physiotherapy practice. However, the results suggested considering the IKDC as one component of an evaluation kit to make decisions regarding the progress of the rehabilitation treatment.

  12. Optimizing whole-body kinematics to minimize valgus knee loading during sidestepping: implications for ACL injury risk.

    Donnelly, C J; Lloyd, D G; Elliott, B C; Reinbolt, J A

    2012-05-11

    The kinematic mechanisms associated with elevated externally applied valgus knee moments during non-contact sidestepping and subsequent anterior cruciate ligament (ACL) injury risk are not well understood. To address this issue, the residual reduction algorithm (RRA) in OpenSim was used to create nine subject-specific, full-body (37 degrees of freedom) torque-driven simulations of athletic males performing unplanned sidestep (UnSS) sport tasks. The RRA was used again to produce an optimized kinematic solution with reduced peak valgus knee torques during the weight acceptance phase of stance. Pre-to-post kinematic optimization, mean peak valgus knee moments were significantly reduced by 44.2 Nm (p=0.045). Nine of a possible 37 upper and lower body kinematic changes in all three planes of motion were consistently used during the RRA to decrease peak valgus knee moments. The generalized kinematic strategy used by all nine simulations to reduce peak valgus knee moments and subsequent ACL injury risk during UnSS was to redirect the whole-body center of mass medially, towards the desired direction of travel. PMID:22387123

  13. Assessing the progress of rehabilitation in patients with ACL reconstruction using the International Knee Documentation Committee Subjective Knee Form

    There are numerous assessment tools designed to provide information on the results of reconstructive surgery of anterior cruciate ligament (ACL). They are also used for monitoring progress and facilitating clinical decision-making during the rehabilitation process. A brief summary of some existing tools specifically designed to evaluate knee ligament injuries is presented in this article. Then, one of those outcome measures, the International Knee Documentation Committee Subjective Knee Form (IKDC) was applied to a group of patients (N = 10) who had undergone surgery for ACL reconstruction. The patients attended the same physiotherapy service and followed a unified rehabilitation protocol. The assessment was performed twice: four and six months after surgery. The results showed an improvement in the rehabilitation of most patients tested (verified by a difference equal to or greater than 9 points on the IKDC outcome between measurements 1 and 2). The IKDC probed to be an instrument of quick and easy application. It provided quantitative data about the progress of rehabilitation and could be applied in everyday clinical physiotherapy practice. However, the results suggested considering the IKDC as one component of an evaluation kit to make decisions regarding the progress of the rehabilitation treatment.

  14. Acute pancreatitis

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  15. Acute pancreatitis

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  16. Disseminated intravascular coagulation or acute coagulopathy of trauma shock early after trauma? A prospective observational study

    Johansson, Per Ingemar; Sorensen, Anne Marie; Perner, Anders; Welling, Karen-Lise; Wanscher, Michael; Larsen, Claus F; Ostrowski, Sisse R

    2011-01-01

    ABSTRACT: INTRODUCTION: It is debated whether the early trauma induced coagulopathy (TIC) in severely injured patients reflects disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype, acute coagulopathy of trauma shock (ACoTS) or yet other entities. This study investigated the...

  17. Effect of Prone Position on Regional Shunt, Aeration, and Perfusion in Experimental Acute Lung Injury

    Richter, Torsten; Bellani, Giacomo; Harris, R. Scott; Melo, Marcos F. Vidal; Winkler, Tilo; Venegas, Jose G.; Musch, Guido

    2005-01-01

    Rationale: The prone position is used to improve gas exchange in patients with acute respiratory distress syndrome. However, the regional mechanism by which the prone position improves gas exchange in acutely injured lungs is still incompletely defined. Methods: We used positron emission tomography imaging of [13N]nitrogen to assess the regional distribution of pulmonary shunt, aeration, perfusion, and ventilation in seven surfactant-depleted sheep in supine and prone positions. Results: In t...

  18. A prospective study on time to recovery in 254 injured novice runners.

    Rasmus Oestergaard Nielsen

    Full Text Available Describe the diagnoses and the time to recovery of running-related injuries in novice runners.Prospective cohort study on injured runners.This paper is a secondary data analysis of a 933-person cohort study (DANO-RUN aimed at characterizing risk factors for injury in novice runners. Among those sustaining running-related injuries, the types of injuries and time to recovery is described in the present paper. All injured runners were diagnosed after a thorough clinical examination and then followed prospectively during their recovery. If they recovered completely from injury, time to recovery of each injury was registered.A total of 254 runners were injured. The proportion of runners diagnosed with medial tibial stress syndrome was 15%, 10% for patellofemoral pain, 9% for medial meniscal injury, 7% for Achilles tendinopathy and 5% for plantar fasciitis. Among the 220 runners (87% recovering from their injury, the median time to recovery was 71 days (minimum  = 9 days, maximum  = 617 days.Medial tibial stress syndrome was the most common injury followed by patellofemoral pain, medial meniscal injury and Achilles tendinopathy. Half of the injured runners were unable to run 2×500 meters without pain after 10 weeks. Almost 5% of the injured runners received surgical treatment.

  19. Correlates of suicide attempts among self-injurers: a meta-analysis.

    Victor, Sarah E; Klonsky, E David

    2014-06-01

    Suicide attempts (SAs) are common among those who engage in non-suicidal self-injury (NSSI). It is therefore important to determine which suicide risk factors are most predictive of SA among those who self-injure. Toward this aim, we conducted a systematic review of studies examining predictors of SA history among self-injurers. A total of 52 empirical articles provided data comparing self-injurers with and without SA. From these studies we focused our meta-analysis on the 20 variables that were evaluated with respect to SA history in five or more different samples. The strongest correlate of SA history was suicidal ideation. After suicidal ideation, the strongest predictors of SA history were NSSI frequency, number of NSSI methods, and hopelessness. Additional, moderate predictors of SA history included Borderline Personality Disorder, impulsivity, Post-Traumatic Stress Disorder, the NSSI method of cutting, and depression. Demographic characteristics, such as gender, ethnicity, and age, were weakly associated with SA history. Notably, some oft-cited risk factors for SA displayed small or negligible associations with SA among self-injurers, including histories of sexual and physical abuse, anxiety, substance use, and eating disorders. Findings have implications for conceptual models of the NSSI-SA relationship and the evaluation of suicide risk among self-injuring populations. PMID:24742496

  20. Imaging following acute knee trauma.

    Kijowski, R; Roemer, F; Englund, M; Tiderius, C J; Swärd, P; Frobell, R B

    2014-10-01

    Joint injury has been recognized as a potent risk factor for the onset of osteoarthritis. The vast majority of studies using imaging technology for longitudinal assessment of patients following joint injury have focused on the injured knee joint, specifically in patients with anterior cruciate ligament injury and meniscus tears where a high risk for rapid onset of post-traumatic osteoarthritis is well known. Although there are many imaging modalities under constant development, magnetic resonance (MR) imaging is the most important instrument for longitudinal monitoring after joint injury. MR imaging is sensitive for detecting early cartilage degeneration and can evaluate other joint structures including the menisci, bone marrow, tendons, and ligaments which can be sources of pain following acute injury. In this review, focusing on imaging following acute knee trauma, several studies were identified with promising short-term results of osseous and soft tissue changes after joint injury. However, studies connecting these promising short-term results to the development of osteoarthritis were limited which is likely due to the long follow-up periods needed to document the radiographic and clinical onset of the disease. Thus, it is recommended that additional high quality longitudinal studies with extended follow-up periods be performed to further investigate the long-term consequences of the early osseous and soft tissue changes identified on MR imaging after acute knee trauma. PMID:25278054

  1. Quality of life in severely injured patients depends on psychosocial factors rather than on severity or type of injury

    Delft-Schreurs, C. C H M; Bergen, J.J.M.; Jongh, M.A.C. de; Sande, P.; Verhofstad, Michiel; de Vries, Jolanda

    2014-01-01

    textabstractBackground: Former studies have demonstrated that health-related quality of life is decreased in severely injured patients. However, in those studies patients were asked about their functioning and not about their (dis)contentment concerning their functioning. Little is known about how severely injured patients experience their quality of life (QOL). The objective of this cross-sectional study was to measure this subjective QOL of severely injured patients after their rehabilitati...

  2. Original Rehabilitation Programme after Anatomical ACL Reconstruction Based on MRI Evaluated Graft Remodelling

    Plenzler, Marcin; Straszewski, Dariusz; Ciszkowska-Łysoń, Beata; Śmigielski, Robert; Popieluch, Marcin

    2014-01-01

    Objectives: This study was carried out to design a rehabilitation program allowing for complete functional post-surgical recovery of the limb, that would not affect the remodelling process of the transplanted graft evaluated on MRI imaging. The main reason for changing the rehabilitation protocol was the 14 months of observation of the MRI images (a series of 9 MRIs performed over a two year period) among the patients after ACL reconstruction, in whom the adverse characteristics in remodelling of the graft were observed in line with the implementation of the traditional rehabilitation program. Methods: A 23 years old patient, a professional hi-rank skateboarder, took part in this pilot study. He had a torsion injury of the left knee joint. The main concepts of the rehabilitation program were: functional training in CKC that would involve muscles of the entire kinetic chain of the operated limb; the co-contraction training under the axial load, active extension training, the avoidance of static flexor stretching for at least 24 weeks after the surgery, no passive movements while exercising, the use of posterior translation of the tibia while doing the exercises, and no knee joint extensor strengthening activities in OKC for at least six months after the surgery. In order to evaluate the remodelling of the graft, seven oblique axial MR images (DOA) were taken, on which the graft’s cross-sectional area was measured. The MRI's were performed in the second, sixth, and twelfth week; then in the fourth, sixth, and ninth month, and, finally a year after the surgery. The angle of the graft and PCL was also measured. Additionally, the quality of tendon signal was assessed. For the functional evaluation, isokinetic and isometric tests of the knee extensor and the flexor muscles, along with the tibial rotator functions were performed using Humac Norm device. Postural stability based on COP parameter was established, as well, using the stabilometric platform HUR. For the

  3. Constitutive modeling of the human Anterior Cruciate Ligament (ACL) under uniaxial loading using viscoelastic prony series and hyperelastic five parameter Mooney-Rivlin model

    Chakraborty, Souvik; Mondal, Debabrata; Motalab, Mohammad

    2016-07-01

    In this present study, the stress-strain behavior of the Human Anterior Cruciate Ligament (ACL) is studied under uniaxial loads applied with various strain rates. Tensile testing of the human ACL samples requires state of the art test facilities. Furthermore, difficulty in finding human ligament for testing purpose results in very limited archival data. Nominal Stress vs. deformation gradient plots for different strain rates, as found in literature, is used to model the material behavior either as a hyperelastic or as a viscoelastic material. The well-known five parameter Mooney-Rivlin constitutivemodel for hyperelastic material and the Prony Series model for viscoelastic material are used and the objective of the analyses comprises of determining the model constants and their variation-trend with strain rates for the Human Anterior Cruciate Ligament (ACL) material using the non-linear curve fitting tool. The relationship between the model constants and strain rate, using the Hyperelastic Mooney-Rivlin model, has been obtained. The variation of the values of each coefficient with strain rates, obtained using Hyperelastic Mooney-Rivlin model are then plotted and variation of the values with strain rates are obtained for all the model constants. These plots are again fitted using the software package MATLAB and a power law relationship between the model constants and strain rates is obtained for each constant. The obtained material model for Human Anterior Cruciate Ligament (ACL) material can be implemented in any commercial finite element software package for stress analysis.

  4. Alcohol and drugs in seriously injured drivers in 6 European countries

    Legrand, Sara-Ann; Isalberti, Cristina; Linden, Trudy Van der;

    2012-01-01

    lower than therapeutic. Cannabis (0.5-7.6%) was the most prevailing illicit drug. Alcohol was found in combination with drugs in 2.3-13.2% of the drivers. Drug combinations were found in 0.5-4.3% of the drivers. Conclusion: This study confirms the high prevalence of psychoactive substances in injured...... drivers, but we observed large differences between the participating countries. Alcohol was the most common finding, followed by cannabis and benzodiazepines. Notable are the many drivers having a BAC ≥ 1.3 g/L. The majority of the substances were found in combination with another psychoactive substance......Objective: To determine the presence of alcohol and drugs in drivers severely injured in traffic crashes in 6 European countries. Methods: Data were collected from 2492 seriously injured drivers of cars and vans in Belgium, Denmark, Finland, Italy, Lithuania and The Netherlands, between 2007 and...

  5. Alcohol and drugs in seriously injured drivers in six European countries

    Legrand, Sara‐Ann; Isalberti, Cristina; Linden, Trudy Van;

    2013-01-01

    therapeutic. Cannabis (0.5–7.6%) was the most prevailing illicit drug. Alcohol was found in combination with drugs in 2.3-13.2% of the drivers. Drug combinations were found in 0.5–4.3% of the drivers. This study confirms the high prevalence of psychoactive substances in injured drivers, but we observed large...... differences between the participating countries. Alcohol was the most common finding, followed by cannabis and benzodiazepines. Notable are the many drivers having a BAC ≥ 1.3 g/L. The majority of the substances were found in combination with another psychoactive substance, mostly alcohol. The high prevalence......The objective of this study was to determine the presence of alcohol and drugs in drivers severely injured in traffic crashes in six European countries. Data were collected from 2492 seriously injured drivers of cars and vans in Belgium, Denmark, Finland, Italy, Lithuania, and the Netherlands...

  6. Single dose of inducible nitric oxide synthase inhibitor induces prolonged inflammatory cell accumulation and fibrosis around injured tendon and synovium.

    Darmani, Homa; Crossan, James C; Curtis, Adam

    2004-06-01

    The aim of the current study was to investigate the effect of inhibition of nitric oxide (NO) production after injury on inflammatory cell accumulation and fibrosis around digital flexor tendon and synovium. A standard crush injury was applied to the flexor tendons of the middle digit of the hindpaw and the overlying muscle and synovium of female Wistar rats. Thirty animals received an intraperitoneal injection of either isotonic saline or N(G)-nitro-l-arginine methyl ester (L-NAME; 5 mg/kg) immediately following the crush injury, and five animals were then sacrificed at various intervals and the paws processed for histology. Another group of five animals was sacrificed after 3 days for nitrite determinations. The results showed that nitrite production and hence NO synthase activity is doubled at the acute phase of tendon wound healing, and we can prevent this by administering a single dose of L-NAME immediately after injury. The incidence and severity of fibrocellular adhesions between tendon and synovium was much more marked in animals treated with L-NAME. Treatment with L-NAME elicited a chronic inflammatory response characterised by a persistent and extraordinarily severe accumulation of large numbers of inflammatory cells in the subcutaneous tissues, in muscle and in tendon. These findings indicate that in the case of injured tendon and synovium, NO could act to protect the healing tissue from an uncontrolled inflammatory response. PMID:15223606

  7. Migration and distribution of bone marrow stromal cells in injured spinal cord with different transplantation techniques

    FAN Li; DU Fei; CHENG Bang-chang; PENG Hao; LIU Shi-qing

    2008-01-01

    To study the regularity of migration and distribution of bone marrow stromal cells (BMSCs)in iniured spinal cord with intradural space transplantation.Methods:Forty Wistar rats were randomly assigned into 4 groups. The spinal cord injury,model was prepared according to the modified Allen method. BMSCs were labeled by CM-Dil. And 5.0×10 6 cells were transplanted by different channels including intraventricular injection(Group A),injured spinal cord intrathecally injection(Group B),remote intrathecally injection at the L3-L4 level(Group C),and intravenous injection(Group D). Spinal cord was dissected at 24 hours,1,2,3 and 4 weeks after transplantation.Sections of 4 μm were cut on a cryostat and observed under fluorescence microscopy.Results:No fluorescence was observed 24 hours after transplantation in spinal cord injury parenchyma except Group B. One week later,BMSCs in Groups A and C began to migrate to the injured parenchyma;2-4 weeks later,BMSCs penetrated into the injured parenchyma except Group D.The number of BMSCS decreased at 3-4 weeks after transplantation. The number of cells in Group B decreased faster than that of Groups A and C.Conclusions:BMSCs transplanted through intraventricular injection,injured spinal cord intrathecally injection and remote intrathecal injection could migrate to the injured parenchyma of spinal cord effectively. The number of BMSCs migrated into injured spinal cord parenchyma is rare by intravenous injection.

  8. Robust Axonal Regeneration Occurs in the Injured CAST/Ei Mouse CNS

    Omura, T; Omura, K.; Tedeschi, A; Riva, P; Painter, MW; L. Rojas; Martin, J.; Lisi, V; Huebner, EA; Latremoliere, A; Yin, Y.; Barrett, LB; Singh, B; Lee, S.; Crisman, T

    2015-01-01

    © 2015 Elsevier Inc. Axon regeneration in the CNS requires reactivating injured neurons' intrinsic growth state and enabling growth in an inhibitory environment. Using an inbred mouse neuronal phenotypic screen, we find that CAST/Ei mouse adult dorsal root ganglion neurons extend axons more on CNS myelin than the other eight strains tested, especially when pre-injured. Injury-primed CAST/Ei neurons also regenerate markedly in the spinal cord and optic nerve more than those from C57BL/6 mice a...

  9. Arterial injures in open fractures of the leg; Uszkodzenia ukladu tetniczego w otwartych zlamaniach goleni

    Konarski, K. [Szpital im. J. Jonstona, Lublin (Poland)

    1993-12-31

    Patterns of arterial injures in open fractures of the leg are presented. It was noted, that union disorders and infection result from changes in both primarily pathological and only recently injured (compression or contusion) arteries. In 23 cases of 3 and 4 degree open fracture femoral arteriography has been performed. In 19 cases (84%) vascular injuries were detected. Most of the arteriographies carried out immediately after injury revealed compression and transposition of the leg arteries. Those cases are prone to develop subsequent arterial occlusion. (author). 19 refs, 6 figs.

  10. ACL reconstruction in sports active people: transtibial DB technique with ST/G vs. transtibial SB technique with BPTB: preliminary results.

    Volpi, Piero; Cervellin, Matteo; Denti, Matteo; Bait, Corrado; Melegati, Gianluca; Quaglia, Alessandro; de Girolamo, Laura

    2010-11-01

    The single-bundle ACL reconstruction ensures good outcomes and it is a well-established and widespread technique. Nevertheless, some patients still present residual pain and instability. Recent studies have showed that the double-bundle technique restores better natural ACL-fitting kinematics. Long-term clinical studies comparing the two surgical techniques are not frequent and there is no instrument to evaluate function and kinematics during the knee rotation in vivo. In this randomised prospective study performed on sportive people, we compare the BPTB single-bundle ACL reconstruction technique, which is the most common surgical technique performed on these patients' category, with the ACL double-bundle reconstruction technique (DB), in order to evaluate possible differences between the groups. Comparing the two groups, no statistically significant difference regarding the post-operative Lysholm score (p=0.368) the Tegner activity scale (p=0.519) and the arthrometric evaluation with KT-1000 (p=0.74) have been observed. On the contrary, the IKDC evaluation showed a statistically significant difference (p=0.004) better results of the DB group. Moreover, as assessed by the Tegner activity scale, only patients of the DB group were able to return to sports at a pre-injury level. Our data suggest that the double bundle ST/G ACL reconstruction technique results into slightly better outcome than the traditional technique of single-bundle BPTB. The verification and quantification of the advantages of this technique is anticipated with future studies focusing to the accurate measurement of knee rotation during different activities. PMID:20934698

  11. Comparative adaptations of lower limb biomechanics during unilateral and bilateral landings after different neuromuscular-based ACL injury prevention protocols.

    Brown, Tyler N; Palmieri-Smith, Riann M; McLean, Scott G

    2014-10-01

    Potentially valuable anterior cruciate ligament (ACL) injury prevention strategies are lengthy, limiting training success. Shorter protocols that achieve beneficial biomechanical adaptations may improve training effectiveness. This study examined whether core stability/balance and plyometric training can modify female landing biomechanics compared with the standard neuromuscular and no training models. Forty-three females had lower limb biomechanics analyzed during unilateral and bilateral landings immediately before and after a 6-week neuromuscular or no training programs. Sagittal and frontal plane hip and knee kinematics and kinetics were submitted to 3-way repeated-measures analyses of variance to test for the main and interaction effects of training group, landing type, and testing time. Greater peak knee flexion was evident in the standard neuromuscular group following training, during both bilateral (p = 0.027) and unilateral landings (p = 0.076 and d = 0.633). The plyometric group demonstrated reduced hip adduction (p = 0.010) and greater knee flexion (p = 0.065 and d = 0.564) during bilateral landings following training. The control group had significant reduction in peak stance knee abduction moment (p = 0.003) posttraining as compared with pretraining. The current outcomes suggest that significant biomechanical changes are possible by an isolated plyometric training component. The benefits, however, may not be evident across all landing types, seemingly limited to simplistic, bilateral landings. Integrated training protocols may still be the most effective training model, currently improving knee flexion posture during both bilateral and unilateral landings following training. Future prevention efforts should implement integrated training protocols that include plyometric exercises to reduce ACL injury risk of female athletes. PMID:24714537

  12. 20 CFR 10.730 - What are the conditions of coverage for Peace Corps volunteers and volunteer leaders injured...

    2010-04-01

    ... Corps volunteers and volunteer leaders injured while serving outside the United States? 10.730 Section... Corps volunteers and volunteer leaders injured while serving outside the United States? (a) Any injury sustained by a volunteer or volunteer leader while he or she is located abroad shall be presumed to...

  13. The role of cystatin C in vascular remodeling of balloon-injured abdominal aorta of rabbits.

    Wu, Xiang-Jun; Dong, Zhao-Qiang; Lu, Qing-Hua

    2014-09-01

    This study aimed to evaluate the role of cystatin C (CysC) in the vascular remodeling of balloon-injured abdominal aorta of rabbits. Forty-eight New Zealand white rabbits were randomly divided into three groups: the balloon-injured injury group (n = 16), the CysC monoclonal antibody group (n = 16), and the sham-operative group (n = 16). Serum CysC levels were detected by enzyme linked immunosorbent assay. Changes in adventitial area, adventitial thickness, lumen area (LA), neointimal area (IA), internal elastic lamina area (IELA), external elastic lamina area (EELA), vascular remodeling index (VRI) and residual stenosis (RS) were measured by the Leica image analysis system. Immunohistochemical analysis of α-smooth muscle actin (α-SMA) and proliferating cell nuclear antigen (PCNA) were performed. Serum CysC levels of rabbits in the balloon-injured injury group were significantly higher than those in the CysC monoclonal antibody group and the sham-operative group (both P IA, IELA and EELA in the balloon-injured injury group were also higher than those in the CysC monoclonal antibody and sham-operative groups (all P rabbits. PMID:24981928

  14. First clinical experience with intranasal cooling for hyperthermia in brain-injured patients

    Springborg, Jacob Bertram; Springborg, Karoline Kanstrup; Romner, Bertil

    2013-01-01

    Hyperthermia is common in brain-injured patients and associated with a worse outcome. As brain rather than body temperature reduction, theoretically, is the most important in cerebral protection, there is logic in targeting cooling at the brain. Selective brain cooling can, in theory, be obtained...

  15. Key Considerations for Using No-Harm Contracts with Clients Who Self-Injure

    Hyldahl, Rebecca S.; Richardson, Brent

    2011-01-01

    One of the more controversial issues in working with people who self-injure is whether counselors should use no-harm contracts. Important therapeutic considerations include the efficacy of such contracts or agreements in preventing self-injury, the emotional and behavioral responses of clients, and the perceived protection these contracts or…

  16. Differences in kinetic variables between injured and noninjured novice runners : A prospective cohort study

    Bredeweg, Steef W.; Kluitenberg, Bas; Bessem, Bram; Buist, Ida

    2013-01-01

    Objectives: This prospective study examined differences in kinetic variables between injured and noninjured novice female and male runners and their potential contribution to RRIs. Design: A prospective cohort study. Methods: At baseline vertical ground reaction forces were assessed with an instrume

  17. Injury, imagery, and self-esteem in dance healthy minds in injured bodies?

    Nordin-Bates, Sanna M; Walker, Imogen J; Baker, Jo; Garner, Jocelyn; Hardy, Cinzia; Irvine, Sarah; Jola, Corinne; Laws, Helen; Blevins, Peta

    2011-06-01

    The purpose of this study was to investigate a selection of psychological variables (help-seeking behaviors, mental imagery, self-esteem) in relation to injury among UK dancers. We recruited 216 participants from eight dance styles and six levels of involvement. It was found that 83.5% of the participants had experienced at least one injury in the past year. The most common response to injury was to inform someone, and most continued to dance when injured, albeit carefully. Physical therapy was the most common treatment sought when an injury occurred (38.1%), and dancers seemed to follow recommendations offered. Injured and non-injured dancers did not differ in their imagery frequencies (facilitative, debilitative, or injury-related) and scored similarly (and relatively high) in self-esteem. Neither facilitative nor debilitative imagery was correlated with self-esteem, but dancers who engaged in more facilitative imagery in general also reported doing so when injured. Altogether, it appears that injury is not related to dancers' self-esteem or imagery, at least not when injuries are mild or moderate. Even so, such conclusions should be made with caution, given that most dancers do sustain at least one injury each year. PMID:21703096

  18. Comparison of supplements to enhance recovery of heat-injured Salmonella from egg albumen

    The recovery of Salmonella from liquid egg white (LEW) is complicated by thermal and innate LEW antimicrobial-induced injury. Numerous supplements have been reported to promote the recovery of injured bacteria. The purpose of this study was to determine the efficacy of twelve media supplements to af...

  19. Sites of inhibition of mitochondrial electron transport in macrophage-injured neoplastic cells.

    Granger, D L; Lehninger, A L

    1982-11-01

    Previous work has shown that injury of neoplastic cells by cytotoxic macrophages (CM) in cell culture is accompanied by inhibition of mitochondrial respiration. We have investigated the nature of this inhibition by studying mitochondrial respiration in CM-injured leukemia L1210 cells permeabilized with digitonin. CM-induced injury affects the mitochondrial respiratory chain proper. Complex I (NADH-coenzyme Q reductase) and complex II (succinate-coenzyme Q reductase) are markedly inhibited. In addition a minor inhibition of cytochrome oxidase was found. Electron transport from alpha-glycerophosphate through the respiratory chain to oxygen is unaffected and permeabilized CM-injured L1210 cells oxidizing this substrate exhibit acceptor control. However, glycerophosphate shuttle activity was found not to occur within CM-injured or uninjured L1210 cells in culture hence, alpha-glycerophosphate is apparently unavailable for mitochondrial oxidation in the intact cell. It is concluded that the failure of respiration of intact neoplastic cells injured by CM is caused by the nearly complete inhibition of complexes I and II of the mitochondrial electron transport chain. The time courses of CM-induced electron transport inhibition and arrest of L1210 cell division are examined and the possible relationship between these phenomena is discussed. PMID:6292238

  20. Analysis of the Completion of the Certificate of First Medical Assistance to an Injured Person

    Manuel Rodríguez González

    2014-02-01

    Full Text Available Background: the certificate of first medical assistance to an injured person is a medicolegal document that every medical professional should know how to complete. Any problem with the data requested in this form can cause a number of limitations on the prosecution of injury-related offenses. Objective: to characterize the process for completing the certificate of first medical assistance to an injured person. Methods: A descriptive cross-sectional study was conducted at the consultation for injured patients in the province of Cienfuegos, in the year 2012. A total of 2189 certificates were analyzed considering: medical specialty, level of care and data required in the document. Results: over 50% of the certificates issued had problems in their completion; the most frequent was non-detailed description of the lesions, present in 329 certificates (27.7%, followed by inaccurate medicolegal prognosis in 298 certificates (25.1%. Specialists in General Medicine issued the largest number of certificates and 100% of them had problems. Conclusion: attending physicians lack scientific and methodological criteria for accurately completing the certificates of first medical assistance to an injured person.

  1. Efficient delivery of small interfering RNA into injured spinal cords in rats by photomechanical waves

    Ando, Takahiro; Sato, Shunichi; Toyooka, Terushige; Kobayashi, Hiroaki; Nawashiro, Hiroshi; Ashida, Hiroshi; Obara, Minoru

    2011-03-01

    In the central nervous system, lack of axonal regeneration leads to permanent functional disabilities. In spinal cord injury (SCI), the over-expressions of intermediate filament (IF) proteins, such as glial fibrillary acidic protein (GFAP) and vimentin, are mainly involved in glial scar formation; these proteins work as both physical and biochemical barriers to axonal regeneration. Thus, silencing of these IF proteins would be an attractive strategy to treat SCI. In this study, we first attempted to deliver fluorescent probe-labeled siRNAs into injured spinal cords in rats by applying photomechanical waves (PMWs) to examine the capability of PMWs as a tool for siRNA delivery. Intense fluorescence from siRNAs was observed in much broader regions in the spinal cords with PMW application when compared with those with siRNA injection alone. Based on this result, we delivered siRNAs for GFAP and vimentin into injured spinal tissues in rats by applying PMWs. The treatment resulted in efficient silencing of the proteins at five days after SCI and a decrease of the cavity area in the injured tissue at three weeks after SCI when compared with those with siRNA injection alone. These results demonstrate the capability of PMWs for efficient delivery of siRNAs into injured spinal cords and treatment of SCIs.

  2. Protective effects of paroxetine on the lipopolysaccharide injured hippocampal-derived neural stem cell

    彭正午

    2013-01-01

    Objective To investigate the effects of paroxetine on the cell viability and expression of the phosphorylated ERK1/2 in lipopolysaccharide LPS injured hippocampalderived neural stem cells (NSCs) .Methods The NSCs were derived from hippocampus of fetal rats,after the

  3. Survival benefit of physician-staffed Helicopter Emergency Medical Services (HEMS) assistance for severely injured patients

    D. den Hartog (Dennis); J. Romeo (Jamie); A.N. Ringburg (Akkie); M.H.J. Verhofstad (Michiel); E.M.M. van Lieshout (Esther)

    2015-01-01

    markdownabstractBackground: Physician-staffed Helicopter Emergency Medical Services (HEMS) provide specialist medical care to the accident scene and aim to improve survival of severely injured patients. Previous studies were often underpowered and showed heterogeneous results, leaving the subject at

  4. Augmentation by 4-aminopyridine of vestibulospinal free fall responses in chronic spinal-injured cats.

    Blight, A R; Gruner, J A

    1987-12-01

    This study examines the effect of the potassium channel blocker 4-aminopyridine (4-AP) on free fall responses (FFR) in the hindlimb muscles of chronically spinal injured cats. The thoracic spinal cord of 7 adult female cats was injured by a standardized contusion method. At 3-7 months post-injury the FFR in 6 hindlimb muscles was recorded electromyographically in each animal, under ketamine sedation. The normal short-latency response to a sudden drop was severely attenuated in all injured animals and practically undetectable in 2 cases. Within 15 min following intravenous administration of 1 mg/kg 4-AP, there was profound augmentation of the amplitude of the FFR and a tendency toward normalization of latency in all animals, though the normal amplitude range was not attained. The same 4-AP dose produced a relatively small increase of FFR amplitude in only 2 of 4 normal, uninjured animals tested. The data are consistent with previous observations that low doses of 4-AP restore conduction in some critically demyelinated axons, and provide support for the hypothesis that conduction block in surviving axons is responsible for a proportion of the dysfunction in chronic spinal injury. Augmentation of FFR in injured animals may also result partly from increased transmitter release in both spinal cord and periphery, due to the presynaptic effects of 4-AP. PMID:2831307

  5. Demographic Profile and Athletic Identity of Traumatic Spinal Cord Injured Wheelchair Basketball Athletes in Greece

    Vasiliadis, Angelo; Evaggelinou, Christina; Avourdiadou, Sevastia; Grekinis, Petros

    2010-01-01

    An epidemiological study conducted across the country of Greece was conducted in order to determine the profile and the athletic identity of spinal cord injured (SCI) wheelchair basketball athletes who participated to the 13th Greek Wheelchair Basketball Championship and Cup. The Disability Sport Participation questionnaire was used for data…

  6. Imaging corticospinal tract connectivity in injured rat spinal cord using manganese-enhanced MRI

    Manganese-enhanced MRI (MEI) offers a novel neuroimaging modality to trace corticospinal tract (CST) in live animals. This paper expands this capability further and tests the utility of MEI to image axonal fiber connectivity in CST of injured spinal cord (SC). A rat was injured at the thoracic T4 level of the SC. The CST was labeled with manganese (Mn) injected intracortically at two weeks post injury. Next day, the injured SC was imaged using MEI and diffusion tensor imaging (DTI) modalities. In vivo MEI data obtained from cervical SC confirmed that CST was successfully labeled with Mn. Ex vivo MEI data obtained from excised SC depicted Mn labeling of the CST in SC sections caudal to the lesion, which meant that Mn was transported through the injury, possibly mediated by viable CST fibers present at the injury site. Examining the ex vivo data from the injury epicenter closely revealed a thin strip of signal enhancement located ventrally between the dorsal horns. This enhancement was presumably associated with the Mn accumulation in these intact fibers projecting caudally as part of the CST. Additional measurements with DTI supported this view. Combining these preliminary results collectively demonstrated the feasibility of imaging fiber connectivity in experimentally injured SC using MEI. This approach may play important role in future investigations aimed at understanding the neuroplasticity in experimental SCI research

  7. Comparison of supplements to enhance recovery of thermally-injured Salmonella from liquid egg white

    The recovery of Salmonella from liquid egg white (LEW) is complicated by thermal and innate LEW antimicrobial-induced injury. Numerous supplements have been reported to promote the recovery of injured bacteria. The purpose of this study was to determine the efficacy of twelve media supplements to ...

  8. E-Message Boards for Those Who Self-Injure: Implications for E-Health

    Johnson, Genevieve Marie; Zastawny, Sylvia; Kulpa, Anastasia

    2010-01-01

    Virtual communities for those who self-injure (SI) are increasingly popular and involve Internet communication technologies including e-message boards. The social and emotional support of an accepting virtual community may facilitate individual recovery from SI. Via self-report data, this study describes individuals who participate in virtual…

  9. A peptide for targeted, systemic delivery of imaging and therapeutic compounds into acute brain injuries

    Mann, Aman P.; Scodeller, Pablo; Hussain, Sazid; Joo, Jinmyoung; Kwon, Ester; Braun, Gary B.; Mölder, Tarmo; She, Zhi-Gang; Kotamraju, Venkata Ramana; Ranscht, Barbara; Krajewski, Stan; Teesalu, Tambet; Bhatia, Sangeeta; Sailor, Michael J.; Ruoslahti, Erkki

    2016-06-01

    Traumatic brain injury (TBI) is a major health and socio-economic problem, but no pharmacological agent is currently approved for the treatment of acute TBI. Thus, there is a great need for advances in this field. Here, we describe a short peptide (sequence CAQK) identified by in vivo phage display screening in mice with acute brain injury. The CAQK peptide selectively binds to injured mouse and human brain, and systemically injected CAQK specifically homes to sites of brain injury in mouse models. The CAQK target is a proteoglycan complex upregulated in brain injuries. Coupling to CAQK increased injury site accumulation of systemically administered molecules ranging from a drug-sized molecule to nanoparticles. CAQK-coated nanoparticles containing silencing oligonucleotides provided the first evidence of gene silencing in injured brain parenchyma by systemically administered siRNA. These findings present an effective targeting strategy for the delivery of therapeutics in clinical management of acute brain injuries.

  10. Soluble axoplasm enriched from injured CNS axons reveals the early modulation of the actin cytoskeleton.

    Patrick Garland

    Full Text Available Axon injury and degeneration is a common consequence of diverse neurological conditions including multiple sclerosis, traumatic brain injury and spinal cord injury. The molecular events underlying axon degeneration are poorly understood. We have developed a novel method to enrich for axoplasm from rodent optic nerve and characterised the early events in Wallerian degeneration using an unbiased proteomics screen. Our detergent-free method draws axoplasm into a dehydrated hydrogel of the polymer poly(2-hydroxyethyl methacrylate, which is then recovered using centrifugation. This technique is able to recover axonal proteins and significantly deplete glial contamination as confirmed by immunoblotting. We have used iTRAQ to compare axoplasm-enriched samples from naïve vs injured optic nerves, which has revealed a pronounced modulation of proteins associated with the actin cytoskeleton. To confirm the modulation of the actin cytoskeleton in injured axons we focused on the RhoA pathway. Western blotting revealed an augmentation of RhoA and phosphorylated cofilin in axoplasm-enriched samples from injured optic nerve. To investigate the localisation of these components of the RhoA pathway in injured axons we transected axons of primary hippocampal neurons in vitro. We observed an early modulation of filamentous actin with a concomitant redistribution of phosphorylated cofilin in injured axons. At later time-points, RhoA is found to accumulate in axonal swellings and also colocalises with filamentous actin. The actin cytoskeleton is a known sensor of cell viability across multiple eukaryotes, and our results suggest a similar role for the actin cytoskeleton following axon injury. In agreement with other reports, our data also highlights the role of the RhoA pathway in axon degeneration. These findings highlight a previously unexplored area of axon biology, which may open novel avenues to prevent axon degeneration. Our method for isolating CNS axoplasm

  11. Acute pancreatitis

    ... page: //medlineplus.gov/ency/article/000287.htm Acute pancreatitis To use the sharing features on this page, ... fatty foods after the attack has improved. Outlook (Prognosis) Most cases go away in a week. However, ...

  12. Acute Pericarditis

    ... Sugar Control Helps Fight Diabetic Eye Disease Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... cancer, or heart surgery, the fluid is blood. Causes Acute pericarditis usually results from infection or other ...

  13. Acute dyspnea

    Radiodiagnosis is applied to determine the causes of acute dyspnea. Acute dyspnea is shown to aggravate the course of pulmonary diseases (bronchial asthma, obstructive bronchitis, pulmonary edema, throboembolism of pulmonary arteries etc) and cardiovascular diseases (desiseas of myocardium). The main tasks of radiodiagnosis are to determine volume and state of the lungs, localization and type of pulmonary injuries, to verify heart disease and to reveal concomitant complications

  14. Bronchitis (acute)

    Wark, Peter

    2008-01-01

    Acute bronchitis, with transient inflammation of the trachea and major bronchi, affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.A third of people may have longer-term symptoms or recurrence.

  15. Post-exercise dynamics of serum amyloid A blood concentration in thoroughbred horses classified as injured and non-injured after the race.

    Turlo, A; Cywinska, A; Czopowicz, M; Witkowski, L; Szarska, E; Winnicka, A

    2015-06-01

    The aim of this study was to evaluate serum amyloid A (SAA) concentration in horses with orthopedic injuries acquired during racing and in healthy ones after completing the race. Injuries of bone and tendon did not cause radical increase in SAA concentration observed in other inflammatory conditions. SAA concentration correlated positively with white blood cell count (WBC) on the 3rd-4th days after race being significantly higher in the injured horses than in the control group in that time. It was suggested that racing effort may cause increase in SAA level, more pronounced in horses manifesting clinical signs of orthopedic injury after the race. PMID:25933933

  16. Acute tears of the anterior cruciate ligament: analysis of the tear site and the degree using MR imaging

    Jin, Uk; Ryu, Kyung Nam; Kim, Eui Jong; Yoon, Yup; Ahn, Jin Whan [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1995-05-15

    To evaluate the sensitivity of MR imaging in determining tear sites and degrees in acute anterior cruciate ligament tear. MR imagings were undertaken in 19 patients who had trauma on their knee joints. All imaging studies were performed within 2 weeks after trauma and compared with operative findings. The degree of ligament tear were divided into complete and incomplete, and sites of tears were divided into superior, middle and inferior portions. MR findings were compared with operative findings. There were 14 cases of complete ligament tear and 5 cases of partial ligament tear. We could diagnose correctly in all 14 cases with complete tear and in 3 of 5 cases with partial tear. The tear sites were correctly predicted in 10 of 14 cases with complete tear(71%) and 1 of 5 cases with partial tear(20%). In complete tears, MR findings were transversely or obliquely coursed band-like high signal intensity within the ACL or abrupt switch over to as indistinct signal intensity. In partial tears, the tear sites could not be evaluated mostly and the tear appeared as linear low signal intensity lesions in posterolateral bundles of ACL. MR revealed higher sensitivity in determining the degree and sites of ACL tear in complete tear as compared with partial tear.

  17. Acute tears of the anterior cruciate ligament: analysis of the tear site and the degree using MR imaging

    To evaluate the sensitivity of MR imaging in determining tear sites and degrees in acute anterior cruciate ligament tear. MR imagings were undertaken in 19 patients who had trauma on their knee joints. All imaging studies were performed within 2 weeks after trauma and compared with operative findings. The degree of ligament tear were divided into complete and incomplete, and sites of tears were divided into superior, middle and inferior portions. MR findings were compared with operative findings. There were 14 cases of complete ligament tear and 5 cases of partial ligament tear. We could diagnose correctly in all 14 cases with complete tear and in 3 of 5 cases with partial tear. The tear sites were correctly predicted in 10 of 14 cases with complete tear(71%) and 1 of 5 cases with partial tear(20%). In complete tears, MR findings were transversely or obliquely coursed band-like high signal intensity within the ACL or abrupt switch over to as indistinct signal intensity. In partial tears, the tear sites could not be evaluated mostly and the tear appeared as linear low signal intensity lesions in posterolateral bundles of ACL. MR revealed higher sensitivity in determining the degree and sites of ACL tear in complete tear as compared with partial tear

  18. Macrophage activation by factors released from acetaminophen-injured hepatocytes: Potential role of HMGB1

    Toxic doses of acetaminophen (AA) cause hepatocellular necrosis. Evidence suggests that activated macrophages contribute to the pathogenic process; however, the factors that activate these cells are unknown. In these studies, we assessed the role of mediators released from AA-injured hepatocytes in macrophage activation. Treatment of macrophages with conditioned medium (CM) collected 24 hr after treatment of mouse hepatocytes with 5 mM AA (CM-AA) resulted in increased production of reactive oxygen species (ROS). Macrophage expression of heme oxygenase-1 (HO-1) and catalase mRNA was also upregulated by CM-AA, as well as cyclooxygenase (COX)-2 and 12/15-lipoxygenase (LOX). CM-AA also upregulated expression of the proinflammatory chemokines, MIP-1α and MIP-2. The effects of CM-AA on expression of COX-2, MIP-1α and MIP-2 were inhibited by blockade of p44/42 MAP kinase, suggesting a biochemical mechanism mediating macrophage activation. Hepatocytes injured by AA were found to release HMGB1, a potent macrophage activator. This was inhibited by pretreatment of hepatocytes with ethyl pyruvate (EP), which blocks HMGB1 release. EP also blocked CM-AA induced ROS production and antioxidant expression, and reduced expression of COX-2, but not MIP-1α or MIP-2. These findings suggest that HMGB1 released by AA-injured hepatocytes contributes to macrophage activation. This is supported by our observation that expression of the HMGB1 receptor RAGE is upregulated in macrophages in response to CM-AA. These data indicate that AA-injured hepatocytes contribute to the inflammatory environment in the liver through the release of mediators such as HMGB1. Blocking HMGB1/RAGE may be a useful approach to limiting classical macrophage activation and AA-induced hepatotoxicity. - Research Highlights: → These studies analyze macrophage activation by mediators released from acetaminophen-damaged hepatocytes. → Factors released from acetaminophen-injured hepatocytes induce macrophage ROS

  19. Kinetic and kinematic analysis of the lower extremities during a vertical drop-jump with and without an overhead target: Implications for ACL injury screening

    Bundegaard, André

    2013-01-01

    Former studies have indicated that knee valgus angles and -moments in a Vertical Drop-Jump (VDJ) can predict future Anterior Cruciate Ligament (ACL) injuries. The use of an overhead target has proved to improve effort on subjects tested. This may in turn result in a test, which challenges the dynamic knee control to a greater extent. The aims of the study were to investigate if: 1) Elite female handball and football and handball athletes improve jump-height in overhead-targe...

  20. Effects of Cardiorespiratory Fitness on Serum Ferritin Concentration and Incidence of Type 2 Diabetes: Evidence from the Aerobics Center Longitudinal Study (ACLS)

    Le, Tuan D.; Bae, Sejong; Ed Hsu, Chiehwen; Karan P. Singh; Blair, Steven N.; Shang, Ning

    2008-01-01

    BACKGROUND: Cardiorespiratory fitness (CRF) and physical activity (PA) are inversely related to the occurrence of type 2 diabetes (T2D). Both play an important role in reducing serum ferritin (SF) concentration. Increased SF concentration is considered a contributing factor for developing T2D. METHODS: The present cohort study investigated 5,512 adult participants enrolled in the Aerobics Center Longitudinal Study (ACLS) between 1995 and 2001. The subjects completed a comprehensive medical ex...

  1. Acute myelogenous leukemia (AML) - children

    Acute myelogenous leukemia - children; AML; Acute myeloid leukemia - children; Acute granulocytic leukemia - children; Acute myeloblastic leukemia - children; Acute non-lymphocytic leukemia (ANLL) - children

  2. Whole Body Vibration Exercise Protocol versus a Standard Exercise Protocol after ACL Reconstruction: A Clinical Randomized Controlled Trial with Short Term Follow-Up

    Gereon Berschin

    2014-09-01

    Full Text Available The suitability and effectiveness of whole body vibration (WBV exercise in rehabilitation after injury of the anterior cruciate ligament (ACL was studied using a specially designed WBV protocol. We wanted to test the hypothesis if WBV leads to superior short term results regarding neuromuscular performance (strength and coordination and would be less time consuming than a current standard muscle strengthening protocol. In this prospective randomized controlled clinical trial, forty patients who tore their ACL and underwent subsequent ligament reconstruction were enrolled. Patients were randomized to the whole body vibration (n=20 or standard rehabilitation exercise protocol (n=20. Both protocols started in the 2nd week after surgery. Isometric and isokinetic strength measurements, clinical assessment, Lysholm score, neuromuscular performance were conducted weeks 2, 5, 8 and 11 after surgery. Time spent for rehabilitation exercise was reduced to less than a half in the WBV group. There were no statistically significant differences in terms of clinical assessment, Lysholm score, isokinetic and isometric strength. The WBV group displayed significant better results in the stability test. In conclusion, preliminary data indicate that our whole body vibration muscle exercise protocol seems to be a good alternative to a standard exercise program in ACL-rehabilitation. Despite of its significant reduced time requirement it is at least equally effective compared to a standard rehabilitation protocol.

  3. Expression of nitric oxide synthase and transforming growth factor-beta in crush-injured tendon and synovium

    Adam Curtis

    1992-01-01

    Full Text Available THIS study examined the expression of inducible nitric oxide synthase (iNOS and transforming growth factor-beta (TGF-β in macrophage infiltrates within crush-injured digital flexor tendon and synovium of control rats and rats treated with N(G-nitro-l-arginine methyl ester (L-NAME (5 mg/kg. Release of TGF-β from organ cultures of tendon, muscle, and synovium, and the effects of L-NAME treatment (in vitro and in vivo, on adhesion of peritoneal macrophages to epitenon monolayers were also investigated. The results showed that during normal tendon healing the levels of TGF-β are high at first and gradually decrease after 3 weeks of injury to slightly above control uninjured levels. However, when L-NAME was administered at the time of injury, the macrophage infiltrates were expressing high levels of TGF-β even at 5 weeks after the injury, with no evidence of reduction. In the standard injury, iNOS activity was greatest at the acute phase of the inflammatory response and then gradually returned to normal. Treatment with L-NAME, however, resulted in inhibition of iNOS activity at 3 days and a reduction in the activity at the later time points examined after injury. We also found greatly increased levels of adhesion of peritoneal macrophages from L-NAME-treated rats to epitenon monolayers in vitro, which reflect a chronic imbalance in expression of TGF-β, which is overexpressed, and nitric oxide, which is underexpressed. The results of the current study show that formation of nitric oxide is an important event in the course of tendon healing since its inhibition results in chronic inflammation and fibrosis due to an imbalance in TGF-β expression in vivo.

  4. Expression of nitric oxide synthase and transforming growth factor-beta in crush-injured tendon and synovium.

    Darmani, Horma; Crossan, James; McLellan, Sarah D; Meek, Dominic; Adam, Curtis

    2004-12-01

    This study examined the expression of inducible nitric oxide synthase (iNOS) and transforming growth factor-beta (TGF-beta) in macrophage infiltrates within crush-injured digital flexor tendon and synovium of control rats and rats treated with N(G)-nitro-1-arginine methyl ester (L-NAME) (5 mg/kg). Release of TGF-beta from organ cultures of tendon, muscle, and synovium, and the effects of L-NAME treatment (in vitro and in vivo), on adhesion of peritoneal macrophages to epitenon monolayers were also investigated. The results showed that during normal tendon healing the levels of TGF-beta are high at first and gradually decrease after 3 weeks of injury to slightly above control uninjured levels. However, when L-NAME was administered at the time of injury, the macrophage infiltrates were expressing high levels of TGF-beta even at 5 weeks after the injury, with no evidence of reduction. In the standard injury, iNOS activity was greatest at the acute phase of the inflammatory response and then gradually returned to normal. Treatment with L-NAME, however, resulted in inhibition of iNOS activity at 3 days and a reduction in the activity at the later time points examined after injury. We also found greatly increased levels of adhesion of peritoneal macrophages from L-NAME-treated rats to epitenon monolayers in vitro, which reflect a chronic imbalance in expression of TGF-beta, which is overexpressed, and nitric oxide, which is underexpressed. The results of the current study show that formation of nitric oxide is an important event in the course of tendon healing since its inhibition results in chronic inflammation and fibrosis due to an imbalance in TGF-beta expression in vivo. PMID:15770044

  5. Effects of low-intensity pulsed ultrasound in repairing injured articular cartilage

    JIA Xiao-lin; CHEN Wen-zhi; ZHOU Kun; WANG Zhi-biao

    2005-01-01

    Objective: To investigate the effects of low-intensity pulsed ultrasound in repairing injured articular cartilage. Methods: Ten adult New Zealand rabbits with bilateral full-thickness osteochondral defects on the cartilage surface of intercondylar fossas were used in this study. The wounds in the left knees were treated with low-intensity pulsed ultrasound as the experimental group. The right knees received no treatment as the control group. All the animals were killed at 8 weeks after injury and the tissues in the wounds were collected for gross appearance grading, histological grading and proteoglycan quantity. Results: The scores of the gross appearance grades, histological grades and the optical density of toluidine blue of the tissues in the experimental group were significantly higher than those of the controls at 8 weeks after injury (P<0.05). Conclusions: Low-intensity pulsed ultrasound can accelerate the repair of injured articular cartilage.

  6. Co-culture of astrocytes with neurons from injured brain A time-dependent dichotomy

    Xiaojing Xu; Min Wang; Jing Liu; Jingya Lv; Yanan Hu; Huanxiang Zhang

    2011-01-01

    As supportive cells for neuronal growth and development, much effort has been devoted to the role of astrocytes in the normal state. However, the effect of the astrocytes after injury remains elusive. In the present study, neurons isolated from the subventricular zone of injured neonatal rat brains were co-cultured with astrocytes. After 6 days, these astrocytes showed a mature neuron-like appearance and the number of survivingneurons, primary dendrites and total branches was significantly higher than those at 3 days. The neurons began to shrink at 9 days after co-culture with shorter and thinner processes and the number of primary dendrites and total branches was significantly reduced. These experimental findings indicate that astrocytes in the injured brain promote the development of neurons in the early stages of co-culture while these cells reversely inhibit neuronal growth and development at the later states.

  7. Protective effect study of polysaccharides from tremella fuciformis on hematopoietic function in radiation-injured mice

    Objective: To study the protective effects of polysaccharides of Tremella fuciformis on hematopoietic function in radiation-injured mice. Methods; Colony-forming unit of spleen (CFU-S), number of nucleated cells in bone marrow (BMNC) and spleen index were used to investigated the effect of polysacharides from tremella fuciformis at 6 mg/kg, 12 mg/kg, 24 mg/kg on hematopoietic function of mice irradiated with 7.5 Gy 137Cs γ-rays. Results: On the 9 the day after irradiation compared with the negative control group number of nucleated cells in bone marrow, colony-forming unit of spleen and spleen index of mice have treated with polysaccharides from Tremella fuciformis intraperitoneally for three days prior to irradiation increased markedly. Conclusion: Polysaccharides of tremella fuciformis have protective effect on hematopoietic function of radiation-injured mice. (authors)

  8. Effects of brief intervention on subgroups of injured patients who drink at risk levels.

    Cochran, Gerald; Field, Craig; Foreman, Michael; Ylioja, Thomas; Brown, Carlos V R

    2016-06-01

    Alcohol-related injuries are a major source of admission for trauma care. Screening and brief intervention (SBI) for injured patients can result in decreased drinking and risk behaviors. It is not clear SBI is equally beneficial for all injured patients. A secondary data analysis of 553 patients admitted to two Level-1 trauma centers was conducted. Latent class analysis was used to identify patient subgroups based on injury-related risks and consequences of alcohol use. Intervention effects on drinking were examined among subgroups. Five subgroups were identified. Drinking improved in patients reporting multiple risks and injuries/accidents and drinking and driving. Patients that reported drinking and driving and taking foolish risks or fighting while drinking and taking foolish risks did not show improvements. Trauma centers may benefit from targeting interventions based on injury-related risks and consequences of alcohol use. Further research is needed to test bedside approaches for tailored interventions. PMID:26124071

  9. Intervening factors in attention flow of professionals injured by biological material

    Luana Cássia Miranda Ribeiro

    2014-06-01

    Full Text Available Objective: To describe the barriers and facilitator factors to follow the attention flow of professionals injured by biological material in the worker perspective. Method: Qualitative descriptive study with data collected through individual interviews with 18 injured workers, assisted in reference public units in the city of Goiânia. The content analysis was carried out with assistance of the ATLAS.ti 6.2 software, under the work organization and subjective perspectives. Results: From the interviews regarding the barriers and facilitator factors emerged the categories: organizational structure, Support from close people, and Knowledge influence. Conclusion: The organized services have enabled more qualified consultations and the workers follow-up, which caused a satisfaction feeling in relation to the working environment.

  10. Central sensitization in spinal cord injured humans assessed by reflex receptive fields

    Biurrun Manresa, José Alberto; Finnerup, Nanna Susanne Brix; Johannesen, Inger Lauge; Biering-Sørensen, Fin; Jensen, Troels Staehelin; Arendt-Nielsen, Lars; Andersen, Ole Kæseler

    2014-01-01

    OBJECTIVE: To investigate the effects of central sensitization, elicited by intramuscular injection of capsaicin, by comparing the reflex receptive fields (RRF) of spinally-intact volunteers and spinal cord injured volunteers that present presensitized spinal nociceptive mechanisms. METHODS...... after an intramuscular injection of capsaicin in the foot sole in order to induce central sensitization. RESULTS: Both groups presented RRF expansion and lowered NWR thresholds immediately after capsaicin injection, reflected by the enlargement of RRF sensitivity areas and RRF probability areas...

  11. Chondroitinase ABC Improves Basic and Skilled Locomotion in Spinal Cord Injured Cats

    Tester, Nicole J.; Howland, Dena R.

    2007-01-01

    Chondroitin sulfate proteoglycans (CSPGs) are upregulated in the central nervous system following injury. Chondroitin sulfate glycosaminoglycan (CS GAG) side chains substituted on this family of molecules contribute to the limited functional recovery following injury by restricting axonal growth and synaptic plasticity. In the current study, the effects of degrading CS GAGs with Chondroitinase ABC (Ch’ase ABC) in the injured spinal cords of adult cats were assessed. Three groups were evaluate...

  12. Memories of being injured and patients' care trajectory after physical trauma

    Bergbom Ingegerd; Plos Kaety; Ringdal Mona

    2008-01-01

    Abstract Background The purpose of this study was to acquire a deeper understanding of patients' memories of being injured and the trajectory of care before, during and after their Intensive Care Unit (ICU) stay. Methods Interviews were conducted with eighteen informants who after physical trauma had been cared for in the ICU. The interviews were analyzed by using a phenomenological hermeneutical method. Results The memories of injury during the trajectory of care are illustrated in a figure ...

  13. Bullet embolisation from injured inferior cava vein to the right ventricle

    Zenelaj, A; M Brati; Kerci, M

    2010-01-01

    Gunshot injuries of the human body challenge surgical teams in the emergency department. Since such injuries do not follow any rule, every patient should be considered a special case. Our case, of bullet embolism from injured inferior cava vein to the right heart ventricle is a rare one. Such cases make us be more alert for diagnosis and treatment of this kind of injury. Well equipped hospitals and experienced medical teams are necessary for successful outcome.

  14. In vivo pectin solubility in ripening and chill-injured tomato fruit

    Almeida, Domingos P. F.; Huber, Donald J.

    2008-01-01

    In vivo pectin solubility was examined in ripening and chill-injured tomato fruit with down-regulated polygalacturonase (PG, EC 3.2.1.15) activity and untransformed wild-type fruit by analyzing a pressure-extracted fluid of apoplastic origin. Pectin concentration in the apoplastic fluid increased threefold during ripening and was not affected by endogenous PG. In contrast, PG strongly affected pectin concentration in a bulk pericarp fluid obtained after tissue disruption. There was a 14-fo...

  15. Optimising diagnosis and treatment of coagulopathy in severely injured trauma patients

    Balvers, K

    2016-01-01

    Trauma has a profound impact on public health around the world. Yearly approximately 5 million people die due to traumatic injury, which is 1 out of every 3 severely injured patients. Therefore, improving survival after trauma is a major challenge in which timely therapy is of great importance. In trauma patients, massive haemorrhage is one of the leading causes of mortality. Exsanguination accounts for more than 30% of mortality in trauma patients. The main part of the treatment of massive h...

  16. A Communitywide Intervention to Improve Outcomes and Reduce Disability among Injured Workers in Washington State

    Wickizer, Thomas M.; Franklin, Gary M.; Mootz, Robert D.; Fulton-Kehoe, Deborah; Plaeger-Brockway, Roy; Drylie, Diana; Turner, Judith A.; Smith-Weller, Terri

    2004-01-01

    One pressing challenge facing the U.S. health care system is the development of effective policies and clinical management strategies to address deficiencies in health care quality. In collaboration with researchers at the University of Washington, the Washington State Department of Labor and Industries has created a communitywide delivery system intervention to improve health outcomes and reduce disability among injured workers. This intervention is currently being tested in two sites in wes...

  17. A Crucial Role of Glycoprotein VI for Platelet Recruitment to the Injured Arterial Wall In Vivo

    Massberg, Steffen; Gawaz, Meinrad; Grüner, Sabine; Schulte, Valerie; Konrad, Ildiko; Zohlnhöfer, Dietlind; Heinzmann, Ulrich; Nieswandt, Bernhard

    2003-01-01

    Platelet adhesion and aggregation at sites of vascular injury is crucial for hemostasis but may lead to arterial occlusion in the setting of atherosclerosis and precipitate diseases such as myocardial infarction. A current hypothesis suggests that platelet glycoprotein (GP) Ib interaction with von Willebrand factor recruits flowing platelets to the injured vessel wall, where subendothelial fibrillar collagens support their firm adhesion and activation. However, so far this hypothesis has not ...

  18. Axonal Transport Proteomics Reveals Mobilization of Translation Machinery to the Lesion Site in Injured Sciatic Nerve*

    Michaelevski, Izhak; Medzihradszky, Katalin F.; Lynn, Aenoch; Burlingame, Alma L.; Fainzilber, Mike

    2009-01-01

    Investigations of the molecular mechanisms underlying responses to nerve injury have highlighted the importance of axonal transport systems. To obtain a comprehensive view of the protein ensembles associated with axonal transport in injured axons, we analyzed the protein compositions of axoplasm concentrated at ligatures following crush injury of rat sciatic nerve. LC-MS/MS analyses of iTRAQ-labeled peptides from axoplasm distal and proximal to the ligation sites revealed protein ensembles tr...

  19. A cross-sectional study of psychological complaints and quality of life in severely injured patients

    Delft-Schreurs, C. C H M; Bergen, J.J.M.; Sande, P.; Verhofstad, Michiel; De Vries, J.; Jongh, M.A.C. de

    2013-01-01

    textabstractPurpose: The purpose of this study was to examine the incidence of psychological complaints and the relationship of these complaints with the quality of life (QOL) and accident- and patient-related factors among severely injured patients after the rehabilitation phase. Methods: Patients of 18 years or older with an injury severity score above 15 were included 15-53 months after their accident. Accident and patient characteristics were obtained from questionnaires and the trauma re...

  20. A powered lower limb orthosis for gait assistance in incomplete spinal cord injured subjects

    Font Llagunes, Josep Maria; Arroyo, Guillermo; Serrancolí, Gil; Romero, Francisco

    2011-01-01

    The paper deals with the mechanical design of a new active stance-control knee-ankle-foot orthosis (SCKAFO). The orthosis is intended to provide gait assistance for incomplete spinal cord injured patients that present functional hip muscles, but partially denervated knee and ankle muscles. It consists of a passive compliant joint that constrains ankle plantar flexion, along with a powered knee unit that prevents knee flexion during stance and controls flexion-extension du...

  1. STIMULATION OF REPARATIVE REGENERATION OF THE YOUNG RAT’S TIBIA INJURED BY SEVERE DEHYDRATION

    Ohienko M. M.; Bumeister V. I.

    2014-01-01

    In modern life trauma, along with cardiovascular and oncological diseases, is one of the three causes leading to mortality. Our aim was to study the reparative regeneration process in young animals (control group); in animals with stimulated severe degree of dehydration (experimental group) and general conditions to correct morphological changes of the injured tibiae caused by severe degree of dehydration (applying "SOLCOSERYL" drug). The experiment was conducted on yo...

  2. Cartilage metabolism in the injured and uninjured knee of the same patient.

    Dahlberg, L; Roos, H; Saxne, T.; Heinegård, D; Lark, M W; Hoerrner, L A; Lohmander, L.S.

    1994-01-01

    OBJECTIVE--To examine if unilateral knee injury affects the synovial fluid concentrations of aggrecan fragments, cartilage oligomeric matrix protein (COMP) fragments, stromelysin-1, and tissue inhibitor of metalloproteinases-1 (TIMP-1) in the contralateral uninjured knee. METHODS--Synovial fluids from the injured and uninjured knees were obtained at different times in a group of patients after unilateral knee trauma. Serum samples were obtained on the same occasion. Concentrations of aggrecan...

  3. Single Visit Apexification Procedure of a Traumatically Injured Tooth with a Novel Bioinductive Material (Biodentine)

    Bajwa, Navroop Kaur; Jingarwar, Mahesh Madhukar; Pathak, Anuradha

    2015-01-01

    ABSTRACT Aim of this article is to present a case wherein single visit apexification of a traumatically injured tooth was done with a bioactive material–Biodentine. An injury sustained between the ages of 6 and 14 can adversely affect pulpal health and interrupt root development. In these instances, apexification is generally the preferred treatment. A 10 years old male patient presented with coronal fracture of the left upper central incisor. Clinical and radiographic assessment showed negat...

  4. Assessment and detection of pain in noncommunicative severely brain-injured patients.

    Schnakers, Caroline; Chatelle, Camille; Majerus, Steve; Gosseries, Olivia; De Val, Marie; Laureys, Steven

    2010-01-01

    Detecting pain in severely brain-injured patients recovering from coma represents a real challenge. Patients with disorders of consciousness are unable to consistently or reliably communicate their feelings and potential perception of pain. However, recent studies suggest that patients in a minimally conscious state can experience pain to some extent. Pain monitoring in these patients is hence of medical and ethical importance. In this article, we will focus on the possible use of behavioral ...

  5. Repair of astrocytes, blood vessels, and myelin in the injured brain: possible roles of blood monocytes

    Jeong, Hey-Kyeong; Ji, Kyung-min; Kim, Jun; Jou, Ilo; Joe, Eun-hye

    2013-01-01

    Inflammation in injured tissue has both repair functions and cytotoxic consequences. However, the issue of whether brain inflammation has a repair function has received little attention. Previously, we demonstrated monocyte infiltration and death of neurons and resident microglia in LPS-injected brains (Glia. 2007. 55:1577; Glia. 2008. 56:1039). Here, we found that astrocytes, oligodendrocytes, myelin, and endothelial cells disappeared in the damage core within 1–3 d and then re-appeared at 7...

  6. Clinical outcome of conservative treatment of injured inferior alveolar nerve during dental implant placement

    Kim, Yoon-Tae; Pang, Kang-Mi; Jung, Hun-Jong; Kim, Soung-Min; Kim, Myung-Jin; Lee, Jong-Ho

    2013-01-01

    Objectives Infererior alveolar nerve (IAN) damage may be one of the distressing complications occurring during implant placement. Because of nature of closed injury, a large proportion is approached non-invasively. The purpose of this study was to analyze the outcomes of conservative management of the injured nerve during dental implant procedure. Materials and Methods Sixty-four patients of implant related IAN injury, who were managed by medication or observation from January 1997 to March 2...

  7. Prevalence and predictors of mental disorders in intentionally and unintentionally injured emergency centre patients

    van der Westhuizen, Claire; Wyatt, Gail; Williams, John K.; Stein, Dan J.; Sorsdahl, Katherine

    2014-01-01

    Little is known about the prevalence and predictors of mental disorders amongst injured emergency centre (EC) patients in low- and middle-income countries. Patients presenting with either an intentional or unintentional injury were recruited (n=200). Mental health, injury and psychological trauma histories were assessed. Descriptive statistics and logistic regressions were conducted and predictors for current mental disorder were identified. Diagnostic criteria for a current mental disorder, ...

  8. The effect of anterior cruciate ligament injury on bone curvature

    Hunter, D J; Lohmander, Stefan; Makovey, J;

    2014-01-01

    OBJECTIVE: Investigate the 5-year longitudinal changes in bone curvature after acute anterior cruciate ligament (ACL) injury, and identify predictors of such changes. METHODS: In the KANON-trial (ISRCTN 84752559), 111/121 young active adults with an acute ACL tear to a previously un-injured knee...... MR images. Curvature (mm(-1)) was determined for femur, tibia, medial/lateral femur, trochlea, medial/lateral tibia. Age, sex, treatment, BMI, meniscal injury, osteochondral fracture on baseline MR images were tested for association. RESULTS: Over 5 years, curvature decreased in each region (P < 0...

  9. Single-leg drop landing motor control strategies following acute ankle sprain injury.

    Doherty, C; Bleakley, C; Hertel, J; Caulfield, B; Ryan, J; Delahunt, E

    2015-08-01

    No research currently exists investigating the effect of acute injury on single-limb landing strategies. The aim of the current study was to analyze the coordination strategies of participants in the acute phase of lateral ankle sprain (LAS) injury. Thirty-seven participants with acute, first-time LAS and 19 uninjured participants completed a single-leg drop landing task on both limbs. Three-dimensional kinematic (angular displacement) and sagittal plane kinetic (moment-of-force) data were acquired for the joints of the lower extremity from 200 ms pre-initial contact (IC) to 200 ms post-IC. The peak magnitude of the vertical component of the ground reaction force (GRF) was also computed. Injured participants displayed a bilateral increase in hip flexion, with altered transverse plane kinematic profiles at the knee and ankle for both limbs (P < 0.05). This coincided with a reduction in the net-supporting flexor moment of the lower extremity (P < 0.05) and magnitude of the peak vertical GRF for the injured limb (21.82 ± 2.44 N/kg vs 24.09 ± 2.77 N/kg; P = 0.013) in injured participants compared to control participants. These results demonstrate that compensatory movement strategies are utilized by participants with acute LAS to successfully reduce the impact forces of landing. PMID:24975875

  10. MRI based volumetric assessment of knee cartilage after ACL-reconstruction, correlated with qualitative morphologic changes in the joint and with clinical outcome. Is there evidence for early posttraumatic degeneration?; MRT-basierte Knorpelvolumetrie nach Kreuzbandersatzplastik in Korrelation mit qualitativen Gelenkveraenderungen und dem klinischen Outcome. Gibt es Hinweise auf fruehzeitige posttraumatische degenerative Veraenderungen?

    Arnoldi, A.P.; Weckbach, S.; Horng, A.; Reiser, M. [Ludwig-Maximilians-Univ. Muenchen (Germany). Dept. of Clinical Radiology; Nussbickel, C. [Klinikum Garmisch-Partenkirchen (Germany). Dept. of Internal Medicine; Noebauer, I. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik; Zysk, S. [Orthopaedie Zentrum Groebenzell (Germany). Center of Orthopaedics; Glaser, C. [NYU Medical Center, New York, NY (United States). Dept. of Radiology

    2011-12-15

    Purpose: The purpose of this study was to analyze potential quantitative and qualitative changes of the knee cartilage and joint indicative of early posttraumatic OA 4 years after ACL-reconstruction and to correlate the MRI-findings with the clinical outcome (CO). Materials and Methods: 1.5 T MRI-scans were performed on 9 patients post-op and 4 years later. Using a high-resolution T 1-w-fs-FLASH-3D-sequence cartilage volume (cVol) and thickness (mTh) were quantified. Using standard PD-w fs and T 1-w sequences qualitative changes of the joint structures were analyzed based on the WORMS-score. CO was rated by an orthopaedic surgeon using Lysholm-score, OAK-score, Tegner-activity-score (TAS), and Arthrometer KT-1000 testing. Results: Mean changes of cVol were -1.8 % (range: -5.9 %; + 0.7 %) and of mTh -0.8 % (range: -3.0 %; + 1.1 %). No significant change (95 %-CI) could be identified for any compartment. Three patients developed new peripatellar ostheophytes, acute trauma related changes mostly decreased. Mean outcome of Lysholm-score and OAK-score were 90 pts and 86 pts, mean TAS was 4.3 pts. Average maximum tibial translation reached 5.2 mm comparing to 6.7 mm on the healthy contralateral side. Conclusion: Despite a tendency towards decreased cVol and mTh 4 years after ACL-reconstruction qMRI revealed no significant cartilage loss. Newly developing osteophytes did not match with the observed good CO. This small pilot study motivates future quantitative and qualitative-structural MRI-based assessment of articular cartilage and other joint structures in order to improve diagnostic tools for the detection of early OA. (orig.)

  11. BIOMECHANICAL STUDY OF TRANSCORTICAL OR TRANSTRABECULAR BONE FIXATION OF PATELLAR TENDON GRAFT WITH BIOABSORBABLE PINS IN ACL RECONSTRUCTION IN SHEEP

    Albano, Mauro Batista; Borges, Paulo César; Namba, Mario Massatomo; da Silva, João Luiz Vieira; de Assis Pereira Filho, Francisco; Filho, Edmar Stieven; Matias, Jorge Eduardo Fouto

    2015-01-01

    Objective: To determine the initial resistance of fixation using the Rigid Fix® system, and compare it with traditional fixation methods using metal interference screws; and to evaluate the resistance of the fixation with the rigid fix system when the rotational position of the bone block is altered in the interior of the femoral tunnel. Methods: forty ovine knee specimens (stifle joints) were submitted to anterior cruciate ligament reconstruction (ACL) using a bone-tendon-bone graft. In twenty specimens, the Rigid Fix method was used; this group was subdivided into two groups: ten knees the pins transfixed only the spongious area of the bone block, and ten for fixation passing through the layer of cortical bone. In the twenty remaining specimens, the graft was fixed with 9mm metal interference screws. Results: comparison of the RIGIDFIX® method with the metal interference screw fixation method did not show any statistically significant differences in terms of maximum load and rigidity; also, there were no statistically significant differences when the rotational position of the bone block was altered inside the femoral tunnel. For these evaluations, a level of significance of p < 0.017 was considered. Conclusion: fixation of the bone-tendon-bone graft with 2 bioabsorbable pines, regardless of the rotational position inside the femoral tunnel, gave a comparable fixation in terms of initial resistance to the metal interference screw, in this experimental model. PMID:27027081

  12. The Triage of Injured Patients: Mechanism of Injury, Regardless of Injury Severity, Determines Hospital Destination.

    Staudenmayer, Kristan; Wang, N Ewen; Weiser, Thomas G; Maggio, Paul; Mackersie, Robert C; Spain, David; Hsia, Renee Y

    2016-04-01

    The target rate for trauma undertriage is high as 30 to 40 per cent in many trauma systems. We hypothesized that high undertriage rates were due to the tendency to undertriage injured elderly patients and a growing elderly population. We conducted a retrospective analysis of all hospital visits in California using the Office of Statewide Health Planning and Development Database over a 5-year period. All hospital admissions and emergency department visits associated with injury were longitudinally linked. The primary outcome was triage pattern. Triage patterns were stratified across three dimensions: age, mechanism of injury, and access to care. A total of 60,182 severely injured patients were included in the analysis. Fall-related injuries were frequently undertriaged compared with injuries from motor vehicle collisions (MVCs) and penetrating trauma (52% vs 12% and 10%, respectively). This pattern was true for all age groups. Conversely, MVCs and penetrating traumas were associated with high rates of overtriage (>70% for both). In conclusion, in contrast to our hypothesis, we found that triage is largely determined by mechanism of injury regardless of injury severity. High rates of undertriage are largely due to the undertriage of fall-related injuries, which occurs in both younger and older adults. Patients injured after MVCs and penetrating trauma victims are brought to trauma centers regardless of injury severity, resulting in high rates of overtriage. These findings suggest an opportunity to improve trauma system performance. PMID:27097630

  13. [Unidimensionality of a functional measure for patient with an injured upper limb].

    Luquet, C; Chau, N; Nadif, M; Guillemin, F; Gavillot, C; Petry, D; Moreau, T; Bourgkard, E; Hecquet, B; André, J M; Mur, J M

    1996-06-01

    The construction of an instrument including a number of tests requires an analysis of its structure and its unidimensionality (which allows calculation of global score), and the determination of the difficulty level of various tests. This study examined a tool including 67 tests designed to evaluate the functional ability of patients with an injured upper limb. The patients seen in a rehabilitation centre during 12 months (173 subjects) were evaluated by the occupational therapists familiar with the tool. The statistical analyses were made using the principal component analysis method (PCAM), the Cronbach's coefficient and the Rasch model. The PCAM showed 3 principal factors which explained 44%, 10% and 4% of the total variance respectively in the case of patients with injured dominant limb. The predominance of the first axis and the high ratio of first by second eigenvalues suggested the unidimensionality of the tool. The Cronbach's value of 0.97 attested the good congruence of the items. The results obtained with the Rasch model seemed to be consistent with the hypothesis of the unidimensionality of the tool. This analysis also provided the difficulty scale of various tests. Similar results were obtained in patients with injured non dominant limb or with all the sample. The methods used provide complementary results. PMID:8766984

  14. Cross-Sectional Nakagami Images in Passive Stretches Reveal Damage of Injured Muscles

    Shih-Ping Lin

    2016-01-01

    Full Text Available Muscle strain is still awanting a noninvasive quantitatively diagnosis tool. High frequency ultrasound (HFU improves image resolution for monitoring changes of tissue structures, but the biomechanical factors may influence ultrasonography during injury detection. We aim to illustrate the ultrasonic parameters to present the histological damage of overstretched muscle with the consideration of biomechanical factors. Gastrocnemius muscles from mice were assembled and ex vivo passive stretching was performed before or after injury. After injury, the muscle significantly decreased mechanical strength. Ultrasonic images were obtained by HFU at different deformations to scan in cross and longitudinal orientations of muscle. The ultrasonography was quantified by echogenicity and Nakagami parameters (NP for structural evaluation and correlated with histological results. The injured muscle at its original length exhibited decreased echogenicity and NP from HFU images. Cross-sectional ultrasonography revealed a loss of correlation between NP and passive muscle stretching that suggested a special scatterer pattern in the cross section of injured muscle. The independence of NP during passive stretching of injured muscle was confirmed by histological findings in ruptured collagen fibers, decreased muscle density, and increased intermuscular fiber space. Thus, HFU analysis of NP in cross section represents muscle injury that may benefit the clinical diagnosis.

  15. Cerebral Blood Flow and Transcranial Doppler Sonography Measurements of CO(2)-Reactivity in Acute Traumatic Brain Injured Patients

    Reinstrup, Peter; Ryding, Erik Hilmer; Asgeirsson, Bogi; Hesselgard, Karin; Unden, Johan; Romner, Bertil

    2013-01-01

    BACKGROUND: Cerebral blood flow (CBF) measurements are helpful in managing patients with traumatic brain injury (TBI), and testing the cerebrovascular reactivity to CO(2) provides information about injury severity and outcome. The complexity and potential hazard of performing CBF measurements lim...

  16. Rapid washout of Tc-99m tetrofosmin between immediate and two-hour myocardial images in the injured but viable myocardium with impaired of fatty acid uptake

    The purpose of this study was to assess Tc-99m tetrofosmin (TF) kinetics in viable but injured myocardium in patients with acute myocardial infarction (AMI). Fourteen patients (11 males, 72±10 years) with AMI were studied. Ten patients undergoing successful reperfusion therapy and 4 treated medically. All patients showed viable but injured myocardium revealed as Tc-99m pyrophosphate (PYP) and thallium-201 (Tl) overlap lesions. PYP and Tl SPECT was performed 90 mins after injection of PYP 740 MBq and Tl 111 MBq by dual SPECT aquisition within 8 days from onset of AMI. Rest TF SPECT was performed 15 mins and 120 mins after injection of TF 740 MBq at one month after the onset of AMI. Rest I-123 betamethyl branched fatty acid (BMIPP) SPECT was performed 15 mins after injection of BMIPP 111 MBq at one month after the onset of AMI. All tracers activities were visually scored using a four-point grading system: 0=normal to 3=severe defect and a 17 segmental model. The lower cutoff level of PYP and Tl were 40% and 25%. Overlap lesions were defined as PYP positive and defect score of Tl was 0 to 2 in at least 2 segments. For quantitative analysis, the decay-corrected washout rate (WO) was calculated in each segment. The number of score deteriorated (tracer washout) segments and WO values were larger in overlap segments than PYP negative segments (34/69 vs 25/115, p<0.01, 18.6±11.6 vs 10.6±13.2, p<0.01). Ninety percents of the segments with high washout of TF showed decreased BMIPP uptake. One patient showed residual myocardium with endocardial fibrosis by the results of autopsy. Those patients with AMI after one month from the onset showed high washout, of TF and TF kinetics was modulated by intracellular calcium concentration as shown by PYP accumulation. (author)

  17. Fine structure of reactive cells in injured nervous tissue labeled with 3H-thymidine injected before injury

    To examine the fine structure of blood mononuclear cells in injured nervous tissue, mice were given repeated injections of 3H-thymidine. Under ether anesthesia the animals either were given a stab wound to the spinal cord or had their left hypoglossal nerve transected. Tissue sections were prepared for electron microscopic radioautography, and all labeled cells were photographed. About half the labeled cells in the injured spinal cords and almost all the labeled cells in the nuclei of the injured hypoglossal nerves had nuclei with dark staining peripheral heterochromatin, dark cytoplasm with long cisternae of granular endoplasmic reticulum, and other ultrastructural features characteristic of the cells usually identifed as microglia. The remaining labeled cells in the injured spinal cords were macrophages, fibroblasts, and vascular cells. Since uninjured nervous tissue has extremely few labeled cells, most of the labeled cells in this experiment should be derived from blood mononuclear cells

  18. The Relationship between Perceived Sleep Quality, Polysomnographic Measures and Depressive Symptoms in Chemically-Injured Veterans: A Pilot Study

    Davood Moshkani Farahani; Abbas Tavallaie; Ensieh Vahedi; Peyman Rezaiemaram; Zohreh Naderi; Akram Talaie

    2014-01-01

    Objective Sleep complaints are common among Iranian chemically-injured veterans. The growing body of research has investigated (in) equalities between such subjective complaints and objective sleep records. Moreover, sleep complaints are associated with depressive symptoms. Depressive symptoms, also, have been frequently reported in chemically-injured veterans. Therefore, the purpose of this pilot study was to investigate the relationship between perceived sleep quality, polysomnographic meas...

  19. Combined treatment with antioxidants and immunosuppressants on cytokine release by human peripheral blood mononuclear cells - chemically injured keratocyte reaction

    Yi, Kayoung; Chung, Tae Young; Hyon, Joon Young; Koh, Jae Woong; Wee, Won Ryang; Shin, Young Joo

    2011-01-01

    Purpose To investigate the effect of antioxidants and immunosuppresants on mixed peripheral blood mononuclear cells (PBMC) - chemically injured keratocytes reaction (MLKR). Methods The PBMC stimulation assay was performed using chemically injured keratocytes treated with 0.05 N NaOH for 90 s (MLKR). MLKR were treated with various drugs including rapamycin, dexamethasone, mycophenoleic acid (MPA), alpha lipoic acid (ALA), and N-acetyl cysteine (NAC). Matrix metalloprotease-9 (MMP-9), transform...

  20. Gamma knife irradiation of injured sciatic nerve induces histological and behavioral improvement in the rat neuropathic pain model.

    Yuki Yagasaki

    Full Text Available We examined the effects of gamma knife (GK irradiation on injured nerves using a rat partial sciatic nerve ligation (PSL model. GK irradiation was performed at one week after ligation and nerve preparations were made three weeks after ligation. GK irradiation is known to induce immune responses such as glial cell activation in the central nervous system. Thus, we determined the effects of GK irradiation on macrophages using immunoblot and histochemical analyses. Expression of Iba-1 protein, a macrophage marker, was further increased in GK-treated injured nerves as compared with non-irradiated injured nerves. Immunohistochemical study of Iba-1 in GK-irradiated injured sciatic nerves demonstrated Iba-1 positive macrophage accumulation to be enhanced in areas distal to the ligation point. In the same area, myelin debris was also more efficiently removed by GK-irradiation. Myelin debris clearance by macrophages is thought to contribute to a permissive environment for axon growth. In the immunoblot study, GK irradiation significantly increased expressions of βIII-tubulin protein and myelin protein zero, which are markers of axon regeneration and re-myelination, respectively. Toluidine blue staining revealed the re-myelinated fiber diameter to be larger at proximal sites and that the re-myelinated fiber number was increased at distal sites in GK-irradiated injured nerves as compared with non-irradiated injured nerves. These results suggest that GK irradiation of injured nerves facilitates regeneration and re-myelination. In a behavior study, early alleviation of allodynia was observed with GK irradiation in PSL rats. When GK-induced alleviation of allodynia was initially detected, the expression of glial cell line-derived neurotrophic factor (GDNF, a potent analgesic factor, was significantly increased by GK irradiation. These results suggested that GK irradiation alleviates allodynia via increased GDNF. This study provides novel evidence that GK

  1. Development of a repair-enrichment broth for resuscitation of heat-injured Listeria monocytogenes and Listeria innocua.

    Busch, S V; Donnelly, C W

    1992-01-01

    The ability of the divalent cations magnesium, iron, calcium and manganese; yeast extract; pyruvate; catalase; and the carbohydrates glucose, lactose, sucrose, esculin, fructose, galactose, maltose, and mannose to facilitate repair of heat-injured Listeria monocytogenes and Listeria innocua was evaluated. Listeria populations were injured by heating at 56 degrees C for 50 min. To determine the effects on repair, Trypticase soy broth (TSB) was supplemented with each medium component to be eval...

  2. Activated platelet-rich plasma improves adipose-derived stem cell transplantation efficiency in injured articular cartilage

    Pham, Phuc Van; Bui, Khanh Hong-Thien; Ngo, Dat Quoc; Vu, Ngoc Bich; Truong, Nhung Hai; Phan, Nhan Lu-Chinh; Le, Dung Minh; Duong, Triet Dinh; Nguyen, Thanh Duc; Le, Vien Tuong; Phan, Ngoc Kim

    2013-01-01

    Introduction Adipose-derived stem cells (ADSCs) have been isolated, expanded, and applied in the treatment of many diseases. ADSCs have also been used to treat injured articular cartilage. However, there is controversy regarding the treatment efficiency. We considered that ADSC transplantation with activated platelet-rich plasma (PRP) may improve injured articular cartilage compared with that of ADSC transplantation alone. In this study, we determined the role of PRP in ADSC transplantation t...

  3. Procedural and legal status of the injured party according to the new criminal procedure code of the Republic of Serbia

    Grubač Momčilo

    2012-01-01

    Full Text Available In this article the author is critically analyzing certain solutions of the new Criminal Procedure Code of the Republic of Serbia from 2011 which consider the injured party and their rights in the criminal proceeding. He states that unlike the previous ones, this Code does not improve the status of the injured party but makes it even worse. The author particularly claims that the legislator yet again failed to establish the right of the injured party to be efficiently compensated in the event of a serious offense from a special fund and immediately after the crime has been committed, but prior to the end of the criminal proceeding. In the provision of the Code which states that the injured party may take over the prosecution and become a prosecutor replacing the Public Prosecutor (subsidiary prosecutor only if the Public Prosecutor withdraws after having confirmed the indictment, however not in the cases of rejection of criminal charges or withdrawal from the prosecution in the previous proceeding, the author sees not only the limitation of the rights of the injured party, but also jeopardy of the public interest. This is due to the fact that, freed from a threat of the subsidiary accusation by the injured party, the Public Prosecutor has gained an absolute and uncontrolled monopoly over the initiation of criminal proceeding. According to the author, the subject of the proceedings will not have any substantial use from some rights which the new Code assigns to the injured party (for example the right to appeal against the judgment on the adjudicated property claim. In conclusion, the author stresses out that in spite of his objections against certain provisions in the Code, the legal status of the injured party is more favorable in the criminal law of Serbia then in many other countries.

  4. Effect of ω-3 polyunsaturated fatty acids on the growth of IEC-6 cells injured by heavy metals

    Zhang, Feng; Yu, Haining; Ni, Xiaofeng; ZHU, Jing; Wang, Shanshan; Shen, Shengrong

    2016-01-01

    Environmental pollution is a current area of focus worldwide, particularly heavy metal pollution. Feasible prevention or therapeutic strategies are required. Exploration of the correlation between ω-3 polyunsaturated fatty acids (ω-3 PUFAs) and intestinal epithelial cells injured by heavy metals may be of significance for intestinal health. In the present study, the effects of ω-3 PUFAs on the rat intestinal crypt cell line (IEC-6) injured by heavy metals and its mechanisms were determined ac...

  5. Differentiation potential of bone marrow mesenchymal stem cells into retina in normal and laser-injured rat eye

    ZHANG Jie; SHAN Qing; MA Ping; JIANG Yanming; CHEN Peng; WEN Jingxia; ZHOU You; QIAN Huanwen; PEI Xuetao

    2004-01-01

    Bone marrow mesenchymal stem cells (MSCs) can develop into hematopoietic and mesenchymal lineages but have not been known to participate in the production of retina. Here we report that bone marrow mesenchymal stem cells, after being subretinally transplanted into normal or Nd: YAG laser-injured rat eye, can integrate into RPE layer, photoreceptor layer, bipolar cell layer and ganglion layer. DAPI-labeling detection was used to trace the origin of the repopulating cells. DAPI fluorescence was used to identify retina cells of bone marrow origin 10, 20, 35 and 50 days after transplantation. No formation of rosettes was found but some random cells were found at the end of the observation. MSCs-originated cells spread more widely in the injured retinas than in the normal ones. Immunohistochemical detection showed that though the cells could express neuronal nuclei (NeuN), neuron specific enolase (NSE), glial fibrillary acidic protein (GFAP) and cytokeratin (CK), the proteins expression in the injured transplantation group was abnormal in some region compared with that in the normal transplantation group. Electroretinogram (ERG) showed that ERG-b wave of the injured transplantation group is significantly higher than that of the two laser-injured control groups. These results suggest that a proportion of MSCs can differentiate into retina-like structure in vivo and the differentiation differs in normal and laser-injured retinas.

  6. Medical management of severe local radiation injury after acute X-ray exposure

    Medical management during acute period in a case of severe local radiation injury after acute X-ray exposure includes 3 stages. During the fist stage patient got conservative treatment according to the common pathogenetic mechanisms of LRI (dis aggregating therapy, stimulation of regeneration, dis intoxication therapy, antibiotic therapy, pain relief therapy, Local anti-burn therapy-specific non-adhesive bandage with antiseptic and anti-burn medicaments); estimation of severity, deepness and area of injury by clinical picture and dates of instrumental methods of examining; defining necessity and volume of surgical treatment; preparing arrangements for surgical treatment. This stage ends with forming of demarcation line of a very hard severity of a Local Radiation Injure. The second stage includes necrectomy of the area of a very hard severity with microsurgical plastic by re vascularized flap and auto dermoplastic. The third stage - adaptation of re vascularized flap and total epithelization of injured area. (author)

  7. The Diagnostic and Prognostic Value of Ultrasonography in Soccer Players With Acute Hamstring Injuries

    Petersen, Jesper; Thorborg, Kristian; Nielsen, Michael Bachmann;

    2014-01-01

    BACKGROUND: An injury to the hamstring muscle complex is the most common injury in soccer. Ultrasound of acute hamstring injuries is often used as a clinical tool for diagnosing hamstring injuries and guiding players in when they can return to play. PURPOSE: To (1) investigate the characteristic...... sonographic findings of acute hamstring injuries in soccer players, (2) compare the mean injury severity (time to return to play) in injured players with and without sonographically verified abnormalities, and (3) correlate the length of the injured area and absence from soccer play (time to return to play......) to investigate if ultrasonography can be used as a prognostic indicator of time to return to play. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Players from 50 teams participating in 1 of the top 5 Danish soccer divisions were followed in the period from January to December 2008. Of 67...

  8. Bone bruises in anterior cruciate ligament injured knee and long-term outcomes. A review of the evidence

    Papalia R

    2015-02-01

    Full Text Available Rocco Papalia,1 Guglielmo Torre,1 Sebastiano Vasta,1 Biagio Zampogna,1 Douglas R Pedersen,2,3 Vincenzo Denaro,1 Annunziato Amendola3 1Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy; 2Department of Biomedical Engineering, 3Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA Background: Bone bruises are frequently associated with anterior cruciate ligament (ACL tears as a result of trauma or direct shear stress of the bone. Purpose: To review the evidence regarding the characteristics of the bone bruise associated with ACL tears, its relevance on clinical outcomes, and its progression over time. In particular, the long-term effects of the bone bruise on the knee osteochondral architecture and joint function were evaluated. Study design: Review; level of evidence: 4. Methods: An electronic search was performed on PubMed. Combinations of keywords included: “bone bruise AND knee”; “bone bruise AND anterior cruciate ligament”; “bone bruise AND osteo-chondral defects”. Any level of evidence studies concerning bone bruises in patients with partial or complete ACL tears were retrieved. Results: A total of 25 studies were included; three of them investigated biomechanical parameters, seven were concerned with clinical outcomes, and 15 were radiological studies. Evaluation of the bone bruise is best performed using a fat-saturated T2-weighted fast spin echo exam or a short tau inversion recovery sequence where fat saturation is challenging. The location of the injury has been demonstrated to be more frequent in the lateral compartment of the joint (lateral femoral condyle and lateral tibial plateau. It is associated with ACL tears in approximately 70% of cases, often with collateral ligament or meniscal tears. Mid- and long-term outcomes demonstrated a complete healing of the marrow lesions at magnetic ρresonance imaging, but chondral defects detected with T1

  9. Acute pancreatitis

    Al Mofleh Ibrahim

    1997-01-01

    Full Text Available The past few years have witnessed a tremendous progress in our knowledge regarding the pathogenesis, diagnosis, prognostic evaluation and classification of acute pancreatitis. The role of ischemia, lysosomal enzymes, oxygen free radicals, polymorphnuclear cells-byproducts and inflammatory mediators in the pathogenesis of pancreatic necrosis and multiple organ failure has been emphasized. Furthermore, the recent knowledge about agents infecting pancreatic necrosis, routes of infection, bacteriological examination of fine needle aspirate and appropriate antibiotics have changed the concept of acute pancreatitis. New diagnostic tests such as rapid urinary trypsinogen-2 test and inflammatory mediators including polymorphnuclear elastase, C-reactive protein and interleukin-6 contribute to early diagnosis, prognostic evaluation and initiation of an appropriate therapy.

  10. Mechanisms of post-myocardial infarction healing : from acute survival to chronic remodeling

    Hunt, Darlene L.

    2009-01-01

    Acute survival and chronic healing after myocardial infarction (MI) depend on a myriad of processes that begin within hours of the injury and can continue in the form of remodeling even years thereafter. The myocardium has very little self-renewal capability, and tissue lost to MI is replaced with a collagenous scar. There are currently no clinical therapies that directly target myocardial healing, due in part to the pleiotropic effects and redundancy of signaling factors released after injur...

  11. Pseudomonas aeruginosa Forms Biofilms in Acute Infection Independent of Cell-to-Cell Signaling▿ †

    Schaber, J. Andy; Triffo, W.J.; Suh, Sang J.; Oliver, Jeffrey W.; Hastert, Mary C.; Griswold, John A.; Auer, Manfred; Hamood, Abdul N; Rumbaugh, Kendra P.

    2007-01-01

    Biofilms are bacterial communities residing within a polysaccharide matrix that are associated with persistence and antibiotic resistance in chronic infections. We show that the opportunistic pathogen Pseudomonas aeruginosa forms biofilms within 8 h of infection in thermally injured mice, demonstrating that biofilms contribute to bacterial colonization in acute infections as well. Using light, electron, and confocal scanning laser microscopy, P. aeruginosa biofilms were visualized within burn...

  12. Ethnoracial Variations in Acute PTSD Symptoms Among Hospitalized Survivors of Traumatic Injury

    Stephens, Kari A.; Sue, Stanley; Roy-Byrne, Peter; Unützer, Jürgen; Wang, Jin; Rivara, Frederick P.; Jurkovich, Gregory J.; Zatzick, Douglas F.

    2010-01-01

    Ethnoracial minority status contributes to an increased risk for posttraumatic stress disorder (PTSD) after trauma exposure, beyond other risk factors. A population-based sampling frame was used to examine the associations between ethnoracial groups and early PTSD symptoms while adjusting for relevant clinical and demographic characteristics. Acutely injured trauma center inpatients (N = 623) were screened with the PTSD Checklist. American Indian and African American patients reported the hig...

  13. Therapeutic effect of transplanting bone mesenchymal stem cells on the hind limbs’ motor function of rats with acute spinal cord injury

    Song, Qinghua; Xu, Rongmei; Zhang, Quanhai; Ma, Ming; Zhao, Xinping

    2014-01-01

    Purpose: To research the therapeutic effect of the allograft of bone mesenchymal stem cells (BMSCs) on hind limbs’ motor function of rats that underwent acute injury to their spinal nerve. Design: 40 Wistar rat samples with the acute injury to the spinal cord were established and divided into the transplantation group and the control group, 20 for each group; One week after injury, BMSCs were slowly injected into the center of the injured spinal cord of the rats, and the physiological saline ...

  14. Acute Blast Injury Reduces Brain Abeta in Two Rodent Species

    GregoryAElder; MiguelA.Gama Sosa; RitaDe Gasperi; MichaelCShaughness; StevenTDeKosky; SamGandy; MadhusoodanaPNambiar; JohnWSteele

    2012-01-01

    Blast-induced traumatic brain injury (TBI) has been a major cause of morbidity and mortality in the conflicts in Iraq and Afghanistan. How the primary blast wave affects the brain is not well understood. In particular, it is unclear whether blast injures the brain through mechanisms similar to those found in non-blast closed impact injuries (nbTBI). The β-amyloid (Aβ) peptide associated with the development of Alzheimer’s disease (AD) is elevated acutely following TBI in humans as well as in ...

  15. Acute Blast Injury Reduces Brain Abeta in Two Rodent Species

    De Gasperi, Rita; Gama Sosa, Miguel A; Kim, Soong Ho; Steele, John W.; Shaughness, Michael C; Maudlin-Jeronimo, Eric; Hall, Aaron A.; DeKosky, Steven T.; McCarron, Richard M; Nambiar, Madhusoodana P.; Gandy, Sam; Ahlers, Stephen T.; Elder, Gregory A.

    2012-01-01

    Blast-induced traumatic brain injury (TBI) has been a major cause of morbidity and mortality in the conflicts in Iraq and Afghanistan. How the primary blast wave affects the brain is not well understood. In particular, it is unclear whether blast injures the brain through mechanisms similar to those found in non-blast closed impact injuries (nbTBI). The β-amyloid (Aβ) peptide associated with the development of Alzheimer’s disease is elevated acutely following TBI in humans as well as in exper...

  16. Cytoskeleton, L-type Ca2+ and stretch activated channels in injured skeletal muscle

    Fabio Francini

    2013-07-01

    Full Text Available The extra-sarcomeric cytoskeleton (actin microfilaments and anchoring proteins is involved in maintaining the sarco-membrane stiffness and integrity and in turn the mechanical stability and function of the intra- and sub-sarcoplasmic proteins. Accordingly, it regulates Ca2+ entry through the L-type Ca2+ channels and the mechano-sensitivity of the stretch activated channels (SACs. Moreover, being intra-sarcomeric cytoskeleton bound to costameric proteins and other proteins of the sarcoplasma by intermediate filaments, as desmin, it integrates the properties of the sarcolemma with the skeletal muscle fibres contraction. The aim of this research was to compare the cytoskeleton, SACs and the ECC alterations in two different types of injured skeletal muscle fibres: by muscle denervation and mechanical overload (eccentric contraction. Experiments on denervation were made in isolated Soleus muscle of male Wistar rats; forced eccentric-contraction (EC injury was achieved in Extensor Digitorum Longus muscles of Swiss mice. The method employed conventional intracellular recording with microelectrodes inserted in a single fibre of an isolated skeletal muscle bundle. The state of cytoskeleton was evaluated by recording SAC currents and by evaluating the resting membrane potential (RMP value determined in current-clamp mode. The results demonstrated that in both injured skeletal muscle conditions the functionality of L-type Ca2+ current, ICa, was affected. In parallel, muscle fibres showed an increase of the resting membrane permeability and of the SAC current. These issues, together with a more depolarized RMP are an index of altered cytoskeleton. In conclusion, we found a symilar alteration of ICa, SAC and cytoskeleton in both injured skeletal muscle conditions.

  17. Delivery of large molecules via poly(butyl cyanoacrylate) nanoparticles into the injured rat brain

    Lin, Yong; Pan, Yaohua; Shi, Yinfeng; Huang, Xianjian; Jia, Nengqin; Jiang, Ji-yao

    2012-04-01

    Poly(n-butyl-2-cyanoacrylate) (PBCA) nanoparticles have been successfully applied to deliver small-molecule drugs to the central nervous system (CNS). However, it is unclear whether PBCA nanoparticles can be used as the delivery system for large molecules to potentially treat traumatic brain injury (TBI). In this study, we tested the capacity of PBCA nanoparticles in passing through the blood-brain barrier (BBB) and transporting large molecules into normal and injured brains in the rat. We first synthesized PBCA nanoparticles by dispersion polymerization and then loaded the particles with either horseradish peroxidase (HRP, 44 kDa) or enhanced green fluorescent protein (EGFP, 29 kDa), which were further coated with polysorbate 80. Next, the polysorbate 80-coated HRP or EGFP-loaded PBCA nanoparticles were intravenously injected into the normal and brain-injured rats. We found that, at 45 min after injection, PBCA nanoparticle-delivered HRP or EGFP was hardly detected in the normal brains of the rats, but a small amount of EGFP carried by PBCA nanoparticles was noted in the normal brains 48 h after administration, which was further confirmed by immunolocalization with anti-EGFP antibodies. In contrast, at 4 h after TBI with a circulation time of 45 min, although the penetration of HRP or EGFP alone was hampered by the BBB, the PBCA nanoparticle-delivered HRP or EGFP was widely distributed near injured sites. Together, our findings provide histological evidence that PBCA nanoparticles can be used as an efficient delivery system for large molecules to overcome the barrier in the brain with TBI.

  18. Delivery of large molecules via poly(butyl cyanoacrylate) nanoparticles into the injured rat brain

    Poly(n-butyl-2-cyanoacrylate) (PBCA) nanoparticles have been successfully applied to deliver small-molecule drugs to the central nervous system (CNS). However, it is unclear whether PBCA nanoparticles can be used as the delivery system for large molecules to potentially treat traumatic brain injury (TBI). In this study, we tested the capacity of PBCA nanoparticles in passing through the blood–brain barrier (BBB) and transporting large molecules into normal and injured brains in the rat. We first synthesized PBCA nanoparticles by dispersion polymerization and then loaded the particles with either horseradish peroxidase (HRP, 44 kDa) or enhanced green fluorescent protein (EGFP, 29 kDa), which were further coated with polysorbate 80. Next, the polysorbate 80-coated HRP or EGFP-loaded PBCA nanoparticles were intravenously injected into the normal and brain-injured rats. We found that, at 45 min after injection, PBCA nanoparticle-delivered HRP or EGFP was hardly detected in the normal brains of the rats, but a small amount of EGFP carried by PBCA nanoparticles was noted in the normal brains 48 h after administration, which was further confirmed by immunolocalization with anti-EGFP antibodies. In contrast, at 4 h after TBI with a circulation time of 45 min, although the penetration of HRP or EGFP alone was hampered by the BBB, the PBCA nanoparticle-delivered HRP or EGFP was widely distributed near injured sites. Together, our findings provide histological evidence that PBCA nanoparticles can be used as an efficient delivery system for large molecules to overcome the barrier in the brain with TBI. (paper)

  19. Wood anatomical analysis of Alnus incana and Betula pendula injured by a debris-flow event.

    Arbellay, Estelle; Stoffel, Markus; Bollschweiler, Michelle

    2010-10-01

    Vessel chronologies in ring-porous species have been successfully employed in the past to extract the climate signal from tree rings. Environmental signals recorded in vessels of ring-porous species have also been used in previous studies to reconstruct discrete events of drought, flooding and insect defoliation. However, very little is known about the ability of diffuse-porous species to record environmental signals in their xylem cells. Moreover, time series of wood anatomical features have only rarely been used to reconstruct former geomorphic events. This study was therefore undertaken to characterize the wood anatomical response of diffuse-porous Alnus incana (L.) Moench and Betula pendula Roth to debris-flow-induced wounding. Tree microscopic response to wounding was assessed through the analysis of wood anatomical differences between injured rings formed in the debris-flow event year and uninjured rings formed in the previous year. The two ring types were examined close and opposite to the injury in order to determine whether wound effects on xylem cells decrease with increasing tangential distance from the injury. Image analysis was used to measure vessel parameters as well as fiber and parenchyma cell (FPC) parameters. The results of this study indicate that injured rings are characterized by smaller vessels as compared with uninjured rings. By contrast, FPC parameters were not found to significantly differ between injured and uninjured rings. Vessel and FPC parameters mainly remained constant with increasing tangential distance from the injury, except for a higher proportion of vessel lumen area opposite to the injury within A. incana. This study highlights the existence of anatomical tree-ring signatures-in the form of smaller vessels-related to past debris-flow activity and addresses a new methodological approach to date injuries inflicted on trees by geomorphic processes. PMID:20639516

  20. A psychological study of spinal cord injured patients involved in the Madras Paraplegia Project.

    Somasundaram, O; Balakrishnan, S; Ravindran, O S; Shanmugasundaram, T K

    1992-11-01

    The psychological features of spinal cord injured (SCI) patients involved in the Madras Paraplegia Project are described. Three hundred and twenty-eight patients were studied. Based on personality tests, 11% were extroverts, 14% were introverts and 76% were neither extroverts nor introverts. Twenty-four percent of the subjects were neurotic, 11% had a depressive illness, and 26% had pathological anxiety. The study has highlighted the psychological status of SCI patients, and the usefulness of a psychiatric team in the multidisciplinary care of such patients. This is probably the first large psychological study of SCI patients from a developing country. PMID:1484733

  1. On the use of dreams as a means of diagnosis of brain-injured patients.

    Stern, B; Stern, J M

    1985-01-01

    In our psychotherapeutic work with brain injured patients it has become apparent that there exists a divergence between the two modes of expression with which the patient reflects his inner truth. In contrast to the patient's conscious self-perception, which is usually distorted by his cognitive deficits and by his defense mechanisms, the dream--the unconscious, uncovers another reality. The present paper cites a repeated pattern of initial dreams and an attempt is made to understand its diagnostic and prognostic meaning. PMID:3868047

  2. The Synergistic Effect of Treadmill Running on Stem-Cell Transplantation to Heal Injured Skeletal Muscle

    Ambrosio, Fabrisia; Ferrari, Ricardo J.; DiStefano, Giovanna; Plassmeyer, Joshua M.; Carvell, George E.; Deasy, Bridget M.; Boninger, Michael L.; Fitzgerald, G. Kelley; Huard, Johnny

    2010-01-01

    Muscle-derived stem-cell (MDSC) transplantation presents a promising method for the treatment of muscle injuries. This study investigated the ability of exercise to enhance MDSC transplantation into the injured muscle. Mice were divided into four groups: contusion + phosphate-buffered saline (C + PBS; n = 14 muscles), C + MDSC transplantation (n = 12 muscles), C + PBS + treadmill running (C + PBS + TM; n = 17 muscles), and C + MDSC + TM (n = 13 muscles). One day after injury, the TM groups be...

  3. Assessment and detection of pain in noncommunicative severely brain-injured patients.

    Schnakers, Caroline; Chatelle, Camille; Majerus, Steve; Gosseries, Olivia; De Val, Marie; Laureys, Steven

    2010-11-01

    Detecting pain in severely brain-injured patients recovering from coma represents a real challenge. Patients with disorders of consciousness are unable to consistently or reliably communicate their feelings and potential perception of pain. However, recent studies suggest that patients in a minimally conscious state can experience pain to some extent. Pain monitoring in these patients is hence of medical and ethical importance. In this article, we will focus on the possible use of behavioral scales for the assessment and detection of pain in noncommunicative patients. PMID:20977329

  4. The effects of low laser irradiation on angiogenesis in injured rat tibiae

    Garavello, I.; Baranauskas, V.; da Cruz Hoflingl, M.A.

    2004-01-01

    The influence of He-Ne laser radiation on the formation of new blood vessels in the bone marrow compartment of a regenerating area of the mid-cortical diaphysis of the tibiae of young adult rats was studied. A small hole was surgically made with a dentistry burr in the tibia and the injured area received a daily laser therapy over 7 or 14 days transcutaneously starting 24 h from surgery. Incident energy density dosages of 31.5 and 94.5 Jcm-2 were applied during...

  5. Multidisciplinary approach to sex education of spinal cord-injured patients.

    Evans, R L; Halar, E M; DeFreece, A B; Larsen, G L

    1976-05-01

    The need for sex education of spinal cord-injured patients is often unmet by current rehabilitation programs. In the programs which do exist, therapeutic objectives vary widely, indicating a need for clarity and communication among professionals. An interdisciplinary approach to evaluating and treating sexual dysfunction is described which provides information to patients and families about sexual disorders related to spinal injury and offers counseling services to patients experiencing problems in their altered sex relations. Physiological, psychological, and social aspects of human sexuality as they are integrated into a multidisciplinary sex education program are discussed with specific recommendations for content which should be included in the information-giving counseling process. PMID:1265117

  6. Fixation strength of biocomposite wedge interference screw in ACL reconstruction: effect of screw length and tunnel/screw ratio. A controlled laboratory study

    Herrera Antonio

    2010-06-01

    Full Text Available Abstract Background Primary stability of the graft is essential in anterior cruciate ligament surgery. An optimal method of fixation should be easy to insert and provide great resistance against pull-out forces. A controlled laboratory study was designed to test the primary stability of ACL tendinous grafts in the tibial tunnel. The correlation between resistance to traction forces and the cross-section and length of the screw was studied. Methods The tibial phase of ACL reconstruction was performed in forty porcine tibias using digital flexor tendons of the same animal. An 8 mm tunnel was drilled in each specimen and two looped tendons placed as graft. Specimens were divided in five groups according to the diameter and length of the screw used for fixation. Wedge interference screws were used. Longitudinal traction was applied to the graft with a Servohydraulic Fatigue System. Load and displacement were controlled and analyzed. Results The mean loads to failure for each group were 295,44 N (Group 1; 9 × 23 screw, 564,05 N (Group 2; 9 × 28, 614,95 N (Group 3; 9 × 35, 651,14 N (Group 4; 10 × 28 and 664,99 (Group 5; 10 × 35. No slippage of the graft was observed in groups 3, 4 and 5. There were significant differences in the load to failure among groups (ANOVA/P Conclusions Longer and wider interference screws provide better fixation in tibial ACL graft fixation. Short screws (23 mm do not achieve optimal fixation and should be implanted only with special requirements.

  7. Reconstrução anatômica do LCA com duplo feixe: primeiros 40 casos Anatomical ACL reconstruction with double bundle: first 40 cases

    Ari Zekcer

    2011-01-01

    Full Text Available OBJETIVO: Discutir a técnica de reconstrução anatômica do ligamento cruzado anterior (LCA com duplo feixe, a curva de aprendizado e os resultados preliminares. MÉTODOS: Quarenta pacientes com lesão do LCA foram submetidos à reconstrução anatômica com duplo feixe, utilizando-se do tendão semitendinoso para refazer a banda anteromedial (AM e gracilis para refazer a banda posterolateral (PL do joelho. RESULTADOS: Tivemos dois casos de limitação de extensão, sendo que em um deles foi necessária a realização de artrólise artroscópica, e um caso de trombose venosa profunda. CONCLUSÃO: A reconstrução do LCA com duplo feixe se mostrou factível, apesar de apresentar uma maior curva de aprendizado; e as vantagens da técnica proposta ainda deverão ser comprovadas se comparada com a técnica de feixe único.OBJECTIVE: To discuss the technique of anatomical reconstruction of the anterior cruciate ligament (ACL with double beam, the learning curve and preliminary results. METHODS: Forty patients with ACL injury underwent reconstruction with anatomical double-bundle, using the semitendinosus tendon to remake the band anterior medial (AM and gracile to remake the band posterior lateral (PL of the knee. RESULTS: We had two cases of limitation of extension, and in one of them were necessary to perform arthroscopic artrolise, and one case of deep vein thrombosis. CONCLUSION: ACL reconstruction with double bundle proved feasible, despite having a higher learning curve, and the advantages of the proposed technique still must be proven compared to the single-beam technique.

  8. Effects of isokinetic eccentric training on knee extensor and flexor torque and on gait of individuals with long term ACL reconstruction: A controlled clinical trial

    Heleodório Honorato dos Santos

    2014-12-01

    Full Text Available This study investigated the effects of the isokinetic eccentric training (IET on the knee extensor and flexor torque and kinematic gait parameters in individuals with ACL reconstruction. Sixteen men with ACL reconstructed (ACLr whose torque and the gait were evaluated, before and after 12 weeks of IET, was compared to a control group (14 individuals. Student t, MANOVA and ANOVA tests were performed with 5% of significance. The training increased the isometric, concentric at 30 and 120º/s (p < .05 and eccentric at 30º/s (p < .01 extensor torque on the affected limb (AL, and eccentric at 30 and 120º/s (p < .01, on the non-affected limb (NAL. In the flexors, there was an increase on the torque: isometric, concentric at 30º/s and eccentric at 30 and 120º/s (p < .01 in AL and in eccentric at 30 (p < .05 and 120º/s (p< .01 in NAL. With respect to the angular and spatio-temporal variables gait, there was no difference between pre-and post-training in LCAr group. Compared to control group, the cycle time, in two members, was lower in LCAr group, and stride length and cadence were higher in the AL of the LCAr (p < .05. Moreover, the knee flexion-extension angles (minimum and maximum remained lower in LCAr, pre- and post-training (p < .01. The torque gain associated with eccentric isokinetic training did not affect the kinematic parameters of gait in patients undergoing ACL reconstruction.

  9. Acute abdomen

    Acute abdomen may be connected with the injury of one of the internal organs, injury of large blood vessels, with the spreading of pains from some other area. It may also be a manifestation of systemic disease or poisoning. The main purposes of radiodiagnosis are: determination of the cause of clinical syndrome; determination of the localization and spreading of pathological changes in abdominal organs; finding out the character of complications. If the data of the ordinary roentgenological investiagtion and isn't complete, the computer tomography of abdominal and pelvic cavities is needed

  10. The effects of low level laser therapy on injured skeletal muscle

    Ana Claudia Muniz Renno

    2014-02-01

    Full Text Available The main purpose of the present study was to investigate the effects of low-level laser therapy (LLLT used in two different fluencies on injured skeletal muscle after cryolesion by means of histopathological analysis and immunohistochemistry for COX-2. A total of sixty male Wistar rats were randomly distributed into three groups: injured animals without any treatment; 808 nm laser treated group, at 10 J/cm² and 808 nm laser treated group, at 50 J/cm². Each group was divided into two different subgroups (n=10 on days 6 and 13 post-injury. The results showed that the animals irradiated with laser at 10 J/cm² or 50 J/cm² presented the areas with cell infiltrate and pointed out to minor and mild areas with destroyed zones compared with the control group. Also, a COX-2 downregulation was noticed in the groups exposed to laser at two fluences evaluated in this study. Significant statistically differences (p<0.05 were noticed to collagen deposition in the laser treated animals, with the fluence of 50 J/cm² when compared to the other groups on day 13 post-surgery. Taken together, these results suggested that laser therapy could have positive effects on muscle repair in the rats after cryolesion.

  11. Understanding physical activity participation in spinal cord injured populations: Three narrative types for consideration

    Anthony Papathomas

    2015-08-01

    Full Text Available The aim of this study was to identity the types of physical activity narratives drawn upon by active spinal injured people. More than 50 h of semi-structured life-story interview data, collected as part of larger interdisciplinary program of disability lifestyle research, was analysed for 30 physically active male and female spinal cord injury (SCI participants. A structural narrative analysis of data identified three narrative types which people with SCI draw on: (1 exercise is restitution, (2 exercise is medicine, and (3 exercise is progressive redemption. These insights contribute new knowledge by adding a unique narrative perspective to existing cognitive understanding of physical activity behaviour in the spinal cord injured population. The implications of this narrative typology for developing effective positive behavioural change interventions are critically discussed. It is concluded that the identified narratives types may be constitutive, as well as reflective, of physical activity experiences and therefore may be a useful tool on which to base physical activity promotion initiatives.

  12. Single Visit Apexification Procedure of a Traumatically Injured Tooth with a Novel Bioinductive Material (Biodentine)

    Jingarwar, Mahesh Madhukar; Pathak, Anuradha

    2015-01-01

    ABSTRACT Aim of this article is to present a case wherein single visit apexification of a traumatically injured tooth was done with a bioactive material–Biodentine. An injury sustained between the ages of 6 and 14 can adversely affect pulpal health and interrupt root development. In these instances, apexification is generally the preferred treatment. A 10 years old male patient presented with coronal fracture of the left upper central incisor. Clinical and radiographic assessment showed negative pulpal sensibility and arrested apical root development. Artificial apical barrier induction with Biodentine followed by endodontic treatment and prosthetic rehabilitation was decided as the line of treatment. To conclude, this bioactive and biocompatible calcium-based cement can regenerate damaged dental tissues and represents a promising alternative to the conventional multivisit apexification technique. Clinical significance: Biodentine which is a biologically active cement can be an efficient alternative to the conventional apexification materials which were hitherto recommended. How to cite this article: Bajwa NK, Jingarwar MM, Pathak A. Single Visit Apexification Procedure of a Traumatically Injured Tooth with a Novel Bioinductive Material (Biodentine). Int J Clin Pediatr Dent 2015;8(1):58-61. PMID:26124583

  13. Protective effect of egg-milk with MT on mice injured by X-irradiation

    Objective: To explore the protective effect of egg-milk with metallothionein (MT) on the mice injured by X-irradiation. Methods: After fed intragastrically with egg-milk plus MT for 14 d, mice were irradiated with 2.5 Gy X-rays. Twenty-four hours after the mice were irradiated, the number of WBC in peripheral blood, lymphocyte proliferation rate, DNA content of marrow cells, thymocyte cycle progression, malondialdehyde (MDA) level and the activities of SOD, CAT, GSH-Px in liver, serum and kidney were measured. Results: In irradiated mice fed with egg-milk plus MT, the WBC number, lymphocyte proliferation rate, DNA content of marrow cells, the activities of SOD, CAT and GSH-Px in liver, kidney and serum were all significantly higher than those in the irradiation alone group. Besides in the former group the MDA level decreased significantly, the G1 phase arrest in thymocytes was weakened and DNA synthesis was promoted. Conclusion: The egg-milk with MT has protective effect on the mice injured by X-irradiation. (authors)

  14. Artificial gait in complete spinal cord injured subjects: how to assess clinical performance

    Karla Rocha Pithon

    2015-02-01

    Full Text Available Objective Adapt the 6 minutes walking test (6MWT to artificial gait in complete spinal cord injured (SCI patients aided by neuromuscular electrical stimulation. Method Nine male individuals with paraplegia (AIS A participated in this study. Lesion levels varied between T4 and T12 and time post injured from 4 to 13 years. Patients performed 6MWT 1 and 6MWT 2. They used neuromuscular electrical stimulation, and were aided by a walker. The differences between two 6MWT were assessed by using a paired t test. Multiple r-squared was also calculated. Results The 6MWT 1 and 6MWT 2 were not statistically different for heart rate, distance, mean speed and blood pressure. Multiple r-squared (r2 = 0.96 explained 96% of the variation in the distance walked. Conclusion The use of 6MWT in artificial gait towards assessing exercise walking capacity is reproducible and easy to apply. It can be used to assess SCI artificial gait clinical performance.

  15. A comparison of conventional surfactant treatment and partial liquid ventilation on the lung volume of injured ventilated small lungs

    As an alternative to surfactant therapy (ST), partial liquid ventilation (PLV) with perfluorocarbons (PFC) has been considered as a treatment for acute lung injury (ALI) in newborns. The instilled PFC is much heavier than the instilled surfactant and the aim of this study was to investigate whether PLV, compared to ST, increases the end-expiratory volume of the lung (VL). Fifteen newborn piglets (age <12 h, mean weight 678 g) underwent saline lung lavage to achieve a surfactant depletion. Thereafter animals were randomized to PLV (n = 8), receiving PFC PF5080 (3M, Germany) at 30 mL kg−1, and ST (n = 7) receiving 120 mg Curosurf®. Blood gases, hemodynamics and static compliance were measured initially (baseline), immediately after ALI, and after 240 min mechanical ventilation with either technique. Subsequently all piglets were killed; the lungs were removed in toto and frozen in liquid N2. After freeze-drying the lungs were cut into lung cubes (LCs) with edge lengths of 0.7 cm, to calculate VL. All LCs were weighed and the density of the dried lung tissue was calculated. No statistically significant differences between treatment groups PLV and ST (means ± SD) were noted in body weight (676 ± 16 g versus 679 ± 17 g; P = 0.974) or lung dry weight (1.64 ± 0.29 g versus 1.79 ± 0.48 g; P = 0.48). Oxygenation index and ventilatory efficacy index did not differ significantly between both groups at any time. VL (34.28 ± 6.13 mL versus 26.22 ± 8.1 mL; P < 0.05) and the density of the dried lung tissue (48.07 ± 5.02 mg mL−1 versus 69.07 ± 5.30 mg mL−1; P < 0.001), however, differed significantly between the PLV and ST groups. A 4 h PLV treatment of injured ventilated small lungs increased VL by 30% and decreased lung density by 31% compared to ST treatment, indicating greater lung distension after PLV compared to ST. (paper)

  16. A comparison of conventional surfactant treatment and partial liquid ventilation on the lung volume of injured ventilated small lungs.

    Proquitté, Hans; Hartenstein, Sebastian; Koelsch, Uwe; Wauer, Roland R; Rüdiger, Mario; Schmalisch, Gerd

    2013-08-01

    As an alternative to surfactant therapy (ST), partial liquid ventilation (PLV) with perfluorocarbons (PFC) has been considered as a treatment for acute lung injury (ALI) in newborns. The instilled PFC is much heavier than the instilled surfactant and the aim of this study was to investigate whether PLV, compared to ST, increases the end-expiratory volume of the lung (VL). Fifteen newborn piglets (age <12 h, mean weight 678 g) underwent saline lung lavage to achieve a surfactant depletion. Thereafter animals were randomized to PLV (n = 8), receiving PFC PF5080 (3M, Germany) at 30 mL kg(-1), and ST (n = 7) receiving 120 mg Curosurf®. Blood gases, hemodynamics and static compliance were measured initially (baseline), immediately after ALI, and after 240 min mechanical ventilation with either technique. Subsequently all piglets were killed; the lungs were removed in toto and frozen in liquid N2. After freeze-drying the lungs were cut into lung cubes (LCs) with edge lengths of 0.7 cm, to calculate VL. All LCs were weighed and the density of the dried lung tissue was calculated. No statistically significant differences between treatment groups PLV and ST (means ± SD) were noted in body weight (676 ± 16 g versus 679 ± 17 g; P = 0.974) or lung dry weight (1.64 ± 0.29 g versus 1.79 ± 0.48 g; P = 0.48). Oxygenation index and ventilatory efficacy index did not differ significantly between both groups at any time. VL (34.28 ± 6.13 mL versus 26.22 ± 8.1 mL; P < 0.05) and the density of the dried lung tissue (48.07 ± 5.02 mg mL(-1) versus 69.07 ± 5.30 mg mL(-1); P < 0.001), however, differed significantly between the PLV and ST groups. A 4 h PLV treatment of injured ventilated small lungs increased VL by 30% and decreased lung density by 31% compared to ST treatment, indicating greater lung distension after PLV compared to ST. PMID:23893018

  17. Autologous bone marrow mesenchymal stromal cells for regeneration of injured equine ligaments and tendons: a clinical report.

    Renzi, S; Riccò, S; Dotti, S; Sesso, L; Grolli, S; Cornali, M; Carlin, S; Patruno, M; Cinotti, S; Ferrari, M

    2013-08-01

    The use of Mesenchymal Stromal Cells (MSCs) in orthopedic practice has recently and rapidly acquired an important role. Therapies based on the use of MSCs for the treatment of acute injuries as well as chronic inflammatory disorders are gradually becoming clinical routine. These cells have demonstrated intriguing therapeutic potentialities (i.e.: inflammation control, tissue regeneration and pathological scar prevention), that have been taken into consideration for use in both human and veterinary medicine. In particular, horses represent high performance athletes considered models for human pathologies since musculo-skeletal disorders frequently occur in this species. In the past, repair of tendon injures were performed by different methods. In particular, clinical therapy was based on ice application, bandage, box rest and controlled exercise. An alternative approach consisted on the use of corticosteroid (inflammation reduction) and other drugs (sodium hyaluronate, polysulphated glycosaminoglycans, beta aminoproprionitrile fumarate). Furthermore, surgical treatments like accessory ligament desmotomy, local irritation by line firing or pin firing were commonly used. More recently ultrasound, laser therapy, electromagnetic field therapy have been considered. Unfortunately, they did not allow complete tissue healing and quite often animals did not regain competitiveness. In order to minimize this inconvenience, the use of MSCs has been introduced as an alternative to the traditional approach since it represents a potential tool to improve tissue regeneration. Aim of this study was to evaluate the capability of MSCs to improve the functional outcome of horses affected by tendonitis and desmitis. Thirty-three breed and activity-matched horses affected by tendonitis or desmitis, were included in clinical trial scored for lesions and subdivided into two groups. Group 1 animals were treated with autologous MSCs, associated with platelet rich plasma (group 1). Bone

  18. 5-Hydroxymethylfurfural protects against ER stress-induced apoptosis in GalN/TNF-α-injured L02 hepatocytes through regulating the PERK-eIF2α signaling pathway.

    Jiang, Ze-Qun; Ma, Yan-Xia; Li, Mu-Han; Zhan, Xiu-Qin; Zhang, Xu; Wang, Ming-Yan

    2015-12-01

    5-Hydroxymethylfurfural (5-HMF), a water-soluble compound extracted from wine-processed Fructus corni, is a novel hepatic protectant for treating acute liver injury. The present study was designed to investigate the protective effect of 5-HMF in human L02 hepatocytes injured by D-galactosamine (GalN) and tumor necrosis factor-α (TNF-α) in vitro and to explore the underlying mechanisms of action. Our results showed that 5-HMF caused significant increase in the viability of L02 cells injured by GalN/TNF-α, in accordance with a dose-dependent decrease in apoptotic cell death confirmed by morphological and flow cytometric analyses. Based on immunofluorescence and Western blot assays, we found that GalN/TNF-α induced ER stress in the cells, as indicated by the disturbance of intracellular Ca(2+) concentration, the activation of protein kinase RNA (PKR)-like ER kinase (PERK), phosphorylation of eukaryotic initiation factor 2 alpha (eIF2α), and expression of ATF4 and CHOP proteins, which was reversed by 5-HMF pre-treatment in a dose-dependent manner. The anti-apoptotic effect of 5-HMF was further evidenced by balancing the expression of Bcl-2 family members. In addition, the knockdown of PERK suppressed the expression of phospho-PERK, phospho-eIF2α, ATF4, and CHOP, resulting in a significant decrease in cell apoptosis after the treatment with GalN/TNF-α. 5-HMF could enhance the effects of PERK knockdown, protecting the cells against the GalN/TNF-α insult. In conclusion, these findings demonstrate that 5-HMF can effectively protect GalN/TNF-α-injured L02 hepatocytes against ER stress-induced apoptosis through the regulation of the PERK-eIF2α signaling pathway, suggesting that it is a possible candidate for liver disease therapy. PMID:26721708

  19. A prospective study of the 1-year incidence of fibromyalgia after acute whiplash injury

    Ferrari, Robert

    2015-01-01

    Objective To measure the 1-year incidence of fibromyalgia in a cohort of acute whiplash-injured participants. Methods Consecutive acute patients with whiplash were assessed via the 2010 Modified American College of Rheumatology (ACR) criteria for fibromyalgia at 3 months, 6 months and 1 year postinjury. At each of these follow-up points, participants were also examined for recovery from whiplash injury. Results Of an initial 268 participants, data on recovery was available for 264 participant...

  20. Music as Medicine: The Therapeutic Potential of Music for Acute Stroke Patients.

    Supnet, Charlene; Crow, April; Stutzman, Sonja; Olson, DaiWai

    2016-04-01

    Nurses caring for patients with acute stroke are likely to administer both music and medication with therapeutic intent. The administration of medication is based on accumulated scientific evidence and tailored to the needs of each patient. However, the therapeutic use of music is generally based on good intentions and anecdotal evidence. This review summarizes and examines the current literature regarding the effectiveness of music in the treatment of critically ill patients and the use of music in neurologically injured patients. The rationale for hypothesis-driven research to explore therapeutic music intervention in acute stroke is compelling. PMID:27037347