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Sample records for abnormal palmar flexion

  1. Connective Tissue Degeneration: Mechanisms of Palmar Fascia Degeneration (Dupuytren's Disease)

    NARCIS (Netherlands)

    Karkampouna, S.; Kreulen, M.; Obdeijn, M. C.; Kloen, P.; Dorjée, A. L.; Rivellese, F.; Chojnowski, A.; Clark, I.; Kruithof-de Julio, Marianna

    2016-01-01

    Dupuytren's disease is a connective tissue disorder of the hand causing excessive palmar fascial fibrosis with associated finger contracture and disability. The aetiology of the disease is heterogeneous, with both genetic and environmental components. The connective tissue is abnormally infiltrated

  2. "Palmar pivot flap" for resurfacing palmar lateral defects of the fingers.

    Science.gov (United States)

    Yam, Andrew; Peng, Yeong-Pin; Pho, Robert Wan-Heng

    2008-12-01

    Soft tissue defects on the lateral borders of the digits are difficult to reconstruct using local or local-regional flaps. We describe a "palmar pivot flap" to resurface an adjacent defect on the palmar-lateral aspect of the digit. The surgical technique is described. This flap is an axial pattern flap based on the subcutaneous transverse branches of the digital artery. The flap is pivoted up to 90 degrees on the neurovascular bundle in its base, into an adjacent defect. The flap can be raised from either the proximal or the middle phalangeal segments. It can cover defects sited from the level of the proximal interphalangeal joint up to the fingertip. The donor defect is limited to the same digit and is covered with a full-thickness skin graft. We have used this flap on 3 patients with defects at the middle phalangeal segment, the distal interphalangeal joint, and the fingertip. All healed primarily. One patient had a mild flexion contracture of the proximal interphalangeal joint, whereas the other 2 had no complications. The patients with distal interphalangeal joint and fingertip defects had excellent sensation in the flap (2-point discrimination of 5-6 mm). The palmar pivot flap is useful for resurfacing otherwise difficult defects on the lateral borders of the digits around and distal to the proximal interphalangeal joint, including those at the fingertip. It provides sensate, glabrous skin. The donor defect is on the same digit and is well hidden, producing an aesthetic and functional reconstruction.

  3. Keratosis Punctata of Palmar Creases

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    T P Thankappan

    1982-01-01

    Full Text Available Five cases of keratosis punctata of palmar creases which isaa variant of keratosis punctata are reported. Two of these cases were associated with psoriasis and one case with dermatitis herpetiformis. Familial tendency was noticed in 4 cases.

  4. Evaluation of anatomy and variations of superficial palmar arch and upper extremity arteries with CT angiography.

    Science.gov (United States)

    Kaplanoglu, Hatice; Beton, Osman

    2017-04-01

    To evaluate the abnormalities and variations of the arterial system of upper extremities and superficial palmar arch with computed tomography angiography and to guide the clinician during this procedure. A total of 156 upper extremities of 78 cases were retrospectively analyzed using computed tomography angiography. The study was approved by the local ethics committee of the hospital. From the analysis of the computed tomography angiography images, the following information was recorded; the diameters and abnormalities of radial, ulnar and brachial arteries in both upper extremities, the presence of atherosclerotic changes or stenosis in these arteries, whether the superficial palmar arch was complete or incomplete, and arterial dominance. Also, the computed tomography angiography classification of superficial palmar arch distribution and anatomic configuration was performed. The mean baseline diameters of the radial, ulnar and brachial arteries of the cases were; 2.8 ± 0.6, 2.5 ± 0.7, and 4.7 ± 0.6 mm, respectively. A complete superficial palmar arch was observed in 69.2 % of the right hands and 70.5 % of the left hands. For the superficial palmar arches on the right side, the radial artery was dominant in two and the ulnar artery was dominant in 47 with the remaining showing codominance. On the left side, the radial artery was dominant in one hand, with the ulnar artery being dominant in 49 cases, and in 28 cases, there was codominance. In the superficial palmar arch classification, four of the arches (A-D) were defined as complete and the remaining three (E-G) as incomplete. The current study clarified different variations in palmar circulation and forearm arteries to aid the surgeon during trans-radial or trans-ulnar catheterization, hemodialysis, or coronary artery bypass grafting.

  5. Zumbi dos Palmares: a afroresiliencia

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    Josué Petrônio Quirino de Oliveira

    2017-10-01

    Full Text Available O artigo buscou fazer uma releitura de Zumbi dos Palmares sob o prisma da resiliência, demonstrando uma visão singular ao olhar para os escravos nos quilombos e suas histórias de superação e transformação perante as adversidades, levando não só a reconstruir o imaginário afrodescendente brasileiro com o caleidoscópio da resiliência, mas revelar que a resiliência sempre foi inerente a história dos negros no Brasil. Para tanto se caracterizou como uma pesquisa exploratória com abordagem qualitativa e procedimentos bibliográficos que foram essenciais para a construção do artigo, amadurecendo e ampliando os conhecimentos envolvidos na temática. Nesta abordagem o quilombo dos Palmares foi um conjunto complexo de condições, atitudes e ações que apesar das adversidades tiveram resultados positivos, os fatos demonstraram que os negros nos quilombos foram uma prova que a resiliência negra não foi apenas um fator individual, mas uma característica comunitária que desencadeou um processo de ruptura e recuperação social, um grito de liberdade em defesa da consciência de uma raça, e de um povo. Zumbi não foi apenas um líder de um movimento libertário que marcou a história dos negros oriundos de Pernambuco e Alagoas, mas a história de uma raça por gerações no país, que se tornou sinônimo de resiliência.

  6. A surprising palmar nevus: A case report

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    Rana Rafiei

    2018-02-01

    Full Text Available Raised palmar or plantar nevus especially in white people is an unusual feature. We present an uncommon palmar compound nevus in a 26-year-old woman with a large diameter (6 mm which had a collaret-shaped margin. In histopathologic evaluation intralymphatic protrusions of nevic nests were noted. This case was surprising to us for these reasons: size, shape, location and histopathology of the lesion. Palmar nevi are usually junctional (flat and below 3 mm diameter and intra lymphatic protrusion or invasion in nevi is an extremely rare phenomenon.

  7. Palmar dislocation of scaphoid and lunate

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    Khalid Koulali Idrissi

    2011-11-01

    Full Text Available A palmar dislocation of scaphoid and lunate is uncommon. We have found only 19 reported cases in the literature. We reported a simultaneous, divergent dislocation. The closed reduction followed by percutaneous pinning has given a good result without avascular necrosis of any carpal bone.

  8. Palmar-plantar erythrodysesthesia associated with capecitabine ...

    African Journals Online (AJOL)

    We report a case of a 62 year-old patient who developed Palmar-plantar erythrodysesthesia upon receiving four cycles of capacitabine-based chemotherapy. She was on post surgical adjuvant treatment for invasive well differentiated adenocarcinoma of the colon. The clinical and therapeutic aspects of this ...

  9. Flexion in Abell 2744

    Science.gov (United States)

    Bird, J. P.; Goldberg, D. M.

    2018-05-01

    We present the first flexion-focused gravitational lensing analysis of the Hubble Frontier Field observations of Abell 2744 (z = 0.308). We apply a modified Analytic Image Model technique to measure source galaxy flexion and shear values at a final number density of 82 arcmin-2. By using flexion data alone, we are able to identify the primary mass structure aligned along the heart of the cluster in addition to two major substructure peaks, including an NE component that corresponds to previous lensing work and a new peak detection offset 1.43 arcmin from the cluster core towards the east. We generate two types of non-parametric reconstructions: flexion aperture mass maps, which identify central core, E, and NE substructure peaks with mass signal-to-noise contours peaking at 3.5σ, 2.7σ, and 2.3σ, respectively; and convergence maps derived directly from the smoothed flexion field. For the primary peak, we find a mass of (1.62 ± 0.12) × 1014 h-1 M⊙ within a 33 arcsec (105 h-1 kpc) aperture, a mass of (2.92 ± 0.26) × 1013 h-1 M⊙ within a 16 arcsec (50 h-1 kpc) aperture for the north-eastern substructure, and (8.81 ± 0.52) × 1013 h-1 M⊙ within a 25 arcsec (80 h-1 kpc) aperture for the novel eastern substructure.

  10. Radiographic characteristics of the forelimb distal phalanx and microscopic morphology of the lateral palmar process in foals 3-32 weeks old

    International Nuclear Information System (INIS)

    Kaneps, A.J.; Stover, S.M.; O'Brien, T.R.; Pool, R.R.; Willits, N.H.

    1995-01-01

    Developmental morphology of the forelimb distal phalanges and lateral palmar processes of 9 Thoroughbred foals aged 3–32 weeks was assessed using radiography, microradiography and histology. For inclusion in the study, all distal phalanges had no pathologic radiographic abnormalities.Vascular channels that are characteristically found in the dorsal region of the distal phalanx were not evident radiographically in the palmar process. The proximal and distal angles of the palmar processes were separated by a lucent line continuous with the incisure in foals only through 12 weeks of age. The distal phalanges were triangular-shaped in foals 3–12 weeks of age, and were oval-shaped in older foals.The palmar aspect of the distal phalanx was the major contributor to growth of the distal phalanx in the sagittal plane, especially between 3 and 12 weeks of age. Growth of the lateral palmar process occurred through the means of endochondral ossification. The body and cortices of the lateral palmar process were composed of coarse cancellous bone. Porosity within the lateral palmar process was greater in regions sampled axial, compared to abaxial, to the parietal sulcus and did not change with age.A fracture was identified microradiographically and/or histologically in 9 of 18 (50%) and 10 of 17 (59%), respectively, of the lateral palmar processes examined. The fracture line was consistently associated with the parietal sulcus on the dorsal cortical surface and was always immediately abaxial to the deep digital flexor tendon attachment. No age-related morphological changes of the lateral palmar processes were identified with microradiography or histological examinations

  11. Contact sensitivity in palmar hyperkeratotic dermatitis

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    Minocha Y

    1993-01-01

    Full Text Available 230 patients presenting with palmar hyperkeratotic dermatitis were investigated by patch tests against various antigens depending upon occupation of the patients. Contact sensitivity was detected in 130 patients comprising of housewives (55, businessmen (20, farmers (15, teachers / clerks / students (13, doctors and nurses (9, factory workers and labourers (8, massons (7 and motor mechanics (3. Vegetables were found to be the most common agents followed by detergents and metals predominantly affecting housewives. Among the vegetables, garlic and onion were the most potent sensitizers whereas nickel was a common sensitizer among metals. Occupational factors were seen to have some influence in relation to the causative agents as indicated by higher positivity of vegetables in housewives; detergents, metals, rubber, leather, plastics in businessmen, teachers, clerks and students; fertilizers or animal foods in farmers; drugs in doctors and nurses and chromium and cobalt in massons.

  12. Imaginando Palmares: a obra de Gayl Jones

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    Stelamaris Coser

    2005-01-01

    Full Text Available http://dx.doi.org/10.1590/S0104-026X2005000300010 O longo poema narrativo Song for Anninho (1981, da escritora negra Gayl Jones (Estados Unidos, interfere na narrativa da história colonial brasileira ao resgatar a figura feminina na República de Palmares, reescrever a saga de resistência dos palmaristas do ponto de vista imaginário de uma mulher negra do século XVII e, através dela, reinventar o cotidiano, os amores, as disputas e os sonhos das pessoas comuns que integravam o quilombo. O texto reflete sobre a verdade histórica, o aspecto construído de documentos, as seleções e exclusões da linguagem, e a importância do relato oral para o conhecimento de vivências e identidades à margem da história oficial. Nessa versão especial, o relato dramático do sonho, da luta e da destruição do mais famoso quilombo brasileiro usa a imaginação literária para expandir a memória e os arquivos de um dos fatos mais importantes da história das Américas, contribuindo para estimular o diálogo interamericano e iluminar a diáspora africana no Brasil e no continente.

  13. Soft tissue stabilization for palmar midcarpal instability using a palmaris longus tendon graft.

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    Chaudhry, Tahseen; Shahid, Mohammed; Wu, Feiran; Mishra, Anuj; Deshmukh, Subodh

    2015-01-01

    To report the results of a technique of soft tissue stabilization for palmar midcarpal instability using a palmaris longus graft. In patients' symptomatic wrists with palmar midcarpal instability that had failed conservative management, we used a dorsal approach and stabilized the hamate and triquetrum by reconstructing the dorsal triquetrohamate ligament. The palmaris longus tendon graft was fixed with bone anchors. Seven wrists in 6 patients were available for follow-up at a mean of 28 months (range, 17-37 mo). There was an overall meaningful improvement in function (mean preoperative Disabilities of the Arm, Shoulder, and Hand score, 49 preoperatively, 28 postoperatively). There was a significant increase in grip strength from 15 to 21 kg. At final follow-up, 2 patients had moderate pain. The others had mild or no pain. Four patients returned to their previous occupation or activity. Patients retained full pronation and supination. When compared with the normal side, flexion was reduced to 71%, extension to 81%, radial deviation to 90%, and ulnar deviation to 65% of the opposite side. Although the mean results show an improvement, one patient had a poor result with deterioration in Disabilities of the Arm, Shoulder, and Hand score in spite of a clinically stable wrist, and another had clinical evidence of recurrent instability during pregnancy. One patient had residual symptoms from a prominent bone anchor. Overall, this technique showed good medium-term results in most of our patients. It retained some midcarpal mobility, eliminated clunking in most patients, and provided a noteworthy improvement in grip strength and function. We continue to use this technique for patients with symptomatic midcarpal instability, but it requires further evaluation with larger patient numbers and a longer follow-up to assess its overall value. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  14. Improved knee flexion following high-flexion total knee arthroplasty

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    Lionberger David R

    2012-06-01

    Full Text Available Abstract Background The application of new techniques and materials in total knee arthroplasty (TKA continue to be a primary focus in orthopedic surgery. The primary aim of the present study is to evaluate post TKA total range of motion (ROM among a group of patients who received a gender specific high-flexion design modification implant compared to a control group of patients who received non-gender specific implants. Methods and results The control group was comprised of 39 TKAs that were recruited pre-operatively and received the non-gender specific implant while the study group consisted of 39 TKAs who received gender specific implants. The study group yielded an improvement in mean post-operative ROM of 21° at 12 months, whereas the mean improvement in ROM among the control group was 11°. Thus, the study group had a 10° increased ROM improvement (91% over the control group (p = 0.00060. In addition, 100% of the subjects with gender specific high-flexion implants achieved greater or equal ROM post-operatively compared to 82% for the control cohort. Lastly, women who exhibited greater pre-operative ROM and lower body mass index (BMI were found to benefit the most with the gender specific prosthesis. Conclusion Our study demonstrates that among subjects with a normal BMI, the gender specific high-flexion knee implant is associated with increased ROM as compared to the non-gender specific non-high-flexion implant designs.

  15. Uruguay project - Metalic silicon manufacturing. Palmar location study

    International Nuclear Information System (INIS)

    2003-01-01

    This work is about the Soriano town possibilities offered to Rima Industrial S.A in relation with the metallic silicon project in Uruguay. In this zone there is the Palmar hydroelectric plant with a capacity of 33 MW and its development is part of the Rio Negro river

  16. Imaginando Palmares: a obra de Gayl Jones Imagining Palmares: the work of Gayl Jones

    Directory of Open Access Journals (Sweden)

    Stelamaris Coser

    2005-12-01

    Full Text Available O longo poema narrativo Song for Anninho (1981, da escritora negra Gayl Jones (Estados Unidos, interfere na narrativa da história colonial brasileira ao resgatar a figura feminina na República de Palmares, reescrever a saga de resistência dos palmaristas do ponto de vista imaginário de uma mulher negra do século XVII e, através dela, reinventar o cotidiano, os amores, as disputas e os sonhos das pessoas comuns que integravam o quilombo. O texto reflete sobre a verdade histórica, o aspecto construído de documentos, as seleções e exclusões da linguagem, e a importância do relato oral para o conhecimento de vivências e identidades à margem da história oficial. Nessa versão especial, o relato dramático do sonho, da luta e da destruição do mais famoso quilombo brasileiro usa a imaginação literária para expandir a memória e os arquivos de um dos fatos mais importantes da história das Américas, contribuindo para estimular o diálogo interamericano e iluminar a diáspora africana no Brasil e no continente.The long narrative poem Song for Anninho (1981, written by black U.S. writer Gayl Jones, interferes in the narrative of Brazilian colonial history as it highlights the female presence in the Republic of Palmares, rewrites the tale of resistance from the point of view of a black woman in the 17th Century, and, through her, reinvents the everyday lives, loves, disputes, and dreams of common people in the quilombo. The text reflects about historical truth, the constructed character of documents, selections and exclusions in language, and the importance of oral accounts to give visibility to experiences and identities marginalized by official history. In this special version, the dramatic report of the dreams, struggles, and destruction of the most famous Brazilian quilombo uses literary imagination to expand the memory and the archives of one of the most important facts in the history of the Americas, contributing to stimulate

  17. Imaging of compound palmar ganglion with pathologic correlation

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    Sourav Talukder

    2014-12-01

    Full Text Available Compound palmar ganglion, or chronic flexor tenosynovitis, most commonly of tuberculousorigin, is a rare extrapulmonary manifestation of tuberculosis (TB. The flexor synovialsheath is not a common site for TB but, once involved, causes rapid involvement of all flexortendons. We discuss the case of a 70-year-old farmer who presented to us with pain and progressive swelling of the palmar aspect of the wrist. On clinical examination, swelling both above and below the proximal wrist crease was found, with positive cross-fluctuation. Onultrasonography and magnetic resonance imaging, features suggestive of compound palmarganglion were present. The patient underwent surgical resection (extensive tenosynovectomyand chemotherapy. Post-operative histopatholgical findings correlated with the radiological features.

  18. Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

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    Aram Baram

    2014-02-01

    Full Text Available Background: Primary hyperhidrosis is characterized by excessive sweating beyond physiological needs. It is a common disease (incidence 2.8% that causes intense discomfort for patients. In the last decade, advantages of Single-Incision Thoracoscopic Sympathectomy have become clear, particularly in decreasing morbidity of sympathectomy. Patients and methods: From January 2010 to December 2012, 39 patients (29 females and 10 males with primary palmar or axillary hyperhidrosis were treated by thoracoscopic sympathectomy. The age ranged from 18 to 40 years with a mean of 26.28 years. We used single incision thoracoscopic electrocoagulation through 10 mm incision for thoracic sympathetic chain (T2–T4. Results: The mean follow-up was 23.6 ± 14.2 months (range = 4–24 months. A total of 97.42% of patients were satisfied with the results. A total of 72.5% of patients had cure, one patient (2.5% and another patient (2.5% presented with recurrent axillary hyperhidrosis. The morbidity was 10.2% with no mortality. Percentage of compensatory sweating and gustatory sweating were 5.1% (p = .353 and 2.5% (p = .552, respectively. The result of sympathectomy in patients with both palmar and axillary hyperhidrosis was significantly better (17, 43.58% compared to palmar type (14, 35.89% or axillary type (7, 17.94%. Conclusion: Thoracoscopic sympathectomy is a simple, safe, and cost-effective therapy with good results and low complications.

  19. Fingertip Replantation With Palmar Venous Anastomoses in Children.

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    Wen, Gen; Xu, Jia; Chai, Yi-Min

    2017-06-01

    Fingertip amputation in children is difficult to manage using microsurgical replantation techniques and many salvage procedures have failed owing to the nonavailability of suitable veins for anastomosis in the fingertip. This study reviewed our experience of pediatric fingertip replantation involving palmar venous anastomoses and evaluated the clinical outcomes. From October 2008 to May 2013, 21 pediatric fingertips that had been completely amputated at or distal to the distal interphalangeal joint of the finger, or at or distal to the interphalangeal joint of the thumb were managed using complete replantation. One artery was anastomosed for revascularization with or without nerve repair, and a palmar venous anastomosis was performed to reestablish the outflow system. Twenty (95.2%) of the 21 fingertips survived. One replant involving an avulsion amputation of the left little finger failed, and the patient underwent stump cap-plasty. Excellent restoration of finger motion, pinch strength, and appearance was observed during the mean 39.9-month (range, 18-65 months) follow-up. The mean regained static 2-point discrimination sensation was 3.8 mm (range, 3.2-4.2 mm). All of the children and their families were satisfied with the surgical outcomes. Successful palmar venous anastomosis appears to promote the survival of replanted fingertips in children. Given that the procedure may simplify postoperative care, minimize complications, and achieve a high survival rate, it should be attempted if the technical expertise is available.

  20. Replantation of multi-level fingertip amputation using the pocket principle (palmar pocket method).

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    Arata, J; Ishikawa, K; Soeda, H; Kitayama, T

    2003-07-01

    Two cases of multi-level fingertip amputation are presented. In each case, replantation was achieved in a two-stage procedure, involving reattachment, de-epithelialisation and insertion into a palmar pocket in stage 1, followed by removal from the palmar pocket 16 days later. The cases are described and the technique is discussed.

  1. Phytolith analysis in fluvial quaternary sediment (San Salvador and Palmar formation) Uruguay river and Argentina eastern

    International Nuclear Information System (INIS)

    Patterer, N.; Passeggi, E.; Zucol, A.; Brea, M.; Krohling, D.

    2012-01-01

    This work is about two microfossils fluvial units deposited by the Uruguay river during the Quaternary. These are San Salvador and Palmar formation (Plio-Pleistocene - Upper Pleistocene).The Palmar formation is a band of 4-15 km along the right bank of the Uruguay river outcropping from the eastern provinces of Corrientes and Entre Rios, to Concepcion del Uruguay

  2. Reverse Distal Transverse Palmar Arch in Distal Digital Replantation.

    Science.gov (United States)

    Wei, Ching-Yueh; Orozco, Oscar; Vinagre, Gustavo; Shafarenko, Mark

    2017-11-01

    Refinements in microsurgery have made distal finger replantation an established technique with high success rates and good functional and aesthetic outcomes. However, it still represents a technically demanding procedure due to the small vessel caliber and frequent lack of vessel length, requiring the use of interpositional venous grafts in some instances. We describe a new technique for anastomosis in fingertip replantation, whereby the need for venous grafts is eliminated. Applying the reverse distal transverse palmar arch technique, 11 cases of distal digital replantation were performed between January 2011 and July 2016. The described procedure was used for arterial anastomosis in 10 cases and arteriovenous shunting for venous drainage in 1 case. A retrospective case review was conducted. The technical description and clinical outcome evaluations are presented. Ten of the 11 replanted digits survived, corresponding to an overall success rate of 91%. One replant failed due to venous insufficiency. Blood transfusions were not required for any of the patients. Follow-up (range, 1.5-5 months) revealed near-normal range of motion and good aesthetic results. All of the replanted digits developed protective sensation. The average length of hospital admission was 5 days. All patients were satisfied with the results and were able to return to their previous work. The use of the reverse distal transverse palmar arch is a novel and reliable technique in distal digital replantation when an increase in vessel length is required, allowing for a tension-free arterial repair without the need for vein grafts.

  3. [Circumscribed palmar hypokeratosis (CPM): The diagnostic value of dermoscopy].

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    Topin-Ruiz, S; Debarre, J-M; Blanchard, E; Kettani, S; Valmier, P-J; Martin, L; Le Corre, Y

    2017-03-01

    Circumscribed palmar hypokeratosis (CPH) is a rare skin disease, first described in 2002, associated with sudden localized reduction of the corneal layer. In most cases, it presents as an isolated rounded erythematous palmar lesion on the thenar eminence. We describe the dermoscopic semiology of CPH in 3 cases. Three patients between the ages of 59 and 72 presented very limited erythematous lesions suggestive of CPH. Dermoscopic examination of these lesions provided similar findings. Biopsy, which was performed in one patient, confirmed the diagnosis of CPH. Two dermoscopic elements of CPH are characteristic: (1) the sides of the lesion have a "stair step" or "geological strata" type of configuration, and the thickness of the different strata varies; (2) the centre of the lesion showed a homogeneous erythematous area with a vascular pattern composed of dotted vessels of the superficial dermis and sometime vascular loops. These dermoscopic aspects are characteristic and enable CPH to be differentiated from Bowen's disease or porokeratosis of Mibelli. In Bowen's disease, there is no stair step like aspect to the sides of lesions; further, the centre of the lesion shows glomerular vessels (coiled vessels) and/or globular vessels (small red clods). In porokeratosis, peripheral keratotic "white track" structures comprise a single pigmented channel or a double white line. There is no "stair step" or central vascular pattern. The dermoscopic semiology of CPH is highly characteristic and enables differentiation from Bowen's disease and porokeratosis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Head flexion angle while using a smartphone.

    Science.gov (United States)

    Lee, Sojeong; Kang, Hwayeong; Shin, Gwanseob

    2015-01-01

    Repetitive or prolonged head flexion posture while using a smartphone is known as one of risk factors for pain symptoms in the neck. To quantitatively assess the amount and range of head flexion of smartphone users, head forward flexion angle was measured from 18 participants when they were conducing three common smartphone tasks (text messaging, web browsing, video watching) while sitting and standing in a laboratory setting. It was found that participants maintained head flexion of 33-45° (50th percentile angle) from vertical when using the smartphone. The head flexion angle was significantly larger (p smartphone, could be a main contributing factor to the occurrence of neck pain of heavy smartphone users. Practitioner Summary: In this laboratory study, the severity of head flexion of smartphone users was quantitatively evaluated when conducting text messaging, web browsing and video watching while sitting and standing. Study results indicate that text messaging while sitting caused the largest head flexion than that of other task conditions.

  5. Deep erosions of the palmar aspect of the navicular bone diagnosed by standing magnetic resonance imaging.

    Science.gov (United States)

    Sherlock, C; Mair, T; Blunden, T

    2008-11-01

    Erosion of the palmar (flexor) aspect of the navicular bone is difficult to diagnose with conventional imaging techniques. To review the clinical, magnetic resonance (MR) and pathological features of deep erosions of the palmar aspect of the navicular bone. Cases of deep erosions of the palmar aspect of the navicular bone, diagnosed by standing low field MR imaging, were selected. Clinical details, results of diagnostic procedures, MR features and pathological findings were reviewed. Deep erosions of the palmar aspect of the navicular bone were diagnosed in 16 mature horses, 6 of which were bilaterally lame. Sudden onset of lameness was recorded in 63%. Radiography prior to MR imaging showed equivocal changes in 7 horses. The MR features consisted of focal areas of intermediate or high signal intensity on T1-, T2*- and T2-weighted images and STIR images affecting the dorsal aspect of the deep digital flexor tendon, the fibrocartilage of the palmar aspect, subchondral compact bone and medulla of the navicular bone. On follow-up, 7/16 horses (44%) had been subjected to euthanasia and only one was being worked at its previous level. Erosions of the palmar aspect of the navicular bone were confirmed post mortem in 2 horses. Histologically, the lesions were characterised by localised degeneration of fibrocartilage with underlying focal osteonecrosis and fibroplasia. The adjacent deep digital flexor tendon showed fibril formation and fibrocartilaginous metaplasia. Deep erosions of the palmar aspect of the navicular bone are more easily diagnosed by standing low field MR imaging than by conventional radiography. The lesions involve degeneration of the palmar fibrocartilage with underlying osteonecrosis and fibroplasia affecting the subchondral compact bone and medulla, and carry a poor prognosis for return to performance. Diagnosis of shallow erosive lesions of the palmar fibrocartilage may allow therapeutic intervention earlier in the disease process, thereby preventing

  6. Improved identification of the palmar fibrocartilage of the navicular bone with saline magnetic resonance bursography.

    Science.gov (United States)

    Schramme, Michael; Kerekes, Zoltan; Hunter, Stuart; Nagy, Krisztina; Pease, Anthony

    2009-01-01

    Fibrocartilage degeneration is the earliest pathologic finding in navicular disease but remains difficult to detect, even with magnetic resonance (MR) imaging. We hypothesized that injection of the navicular bursa with saline would improve accuracy of MR imaging evaluation of palmar fibrocartilage. Thoracic limbs were collected from 11 horses within 6 h of death. Imaging was performed with a 1.5 T magnet using sagittal 2D proton density and transverse 3D FLASH sequences with fat saturation. For the purpose of determining sensitivity and specificity of the MR images, fibrocartilage was classified as normal or abnormal, based on combination of the findings of gross and microscopic pathology. Thickness of fibrocartilage was measured on histologic sections and corresponding transverse FLASH MR images before and after injection of saline. A paired Student's t-test was used for comparison of measurements. Partial thickness fibrocartilage loss was present in 6 of 22 limbs. Sensitivity of precontrast MR images for detection of lesions was 100% while specificity was 6%. Saline MR arthrography resulted in both sensitivity and specificity of 100% based on consensus review. Mean histologic fibrocartilage thickness was 0.75 +/- 0.12 mm. Mean fibrocartilage thickness on precontrast transverse FLASH images was 0.93 +/- 0.065 and 0.73 +/- 0.09 mm on postsaline images. The histologic cartilage thickness was signficantly different from that in precontrast images (Pfibrocartilage can only be evaluated reliably for the presence of partial thickness lesions after intrabursal injection of saline.

  7. Palmar dermatoglyphics as diagnostic tool: Mayer-rokintansky-kuster-hauser syndrome

    Directory of Open Access Journals (Sweden)

    Kumar A

    2003-03-01

    Full Text Available The congential anomalies involving Mullerian duct dysgenesis, the MRKH (Mayer-Rokitansky-Kuster-Hauser syndrome overlaps a ′community of syndromes′ which share, apart from a complete absence of uterus and vagina, associated presentations that include developmental abnormalities of skeletal, renal, dental and other dysmorphias. First described more than 400 years ago, this complement of anomalies now rechristened, the MRKH syndrome has been extensively studied. Found to occur once in every 4000 females; estimated on its incidence vary from 1/5000 to 1/20,000. Despite its fairly wide prevalence, this syndrome has remained largely underdiagnosed or cryptic. Social and cultural perceptions have perforce driven, the wide existence of the very personal handicap underground and unacceptable. Accidentally discovered during routine examination, during secondarily associated medical problems, the mullerian agenecies syndrome has been subject of a wide range of clinical and laboratory investigations. The oddity in the syndrome is that the patient appears absolutely normal and that it presents with no genetic marker. We herein report the palmar dermatoglyphic and doctylographic features of a patient with MRKH syndrome. However interpretation, show conclusively, at least in this single case that the MRKH syndrome can be diagnosed through its characteristic dermatography patterns. In our view, routine dermatographic study of all live females births may lead to not only an early but also a cost effective diagnostic method.

  8. A comparison of radiography, computed tomography, and magnetic resonance imaging for the diagnosis of palmar process fractures in foals

    International Nuclear Information System (INIS)

    Kaneps, A.J.; Koblik, P.D.; Freeman, D.M.; Pool, R.R.; O'Brien, T.R.

    1995-01-01

    The relative sensitivity of radiography, computed tomography, and magnetic resonance imaging for detecting palmar process fractures of the distal phalanx in foals was determined and the imaging findings were compared with histomorphologic evaluations of the palmar processes. Compared to radiography, computed tomography and magnetic resonance imaging did not improve the sensitivity for detection of palmar process fractures. Statistical agreement for palmar process fracture diagnosis was excellent among the three imaging modalities. Histomorphologic evaluations were more sensitive for diagnosis of palmar process fracture than any of the imaging modalities. Three-dimensional image reconstructions and volume measurements of distal phalanges and palmar process fracture fragments from computed tomography studies provided more complete anatomical information than radiography. Magnetic resonance imaging confirmed that the deep digital flexor tendon insertion on the distal phalanx is immediately axial to the site where palmar process fractures occur, and differentiated cartilage, bone, and soft tissue structures of the hoof

  9. Circumscribed palmar or plantar hypokeratosis: report of a Korean case and published work review.

    Science.gov (United States)

    Lee, Sang Eun; Kim, You Chan; Kim, Soo-Chan

    2006-06-01

    Circumscribed palmar or plantar hypokeratosis is a rare dermatosis characterized by a solitary, well-circumscribed patch with scaly borders chiefly on the palm or sole; it usually occurs in middle-aged or elderly women. We report the case of a 52-year-old Korean woman with two characteristic lesions of circumscribed palmar hypokeratosis on the left palm. Clinically, the lesions simulated porokeratosis of Mibelli, but histologically there was no cornoid lamellation in the serial sections and there were the characteristic histopathological features of circumscribed palmar or plantar hypokeratosis including a stair-like configuration with an abrupt thinning of the stratum corneum and a decreased granular layer. We also review the 16 cases of circumscribed palmar or plantar hypokeratosis reported in the published work.

  10. Glabrous skin reconstruction of palmar/plantar defects: a case for the ...

    African Journals Online (AJOL)

    DR LEGBO

    Methods: A prospective descriptive study of consecutive patients with benign soft tissue palmar/plantar defects .... cannot be closed by direct suturing. In the authors' view ... splintage ) did not lead to joint stiffness since majority were children ...

  11. Thumb fingertip reconstruction with palmar V-Y flaps combined with bone and nail bed grafts following amputation.

    Science.gov (United States)

    Zhou, Xiao; Wang, Libo; Mi, Jingyi; Xu, Yajun; Rui, Yongjun; Xue, Mingyu; Shen, Xiaofang; Qiang, Li

    2015-04-01

    The aim of treating thumb fingertip amputations with no indication for replantation is to reestablish functional and esthetic properties. From March 2005 to October 2008, we treated 14 patients with thumb fingertip amputation using palmar V-Y flaps combined with bone and nail bed grafts. There were 10 men and 4 women, whose ages at surgery ranged from 19 to 63 years (mean 35.8 years). In all, 11 of the injuries occurred in the dominant hand. According to Allen's classification, two were type II, seven were type III, and five were type IV. All patients underwent emergency surgery, with a time delay after injury of 3-12 h (mean 6.4 h). In each case, the amputation was a crush or avulsion injury, making microsurgical replantation not feasible. All of the flaps survived. At 8-17 months (average 12.8 months) of follow-up, the average subjective satisfaction score was 8.64. All patients experienced cold intolerance, and none of the patients complained of dysesthesia. Favorable results (excellent or good) were found in 78.6%. Thin primary nails appeared on the grafted nail bed about 3 weeks after surgery, following which the newly formed nail thickened and developed a more natural appearance. In one case, the new nail plate showed abnormal thickening due to hyperkeratosis. The bone graft healed at 5 weeks. The mean two-point discrimination was 7.5 mm. Grip strength was 10% less than that in the unaffected hand. Metacarpophalangeal and proximal interphalangeal joint mobility losses were less than 10°. All patients returned to their jobs. No patients had postoperative complications. We believe that the combination of palmar V-Y flap and bone and nail bed grafts provides a distinct advantage over other choices. It improves function when replantation is not an option.

  12. Measuring Gravitational Flexion in ACS Clusters

    Science.gov (United States)

    Goldberg, David

    2005-07-01

    We propose measurement of the gravitational "Flexion" signal in ACS cluster images. The flexion, or "arciness" of a lensed background galaxy arises from variations in the lensing field. As a result, it is extremely sensitive to small scale perturbations in the field, and thus, to substructure in clusters. Moreover, because flexion represents gravitationally induced asymmetries in the lensed image, it is completely separable from traditional measurements of shear, which focus on the induced ellipticity of the image, and thus, the two signals may be extracted simultaneously. Since typical galaxies are roughly symmetric upon 180 degree rotation, even a small induced flexion can potentially produce a noticeable effect {Goldberg & Bacon, 2005}. We propose the measurement of substructure within approximately 4 clusters with high-quality ACS data, and will further apply a test of a new tomographic technique whereby comparisons of lensed arcs at different redshifts may be used to estimate the background cosmology, and thus place constraints on the equation of state of dark energy.

  13. Role of linoleic acid in arsenical palmar keratosis.

    Science.gov (United States)

    Ahmed, Tarafder S; Misbahuddin, Mir

    2016-03-01

    Chronic arsenic exposure can lead to palmoplantar keratosis. In the stratum corneum of skin, linoleic acid is of the utmost importance to the inflammation, keratinization, and regeneration processes. The aims of this study were: (i) to present quantitative information on the linoleic acid fraction of intercorneocyte lipids, and (ii) to elucidate the role of linoleic acid in the pathophysiology of arsenical keratosis. Lipid extracts were collected from keratotic lesions in seven patients, seven arsenic-exposed subjects, and seven non-exposed control subjects. Linoleic acid levels of the specimens were estimated by reverse-phase high-performance liquid chromatography (RP-HPLC). There was a significant (P keratosis patients (palm: 25.66 ± 4.95 μg/cm(2); dorsum: 28.25 ± 6.20 μg/cm(2)) compared with arsenic-exposed (palm: 2.75 ± 0.85 μg/cm(2); dorsum: 1.96 ± 0.64 μg/cm(2)) and non-exposed (palm: 1.52 ± 0.61 μg/cm(2); dorsum: 1.28 ± 0.39 μg/cm(2)) control subjects. There was no significant difference (P = 0.556) in linoleic acid concentration in the non-affected skin of the dorsum of the hand (28.25 ± 6.20 μg/cm(2)) compared with that in the palmar sites (25.66 ± 4.95 μg/cm(2)) in the patient group. The change in linoleic acid levels in the arsenic-exposed control group did not differ from that in non-exposed controls (P = 1.000). Linoleic acid concentration is elevated in arsenical keratosis; this finding warrants further investigation to ascertain whether linoleic acid plays a direct role in the pathophysiology of arsenical keratosis. © 2015 The International Society of Dermatology.

  14. Analysis of the quantitative dermatoglyphics of the digito-palmar complex in patients with multiple sclerosis.

    Science.gov (United States)

    Supe, S; Milicić, J; Pavićević, R

    1997-06-01

    Recent studies on the etiopathogenesis of multiple sclerosis (MS) all point out that there is a polygenetical predisposition for this illness. The so called "MS Trait" determines the reactivity of the immunological system upon ecological factors. The development of the glyphological science and the study of the characteristics of the digito-palmar dermatoglyphic complex (for which it was established that they are polygenetically determined characteristics) all enable a better insight into the genetic development during early embriogenesis. The aim of this study was to estimate certain differences in the dermatoglyphics of digito-palmar complexes between the group with multiple sclerosis and the comparable, phenotypically healthy groups of both sexes. This study is based on the analysis of 18 quantitative characteristics of the digito-palmar complex in 125 patients with multiple sclerosis (41 males and 84 females) in comparison to a group of 400 phenotypically healthy patients (200 males and 200 females). The conducted analysis pointed towards a statistically significant decrease of the number of digital and palmar ridges, as well as with lower values of atd angles in a group of MS patients of both sexes. The main discriminators were the characteristic palmar dermatoglyphics with the possibility that the discriminate analysis classifies over 80% of the examinees which exceeds the statistical significance. The results of this study suggest a possible discrimination of patients with MS and the phenotypically health population through the analysis of the dermatoglyphic status, and therefore the possibility that multiple sclerosis is genetically predisposed disease.

  15. Improving Pre-Operative Flexion in Primary TKA: A Surgical Technique Emphasizing Knee Flexion with 5-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Edward McPherson

    2014-06-01

    Full Text Available This study prospectively reviews a consecutive series of 228 primary total knee arthroplasty (TKA procedures utilizing a technique to optimize knee flexion. The main features include: (1the use of a “patellar friendly” femoral component and reduced thickness patellar components, (2 patient individualized adjustment of the femoral component rotation set strictly to the anterior-posterior femoral axis, (3a rigorous flexion compartment debridement to remove non-essential posterior femoral bone with a Z-osteotome, and (4incorporation of a rapid recovery protocol with features to promote knee flexion. Results were categorized into three groups: low pre-op flexion (90 degrees and below, regular pre-op flexion (91-125 degrees, and high pre-op flexion (126 degrees and above. Average flexion in the low flexion group improved by 20 degrees at 6 weeks, 28 degrees at 3 months, 31 degrees at 1 year, and 30 degrees at 5 years. In the regular flexion group, average flexion improved by 2 degrees at 6 weeks, 10 degrees at 3 months, 12 degrees at 1 year, and 13 degrees at 5 years. Finally, in the high flexion group, average flexion decreased by 7 degrees at 6 weeks, regained preoperative levels at 3 months, and increased by 3 degrees at 1 year and 4 degrees at 5 years. In summary, a technique that emphasizes patellofemoral kinematics can consistently improve flexion in TKA in short and long-term follow-up.

  16. Unilateral Palmar Callus and Irritant Hand Eczema – Underreported Signs of Dependency on Crutches

    Directory of Open Access Journals (Sweden)

    Uwe Wollina

    2018-01-01

    Full Text Available Leg amputees who can’t use prostheses and patients with arthritis are often dependent on crutches. Their chronic use can exert significant friction forces. The palmar skin will respond by forming a hyperkeratotic callus. We report for the first time unilateral palmar callus formation caused by friction from using crutches. Another possible adverse effect is the triggering of irritant contact dermatitis by the handholes of crutches. We report two cases with hand dermatitis due to the chronic dependence on crutches and discuss treatment options.

  17. Macro fossils vegetable in Palmar formation (later pleistocene) in Entre Rios - Argentina

    International Nuclear Information System (INIS)

    Ramos, R.; Brea, M.; Krohling, D.

    2012-01-01

    This work is about the macro fossil knowledge preserved like wood fossils in the El Palmar Formation (Late Pleistocene) from a systematic - anatomical as well as paleoecological and paleoclimate point of view.The paleo Flora comes from various fossil located in the province of Entre Rios - Argentina

  18. Periostin differentially induces proliferation, contraction and apoptosis of primary Dupuytren's disease and adjacent palmar fascia cells

    International Nuclear Information System (INIS)

    Vi, Linda; Feng, Lucy; Zhu, Rebecca D.; Wu, Yan; Satish, Latha; Gan, Bing Siang; O'Gorman, David B.

    2009-01-01

    Dupuytren's disease, (DD), is a fibroproliferative condition of the palmar fascia in the hand, typically resulting in permanent contracture of one or more fingers. This fibromatosis is similar to scarring and other fibroses in displaying excess collagen secretion and contractile myofibroblast differentiation. In this report we expand on previous data demonstrating that POSTN mRNA, which encodes the extra-cellular matrix protein periostin, is up-regulated in Dupuytren's disease cord tissue relative to phenotypically normal palmar fascia. We demonstrate that the protein product of POSTN, periostin, is abundant in Dupuytren's disease cord tissue while little or no periostin immunoreactivity is evident in patient-matched control tissues. The relevance of periostin up-regulation in DD was assessed in primary cultures of cells derived from diseased and phenotypically unaffected palmar fascia from the same patients. These cells were grown in type-1 collagen-enriched culture conditions with or without periostin addition to more closely replicate the in vivo environment. Periostin was found to differentially regulate the apoptosis, proliferation, α smooth muscle actin expression and stressed Fibroblast Populated Collagen Lattice contraction of these cell types. We hypothesize that periostin, secreted by disease cord myofibroblasts into the extra-cellular matrix, promotes the transition of resident fibroblasts in the palmar fascia toward a myofibroblast phenotype, thereby promoting disease progression.

  19. Treatment of fingertip amputation in adults by palmar pocketing of the amputated part.

    Science.gov (United States)

    Jung, Mi Sun; Lim, Young Kook; Hong, Yong Taek; Kim, Hoon Nam

    2012-07-01

    First suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults. Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm. Of a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results. A composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.

  20. Treatment of Fingertip Amputation in Adults by Palmar Pocketing of the Amputated Part

    Directory of Open Access Journals (Sweden)

    Mi Sun Jung

    2012-07-01

    Full Text Available BackgroundFirst suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults.MethodsBetween 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm.ResultsOf a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results.ConclusionsA composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.

  1. Radiographic and pathologic characterization of lateral palmar intercarpal ligament avulsion fractures in the horse.

    Science.gov (United States)

    Beinlich, Christopher P; Nixon, Alan J

    2004-01-01

    In this study, the radiographic and histologic appearance of lateral palmar intercarpal ligament (LPICL) avulsion in the horse was characterized. Thirty-seven horses with radiographic evidence of avulsion fragments originating from the medial palmar aspect of the ulnar carpal bone were examined. The dorsolateral to palmaromedial projection was useful for evaluating the size and shape of the avulsed bone fragment, and the dorsopalmar projection added information on the relative proximity of the fragment to its fracture bed. Radiographic features that differentiated LPICL avulsion from subchondral cystic lesions of the ulnar carpal bone included a variable-sized osseous opacity adjacent to the lucent concavity of the fracture bed and the consistent location within the palmar transition zone at the confluence of LPICL insertion and hyaline cartilage on the palmar surface of the ulnar carpal bone. All 26 horses having surgical removal of the fragments had arthroscopic confirmation that the fragment was within the LPICL. Histologic examination confirmed the fragments were fracture related rather than developmental or the result of dystrophic mineralization. Many of the fragments had attached remnants of a ligament. This study describes the radiographic, surgical, and histologic features in 37 horses which better characterize LPICL avulsion fracture in the carpus and provide differentiating features to assist in separating this syndrome from true osseous cyst-like lesions within the ulnar carpal bone.

  2. Palmar-plantar erythrodysesthesia secondary to docetaxel chemotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Al-Niaimi Amjad

    2011-02-01

    Full Text Available Abstract Introduction Docetaxel is a chemotherapeutic agent used alone or in combination for the management of many neoplastic conditions. Numerous side effects are well described as a consequence. Palmar-plantar erythrodysesthesia, although a relatively common side effect of some types of chemotherapy, occurs infrequently with docetaxel and is often attributed to other drug agents. Case Presentation We report the case of a 66-year-old Caucasian woman who received adjuvant docetaxel monotherapy for invasive breast cancer. She developed palmar-plantar erythrodysesthesia following her first cycle of treatment, which necessitated a change in management. Conclusion Palmar-plantar erythrodysesthesia is a relatively common side effect of cytotoxic chemotherapy, particularly with drugs such as 5-fluorouracil, capecitabine and liposomal doxorubicin. Docetaxel is commonly used both alone and in combination with a number of these agents for the management of various malignant conditions. We would like to highlight the occurrence of palmar-plantar erythrodysesthesia as a result of docetaxel monotherapy so that it can be considered as a potential cause in patients receiving combination treatment with chemotherapeutic agents better known to cause this toxicity.

  3. Geological map of Uruguay Esc 1,100,000. Paso del Palmar Sheet N-19

    International Nuclear Information System (INIS)

    Ford, I.; Montana, J.; Morales, H.

    1990-01-01

    This work is about the geological map of Uruguay Esc.1.100.000 (Paso del Palmar) and the explanatory memoranda which describes the geological , lithological and sedimentological characteristics soils belong to Cretaceous, Tertiary and Quaternary period in San Gregorio, Arapey, Mercedes, Asencio and Fray Bentos formations

  4. Arcuate ligament of the wrist: normal MR appearance and its relationship to palmar midcarpal instability: a cadaveric study

    International Nuclear Information System (INIS)

    Chang, Weiling; Peduto, Anthony J.; Aguiar, Rodrigo O.C.; Trudell, Debra J.; Resnick, Donald L.

    2007-01-01

    To describe the magnetic resonance (MR) imaging and gross anatomic appearance of the scaphocapitate (SC) ligament and triquetrohamocapitate (THC) ligament, which are the radial and ulnar limbs of the composite arcuate ligament, a critical volar midcarpal stabilizing ligament. T1 spin-echo and 3D gradient-echo MR imaging in the standard, coronal oblique, and axial oblique planes were performed both before and following midcarpal arthrography in seven cadaveric wrists. The seven specimens were then sectioned in selected planes to optimally visualize the SC and THC ligaments. These specimens were analyzed and correlated with their corresponding MR images. The SC and THC ligaments can be visualized in MR images as structures of low signal intensity that form an inverted ''V'' joining the proximal and distal carpal rows. The entire ligamentous complex is best visualized with coronal and axial oblique MR imaging but can also be seen in standard imaging planes. SC and THC ligaments together form the arcuate ligament of the wrist. Their function is crucial to the normal functioning of the wrist. Palmar midcarpal instability (PMCI) is a resulting condition when abnormalities of these ligaments occur. Dedicated MR imaging in the coronal and axial imaging planes can be performed in patients suspected of having PCMI. (orig.)

  5. Arcuate ligament of the wrist: normal MR appearance and its relationship to palmar midcarpal instability: a cadaveric study

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Weiling [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Sharp-Grossmont Hospital, Department of Radiology, La Mesa, CA (United States); Peduto, Anthony J. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Westmead Hospital and Western Clinical School of Sydney University, Department of Radiology, Sydney (Australia); Aguiar, Rodrigo O.C. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Universidade Federal do Rio de Janeiro, Rio de Janerio (Brazil); Trudell, Debra J.; Resnick, Donald L. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States)

    2007-07-15

    To describe the magnetic resonance (MR) imaging and gross anatomic appearance of the scaphocapitate (SC) ligament and triquetrohamocapitate (THC) ligament, which are the radial and ulnar limbs of the composite arcuate ligament, a critical volar midcarpal stabilizing ligament. T1 spin-echo and 3D gradient-echo MR imaging in the standard, coronal oblique, and axial oblique planes were performed both before and following midcarpal arthrography in seven cadaveric wrists. The seven specimens were then sectioned in selected planes to optimally visualize the SC and THC ligaments. These specimens were analyzed and correlated with their corresponding MR images. The SC and THC ligaments can be visualized in MR images as structures of low signal intensity that form an inverted ''V'' joining the proximal and distal carpal rows. The entire ligamentous complex is best visualized with coronal and axial oblique MR imaging but can also be seen in standard imaging planes. SC and THC ligaments together form the arcuate ligament of the wrist. Their function is crucial to the normal functioning of the wrist. Palmar midcarpal instability (PMCI) is a resulting condition when abnormalities of these ligaments occur. Dedicated MR imaging in the coronal and axial imaging planes can be performed in patients suspected of having PCMI. (orig.)

  6. Malposition of the tibial tubercle during flexion in knees with patellofemoral arthritis

    International Nuclear Information System (INIS)

    Nagamine, R.; Miura, H.; Tanaka, K.; Urabe, K.; Iwamoto, Y.; Inoue, Y.; Okamoto, Y.; Nishizawa, M.

    1997-01-01

    Objective. To assess the mechanisms contributing to the induction of patellofemoral arthritis (PF-OA). Design and patients. A computed tomography scan was taken at three levels of the lower extremity in full extension and at 30 of flexion. The cuts were superimposed and 12 parameters were compared in 17 PF-OA knees and 27 normal knees to assess the rotation angle of the tibial tubercle. Results. Although the tibial tubercle was in almost the same position in full extensioin in the normal and PF-OA knees, it was positioned significantly laterally at 30 of flexion in PF-OA knees. Also the articular surface of the lateral femoral condyle was significantly narrower or steeper in PF-OA knees. Conclusion. Anatomic variations and mechanical abnormalities were identified in the PF-OA knees. (orig.)

  7. Malposition of the tibial tubercle during flexion in knees with patellofemoral arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Nagamine, R.; Miura, H.; Tanaka, K.; Urabe, K.; Iwamoto, Y. [Department of Orthopaedic Surgery, Kyushu Univ. (Japan); Inoue, Y.; Okamoto, Y.; Nishizawa, M. [Department of Orthopaedic Surgery, JR Kyushu Hospital, Kitakyushu City (Japan)

    1997-10-01

    Objective. To assess the mechanisms contributing to the induction of patellofemoral arthritis (PF-OA). Design and patients. A computed tomography scan was taken at three levels of the lower extremity in full extension and at 30 of flexion. The cuts were superimposed and 12 parameters were compared in 17 PF-OA knees and 27 normal knees to assess the rotation angle of the tibial tubercle. Results. Although the tibial tubercle was in almost the same position in full extensioin in the normal and PF-OA knees, it was positioned significantly laterally at 30 of flexion in PF-OA knees. Also the articular surface of the lateral femoral condyle was significantly narrower or steeper in PF-OA knees. Conclusion. Anatomic variations and mechanical abnormalities were identified in the PF-OA knees. (orig.) With 8 figs., 1 tab., 11 refs.

  8. The effect of prior lumbar surgeries on the flexion relaxation phenomenon and its responsiveness to rehabilitative treatment.

    Science.gov (United States)

    Neblett, Randy; Mayer, Tom G; Brede, Emily; Gatchel, Robert J

    2014-06-01

    Abnormal pretreatment flexion-relaxation in chronic disabling occupational lumbar spinal disorder patients has been shown to improve with functional restoration rehabilitation. Little is known about the effects of prior lumbar surgeries on flexion-relaxation and its responsiveness to treatment. To quantify the effect of prior lumbar surgeries on the flexion-relaxation phenomenon and its responsiveness to rehabilitative treatment. A prospective cohort study of chronic disabling occupational lumbar spinal disorder patients, including those with and without prior lumbar spinal surgeries. A sample of 126 chronic disabling occupational lumbar spinal disorder patients with prior work-related injuries entered an interdisciplinary functional restoration program and agreed to enroll in this study. Fifty-seven patients had undergone surgical decompression or discectomy (n=32) or lumbar fusion (n=25), and the rest had no history of prior injury-related spine surgery (n=69). At post-treatment, 116 patients were reevaluated, including those with prior decompressions or discectomies (n=30), lumbar fusions (n=21), and no surgery (n=65). A comparison group of 30 pain-free control subjects was tested with an identical assessment protocol, and compared with post-rehabilitation outcomes. Mean surface electromyography (SEMG) at maximum voluntary flexion; subject achievement of flexion-relaxation (SEMG≤3.5 μV); gross lumbar, true lumbar, and pelvic flexion ROM; and a pain visual analog scale self-report during forward bending task. Identical measures were obtained at pretreatment and post-treatment. Patients entered an interdisciplinary functional restoration program, including a quantitatively directed, medically supervised exercise process and a multimodal psychosocial disability management component. The functional restoration program was accompanied by a SEMG-assisted stretching training program, designed to teach relaxation of the lumbar musculature during end-range flexion

  9. A influência de palmares e parachute na coordenação dos nados

    OpenAIRE

    Thiago Telles

    2012-01-01

    Resumo: A natação é uma modalidade esportiva que, ao longo dos anos, sofreu modificações, atingindo um alto nível de exigência, o que é refletido nas sessões de treinamentos e nas pesquisas sobre a modalidade. Sendo assim, para otimizar o deslocamento nos nadadores pode-se otimizar a força propulsora. Para isso, pode-se utilizar palmares e parachute. Os palmares tem como função promover o aumento artificial da área da mão, desta maneira, aumenta-se a área frontal da mão do sujeito em contato ...

  10. Cooling modifies mixed median and ulnar palmar studies in carpal tunnel syndrome.

    Science.gov (United States)

    Araújo, Rogério Gayer Machado de; Kouyoumdjian, João Aris

    2007-09-01

    Temperature is an important and common variable that modifies nerve conduction study parameters in practice. Here we compare the effect of cooling on the mixed palmar median to ulnar negative peak-latency difference (PMU) in electrodiagnosis of carpal tunnel syndrome (CTS). Controls were 22 subjects (19 women, mean age 42.1 years, 44 hands). Patients were diagnosed with mild symptomatic CTS (25 women, mean age 46.6 years, 34 hands). PMU was obtained at the usual temperature, >32 degrees C, and after wrist/hand cooling to PMU and mixed ulnar palmar latency in patients versus controls. We concluded that cooling significantly modifies the PMU. We propose that the latencies of compressed nerve overreact to cooling and that this response could be a useful tool for incipient CTS electrodiagnosis. There was a significant latency overreaction of the ulnar nerve to cooling in CTS patients. We hypothesize that subclinical ulnar nerve compression is associated with CTS.

  11. Propuesta de un proyecto comunitario como alternativa de desarrollo del recinto El Palmar mediante el Agroturismo

    OpenAIRE

    Pino Panchig, Silvana Fernanda; Rivera Núñez, Lorena Marisol

    2006-01-01

    Given the above problems, it was necessary to raise a proposal that can be developed in rural areas in which it seeks to improve living conditions by promoting community tourism, agrotourism in this case is an activity for the population of El Palmar can be a source of additional income that depend on their main economic activity, becoming a productive heading over the agricultural enterprise. Ante la problemática antes mencionada, fue necesario plantear una propuesta que pueda ser desarro...

  12. Arthroscopic removal of discrete palmar carpal osteochondral fragments in horses: 25 cases (1999-2013).

    Science.gov (United States)

    Lang, Hayley M; Nixon, Alan J

    2015-05-01

    To characterize discrete palmar carpal osteochondral fragmentation in horses and to document the effect of osteoarthritis and surgical removal of these fragments on functional outcome. Retrospective case series. 25 horses. Medical records and radiographic views were reviewed to identify horses that had radiographic evidence of palmar carpal fragmentation, which was subsequently treated by arthroscopic removal. Information collected included cause of fracture, initial and long-term clinical and radiographic findings, and functional outcome. Palmar carpal fragmentation of 30 carpal bones was identified in 25 unilaterally affected horses. A known traumatic event was reported to cause the fragmentation in 17 of the 25 (68%) horses. Of the 25 horses, 17 (68%) had fragmentation involving the antebrachiocarpal joint, 7 (28%) had fragmentation involving the middle carpal joint, and 1 (4%) had fragmentation involving the carpometacarpal joint. The proximal aspect of the radial carpal bone was the most commonly affected site (12/30 fragments), followed by the accessory carpal bone (6/30). Of the 25 horses, 19 (76%) were not lame (sound) after surgery and returned to their intended use, 4 (16%) were considered pasture sound, and 2 were euthanized (because of severe postoperative osteoarthritis or long bone fracture during recovery from anesthesia). Eight of the 14 horses with preoperative evidence of osteoarthritis returned to function after surgery. Twelve of 17 horses with antebrachiocarpal joint fragments and 6 of 7 horses with middle carpal joint fragments returned to their previous use. Results indicated that the prognosis for horses after arthroscopic removal of palmar carpal osteochondral fragments is good. Early intervention, before the development of osteoarthritis, is recommended.

  13. Comminuted Distal Radial Fracture with Large Rotated Palmar Medial Osteochondral Fragment in the Joint.

    Science.gov (United States)

    Gökkus, Kemal; Sagtas, Ergin; Kesgin, Engin; Aydin, Ahmet Turan

    2018-01-01

    Intra-articular distal radius fractures have long been massively discussed in the literature, but regarding to fractures that possess rotated volar medial fragment in the joint a few amount papers has been written. In this article, we would like to emphasize the significance of the rotated palmar medial (lunate facet) fragment. A 39-year-old man fell from a height of about 3 m and landed on his right outstretched hand; within 40 min, he arrived at our clinic presenting with a severe pain and swelling in his right wrist. Initial X-rays of the wrist revealed dorsal subluxation of the radiocarpal joint with dorsal comminution of the radial articular surface and fracture of the radial styloid process, with (nearly inverted) ~ 140-150° rotation of the palmar medial fragment. With an additional volar approach, the fragment reduced and stabilized with two K-wires and wrist immobilized in external fixator. The patient returned to daily activities without any discomfort and pain after the 1 year from the surgery. Overlooking of palmar rotated osteochondral fragment will cause deficiency to build proper pre-operative strategy to approach the reduction of the fragment. The incompetence of reduction will deteriorate the articular surface and lead to early osteoarthritis of the wrist. The surgeon should detect this fragment and should be familiar with volar approaches of the wrist. Above average surgical experience would be needed for successful reduction.

  14. Treatment of Fingertip Amputation in Adults by Palmar Pocketing of the Amputated Part

    Directory of Open Access Journals (Sweden)

    Mi Sun Jung

    2012-07-01

    Full Text Available Background First suggested by Brent in 1979, the pocket principle is an alternative methodfor patients for whom a microsurgical replantation is not feasible. We report the successfulresults of a modified palmar pocket method in adults.Methods Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantationusing palmar pocketing. All patients were adults who sustained a complete fingertip amputationfrom the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crushor avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmarpocketing method following a composite graft in these patients and prepared the pocket in thesubcutaneous layer of the ipsilateral palm.Results Of a total of 10 cases, nine had complete survival of the replantation and one had20% partial necrosis. All of the cases were managed to conserve the fingernails, which led toacceptable cosmetic results.Conclusions A composite graft and palmar pocketing in adult cases of fingertip injuryconstitute a simple, reliable operation for digital amputation extending from the tip to thelunula. These methods had satisfactory results.

  15. Fingertip Replantation Without and With Palmar Venous Anastomosis: Analysis of the Survival Rates and Vein Distribution.

    Science.gov (United States)

    Aksoy, Alper; Gungor, Melike; Sir, Emin

    2017-01-01

    The purpose of this study was to compare the results of fingertip replantations without (artery anastomosis only replantations) and with venous anastomosis (replantations in which both arterial and palmar venous anastomoses were performed). Also, distribution of the veins used for anastomosis was analyzed retrospectively. First 53 digits (47 patients) received only arterial anastomosis (group 1). For relieving venous congestion, external bleeding method was used. Last 41 digits (38 patients) received both arterial and palmar venous anastomoses without external bleeding (group 2). There was statistical significance of the survival rate between group 1 [77.3% (41/53)] and group 2 [92.6% (38/41)] (P = 0.039). Venous congestion was encountered at 10 digits in group 1 (all underwent necrosis totally) and at 3 digits in group 2 (both were moderate and could be salvaged partially) (P = 0.094, no statistical significance). There was statistical significance of the mean operation time for single-fingertip replantation between group 1 (80 ± 7.8 minutes) and group 2 (105 ± 14.5 minutes) (P replantations with palmar venous anastomosis have simpler postoperative care and lower drawbacks as compared with artery anastomosis-only replantations.

  16. Incomplete longitudinal fracture of the proximal palmar cortex of the third metacarpal bone in horses

    International Nuclear Information System (INIS)

    Ross, M.W.; Ford, T.S.; Orsini, P.G.

    1988-01-01

    Seven horses, 2 to 4 years of age, were examined because of moderate-to-severe forelimb lameness, mild effusion of the middle carpal joint (3 horses), and pain on palpation of the origin of the suspensory ligament (4 horses). The lameness was abolished by anesthetic infiltration of the middle carpal joint in six horses. In four of them, a high palmar nerve block also abolished the lameness. A linear radiolucency in the proximal end of the third metacarpal bone (McIII) was interpreted as an incomplete longitudinal fracture. In one horse, distinct intramedullary sclerosis limited to the palmar cortex was indicative of an incomplete fracture confined to the palmar cortex. No osteoproliferative lesions were identified on the dorsal cortex of any of the horses. Surgical treatment with cortical screws in lag fashion accompanied by a rest period was successful in one horse. In four horses, rest for at least 3 months resulted in clinical soundness. In two horses, a shorter rest period resulted in recurrence of the lameness even though the horses were sound when put back into training. Careful clinical and radiographic examinations helped differentiate incomplete longitudinal fractures from lesions involving the carpus and proximal aspect of the suspensory ligament

  17. In vivo metacarpophalanageal joint collateral ligament length changes during flexion.

    Science.gov (United States)

    Sun, Y C; Sheng, X M; Chen, J; Qian, Z W

    2017-07-01

    We investigated the in vivo length changes of the collateral ligaments of metacarpophalangeal joint during flexion. We obtained computed tomography scans of index, middle, ring and little fingers at 0°, 30°, 60° and 90° of joint flexion from six hands of six healthy adult volunteers. Three of them had their dominant right hand studied, and the other three had their non-dominant left hand studied. We measured and analysed the radial and ulnar collateral ligaments of each metacarpophalangeal joint from the reconstructed images. We found that the dorsal and middle portions of the both radial and ulnar collateral ligament lengthened progressively during digital flexion and reached the maximum at 90° flexion. The length of the volar portion increased from 0° to 30° flexion and then decreased from 30° to 60° flexion, reaching the minimum at 90°. In conclusion, three portions of collateral ligaments on both sides of the metacarpophalangeal joint have variable length changes during flexion, which act to stabilize the joint through its flexion arc.

  18. Do patients care about higher flexion in total knee arthroplasty?

    DEFF Research Database (Denmark)

    Thomsen, Morten G; Husted, Henrik; Otte, Kristian Stahl

    2013-01-01

    BACKGROUND: Little information exists to support that patients care about flexion beyond what is needed to perform activities of daily living (ADL) after Total knee arthroplasty (TKA). The purpose of this study was to investigate if the achievement of a higher degree of knee flexion after TKA would...

  19. A Pseudoaneurysm of the Deep Palmar Arch After Penetrating Trauma to the Hand: Successful Exclusion by Ultrasound Guided Percutaneous Thrombin Injection

    Directory of Open Access Journals (Sweden)

    A. Bosman

    Full Text Available : Introduction: Pseudoaneurysm of the hand is a rare condition; most are treated surgically. Ultrasound guided thrombin injection has not previously been reported as a treatment option for pseudoaneurysms of the deep palmar arch. Report: A man was referred to the emergency department with a swollen, painful hand after penetrating trauma. On physical examination, a pulsating tumor was found on the dorsum of the hand. Imaging revealed a pseudoaneurysm vascularized by the deep palmar arch. Ultrasound guided percutaneous thrombin injection was successfully performed. Conclusion: Thrombin injection might be a safe alternative option in the treatment of pseudoaneurysm of the deep palmar arch. Keywords: Deep palmar arch, Pseudoaneurysm, Thrombin injection

  20. Simpatectomia por videotoracoscopia no tratamento da hiperhidrose palmar: implicações anestésicas Simpatectomia por videotoracoscopia en el tratamiento de la hiperhidrosis palmar: implicaciones anestésicas Thoracoscopic sympathectomy to treat palmar hyperhydrosis: anesthetic implications

    Directory of Open Access Journals (Sweden)

    Monia Di Lara Dias

    2005-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A hiperhidrose primária é uma desordem caracterizada por sudorese excessiva difusa ou localizada. Existem inúmeros métodos terapêuticos não-invasivos que, em geral, não solucionam o problema, o que gera mais ansiedade, dispêndio de tempo e de dinheiro para os pacientes que sofrem com hiperhidrose. A ressecção de parte da cadeia simpática torácica está indicada em casos de hiperhidrose palmar e pode ser feita através de cirurgia toracoscópica com bons resultados e poucas complicações. A finalidade desta revisão é discutir as possíveis técnicas anestésicas para este procedimento, bem como possíveis complicações e seu manuseio. CONTEÚDO: Estima-se que a incidência de hiperhidrose primária seja de 0,6% a 1%, ocorrendo com maior freqüência em pacientes jovens. Enquanto a sudorese axilar e plantar, na maioria dos casos, causa apenas desconforto, o excesso de suor nas mãos causa problemas sociais, profissionais e psicológicos. A simpatectomia por videotoracoscopia tem sido realizada em vários hospitais e seu número é crescente. A não ser que ocorram contra-indicações específicas, a simpatectomia é realizada bilateralmente, sob anestesia geral, através de um tubo de duplo lúmen ou tubo simples com ou sem associação de insuflação de dióxido de carbono intrapleural. Os principais cuidados pós-operatórios são o diagnóstico precoce de pneumotórax ou hemotórax residual, prevenção de náuseas e vômitos e controle da dor pós-operatória. CONCLUSÕES: A simpatectomia torácica é método eficaz para o tratamento da hiperhidrose palmar e o número de procedimentos é crescente. A introdução da videotoracoscopia melhorou a técnica, reduziu a morbidade, o tempo cirúrgico e o tempo de permanência hospitalar. O adequado manuseio anestésico, monitorização contínua e as técnicas disponíveis permitem que o procedimento seja realizado com segurança ou modifiquem-se as

  1. Clinical outcome of increased flexion gap after total knee arthroplasty. Can controlled gap imbalance improve knee flexion?

    Science.gov (United States)

    Ismailidis, P; Kuster, M S; Jost, B; Giesinger, K; Behrend, H

    2017-06-01

    Increased range of motion (ROM) while maintaining joint stability is the goal of modern total knee arthroplasty (TKA). A biomechanical study has shown that small increases in flexion gap result in decreased tibiofemoral force beyond 90° flexion. The purpose of this paper was to investigate clinical implications of controlled increased flexion gap. Four hundred and four TKAs were allocated into one of two groups and analysed retrospectively. In the first group (n = 352), flexion gap exceeded extension gap by 2.5 mm, while in the second group (n = 52) flexion gap was equal to the extension gap. The procedures were performed from 2008 to 2012. The patients were reviewed 12 months postoperatively. Objective clinical results were assessed for ROM, mediolateral and sagittal stability. Patient-reported outcome measures were the WOMAC score and the Forgotten Joint Score (FJS-12). After categorizing postoperative flexion into three groups (poor < 90°, satisfactory 91°-119°, good ≥ 120°) significantly more patients in group 1 achieved satisfactory or good ROM (p = 0.006). Group 1 also showed a significantly higher mean FJS-12 (group 1: 73, group 2: 61, p = 0.02). The mean WOMAC score was 11 in the first and 14 in the second group (n.s.). Increase in flexion gap did not influence knee stability. The clinical relevance of this study is that a controlled flexion gap increase of 2.5 mm may have a positive effect on postoperative flexion and patient satisfaction after TKA. Neither knee stability in the coronal and sagittal planes nor complications were influenced by a controlled increase in flexion gap. III.

  2. Femoral neck radiography: effect of flexion on visualization

    International Nuclear Information System (INIS)

    Garry, S.C.; Jhangri, G.S.; Lambert, R.G.W.

    2005-01-01

    To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15 o and flexion in 10 o increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0 o and 20 o flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation (ρ o internal rotation to 30 o external rotation (ρ o flexion was applied to bones in external rotation, visualization significantly improved at 15 o (ρ o (ρ o ) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg. (author)

  3. Caracterización del nervio digital palmar en el miembro anterior equino

    Directory of Open Access Journals (Sweden)

    Carolina Ortiz

    2017-05-01

    Full Text Available A partir de 60 miembros anteriores de caballos mestizos recolectados de un matadero en Santiago, Chile, se determinó que lo más frecuente es que el nervio digital palmar emita sus ramas dorsal y palmar antes (33% o al comienzo de la articulación metacarpofalángica (33%. En un 60% de los nervios analizados se evidenció la presencia de una a cuatro ramas accesorias y que ésta se presenta de manera similar entre diversas zonas, siendo la presentación más frecuente (26% en la zona de la articulación interfalángica proximal y que se dirigen hacia dorsal. En un 46,66% de las muestras el nervio digital palmar no se relaciona íntimamente con alguna estructura, seguido con 33,33% por la unión de éste al ligamento del espolón. Es muy poco frecuente que el nervio emita ramas superficiales que se dirijan hacia la dermis (6,66%, que se divida en tres grandes ramas en la articulación metacarpofalángica (3,33% o que pase bajo la arteria digital (3,33%, y más frecuente es que éste se disponga sobre la arteria en algún lugar de su recorrido hecho que ocurrió en el 35% de los casos. Estos resultados se presentan de manera relevante de considerar en procedimientos diagnósticos o quirúrgicos en la zona distal del miembro anterior del equino, ya que pueden alterar su sensibilidad y eficacia.

  4. MR imaging and radiography of patients with cervical hyperextension-flexion injuries after car accidents

    Energy Technology Data Exchange (ETDEWEB)

    Borchgrevink, G E [The Emergency Clinic, Trondheim Univ. Hospital (Norway); Smevik, O [MR-Centre Medical Section, Trondheim Univ. Hospital (Norway); Nordby, A [Dept. of Radiology, Trondheim Univ. Hospital (Norway); Rinck, P A [MR-Centre Medical Section, Trondheim Univ. Hospital (Norway); Stiles, T C [Dept. of Psychiatry and Behavioural Medicine, Trondheim Univ. (Norway); Lereim, I [The Emergency Clinic, Trondheim Univ. Hospital (Norway)

    1995-07-01

    Fifty-two patients underwent MR imaging and conventional radiography of the neck within 4 days after a hyperextension-flexion injury. The patients also had follow-up investigations during the first 2 years. The images did not reveal any serious lesions in any of them. Based on the main MR and radiographical findings the patients were divided into 4 groups; no findings, posture abnormalities, spondylosis and disc pathology (from MR images) or reduced intervertebral space (from the radiographs). The outcomes of the different groups were compared with reference to neck stiffness, neck pain and headache during a 2-year follow-up period. The patient groups did not correspond completely when diagnosed from MR imaging and radiography. However, patients with pre-existing spondylosis had more symptoms when examined by both modalities. Based on the radiographs, the group with posture abnormalities had significant fewer symptoms than the other groups. (orig.).

  5. Diversidad de anfibios anuros del Parque Nacional El Palmar (Provincia de Entre Ríos, Argentina)

    OpenAIRE

    Gangenova, Elena; Guzmán, Atilio; Marangoni, Federico

    2012-01-01

    El Parque Nacional El Palmar (PNEP) es una importante área protegida de la zona este de la provincia de Entre Ríos, Argentina, creado para conservar uno de los últimos fragmentos de palmera yatay (Butia yatay). En este estudio se examina la biodiversidad de la comunidad de anfibios anuros que habitan tres tipos de ambientes del Parque; el pajonal, el pastizal y la selva en galería. Los muestreos se llevaron a cabo entre los meses de primavera-verano de 2008 y 2009. En total se registraron 16 ...

  6. Palmar reconstruction of the triangular fibrocartilage complex for instability of the distal radioulnar joint: a biomechanical study.

    Science.gov (United States)

    Kataoka, T; Moritomo, H; Omokawa, S; Iida, A; Wada, T; Aoki, M

    2013-06-01

    We developed a new triangular fibrocartilage complex reconstruction technique for distal radioulnar joint instability in which the palmar portion of the triangular fibrocartilage complex was predominantly reconstructed, and evaluated whether such reconstruction can restore stability of the distal radioulnar joint in seven fresh cadaver upper extremities. Distal radioulnar joint instability was induced by cutting all soft-tissue stabilizers around the distal ulna. Using a palmar approach, a palmaris longus tendon graft was sutured to the remnant of the palmar radioulnar and ulnocarpal ligaments. The graft was then passed through a bone tunnel created at the fovea and was sutured. Loads were applied to the radius, and dorsopalmar displacements of the radius relative to the ulna were measured using an electromagnetic tracking device in neutral rotation, 60° supination and 60° pronation. We compared the dorsopalmar displacements before sectioning, before reconstruction and after reconstruction. Dorsopalmar instability produced by sectioning significantly improved in all forearm positions after reconstruction.

  7. Micromechanics of the human vertebral body for forward flexion.

    Science.gov (United States)

    Yang, Haisheng; Nawathe, Shashank; Fields, Aaron J; Keaveny, Tony M

    2012-08-09

    To provide mechanistic insight into the etiology of osteoporotic wedge fractures, we investigated the spatial distribution of tissue at the highest risk of initial failure within the human vertebral body for both forward flexion and uniform compression loading conditions. Micro-CT-based linear elastic finite element analysis was used to virtually load 22 human T9 vertebral bodies in either 5° of forward flexion or uniform compression; we also ran analyses replacing the simulated compliant disc (E=8 MPa) with stiff polymethylmethacrylate (PMMA, E=2500 MPa). As expected, we found that, compared to uniform compression, forward flexion increased the overall endplate axial load on the anterior half of the vertebra and shifted the spatial distribution of high-risk tissue within the vertebra towards the anterior aspect of the vertebral body. However, despite that shift, the high-risk tissue remained primarily within the central regions of the trabecular bone and endplates, and forward flexion only slightly altered the ratio of cortical-to-trabecular load sharing at the mid-vertebral level (mean±SD for n=22: 41.3±7.4% compression; 44.1±8.2% forward flexion). When the compliant disc was replaced with PMMA, the anterior shift of high-risk tissue was much more severe. We conclude that, for a compliant disc, a moderate degree of forward flexion does not appreciably alter the spatial distribution of stress within the vertebral body. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. A prospective randomized study of conservative versus surgical treatment of unstable palmar plate disruption in the proximal interphalangeal finger joint

    DEFF Research Database (Denmark)

    Werlinrud, Jens Christian; Petersen, Kirstin; Lauritsen, Jens

    2013-01-01

    study in which 83 patients were randomly assigned into 2 groups: (1) conservative treatment with a rigid splint for 2 weeks, (2) surgical reattachment of the palmar plate in local anesthesia followed by 2 weeks of immobilization in a plaster cast. Both groups were thereafter treated by taping...... to the neighboring finger for 3 weeks. With regard to hyperextension instability, stiffness, and pain, there is no significant difference in outcome between patients with traumatic palmar plate lesions and hyperextension instability treated with surgical repair and patients treated conservatively with a splint. We...

  9. Congenital Abnormalities

    Science.gov (United States)

    ... tube defects. However, there is also a genetic influence to this type of congenital anomaly. Unknown Causes The vast majority of congenital abnormalities have no known cause. This is particularly troubling for parents who plan to have more children, because there is no way to predict if ...

  10. The effect of ex vivo flexion and extension on intervertebral foramina dimensions in the equine cervical spine.

    Science.gov (United States)

    Sleutjens, J; Voorhout, G; Van Der Kolk, J H; Wijnberg, I D; Back, W

    2010-11-01

    In dressage, the head and neck position has become an issue of concern as certain extreme positions may imply a welfare risk for the horse. In man, extension and flexion of the cervical spine cause a decrease and increase in intervertebral foramina dimensions, respectively. However, in horses, the influence of flexion and extension on foramina dimensions and its possible interference with peripheral nerve functioning remains unknown. To determine the effect of ex vivo flexion and extension on intervertebral foramina dimensions in the equine cervical spine. Computed tomography was performed on 6 cadaver cervical spines from adult Warmblood horses subjected to euthanasia for reasons unrelated to cervical spine abnormalities, in a neutral position, in 20 and 40° extension, and in 20 and 40° flexion. Multiplanar reconstructions were made to obtain transverse images perpendicular to the long axis of each pair of intervertebral foramina from C2-T1. Intervertebral foramina dimensions were measured in the 5 positions. Compared to the neutral position, 40° extension caused a decrease in foramina dimensions at segments C4-C5, C5-C6, C6-C7 (P dimensions at segments C5-C6 (P dimensions at segments C4-T1, similar to that found in man. In vivo extension of the cervical spine could possibly interfere with peripheral nerve functioning at segments C4-T1. This effect may be even more profound in patients with a reduced intervertebral foramina space, for example in the presence of facet joint arthrosis. © 2010 EVJ Ltd.

  11. Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

    OpenAIRE

    Nicodemo, Alberto; Arrigoni, Chiara; Bersano, Andrea; Massè, Alessandro

    2014-01-01

    Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this stu...

  12. Extrinsic versus intrinsic hand muscle dominance in finger flexion.

    Science.gov (United States)

    Al-Sukaini, A; Singh, H P; Dias, J J

    2016-05-01

    This study aims to identify the patterns of dominance of extrinsic or intrinsic muscles in finger flexion during initiation of finger curl and mid-finger flexion. We recorded 82 hands of healthy individuals (18-74 years) while flexing their fingers and tracked the finger joint angles of the little finger using video motion tracking. A total of 57 hands (69.5%) were classified as extrinsic dominant, where the finger flexion was initiated and maintained at proximal interphalangeal and distal interphalangeal joints. A total of 25 (30.5%) were classified as intrinsic dominant, where the finger flexion was initiated and maintained at the metacarpophalangeal joint. The distribution of age, sex, dominance, handedness and body mass index was similar in the two groups. This knowledge may allow clinicians to develop more efficient rehabilitation regimes, since intrinsic dominant individuals would not initiate extrinsic muscle contraction till later in finger flexion, and might therefore be allowed limited early active motion. For extrinsic dominant individuals, by contrast, initial contraction of extrinsic muscles would place increased stress on the tendon repair site if early motion were permitted. © The Author(s) 2016.

  13. A comparative trial of ice application versus EMLA cream in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Alsantali A

    2018-04-01

    Full Text Available Adel Alsantali Department of Dermatology, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia Background: Botulinum toxin is a safe and effective therapy for palmar hyperhidrosis, but the associated pain from injections limits the usefulness of this method of treatment. Purpose: To evaluate the efficacy of Eutectic Mixture of Local Anesthetics (EMLA cream versus ice application in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis. Methods: In this prospective study, 23 patients underwent palm Botox injections to treat their excessive sweating. In each patient, EMLA cream was applied to one palm and ice was applied directly before the injections in the other palm. Pain was evaluated using a Visual Analog Scale. Results: Statistically, there was a significant difference in pain control between EMLA cream group and ice application group (p<0.05. The average pain score on the hands where EMLA cream was applied was 8.9 (SD=0.81, whereas it was 4.8 (±0.9 in the ice group. Conclusion: In this study, the successful use of ice application in reducing pain by 40% in comparison to EMLA cream during Botox toxin injection for palmar hyperhidrosis is demonstrated.Keywords: ice, local anesthetics, EMLA, palmar hyperhidrosis, Botox injection, pain reduction

  14. Localized palmar-plantar epidermal hyperplasia: a previously undefined dermatologic toxicity to sorafenib.

    Science.gov (United States)

    Beldner, Matthew; Jacobson, Michael; Burges, Gene E; Dewaay, Deborah; Maize, John C; Chaudhary, Uzair B

    2007-10-01

    The development of multitargeted tyrosine kinase inhibitors has provided significant advances in the treatment of renal cell carcinoma. This case describes initial therapy for managing renal cell cancer with the administration of sorafenib, a multitargeted tyrosine kinase inhibitor. We report the development of localized palmar-plantar epidermal hyperplasia, a rare but significant cutaneous adverse event from sorafenib therapy. Mild-to-moderate dermatologic toxicity from sorafenib has been well described in the literature. We also review the current knowledge and the proposed hypothesis for the development of cutaneous events related to tyrosine kinase inhibitors. This particular case represents a unique form of dermatologic toxicity to sorafenib that has not previously been described in the literature.

  15. Knee flexion contracture treated with botulinum toxin type A in patients with haemophilia (PWH).

    Science.gov (United States)

    Daffunchio, C; Caviglia, H; Nassif, J; Morettil, N; Galatro, G

    2016-01-01

    Knee flexion contracture (KFC) remains a common complication of haemoarthrosis in children and young adults with haemophilia. If the KFC is not treated properly it produces disability, postural and gait abnormalities. Evaluate the effectiveness of conservative treatment of KFC with Botulinum toxin type A (BTX-A) in PWH. Seventeen patients were treated, with 21 affected knees. Mean age was 26 years. The mean follow up was 12 months. We evaluated flexion and KFC pretreatment BTX-A and up to 12 months posttreatment. BTX-A application was in hamstring and calf muscles. To evaluate the function, a questionnaire about different activities was made, and it was checked 3, 6 and 12 months after BTX-A. According to the degree of KFC, knees were divided into 3 groups: Group 1: -10° to -30° (n = 10), Group 2: -31° to -45° (n = 6) Group 3: -46° or more (n = 5). The average KFC improved from -38° to -24°. The improvement was 14° (P KFC improvement was 9° in group 1, 17° in group 2, and 23° in group 3. There was a high correlation between the improvement in KFC and the total score of the questionnaire R = 0.77. Treatment of KFC with BTX-A improves knee-related functional activities, with the advantage of being a low-cost procedure and easy to apply. © 2015 John Wiley & Sons Ltd.

  16. CT-Guided, Ethanol Sympatholysis for Primary Axillary–Palmar Hyperhidrosis

    Energy Technology Data Exchange (ETDEWEB)

    Tsitskari, Maria, E-mail: mariadote@hotmail.com [American Medical Center, Vascular & Interventional Radiology (Cyprus); Friehs, Gerhard, E-mail: gerhardf@amc.com.cy; Zerris, Vassilis, E-mail: vassilisz@amc.com.cy [American Medical Center, Neurosurgery (Cyprus); Georgiades, Christos, E-mail: g-christos@hotmail.com [Johns Hopkins Hospital, Vascular & Interventional Radiology (United States)

    2016-12-15

    PurposePrimary hyperhidrosis is an excessive sweating due to an overactive sympathetic system. Our objective was to test the feasibility and provide early data on the safety/efficacy of CT-guided sympatholysis, for primary hyperhidrosis.Materials and MethodsNine consecutive patients with axillary–palmar hyperhidrosis were treated between 2013 and 2015. CT-guided sympathetic block was performed in the outpatients at T-2, T-3, and T-4, bilaterally using alcohol under local anesthesia. Immediate postprocedure CT was obtained to assess the complications as per Common Terminology Criteria for Adverse Events, version 4. Technical success and clinical success were recorded. Primary and secondary efficacy were assessed by phone and clinical visits; mean follow-up was 12 months (6–26 months). Descriptive statistics was used to report the outcomes.ResultsOne procedure was aborted due to eyelid ptosis after lidocaine injection. All other eight patients (5:3, F:M) (median age 32) had immediate cessation of sweating. Two major complications (pneumothorax, one requiring a chest tube) occurred. Two patients recurred with unilateral and one with bilateral symptoms. One of the unilateral recurrence and the bilateral recurrence patients was retreated successfully. Median follow-up was 1 year. No cases of Horner’s or compensatory hyperhidrosis were observed.ConclusionsCT-guided EtOH sympatholysis for axillary/palmar primary hyperhidrosis is feasible. Technical failure rate was 11 %. Primary and secondary efficacy are 75 and 94 %, respectively, to a median follow-up of 1 year. Risk profile appears favorable. Despite a small sample size, results confirm feasibility and encourage a larger study.

  17. Comparison of hyperpronation and supination‑flexion techniques in ...

    African Journals Online (AJOL)

    2013-07-24

    Jul 24, 2013 ... Green DA, Linares YM, Garcia Pena MB, Greenberg M, Baker RL: Randomized comparison of pain perception during radial head subluxation using supination‑ flexion or forced pronation. Pediatr Emerg Care 2006;22:235‑8. 8. McDonald LJ, Whitelaw C, Goldsmith L. Radial head subluxation: Comparing.

  18. MR imaging evaluation of the temporomandibular joint following cervical extension-flexion injury (whiplash)

    International Nuclear Information System (INIS)

    Shellock, F.G.; Pressman, B.D.; Schames, J.; Schames, M.; Meeks, T.

    1990-01-01

    To determine abnormalities of the temporomandibular joint (TMJ) associated with cervical extension-flexion injury (whiplash) with use of MR imaging. Sixteen patients (32 joints) with TMJ syndrome-related symptoms after whiplash injuries from automobile accidents were evaluated by MR imaging. None of the patients had direct trauma to the jaw, mouth, or face. T1-weighted closed- and opened-mouth views were obtained in the sagittal plane, and closed-mouth views were obtained in the coronal plane. T2-weighted closed-mouth views obtained in the sagittal plane were also obtained to optimize identification of fluid/edema. Fourteen (87%) of 16 patients had one or more of the following TMJ abnormalities: 11 (34%) had anterior displacement of the disk with reduction and 2 (6%) had anterior displacement of the disk without reduction. On T2-weighted images, 17 TMJs (53%) had joint fluid and 5 (16%) had fluid localized to the capsule and/or pterygoid muscle. These data demonstrated a high incidence of TMJ abnormalities related to whiplash injury. The predominant finding was associated fluid/edema, suggesting that T2-weighted images are particularly useful for the evaluation of patients who present with whiplash injury

  19. Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

    Directory of Open Access Journals (Sweden)

    Alberto Nicodemo

    2014-01-01

    Full Text Available Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible.

  20. Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

    Science.gov (United States)

    Nicodemo, Alberto; Arrigoni, Chiara; Bersano, Andrea; Massè, Alessandro

    2014-01-01

    Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible. PMID:24707293

  1. Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol-Surgical Treatment of Neurological Hip Flexion Contracture.

    Science.gov (United States)

    Nicodemo, Alberto; Arrigoni, Chiara; Bersano, Andrea; Massè, Alessandro

    2014-01-01

    Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible.

  2. Predictive value of fever and palmar pallor for P. falciparum parasitaemia in children from an endemic area.

    Science.gov (United States)

    Vinnemeier, Christof David; Schwarz, Norbert Georg; Sarpong, Nimako; Loag, Wibke; Acquah, Samuel; Nkrumah, Bernard; Huenger, Frank; Adu-Sarkodie, Yaw; May, Jürgen

    2012-01-01

    Although the incidence of Plasmodium falciparum malaria in some parts of sub-Saharan Africa is reported to decline and other conditions, causing similar symptoms as clinical malaria are gaining in relevance, presumptive anti-malarial treatment is still common. This study traced for age-dependent signs and symptoms predictive for P. falciparum parasitaemia. In total, 5447 visits of 3641 patients between 2-60 months of age who attended an outpatient department (OPD) of a rural hospital in the Ashanti Region, Ghana, were analysed. All Children were examined by a paediatrician and a full blood count and thick smear were done. A Classification and Regression Tree (CART) model was used to generate a clinical decision tree to predict malarial parasitaemia a7nd predictive values of all symptoms were calculated. Malarial parasitaemia was detected in children between 2-12 months and between 12-60 months of age with a prevalence of 13.8% and 30.6%, respectively. The CART-model revealed age-dependent differences in the ability of the variables to predict parasitaemia. While palmar pallor was the most important symptom in children between 2-12 months, a report of fever and an elevated body temperature of ≥37.5°C gained in relevance in children between 12-60 months. The variable palmar pallor was significantly (p<0.001) associated with lower haemoglobin levels in children of all ages. Compared to the Integrated Management of Childhood Illness (IMCI) algorithm the CART-model had much lower sensitivities, but higher specificities and positive predictive values for a malarial parasitaemia. Use of age-derived algorithms increases the specificity of the prediction for P. falciparum parasitaemia. The predictive value of palmar pallor should be underlined in health worker training. Due to a lack of sensitivity neither the best algorithm nor palmar pallor as a single sign are eligible for decision-making and cannot replace presumptive treatment or laboratory diagnosis.

  3. Diversidad de anfibios anuros del Parque Nacional El Palmar (Provincia de Entre Ríos, Argentina

    Directory of Open Access Journals (Sweden)

    Guzmán, Atilio

    2012-02-01

    Full Text Available El Parque Nacional El Palmar (PNEP es una importante área protegida de la zona este de la provincia de Entre Ríos, Argentina, creado para conservar uno de los últimos fragmentos de palmera yatay (Butia yatay. En este estudio se examina la biodiversidad de la comunidad de anfibios anuros que habitan tres tipos de ambientes del Parque; el pajonal, el pastizal y la selva en galería. Los muestreos se llevaron a cabo entre los meses de primavera-verano de 2008 y 2009. En total se registraron 16 especies de anfibios para el PNEP, distribuidas en 6 familias y 9 géneros. Entre los tipos de ambientes, el pajonal exhibió la mayor diversidad y riqueza de especies. Las abundancias relativas de las especies fueron equitativas dentro de los tres ambientes y existieron diferencias significativas en la composición de especies entre los mismos, siendo el pajonal y el pastizal los más similares. Este trabajo es un aporte significativo al conocimiento de la herpetofauna del PNEP y una base para estudios futuros sobre historia natural de los anfibios. Así también brinda una herramienta para el manejo y conservación del área protegida. El Palmar National Park (NPEP is an important protected area in the eastern of Entre Rios Province, Argentina. It was created for preserving one of the last fragments of yatay palm (Butia yatay. This study examines the biodiversity of the community of anurans that inhabit three types of environments of the Park, the grassland, the straw zone and the gallery forest. Sampling was conducted between the spring-summer 2008 and 2009. There were found 16 species of amphibians for NPEP, belonging to 6 families and 9 genera. Among the types of environments, the straw zone showed the highest diversity and species richness. The relative abundances of the species were equitative in all three environments and there were significant differences in species composition among them being the grassland and pasture the most similar. This work

  4. MR assessment of movement and morphologic change in the menisci during knee flexion

    International Nuclear Information System (INIS)

    Kawahara, Y.; Uetani, M.; Fuchi, K.; Eguchi, H.; Hayashi, K.

    1999-01-01

    To examine movement and morphologic alteration in the menisci during knee flexion. Twenty healthy knees were imaged at 0 degrees, 45 degrees, and 90 degrees of passive non-weight-bearing flexion in the sagittal plane with MR. In each meniscus, posterior movement distance during knee flexion and the ratio of anteroposterior (a.p.) diameter at flexion to that at extension were calculated. Each meniscus moved posteriorly during knee flexion. Movement was greater in the anterior horn than in the posterior horn, and greater in the medial meniscus than in the lateral meniscus (p<0.05). The a.p. diameter of each meniscus was reduced at flexion (p<0.05). Knee flexion normally leads to posterior movement and shortening of the a.p. diameter of the menisci, which may be related to the positioning and curvature of femoral condyles at the femorotibial contact point at knee flexion

  5. MR assessment of movement and morphologic change in the menisci during knee flexion

    International Nuclear Information System (INIS)

    Kawahara, Y.; Uetani, M.; Hayashi, K.; Fuchi, K.; Eguchi, H.

    1999-01-01

    Purpose: To examine movement and morphologic alteration in the menisci during knee flexion. Material and Methods: Twenty healthy knees were imaged at 0 , 45 , and 90 of passive non-weight-bearing flexion in the sagittal plane with MR. In each meniscus, posterior movement distance during knee flexion and the ratio of anteroposterior (a.p.) diameter at flexion to that at extension were calculated. Results: Each meniscus moved posteriorly during knee flexion. Movement was greater in the anterior horn than in the posterior horn, and greater in the medial meniscus than in the lateral meniscus (p<0.05). The a.p. diameter of each meniscus was reduced at flexion (p<0.05). Conclusion: Knee flexion normally leads to posterior movement and shortening of the a.p. diameter of the menisci, which may be related to the positioning and curvature of femoral condyles at the femorotibial contact point at knee flexion. (orig.)

  6. A comparative trial of ice application versus EMLA cream in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis.

    Science.gov (United States)

    Alsantali, Adel

    2018-01-01

    Botulinum toxin is a safe and effective therapy for palmar hyperhidrosis, but the associated pain from injections limits the usefulness of this method of treatment. To evaluate the efficacy of Eutectic Mixture of Local Anesthetics (EMLA) cream versus ice application in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis. In this prospective study, 23 patients underwent palm Botox injections to treat their excessive sweating. In each patient, EMLA cream was applied to one palm and ice was applied directly before the injections in the other palm. Pain was evaluated using a Visual Analog Scale. Statistically, there was a significant difference in pain control between EMLA cream group and ice application group ( p cream was applied was 8.9 (SD=0.81), whereas it was 4.8 (±0.9) in the ice group. In this study, the successful use of ice application in reducing pain by 40% in comparison to EMLA cream during Botox toxin injection for palmar hyperhidrosis is demonstrated.

  7. Comparison of digito-palmar dermatoglyphic traits in children with cerebral palsy and their close family members.

    Science.gov (United States)

    Polovina-Proloscić, Tajana; Milicić, Jasna; Cvjeticanin, Miljenko; Polovina, Andrea; Polovina, Svetislav

    2009-09-01

    Cerebral palsy is one of the main causes of severe disability in children. Sixty children (30 boys and 30 girls) were included in the study. Quantitative digito-palmar dermatoglyphic traits were analyzed. Prints of digito-palmar dermatoglyphs obtained from the children's parents (60 mothers and 60 fathers) and from 400 phenotypically healthy adults from the Zagreb ware used as control groups. Analysis of quantitative dermatoglyphic traits of the digito-palmar complex revealed statistically significant differences in a number of variables between the fathers and their children suffering from cerebral palsy (TRC 180.3 > 158.6), with a greater number of variables involved in male children with cerebral palsy. Some variables showed statistically significant differences in dermatoglyphic patterns between fathers and control group of healthy males as well as between boys with cerebral palsy and healthy control males. Differences in dermatoglyphic patterns were significantly lower between mothers and girls with cerebral palsy (TRC 152.1 mothers and healthy control females. Study results support the hypothesis on the possible role of genetic predisposition in the occurrence of central nervous system lesion, with a more pronounced paternal impact.

  8. Analytical shear and flexion of Einasto dark matter haloes

    OpenAIRE

    Retana-Montenegro, E.; Frutos-Alfaro, F.; Baes, M.

    2012-01-01

    N-body simulations predict that dark matter haloes are described by specific density profiles on both galactic- and cluster-sized scales. Weak gravitational lensing through the measurements of their first and second order properties, shear and flexion, is a powerful observational tool for investigating the true shape of these profiles. One of the three-parameter density profiles recently favoured in the description of dark matter haloes is the Einasto profile. We present exact expressions for...

  9. Load and speed effects on the cervical flexion relaxation phenomenon

    Directory of Open Access Journals (Sweden)

    Descarreaux Martin

    2010-03-01

    Full Text Available Abstract Background The flexion relaxation phenomenon (FRP represents a well-studied neuromuscular response that occurs in the lumbar and cervical spine. However, the cervical spine FRP has not been investigated extensively, and the speed of movement and loading effects remains to be characterized. The objectives of the present study were to evaluate the influence of load and speed on cervical FRP electromyographic (EMG and kinematic parameters and to assess the measurement of cervical FRP kinematic and EMG parameter repeatability. Methods Eighteen healthy adults (6 women and 12 men, aged 20 to 39 years, participated in this study. They undertook 2 sessions in which they had to perform a standardized cervical flexion/extension movement in 3 phases: complete cervical flexion; the static period in complete cervical flexion; and extension with return to the initial position. Two different rhythm conditions and 3 different loading conditions were applied to assess load and speed effects. Kinematic and EMG data were collected, and dependent variables included angles corresponding to the onset and cessation of myoelectric silence as well as the root mean square (RMS values of EMG signals. Repeatability was examined in the first session and between the 2 sessions. Results Statistical analyses revealed a significant load effect (P Conclusions The load increase evoked augmented FRP onset and cessation angles as well as heightened muscle activation. Such increments may reflect the need to enhance spinal stability under loading conditions. The kinematic and EMG parameters showed promising repeatability. Further studies are needed to assess kinematic and EMG differences between healthy subjects and patients with neck pain.

  10. Biomechanical analysis of posterior cruciate ligament retaining high-flexion total knee arthroplasty

    NARCIS (Netherlands)

    Zelle, J.; van der Zanden, A.C.; De Waal Malefijt, M.; Verdonschot, Nicolaas Jacobus Joseph

    2009-01-01

    Background High-flexion knee replacements have been developed to accommodate a large range of flexion (>120°) after total knee arthroplasty. Both posterior cruciate ligament retaining and sacrificing high-flexion knee designs have been marketed. The main objective of this study was to evaluate the

  11. Relationship Between Force Production During Isometric Squats and Knee Flexion Angles During Landing.

    Science.gov (United States)

    Fisher, Harry; Stephenson, Mitchell L; Graves, Kyle K; Hinshaw, Taylour J; Smith, Derek T; Zhu, Qin; Wilson, Margaret A; Dai, Boyi

    2016-06-01

    Decreased knee flexion angles during landing are associated with increased anterior cruciate ligament loading. The underlying mechanisms associated with decreased self-selected knee flexion angles during landing are still unclear. The purpose of this study was to establish the relationship between the peak force production at various knee flexion angles (35, 55, 70, and 90°) during isometric squats and the actual knee flexion angles that occur during landing in both men and women. A total of 18 men and 18 women recreational/collegiate athletes performed 4 isometric squats at various knee flexion angles while vertical ground reaction forces were recorded. Participants also performed a jump-landing-jump task while lower extremity kinematics were collected. For women, significant correlations were found between the peak force production at 55 and 70° of knee flexion during isometric squats and the knee flexion angle at initial contact of landing. There were also significant correlations between the peak force production at 55, 70, and 90° of knee flexion during isometric squats and the peak knee flexion angle during landing. These correlations tended to be stronger during isometric squats at greater knee flexion compared with smaller knee flexion. No significant correlations were found for men. Posture-specific strength may play an important role in determining self-selected knee flexion angles during landing for women.

  12. Spine lateral flexion strength development differences between exercises with pelvic stabilization and without pelvic stabilization

    Science.gov (United States)

    Straton, Alexandru; Gidu, Diana Victoria; Micu, Alexandru

    2015-02-01

    Poor lateral flexor muscle strength can be an important source of lumbar/thoracic back pain in women. The purpose of this study was to evaluate pelvic stabilization (PS) and no pelvic stabilization (NoPS) lateral flexion strength exercise training on the development of isolated right and left lateral flexion strength. Isometric torque of the isolated right and left lateral flexion muscles was measured at two positions (0° and 30° opposed angle range of motion) on 42 healthy women before and after 8 weeks of PS and NoPS lateral flexion strength exercise training. Subjects were assigned in three groups, the first (n=14) trained 3 times/week with PS lateral flexion strength exercise, the second (n=14) trained 3 times/week with NoPS lateral flexion strength exercise and the third (control, n=14) did not train. Post training isometric strength values describing PS and NoPS lateral flexion strength improved in greater extent for the PS lateral flexion strength exercise group and in lesser extent for the NoPS lateral flexion strength exercise group, in both angles (pstrength exercises; NoPS lateral flexion strength exercises can be an effective way of training for the spine lateral flexion muscles, if there is no access to PS lateral flexion strength training machines.

  13. Lumbopelvic flexibility modulates neuromuscular responses during trunk flexion-extension.

    Science.gov (United States)

    Sánchez-Zuriaga, Daniel; Artacho-Pérez, Carla; Biviá-Roig, Gemma

    2016-06-01

    Various stimuli such as the flexibility of lumbopelvic structures influence the neuromuscular responses of the trunk musculature, leading to different load sharing strategies and reflex muscle responses from the afferents of lumbopelvic mechanoreceptors. This link between flexibility and neuromuscular response has been poorly studied. The aim of this study was to investigate the relationship between lumbopelvic flexibility and neuromuscular responses of the erector spinae, hamstring and abdominal muscles during trunk flexion-extension. Lumbopelvic movement patterns were measured in 29 healthy women, who were separated into two groups according to their flexibility during trunk flexion-extension. The electromyographic responses of erector spinae, rectus abdominis and biceps femoris were also recorded. Subjects with greater lumbar flexibility had significantly less pelvic flexibility and vice versa. Subjects with greater pelvic flexibility had a higher rate of relaxation and lower levels of hamstring activation during maximal trunk flexion. The neuromuscular response patterns of the hamstrings seem partially modulated by pelvic flexibility. Not so with the lumbar erector spinae and lumbar flexibility, despite the assertions of some previous studies. The results of this study improve our knowledge of the relationships between trunk joint flexibility and neuromuscular responses, a relationship which may play a role in low back pain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Fossil woods of Detarioideae subfamily (Fabaceae) from El Palmar Formation (Late Pleistocene) in South America

    Science.gov (United States)

    Ramos, R. Soledad; Brea, Mariana; Kröhling, Daniela M.

    2017-11-01

    The main aim of the present paper is to describe the first Detarioideae fossil woods from El Palmar Formation (Late Pleistocene) in the Uruguay River Basin (Entre Ríos, Argentina). This study is based on five silicified wood specimens preserved in fluvial deposits, which were transported from their growth site. Two new genera and species are described: Paraoxystigma concordiensis gen. nov and sp. nov. has medium-sized vessels, paratracheal axial parenchyma, heterocellular and multiseriate rays, and diffuse axial canals similar in size and shape to vessels, and Gossweilerodendroxylon palmariensis gen. nov and sp. nov. has medium-sized vessels, alternate intervessel pits, paratracheal and apotracheal axial parenchyma, homocellular and uni to-multiseriate rays, and small diffuse axial canals. These Detarioideae fossil records in south-eastern South America support the existence of a very old relationship with the extant West African forests. Eco-anatomical features observed in these fossil woods, along with the climatic information available from the Nearest Living Relatives (NLRs) comparison, suggest warm and humid climatic conditions for the upper-middle basin of the Uruguay River during some periods of the Late Pleistocene.

  15. Power-assistive finger exoskeleton with a palmar opening at the fingerpad.

    Science.gov (United States)

    Heo, Pilwon; Kim, Jung

    2014-11-01

    This paper presents a powered finger exoskeleton with an open fingerpad, named the Open Fingerpad eXoskeleton (OFX). The palmar opening at the fingerpad allows for direct contact between the user's fingerpad and objects in order to make use of the wearer's own tactile sensation for dexterous manipulation. Lateral side walls at the end of the OFX's index finger module are equipped with custom load cells for estimating the wearer's pinch grip force. A pneumatic cylinder generates assistance force, which is determined according to the estimated pinch grip force. The OFX transmits the assistance force directly to the objects without exerting pressure on the wearer's finger. The advantage of the OFX over an exoskeleton with a closed fingerpad was validated experimentally. During static and dynamic manipulation of a test object, the OFX exhibited a lower safety margin than the closed exoskeleton, indicating a higher ability to adjust the grip force within an appropriate range. Furthermore, the benefit of force assistance in reducing the muscular burden was observed in terms of muscle fatigue during a static pinch grip. The median frequency (MDF) of the surface electromyography (sEMG) signal from the first dorsal interosseous (FDI) muscle displayed a lower reduction rate for the assisted condition, indicating a lower accumulation rate of muscle fatigue.

  16. Anatomy of the palmar cutaneous branch of the median nerve: clinical significance.

    Science.gov (United States)

    DaSilva, M F; Moore, D C; Weiss, A P; Akelman, E; Sikirica, M

    1996-07-01

    A detailed anatomic, histologic, and immunohistochemical study of the palmar cutaneous branch of the median nerve (PCBMN) and its distal arborization was undertaken on 12 fresh human cadaveric hands. Small unmyelinated fibers terminated in the superficial loose connective tissue of the transverse carpal ligament. There were no nerve fibers detected in the deep, dense collagen aspect of the ligament. Based on these findings, during open carpal tunnel release, the skin incision should be placed along the axis of the ring finger to avoid injury to the superficial branches of the PCBMN. When open release is used, the very small terminal branches in the loose tissue of the ligament will be transected; this may in part be responsible for postoperative soft tissue pain. For endoscopic releases, some risk for transection of the main trunk of the PCBMN at the proximal incision exists. Repeated passes of the endoscopic knife should be avoided in an attempt to limit damage to the small fibers in the superficial aspect of the ligament.

  17. Treatment of type III middle phalangeal neck fractures through a palmar approach: a case report

    Directory of Open Access Journals (Sweden)

    Lucchina Stefano

    2013-04-01

    Full Text Available 【Abstract】 Phalangeal neck fractures occur almost exclusively in children. We present the case of a 49 years old man with a dislocated fracture of the neck of the middle phalanx with the distal fragment rotated at 180°, due to a traumatic circular saw injury to the left index, which was solved by anatomical reduction and bone fixation with two 1.5 mm Synthes screws and a temporary transarticular K-wire at the distal interphalangeal joint. Zone I flexor digitorum profundus repair was performed using a modification of the Kessler 4-strands core suture and a full-thickness skin graft from the hypothenar eminence was taken to cover the skin gap. At 6-month follow-up the patient was pain-free and with a total active movement equivalent to 190°. No radio-logical signs of avascular necrosis of the head of the middle phalanx or nonunion of the distal fragment was detectable with recovery to the previous manual work. Owing to the position of the phalangeal head maintained in position by the collateral ligaments an anatomic reduction from dorsal approach is difficult to be performed and a longitudinal trac-tion can render the reduction harder too. The volar approach permits an easier reduction of the fracture through a derotation of the distal fragment facing palmar. Key words: Finger phalanges; Fractures, bone; Finger joint

  18. Is there any place for spontaneous healing in deep palmar burn of the child?

    Science.gov (United States)

    Chateau, J; Guillot, M; Zevounou, L; Braye, F; Foyatier, J-L; Comparin, J-P; Voulliaume, D

    2017-06-01

    Child palm burns arise by contact and are often deep. The singular difficulty of such a disease comes from the necessity of the child growth and from the potential occurrence of constricted scars. In order to avoid sequelae, the actual gold standard is to practice an early excision of the burn, followed by a skin graft. The aim of this study is to evaluate the results of spontaneous healing combined with rehabilitation versus early skin grafting and rehabilitation concerning the apparition of sequelae. We performed a retrospective study in two burn centers and one rehabilitation hospital between 1995 and 2010. Eighty-seven hands have been included in two groups: one group for spontaneous healing and the other group for excision and skin grafting. Every child benefited from a specific rehabilitation protocol. The two main evaluation criteria were the duration of permanent splint wearing and the number of reconstructive surgery for each child. The median follow-up duration is about four years. The two groups were comparable. For the early skin grafting group, the splint wearing duration was 1/3 longer than for the spontaneous healing group. Concerning the reconstructive surgery, half of the grafted hands needed at least one procedure versus 1/5 of spontaneous healing hands. Our results show the interest of spontaneous healing in palmar burn in child, this observation requires a specific and intense rehabilitation protocol. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Quantifying the lumbar flexion-relaxation phenomenon: theory, normative data, and clinical applications.

    Science.gov (United States)

    Neblett, Randy; Mayer, Tom G; Gatchel, Robert J; Keeley, Janice; Proctor, Tim; Anagnostis, Christopher

    2003-07-01

    normative data. In Part 2, 54 patients with chronic disabled work-related spinal disorder referred as candidates for tertiary functional restoration rehabilitation participated in a standardized assessment protocol for sEMG and ROM measurement before rehabilitation. Those who completed the program were retested with the identical methodology after rehabilitation (n = 34) using the empirically derived cutoff scores for sEMG readings at FR and ROM from Part 1 and prior scientific literature. Pain disability self-reported scores were correlated with sEMG and ROM. Sensitivity and specificity of the sEMG for identifying abnormal motion were assessed. In Part 1, the ability of the experienced testers to measure ROM and sEMG reliably at FR was high (r >or= 0.92; P or= 0.82; P pain disability self-report. Flexion-relaxation measures a point at which true lumbar flexion ROM approaches its maximum in asymptomatic subjects. This also is the point at which lumbar extensor muscle contraction relaxes, allowing the lumbar spine to hang on its posterior ligaments. The gluteal and hamstring muscles then lower the flexed trunk even further by allowing the pelvis to rotate around the hips. This phenomenon was subsequently found in Part 2 to offer a potentially promising method for individualizing rehabilitation treatment, decreasing unnecessary utilization, identifying potential postrehabilitation treatment failures, and assessing permanent impairment rating validity. Moreover, this is the first study to demonstrate systematically that an absence of FR in patients with chronic low back pain can be corrected with treatment.

  20. CT of the canine lumbosacral spine in extension - flexion rotation; part I: bony window

    International Nuclear Information System (INIS)

    Henninger, W.; Werner, G.

    2002-01-01

    The canine lumbosacral spine is examined radiographically in extended and flexed lateral position as well as ventrodorsally. Superimposition of bones hinders exact evaluation of the lumbosacral intervertebral foramen in case of cauda equina syndrome, especially when degenerative changes overlap. CT or MRI are more and more indicated to get reliable findings because myelography is not always of diagnostic value. For this study twelve dogs (7 German Shepherd dogs, 4 Cross-breds, and 1 Rottweiler) of different age and sex were taken which had been referred for CT examination of the lumbosacral area. Plain radiographs did not show abnormalities. The anaesthetized dogs were positioned in dorsal recumbency with the legs firstly extended and secondly flexed according to flexion-extension radiography. Slice thickness was 2 mm, the CT images were evaluated in both bony and soft tissue windows. Bony window easily showed vertebral bodies, vertebral canal, pedicles, vertebral laminae, and articular processes of L7 and S1. Median height of the vertebral canal did not change during extension or flexion at the level of L7 and the sacrum. Height and width of the intervertebral foramen and width of the interarcual foramen changed markedly from extension to flexion. Lateral recessus of the vertebral canal always could be observed as ventrolateral widening. In sagittal CT scans of the lumbosacral specimen of a normal German Shepherd dog cranial articular processes of the sacrum were detected to be responsible for maximum height or width of the intervertebral foramen. Evolving from the lateral recessus the intervertebral foramen was initially oval-shaped and got rounded and narrowed by the cranial articular process of the sacrum. Position and shape of the cranial articular processes of the sacrum were evaluated. Surface of the cranial articular processes of S1 were found even with articular spaces congruent, but some also appeared slightly concave or convex where incongruity of the

  1. Correlation between the elbow flexion and the hand and wrist flexion after neurotization of the fascicles of the ulnar nerve to the motor branch to the biceps

    Directory of Open Access Journals (Sweden)

    Ricardo Boso Escudero

    Full Text Available ABSTRACT OBJECTIVE: Gain in elbow flexion in patients with brachial plexus injury is extremely important. The transfer of a fascicle from the ulnar nerve to the motor branch of the musculocutaneous nerve (Oberlin surgery is a treatment option. However, in some patients, gain in elbow flexion is associated with wrist and finger flexion. This study aimed to assess the frequency of this association and the functional behavior of the limb. METHODS: Case-control study of 18 patients who underwent the Oberlin surgery. Group 1 included patients without disassociation of range of elbow flexion and that of the fingers and wrist; Group 2 included patients in whom this disassociation was present. In the functional evaluation, the Sollerman and DASH tests were used. RESULTS: It was observed that 38.89% of the patients did not present disassociation of elbow flexion with flexion of the wrist and fingers. Despite the existence of a favorable difference in the group with disassociation of the movement, when the Sollerman protocol was applied to the comparison between both groups, this difference was not statistically significant. With the DASH test, however, there was a statistically significant difference in favor of the group of patients who managed to disassociate the movement. CONCLUSION: The association of elbow flexion with flexion of the wrist and fingers, in the group studied, was shown to be a frequent event, which influenced the functional result of the affected limb.

  2. A flexible wearable sensor for knee flexion assessment during gait.

    Science.gov (United States)

    Papi, Enrica; Bo, Yen Nee; McGregor, Alison H

    2018-05-01

    Gait analysis plays an important role in the diagnosis and management of patients with movement disorders but it is usually performed within a laboratory. Recently interest has shifted towards the possibility of conducting gait assessments in everyday environments thus facilitating long-term monitoring. This is possible by using wearable technologies rather than laboratory based equipment. This study aims to validate a novel wearable sensor system's ability to measure peak knee sagittal angles during gait. The proposed system comprises a flexible conductive polymer unit interfaced with a wireless acquisition node attached over the knee on a pair of leggings. Sixteen healthy volunteers participated to two gait assessments on separate occasions. Data was simultaneously collected from the novel sensor and a gold standard 10 camera motion capture system. The relationship between sensor signal and reference knee flexion angles was defined for each subject to allow the transformation of sensor voltage outputs to angular measures (degrees). The knee peak flexion angle from the sensor and reference system were compared by means of root mean square error (RMSE), absolute error, Bland-Altman plots and intra-class correlation coefficients (ICCs) to assess test-retest reliability. Comparisons of knee peak flexion angles calculated from the sensor and gold standard yielded an absolute error of 0.35(±2.9°) and RMSE of 1.2(±0.4)°. Good agreement was found between the two systems with the majority of data lying within the limits of agreement. The sensor demonstrated high test-retest reliability (ICCs>0.8). These results show the ability of the sensor to monitor knee peak sagittal angles with small margins of error and in agreement with the gold standard system. The sensor has potential to be used in clinical settings as a discreet, unobtrusive wearable device allowing for long-term gait analysis. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Incomplete palmar fracture of the proximal extremity of the third metacarpal bone in horses: ten cases (1981-1986)

    International Nuclear Information System (INIS)

    Lloyd, K.C.K.; Koblik, P.; Ragle, C.; Wheat, J.D.; Lakritz, J.

    1988-01-01

    In 4 adult horses, simple, non displaced, incomplete fracture of the proximal extremity of the third metacarpal bone (MC3) was identified radiographically only on the dorsopalmar projection. Lameness was slight to moderate. Although nerve blocks of the foot and fetlock did not alter the lameness, high palmar regional nerve block improved the gait in 1 of the 2 horses on which it was performed. Pain on palpation or swollen distal accessory (inferior check) ligament, flexor tendons, and suspensory ligament were not found in any horse. The fracture was localized to the palmar surface of the proximal extremity of the MC3 on the basis of the intense uptake of radiopharmaceutical (99MTc-labeled sodium medronate) observed in that area during the soft tissue and delayed bone phases of a nuclear scintigraphic examination (nuclear scan) performed concurrently with radiography. Of 4 horses evaluated 6 months after the initial diagnosis, 3 had medullary sclerosis without radiographic evidence of fracture; results of follow-up nuclear scintigraphy performed in one of these horses at the same time were normal. Incomplete fracture also was suspected in another 6 adult horses with clinical lameness referable to the proximal extremity of the MC3. Although a fracture line could not be seen radiographically, trabecular hypertrophy and/or medullary sclerosis of the proximal extremity of the MC3 were detected on the dorsopalmar projection. Further, during nuclear scintigraphy, an intense uptake of the radiopharmaceutical was observed on the palmar aspect of the proximal extremity of the MC3 in all 6 horses

  4. Predictive value of fever and palmar pallor for P. falciparum parasitaemia in children from an endemic area.

    Directory of Open Access Journals (Sweden)

    Christof David Vinnemeier

    Full Text Available INTRODUCTION: Although the incidence of Plasmodium falciparum malaria in some parts of sub-Saharan Africa is reported to decline and other conditions, causing similar symptoms as clinical malaria are gaining in relevance, presumptive anti-malarial treatment is still common. This study traced for age-dependent signs and symptoms predictive for P. falciparum parasitaemia. METHODS: In total, 5447 visits of 3641 patients between 2-60 months of age who attended an outpatient department (OPD of a rural hospital in the Ashanti Region, Ghana, were analysed. All Children were examined by a paediatrician and a full blood count and thick smear were done. A Classification and Regression Tree (CART model was used to generate a clinical decision tree to predict malarial parasitaemia a7nd predictive values of all symptoms were calculated. RESULTS: Malarial parasitaemia was detected in children between 2-12 months and between 12-60 months of age with a prevalence of 13.8% and 30.6%, respectively. The CART-model revealed age-dependent differences in the ability of the variables to predict parasitaemia. While palmar pallor was the most important symptom in children between 2-12 months, a report of fever and an elevated body temperature of ≥37.5°C gained in relevance in children between 12-60 months. The variable palmar pallor was significantly (p<0.001 associated with lower haemoglobin levels in children of all ages. Compared to the Integrated Management of Childhood Illness (IMCI algorithm the CART-model had much lower sensitivities, but higher specificities and positive predictive values for a malarial parasitaemia. CONCLUSIONS: Use of age-derived algorithms increases the specificity of the prediction for P. falciparum parasitaemia. The predictive value of palmar pallor should be underlined in health worker training. Due to a lack of sensitivity neither the best algorithm nor palmar pallor as a single sign are eligible for decision-making and cannot replace

  5. Study of palmar dermatoglyphics in patients with essential hypertension between the age group of 20-50 years

    OpenAIRE

    Rudragouda S Bulagouda, Purnima J Patil, Gavishiddppa A Hadimani, Balappa M Bannur, Patil BG, Nagaraj S. Mallashetty, Ishwar B Bagoji

    2013-01-01

    Background: In present study, we tried to determine significant palmar dermatoglyphic parameters in case of essential hypertensive’s in age group between 20-50 years and whether the parameters can be used for screening purpose i.e., early detection of hypertension. Method: With the use of modified Purvis Smith method, Black duplicating ink (Kores, Bombay) was smeared on both hands one by one and prints will be taken by rolling the hands from wrist creases to finger tips on the roller covered ...

  6. Velocity of lordosis angle during spinal flexion and extension.

    Directory of Open Access Journals (Sweden)

    Tobias Consmüller

    Full Text Available The importance of functional parameters for evaluating the severity of low back pain is gaining clinical recognition, with evidence suggesting that the angular velocity of lordosis is critical for identification of musculoskeletal deficits. However, there is a lack of data regarding the range of functional kinematics (RoKs, particularly which include the changing shape and curvature of the spine. We address this deficit by characterising the angular velocity of lordosis throughout the thoracolumbar spine according to age and gender. The velocity of lumbar back shape changes was measured using Epionics SPINE during maximum flexion and extension activities in 429 asymptomatic volunteers. The difference between maximum positive and negative velocities represented the RoKs. The mean RoKs for flexion decreased with age; 114°/s (20-35 years, 100°/s (36-50 years and 83°/s (51-75 years. For extension, the corresponding mean RoKs were 73°/s, 57°/s and 47°/s. ANCOVA analyses revealed that age and gender had the largest influence on the RoKs (p<0.05. The Epionics SPINE system allows the rapid assessment of functional kinematics in the lumbar spine. The results of this study now serve as normative data for comparison to patients with spinal pathology or after surgical treatment.

  7. Nociceptive flexion reflexes during analgesic neurostimulation in man.

    Science.gov (United States)

    García-Larrea, L; Sindou, M; Mauguière, F

    1989-11-01

    Nociceptive flexion reflexes of the lower limbs (RIII responses) have been studied in 21 patients undergoing either epidural (DCS, n = 16) or transcutaneous (TENS, n = 5) analgesic neurostimulation (AN) for chronic intractable pain. Flexion reflex RIII was depressed or suppressed by AN in 11 patients (52.4%), while no modification was observed in 9 cases and a paradoxical increase during AN was evidenced in 1 case. In all but 2 patients, RIII changes were rapidly reversible after AN interruption. RIII depression was significantly associated with subjective pain relief, as assessed by conventional self-rating; moreover, in 2 patients it was possible to ameliorate the pain-suppressing effects of AN by selecting those stimulation parameters (intensity and frequency) that maximally depressed nociceptive reflex RIII. We recorded 2 cases of RIII attenuation after contralateral neurostimulation. AN appeared to affect nociceptive reflexes rather selectively, with no or very little effect on other cutaneous, non-nociceptive responses. Recording of RIII reflexes is relatively simple to implement as a routine paraclinical procedure. It facilitates the objective assessment of AN efficacy and may help to choose the most appropriate parameters of neurostimulation. In addition, RIII behavior in patients could be relevant to the understanding of some of the mechanisms involved in AN-induced pain relief.

  8. Magnetic resonance imaging of the posterior cruciate ligament in flexion.

    Science.gov (United States)

    Craddock, William; Smithers, Troy; Harris, Craig; du Moulin, William; Molnar, Robert

    2018-06-01

    Posterior cruciate ligament (PCL) injuries of the knee are common and sometimes difficult to diagnose. Magnetic resonance imaging (MRI), performed using standard orthogonal plane views, is the investigation of choice. It can be particularly difficult to differentiate acute partial and complete tears and identify elongation of chronic healed tears. The aim of the paper is to describe a new method of positioning the patient with the knee flexed at 90°, allowing the PCL to be visualised in a position of greatest length and tension which may assist in differentiating and identifying these injuries. Four symptomatic patients with suspected PCL injuries, two acute and two chronic, were MRI scanned using a routine protocol with the knee in extension before performing oblique sagittal fast spin-echo (FSE) proton-density (PD) sequences with the knee positioned in 90° of flexion. The appearance of the PCLs were then qualitatively assessed. MRI scanning with the knee in flexion identified more extensive PCL injury than standard imaging. In the two patients with acute injuries, partial tears on the standard orthogonal plane views were found to be complete ruptures. In the two patients with chronic injuries, elongation of the PCL not identifiable on the standard orthogonal plane views was apparent. MRI scanning of the PCL with the knee flexed at 90° may help in differentiating partial and complete ruptures of the PCL and identifying elongation of the PCL in chronic injuries. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Entretien sur la psychanalyse: réflexions en marge

    Directory of Open Access Journals (Sweden)

    Giuseppe Martini

    2016-08-01

    Full Text Available L’auteur propose ici un commentaire sur les points les plus importants de son entretien de février 2003 avec Paul Ricœur consacré aux rapports entre herméneutique et psychanalyse. Bien que le philosophe se situe dans une réelle continuité par rapport à sa contribution de 1965, il enrichit toutefois sa réflexion philosophique sur la psychanalyse en proposant plusieurs innovations, en ce qui concerne plus particulièrement les thèmes du récit, du soi et de l’éthique. Dans les conclusions de son commentaire, l’auteur souligne l’importance des concepts d’“irreprésentable” et d’“intraduisible”: non seulement, en effet, ces concepts sont dans la ligne de nombreuses contributions de la psychanalyse contemporaine, mais la profondeur de la réflexion ricœurienne augmente en outre leur potentiel théorique et même clinique.

  10. Secuencia constructiva de las plazas en el Grupo Principal de El Palmar, Campeche, México Constructive Sequence of Plazas in the Main Group of El Palmar, Campeche, México

    Directory of Open Access Journals (Sweden)

    Kenichiro Tsukamoto

    2012-01-01

    Full Text Available La ubicación y dimensión de los espacios abiertos fueron aspectos considerados al planificar las ciudades de las Tierras Bajas Mayas en el periodo prehispánico. Las plazas eran los espacios políticos donde las élites gobernantes legitimaban a sus autoridades y manifestaban a otros participantes sus capacidades para comunicarse con los ancestros o deidades. Este trabajo se centra en la secuencia constructiva de ocho plazas en el Grupo Principal del sitio arqueológico de El Palmar, Campeche, México. Los resultados obtenidos durante las temporadas de campo en el 2007 y el 2009 indican que las grandes plazas fueron construidas durante la segunda mitad del Clásico Temprano (400-600 d.C. y que en ellas se celebraron ceremonias públicas inscritas en los monumentos conmemorativos.The location and dimension of open spaces were important aspects involved in Maya Lowlands planning during the prehispanic period. Plazas were political spaces in which ruling elites legitimated their authorities and manifested to other participants their capacities of communication with ancestors or deities. This paper focuses on the construction sequence of eight plazas at the Main Group of El Palmar, Campeche, Mexico. The results recovered from the 2007 and 2009 fieldwork seasons indicate that large plazas were build during the second part of the Early Classic period (400-600 AD, with the erection of commemorative monuments narrating public ceremonies.

  11. Prevention of palmar-plantar erythrodysesthesia with an antiperspirant in breast cancer patients treated with pegylated liposomal doxorubicin (SAKK 92/08).

    Science.gov (United States)

    Templeton, Arnoud J; Ribi, Karin; Surber, Christian; Sun, Hong; Hsu Schmitz, Shu-Fang; Beyeler, Michael; Dietrich, Daniel; Borner, Markus; Winkler, Annette; Müller, Andreas; von Rohr, Lukas; Winterhalder, Ralph C; Rochlitz, Christoph; von Moos, Roger; Zaman, Khalil; Thürlimann, Beat J K; Ruhstaller, Thomas

    2014-06-01

    Elevated concentrations of doxorubicin are found in eccrine sweat glands of the palms and soles. We therefore evaluated an antiperspirant as preventive treatment for palmar-plantar erythrodysesthesia (hand-foot syndrome) in patients with metastatic breast cancer treated with pegylated liposomal doxorubicin. An antiperspirant containing aluminum chlorohydrate or placebo cream was applied to the left or right hand and foot in a double-blinded manner (intra-patient randomization). The primary endpoint was the rate of grade 2 or 3 palmar-plantar erythrodysesthesia. A secondary endpoint was the patient-reported symptom burden (tingling, numbness, pain, or skin problems). Using McNemar's matched pairs design, 53 patients were needed to detect a 20% difference between the treatment and placebo sides with a significance level of 5% and power of 90%. Grade 2 or 3 PPE occurred in 30 (58%) of 52 evaluable patients; in six patients adverse effects occurred on the placebo side but not on the treatment side, whereas one patient developed palmar-plantar erythrodysesthesia on the treatment side only (P = 0.07). Four patients developed grade 2 or 3 palmar-plantar erythrodysesthesia on their foot on the placebo side but not on the treatment side (P = 0.05). In the cohort with grade 2 or 3 palmar-plantar erythrodysesthesia there was a trend towards fewer dermatologic symptomatologies with the active treatment (P = 0.05), and no difference for other adverse events. Using topical aluminum chlorohydrate as an antiperspirant appears to reduce the incidence of grade 2 or 3 palmar-plantar erythrodysesthesia following pegylated liposomal doxorubicin chemotherapy for metastatic breast cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. [Research progress of larger flexion gap than extension gap in total knee arthroplasty].

    Science.gov (United States)

    Zhang, Weisong; Hao, Dingjun

    2017-05-01

    To summarize the progress of larger flexion gap than extension gap in total knee arthro-plasty (TKA). The domestic and foreign related literature about larger flexion gap than extension gap in TKA, and its impact factors, biomechanical and kinematic features, and clinical results were summarized. During TKA, to adjust the relations of flexion gap and extension gap is one of the key factors of successful operation. The biomechanical, kinematic, and clinical researches show that properly larger flexion gap than extension gap can improve both the postoperative knee range of motion and the satisfaction of patients, but does not affect the stability of the knee joint. However, there are also contrary findings. So adjustment of flexion gap and extension gap during TKA is still in dispute. Larger flexion gap than extension gap in TKA is a new joint space theory, and long-term clinical efficacy, operation skills, and related complications still need further study.

  13. Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients.

    Science.gov (United States)

    Rodríguez, Pedro M; Freixinet, Jorge L; Hussein, Mohamed; Valencia, Jose M; Gil, Rita M; Herrero, Jorge; Caballero-Hidalgo, Araceli

    2008-09-01

    Thoracic sympathectomy (TS) is the treatment of choice for severe primary hyperhidrosis. However, complications, side effects and satisfaction have not been well defined. To analyze the complications, side effects, satisfaction degree and quality of life of patients after TS for primary upper limb hyperhidrosis. One-year follow-up after 406 consecutive TS for primary upper limb hyperhidrosis. Bilateral TS was completed in all patients. Complications arose in 23 cases (5.6%), with pneumothorax being the most frequent. The success rate after discharge, 6 and 12 months was respectively, 100%, 98.1% and 96.5% for palmo-axillary hyperhidrosis; 100%, 99.3% and 97.8% for isolated palmar hyperhidrosis and 100%, 85.7% and 71.4% for isolated axillary hyperhidrosis. No persistence of hyperhidrosis was observed. Global recurrence was 3.7% (28.5% axillary hyperhidrosis group). Compensatory sweating (CS) appeared in 55% and was not related to the extension of the TS. Being female was a predisposing factor of CS (p<0.004). Excessive dryness appeared at 9% and was associated with extensive TS (P<0.001). Plantar hyperhidrosis improved at 33.6%, worsened at 10% and remained stable during the follow-up. Satisfaction degree decreased with the passage of time and was associated with recurrence. Quality of life was excellent at discharge, 6 and 12 month in 100%, 100% and 97%, respectively. Pneumothorax is the most frequent complication of TS. CS is the main and undesirable side effect, appears with the passage of time, and is not related to the extension of TS. Being female is the only predictor factor of suffering CS. Plantar hyperhidrosis improves initially, although tends to reappear. Excessive dryness appears in extensive TS and does not improve over time. Postoperative satisfaction degree is high but decreases over time owing to the appearance of recurrence. Effectiveness and the absence of CS determine an excellent quality of life. Six percent of the patients regret the surgery

  14. LAS COMUNIDADES VEGETALES DE LA SABANA DEL PARQUE NACIONAL EL PALMAR (ARGENTINA

    Directory of Open Access Journals (Sweden)

    William B. Batista

    2014-01-01

    Full Text Available El Parque Nacional El Palmar, Entre Ríos, preserva desde 1965 el mayor remanente de la sabana de Butia yatay , un ecosistema rico en especies amenazado por la actividad humana. Para estudiar el funcio - namiento de este ecosistema y gestionar su preservación, es necesario contar con una adecuada carac - terización de la heterogeneidad de su vegetación. En este trabajo presentamos una clasificación fitoso - ciológica de las comunidades vegetales de la sabana del Parque, describimos su estructura, composición y diversidad florística y detallamos su distribución en el paisaje. Con el fin de estratificar la obtención de datos, delimitamos primero las principales unidades geomorfológicas del paisaje. En la primavera de 1999 y en el verano siguiente, realizamos censos florísticos completos en 73 “stands” de sabana con diferentes historias de incendio, distribuidos en las diferentes unidades geomorfológicas. Utilizamos técnicas de análisis multivariado y clasificación numérica para agrupar los censos en comunidades y las especies en grupos florísticos. Finalmente, resumimos las diferencias entre las comunidades en un esca - lamiento multidimensional métrico. Obtuvimos 7 comunidades, descriptas por 20 grupos florísticos. El patrón de similitudes entre estas comunidades sugiere que la heterogeneidad florística se ordena según dos componentes, uno asociado con diferencias en la textura del suelo y el otro con diferencias en el régimen de humedad del suelo. Tres de las comunidades, afines entre sí, se distribuyen en las terrazas altas e interfluvios que conforman la matriz del paisaje, en correspondencia con diferencias graduales de topografía y suelos. Estas comunidades cambian sucesionalmente por el avance de la lignificación des - encadenada por la exclusión del ganado y mantenida por la escasez de incendios naturales. Las restantes cuatro comunidades aparecen estrictamente asociadas con afloramientos rocosos, dep

  15. Fractures of the distal phalanx and associated soft tissue and osseous abnormalities in 22 horses with ossified sclerotic ungual cartilages diagnosed with magnetic resonance imaging.

    Science.gov (United States)

    Selberg, Kurt; Werpy, Natasha

    2011-01-01

    Ungual cartilage ossification in the forelimb is a common finding in horses. Subtle abnormalities associated with the ungual cartilages can be difficult to identify on radiographs. Magnetic resonance (MR) imaging findings of 22 horses (23 forelimbs) with a fracture of the distal phalanx and ossified ungual cartilage were characterized and graded. All horses had a forelimb fracture. Eleven involved a left forelimb (seven medial; four lateral), and 12 involved a right forelimb (five medial; seven lateral). All fractures were nonarticular, simple in configuration, and nondisplaced. The fractures were oriented in an axial proximal to abaxial distal and palmar to dorsal direction, and extended from the base of the ossified ungual cartilage into the distal phalanx. The fracture involved the fossa of the collateral ligament on the distal phalanx in 17 of 23 limbs. The palmar process and ossified ungual cartilage was abnormally mineralized in all horses. Ligaments and soft tissues adjacent to the ossified ungual cartilages were affected in all horses. The routine site of fracture in this study at the base of the ossified ungual cartilage extending into the distal phalanx suggests a biomechanical cause or focal stress point from cycling. The ligamentous structures associated with the ungual cartilages were often affected, showed altered signal intensity as well as enlargement and were thought to be contributing to the lameness. In conclusion, ossified ungual cartilages may lead to fracture of the palmar process of the distal phalanx and injury of the ungual cartilage ligaments. © 2011 Veterinary Radiology & Ultrasound.

  16. Flexion relaxation of the hamstring muscles during lumbar-pelvic rhythm.

    Science.gov (United States)

    Sihvonen, T

    1997-05-01

    This study investigated the simultaneous activity of back muscles and hamstring muscles during sagittal forward body flexion and extension in healthy persons. The study was cross-sectional. A descriptive study of paraspinal and hamstring muscle activity in normal persons during lumbar-pelvic rhythm. A university hospital. Forty healthy volunteers (21 men, 19 women, ages 17 to 48 years), all without back pain or other pain syndromes. Surface electromyography (EMG) was used to follow activities in the back and the hamstring muscles. With movement sensors, real lumbar flexion was separated from simultaneous pelvic motion by monitoring the components of motion with a two-inclinometer method continuously from the initial upright posture into full flexion. All signals were sampled during real-time monitoring for off-line analyses. Back muscle activity ceased (ie, flexion relaxation [FR] occurred) at lumbar flexion with a mean of 79 degrees. Hamstring activity lasted longer and EMG activity ceased in the hamstrings when nearly full lumbar flexion (97%) was reached. After this point total flexion and pelvic flexion continued further, so that the last part of lumbar flexion and the last part of pelvic flexion happened without back muscle activity or hamstring bracing, respectively. FR of the back muscles during body flexion has been well established and its clinical significance in low back pain has been confirmed. In this study, it was shown for the first time that the hip extensors (ie, hamstring muscles) relax during forward flexion but with different timing. FR in hamstrings is not dependent on or coupled firmly with back muscle behavior in spinal disorders and the lumbar pelvic rhythm can be locally and only partially disturbed.

  17. Two Paraneoplastic Autoimmune Syndromes: Limbic Encephalitis and Palmar Fasciitis in a Patient with Small Cell Lung Cancer.

    Science.gov (United States)

    Lazarev, Irina; Shelef, Ilan; Refaely, Yael; Ariad, Samuel; Ifergane, Gal

    2015-09-07

    Small cell lung cancer (SCLC) is characterized by a relatively high rate of autoimmune phenomena. Paraneoplastic limbic encephalitis (PLE) is an autoimmune syndrome in which a non-neural tumor containing an antigen normally present in the nervous system precipitates an antibody attack on neural tissues. Patients with PLE usually present with rapidly progressive short-term memory deficits, confusion or even dementia. Palmar fasciitis and polyarthritis syndrome (PFPAS) is another autoimmune syndrome characterized by rheumatologic manifestations, especially involving the palms of the hands. We report a case of a 59-year old woman who presented with worsening neurological symptoms of two-week duration, and later coma. The combined clinical, serological, and imaging studies suggested a diagnosis of PLE. A chest computed tomographic scan showed a 1.2 cm-diameter mass in the upper lobe of the left lung that was surgically removed and showed SCLC. Following surgery, neurological symptoms rapidly improved, allowing the patient to receive adjuvant chemotherapy. While in remission for both SCLC and PLE, the patient developed pain, soft-tissue swelling, and stiffness in both palms, suggesting the diagnosis of PFPAS. Five months following the diagnosis of palmar fasciitis, SCLC relapsed with mediastinal and cervical lymphadenopathy. This case report underlines the continuous interaction of SCLC with the immune system, expressed by coexistence of two rare paraneoplastic diseases, PLE, and PFPAS, in a patient with SCLC. While symptoms related to PLE preceded the initial diagnosis of SCLC, other symptoms related to PFPAS preceded relapse.

  18. Two paraneoplastic autoimmune syndromes: limbic encephalitis and palmar fasciitis in a patient with small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Irina Lazarev

    2015-09-01

    Full Text Available Small cell lung cancer (SCLC is characterized by a relatively high rate of autoimmune phenomena. Paraneoplastic limbic encephalitis (PLE is an autoimmune syndrome in which a non-neural tumor containing an antigen normally present in the nervous system precipitates an antibody attack on neural tissues. Patients with PLE usually present with rapidly progressive short-term memory deficits, confusion or even dementia. Palmar fasciitis and polyarthritis syndrome (PFPAS is another autoimmune syndrome characterized by rheumatologic manifestations, especially involving the palms of the hands. We report a case of a 59-year old woman who presented with worsening neurological symptoms of two-week duration, and later coma. The combined clinical, serological, and imaging studies suggested a diagnosis of PLE. A chest computed tomographic scan showed a 1.2 cm-diameter mass in the upper lobe of the left lung that was surgically removed and showed SCLC. Following surgery, neurological symptoms rapidly improved, allowing the patient to receive adjuvant chemotherapy. While in remission for both SCLC and PLE, the patient developed pain, soft-tissue swelling, and stiffness in both palms, suggesting the diagnosis of PFPAS. Five months following the diagnosis of palmar fasciitis, SCLC relapsed with mediastinal and cervical lymphadenopathy. This case report underlines the continuous interaction of SCLC with the immune system, expressed by coexistence of two rare paraneoplastic diseases, PLE, and PFPAS, in a patient with SCLC. While symptoms related to PLE preceded the initial diagnosis of SCLC, other symptoms related to PFPAS preceded relapse.

  19. The Arterial Folding Point During Flexion of the Hip Joint

    International Nuclear Information System (INIS)

    Park, Sung Il; Won, Je Hwan; Kim, Byung Moon; Kim, Jae Keun; Lee, Do Yun

    2005-01-01

    Purpose: Endovascular stents placed in periarticular vessels may be at a greater risk of neointimal hyperplasia and eventual occlusion than those placed in non-periarticular vessels. The purpose of this study was to investigate the location of maximal conformational change along the iliac and femoral artery, the folding point, during flexion of the hip joint and its location relative to the hip joint and the inguinal ligament. Methods: Seventy patients undergoing femoral artery catheterization were evaluated. The patients were 47 men and 23 women and ranged in age from 26 to 75 years (mean 54 years). The arteries (right:left = 34:36) were measured using a marked catheter for sizing vessels. Fluoroscopic images were obtained in anteroposterior and lateral projections in neutral position, and in the lateral projection in flexed position of the hip joint. The folding point was determined by comparing the lateral projection images in the neutral and flexed positions. The distance from the acetabular roof to the folding point and the distance from the inguinal ligament to the folding point was evaluated. Results: : The folding point was located 42.8 ± 28.6 mm cranial to the acetabular roof and 35.1 ± 30.1 mm cranial to the inguinal ligament. As the patient’s age increased, the folding point was located more cranially (p < 0.001). Conclusions: The folding point during flexion of the hip joint was located 42.8 ± 28.6 mm cranial to the acetabular roof and 35.1 ± 30.1 mm cranial to the inguinal ligament. As the patient's age increased, the folding point was located more cranially. When a stent is inserted over this region, more attention may be needed during follow-up to monitor possible occlusion and stent failure.

  20. Urine - abnormal color

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003139.htm Urine - abnormal color To use the sharing features on this page, please enable JavaScript. The usual color of urine is straw-yellow. Abnormally colored urine ...

  1. Tooth - abnormal colors

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003065.htm Tooth - abnormal colors To use the sharing features on this page, please enable JavaScript. Abnormal tooth color is any color other than white to yellowish- ...

  2. Abnormal uterine bleeding

    Science.gov (United States)

    Anovulatory bleeding; Abnormal uterine bleeding - hormonal; Polymenorrhea - dysfunctional uterine bleeding ... ACOG committee opinion no. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Reaffirmed 2015. www. ...

  3. The Effects of Psoas Major and Lumbar Lordosis on Hip Flexion and Sprint Performance

    Science.gov (United States)

    Copaver, Karine; Hertogh, Claude; Hue, Olivier

    2012-01-01

    In this study, we analyzed the correlations between hip flexion power, sprint performance, lumbar lordosis (LL) and the cross-sectional area (CSA) of the psoas muscle (PM). Ten young adults performed two sprint tests and isokinetic tests to determine hip flexion power. Magnetic resonance imaging was used to determine LL and PM CSA. There were…

  4. Repeatability of cervical joint flexion and extension within and between days

    DEFF Research Database (Denmark)

    Wang, Xu; Lindstroem, René; Plocharski, Maciej

    2018-01-01

    OBJECTIVE: The purpose of this study was to investigate within- and between-day repeatability of free and unrestricted healthy cervical flexion and extension motion when assessing dynamic cervical spine motion. METHODS: Fluoroscopy videos of 2 repeated cervical flexion and 2 repeated extension...

  5. Angioleiomyoma: A Rare Cause of Fixed Flexion Contracture of the Elbow

    Directory of Open Access Journals (Sweden)

    Asterios Dramis

    2006-01-01

    Full Text Available We describe an unusual case of a patient presented with a painless fixed flexion contracture of the elbow due to an angioleiomyoma. This benign smooth muscle tumour should be considered in the differential diagnosis of flexion contractures of the elbow.

  6. Posterior-anterior weight-bearing radiograph in 15 knee flexion in medial osteoarthritis

    International Nuclear Information System (INIS)

    Yamanaka, Norio; Takahashi, Toshiaki; Yamamoto, Hiroshi; Ichikawa, Norikazu

    2003-01-01

    To evaluate the degree of knee flexion at which: (1) degenerative joint space narrowing is best seen, (2) the tibial plateau is best visualized and (3) the tibiofemoral angle is most correct, in order to assess the degree of flexion in the anteroposterior radiographic view that is most useful for assessing medial compartment osteoarthritis (OA) of the knee.Design and patients. We compared the conventional extended view of the knee and views at 15 , 30 , and 45 of flexion with respect to joint space narrowing, alignment of the medial tibial plateau (MTP), and tibiofemoral angles in 113 knees of 95 patients with medial osteoarthritis of the knee (22 men, 73 women; mean age 67 years).Results. At the midpoint and the narrowest point of the medial compartment, joint space narrowing values at 15 , 30 , and 45 of flexion of the knee were smaller than that of the conventional extended view. Superimposition of the margins of the tibial plateau was satisfactory in 12% of patients in the conventional extended view, in 36% at 15 of flexion, in 20% at 30 of flexion, and in 19% at 45 of flexion of the knee. When the knee was at 15 of flexion there was a smaller difference in the tibiofemoral angle, in comparison with the knee extended, than was the case at 30 and 45 of flexion in patients with medial OA.Conclusion. A posteroanterior view with 15 of flexion of the knee was able to detect joint space narrowing accurately, to achieve good alignment of the MTP in the medial compartment, and to reduce the difference in tibiofemoral angle compared with a view of the knee in conventional extension, and may be an alternative view in cases of medial OA of the knee. (orig.)

  7. Knowledge about useful entomofauna in the county of La Purísima Palmar de Bravo, Puebla State, Mexico

    Directory of Open Access Journals (Sweden)

    D. H. Zetina

    2007-06-01

    Full Text Available Eighteen species of edible insects belonging to 15 families of six orders of Insecta were recorded in the county of La Purísima Palmar de Bravo in Puebla State, Mexico. They had the following taxonomic distribution among the different families: Lygaeidae, Pentatomidae, Membracidae, Cercopidae, Psocidae, Melolonthidae, Curculionidae, Cossidae, Megathymidae, Pyralidae, Geometridae and Apidae, all with a single recorded species; the families Acrididae, Formicidae and Vespidae with two species in each family. The latter were the most abundant families, and Hymenoptera was the most salient order with five species. Three species were reported as new registers of edible insects for Mexico and also for the world. The nutritive value of insects in terms of macro and micronutrients is discussed.

  8. "Popeye muscle" morphology in OBPI elbow flexion contracture.

    Science.gov (United States)

    Coroneos, Christopher J; Maizlin, Zeev V; DeMatteo, Carol; Gjertsen, Deborah; Bain, James R

    2015-01-01

    The pathophysiology of elbow flexion contracture (EFC) in obstetrical brachial plexus injury (OBPI) is not established. In basic science models, neonatal denervation leads to impaired muscle growth. In clinical studies, diminished growth is correlated with extent of denervation, and improved with surgical repair. In EFC, the biceps are clinically short and round vs the contralateral size, termed the "Popeye muscle". The objective of this study was to determine if the biceps morphology (muscle belly and tendon length) in arms with EFC secondary to OBPI is different vs the contralateral. This is a retrospective matched-cohort study. Patients with unilateral EFC (>20°) secondary to OBPI were identified (median = 6.6 years, range = 4.7-16.8). A blinded radiologist used computed tomography to measure length of the biceps short head muscle belly, and tendon bilaterally using standardised anatomical landmarks. Twelve patients were analyzed. The biceps muscle belly in the injured arm was shorter in all patients vs contralateral, mean difference = 3.6 cm (80%), p muscle belly and overall length, but longer tendon vs normal. This is termed the "Popeye muscle" for its irregular morphology. Findings are consistent with impaired limb growth in denervation.

  9. Incidence of palmar process fractures of the distal phalanx and association with front hoof conformation in foals.

    Science.gov (United States)

    Faramarzi, B; McMicking, H; Halland, S; Kaneps, A; Dobson, H

    2015-11-01

    Recent studies indicate a high prevalence of fractures of the palmar processes (PP) of the distal phalanx in foals. However, information on the prevalence of such fractures in different breeds and the effect of predisposing factors, such as hoof conformation, is limited. To examine the prevalence of distal phalanx PP fractures in foals and report the relationship of distal limb and hoof conformation with the prevalence of fracture. Longitudinal study. Front hooves of 19 Thoroughbred, Quarter Horse and Arabian foals were examined. Digital radiographic and photographic images of the distal aspect of the forelimbs were taken at ∼2.5 month intervals. Five radiographic projections of each limb were as follows: lateromedial; horizontal beam dorsopalmar; dorso60°proximal-palmarodistal oblique; dorso60°proximo45°lateral-palmarodistomedial oblique; and dorso60°proximo45°medial-palmarodistolateral oblique. The relationship between measurements and the prevalence of fractures was assessed by 3-way ANOVA. Fractures were found in 74% (n = 14) of the foals during the study period. The prevalences of lateral PP and medial PP fractures were not significantly different. Several hoof measurements were associated with PP fractures. Longer dorsal length of the distal phalanx was associated with medial PP fractures, while smaller lateral angle and shorter lateral palmar length were associated with a higher prevalence of lateral PP fractures. This study revealed a high prevalence of PP fractures in young foals, particularly in Thoroughbred foals. The hoof conformation may be one of the contributory factors to PP fractures in foals. © 2014 EVJ Ltd.

  10. Clinical Evaluation of Fused/Ankylosed Hip with Severe Flexion Deformity after Conversion to Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Saroj Kumar Suwal

    2016-06-01

    Conclusions: THA is an effective treatment for ankylosed hip with severe flexion deformity although complications are noted more than routine hip arthroplasties. Keywords: ankylosed hip; fused hip; severe flexion deformity; total hip arthroplasty. | PubMed

  11. Plant abnormality inspection device

    International Nuclear Information System (INIS)

    Takenaka, Toshio.

    1990-01-01

    The present invention concerns a plant abnormality inspection device for conducting remote or automatic patrolling inspection in a plant and, more particularly, relates to such a device as capable of detecting abnormal odors. That is, the device comprises a moving device for moving to a predetermined position in the plant, a plurality of gas sensors for different kind of gases to be inspected mounted thereon, a comparator for comparing the concentration of a gas detected by the gas sensor with the normal gas concentration at the predetermined position and a judging means for judging the absence or presence of abnormality depending on the combination of the result of the comparison and deliverying a signal if the state is abnormal. As a result, a slight amount of gas responsible to odors released upon abnormality of the plant can be detected by a plurality of gas sensors for different kinds gases to rapidly and easily find abnormal portions in the plant. (I.S.)

  12. Relative sensitivity of depth discrimination for ankle inversion and plantar flexion movements.

    Science.gov (United States)

    Black, Georgia; Waddington, Gordon; Adams, Roger

    2014-02-01

    25 participants (20 women, 5 men) were tested for sensitivity in discrimination between sets of six movements centered on 8 degrees, 11 degrees, and 14 degrees, and separated by 0.3 degrees. Both inversion and plantar flexion movements were tested. Discrimination of the extent of inversion movement was observed to decline linearly with increasing depth; however, for plantar flexion, the discrimination function for movement extent was found to be non-linear. The relatively better discrimination of plantar flexion movements than inversion movements at around 11 degrees from horizontal is interpreted as an effect arising from differential amounts of practice through use, because this position is associated with the plantar flexion movement made in normal walking. The fact that plantar flexion movements are discriminated better than inversion at one region but not others argues against accounts of superior proprioceptive sensitivity for plantar flexion compared to inversion that are based on general properties of plantar flexion such as the number of muscle fibres on stretch.

  13. The effect of posterior tibial slope on knee flexion in posterior-stabilized total knee arthroplasty.

    Science.gov (United States)

    Shi, Xiaojun; Shen, Bin; Kang, Pengde; Yang, Jing; Zhou, Zongke; Pei, Fuxing

    2013-12-01

    To evaluate and quantify the effect of the tibial slope on the postoperative maximal knee flexion and stability in the posterior-stabilized total knee arthroplasty (TKA). Fifty-six patients (65 knees) who had undergone TKA with the posterior-stabilized prostheses were divided into the following 3 groups according to the measured tibial slopes: Group 1: ≤4°, Group 2: 4°-7° and Group 3: >7°. The preoperative range of the motion, the change in the posterior condylar offset, the elevation of the joint line, the postoperative tibiofemoral angle and the preoperative and postoperative Hospital for Special Surgery (HSS) scores were recorded. The tibial anteroposterior translation was measured using the Kneelax 3 Arthrometer at both the 30° and the 90° flexion angles. The mean values of the postoperative maximal knee flexion were 101° (SD 5), 106° (SD 5) and 113° (SD 9) in Groups 1, 2 and 3, respectively. A significant difference was found in the postoperative maximal flexion between the 3 groups (P slope resulted in a 1.8° flexion increment (r = 1.8, R (2) = 0.463, P slope can significantly increase the postoperative maximal knee flexion. The tibial slope with an appropriate flexion and extension gap balance during the operation does not affect the joint stability.

  14. Biomechanical Considerations in the Design of High-Flexion Total Knee Replacements

    Directory of Open Access Journals (Sweden)

    Cheng-Kung Cheng

    2014-01-01

    Full Text Available Typically, joint arthroplasty is performed to relieve pain and improve functionality in a diseased or damaged joint. Total knee arthroplasty (TKA involves replacing the entire knee joint, both femoral and tibial surfaces, with anatomically shaped artificial components in the hope of regaining normal joint function and permitting a full range of knee flexion. In spite of the design of the prosthesis itself, the degree of flexion attainable following TKA depends on a variety of factors, such as the joint’s preoperative condition/flexion, muscle strength, and surgical technique. High-flexion knee prostheses have been developed to accommodate movements that require greater flexion than typically achievable with conventional TKA; such high flexion is especially prevalent in Asian cultures. Recently, computational techniques have been widely used for evaluating the functionality of knee prostheses and for improving biomechanical performance. To offer a better understanding of the development and evaluation techniques currently available, this paper aims to review some of the latest trends in the simulation of high-flexion knee prostheses.

  15. Balanced Flexion and Extension Gaps Are Not Always of Equal Size.

    Science.gov (United States)

    Kinsey, Tracy L; Mahoney, Ormonde M

    2018-04-01

    It has been widely accepted in total knee arthroplasty (TKA) that flexion and extension gaps in the disarticulated knee during surgery should be equalized. We hypothesized that tensioning during assessment of the flexion gap can induce temporary widening of the gap due to posterior tibial translation. We aimed to describe posterior tibial translation at flexion gap (90°) assessments and assess the correlation of tibial translation with laxity (flexion space increase) using constrained and non-constrained inserts. Imageless navigation was used to measure flexion angle, tibial position relative to the femoral axis, and lateral/medial laxity in 30 patients undergoing primary TKA. Trialing was conducted using posteriorly stabilized and cruciate retaining trials of the same size to elucidate the association of posterior tibial translation with changes in joint capsule laxity at 90° knee flexion. All patients demonstrated posterior tibial translation during flexion gap assessment relative to their subsequent final implantation [mean ± standard deviation (range), 11.3 ± 4.4 (4-21) mm]. Positive linear correlation [r = 0.69, 95% confidence interval (CI) 0.44-0.84, P ≤ .001] was demonstrated between translations [8.7 ± 2.4 (3-13) mm] and laxity changes [2.9° ± 2.0° (-0.7° to 7.4°)] at 90° of flexion. Posterior tibial translation can cause artifactual widening of the flexion gap during gap balancing in posteriorly stabilized TKA, which can be of sufficient magnitude to alter femoral component size selection for some patients. Recognition and management of these intra-operative dynamics for optimal kinematics could be feasible with the advent of robotic applications. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Comparative study of phrenic and intercostal nerve transfers for elbow flexion after global brachial plexus injury.

    Science.gov (United States)

    Liu, Yuzhou; Lao, Jie; Zhao, Xin

    2015-04-01

    Global brachial plexus injuries (BPIs) are devastating events frequently resulting in severe functional impairment. The widely used nerve transfer sources for elbow flexion in patients with global BPIs include intercostal and phrenic nerves. The aim of this study was to compare phrenic and intercostal nerve transfers for elbow flexion after global BPI. A retrospective review of 33 patients treated with phrenic and intercostal nerve transfer for elbow flexion in posttraumatic global root avulsion BPI was carried out. In the phrenic nerve transfer group, the phrenic nerve was transferred to the anterolateral bundle of the anterior division of the upper trunk (23 patients); in the intercostal nerve transfer group, three intercostal nerves were coapted to the anterolateral bundles of the musculocutaneous nerve. The British Medical Research Council (MRC) grading system, angle of elbow flexion, and electromyography (EMG) were used to evaluate the recovery of elbow flexion at least 3 years postoperatively. The efficiency of motor function in the phrenic nerve transfer group was 83%, while it was 70% in the intercostal nerve transfer group. The two groups were not statistically different in terms of the MRC grade (p=0.646) and EMG results (p=0.646). The outstanding rates of angle of elbow flexion were 48% and 40% in the phrenic and intercostal nerve transfer groups, respectively. There was no significant difference of outstanding rates in the angle of elbow flexion between the two groups. Phrenic nerve transfer had a higher proportion of good prognosis for elbow flexion than intercostal nerve transfer, but the effective and outstanding rate had no significant difference for biceps reinnervation between the two groups according to MRC grading, angle of elbow flexion, and EMG. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. The use of forced flexion/extension views in the obtunded trauma patient

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, Harry J.; Wagner, Jason; Anglen, Jeff; Bunn, Paul; Metzler, Michael [Department of Radiology, Departments of Radiology/Orthopaedics and Surgery, University of Missouri-Columbia, One Hospital Drive - DC069.10, Columbia, MO 65212 (United States)

    2002-10-01

    To determine whether forced flexion/extension (F/E) films for ''clearing'' the cervical spine in unconscious or semiconscious patients are useful or actually dangerous.Design and patients. Of 810 patients admitted for blunt trauma over a 5-year period, 479 patients whose films and charts were available received passive F/E film views of the cervical spine. Of these, 447 were reviewed retrospectively in masked fashion for any exacerbation of neurological changes subsequent to the procedure and with respect to the final neurological status at discharge.Results. Twenty-nine patients (6%) had various abnormalities including fractures and ligamentous injuries seen on the initial films. Following forced F/E films no change was made in the diagnosis of 23 patients. Of the remaining six patients, two required no treatment, two only required the use of a collar but two did have surgical intervention, this decision being based on the findings seen in the initial films. However, 285 films (59%) were judged inadequate due either to inadequate F/E (150 patients, 31%) or poor visualization (194 patients, 40%). There were three false positives all subsequently cleared by other studies and there were no false negatives. From the chart review, there were no complications or deaths attributable to the procedure.Conclusion. Although we were unable to find any complication or deaths directly attributable to the procedure, the clinicians abandoned passive F/E views in obtunded patients on the grounds of expense. Our present method of ''clearing'' a cervical spine in an obtunded patient is a cross-table lateral radiograph followed by a high-resolution thin-slice CT scan with sagittal and coronal reconstruction. We are against the use of routine MRI studies and of a forced F/E view in these patients. (orig.)

  18. Avaliação de populações de Butia capitata de Santa Vitória do Palmar Performance of populations of Butia capitata of Santa Vitória do Palmar

    Directory of Open Access Journals (Sweden)

    Elisane Schwartz

    2010-09-01

    Full Text Available O gênero Butia pertence à família Arecaceae e possui cinco espécies com ocorrência no Rio Grande do Sul. A espécie Butia capitata está recebendo atenção especial, não só pelo seu uso no consumo in natura como também em formas processadas. No entanto, mesmo sendo uma espécie que tem sua utilização registrada desde os tempos pré-históricos, vem sendo explorada apenas de modo extrativista, como a maioria das espécies de frutíferas nativas. Além disso, a espécie está seriamente comprometida em médio prazo pela ausência de regeneração natural e com risco muito alto de extinção num futuro próximo. Nesse sentido, o objetivo deste trabalho foi comparar os frutos, a partir de parâmetros químicos e físicos, e também observar os dados produtivos das plantas de três populações de butiazeiros do município de Santa Vitória do Palmar-RS. Os dados foram obtidos em experimentos conduzidos na safra de 2005/2006 e na safra de 2006/2007, em três propriedades localizadas em Santa Vitória do Palmar. Os resultados permitiram verificar que as propriedades e ou variações genéticas entre as populações de Butia capitata avaliadas propiciaram variabilidade para duração do ciclo, coloração da epiderme dos frutos, volume de suco produzido, relação entre sólidos solúveis totais e acidez titulável, características biométricas de fruto e produtividade anual. Uma das populações, denominada Celina, apresentou maior produtividade e rendimento industrial. As populações Celina e São José apresentaram as melhores características biométricas de fruto. A população Aguiar apresentou a melhor relação entre sólidos solúveis totais e acidez titulável.The genus Butia belongs to the Arecaceae family and shows five species occurring in Rio Grande de Sul. The specie Butia capitata requires special attention, not just for its use as fresh consumption but also as processed product. However, even having its use recorded since

  19. Plantar-flexion of the ankle joint complex in terminal stance is initiated by subtalar plantar-flexion: A bi-planar fluoroscopy study.

    Science.gov (United States)

    Koo, Seungbum; Lee, Kyoung Min; Cha, Young Joo

    2015-10-01

    Gross motion of the ankle joint complex (AJC) is a summation of the ankle and subtalar joints. Although AJC kinematics have been widely used to evaluate the function of the AJC, the coordinated movements of the ankle and subtalar joints are not well understood. The purpose of this study was to accurately quantify the individual kinematics of the ankle and subtalar joints in the intact foot during ground walking by using a bi-planar fluoroscopic system. Bi-planar fluoroscopic images of the foot and ankle during walking and standing were acquired from 10 healthy subjects. The three-dimensional movements of the tibia, talus, and calcaneus were calculated with a three-dimensional/two-dimensional registration method. The skeletal kinematics were quantified from 9% to 86% of the full stance phase because of the limited camera speed of the X-ray system. At the beginning of terminal stance, plantar-flexion of the AJC was initiated in the subtalar joint on average at 75% ranging from 62% to 76% of the stance phase, and plantar-flexion of the ankle joint did not start until 86% of the stance phase. The earlier change to plantar-flexion in the AJC than the ankle joint due to the early plantar-flexion in the subtalar joint was observed in 8 of the 10 subjects. This phenomenon could be explained by the absence of direct muscle insertion on the talus. Preceding subtalar plantar-flexion could contribute to efficient and stable ankle plantar-flexion by locking the midtarsal joint, but this explanation needs further investigation. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Comparison of High-Flexion Fixed-Bearing and High-Flexion Mobile-Bearing Total Knee Arthroplasties-A Prospective Randomized Study.

    Science.gov (United States)

    Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik

    2018-01-01

    There is none, to our knowledge, about comparison of high-flexion fixed-bearing and high-flexion mobile-bearing total knee arthroplasties (TKAs) in the same patients. The purpose of this study was to determine whether clinical results; radiographic and computed tomographic scan results; and the survival rate of a high-flexion mobile-bearing TKA is better than that of a high-flexion fixed-bearing TKA. The present study consisted of 92 patients (184 knees) who underwent same-day bilateral TKA. Of those, 17 were men and 75 were women. The mean age at the time of index arthroplasty was 61.5 ± 8.3 years (range 52-65 years). The mean body mass index was 26.2 ± 3.3 kg/m 2 (range 23-34 kg/m 2 ). The mean follow-up was 11.2 years (range 10-12 years). The Knee Society knee scores (93 vs 92 points; P = .531) and function scores (80 vs 80 points; P = 1.000), WOMAC scores (14 vs 15 points; P = .972), and UCLA activity scores (6 vs 6 points; P = 1.000) were not different between the 2 groups at 12 years follow-up. There were no differences in any radiographic and CT scan parameters between the 2 groups. Kaplan-Meier survivorship of the TKA component was 98% (95% confidence interval, 93-100) in the high-flexion fixed-bearing TKA group and 99% (95% confidence interval, 94-100) in the high-flexion mobile-bearing TKA group 12 years after the operation. We found no benefit to mobile-bearing TKA in terms of pain, function, radiographic and CT scan results, and survivorship. Longer-term follow-up is necessary to prove the benefit of the high-flexion mobile-bearing TKA over the high-flexion fixed-bearing TKA. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Defining Abnormally Low Tenders

    DEFF Research Database (Denmark)

    Ølykke, Grith Skovgaard; Nyström, Johan

    2017-01-01

    The concept of an abnormally low tender is not defined in EU public procurement law. This article takes an interdisciplinary law and economics approach to examine a dataset consisting of Swedish and Danish judgments and verdicts concerning the concept of an abnormally low tender. The purpose...

  2. The range of excursion of flexor tendons in Zone V: a comparison of active vs passive flexion mobilisation regimes.

    LENUS (Irish Health Repository)

    Panchal, J

    1997-10-01

    A number of early postoperative mobilisation regimes have been developed in an attempt to increase tendon excursion and gliding and thereby reduce formation of adhesions following repair of flexor tendons. Early active flexion mobilisation regimes are becoming more popular, and have replaced early passive flexion regimes in many centres. The aim of the present study was: (a) to determine the range of excursion of flexor tendons in Zone V, and (b) to compare the excursion ranges between active (Belfast) and passive (modified Duran) flexion mobilisation regimes postoperatively. This was done (a) in two cadavers, and (b) in two patients intraoperatively, and postoperatively at 10 days, 3 weeks and 6 weeks. With passive flexion, the mean tendon excursion in Zone V in cadavers was 1 mm for flexor digitorum superficialis (FDS), flexor digitorum profundus (FDP) and flexor pollicis longus (FPL) tendons respectively. With simulated active flexion, the mean tendon excursion was 14 mm, 10 mm and 11 mm respectively. The mean tendon excursion in clinical cases intraoperatively following passive flexion was 2 mm for FDS, FDP and FPL respectively; following simulated active flexion it was 10 mm, 11 mm and 11 mm for FDS, FDP and FPL respectively. On the tenth day following repair, the mean excursions of FDS, FDP and FPL were 1 mm, 4 mm and 4 mm on passive flexion as compared to 3 mm, 10 mm and 12 mm on active flexion respectively. Three weeks postoperatively, the mean excursions of FDS, FDP and FPL tendons were 1 mm, 2 mm and 1 mm on passive flexion as compared to 5 mm, 15 mm on active flexion respectively. Six weeks postoperatively, the mean excursions of FDS, FDP and FPL tendons were 9 mm, 7 mm and 4 mm on passive flexion as compared to 12 mm, 33 mm and 20 mm on active flexion respectively. These results demonstrate an increased excursion of repaired flexor tendons in Zone V following an active flexion mobilisation regime as compared to a passive flexion mobilisation regime.

  3. Emergency management of traumatic collateral palmar digital nerve defect inferior to 30 mm by venous grafting. Report of 12 clinical cases.

    Science.gov (United States)

    Laveaux, C; Pauchot, J; Obert, L; Choserot, V; Tropet, Y

    2011-02-01

    When traumatic collateral palmar digital nerve defect occurs, emergency venous grafting is an alternative to the two-step nervous grafting procedure. During the course of a monocentric retrospective study, 12 cases of emergency venous grafting were reviewed by a single independent examiner 11 months, at least, post-intervention. Clinical and functional evaluation was carried out, together with a self-assessment of the results by the patient. Data were compacted using a filtering method and the final result was considered in terms of "good" or "bad". Good result was observed in ten cases out of 12. Bad results were associated with poor sensory recovery in the two other cases. In one of these, the bad result was also related to severe symptoms in cold conditions and a troublesome hyperesthesia. Through a review of the literature, we justify the emergency treatment of nerve defects of the collateral palmar digital nerves with venous grafting. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  4. Turtle Flexion Reflex Motor Patterns Show Windup, Mediated Partly by L-type Calcium Channels

    Directory of Open Access Journals (Sweden)

    Keith P. Johnson

    2017-10-01

    Full Text Available Windup is a form of multisecond temporal summation in which identical stimuli, delivered seconds apart, trigger increasingly strong neuronal responses. L-type Ca2+ channels have been shown to play an important role in the production of windup of spinal cord neuronal responses, initially in studies of turtle spinal cord and later in studies of mammalian spinal cord. L-type Ca2+ channels have also been shown to contribute to windup of limb withdrawal reflex (flexion reflex in rats, but flexion reflex windup has not previously been described in turtles and its cellular mechanisms have not been studied. We studied windup of flexion reflex motor patterns, evoked with weak mechanical and electrical stimulation of the dorsal hindlimb foot skin and assessed via a hip flexor (HF nerve recording, in spinal cord-transected and immobilized turtles in vivo. We found that an L-type Ca2+ channel antagonist, nifedipine, applied at concentrations of 50 μM or 100 μM to the hindlimb enlargement spinal cord, significantly reduced windup of flexion reflex motor patterns, while lower concentrations of nifedipine had no such effect. Nifedipine similarly reduced the amplitude of an individual flexion reflex motor pattern evoked by a stronger mechanical stimulus, in a dose-dependent manner, suggesting that L-type Ca2+ channels contribute to each flexion reflex as well as to multisecond summation of flexion reflex responses in turtles. We also found that we could elicit flexion reflex windup consistently using a 4-g von Frey filament, which is not usually considered a nociceptive stimulus. Thus, it may be that windup can be evoked by a wide range of tactile stimuli and that L-type calcium channels contribute to multisecond temporal summation of diverse tactile stimuli across vertebrates.

  5. Modelling knee flexion effects on joint power absorption and adduction moment.

    Science.gov (United States)

    Nagano, Hanatsu; Tatsumi, Ichiroh; Sarashina, Eri; Sparrow, W A; Begg, Rezaul K

    2015-12-01

    Knee osteoarthritis is commonly associated with ageing and long-term walking. In this study the effects of flexing motions on knee kinetics during stance were simulated. Extended knees do not facilitate efficient loading. It was therefore, hypothesised that knee flexion would promote power absorption and negative work, while possibly reducing knee adduction moment. Three-dimensional (3D) position and ground reaction forces were collected from the right lower limb stance phase of one healthy young male subject. 3D position was sampled at 100 Hz using three Optotrak Certus (Northern Digital Inc.) motion analysis camera units, set up around an eight metre walkway. Force plates (AMTI) recorded ground reaction forces for inverse dynamics calculations. The Visual 3D (C-motion) 'Landmark' function was used to change knee joint positions to simulate three knee flexion angles during static standing. Effects of the flexion angles on joint kinetics during the stance phase were then modelled. The static modelling showed that each 2.7° increment in knee flexion angle produced 2.74°-2.76° increments in knee flexion during stance. Increased peak extension moment was 6.61 Nm per 2.7° of increased knee flexion. Knee flexion enhanced peak power absorption and negative work, while decreasing adduction moment. Excessive knee extension impairs quadriceps' power absorption and reduces eccentric muscle activity, potentially leading to knee osteoarthritis. A more flexed knee is accompanied by reduced adduction moment. Research is required to determine the optimum knee flexion to prevent further damage to knee-joint structures affected by osteoarthritis. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. COMPARATIVE BIOMECHANICAL ANALYSES OF SQUAT JUMP WITHOUT AND WITH FLEXION IN KNEE JOINT

    Directory of Open Access Journals (Sweden)

    Saša Bubanj

    2009-11-01

    Full Text Available In sports hall of Faculty of sports and physical education in Niš, student demon- strated technique of squat jump – without and with flexion in knee joint. Elements of technique were recorded by using one digital video camera in sagital plane. By using comparative kinematics analyses, there were establish differences in values of kinema- tics parametres of different body segments. Bigger elevation of body centre of gravity was ascertain at bounce without flexion in knee joint.

  7. Incomplete fracture of the proximo-palmar aspect of the third metacarpal bone

    International Nuclear Information System (INIS)

    Riggs, C.M.

    1994-01-01

    Previous descriptions of incomplete longitudinal fractures and fatigue injury of the proximopalmar aspect of the third metacarpal bone (McIII) have focused on diagnostic imaging findings, especially in racehorses. Objectives: To document the case details, clinical features, response to diagnostic analgesia, diagnostic imaging findings and follow-up data in a large group of horses with an incomplete longitudinal fracture or fatigue injury of the proximopalmar medial aspect of the McIII. Materials And Methods: Horses were included in the study if pain was localised to the proximopalmar aspect of the metacarpal region, with radiological evidence of an incomplete longitudinal fracture or generalised increased radiopacity in the proximopalmar medial aspect of the McIII, or focal increased radiopharmaceutical uptake (IRU) in the proximopalmar aspect of the McIII. Age, breed, gender, height, bodyweight, work discipline, work history, duration of lameness, clinical signs and responses to diagnostic analgesia were recorded. Radiographic and scintigraphic images were assessed subjectively and objectively. Results: There were 55 horses representing a broad spectrum of ages and work disciplines, 73% of which had radiological abnormalities. The majority had no localising clinical signs, although 73% of horses with radiological abnormalities showed a characteristic pattern of lameness. Lameness was generally worse in straight lines than in circles. Increased radiopharmaceutical uptake ranged from mild to intense in the lame limb; 14% of nonlame limbs had mild IRU. Of horses for which long-term follow-up was available, 98% returned to full athletic function. Conclusions And Potential Relevance: Incomplete longitudinal fractures and fatigue injury of the proximopalmar medial aspect of the McIII may occur in horses of many types and sports disciplines, and are not confined to immature performance horses. They should be considered an important differential diagnosis for proximal

  8. Isokinetic profile of elbow flexion and extension strength in elite junior tennis players.

    Science.gov (United States)

    Ellenbecker, Todd S; Roetert, E Paul

    2003-02-01

    Descriptive study. To determine whether bilateral differences exist in concentric elbow flexion and extension strength in elite junior tennis players. The repetitive nature of tennis frequently produces upper extremity overuse injuries. Prior research has identified tennis-specific strength adaptation in the dominant shoulder and distal upper extremity musculature of elite players. No previous study has addressed elbow flexion and extension strength. Thirty-eight elite junior tennis players were bilaterally tested for concentric elbow flexion and extension muscle performance on a Cybex 6000 isokinetic dynamometer at 90 degrees/s, 210 degrees/s, and 300 degrees/s. Repeated-measures ANOVAs were used to test for differences between extremities, muscle groups, and speed. Significantly greater (Pelbow extension peak torque values were measured at 90 degrees/s, 210 degrees/s, and 300 degrees/s for males. Significantly greater (Pelbow flexion muscular performance in males and for elbow flexion or extension peak torque and single-repetition work values in females. No significant difference between extremities was measured in elbow flexion/extension strength ratios in females and significant differences between extremities in this ratio were only present at 210 degrees/s in males (Pelbow in male elite junior tennis players but not females. These data have ramifications for clinicians rehabilitating upper extremity injuries in patients from this population.

  9. Experimental measurement of flexion-extension movement in normal and corpse prosthetic elbow joint.

    Science.gov (United States)

    TarniŢă, Daniela; TarniŢă, DănuŢ Nicolae

    2016-01-01

    This paper presents a comparative experimental study of flexion-extension movement in healthy elbow and in the prosthetic elbow joint fixed on an original experimental bench. Measurements were carried out in order to validate the functional morphology and a new elbow prosthesis type ball head. The three-dimensional (3D) model and the physical prototype of our experimental bench used to test elbow endoprosthesis at flexion-extension and pronation-supination movements is presented. The measurements were carried out on a group of nine healthy subjects and on the prosthetic corpse elbow, the experimental data being obtained for flexion-extension movement cycles. Experimental data for the two different flexion-extension tests for the nine subjects and for the corpse prosthetic elbow were acquired using SimiMotion video system. Experimental data were processed statistically. The corresponding graphs were obtained for all subjects in the experimental group, and for corpse prosthetic elbow for both flexion-extension tests. The statistical analysis has proved that the flexion angles of healthy elbows were significantly close to the values measured at the prosthetic elbow fixed on the experimental bench. The studied elbow prosthesis manages to re-establish the mobility for the elbow joint as close to the normal one.

  10. [Unidirectional versus multidirectional palmar locking osteosynthesis of unstable distal radius fractures: comparative analysis with LDR 2.4 mm versus 2.7 mm matrix-Smartlock].

    Science.gov (United States)

    Hakimi, M; Jungbluth, P; Gehrmann, S; Nowak, J; Windolf, J; Wild, M

    2010-03-01

    Due to advances in the development of the unidirectional locking plates there is now an increased use of multidirectional palmar locking plates in the treatment of distal radius factures. The purpose of this study was to evaluate a possible improvement of the treatment and results. This prospective cohort study investigated 40 patients with C1 and C2 Colles' fractures who had been treated with unidirectional and multidirectional locking plates. The average time for the follow-up examinations was 12.3 months (range 12-15 months) after surgery. The intra-operative functional (neutral-zero method), radiological and subjective (DASH score, VAS) results were evaluated. The intra-operative fluoroscopy time of the unidirectional group was 58 s shorter compared to the multidirectional group. All fractures healed without any complication. The radiological, subjective (DASH score) and objective results for both groups were good and showed no differences. Unidirectional palmar locking plates are equally suited for the therapy of C1 and C2 fractures as multidirectional palmar locking plates but multidirectional plates require a longer fluoroscopy time.

  11. [Reconstruction of combined skin and bilateral artey defects at palmar side of fingers by free posterior interrosseous artery flap in a bridge fashion].

    Science.gov (United States)

    Xu, Bao-cheng; Liang, Gang; Chen, Fu-sheng

    2012-05-01

    To investigate the feasibility and therapeutic effect of free posterior interrosseous artery flap in a bridge fashion for combined skin and bilateral artery defects at palmar side of fingers. 6 cases with combined skin and bilateral artery defects at palmar side of fingers were treated with long-pedicled free posterior interrosseous artery flap in a bridge fashion. The flap size ranged from 3.5 cm x 2.0 cm to 6.5 em x 3.0 cm. The wounds at donor sites were closed directly. All the 6 flaps survived completely without any complication, and the wounds healed primarily. The blood supply and vein drainage in all the 6 fingers were normal. 4 cases were followed up for 1-12 months (average, 7 months). Satisfactory cosmetic and functional results were achieved. The flaps looked a little bit thicker than the surrounding tissue. The long-pedicled free posterior interrosseous artery flap in a bridge fashion is a good option for reconstruction of the combined skin and bilateral artery defects at palmar side of fingers in one stage.

  12. Chromosomal abnormalities and autism

    Directory of Open Access Journals (Sweden)

    Farida El-Baz

    2016-01-01

    Conclusion: Chromosomal abnormalities were not detected in the studied autistic children, and so the relation between the genetics and autism still needs further work up with different study methods and techniques.

  13. Chromosomal Abnormalities in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-07-01

    Full Text Available The prevalence of fragile X syndrome, velocardiofacial syndrome (VCFS, and other cytogenetic abnormalities among 100 children (64 boys with combined type ADHD and normal intelligence was assessed at the NIMH and Georgetown University Medical Center.

  14. "Jeopardy" in Abnormal Psychology.

    Science.gov (United States)

    Keutzer, Carolin S.

    1993-01-01

    Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)

  15. Abnormal Uterine Bleeding

    Science.gov (United States)

    ... especially the progestin-only pill (also called the “mini-pill”) can actually cause abnormal bleeding for some ... Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality ...

  16. Circumscribed palmar or plantar hypokeratosis 10 years after the first description: what is known and the issues under discussion.

    Science.gov (United States)

    Urbina, F; Pérez, A; Requena, L; Rütten, A

    2014-01-01

    This review of the literature on palmoplantar hypokeratosis, a process that was first indentified only 10 years ago, discusses the current state of our understanding, the therapeutic options available, and the debate about etiology. Forty-four publications reporting 69 cases were found. Palmar or plantar hypokeratosis occurs mainly in women (76.8%) and age at the time of a first visit to a physician ranges from 42 to 84 years. Most cases present between the ages of 51 and 70 years. The majority of patients have had solitary lesions usually located on the right palm, particularly in the regions of the thenar (in 44/79 lesions [55.7%]) or hypothenar eminences (in 11/79 lesions [13.9%]). In only 8 cases was there a history of prior trauma at the site. Studies using polymerase chain reaction techniques to identify human papillomavirus involvement were negative in most cases. These hypokeratotic lesions are localized epidermal depressions formed by an abrupt thinning of the stratum corneum, providing a singular histopathologic feature. This condition can currently be considered a localized keratinization disorder affecting zones where there is a thick stratum corneum. The precipitating cause is unknown and a definitive treatment remains to be found. The mechanism would be the localized failure of a clone of keratinocytes during differentiation toward normal palmoplantar hyperkeratinization. Copyright © 2012 Elsevier España, S.L. y AEDV. All rights reserved.

  17. Abnormal sound detection device

    International Nuclear Information System (INIS)

    Yamada, Izumi; Matsui, Yuji.

    1995-01-01

    Only components synchronized with rotation of pumps are sampled from detected acoustic sounds, to judge the presence or absence of abnormality based on the magnitude of the synchronized components. A synchronized component sampling means can remove resonance sounds and other acoustic sounds generated at a synchronously with the rotation based on the knowledge that generated acoustic components in a normal state are a sort of resonance sounds and are not precisely synchronized with the number of rotation. On the other hand, abnormal sounds of a rotating body are often caused by compulsory force accompanying the rotation as a generation source, and the abnormal sounds can be detected by extracting only the rotation-synchronized components. Since components of normal acoustic sounds generated at present are discriminated from the detected sounds, reduction of the abnormal sounds due to a signal processing can be avoided and, as a result, abnormal sound detection sensitivity can be improved. Further, since it is adapted to discriminate the occurrence of the abnormal sound from the actually detected sounds, the other frequency components which are forecast but not generated actually are not removed, so that it is further effective for the improvement of detection sensitivity. (N.H.)

  18. Neuromuscular Activation of the Vastus Intermedius Muscle during Isometric Hip Flexion.

    Directory of Open Access Journals (Sweden)

    Akira Saito

    Full Text Available Although activity of the rectus femoris (RF differs from that of the other synergists in quadriceps femoris muscle group during physical activities in humans, it has been suggested that the activation pattern of the vastus intermedius (VI is similar to that of the RF. The purpose of present study was to examine activation of the VI during isometric hip flexion. Ten healthy men performed isometric hip flexion contractions at 25%, 50%, 75%, and 100% of maximal voluntary contraction at hip joint angles of 90°, 110° and 130°. Surface electromyography (EMG was used to record activity of the four quadriceps femoris muscles and EMG signals were root mean square processed and normalized to EMG amplitude during an isometric knee extension with maximal voluntary contraction. The normalized EMG was significantly higher for the VI than for the vastus medialis during hip flexion at 100% of maximal voluntary contraction at hip joint angles of 110° and 130° (P < 0.05. The onset of VI activation was 230-240 ms later than the onset of RF activation during hip flexion at each hip joint angle, which was significantly later than during knee extension at 100% of maximal voluntary contraction (P < 0.05. These results suggest that the VI is activated later than the RF during hip flexion. Activity of the VI during hip flexion might contribute to stabilize the knee joint as an antagonist and might help to smooth knee joint motion, such as in the transition from hip flexion to knee extension during walking, running and pedaling.

  19. Constraining primordial non-Gaussianity with cosmological weak lensing: shear and flexion

    International Nuclear Information System (INIS)

    Fedeli, C.; Bartelmann, M.; Moscardini, L.

    2012-01-01

    We examine the cosmological constraining power of future large-scale weak lensing surveys on the model of the ESA planned mission Euclid, with particular reference to primordial non-Gaussianity. Our analysis considers several different estimators of the projected matter power spectrum, based on both shear and flexion. We review the covariance and Fisher matrix for cosmic shear and evaluate those for cosmic flexion and for the cross-correlation between the two. The bounds provided by cosmic shear alone are looser than previously estimated, mainly due to the reduced sky coverage and background number density of sources for the latest Euclid specifications. New constraints for the local bispectrum shape, marginalized over σ 8 , are at the level of Δf NL ∼ 100, with the precise value depending on the exact multipole range that is considered in the analysis. We consider three additional bispectrum shapes, for which the cosmic shear constraints range from Δf NL ∼ 340 (equilateral shape) up to Δf NL ∼ 500 (orthogonal shape). Also, constraints on the level of non-Gaussianity and on the amplitude of the matter power spectrum σ 8 are almost perfectly anti-correlated, except for the orthogonal bispectrum shape for which they are correlated. The competitiveness of cosmic flexion constraints against cosmic shear ones depends by and large on the galaxy intrinsic flexion noise, that is still virtually unconstrained. Adopting the very high value that has been occasionally used in the literature results in the flexion contribution being basically negligible with respect to the shear one, and for realistic configurations the former does not improve significantly the constraining power of the latter. Since the shear shot noise is white, while the flexion one decreases with decreasing scale, by considering high enough multipoles the two contributions have to become comparable. Extending the analysis up to l max = 20,000 cosmic flexion, while being still subdominant

  20. Biceps brachii long head overactivity associated with elbow flexion contracture in brachial plexus birth palsy.

    Science.gov (United States)

    Sheffler, Lindsey C; Lattanza, Lisa; Sison-Williamson, Mitell; James, Michelle A

    2012-02-15

    The etiology of elbow flexion contracture in children with brachial plexus birth palsy remains unclear. We hypothesized that the long head of the biceps brachii muscle assists with shoulder stabilization in children with brachial plexus birth palsy and that overactivity of the long head during elbow and shoulder activity is associated with an elbow flexion contracture. Twenty-one patients with brachial plexus birth palsy-associated elbow flexion contracture underwent testing with surface electromyography. Twelve patients underwent repeat testing with fine-wire electromyography. Surface electrodes were placed on the muscle belly, and fine-wire electrodes were inserted bilaterally into the long and short heads of the biceps brachii. Patients were asked to perform four upper extremity tasks: elbow flexion-extension, hand to head, high reach, and overhead ball throw. The mean duration of muscle activity in the affected limb was compared with that in the contralateral, unaffected limb, which was used as a control. Three-dimensional motion analysis, surface dynamometry, and validated function measures were used to evaluate upper extremity kinematics, elbow flexor-extensor muscle imbalance, and function. The mean activity duration of the long head of the biceps brachii muscle was significantly higher in the affected limb as compared with the contralateral, unaffected limb during hand-to-head tasks (p = 0.02) and high-reach tasks (p = 0.03). No significant differences in mean activity duration were observed for the short head of the biceps brachii muscle between the affected and unaffected limbs. Isometric strength of elbow flexion was not significantly higher than that of elbow extension in the affected limb (p = 0.11). Overactivity of the long head of the biceps brachii muscle is associated with and may contribute to the development of elbow flexion contracture in children with brachial plexus birth palsy. Elbow flexion contracture may not be associated with an elbow

  1. Constraining primordial non-Gaussianity with cosmological weak lensing: shear and flexion

    Energy Technology Data Exchange (ETDEWEB)

    Fedeli, C. [Department of Astronomy, University of Florida, 211 Bryant Space Science Center, Gainesville, FL 32611-2055 (United States); Bartelmann, M. [Zentrum für Astronomie, Universität Heidelberg, Albert-Überle-Straße 2, 69120 Heidelberg (Germany); Moscardini, L., E-mail: cosimo.fedeli@astro.ufl.edu, E-mail: bartelmann@uni-heidelberg.de, E-mail: lauro.moscardini@unibo.it [Dipartimento di Astronomia, Università di Bologna, Via Ranzani 1, 40127 Bologna (Italy)

    2012-10-01

    We examine the cosmological constraining power of future large-scale weak lensing surveys on the model of the ESA planned mission Euclid, with particular reference to primordial non-Gaussianity. Our analysis considers several different estimators of the projected matter power spectrum, based on both shear and flexion. We review the covariance and Fisher matrix for cosmic shear and evaluate those for cosmic flexion and for the cross-correlation between the two. The bounds provided by cosmic shear alone are looser than previously estimated, mainly due to the reduced sky coverage and background number density of sources for the latest Euclid specifications. New constraints for the local bispectrum shape, marginalized over σ{sub 8}, are at the level of Δf{sub NL} ∼ 100, with the precise value depending on the exact multipole range that is considered in the analysis. We consider three additional bispectrum shapes, for which the cosmic shear constraints range from Δf{sub NL} ∼ 340 (equilateral shape) up to Δf{sub NL} ∼ 500 (orthogonal shape). Also, constraints on the level of non-Gaussianity and on the amplitude of the matter power spectrum σ{sub 8} are almost perfectly anti-correlated, except for the orthogonal bispectrum shape for which they are correlated. The competitiveness of cosmic flexion constraints against cosmic shear ones depends by and large on the galaxy intrinsic flexion noise, that is still virtually unconstrained. Adopting the very high value that has been occasionally used in the literature results in the flexion contribution being basically negligible with respect to the shear one, and for realistic configurations the former does not improve significantly the constraining power of the latter. Since the shear shot noise is white, while the flexion one decreases with decreasing scale, by considering high enough multipoles the two contributions have to become comparable. Extending the analysis up to l{sub max} = 20,000 cosmic flexion, while

  2. Serial casting for elbow flexion contractures in neonatal brachial plexus palsy.

    Science.gov (United States)

    Duijnisveld, B J; Steenbeek, D; Nelissen, R G H H

    2016-09-02

    The objective of this study was to evaluate the effectiveness of serial casting of elbow flexion contractures in neonatal brachial plexus palsy. A prospective consecutive cohort study was performed with a median follow-up of 5 years. Forty-one patients with elbow flexion contractures ≥ 30° were treated with serial casting until the contracture was ≤ 10°, for a maximum of 8 weeks. Range of motion, number of recurrences and patient satisfaction were recorded and analyzed using Wilcoxon signed-rank and Cox regression tests. Passive extension increased from a median of -40° (IQR -50 to -30) to -15° (IQR -10 to -20, p casting had to be prematurely replaced by night splinting due to complaints. Serial casting improved elbow flexion contractures, although recurrences were frequent. The severity of elbow flexion contracture is a predictor of recurrence. We recommend more research on muscle degeneration and determinants involved in elbow flexion contractures to improve treatment strategies and prevent side-effects.

  3. ARTHROMETRIC EVALUATION OF STABILIZING EFFECT OF KNEE FUNCTIONAL BRACING AT DIFFERENT FLEXION ANGLES

    Directory of Open Access Journals (Sweden)

    Saeedeh Seyed Mohseni

    2009-06-01

    Full Text Available Previous in-vivo investigations on the stabilizing efficacy of knee bracing for ACL reconstructed patients have been often limited to 20-30 degrees of knee flexion. In this study, the effectiveness of a uniaxial hinged functional brace to improve the knee stability was assessed at 30, 60 and 90 degrees of knee flexion. Arthrometry tests were conducted on 15 healthy subjects before and following wearing the brace and the tibial displacements were measured at up to 150 N anterior forces. Results indicated that functional bracing has a significant stabilizing effect throughout the range of knee flexion examined (p < 0.05. The rate of effectiveness, however, was not consistent across the flexion range, e.g., 50% at 30 degrees and only 4% at 90 degrees. It was suggested that accurate sizing and fitting as well as attention to correct hinge placement relative to the femoral condyles can limit brace migration and improve its effectiveness in mid and deep knee flexion. With using adaptive limb fittings, through flexible pads, and a polycentric joint a more significant improvement of the overall brace performance and efficacy might be obtained

  4. MR imaging of the knee extension and flexion. Diagnostic value for reconstructed anterior cruciate ligament

    Energy Technology Data Exchange (ETDEWEB)

    Niitsu, Mamoru; Ikeda, Kotaroh; Fukubayashi, Tohru [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine] [and others

    1995-09-01

    The purpose of this study is to determine the value of extended and flexed knee positions in MR imaging of the surgically reconstructed anterior cruciate ligament (ACL). With a mobile knee brace and a flexible surface coil, knee joint was enabled to extend to a full-extension and bend vertically to a semi-flexion (average 45deg of flexion) within the confines of the magnet bore. Sets of 3-mm-thick oblique sagittal proton-weighted turbo spin echo MR images were obtained at both extended and flexed positions. Twenty-five knees with intact ACL grafts and three knees with arthroscopically proved graft tears were evaluated. Compared to the extended position, MR images of flexed knee provided better delineation of the intact and complicated ACL grafts with statistical significance. The intact graft appeared relaxed at the semi-flexion and taut at the extension. Overall lengths of the intact grafts were readily identified at the flexion. Stretched along the intercondylar roof, the grafts were poorly outlined at the extension. MR images with knee flexion delineated the disrupted site from the impingement more clearly than that with knee extension. (author).

  5. Isolated flexor pollicis longus nerve fascicle lesion – a rare differential diagnosis of thumb flexion deficiency

    Directory of Open Access Journals (Sweden)

    Glauser, Eva

    2016-12-01

    Full Text Available A rare differential diagnosis of thumb flexion deficiency is an isolated flexor pollicis longus (FPL nerve fascicle lesion. We present a 42-year-old otherwise healthy female patient who developed a weak thumb-to-index pinch and deficient right thumb flexion following the removal of osteosynthesis plates after a forearm fracture. Clinically,the flexor pollicis longus function was absent, yet index flexion and sensibility were unimpaired. Tendon rupture was excluded using a tenodesis test and the electro-physiological result of isolated interosseus nerve fascicle lesion was confirmed intraoperatively by inspection and electrostimulation. Tendon transfer using the extensor carpi radialis longus reconstruct strong thumb flexion during pinch. In summary, due to its specific location and anatomy, the FPL branch is more prone to isolated neuropathy, e.g. by injections or operations, than to other fascicles of the anterior interosseus nerve. When confronted with sudden and isolated thumb flexion deficiency, specialists should be aware of this rare phenomenon.

  6. Extension and flexion in the upper cervical spine in neck pain patients.

    Science.gov (United States)

    Ernst, Markus J; Crawford, Rebecca J; Schelldorfer, Sarah; Rausch-Osthoff, Anne-Kathrin; Barbero, Marco; Kool, Jan; Bauer, Christoph M

    2015-08-01

    Neck pain is a common problem in the general population with high risk of ongoing complaints or relapses. Range of motion (ROM) assessment is scientifically established in the clinical process of diagnosis, prognosis and outcome evaluation in neck pain. Anatomically, the cervical spine (CS) has been considered in two regions, the upper and lower CS. Disorders like cervicogenic headache have been clinically associated with dysfunctions of the upper CS (UCS), yet ROM tests and measurements are typically conducted on the whole CS. A cross-sectional study assessing 19 subjects with non-specific neck pain was undertaken to examine UCS extension-flexion ROM in relation to self-reported disability and pain (via the Neck Disability Index (NDI)). Two measurement devices (goniometer and electromagnetic tracking) were employed and compared. Correlations between ROM and the NDI were stronger for the UCS compared to the CS, with the strongest correlation between UCS flexion and the NDI-headache (r = -0.62). Correlations between UCS and CS ROM were fair to moderate, with the strongest correlation between UCS flexion and CS extension ROM (r = -0.49). UCS flexion restriction is related to headache frequency and intensity. Consistency and agreement between both measurement systems and for all tests was high. The results demonstrate that separate UCS ROM assessments for extension and flexion are useful in patients with neck pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. The Immediate Effect of Neuromuscular Joint Facilitation (NJF) Treatment on Electromechanical Reaction Times of Hip Flexion.

    Science.gov (United States)

    Huo, Ming; Wang, Hongzhao; Ge, Meng; Huang, Qiuchen; Li, Desheng; Maruyama, Hitoshi

    2013-11-01

    [Purpose] The aim of this study was to investigate the change in electromechanical reaction times (EMG-RT) of hip flexion of younger persons after neuromuscular joint facilitation (NJF) treatment. [Subjects] The subjects were 39 healthy young people, who were divided into two groups: a NJF group and a proprioceptive neuromuscular facilitation (PNF) group. The NJF group consisted of 16 subjects (7 males, 9 females), and the PNF group consisted of 23 subjects (10 males, 13 females). [Methods] Participants in the NJF group received NJF treatment. We measured the EMG-RT, the premotor time (PMT) and the motor time (MT) during hip flexion movement before and after the intervention in both groups. [Results] There were no significant differences among the results of the PNF group. For the NJF group, there were significant differences in PMT and EMG-RT after NJF treatment. [Conclusion] These results suggest that there is an immediate effect of NJF intervention on electromechanical reaction times of hip flexion.

  8. Flexion synergy overshadows flexor spasticity during reaching in chronic moderate to severe hemiparetic stroke.

    Science.gov (United States)

    Ellis, Michael D; Schut, Ingrid; Dewald, Julius P A

    2017-07-01

    Pharmaceutical intervention targets arm flexor spasticity with an often-unsuccessful goal of improving function. Flexion synergy is a related motor impairment that may be inadvertently neglected. Here, flexor spasticity and flexion synergy are disentangled to determine their contributions to reaching dysfunction. Twenty-six individuals participated. A robotic device systematically modulated shoulder abduction loading during ballistic reaching. Elbow muscle electromyography data were partitioned into windows delineated by elbow joint velocity allowing for the separation of synergy- and spasticity-related activation. Reaching velocity decreased with abduction loading (psynergy increased with abduction loading (psynergy is the predominant contributor to reaching dysfunction while flexor spasticity appears only relevant during unnaturally occurring passively supported movement. Interventions targeting flexion synergy should be leveraged in future stroke recovery trials. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  9. Modelling and Analysis on Biomechanical Dynamic Characteristics of Knee Flexion Movement under Squatting

    Directory of Open Access Journals (Sweden)

    Jianping Wang

    2014-01-01

    Full Text Available The model of three-dimensional (3D geometric knee was built, which included femoral-tibial, patellofemoral articulations and the bone and soft tissues. Dynamic finite element (FE model of knee was developed to simulate both the kinematics and the internal stresses during knee flexion. The biomechanical experimental system of knee was built to simulate knee squatting using cadaver knees. The flexion motion and dynamic contact characteristics of knee were analyzed, and verified by comparing with the data from in vitro experiment. The results showed that the established dynamic FE models of knee are capable of predicting kinematics and the contact stresses during flexion, and could be an efficient tool for the analysis of total knee replacement (TKR and knee prosthesis design.

  10. "Pollical palmar interosseous muscle" (musculus adductor pollicis accessorius): attachments, innervation, variations, phylogeny, and implications for human evolution and medicine.

    Science.gov (United States)

    Bello-Hellegouarch, Gaelle; Aziz, M Ashraf; Ferrero, Eva M; Kern, Michael; Francis, Nadia; Diogo, Rui

    2013-03-01

    Most atlases and textbooks dealing with human anatomy do not refer to the "pollical palmar interosseous" (PPI) muscle of Henle. In order to undertake a fresh and detailed study of this muscle and to thus better understand human comparative anatomy and evolution, we: 1) analyze the frequency of the PPI in a large sample of human hands; 2) describe the attachments, innervation and varieties of the PPI in these hands; 3) compare the data obtained with the information available in the literature; and 4) discuss the phylogenetic origin of the PPI and the implications of our observations and comparisons for medicine and for the understanding of human evolutionary history. Within the 72 hands dissected by us, the PPI is present in 67 hands (93%), commonly having a single muscular branch, originating from the medial side of the base of metacarpal I only, inserting onto the medial side of the base of the pollical proximal phalanx and/or surrounding structures (e.g., ulnar sesamoid bone, wing tendon of extensor apparatus), and passing at least partially, and usually mainly, medial to the princeps pollicis artery. A careful study of the human PPI, as well as a detailed comparison with other mammals, strongly suggest that the muscle is evolutionarily derived from the adductor pollicis, and namely from its oblique head. Therefore, we propose that PPI should be designated by the name musculus adductor pollicis accessorius, which indicates that the muscle is most likely a de novo structure derived from the adductor pollicis. Copyright © 2012 Wiley Periodicals, Inc.

  11. Racing performance in Standardbred trotting horses with proximal palmar/plantar first phalangeal fragments relative to the timing of surgery.

    Science.gov (United States)

    Carmalt, J L; Borg, H; Näslund, H; Waldner, C

    2015-07-01

    Proximal palmar/plantar osteochondral fragmentation of the first phalanx is a frequent radiographic finding in Standardbred horses. These lesions are routinely removed prior to the onset of a racing career with no evidence to support the timing of this surgical intervention. To determine whether horses racing before surgery slowed as they approached surgery date and whether they speeded up after surgery. To investigate the factors affecting whether a horse raced after surgery and compare the performance of horses that did and did not race before surgery. A retrospective study using 193 Swedish Standardbred trotters. Medical records and radiographs of each horse were examined. Racing data were retrieved from official online records. Generalising estimating equations were used to examine presurgery racing performance and determine whether this differed between horses that raced before surgery and those that had not. Multivariable regression was used to examine career earnings and number of career races. Horses racing before surgery neither slowed as they approached surgery, nor speeded up after surgery. Race speed of horses raced before surgery was not different from those that only raced after surgery. Racing before surgery was not associated with whether horses raced following surgery. Only horses with 3 affected legs had slower race speeds than other horses. No other horse level variables affected race speed, number of career races, career earnings or top speed. There was no significant difference in race speed between horses that raced before surgery and those that did not. Horses did not slow down prior to surgery. Horses with 3 affected legs ran slower than those with only a single or 2 affected limbs. There was no association between timing of surgery and race speed or career longevity. The potential benefits of surgical intervention should be critically examined. © 2014 EVJ Ltd.

  12. Are magnetic resonance flexion views useful in evaluating the cervical spine of patients with rheumatoid arthritis?

    Energy Technology Data Exchange (ETDEWEB)

    Reijnierse, M.; Kroon, H.M.; Bloem, J.L. [Dept. of Radiology, Leiden University Medical Center (Netherlands); Breedveld, F.C. [Dept. of Rheumatology, Leiden University Medical Center, Leiden (Netherlands); Hansen, B. [Dept. of Medical Statistics, Leiden University Medical Center, Leiden (Netherlands); Pope, T.L. [Dept. of Diagnostic Radiology, Bowman Gray School of Medicine, Winston-Salem (United States)

    2000-02-01

    Objective. To determine whether MR imaging in flexion adds value relative to imaging in the neutral position with respect to displaying involvement of the subarachnoid space, brainstem and spinal cord. Design and patients. T1-weighted MR images of the cervical spine in 42 rheumatoid arthritis patients with cervical spine involvement were obtained and analyzed prospectively. We assessed changes between images obtained in the neutral position and following active flexion, especially horizontal atlantoaxial and subaxial motion, presence or absence of brainstem compression, subarachnoid space involvement at the atlantoaxial and subaxial level and the cervicomedullary angle. Vertical atlantoaxial subluxation and the amount of pannus were correlated with motion and change in subarachnoid space. Results. The flexion images showed horizontal atlantoaxial motion in 21 patients and subaxial motion in one patient. The flexion view displayed brainstem compression in only one patient. Involvement of the subarachnoid space increased at the atlantoaxial level in eight (19%) patients (P=0.004) and at the level below C2 in five (12%) patients (P=0.03). There were no patients with a normal subarachnoid space in neutral position and compression in the flexed position. The cervicomedullary angle changed significantly with flexion. Vertical atlantoaxial subluxation and the amount of pannus did not show a significant correlation with motion or subarachnoid space involvement. Conclusion. MR imaging in the flexed position shows a statistically significant narrowing of the subarachnoid space at the atlantoaxial level and below C2. Cord compression is only observed on flexion views if the subarachnoid space in neutral position is already decreased. MR imaging in the flexed position might be useful, since subarachnoid space involvement may be an indicator for the development of neurologic dysfunction. (orig.)

  13. A Textile-Based Wearable Sensing Device Designed for Monitoring the Flexion Angle of Elbow and Knee Movements

    Directory of Open Access Journals (Sweden)

    Tien-Wei Shyr

    2014-02-01

    Full Text Available In this work a wearable gesture sensing device consisting of a textile strain sensor, using elastic conductive webbing, was designed for monitoring the flexion angle of elbow and knee movements. The elastic conductive webbing shows a linear response of resistance to the flexion angle. The wearable gesture sensing device was calibrated and then the flexion angle-resistance equation was established using an assembled gesture sensing apparatus with a variable resistor and a protractor. The proposed device successfully monitored the flexion angle during elbow and knee movements.

  14. Ocular abnormalities in atopic dermatitis in Indian patients

    Directory of Open Access Journals (Sweden)

    Kaujalgi Radhika

    2009-01-01

    Full Text Available Background and Aims: Atopic dermatitis (AD is a common skin disease. Long-standing, severe AD with repeated scratching and rubbing of the face, which requires continuous dermatologic care, predisposes the patient to various ocular complications. The knowledge of the frequency and significance of these ocular complications may allow their early diagnosis and treatment. The present study assesses the ocular complications in Indian children suffering from AD. Methods: In order to study the ocular complications in AD, 100 patients (61 male and 39 female between the ages of 1 and 14 years were recruited. All the patients had complete dilated fundus examination with indirect ophthalmoscopy. The lid, conjunctiva and cornea were examined. Also, any evidence of cataract formation and retinal disorders were recorded. Results: The mean age of the children was 5.4 years. Forty-three (43.0% AD patients showed ocular abnormalities in the form of lid and conjunctival changes. Of these, 18 (41.9% patients showed only lid involvement, 16 (37.2% only conjunctival involvement and both conjunctival and lid changes were seen in nine (20.9% patients. Conjunctival changes were mostly in the form of a cobblestone appearance of the papillae, with mild to moderate papillary reaction and papillary hypertrophy. Variables observed to have a significant impact on the development of ocular abnormalities were age more than 5 years, duration of illness> 12 months, positive family history of atopy, presence of palmar hyperlinearity and a combination of both xerosis and Dennie-Morgan fold. Conclusions: The present study is the first of its kind from India to document an association between AD in children and various ocular manifestations. The ocular manifestations observed in our cohort were not associated with significant ocular morbidity or visual impairment possibly because of a less-severe disease in Indians.

  15. Bilateral Distal Femoral Flexion Deformity After Total Knee Arthroplasty in a Patient with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Jimmy Chan Chun-Ming

    2013-12-01

    Full Text Available Rheumatoid arthritis is an autoimmune systemic disease with predominant peripheral polyarthritis, often leading to severe joint destruction. This is a case report of an 81-year-old woman with long-standing severe rheumatoid arthritis requiring multiple orthopaedic operations for joint destruction since 2000. These operated joints improved her functional mobility until recently, when she found that her knees were fixed at around 70° of flexion with limited motion. There was chronic progressive flexion deformity of bilateral distal femurs, which was an extremely rare complication of total knee arthroplasty.

  16. CT of pleural abnormalities

    International Nuclear Information System (INIS)

    Webb, W.R.

    1995-01-01

    Briefly discussed were CT diagnosis of pleural thickening, CT technique for examining the pleura or pleuro-pulmonary disease, diagnosis of pleural collections, diagnosis of pleural fluid abnormalities in patients with pneumonia, pleural neoplasms, malignant (diffuse) mesothelioma, metastases, local fibrous tumor of the pleura (benign mesothelioma) (21 refs.)

  17. CT of pleural abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Webb, W R [California Univ., San Francisco, CA (United States). Dept. of Radiology

    1996-12-31

    Briefly discussed were CT diagnosis of pleural thickening, CT technique for examining the pleura or pleuro-pulmonary disease, diagnosis of pleural collections, diagnosis of pleural fluid abnormalities in patients with pneumonia, pleural neoplasms, malignant (diffuse) mesothelioma, metastases, local fibrous tumor of the pleura (benign mesothelioma) (21 refs.).

  18. Neurologic abnormalities in murderers.

    Science.gov (United States)

    Blake, P Y; Pincus, J H; Buckner, C

    1995-09-01

    Thirty-one individuals awaiting trial or sentencing for murder or undergoing an appeal process requested a neurologic examination through legal counsel. We attempted in each instance to obtain EEG, MRI or CT, and neuropsychological testing. Neurologic examination revealed evidence of "frontal" dysfunction in 20 (64.5%). There were symptoms or some other evidence of temporal lobe abnormality in nine (29%). We made a specific neurologic diagnosis in 20 individuals (64.5%), including borderline or full mental retardation (9) and cerebral palsy (2), among others. Neuropsychological testing revealed abnormalities in all subjects tested. There were EEG abnormalities in eight of the 20 subjects tested, consisting mainly of bilateral sharp waves with slowing. There were MRI or CT abnormalities in nine of the 19 subjects tested, consisting primarily of atrophy and white matter changes. Psychiatric diagnoses included paranoid schizophrenia (8), dissociative disorder (4), and depression (9). Virtually all subjects had paranoid ideas and misunderstood social situations. There was a documented history of profound, protracted physical abuse in 26 (83.8%) and of sexual abuse in 10 (32.3%). It is likely that prolonged, severe physical abuse, paranoia, and neurologic brain dysfunction interact to form the matrix of violent behavior.

  19. The Effect of Malrotation of Tibial Component of Total Knee Arthroplasty on Tibial Insert during High Flexion Using a Finite Element Analysis

    Directory of Open Access Journals (Sweden)

    Kei Osano

    2014-01-01

    Full Text Available One of the most common errors of total knee arthroplasty procedure is a malrotation of tibial component. The stress on tibial insert is closely related to polyethylene failure. The objective of this study is to analyze the effect of malrotation of tibial component for the stress on tibial insert during high flexion using a finite element analysis. We used Stryker NRG PS for analysis. Three different initial conditions of tibial component including normal, 15° internal malrotation, and 15° external malrotation were analyzed. The tibial insert made from ultra-high-molecular-weight polyethylene was assumed to be elastic-plastic while femoral and tibial metal components were assumed to be rigid. Four nonlinear springs attached to tibial component represented soft tissues around the knee. Vertical load was applied to femoral component which rotated from 0° to 135° while horizontal load along the anterior posterior axis was applied to tibial component during flexion. Maximum equivalent stresses on the surface were analyzed. Internal malrotation caused the highest stress which arose up to 160% of normal position. External malrotation also caused higher stress. Implanting prosthesis in correct position is important for reducing the risk of abnormal wear and failure.

  20. Avaliação da força de preensão palmar frente à terapia com mobilização neural

    Directory of Open Access Journals (Sweden)

    Bruna Formentão Araujo

    2012-08-01

    Full Text Available INTRODUÇÃO: A mobilização neural é uma técnica que visa a restauração do movimento e da elasticidade do sistema nervoso; contudo, ainda são poucos os estudos que avaliam sua eficácia sobre variáveis clínicas. OBJETIVO: Avaliar a força de preensão palmar em indivíduos submetidos à intervenção com mobilização neural. Metodologia: Estudo cruzado em que compuseram a amostra 20 sujeitos, com média de idade de 19,5 ± 0,92 anos, divididos em dois grupos (G1 e G2 que receberam, a cada semana, uma sessão única de intervenção de forma que o G1 recebeu mobilização neural e o G2 alongamentos convencionais para o supraespinal na primeira semana; o inverso aconteceu na segunda semana, em que o G1 recebeu alongamentos convencionais para o supraespinal e o G2 a mobilização neural. Os alongamentos para o supraespinal serviram apenas como placebo e não impuseram tensão aos nervos em estudo. As mobilizações neurais foram aplicadas nos nervos radial, mediano e ulnar. A força de preensão palmar foi avaliada por meio de um dinamômetro de preensão palmar em vários momentos: antes e imediatamente, 20 minutos e uma hora após cada intervenção. RESULTADOS: Não houve resultados significativos para a mobilização neural, nem para o alongamento. CONCLUSÃO: A mobilização neural não foi eficaz para produzir o aumento da força de preensão palmar em indivíduos saudáveis.

  1. The Brahea edulis palm forest in Guadalupe Island: A North American fog oasis? El palmar de Brahea edulis de Isla Guadalupe: ¿Un oasis de niebla en Norteamérica?

    Directory of Open Access Journals (Sweden)

    PEDRO P GARCILLÁN

    2012-03-01

    Full Text Available Fog is a factor that affects deeply the structure of vegetation of coastal deserts. Guadalupe is an oceanic island located 260 km off the coast of Baja California, and is one of the few places of the Sonoran Desert coasts with scarped coastal topography and frequent fog. With the aim to identify the effect of fog on the community of the palm forest (palmar of Brahea edulis located in the northern tip of the island: (1 we analyzed the richness and composition of vascular plants in the palmar compared to the remainder of the island, and (2 we analyzed the altitudinal variation of the abundance of palms, herbs and mosses to identify if there is altitudinal variation of the vegetation. Although species composition was not different between palmar and the rest of island, species richness and vascular plant cover were greater in the palmar. On the other hand, we found a clear altitudinal zonation of the vegetation in the palmar that is similar to that found in South American fog-driven plant communities such as the lomas. Thus, the palmar community of Guadalupe Island may be considered as a fog oasis, one of the very few that occur in North America.La niebla es un factor que afecta profundamente la estructura de la vegetación de los desiertos costeros. Guadalupe es una isla oceánica a 260 km de la costa de Baja California y constituye uno de los pocos lugares de la costa del Desierto Sonorense donde se reúnen una topografía escarpada próxima a la costa y una alta frecuencia de nieblas. Con el objeto de identificar el efecto de la niebla sobre la comunidad del palmar de Brahea edulis presente en la ladera norte de la isla: (1 analizamos la diferencia de la riqueza y la composición de plantas vasculares del palmar respecto del resto de la isla, y (2 analizamos la variación altitudinal de la abundancia de palmas, plantas acompañantes y musgo para determinar si existe variación altitudinal de la vegetación. Encontramos que, aunque la composici

  2. Nitrofurantoin and congenital abnormalities

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft

    2001-01-01

    or fetuses with Down’s syndrome (patient controls), 23 (2.8%) pregnant women were treated with nitrofurantoin. The above differences between population controls and cases may be connected with recall bias, because the case-control pair analysis did not indicate a teratogenic potential of nitrofurantoin use......Objective: To study human teratogenic potential of oral nitrofurantoin treatment during pregnancy. Materials and Methods: Pair analysis of cases with congenital abnormalities and matched population controls in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital...... during the second and the third months of gestation, i.e. in the critical period for major congenital abnormalities. Conclusion: Treatment with nitrofurantoin during pregnancy does not present detectable teratogenic risk to the fetus....

  3. Neurological abnormalities predict disability

    DEFF Research Database (Denmark)

    Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje

    2014-01-01

    To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...... at evaluating age-related white matter changes (ARWMC) as an independent predictor of the transition to disability (according to Instrumental Activities of Daily Living scale) or death in independent elderly subjects that were followed up for 3 years. At baseline, a standardized neurological examination.......0 years, 45 % males), 327 (51.7 %) presented at the initial visit with ≥1 neurological abnormality and 242 (38 %) reached the main study outcome. Cox regression analyses, adjusting for MRI features and other determinants of functional decline, showed that the baseline presence of any neurological...

  4. Knee extension and flexion: MR delineation of normal and torn anterior cruciate ligaments

    Energy Technology Data Exchange (ETDEWEB)

    Niitsu, Mamoru; Ikeda, Kotaroh; Fukubayashi, Tohru; Anno, Izumi; Itai, Yuji [Univ. of Tsukuba, Ibaraki (Japan)

    1996-03-01

    Our goal was to assess the effect of joint position of semiflexed and extended knees in MR delineation of the anterior cruciate ligament (ACL). With a mobile knee brace and a flexible surface coil, the knee joint was either fully extended or bent to a semiflexed position (average 45{degrees} of flexion) within the magnet bore. Sets of oblique sagittal MR images were obtained for both extended and flexed knee positions. Thirty-two knees with intact ACLs and 43 knees with arthroscopically proven ACL tears were evaluated. Two observers compared paired MR images of both extended and flexed positions and rated them by a relative three point scale. Anatomic correlation in MR images was obtained by a cadaveric knee with incremental flexion. The MR images of flexed knees were more useful than of extended knees in 53% of the case reviews of femoral attachments and 36% of reviews of midportions of normal ACLs. Compared with knee extensions, the MR images for knee flexion provided better clarity in 48% of reviews of disrupted sites and 52% of residual bundles of torn ACLs. Normal ACL appeared taut in the knee extension and lax in semiflexion. Compared with MR images of knees in extension, MR images of knees in flexion more clearly delineate the femoral side of the ligament with wider space under the intercondylar roof and with decreased volume-averaging artifacts, providing superior visualization of normal and torn ACLs. 13 refs., 7 figs., 1 tab.

  5. Flexion-relaxation ratio in computer workers with and without chronic neck pain.

    Science.gov (United States)

    Pinheiro, Carina Ferreira; dos Santos, Marina Foresti; Chaves, Thais Cristina

    2016-02-01

    This study evaluated the flexion-relaxation phenomenon (FRP) and flexion-relaxation ratios (FR-ratios) using surface electromyography (sEMG) of the cervical extensor muscles of computer workers with and without chronic neck pain, as well as of healthy subjects who were not computer users. This study comprised 60 subjects 20-45years of age, of which 20 were computer workers with chronic neck pain (CPG), 20 were computer workers without neck pain (NPG), and 20 were control individuals who do not use computers for work and use them less than 4h/day for other purposes (CG). FRP and FR-ratios were analyzed using sEMG of the cervical extensors. Analysis of FR-ratios showed smaller values in the semispinalis capitis muscles of the two groups of workers compared to the control group. The reference FR-ratio (flexion relaxation ratio [FRR], defined as the maximum activity in 1s of the re-extension/full flexion sEMG activity) was significantly higher in the computer workers with neck pain compared to the CG (CPG: 3.10, 95% confidence interval [CI95%] 2.50-3.70; NPG: 2.33, CI95% 1.93-2.74; CG: 1.99, CI95% 1.81-2.17; pneck pain, and such results suggested that each FR-ratio could have a different application. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. 49 CFR 572.145 - Upper and lower torso assemblies and torso flexion test procedure.

    Science.gov (United States)

    2010-10-01

    ...) ANTHROPOMORPHIC TEST DEVICES 3-year-Old Child Crash Test Dummy, Alpha Version § 572.145 Upper and lower torso... lumbar spine and abdomen of a fully assembled dummy (drawing 210-0000) to flexion articulation between... in paragraph (c) of this section, the lumbar spine-abdomen assembly shall flex by an amount that...

  7. Impact of esophageal flexion level on the surgical outcome in patients with sigmoid esophageal achalasia.

    Science.gov (United States)

    Tsuboi, Kazuto; Omura, Nobuo; Yano, Fumiaki; Hoshino, Masato; Yamamoto, Se-Ryung; Akimoto, Shunsuke; Masuda, Takahiro; Kashiwagi, Hideyuki; Yanaga, Katsuhiko

    2017-11-01

    Esophageal achalasia can be roughly divided into non-sigmoid and sigmoid types. Laparoscopic surgery has been reported to be less than optimally effective for sigmoid type. The aim of this study was to examine the impact of the esophageal flexion level on the clinical condition and surgical outcomes of patients with sigmoid esophageal achalasia. The subjects were 36 patients with sigmoid esophageal achalasia who had been observed for >1 year after surgery. The subjects were divided into sigmoid type (Sg) and advanced sigmoid type (aSg) groups based on the flexion level of the lower esophagus to compare their clinical parameters and surgical outcomes. The Sg and aSg groups included 26 (72%) and 10 subjects, respectively. There were no marked differences in the clinical parameters or surgical outcomes between the two groups. However, the clearance rate calculated using the timed barium esophagogram was lower in the aSg group than in the Sg group. No differences were found in the postoperative symptom scores between the two groups, and both reported a high level of satisfaction. Although laparoscopic surgery for symptoms of sigmoid esophageal achalasia was highly successful regardless of the flexion level, the improvement in esophageal clearance was lower when the flexion level was higher.

  8. Evaluation of movements of lower limbs in non-professional ballet dancers: hip abduction and flexion

    Directory of Open Access Journals (Sweden)

    Valenti Erica E

    2011-08-01

    Full Text Available Abstract Background The literature indicated that the majority of professional ballet dancers present static and active dynamic range of motion difference between left and right lower limbs, however, no previous study focused this difference in non-professional ballet dancers. In this study we aimed to evaluate active movements of the hip in non-professional classical dancers. Methods We evaluated 10 non professional ballet dancers (16-23 years old. We measured the active range of motion and flexibility through Well Banks. We compared active range of motion between left and right sides (hip flexion and abduction and performed correlation between active movements and flexibility. Results There was a small difference between the right and left sides of the hip in relation to the movements of flexion and abduction, which suggest the dominant side of the subjects, however, there was no statistical significance. Bank of Wells test revealed statistical difference only between the 1st and the 3rd measurement. There was no correlation between the movements of the hip (abduction and flexion, right and left sides with the three test measurements of the bank of Wells. Conclusion There is no imbalance between the sides of the hip with respect to active abduction and flexion movements in non-professional ballet dancers.

  9. Evaluation of movements of lower limbs in non-professional ballet dancers: hip abduction and flexion

    Science.gov (United States)

    2011-01-01

    Background The literature indicated that the majority of professional ballet dancers present static and active dynamic range of motion difference between left and right lower limbs, however, no previous study focused this difference in non-professional ballet dancers. In this study we aimed to evaluate active movements of the hip in non-professional classical dancers. Methods We evaluated 10 non professional ballet dancers (16-23 years old). We measured the active range of motion and flexibility through Well Banks. We compared active range of motion between left and right sides (hip flexion and abduction) and performed correlation between active movements and flexibility. Results There was a small difference between the right and left sides of the hip in relation to the movements of flexion and abduction, which suggest the dominant side of the subjects, however, there was no statistical significance. Bank of Wells test revealed statistical difference only between the 1st and the 3rd measurement. There was no correlation between the movements of the hip (abduction and flexion, right and left sides) with the three test measurements of the bank of Wells. Conclusion There is no imbalance between the sides of the hip with respect to active abduction and flexion movements in non-professional ballet dancers. PMID:21819566

  10. Prior Knowledge Improves Decoding of Finger Flexion from Electrocorticographic (ECoG Signals

    Directory of Open Access Journals (Sweden)

    Zuoguan eWang

    2011-11-01

    Full Text Available Brain-computer interfaces (BCIs use brain signals to convey a user's intent. Some BCI approaches begin by decoding kinematic parameters of movements from brain signals, and then proceed to using these signals, in absence of movements, to allow a user to control an output. Recent results have shown that electrocorticographic (ECoG recordings from the surface of the brain in humans can give information about kinematic parameters (eg{} hand velocity or finger flexion. The decoding approaches in these studies usually employed classical classification/regression algorithms that derive a linear mapping between brain signals and outputs. However, they typically only incorporate little prior information about the target movement parameter. In this paper, we incorporate prior knowledge using a Bayesian decoding method, and use it to decode finger flexion from ECoG signals. Specifically, we exploit the anatomic constraints and dynamic constraints that govern finger flexion and incorporate these constraints in the construction, structure, and the probabilistic functions of the prior model of a switched non-parametric dynamic system (SNDS. Given a measurement model resulting from a traditional linear regression method, we decoded finger flexion using posterior estimation that combined the prior and measurement models. Our results show that the application of the Bayesian decoding model, which incorporates prior knowledge, improves decoding performance compared to the application of a linear regression model, which does not incorporate prior knowledge. Thus, the results presented in this paper may ultimately lead to neurally controlled hand prostheses with full fine-grained finger articulation.

  11. Equipment abnormality monitoring device

    International Nuclear Information System (INIS)

    Ando, Yasumasa

    1991-01-01

    When an operator hears sounds in a plantsite, the operator compares normal sounds of equipment which he previously heard and remembered with sounds he actually hears, to judge if they are normal or abnormal. According to the method, there is a worry that abnormal conditions can not be appropriately judged in a case where the number of objective equipments is increased and in a case that the sounds are changed gradually slightly. Then, the device of the present invention comprises a plurality of monitors for monitoring the operation sound of equipments, a recording/reproducing device for recording and reproducing the signals, a selection device for selecting the reproducing signals among the recorded signals, an acoustic device for converting the signals to sounds, a switching device for switching the signals to be transmitted to the acoustic device between to signals of the monitor and the recording/reproducing signals. The abnormality of the equipments can be determined easily by comparing the sounds representing the operation conditions of equipments for controlling the plant operation and the sounds recorded in their normal conditions. (N.H.)

  12. Intrathecal volume changes in lumbar spinal canal stenosis following extension and flexion: An experimental cadaver study.

    Science.gov (United States)

    Teske, Wolfram; Schwert, Martin; Zirke, Sonja; von Schulze Pellengahr, Christoph; Wiese, Matthias; Lahner, Matthias

    2015-01-01

    The spinal canal stenosis is a common disease in elderly. The thecal sac narrowing is considered as the anatomical cause for the disease. There is evidence that the anatomical proportions of the lumbar spinal canal are influenced by postural changes. The liquor volume shift during these postural changes is a valuable parameter to estimate the dynamic qualities of this disease. The aim of this human cadaver study was the determination of intrathecal fluid volume changes during the lumbar flexion and the extension. A special measuring device was designed and built for the study to investigate this issue under controlled conditions. The measuring apparatus fixed the lumbar spine firmly and allowed only flexion and extension. The dural sac was closed water tight. The in vitro changes of the intrathecal volumes during the motion cycle were determined according to the principle of communicating vessels. Thirteen human cadaver spines from the Institute of Anatomy were examined in a test setting with a continuous adjustment of motion. The diagnosis of the lumbar spinal stenosis was confirmed by a positive computer tomography prior testing. The volume changes during flexion and extension cycles were measured stepwise in a 2 degree distance between 18° flexion and 18° extension. Three complete series of measurements were performed for each cadaver. Two specimens were excluded because of fluid leaks from further investigation. The flexion of the lumbar spine resulted in an intrathecal volume increase. The maximum volume effects were seen in the early flexion positions of 2° and 4°. The spine reclination resulted in a volume reduction. The maximum extension effect was seen between 14° and 16°. According to our results, remarkable volume effects were seen in the early movements of the lumbar spine especially for the flexion. The results support the concept of the spinal stenosis as a dynamic disease and allow a better understanding of the pathophysiology of this

  13. Decoding subtle forearm flexions using fractal features of surface electromyogram from single and multiple sensors.

    Science.gov (United States)

    Arjunan, Sridhar Poosapadi; Kumar, Dinesh Kant

    2010-10-21

    Identifying finger and wrist flexion based actions using a single channel surface electromyogram (sEMG) can lead to a number of applications such as sEMG based controllers for near elbow amputees, human computer interface (HCI) devices for elderly and for defence personnel. These are currently infeasible because classification of sEMG is unreliable when the level of muscle contraction is low and there are multiple active muscles. The presence of noise and cross-talk from closely located and simultaneously active muscles is exaggerated when muscles are weakly active such as during sustained wrist and finger flexion. This paper reports the use of fractal properties of sEMG to reliably identify individual wrist and finger flexion, overcoming the earlier shortcomings. SEMG signal was recorded when the participant maintained pre-specified wrist and finger flexion movements for a period of time. Various established sEMG signal parameters such as root mean square (RMS), Mean absolute value (MAV), Variance (VAR) and Waveform length (WL) and the proposed fractal features: fractal dimension (FD) and maximum fractal length (MFL) were computed. Multi-variant analysis of variance (MANOVA) was conducted to determine the p value, indicative of the significance of the relationships between each of these parameters with the wrist and finger flexions. Classification accuracy was also computed using the trained artificial neural network (ANN) classifier to decode the desired subtle movements. The results indicate that the p value for the proposed feature set consisting of FD and MFL of single channel sEMG was 0.0001 while that of various combinations of the five established features ranged between 0.009 - 0.0172. From the accuracy of classification by the ANN, the average accuracy in identifying the wrist and finger flexions using the proposed feature set of single channel sEMG was 90%, while the average accuracy when using a combination of other features ranged between 58% and 73

  14. Decoding subtle forearm flexions using fractal features of surface electromyogram from single and multiple sensors

    Directory of Open Access Journals (Sweden)

    Kumar Dinesh

    2010-10-01

    Full Text Available Abstract Background Identifying finger and wrist flexion based actions using a single channel surface electromyogram (sEMG can lead to a number of applications such as sEMG based controllers for near elbow amputees, human computer interface (HCI devices for elderly and for defence personnel. These are currently infeasible because classification of sEMG is unreliable when the level of muscle contraction is low and there are multiple active muscles. The presence of noise and cross-talk from closely located and simultaneously active muscles is exaggerated when muscles are weakly active such as during sustained wrist and finger flexion. This paper reports the use of fractal properties of sEMG to reliably identify individual wrist and finger flexion, overcoming the earlier shortcomings. Methods SEMG signal was recorded when the participant maintained pre-specified wrist and finger flexion movements for a period of time. Various established sEMG signal parameters such as root mean square (RMS, Mean absolute value (MAV, Variance (VAR and Waveform length (WL and the proposed fractal features: fractal dimension (FD and maximum fractal length (MFL were computed. Multi-variant analysis of variance (MANOVA was conducted to determine the p value, indicative of the significance of the relationships between each of these parameters with the wrist and finger flexions. Classification accuracy was also computed using the trained artificial neural network (ANN classifier to decode the desired subtle movements. Results The results indicate that the p value for the proposed feature set consisting of FD and MFL of single channel sEMG was 0.0001 while that of various combinations of the five established features ranged between 0.009 - 0.0172. From the accuracy of classification by the ANN, the average accuracy in identifying the wrist and finger flexions using the proposed feature set of single channel sEMG was 90%, while the average accuracy when using a combination

  15. Femoral loosening of high-flexion total knee arthroplasty: The effect of posterior cruciate ligament retention and bone quality reduction

    NARCIS (Netherlands)

    Zelle, J.; van de Groes, S.A.W.; De Waal Malefijt, M.C.; Verdonschot, Nicolaas Jacobus Joseph

    2014-01-01

    High-flexion total knee arthroplasty (TKA) may be more sensitive to femoral loosening than conventional TKA as the knee joint force increases during deep flexion. The objective of this study was to evaluate whether the probability of femoral loosening is equal in posterior cruciate ligament (PCL)

  16. Neck muscle fatigue alters the cervical flexion relaxation ratio in sub-clinical neck pain patients.

    Science.gov (United States)

    Zabihhosseinian, Mahboobeh; Holmes, Michael W R; Ferguson, Brad; Murphy, Bernadette

    2015-06-01

    The cervical flexion relaxation ratio is lower in neck pain patients compared to healthy controls. Fatigue modulates the onset and offset angles of the silent period in both the lumbar and cervical spine in healthy individuals; however, this response has not been studied with neck pain patients. The purpose of this study was to determine if cervical extensor fatigue would alter the parameters of the cervical flexion relaxation more in a neck pain group than a healthy control group. Thirteen healthy and twelve neck pain patients participated. Cervical extensor activity was examined bilaterally and kinematics of the neck and head were collected. An isometric, repetitive neck extension task at 70% of maximum elicited fatigue. Participants performed 3 trials of maximal cervical flexion both pre and post fatigue. The healthy controls and neck pain groups fatigued after 56 (41) and 39 (31) repetitions, respectively. There was a significant interaction effect for the flexion relaxation ratio between the control and neck pain groups from pre to post fatigue trials (F1,96=22.67, P=0.0001), but not for onset and offset angles (F1, 96=0.017, P=0.897), although the onset and offset angles did decrease significantly for both groups following fatigue (F1,96=9.26, P=0.002). Individuals with mild to moderate neck pain have significant differences in their neuromuscular control relative to controls, experienced myoelectric fatigue with fewer repetitions in a shorter time, had a lower cervical flexion relaxation ratio at baseline and had an inability to decrease this ratio further in response to fatigue. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Study of palmar dermatoglyphics in patients with essential hypertension between the age group of 20-50 years

    Directory of Open Access Journals (Sweden)

    Rudragouda S Bulagouda, Purnima J Patil, Gavishiddppa A Hadimani, Balappa M Bannur, Patil BG, Nagaraj S. Mallashetty, Ishwar B Bagoji

    2013-10-01

    Full Text Available Background: In present study, we tried to determine significant palmar dermatoglyphic parameters in case of essential hypertensive’s in age group between 20-50 years and whether the parameters can be used for screening purpose i.e., early detection of hypertension. Method: With the use of modified Purvis Smith method, Black duplicating ink (Kores, Bombay was smeared on both hands one by one and prints will be taken by rolling the hands from wrist creases to finger tips on the roller covered with bond paper. While crystal bond paper, applied firmly over a wooden pad, was used for recording the inked epidermal ridge patterns. Rolled finger prints were recorded after applying uniform pressure on white bond paper from ulnar to radial side. Complete palm impression, including the hollow or the palm was obtained over paper. Thus one set of finger prints and palm prints was obtained. The prints obtained were immediately examined with hand-lens. Result: Right hand and left hand of the both male and female study group showed more number of arches than controls. Right hand and left hand of the both male and female study group showed more number of Radial loops than controls. The right hand and left hand of both male and female control group showed more number of ulnar loops than study group. The right hand and left hand of the male control group showed more number of Whorls than study, while in females, the right hand study group showed more number of whorls than control group and the left hand study group showed less number of Whorls as compared to control group. Conclusion: The present study indicates that there are some genetic factors which are involved in the causation of essential hypertension and it is possible to certain extent to predict from dermatoglyphics individual’s chance of acquiring essential hypertension. Like clinical history, examination and investigations, the dermatoglyphics will play an important role revealing the genetic

  18. Abnormal pressures as hydrodynamic phenomena

    Science.gov (United States)

    Neuzil, C.E.

    1995-01-01

    So-called abnormal pressures, subsurface fluid pressures significantly higher or lower than hydrostatic, have excited speculation about their origin since subsurface exploration first encountered them. Two distinct conceptual models for abnormal pressures have gained currency among earth scientists. The static model sees abnormal pressures generally as relict features preserved by a virtual absence of fluid flow over geologic time. The hydrodynamic model instead envisions abnormal pressures as phenomena in which flow usually plays an important role. This paper develops the theoretical framework for abnormal pressures as hydrodynamic phenomena, shows that it explains the manifold occurrences of abnormal pressures, and examines the implications of this approach. -from Author

  19. Feeling Abnormal: Simulation of Deviancy in Abnormal and Exceptionality Courses.

    Science.gov (United States)

    Fernald, Charles D.

    1980-01-01

    Describes activity in which student in abnormal psychology and psychology of exceptional children classes personally experience being judged abnormal. The experience allows the students to remember relevant research, become sensitized to the feelings of individuals classified as deviant, and use caution in classifying individuals as abnormal.…

  20. Racing performance of Swedish Standardbred trotting horses with proximal palmar/plantar first phalangeal (Birkeland) fragments compared to fragment free controls.

    Science.gov (United States)

    Carmalt, James L; Borg, Hanna; Näslund, Hans; Waldner, Cheryl

    2014-10-01

    The aim of this study was to determine whether horses with a proximal palmar/plantar first phalangeal osteochondral fragment (POF) had comparable racing careers (prior to and following surgery) to horses without this fracture. A retrospective cohort study included 174 Swedish Standardbred trotters with osteochondral fragmentation in the palmar/plantar fetlock joint and 613 radiographically negative control horses presented for prepurchase examinations. Medical records and radiographs were examined for each horse. Racing data were retrieved from online Swedish Standardbred harness racing records. The effect of having a POF on race speed compared to radiographically negative control horses was examined using generalised estimating equations. Multivariable regression was used to examine differences in money earned and career longevity. The horses raced a total of 16,448 races. Horses gained speed as a function of race number. There was no difference in racing speed between horses with POF fractures that raced before surgery and control horses. Horses did not slow before, nor speed up after, surgery. There was no difference in the number of days between the last race prior to, or the first race after, the hospital visit between POF and control horses. Career earnings and lifetime starts were not significantly different between groups. The results of this study suggest the need to reevaluate the previously reported benefits of surgical intervention for POF. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. AVALIAÇÃO DA IMAGEM TURÍSTICA DE SANTA VITÓRIA DO PALMAR (RS, BRASIL, NA PERSPECTIVA DOS RESIDENTES

    Directory of Open Access Journals (Sweden)

    Melise de Lima Pereira

    2017-06-01

    Full Text Available O presente artigo busca identificar os fatores que compõem a imagem turística do destino Santa Vitória do Palmar (RS, Brasil, na perspectiva dos residentes, como medida de manifestação da identidade. A pesquisa possui caráter exploratório, descritivo, empírico e com abordagem predominantemente quantitativa. Foi utilizada uma amostra, não probabilística por conveniência, composta por 93 respondentes, colhida diretamente no município, durante outubro de 2015. Através de Análise Fatorial Exploratória foram identificados os componentes da imagem turística de Santa Vitória do Palmar, que são: Lugares históricos e serviços ofertados, opções de entretenimento, atrativos turísticos, hotelaria e transmissão da cultura local, higiene e comércio e fama do município.

  2. Exercises to Improve Gait Abnormalities

    Science.gov (United States)

    ... Articles Directories Videos Resources Contact Exercises to Improve Gait Abnormalities Home » Article Categories » Exercise and Fitness Font Size: A A A A Exercises to Improve Gait Abnormalities Next Page The manner of how a ...

  3. Pregnancy Complications: Umbilical Cord Abnormalities

    Science.gov (United States)

    ... Umbilical cord abnormalities Umbilical cord abnormalities Now playing: E-mail to a friend Please fill in all fields. ... blood supply) to the baby. The two arteries transport waste from the baby to the placenta (where ...

  4. Normal and abnormal growth plate

    International Nuclear Information System (INIS)

    Kumar, R.; Madewell, J.E.; Swischuk, L.E.

    1987-01-01

    Skeletal growth is a dynamic process. A knowledge of the structure and function of the normal growth plate is essential in order to understand the pathophysiology of abnormal skeletal growth in various diseases. In this well-illustrated article, the authors provide a radiographic classification of abnormal growth plates and discuss mechanisms that lead to growth plate abnormalities

  5. Finger island flaps for treatment of dermato-desmogenic flexion contractures of proximal interphalangeal joints

    Directory of Open Access Journals (Sweden)

    T. S. Antonova

    2016-12-01

    Full Text Available Soft tissue defect will form after operative treatment of the dermato-desmogenic flexion contractures of fingers interphalangeal joints of the 2–3 grades after excision of the scar. Using the island flaps (Littler at the central vascular pedicle is one of the classical methods of plastic closure of such defects. Goal. To study the effectiveness of the surgical treatment of dermato-desmogenic flexion contractures of proximal interphalangeal joints of the fingers by using finger island flaps at the central vascular or neuro-vascular pedicle. Materials and methods. 14 operations were carried out on 13 patients for removing dermato-desmogenic flexion contractures of proximal interphalangeal (PIP joints of triphalangeal fingers over a 2-year period (2013–2015. The group included patients with a flexion contracture of the 2–3 grades PIP joints of triphalangeal fingers. Operations were performed on average 5 months after the injury (from 1.5 up to 16 months. Finger island flap in all cases was taken from adjacent finger by using the blood supply of their common finger artery. In all cases the island flap on the central pedicel was used, in 9 cases digital nerve was included in the pedicle (Littler. Closure of donor wound was made with free-skin grafts. Permanent splinting of the hand with extension of the interphalangeal joints and moderate flexion of the metacarpophalangeal joints were performed during 7–8 days after surgery, then exercise therapy was prescribed. Results. The results were estimated 6 and 12 months after surgery. All the results were regarded as excellent. In 5 cases of using the flap on a vascular pedicle flap hypoesthesia was detected, that has not led to dysfunction of the hand. Contracture recurrence during follow-up was not observed. Conclusions. Using the surgery for treatment of dermato-desmogenic flexion contractures of proximal interphalangeal joints of the fingers with the island flaps at the central vascular or neuro

  6. Blood pressure and calf muscle oxygen extraction during plantar flexion exercise in peripheral artery disease.

    Science.gov (United States)

    Luck, J Carter; Miller, Amanda J; Aziz, Faisal; Radtka, John F; Proctor, David N; Leuenberger, Urs A; Sinoway, Lawrence I; Muller, Matthew D

    2017-07-01

    Peripheral artery disease (PAD) is an atherosclerotic vascular disease that affects 200 million people worldwide. Although PAD primarily affects large arteries, it is also associated with microvascular dysfunction, an exaggerated blood pressure (BP) response to exercise, and high cardiovascular mortality. We hypothesized that fatiguing plantar flexion exercise that evokes claudication elicits a greater reduction in skeletal muscle oxygenation (SmO 2 ) and a higher rise in BP in PAD compared with age-matched healthy subjects, but low-intensity steady-state plantar flexion elicits similar responses between groups. In the first experiment, eight patients with PAD and eight healthy controls performed fatiguing plantar flexion exercise (from 0.5 to 7 kg for up to 14 min). In the second experiment, seven patients with PAD and seven healthy controls performed low-intensity plantar flexion exercise (2.0 kg for 14 min). BP, heart rate (HR), and SmO 2 were measured continuously using near-infrared spectroscopy (NIRS). SmO 2 is the ratio of oxygenated hemoglobin to total hemoglobin, expressed as a percent. At fatigue, patients with PAD had a greater increase in mean arterial BP (18 ± 2 vs. vs. 10 ± 2 mmHg, P = 0.029) and HR (14 ± 2 vs. 6 ± 2 beats/min, P = 0.033) and a greater reduction in SmO 2 (-54 ± 10 vs. -12 ± 4%, P = 0.001). However, both groups had similar physiological responses to low-intensity, nonpainful plantar flexion exercise. These data suggest that patients with PAD have altered oxygen uptake and/or utilization during fatiguing exercise coincident with an augmented BP response. NEW & NOTEWORTHY In this laboratory study, patients with peripheral artery disease performed plantar flexion exercise in the supine posture until symptoms of claudication occurred. Relative to age- and sex-matched healthy subjects we found that patients had a higher blood pressure response, a higher heart rate response, and a greater reduction in skeletal muscle oxygenation as

  7. [Penile congenital abnormalities].

    Science.gov (United States)

    Boillot, B; Teklali, Y; Moog, R; Droupy, S

    2013-07-01

    Congenital abnormalities of the penis are usually diagnosed at birth and pose aesthetic and functional problems sometimes requiring surgical management. A literature review was conducted on Medline considering the articles listed until January 2012. Hypospadias is the most common malformation (1 in 250 boys. Familial forms: 7%). The causes remain hypothetical but the doubling of the incidence in 30 years could be linked to fetal exposure to endocrine disruptors "estrogen-like" used in the food industry in particular. Surgical treatment is usually intended to improve the aesthetic appearance but sometimes, in case of significant curvature or posterior meatus, necessary for normal sexual life and fertility. Other malformations (epispades, buried penis, transpositions, twists and preputial abnormalities) as well as management for functional or aesthetic consequences of these malformations in adulthood require complex surgical care in a specialized environment. The improvement of surgical techniques and pediatric anesthesia allows an early and effective specialized surgical approach of penile malformations. Management of sequelae in adulthood must be discussed and requires experience of surgical techniques on pediatric and adult penis. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  8. Comparison of the Hamstring Muscle Activity and Flexion-Relaxation Ratio between Asymptomatic Persons and Computer Work-related Low Back Pain Sufferers.

    Science.gov (United States)

    Kim, Min-Hee; Yoo, Won-Gyu

    2013-05-01

    [Purpose] The purpose of this study was to compare the hamstring muscle (HAM) activities and flexion-relaxation ratios of an asymptomatic group and a computer work-related low back pain (LBP) group. [Subjects] For this study, we recruited 10 asymptomatic computer workers and 10 computer workers with work-related LBP. [Methods] We measured the RMS activity of each phase (flexion, full-flexion, and re-extension phase) of trunk flexion and calculated the flexion-relaxation (FR) ratio of the muscle activities of the flexion and full-flexion phases. [Results] In the computer work-related LBP group, the HAM muscle activity increased during the full-flexion phase compared to the asymptomatic group, and the FR ration was also significantly higher. [Conclusion] We thought that prolonged sitting of computer workers might cause the change in their HAM muscle activity pattern.

  9. Roentgenologic abnormalities in Down's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Higuchi, Takehiko; Russell, W J; Komatsuda, Michio; Neriishi, Shotaro

    1968-07-25

    Roentgenograms of 28 patients with Down's syndrome were reviewed with emphasis on all previously reported abnormalities and any possible additional ones. Most of the abnormalities occurred with the same frequency as previously reported, but some less frequently reported findings were also seen. One abnormal vertebral measurement found in this series may be an additional stigma of Down's syndrome. All of the 27 cases studied cytogenetically had chromosomal abnormalities consistent with this disease. This study emphasizes the need for roentgenologic norms for the Japanese, and the desirability of combining chromosome studies with roentgenological abnormalities and clinical observations in diagnosing Down's syndrome. 19 references, 2 figures, 5 tables.

  10. Global analysis of sagittal spinal alignment in major deformities: correlation between lack of lumbar lordosis and flexion of the knee.

    Science.gov (United States)

    Obeid, Ibrahim; Hauger, Olivier; Aunoble, Stéphane; Bourghli, Anouar; Pellet, Nicolas; Vital, Jean-Marc

    2011-09-01

    It has become well recognised that sagittal balance of the spine is the result of an interaction between the spine and the pelvis. Knee flexion is considered to be the last compensatory mechanism in case of sagittal imbalance, but only few studies have insisted on the relationship between spino-pelvic parameters and lower extremity parameters. Correlation between the lack of lumbar lordosis and knee flexion has not yet been established. A retrospective study was carried out on 28 patients with major spinal deformities. The EOS system was used to measure spinal and pelvic parameters and the knee flexion angle; the lack of lumbar lordosis was calculated after prediction of lumbar lordosis with two different formulas. Correlation analysis between the different measured parameters was performed. Lumbar lordosis correlated with sacral slope (r = -0.71) and moderately with knee flexion angle (r = 0.42). Pelvic tilt correlated moderately with knee flexion angle (r = 0.55). Lack of lumbar lordosis correlated best with knee flexion angle (r = 0.72 and r = 0.63 using the two formulas, respectively). Knee flexion as a compensatory mechanism to sagittal imbalance was well correlated to the lack of lordosis and, depending on the importance of the former parameter, the best procedure to correct sagittal imbalance could be chosen.

  11. Pneumatic-type dynamic traction and flexion splint for treating patients with extension contracture of the metacarpophalangeal joint.

    Science.gov (United States)

    Nakayama, Jun; Horiki, Mituru; Denno, Kakurou; Ogawa, Kazunori; Oka, Hisao; Domen, Kazuhisa

    2016-02-01

    Collateral ligament shortening causes extension contractures of the metacarpophalangeal joint, and dynamic flexion splinting has been widely used to treat these contractures; however, there are various problems with these approaches. We developed a novel, pneumatic-type dynamic traction and flexion splint to solve these problems. A total of 25 fingers were treated with the dynamic traction and flexion splint for 8 weeks. Every 2 weeks, the average metacarpophalangeal joint flexion angle, total active motion, grasp strength, and pain scores were assessed. The finger flexion angle was significantly greater at the final evaluation, starting after 6 weeks of treatment (p < 0.05), than prior to treatment. Similarly, the total active motion results improved significantly over 8 weeks. Our results show that use of the dynamic traction and flexion splint improves patient finger functioning and flexural angle. The dynamic traction and flexion (DTF) splint appears to be effective for treating patients. © The International Society for Prosthetics and Orthotics 2015.

  12. Design of a wearable hand exoskeleton for exercising flexion/extension of the fingers.

    Science.gov (United States)

    Jo, Inseong; Lee, Jeongsoo; Park, Yeongyu; Bae, Joonbum

    2017-07-01

    In this paper, design of a wearable hand exoskeleton system for exercising flexion/extension of the fingers, is proposed. The exoskeleton was designed with a simple and wearable structure to aid finger motions in 1 degree of freedom (DOF). A hand grasping experiment by fully-abled people was performed to investigate general hand flexion/extension motions and the polynomial curve of general hand motions was obtained. To customize the hand exoskeleton for the user, the polynomial curve was adjusted to the joint range of motion (ROM) of the user and the optimal design of the exoskeleton structure was obtained using the optimization algorithm. A prototype divided into two parts (one part for the thumb, the other for rest fingers) was actuated by only two linear motors for compact size and light weight.

  13. MRI-based analysis of patellofemoral cartilage contact, thickness, and alignment in extension, and during moderate and deep flexion.

    Science.gov (United States)

    Freedman, Benjamin R; Sheehan, Frances T; Lerner, Amy L

    2015-10-01

    Several factors are believed to contribute to patellofemoral joint function throughout knee flexion including patellofemoral (PF) kinematics, contact, and bone morphology. However, data evaluating the PF joint in this highly flexed state have been limited. Therefore, the purpose of this study was to evaluate patellofemoral contact and alignment in low (0°), moderate (60°), and deep (140°) knee flexion, and then correlate these parameters to each other, as well as to femoral morphology. Sagittal magnetic resonance images were acquired on 14 healthy female adult knees (RSRB approved) using a 1.5 T scanner with the knee in full extension, mid-flexion, and deep flexion. The patellofemoral cartilage contact area, lateral contact displacement (LCD), cartilage thickness, and lateral patellar displacement (LPD) throughout flexion were defined. Intra- and inter-rater repeatability measures were determined. Correlations between patellofemoral contact parameters, alignment, and sulcus morphology were calculated. Measurement repeatability ICCs ranged from 0.94 to 0.99. Patellofemoral cartilage contact area and thickness, LCD, and LPD were statistically different throughout all levels of flexion (ppatellofemoral joint throughout its range of motion. This study agrees with past studies that investigated patellofemoral measures at a single flexion angle, and provides new insights into the relationship between patellofemoral contact and alignment at multiple flexion angles. The study provides a detailed analysis of the patellofemoral joint in vivo, and demonstrates the feasibility of using standard clinical magnetic resonance imaging scanners to image the knee joint in deep flexion. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. ANÁLISIS FITOLÍTICOS EN SUELOS FORMADOS SOBRE ANTIGUAS TERRAZAS DEL RÍO URUGUAY (COLÓN, ENTRE RÍOS: PRIMERA EVIDENCIA DE RETRACCIÓN DE LOS PALMARES DE BUTIA YATAY (MART.. BECC.

    Directory of Open Access Journals (Sweden)

    Patterer, Noelia I.

    2017-06-01

    Full Text Available Los palmares de Butia yatay (Mart. Becc. en el Parque Nacional El Palmar (Colón, Entre Ríos, son comunidades relictuales que se desarrollan sobre los suelos arenosos que pertenecen al orden de los Entisoles. Estos suelos constituyen las terrazas antiguas del río Uruguay. La serie de suelos Puerto Yeruá son suelos arenosos pardos formados sobre terrazas y poseen un mayor desarrollo pedológico. Se ha estudiado la composición fitolítica de la secuencia pedológica de esta serie de suelos con la finalidad de contribuir al conocimiento de la flora que acompañó el desarrollo de los mismos. Las asociaciones fitolíticas observadas reflejan el cambio de dos ciclos pedológicos, que dividen al perfil analizado en dos zonas demarcadas por la presencia de diferentes paleocomunidades: una de palmares asociados a un estrato herbáceo pobre y una superior de pastizales meso-megatérmicos con escasa presencia de microrestos afines a elementos arbóreos. El registro fitolítico descripto en el presente trabajo es el primer antecedente que muestra el posible punto de cambio en la fisonomía del paisaje y la retracción de los palmares de yatay en el área de estudio.

  15. Ictal Cardiac Ryhthym Abnormalities.

    Science.gov (United States)

    Ali, Rushna

    2016-01-01

    Cardiac rhythm abnormalities in the context of epilepsy are a well-known phenomenon. However, they are under-recognized and often missed. The pathophysiology of these events is unclear. Bradycardia and asystole are preceded by seizure onset suggesting ictal propagation into the cortex impacting cardiac autonomic function, and the insula and amygdala being possible culprits. Sudden unexpected death in epilepsy (SUDEP) refers to the unanticipated death of a patient with epilepsy not related to status epilepticus, trauma, drowning, or suicide. Frequent refractory generalized tonic-clonic seizures, anti-epileptic polytherapy, and prolonged duration of epilepsy are some of the commonly identified risk factors for SUDEP. However, the most consistent risk factor out of these is an increased frequency of generalized tonic-clonic seizures (GTC). Prevention of SUDEP is extremely important in patients with chronic, generalized epilepsy. Since increased frequency of GTCS is the most consistently reported risk factor for SUDEP, effective seizure control is the most important preventive strategy.

  16. A Rare Stapes Abnormality

    Directory of Open Access Journals (Sweden)

    Hala Kanona

    2015-01-01

    Full Text Available The aim of this study is to increase awareness of rare presentations, diagnostic difficulties alongside management of conductive hearing loss and ossicular abnormalities. We report the case of a 13-year-old female reporting progressive left-sided hearing loss and high resolution computed tomography was initially reported as normal. Exploratory tympanotomy revealed an absent stapedius tendon and lack of connection between the stapes superstructure and footplate. The footplate was fixed. Stapedotomy and stapes prosthesis insertion resulted in closure of the air-bone gap by 50 dB. A review of world literature was performed using MedLine. Middle ear ossicular discontinuity can result in significant conductive hearing loss. This can be managed effectively with surgery to help restore hearing. However, some patients may not be suitable or decline surgical intervention and can be managed safely conservatively.

  17. Modification of Knee Flexion Angle Has Patient-Specific Effects on Anterior Cruciate Ligament Injury Risk Factors During Jump Landing.

    Science.gov (United States)

    Favre, Julien; Clancy, Caitlin; Dowling, Ariel V; Andriacchi, Thomas P

    2016-06-01

    The incidence of anterior cruciate ligament (ACL) injuries may be decreased through the use of intervention programs that focus on increasing the knee flexion angle during jump landing, which decreases strain on the ACL. To investigate whether intervention training designed to change the knee flexion angle during landing causes secondary changes in other known measures associated with the risk of ACL injuries and to examine the time points when these secondary measures change. Controlled laboratory study. A total of 39 healthy recreational athletes performed a volleyball block jump task in an instrumented gait laboratory. The participants first completed the jumps without any modification to their normal landing technique. They were then given oral instruction to land softly and to increase their knee flexion angle during landing. Lower body kinematics and kinetics were measured before and after the modification using an optoelectronic motion capture system. The knee flexion angle after the modification significantly increased from 11.2° to 15.2° at initial contact and from 67.8° to 100.7° at maximum flexion, and the time between initial contact and maximum flexion increased from 177.4 to 399.4 milliseconds. The flexion modification produced a substantial reduction in vertical ground-reaction force (243.1 to 187.8 %BW) with a concomitant reduction in the maximum flexion moment. Interestingly, the flexion modification only affected the abduction angle and abduction moment for the group of participants that landed in an initial adducted position before the modification and had no significant effect on the group that landed in an abducted position. Increasing the knee flexion angle during jump landing may be an effective intervention to improve knee biomechanical risk factors associated with an ACL injury. However, the fact that the flexion modification only influenced critical risk factors (the abduction angle and abduction moment) in participants who initially

  18. Treatable Bedridden Elderly―Recovery from Flexion Contracture after Cortisol Replacement in a Patient with Isolated Adrenocorticotropic Hormone Deficiency

    Science.gov (United States)

    Tanaka, Takamasa; Terada, Norihiko; Fujikawa, Yoshiki; Fujimoto, Takushi

    2016-01-01

    Isolated adrenocorticotropic hormone deficiency (IAD) is a rare disorder with diverse clinical presentations. A 79-year-old man was bedridden for six months due to flexion contractures of the bilateral hips and knees, along with hyponatremia. He was diagnosed with IAD based on the results of endocrine tests. After one month of corticosteroid replacement, he recovered and was able to stand up by himself. Although flexion contracture is a rare symptom of IAD, steroid replacement therapy may be effective, even for seemingly irreversibly bedridden elderly patients. In bedridden elderly patients with flexion contractures, we should consider and look for any signs of adrenal insufficiency. PMID:27746435

  19. Treatable Bedridden Elderly -Recovery from Flexion Contracture after Cortisol Replacement in a Patient with Isolated Adrenocorticotropic Hormone Deficiency.

    Science.gov (United States)

    Tanaka, Takamasa; Terada, Norihiko; Fujikawa, Yoshiki; Fujimoto, Takushi

    Isolated adrenocorticotropic hormone deficiency (IAD) is a rare disorder with diverse clinical presentations. A 79-year-old man was bedridden for six months due to flexion contractures of the bilateral hips and knees, along with hyponatremia. He was diagnosed with IAD based on the results of endocrine tests. After one month of corticosteroid replacement, he recovered and was able to stand up by himself. Although flexion contracture is a rare symptom of IAD, steroid replacement therapy may be effective, even for seemingly irreversibly bedridden elderly patients. In bedridden elderly patients with flexion contractures, we should consider and look for any signs of adrenal insufficiency.

  20. Normal postural responses preceding shoulder flexion: co-activation or asymmetric activation of transverse abdominis?

    Science.gov (United States)

    Davarian, Sanaz; Maroufi, Nader; Ebrahimi, Esmaeil; Parnianpour, Mohammad; Farahmand, Farzam

    2014-01-01

    It is suggested that activation of the transverse abdominis muscle has a stabilizing effect on the lumbar spine by raising intra-abdominal pressure without added disc compression. However, its feedforward activity has remained a controversial issue. In addition, research regarding bilateral activation of trunk muscles during a unilateral arm movement is limited. The aim of this study was to evaluate bilateral anticipatory activity of trunk muscles during unilateral arm flexion. Eighteen healthy subjects (aged 25 ± 3.96 years) participated in this study and performed 10 trials of rapid arm flexion in response to a visual stimulus. The electromyographic activity of the right anterior deltoid (AD) and bilateral trunk muscles including the transverse abdominis/internal oblique (TA/IO), superficial lumbar multifidus (SLM) and lumbar erector spine (LES) was recorded. The onset latency and anticipatory activity of the recorded trunk muscles were calculated. The first muscle activated in anticipation of the right arm flexion was the left TA/IO. The right TA/IO activated significantly later than all other trunk muscles (P 0.05). Healthy subjects showed no bilateral anticipatory co-activation of TA/IO in unilateral arm elevation. Further investigations are required to delineate normal muscle activation pattern in healthy subjects prior to prescribing bilateral activation training of transverse abdominis for subjects with chronic low back pain.

  1. Muscle changes in brachial plexus birth injury with elbow flexion contracture: an MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Poeyhiae, Tiina H; Koivikko, Mika P; Lamminen, Antti E [University of Helsinki, Helsinki Medical Imaging Center, Helsinki (Finland); Peltonen, Jari I; Nietosvaara, A Y [Helsinki University Central Hospital, Hospital for Children and Adolescents, Helsinki (Finland); Kirjavainen, Mikko O [Helsinki University Central Hospital, Department of Orthopaedics and Traumatology, Helsinki (Finland)

    2007-02-15

    Muscle pathology of the arm and forearm in brachial plexus birth injury (BPBI) with elbow flexion contracture has not been evaluated with MRI. To determine whether limited range of motion of the elbow in BPBI is correlated with specific patterns of muscular pathology. For 15 BPBI patients, total active motion (TAM) of the elbow (extension-flexion) and the forearm (pronation-supination) were measured. MRI of the elbow joints and musculature allowed assessment of elbow congruency. Fatty infiltration and size reduction of the muscles were graded semiquantitatively. Mean TAM of the elbow was 113 (50 -140 ) and that of the forearm 91 (10 -165 ). The greater the size reduction of the brachioradialis muscle, the more diminished was elbow TAM. The more extensive the BPBI and muscle pathology of the pronator teres muscle, the more limited was the TAM of the forearm. Pathology of the supinator and brachialis muscles was evident in every patient. Extensive BPBI may result in marked limitation of TAM. Elbow flexion contracture seems to be caused mainly by brachialis muscle pathology. Prosupination of the forearm is better preserved when the pronator teres is not severely affected. MRI can reliably show the extent of muscle pathology in BPBI. (orig.)

  2. Detection method of flexion relaxation phenomenon based on wavelets for patients with low back pain

    Science.gov (United States)

    Nougarou, François; Massicotte, Daniel; Descarreaux, Martin

    2012-12-01

    The flexion relaxation phenomenon (FRP) can be defined as a reduction or silence of myoelectric activity of the lumbar erector spinae muscle during full trunk flexion. It is typically absent in patients with chronic low back pain (LBP). Before any broad clinical utilization of this neuromuscular response can be made, effective, standardized, and accurate methods of identifying FRP limits are needed. However, this phenomenon is clearly more difficult to detect for LBP patients than for healthy patients. The main goal of this study is to develop an automated method based on wavelet transformation that would improve time point limits detection of surface electromyography signals of the FRP in case of LBP patients. Conventional visual identification and proposed automated methods of time point limits detection of relaxation phase were compared on experimental data using criteria of accuracy and repeatability based on physiological properties. The evaluation demonstrates that the use of wavelet transform (WT) yields better results than methods without wavelet decomposition. Furthermore, methods based on wavelet per packet transform are more effective than algorithms employing discrete WT. Compared to visual detection, in addition to demonstrating an obvious saving of time, the use of wavelet per packet transform improves the accuracy and repeatability in the detection of the FRP limits. These results clearly highlight the value of the proposed technique in identifying onset and offset of the flexion relaxation response in LBP subjects.

  3. Segmental lumbar spine instability at flexion-extension radiography can be predicted by conventional radiography

    Energy Technology Data Exchange (ETDEWEB)

    Pitkaenen, M.T.; Manninen, H.I.; Lindgren, K.-A.J.; Sihvonen, T.A.; Airaksinen, O.; Soimakallio, S

    2002-07-01

    AIM: To identify plain radiographic findings that predict segmental lumbar spine instability as shown by functional flexion-extension radiography. MATERIALS AND METHODS: Plain radiographs and flexion-extension radiographs of 215 patients with clinically suspected lumbar spine instability were analysed. Instability was classified into anterior or posterior sliding instability. The registered plain radiographic findings were traction spur, spondylarthrosis, arthrosis of facet joints, disc degeneration, retrolisthesis, degenerative spondylolisthesis, spondylolytic spondylolisthesis and vacuum phenomena. Factors reaching statistical significance in univariate analyses (P < 0.05) were included in stepwise multiple logistic regression analysis. RESULTS: Degenerative spondylolisthesis (P = 0.004 at L3-4 level and P = 0.017 at L4-5 level in univariate analysis and odds ratio 16.92 at L4-5 level in multiple logistic regression analyses) and spondylolytic spondylolisthesis (P = 0.003 at L5-S1 level in univariate analyses) were the strongest independent determinants of anterior sliding instability. Retrolisthesis (odds ratio 10.97), traction spur (odds ratio 4.45) and spondylarthrosis (odds ratio 3.20) at L3-4 level were statistically significant determinants of posterior sliding instability in multivariate analysis. CONCLUSION: Sliding instability is strongly associated with various plain radiographic findings. In mechanical back pain, functional flexion-extension radiographs should be limited to situations when symptoms are not explained by findings of plain radiographs and/or when they are likely to alter therapy. Pitkaenen, M.T. et al. (2002)

  4. Segmental lumbar spine instability at flexion-extension radiography can be predicted by conventional radiography

    International Nuclear Information System (INIS)

    Pitkaenen, M.T.; Manninen, H.I.; Lindgren, K.-A.J.; Sihvonen, T.A.; Airaksinen, O.; Soimakallio, S.

    2002-01-01

    AIM: To identify plain radiographic findings that predict segmental lumbar spine instability as shown by functional flexion-extension radiography. MATERIALS AND METHODS: Plain radiographs and flexion-extension radiographs of 215 patients with clinically suspected lumbar spine instability were analysed. Instability was classified into anterior or posterior sliding instability. The registered plain radiographic findings were traction spur, spondylarthrosis, arthrosis of facet joints, disc degeneration, retrolisthesis, degenerative spondylolisthesis, spondylolytic spondylolisthesis and vacuum phenomena. Factors reaching statistical significance in univariate analyses (P < 0.05) were included in stepwise multiple logistic regression analysis. RESULTS: Degenerative spondylolisthesis (P = 0.004 at L3-4 level and P = 0.017 at L4-5 level in univariate analysis and odds ratio 16.92 at L4-5 level in multiple logistic regression analyses) and spondylolytic spondylolisthesis (P = 0.003 at L5-S1 level in univariate analyses) were the strongest independent determinants of anterior sliding instability. Retrolisthesis (odds ratio 10.97), traction spur (odds ratio 4.45) and spondylarthrosis (odds ratio 3.20) at L3-4 level were statistically significant determinants of posterior sliding instability in multivariate analysis. CONCLUSION: Sliding instability is strongly associated with various plain radiographic findings. In mechanical back pain, functional flexion-extension radiographs should be limited to situations when symptoms are not explained by findings of plain radiographs and/or when they are likely to alter therapy. Pitkaenen, M.T. et al. (2002)

  5. Muscle changes in brachial plexus birth injury with elbow flexion contracture: an MRI study

    International Nuclear Information System (INIS)

    Poeyhiae, Tiina H.; Koivikko, Mika P.; Lamminen, Antti E.; Peltonen, Jari I.; Nietosvaara, A.Y.; Kirjavainen, Mikko O.

    2007-01-01

    Muscle pathology of the arm and forearm in brachial plexus birth injury (BPBI) with elbow flexion contracture has not been evaluated with MRI. To determine whether limited range of motion of the elbow in BPBI is correlated with specific patterns of muscular pathology. For 15 BPBI patients, total active motion (TAM) of the elbow (extension-flexion) and the forearm (pronation-supination) were measured. MRI of the elbow joints and musculature allowed assessment of elbow congruency. Fatty infiltration and size reduction of the muscles were graded semiquantitatively. Mean TAM of the elbow was 113 (50 -140 ) and that of the forearm 91 (10 -165 ). The greater the size reduction of the brachioradialis muscle, the more diminished was elbow TAM. The more extensive the BPBI and muscle pathology of the pronator teres muscle, the more limited was the TAM of the forearm. Pathology of the supinator and brachialis muscles was evident in every patient. Extensive BPBI may result in marked limitation of TAM. Elbow flexion contracture seems to be caused mainly by brachialis muscle pathology. Prosupination of the forearm is better preserved when the pronator teres is not severely affected. MRI can reliably show the extent of muscle pathology in BPBI. (orig.)

  6. Knee flexion with quadriceps cocontraction: A new therapeutic exercise for the early stage of ACL rehabilitation.

    Science.gov (United States)

    Biscarini, Andrea; Contemori, Samuele; Busti, Daniele; Botti, Fabio M; Pettorossi, Vito E

    2016-12-08

    Quadriceps strengthening exercises designed for the early phase of anterior cruciate ligament (ACL) rehabilitation should limit the anterior tibial translation developed by quadriceps contraction near full knee extension, in order to avoid excessive strain on the healing tissue. We hypothesize that knee-flexion exercises with simultaneous voluntary contraction of quadriceps (voluntary quadriceps cocontraction) can yield considerable levels of quadriceps activation while preventing the tibia from translating forward relative to the femur. Electromyographic activity in quadriceps and hamstring muscles was measured in 20 healthy males during isometric knee-flexion exercises executed near full knee extension with maximal voluntary effort of quadriceps cocontraction and external resistance (R) ranging from 0% to 60% of the 1-repetition maximum (1RM). Biomechanical modeling was applied to derive the shear (anterior/posterior) tibiofemoral force developed in each exercise condition. Isometric knee-flexion exercises with small external resistance (R=10% 1RM) and maximal voluntary effort of quadriceps cocontraction yielded a net posterior (ACL-unloading) tibial pull (P=0.005) and levels of activation of 32%, 50%, and 45% of maximum voluntary isometric contraction, for the rectus femoris, vastus medialis, and vastus lateralis, respectively. This exercise might potentially rank as one of the most appropriate quadriceps strengthening interventions in the early phase of ACL rehabilitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Decoding Finger Flexion From Band-specific ECoG Signals in Humans

    Directory of Open Access Journals (Sweden)

    Nanying eLiang

    2012-06-01

    Full Text Available This article presents the method that won the BCI competition IV addressed to the pre- diction of the finger flexion from ECoG signals. ECoG-based BCIs have recently drawn the attention from the community. Indeed, ECoG can provide a higher spatial resolution, a higher signal quality and is more suitable for long-term use than classical EEG recordings. These characteristics allow to decode precise brain activities and to realize efficient ECoG-based neu- roprostheses. Signal processing is a very important task in BCIs research for translating brain signals into commands. Here, we present a linear regression method based on the amplitude modulation of band-specific ECoG including a short term memory for individual finger flexion prediction. The effectiveness of the method was proven by achieving the highest value of corre- lation coefficient between the predicted and recorded finger flexion values on data set 4 during the BCI competition IV.

  8. Motor unit activation patterns during concentric wrist flexion in humans with different muscle fibre composition.

    Science.gov (United States)

    Søgaard, K; Christensen, H; Fallentin, N; Mizuno, M; Quistorff, B; Sjøgaard, G

    1998-10-01

    Muscle activity was recorded from the flexor carpi radialis muscle during static and dynamic-concentric wrist flexion in six subjects, who had exhibited large differences in histochemically identified muscle fibre composition. Motor unit recruitment patterns were identified by sampling 310 motor units and counting firing rates in pulses per second (pps). During concentric wrist flexion at 30% of maximal exercise intensity the mean firing rate was 27 (SD 13) pps. This was around twice the value of 12 (SD 5) pps recorded during sustained static contraction at 30% of maximal voluntary contraction, despite a larger absolute force level during the static contraction. A similar pattern of higher firing rates during dynamic exercise was seen when concentric wrist flexion at 60% of maximal exercise intensity [30 (SD 14) pps] was compared with sustained static contraction at 60% of maximal voluntary contraction [19 (SD 8) pps]. The increase in dynamic exercise intensity was accomplished by recruitment of additional motor units rather than by increasing the firing rate as during static contractions. No difference in mean firing rates was found among subjects with different muscle fibre composition, who had previously exhibited marked differences in metabolic response during corresponding dynamic contractions. It was concluded that during submaximal dynamic contractions motor unit firing rate cannot be deduced from observations during static contractions and that muscle fibre composition may play a minor role.

  9. Fixed-flexion radiography of the knee provides reproducible joint space width measurements in osteoarthritis

    International Nuclear Information System (INIS)

    Kothari, Manish; Sieffert, Martine; Block, Jon E.; Peterfy, Charles G.; Guermazi, Ali; Ingersleben, Gabriele von; Miaux, Yves; Stevens, Randall

    2004-01-01

    The validity of a non-fluoroscopic fixed-flexion radiographic acquisition and analysis protocol for measurement of joint space width (JSW) in knee osteoarthritis is determined. A cross-sectional study of 165 patients with documented knee osteoarthritis participating in a multicenter, prospective study of chondroprotective agents was performed. All patients had posteroanterior, weight-bearing, fixed-flexion radiography with 10 caudal beam angulation. A specially designed frame (SynaFlexer) was used to standardize the positioning. Minimum medial and lateral JSW were measured manually and twice by an automated analysis system to determine inter-technique and intra-reader concordance and reliability. A random subsample of 30 patients had repeat knee radiographs 2 weeks apart to estimate short-term reproducibility using automated analysis. Concordance between manual and automated medial JSW measurements was high (ICC=0.90); lateral compartment measurements showed somewhat less concordance (ICC=0.72). There was excellent concordance between repeated automated JSW measurements performed 6 months apart for the medial (ICC=0.94) and lateral (ICC=0.86) compartments. Short-term reproducibility for the subsample of 30 cases with repeat acquisitions demonstrated an average SD of 0.14 mm for medial JSW (CV=4.3%) and 0.23 mm for lateral JSW (CV=4.0%). Fixed-flexion radiography of the knee using a positioning device provides consistent, reliable and reproducible measurement of minimum JSW in knee osteoarthritis without the need for concurrent fluoroscopic guidance. (orig.)

  10. Prevalência da anemia em crianças avaliada pela palidez palmar e exame laboratorial: implicações para enfermagem Sentimientos de mujeres-madres delante de la cirugía neonatal en las malformaciones congénitas Prevalence of anemia in children assessed by clinical method known as "palmar pallor" and the laboratory exam: implications for nursing

    Directory of Open Access Journals (Sweden)

    Ethel Bastos da Silva

    2011-09-01

    Full Text Available Buscou-se analisar a prevalência de anemia ferropriva em crianças e comparar os dados obtidos pelo método clínico "palidez palmar" e exame laboratorial em uma Estratégia de Saúde da Família no município de Panambi/RS. Pesquisa exploratória/descritiva, quantitativa, realizada de março a junho de 2009. Foram sujeitos 41 crianças de 2 meses a 5 anos. Os dados foram analisados pela estatística descritiva. Das crianças, 51,2% eram do sexo masculino; 41,46% estavam na faixa etária de 0 a 12 meses; 53,6% das famílias situavam-se no nível social D e 43,9% dos chefes de família tinham o Ensino Fundamental completo ou o Ensino Médio incompleto. Pela palidez palmar, a prevalência de anemia foi de 51,2% e pelo exame laboratorial, de 58,53%. O estudo mostra que a palidez palmar e o exame laboratorial, quando usados juntos, fornecem um diagnóstico mais preciso da anemia ferropriva, podendo ser inseridos na prática assistencial da enfermagem na ESF.Se intenta analizar la prevalencia de anemia por deficiencia de fierro en niños y comparar el método clínico "palidez palmar" y el examen de laboratorio en una Estrategia de Salud de la Familia en la municipalidad de Panambi-RS. La pesquisa exploratoria, descriptiva y cuantitativa fue realizada de marzo hasta junio de 2009. Los sujetos fueron 41 niños de 2 meses a 5 años de edad. Los datos fueron analizados por la estadística descriptiva. Del total de niños, 51,2% eran del sexo masculino; 41,46% estaban en la franja etaria de 0 a 12 meses; 53,6% de las familias se sitúan en el nivel social D y 43,9% de los jefes de familia tienen la Enseñanza Fundamental Completa o la Enseñanza Media Incompleta. Por la palidez palmar, la prevalencia de anemia fue de 51,2% y por el examen de laboratorio, de 58,53%. El estudio muestra que la palidez palmar y el examen de laboratorio, cuando usados juntos, proveen un diagnóstico más preciso de la anemia por deficiencia de fierro, pudiendo ser inserido

  11. Frecuencia del alelo causante de la enfermedad de Charcot-Marie-Tooth (tipo axonal con herencia autosómica recesiva en Palmares, Costa Rica

    Directory of Open Access Journals (Sweden)

    Melissa Rojas-Araya

    2009-11-01

    Full Text Available La enfermedad de Charcot-Marie-Tooth constituye elgrupo de neuropatías periféricas hereditarias más común a nivel mundial. Una familia con 18 afectados del cantón de Palmares (Alajuela, Costa Rica con una neuropatía de tipo axonal y herencia autosómica recesiva, permitió localizar el gen responsable en la región 19q13.33. Posteriormente se identificó la mutación causante en el gen MED25. El presente estudio determinó la frecuencia del alelo mutante, así como la distribución geográfica de este alelo. En una muestra al azar de 103 individuos se encontraron seis individuos heteroigotas para la mutación, distribuidos por todo el cantón. No se encontró ninguna persona en estado homocigota para este alelo. No hallamos algunacaracterística clínica que difiera significativamente entre los individuos homocigotos silvestres y los heterocigotos para la mutación. El 5.83% de la población es heterocigota y la frecuencia del alelo Ala335Val es de 0.029, seis veces mayor que en una muestra de toda la población costarricense. Por esta razón se recomienda un análisis molecular de portadores con el fin de alertar sobre la posibilidad de aparición de más casos en el cantón.Frecuency of the allele causing the axonal form of autosomal recessive Charcot-Marie-Tooth in Palmares, Costa Rica. The Charcot-Marie-Tooth disease constitutes is among the most frequent hereditary peripheral neuropathies world-wide. We identified a family from Palmares (Alajuela, Costa Rica with 18 affected members. Their neuropathy is axonal, with an autosomal recessive pattern of inheritance; the responsible gene is at the 19q13.33 chromosomal region. Later the mutation was identified in gene MED25. We studied the frequency and geographic distribution of the mutant allele. In a random sample of 103 individuals, six were heterozygote and were widely distributed in Palmares. There was no person in homozigote state for the mutant allele. Clinical characteristics do

  12. Autoshaping of abnormal children.

    Science.gov (United States)

    Deckner, C W; Wilcox, L M; Maisto, S A; Blanton, R L

    1980-09-01

    Three experimentally naive abnormal children were exposed to a terminal operant contingency, i.e., reinforcement was delivered only if the children pressed a panel during intervals when it was lighted. Despite the absence of both successive approximation and manual shaping, it was found that each child began to respond discriminatively within a small number of trials. These data replicated previous animal studies concerned with the phenomena of autoshaping and signal-controlled responding. It was also found, however, that one type of autoshaping, the classical conditioning procedure, had a powerful suppressive effect on the discriminative responding. An experimental analysis that consisted procedure, had a powerful suppressive effect on discriminative responding. An experimental analysis that consisted of intrasubject reversal an multiple baseline designs established the internal validity of the findings. The finding of rapid acquisition of signal-controlled responding obtained with the initial procedure is suggessted to have practical significance. The disruptive effects of the classical form of autoshaping are discussed in terms of negative behavioral contrast.

  13. Communication and abnormal behaviour.

    Science.gov (United States)

    Crown, S

    1979-01-01

    In this paper the similarities between normal and abnormal behaviour are emphasized and selected aspects of communication, normal and aberrant, between persons are explored. Communication in a social system may be verbal or non-verbal: one person's actions cause a response in another person. This response may be cognitive, behavioural or physiological. Communication may be approached through the individual, the social situation or social interaction. Psychoanalysis approaches the individual in terms of the coded communications of psychoneurotic symptoms or psychotic behaviour; the humanist-existential approach is concerned more with emotional expression. Both approaches emphasize the development of individual identity. The interaction between persons and their social background is stressed. Relevant are sociological concepts such as illness behaviour, stigma, labelling, institutionalization and compliance. Two approaches to social interactions are considered: the gamesplaying metaphor, e.g. back pain as a psychosocial manipulation--the 'pain game'; and the 'spiral of reciprocal perspectives' which emphasizes the interactional complexities of social perceptions. Communicatory aspects of psychological treatments are noted: learning a particular metaphor such as 'resolution' of the problem (psychotherapy), learning more 'rewarding' behaviour (learning theory) or learning authenticity or self-actualization (humanist-existential).

  14. Abnormally dark or light skin

    Science.gov (United States)

    Hyperpigmentation; Hypopigmentation; Skin - abnormally light or dark ... Normal skin contains cells called melanocytes. These cells produce melanin , the substance that gives skin its color. Skin with ...

  15. Knee Flexion and Daily Activities in Patients following Total Knee Replacement: A Comparison with ISO Standard 14243

    Directory of Open Access Journals (Sweden)

    Markus A. Wimmer

    2015-01-01

    Full Text Available Walking is only one of many daily activities performed by patients following total knee replacement (TKR. The purpose of this study was to examine the hypotheses (a that subject activity characteristics are correlated with knee flexion range of motion (ROM and (b that there is a significant difference between the subject’s flexion/extension excursion throughout the day and the ISO specified input for knee wear testing. In order to characterize activity, the number of walking and stair stepping cycles, the time spent with dynamic and stationary activities, the number of activity sequences, and the knee flexion/extension excursion of 32 TKR subjects were collected during daily activity. Flexion/extension profiles were compared with the ISO 14243 simulator input profile using a level crossing classification algorithm. Subjects took an average of 3102 (range: 343–5857 walking cycles including 65 (range: 0–319 stair stepping cycles. Active and passive ROMs were positively correlated with stair walking time, stair step counts, and stair walking sequences. Simulated knee motion according to ISO showed significantly fewer level crossings at the flexion angles 20–40° and beyond 50° than those measured with the monitor. This suggests that implant wear testing protocols should contain more cycles and a variety of activities requiring higher knee flexion angles with incorporated resting/transition periods to account for the many activity sequences.

  16. The importance of bony impingement in restricting flexion after total knee arthroplasty: computer simulation model with clinical correlation.

    Science.gov (United States)

    Mizu-Uchi, Hideki; Colwell, Clifford W; Fukagawa, Shingo; Matsuda, Shuichi; Iwamoto, Yukihide; D'Lima, Darryl D

    2012-10-01

    We constructed patient-specific models from computed tomography data after total knee arthroplasty to predict knee flexion based on implant-bone impingement. The maximum flexion before impingement between the femur and the tibial insert was computed using a musculoskeletal modeling program (KneeSIM; LifeModeler, Inc, San Clemente, California) during a weight-bearing deep knee bend. Postoperative flexion was measured in a clinical cohort of 21 knees (low-flex group: 6 knees with 125° of flexion at 2 years). Average predicted flexion angles were within 2° of clinical measurements for the high-flex group. In the low-flex group, 4 cases had impingement involving the bone cut at the posterior condyle, and the average predicted knee flexion was 102° compared with 93° measured clinically. These results indicate that the level of the distal femoral resection should be carefully planned and that exposed bone proximal to the tips of the posterior condyles of the femoral component should be removed if there is risk of impingement. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. ANALYSIS OF ISOKINETIC KNEE EXTENSION / FLEXION IN MALE ELITE ADOLESCENT WRESTLERS

    Directory of Open Access Journals (Sweden)

    Sanli Sadi Kurdak

    2005-12-01

    Full Text Available Wrestling requires strength of the upper and lower body musculature which is critical for the athletic performance. Evaluation of the adolescent's skeletal muscle is important to understand body movement, especially including those involved in sports. Strength, power and endurance capacity are defined as parameters of skeletal muscle biomechanical properties. The isokinetic dynamometer is an important toll for making this type of evaluation. However, load range phase of range of motion has to be considered to interpret the data correctly. With this in mind we aimed to investigate the lover body musculature contractile characteristics of adolescent wrestlers together with detailed analyses of load range phase of motion. Thirteen boys aged 12 - 14 years participated to this study. Concentric load range torque, work and power of knee extension and flexion were measured by a Cybex Norm dynamometer at angular velocities from 450°/sec to 30°/sec with 30°/sec decrements for each set. None of the wrestlers were able to attain load range for angular velocities above 390°/sec and 420°/sec for extension and flexion respectively. Detailed analyses of the load range resulted in statistically significant differences in the normalized load range peak torque for extension at 270°/sec (1.44 ± 0.28 Nm·kg-1 and 1.14 ± 0.28 Nm·kg-1 for total and load range peak torque respectively, p < 0.05, and for flexion at 300°/sec (1.26 ± 0.28 Nm·kg-1 and 1.03 ± 0.23 Nm·kg-1 for total and load range peak torque respectively, p < 0.05, compared to total peak torque data. Similarly, the significant difference was found for the work values at 90°/sec (1.91 ± 0.23 Nm·kg-1 and 1.59 ± 0.24 Nm·kg-1 for total and load range work respectively for extension and 1.73 ± 0.21 Nm·kg-1 and 1.49 ± 0.19 Nm·kg-1 for total and load range work respectively for flexion, p < 0.05, and was evident at higher angular velocities (p < 0.001 for both extension and flexion. At

  18. A successful backward step correlates with hip flexion moment of supporting limb in elderly people.

    Science.gov (United States)

    Takeuchi, Yahiko

    2018-01-01

    The objective of this study was to determine the positional relationship between the center of mass (COM) and the center of pressure (COP) at the time of step landing, and to examine their relationship with the joint moments exerted by the supporting limb, with regard to factors of the successful backward step response. The study population comprised 8 community-dwelling elderly people that were observed to take successive multi steps after the landing of a backward stepping. Using a motion capture system and force plate, we measured the COM, COP and COM-COP deviation distance on landing during backward stepping. In addition, we measured the moment of the supporting limb joint during backward stepping. The multi-step data were compared with data from instances when only one step was taken (single-step). Variables that differed significantly between the single- and multi-step data were used as objective variables and the joint moments of the supporting limb were used as explanatory variables in single regression analyses. The COM-COP deviation in the anteroposterior was significantly larger in the single-step. A regression analysis with COM-COP deviation as the objective variable obtained a significant regression equation in the hip flexion moment (R2 = 0.74). The hip flexion moment of supporting limb was shown to be a significant explanatory variable in both the PS and SS phases for the relationship with COM-COP distance. This study found that to create an appropriate backward step response after an external disturbance (i.e. the ability to stop after 1 step), posterior braking of the COM by a hip flexion moment are important during the single-limbed standing phase.

  19. Trunk Muscle Activation at the Initiation and Braking of Bilateral Shoulder Flexion Movements of Different Amplitudes.

    Directory of Open Access Journals (Sweden)

    M Eriksson Crommert

    Full Text Available The aim of this study was to investigate if trunk muscle activation patterns during rapid bilateral shoulder flexions are affected by movement amplitude. Eleven healthy males performed shoulder flexion movements starting from a position with arms along sides (0° to either 45°, 90° or 180°. EMG was measured bilaterally from transversus abdominis (TrA, obliquus internus (OI with intra-muscular electrodes, and from rectus abdominis (RA, erector spinae (ES and deltoideus with surface electrodes. 3D kinematics was recorded and inverse dynamics was used to calculate the reactive linear forces and torque about the shoulders and the linear and angular impulses. The sequencing of trunk muscle onsets at the initiation of arm movements was the same across movement amplitudes with ES as the first muscle activated, followed by TrA, RA and OI. All arm movements induced a flexion angular impulse about the shoulders during acceleration that was reversed during deceleration. Increased movement amplitude led to shortened onset latencies of the abdominal muscles and increased level of activation in TrA and ES. The activation magnitude of TrA was similar in acceleration and deceleration where the other muscles were specific to acceleration or deceleration. The findings show that arm movements need to be standardized when used as a method to evaluate trunk muscle activation patterns and that inclusion of the deceleration of the arms in the analysis allow the study of the relationship between trunk muscle activation and direction of perturbing torque during one and the same arm movement.

  20. Pneumatic Multi-Pocket Elastomer Actuators for Metacarpophalangeal Joint Flexion and Abduction-Adduction

    Directory of Open Access Journals (Sweden)

    Tapio Veli Juhani Tarvainen

    2017-09-01

    Full Text Available During recent years, interest has been rising towards developing fluidic fiber-reinforced elastomer actuators for wearable soft robotics used in hand rehabilitation and power-assist. However, they do not enable finger abduction-adduction, which plays an important role in activities of daily living, when grasping larger objects. Furthermore, the developed gloves often do not have separate control of joints, which is important for doing various common rehabilitation motions. The main obstacle for the development of a fully-assisting glove is moving a joint with multiple degrees of freedom. If the functions are built into the same structure, they are naturally coupled and affect each other, which makes them more difficult to design and complex to control than a simple flexion-extension actuator. In this study, we explored the key design elements and fabrication of pneumatic multi-pocket elastomer actuators for a soft rehabilitation glove. The goal was to gain more control over the metacarpophalangeal joint’s response by increasing the degree of actuation. Three main functional designs were tested for achieving both flexion and abduction-adduction. Five prototypes, with four different actuator geometries and four different reinforcement types, were designed and fabricated. They were evaluated by recording their free motion with motion capture and measuring their torque output using a dummy finger. Results showed the strengths and weaknesses of each design in separating the control of the two functions. We discuss the different improvements that are needed in order to make each design plausible for developing an actuator that meets the requirements for full assist of the hand’s motions. In conclusion, we show that it is possible to produce multi-pocket actuators for assisting MCP joint motion in both flexion and abduction-adduction, although coupling between the separate functions is still problematic and should be considered further.

  1. Effects of a 16-week Pilates exercises training program for isometric trunk extension and flexion strength.

    Science.gov (United States)

    Kliziene, Irina; Sipaviciene, Saule; Vilkiene, Jovita; Astrauskiene, Audrone; Cibulskas, Gintautas; Klizas, Sarunas; Cizauskas, Ginas

    2017-01-01

    To evaluate the effects of Pilates exercises designed to improve isometric trunk extension and flexion strength of muscles in women with chronic low back pain (cLBP). Female volunteers with cLBP were divided into an experimental group (EG; n = 27) and a control group (CG; n = 27). Pilates exercises were performed twice per week by the EG; the duration of each session was 60 min. The program lasted for 16 weeks; thus patients underwent a total of 32 exercise sessions. The maximum isometric waist bending strength of the EG had improved significantly (p = 0.001) after 16 weeks of the Pilates program. The results of trunk flexion muscle endurance tests significantly depended on the trunk extension muscle endurance before the intervention, and at 1 month (r = 0.723, p Pilates exercise program. At the end of the 16-week exercise program, cLBP intensity decreased by 2.01 ± 0.8 (p Pilates exercise program the pain intensified and the functional state deteriorated much faster than the maximum trunk muscle strength. Therefore, it can be concluded that, to decrease pain and improve functional condition, regular exercise (and not only improved strength and endurance) is required. We established that, although the 16-week lumbar stabilization exercise program increased isometric trunk extension and flexion strength and this increase in strength persisted for 2 months, decreased LBP and improved functional condition endured for only 1 month. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Measurement properties of the craniocervical flexion test: a systematic review protocol.

    Science.gov (United States)

    Araujo, Francisco Xavier de; Ferreira, Giovanni Esteves; Scholl Schell, Maurício; Castro, Marcelo Peduzzi de; Silva, Marcelo Faria; Ribeiro, Daniel Cury

    2018-02-22

    Neck pain is the leading cause of years lived with disability worldwide and it accounts for high economic and societal burden. Altered activation of the neck muscles is a common musculoskeletal impairment presented by patients with neck pain. The craniocervical flexion test with pressure biofeedback unit has been widely used in clinical practice to assess function of deep neck flexor muscles. This systematic review will assess the measurement properties of the craniocervical flexion test for assessing deep cervical flexor muscles. This is a protocol for a systematic review that will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. MEDLINE (via PubMed), EMBASE, PEDro, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus and Science Direct will be systematically searched from inception. Studies of any design that have investigated and reported at least one measurement property of the craniocervical flexion test for assessing the deep cervical flexor muscles will be included. All measurement properties will be considered as outcomes. Two reviewers will independently rate the risk of bias of individual studies using the updated COnsensus-based Standards for the selection of health Measurement Instruments risk of bias checklist. A structured narrative synthesis will be used for data analysis. Quantitative findings for each measurement property will be summarised. The overall rating for a measurement property will be classified as 'positive', 'indeterminate' or 'negative'. The overall rating will be accompanied with a level of evidence. Ethical approval and patient consent are not required since this is a systematic review based on published studies. Findings will be submitted to a peer-reviewed journal for publication. CRD42017062175. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Increasing trunk flexion transforms human leg function into that of birds despite different leg morphology.

    Science.gov (United States)

    Aminiaghdam, Soran; Rode, Christian; Müller, Roy; Blickhan, Reinhard

    2017-02-01

    Pronograde trunk orientation in small birds causes prominent intra-limb asymmetries in the leg function. As yet, it is not clear whether these asymmetries induced by the trunk reflect general constraints on the leg function regardless of the specific leg architecture or size of the species. To address this, we instructed 12 human volunteers to walk at a self-selected velocity with four postures: regular erect, or with 30 deg, 50 deg and maximal trunk flexion. In addition, we simulated the axial leg force (along the line connecting hip and centre of pressure) using two simple models: spring and damper in series, and parallel spring and damper. As trunk flexion increases, lower limb joints become more flexed during stance. Similar to birds, the associated posterior shift of the hip relative to the centre of mass leads to a shorter leg at toe-off than at touchdown, and to a flatter angle of attack and a steeper leg angle at toe-off. Furthermore, walking with maximal trunk flexion induces right-skewed vertical and horizontal ground reaction force profiles comparable to those in birds. Interestingly, the spring and damper in series model provides a superior prediction of the axial leg force across trunk-flexed gaits compared with the parallel spring and damper model; in regular erect gait, the damper does not substantially improve the reproduction of the human axial leg force. In conclusion, mimicking the pronograde locomotion of birds by bending the trunk forward in humans causes a leg function similar to that of birds despite the different morphology of the segmented legs. © 2017. Published by The Company of Biologists Ltd.

  4. Variability of ischiofemoral space dimensions with changes in hip flexion: an MRI study

    International Nuclear Information System (INIS)

    Johnson, Adam C.; Howe, Benjamin M.; Hollman, John H.; Finnoff, Jonathan T.

    2017-01-01

    The primary aim of this study was to determine if ischiofemoral space (IFS) dimensions vary with changes in hip flexion as a result of placing a bolster behind the knees during magnetic resonance imaging (MRI). A secondary aim was to determine if IFS dimensions vary between supine and prone hip neutral positions. The study employed a prospective design. Sports medicine center within a tertiary care institution. Five male and five female adult subjects (age mean = 29.2, range = 23-35; body mass index [BMI] mean = 23.5, range = 19.5-26.6) were recruited to participate in the study. An axial, T1-weighted MRI sequence of the pelvis was obtained of each subject in a supine position with their hips in neutral and flexed positions, and in a prone position with their hips in neutral position. Supine hip flexion was induced by placing a standard, 9-cm-diameter MRI knee bolster under the subject's knees. The order of image acquisition (supine hip neutral, supine hip flexed, prone hip neutral) was randomized. The IFS dimensions were then measured on a separate workstation. The investigator performing the IFS measurements was blinded to the subject position for each image. The main outcome measurements were the IFS dimensions acquired with MRI. The mean IFS dimensions in the prone position were 28.25 mm (SD 5.91 mm, standard error mean 1.32 mm). In the supine hip neutral position, the IFS dimensions were 25.1 (SD 5.6) mm. The mean difference between the two positions of 3.15 (3.6) mm was statistically significant (95 % CI of the difference = 1.4 to 4.8 mm, t_1_9 = 3.911, p =.001). The mean IFS dimensions in the hip flexed position were 36.9 (SD 5.7) mm. The mean difference between the two supine positions of 11.8 (4.1) mm was statistically significant (95 % CI of the difference = 9.9 to 13.7 mm, t_1_9 = 12.716, p <.001). Our findings demonstrate that the IFS measurements obtained with MRI are dependent upon patient positioning with respect to hip flexion and supine versus

  5. Variability of ischiofemoral space dimensions with changes in hip flexion: an MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Adam C.; Howe, Benjamin M. [Mayo Clinic College of Medicine, Department of Radiology, Rochester, MN (United States); Hollman, John H.; Finnoff, Jonathan T. [Mayo Clinic College of Medicine, Department of Physical Medicine and Rehabilitation, Rochester, MN (United States)

    2017-01-15

    The primary aim of this study was to determine if ischiofemoral space (IFS) dimensions vary with changes in hip flexion as a result of placing a bolster behind the knees during magnetic resonance imaging (MRI). A secondary aim was to determine if IFS dimensions vary between supine and prone hip neutral positions. The study employed a prospective design. Sports medicine center within a tertiary care institution. Five male and five female adult subjects (age mean = 29.2, range = 23-35; body mass index [BMI] mean = 23.5, range = 19.5-26.6) were recruited to participate in the study. An axial, T1-weighted MRI sequence of the pelvis was obtained of each subject in a supine position with their hips in neutral and flexed positions, and in a prone position with their hips in neutral position. Supine hip flexion was induced by placing a standard, 9-cm-diameter MRI knee bolster under the subject's knees. The order of image acquisition (supine hip neutral, supine hip flexed, prone hip neutral) was randomized. The IFS dimensions were then measured on a separate workstation. The investigator performing the IFS measurements was blinded to the subject position for each image. The main outcome measurements were the IFS dimensions acquired with MRI. The mean IFS dimensions in the prone position were 28.25 mm (SD 5.91 mm, standard error mean 1.32 mm). In the supine hip neutral position, the IFS dimensions were 25.1 (SD 5.6) mm. The mean difference between the two positions of 3.15 (3.6) mm was statistically significant (95 % CI of the difference = 1.4 to 4.8 mm, t{sub 19} = 3.911, p =.001). The mean IFS dimensions in the hip flexed position were 36.9 (SD 5.7) mm. The mean difference between the two supine positions of 11.8 (4.1) mm was statistically significant (95 % CI of the difference = 9.9 to 13.7 mm, t{sub 19} = 12.716, p <.001). Our findings demonstrate that the IFS measurements obtained with MRI are dependent upon patient positioning with respect to hip flexion and

  6. Age-related decreases in motor unit discharge rate and force control during isometric plantar flexion

    DEFF Research Database (Denmark)

    Kallio, J; Søgaard, Karen; Avela, J

    2012-01-01

    Aging is related to multiple changes in muscle physiology and function. Previous findings concerning the effects of aging on motor unit discharge rate (DR) and fluctuations in DR and force are somewhat contradictory. Eight YOUNG and nine OLD physically active males performed isometric ramp (RECR......) and isotonic (ISO) plantar flexions at 10 and 20% of surface EMG at MVC. Motor unit (MU) action potentials were recorded with intramuscular fine-wire electrodes and decomposed with custom build software "Daisy". DR was lower in OLD in RECR-10% (17.9%, p...

  7. Knee joint moments during high flexion movements: Timing of peak moments and the effect of safety footwear.

    Science.gov (United States)

    Chong, Helen C; Tennant, Liana M; Kingston, David C; Acker, Stacey M

    2017-03-01

    (1) Characterize knee joint moments and peak knee flexion moment timing during kneeling transitions, with the intent of identifying high-risk postures. (2) Determine whether safety footwear worn by kneeling workers (construction workers, tile setters, masons, roofers) alters high flexion kneeling mechanics. Fifteen males performed high flexion kneeling transitions. Kinetics and kinematics were analyzed for differences in ascent and descent in the lead and trail legs. Mean±standard deviation peak external knee adduction and flexion moments during transitions ranged from 1.01±0.31 to 2.04±0.66% body weight times height (BW∗Ht) and from 3.33 to 12.6% BW∗Ht respectively. The lead leg experienced significantly higher adduction moments compared to the trail leg during descent, when work boots were worn (interaction, p=0.005). There was a main effect of leg (higher lead vs. trail) on the internal rotation moment in both descent (p=0.0119) and ascent (p=0.0129) phases. Peak external knee adduction moments during transitions did not exceed those exhibited during level walking, thus increased knee adduction moment magnitude is likely not a main factor in the development of knee OA in occupational kneelers. Additionally, work boots only significantly increased the adduction moment in the lead leg during descent. In cases where one knee is painful, diseased, or injured, the unaffected knee should be used as the lead leg during asymmetric bilateral kneeling. Peak flexion moments occurred at flexion angles above the maximum flexion angle exhibited during walking (approximately 60°), supporting the theory that the loading of atypical surfaces may aid disease development or progression. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Electrocardiographic abnormalities in opiate addicts.

    Science.gov (United States)

    Wallner, Christina; Stöllberger, Claudia; Hlavin, Anton; Finsterer, Josef; Hager, Isabella; Hermann, Peter

    2008-12-01

    To determine in a cross-sectional study the prevalence of electrocardiographic (ECG) abnormalities in opiate addicts who were therapy-seeking and its association with demographic, clinical and drug-specific parameters. In consecutive therapy-seeking opiate addicts, a 12-lead ECG was registered within 24 hours after admission and evaluated according to a pre-set protocol between October 2004 and August 2006. Additionally, demographic, clinical and drug-specific parameters were recorded. Included were 511 opiate-addicts, 25% female, with a mean age of 29 years (range 17-59 years). One or more ECG abnormalities were found in 314 patients (61%). In the 511 patients we found most commonly ST abnormalities (19%), QTc prolongation (13%), tall R- and/or S-waves (11%) and missing R progression (10%). ECG abnormalities were more common in males than in females (64 versus 54%, P seizures less often (16 versus 27%, P opiate addicts. The most frequent ECG abnormalities are ST abnormalities, QTc prolongation and tall R- and/or S-waves. ST abnormalities are associated with cannabis, and QTc prolongation with methadone and benzodiazepines.

  9. Effect of Ankle Positioning During Hamstring Stretches for Improving Straight Leg Hip Flexion Motion.

    Science.gov (United States)

    Laudner, Kevin G; Benjamin, Peter J; Selkow, Noelle M

    2016-03-01

    To compare the effects of stretching the hamstrings with the ankle in either a plantar-flexed (PF) or dorsiflexed (DF) position for improving straight leg hip flexion range of motion (ROM) over a 4-week period. Randomized, single-blinded, pretest, posttest design. Athletic training facility. Each limb of 34 asymptomatic individuals (15 males, 19 females) was randomly assigned to one of the 3 groups. Twenty-four limbs received hamstring stretches with the ankle in DF, 24 limbs received hamstring stretches with the ankle in PF, and 20 limbs received no stretch (control). Ankle position (PF, DF) during hamstring stretching. We measured pretest and posttest passive straight leg hip flexion ROM with the test ankle in a neutral position. For the intervention groups, the test limb was passively stretched with the ankle held in end range DF or PF for their respective group. Each stretch was held for 30 seconds for a total of 3 applications. Two treatment sessions were completed per week for a total of 4 weeks. The control limbs received no stretching during the 4-week period. We conducted 1-way analyses of covariance to determine significant changes in ROM between groups (P hamstrings in either PF or DF improve straight leg hip ROM compared with a control group. The results of this study should be considered by clinicians when determining the optimal stretching techniques aimed at increasing hamstring length.

  10. Rites thérapeutiques : réflexion sur le terrain et les archives

    Directory of Open Access Journals (Sweden)

    Chantal Radimilahy

    2008-08-01

    Full Text Available Rites thérapeutiques : réflexion sur le terrain et les archives. En comparant la façon dont l’écrit sert à noter et à fixer des pratiques de guérissage, d’une part dans les archives de L. Vig et d’autre part dans les carnets d’un guérisseur malgache contemporain, l’auteur esquisse une réflexion sur la stabilité apparente des formes du langage et des pratiques rituelles dans un contexte social transformé.Therapeutic rituals: consideration on fieldwork and archives. By comparing the way in which writing is used to record and establish traditional healing practices, on the one hand in the archives of L. Vig and on the other, in the notes of a contemporary Madagascan traditional healer, the author outlines her reflections on the apparent stability of language forms and ritual practices in a transformed social context.

  11. Comportement en flexion des bétons fibrés sous chargement cyclique

    Directory of Open Access Journals (Sweden)

    Boulekbache Bensaid

    2014-04-01

    Full Text Available Ce papier présente les résultats d’une étude expérimentale sur le comportement en flexion des bétons de fibres métalliques. On étudie l’effet de la rhéologie du béton sur l’orientation des fibres et l’influence de l’orientation sur les propriétés mécaniques. La rigidité de l’ancrage des fibres étudiée par les essais cycliques est liée aux caractéristiques rhéologiques et mécaniques de la matrice. Les résultats montrent que la fluidité des bétons est un paramètre essentiel de l’orientation des fibres. Dès lors que l’on obtient une orientation dans le sens de l’efficacité mécanique, la résistance à la flexion est nettement améliorée.

  12. Imaging findings of sternal abnormalities

    International Nuclear Information System (INIS)

    Franquet, T.; Gimenez, A.; Alegret, X.; Sanchis, E.; Rivas, A.

    1997-01-01

    Radiographic findings in the sternal abnormalities are often nonspecific, showing appearances from a localized benign lesion to an aggressive lesion as seen with infections and malignant neoplasms. A specific diagnosis of sternal abnormalities can be suggested on the basis of CT and MR characteristics. Familiarity with the presentation and variable appearance of sternal abnormalities may aid the radiologist is suggesting a specific diagnosis. We present among others characteristic radiographic findings of hemangioma, chondrosarcoma, hydatid disease, and SAPHO syndrome. In those cases in which findings are not specific, cross-sectional imaging modalities may help the clinician in their management. (orig.)

  13. Sonographic measurements of the ulnar nerve at the elbow with different degrees of elbow flexion.

    Science.gov (United States)

    Patel, Prutha; Norbury, John W; Fang, Xiangming

    2014-05-01

    To determine whether there were differences in the cross-sectional area (CSA) and the flattening ratio of the normative ulnar nerve as it passes between the medial epicondyle and the olecranon at 30° of elbow flexion versus 90° of elbow flexion. Bilateral upper extremities of normal healthy adult volunteers were evaluated with ultrasound. The CSA and the flattening ratio of the ulnar nerve at the elbow as it passes between the medial epicondyle and the olecranon were measured, with the elbow flexed at 30° and at 90°, by 2 operators with varying ultrasound scanning experience by using ellipse and direct tracing methods. The results from the 2 different angles of elbow flexion were compared for each individual operator. Finally, intraclass correlations for absolute agreement and consistency between the 2 raters were calculated. An outpatient clinic room at a regional rehabilitation center. Twenty-five normal healthy adult volunteers. The mean CSA and the mean flattening ratio of the ulnar nerve at 30° of elbow flexion and at 90° of elbow flexion. First, for the ellipse method, the mean CSA of the ulnar nerve at 90° (9.93 mm(2)) was slightly larger than at 30° (9.77 mm(2)) for rater 1. However, for rater 2, the mean CSA of the ulnar nerve at 90° (6.80 mm(2)) was slightly smaller than at 30° (7.08 mm(2)). This was found to be statistically insignificant when using a matched pairs t test and the Wilcoxon signed-rank test, with a significance level of .05. Similarly, the difference between the right side and the left side was not statistically significant. The intraclass correlations for absolute agreement between the 2 raters were not very high due to different measurement locations, but the intraclass correlations for consistency were high. Second, for the direct tracing method, the mean CSA at 90° (7.26 mm(2)) was slightly lower than at 30° (7.48 mm(2)). This was found to be statistically nonsignificant when using the matched pairs t test and the

  14. Déficit bilateral nos movimentos de flexão e extensão de perna e flexão do cotovelo Déficit bilateral en los movimientos de flexion y extension de la pierna y flexion del codo Bilateral deficit in leg flexion and extension and elbow flexion movements

    Directory of Open Access Journals (Sweden)

    Christianne Pereira Giesbrecht Chaves

    2004-12-01

    áxima (CM en la flexión y extensión de pierna e flexión del de codo aisladamente y entre la suma de esos dos resultados con aquel desarrollado simultaneamente por las dos piernas y los dos brazos, respectivamente. Sometemos a 60 indivíduos al ejercicio de flexión y extensión de pierna y a flexión de codo a un test de 1RM. Los resultados para los movimientos de flexión y extensión de pierna y flexión de codo izquierdos y derechos en la CM fueron de 31,6 (± 7,9, 32,0 (± 8,0, 20,2 (± 9,2, 20,2 (± 9,8, 29,3 (± 13,9 e 29,8 (± 14,1 kg respectivamente, y se mostraron similares (p > 0,05 y fuertemente asociados (r = 0,96, 0,96 e 0,98. Comparando la suma de los valores unilaterales con los de ejecución bilateral, la CM presentó una diferencia significativa para los movimientos de extensión de pierna (p = 0,04 y flexión de codo (p = 0,03, el mismo no fué observado en el movimiento de flexión de pierna (p = 0,75. Este resultado puede ser explicado por el menor incremento de carga - dos kilos y medio en este último movimiento en relación a los dos movimientos anteriores - cinco kilos. A pesar de la mayoría de los sujetos sean diestros, no hubo diferencias unilaterales en la CM a pesar de no todos estar entrenados. La suma de los resultados unilaterales fué mayor en 9,8% y 4,0% para los movimientos de extensión de la pierna y flexión del codo, respectivamente, de aquel obtenido bilateralmente, mostrando, probablemente una limitación central en la coordenación motora de un movimiento complejo hecho en máxima velocidad y con carga elevada. Por otro lado, en el movimiento de flexión de pierna, la suma de los resultados unilaterales fué inferior a la bilateral (-0,6%, presentando un posible aprendizage del movimiento y adaptación al entrenamiento con pesos a partir de las doce semanas.Endurance exercises (EE may be performed unilaterally and bilaterally. The objective was to compare the maximum load (ML in leg flexion and extension and elbow flexion alone

  15. Exercising upper respiratory videoendoscopic evaluation of 100 nonracing performance horses with abnormal respiratory noise and/or poor performance.

    Science.gov (United States)

    Davidson, E J; Martin, B B; Boston, R C; Parente, E J

    2011-01-01

    Although well documented in racehorses, there is paucity in the literature regarding the prevalence of dynamic upper airway abnormalities in nonracing performance horses. To describe upper airway function of nonracing performance horses with abnormal respiratory noise and/or poor performance via exercising upper airway videoendoscopy. Medical records of nonracing performance horses admitted for exercising evaluation with a chief complaint of abnormal respiratory noise and/or poor performance were reviewed. All horses had video recordings of resting and exercising upper airway endoscopy. Relationships between horse demographics, resting endoscopic findings, treadmill intensity and implementation of head and neck flexion during exercise with exercising endoscopic findings were examined. Dynamic upper airway obstructions were observed in 72% of examinations. Head and neck flexion was necessary to obtain a diagnosis in 21 horses. Pharyngeal wall collapse was the most prevalent upper airway abnormality, observed in 31% of the examinations. Complex abnormalities were noted in 27% of the examinations. Resting laryngeal dysfunction was significantly associated with dynamic arytenoid collapse and the odds of detecting intermittent dorsal displacement of the soft palate (DDSP) during exercise in horses with resting DDSP was only 7.7%. Exercising endoscopic observations were different from the resting observations in 54% of examinations. Dynamic upper airway obstructions were common in nonracing performance horses with respiratory noise and/or poor performance. Resting endoscopy was only helpful in determining exercising abnormalities with recurrent laryngeal neuropathy. This study emphasises the importance of exercising endoscopic evaluation in nonracing performance horses with abnormal respiratory noise and/or poor performance for accurate assessment of dynamic upper airway function. © 2010 EVJ Ltd.

  16. Biceps Tendon Lengthening Surgery for Failed Serial Casting Patients With Elbow Flexion Contractures Following Brachial Plexus Birth Injury.

    Science.gov (United States)

    Nath, Rahul K; Somasundaram, Chandra

    2016-01-01

    Assessment of surgical outcomes of biceps tendon lengthening (BTL) surgery in obstetric brachial plexus injury (OBPI) patients with elbow flexion contractures, who had unsuccessful serial casting. Serial casting and splinting have been shown to be effective in correcting elbow flexion contractures in OBPI. However, the possibilities of radial head dislocations and other complications have been reported in serial casting and splinting. Literature indicates surgical intervention when such nonoperative techniques and range-of-motion exercises fail. Here, we demonstrated a significant reduction of the contractures of the affected elbow and improvement in arm length to more normal after BTL in these patients, who had unsuccessful serial casting. Ten OBPI patients (6 girls and 4 boys) with an average age of 11.2 years (4-17.7 years) had BTL surgery after unsuccessful serial casting. Mean elbow flexion contracture was 40° before and 37° (average) after serial casting. Mean elbow flexion contracture was reduced to 8° (0°-20°) post-BTL surgical procedure with an average follow-up of 11 months. This was 75% improvement and statistically significant (P casting. These OBPI patients in our study had 75% significant reduction in elbow flexion contractures and achieved an improved and more normal length of the affected arm after the BTL surgery when compared to only 7% insignificant reduction and no improvement in arm length after serial casting.

  17. Somatosensory abnormalities in knee OA.

    Science.gov (United States)

    Wylde, Vikki; Palmer, Shea; Learmonth, Ian D; Dieppe, Paul

    2012-03-01

    The aim of this study was to use quantitative sensory testing (QST) to explore the range and prevalence of somatosensory abnormalities demonstrated by patients with advanced knee OA. One hundred and seven knee OA patients and 50 age- and sex-matched healthy participants attended a 1-h QST session. Testing was performed on the medial side of the knee and the pain-free forearm. Light-touch thresholds were assessed using von Frey filaments, pressure pain thresholds using a digital pressure algometer, and thermal sensation and pain thresholds using a Thermotest MSA. Significant differences in median threshold values from knee OA patients and healthy participants were identified using Mann-Whitney U-tests. The z-score transformations were used to determine the prevalence of the different somatosensory abnormalities in knee OA patients. Testing identified 70% of knee OA patients as having at least one somatosensory abnormality. Comparison of median threshold values between knee OA patients and healthy participants revealed that patients had localized thermal and tactile hypoaesthesia and pressure hyperalgesia at the osteoarthritic knee. Tactile hypoaesthesia and pressure hyperalgesia were also present at the pain-free forearm. The most prevalent somatosensory abnormalities were tactile hypoaesthesia and pressure hyperalgesia, evident in between 20 and 34% of patients. This study found that OA patients demonstrate an array of somatosensory abnormalities, of which the most prevalent were tactile hypoaesthesia and pressure hyperalgesia. Further research is now needed to establish the clinical implications of these somatosensory abnormalities.

  18. Modification of Spastic Stretch Reflexes at the Elbow by Flexion Synergy Expression in Individuals With Chronic Hemiparetic Stroke.

    Science.gov (United States)

    McPherson, Jacob G; Stienen, Arno H; Drogos, Justin M; Dewald, Julius P

    2018-03-01

    To systematically characterize the effect of flexion synergy expression on the manifestation of elbow flexor stretch reflexes poststroke, and to relate these findings to elbow flexor stretch reflexes in individuals without neurologic injury. Controlled cohort study. Academic medical center. Participants (N=20) included individuals with chronic hemiparetic stroke (n=10) and a convenience sample of individuals without neurologic or musculoskeletal injury (n=10). Participants with stroke were interfaced with a robotic device that precisely manipulated flexion synergy expression (by regulating shoulder abduction loading) while delivering controlled elbow extension perturbations over a wide range of velocities. This device was also used to elicit elbow flexor stretch reflexes during volitional elbow flexor activation, both in the cohort of individuals with stroke and in a control cohort. In both cases, the amplitude of volitional elbow flexor preactivation was matched to that generated involuntarily during flexion synergy expression. The amplitude of short- and long-latency stretch reflexes in the biceps brachii, assessed by electromyography, and expressed as a function of background muscle activation and stretch velocity. Increased shoulder abduction loading potentiated elbow flexor stretch reflexes via flexion synergy expression in the paretic arm. Compared with stretch reflexes in individuals without neurologic injury, paretic reflexes were larger at rest but were approximately equal to control muscles at matched levels of preactivation. Because flexion synergy expression modifies stretch reflexes in involved muscles, interventions that reduce flexion synergy expression may confer the added benefit of reducing spasticity during functional use of the arm. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Posterior tibial slope impacts intraoperatively measured mid-flexion anteroposterior kinematics during cruciate-retaining total knee arthroplasty.

    Science.gov (United States)

    Dai, Yifei; Cross, Michael B; Angibaud, Laurent D; Hamad, Cyril; Jung, Amaury; Jenny, Jean-Yves

    2018-02-23

    Posterior tibial slope (PTS) for cruciate-retaining (CR) total knee arthroplasty (TKA) is usually pre-determined by the surgeon. Limited information is available comparing different choices of PTS on the kinematics of the CR TKA, independent of the balancing of the extension gap. This study hypothesized that with the same balanced extension gap, the choice of PTS significantly impacts the intraoperatively measured kinematics of CR TKA. Navigated CR TKAs were performed on seven fresh-frozen cadavers with healthy knees and intact posterior cruciate ligament (PCL). A custom designed tibial baseplate was implanted to allow in situ modification of the PTS, which altered the flexion gap but maintained the extension gap. Knee kinematics were measured by performing passive range of motion (ROM) tests from full extension to 120° of flexion on the intact knee and CR TKAs with four different PTSs (1°, 4°, 7°, and 10°). The measured kinematics were compared across test conditions to assess the impact of PTS. With a consistent extension gap, the change of PTS had significant impact on the anteroposterior (AP) kinematics of the CR TKA knees in mid-flexion range (45°-90°), but not so much for the high-flexion range (90°-120°). No considerable impacts were found on internal/external (I/E) rotation and hip-knee-ankle (HKA) angle. However, the findings on the individual basis suggested the impact of PTS on I/E rotation and HKA angle may be patient-specific. The data suggested that the choice of PTS had the greatest impact on the mid-flexion AP translation among the intraoperatively measured kinematics. This impact may be considered while making surgical decisions in the context of AP kinematics. When using a tibial component designed with "center" pivoting PTS, a surgeon may be able to fine tune the PTS to achieve proper mid-flexion AP stability.

  20. Are the Outcomes of Revision Knee Arthroplasty for Flexion Instability the Same as for Other Major Failure Mechanisms?

    Science.gov (United States)

    Rajgopal, Ashok; Panjwani, Taufiq R; Rao, Arun; Dahiya, Vivek

    2017-10-01

    Aseptic loosening, infection, and flexion instability have emerged as the leading etiologies for revision after total knee arthroplasty (TKA). Although studies have reported improved outcomes after revision TKA, the relative functional and clinical outcomes of patients revised for flexion instability and other failure etiologies have not been extensively reported. The aim of the study was to compare the functional and patient-reported outcomes of revision TKA for the common failure etiologies. We retrospectively reviewed records of 228 consecutive cases of revision TKA from 2008 to 2014. Revisions performed for aseptic loosening (n = 53), septic revisions (n = 48), and isolated flexion instability (n = 45) with a minimum of 18 months follow-up were included for analysis. Revision for all other etiologies (n = 82) were excluded. The Modified Knee Society Score (KSS), KSS Function, and Western Ontario and McMaster Universities Osteoarthritis Index were recorded for all cases. A 7-point Likert scale was used to record patient's perception of outcomes after revision surgery and analyzed based on etiology. Although all groups showed improvement in outcome after revision TKA, the changes in Modified KSS and KSS-Function varied according to the etiology of failure of the primary procedure with the smallest improvement being reported by the flexion instability group. Patients undergoing revision for isolated flexion instability have less improvement in functional outcome as compared with other etiologies. We hypothesize this is due to a higher baseline preoperative knee function in the flexion instability group. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Memetics clarification of abnormal behavior

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: Biological medicine is hard to fully and scientifically explain the etiological factor and pathogenesis of abnormal behaviors; while, researches on philosophy and psychology (including memetics) are beneficial to better understand and explain etiological factor and pathogenesis of abnormal behaviors. At present, the theory of philosophy and psychology is to investigate the entity of abnormal behavior based on the views of memetics.METHODS: Abnormal behavior was researched in this study based on three aspects, including instinctive behavior disorder, poorly social-adapted behavior disorder and mental or body disease associated behavior disorder. Most main viewpoints of memetics were derived from "The Meme Machine", which was written by Susan Blackmore. When questions about abnormal behaviors induced by mental and psychological diseases and conduct disorder of teenagers were discussed, some researching achievements which were summarized by authors previously were added in this study, such as aggressive behaviors, pathologically aggressive behaviors, etc.RESULTS: The abnormal behaviors mainly referred to a part of people's substandard behaviors which were not according with the realistic social environment, culture background and the pathologic behaviors resulted from people's various psychological diseases. According to the theory of "meme", it demonstrated that the relevant behavioral obstacles of various psychological diseases, for example, the unusual behavior of schizophrenia, were caused, because the old meme was destroyed thoroughly but the new meme was unable to establish; psychoneurosis and personality disorder were resulted in hard establishment of meme; the behavioral obstacles which were ill-adapted to society, for example, various additional and homosexual behaviors, were because of the selfish replications and imitations of "additional meme" and "homosexual meme"; various instinct behavioral and congenital intelligent obstacles were not significance

  2. Spontaneous Improvement of Compensatory Knee Flexion After Surgical Correction of Mismatch Between Pelvic Incidence and Lumbar Lordosis.

    Science.gov (United States)

    Cheng, Xiaofei; Zhang, Feng; Wu, Jigong; Zhu, Zhenan; Dai, Kerong; Zhao, Jie

    2016-08-15

    A retrospective study. The aim of this study was to investigate the correlation between pelvic incidence (PI) and lumbar lordosis (LL) mismatch and knee flexion during standing in patients with lumbar degenerative diseases and to examine the effects of surgical correction of the PI-LL mismatch on knee flexion. Only several studies focused on knee flexion as a compensatory mechanism of the PI-LL mismatch. Little information is currently available on the effects of lumbar correction on knee flexion in patients with the PI-LL mismatch. A group of patients with lumbar degenerative diseases were divided into PI-LL match group (PI-LL ≤ 10°) and PI-LL mismatch group (PI-LL > 10°). A series of radiographic parameters and knee flexion angle (KFA) were compared between the two groups. The PI-LL mismatch group was further subdivided into operative and nonoperative group. The changes in KFA with PI-LL were examined. The PI-LL mismatch group exhibited significantly greater sagittal vertical axis (SVA), pelvic tilt (PT) and KFA, and smaller LL, thoracic kyphosis (TK), and sacral slope than the PI-LL match group. PI-LL, LL, PI, SVA, and PT were significantly correlated with KFA in the PI-LL mismatch group. From baseline to 6-month follow-up, all variables were significantly different in the operative group with the exception of PI, although there was no significant difference in any variable in the nonoperative group. The magnitude of surgical correction in the PI-LL mismatch was significantly correlated with the degree of spontaneous changes in KFA, PT, and TK. The PI-LL mismatch would contribute to compensatory knee flexion during standing in patients with lumbar degenerative disease. Surgical correction of the PI-LL mismatch could lead to a spontaneous improvement of compensatory knee flexion. The degree of improvement in knee flexion depends in part on the amount of correction in the PI-LL mismatch. 3.

  3. Does rehabilitation of cervical lordosis influence sagittal cervical spine flexion extension kinematics in cervical spondylotic radiculopathy subjects?

    Science.gov (United States)

    Moustafa, Ibrahim Moustafa; Diab, Aliaa Attiah Mohamed; Hegazy, Fatma A; Harrison, Deed E

    2017-01-01

    To test the hypothesis that improvement of cervical lordosis in cervical spondylotic radiculopathy (CSR) will improve cervical spine flexion and extension end range of motion kinematics in a population suffering from CSR. Thirty chronic lower CSR patients with cervical lordosis lordosis (p lordosis in the study group was associated with significant improvement in the translational and rotational motions of the lower cervical spine. This finding provides objective evidence that cervical flexion/extension is partially dependent on the posture and sagittal curve orientation. These findings are in agreement with several other reports in the literature; whereas ours is the first post treatment analysis identifying this relationship.

  4. Múltiplos cornos cutâneos em coxins palmares e plantares de um gato persa Multiple cutaneous horns on the footpads of a persian cat

    Directory of Open Access Journals (Sweden)

    Heloisa Justen Moreira de Souza

    2010-03-01

    Full Text Available Cornos cutâneos são infrequentes em gatos, principalmente em felinos jovens. Neste trabalho, é relatado um caso de um felino da raça Persa, macho, com oito meses de idade e apresentando histórico de espirros. Ao exame clínico, identificaram-se projeções corniformes originadas nos coxins palmares e plantares. A avaliação histológica de biópsia excisional demonstrou hiperqueratose densa, com numerosos queratinócitos sobre epiderme hiperplásica, não sendo identificado nenhum grau de malignidade. Não foi constatada a associação das lesões com a infecção pelo vírus da leucemia felina. O tratamento instituído incluiu excisão parcial mensal dos cornos cutâneos e acompanhamento clínico do animal.Cutaneous horns are seldom seen in cats, especially in young ones. A case of a Persian cat, male, eight months old, with a history of sneezes is described. During physical examination, multiple horns on the all footpads were noticed. The histopathological diagnosis of excisional biopsy was dense hyperkeratosis, with numerous keratinocytes above hyperplastic epidermis and no evidence of malignity. There was no association between the lesions and infection with leukemia virus. The treatment was mensal trimming off the cutaneous horns and clinical follow up of the animal.

  5. ATIVIDADES RECREATIVAS E LÚDICAS: um estudo nas escolas estaduais da cidade de Santa Vitória do Palmar, RS – Brasil

    Directory of Open Access Journals (Sweden)

    Alex Borges Dias

    2017-11-01

    Full Text Available Os processos educativos são fundamentais para a formação de cidadãos mais conscientes de seu papel na construção de uma sociedade mais justa e igualitária. Em um mundo onde as atividades humanas são constantemente aceleradas pelas práticas capitalistas, se torna cada vez mais necessário pensar o papel da educação na formação de novos cidadãos conscientes de sua importância na sociedade. Desse modo, este trabalho teve por objetivo identificar as atividades recreativas e lúdicas que contribuem nos processos educativos dos alunos do 1º ano das escolas estaduais em Santa Vitória do Palmar, RS - Brasil. Na metodologia foi feita uma pesquisa bibliográfica. Para a coleta de dados foram feitas entrevistas com os professores responsáveis pelas turmas do primeiro ano de cada escola e foi utilizado o método de observação não-participante, além do levantamento fotográfico. Identificou-se que todas as escolas estaduais da cidade possuem atividades recreativas e lúdicas que contribuem para os processos educativos dos alunos matriculados.

  6. A restrained-torque-based motion instructor: forearm flexion/extension-driving exoskeleton

    Science.gov (United States)

    Nishimura, Takuya; Nomura, Yoshihiko; Sakamoto, Ryota

    2013-01-01

    When learning complicated movements by ourselves, we encounter such problems as a self-rightness. The self-rightness results in a lack of detail and objectivity, and it may cause to miss essences and even twist the essences. Thus, we sometimes fall into the habits of doing inappropriate motions. To solve these problems or to alleviate the problems as could as possible, we have been developed mechanical man-machine human interfaces to support us learning such motions as cultural gestures and sports form. One of the promising interfaces is a wearable exoskeleton mechanical system. As of the first try, we have made a prototype of a 2-link 1-DOF rotational elbow joint interface that is applied for teaching extension-flexion operations with forearms and have found its potential abilities for teaching the initiating and continuing flection motion of the elbow.

  7. flexion sur l’origine du processus de segmentation du marche du travail

    Directory of Open Access Journals (Sweden)

    Attia Nicole

    2006-01-01

    Full Text Available (francuski Ce travail propose une réflexion sur l'origine du processus de segmentation du marché du travail par rapport à l'entreprise. Se situe-t-elle au sein même de l'entreprise ou en amont, c'est à dire entre les entreprises? Cela revient à se demander si on peut avoir une approche microéconomique ou macroéconomique de la segmentation et, à s'interroger sur le rôle réel tenu par les firmes dans le processus. Déterminant pour la théorie, ce rôle est à repenser selon la réponse apportée à notre question.

  8. Evaluation experimentale et theorique du comportement a la flexion de nouveaux poteaux en materiaux composites

    Science.gov (United States)

    Metiche, Slimane

    La demande croissante en poteaux pour les differents reseaux d'electricite et de telecommunications a rendu necessaire l'utilisation de materiaux innovants, qui preservent l'environnement. La majorite des poteaux electriques existants au Canada ainsi qu'a travers le monde, sont fabriques a partir de materiaux traditionnels tel que le bois, le beton ou l'acier. Les motivations des industriels et des chercheurs a penser a d'autres solutions sont diverses, citons entre autre: La limitation en longueur des poteaux en bois ainsi que la vulnerabilite des poteaux fabriques en beton ou en acier aux agressions climatiques. Les nouveaux poteaux en materiaux composites se presentent comme de bons candidats a cet effet, cependant; leur comportement structural n'est pas connu et des etudes theoriques et experimentales approfondies sont necessaires avant leur mise en marche a grande echelle. Un programme de recherche intensif comportant plusieurs projets experimentaux, analytiques et numeriques est en cours a l'Universite de Sherbrooke afin d'evaluer le comportement a court et a long termes de ces nouveaux poteaux en Polymeres Renforces de Fibres (PRF). C'est dans ce contexte que s'inscrit la presente these, et notre recherche vise a evaluer le comportement a la flexion de nouveaux poteaux tubulaires coniques fabriques en materiaux composites par enroulement filamentaire et ce, a travers une etude theorique, ainsi qu'a travers une serie d'essais de flexion en "grandeur reelle" afin de comprendre le comportement structural de ces poteaux, d'optimiser la conception et de proposer une procedure de dimensionnement pour les utilisateurs. Les poteaux en Polymeres Renforces de Fibres (PRF) etudies dans cette these sont fabriques avec une resine epoxyde renforcee de fibres de verre type E. Chaque type poteaux est constitue principalement de trois zones ou les proprietes geometriques (epaisseur, diametre) et les proprietes mecaniques sont differentes d'une zone a l'autre. La difference

  9. Quasi-stiffness of the knee joint in flexion and extension during the golf swing.

    Science.gov (United States)

    Choi, Ahnryul; Sim, Taeyong; Mun, Joung Hwan

    2015-01-01

    Biomechanical understanding of the knee joint during a golf swing is essential to improve performance and prevent injury. In this study, we quantified the flexion/extension angle and moment as the primary knee movement, and evaluated quasi-stiffness represented by moment-angle coupling in the knee joint. Eighteen skilled and 23 unskilled golfers participated in this study. Six infrared cameras and two force platforms were used to record a swing motion. The anatomical angle and moment were calculated from kinematic and kinetic models, and quasi-stiffness of the knee joint was determined as an instantaneous slope of moment-angle curves. The lead knee of the skilled group had decreased resistance duration compared with the unskilled group (P golf swing and developing rehabilitation strategies following surgery.

  10. Bethlem myopathy: An autosomal dominant myopathy with flexion contractures, keloids, and follicular hyperkeratosis.

    Science.gov (United States)

    Saroja, Aralikatte Onkarappa; Naik, Karkal Ravishankar; Nalini, Atcharayam; Gayathri, Narayanappa

    2013-10-01

    Bethlem myopathy and Ullrich congenital muscular dystrophy form a spectrum of collagenopathies caused by genetic mutations encoding for any of the three subunits of collagen VI. Bethlem phenotype is relatively benign and is characterized by proximal dominant myopathy, keloids, contractures, distal hyperextensibility, and follicular hyperkeratosis. Three patients from a single family were diagnosed to have Bethlem myopathy based on European Neuromuscular Centre Bethlem Consortium criteria. Affected father and his both sons had slowly progressive proximal dominant weakness and recurrent falls from the first decade. Both children aged 18 and 20 years were ambulant at presentation. All had flexion contractures, keloids, and follicular hyperkeratosis without muscle hypertrophy. Creatinine kinase was mildly elevated and electromyography revealed myopathic features. Muscle imaging revealed severe involvement of glutei and vasti with "central shadow" in rectus femoris. Muscle biopsy in the father showed dystrophic changes with normal immmunostaining for collagen VI, sarcoglycans, and dysferlin.

  11. Bethlem myopathy: An autosomal dominant myopathy with flexion contractures, keloids, and follicular hyperkeratosis

    Directory of Open Access Journals (Sweden)

    Aralikatte Onkarappa Saroja

    2013-01-01

    Full Text Available Bethlem myopathy and Ullrich congenital muscular dystrophy form a spectrum of collagenopathies caused by genetic mutations encoding for any of the three subunits of collagen VI. Bethlem phenotype is relatively benign and is characterized by proximal dominant myopathy, keloids, contractures, distal hyperextensibility, and follicular hyperkeratosis. Three patients from a single family were diagnosed to have Bethlem myopathy based on European Neuromuscular Centre Bethlem Consortium criteria. Affected father and his both sons had slowly progressive proximal dominant weakness and recurrent falls from the first decade. Both children aged 18 and 20 years were ambulant at presentation. All had flexion contractures, keloids, and follicular hyperkeratosis without muscle hypertrophy. Creatinine kinase was mildly elevated and electromyography revealed myopathic features. Muscle imaging revealed severe involvement of glutei and vasti with "central shadow" in rectus femoris. Muscle biopsy in the father showed dystrophic changes with normal immmunostaining for collagen VI, sarcoglycans, and dysferlin.

  12. Mechanical Simulation of the Extension and Flexion of the Elbow Joint in Rehabilitation

    Directory of Open Access Journals (Sweden)

    Iman Vahdat

    2013-01-01

    Full Text Available Objective: The goal of the present study was to improve the extension and flexion of the elbow joint for rehabilitation purposes, in terms of energy dissipation and of injuries caused by stress imposed on connective tissue by exercise equipments during force transfer , by investigation of viscoelastic property variations during change in speed of motion. Materials & Methods: A sample of five men without any previous neuromuscular impairment of the elbow joint was chosen by the BMI factor. The passive continuous motion test (CPM was performed by the CYBEX isokinetic system in the extension and flexion movements of the elbow joint of the left hand, at 4 different speeds (15, 45, 75 and120 Deg/s during 5 consecutive cycles at the range of motion of about 0 to 130 degrees. The experimental data was exported to the MATLAB software for analysis. In order to determine viscoelastic property effects and biomechanical parameters, we used a passive viscoelastic mechanical model constructed by 3 elements for simulation, and also we used the curve fitting method to derive the elastic and viscose coefficients for the model.,. Results: Results of experiments showed that by increasing the speed of motion, the value of work done, hysteresis and elastic coefficient increased and the value of viscose coefficient decreased. Also, it appeared that by increasing the speed of motion, the effect of viscose resistance on the passive torque curves increased. In addition, there was significant correlation between the action of the mechanical model and the action of the concerned limbs, during the movement. Conclusion: It was concluded that in order to improve motion and to reduce imposed risks and injuries to joints and limbs, rehabilitation exercises better be performed at lower speeds and with rehabilitation equipments supported by viscoelastic resistant force.

  13. Comparison of tibiofemoral joint space width measurements from standing CT and fixed flexion radiography.

    Science.gov (United States)

    Segal, Neil A; Frick, Eric; Duryea, Jeffrey; Nevitt, Michael C; Niu, Jingbo; Torner, James C; Felson, David T; Anderson, Donald D

    2017-07-01

    The objective of this project was to determine the relationship between medial tibiofemoral joint space width measured on fixed-flexion radiographs and the three-dimensional joint space width distribution on low-dose, standing CT (SCT) imaging. At the 84-month visit of the Multicenter Osteoarthritis Study, 20 participants were recruited. A commercial SCT scanner for the foot and ankle was modified to image knees while standing. Medial tibiofemoral joint space width was assessed on radiographs at fixed locations from 15% to 30% of compartment width using validated software and on SCT by mapping the distances between three-dimensional subchondral bone surfaces. Individual joint space width values from radiographs were compared with three-dimensional joint space width values from corresponding sagittal plane locations using paired t-tests and correlation coefficients. For the four medial-most tibiofemoral locations, radiographic joint space width values exceeded the minimal joint space width on SCT by a mean of 2.0 mm and were approximately equal to the 61st percentile value of the joint space width distribution at each respective sagittal-plane location. Correlation coefficients at these locations were 0.91-0.97 and the offsets between joint space width values from radiographs and SCT measurements were consistent. There were greater offsets and variability in the offsets between modalities closer to the tibial spine. Joint space width measurements on fixed-flexion radiographs are highly correlated with three-dimensional joint space width from SCT. In addition to avoiding bony overlap obscuring the joint, a limitation of radiographs, the current study supports a role for SCT in the evaluation of tibiofemoral OA. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1388-1395, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  14. The flexion synergy, mother of all synergies and father of new models of gait

    Directory of Open Access Journals (Sweden)

    Jacques eDuysens

    2013-03-01

    Full Text Available Recently there has been a growing interest in the modular organization of leg movements, in particular those related to locomotion. One of the basic modules involves the flexion of the leg during swing and it was shown that this module is already present in neonates (Dominici, et al. 2011. In this paper, we question how these finding build upon the original work by Sherrington, who proposed that the flexor reflex is the basic building block of the flexion during swing phase. Similarly, the relation between the flexor reflex and the withdrawal reflex modules of Schouenborg et al. (1994 will be discussed. It will be argued that there is large overlap between these notions on modules and the older concepts of reflexes. In addition, it will be shown that there is a great flexibility in the expression of some of these modules during gait, thereby allowing for a phase-dependent modulation of the appropriate responses. In particular, the end of the stance phase is a period when the flexor synergy is facilitated. It is proposed that this is linked to the activation of circuitry that is responsible for the generation of locomotor patterns (CPG, central pattern generator. More specifically, it is suggested that the responses in that period relate to the activation of a flexor burst generator. The latter structure forms the core of a new asymmetric model of the CPG. This activation is controlled by afferent input (facilitation by a broad range of afferents, suppression by load afferent input. Meanwhile, many of these physiologic features have found their way in the control of very flexible walking bipedal robots.

  15. Abnormal Cervical Cancer Screening Test Results

    Science.gov (United States)

    ... AQ FREQUENTLY ASKED QUESTIONS FAQ187 GYNECOLOGIC PROBLEMS Abnormal Cervical Cancer Screening Test Results • What is cervical cancer screening? • What causes abnormal cervical cancer screening test ...

  16. Gender differences in tibio-femoral kinematics and quadriceps muscle force during weight-bearing knee flexion in vitro.

    Science.gov (United States)

    Wünschel, Markus; Wülker, Nikolaus; Müller, Otto

    2013-11-01

    Females have a higher risk in terms of anterior cruciate ligament injuries during sports than males. Reasons for this fact may be different anatomy and muscle recruitment patterns leading to less protection for the cruciate- and collateral-ligaments. This in vitro study aims to evaluate gender differences in knee joint kinematics and muscle force during weight-bearing knee flexions. Thirty-four human knee specimens (17 females/17 males) were mounted on a dynamic knee simulator. Weight-bearing single-leg knee flexions were performed with different amounts of simulated body weight (BW). Gender-specific kinematics was measured with an ultrasonic motion capture system and different loading conditions were examined. Knee joint kinematics did not show significant differences regarding anteroposterior and medial-lateral movement as well as tibial varus-valgus and internal-external rotation. This applied to all simulated amounts of BW. Simulating 100 N BW in contrast to AF50 led to a significant higher quadriceps overall force in female knees from 45° to 85° of flexion in contrast to BW 50 N. In these female specimens, the quadriceps overall force was about 20 % higher than in male knees being constant in higher flexion angles. It is indicated by our results that in a squatting movement females compared with males produce higher muscle forces, suggesting an increased demand for muscular stabilization, whereas tibio-femoral kinematics was similar for both genders.

  17. Can total knee arthroplasty (TKA) achieve its goal in knee flexion floor activity of Thai Buddhist monks?

    Science.gov (United States)

    Sresuriyasawad, Viriya

    2012-10-01

    To study knee's angulation required for Thai Buddhist monks whose activity based on floor sitting basis. And to identify an inter-observer reliability of knee flexion measurement based on radiologic reading. Descriptive analysis study comprised of measuring bilateral knee flexing angulation in 4 postures of floor activities; kneeling, monk's position in both right and left manner and sit cross-legged position, in 35 Thai Buddhist monks at Priest Hospital using plain radiograph image. The radiograph imaging for each patient was performed by one radiologist and two orthopedics. The measurement result was also analyzed for inter-observer reliability. Mean knee flexion angle in kneel, left monk's position, right monk's position and sit cross-legged postures were 163.21, 146.49, 148.89 and 138.38 degree, respectively. No statistical difference between knee flexion measurements among 3 investigators. Daily floor activity of Thai Buddhist monks need more flexion capacity than that can achieve by total knee arthroplasty instrument using nowadays.

  18. In-situ mechanical behavior and slackness of the anterior cruciate ligament at multiple knee flexion angles

    NARCIS (Netherlands)

    Rachmat, H.H.; Janssen, D.W.; Verkerke, G.J.; Diercks, R.L.; Verdonschot, N.J.J.

    2016-01-01

    In this study the in-situ tensile behavior and slackness of the anterior cruciate ligament (ACL) was evaluated at various knee flexion angles. In four cadaveric knees the ACL was released at the tibial insertion, after which it was re-connected to a tensiometer. After pre-tensioning (10 N) the ACL

  19. Variability of Measurement of Patellofemoral Indices with Knee Flexion and Quadriceps Contraction: An MRI-Based Anatomical Study

    Science.gov (United States)

    Laugharne, Edward; Bali, Navi; Purushothamdas, Sanjay; Almallah, Faris; Kundra, Rik

    2016-01-01

    Purpose The purpose of this study was to investigate the impact of varying knee flexion and quadriceps activity on patellofemoral indices measured on magnetic resonance imaging (MRI). Materials and Methods MRI of the knee was performed in 20 patients for indications other than patellar or patellofemoral pathology. Axial and sagittal sequences were performed in full extension of the knee with the quadriceps relaxed, full extension of the knee with the quadriceps contracted, 30° flexion of the knee with the quadriceps relaxed, and 30° flexion with the quadriceps contracted. Bisect offset, patella tilt angle, Insall-Salvati ratio and Caton-Deschamps index were measured. Results With the knee flexed to 30° and quadriceps relaxed, the mean values of patellar tilt angle, bisect offset, Insall-Salvati ratio and Caton-Deschamps index were all within normal limits. With the knee extended and quadriceps contracted, the mean patellar tilt angle (normal value, patellofemoral indices. MRI taken with the knee in 30° of flexion allows more reliable assessment of the patellofemoral joint and minimises the confounding effect of quadriceps contraction. PMID:27894177

  20. Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study

    NARCIS (Netherlands)

    Ariens, G.A.M.; Bongers, P.M.; Douwes, M.; Miedema, M.C.; Hoogendoorn, W.E.; van der Wal, G.; Bouter, L.M.; van Mechelen, W.

    2001-01-01

    Objective: To study the relation between neck pain and work related neck flexion, neck rotation, and sitting. Methods: A prospective cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies. Work related physical load was assessed by analysing objectively measured

  1. Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? : Results of a prospective cohort study

    NARCIS (Netherlands)

    Ariëns, G A; Bongers, P M; Douwes, M; Miedema, M C; Hoogendoorn, W E; van der Wal, G; Bouter, L M; van Mechelen, W

    OBJECTIVE: To study the relation between neck pain and work related neck flexion, neck rotation, and sitting. METHODS: A prospective cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies. Work related physical load was assessed by analysing objectively measured

  2. Lentiginosis, Deafness and Cardiac Abnormalities*

    African Journals Online (AJOL)

    1973-01-06

    Jan 6, 1973 ... His height. mass. intelligence and genitalia were normal. The aSSOCiatIOn between deafness and disturbance of cardiac conduction and between pigmented skin lesions and cardiac abnormalities, has been well described. Should. ~I patient present with multiple lentigines and/or familial sensineural ...

  3. Cardiac abnormalities after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart

  4. Chromosomal Abnormalities Associated With Omphalocele

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2007-03-01

    Full Text Available Fetuses with omphalocele have an increased risk for chromosomal abnormalities. The risk varies with maternal age, gestational age at diagnosis, association with umbilical cord cysts, complexity of associated anomalies, and the contents of omphalocele. There is considerable evidence that genetics contributes to the etiology of omphalocele. This article provides an overview of chromosomal abnormalities associated with omphalocele and a comprehensive review of associated full aneuploidy such as trisomy 18, trisomy 13, triploidy, trisomy 21, 45,X, 47,XXY, and 47,XXX, partial aneuploidy such as dup(3q, dup(11p, inv(11, dup(1q, del(1q, dup(4q, dup(5p, dup(6q, del(9p, dup(15q, dup(17q, Pallister-Killian syndrome with mosaic tetrasomy 12p and Miller-Dieker lissencephaly syndrome with deletion of 17p13.3, and uniparental disomy (UPD such as UPD 11 and UPD 14. Omphalocele is a prominent marker for chromosomal abnormalities. Perinatal identification of omphalocele should alert chromosomal abnormalities and familial unbalanced translocations, and prompt thorough cytogenetic investigations and genetic counseling.

  5. Admission haematological abnormalities and postoperative ...

    African Journals Online (AJOL)

    Admission haematological abnormalities and postoperative outcomes in neonates with acute surgical conditions in Alexandria, Egypt. HL Wella, SMM Farahat. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals ...

  6. Association of bone scintigraphic abnormalities with knee malalignment and pain.

    Science.gov (United States)

    Kraus, V B; McDaniel, G; Worrell, T W; Feng, S; Vail, T P; Varju, G; Coleman, R E

    2009-11-01

    The information content of knee bone scintigraphy was evaluated, including pattern, localisation and intensity of retention relative to radiographic features of knee osteoarthritis, knee alignment and knee symptoms. A total of 308 knees (159 subjects) with symptomatic and radiographic knee osteoarthritis of at least one knee was assessed by late-phase (99m)Technetium methylene disphosphonate bone scintigraph, fixed-flexion knee radiograph, full limb radiograph for knee alignment and for self-reported knee symptom severity. Generalised linear models were used to control for within-subject correlation of knee data. The compartmental localisation (medial vs lateral) and intensity of knee bone scan retention were associated with the pattern (varus vs valgus) (p<0.001) and severity (p<0.001) of knee malalignment and localisation and severity of radiographic osteoarthritis (p<0.001). Bone scan agent retention in the tibiofemoral, but not patellofemoral, compartment was associated with severity of knee symptoms (p<0.001) and persisted after adjusting for radiographic osteoarthritis (p<0.001). To the authors' knowledge, this is the first study describing a relationship between knee malalignment, joint symptom severity and compartment-specific abnormalities by bone scintigraphy. This work demonstrates that bone scintigraphy is a sensitive and quantitative indicator of symptomatic knee osteoarthritis. Used selectively, bone scintigraphy is a dynamic imaging modality that holds great promise as a clinical trial screening tool and outcome measure.

  7. Posterior cruciate ligament recruitment affects antero-posterior translation during flexion gap distraction in total knee replacement. An intraoperative study involving 50 patients.

    NARCIS (Netherlands)

    Heesterbeek, P.J.C.; Keijsers, N.; Jacobs, W.; Verdonschot, N.J.J.; Wymenga, A.B.

    2010-01-01

    BACKGROUND AND PURPOSE: Because of the oblique orientation of the posterior cruciate ligament (PCL), flexion gap distraction could lead to anterior movement of the tibia, which would influence the tibiofemoral contact point. This would affect the kinematics of the TKR. We assessed the flexion gap

  8. Serial casting versus stretching technique to treat knee flexion contracture in children with spina bifida: a comparative study.

    Science.gov (United States)

    Al-Oraibi, S; Tariah, Hashem Abu; Alanazi, Abdullah

    2013-01-01

    Severe knee contractures that develop soon after muscle imbalance may not improve with stretching exercises and splinting. An alternative treatment is serial casting, which has been used to promote increased range of motion. The purpose of this study was to compare the effectiveness of using serial casting and passive stretching approaches to treat knee flexion contracture in children with spina bifida. In a pre/post randomized controlled study, ten participants were included in the serial casting group, while eight participants were included in the passive stretching intervention group. The degree of knee extension was measured at baseline, immediately after intervention, and at a one-year follow-up using a standard goniometer. Both groups showed significant improvements in the degree of flexion contracture at the post-treatment evaluation and the follow-up evaluation. The serial casting group showed significant improvements in knee flexion contracture at the post-treatment evaluation, t (9)=13.4, p casting group compared with passive stretching group in relation to the degree of flexion contracture were found at the immediate post-treatment evaluation, F(1, 15)=246, p=0.0001, and the one-year follow-up evaluation, F (1, 15)=51.5, p=0.0001. The outcomes of this study provide the first evidence that serial casting may be a useful intervention in treating knee flexion contracture in children with spina bifida. However, further investigations into serial casting, as well as investigations into the use of serial casting with other interventions, are warranted.

  9. Quengel Casting for the Management of Pediatric Knee Flexion Contractures: A 26-Year Single Institution Experience.

    Science.gov (United States)

    Wiley, Marcel R; Riccio, Anthony I; Felton, Kevin; Rodgers, Jennifer A; Wimberly, Robert L; Johnston, Charles E

    Quengel casting was introduced in 1922 for nonsurgical treatment of knee flexion contractures (KFC) associated with hemophilic arthropathy. It consists of an extension-desubluxation hinge fixed to a cast allowing for gradual correction of a flexion deformity while preventing posterior tibial subluxation. The purpose of this study is to report 1 center's experience with this technique for the treatment of pediatric KFC. A retrospective review was conducted over a 26-year period. All patients with KFC treated with Quengel casting were included. Demographic data, associated medical conditions, adjunctive soft tissue releases, complications, and the need for late surgical intervention were recorded. Tibiofemoral angle measurements in maximal extension were recorded at initiation and termination of casting, 1-year follow-up, and final follow-up. Success was defined as no symptomatic recurrence of KFC or need for subsequent surgery. Eighteen patients (26 knees) were treated for KFC with Quengel casting. Average age at initiation of casting was 8.1 years with average follow-up of 59.9 months. Fifteen knees (58%) underwent soft tissue releases before casting. An average of 1.5 casts per knee were applied over an average of 23.9 days. Average KFC before casting was 50.6 degrees (range, 15 to 100 degrees) which improved to 5.96 degrees (0 to 40 degrees) at cast removal (Pcasting before 1 year. Of these, 11 knees (50%) had a successful outcome. Residual KFC of those treated successfully was 6.8 degrees (range, 0 to 30 degrees) at 1 year and 8.2 degrees (range, 0 to 30 degrees) at final follow-up, averaging 71.4 months (P=0.81). Of the 11 knees deemed failures, all had recurrence of deformity within an average of 1 year from cast removal. Surgical release before Quengel casting did not improve the chances for success (P=0.09). Quengel casting can improve pediatric KFC an average of 44.2 degrees with minimal complications. Although 50% of treated patients will demonstrate

  10. Limb flexion-induced axial compression and bending in human femoropopliteal artery segments.

    Science.gov (United States)

    Poulson, William; Kamenskiy, Alexey; Seas, Andreas; Deegan, Paul; Lomneth, Carol; MacTaggart, Jason

    2018-02-01

    High failure rates of femoropopliteal artery (FPA) interventions are often attributed in part to severe mechanical deformations that occur with limb movement. Axial compression and bending of the FPA likely play significant roles in FPA disease development and reconstruction failure, but these deformations are poorly characterized. The goal of this study was to quantify axial compression and bending of human FPAs that are placed in positions commonly assumed during the normal course of daily activities. Retrievable nitinol markers were deployed using a custom-made catheter system into 28 in situ FPAs of 14 human cadavers. Contrast-enhanced, thin-section computed tomography images were acquired with each limb in the standing (180 degrees), walking (110 degrees), sitting (90 degrees), and gardening (60 degrees) postures. Image segmentation and analysis allowed relative comparison of spatial locations of each intra-arterial marker to determine axial compression and bending using the arterial centerlines. Axial compression in the popliteal artery (PA) was greater than in the proximal superficial femoral artery (SFA) or the adductor hiatus (AH) segments in all postures (P = .02). Average compression in the SFA, AH, and PA ranged from 9% to 15%, 11% to 19%, and 13% to 25%, respectively. The FPA experienced significantly more acute bending in the AH and PA segments compared with the proximal SFA (P < .05) in all postures. In the walking, sitting, and gardening postures, average sphere radii in the SFA, AH, and PA ranged from 21 to 27 mm, 10 to 18 mm, and 8 to 19 mm, whereas bending angles ranged from 150 to 157 degrees, 136 to 147 degrees, and 137 to 148 degrees, respectively. The FPA experiences significant axial compression and bending during limb flexion that occur at even modest limb angles. Moreover, different segments of the FPA appear to undergo significantly different degrees of deformation. Understanding the effects of limb flexion on axial compression and

  11. An observer-blinded randomized controlled pilot trial comparing localized immersion psoralen-ultraviolet A with localized narrowband ultraviolet B for the treatment of palmar hand eczema.

    Science.gov (United States)

    Brass, D; Fouweather, T; Stocken, D D; Macdonald, C; Wilkinson, J; Lloyd, J; Farr, P M; Reynolds, N J; Hampton, P J

    2017-12-13

    Hand eczema is a common inflammatory dermatosis that causes significant patient morbidity. Previous studies comparing psoralen-ultraviolet A (PUVA) with narrowband ultraviolet B (NB-UVB) have been small, nonrandomized and retrospective. To conduct an observer-blinded randomized controlled pilot study using validated scoring criteria to compare immersion PUVA with NB-UVB for the treatment of chronic hand eczema unresponsive to topical steroids. Sixty patients with hand eczema unresponsive to clobetasol propionate 0·05% were randomized to receive either immersion PUVA or NB-UVB twice weekly for 12 weeks with assessments at intervals of 4 weeks. The primary outcome measure was the proportion of patients achieving 'clear' or 'almost clear' Physician's Global Assessment (PGA) response at 12 weeks. Secondary outcome measures included assessment of the modified Total Lesion and Symptom Score (mTLSS) and the Dermatology Life Quality index (DLQI). In both treatment arms, 23 patients completed the 12-week assessment for the primary outcome measure. In the PUVA group, five patients achieved 'clear' and eight 'almost clear' [intention-to-treat (ITT) response rate 43%]. In the NB-UVB group, two achieved 'clear' and five 'almost clear' (ITT response rate 23%). For the secondary outcomes, median mTLSS scores were similar between groups at baseline (PUVA 9·5, NB-UVB 9) and at 12 weeks (PUVA 3, NB-UVB 4). Changes in DLQI were similar, with improvements in both groups. In this randomized pilot trial recruitment was challenging. After randomization, there were acceptable levels of compliance and safety in each treatment schedule, but lower levels of retention. Using validated scoring systems - PGA, mTLSS and DLQI - as measures of treatment response, the trial demonstrated that both PUVA and NB-UVB reduced the severity of chronic palmar hand eczema. © 2017 British Association of Dermatologists.

  12. REESTRUTURAÇÃO NO PROJETO EDUCAÇÃO PATRIMONIAL EM ESCOLAS MUNICIPAIS DE SANTA VITÓRIA DO PALMAR, RS – BRASIL

    Directory of Open Access Journals (Sweden)

    Viviane Rocha Teixeira

    2016-12-01

    Full Text Available O presente trabalho surgiu de uma nova análise que foi feita através de observação participante dos membros do grupo PET (Programa de Educação Tutorial Turismo. Identificou-se a necessidade de uma reestruturação no projeto Educação Patrimonial para adequar-se melhor ao perfil das crianças. Assim, como principais resultados, diminuiu-se o número de encontros visando otimizar o tempo e foi realizada algumas modificações como o aumento do tempo de realização de atividades que favorecem a interação entre estudantes. O objetivo deste trabalho é descrever como se efetuou a reestruturação no projeto Educação Patrimonial em escolas municipais de Santa Vitória do Palmar, RS – Brasil. O projeto, que tem como sujeitos crianças do 5º ano, propõem-se a sensibilizá-las e que essas multipliquem os conhecimentos construídos com os adultos (familiares, vizinhos, amigos, entre outros. Acredita-se que pode contribuir, também, em relação ao incremento do turismo histórico-cultural e de lazer na cidade. Para a coleta de dados foi utilizado o método de observação participante e uma pesquisa bibliográfica em trabalhos do próprio Grupo PET. Na análise dos resultados encontra-se a descrição detalhada da reestrputuração do projeto e a justificativa da modificação da estrutura. Palavras-chave: Patrimônio.  Turismo.  Reestruturação.

  13. Frecuencia del alelo causante de la enfermedad de Charcot-Marie-Tooth (tipo axonal con herencia autosómica recesiva en Palmares, Costa Rica

    Directory of Open Access Journals (Sweden)

    Melissa Rojas-Araya

    2009-11-01

    Full Text Available La enfermedad de Charcot-Marie-Tooth constituye elgrupo de neuropatías periféricas hereditarias más común a nivel mundial. Una familia con 18 afectados del cantón de Palmares (Alajuela, Costa Rica con una neuropatía de tipo axonal y herencia autosómica recesiva, permitió localizar el gen responsable en la región 19q13.33. Posteriormente se identificó la mutación causante en el gen MED25. El presente estudio determinó la frecuencia del alelo mutante, así como la distribución geográfica de este alelo. En una muestra al azar de 103 individuos se encontraron seis individuos heteroigotas para la mutación, distribuidos por todo el cantón. No se encontró ninguna persona en estado homocigota para este alelo. No hallamos algunacaracterística clínica que difiera significativamente entre los individuos homocigotos silvestres y los heterocigotos para la mutación. El 5.83% de la población es heterocigota y la frecuencia del alelo Ala335Val es de 0.029, seis veces mayor que en una muestra de toda la población costarricense. Por esta razón se recomienda un análisis molecular de portadores con el fin de alertar sobre la posibilidad de aparición de más casos en el cantón.

  14. Factores bióticos y abióticos que determinan la seroprevalencia de anticuerpos contra Trypanosoma Cruzi en el municipio de Palmar de Bravo, Puebla, México Biotic and abiotic determinants of seroprevalence of antibodies against Trypanosoma cruzi in Palmar de Bravo, Puebla, Mexico

    Directory of Open Access Journals (Sweden)

    Francisca Sosa-Jurado

    2004-02-01

    Full Text Available OBJETIVO: Determinar la prevalencia de anticuerpos contra Trypanosoma cruzi y su relación con los factores bióticos y abióticos en Palmar de Bravo, Puebla, México. MATERIAL Y MÉTODOS: Estudio transversal efectuado en agosto de 2000 a septiembre de 2001, con una muestra aleatoria simple de 390 voluntarios residentes en Palmar de Bravo, Puebla, México. Se hizo determinación de anticuerpos contra T cruzi con técnicas serológicas validadas, búsqueda del vector y de reservorios domésticos, así como determinación de asociación entre caso positivo y factores de riesgo bióticos y abióticos. El análisis estadístico consistió en índice Kappa para las pruebas diagnósticas, empleando tabla de contingencia de 2 x 2; ji cuadrada corregida de Yates, exacta de Fisher y la razón de posibilidad para estimar la significancia de la asociación de factores bióticos y abióticos. RESULTADOS: La seroprevalencia fue de 4% en la población humana estudiada y de los reservorios (equinos, porcinos y caninos, sólo 10% de los caninos resultaron reactivos. Los vectores identificados fueron T barberi y T pallidipennis, con índice de dispersión e índice de colonización de 55 y 40%, respectivamente. Los factores de riesgo más importantes fueron la altitud (>2 150 y OBJECTIVE: To establish the relationship between seroprevalence for antibodies against Trypanosoma cruzi and its relationship with biotic and abiotic factors. MATERIAL AND METHODS: A cross-sectional study was conducted between August 2000 and September 2001. The study population consisted of a simple random sample of 390 volunteers residing in Palmar de Bravo, Puebla, Mexico. Sample and data collection procedures included assaying antibodies against T cruzi with validated assays, and searching for domestic reservoirs and triatomine bugs. The relationship between biotic and abiotic factors with seropositivity was assessed. Statistical analysis was conducted using Kappa values for

  15. Analysis of right anterolateral impacts: the effect of trunk flexion on the cervical muscle whiplash response

    Directory of Open Access Journals (Sweden)

    Narayan Yogesh

    2006-05-01

    Full Text Available Abstract Background The cervical muscles are considered a potential site of whiplash injury, and there is a need to understand the cervical muscle response under non-conventional whiplash impact scenarios, including variable body position and impact direction. There is no data, however, on the effect of occupant position on the muscle response to frontal impacts. Therefore, the objective of the study was to measure cervical muscle response to graded right anterolateral impacts. Methods Twenty volunteers were subjected to right anterolateral impacts of 4.3, 7.8, 10.6, and 12.8 m/s2 acceleration with their trunk flexed forward 45 degrees and laterally flexed right or left by 45 degrees. Bilateral EMG of the sternocleidomastoids, trapezii, and splenii capitis and acceleration of the sled, torso, and head were measured. Results and discussion With either direction of trunk flexion at impact, the trapezius EMGs increased with increasing acceleration (p Conclusion When the subject sits with trunk flexed out of neutral posture at the time of anterolateral impact, the cervical muscle response is dramatically reduced compared to frontal impacts with the trunk in neutral posture. In the absence of bodily impact, the flexed trunk posture appears to produce a biomechanical response that would decrease the likelihood of cervical muscle injury in low velocity impacts.

  16. Serial elongation derotation flexion (EDF) casting for patients with infantile and juvenile scoliosis.

    Science.gov (United States)

    Canavese, Federico; Rousset, Marie; Mansour, Mounira; Samba, Antoine; Dimeglio, Alain

    2016-02-01

    Infantile and juvenile scoliosis, among different types of spinal deformity, is still a challenge for pediatric orthopedic surgeons. The ideal treatment of infantile and juvenile scoliosis has not yet been identified as both clinicians and surgeons still face multiple challenges, including preservation of the thoracic spine, thoracic cage, lung growth and cardiac function without reducing spinal motion. Elongation, derotation, flexion (EDF) casting technique is a custom-made thoracolumbar cast based on a three dimensional correction concept. This cast offers three-dimensional correction and can control the evolution of the deformity in some cases. Spinal growth can be guided by EDF casting as it can influence the initially curved spine to grow straighter. This article aimed to provide a comprehensive review of how infantile and juvenile scoliosis can affect normal spine and thorax and how these deformities can be treated with serial EDF casting technique. A current literature review is mandatory in order to understand the principles of the serial EDF casting technique and the effectiveness of conservative treatment in young and very young patients.

  17. Serial elongation-derotation-flexion casting for children with early-onset scoliosis.

    Science.gov (United States)

    Canavese, Federico; Samba, Antoine; Dimeglio, Alain; Mansour, Mounira; Rousset, Marie

    2015-12-18

    Various early-onset spinal deformities, particularly infantile and juvenile scoliosis (JS), still pose challenges to pediatric orthopedic surgeons. The ideal treatment of these deformities has yet to emerge, as both clinicians and surgeons still face multiple challenges including preservation of thoracic motion, spine and cage, and protection of cardiac and lung growth and function. Elongation-derotation-flexion (EDF) casting is a technique that uses a custom-made thoracolumbar cast based on a three-dimensional correction concept. EDF can control progression of the deformity and - in some cases-coax the initially-curved spine to grow straighter by acting simultaneously in the frontal, sagittal and coronal planes. Here we provide a comprehensive review of how infantile and JS can affect normal spine and thorax and how serial EDF casting can be used to manage these spinal deformities. A fresh review of the literature helps fully understand the principles of the serial EDF casting technique and the effectiveness of conservative treatment in patients with early-onset spinal deformities, particularly infantile and juvenile scolisois.

  18. Immediate effects of the toe spreader on the tonic toe flexion reflex.

    Science.gov (United States)

    de Saca, L R; Catlin, P A; Segal, R L

    1994-06-01

    The purpose of the study was to determine whether the use of a toe spreader to inhibit the tonic toe flexion reflex (TTFR) immediately alters temporal-distance gait characteristics, plantar surface contact, or muscle activity in the limb exhibiting the TTFR of subjects with hemiparesis secondary to supraspinal lesion. Eighteen adults with hemiparesis secondary to supraspinal lesions served as subjects for the standing portion of the study. Sixteen of the subjects participated in the gait portion of the study. The study was a randomized, within-subject, between-conditions comparison consisting of standing and gait phases, with four conditions for each phase (shoe off, toe spreader off/on, shoe on, toe spreader off/on). Measures performed were ink footprint gait analysis and integrated electromyography from the limb exhibiting the TTFR. Presence of the TTFR was reduced significantly with the use of the toe spreader. Velocity and cadence were increased significantly by use of the toe spreader. The toe spreader may be a useful treatment option for improving gait. The clinical significance of these findings, however, will depend on the functional context of toe-spreader use.

  19. 3D Analysis of the Proximal Interphalangeal Joint Kinematics during Flexion

    Directory of Open Access Journals (Sweden)

    Florian Hess

    2013-01-01

    Full Text Available Background. Dynamic joint motion recording combined with CT-based 3D bone and joint surface data is accepted as a helpful and precise tool to analyse joint. The purpose of this study is to demonstrate the feasibility of these techniques for quantitative motion analysis of the interphalangeal joint in 3D. Materials and Method. High resolution motion data was combined with an accurate 3D model of a cadaveric index finger. Three light-emitting diodes (LEDs were used to record dynamic data, and a CT scan of the finger was done for 3D joint surface geometry. The data allowed performing quantitative evaluations such as finite helical axis (FHA analysis, coordinate system optimization, and measurement of the joint distances in 3D. Results. The FHA varies by 4.9±1.7° on average. On average, the rotation in adduction/abduction and internal/external rotation were 0.3±0.91° and 0.1±0.97°, respectively. During flexion, a translational motion between 0.06 mm and 0.73 mm was observed. Conclusions. The proposed technique and methods appear to be feasible for the accurate assessment and evaluation of the PIP joint motion in 3D. The presented method may help to gain additional insights for the design of prosthetic implants, rehabilitation, and new orthotic devices.

  20. Trunk muscle activation. The effects of torso flexion, moment direction, and moment magnitude.

    Science.gov (United States)

    Lavender, S; Trafimow, J; Andersson, G B; Mayer, R S; Chen, I H

    1994-04-01

    This study was performed to quantify the electromyographic trunk muscle activities in response to variations in moment magnitude and direction while in forward-flexed postures. Recordings were made over eight trunk muscles in 19 subjects who maintained forward-flexed postures of 30 degrees and 60 degrees. In each of the two flexed postures, external moments of 20 Nm and 40 Nm were applied via a chest harness. The moment directions were varied in seven 30 degrees increments to a subject's right side, such that the direction of the applied load ranged from the upper body's anterior midsagittal plane (0 degree) to the posterior midsagittal plane (180 degrees). Statistical analyses yielded significant moment magnitude by moment-direction interaction effects for the EMG output from six of the eight muscles. Trunk flexion by moment-direction interactions were observed in the responses from three muscles. In general, the primary muscle supporting the torso and the applied load was the contralateral (left) erector spinae. The level of electromyographic activity in the anterior muscles was quite low, even with the posterior moment directions.

  1. Motion as motivation: using repetitive flexion movements to stimulate the approach system.

    Science.gov (United States)

    Haeffel, Gerald J

    2011-12-01

    Research suggests that having a healthy approach system is critical for adaptive emotional functioning. The goal of the current study (n=186 undergraduates) was to determine the efficacy of an easy-to-disseminate and cost-efficient strategy for stimulating this system. The experiment tested the effects of repeated flexion movements (rFM) on approach system activation as measured by both self-report (BAS scales) and behavior. The results showed that rFM increased approach system motivation in men but not women. Men who completed the rFM task reported significantly greater levels of fun-seeking motivation than men in the control task. Moreover, the rFM task led to changes in actual behavior. Men who completed the rFM task exhibited significantly greater persistence on a difficult laboratory task than men in the control task. In contrast, women who completed the rFM task reported significantly lower levels of fun seeking and tended to exhibit less persistence on a difficult laboratory task than women in the control task. These results provide support for embodied theories of emotion as well as additional evidence for a gender difference in approach-avoidance tendencies. Copyright © 2011. Published by Elsevier Ltd.

  2. Systematic review of flexion/extension radiography of the cervical spine in trauma patients

    International Nuclear Information System (INIS)

    Sierink, J.C.; Lieshout, W.A.M. van; Beenen, L.F.M.; Schep, N.W.L.; Vandertop, W.P.; Goslings, J.C.

    2013-01-01

    Introduction: The aim of this review was to investigate whether Flexion/Extension (F/E) radiography adds diagnostic value to CT or MRI in the detection of cervical spine ligamentous injury and/or clinically significant cervical spine instability of blunt trauma patients. Methods: A systematic search of literature was done in Pubmed, Embase and Cochrane Library databases. Primary outcome was sensitivity and specificity of F/E radiography. Secondary outcomes were the positive predicting value (PPV) and negative predicting value (NPV) (with CT or MRI as reference tests due to the heterogeneity of the included studies) of each modality and the quality of F/E radiography. Results: F/E radiography was overall regarded to be inferior to CT or MRI in the detection of ligamentous injury. This was reflected by the high specificity and NPV for CT with F/E as reference test (ranging from 97 to 100% and 99 to 100% respectively) and the ambiguous results for F/E radiography with MRI as its reference test (0–98% and 0–83% for specificity and NPV respectively). Image quality of F/E radiography was reported to have 31 to 70% adequacy, except in two studies which reported an adequacy of respectively 4 and 97%. Conclusion: This systematic review of the literature shows that F/E radiography adds little diagnostic value to the evaluation of blunt trauma patients compared to CT and MRI, especially in those cases where CT or MRI show no indication of ligamentous injury

  3. Systematic review of flexion/extension radiography of the cervical spine in trauma patients

    Energy Technology Data Exchange (ETDEWEB)

    Sierink, J.C., E-mail: j.c.sierink@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Lieshout, W.A.M. van, E-mail: w.a.vanlieshout@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Beenen, L.F.M., E-mail: l.f.beenen@amc.nl [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Schep, N.W.L., E-mail: n.w.schep@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Vandertop, W.P., E-mail: w.p.vandertop@amc.nl [Neurosurgical Center Amsterdam, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Goslings, J.C., E-mail: j.c.goslings@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2013-06-15

    Introduction: The aim of this review was to investigate whether Flexion/Extension (F/E) radiography adds diagnostic value to CT or MRI in the detection of cervical spine ligamentous injury and/or clinically significant cervical spine instability of blunt trauma patients. Methods: A systematic search of literature was done in Pubmed, Embase and Cochrane Library databases. Primary outcome was sensitivity and specificity of F/E radiography. Secondary outcomes were the positive predicting value (PPV) and negative predicting value (NPV) (with CT or MRI as reference tests due to the heterogeneity of the included studies) of each modality and the quality of F/E radiography. Results: F/E radiography was overall regarded to be inferior to CT or MRI in the detection of ligamentous injury. This was reflected by the high specificity and NPV for CT with F/E as reference test (ranging from 97 to 100% and 99 to 100% respectively) and the ambiguous results for F/E radiography with MRI as its reference test (0–98% and 0–83% for specificity and NPV respectively). Image quality of F/E radiography was reported to have 31 to 70% adequacy, except in two studies which reported an adequacy of respectively 4 and 97%. Conclusion: This systematic review of the literature shows that F/E radiography adds little diagnostic value to the evaluation of blunt trauma patients compared to CT and MRI, especially in those cases where CT or MRI show no indication of ligamentous injury.

  4. Reliable four-point flexion test and model for die-to-wafer direct bonding

    Energy Technology Data Exchange (ETDEWEB)

    Tabata, T., E-mail: toshiyuki.tabata@cea.fr; Sanchez, L.; Fournel, F.; Moriceau, H. [Univ. Grenoble Alpes, F-38000 Grenoble, France and CEA, LETI, MINATEC Campus, F-38054 Grenoble (France)

    2015-07-07

    For many years, wafer-to-wafer (W2W) direct bonding has been very developed particularly in terms of bonding energy measurement and bonding mechanism comprehension. Nowadays, die-to-wafer (D2W) direct bonding has gained significant attention, for instance, in photonics and microelectro-mechanics, which supposes controlled and reliable fabrication processes. So, whatever the stuck materials may be, it is not obvious whether bonded D2W structures have the same bonding strength as bonded W2W ones, because of possible edge effects of dies. For that reason, it has been strongly required to develop a bonding energy measurement technique which is suitable for D2W structures. In this paper, both D2W- and W2W-type standard SiO{sub 2}-to-SiO{sub 2} direct bonding samples are fabricated from the same full-wafer bonding. Modifications of the four-point flexion test (4PT) technique and applications for measuring D2W direct bonding energies are reported. Thus, the comparison between the modified 4PT and the double-cantilever beam techniques is drawn, also considering possible impacts of the conditions of measures such as the water stress corrosion at the debonding interface and the friction error at the loading contact points. Finally, reliability of a modified technique and a new model established for measuring D2W direct bonding energies is demonstrated.

  5. Prototype of a mechanical assistance device for the wrists' flexion-extension movement

    International Nuclear Information System (INIS)

    Politti, Julio C; Puglisi, Lisandro J; Farfan, Fernando D

    2007-01-01

    Using CMU actuators, a Prototype of Mechanical Assistance Device for the Wrist's Flexion Movement (PMA) was developed and probed in a mechanical model, in order to be implemented in a future as a dynamic powered orthosis or as a rehabilitation assistant instrument. Two Mayor Actuators conformed by three CMU actuators arranged in a series configuration, allows to an artificial hand to be placed in four predefined positions: 0 0 , 20 0 , 40 0 and 60 0 . The synchronism and control of the actuators is achieved with the Programmable Control Module (PCM). It is capable to drive up to six CMU actuators, and possess two different modes of execution: a Manual mode and an Exercise mode. In the Manual Mode, the position of the hand responds directly to the commands of the keyboard of the front panel, and in the Exercise mode, the hand realizes a repetitive and programmed movement. The prototype was tested in 100 positions in the Manual Mode and for 225 works cycles in the Exercise Mode. The relative repetition error was less than 5% for both test. This prototype only consumes 4,15W, which makes it possible to be powered by small rechargeable batteries, allowing its use as a portable device

  6. Peak activation of lower limb musculature during high flexion kneeling and transitional movements.

    Science.gov (United States)

    Kingston, David C; Tennant, Liana M; Chong, Helen C; Acker, Stacey M

    2016-09-01

    Few studies have measured lower limb muscle activation during high knee flexion or investigated the effects of occupational safety footwear. Therefore, our understanding of injury and disease mechanisms, such as knee osteoarthritis, is limited for these high-risk postures. Peak activation was assessed in eight bilateral lower limb muscles for twelve male participants, while shod or barefoot. Transitions between standing and kneeling had peak quadriceps and tibialis anterior (TA) activations above 50% MVC. Static kneeling and simulated tasks performed when kneeling had peak TA activity above 15% MVC but below 10% MVC for remaining muscles. In three cases, peak muscle activity was significantly higher (mean 8.9% MVC) when shod. However, net compressive knee joint forces may not be significantly increased when shod. EMG should be used as a modelling input when estimating joint contact forces for these postures, considering the activation levels in the hamstrings and quadriceps muscles during transitions. Practitioner Summary: Kneeling transitional movements are used in activities of daily living and work but are linked to increased knee osteoarthritis risk. We found peak EMG activity of some lower limb muscles to be over 70% MVC during transitions and minimal influence of wearing safety footwear.

  7. Echocardiographic abnormalities in hypertensive patients

    International Nuclear Information System (INIS)

    Rodulfo Garcia, Maikel; Tornes Perez, Victor Manuel; Castellanos Tardo, Juan Ramon

    2012-01-01

    A descriptive cross-sectional study was carried out in 120 hypertensive patients with a course of 5 or more years, who went to the emergency room of 'Saturnino Lora' Provincial Teaching Hospital from November 2010 to November 2011 in order to determine the presence or absence of echocardiographic abnormalities typical of hypertension. Of these, 78,3 % was affected, most of whom reported not to continue with regular previous medical treatment, and 21,7 % had not these abnormalities. Age group of 50-60 years, males and blacks prevailed in the case material. The most significant echocardiographic findings were left ventricular hypertrophy and heart failure with ejection fraction of left ventricle preserved

  8. Goldenhar syndrome and urogenital abnormalities

    Directory of Open Access Journals (Sweden)

    Mohan Marulaiah

    2003-01-01

    Full Text Available The Goldenhar syndrome (oculo-auriculo-vertebral syn-drome or 1st and 2nd branchial arch syndrome is a com-plex of craniofacial anomalies. It has been associated with anomalies in other systems and with abnormalities of the urogenital system. We present a case of Goldenhar syn-drome with multiple renal anomalies and a urogenital si-nus, which has not been reported before.

  9. Mastoid abnormalities in Down syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Glass, R.B.J.; Yousefzadeh, D.K.; Roizen, N.J.

    1989-06-01

    Hearing loss and otitis media are commonly associated with Down syndrome. Hypoplasia of the mastoids is seen in many affected children and sclerosis of mastoid bones is not uncommon in Down syndrome. Awareness and early recognition of mastoid abnormality may lead to appropriate and timely therapy, thereby preserving the child's hearing or compensating for hearing loss; factors which are important for learning and maximum development.

  10. Computed tomography of thymic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Schnyder, P.; Candardjis, G.

    1987-05-01

    Computed tomographic examinations of 38 patients with surgically and histologically proven diagnosis were reviewed. Twenty subjects (52%) had an invasive thymoma and 16% an hyperplastic thymus. Myasthenia gravis was present in 6 cases (16%) of thymic abnormalities, four (10,5%) with invasive thymoma and two (5%) with thymic hyperplasia. Graves' disease was also present in one case of thymic hyperplasia. We emphasize the contribution of CT to the diagnosis and the prognosis.

  11. Computed tomography of thymic abnormalities

    International Nuclear Information System (INIS)

    Schnyder, P.; Candardjis, G.

    1987-01-01

    Computed tomographic examinations of 38 patients with surgically and histologically proven diagnosis were reviewed. Twenty subjects (52%) had an invasive thymoma and 16% an hyperplastic thymus. Myasthenia gravis was present in 6 cases (16%) of thymic abnormalities, four (10,5%) with invasive thymoma and two (5%) with thymic hyperplasia. Graves' disease was also present in one case of thymic hyperplasia. We emphasize the contribution of CT to the diagnosis and the prognosis. (orig.)

  12. Mastoid abnormalities in Down syndrome

    International Nuclear Information System (INIS)

    Glass, R.B.J.; Yousefzadeh, D.K.; Roizen, N.J.

    1989-01-01

    Hearing loss and otitis media are commonly associated with Down syndrome. Hypoplasia of the mastoids is seen in many affected children and sclerosis of mastoid bones is not uncommon in Down syndrome. Awareness and early recognition of mastoid abnormality may lead to appropriate and timely therapy, thereby preserving the child's hearing or compensating for hearing loss; factors which are important for learning and maximum development. (orig.)

  13. Abnormal uterine bleeding in perimenopause.

    Science.gov (United States)

    Goldstein, S R; Lumsden, M A

    2017-10-01

    Abnormal uterine bleeding is one of the commonest presenting complaints encountered in a gynecologist's office or primary-care setting. The wider availability of diagnostic tools has allowed prompt diagnosis and treatment of an increasing number of menstrual disorders in an office setting. This White Paper reviews the advantages and disadvantages of transvaginal ultrasound, blind endometrial sampling and diagnostic hysteroscopy. Once a proper diagnosis has been established, appropriate therapy may be embarked upon. Fortunately, only a minority of such patients will have premalignant or malignant disease. When bleeding is sufficient to cause severe anemia or even hypovolemia, prompt intervention is called for. In most of the cases, however, the abnormal uterine bleeding will be disquieting to the patient and significantly affect her 'quality of life'. Sometimes, reassurance and expectant management will be sufficient in such patients. Overall, however, in cases of benign disease, some intervention will be required. The use of oral contraceptive pills especially those with a short hormone-free interval, the insertion of the levonorgestrel intrauterine system, the incorporation of newer medical therapies including antifibrinolytic drugs and selective progesterone receptor modulators and minimally invasive treatments have made outpatient therapy increasingly effective. For others, operative hysteroscopy and endometrial ablation are proven therapeutic tools to provide both long- and short-term relief of abnormal uterine bleeding, thus avoiding, or deferring, hysterectomy.

  14. Hemostatic abnormalities in Noonan syndrome.

    Science.gov (United States)

    Artoni, Andrea; Selicorni, Angelo; Passamonti, Serena M; Lecchi, Anna; Bucciarelli, Paolo; Cerutti, Marta; Cianci, Paola; Gianniello, Francesca; Martinelli, Ida

    2014-05-01

    A bleeding diathesis is a common feature of Noonan syndrome, and various coagulation abnormalities have been reported. Platelet function has never been carefully investigated. The degree of bleeding diathesis in a cohort of patients with Noonan syndrome was evaluated by a validated bleeding score and investigated with coagulation and platelet function tests. If ratios of prothrombin time and/or activated partial thromboplastin time were prolonged, the activity of clotting factors was measured. Individuals with no history of bleeding formed the control group. The study population included 39 patients and 28 controls. Bleeding score was ≥2 (ie, suggestive of a moderate bleeding diathesis) in 15 patients (38.5%) and ≥4 (ie, suggestive of a severe bleeding diathesis) in 7 (17.9%). Abnormal coagulation and/or platelet function tests were found in 14 patients with bleeding score ≥2 (93.3%) but also in 21 (87.5%) of those with bleeding score Noonan syndrome had a bleeding diathesis and >90% of them had platelet function and/or coagulation abnormalities. Results of these tests should be taken into account in the management of bleeding or invasive procedures in these patients. Copyright © 2014 by the American Academy of Pediatrics.

  15. Special report on abnormal climate in 2010

    International Nuclear Information System (INIS)

    2010-12-01

    This reports on abnormal climate in 2010 with impact on the each field. It is comprised of four chapters, which deal with Introduction with purpose of publish and background, current situation and cause of abnormal climate in 2010 on abnormal climate around the world and Korea, Action and impact against abnormal climate in 2010 to agriculture, industry and energy, prevention of disasters, forest, fishery products, environment and health, Evaluation and policy proposal. It also has an appendix about occurrence and damage on abnormal climate of the world in 2010 and media reports on abnormal climate in Korea in 2010.

  16. Differences between two subgroups of low back pain patients in lumbopelvic rotation and symmetry in the erector spinae and hamstring muscles during trunk flexion when standing.

    Science.gov (United States)

    Kim, Min-hee; Yoo, Won-gyu; Choi, Bo-ram

    2013-04-01

    The present study was performed to examine lumbopelvic rotation and to identify asymmetry of the erector spinae and hamstring muscles in people with and without low back pain (LBP). The control group included 16 healthy subjects, the lumbar-flexion-rotation syndrome LBP group included 17 subjects, and the lumbar-extension-rotation syndrome LBP group included 14 subjects. Kinematic parameters were recorded using a 3D motion-capture system, and electromyography parameters were measured using a Noraxon TeleMyo 2400T. The two LBP subgroups showed significantly more lumbopelvic rotation during trunk flexion in standing than did the control group. The muscle activity and flexion-relaxation ratio asymmetries of the erector spinae muscles in the lumbar-flexion-rotation syndrome LBP group were significantly greater than those in the control group, and the muscle activity and flexion-relaxation ratio asymmetry of the hamstring muscles in the lumbar-extension-rotation syndrome LBP group were significantly greater than those in the control group. Imbalance or asymmetry of passive tissue could lead to asymmetry of muscular activation. Muscle imbalance can cause asymmetrical alignment or movements such as unexpected rotation. The results showed a greater increase in lumbopelvic rotation during trunk flexion in standing among the lumbar-flexion-rotation syndrome and lumbar-extension-rotation syndrome LBP groups compared with the control group. The differences between the two LBP subgroups may be a result of imbalance and asymmetry in erector spinae and hamstring muscle properties. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. The role of the faceguard in the production of flexion injuries to the cervical spine in football.

    Science.gov (United States)

    Melvin, W J; Dunlop, H W; Hetherington, R F; Kerr, J W

    1965-11-20

    The precise role of the single-bar face mask in producing major flexion violence to the cervical spine has been studied by review of game movies, analysis of the radiographs and detailed interviews with two players who sustained fractures of cervical spine. The single-bar face mask can become fixed in the ground, thereby forcing a runner's head down onto his chest as the trunk moves forward. Preventive measures embodying modifications in the face mask, strict coaching in football techniques and the institution of safety factors in the playing rules are proposed. Appreciation of the mechanism of injury is urged in order to encourage careful inspection of protective head gear as well as to direct the attention of team physicians to the possibility of serious flexion injury to the cervical spine occurring without dramatic evidence. This report is not a plea for abandonment of the face mask but rather a suggestion for careful selection of a safe and efficient mask.

  18. Post-operative Hypertension following Correction of Flexion Deformity of the Knees in a Spastic Diplegic Child: A Case Report

    Directory of Open Access Journals (Sweden)

    Vipin Mohan

    2016-11-01

    Full Text Available An adolescent boy with spastic diplegic cerebral palsy presented with crouch gait. He had bilateral severe flexion deformities of knees and hips. He was treated with single event multilevel surgery for the correction of deformities. Surgical procedures included bilateral adductor release, iliopsoas lengthening, bilateral femoral shortening and patella plication. Persistent hypertension was noted in the post-operative period. All causes of secondary hypertension were ruled out. Having persistent hypertension following the femoral shortening procedure is unusual. Antihypertensive medication controlled his blood pressure 15 months after surgery. Hypertension following correction of knee flexion deformity and limb lengthening is well known. Hypertension has not been described with the shortening osteotomy of the femur. Hypertension is a rare complication following the corrective surgery for the treatment of crouch gait. Blood pressure should be monitored during the post-operative period to detect such a rare complication.

  19. Using verbal instructions to influence lifting mechanics - Does the directive "lift with your legs, not your back" attenuate spinal flexion?

    Science.gov (United States)

    Beach, Tyson A C; Stankovic, Tatjana; Carnegie, Danielle R; Micay, Rachel; Frost, David M

    2018-02-01

    "Use your legs" is commonly perceived as sound advice to prevent lifting-related low-back pain and injuries, but there is limited evidence that this directive attenuates the concomitant biomechanical risk factors. Body segment kinematic data were collected from 12 men and 12 women who performed a laboratory lifting/lowering task after being provided with different verbal instructions. The main finding was that instructing participants to lift "without rounding your lower back" had a greater effect on the amount of spine flexion they exhibited when lifting/lowering than instructing them to lift "with your legs instead of your back" and "bend your knees and hips". It was concluded that if using verbal instructions to discourage spine flexion when lifting, the instructions should be spine- rather than leg-focused. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Age-Related Differences in Motor Coordination during Simultaneous Leg Flexion and Finger Extension: Influence of Temporal Pressure

    OpenAIRE

    Hussein, Tarek; Yiou, Eric; Larue, Jacques

    2013-01-01

    Although the effect of temporal pressure on spatio-temporal aspects of motor coordination and posture is well established in young adults, there is a clear lack of data on elderly subjects. This work examined the aging-related effects of temporal pressure on movement synchronization and dynamic stability. Sixteen young and eleven elderly subjects performed series of simultaneous rapid leg flexions in an erect posture paired with ipsilateral index-finger extensions, minimizing the difference b...

  1. Influence of increasing knee flexion angle on knee-ankle varus stress during single-leg jump landing

    Directory of Open Access Journals (Sweden)

    Mariam A. Ameer, PhD

    2017-12-01

    Full Text Available Objectives: The primary aim of this study was to identify the relationship between the peak knee flexion angle and knee-ankle varus stress in the landing phase of the single-leg jump during running. Methods: Fifteen male handball players from the first Saudi Arabian handball team were incorporated in this study. Each player performed a single-leg jump-land after running a fixed distance of 450 cm. The data were measured using a 3D motion analysis system. The maximum knee flexion angle, knee varus angle, centre of pressure pathway in the medio-lateral direction, and ankle varus moment were measured. Results: The Pearson Product Moment Correlation showed that a greater knee flexion angle was related to a greater lateral displacement of the centre of pressure (r = 0.794, P = 0.000, a greater ankle varus moment (r = 0.707, P = 0.003, and a greater knee varus angle (r = 0.753, P = 0.001. In addition, the greater ankle varus moment was related to the greater lateral displacement of the centre of pressure (r = 0.734, P = 0.002. Conclusions: These findings may help physical therapists and conditioning professionals to understand the impact of increasing knee flexion angle on the lower limb joints. Such findings may help to develop training protocols for enhancing the lateral body reaction during the landing phase of the single-leg jump, which may protect the knee and ankle joints from excessive varus stresses. Keywords: 3D motion analysis, Ankle kinetic, Centre of pressure pathway, Handball playing, Knee kinematic, Single-leg jump

  2. Reliability and validity of a brief method to assess nociceptive flexion reflex (NFR) threshold.

    Science.gov (United States)

    Rhudy, Jamie L; France, Christopher R

    2011-07-01

    The nociceptive flexion reflex (NFR) is a physiological tool to study spinal nociception. However, NFR assessment can take several minutes and expose participants to repeated suprathreshold stimulations. The 4 studies reported here assessed the reliability and validity of a brief method to assess NFR threshold that uses a single ascending series of stimulations (Peak 1 NFR), by comparing it to a well-validated method that uses 3 ascending/descending staircases of stimulations (Staircase NFR). Correlations between the NFR definitions were high, were on par with test-retest correlations of Staircase NFR, and were not affected by participant sex or chronic pain status. Results also indicated the test-retest reliabilities for the 2 definitions were similar. Using larger stimulus increments (4 mAs) to assess Peak 1 NFR tended to result in higher NFR threshold estimates than using the Staircase NFR definition, whereas smaller stimulus increments (2 mAs) tended to result in lower NFR threshold estimates than the Staircase NFR definition. Neither NFR definition was correlated with anxiety, pain catastrophizing, or anxiety sensitivity. In sum, a single ascending series of electrical stimulations results in a reliable and valid estimate of NFR threshold. However, caution may be warranted when comparing NFR thresholds across studies that differ in the ascending stimulus increments. This brief method to assess NFR threshold is reliable and valid; therefore, it should be useful to clinical pain researchers interested in quickly assessing inter- and intra-individual differences in spinal nociceptive processes. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

  3. Knee flexion contractures in institutionalized elderly: prevalence, severity, stability, and related variables.

    Science.gov (United States)

    Mollinger, L A; Steffen, T M

    1993-07-01

    The purpose of this study was to document the prevalence, severity, and progression of knee flexion contractures (KFCs) in a population of institutionalized elderly and to identify relationships between knee extension and other variables. The subjects were 112 nursing home residents who exhibited a broad range of ambulation and cognitive function abilities. Data were collected initially (T1) and after a 10-month period (T2). Only 25% of the population had extension in the 0- to 5-degree (lacking full extension) range bilaterally at T1 and T2, leaving the majority of subjects with some degree of unilateral KFC. Most of the subjects with a KFC greater than 20 degrees were nonambulatory and had a significantly higher occurrence of resistance to motion than did nonambulators with a KFC of less than 20 degrees. Knee extension measurements did not change in most subjects between T1 and T2. The knees that did show a change in KFC (either an increase or a decrease) had a significantly higher occurrence of resistance to passive motion than did other knees. Compared with the subjects who gained extension, the subjects who lost extension over the study period more frequently had minimal KFC at T1, were ambulatory at T1, showed a regression in ambulation at T2, and developed resistance to motion at T2. The data confirmed significant positive correlations between degree of KFC and presence of resistance to passive knee motion, cognitive impairment, impaired ambulation, and presence of knee pain. Physical therapy assessment and intervention may be appropriate in nonambulatory nursing home residents with resistance to passive motion, residents with KFC approaching 20 degrees, and ambulatory residents with minimal KFC who develop resistance and begin to regress in ambulation. Several areas for future study are suggested.

  4. Low-set ears and pinna abnormalities

    Science.gov (United States)

    Low-set ears; Microtia; "Lop" ear; Pinna abnormalities; Genetic defect - pinna; Congenital defect - pinna ... conditions: Abnormal folds or location of the pinna Low-set ears No opening to the ear canal ...

  5. Enhanced monitoring of abnormal emergency department demands

    KAUST Repository

    Harrou, Fouzi; Sun, Ying; Kadri, Farid

    2016-01-01

    of abnormal situations caused by abnormal patient arrivals to the ED. More specifically, This work proposed the application of autoregressive moving average (ARMA) models combined with the generalized likelihood ratio (GLR) test for anomaly-detection. ARMA

  6. Infrapatellar plica of the knee: Revisited with MR arthrographies undertaken in the knee flexion position mimicking operative arthroscopic posture

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Han; Song, Ho-Taek; Kim, Sungjun [Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752 (Korea, Republic of); Kim, Sung-Jae [Department of Orthopedic Surgery and Arthroscopic Surgery Unit, Yonsei University College of Medicine (Korea, Republic of); Suh, Jin-Suck, E-mail: jss@yuhs.ac [Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752 (Korea, Republic of)

    2012-10-15

    Purpose: To describe the appearance of the infrapatellar plica (IPP) on magnetic resonance arthrography (MRA) taken in 70° knee flexion, corresponding to the arthroscopic posture. Materials and methods: Twenty-two patients (23 knee joints) who underwent MRA with 70° knee flexion were enrolled. All patients underwent MRA with 70° knee flexion to simulate operative arthroscopy. The images included fat-suppressed T1-weighted spin echo axial, sagittal, and coronal images. The visualization and morphology of the IPP were retrospectively assessed by two musculoskeletal radiologists. Results: The IPP was demonstrated in 78.3% (n = 18/23) and was best visualized on the sagittal section through the intercondylar notch. The IPP manifested as a linear hypointense structure with variable thicknesses. The intercondylar component was delineated clearly, arising from the anterior intercondylar notch in parallel with the ACL and curving gently downward to attach to the infrapatellar fat pad. On the other hand, the Hoffa's fat pad component was not depicted clearly. The morphology of the IPP was either a separate type (60.9%) or a split type (17.4%). Conclusion: The IPPs can be visualized with a high rate of detection and various morphologic appearances must be appreciated under the review of a flexed knee MRA.

  7. An Accurate Full-flexion Anterolateral Portal for Needle Placement in the Knee Joint With Dry Osteoarthritis.

    Science.gov (United States)

    Hussein, Mohamed

    2017-07-01

    Accurate delivery of an injection into the intra-articular space of the knee is achieved in only two thirds of knees when using the standard anterolateral portal. The use of a modified full-flexion anterolateral portal provides a highly accurate, less painful, and more effective method for reproducible intra-articular injection without the need for ultrasonographic or fluoroscopic guidance in patients with dry osteoarthritis of the knee. The accuracy of needle placement was assessed in a prospective series of 140 consecutive injections in patients with symptomatic degenerative knee arthritis without clinical knee effusion. Procedural pain was determined using the Numerical Rating Scale. The accuracy rates of needle placement were confirmed with fluoroscopic imaging to document the dispersion pattern of injected contrast material. Using the standard anterolateral portal, 52 of 70 injections were confirmed to have been placed in the intra-articular space on the first attempt (accuracy rate, 74.2%). Using the modified full-flexion anterolateral portal, 68 of 70 injections were placed in the intra-articular space on the first attempt (accuracy rate, 97.1%; P = 0.000). This study revealed that using the modified full-flexion anterolateral portal for injections into the knee joint resulted in more accurate and less painful injections than those performed by the same orthopaedic surgeon using the standard anterolateral portal. In addition, the technique offered therapeutic delivery into the joint without the need for fluoroscopic confirmation. Therapeutic Level II.

  8. MR imaging of abnormal synovial processes

    International Nuclear Information System (INIS)

    Quinn, S.F.; Sanchez, R.; Murray, W.T.; Silbiger, M.L.; Ogden, J.; Cochran, C.

    1987-01-01

    MR imaging can directly image abnormal synovium. The authors reviewed over 50 cases with abnormal synovial processes. The abnormalities include Baker cysts, semimembranous bursitis, chronic shoulder bursitis, peroneal tendon ganglion cyst, periarticular abscesses, thickened synovium from rheumatoid and septic arthritis, and synovial hypertrophy secondary to Legg-Calve-Perthes disease. MR imaging has proved invaluable in identifying abnormal synovium, defining the extent and, to a limited degree, characterizing its makeup

  9. Operator training for the abnormal

    International Nuclear Information System (INIS)

    Marzec, R.J.

    1977-01-01

    Training of nuclear power plant control room operators, on actions to be taken for an abnormal event, has classically been limited to discussion, on-shift and/or during requalification training classes, of symptoms, logical thought processes, systems analysis, and operator experience. The prerequisites for these discussions are a common technical vocabulary, and a minimum basic comprehension of nuclear power plant fundamentals, plant component theory of operation, system configuration, system control philosophy and operating procedures. Nuclear power plant control room operators are not the only personnel who are or should be involved in these discussions. The shift supervisors, operations management, and auxiliary equipment operators require continuing training in abnormal operations, as well. More in-depth training is necessary for shift supervisors and control room operators. The availability of vendor simulators has improved the effectiveness of training efforts for these individuals to some extent by displaying typical situations and plant performance characteristics and by providing a degree of ''hands on'' experience. The evolution of in-depth training with these simulators is reviewed

  10. PRÁTICAS AMBIENTALMENTE CORRETAS EM MEIOS DE HOSPEDAGEM: um estudo sobre a percepção ambiental e perfil dos gestores hoteleiros de Santa Vitória do Palmar/RS

    Directory of Open Access Journals (Sweden)

    Siuza Monteiro Guedes

    2017-09-01

    Full Text Available Este estudo foi realizado no município de Santa Vitória do Palmar, RS, teve por objetivo analisar a percepção das práticas ambientalmente corretas de gestão ambiental e de economia de recursos naturais entre os gestores do setor de hospedagem do Município de Santa Vitória do Palmar. Trata-se de um estudo qualiquantitavo de caráter exploratório, representativo e participante, com aplicação de instrumento de coleta de dados, realizado no período de novembro de 2016 a março de 2017 em empreendimentos do setor de hoteleiro e extra-hoteleiro, na cidade sede do Município e em três dos balneários marítimos do mesmo. Como principal resultado pode ser destacado a falta de planos de gestão ambiental dos empreendimentos pesquisados. O estudo se justifica uma vez que não foram encontrados estudos similares.

  11. An explorative, cross-sectional study into abnormal muscular coupling during reach in chronic stroke patients

    Directory of Open Access Journals (Sweden)

    Stienen Arno HA

    2010-03-01

    Full Text Available Abstract Background In many stroke patients arm function is limited, which can be related to an abnormal coupling between shoulder and elbow joints. The extent to which this can be translated to activities of daily life (ADL, in terms of muscle activation during ADL-like movements, is rather unknown. Therefore, the present study examined the occurrence of abnormal coupling on functional, ADL-like reaching movements of chronic stroke patients by comparison with healthy persons. Methods Upward multi-joint reaching movements (20 repetitions at a self-selected speed to resemble ADL were compared in two conditions: once facilitated by arm weight compensation and once resisted to provoke a potential abnormal coupling. Changes in movement performance (joint angles and muscle activation (amplitude of activity and co-activation between conditions were compared between healthy persons and stroke patients using a repeated measures ANOVA. Results The present study showed slight changes in joint excursion and muscle activation of stroke patients due to shoulder elevation resistance during functional reach. Remarkably, in healthy persons similar changes were observed. Even the results of a sub-group of the more impaired stroke patients did not point to an abnormal coupling between shoulder elevation and elbow flexion during functional reach. Conclusions The present findings suggest that in mildly and moderately affected chronic stroke patients ADL-like arm movements are not substantially affected by abnormal synergistic coupling. In this case, it is implied that other major contributors to limitations in functional use of the arm should be identified and targeted individually in rehabilitation, to improve use of the arm in activities of daily living.

  12. Abnormality diagnosis device for nuclear reactor

    Energy Technology Data Exchange (ETDEWEB)

    Utsunomiya, Kazuhiro; Oyama, Shinmi; Sakaba, Hideo

    1989-02-21

    According to the present invention, abnormality such as abnormal increase of temperature in a nuclear reactor is detected to send a signal to control rod drives, etc. thereby stopping the operation of the nuclear reactor. Receiving/transmission device transmits a signal for conducting normal operation of an abnormality information section, as well as receives an echo signal from the abnormality information section to transmit an abnormal signal to a reactor protection system. The abnormality information section is disposed to fuel assemblies, receives a signal from the receiving/transmission device for conducting the normal operation to transmit a normal echo signal, as well as changes the echo signal when detecting the nuclear reactor abnormality. By the foregoing method, since the abnormality information section is disposed to the fuel assemblies, various effects can be attained such as: (1) there is no response delay from the occurrence of abnormality to emergency counter measure after detection, (2) high burnup degree for fuels can thus be possible to improve the economical property, (3) the abnormality information section can be taken out from the reactor container together with fuel assemablies by an existent take-out mechanism and (4) since wireless transmission and reception are established between the receiving/transmission device and the abnormality information section, cables are not required in the container. (K.M.).

  13. Reliability of Measuring Lumbar Lordosis, Flexion and Extension Using Dual Inclinometer in Healthy Subjects and Patients with Non-Specific Chronic Low Back Pain

    Directory of Open Access Journals (Sweden)

    Samira Garmabi

    2012-07-01

    Full Text Available Objective: Accurate assessment of lumbar range of motion is of great value for both evaluating lumbar functions and monitoring treatment progress. Recent research indicates that there is no general consensus on the most valid and reliable method of measuring spinal range of motion. The purpose of this study was to determine the intra-rater reliability of lumbar flexion and extension measurements (within-day and between-days using the dual inclinometer technique.   Materials & Methods: Lumbar flexion and extension of 22 women (14 healthy and 8 with low back pain, were measured by the same examiner on three occasions. The first two measurements were taken with half an hour apart on the first occasion to assess the within-day reliability and the third measurement was taken one week later to assess the between-days reliability.  Results: Within-day lumbar lordosis, flexion and extension measurements using dual inclinometer technique were shown to be very reliable with high Intraclass Correlation Coefficients (ICC values (ICC were 98%, 77% and 69% for lordosis, flexion and extension measurements, respectively in healthy subjects and 94%, 95% and 69% for lordosis, flexion and extension measurements, respectively in patients group. Between-Days measurements also demonstrated high reliability with the high values of ICC (ICC were 96%, 70% and 67% for lordosis, flexion and extension measurements, in healthy subjects and 91%, 71% and 66% for lordosis, flexion and extension measurements, respectively in patients group. Conclusion: The results indicated that, the dual inclinometer technique appears to be a highly reliable method for measuring lumbar lordosis, flexion and extension and can be used as a reliable tool in the assessment of lumbar range of motion and monitoring therapeutic interventions.

  14. Abnormal Returns and Contrarian Strategies

    Directory of Open Access Journals (Sweden)

    Ivana Dall'Agnol

    2003-12-01

    Full Text Available We test the hypothesis that strategies which are long on portfolios of looser stocks and short on portfolios of winner stocks generate abnormal returns in Brazil. This type of evidence for the US stock market was interpreted by The Bondt and Thaler (1985 as reflecting systematic evaluation mistakes caused by investors overreaction to news related to the firm performance. We found evidence of contrarian strategies profitability for horizons from 3 months to 3 years in a sample of stock returns from BOVESPA and SOMA from 1986 to 2000. The strategies are more profitable for shorter horizons. Therefore, there was no trace of the momentum effect found by Jagadeesh and Titman (1993 for the same horizons with US data. There are remaing unexplained positive returns for contrarian strategies after accounting for risk, size, and liquidity. We also found that the strategy profitability is reduced after the Real Plan, which suggests that the Brazilian stock market became more efficient after inflation stabilization.

  15. Distal nerve transfer versus supraclavicular nerve grafting: comparison of elbow flexion outcome in neonatal brachial plexus palsy with C5-C7 involvement.

    Science.gov (United States)

    Heise, Carlos O; Siqueira, Mario G; Martins, Roberto S; Foroni, Luciano H; Sterman-Neto, Hugo

    2017-09-01

    Ulnar and median nerve transfers to arm muscles have been used to recover elbow flexion in infants with neonatal brachial plexus palsy, but there is no direct outcome comparison with the classical supraclavicular nerve grafting approach. We retrospectively analyzed patients with C5-C7 neonatal brachial plexus palsy submitted to nerve surgery and recorded elbow flexion recovery using the active movement scale (0-7) at 12 and 24 months after surgery. We compared 13 patients submitted to supraclavicular nerve grafting with 21 patients submitted to distal ulnar or median nerve transfer to biceps motor branch. We considered elbow flexion scores of 6 or 7 as good results. The mean elbow flexion score and the proportion of good results were better using distal nerve transfers than supraclavicular grafting at 12 months (p nerve grafting at 12 months showed good elbow flexion recovery after ulnar nerve transfers. Distal nerve transfers provided faster elbow flexion recovery than supraclavicular nerve grafting, but there was no significant difference in the outcome after 24 months of surgery. Patients with failed supraclavicular grafting operated early can still benefit from late distal nerve transfers. Supraclavicular nerve grafting should remain as the first line surgical treatment for children with neonatal brachial plexus palsy.

  16. Comparison of knee flexion isokinetic deficits between seated and prone positions after ACL reconstruction with hamstrings graft: Implications for rehabilitation and return to sports decisions.

    Science.gov (United States)

    Koutras, Georgios; Bernard, Manfred; Terzidis, Ioannis P; Papadopoulos, Pericles; Georgoulis, Anastasios; Pappas, Evangelos

    2016-07-01

    Hamstrings grafts are commonly used in ACL reconstruction, however, the effect of graft harvesting on knee flexion strength has not been longitudinally evaluated in functional positions. We hypothesized that greater deficits in knee flexion strength exist in the prone compared to the seated position and these deficits remain as rehabilitation progresses. Case series. Forty-two consecutive patients who underwent ACL reconstruction with a hamstrings graft were followed prospectively for 9 months. Isokinetic knee flexion strength at a slow and a fast speed were collected at 3, 4, 6, and 9 months in two different positions: conventional (seated) and functional (0° of hip flexion). Peak torque knee flexion deficits were higher in the prone position compared to the seated position by an average of 6.5% at 60°/s and 9.1% at 180°/s (p<0.001). Measuring knee flexion strength in prone demonstrates higher deficits than in the conventional seated position. Most athletes would not be cleared to return to sports even at 9 months after surgery with this method. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  17. Tactile cues can change movement: An example using tape to redistribute flexion from the lumbar spine to the hips and knees during lifting.

    Science.gov (United States)

    Pinto, Brendan L; Beaudette, Shawn M; Brown, Stephen H M

    2018-05-14

    Given the appropriate cues, kinematic factors associated with low back injury risk and pain, such as spine flexion, can be avoided. Recent research has demonstrated the potential for tactile sensory information to change movement. In this study an athletic strapping tape was applied bilaterally along the lumbar extensor muscles to provide continuous tactile feedback information during a repeated lifting and lowering task. The presence of the tape resulted in a statistically significant reduction in lumbar spine flexion when compared to a baseline condition in which no tape was present. This reduction was further increased with the explicit instruction to pay attention to the sensations elicited by the tape. In both cases, the reduction in lumbar spine flexion was compensated for by increases in hip and knee flexion. When the tape was then removed and participants were instructed to continue lifting as if it was still present, the reduction in lumbar flexion and increases in hip and knee flexion were retained. Thus this study provides evidence that tactile cues can provide vital feedback information that can cue human lumbar spine movement to reduce kinematic factors associated with injury risk and pain. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Resultados clínico-radiológicos en pacientes jóvenes con fractura articular completa de radio distal tratados con placa palmar bloqueada. [Clinical and radiological results in young patients with complete articular distal radius fractures treated with volar locked plate.

    Directory of Open Access Journals (Sweden)

    Pablo De Carli

    2016-02-01

    Conclusión: El tratamiento de las fracturas de radio distal tipo C en pacientes jóvenes con placa palmar bloqueada muestra resultados clínicos y radiológicos favorables con corrección de la mayoría de los escalones articulares.

  19. The bending stiffness of shoes is beneficial to running energetics if it does not disturb the natural MTP joint flexion.

    Science.gov (United States)

    Oh, Keonyoung; Park, Sukyung

    2017-02-28

    A local minimum for running energetics has been reported for a specific bending stiffness, implying that shoe stiffness assists in running propulsion. However, the determinant of the metabolic optimum remains unknown. Highly stiff shoes significantly increase the moment arm of the ground reaction force (GRF) and reduce the leverage effect of joint torque at ground push-off. Inspired by previous findings, we hypothesized that the restriction of the natural metatarsophalangeal (MTP) flexion caused by stiffened shoes and the corresponding joint torque changes may reduce the benefit of shoe bending stiffness to running energetics. We proposed the critical stiffness, k cr , which is defined as the ratio of the MTP joint (MTPJ) torque to the maximal MTPJ flexion angle, as a possible threshold of the elastic benefit of shoe stiffness. 19 subjects participated in a running test while wearing insoles with five different bending stiffness levels. Joint angles, GRFs, and metabolic costs were measured and analyzed as functions of the shoe stiffness. No significant changes were found in the take-off velocity of the center of mass (CoM), but the horizontal ground push-offs were significantly reduced at different shoe stiffness levels, indicating that complementary changes in the lower-limb joint torques were introduced to maintain steady running. Slight increases in the ankle, knee, and hip joint angular impulses were observed at stiffness levels exceeding the critical stiffness, whereas the angular impulse at the MTPJ was significantly reduced. These results indicate that the shoe bending stiffness is beneficial to running energetics if it does not disturb the natural MTPJ flexion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. CT imaging techniques for describing motions of the cervicothoracic junction and cervical spine during flexion, extension, and cervical traction.

    Science.gov (United States)

    Simon, Scott; Davis, Martin; Odhner, Dewey; Udupa, Jayaram; Winkelstein, Beth

    2006-01-01

    Computerized tomographic study of human cadavers undergoing traction and flexion-extension bending. To investigate the feasibility of using computerized tomography techniques to quantify relative vertebral motions of the cervical spine and cervicothoracic junction (CTJ), and to define normative CTJ kinematics. Despite developing an understanding of the mechanical behavior of the cervical spine, little remains known about the cervicothoracic junction. The CTJ is more difficult to image than other cervical regions given the anatomic features of the surrounding bones obstructing CTJ visualization. As such, limited data have been reported describing the responses of the CTJ for motions and loading in the sagittal plane, confounding the clinical assessment of its injuries and surgical treatments used at this region. Helical CT images of the cervical spine and CTJ were acquired incrementally during each of flexion, extension, and cervical traction. Vertebral surfaces were reconstructed using the specialized image analysis software, 3DVIEWNIX. A mathematical description of relative vertebral motions was derived by computing rigid transformations. Euler angles and translations were calculated. Regional spine stiffness was defined for traction. The CTJ was found to be much stiffer (779 N/mm) than the cervical spine (317 N/mm) in tension. In flexion-extension bending, the CTJ was similar to the lower cervical spine. The CTJ demonstrated significantly less coupled motion than the cervical spine. The CTJ, as a transition region between the cervical and thoracic spines, has unique kinematic characteristics. This application of kinematic CT methods is useful for quantifying unreported normative ranges of motion for the CTJ, difficult by other conventional radiologic means.

  1. Effects of knee extension constraint training on knee flexion angle and peak impact ground-reaction force.

    Science.gov (United States)

    Liu, Hui; Wu, Will; Yao, Wanxiang; Spang, Jeffrey T; Creighton, R Alexander; Garrett, William E; Yu, Bing

    2014-04-01

    Low compliance with training programs is likely to be one of the major reasons for inconsistency of the data regarding the effectiveness of current anterior cruciate ligament (ACL) injury prevention programs. Training methods that reduce training time and cost could favorably influence the effectiveness of ACL injury prevention programs. A newly designed knee extension constraint training device may serve this purpose. (1) Knee extension constraint training for 4 weeks would significantly increase the knee flexion angle at the time of peak impact posterior ground-reaction force and decrease peak impact ground-reaction forces during landing of a stop-jump task and a side-cutting task, and (2) the training effects would be retained 4 weeks after completion of the training program. Controlled laboratory study. Twenty-four recreational athletes were randomly assigned to group A or B. Participants in group A played sports without wearing a knee extension constraint device for 4 weeks and then played sports while wearing the device for 4 weeks, while participants in group B underwent a reversed protocol. Both groups were tested at the beginning of week 1 and at the ends of weeks 4 and 8 without wearing the device. Knee joint angles were obtained from 3-dimensional videographic data, while ground-reaction forces were measured simultaneously using force plates. Analyses of variance were performed to determine the training effects and the retention of training effects. Participants in group A significantly increased knee flexion angles and decreased ground-reaction forces at the end of week 8 (P ≤ .012). Participants in group B significantly increased knee flexion angles and decreased ground-reaction forces at the ends of weeks 4 and 8 (P ≤ .007). However, participants in group B decreased knee flexion angles and increased ground-reaction forces at the end of week 8 in comparison with the end of week 4 (P ≤ .009). Knee extension constraint training for 4 weeks

  2. Comparative study of phrenic nerve transfers with and without nerve graft for elbow flexion after global brachial plexus injury.

    Science.gov (United States)

    Liu, Yuzhou; Lao, Jie; Gao, Kaiming; Gu, Yudong; Zhao, Xin

    2014-01-01

    Nerve transfer is a valuable surgical technique in peripheral nerve reconstruction, especially in brachial plexus injuries. Phrenic nerve transfer for elbow flexion was proved to be one of the optimal procedures in the treatment of brachial plexus injuries in the study of Gu et al. The aim of this study was to compare phrenic nerve transfers with and without nerve graft for elbow flexion after brachial plexus injury. A retrospective review of 33 patients treated with phrenic nerve transfer for elbow flexion in posttraumatic global root avulsion brachial plexus injury was carried out. All the 33 patients were confirmed to have global root avulsion brachial plexus injury by preoperative and intraoperative electromyography (EMG), physical examination and especially by intraoperative exploration. There were two types of phrenic nerve transfers: type1 - the phrenic nerve to anterolateral bundle of anterior division of upper trunk (14 patients); type 2 - the phrenic nerve via nerve graft to anterolateral bundle of musculocutaneous nerve (19 patients). Motor function and EMG evaluation were performed at least 3 years after surgery. The efficiency of motor function in type 1 was 86%, while it was 84% in type 2. The two groups were not statistically different in terms of Medical Research Council (MRC) grade (p=1.000) and EMG results (p=1.000). There were seven patients with more than 4 month's delay of surgery, among whom only three patients regained biceps power to M3 strength or above (43%). A total of 26 patients had reconstruction done within 4 months, among whom 25 patients recovered to M3 strength or above (96%). There was a statistically significant difference of motor function between the delay of surgery within 4 months and more than 4 months (p=0.008). Phrenic nerve transfers with and without nerve graft for elbow flexion after brachial plexus injury had no significant difference for biceps reinnervation according to MRC grading and EMG. A delay of the surgery

  3. Vicious Cycle of Multiple Invasive Treatments in a Hemophilic Inhibitor Positive Child with Resistant Knee Flexion Contracture, A Case Report

    Directory of Open Access Journals (Sweden)

    Amir Reza Kachooei

    2013-12-01

    Full Text Available   Uncontrolled recurrent hemarthrosis can end to contracture, deformity, pain, joint destruction and gait disorders which are disabling. We are going to report a challenge, a unilateral knee flexion contracture in a child with severe hemophilia A and inhibitor who underwent different treatment options with unsatisfactory improvement of knee range of motion. Mismanaging postoperatively, patient and parents irresponsibility in managing self-care, lack of access and affordability to treatment and unavailability of proper treatment can be the reasons of recurrence in addition to the tough nature of a patient with inhibitor.  

  4. Vicious Cycle of Multiple Invasive Treatments in a Hemophilic Inhibitor Positive Child with Resistant Knee Flexion Contracture, A Case Report

    Directory of Open Access Journals (Sweden)

    Amir Reza Kachooei

    2013-12-01

    Full Text Available Uncontrolled recurrent hemarthrosis can end to contracture, deformity, pain, joint destruction and gait disorders which are disabling. We are going to report a challenge, a unilateral knee flexion contracture in a child with severe hemophilia A and inhibitor who underwent different treatment options with unsatisfactory improvement of knee range of motion. Mismanaging postoperatively, patient and parents irresponsibility in managing self-care, lack of access and affordability to treatment and unavailability of proper treatment can be the reasons of recurrence in addition to the tough nature of a patient with inhibitor.

  5. PARQUES DE PRODUÇÃO DE ENERGIA EÓLICA E TRANSFORMAÇÕES NA PAISAGEM – ESTUDO DE CASO EM SANTA VITÓRIA DO PALMAR/RS

    Directory of Open Access Journals (Sweden)

    Anelize Milano Cardoso

    2015-07-01

    Full Text Available Numa região das mais isoladas do Estado, no extremo sul do país, logo no início da BR-471, rodovia que liga o município do Chuí ao município de Santa Vitória do Palmar, já estão instalados os primeiros aerogeradores do Complexo Eólico Campos Neutrais, que reúne três grandes parques: Geribatu, Chuí e Hermenegildo. As dez plantas, cada uma com mais de dez aerogeradores do Parque Eólico Geribatu já estão finalizados e em funcionamento, causando uma alteração drástica na fisionomia da paisagem. O objetivo deste trabalho foi compreender, a partir da literatura referente, o crescimento da produção de energia eólica, as características das áreas em que se implantaram parques ou complexos eólicos e os impactos dos objetos técnicos relacionados a esta produção na paisagem. Foi realizado, primeiramente, um levantamento de material bibliográfico sobre os métodos relativos ao estudo da paisagem, destacando-se a abordagem da percepção. Atualmente observa-se que as alterações sentidas na dinâmica do município, devido à instalação do Parque Eólico, não se limitam apenas ao impacto visual, tais como o aumento do fluxo do trânsito e a maior circulação de pessoas. Santa Vitória do Palmar, com a implementação do Parque, vive uma atmosfera de otimismo, ganhando uma nova identidade, alterando assim de forma positiva, a própria relação da comunidade local com o contexto que a circunda. Santa Vitória do Palmar, no imaginário local, passou a contextualizar-se no mundo globalizado através de um símbolo que representa a ideia de desenvolvimento limpo e responsável.

  6. Hemostatic abnormalities in liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Kendal YALÇIN

    2009-06-01

    Full Text Available In this study, 44 patients with liver cirrhosis were investigated for hemostatic parameters. Patients with spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome and cholestatic liver diseases were excluded. Patients were classified by Child-Pugh criterion and according to this 4 patients were in Class A, 20 in Class B and 20 in C. Regarding to these results, it was aimed to investigate the haematological disturbances in liver cirrhotic patients.In the result there was a correlation between activated partial thromboplastin time, serum iron, ferritin, transferrin, haptoglobin and Child-Pugh classification. Besides there was no correlation between prothrombin time, factor 8 and 9, protein C and S, anti-thrombin 3, fibrinogen, fibrin degradation products, serum iron binding capacity, hemoglobin, leukocyte, mean corpuscular volume and Child-Pugh classification.There were significant difference, in terms of AST, ferritin, haptoglobulin, sex and presence of ascites between groups (p0.05. In the summary, we have found correlation between hemostatic abnormalities and disease activity and clinical prognosis in patients with liver cirrhosis which is important in the management of these patients. This is also important for identification of liver transplant candidiates earlier.

  7. [Cognitive abnormalities and cannabis use].

    Science.gov (United States)

    Solowij, Nadia; Pesa, Nicole

    2010-05-01

    Evidence that cannabis use impairs cognitive function in humans has been accumulating in recent decades. The purpose of this overview is to update knowledge in this area with new findings from the most recent literature. Literature searches were conducted using the Web of Science database up to February 2010. The terms searched were: "cannabi*" or "marijuana", and "cogniti*" or "memory" or "attention" or "executive function", and human studies were reviewed preferentially over the animal literature. Cannabis use impairs memory, attention, inhibitory control, executive functions and decision making, both during the period of acute intoxication and beyond, persisting for hours, days, weeks or more after the last use of cannabis. Pharmacological challenge studies in humans are elucidating the nature and neural substrates of cognitive changes associated with various cannabinoids. Long-term or heavy cannabis use appears to result in longer-lasting cognitive abnormalities and possibly structural brain alterations. Greater adverse cognitive effects are associated with cannabis use commencing in early adolescence. The endogenous cannabinoid system is involved in regulatory neural mechanisms that modulate processes underlying a range of cognitive functions that are impaired by cannabis. Deficits in human users most likely therefore reflect neuroadaptations and altered functioning of the endogenous cannabinoid system.

  8. Report on abnormal climate in 2011

    International Nuclear Information System (INIS)

    2011-12-01

    This paper reports of impact on abnormal climate in 2011. It has Introduction with purpose and background of publish and summary of this report. The cause and current state on abnormal climate of the world and Korea in 2011, Measurement and impact against abnormal climate in 2011 to agriculture, land and maritime, industry and energy, prevention of disasters, environment and health, assessment and advice on the policy. It lists the appendix about occurrence and damage on abnormal climate of the world and Korea in 2011 and media report data.

  9. Evaluation of Chromosomal Abnormalities and Common ...

    African Journals Online (AJOL)

    Evaluation of Chromosomal Abnormalities and Common Trombophilic Mutations in Cases with Recurrent Miscarriage. Ahmet Karatas, Recep Eroz, Mustafa Albayrak, Tulay Ozlu, Bulent Cakmak, Fatih Keskin ...

  10. Do the cerebellar tonsils move during flexion and extension of the neck in patients with Chiari I malformation? A radiological study with clinical implications.

    Science.gov (United States)

    Tubbs, R Shane; Kirkpatrick, Christina M; Rizk, Elias; Chern, Joshua J; Oskouian, Rod J; Oakes, W Jerry

    2016-03-01

    In the past, diagnosis of the Chiari I malformation has primarily been made on midsagittal MRI. We hypothesized that based on the frequent presentation of opisthotonos in patients with hindbrain hernia (primarily Chiari II malformation but sometimes Chiari I malformation) that the hyperextension might be a compensatory technique used by such patients to bring the cerebellar tonsils up out of the cervical spine. This prospective study reviewed imaging of patients with Chiari I malformation who underwent flexion/extension MRI for evaluation of their hindbrain herniation. Age-matched controls were used for comparison. In general, there was elevation of the cerebellar tonsils with extension and increased descent with flexion of the cervical spine. In 72 % of patients, flexion of the neck resulted in descent of the cerebellar tonsils. In 64 % of patients, extension of the neck resulted in ascent of the cerebellar tonsils. In the 14 patients with an associated syrinx, 71 % were found to have caudal movement of the cerebellar tonsils with neck flexion, and only 43 % were observed to have any movement of the cerebellar tonsils in neck extension compared to patients without a syrinx where ascent of the tonsils was seen in only nine during neck extension. Two patients were observed to have the reverse finding of ascent of the cerebellar tonsils with neck flexion and descent of the cerebellar tonsils with neck extension. Five patients had no movement of the cerebellar tonsils in either flexion or extension of the neck, and one of these had a small syrinx. Although minimal and not in all patients, we observed elevation of the herniated cerebellar tonsils with extension of the cervical spine in patients with Chiari I malformation. This finding provides evidence as to why some patients with hindbrain herniation present with opisthotonos and supports earlier findings that CSF flow is reduced at the craniocervical junction in flexion in patients with Chiari I malformation.

  11. Influence of fear of falling on anticipatory postural control of medio-lateral stability during rapid leg flexion.

    Science.gov (United States)

    Yiou, E; Deroche, T; Do, M C; Woodman, T

    2011-04-01

    During leg flexion from erect posture, postural stability is organized in advance during "anticipatory postural adjustments" (APA). During these APA, inertial forces are generated that propel the centre of gravity (CoG) laterally towards stance leg side. This study examined how fear of falling (FoF) may influence this anticipatory postural control of medio-lateral (ML) stability. Ten young healthy participants performed a series of leg flexions at maximal velocity from low and high surface heights (6 and 66 cm above ground, respectively). In this latter condition with increased FoF, stance foot was placed at the lateral edge of the support surface to induce maximal postural threat. Results showed that the amplitude of ML inertial forces generated during APA decreased with FoF; this decrease was compensated by an increase in APA duration so that the CoG position at time of swing foot-off was located further towards stance leg side. With these changes in ML APA, the CoG was propelled in the same final (unipodal) position above stance foot as in condition with low FoF. These results contrast with those obtained in the literature during quiet standing which showed that FoF did not have any influence on the ML component of postural control. It is proposed that ML APA are modified with increased FoF, in such a way that the risk of a sideway fall induced by the large CoG motion is attenuated.

  12. Does Semi-Rigid Instrumentation Using Both Flexion and Extension Dampening Spacers Truly Provide an Intermediate Level of Stabilization?

    Directory of Open Access Journals (Sweden)

    Dilip Sengupta

    2013-01-01

    Full Text Available Conventional posterior dynamic stabilization devices demonstrated a tendency towards highly rigid stabilization approximating that of titanium rods in flexion. In extension, they excessively offload the index segment, making the device as the sole load-bearing structure, with concerns of device failure. The goal of this study was to compare the kinematics and intradiscal pressure of monosegmental stabilization utilizing a new device that incorporates both a flexion and extension dampening spacer to that of rigid internal fixation and a conventional posterior dynamic stabilization device. The hypothesis was the new device would minimize the overloading of adjacent levels compared to rigid and conventional devices which can only bend but not stretch. The biomechanics were compared following injury in a human cadaveric lumbosacral spine under simulated physiological loading conditions. The stabilization with the new posterior dynamic stabilization device significantly reduced motion uniformly in all loading directions, but less so than rigid fixation. The evaluation of adjacent level motion and pressure showed some benefit of the new device when compared to rigid fixation. Posterior dynamic stabilization designs which both bend and stretch showed improved kinematic and load-sharing properties when compared to rigid fixation and when indirectly compared to existing conventional devices without a bumper.

  13. Simulation of lumbar and neck angle flexion while ingress of paratransit (angkot in Indonesia as a preliminary design study

    Directory of Open Access Journals (Sweden)

    Yukhi Mustaqim Kusuma Sya’bana

    2017-12-01

    Full Text Available This is the preliminary finding of a study to simulate lumbar and neck flexion while ingress to the paratransit. The result of simulation will determine design aspect criteria as a preliminary step before ideation and implementation design steps. Biomechanics of Bodies (BoB is software that used to represent passenger task during paratransit ingress simulation, with skeleton model that used is height 165 cm and weight 65 kg. Environment to represent this simulation is measured Suzuki Carry SS 2013 as a private car that has been modified into a public transportation in accordance with the Indonesian government road-worthy test. Due to the low height of the entrance and the high ground clearance, lumbar and neck joint angle was a focus of this ingress simulation. The peak angle at the neck joint is 40° when 2 s skeleton nod in the door limitation ingress and lumbar flexion is 70° when 5 s skeleton is walking while bend over that will increase the load on that area. Based on biomechanical simulation approach, we may suggest the dimension of public transportation design framework developments, especially paratransit.

  14. Muscle releases to improve passive motion and relieve pain in patients with spastic hemiplegia and elbow flexion contractures.

    Science.gov (United States)

    Namdari, Surena; Horneff, J Gabe; Baldwin, Keith; Keenan, Mary Ann

    2012-10-01

    Patients with spastic hemiplegia after upper motor neuron (UMN) injury can develop elbow contractures. This study evaluated outcomes of elbow releases in treating spastic elbow flexion contractures in hemiplegic patients. Adults with spastic hemiplegia due to UMN injury who underwent elbow releases (brachialis, brachioradialis, and biceps muscles) were included. Nonoperative treatment was unsuccessful in all patients. Patients complained of difficulty with passive functions. Passive range of motion (ROM), pain relief, Modified Ashworth spasticity score, and complications were evaluated preoperatively and postoperatively. There were 8 men and 21 women with an average age of 52.4 years (range, 24.1-81.4 years). Seventeen patients had pain preoperatively. Postoperative follow-up was a mean of 1.7 years (range, 1-4.5 years). Preoperatively, patients lacked a mean of 78° of passive elbow extension compared with 17° postoperatively (P .05). Releases of the brachialis, brachioradialis, and biceps muscles can be an effective means of pain relief, improved passive ROM, and decreased spasticity in patients with elbow flexion deformity after UMN injury. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  15. A Pilot Study of Individual Muscle Force Prediction during Elbow Flexion and Extension in the Neurorehabilitation Field

    Directory of Open Access Journals (Sweden)

    Jiateng Hou

    2016-11-01

    Full Text Available This paper proposes a neuromusculoskeletal (NMS model to predict individual muscle force during elbow flexion and extension. Four male subjects were asked to do voluntary elbow flexion and extension. An inertial sensor and surface electromyography (sEMG sensors were attached to subject's forearm. Joint angle calculated by fusion of acceleration and angular rate using an extended Kalman filter (EKF and muscle activations obtained from the sEMG signals were taken as the inputs of the proposed NMS model to determine individual muscle force. The result shows that our NMS model can predict individual muscle force accurately, with the ability to reflect subject-specific joint dynamics and neural control solutions. Our method incorporates sEMG and motion data, making it possible to get a deeper understanding of neurological, physiological, and anatomical characteristics of human dynamic movement. We demonstrate the potential of the proposed NMS model for evaluating the function of upper limb movements in the field of neurorehabilitation.

  16. Effects of theophylline administration and intracranial abnormalities ...

    African Journals Online (AJOL)

    Objective: To determine effects of theophylline therapy for recurrent apnoea of prematurity and abnormal early (within the first 24 hours) cranial ultrasound abnormalities on protective neck turning response in preterm infants. Design: A cross sectional descriptive study. Setting: The Neonatal Unit of Hammersmith Hospital, ...

  17. An Abnormal Psychology Community Based Interview Assignment

    Science.gov (United States)

    White, Geoffry D.

    1977-01-01

    A course option in abnormal psychology involves students in interviewing and observing the activities of individuals in the off-campus community who are concerned with some aspect of abnormal psychology. The technique generates student interest in the field when they interview people about topics such as drug abuse, transsexualism, and abuse of…

  18. Prevalence of biochemical and immunological abnormalities in ...

    African Journals Online (AJOL)

    Tile prevalence of biochemical and immunological abnormalities was studied in a group of 256 patients with rheumatoid arthritis (104 coloureds, 100 whites and 52 blacks). The most common biochemical abnormalities detected were a reduction in the serum creatinine value (43,4%), raised globulins (39,7%), raised serum ...

  19. Contrast sensitivity abnormalities in deaf individuals

    Directory of Open Access Journals (Sweden)

    Masoud Khorrami-Nejad

    2018-01-01

    Conclusion: Hearing impaired boys are at a greater risk for contrast sensitivity abnormalities than boys with normal hearing. The larger frequency of contrast sensitivity abnormalities in high spatial frequencies than in other frequencies may demonstrate greater defects in the central visual system compared with the periphery in individuals with hearing loss.

  20. Relationship among sera lipoprotein abnormalities in healthy ...

    African Journals Online (AJOL)

    As the prevalence of lipoprotein abnormalities in adolescents is increasing dramatically, the identification of relevant risk factors is a major public health challenge. The aim of this study was to investigate whether a family history of diabetes could be a risk factor for lipid abnormalities in healthy individuals. This study is a ...

  1. Reproducibility of joint space width and the intermargin distance measurements in patients with medial osteoarthritis of the knee in various degrees of flexion

    International Nuclear Information System (INIS)

    Takahashi, Toshiaki; Yamamoto, Haruyasu; Yamanaka, Norio; Ikeuchi, Masahiko

    2009-01-01

    This study tested the variability and reproducibility of measurements of the joint space width (JSW) and intermargin distance (IMD) of the medial tibial plateau in specific positions of knee flexion in osteoarthritic knees in order to evaluate the most useful knee angle for radiographic measurements. Radiographs from 56 knees with osteoarthritis from 46 patients were taken with the knees in conventional full extension and 15 , 30 , and 45 of flexion with weight bearing. Three orthopedic surgeons independently measured the JSW and IMD at the narrowest point and the midpoint of medial tibial plateau using a computer-assisted method. The JSW and IMD were smallest at 15 flexion, both measured at the narrowest point and the midpoint of the medial compartment. Reproducibility of the IMD at the midpoint was better than at the narrowest point for all four flexion angles. Measurements of the medial JSW and IMD are smallest at 15 of knee flexion indicating that radiographs should be obtained at this angle in order to best demonstrate the extent of osteoarthritis. (orig.)

  2. Reproducibility of joint space width and the intermargin distance measurements in patients with medial osteoarthritis of the knee in various degrees of flexion

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Toshiaki; Yamamoto, Haruyasu [Ehime University Graduate School of Medicine, Department of Bone and Joint Surgery, Toon, Ehime (Japan); Yamanaka, Norio; Ikeuchi, Masahiko [Kochi University, Department of Orthopaedics, Kochi Medical School, Nankoku, Kochi (Japan)

    2009-01-15

    This study tested the variability and reproducibility of measurements of the joint space width (JSW) and intermargin distance (IMD) of the medial tibial plateau in specific positions of knee flexion in osteoarthritic knees in order to evaluate the most useful knee angle for radiographic measurements. Radiographs from 56 knees with osteoarthritis from 46 patients were taken with the knees in conventional full extension and 15 , 30 , and 45 of flexion with weight bearing. Three orthopedic surgeons independently measured the JSW and IMD at the narrowest point and the midpoint of medial tibial plateau using a computer-assisted method. The JSW and IMD were smallest at 15 flexion, both measured at the narrowest point and the midpoint of the medial compartment. Reproducibility of the IMD at the midpoint was better than at the narrowest point for all four flexion angles. Measurements of the medial JSW and IMD are smallest at 15 of knee flexion indicating that radiographs should be obtained at this angle in order to best demonstrate the extent of osteoarthritis. (orig.)

  3. Comparison of cranio-cervical flexion training versus cervical proprioception training in patients with chronic neck pain: A randomized controlled clinical trial.

    Science.gov (United States)

    Gallego Izquierdo, Tomás; Pecos-Martin, Daniel; Lluch Girbés, Enrique; Plaza-Manzano, Gustavo; Rodríguez Caldentey, Ricardo; Mayor Melús, Rodrigo; Blanco Mariscal, Diego; Falla, Deborah

    2016-01-01

    To compare the effects of cranio-cervical flexion vs cervical proprioception training on neuromuscular control, pressure pain sensitivity and perceived pain and disability in patients with chronic neck pain. Twenty-eight volunteers with chronic non-specific neck pain were randomly assigned to 1 of 2 interventions and undertook 6 physiotherapist-supervised sessions over a period of 2 months. Both groups performed daily home exercise. Performance on the cranio-cervical flexion test, pressure pain thresholds and reported levels of pain and disability were measured before and immediately after the first treatment session, 1 month after starting treatment and 2 months after starting treatment (at completion of the intervention). At 2 months, both groups improved their performance on the cranio-cervical flexion test (p  0.05). Both groups showed a reduction in their pain at rest and disability at 2 months, but this was also not different between groups (p > 0.05). Pressure pain sensitivity did not change for either group. Both specific cranio-cervical flexion training and proprioception training had a comparable effect on performance on the cranio-cervical flexion test, a test of the neuromuscular control of the deep cervical flexors. These results indicate that proprioception training may have positive effects on the function of the deep cervical flexors.

  4. Report to Congress on abnormal occurrences

    International Nuclear Information System (INIS)

    1993-06-01

    Section 208 of the Energy Reorganization Act of 1974 identifies an abnormal occurrence as an unscheduled incident or event that the Nuclear Regulatory Commission determines to be significant from the standpoint of public health and safety and requires a quarterly report of such events to be made to Congress. This report covers the period January through March 1993. There is one abnormal occurrence at a nuclear power plant disposed in this report that involved a steam generator tube rupture at Palo Verde Unit 2, and none for fuel cycle facilities. Three abnormal occurrences involving medical misadminstrations (two therapeutic and one diagnostic) at NRC-licensed facilities are also discussed in this report. No abnormal occurrences were reported by NRC's Agreement States. The report also contains information updating previously reported abnormal occurrences

  5. Força de preensão palmar em idosos com demência: estudo da confiabilidade Handgrip strength in elderly with dementia: study of reliability

    Directory of Open Access Journals (Sweden)

    Mariana A. Alencar

    2012-01-01

    Full Text Available CONTEXTUALIZAÇÃO: Instrumentos de medida devem ser analisados quanto a sua utilidade clínica e científica em diferentes populações. Apesar de o teste da força de preensão palmar (FPP ser amplamente utilizado, pouco foi investigado quanto a sua confiabilidade ao ser utilizado em idosos com demência e em qual grau de demência seria inviabilizado o seu uso. OBJETIVO: Avaliar a confiabilidade teste-reteste da FPP em idosos com diferentes graus de demência. MÉTODO: Realizou-se uma avaliação dos aspectos cognitivos de 76 idosos com demência e uma entrevista com o cuidador, permitindo a classificação do idoso segundo os critérios da Escala Clínica de Demência (Clinical dementia rating - CDR. Para essas avaliações, foram utilizados o Miniexame do Estado Mental e os questionários Pfeffer, Lawton e Katz. Vinte idosos foram classificados como grau questionável (83,4±5,8 anos; 19, como leve (82,4±6,8 anos; 19, como moderado (85,8±5,6 anos e 18, como grave (84,0±5,1 anos. Os idosos tiveram a FPP avaliada por meio de um dinamômetro hidráulico JAMAR e, após uma semana, foram reavaliados. A confiabilidade foi estimada pelo Coeficiente de Correlação Intraclasse (ICC. O nível de significância foi α=0,05. RESULTADOS: A confiabilidade teste-reteste foi excelente para os grupos que apresentaram o CDR questionável (ICC=0,975; p=0,001, leve (ICC=0,968; p=0,002 e moderado (ICC=0,964; p=0,001. A análise do grupo com CDR grave mostrou não haver uma significância estatística e um ICC baixo (ICC=0,415; p=0,376. CONCLUSÃO: O teste de FPP apresenta excelente confiabilidade ao ser utilizado em idosos com demências questionável, leve e moderada, viabilizando seu uso em pesquisas. Já em idosos classificados como graves, seu uso não é recomendado visto que a confiabilidade da medida é baixa e, portanto, sem relevância clínica para uso na prática.BACKGROUND: Measuring instruments should have their scientific and clinical value

  6. Força de preensão palmar em idosos com demência: estudo da confiabilidade Handgrip strength in elderly with dementia: study of reliability

    Directory of Open Access Journals (Sweden)

    Mariana A. Alencar

    2012-12-01

    Full Text Available CONTEXTUALIZAÇÃO: Instrumentos de medida devem ser analisados quanto a sua utilidade clínica e científica em diferentes populações. Apesar de o teste da força de preensão palmar (FPP ser amplamente utilizado, pouco foi investigado quanto a sua confiabilidade ao ser utilizado em idosos com demência e em qual grau de demência seria inviabilizado o seu uso. OBJETIVO: Avaliar a confiabilidade teste-reteste da FPP em idosos com diferentes graus de demência. MÉTODO: Realizou-se uma avaliação dos aspectos cognitivos de 76 idosos com demência e uma entrevista com o cuidador, permitindo a classificação do idoso segundo os critérios da Escala Clínica de Demência (Clinical dementia rating - CDR. Para essas avaliações, foram utilizados o Miniexame do Estado Mental e os questionários Pfeffer, Lawton e Katz. Vinte idosos foram classificados como grau questionável (83,4±5,8 anos; 19, como leve (82,4±6,8 anos; 19, como moderado (85,8±5,6 anos e 18, como grave (84,0±5,1 anos. Os idosos tiveram a FPP avaliada por meio de um dinamômetro hidráulico JAMAR e, após uma semana, foram reavaliados. A confiabilidade foi estimada pelo Coeficiente de Correlação Intraclasse (ICC. O nível de significância foi α=0,05. RESULTADOS: A confiabilidade teste-reteste foi excelente para os grupos que apresentaram o CDR questionável (ICC=0,975; p=0,001, leve (ICC=0,968; p=0,002 e moderado (ICC=0,964; p=0,001. A análise do grupo com CDR grave mostrou não haver uma significância estatística e um ICC baixo (ICC=0,415; p=0,376. CONCLUSÃO: O teste de FPP apresenta excelente confiabilidade ao ser utilizado em idosos com demências questionável, leve e moderada, viabilizando seu uso em pesquisas. Já em idosos classificados como graves, seu uso não é recomendado visto que a confiabilidade da medida é baixa e, portanto, sem relevância clínica para uso na prática.BACKGROUND: Measuring instruments should have their scientific and clinical value

  7. The effect of resistance level and stability demands on recruitment patterns and internal loading of spine in dynamic flexion and extension using a simple trunk model.

    Science.gov (United States)

    Zeinali-Davarani, Shahrokh; Shirazi-Adl, Aboulfazl; Dariush, Behzad; Hemami, Hooshang; Parnianpour, Mohamad

    2011-07-01

    The effects of external resistance on the recruitment of trunk muscles in sagittal movements and the coactivation mechanism to maintain spinal stability were investigated using a simple computational model of iso-resistive spine sagittal movements. Neural excitation of muscles was attained based on inverse dynamics approach along with a stability-based optimisation. The trunk flexion and extension movements between 60° flexion and the upright posture against various resistance levels were simulated. Incorporation of the stability constraint in the optimisation algorithm required higher antagonistic activities for all resistance levels mostly close to the upright position. Extension movements showed higher coactivation with higher resistance, whereas flexion movements demonstrated lower coactivation indicating a greater stability demand in backward extension movements against higher resistance at the neighbourhood of the upright posture. Optimal extension profiles based on minimum jerk, work and power had distinct kinematics profiles which led to recruitment patterns with different timing and amplitude of activation.

  8. Full Range of Motion Induces Greater Muscle Damage Than Partial Range of Motion in Elbow Flexion Exercise With Free Weights.

    Science.gov (United States)

    Baroni, Bruno M; Pompermayer, Marcelo G; Cini, Anelize; Peruzzolo, Amanda S; Radaelli, Régis; Brusco, Clarissa M; Pinto, Ronei S

    2017-08-01

    Baroni, BM, Pompermayer, MG, Cini, A, Peruzzolo, AS, Radaelli, R, Brusco, CM, and Pinto, RS. Full range of motion induces greater muscle damage than partial range of motion in elbow flexion exercise with free weights. J Strength Cond Res 31(8): 2223-2230, 2017-Load and range of motion (ROM) applied in resistance training (RT) affect the muscle damage magnitude and the recovery time-course. Because exercises performed with partial ROM allow a higher load compared with those with full ROM, this study investigated the acute effect of a traditional RT exercise using full ROM or partial ROM on muscle damage markers. Fourteen healthy men performed 4 sets of 10 concentric-eccentric repetitions of unilateral elbow flexion on the Scott bench. Arms were randomly assigned to partial-ROM (50-100°) and full-ROM (0-130°) conditions, and load was determined as 80% of 1 repetition maximum (1RM) in the full- and partial-ROM tests. Muscle damage markers were assessed preexercise, immediately, and 24, 48, and 72 hours after exercise. Primary outcomes were peak torque, muscle soreness during palpation and elbow extension, arm circumference, and joint ROM. The load lifted in the partial-ROM condition (1RM = 19.1 ± 3.0 kg) was 40 ± 18% higher compared with the full-ROM condition (1RM = 13.7 ± 2.2 kg). Seventy-two hours after exercise, the full-ROM condition led to significant higher soreness sensation during elbow extension (1.3-4.1 cm vs. 1.0-1.9 cm) and smaller ROM values (97.5-106.1° vs. 103.6-115.7°). Peak torque, soreness from palpation, and arm circumference were statistically similar between conditions, although mean values in all time points of these outcomes have suggested more expressive muscle damage for the full-ROM condition. In conclusion, elbow flexion exercise with full ROM seems to induce greater muscle damage than partial-ROM exercises, even though higher absolute load was achieved with partial ROM.

  9. Effects of upright weight bearing and the knee flexion angle on patellofemoral indices using magnetic resonance imaging in patients with patellofemoral instability.

    Science.gov (United States)

    Becher, Christoph; Fleischer, Benjamin; Rase, Marten; Schumacher, Thees; Ettinger, Max; Ostermeier, Sven; Smith, Tomas

    2017-08-01

    This study analysed the effects of upright weight bearing and the knee flexion angle on patellofemoral indices, determined using magnetic resonance imaging (MRI), in patients with patellofemoral instability (PI). Healthy volunteers (control group, n = 9) and PI patients (PI group, n = 16) were scanned in an open-configuration MRI scanner during upright weight bearing and supine non-weight bearing positions at full extension (0° flexion) and at 15°, 30°, and 45° flexion. Patellofemoral indices included the Insall-Salvati Index, Caton-Deschamp Index, and Patellotrochlear Index (PTI) to determine patellar height and the patellar tilt angle (PTA), bisect offset (BO), and the tibial tubercle-trochlear groove (TT-TG) distance to assess patellar rotation and translation with respect to the femur and alignment of the extensor mechanism. A significant interaction effect of weight bearing by flexion angle was observed for the PTI, PTA, and BO for subjects with PI. At full extension, post hoc pairwise comparisons revealed a significant effect of weight bearing on the indices, with increased patellar height and increased PTA and BO in the PI group. Except for the BO, no such changes were seen in the control group. Independent of weight bearing, flexing the knee caused the PTA, BO, and TT-TG distance to be significantly reduced. Upright weight bearing and the knee flexion angle affected patellofemoral MRI indices in PI patients, with significantly increased values at full extension. The observations of this study provide a caution to be considered by professionals when treating PI patients. These patients should be evaluated clinically and radiographically at full extension and various flexion angles in context with quadriceps engagement. Explorative case-control study, Level III.

  10. Prediction of heart abnormality using MLP network

    Science.gov (United States)

    Hashim, Fakroul Ridzuan; Januar, Yulni; Mat, Muhammad Hadzren; Rizman, Zairi Ismael; Awang, Mat Kamil

    2018-02-01

    Heart abnormality does not choose gender, age and races when it strikes. With no warning signs or symptoms, it can result to a sudden death of the patient. Generally, heart's irregular electrical activity is defined as heart abnormality. Via implementation of Multilayer Perceptron (MLP) network, this paper tries to develop a program that allows the detection of heart abnormality activity. Utilizing several training algorithms with Purelin activation function, an amount of heartbeat signals received through the electrocardiogram (ECG) will be employed to condition the MLP network.

  11. Hysterosalpingography: analysis of 473 abnormal examinations

    International Nuclear Information System (INIS)

    Petta, C.A.; Costa-Paiva, L.H.S. da; Pinto-Neto, A.M.; Martins, R.; Souza, G.A.

    1990-01-01

    The authors reviewed the reports of 4/3 abnormal hysterosalpingographies from 1,200 medical records of patients at the sterility and infertility out-patient clinic of the School of Medical Sciences of the State University of Campinas (Unicamp), from July, 1974 to December, 1981. The objective was to evaluate the incidence and main alterations diagnosed by hysterosalpingography. The most frequent findings were tuboperitoneal factors in 91% of the examinations, uterine cavity abnormalities in 17.4% and cervical factor in 6.3% of the cases. The examinations showed a great incident of tuboperitoneal abnormalities as cause of sterility from lower social classes. (author) [pt

  12. Numerically abnormal chromosome constitutions in humans

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    Chapter 24, discusses numerically abnormal chromosome constitutions in humans. This involves abnormalities of human chromosome number, including polyploidy (when the number of sets of chromosomes increases) and aneuploidy (when the number of individual normal chromosomes changes). Chapter sections discuss the following chromosomal abnormalities: human triploids, imprinting and uniparental disomy, human tetraploids, hydatidiform moles, anomalies caused by chromosomal imbalance, 13 trisomy (D{sub 1} trisomy, Patau syndrome), 21 trisomy (Down syndrome), 18 trisomy syndrome (Edwards syndrome), other autosomal aneuploidy syndromes, and spontaneous abortions. The chapter concludes with remarks on the nonrandom participation of chromosomes in trisomy. 69 refs., 3 figs., 4 tabs.

  13. Brain and bone abnormalities of thanatophoric dwarfism.

    Science.gov (United States)

    Miller, Elka; Blaser, Susan; Shannon, Patrick; Widjaja, Elysa

    2009-01-01

    The purpose of this article is to present the imaging findings of skeletal and brain abnormalities in thanatophoric dwarfism, a lethal form of dysplastic dwarfism. The bony abnormalities associated with thanatophoric dwarfism include marked shortening of the tubular bones and ribs. Abnormal temporal lobe development is a common associated feature and can be visualized as early as the second trimester. It is important to assess the brains of fetuses with suspected thanatophoric dwarfism because the presence of associated brain malformations can assist in the antenatal diagnosis of thanatophoric dwarfism.

  14. Abnormal Event Detection Using Local Sparse Representation

    DEFF Research Database (Denmark)

    Ren, Huamin; Moeslund, Thomas B.

    2014-01-01

    We propose to detect abnormal events via a sparse subspace clustering algorithm. Unlike most existing approaches, which search for optimized normal bases and detect abnormality based on least square error or reconstruction error from the learned normal patterns, we propose an abnormality measurem...... is found that satisfies: the distance between its local space and the normal space is large. We evaluate our method on two public benchmark datasets: UCSD and Subway Entrance datasets. The comparison to the state-of-the-art methods validate our method's effectiveness....

  15. Modified Pectoralis Major Tendon Transfer for Reanimation of Elbow Flexion as a Salvage Procedure in Complete Brachial Plexus Injury: A Case Report

    Directory of Open Access Journals (Sweden)

    S Taran

    2013-03-01

    Full Text Available Traumatic brachial plexus injuries rarely recover spontaneously and if the window period for neurotisation has elapsed, the only option for restoration of function lies in a salvage procedure. Many such salvage procedures have been described in the literature with variable functional results. We report the case of a 16-year-old boy who presented after unsuccessful treatment for a complete brachial plexus injury; we performed a pectoralis major tendon transfer to attain elbow flexion. Postoperatively, the elbow was splinted with flexion at 100°. After 4 weeks of immobilization the splint was removed and the patient could actively flex his elbow from 30° to 100°.

  16. Physical therapy intervention for an adolescent with a knee flexion contracture and diagnosis of multiple pterygium syndrome.

    Science.gov (United States)

    Bellamy, Sandra Gail; Gibbs, Karen; Lazaro, Rolando

    2007-01-01

    The purpose of this case report is to describe a course of physical therapy for a client with a rare genetic condition, multiple pterygium syndrome (MPS). MPS is a rare genetic disorder characterized by connective tissue webbing across multiple joints, dysmorphic facies, and various visceral and skeletal deformities. Before the patient commenced physical therapy, surgical amputation was recommended for the client's knee flexion contracture. The client's treatment plan included stretching, manual therapy, and resisted exercise. Long-term outcomes were decreased back and knee pain and improved range of motion, strength, and ambulation. Therapists using techniques to improve joint range of motion in clients with MPS should be aware that pterygia may include contractile tissue, nerves, and blood vessels and there may be underlying skeletal deformity or weakness in these areas. Children with MPS are at high risk of developing scoliosis and should be appropriately assessed in early childhood.

  17. Selective recruitment of single motor units in human flexor digitorum superficialis muscle during flexion of individual fingers.

    Science.gov (United States)

    Butler, T J; Kilbreath, S L; Gorman, R B; Gandevia, S C

    2005-08-15

    Flexor digitorum superficialis (FDS) is an extrinsic multi-tendoned muscle which flexes the proximal interphalangeal joints of the four fingers. It comprises four digital components, each with a tendon that inserts onto its corresponding finger. To determine the degree to which these digital components can be selectively recruited by volition, we recorded the activity of a single motor unit in one component via an intramuscular electrode while the subject isometrically flexed each of the remaining fingers, one at a time. The finger on which the unit principally acted was defined as the 'test finger' and that which flexed isometrically was the 'active' finger. Activity in 79 units was recorded. Isometric finger flexion forces of 50% maximum voluntary contraction (MVC) activated less than 50% of single units in components of FDS acting on fingers that were not voluntarily flexed. With two exceptions, the median recruitment threshold for all active-test finger combinations involving the index, middle, ring and little finger test units was between 49 and 60% MVC (60% MVC being the value assigned to those not recruited). The exceptions were flexion of the little finger while recording from ring finger units (median: 40% MVC), and vice versa (median: 2% MVC). For all active-test finger combinations, only 35/181 units were activated when the active finger flexed at less than 20% MVC, and the fingers were adjacent for 28 of these. Functionally, to recruit FDS units during grasping and lifting, relatively heavy objects were required, although systematic variation occurred with the width of the object. In conclusion, FDS components can be selectively activated by volition and this may be especially important for grasping at high forces with one or more fingers.

  18. Reciprocal activation of gastrocnemius and soleus motor units is associated with fascicle length change during knee flexion.

    Science.gov (United States)

    Lauber, Benedikt; Lichtwark, Glen A; Cresswell, Andrew G

    2014-06-01

    While medial gastrocnemius (MG) and soleus (SOL) are considered synergists, they are anatomically exclusive in that SOL crosses only the ankle, while MG crosses both the knee and ankle. Due to the force-length properties of both active and passive structures, activation of SOL and MG must be constantly regulated to provide the required joint torques for any planned movement. As such, the aim of this study was to investigate the neural regulation of MG and SOL when independently changing their length by changing only the knee joint angle, thus exclusively altering the length of MG fibers. MG and SOL motor units (MU) were recorded intramuscularly along with ultrasound imaging of MG and SOL fascicle lengths, while moving the knee through 60° of rotation and maintaining a low level of voluntary plantar flexor torque. The results showed a reciprocal activation of MG and SOL as the knee was moved into flexion and extension. A clear reduction in MG MU firing rates occurred as the knee was flexed (MG fascicles shortening), with de-recruitment of most MG MU occurring at close to full knee flexion. A concomitant increase in SOL MU activity was observed while no change in the length of its fascicles was found. The opposite effects were found when the knee was moved into extension. A strong correlation (ICC = 0.78) was found between the fascicle length at which MG MUs were de-recruited and subsequently re-recruited. This was stronger than the relationship of de-recruitment and re-recruitment with knee angle (ICC = 0.52), indicating that in this instance, muscle fascicle length rather than joint angle is more influential in regulating MG recruitment. Such a reciprocal arrangement like the one presented here for SOL and MG is essential for human voluntary movements such as walking or cycling. © 2014 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  19. Measurement of Resistive Plantar Flexion Torque of the Ankle during Passive Stretch in Healthy Subjects and Patients with Poststroke Hemiplegia.

    Science.gov (United States)

    Mizuno, Shiho; Sonoda, Shigeru; Takeda, Kotaro; Maeshima, Shinichiro

    2016-04-01

    Quantification of increased muscle tone for patients with spasticity has been performed to date using various devices to replace the manual scales, such as the modified Ashworth scale or the Tardieu scale. We developed a device that could measure resistive plantar flexion (PF) torque of the ankle during passive dorsiflexion (DF) as an indicator of muscle tone of ankle plantar flexors. The primary objective was to explore the test-retest intrarater reliability of a custom-built device. Participants were 11 healthy subjects (7 men, 4 women; mean age 47.0 years) and 22 patients with poststroke hemiplegia (11 hemorrhagic, 11 ischemic; 14 men, 8 women; mean age 57.2 years). The device was affixed to the ankle. Subjects were seated with knees either flexed or extended. The ankle was passively dorsiflexed from 20° of PF to more than 10° of DF at 5°/second (slow stretch) or 90°/second (fast stretch). Angle and torque were measured twice during the stretches. The intraclass correlation coefficients (ICCs) of torque at 10° of DF (T10) in the 4 conditions-slow and fast stretches with knee flexed or extended-were calculated. The T10 ICCs of the 4 conditions were .95-.99 in both groups. The healthy subjects showed significantly higher T10 of knee extension than of knee flexion during slow and fast stretches. The patients showed increased velocity-dependent torque during fast stretches. Excellent reliability was observed. The device is suitable for measuring resistive PF torque during passive stretch in a flexed knee condition. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  20. A novel closed reduction with extension block and flexion block using Kirschner wires and microscrew fixation for mallet fractures.

    Science.gov (United States)

    Shimura, Haruhiko; Wakabayashi, Yoshiaki; Nimura, Akimoto

    2014-03-01

    Some patients with mallet fractures who undergo extension block pinning complain of exposed wires, which delay their return to sports and causes inconvenience while performing tasks that require the use of hands during the early postoperative period. The purpose of this retrospective study was to present and evaluate a novel surgical procedure for mallet fractures. We treated 20 patients (14 males and six females; mean age, 38.4 years; range 17-68 years) with displaced mallet fractures involving >30 % of the articular surface using the closed reduction and microscrew fixation between January 2009 and January 2012. The distal interphalangeal joint (DIP) joint was immobilized with a splint for 1-3 weeks on an individual case basis. According to Wehbe and Schneider's classification, there were 12 type IB, six type IIB, and two type IA fractures. The mean follow-up duration was 12.6 months (range 6-31 months). Bone union was achieved in all patients within a mean period of 6.8 weeks, with no incidence of infection, skin necrosis, permanent nail deformity, or secondary osteoarthritis. Only two complications-temporary nail ridging in one patient and a dorsal bump caused by the screw in one patient-were observed. Minimum postoperative displacement was observed in one patient, for whom immobilization with a splint was continued for 4 weeks. Articular incongruity was <1.0 mm in four patients and 1.0-2.0 mm in two patients. Mean DIP joint extension loss was 6.5° and mean flexion was 67.8°. The surgical outcomes were excellent in seven patients, good in nine, and fair in four according to Crawford's evaluation criteria. Our novel surgical procedure combining closed reduction with extension block and flexion block using Kirschner wires and microscrew fixation produces good clinical results with relatively few complications.

  1. Clinical and radiological profile of Hirayama disease: A flexion myelopathy due to tight cervical dural canal amenable to collar therapy

    Directory of Open Access Journals (Sweden)

    K M Hassan

    2012-01-01

    Full Text Available Background: Hirayama disease (HD is benign focal amyotrophy of the distal upper limbs, often misdiagnosed as motor neuron disease. Routine magnetic resonance imaging (MRI is often reported normal. Objective: To study the clinicoradiological profile of hand wasting in young males. Materials and Methods: Patients presenting with insidious-onset hand wasting from March 2008 to May 2011 were evaluated electrophysiologically. Cervical MRI in neutral position was done in 11 patients and flexion contrast imaging was done in 10 patients. Results: All patients were males less than 25 years of age, with median age 23 years, except one patient who was 50 years old. Duration of illness was 3 months to 3 years. All (100% had oblique amyotrophy, four (36% cold paresis, 10 (91% minipolymyoclonus and three (27% had fasciculations. Regional reflexes were variably absent. Two patients (18% had brisk reflexes of lower limbs with flexor plantars. Electromyography (EMG showed chronic denervation in the C7-T1 myotomes. Neutral position MRI showed loss of cervical lordosis in 10/11 (91%, localized lower cervical cord atrophy in 9/11 (82%, asymmetric cord flattening in 11/11 (100% and intramedullary hyperintensity in 2/11 (18%; flexion study showed loss of dural attachment, anterior displacement of dorsal dura, epidural flow voids in 9/10 (90% and enhancing epidural crescent in 10/10 (100%. Clinical profile, imaging and electrophysiological findings of the patient aged 50 years will be described in detail as presentation at this age is exceptional. Collar therapy slowed progression in most cases. Conclusion: Clinical features of HD corroborated well with electrophysiological diagnosis of anterior horn cell disease of lower cervical cord. While dynamic contrast MRI is characteristic, routine studies have a high predictive value for diagnosis. Prompt diagnosis is important to institute early collar therapy.

  2. Effects of pretension on work and power output of the muscle-tendon complex in dynamic elbow flexion.

    Science.gov (United States)

    Wakayama, Akinobu; Nagano, Akinori; Hay, Dean; Fukashiro, Senshi

    2005-06-01

    The purpose of the present study was to investigate the effects of pretension on work and power output of the muscle-tendon complex during dynamic elbow flexion under several submaximal and maximal conditions. The subjects were 10 healthy female students. Randomized trials from 0% to 100% maximal voluntary contraction (MVC) pretension (PT) at 60 degrees elbow flexion were conducted. After about 3 s of static PT, subjects maximally flexed the elbow joint to 90 degrees using a quick release method. The weight was individually selected for each subject to provide an optimal load for the development of maximal power. A Hill-type model was utilized to analyze the performance of the elbow muscle-tendon complex (MTC). PT 0, 30, 60 and 90% MVC data were used for comparison, and all data were expressed as the mean and standard deviation. Multiple paired comparisons between the value of PT 0% MVC and that of the other PT levels were performed post-hoc using Dunnett's method. The work of the series elastic component (SEC) increased gradually with the PT level because elastic energy was stored in the PT phase. However, the work of the contractile component (CC) decreased gradually with an increase in PT level. Moreover, the work of the MTC also decreased, closely related to the CC work decrement. The phenomenon of CC work decrement was caused by force depression and was not related to either the force-length or force-velocity relationships of the CC. EMG activity (agonist and antagonist) showed no significant differences. Muscle geometry changes or intracellular chemical shifts may have occurred in the PT phase.

  3. Active elbow flexion is possible in C4 quadriplegia using hybrid assistive limb (HAL®) technology: A case study.

    Science.gov (United States)

    Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Ikumi, Akira; Abe, Tetsuya; Marushima, Aiki; Ueno, Tomoyuki; Endo, Ayumu; Kawamoto, Hiroaki; Saotome, Kousaku; Matsushita, Akira; Matsumura, Akira; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

    2017-07-01

    Patients with complete quadriplegia after high cervical spinal cord injury are fully dependent with activities of daily living. Assistive technology can improve their quality of life. We examined the use of a hybrid assistive limb for single joints (HAL-SJ) in a 19-year-old man with complete C4 quadriplegia due to chronic spinal cord injury to restore function of active elbow flexion. This is the first report on the use of the HAL-SJ in a patient with spinal cord injury. The HAL-SJ intervention for each elbow was administered in 10 sessions. Clinical assessment using surface EMG was conducted to evaluate muscle activity of the trapezius, biceps brachii, infraspinatus, and triceps brachii muscle before, and during the 2nd, 3rd, 6th, and 9th interventions. Surface electromyography (EMG) before intervention showed no contraction in the upper arms, but in the bilateral trapezius. The HAL-SJ used motion intention from the right trapezius for activation. After the 6th and 7th session, respectively, biceps EMG showed that voluntary contraction and right elbow flexion could be performed by motion intention from the right biceps. After the 10th session, voluntary bicep contraction was possible. HAL-SJ treatment on the left elbow was performed using the same protocol with a similar outcome. After completing treatment on both upper extremities, both biceps contracted voluntarily, and he could operate a standard wheelchair for a short distance independently. HAL-SJ intervention is feasible and effective in restoring elbow flexor function in a patient with C4 chronic spinal cord injury and complete quadriplegia.

  4. ORIGINAL ARTICLE EEG changes and neuroimaging abnormalities ...

    African Journals Online (AJOL)

    salah

    Clinical Genetics Department, Human Genetics & Genome Research Division, ... neuroimaging changes of the brain and EEG abnormalities in correlation to the ... level and by developmental changes2. .... for IQ as a confounding factor.30.

  5. Report to Congress on abnormal occurrences

    International Nuclear Information System (INIS)

    1990-10-01

    Section 208 of the Energy Reorganization Act of 1974 identifies an abnormal occurrence as an unscheduled incident or event that the Nuclear Regulatory Commission determines to be significant from the standpoint of public health or safety and requires a quarterly report of such events to be made to Congress. This report covers the period from April 1 through June 30, 1990. The report discusses six abnormal occurrences, none involving a nuclear power plant. There were five abnormal occurrences at NRC licensees: (1) deficiencies in brachytherapy program; (2) a radiation overexposure of a radiographer; (3) a medical diagnostic misadministration; (4) administration of iodine-131 to a lactating female with subsequent uptake by her infant; and (5) a medical therapy misadministration. An Agreement State (Arizona) reported an abnormal occurrence involving a medical diagnostic misadministration. The report also contains information that updates a previously reported occurrence

  6. Evaluation of chromosomal abnormalities and common trombophilic ...

    African Journals Online (AJOL)

    2014-03-01

    Mar 1, 2014 ... Infections, genetic, endocrine, anatomic and immunologic problems have been suggested as causes for RM. ... Metaphase chromosome preparations from the .... The rate of karyotypically abnormal abortion specimens.

  7. On two abnormal sharks from Gujarat

    Digital Repository Service at National Institute of Oceanography (India)

    Gopalan, U.K.

    The description of the two abnormal sharks, Carchariaswalbeehmi and Eulamia dussumieri collected from Gujarat, India, is given Of these C walbeehmi was double-headed The other shark E dussumieri had thumb snouted albino...

  8. Abnormal Position and Presentation of the Fetus

    Science.gov (United States)

    ... Delivery Introduction to Complications of Labor and Delivery Abnormal Position and Presentation of the Fetus Amniotic Fluid Embolism Excessive Uterine Bleeding at Delivery Fetal Distress Inverted Uterus Labor That ...

  9. Morphological Abnormalities of Thalamic Subnuclei in Migraine

    DEFF Research Database (Denmark)

    Magon, Stefano; May, Arne; Stankewitz, Anne

    2015-01-01

    UNLABELLED: The thalamus contains third-order relay neurons of the trigeminal system, and animal models as well as preliminary imaging studies in small cohorts of migraine patients have suggested a role of the thalamus in headache pathophysiology. However, larger studies using advanced imaging te...... is a disorder of the CNS in which not only is brain function abnormal, but also brain structure is undergoing significant remodeling....... a fully automated multiatlas approach. Deformation-based shape analysis was performed to localize surface abnormalities. Differences between patients with migraine and healthy subjects were assessed using an ANCOVA model. After correction for multiple comparisons, performed using the false discovery rate.......9) was observed in patients. This large-scale study indicates structural thalamic abnormalities in patients with migraine. The thalamic nuclei with abnormal volumes are densely connected to the limbic system. The data hence lend support to the view that higher-order integration systems are altered in migraine...

  10. Ophthalmologic abnormalities among deaf students in Kaduna ...

    African Journals Online (AJOL)

    Annals of African Medicine. Vol. ... Medicine, Harvard University, U.S.A. ... abnormalities such as corneal opacities (0.5%) and allergic conjunctivitis (3.4%) while others had posterior .... were administered to those with treatable eye disease.

  11. Errata :Chromosomal Abnormalities in Couples with Recurrent ...

    African Journals Online (AJOL)

    Chromosomal Abnormalities in Couples with Recurrent Abortions in Lagos, Nigeria. Akinde OR, Daramola A O, Taiwo I A, Afolayan M O and Akinsola Af. Sonographic Mammary Gland Density Pattern in Women in Selected ommunities of Southern Nigeria.

  12. Diagnosis and treatment of abnormal dental pain

    OpenAIRE

    Fukuda, Ken-ichi

    2016-01-01

    Most dental pain is caused by an organic problem such as dental caries, periodontitis, pulpitis, or trauma. Diagnosis and treatment of these symptoms are relatively straightforward. However, patients often also complain of abnormal dental pain that has a non-dental origin, whose diagnosis is challenging. Such abnormal dental pain can be categorized on the basis of its cause as referred pain, neuromodulatory pain, and neuropathic pain. When it is difficult to diagnose a patient's dental pain, ...

  13. Normal and Abnormal Behavior in Early Childhood

    OpenAIRE

    Spinner, Miriam R.

    1981-01-01

    Evaluation of normal and abnormal behavior in the period to three years of age involves many variables. Parental attitudes, determined by many factors such as previous childrearing experience, the bonding process, parental psychological status and parental temperament, often influence the labeling of behavior as normal or abnormal. This article describes the forms of crying, sleep and wakefulness, and affective responses from infancy to three years of age.

  14. Syringomyelia and Craniocervical Junction Abnormalities in Chihuahuas

    OpenAIRE

    Kiviranta, A.‐M.; Rusbridge, C.; Laitinen‐Vapaavuori, O.; Hielm‐Björkman, A.; Lappalainen, A.K.; Knowler, S.P.; Jokinen, T.S.

    2017-01-01

    Background: Chiari-like malformation (CM) and syringomyelia (SM) are widely reported in Cavalier King Charles Spaniels and Griffon Bruxellois dogs. Increasing evidence indicates that CM and SM also occur in other small and toy breed dogs, such as Chihuahuas. Objectives: To describe the presence of SM and craniocervical junction (CCJ) abnormalities in Chihuahuas and to evaluate the possible association of CCJ abnormalities with SM. To describe CM/SM-related clinical signs and neuro...

  15. Heterotaxy syndromes and abnormal bowel rotation

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [Stanford University, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Koppolu, Raji; Sylvester, Karl [Lucile Packard Children' s Hospital at Stanford, Department of Surgery, Stanford, CA (United States); Murphy, Daniel [Lucile Packard Children' s Hospital at Stanford, Department of Cardiology, Stanford, CA (United States)

    2014-05-15

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  16. Heterotaxy syndromes and abnormal bowel rotation

    International Nuclear Information System (INIS)

    Newman, Beverley; Koppolu, Raji; Sylvester, Karl; Murphy, Daniel

    2014-01-01

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  17. Prevalence of asymptomatic urinary abnormalities among adolescents

    Directory of Open Access Journals (Sweden)

    Mohamed Fouad

    2016-01-01

    Full Text Available To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1% individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8% at the second screening, (P <0.001. Hematuria was the most common urinary abnormalities detected in 245 (9.8% adolescents who had persistent urine abnormalities; 228 (9.1% individuals had non glomerular hematuria. The hematuria was isolated in 150 (6% individuals, combined with leukocyturia in 83 (3.3% individuals, and combined with proteinuria in 12 (0.5% individuals. Leukocyturia was detected in 150 (6% of all studied adolescents; it was isolated in 39 (1.6% individuals and combined with proteinuria in 28 (1.1% of them. Asymp- tomatic bacteriuria was detected in 23 (0.9% of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6% of all the studied adolescents; 45 (1.8% indivi- duals had <0.5 g/day and twenty (0.8% individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01 and (P <0.001, respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population.

  18. Abnormal ''Contamination' Levels On Garden Appliances

    International Nuclear Information System (INIS)

    German, U.; Levinson, S.; Elmelech, V.; Pelled, O.; Tshuva, A.; Laichter, Y.

    1999-01-01

    During routine contamination checks we encountered an abnormal high level of Alpha and Beta emitting radioisotopes on working gloves of employees of the gardening department. It came out that the source was due to ''contamination'' levels on steering wheels of some gardening machines. In order to ensure that no real contamination of these workers was involved , a series of checks was started to identity the source of the abnormal levels found during monitoring

  19. Visual field abnormalities in multiple sclerosis.

    OpenAIRE

    Patterson, V H; Heron, J R

    1980-01-01

    Visual fields were examined with a tangent screen in 54 patients with multiple sclerosis (MS) or optic neuritis (ON). Visual fields were abnormal in all patients with definite MS, 94% with probable MS and 81% with possible MS. Three-quarters of the MS patients with no history of visual symptoms had abnormal fields. The commonest defect found was an arcuate scotoma. As a diagnostic test of visual pathway involvement in MS, tangent screen examination compares favourably with more sophisticated ...

  20. White matter abnormalities in tuberous sclerosis complex

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, P.D. [Sheffield Univ. (United Kingdom). Academic Dept. of Radiology; Bolton, P. [Cambridge Univ. (United Kingdom). Section of Developmental Psychiatry; Verity, C. [Addenbrooke`s NHS Trust, Cambridge (United Kingdom). Dept. of Paediatric Radiology

    1998-09-01

    The aim of this study was to investigate and describe the range of white matter abnormalities in children with tuberous sclerosis complex by means of MR imaging. Material and Methods: A retrospective cross-sectional study was performed on the basis of MR imaging findings in 20 cases of tuberous sclerosis complex in children aged 17 years or younger. Results: White matter abnormalities were present in 19/20 (95%) cases of tuberous sclerosis complex. These were most frequently (19/20 cases) found in relation to cortical tubers in the supratentorial compartment. White matter abnormalities related to tubers were found in the cerebellum in 3/20 (15%) cases. White matter abnormalities described as radial migration lines were found in relation to 5 tubers in 3 (15%) children. In 4/20 (20%) cases, white matter abnormalities were found that were not related to cortical tubers. These areas had the appearance of white matter cysts in 3 cases and infarction in the fourth. In the latter case there was a definable event in the clinical history, supporting the diagnosis of stroke. Conclusion: A range of white matter abnormalities were found by MR imaging in tuberous sclerosis complex, the commonest being gliosis and hypomyelination related to cortical tubers. Radial migration lines were seen infrequently in relation to cortical tubers and these are thought to represent heterotopic glia and neurons along the expected path of cortical migration. (orig.)

  1. [Hysteroscopic polypectomy, treatment of abnormal uterine bleeding].

    Science.gov (United States)

    de Los Rios, P José F; López, R Claudia; Cifuentes, P Carolina; Angulo, C Mónica; Palacios-Barahona, Arlex U

    2015-07-01

    To evaluate the effectiveness of the hysteroscopic polypectomy in terms of the decrease of the abnormal uterine bleeding. A cross-sectional and analytical study was done with patients to whom a hysteroscopic polypectomy was done for treating the abnormal uterine bleeding, between January 2009 and December 2013. The response to the treatment was evaluated via a survey given to the patients about the behavior of the abnormal uterine bleeding after the procedure and about overall satisfaction. The results were obtained after a hysteroscopic polypectomy done to 128 patients and were as follows. The average time from the polypectomy applied until the survey was 30.5 months, with a standard deviation of 18 months. 67.2% of the patients reported decreased abnormal uterine bleeding and the 32.8% reported a persistence of symptoms. On average 82.8% of the. patients were satisfied with the treatment. Bivariate and multivariate analysis showed no association between the variables studied and no improvement of abnormal uterine bleeding after surgery (polypectomy). There were no complications. Hysteroscopic polypectomy is a safe surgical treatment, which decreases on two of three patients the abnormal uterine bleeding in the presence of endometrial polyps, with an acceptable level of satisfaction.

  2. Dynamic Analysis of the Abnormal Isometric Strength Movement Pattern between Shoulder and Elbow Joint in Patients with Hemiplegia

    Directory of Open Access Journals (Sweden)

    Yali Liu

    2018-01-01

    Full Text Available Patients with hemiplegia usually have weak muscle selectivity and usually perform strength at a secondary joint (secondary strength during performing a strength at one joint (primary strength. The abnormal strength pattern between shoulder and elbow joint has been analyzed by the maximum value while the performing process with strength changing from 0 to maximum then to 0 was a dynamic process. The objective of this study was to develop a method to dynamically analyze the strength changing process. Ten patients were asked to perform four group asks (maximum and 50% maximum voluntary strength in shoulder abduction, shoulder adduction, elbow flexion, and elbow extension. Strength and activities from seven muscles were measured. The changes of secondary strength had significant correlation with those of primary strength in all tasks (R>0.76, p0.4, p<0.01. Deltoid muscles, biceps brachii, triceps brachii, and brachioradialis had significant influences on the abnormal strength pattern (all p<0.01. The dynamic method was proved to be efficient to analyze the different influences of muscles on the abnormal strength pattern. The muscles, deltoid muscles, biceps brachii, triceps brachii, and brachioradialis, much influenced the stereotyped movement pattern between shoulder and elbow joint.

  3. Effect of cranial cruciate ligament deficiency, tibial plateau leveling osteotomy, and tibial tuberosity advancement on contact mechanics and alignment of the stifle in flexion.

    Science.gov (United States)

    Kim, Stanley E; Pozzi, Antonio; Banks, Scott A; Conrad, Bryan P; Lewis, Daniel D

    2010-04-01

    To assess contact mechanics and 3-dimensional (3-D) joint alignment in cranial cruciate ligament (CCL)-deficient stifles before and after tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA) with the stifle in 90 degrees of flexion. In vitro biomechanical study. Cadaveric pelvic limb pairs (n=8) from dogs weighing 28-35 kg. Contralateral limbs were assigned to receive TPLO or TTA. Digital pressure sensors were used to measure femorotibial contact area, peak and mean contact pressure, and peak pressure location with the limb under a load of 30% body weight and stifle flexion angle of 90 degrees . 3-D poses were obtained using a Microscribe digitizer. Specimens were tested under normal, CCL deficient, and treatment conditions. Significant disturbances in alignment were not observed after CCL transection, although medial contact area was 10% smaller than normal (P=.003). There were no significant differences in contact mechanics or alignment between normal and TTA conditions; TPLO induced 6 degrees varus angulation (PCranial tibial subluxation is nominal in CCL-deficient stifles loaded in flexion. Stifle alignment and contact mechanics are not altered by TTA, whereas TPLO causes mild varus and a subsequent increase in medial compartment loading. Cranial tibial subluxation of CCL-deficient stifles may not occur during postures that load the stifle in flexion. The significance of minor changes in loading patterns after TPLO is unknown.

  4. Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study

    NARCIS (Netherlands)

    Kerkum, Y.L.; Harlaar, J.; Buizer, A.I.; van den Noort, J.C.; Becher, J.G.; Brehm, M.A.

    2013-01-01

    Background: Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of

  5. Optimising Ankle Foot Orthoses for children with cerebral palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study

    NARCIS (Netherlands)

    Kerkum, Yvette L.; Harlaar, Jaap; Buizer, Annemieke I.; van den Noort, Josien C.; Becher, Jules G.; Brehm, Merel-Anne

    2013-01-01

    Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy

  6. The effects of gender, level of co-contraction, and initial angle on elbow extensor muscle stiffness and damping under a step increase in elbow flexion moment.

    Science.gov (United States)

    Lee, Yunju; Ashton-Miller, James A

    2011-10-01

    Flexion buckling of an arm under the large ground reaction loads associated with arresting a fall to the ground increases the risk for head and thorax injuries. Yet, the factors that determine the arm buckling load remain poorly understood. We tested the hypothesis in 18 healthy young adults that neither gender, triceps co-contraction level (i.e., 25, 50, or 75% MVC) nor elbow angle would affect the rotational stiffness and damping resistance to step changes in elbow flexion loading. Data on the step response were gathered using optoelectronic markers (150 Hz) and myoelectric activity measurements (2 kHz), and an inverse dynamics analysis was used to estimate elbow extensor stiffness and damping coefficients. A repeated-measures analysis of variance showed that gender (p = 0.032), elbow flexion angle and co-contraction level (both p initial elbow flexion angle and maximum co-contraction, female stiffness and damping coefficients were 18 and 30% less, respectively, than male values after normalization by body height and weight. We conclude that the maximum extensor rotational stiffness and damping at the elbow is lower in women than in men of the same body size, and varies with triceps co-contraction level and initial elbow angle.

  7. The effects of joint aspiration and intra-articular corticosteroid injection on flexion reflex excitability, quadriceps strength and pain in individuals with knee synovitis: a prospective observational study.

    Science.gov (United States)

    Rice, David Andrew; McNair, Peter John; Lewis, Gwyn Nancy; Dalbeth, Nicola

    2015-07-28

    Substantial weakness of the quadriceps muscles is typically observed in patients with arthritis. This is partly due to ongoing neural inhibition that prevents the quadriceps from being fully activated. Evidence from animal studies suggests enhanced flexion reflex excitability may contribute to this weakness. This prospective observational study examined the effects of joint aspiration and intra-articular corticosteroid injection on flexion reflex excitability, quadriceps muscle strength and knee pain in individuals with knee synovitis. Sixteen patients with chronic arthritis and clinically active synovitis of the knee participated in this study. Knee pain flexion reflex threshold, and quadriceps peak torque were measured at baseline, immediately after knee joint aspiration alone and 5 ± 2 and 15 ± 2 days after knee joint aspiration and the injection of 40 mg of methylprednisolone acetate. Compared to baseline, knee pain was significantly reduced 5 (p = 0.001) and 15 days (p = 0.009) post intervention. Flexion reflex threshold increased immediately after joint aspiration (p = 0.009) and 5 (p = 0.01) and 15 days (p = 0.002) post intervention. Quadriceps peak torque increased immediately after joint aspiration (p = 0.004) and 5 (p = 0.001) and 15 days (p knee synovitis.

  8. Comparison of erector spinae and hamstring muscle activities and lumbar motion during standing knee flexion in subjects with and without lumbar extension rotation syndrome.

    Science.gov (United States)

    Kim, Si-hyun; Kwon, Oh-yun; Park, Kyue-nam; Kim, Moon-Hwan

    2013-12-01

    The aim of this study was to compare the activity of the erector spinae (ES) and hamstring muscles and the amount and onset of lumbar motion during standing knee flexion between individuals with and without lumbar extension rotation syndrome. Sixteen subjects with lumbar extension rotation syndrome (10 males, 6 females) and 14 healthy subjects (8 males, 6 females) participated in this study. During the standing knee flexion, surface electromyography (EMG) was used to measure muscle activity, and surface EMG electrodes were attached to both the ES and hamstring (medial and lateral) muscles. A three-dimensional motion analysis system was used to measure kinematic data of the lumbar spine. An independent-t test was conducted for the statistical analysis. The group suffering from lumbar extension rotation syndrome exhibited asymmetric muscle activation of the ES and decreased hamstring activity. Additionally, the group with lumbar extension rotation syndrome showed greater and earlier lumbar extension and rotation during standing knee flexion compared to the control group. These data suggest that asymmetric ES muscle activation and a greater amount of and earlier lumbar motion in the sagittal and transverse plane during standing knee flexion may be an important factor contributing to low back pain. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. The effects of denervation, reinnervation, and muscle imbalance on functional muscle length and elbow flexion contracture following neonatal brachial plexus injury.

    Science.gov (United States)

    Weekley, Holly; Nikolaou, Sia; Hu, Liangjun; Eismann, Emily; Wylie, Christopher; Cornwall, Roger

    2012-08-01

    The pathophysiology of paradoxical elbow flexion contractures following neonatal brachial plexus injury (NBPI) is incompletely understood. The current study tests the hypothesis that this contracture occurs by denervation-induced impairment of elbow flexor muscle growth. Unilateral forelimb paralysis was created in mice in four neonatal (5-day-old) BPI groups (C5-6 excision, C5-6 neurotomy, C5-6 neurotomy/repair, and C5-T1 global excision), one non-neonatal BPI group (28-day-old C5-6 excision), and two neonatal muscle imbalance groups (triceps tenotomy ± C5-6 excision). Four weeks post-operatively, motor function, elbow range of motion, and biceps/brachialis functional lengths were assessed. Musculocutaneous nerve (MCN) denervation and reinnervation were assessed immunohistochemically. Elbow flexion motor recovery and elbow flexion contractures varied inversely among the neonatal BPI groups. Contracture severity correlated with biceps/brachialis shortening and MCN denervation (relative axon loss), with no contractures occurring in mice with MCN reinnervation (presence of growth cones). No contractures or biceps/brachialis shortening occurred following non-neonatal BPI, regardless of denervation or reinnervation. Neonatal triceps tenotomy did not cause contractures or biceps/brachialis shortening, nor did it worsen those following neonatal C5-6 excision. Denervation-induced functional shortening of elbow flexor muscles leads to variable elbow flexion contractures depending on the degree, permanence, and timing of denervation, independent of muscle imbalance. Copyright © 2012 Orthopaedic Research Society.

  10. Elbow Flexion Contractures in Childhood in Obstetric Brachial Plexus Lesions: A Longitudinal Study of 20 Neurosurgically Reconstructed Infants with 8-Year Follow-up

    NARCIS (Netherlands)

    van der Sluijs, M.; van Ouwerkerk, W.J.R.; van der Sluijs, J.A.; van Royen, B.J.

    2015-01-01

    Objective Little knowledge exists on the development of elbow flexion contractures in children with obstetrical brachial plexus lesion (OBPL). This study aims to evaluate the prognostic significance of several neuromuscular parameters in infants with OBPL regarding the later development of elbow

  11. The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion

    NARCIS (Netherlands)

    Kerkum, Yvette L.; Buizer, Annemieke I.; van den Noort, Josien C.; Becher, Jules G.; Harlaar, Jaap; Brehm, Merel-Anne

    2015-01-01

    Rigid Ankle-Foot Orthoses (AFOs) are commonly prescribed to counteract excessive knee flexion during the stance phase of gait in children with cerebral palsy (CP). While rigid AFOs may normalize knee kinematics and kinetics effectively, it has the disadvantage of impeding push-off power. A

  12. The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion

    NARCIS (Netherlands)

    Kerkum, Y.L.; Buizer, A.I.; van den Noort, J.C.; Becher, J.G.; Harlaar, J.; Brehm, M.A.

    2015-01-01

    Introduction: Rigid Ankle-Foot Orthoses (AFOs) are commonly prescribed to counteract excessive knee flexion during the stance phase of gait in children with cerebral palsy (CP). While rigid AFOs may normalize knee kinematics and kinetics effectively, it has the disadvantage of impeding push-off

  13. Medial Patellofemoral Ligament Reconstruction: Impact of Knee Flexion Angle During Graft Fixation on Dynamic Patellofemoral Contact Pressure-A Biomechanical Study.

    Science.gov (United States)

    Lorbach, Olaf; Zumbansen, Nikolaus; Kieb, Matthias; Efe, Turgay; Pizanis, Antonius; Kohn, Dieter; Haupert, Alexander

    2018-04-01

    Objective evaluation of the optimal graft tension angle to fully restore patellofemoral contact pressure in reconstruction of the medial patellofemoral ligament (MPFL) in comparison to the native knee. Twelve cadaveric knee specimens were fixed in a custom-made fixation device. A sensitive pressure film (Tekscan) was fixed in the patellofemoral joint, and patellofemoral contact pressure was assessed during a dynamic flexion movement from 0° to 90°. The MPFL was cut and measurements were repeated. Reconstruction of the MPFL was performed with the gracilis tendon subsequently fixed in the femur at 15°, 30°, 45°, 60°, 75°, and 90° of knee flexion under controlled tension (2 N). The sequence of the flexion angles was alternated. Pressure measurements were repeated after every fixation of the graft. No significant differences were seen in the overall patellofemoral contact pressure compared to the native knee (P > .05). However, medial patellofemoral pressure showed a significant increased patellofemoral contact pressure after MPFL reconstruction at a knee flexion angle during graft fixation of 15° (P = .027), 45° (P = .050, P = .044), and 75° (P = .039). Moreover, proximal/distal patellofemoral contact pressure revealed a significantly reduced contact pressure at 15° (P = .003), 30° (P = .009), 45° (P = .025), 75° (P = .021), and 90° (P = .022) of flexion distal after MPFL reconstruction compared with the intact knee. Lateral patellofemoral contact pressure was significantly reduced in all performed reconstructions (P angle during graft fixation for MPFL reconstruction did not have a significant impact on the overall patellofemoral contact pressure. However, selective medial, proximal, distal, and lateral patellofemoral contact pressure was significantly altered for all reconstructions. Fixation of the MPFL graft at 60° of flexion was able to most closely restore patellofemoral contact pressure compared with the intact knee. Based on the

  14. Relationship between flexion contractures of the joints of the lower extremities and the sagittal profile of the spine in patients with cerebral palsy: a preliminary report

    Directory of Open Access Journals (Sweden)

    Valery V. Umnov

    2016-11-01

    Full Text Available Background. The considerable incidence of kyphosis in patients with cerebral palsy (CP causes back pain and aggravates movement disorders. However, few studies have investigated the pathogenesis of this condition. Aim. To identify the relationship between patient motor abilities, the severity of flexion contractures of the knee and hip joints and spinal sagittal profile changes, and the impact on the latter by surgical correction of flexion contracture of the knee joint. Material and methods. The study cohort included 17 pediatric CP patients (11 boys and 6 girls with a mean age of 13.1 ± 1.3 (range, 10–16 years and level 2–4 spastic diplegia according to the Gross Motor Function Classification System. The relationship between radiological indicators of the spine sagittal profile and motor abilities of children, as well as the severity of flexion contractures at the hip and knee, and the degree of insufficiency of the active extension of the knee were investigated. Of these 17 patients, 12 underwent surgery to correct flexion contracture of the knee, which involved lengthening of leg flexors, to analyze the impact of contracture on the sagittal profile of the spine. The following radiological indicators were assessed: angle of thoracic kyphosis (CC, lordosis angle (UL of the lumbar spine, and sacral inclination angle (SS. The study included patients with a CC of at least 30°. Results. Results of an X-ray study showed that the severity of kyphosis was 50.7° ± 2.1°, lordosis was 30.3° ± 4.3°, and SS was 30.5° ± 3.3°. There was a significant association between kyphosis and flexion contracture of the knee joint, as well as between lordosis and insufficient active extension of the knee joint. After elimination of the flexion contracture of the knee, the degree of severity of the CC (thoracic kyphosis was unchanged, while UL (lordosis angle and SS (sacral inclination angle increased by approximately 10°. Conclusion. The severity of

  15. Zumbi e a Construção da Identidade Negra: uma Análise sobre a História em Quadrinhos “Zumbi – A Saga de Palmares” * Zumbi and Formation of Black Identity: an Analysis on the Comics "Zumbi - The Saga of Palmares"

    Directory of Open Access Journals (Sweden)

    VINÍCIUS FINGER

    2013-04-01

    Full Text Available Resumo: O objetivo deste artigo é realizar uma análise do personagem de Zumbi encontrado no álbum em quadrinhos “Zumbi - A Saga de Palmares” e sua relação com os princípios, ideologias e políticas que embasaram os movimentos antirracistas ao longo do século XX. Analisa também os modos de construção da figura de Zumbi, através das narrativas propostas pelo Movimento Negro Unificado. Apresentando uma síntese dos movimentos antirracismo mais representativos no Brasil durante o século XX.Palavras-chaves: Zumbi – Palmares – MNU. Abstract: The aim of this article is to analyze Zumbi’s character found in the comic book "Zumbi - The Saga of Palmares" and its relationship with the principles, ideologies and policies which based anti-racist movements throughout the twentieth century. It also analyzes the forms of formation of the figure of Zumbi through the narratives proposed by the Unified Black Movement (Movimento Negro Unificado. It presents a summary of the most significant anti-racism movements in Brazil during the twentieth century.Keywords: Zumbi – Palmares – MNU.

  16. Ultrasound assessment of fascial connectivity in the lower limb during maximal cervical flexion: technical aspects and practical application of automatic tracking.

    Science.gov (United States)

    Cruz-Montecinos, Carlos; Cerda, Mauricio; Sanzana-Cuche, Rodolfo; Martín-Martín, Jaime; Cuesta-Vargas, Antonio

    2016-01-01

    The fascia provides and transmits forces for connective tissues, thereby regulating human posture and movement. One way to assess the myofascial interaction is a fascia ultrasound recording. Ultrasound can follow fascial displacement either manually or automatically through two-dimensional (2D) method. One possible method is the iterated Lucas-Kanade Pyramid (LKP) algorithm, which is based on automatic pixel tracking during passive movements in 2D fascial displacement assessments. Until now, the accumulated error over time has not been considered, even though it could be crucial for detecting fascial displacement in low amplitude movements. The aim of this study was to assess displacement of the medial gastrocnemius fascia during cervical spine flexion in a kyphotic posture with the knees extended and ankles at 90°. The ultrasound transducer was placed on the extreme dominant belly of the medial gastrocnemius. Displacement was calculated from nine automatically selected tracking points. To determine cervical flexion, an established 2D marker protocol was implemented. Offline pressure sensors were used to synchronize the 2D kinematic data from cervical flexion and deep fascia displacement of the medial gastrocnemius. Fifteen participants performed the cervical flexion task. The basal tracking error was 0.0211 mm. In 66 % of the subjects, a proximal fascial tissue displacement of the fascia above the basal error (0.076 mm ± 0.006 mm) was measured. Fascia displacement onset during cervical spine flexion was detected over 70 % of the cycle; however, only when detected for more than 80 % of the cycle was displacement considered statistically significant as compared to the first 10 % of the cycle (ANOVA, p < 0.05). By using an automated tracking method, the present analyses suggest statistically significant displacement of deep fascia. Further studies are needed to corroborate and fully understand the mechanisms associated with these results.

  17. Depression and Anxiety in Traumatic Brachial Plexus Injury Patients Are Associated With Reduced Motor Outcome After Surgical Intervention for Restoration of Elbow Flexion.

    Science.gov (United States)

    Wilson, Thomas J; Chang, Kate W C; Yang, Lynda J-S

    2016-06-01

    Depression has been associated with poor outcomes in neurosurgical patients, including increased pain, poorer functional recovery, delayed return to work, and decreased patient satisfaction. No reports exist regarding an association of psychiatric diagnoses with outcomes after brachial plexus reconstruction. As outcomes and patient satisfaction become increasingly important to payers and physician reimbursement, assessing modifiable preoperative risk factors for their association with poor outcome and patient satisfaction is imperative. To analyze patients undergoing brachial plexus reconstruction to assess the relationship of depression/anxiety with functional outcome. Data were collected retrospectively on all patients who underwent brachial plexus reconstruction to restore elbow flexion between 2005 and 2013. Elbow flexion, graded via the Medical Research Council scale, was assessed at latest follow-up. Multiple variables, including the presence of Axis I psychiatric diagnoses, were assessed for their association with the dichotomous outcome of Medical Research Council scale score ≥3 (antigravity) vs <3 elbow flexion. Standard statistical methods were used. Thirty-seven patients met inclusion criteria. The median postsurgical follow-up time was 21 months. Operations included neurolysis (n = 3), nerve graft repair (n = 6), and nerve transfer (n = 28). Depression was present in 10 of 37 patients (27%). Of variables tested, only depression was associated with poor elbow flexion outcome (odds ratio: 6.038; P = .04). Preoperative depression is common after brachial plexus injury. The presence of depression is associated with reduced elbow flexion recovery after reconstruction. Our data suggest assessment and treatment of preoperative mental health is important in designing a comprehensive postoperative management plan to optimize outcomes and patient satisfaction. MRC, Medical Research CouncilTBI, traumatic brain injury.

  18. Chromosomal abnormality in patients with secondary amenorrhea.

    Science.gov (United States)

    Safai, Akbar; Vasei, Mohammad; Attaranzadeh, Armin; Azad, Fariborz; Tabibi, Narjes

    2012-04-01

    Secondary amenorrhea is a condition in which there is cessation of menses after at least one menstruation. It is a symptom of different diseases, such as hormonal disturbances which range from pituitary to ovarian origin, as well as chromosomal abnormalities. Knowledge of the distinct cause of secondary amenorrhea is of tremendous benefit for the management and monitoring of patients. In this study, we determine the chromosomal abnormalities in patients with secondary amenorrhea in Southwest Iran. We selected 94 patients with secondary amenorrhea who referred to our Cytogenetic Ward from 2004 until 2009. For karyotyping, peripheral blood lymphocyte cultures were set up by conventional technique. In this study, 5.3% (n=5) of patients with secondary amenorrhea presented with chromosomal abnormalities, of which all contained an X element. The chromosomal abnormalities were: i) 45, X (n=1); ii) 47, XXX (n=1); iii) 45, X [13]/ 45, Xi(X)q[17] (n=1);  iv) 45, X[12]/46,X,+mar[12] (n=1); and v) 46,X,del(Xq)(q23q28) (n=1). Our study revealed that some causes of secondary amenorrhea could be due to chromosomal abnormalities. Therefore, cytogenetic studies should be important tests in the evaluation of patients with secondary amenorrhea.

  19. Activation timing of postural muscles of lower legs and prediction of postural disturbance during bilateral arm flexion in older adults.

    Science.gov (United States)

    Yaguchi, Chie; Fujiwara, Katsuo; Kiyota, Naoe

    2017-12-22

    Activation timings of postural muscles of lower legs and prediction of postural disturbance were investigated in young and older adults during bilateral arm flexion in a self-timing task and an oddball task with different probabilities of target presentation. Arm flexion was started from a standing posture with hands suspended 10 cm below the horizontal level in front of the body, in which postural control focused on the ankles is important. Fourteen young and 14 older adults raised the arms in response to the target sound signal. Three task conditions were used: 15 and 45% probabilities of the target in the oddball task and self-timing. Analysis items were activation timing of postural muscles (erector spinae, biceps femoris, and gastrocnemius) with respect to the anterior deltoid (AD), and latency and amplitude of the P300 component of event-related brain potential. For young adults, all postural muscles were activated significantly earlier than AD under each condition, and time of preceding gastrocnemius activation was significantly longer in the order of the self-timing, 45 and 15% conditions. P300 latency was significantly shorter, and P300 amplitude was significantly smaller under the 45% condition than under the 15% condition. For older adults, although all postural muscles, including gastrocnemius, were activated significantly earlier than AD in the self-timing condition, only activation timing of gastrocnemius was not significantly earlier than that of AD in oddball tasks, regardless of target probability. No significant differences were found between 15 and 45% conditions in onset times of all postural muscles, and latency and amplitude of P300. These results suggest that during arm movement, young adults can achieve sufficient postural preparation in proportion to the probability of target presentation in the oddball task. Older adults can achieve postural control using ankle joints in the self-timing task. However, in the oddball task, older adults

  20. Cardiac abnormality prediction using HMLP network

    Science.gov (United States)

    Adnan, Ja'afar; Ahmad, K. A.; Mat, Muhamad Hadzren; Rizman, Zairi Ismael; Ahmad, Shahril

    2018-02-01

    Cardiac abnormality often occurs regardless of gender, age and races but depends on the lifestyle. This problem sometimes does not show any symptoms and usually detected once it already critical which lead to a sudden death to the patient. Basically, cardiac abnormality is the irregular electrical signal that generate by the pacemaker of the heart. This paper attempts to develop a program that can detect cardiac abnormality activity through implementation of Hybrid Multilayer Perceptron (HMLP) network. A certain amount of data of the heartbeat signals from the electrocardiogram (ECG) will be used in this project to train the MLP and HMLP network by using Modified Recursive Prediction Error (MRPE) algorithm and to test the network performance.

  1. Neurological abnormalities associated with CDMA exposure.

    Science.gov (United States)

    Hocking, B; Westerman, R

    2001-09-01

    Dysaesthesiae of the scalp and neurological abnormality after mobile phone use have been reported previously, but the roles of the phone per se or the radiations in causing these findings have been questioned. We report finding a neurological abnormality in a patient after accidental exposure of the left side of the face to mobile phone radiation [code division multiple access (CDMA)] from a down-powered mobile phone base station antenna. He had headaches, unilateral left blurred vision and pupil constriction, unilateral altered sensation on the forehead, and abnormalities of current perception thresholds on testing the left trigeminal ophthalmic nerve. His nerve function recovered during 6 months follow-up. His exposure was 0.015-0.06 mW/cm(2) over 1-2 h. The implications regarding health effects of radiofrequency radiation are discussed.

  2. Report on Congress on abnormal occurrences

    International Nuclear Information System (INIS)

    1991-06-01

    Section 208 of the energy Reorganization Act of 1974 identifies an abnormal occurrence as an unscheduled incident or event that the Nuclear Regulatory Commission determines to be significant from the standpoint of public health or safety and requires a quarterly report of such events to be made to Congress. This report covers the period from January 1 through March 31, 1991. The report discusses six abnormal occurrences, none of which involved a nuclear power plant. Five of the events occurred at NRC-licensed facilities: one involved a significant degradation of plant safety at a nuclear fuel cycle facility, one involved a medical diagnostic misadministration, and three involved medical therapy misadministrations. An Agreement State (Arizona) reported one abnormal occurrence that involved medical therapy misadministrations

  3. Enhanced monitoring of abnormal emergency department demands

    KAUST Repository

    Harrou, Fouzi

    2016-06-13

    This paper presents a statistical technique for detecting signs of abnormal situation generated by the influx of patients at emergency department (ED). The monitoring strategy developed was able to provide early alert mechanisms in the event of abnormal situations caused by abnormal patient arrivals to the ED. More specifically, This work proposed the application of autoregressive moving average (ARMA) models combined with the generalized likelihood ratio (GLR) test for anomaly-detection. ARMA was used as the modelling framework of the ARMA-based GLR anomaly-detection methodology. The GLR test was applied to the uncorrelated residuals obtained from the ARMA model to detect anomalies when the data did not fit the reference ARMA model. The ARMA-based GLR hypothesis testing scheme was successfully applied to the practical data collected from the database of the pediatric emergency department (PED) at Lille regional hospital center, France. © 2015 IEEE.

  4. Osseous temporomandibular joint abnormalities in rheumatic disease

    International Nuclear Information System (INIS)

    Larheim, T.A.; Kolbenstvedt, A.; Rikshospitalet, Oslo

    1990-01-01

    Computed tomography (CT) of the temporomandibular joint (TMJ) was compared with hypocycloidal tomography in 30 joints of 15 adults with rheumatic disease. CT included 1.5 mm thick axial scans (at 1.0 mm intervals) with reformatted oblique sagittal and oblique coronal sections. Multisection (at 2.0 mm intervals) tomography included oblique sagittal and occasionally, oblique coronal sections. CT demonstrated bone abnormalities in 21 and tomography in 20 joints, indicating high agreement between the imaging modalities regarding number of abnormal TMJs. Bone structures were, however, better visualized by multiplanar CT due to superior contrast and spatial resolution particularly in the most lateral and medial parts of the joint, indicating superiority of CT for depicting subtle bony TMJ abnormalities in patients with rheumatic disease. (orig.)

  5. Radiographic abnormalities in tricyclic acid overdose

    International Nuclear Information System (INIS)

    Varnell, R.M.; Richardson, M.L.; Vincent, J.M.; Godwin, J.D.

    1987-01-01

    Several case reports have described adult respiratory distress syndrome (ARDS) secondary to tricyclic acid (TCA) overdose. During a 1-year period 83 patients requiring intubation secondary to drug overdose were evaluated. Abnormalities on chest radiographs occurred in 26 (50%) of the 54 patients with TCA overdose, compared to six (21%) of the 29 patients overdosed with other drugs. In addition, five (9%) of the patients with TCA overdose subsequently had radiographic and clinical abnormalities meeting the criteria for ARDS. Only one (3%) of the patients with non-TCA overdose subsequently had change suggesting ARDS. TCAs should be added to the list of drugs associated with ARDS, and TCA overdose should be considered a major risk factor in the development of radiographically evident abnormalities

  6. Device for diagnoising abnormalities of equipments

    International Nuclear Information System (INIS)

    Nakano, Hiroshi.

    1986-01-01

    Purpose: To measure the collision energy easily and at high accuracy by applying impact shocks at known collision energy from a simulated acoustic wave generator and using the generated acoustic signal as reference data. Constitution: A plurality of acoustic detectors are attached to the surface of a nuclear reactor pressure vessel. These acoustic detectors are connected respectively to an abnormality diagnosis device for equipments. Then, when metal obstacles collide against the inner surface of the reactor pressure vessel, acoustic signals generated upon collision are detected by the acoustic detectors and acoustic information thus obtained from the acoustic detectors determines the colliding position of the metal obstacles by means of the abnormality diagnosis device and then the collision energy is measured. In this case, by applying impact shocks at known collision energy near the colliding position of metal obstacles determined by the abnormality diagnosis device, collision energy can be determined at a higher accuracy. (Kawakami, Y.)

  7. Abnormal Grain Growth Suppression in Aluminum Alloys

    Science.gov (United States)

    Hales, Stephen J. (Inventor); Claytor, Harold Dale (Inventor); Alexa, Joel A. (Inventor)

    2015-01-01

    The present invention provides a process for suppressing abnormal grain growth in friction stir welded aluminum alloys by inserting an intermediate annealing treatment ("IAT") after the welding step on the article. The IAT may be followed by a solution heat treatment (SHT) on the article under effectively high solution heat treatment conditions. In at least some embodiments, a deformation step is conducted on the article under effective spin-forming deformation conditions or under effective superplastic deformation conditions. The invention further provides a welded article having suppressed abnormal grain growth, prepared by the process above. Preferably the article is characterized with greater than about 90% reduction in area fraction abnormal grain growth in any friction-stir-welded nugget.

  8. Nonpathologizing trauma interventions in abnormal psychology courses.

    Science.gov (United States)

    Hoover, Stephanie M; Luchner, Andrew F; Pickett, Rachel F

    2016-01-01

    Because abnormal psychology courses presuppose a focus on pathological human functioning, nonpathologizing interventions within these classes are particularly powerful and can reach survivors, bystanders, and perpetrators. Interventions are needed to improve the social response to trauma on college campuses. By applying psychodynamic and feminist multicultural theory, instructors can deliver nonpathologizing interventions about trauma and trauma response within these classes. We recommend class-based interventions with the following aims: (a) intentionally using nonpathologizing language, (b) normalizing trauma responses, (c) subjectively defining trauma, (d) challenging secondary victimization, and (e) questioning the delineation of abnormal and normal. The recommendations promote implications for instructor self-reflection, therapy interventions, and future research.

  9. Migraine and structural abnormalities in the brain

    DEFF Research Database (Denmark)

    Hougaard, Anders; Amin, Faisal Mohammad; Ashina, Messoud

    2014-01-01

    PURPOSE OF REVIEW: The aim is to provide an overview of recent studies of structural brain abnormalities in migraine and to discuss the potential clinical significance of their findings. RECENT FINDINGS: Brain structure continues to be a topic of extensive research in migraine. Despite advances...... in neuroimaging techniques, it is not yet clear if migraine is associated with grey matter changes. Recent large population-based studies sustain the notion of increased prevalence of white matter abnormalities in migraine, and possibly of silent infarct-like lesions. The clinical relevance of this association...

  10. Temporal abnormalities in children with developmental dyscalculia.

    Science.gov (United States)

    Vicario, Carmelo Mario; Rappo, Gaetano; Pepi, Annamaria; Pavan, Andrea; Martino, Davide

    2012-01-01

    Recent imaging studies have associated Developmental dyscalculia (DD) to structural and functional alterations corresponding Parietal and the Prefrontal cortex (PFC). Since these areas were shown also to be involved in timing abilities, we hypothesized that time processing is abnormal in DD. We compared time processing abilities between 10 children with pure DD (8 years old) and 11 age-matched healthy children. Results show that the DD group underestimated duration of a sub-second scale when asked to perform a time comparison task. The timing abnormality observed in our DD participants is consistent with evidence of a shared fronto-parietal neural network for representing time and quantity.

  11. Intestinal Rotation Abnormalities and Midgut Volvulus.

    Science.gov (United States)

    Langer, Jacob C

    2017-02-01

    Rotation abnormalities may be asymptomatic or may be associated with obstruction caused by bands, midgut volvulus, or associated atresia or web. The most important goal of clinicians is to determine whether the patient has midgut volvulus with intestinal ischemia, in which case an emergency laparotomy should be done. If the patient is not acutely ill, the next goal is to determine whether the patient has a narrow-based small bowel mesentery. In general, the outcomes for children with a rotation abnormality are excellent, unless there has been midgut volvulus with significant intestinal ischemia. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Hemorheological abnormalities in human arterial hypertension

    Science.gov (United States)

    Lo Presti, Rosalia; Hopps, Eugenia; Caimi, Gregorio

    2014-05-01

    Blood rheology is impaired in hypertensive patients. The alteration involves blood and plasma viscosity, and the erythrocyte behaviour is often abnormal. The hemorheological pattern appears to be related to some pathophysiological mechanisms of hypertension and to organ damage, in particular left ventricular hypertrophy and myocardial ischemia. Abnormalities have been observed in erythrocyte membrane fluidity, explored by fluorescence spectroscopy and electron spin resonance. This may be relevant for red cell flow in microvessels and oxygen delivery to tissues. Although blood viscosity is not a direct target of antihypertensive therapy, the rheological properties of blood play a role in the pathophysiology of arterial hypertension and its vascular complications.

  13. Estudo comparativo experimental da injeção perineural do álcool benzílico 0,75% e do álcool etílico absoluto nos nervos palmares de eqüinos

    Directory of Open Access Journals (Sweden)

    José Luiz de Mello Nicoletti

    2007-12-01

    Full Text Available The clinical and histopathological effects of two alcoholic neurolytics were studied in horses. Normal horses were shod with a designed shoe adaptted with 5 screws to produce solar pain. After gait and lameness score analysis, the palmar nerve of 5 horses was injected with 5 ml of 0,75% benzyl alcohol (Group A and 5 horses were injected with 5 ml of absolute ethyl alcohol (Group B. The animals were submitted to regular lameness evaluation and solar sensibility tests during next six months. The solar sensitivity returned 5 months latter in the group injected with benzyl alcohol 0,75%, while in the group injected with absolute ethyl alcohol, the sole was still desensitized 6 months latter. The histopathological findings showed that the nerve injected with benzyl alcohol 0,75%, resulted in axonotmesis, characterized by axonal nerve degeneration, with possibilities for the nerve conduction recovery. The perineural injection of ethyl alcohol absolute, resulted in neurotmesis with difficult nerve regeneration. It was concluded that chemical neurolysis with alcohol is an option for temporary or permanent nerve blocks in horses.

  14. TURISMO CEMITERIAL: proposta de roteirização a partir das potencialidades turísticas impressas no cemitério civil de Santa Vitória do Palmar, RS, Brasil

    Directory of Open Access Journals (Sweden)

    Cláudia Brandão Schwab

    2017-09-01

    Full Text Available Este trabalho apresenta projeto elaborado durante estágio curricular obrigatório, no qual se analisaram as possibilidades de transformação do Cemitério Civil de Santa Vitória do Palmar em um atrativo turístico, a partir da realização de trilhas interpretativas em um processo de roteirização, com vistas à preservação de seu patrimônio. A metodologia utilizada foi análise SWOT partindo da inventariação turística. As incursões exploratórias foram desenvolvidas por meio de pesquisa bibliográfica e em periódicos. A pesquisa de campo realizada fez levantamento da infraestrutura, acessibilidade, segurança do espaço e elementos tumulares visando à elaboração do plano final de roteirização.

  15. Characteristics of the Motor Units during Sternocleidomastoid Isometric Flexion among Patients with Mechanical Neck Disorder and Asymptomatic Individuals.

    Directory of Open Access Journals (Sweden)

    Chia-Chi Yang

    Full Text Available Mechanical neck disorder is a widespread and non-neurological musculoskeletal condition resulting from modern lifestyles. Presently, the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles and the characteristics of the short-term synchronization of the motor unit in patients with neck pain are ambiguous. This study therefore aims to clarify the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles in patients with mechanical neck disorder and in asymptomatic individuals. We further investigated whether alterations in the degree of motor unit short-term synchronization occur. The surface electrophysiological signals of the bilateral sternal heads of the sternocleidomastoid muscles of twelve patients with mechanical neck disorder and asymptomatic individuals were detected at 25% of the maximum voluntary contraction during cervical isometric flexion and then decomposed into individual motor unit action potential trains. We found that the patients with mechanical neck disorder showed significantly higher initial and mean firing rates of the sternocleidomastoid muscles and displayed substantially lower motor unit short-term synchronization values compared with the asymptomatic subjects. Consequently, these convincing findings support the assertion that patients with mechanical neck disorder display altered neuromuscular control strategies, such as the reinforcement of motor unit recruitment firing rates in the sternocleidomastoid muscles. The motor units of these patients also revealed neural recruitment strategies with relatively poor efficiency when executing the required motor tasks.

  16. Characteristics of the Motor Units during Sternocleidomastoid Isometric Flexion among Patients with Mechanical Neck Disorder and Asymptomatic Individuals.

    Science.gov (United States)

    Yang, Chia-Chi; Su, Fong-Chin; Yang, Po-Ching; Lin, Hwai-Ting; Guo, Lan-Yuen

    2016-01-01

    Mechanical neck disorder is a widespread and non-neurological musculoskeletal condition resulting from modern lifestyles. Presently, the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles and the characteristics of the short-term synchronization of the motor unit in patients with neck pain are ambiguous. This study therefore aims to clarify the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles in patients with mechanical neck disorder and in asymptomatic individuals. We further investigated whether alterations in the degree of motor unit short-term synchronization occur. The surface electrophysiological signals of the bilateral sternal heads of the sternocleidomastoid muscles of twelve patients with mechanical neck disorder and asymptomatic individuals were detected at 25% of the maximum voluntary contraction during cervical isometric flexion and then decomposed into individual motor unit action potential trains. We found that the patients with mechanical neck disorder showed significantly higher initial and mean firing rates of the sternocleidomastoid muscles and displayed substantially lower motor unit short-term synchronization values compared with the asymptomatic subjects. Consequently, these convincing findings support the assertion that patients with mechanical neck disorder display altered neuromuscular control strategies, such as the reinforcement of motor unit recruitment firing rates in the sternocleidomastoid muscles. The motor units of these patients also revealed neural recruitment strategies with relatively poor efficiency when executing the required motor tasks.

  17. Side effects and potential risk factors of botulinum toxin type A intramuscular injections in knee flexion contractures of hemophiliacs.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos; De la Corte-Rodriguez, Hortensia

    2017-07-01

    Knee flexion contracture (KFC) is a common complication of recurrent hemarthrosis in children and young adults with hemophilia. If the KFC is not prevented (by means of primary prophylaxis) and treated properly and early (be means of physical medicine and rehabilitation), it will become fixed. Areas covered: The aim of this article is to review the potential role of botulinum toxin type A (BTX-A) intramuscular injections for the treatment of KFC in people with hemophilia (PWH). Expert commentary: Although two recent reports have mentioned the benefits of intramuscular injections of BTX-A in PWH with KFC, the data are still scant and too preliminary. The use of intramuscular injections of BTX-A in PWH today should not be recommended until more case studies/small series (ideally well-designed clinical trials) fully demonstrate that this is safe and effective. The risks of intramuscular injections to a hemophilia patient cannot be underestimated (iatrogenic muscle hematomas and pseudotumors). This paper calls the attention of hemophilia treaters on the potential risks of this apparently interesting technique. The current use of BTX-A intramuscular injections in KFC of PWH could make no sense. Raising false expectations in these patients should be avoided.

  18. Les religieuses au cinéma : quelques pistes de réflexion Nuns at cinema

    Directory of Open Access Journals (Sweden)

    Laura Pettinaroli

    2012-06-01

    Full Text Available Si les films consacrés aux religieuses sont souvent l’occasion de polémiques, l’approche scientifique -notamment historienne- de ces œuvres reste rare. Cet article se propose donc de définir un corpus de films consacrés aux religieuses. Pour illustrer l’intérêt de ce corpus (une cinquantaine de films réalisés dans la seconde moitié du XXe siècle à travers le monde, nous proposons d’ouvrir une réflexion autour de deux questions : la dimension historique et la figuration du cloître.The films dedicated to the Catholic nuns usually provoke a lot of debates and few historical studies. This article aims above all to define a corpus of films dedicated to Catholic nuns. This corpus is about 50 films, produced during the second half of the XXth century all across the world. Beyond this global approach, we focus on two questions: the historical dimension and the representation of the cloister.

  19. 3D skin length deformation of lower body during knee joint flexion for the practical application of functional sportswear.

    Science.gov (United States)

    Choi, Jiyoung; Hong, Kyunghi

    2015-05-01

    With the advent of 3D technology in the design process, a tremendous amount of scanned data is available. However, it is difficult to trace the quantitative skin deformation of a designated location on the 3D body surface data during movement. Without identical landmarks or reflective markers, tracing the same reference points on the different body postures is not easy because of the complex shape change of the body. To find the least deformed location on the body, which is regarded as the optimal position of seams for the various lengths of functional compression pants, landmarks were directly marked on the skin of six subjects and scanned during knee joint flexion. Lines of non-extension (LoNE) and maximum stretch (LoMS) were searched for, both by tracing landmarks and newly drawn guidelines based on ratio division in various directions. Considering the waist as the anchoring position of the pants, holistic changes were quantified and visualized from the waistline in lengthwise and curvilinear deformation along the dermatomes of the lower body for various lengths of pants. Widthwise and unit area skin deformation data of the skin were also provided as guidelines for further use such as streamlined pants or design of other local wearing devices. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  20. Psychology Faculty Perceptions of Abnormal Psychology Textbooks

    Science.gov (United States)

    Rapport, Zachary

    2011-01-01

    The problem. The purpose of the current study was to investigate the perceptions and opinions of psychology professors regarding the accuracy and inclusiveness of abnormal psychology textbooks. It sought answers from psychology professors to the following questions: (1) What are the expectations of the psychology faculty at a private university of…

  1. Chromosome abnormalities in atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Tomonaga, Y [Nagasaki Univ. (Japan). School of Medicine

    1976-09-01

    Chromosome abnormalities in bone marrow cells were recognized in 6 cases which consisted of one case of chronic myelogenous leukemia, two cases of acute myelogenous leukemia, one case of sideroblastic anemia, and two cases of myelodysplasis. Frequency of stable type chromosome abnormalities in bone marrow cells was investigated in 45 atomic bomb survivors without hematologic disorders and 15 controls. It was 1.4% (15 cases) in the group exposed to atomic bomb within 1 km from the hypocenter, which was significantly higher as compared with 0.1% (15 cases) in the group exposed to atomic bomb over 2.5 km from the hypocenter and 0.2% in normal controls. Examination of chromosome was also made on 2 of 3 cases which were the seconds born of female with high chromosome abnormality, who was exposed to within 1 km from the hypocenter, and healthy male exposed 3 km from the hypocenter. These two cases showed chromosome of normal male type, and balanced translocation was not recognized. There was not a significant difference in chromosome abnormalities between the seconds of atomic bomb survivors and controls.

  2. Common echocardiographic abnormalities in Nigerians of different ...

    African Journals Online (AJOL)

    2012-09-17

    Sep 17, 2012 ... artery disease, cardiac murmurs, atrial fibrillation, stroke, and transient ischaemic attack.[4,5] In some circumstances, the examination is an appropriate screening test even in the absence of cardiovascular symptoms, especially. Common echocardiographic abnormalities in. Nigerians of different age groups.

  3. Learning from anticipated and abnormal plant transients

    International Nuclear Information System (INIS)

    Varnado, B.

    1983-01-01

    A report is given of the American Nuclear Society topical meeting on Anticipated and Abnormal Transients in Light Water Reactors held in Jackson, Wyoming in September 1983. Industry involvement in the evaluation of operating experience, human error contributions, transient management, thermal hydraulic modelling, the role of probabilistic risk assessment and the cost of transient incidents are discussed. (U.K.)

  4. Heat stress protection in abnormally hot environments.

    CSIR Research Space (South Africa)

    Schutte, PC

    1994-11-01

    Full Text Available The present report presents the findings of SIMRAC project GAP 045 entitled ‘Heat stress protection in abnormally hot environments’. It is intended as a reference to develop guidelines which, in turn would assist mine management in establishing safe...

  5. Abnormal interhemispheric connectivity in male psychopathic offenders.

    Science.gov (United States)

    Hoppenbrouwers, Sylco S; De Jesus, Danilo R; Sun, Yinming; Stirpe, Tania; Hofman, Dennis; McMaster, Jeff; Hughes, Ginny; Daskalakis, Zafiris J; Schutter, Dennis J L G

    2014-01-01

    Psychopathic offenders inevitably violate interpersonal norms and frequently resort to aggressive and criminal behaviour. The affective and cognitive deficits underlying these behaviours have been linked to abnormalities in functional interhemispheric connectivity. However, direct neurophysiological evidence for dysfunctional connectivity in psychopathic offenders is lacking. We used transcranial magnetic stimulation combined with electroencephalography to examine interhemispheric connectivity in the dorsolateral and motor cortex in a sample of psychopathic offenders and healthy controls. We also measured intracortical inhibition and facilitation over the left and right motor cortex to investigate the effects of local cortical processes on interhemispheric connectivity. We enrolled 17 psychopathic offenders and 14 controls in our study. Global abnormalities in right to left functional connectivity were observed in psychopathic offenders compared with controls. Furthermore, in contrast to controls, psychopathic offenders showed increased intracortical inhibition in the right, but not the left, hemisphere. The relatively small sample size limited the sensitivity to show that the abnormalities in interhemispheric connectivity were specifically related to the dorsolateral prefrontal cortex in psychopathic offenders. To our knowledge, this study provides the first neurophysiological evidence for abnormal interhemispheric connectivity in psychopathic offenders and may further our understanding of the disruptive antisocial behaviour of these offenders.

  6. Teaching Abnormal Psychology in a Multimedia Classroom.

    Science.gov (United States)

    Brewster, JoAnne

    1996-01-01

    Examines the techniques used in teaching an abnormal psychology class in a multimedia environment with two computers and a variety of audiovisual equipment. Students respond anonymously to various questions via keypads mounted on their desks, then immediately view and discuss summaries of their responses. (MJP)

  7. Schizophrenogenic Parenting in Abnormal Psychology Textbooks.

    Science.gov (United States)

    Wahl, Otto F.

    1989-01-01

    Considers the treatment of family causation of schizophrenia in undergraduate abnormal psychology textbooks. Reviews texts published only after 1986. Points out a number of implications for psychologists which arise from the inclusion in these texts of the idea that parents cause schizophrenia, not the least of which is the potential for…

  8. immunological arthritis Prevalence of biochemical and abnormalities ...

    African Journals Online (AJOL)

    1991-02-02

    Feb 2, 1991 ... the serum creatinine valuell and abnormalities of calcium and cholesterol have .... 16 high. Creatinine (JLmolJl). 75 - 115. 81,3 ± 20,9. 6,6 high. 7 high. 43,4 low ... acid levels without any obvious secondary cause. A raised.

  9. Fetal chromosome abnormalities and congenital malformations: an ...

    African Journals Online (AJOL)

    The results also showed that Multiple congenital anomalies (MCA) represented among 42.2%, congenital malformation of CNS represents 26.6%, congenital malformation of the skeletal system 20%, congenital polycystic kidney 8.8% and pyloric stenosis in 2.2%. Among the 21 women with abnormal karyotype of amniotic ...

  10. Neurobehavioural Correlates of Abnormal Repetitive Behaviour

    Directory of Open Access Journals (Sweden)

    R. A. Ford

    1991-01-01

    Full Text Available Conditions in which echolalia and echopraxia occur are reviewed, followed by an attempt to elicit possible mechanisms of these phenomena. A brief description of stereotypical and perseverative behaviour and obsessional phenomena is given. It is suggested that abnormal repetitive behaviour may occur partly as a result of central dopaminergic dysfunction.

  11. Ophthalmologic abnormalities among deaf students in Kaduna ...

    African Journals Online (AJOL)

    ... syndrome (0.6%) and Ushers syndrome (0.6%). Refractive error was the most common (7.9%). Conclusion: Since these deaf students use their sight to compensate for the deafness, routine ophthalmologic examination should be carried out on them so that ophthalmologic abnormalities are detected early and treatment ...

  12. The prevalence of electroencephalographic abnormalities and ...

    African Journals Online (AJOL)

    Adele

    2004-05-20

    May 20, 2004 ... South African studies. There is little South African data examining either prevalence or usefulness of EEG abnormalities among adult psychiatric patients. Some work has been done in adolescents. Szabo1 reviewed all admissions to the adolescent inpatient unit at Tara. Hospital between 1990 and 1995.

  13. Relationship among sera lipoprotein abnormalities in healthy ...

    African Journals Online (AJOL)

    Jane

    2011-08-29

    Aug 29, 2011 ... This study is a cross-sectional case control study. 179 men and women were ... can lead to lipid parameters abnormalities and CVD risk factor via aggregation of ... insulin kit is the brand of DRG German Company. The insulin.

  14. Abnormal Events for Emergency Trip in HANARO

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Guk Hun; Choi, M. J.; Park, S. I.; Kim, H. W.; Kim, S. J.; Park, J. H.; Kwon, I. C

    2006-12-15

    This report gathers abnormal events related to emergency trip of HANARO that happened during its operation over 10 years since the first criticality on February 1995. The collected examples will be utilized to the HANARO's operators as a useful guide.

  15. Gastric emptying abnormal in duodenal ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Holt, S.; Heading, R.C.; Taylor, T.V.; Forrest, J.A.; Tothill, P.

    1986-07-01

    To investigate the possibility that an abnormality of gastric emptying exists in duodenal ulcer and to determine if such an abnormality persists after ulcer healing, scintigraphic gastric emptying measurements were undertaken in 16 duodenal ulcer patients before, during, and after therapy with cimetidine; in 12 patients with pernicious anemia, and in 12 control subjects. No difference was detected in the rate or pattern of gastric emptying in duodenal ulcer patients before and after ulcer healing with cimetidine compared with controls, but emptying of the solid component of the test meal was more rapid during treatment with the drug. Comparison of emptying patterns obtained in duodenal ulcer subjects during and after cimetidine treatment with those obtained in pernicious anemia patients and controls revealed a similar relationship that was characterized by a tendency for reduction in the normal differentiation between the emptying of solid and liquid from the stomach. The similarity in emptying patterns in these groups of subjects suggests that gastric emptying of solids may be influenced by changes in the volume of gastric secretion. The failure to detect an abnormality of gastric emptying in duodenal ulcer subjects before and after ulcer healing calls into question the widespread belief that abnormally rapid gastric emptying is a feature with pathogenetic significance in duodenal ulcer disease.

  16. Chromosome abnormalities in atomic bomb survivors

    International Nuclear Information System (INIS)

    Tomonaga, Yu

    1976-01-01

    Chromosome abnormalities in bone marrow cells were recognized in 6 cases which consisted of one case of chronic myelogenous leukemia, two cases of acute myelogenous leukemia, one case of sideroblastic anemia, and two cases of myelodysplasis. Frequency of stable type chromosome abnormalities in bone marrow cells was investigated in 45 atomic bomb survivors without hematologic disorders and 15 controls. It was 1.4% (15 cases) in the group exposed to atomic bomb within 1 km from the hypocenter, which was significantly higher as compared with 0.1% (15 cases) in the group exposed to atomic bomb over 2.5 km from the hypocenter and 0.2% in normal controls. Examination of chromosome was also made on 2 of 3 cases which were the seconds born of female with high chromosome abnormality, who was exposed to within 1 km from the hypocenter, and healthy male exposed 3 km from the hypocenter. These two cases showed chromosome of normal male type, and balanced translocation was not recognized. There was not a significant difference in chromosome abnormalities between the seconds of atomic bomb survivors and controls. (Kanao, N.)

  17. Correcting abnormal speaking through communication partners ...

    African Journals Online (AJOL)

    The listed characteristics are called speech disorders. Abnormal speaking attracts some penalties to the speaker. The penalties are usually very disturbing to the speaker that undertaking some therapeutic measures becomes inevitable. Communication partners strategy is a speech correction approach which makes use of ...

  18. Abnormality diagnosis device for PWR type reactor

    International Nuclear Information System (INIS)

    Kurosawa, Masahiko.

    1993-01-01

    The device of the present invention rapidly detects a small amount of primary coolants leaked from a heat transfer pipes in a steam generator to estimate the scale of the rupture and forecast the transition of the amount of the leakage. That is, a gamma-ray spectrum and dose rate measuring system having a bypass line capable of decaying short half-time nuclides disposed to each of second main steam pipelines and primary coolant pipelines. Data obtained from the measuring systems are compared, to judge the presence of abnormal symptom due to leakage and further, radioactivity concentration in main steams is calculated based on the dose rate at each of the measuring points. Further, radioactivity concentration of the leakage from the secondary main steam pipelines is calculated by change with passage of time. With such procedures, when primary coolants are leaked to the secondary main steam pipelines, the dose rate of the measured system is changed, thereby enabling to recognize the state at the abnormal point. The transition of abnormalities can be forecast with reference to the dose rate by change with passage of time. Further, state of the abnormal point can be recognized based on the gamma-ray spectrum, which is inherent upon occurrence of fuel rupture. (T.S.)

  19. Craniofacial abnormalities among patients with Edwards Syndrome

    Directory of Open Access Journals (Sweden)

    Rafael Fabiano M. Rosa

    2013-09-01

    Full Text Available OBJECTIVE To determine the frequency and types of craniofacial abnormalities observed in patients with trisomy 18 or Edwards syndrome (ES. METHODS This descriptive and retrospective study of a case series included all patients diagnosed with ES in a Clinical Genetics Service of a reference hospital in Southern Brazil from 1975 to 2008. The results of the karyotypic analysis, along with clinical data, were collected from medical records. RESULTS: The sample consisted of 50 patients, of which 66% were female. The median age at first evaluation was 14 days. Regarding the karyotypes, full trisomy of chromosome 18 was the main alteration (90%. Mosaicism was observed in 10%. The main craniofacial abnormalities were: microretrognathia (76%, abnormalities of the ear helix/dysplastic ears (70%, prominent occiput (52%, posteriorly rotated (46% and low set ears (44%, and short palpebral fissures/blepharophimosis (46%. Other uncommon - but relevant - abnormalities included: microtia (18%, orofacial clefts (12%, preauricular tags (10%, facial palsy (4%, encephalocele (4%, absence of external auditory canal (2% and asymmetric face (2%. One patient had an initial suspicion of oculo-auriculo-vertebral spectrum (OAVS or Goldenhar syndrome. CONCLUSIONS: Despite the literature description of a characteristic clinical presentation for ES, craniofacial alterations may be variable among these patients. The OAVS findings in this sample are noteworthy. The association of ES with OAVS has been reported once in the literature.

  20. Ophthalmological abnormalities in wild European hedgehogs ...

    African Journals Online (AJOL)

    In this study we aimed to examine wild European hedgehogs (Erinaceus europaeus) in rescue centres and to determine ocular abnormalities in this animal population. Three hundred animals varying in age from 2 months to 5 years were examined, 147 being male and 153 female. All animals were evaluated with direct ...

  1. An abnormal carbohydrate tolerance in acromegaly

    International Nuclear Information System (INIS)

    Qi Jinwu

    1988-01-01

    An abnormal secretion of plasma human growth hormore (hGH) and insulin in 67 acromegalic patients had been previously treated by external pituitary radiation were studied. All subjects, following an overnight fast, a standard 100 g oral glucose tolerance test, were performed and venous blood samples were taken at 0, 30, 60, 120 and 180 min. They were measured for blood glucose, plasma insulin and hGH. The results of this study have shown that, of the 67 subjects, 23 cases had an abnormal glucose tolerance(34.32%). Diabetes was detected in 17 cases (23.37%) and 6 patients had decreased glucose tolerance(8.69%). In all, hGH levels were consistantly above 5 ng/ml and were not suppressed after an oral glucose load. In these patients, however, about one-third had abnormal glucose tolerance. Low plasma insulin response to glucose and that of the releasing were evident in them than the normal glucose tolerance and a healthy control group. In addition, the mechanism of the abnormal secretion of hGH and insulin were disscussed

  2. Gastric emptying abnormal in duodenal ulcer

    International Nuclear Information System (INIS)

    Holt, S.; Heading, R.C.; Taylor, T.V.; Forrest, J.A.; Tothill, P.

    1986-01-01

    To investigate the possibility that an abnormality of gastric emptying exists in duodenal ulcer and to determine if such an abnormality persists after ulcer healing, scintigraphic gastric emptying measurements were undertaken in 16 duodenal ulcer patients before, during, and after therapy with cimetidine; in 12 patients with pernicious anemia, and in 12 control subjects. No difference was detected in the rate or pattern of gastric emptying in duodenal ulcer patients before and after ulcer healing with cimetidine compared with controls, but emptying of the solid component of the test meal was more rapid during treatment with the drug. Comparison of emptying patterns obtained in duodenal ulcer subjects during and after cimetidine treatment with those obtained in pernicious anemia patients and controls revealed a similar relationship that was characterized by a tendency for reduction in the normal differentiation between the emptying of solid and liquid from the stomach. The similarity in emptying patterns in these groups of subjects suggests that gastric emptying of solids may be influenced by changes in the volume of gastric secretion. The failure to detect an abnormality of gastric emptying in duodenal ulcer subjects before and after ulcer healing calls into question the widespread belief that abnormally rapid gastric emptying is a feature with pathogenetic significance in duodenal ulcer disease

  3. Decreased Shoulder External Rotation and Flexion Are Greater Predictors of Injury Than Internal Rotation Deficits: Analysis of 132 Pitcher-Seasons in Professional Baseball.

    Science.gov (United States)

    Camp, Christopher L; Zajac, John M; Pearson, David B; Sinatro, Alec M; Spiker, Andrea M; Werner, Brian C; Altchek, David W; Coleman, Struan H; Dines, Joshua S

    2017-09-01

    The primary aims of this work were to (1) describe normal range of motion (ROM) profiles for elite pitchers, (2) describe the characteristics of shoulder and elbow injuries in professional pitchers over a 6-year period in one Major League Baseball organization, and (3) identify ROM measures that were independently associated with a future shoulder or elbow injury. Over 6 seasons (2010-2015), a preseason assessment was performed on all pitchers invited to Major League Baseball Spring Training for a single organization. ROM measures included shoulder flexion, horizontal adduction, external rotation (ER), internal rotation, as well as elbow flexion and extension, were measured for both the dominant and nondominant arm, and total range of motion and deficits were calculated. All noncontact shoulder and elbow injuries were identified. Using multivariate binomial logistic regression analysis to control for age, height, weight, and all other ROM measures, the factors associated with an increased risk of subsequent shoulder or elbow injury were identified. A total of 53 shoulder (n = 25) and elbow (n = 28) injuries occurred during 132 pitcher seasons (n = 81 pitchers). The most significant categorical risk factor associated with increased elbow injury rates was the presence of a shoulder flexion deficit >5° (odds ratio [OR] 2.83; P = .042). For continuous variables, the risk of elbow injury increased by 7% for each degree of increased shoulder ER deficit (OR 1.07; P = .030) and 9% for each degree of decreased shoulder flexion (OR 1.09; P = .017). None of the measures significantly correlated with shoulder injuries. Preseason shoulder ER and flexion deficits are independent risk factors for the development of elbow injuries during the upcoming season. Although prior work has supported the importance of reducing glenohumeral internal rotation deficits in pitchers, this study demonstrates that deficits in shoulder ER and flexion are more significant predictors of

  4. Abnormal Selective Attention Normalizes P3 Amplitudes in PDD

    Science.gov (United States)

    Hoeksma, Marco R.; Kemner, Chantal; Kenemans, J. Leon; van Engeland, Herman

    2006-01-01

    This paper studied whether abnormal P3 amplitudes in PDD are a corollary of abnormalities in ERP components related to selective attention in visual and auditory tasks. Furthermore, this study sought to clarify possible age differences in such abnormalities. Children with PDD showed smaller P3 amplitudes than controls, but no abnormalities in…

  5. Craniocervical junction abnormalities with atlantoaxial subluxation caused by ventral subluxation of C2 in a dog

    Directory of Open Access Journals (Sweden)

    Harumichi Itoh

    2017-03-01

    Full Text Available Craniocervical junction abnormalities with atlantoaxial subluxation caused by ventral subluxation of C2 were diagnosed in a 6-month-old female Pomeranian with tetraplegia as a clinical sign. Lateral survey radiography of the neck with flexion revealed atlantoaxial subluxation with ventral subluxation of C2. Computed tomography revealed absence of dens and atlanto-occipital overlapping. Magnetic resonance imaging showed compression of the spinal cord and indentation of caudal cerebellum. The diagnosis was Chiari-like malformation, atlantoaxial subluxation with ventral displacement of C2, atlanto-occipital overlapping, and syringomyelia. The dog underwent foramen magnum decompression, dorsal laminectomy of C1, and ventral fixation of the atlantoaxial joint. Soon after the operation, voluntary movements of the legs were recovered. Finally, the dog could stand and walk without assistance. The dog had complicated malformations at the craniocervical junction but foramen magnum decompression and dorsal laminectomy for Chiari-like malformation, and ventral fixation for atlantoaxial subluxation resulted in an excellent clinical outcome.

  6. Syringomyelia and Craniocervical Junction Abnormalities in Chihuahuas.

    Science.gov (United States)

    Kiviranta, A-M; Rusbridge, C; Laitinen-Vapaavuori, O; Hielm-Björkman, A; Lappalainen, A K; Knowler, S P; Jokinen, T S

    2017-11-01

    Chiari-like malformation (CM) and syringomyelia (SM) are widely reported in Cavalier King Charles Spaniels and Griffon Bruxellois dogs. Increasing evidence indicates that CM and SM also occur in other small and toy breed dogs, such as Chihuahuas. To describe the presence of SM and craniocervical junction (CCJ) abnormalities in Chihuahuas and to evaluate the possible association of CCJ abnormalities with SM. To describe CM/SM-related clinical signs and neurologic deficits and to investigate the association of CM/SM-related clinical signs with signalment, SM, or CCJ abnormalities. Fifty-three client-owned Chihuahuas. Prospective study. Questionnaire analyses and physical and neurologic examinations were obtained before magnetic resonance and computed tomography imaging. Images were evaluated for the presence of SM, CM, and atlantooccipital overlapping. Additionally, medullary kinking, dorsal spinal cord compression, and their sum indices were calculated. Scratching was the most common CM/SM-related clinical sign and decreased postural reaction the most common neurologic deficit in 73 and 87% of dogs, respectively. Chiari-like malformation and SM were present in 100 and 38% of dogs, respectively. Syringomyelia was associated with the presence of CM/SM-related clinical signs (P = 0.034), and medullary kinking and sum indices were higher in dogs with clinical signs (P = 0.016 and P = 0.007, respectively). Syringomyelia and CCJ abnormalities are prevalent in Chihuahuas. Syringomyelia was an important factor for the presence of CM/SM-related clinical signs, but many dogs suffered from similar clinical signs without being affected by SM, highlighting the clinical importance of CCJ abnormalities in Chihuahuas. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  7. Parenchymal abnormalities associated with developmental venous anomalies

    Energy Technology Data Exchange (ETDEWEB)

    San Millan Ruiz, Diego; Gailloud, Philippe [Johns Hopkins Hospital, Division of Interventional Neuroradiology, Baltimore, MD (United States); Delavelle, Jacqueline [Geneva University Hospital, Neuroradiology Section, Department of Radiology and Medical Informatics, Geneva (Switzerland); Yilmaz, Hasan; Ruefenacht, Daniel A. [Geneva University Hospital, Section of Interventional Neuroradiology, Department of Clinical Neurosciences, Geneva (Switzerland); Piovan, Enrico; Bertramello, Alberto; Pizzini, Francesca [Verona City Hospital, Service of Neuroradiology, Verona (Italy)

    2007-12-15

    To report a retrospective series of 84 cerebral developmental venous anomalies (DVAs), focusing on associated parenchymal abnormalities within the drainage territory of the DVA. DVAs were identified during routine diagnostic radiological work-up based on magnetic resonance imaging (MRI) (60 cases), computed tomography (CT) (62 cases) or both (36 cases). Regional parenchymal modifications within the drainage territory of the DVA, such as cortical or subcortical atrophy, white matter density or signal alterations, dystrophic calcifications, presence of haemorrhage or a cavernous-like vascular malformation (CVM), were noted. A stenosis of the collecting vein of the DVA was also sought for. Brain abnormalities within the drainage territory of a DVA were encountered in 65.4% of the cases. Locoregional brain atrophy occurred in 29.7% of the cases, followed by white matter lesions in 28.3% of MRI investigations and 19.3% of CT investigations, CVMs in 13.3% of MRI investigations and dystrophic calcification in 9.6% of CT investigations. An intracranial haemorrhage possibly related to a DVA occurred in 2.4% cases, and a stenosis on the collecting vein was documented in 13.1% of cases. Parenchymal abnormalities were identified for all DVA sizes. Brain parenchymal abnormalities were associated with DVAs in close to two thirds of the cases evaluated. These abnormalities are thought to occur secondarily, likely during post-natal life, as a result of chronic venous hypertension. Outflow obstruction, progressive thickening of the walls of the DVA and their morphological organization into a venous convergence zone are thought to contribute to the development of venous hypertension in DVA. (orig.)

  8. La réflexion stratégique, objet et outil de recherche pour le management stratégique ?

    OpenAIRE

    Torset, Christophe

    2005-01-01

    International audience; La littérature sur la formation de la stratégie utilise fréquemment l'expression « réflexion stratégique ». Cette notion est susceptible de faciliter l'analyse des processus en favorisant une démarche plus systémique, capable de regrouper et prendre en considération différents niveaux organisationnels et différentes formes de genèse des idées stratégiques. Cette communication propose une revue des caractéristiques de la notion de réflexion stratégique, au regard notamm...

  9. Power frequency spectrum analysis of surface EMG signals of upper limb muscles during elbow flexion - A comparison between healthy subjects and stroke survivors.

    Science.gov (United States)

    Angelova, Silvija; Ribagin, Simeon; Raikova, Rositsa; Veneva, Ivanka

    2018-02-01

    After a stroke, motor units stop working properly and large, fast-twitch units are more frequently affected. Their impaired functions can be investigated during dynamic tasks using electromyographic (EMG) signal analysis. The aim of this paper is to investigate changes in the parameters of the power/frequency function during elbow flexion between affected, non-affected, and healthy muscles. Fifteen healthy subjects and ten stroke survivors participated in the experiments. Electromyographic data from 6 muscles of the upper limbs during elbow flexion were filtered and normalized to the amplitudes of EMG signals during maximal isometric tasks. The moments when motion started and when the flexion angle reached its maximal value were found. Equal intervals of 0.3407 s were defined between these two moments and one additional interval before the start of the flexion (first one) was supplemented. For each of these intervals the power/frequency function of EMG signals was calculated. The mean (MNF) and median frequencies (MDF), the maximal power (MPw) and the area under the power function (APw) were calculated. MNF was always higher than MDF. A significant decrease in these frequencies was found in only three post-stroke survivors. The frequencies in the first time interval were nearly always the highest among all intervals. The maximal power was nearly zero during first time interval and increased during the next ones. The largest values of MPw and APw were found for the flexor muscles and they increased for the muscles of the affected arm compared to the non-affected one of stroke survivors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Increasing hip and knee flexion during a drop-jump task reduces tibiofemoral shear and compressive forces: implications for ACL injury prevention training.

    Science.gov (United States)

    Tsai, Liang-Ching; Ko, Yi-An; Hammond, Kyle E; Xerogeanes, John W; Warren, Gordon L; Powers, Christopher M

    2017-12-01

    Although most ACL injury prevention programmes encourage greater hip and knee flexion during landing, it remains unknown how this technique influences tibiofemoral joint forces. We examined whether a landing strategy utilising greater hip and knee flexion decreases tibiofemoral anterior shear and compression. Twelve healthy women (25.9 ± 3.5 years) performed a drop-jump task before and after a training session (10-15 min) that emphasised greater hip and knee flexion. Peak tibiofemoral anterior shear and compressive forces were calculated using an electromyography (EMG)-driven knee model that incorporated joint kinematics, EMG and participant-specific muscle volumes and patella tendon orientation measured using magnetic resonance imaging (MRI). Participants demonstrated a decrease in peak anterior tibial shear forces (11.1 ± 3.3 vs. 9.6 ± 2.7 N · kg -1 ; P = 0.008) and peak tibiofemoral compressive forces (68.4 ± 7.6 vs. 62.0 ± 5.5 N · kg -1 ; P = 0.015) post-training. The decreased peak anterior tibial shear was accompanied by a decrease in the quadriceps anterior shear force, while the decreased peak compressive force was accompanied by decreased ground reaction force and hamstring forces. Our data provide justification for injury prevention programmes that encourage greater hip and knee flexion during landing to reduce tibiofemoral joint loading.

  11. The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion.

    Science.gov (United States)

    Kerkum, Yvette L; Buizer, Annemieke I; van den Noort, Josien C; Becher, Jules G; Harlaar, Jaap; Brehm, Merel-Anne

    2015-01-01

    Rigid Ankle-Foot Orthoses (AFOs) are commonly prescribed to counteract excessive knee flexion during the stance phase of gait in children with cerebral palsy (CP). While rigid AFOs may normalize knee kinematics and kinetics effectively, it has the disadvantage of impeding push-off power. A spring-like AFO may enhance push-off power, which may come at the cost of reducing the knee flexion less effectively. Optimizing this trade-off between enhancing push-off power and normalizing knee flexion in stance is expected to maximize gait efficiency. This study investigated the effects of varying AFO stiffness on gait biomechanics and efficiency in children with CP who walk with excessive knee flexion in stance. Fifteen children with spastic CP (11 boys, 10±2 years) were prescribed with a ventral shell spring-hinged AFO (vAFO). The hinge was set into a rigid, or spring-like setting, using both a stiff and flexible performance. At baseline (i.e. shoes-only) and for each vAFO, a 3D-gait analysis and 6-minute walk test with breath-gas analysis were performed at comfortable speed. Lower limb joint kinematics and kinetics were calculated. From the 6-minute walk test, walking speed and the net energy cost were determined. A generalized estimation equation (ppush-off power did not lead to greater reductions in walking energy cost. These findings suggest that, in this specific group of children with spastic CP, the vAFO stiffness that maximizes gait efficiency is primarily determined by its effect on knee kinematics and kinetics rather than by its effect on push-off power. Dutch Trial Register NTR3418.

  12. Patterns in the knee flexion-extension moment profile during stair ascent and descent in patients with total knee arthroplasty.

    Science.gov (United States)

    McClelland, Jodie A; Feller, Julian A; Menz, Hylton B; Webster, Kate E

    2014-06-03

    The aim of this study was to investigate the prevalence of abnormal knee biomechanical patterns in 40 patients with a modern TKA prosthesis, compared to 40 matched control participants when ascending and descending stairs. Fewer patients were able to ascend (65%) or descend stairs (53%) unassisted than controls (83%). Of the participants who could ascend and descend, cluster analysis classified most patients (up to 77%) as demonstrating a similar knee moment pattern as all controls. A small subgroup of patients who completed the tasks did so with distinctly abnormal biomechanics compared to other patients and controls. These findings suggest that recovery of normal stair climbing is possible. However, rehabilitation might be more effective if it were tailored to account for these differences between patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Evidence of significant central fatigue in patients with cancer-related fatigue during repetitive elbow flexions till perceived exhaustion.

    Directory of Open Access Journals (Sweden)

    Bin Cai

    Full Text Available To investigate whether fatigue induced by an intermittent motor task in patients with cancer-related fatigue (CRF is more central or peripheral.Ten patients with CRF who were off chemo and radiation therapies and 14 age-matched healthy controls were enrolled. Participants completed a Brief Fatigue Inventory (BFI and performed a fatigue task consisting of intermittent elbow-flexion contractions at submaximal (40% maximal voluntary contraction intensity till self-perceived exhaustion. Twitch force was elicited by an electrical stimulation applied to the biceps brachii muscle. The relative degree of peripheral (muscle vs. central contribution to fatigue induced by the intermittent motor task (IMT was assessed using twitch force ratio (TF ratio defined as post IMT twitch force to pre IMT twitch force. The total number of trials (intermittent contractions and total duration of all trials performed by each subject were also quantified.BFI scores were higher (p < 0.001 in CRF than controls, indicating greater feeling of fatigue in CRF patients than controls. A significantly smaller number of trials and shorter total duration of the trials (p < 0.05 were observed in CRF than control participants. The TF ratio (0.81 ± 0.05 in CRF was higher (p < 0.05 compared with that of controls (0.62 ± 0.05, suggesting CRF patients experienced a significantly lower degree of muscle (peripheral fatigue at the time of perceived exhaustion.Consistent with prior findings for fatigue under submaximal sustained contraction, our results indicate that motor fatigue in CRF is more of central than peripheral origin during IMT. Significant central fatigue in CRF patients limits their ability to prolong motor performance.

  14. Influence of pressure changes on recruitment pattern and neck muscle activities during Cranio-Cervical Flexion Tests (CCFTs).

    Science.gov (United States)

    Park, Junhyung; Hur, Jingang; Ko, Taesung

    2015-01-01

    The muscle activity of the deep cervical flexors is emphasized more than that of the superficial cervical flexors, and it has been reported that functional disorders of the longuscolli are found in patients who experience neck pain. The objective of this study was to analyze the recruitment patterns and muscle activities of the cervical flexors during Cranio-Cervical Flexion Tests (CCFTs) through real-time ultrasonography and surface electromyography with a view to presenting appropriate pressure levels for deep cervical flexor exercise protocols based on the results of the analysis. The twenty subjects without neck pain were trained until they became accustomed to CCFTs, and the pressure level was increased gradually from 20 mmHg to 40 mmHg by increasing the pressure level 5 mmHg at a time. Real-time ultrasonography images of the longuscolli and the sternocleidomastoid were taken to measure the amounts of changes in the thicknesses of these muscles, and surface electromyography was implemented to observe the muscle activity of the sternocleidomastoid. The measured value is RMS. According to the results of the ultrasonography, the muscle thicknesses of both the longuscolli and the sternocleidomastoid showed significant increases, as the pressure increased up to 40 mmHg (p< 0.05). The differences in the muscle thicknesses at all individual pressure levels showed significant increases (p< 0.05). According to the results of the electromyography, the muscle activity of the sternocleidomastoid gradually increased as the pressure increased up to 40 mmHg, the increases were significant between 20 mmHg and 25 mmHg, between 30 mmHg and 35 mmHg (p< 0.05). The pressure levels of exercise methods at which the muscle activity of the deep cervical flexors is maximally increased and the muscle activity of the superficial cervical flexors is minimally increased are 25 mmHg-30 mmHg.

  15. Activation of the gluteus maximus and hamstring muscles during prone hip extension with knee flexion in three hip abduction positions.

    Science.gov (United States)

    Kang, Sun-Young; Jeon, Hye-Seon; Kwon, Ohyun; Cynn, Heon-Seock; Choi, Boram

    2013-08-01

    The direction of fiber alignment within a muscle is known to influence the effectiveness of muscle contraction. However, most of the commonly used clinical gluteus maximus (GM) exercises do not consider the direction of fiber alignment within the muscle. Therefore, the purpose of this study was to investigate the influence of hip abduction position on the EMG (electromyography) amplitude and onset time of the GM and hamstrings (HAM) during prone hip extension with knee flexion (PHEKF) exercise. Surface EMG signals were recorded from the GM and HAM during PHEKF exercise in three hip abduction positions: 0°, 15°, and 30°. Thirty healthy subjects voluntarily participated in this study. The results show that GM EMG amplitude was greatest in the 30° hip abduction position, followed by 15° and then 0° hip abduction during PHEKF exercise. On the other hand, the HAM EMG amplitude at 0° hip abduction was significantly greater than at 15° and 30° hip abduction. Additionally, GM EMG onset firing was delayed relative to that of the HAM at 0° hip abduction. On the contrary, the GM EMG onset occurred earlier than the HAM in the 15° and 30° hip abduction positions. These findings indicate that performing PHEKF exercise in the 30° hip abduction position may be recommended as an effective way to facilitate the GM muscle activity and advance the firing time of the GM muscle in asymptomatic individuals. This finding provides preliminary evidence that GM EMG amplitude and onset time can be modified by the degree of hip abduction. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Genome wide gene expression analysis of the posterior capsule in patients with osteoarthritis and knee flexion contracture.

    Science.gov (United States)

    Campbell, Thomas Mark; Trudel, Guy; Wong, Kayleigh Kristin; Laneuville, Odette

    2014-11-01

    Knee flexion contractures (KFC) are limitations in the ability to fully extend the knee joint. In people with knee osteoarthritis (OA), KFC are common, impair function, and worsen outcomes after arthroplasty. In KFC, the posterior knee capsule is believed to play a key role, but the pathophysiology remains poorly understood. We sought to identify gene expression differences in the posterior knee capsule of patients with OA with and without KFC. Capsule tissue was obtained from the knees of 12 subjects diagnosed with advanced-stage OA at the time of knee arthroplasty surgery. The presence or absence of KFC allocated patients into 2 groups using a case-control design. Genomewide capsular gene expression was compared between the 2 patient groups. Confirmation of differential expression of the corresponding proteins was performed by immunohistochemistry on tissue sections. There were no significant demographic differences between the patients with OA with KFC and without KFC save for reduced extension in their surgical knee (pKFC patients showed a 6.4-fold decrease in CSN1S1 (p=0.017) gene expression and a 3.7-, 2.0-, and 2.6-fold increase in CHAD, Sox9, and Cyr61 gene expression, respectively (p=0.001, 0.004, 0.001, respectively). There were corresponding increases in protein levels for chondroadherin, sex determining region Y-box 9, and casein alphaS1 (all pKFC exhibited differential expression of 4 genes all previously documented to be associated with tissue fibrosis.

  17. Relationship between electromyographic activity of the vastus lateralis while standing and the extent of bilateral simulated knee-flexion contractures.

    Science.gov (United States)

    Potter, P J; Kirby, R L

    1991-12-01

    The effect of simulated bilateral knee-flexion contractures (KFC) on the electromyographic (EMG) activity of the vastus lateralis was studied by testing 10 normal subjects using surface EMG to test the hypothesis that the activity of the knee extensors would increase as a function of the severity of the contracture. The root mean square of the EMG activity was determined from four 4-s samples taken at 30-s intervals, during 2 min of standing in each of five positions of simulated KFC (0 degree, 10 degrees, 20 degrees, 30 degrees and 40 degrees). A randomly balanced order of conditions was used. KFC were simulated in each subject by means of an adjustable line from the subject's waist to the sole of each foot. An analysis of variance was used to contrast EMG activity, and a significant difference was found between each of the positions (P less than 0.05). The mean (+/- 1 SD) EMG activity, expressed as a percentage of the maximum voluntary contraction, was 0.3% (+/- 0.2) at 0 degree, 7.6% (+/- 5.6) at 10 degrees, 10.9% (+/- 7.6) at 20 degrees, 16.6% (+/- 12.4) at 30 degrees and 24.0% (+/- 14.0) at 40 degrees. A linear relationship was found (r2 = 0.986), expressed by the equation y = 0.62 + 0.56 x, where y represents EMG activity and x represents the extent of simulated KFC (P = 0.0007). The results provide insight into the increased knee extensor activity necessary to stand with KFC and underline the importance of treating this common disorder.

  18. A randomized clinical trial to compare the immediate effects of seated thoracic manipulation and targeted supine thoracic manipulation on cervical spine flexion range of motion and pain.

    Science.gov (United States)

    Karas, Steve; Olson Hunt, Megan J

    2014-05-01

    Randomized clinical trial. To determine the effectiveness of seated thoracic manipulation versus targeted supine thoracic manipulation on cervical spine pain and flexion range of motion (ROM). There is evidence that thoracic spine manipulation is an effective treatment for patients with cervical spine pain. This evidence includes a variety of techniques to manipulate the thoracic spine. Although each of them is effective, no research has compared techniques to determine which produces the best outcomes. A total of 39 patients with cervical spine pain were randomly assigned to either a seated thoracic manipulation or targeted supine thoracic manipulation group. Pain and flexion ROM measures were taken before and after the intervention. Pain reduction (post-treatment-pre-treatment) was significantly greater in those patients receiving the targeted supine thoracic manipulation compared to the seated thoracic manipulation (Pmanipulation group. The results of this study indicate that a targeted supine thoracic manipulation may be more effective in reducing cervical spine pain and improving cervical flexion ROM than a seated thoracic manipulation. Future studies should include a variety of patients and physical therapists (PTs) to validate our findings.

  19. Determination of concentric and eccentric peak moment values for trunk flexion and extension in sedentary asymptomatic individuals by isokinetic dynamometry: a pilot study

    Directory of Open Access Journals (Sweden)

    Rafaella Stradiotto Bernardelli

    2017-11-01

    Full Text Available The spine has a direct influence on postural alignment and movement of the whole body. Lumbar muscles constitute a critical element in trunk performance while weakness of these muscles has been associated with low back pain. Hence, strength profiling of trunk muscles is clinically significant. The objective of this research was to determine, by means of isokinetic dynamometry, peak moment (PM values during isokinetic concentric and eccentric efforts of trunk flexion and extension in sedentary asymptomatic individuals. The sample consisted of 100 asymptomatic sedentary volunteers, fifty from each sex, aging 22.2 ± 3.3 years old. The sample underwent concentric and eccentric isokinetic assessment of the trunk flexor and extensor muscles at an angular velocity of 60 degrees/sec for each mode of contraction. The mean concentric PM for trunk flexion and extension were 139.5 and 166.6 Nm, respectively, while the respective values for the eccentric efforts were 188.8 and 221.2 Nm. The PM flexion/extension ratio was 0.87 and 0.89 for the concentric and eccentric efforts, respectively. These values of concentric and eccentric PM and PM ratio will serve as comparison parameters for future research, as well as for the assessment of symptomatic patients, and to help in the creation of the trunk muscle rebalance protocols.

  20. The choice of a constitutive formulation for modeling limb flexion-induced deformations and stresses in the human femoropopliteal arteries of different ages.

    Science.gov (United States)

    Desyatova, Anastasia; MacTaggart, Jason; Poulson, William; Deegan, Paul; Lomneth, Carol; Sandip, Anjali; Kamenskiy, Alexey

    2017-06-01

    Open and endovascular treatments for peripheral arterial disease are notorious for high failure rates. Severe mechanical deformations experienced by the femoropopliteal artery (FPA) during limb flexion and interactions between the artery and repair materials play important roles and may contribute to poor clinical outcomes. Computational modeling can help optimize FPA repair, but these simulations heavily depend on the choice of constitutive model describing the arterial behavior. In this study finite element model of the FPA in the standing (straight) and gardening (acutely bent) postures was built using computed tomography data, longitudinal pre-stretch and biaxially determined mechanical properties. Springs and dashpots were used to represent surrounding tissue forces associated with limb flexion-induced deformations. These forces were then used with age-specific longitudinal pre-stretch and mechanical properties to obtain deformed FPA configurations for seven age groups. Four commonly used invariant-based constitutive models were compared to determine the accuracy of capturing deformations and stresses in each age group. The four-fiber FPA model most accurately portrayed arterial behavior in all ages, but in subjects younger than 40 years, the performance of all constitutive formulations was similar. In older subjects, Demiray (Delfino) and classic two-fiber Holzapfel-Gasser-Ogden formulations were better than the Neo-Hookean model for predicting deformations due to limb flexion, but both significantly overestimated principal stresses compared to the FPA or Neo-Hookean models.

  1. Fractal feature of sEMG from Flexor digitorum superficialis muscle correlated with levels of contraction during low-level finger flexions.

    Science.gov (United States)

    Arjunan, Sridhar P; Kumar, Dinesh K; Naik, Ganesh R

    2010-01-01

    This research paper reports an experimental study on identification of the changes in fractal properties of surface Electromyogram (sEMG) with the changes in the force levels during low-level finger flexions. In the previous study, the authors have identified a novel fractal feature, Maximum fractal length (MFL) as a measure of strength of low-level contractions and has used this feature to identify various wrist and finger movements. This study has tested the relationship between the MFL and force of contraction. The results suggest that changes in MFL is correlated with the changes in contraction levels (20%, 50% and 80% maximum voluntary contraction (MVC)) during low-level muscle activation such as finger flexions. From the statistical analysis and by visualisation using box-plot, it is observed that MFL (p ≈ 0.001) is a more correlated to force of contraction compared to RMS (p≈0.05), even when the muscle contraction is less than 50% MVC during low-level finger flexions. This work has established that this fractal feature will be useful in providing information about changes in levels of force during low-level finger movements for prosthetic control or human computer interface.

  2. [Otoneurologic abnormalities in insulin-dependent diabetes].

    Science.gov (United States)

    Jáuregui-Renaud, K; Domínguez-Rubio, B; Ibarra-Olmos, A; González-Bárcena, D

    1998-01-01

    To assess the auditory and vestibular function in patients with diabetes. We studied and followed for three years, 10 patients (6 females) of 20.6 years of age (SD 5.5 years), with insulindependent diabetes mellitus of 9.5 years (SD 3.7 years). The patients were selected for having peripheral neuropathy without prolipherative retinopathy and otologic disease or individual factors which could cause neurootologic symptoms. Their glomerular filtration rate and renal plasma flow were 150 mL/min (SD 50) and 543 mL/min (SD 113). Initially all patients had normal audiologic responses, including auditory brainstem responses, but had abnormally and simetrically diminished horizontal vestibulo-ocular responses. A year later one patient had vertigo and asymmetric vestibulo-ocular responses. In the third year, another patient showed similar abnormalities and a third one showed sensorineural hearing loss. Our results suggest that patients with insulindependent diabetes mellitus may suffer neuro-otological deterioration.

  3. Selective mutism and abnormal electroencephalography (EEG) tracings.

    Science.gov (United States)

    Politi, Keren; Kivity, Sara; Goldberg-Stern, Hadassa; Halevi, Ayelet; Shuper, Avinoam

    2011-11-01

    Epileptic discharges are not considered a part of the clinical picture of selective mutism, and electroencephalography is generally not recommended in its work-up. This report describes 6 children with selective mutism who were found to have a history of epilepsy and abnormal interictal or subclinical electroencephalography recordings. Two of them had benign epilepsy of childhood with centro-temporal spikes. The mutism was not related in time to the presence of active seizures. While seizures could be controlled in all children by medications, the mutism resolved only in 1. Although the discharges could be coincidental, they might represent a co-morbidity of selective mutism or even play a role in its pathogenesis. Selective mutism should be listed among the psychiatric disorders that may be associated with electroencephalographic abnormalities. It can probably be regarded as a symptom of a more complicated organic brain disorder.

  4. Abnormal cervical cytology and health care use

    DEFF Research Database (Denmark)

    Frederiksen, Maria Eiholm; Baillet, Miguel Vázquez-Prada; Dugué, Pierre-Antoine

    2015-01-01

    OBJECTIVE: This study aimed to assess the long-term use of health care services in women with abnormal cytology results compared to women with normal cytology results. METHODS: We did a nationwide population-based study, using women aged 23 to 59years participating in the national organized...... cervical cancer screening program. We included a study population of 40,153 women with abnormal cytology (exposed) and 752,627 women with normal cytology (non-exposed). We retrieved data from the Danish Civil Registration System, the Danish Pathology Data Bank, the National Health Service, the National......" the cytology result and for the 5-year period "after" the result. RESULTS: During the "before" period exposed women had more contacts to GPs, more contacts to psychologists/psychiatrist, and more hospital admissions than non-exposed women. In both exposed and non-exposed women, health care use increased from...

  5. Gastric emptying abnormalities in progressive systemic sclerosis

    International Nuclear Information System (INIS)

    Sridhar, K.; Magyar, L.; Lange, R.; McCallum, R.W.

    1985-01-01

    The authors studied gastric emptying (GE) in patients with peripheral manifestations of progressive systemic sclerosis (PSS) using a radionuclide method. 18 patients underwent esophageal manometry and a GE study using chicken liver labeled in vivo with Tc-99m sulfur colloid as a marker of solid emptying. GE was also measured in 13 normal volunteers. 4 PSS patients with normal esophageal motility also had normal GE. The GE of 14 PSS patients with abnormal esophageal motility was significantly (p < 0.05) delayed; with 67.4% retention of isotope after 2 hours compared to 49.8 in normals. The authors conclude that GE of solids is slow in approximately 2/3 of PSS patients with abnormal esophageal motility but is normal if the esophagus is uninvolved; Delayed GE may contribute to the severity of gastroesophageal reflux in PSS patients and the degree of dysphasgia; and Metoclopramide accelerates GE in PSS patients and should have a valuable therapeutic role

  6. Chromosomal abnormalities in a psychiatric population

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, K.E.; Lubetsky, M.J.; Wenger, S.L.; Steele, M.W. [Univ. of Pittsburgh Medical Center, PA (United States)

    1995-02-27

    Over a 3.5 year period of time, 345 patients hospitalized for psychiatric problems were evaluated cytogenetically. The patient population included 76% males and 94% children with a mean age of 12 years. The criteria for testing was an undiagnosed etiology for mental retardation and/or autism. Cytogenetic studies identified 11, or 3%, with abnormal karyotypes, including 4 fragile X positive individuals (2 males, 2 females), and 8 with chromosomal aneuploidy, rearrangements, or deletions. While individuals with chromosomal abnormalities do not demonstrate specific behavioral, psychiatric, or developmental problems relative to other psychiatric patients, our results demonstrate the need for an increased awareness to order chromosomal analysis and fragile X testing in those individuals who have combinations of behavioral/psychiatric, learning, communication, or cognitive disturbance. 5 refs., 1 fig., 2 tabs.

  7. Venous abnormalities demonstrated by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, T; Tsukune, Y; Ashida, H; Tokuda, M; Oyama, Y [St. Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

    1980-05-01

    CT is capable of demonstrating various venous changes. However, little have been described on this subject in the literature. Examples of various venous abnormalities such as obstructed jugular vein, superior and inferior vena cava (IVC), tumor invasion of IVC and renal vein and venous changes in portal hypertension were presented. It was stressed that noninvasive CT is a good tool in diagnosis of some of venous changes and may be able to eliminate angiography in such cases.

  8. Abnormal Retained Earnings Around The World

    OpenAIRE

    Alves, Paulo; Silva, Paulo

    2017-01-01

    Using a firm-level survey database covering 50 countries we evaluate firms´ abnormal retained earnings. The results of our work indicate that firms located in emerging markets retain more earnings than firms from developed countries. On the other hand, firms located on common law based countries retain earnings above the expected and higher than firms placed on civil law based countries. A possible explanation, according to our results, can be seen in the economic growth that these countries ...

  9. Abnormal mitochondrial respiration in failed human myocardium.

    Science.gov (United States)

    Sharov, V G; Todor, A V; Silverman, N; Goldstein, S; Sabbah, H N

    2000-12-01

    Chronic heart failure (HF) is associated with morphologic abnormalities of cardiac mitochondria including hyperplasia, reduced organelle size and compromised structural integrity. In this study, we examined whether functional abnormalities of mitochondrial respiration are also present in myocardium of patients with advanced HF. Mitochondrial respiration was examined using a Clark electrode in an oxygraph cell containing saponin-skinned muscle bundles obtained from myocardium of failed explanted human hearts due to ischemic (ICM, n=9) or idiopathic dilated (IDC, n=9) cardiomyopathy. Myocardial specimens from five normal donor hearts served as controls (CON). Basal respiratory rate, respiratory rate after addition of the substrates glutamate and malate (V(SUB)), state 3 respiration (after addition of ADP, V(ADP)) and respiration after the addition of atractyloside (V(AT)) were measured in scar-free muscle bundles obtained from the subendocardial (ENDO) and subepicardial (EPI) thirds of the left ventricular (LV) free wall, interventricular septum and right ventricular (RV) free wall. There were no differences in basal and substrate-supported respiration between CON and HF regardless of etiology. V(ADP)was significantly depressed both in ICM and IDC compared to CON in all the regions studied. The respiratory control ratio, V(ADP)/V(AT), was also significantly decreased in HF compared to CON. In both ICM and IDC, V(ADP)was significantly lower in ENDO compared to EPI. The results indicate that mitochondrial respiration is abnormal in the failing human heart. The findings support the concept of low myocardial energy production in HF via oxidative phosphorylation, an abnormality with a potentially impact on global cardiac performance. Copyright 2000 Academic Press.

  10. Esophageal motility abnormalities in gastroesophageal reflux disease

    Science.gov (United States)

    Martinucci, Irene; de Bortoli, Nicola; Giacchino, Maria; Bodini, Giorgia; Marabotto, Elisa; Marchi, Santino; Savarino, Vincenzo; Savarino, Edoardo

    2014-01-01

    Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophageal motility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from non-erosive reflux disease to erosive reflux disease and Barrett’s esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted. PMID:24868489

  11. The handicap of abnormal colour vision.

    Science.gov (United States)

    Cole, Barry L

    2004-07-01

    All people with abnormal colour vision, except for a few mildly affected deuteranomals, report that they experience problems with colour in everyday life and at work. Contemporary society presents them with increasing problems because colour is now so widely used in printed materials and in computer displays. Equal opportunity law gives them protection against unfair discrimination in employment, so a decision to exclude a person from employment on the grounds of abnormal colour vision must now be well supported by good evidence and sound argument. This paper reviews the investigations that have contributed to understanding the nature and consequences of the problems they have. All those with abnormal colour vision are at a disadvantage with comparative colour tasks that involve precise matching of colours or discrimination of fine colour differences either because of their loss of colour discrimination or anomalous perception of metamers. The majority have problems when colour is used to code information, in man-made colour codes and in naturally occurring colour codes that signal ripeness of fruit, freshness of meat or illness. They can be denied the benefit of colour to mark out objects and organise complex visual displays. They may be unreliable when a colour name is used as an identifier. They are slower and less successful in search when colour is an attribute of the target object or is used to organise the visual display. Because those with the more severe forms of abnormal colour vision perceive a very limited gamut of colours, they are at a disadvantage in the pursuit and appreciation of those forms of art that use colour.

  12. Laryngopharyngeal abnormalities in hospitalized patients with dysphagia.

    Science.gov (United States)

    Postma, Gregory N; McGuirt, W Frederick; Butler, Susan G; Rees, Catherine J; Crandall, Heather L; Tansavatdi, Kristina

    2007-10-01

    To determine the prevalence of laryngopharyngeal (LP) abnormalities in hospitalized patients with dysphagia referred for flexible endoscopic evaluation of swallowing (FEES). Retrospective, blinded review by two otolaryngologists of 100 consecutive FEES studies performed and video-recorded by a speech-language pathologist (SLP). Two otolaryngologists reviewed videos of 100 consecutive FEES studies on hospitalized patients with dysphagia for the presence of abnormal LP findings. Sixty-one male and 38 female patients comprised the hospital dysphagia cohort. The mean age was 62. One subject could not be evaluated because of the severity of the retained secretions, leaving 99 subjects in the cohort. Seventy-six percent had been previously intubated, with a mean intubation duration of 13 days. The overall prevalence of abnormal LP findings was 79%. Forty-five percent of the patients presented with two or more findings, which included arytenoid edema (33%), granuloma (31%), vocal fold paresis (24%), mucosal lesions (17%), vocal fold bowing (14%), diffuse edema (11%), airway stenosis (3%), and ulcer (6%). There was a significant difference in LP findings between those individuals who had or had not been intubated. Hospitalized patients with dysphagia are at high risk for LP abnormalities, particularly if they have been intubated, and may benefit from either 1) an initial joint examination by the SLP and otolaryngologist or 2) an otolaryngologist's review of the recorded examination conducted by the SLP. Such otolaryngology involvement could identify airway stenosis patients at an earlier stage, initiate granuloma treatment sooner, enable earlier biopsy of unexpected lesions, and allow follow-up of mucosal and neuromuscular findings that do not respond to medical management.

  13. Dysglycemia induces abnormal circadian blood pressure variability

    Directory of Open Access Journals (Sweden)

    Kumarasamy Sivarajan

    2011-11-01

    Full Text Available Abstract Background Prediabetes (PreDM in asymptomatic adults is associated with abnormal circadian blood pressure variability (abnormal CBPV. Hypothesis Systemic inflammation and glycemia influence circadian blood pressure variability. Methods Dahl salt-sensitive (S rats (n = 19 after weaning were fed either an American (AD or a standard (SD diet. The AD (high-glycemic-index, high-fat simulated customary human diet, provided daily overabundant calories which over time lead to body weight gain. The SD (low-glycemic-index, low-fat mirrored desirable balanced human diet for maintaining body weight. Body weight and serum concentrations for fasting glucose (FG, adipokines (leptin and adiponectin, and proinflammatory cytokines [monocyte chemoattractant protein-1 (MCP-1 and tumor necrosis factor-α (TNF-α] were measured. Rats were surgically implanted with C40 transmitters and blood pressure (BP-both systolic; SBP and diastolic; DBP and heart rate (HR were recorded by telemetry every 5 minutes during both sleep (day and active (night periods. Pulse pressure (PP was calculated (PP = SBP-DBP. Results [mean(SEM]: The AD fed group displayed significant increase in body weight (after 90 days; p Conclusion These data validate our stated hypothesis that systemic inflammation and glycemia influence circadian blood pressure variability. This study, for the first time, demonstrates a cause and effect relationship between caloric excess, enhanced systemic inflammation, dysglycemia, loss of blood pressure control and abnormal CBPV. Our results provide the fundamental basis for examining the relationship between dysglycemia and perturbation of the underlying mechanisms (adipose tissue dysfunction induced local and systemic inflammation, insulin resistance and alteration of adipose tissue precursors for the renin-aldosterone-angiotensin system which generate abnormal CBPV.

  14. Computed tomography in abnormalities of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Visser, J.D.; Jonkers, A.; Klasen, H.J. (Rijksuniversiteit Groningen (Netherlands). Academisch Ziekenhuis); Hillen, B. (Rijksuniversiteit Groningen (Netherlands). Lab. voor Anatomie en Embryologie)

    1982-06-26

    The value of computed tomography in the assessment of abnormalities of the hip is demonstrated with the aid of an anatomical preparation and in patients with, respectively, congenital dislocation of a hip, dislocation of the hip in spina bifida, an acetabular fracture and a Ewing tumour. The anteversion of the acetabulum and femur and the instability index of the hip joint can be measured by means of computed tomography.

  15. Binocular combination in abnormal binocular vision.

    Science.gov (United States)

    Ding, Jian; Klein, Stanley A; Levi, Dennis M

    2013-02-08

    We investigated suprathreshold binocular combination in humans with abnormal binocular visual experience early in life. In the first experiment we presented the two eyes with equal but opposite phase shifted sine waves and measured the perceived phase of the cyclopean sine wave. Normal observers have balanced vision between the two eyes when the two eyes' images have equal contrast (i.e., both eyes contribute equally to the perceived image and perceived phase = 0°). However, in observers with strabismus and/or amblyopia, balanced vision requires a higher contrast image in the nondominant eye (NDE) than the dominant eye (DE). This asymmetry between the two eyes is larger than predicted from the contrast sensitivities or monocular perceived contrast of the two eyes and is dependent on contrast and spatial frequency: more asymmetric with higher contrast and/or spatial frequency. Our results also revealed a surprising NDE-to-DE enhancement in some of our abnormal observers. This enhancement is not evident in normal vision because it is normally masked by interocular suppression. However, in these abnormal observers the NDE-to-DE suppression was weak or absent. In the second experiment, we used the identical stimuli to measure the perceived contrast of a cyclopean grating by matching the binocular combined contrast to a standard contrast presented to the DE. These measures provide strong constraints for model fitting. We found asymmetric interocular interactions in binocular contrast perception, which was dependent on both contrast and spatial frequency in the same way as in phase perception. By introducing asymmetric parameters to the modified Ding-Sperling model including interocular contrast gain enhancement, we succeeded in accounting for both binocular combined phase and contrast simultaneously. Adding binocular contrast gain control to the modified Ding-Sperling model enabled us to predict the results of dichoptic and binocular contrast discrimination experiments

  16. Renal abnormalities in congenital chloride diarrhea

    International Nuclear Information System (INIS)

    Al-Hamad, Nadia M.; Al-Eisa, Amal A.

    2004-01-01

    Congenital chloride diarrhea CLD is a rare autosomal recessive disorder caused by a defect in the chloride/ bicarbonate exchange in the ileum and colon. It is characterized by watery diarrhea, abdominal distension, hypochloremic hypokalemic metabolic alkalosis with high fecal content of chloride >90 mmol/l. We report 3 patients with CLD associated with various renal abnormalities including chronic renal failure secondary to renal hypoplasia, nephrocalcinosis and congenital nephrotic syndrome. (author)

  17. Additional chromosome abnormalities in chronic myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Hui-Hua Hsiao

    2011-02-01

    Full Text Available The Philadelphia (Ph chromosome and/or Breakpoint cluster region-Abelson leukemia virus oncogene transcript are unique markers for chronic myeloid leukemia (CML. However, CML demonstrates heterogeneous presentations and outcomes. We analyzed the cytogenetic and molecular results of CML patients to evaluate their correlation with clinical presentations and outcome. A total of 84 newly diagnosed CML patients were enrolled in the study. Patients were treated according to disease status. Bone marrow samples were obtained to perform cytogenetic and molecular studies. Clinical presentations, treatment courses, and survival were reviewed retrospectively. Among 84 patients, 72 had chronic phase and 12 had accelerated phase CML. Cytogenetic study showed 69 (82.1% with the classic Ph chromosome, 6 (7.2% with a variant Ph chromosome, and 9 (10.7% with additional chromosome abnormalities. Fifty-four (64.3% cases harbored b3a2 transcripts, 29 (34.5% had b2a2 transcript, and 1 had e19a2 transcript. There was no difference in clinical presentations between different cytogenetic and molecular groups; however, additional chromosome abnormalities were significantly associated with the accelerated phase. Imatinib therapy was an effective treatment, as measured by cytogenetic response, when administered as first- and second-line therapy in chronic phase patients. Survival analysis showed that old age, additional chromosome abnormalities, high Sokal score, and no cytogenetic response in second-line therapy had a significant poor impact (p<0.05. In conclusion, we presented the cytogenetic and molecular pattern of CML patients and demonstrated that the additional chromosome abnormality was associated with poor outcome.

  18. Diagnosis and treatment of abnormal dental pain.

    Science.gov (United States)

    Fukuda, Ken-Ichi

    2016-03-01

    Most dental pain is caused by an organic problem such as dental caries, periodontitis, pulpitis, or trauma. Diagnosis and treatment of these symptoms are relatively straightforward. However, patients often also complain of abnormal dental pain that has a non-dental origin, whose diagnosis is challenging. Such abnormal dental pain can be categorized on the basis of its cause as referred pain, neuromodulatory pain, and neuropathic pain. When it is difficult to diagnose a patient's dental pain, these potential alternate causes should be considered. In this clinical review, we have presented a case of referred pain from the digastric muscle (Patient 1), of pulpectomized (Patient 2), and of pulpectomized pain (Patient 3) to illustrate referred, neuromodulatory, and neuropathic pain, respectively. The Patient 1 was advised muscle stretching and gentle massage of the trigger points, as well as pain relief using a nonsteroidal anti-inflammatory and the tricyclic antidepressant amitriptyline. The pain in Patient 2 was relieved completely by the tricyclic antidepressant amitriptyline. In Patient 3, the pain was controlled using either a continuous drip infusion of adenosine triphosphate or intravenous Mg2+ and lidocaine administered every 2 weeks. In each case of abnormal dental pain, the patient's diagnostic chart was used (Fig.2 and 3). Pain was satisfactorily relieved in all cases.

  19. Abnormality diagnostic technology for nuclear power plants

    International Nuclear Information System (INIS)

    Ishikawa, Satoshi

    1986-01-01

    In nuclear power plants, it is feared that the failure of the installations containing radioactive substances may inflict serious damage on public and workers. Therefore in nuclear power plants, the ensuring of safety is planned by supposing hypothetical accidents which are not likely to occur from engineering viewpoint, and multiple protection measures are taken in the plant constitution. In addition to the safety measures from such hardware aspect, recently in order to prevent the occurrence of accidents by using various safety-confirming means, and to detect early when any accident occurred, the development and putting in practical use of many monitoring equipments have been promoted. In such background, the development of nuclear power generation supporting system was carried out for five years since fiscal year 1980, subsidized by the Ministry of International Trade and Industry, and in this report, the technology of equipment abnormality diagnosis developed as a part of that project and the diagnostic techniques for actual plants are described. The technology of diagnosing nuclear reactor abnormality includes the diagnosis of loose metal pieces and the abnormal vibration of in-core structures. The detection and diagnosis of valve leak and the diagnosis of the deterioration of detectors are also explained. (Kako, I.)

  20. Spermatogenesis Abnormalities following Hormonal Therapy in Transwomen

    Directory of Open Access Journals (Sweden)

    Sirachai Jindarak

    2018-01-01

    Full Text Available Objective. To measure spermatogenesis abnormalities in transwomen at the time of sex reassignment surgery (SRS and to analyze the association between hormonal therapy duration and infertility severity. Design. Retrospective study. Setting. University hospital. Patients. One-hundred seventy-three transwomen who underwent SRS from January 2000 to December 2015. Interventions. All orchidectomy specimens were retrospectively reviewed and classified. History of hormonal therapy duration was retrieved from medical records. Main Outcome Measures. Histological examinations of orchidectomy specimens were performed to assess spermatogenesis. Results. One-hundred seventy-three orchidectomy specimens were evaluated. Histological examinations showed maturation arrest in 36.4%, hypospermatogenesis in 26%, Sertoli cell-only syndrome in 20.2%, normal spermatogenesis in 11%, and seminiferous tubule hyalinization in 6.4% of the specimens. Spermatogenesis abnormality severity was not associated with the total therapy duration (P=0.81 or patient age at the time of surgery (P=0.88. Testicular volumes and sizes were associated with spermatogenesis abnormality severity (P=0.001 and P=0.026, right testicle and left testicle, resp.. Conclusion(s. Feminizing hormonal treatment leads to reductions in testicular germ cell levels. All transwomen should be warned about this consequence, and gamete preservation should be offered before starting hormonal treatment.